Since 1981 Health School

"Comrade, comrade, how are you doing?"

Chen Qi anxiously yelled at the three seriously wounded, but got no answer. Two of them were groaning in pain, and the other seriously injured didn't respond after shouting for a long time, probably fainted from pain.

"Uncle Guo, it is estimated that these three people have fallen into shock, or are in the early stages of shock."

In addition to the cause of the burn itself, continuous washing of patients with large-area deep burns with cold water will not only cause various infections, but also cause a sharp drop in body temperature and blood pressure, resulting in shock.

Shock is an important cause of early death in burn patients.

Guo Yuanhang's expression was also very serious at this time: "There is no need to send it to the emergency room, and it is directly sent to the sterile ward of the burn department for debridement surgery."

Fortunately, these workers were all burnt by molten steel, and the damage to the respiratory tract was not serious, otherwise a tracheotomy would have been performed on site.

Everyone took action, and even many doctors and nurses who passed by saw the emergency situation and stayed to help, especially the three seriously injured were sent to the burn department as quickly as possible.

Zhu Huoyan and the burn doctor had already made preparations and waited.

When Lao Zhu saw the condition of the wounded, he also secretly felt pain in his heart.

I just took over two patients with extensive burns in Huang Tan, and I haven't figured out the experience yet. Good guy, three more seriously injured patients came in a blink of an eye. The pressure is huge.

And look at this appearance, the burn area exceeds 80%, whether it can survive is a question.

It's unlucky to die right after opening, and it will also affect the reputation of the Burn Surgery Department of the People's Hospital, isn't it?

But Zhu Huoyan is not a person who gives up easily. Since he opened the burn department, he will definitely give up his old life.

As the major director of surgery, Zhu Huoyan immediately entered the role of a doctor, giving orders to two "superiors":

"Xiao Chen, take this wounded lightly, and you are in charge of debridement. Guo Shuji, we will debride the wounds one by one for the two most seriously burned patients."

No matter how light it is, it is the difference between 90% and 80% burns.

Both Chen Qi and Lao Guo nodded, and then took their wounded into separate wards for first aid.

Then the first problem arose, because the workers had burns all over their bodies, and their skin was falling off in pieces. Many of their bodies were covered with charcoal, so it was impossible to monitor their vital signs.

The problem is that this is an important indicator for treatment evaluation. Without these data, doctors can't make a next step in treatment.

Chen Qi heard that the ward next door was in chaos, and several nurses were chirping:

"Ah, the cuff of this sphygmomanometer can't even be put on, it can't be fixed at all!"

"This patient's outer lips are all damaged, so he can't take his body temperature. The anus, his pants are cut and I want to take his anal temperature!"

"The skin is rotten, and the heartbeat and pulse rate can't be measured. What should I do?"

After a while, Comrade Guo's scolding came:

"Shout, what are you shouting for? Now the master worker is in danger, so much nonsense for asking you to test your vital signs? You are so precious, so disgusted with dirt and so afraid of disgusting, I will go home and stay, what are you nurses, what are you doing? doctor?"

It seems that Lao Guo was really pushed into a hurry. On the contrary, Zhu Huoyan seldom swears, he is more ruthless.

Compared with the next door, the rescue in Chen Qi's ward is proceeding in an orderly manner.

The assistant head nurse Yang Xiuxiu was paired with Chen Qi. She and Chen Li had learned skills from Dean Chen in Africa.

Chen Qi curled his lips when he heard the scolding from next door, and thought that the quality and clinical level of some medical staff were really not improved. This is also the huge difference between Yuezhong People's Hospital and the top hospitals. The quality of medical staff is a big gap.

This people's hospital is still rated as a top three hospital. It seems that the quality of the staff is really not good.

"Xiuxiu, in a while, you can go and guide them how to rescue and nurse burn patients. It really doesn't work. You make a list and I'll transfer them away. Poor skills are understandable, but a bad attitude is a big deal."

As the dean, Chen Qi gave her confidant a "Shangfang sword", which helped her establish prestige in the department.

"Okay, Dean Chen, I will open the intravenous access for this patient first!"

The first priority of rescue is to open the venous access, that is, where to stick the needle when hanging it?

Patients with large-scale burns on the whole body hardly have much good skin, and the traditional veins on the back of the hand or arm veins will not work at all.

And because of the need for rescue, when rescuing the seriously wounded, often one channel is not enough, two or three are very common, so how to choose the acupuncture site is a test of the nurse's basic skills.

Chen Qi glanced at Yang Xiuxiu. The little girl was wearing a white nurse's cap and mask, with only her big eyes exposed. Regardless of the strong odor of the patient, she was looking for a suitable acupuncture point with her face close to the skin.

Patients with severe burns usually choose the unconventional operation of radial artery or femoral artery.

At this time, the blood vessels cannot be seen, so the only way to touch them is to feel the position and direction of the arteries carefully. Finally, the needles are inserted according to the feeling, which is simply too much for ordinary nurses to do.

If it is more difficult, it has to be completed under the guidance of B-ultrasound, which is a test of technology.

Chen Qi taught Yang Xiuxiu and Chen Li arterial puncture and catheterization in Africa before, and now he just wants to see how Yang Xiuxiu is doing?

An unmarried little girl became the deputy head nurse. If she wanted to convince the public, she had to show her true skills, otherwise she would be overthrown by other nurses sooner or later.

You must know that the palace fight between women is very powerful, and it doesn't just have him, Chen Qi, the "golden father".

Yang Xiuxiu lived up to expectations, and opened two channels in three clicks. At the same time, a hollow needle was implanted in the artery of the wrist, which was connected to the monitor.

A three-channel tube was also implanted in the right jugular vein, one channel was used to monitor the intravascular pressure of the patient, and the other two channels were used for infusion and drug injection during the operation.

The amount of rehydration needs to be strictly evaluated, and it is very critical for the rescue of burn shock patients.

Rehydration is not as much as you want, it needs to be calculated according to the human body's demand, so how can you know if you have overfilled it? At this time, you need to monitor the central venous pressure (CVP).

How to monitor the data? It's also very simple.

For example, if the central venous pressure and blood pressure are both lowered, it generally indicates that the blood volume is seriously insufficient, and adequate fluid replacement therapy should be given.

When the central venous pressure is low and the blood pressure is normal, it means that the blood volume is insufficient, and appropriate fluid therapy should be carried out according to the central venous pressure.

When central venous pressure is high and blood pressure is low, it means cardiac insufficiency, so be careful to prevent heart failure.

When the central venous pressure is high and the blood pressure is normal, it means that the blood vessel volume is excessively contracted, and vasodilation therapy should be performed.

Look, isn't it very simple? Clear at a glance? Some people think they can be doctors too.

So when technology changes medicine, who is more important, machines or people? all important.

Whether the rehydration is in place, doctors of later generations only need to look at the central venous pressure, pulmonary artery wedge pressure, central venous oxygen saturation and other indicators on the display screen, and can adjust the rehydration volume and drip rate in time.

But what if these monitoring instruments are not available? For example, the Huaguo Hospital in the 1980s.

Then you can only look at the patient's urine output, blood pressure, heartbeat, pulse, and mental state.

For example, is it fidgety or quiet? Is there any obvious thirst etc.

The above indicators can indeed reflect the dehydration situation, and can also reflect whether the rehydration is in place.

But they can only be used as a reference, and you cannot accurately monitor the body's fluid needs.

Moreover, the above judgments are often very subjective. For example, if the patient is irritable, is the amount of fluid replacement insufficient and blood volume insufficient, or is the irritableness caused by pain? You are too hard to judge.

Often when you find abnormalities, the filling has been overdone, or it has not been filled at all, and then the patient dies.

In the 1980s, it was not even possible to dynamically observe the changes in patients' blood lactic acid. In Chen Qi's view, all treatments were relatively rough, but this is the national situation, and Chen Qi has nothing to do.

The only thing he can do is to bring in 10 sets of the most advanced monitoring equipment from abroad. Who is called Yuezhong People's Hospital and now has at least 10 million US dollars in the account, a standard big dog.

Therefore, the equipment in the burn department of Yuezhong People's Hospital is definitely leading in China and first-class in the world, but outsiders don't know it yet.

I'm afraid that if it gets out, what if all major hospitals in the country come to "borrow" it?

Will you borrow it by then? If you borrow it out, you are afraid that the meat bun will beat the dog and you will never return, so don't be fooled if you have money.

With money, Chen Qi, the dean, will have great ambitions. If he doesn't build it, he must build a world-class burn department. Coupled with his experience from later generations, it's hard to believe that it won't work.

Seeing that Yang Xiuxiu successfully completed so many tasks that should have been done by an anesthesiologist, Chen Qi was very satisfied:

"Xiuxiu, hurry up and help Guo Shuji and Director Zhu, the old man's scolding is getting louder and louder."

Yang Xiuxiu didn't have time to wipe the sweat off her forehead, so she nodded, picked up the toolbox and ran out quickly.

At this time, Chen Qi looked at Zhang Xing: "Little Zhang, come on, let's do the math again, let's calculate the patient's fluid intake first..."

While Chen Qi and the others were rushing to rescue, burn specialists from provincial capitals and Shanghai were on their way.

Xihu City is only 60 kilometers away from Yuezhong, and it takes one hour to get there.

Shanghai City is not far away, 260 kilometers away, and it won't take long to get there.

This time, such a major liability accident occurred in the Yuezhong Iron and Steel Plant, and the factory director Qi also went all out, and he really did it no matter what the cost. He must save all the workers and not let anyone die.

Although Yuezhong Chen Qi has proven his ability in the field of gastroenterology, the patient in front of him is a burn patient. Director Qi does not think that Chen Qi can complete the rescue work well.

If the Yuezhong Hospital made a mistake and a few workers died, it would be a lot of fun, and he would never want to have Qi Guomin's black hat.

Therefore, for the lives of the workers and for their own interests, it is the best way to ask for foreign aid.

At that time, a red envelope of 1,000 yuan and 2,000 yuan will be included, which is enough to send the experts away.

What is this little money to the Yue Steel Factory with 30,000 people? Yue Steel Factory sometimes entertains people for food and drink, and each meal costs more than 12,000 yuan.

Shanghai Dongshan Hospital.

As one of the best hospitals in Shanghai, Dongshan Hospital has the top burn department in the country.

When the hospital received a rescue call from Vietnam and China, Dr. Deng Changle, as the deputy director of the burn department, was designated by the hospital as the person in charge of the rescue team and asked to leave immediately.

Deng Changle has a younger brother named Deng Changxi.

Who is Deng Changxi? He is the director of hand surgery at UBS Hospital in Shanghai. He had fought with Chen Qi before, and the fight was very unpleasant.

Of course, in the follow-up to the ring incident, Wei Cheng of Jishuitan Hospital, who was behind the scenes, stepped down immediately, and was removed from the post of president of the hand surgery society and the director of the hospital's hand surgery.

Also affected, there are two main black hands.

One is Wu Jianlin from the No. 1 Hospital of Haiyi Hospital, and the other is Deng Changxi from UBS Hospital. Both of them were dismissed from their positions as department directors and downgraded to ordinary doctors.

If a doctor wants to climb to the position of department director, it takes decades of hard work. Not only has he paid a lot of sweat, but he has also paid a lot of cost in interpersonal relationships and money.

In the end, he was kicked into the dust by Chen Qi, a small doctor in a rural hospital, which was unbearable for anyone.

As Deng Changxi's elder brother, Dr. Deng Changle was a little surprised when he received the notice, and Chen Qilai, who had been in the limelight for the past few years, immediately appeared in his mind.

"Isn't Yuezhong People's Hospital the hospital where Chen Qi is the president?"

Thinking of this, Deng Changle intentionally refused to go to Vietnam for support, but then he thought again, since Chen Qi could beat his younger brother in the field of hand surgery, the Deng family became a laughing stock of the health system.

So today there is such a good opportunity for him, a burn doctor, to defeat Chen Qi, a gastroenterologist, and let him know that there are people beyond people, and there is a sky beyond the sky, and it is good to help his brother vent his anger.

Thinking of this, Deng Changle led several burn doctors towards Yuezhong at the fastest speed.

The burn surgeons from the No. 1 Hospital of Haiyi Hospital were the fastest to reach Yuezhong. When Chen Qi saw several experts from the provincial capital, one can imagine his mood.

accurate! ! !

Lao Tzu is a reborn person, an international dual director, and a deputy department head, so he needs people from other hospitals to come to see a doctor? Come to support? To speak out is to slap Chen Qi in the face!

Seeing Chen Qi's face darken, Yang Xingliang, the director of burn surgery at the No. 1 Haiyi Hospital who led the team, was a little embarrassed.

Doctors know doctors best. Under normal circumstances, only local hospitals can’t handle a certain patient and ask for help from higher-level hospitals.

Coming here uninvited like now is the greatest disrespect to the local hospital, and it's no wonder people will take a good look at it.

And Director Yang knew in his heart that even though Chen Qi was young, Chen Qi was at the deputy department level, which was at the same level as Director Yang's immediate boss, the dean of the First Affiliated Hospital of Haidong Medical University.

Can climb to such a high position at a young age, which is simple and easy to get along with? So he quickly said hello.

"Dean Chen, hehe, hello, hello, we meet again."

"Director Yang, hello, who is this?..."