Chapter 185 You Qing? No, your boss’s face is more important
3 minutes later.
The patient's heartbeat recovered, although the heart rate was very fast, but the respiratory and circulatory arrest was reversed.
The golden rescue time for amniotic fluid embolism is only 3-10 minutes, and many scholars even believe that it is not even 3 minutes.
Speaking of embolism, more doctors and scholars now tend to believe that substances in the amniotic fluid enter the capillaries, causing allergic reactions in the mother.
This situation is extremely rare, but the mortality rate when encountered is about 80-90%.
This is under the premise that a large tertiary hospital has strong comprehensive treatment capabilities.
If it were in a rural hospital, it would almost be considered death.
After passing the first level in front of him, Luo Hao glanced at the system panel, which was still frighteningly white.
Based on Luo Hao's experience, this is the background color given by the system when it determines that the patient's mortality rate exceeds 95%.
"Send to ICU." Luo Hao let go and observed for a minute. Seeing that there was no risk of cardiac arrest, he waved and said.
Carry the patient and rush to the ICU.
Luo Hao did not follow.
Boss Chai squatted on the ground with his back against the wall, like a bad old man.
Looking at his condition, he was no better than a mother with amniotic fluid embolism, as if she would be unable to take a breath in the next second and die suddenly.
"Boss." Luo Hao shouted softly.
Chai Lao raised his head and said, "Xiaoluohao, are you good at the next treatment?"
What he said was very vague, but Luo Hao understood what the boss meant.
"Yes, I will go and watch later. The critical care team in the first year of medical school is pretty good, and the ecmo team is very elite, and they are all online."
Luo Hao used the word elite.
Mr. Chai nodded and breathed a sigh of relief.
Chai Lao had never been exposed to Ecmo and other equipment when he was young. If he really looked into it, he knew that he was not as good as the group members who had been playing Ecmo all year round, so he was not prepared to talk too much.
I have finished all the work I should do, and the rest will be left to the emergency department of the First Hospital of Medical University.
The operating room became quiet. People from the First Hospital of the Medical University, including Dean Zhuang, Dean Jin, and Feng Zixuan, were all busy. Only Mr. Fang and the leaders of the provincial and municipal health commissions were left.
The people from the provincial and municipal health commissions have never seen such a scene before. They all had big eyes and small eyes, their faces were pale, and they couldn't say a word.
"Old Chai, what are you trying to do? Let Dr. Luo do the compressions and I'll see how tired you are. Don't you know how old you are? You're so old and scumbag, yet you still run up to do heart compressions. Don't worry, the mother is still rescuing you. I'm really out of breath." Mr. Fang came to help Boss Chai and complained.
Chai Lao smiled.
He was exhausted, and his laughter was uglier than his tears.
Are you old?
"The three armies standing at the camp gate shouted~~~"
Suddenly, a fierce singing voice came.
The sound was not loud, but it was like a drumstick beating on the hearts of Chai Lao and Fang Lao.
The young people didn’t know what the voice was singing, but they knew it.
The operating room was in a mess, and the leaders of the provincial and municipal health commissions stood outside the door, looking confused.
Fang Lao suddenly raised his head and looked at Luo Hao in shock.
The voice was not loud, but it sounded a bit old, and it was not like someone of Luo Hao's age could sing it. It echoed in the operating room, layer by layer, Fang Lao's heartbeat accelerated, and his old face turned red.
“Young and young man listens to the root seedling~~~”
Boss Chai’s eyes lit up.
Boss Chai, in particular, breathes much more evenly.
“Toutonggu~~~” Boss Chai sang along with Luo Hao’s singing.
Luo Hao squatted down in a military posture and supported Boss Chai with his hand.
“Zhanfanzao!” Luo Hao sang.
"Tonggu~"
"Tighten the shirt!!" Luo Hao responded.
Boss Chai stood up, but Luo Hao did not stand up with him. Instead, he squatted in front of Chai Lao in a military posture, like a soldier, waiting for Chai Lao's order.
"Three tongs and drums~"
"The sword is out of its sheath!!!"
"Four tongs and drums~"
"Hand over the troops!!!"
One question, one answer, one old man, one young man, the cooperation is perfect.
The fatigue on Mr. Chai's body faded a little with each question and answer, until Luo Hao sang "Hand over the troops", Mr. Chai's face glowed red, as if he was twenty years younger.
"Everyone who moves forward will be rewarded, but retreating will inevitably result in a knife."
Boss Chai laughed loudly, reached out to hold Luo Hao's hand, and stood up directly.
Although I am still a little out of breath, my mental state is obviously much better, and I am full of energy.
“Let’s go and take a look at the ICU.”
Luo Hao was serious, bowed slightly, and followed Boss Chai.
Mr. Fang’s eyes were so red that they seemed to bleed, and he was so envious that he wanted to cry.
He finally understood why whenever someone touched Luo Hao, those old guys felt as if their tails had been stepped on, and the hair all over their bodies exploded.
In the past, Mr. Fang didn’t understand.
A few years ago, it was said that Luo Hao was reported by his real name. Boss Chai, an old man, didn’t care what others said and flew directly over to support Luo Hao.
Years later, it was said that Dr. Luo's girlfriend, who was the Northeast region manager of Southern MicroPort, was being bullied.
Mr. Zhou and Mr. Miao of 912, who have always been unwilling to offend others and have always been kind to others, actually stood up directly. No matter how much pressure there was, it didn’t matter. They expressed their attitude directly and unabashedly - Ronaldinho is my person. Aiwujiwu, you southern micro-invasives can take care of your own troubles!
Now Mr. Fang finally understood, his envious eyes were bloodshot.
What did you say? Just laugh at the old bones, isn't this true? !
After Luo Hao rescued him, he directly said a few words of "Dingjun Mountain" to himself.
This guy doesn't seem to care about the selection of Youqing at all, he only cares about his boss's face.
And it’s not just about face, Luo Hao sang a few lines, telling himself and Lao Chai that the sword is still young, and that the martyrs are still full of ambition in their old age.
And everything.
Lao Chai too, awesome!
How did he diagnose amniotic fluid embolism at the first time? !
This scene is so seamlessly matched with the scene in "Dingjun Mountain" in which Old Huang Zhong kills Xia Houyuan. It's really hard for Luo Hao to find such a scene that suits the situation.
Singing a few lines, Chai Lao feels rejuvenated and full of energy.
Fang Lao followed behind the old man and the young man with red eyes, bloodshot eyes.
Looking back at my students, although I liked them, they were not as clever as Luo Hao.
Oh, why didn’t I find this seedling back then?
No wonder those old guys almost got into a fight over Luo Hao a few years ago.
"Boss, how did you discover amniotic fluid embolism?" Luo Hao asked.
Got it!
The flattery started now, and Mr. Fang sighed in his heart again.
There are numerous difficulties in successfully rescuing amniotic fluid embolism.
The most difficult point is that the onset of disease is rapid, mainly cardiopulmonary failure. If it is delayed for the first time, it is really delayed. For every 1 second of delay, the possibility of successful rescue will decrease by 1 percentage point.
Boss Chai judged that the patient had amniotic fluid embolism faster than the system. Luo Hao was surprised, and Mr. Fang was also surprised.
This question must be Lao Chai’s proudest point. Being asked and being able to say it in public is considered the highlight of life.
Even if Lao Chai is an academician, this is a highlight moment.
"You young people haven't seen him before. It's enough to meet him a few times." Mr. Chai said lightly.
"..." Luo Hao scratched his head, "Boss, don't hide your secrets."
"Natural delivery + lateral incision are the most likely to cause amniotic fluid embolism, followed by caesarean section. ECG monitoring has started to call, then... Take a look to see if there is no coagulation, and then take a look to see if the mother is apathetic and has difficulty breathing."
"There is nothing difficult to judge."
"Xiaoluohao, remember?"
Chai Lao asked calmly with sharp eyes.
"Boss, I remember it, but if we encounter it again, I guess I still won't be able to diagnose it, at least not as quickly as you." Luo Hao said calmly.
Chai Lao came to the locker room and sat under the "No Smoking" sign.
Luo Hao took out a pack of cigarettes, opened them, found one he had never bitten, and handed it to Boss Chai.
"Click~"
The lighter marked Xiehe Men's Section emits a wisp of flame.
Chai Lao took a beautiful puff.
The smoke is lingering, and the words "No Smoking" are hidden in it, just like a fairyland.
After working hard, a cigarette can greatly reduce the fatigue and tiredness of the body, which is really comfortable.
Mr. Fang sat next to Mr. Chai and looked at Luo Hao.
Luo Hao was startled, and then gave Mr. Fang a cigarette.
"There will be a lot of troubles after that. It used to be a matter of fate, but now things are getting better. The mortality rate of this disease used to be as high as 80% or 90%. After having ecmo, the mortality rate has dropped to less than 50%... or so."
50%, Luo Hao sighed.
"Prepare blood." Mr. Chai smoked a cigarette and told Luo Hao, "Is your dean strong?"
Luo Hao shook his head, indicating that he didn't know.
“This is a shame. The blood bank in the city center must not have enough blood.” Mr. Chai said, “Let me think about it.”
As he spoke, Mr. Chai looked up at the leaders of the provincial and municipal health committees.
“Is there any way?”
“Mr. Chai, how much blood do you need? 20,000? Do you really need so much? Then you have to replace the person’s blood many times.” One person bent down, asked quietly.
"20,000? That's a small amount." Mr. Chai puffed out a puff of cigarette and said calmly, "The mother's heart did not stop, so she performed chest compressions immediately; Xiaoluohao also cut the uterus very quickly, no More allergens entered the blood, so I decided that I would need 10,000 to 20,000 blood products for the time being. "
"If it is ten minutes later, even if the blood is not saved for 50,000 to 60,000 yuan, it will not be possible. "
50,000-60,000!
That’s blood.
The leaders of the provincial and municipal health committees are in trouble.
The "Ponzi scheme" of blood has come to an end. In recent years, the blood bank has been under constant stress. As long as it is not an emergency, they have to "help each other", that is, how much family members donate will be transfused.
As for the words that once you donated enough blood, you and your immediate family members would use the blood for free, no one mentioned it again.
20,000 blood was given at once, which was still a small amount. The leaders of the Health and Medical Commission were in trouble. "It's better to save people than let them water the flowers." Mr. Chai curled his lips and said disdainfully.
“Boss, this joke is too old. Now the department uses the albumin that the patient has ordered.” Luo Hao smiled, “After the albumin is ordered, there is always a little bit of something hanging in the bottle. Open it and add water to water the flowers."
Mr. Chai glanced at Luo Hao and then at the others.
"Xiaoqian, when I was rotating, I encountered a patient with acute pancreatitis who died suddenly and was not given a chance to rescue." Chai Lao said, "But we still struggled for nearly 36 hours. The next day He went back to his dormitory to sleep... He didn't have a mobile phone at the time, so he was taken back directly by the director of the medical department. "
"This kind of thing needs to be reported to the Military Council. This may be the only opportunity for most doctors to communicate with the Council of Ministers in their lives."
"But who wants to think about it?"
< br>The face of the person who just said that 10,000-20,000 blood is a bit too much turned into an eggplant color.
He is not a medical professional.
There are so many people in the National Health Commission who are not from medical backgrounds that it is inevitable that they will not be able to understand the seriousness of things like this.
Every mother is a patient in the hospital before and after delivery.
What Mr. Chai said about the report to the State Council was not groundless, but actually happened.
“If we can save them, the women and children will have less trouble. If we can’t save them, generally speaking, more than half of them will be killed. Patients, their families, doctors, and nurses all suffer from the consequences. It's a crime."
"! "
Mr. Chai simply said that the priority is to save people now, as for the maternal and child line and the dean and deputy director of the First Hospital of the Medical University. He didn't care whether he would suffer or not.
"Lao Chai, your old bones are really useful." Mr. Fang praised while sitting under the "No Smoking" sign and smoking.
Luo Hao smiled, arching his waist a little deeper.
Respectfully.
"Hey, it's okay. But I really can't bear the trouble anymore. It's only been a few minutes of compressions. When I was young..."
When Mr. Chai said this, he stopped talking. , took a deep breath of cigarette, but spit it out without leaving the lungs.
Luo Hao reached out to take the cigarette butt, went to the faucet to put it out, and threw it into the trash can.
“Change your clothes and go to the ICU for a look. Xiaoluohao, you said this ECMO team is very elite?”
“Well, during the epidemic that year, several ECMO teams ran across the province. Some of them There are machines in the local area, but because there are few people using them and the local hospitals are inexperienced, they don’t know how to use them. The National Health Commission coordinated and technical staff from the first and second hospitals of the Medical University provided support from various places and saved many people.”
"Yes." Mr. Chai nodded with satisfaction.
"Rich combat experience and high level." Luo Hao emphasized again.
Mr. Chai didn't say anything, changed his clothes silently, and then went to the ICU to take a look.
The first aid level and critical care level of the First Hospital of Medical University are indeed as Luo Hao said - elite.
Not long after stepping down, the phone was turned on and the mother’s vital signs gradually stabilized.
Not bad. Mr. Chai looked it over and found no major problems. If the current treatment is followed, the mother has a 70% to 80% chance of surviving.
If other diseases require surgery, the mortality rate is over 10%, and not many people are willing to do it.
But it is a blessing that patients with amniotic fluid embolism can have such a high cure rate.
The Ecmo team was already in place and turned on, moving quickly.
As expected, it is the hospital with the largest number of ECMO cases in the province. The team is well-trained and responds promptly and effectively.
Dean Zhuang is not a layman from the Health Commission. His hair has exploded and he keeps calling the phone, shouting for blood.
The atmosphere in the ICU was solemn, but everything was in order. After reading it, Mr. Chai nodded and turned to leave.
"Boss, I'll take you back to have a rest."
"No, I'll go back by myself while you watch here." Chai Lao said, "Send me all the test results and changes in your condition via WeChat. If it doesn't work, I'll Ask our critical care team for support.”
“Okay.” Luo Hao didn’t hesitate and agreed directly.
The country’s policy is here, it is the will of the country, and every independent individual is so small that it is insignificant before the will of the country.
……
"Lao Meng, you and Luo Hao met a patient with amniotic fluid embolism?" Chen Yong asked Meng Liangren after hearing the gossip after undergoing surgery.
“Yes.” Meng Liangren still seemed to be dreaming.
"How is it? Are you rescued?" Chen Yong asked.
Meng Liangren did not answer directly, but hesitated for a long time.
“What are you thinking about?” Chen Yong was a little confused.
"Xiao Chen, it's like this. Whether amniotic fluid embolism can be saved depends on life. If it happens, the ancestral graves of the mother's family will emit green smoke, the kind that is three feet high... Not only that, but also the surgeons, anesthetists, critical care doctors who are present. The ancestral graves in the doctor's house are also covered in smoke. "!" Chen Yong was surprised.
He is considered a clinical novice and has never heard of cases of amniotic fluid embolism, so he does not understand what Meng Liangren said about the smoke coming out of the ancestral graves.
“Anyway, no one who has heard of amniotic fluid embolism has been saved. Let alone amniotic fluid embolism, there is a county below us, and my classmate is an obstetrician and gynecologist there, and the county hospital.”
Meng Liangren was telling Chen Yong some old stories while straightening out his thoughts.
What happened at that time was like a flash of lightning, and Meng Liangren had no time to think about it.
“A mother died in their county hospital. It may have been placenta previa or something, not amniotic fluid embolism. Because she was an advanced maternal age, the patient’s family also recognized it, but later because of this incident, the gynecologist at the county hospital Obstetrics... There is no obstetrics. People who give birth in the county have to come to the city."
"The provincial, city and county health committees will inquire and investigate within half a year. After more than ten times, no good person can withstand this kind of scrutiny. Let's put it this way, the people who came here are all experts in the industry. Although they are not at the level of Mr. Chai, they are still well-known experts and professors in the provincial capital. "
"The medical records were picked out word by word; the questions were asked one by one. It was like interrogating criminals, endless." Meng Liangren sighed deeply.
When encountering amniotic fluid embolism, the mother is unlucky, and so are the doctors and nurses.
“Why?” Chen Yong was stunned.
“The annual maternal mortality index in our provincial capital should be three, based on percentage. It was higher in previous years. After all, there have been fewer children recently. Every mother is precious, so there is no way.”< br>
"Then..."
Chen Yong didn't understand this and was very surprised.
"It's true that today, there are trees growing on the ancestral graves of Dean Zhuang's family." Meng Liangren sighed with emotion, "You didn't see it. The child was just cut out in the surgery room. He was crying. There was an abnormal sound from the monitor. You said you would Do you care?"
Chen Yong shook his head.
"Chai Lao walked by at that time, took a look inside, and then entered the surgery room."
As he said that, Meng Liangren stood up.
He imitated Mr. Chai’s movements and walked to a position.
"When we came to the operating table, Mr. Chai looked at him like this."
"Then Mr. Chai raised his head again."
Meng Liangren simulated it and realized that Mr. Chai looked at the monitor. Numbers and whether ventilators are ready.
“Afterwards, Mr. Chai said something to the mother, glanced at her eyelids, and directly diagnosed amniotic fluid embolism.”
“What a magical method.”
Speaking of gods, Chen Yong raised his eyebrows.
“It’s true, Xiao Chen.” Meng Liangren sighed with emotion, “Most hospitals cannot save similar patients at all. Let’s put it this way, even our First Hospital of Medical University can save the patient. When we come back, the hospital’s homepage will have to advertise this rescue for the rest of its life.”
“Holy shit!”
“And smaller hospitals will have to compete with higher-level hospitals. The relationship is good enough, they go all out, and the ecmo team is in place as soon as possible. It doesn’t matter if the relationship is good, the ecmo team happens to be fine.”
Meng Liangren said a lot. .
Speaking of which, luck always comes down to luck in the end.
Today’s mother’s fate is good or not. If it is really good, she will not encounter amniotic fluid embolism; but it is not good, but she happens to meet Mr. Chai and Mr. Fang to visit the First Hospital of the Medical University. Mr. Chai does not When respiratory and circulatory arrest occurred, chest and heart compressions were performed immediately, and the hysterectomy was completed within a few minutes.
Anyone else would probably not know what happened.
"Is it really that difficult?" Chen Yong frowned.
"Let's put it this way, Dongzi's sister was cured of this disease a few years ago. The hospital is a high-level tertiary hospital, comprehensive. Dongzi wants money and people, tens of thousands of blood can really After rescuing people, Jingdong guys lined up to donate blood.”
"What happened next? It's still gone."
"Xiao Chen, it's a pity that you didn't see the quickness of Mr. Chai and Professor Luo today. But I watched it from beginning to end, and I still don't know that Chai How do you diagnose it?" Meng Liangren said and sighed.
……
A few hours later.
Dean Zhuang sat in the office exhausted.
"Dad, let's have some food." Zhuang Yan went to the cafeteria to fetch some food and brought it to Dean Zhuang.
The close-fitting little cotton-padded jacket is really warm, and Dean Zhuang is a little pleased.
If you don’t want to go abroad, don’t go abroad. It doesn’t matter, it’s better to stay at home.
But Dean Zhuang was too lazy to move a finger, "Put it down, I want to take a breath."
"Dad, how much blood did the ICU side require?"
"Nearly 10,000 yuan of blood was transferred." Dean Zhuang said softly.
“So many!!!” Zhuang Yan was stunned.
The blood cost is tens of thousands, this matter...
Dean Zhuang looked up at his daughter and tried his best to smile.
"Let me tell you this, if I want to use blood, I am also lying on the ICU bed, and my blood type is the same as that of the mother. Who do you think the blood will be given to?"
"..." Zhuang Yan looked at her father with twinkling eyes.
"There are a bunch of vice-deans below having a meeting, and the blood will definitely be given to the mother in the end!" Dean Zhuang said firmly.
Zhuang Yan was really dumbfounded this time.
“They want me to die, and they have such a good excuse. Those people in the provincial and municipal health commissions just want to avoid taking the blame, so who cares about a dean.”
“ If the director dies, only one position will be vacant. But if the mother dies, no one involved will be able to escape from the investigation.”
"Uh..." Zhuang Yan didn't expect this matter to be so serious.
“In hospitals, all assessments and KPIs are fake and just for show.” Seeing Zhuang Yan’s confused look, Director Zhuang endured the exhaustion and continued to explain, “Maternal mortality is the core of the medical system. One of the KPIs, the core! "
"If the mother dies, although it has nothing to do with the hospital, the modern medical system still does not accurately identify amniotic fluid embolism, let alone treat, cure, and avoid it, but who cares. Maternal death is a big deal for you."
Zhuang Yan was even more confused.
"An overcorrection must be overcorrected. If there is no attitude from the top, the implementation below will definitely go wrong. So, I think there is no problem." Dean Zhuang sighed, "I am lucky this time, Boss Chai is really Awesome, I didn’t even react after they rescued me.”
As he said that, Dean Zhuang's cell phone rang.
"Lao Zhuang, the blood bank is out of blood." A tired voice came from the other side of the phone, "What do you think we should do."
(End of this chapter)
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