In the intensive treatment on the battlefield never retreat - — Outbreaks in the front of the battle of life and death

by:Celecare     2020-05-14
Since early February, with the focus on patients, treatment experts, pooling resources, centralization of the implementation of the four principles, wuhan intensive number accounts for the proportion of the number of confirmed volatility fell, the cure rate significantly increased. What is the main threat of the death rate raise disease? Experienced how to fight? What other XianGuan to conquer? The competent department of health management, medical treatment expert tells a line, one month for us to analyse the between life and death battle. Grip the throat of the disease: the three major factors pushing up disease death rate we must not take a step back, like nails, nail here, take the disease's throat. Central to the steering group members of hubei province, ma xiaowei, director of the national health committee said on February 28 in wuhan. Ma xiaowei has in tongji hospital when the department research emphasize court area, central south hospital, to exert the advantages of various national teams, charged treatment in patients with severe joint, firmly take the hill. As of February 22, tongji hospital in the method, the optical valley two campus has 1900 beds, in severe cases accounted for about 80%, the total disease death rate has dropped to 2. 27%. Among them, the court in the area 3. 13%, 1 optical valley campus. There is room down 28%, the former. According to law in tongji hospital in new campus of the analysis, there are mainly three factors may raise the disease death rate: critically ill patients from onset to admission time an average of 9 to 10 days, should also be shortened as far as possible; Some patients transferred to the ICU noninvasive or high flow aeration time is too long, without establishing a respiratory passage; Some patients is overweight, even has multiple organ failure. WeiJianWei state medical hospital authority deputy bureau telephoto fai said, time is too long is a short time were influx of critically ill patients, medical resources appear larger gap between supply and demand. National WeiJianWei assemble at the first time the committee who hospital and provincial high level medical team to the severe fixed-point hospital, the whole system over wuhan ward, and ask the hospital existing rescue equipment to wuhan, such as breathing machine, monitor, ECMO, etc. From lan-juan li, wang Chen, georgy team, led by academicians have arrived, to more than thousands of severe medical personnel gathered in wuhan; From the construction of fire mountain, the thor hill hospital, to create a square hospital in wuhan, with healing ability constantly expanded bed, light, critically ill patients began to separate treatment, screening out severe from hospital patients in a timely manner. Treat the reach mark, grab out of the golden time in treating patients. Ma xiaowei said, the whole system to take over the normal medical order, establish overall job specification, the focus has been completely focused upon the scientific treatment. Virus is very cunning: draw but I don't't wait for your experience in treating severe acute respiratory syndrome (SARS) in Peking University third hospital over severe ward, radiation oncology nurses ma remember one detail, use a noninvasive ventilator patients to avoid nurse, just take off the mask to drink water, immediately appear a sharp drop in oxygen saturation, eyes turn, the gradual loss of consciousness. A lot of patients with clinical manifestations and imaging findings are inconsistent; A few cases of severe involvement of organs like the heart; Individual patients, quick progress, course of disaster treatment is difficult, is the feeling of the numerous clinical experts. The central committee, vice President of the medical treatment group of experts, Beijing chaoyang hospital for children from zhaohui, said patients may appear serious acute respiratory distress syndrome ( ARDS) , compared with SARS, respiratory failure progress faster, the heart attack is very severe. Xiehe medical team in wuhan tongji hospital in new campus treatment in ICU patients, the vast majority have inflammation storm caused a single organ or multiple organ failure. The new virus is very cunning, we won't be able to use existing knowledge to deal with, need to prevent outbreaks, sum up experience, while change measures and strategies. National health committee, a new crown pneumonia outbreak response disposal work team Liang Wannian said. According to the analysis of the method of new city campus in tongji hospital, intubation or tracheotomy invasive treatment, significantly lower than the noninvasive method to disease death rates. National WeiJianWei absorbed the proposal, and the treatment experience to the designated hospital intensive promotion. JiaoYaHui said, there is a treatment for one of the biggest problem, is due to respiratory tract, lungs will choke out, namely, choke and reaction. But on the other hand, the use of drugs can effectively avoid choking, but relatively safe; Has the air pollution emissions amount is only about one 6 of the noninvasive way. At present, the medical team to the best time for intubation are exploring further consensus. Ma xiaowei said, we want to draw but not't wait for your experience in the treatment of severe acute respiratory syndrome (SARS), adhere to the problem oriented, take more targeted treatment, according to sputum bolt, deep breathing congestion problem, for example, using the add humidity sputum suction, using liquid, comfortable, including injection, stomach type ventilation can actively explore, timely summary, curative effect, to be promoted. To go from the whole body to: diagnosis and treatment should improve the integrity of the patients have DIC ( Disseminated intravascular coagulation) He D - Dimer and fibrinogen synchronous rise, it's certainly not the fibrinolytic hyperthyroidism, he is still in high condensation stage, anticoagulant therapy should be taken. His airway pressure is very high, we need to establish hemodynamic monitoring and evaluation, if is the cause of the whole body, from body to think method. In Peking union medical college hospital in a remote consultation, the blood medicine, intensive medicine, vascular surgery, and so on front rear experts working with the medical team to discuss a multidisciplinary, holistic treatment scheme.
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