NOVEL WEB I can see the status bar
Chapter 1134 Goodbye
Chapter 1134 Goodbye
In the end, Cai Huiping also failed to meet Liu Lianzhi for the last time.
Liu Lianzhi's vital signs disappeared quickly after Song Wen made the phone call, and he was officially declared dead 10 minutes later.
Before Cai Huiping arrived...Liu Lianzhi had already put on his usual clothes with the help of the medical staff.
A white shirt and black trousers.And a pair of black socks on the feet.Liu Lianzhi was just lying on the hospital bed, looking no different from before.
Except for his slightly parted and somewhat dry lips, and his undulating chest, Liu Lianzhi just lay on the bed like a statue.His life is gone, but he is still among us, not even far away.
An intercom requesting instructions came from the ICU, "Dean Song, shall we transfer the remains and disinfect the beds now?"
The ICU beds are always in short supply. Even though Quan Yunhe only had more than 500 new patients yesterday, the ICU beds are still in short supply.
In order to improve the order of treatment, Song Wen made a ranking list for each bed in the ICU department he manages.Behind every bed there are at least two patients waiting to be admitted.Their ranking will be adjusted flexibly at any time according to the progress of the disease. In general, the more serious the disease, the higher the priority for admission.
If the patient cannot wait for the ICU bed of Beihu Hospital, and the condition is more serious, he will be transferred to the ICU ward of other hospitals for treatment.Although it is still possible to ensure that patients can receive treatment, there will be one more transfer procedure.This will not only delay the time node for patients to receive intensive care, but also put pressure on the entire transport system.
A better solution is to increase the turnover rate of ICU beds.For example, after the previous patient no longer needs the bed, make and disinfect the bed as soon as possible before admitting the next patient.
Song Wen sighed, she had tried her best to fight for Cai Huiping, but it seemed that even God was deliberately trying to make things difficult for this miserable head nurse.The last time I met Liu Lianzhi... Cai Huiping really couldn't keep up.
"Disinfect." Song Wen was silent for several seconds, and she kept praying that she could hear a hurried footstep during the few seconds of silence.But... From the hotel where Cai Huiping lives to the hospital, the fastest running time is 10 minutes.This time could not be shorter.
She put down the walkie-talkie in her hand, and said to a colleague beside her, "I'll wait for someone downstairs, call me if I need anything." Then she left the ICU department.When entering the elevator, Song Wen kept thinking about what kind of expression he should use to face the head nurse Cai Huiping who came in a hurry.But this question has never been answered.
About 15 minutes later, Cai Huiping hurriedly appeared at the door of the hospital.She saw Song Wen's figure from a distance, her pace changed from fast to slow, and then accelerated again.Cai Huiping covered her mouth and ran all the way to Song Wen. Before she could speak, she squatted down.
From between the fingers, a burst of crying came out.
Song Wen felt distressed and picked up Cai Huiping who was squatting on the ground. She held Cai Huiping in her arms, but for a long time she could only choke out a sentence, "Cry, just cry."
Cai Huiping almost died from crying, it took her a long time to recover, then she looked at Song Wen and asked, "Old Liu has...?"
Song Wen nodded, and then said, "The car has been hired."
Cai Huiping closed her eyes in despair, then she opened them again, "Has the car arrived yet?"
"Not yet." Song Wen said, "The hospital bed needs to be disinfected, and Lao Liu's clothes are already put on..." She said something messy, but Cai Huiping already understood what Song Wen meant.
She interrupted Song Wen, then nodded and said, "I know, I know..." She wiped her red and swollen eyes and asked in a pleading tone, "I... can I, when the car is leaving, Send him off?"
No one can refuse this request, and Song Wen is no exception.She nodded and replied, "I'll take you there."
·
·
·
Tonight's Yunhe is a rare cloudless sky.The sky is full of stars, and the temperature is higher than the previous few days.
The black van of the funeral parlor slowly drove into the underground parking lot. Seeing this scene, Cai Huiping couldn't help crying again.
Liu Lianzhi and her have known each other for many years, and their relationship has always been very good.Even if one of them is the dean and the other is the head nurse.The special nature of the work keeps the two of them together less and more apart. Throughout the year, the two of them can spend no more than ten weekends at home.It is precisely because of this that they cherish every time they can spend together.Even in the ICU, as long as Liu Lianzhi's condition is a little better, Cai Huiping will always stay by his bedside.
At the beginning, Cai Huiping did nursing care before talking. Later, the five beds became the place where the couple who got together less often and separated more often told each other how they missed each other.Cai Huiping even completely let go of her heart that was hanging in the air at one point, and said to Song Wen and Zhu Minhua, "This guy is a small belly, a problem caused by too small a mind. When he recovers later, punish him and invite everyone to dinner!" "
Liu Lianzhi was even in good shape this morning.He repeatedly complained to his wife that he still couldn't turn negative after such a long time, and asked his wife to bring him two bottles of yogurt to drink tomorrow.The taste of nutrients is too bad, and eating too much really makes people feel uncomfortable.
Cai Huiping agreed to her husband's request, and has already bought a yogurt, which she plans to bring to Liu Lianzhi the next day.But who knows, it's just a few hours' time to go back to the hotel, but it's already an eternity, and never... never see each other again.
After Liu Lianzhi entered the ICU, she was more or less mentally prepared.But this psychological preparation was not enough to support her to accept this cruel reality.
The black car slowly drove out of the underground parking lot. Cai Huiping subconsciously took a step forward, wanting to touch the car.She didn't know what effect she was doing.Maybe it was just a subconscious action, maybe it was just a hope... Liu Lianzhi would not be so lonely when he left.
Then, her emotions completely collapsed.
"Old Liu, old Liu!" Cai Huiping cried and tried to chase the car. Song Wen worried that she would be injured by the wheels, so he held her hands firmly.
Crying is the last hold of the living to the dead, and the last kiss of the bereaved to the lover.It is a farewell to nostalgia for the past and a wish for a new life in the future.
At the gate of the underground parking lot of Beihu Hospital, on Yunhe Street in February, Cai Huiping said her last farewell to her husband.She slumped on the ground, crying bitterly.
Song Wen squatted aside, patting Cai Huiping's shoulder with tears, without saying a word.
·
·
·
Time is the panacea that heals everything.Its effectiveness is not obvious, but it is better than a little improvement every day.Such improvements can be seen not only in the hearts of the bereaved, but also in those physically traumatized by infection.
The human body has certain repair and compensation functions.This kind of compensatory function can sometimes solve very huge problems, and some doctors need to take it very seriously, and even the injuries that may be helpless, sometimes can be "perfunctory" under the compensatory function of the human body.
But such "perfunctory" comes at a price.
Sun Lien is dealing with such a patient. It has to be said that his body is indeed trying very hard to keep him alive.But the situation is really beyond the scope of the body's ability.
Repair and compensatory functions, especially the compensatory function, have three major deficiencies, which make it difficult for doctors and patients to use compensation as the main means of fighting diseases.
The first flaw is that it only "sometimes" solves huge problems.In the face of those traumas and lesions that may take the patient's life in a short period of time, compensation is often ineffective.
The second defect is "perfunctory".The compensatory function can never really solve the problem, it can only maintain the patient's normal physiological signs for a period of time after it works.The patient's physiological signs may remain normal or nearly normal under this compensatory effect.
The third flaw is "compensation" itself.The human body is a very efficient tissue, and it tends to use as little energy as possible to perform major actions.In other words, everyone's body is a living Grandet.It is a basic operation to not pull out a penny, and it is an average level to throw it away if you don’t pick it up when you go out.
And such a "stingy level" determines that even if the human body's metabolism is efficient, it still cannot last.
Taking the current patient's situation as an example, his problem lies in the compensation of the heart.
As an obese middle-aged man with high blood pressure for a long time, Zhuang Xinhao himself is of course a high-risk group for cardiovascular diseases.Although the hospitalization was due to a new type of coronavirus infection, Sun Lien discovered something was wrong the first time he saw him.
There is a blue status bar prompt on this patient's head, and the content is "a small number of myocardial ischemic infarctions".
Sun Lien has always been concerned about what the blue status bar means. According to Sun Lien's previous inference, it may mean symptoms that are "highly related to the primary disease and difficult to ignore, but will not cause further danger".The reappearance of the blue status bar this time may also be an important reminder.
This patient currently has some mild arrhythmia, and this is one of the important reasons why he was sent to the North Fifth District for treatment-Chen Xuerong, who was born in the Department of Cardiology, is in the North Fifth District, as a senior attending doctor , he also has emergency PCI access qualifications.
The Infectious Disease Hospital has the conditions for PCI intervention. As a confirmed patient with pneumonia caused by a new type of coronavirus infection, when the circulatory system is severely affected, arrhythmia may only be a transient symptom, but it may also be a more dangerous malignant disease. A precursor to arrhythmia.Insufficient oxygen supply in the body is likely to lead to the rapid deterioration of the existing mild arrhythmia, which is a very risky factor for patients with underlying heart diseases and a history of coronary heart disease.
And Zhuang Xinhao in front of Sun Lien had such a problem.
Although Zhuang Xinhao resolutely denied that he had a history of coronary heart disease or pain in the chest area, whether it was a medical history inquiry or a patient's self-report.But the blue handwriting on the status bar was still hanging above his head brightly, which distracted Sun Lien very much.
"How about this." Sun Li'en thought for a while and said, "Your heart rate is really not right. Since you have already moved in, why don't you just check it all at once?"
"You are a doctor, I will listen to you." Fortunately, Zhuang Xinhao is Sun Lien's favorite type of patient - he is very obedient to the doctor's advice. "Do you need me to sign something?"
"Let's do a radiography. There will be some corresponding informed letters that you need to sign." Sun Lien replied, "If you have no objections, then I will send you the notification and permission of the radiography later."
·
·
·
In Sun Li'en's view, Zhuang Xinhao's problem should actually be relatively simple - this is a matter of compensation.
There must be a problem with myocardial infarction, otherwise the prompt on the status bar would be very unreasonable.And there are patients who have never felt the precordial pain caused by myocardial infarction. Painless myocardial infarction is not a rare thing.
And Zhuang Xinhao's electrocardiogram did not prompt, which led to the possibility of "compensation".
When he suffered from small-scale or chronic myocardial insufficiency, the body's compensatory ability caused his coronary arteries to rapidly grow "branches".And this may be the cause of compensation.
In order to obtain sufficient oxygen supply from the coronary arteries, the myocardium generally has two compensatory modes.One is compensatory thickening of the coronary arteries - which allows more blood to flow through the arteries.The other is compensatory hyperplasia, that is, many tiny blood vessels extend from the coronary arteries, and then extend to the hypoxic place.
From the perspective of no medical conditions and simply prolonging life, this is probably the "optimal solution" that the human body can achieve.But the problem is that these tiny extensions are essentially a "perfunctory" move.
The originally blocked coronary artery has not been dredged, and the myocardium that has died of hypoxia cannot regenerate.The patient's own living habits have not improved, and the cause of the original coronary artery blockage still exists-he still has a high probability of recurrent myocardial infarction.
The situation is even more troublesome now that the main pathways supplying blood to the rest of the myocardium are regenerated, unidentified arterioles.
The diameter of the new small coronary arteries is thinner, and the blood flow that can be accommodated is also limited.They have difficulty meeting the heart's demands for blood flow.Especially when the demand suddenly increases, these new nameless coronary arteries do not have the ability to increase the supply at all.
At the same time, new arterioles are often twisted and twisted—under the principle of "Grantai" in the human body, the blood supply range of each of them needs to cover as much heart muscle as possible.The twisted and twisted blood vessels themselves have "huge defects" in hemodynamics.In addition, the diameter of the neonatal artery is very small, and the cause of coronary artery blockage has not yet been eliminated, which undoubtedly greatly increases the probability of the patient's recurrence of myocardial infarction.
For doctors, such a thin new arteriole has no possibility of coronary artery stent placement.
Therefore, Sun Lien's first step in dealing with Zhuang Xinhao is to perform a coronary angiography on him first, and then judge how these new arteries are doing, and whether they can persist until Zhuang Xinhao defeats the new coronavirus.
If the evaluation of the condition of the blood vessels is okay, the next step is to continue to maintain antiviral treatment and strengthen monitoring.If the situation is not good, it may be necessary to decide whether to do thrombolysis, stent, or simply perform bypass surgery according to the consultation opinion of the cardiology department.
(End of this chapter)
In the end, Cai Huiping also failed to meet Liu Lianzhi for the last time.
Liu Lianzhi's vital signs disappeared quickly after Song Wen made the phone call, and he was officially declared dead 10 minutes later.
Before Cai Huiping arrived...Liu Lianzhi had already put on his usual clothes with the help of the medical staff.
A white shirt and black trousers.And a pair of black socks on the feet.Liu Lianzhi was just lying on the hospital bed, looking no different from before.
Except for his slightly parted and somewhat dry lips, and his undulating chest, Liu Lianzhi just lay on the bed like a statue.His life is gone, but he is still among us, not even far away.
An intercom requesting instructions came from the ICU, "Dean Song, shall we transfer the remains and disinfect the beds now?"
The ICU beds are always in short supply. Even though Quan Yunhe only had more than 500 new patients yesterday, the ICU beds are still in short supply.
In order to improve the order of treatment, Song Wen made a ranking list for each bed in the ICU department he manages.Behind every bed there are at least two patients waiting to be admitted.Their ranking will be adjusted flexibly at any time according to the progress of the disease. In general, the more serious the disease, the higher the priority for admission.
If the patient cannot wait for the ICU bed of Beihu Hospital, and the condition is more serious, he will be transferred to the ICU ward of other hospitals for treatment.Although it is still possible to ensure that patients can receive treatment, there will be one more transfer procedure.This will not only delay the time node for patients to receive intensive care, but also put pressure on the entire transport system.
A better solution is to increase the turnover rate of ICU beds.For example, after the previous patient no longer needs the bed, make and disinfect the bed as soon as possible before admitting the next patient.
Song Wen sighed, she had tried her best to fight for Cai Huiping, but it seemed that even God was deliberately trying to make things difficult for this miserable head nurse.The last time I met Liu Lianzhi... Cai Huiping really couldn't keep up.
"Disinfect." Song Wen was silent for several seconds, and she kept praying that she could hear a hurried footstep during the few seconds of silence.But... From the hotel where Cai Huiping lives to the hospital, the fastest running time is 10 minutes.This time could not be shorter.
She put down the walkie-talkie in her hand, and said to a colleague beside her, "I'll wait for someone downstairs, call me if I need anything." Then she left the ICU department.When entering the elevator, Song Wen kept thinking about what kind of expression he should use to face the head nurse Cai Huiping who came in a hurry.But this question has never been answered.
About 15 minutes later, Cai Huiping hurriedly appeared at the door of the hospital.She saw Song Wen's figure from a distance, her pace changed from fast to slow, and then accelerated again.Cai Huiping covered her mouth and ran all the way to Song Wen. Before she could speak, she squatted down.
From between the fingers, a burst of crying came out.
Song Wen felt distressed and picked up Cai Huiping who was squatting on the ground. She held Cai Huiping in her arms, but for a long time she could only choke out a sentence, "Cry, just cry."
Cai Huiping almost died from crying, it took her a long time to recover, then she looked at Song Wen and asked, "Old Liu has...?"
Song Wen nodded, and then said, "The car has been hired."
Cai Huiping closed her eyes in despair, then she opened them again, "Has the car arrived yet?"
"Not yet." Song Wen said, "The hospital bed needs to be disinfected, and Lao Liu's clothes are already put on..." She said something messy, but Cai Huiping already understood what Song Wen meant.
She interrupted Song Wen, then nodded and said, "I know, I know..." She wiped her red and swollen eyes and asked in a pleading tone, "I... can I, when the car is leaving, Send him off?"
No one can refuse this request, and Song Wen is no exception.She nodded and replied, "I'll take you there."
·
·
·
Tonight's Yunhe is a rare cloudless sky.The sky is full of stars, and the temperature is higher than the previous few days.
The black van of the funeral parlor slowly drove into the underground parking lot. Seeing this scene, Cai Huiping couldn't help crying again.
Liu Lianzhi and her have known each other for many years, and their relationship has always been very good.Even if one of them is the dean and the other is the head nurse.The special nature of the work keeps the two of them together less and more apart. Throughout the year, the two of them can spend no more than ten weekends at home.It is precisely because of this that they cherish every time they can spend together.Even in the ICU, as long as Liu Lianzhi's condition is a little better, Cai Huiping will always stay by his bedside.
At the beginning, Cai Huiping did nursing care before talking. Later, the five beds became the place where the couple who got together less often and separated more often told each other how they missed each other.Cai Huiping even completely let go of her heart that was hanging in the air at one point, and said to Song Wen and Zhu Minhua, "This guy is a small belly, a problem caused by too small a mind. When he recovers later, punish him and invite everyone to dinner!" "
Liu Lianzhi was even in good shape this morning.He repeatedly complained to his wife that he still couldn't turn negative after such a long time, and asked his wife to bring him two bottles of yogurt to drink tomorrow.The taste of nutrients is too bad, and eating too much really makes people feel uncomfortable.
Cai Huiping agreed to her husband's request, and has already bought a yogurt, which she plans to bring to Liu Lianzhi the next day.But who knows, it's just a few hours' time to go back to the hotel, but it's already an eternity, and never... never see each other again.
After Liu Lianzhi entered the ICU, she was more or less mentally prepared.But this psychological preparation was not enough to support her to accept this cruel reality.
The black car slowly drove out of the underground parking lot. Cai Huiping subconsciously took a step forward, wanting to touch the car.She didn't know what effect she was doing.Maybe it was just a subconscious action, maybe it was just a hope... Liu Lianzhi would not be so lonely when he left.
Then, her emotions completely collapsed.
"Old Liu, old Liu!" Cai Huiping cried and tried to chase the car. Song Wen worried that she would be injured by the wheels, so he held her hands firmly.
Crying is the last hold of the living to the dead, and the last kiss of the bereaved to the lover.It is a farewell to nostalgia for the past and a wish for a new life in the future.
At the gate of the underground parking lot of Beihu Hospital, on Yunhe Street in February, Cai Huiping said her last farewell to her husband.She slumped on the ground, crying bitterly.
Song Wen squatted aside, patting Cai Huiping's shoulder with tears, without saying a word.
·
·
·
Time is the panacea that heals everything.Its effectiveness is not obvious, but it is better than a little improvement every day.Such improvements can be seen not only in the hearts of the bereaved, but also in those physically traumatized by infection.
The human body has certain repair and compensation functions.This kind of compensatory function can sometimes solve very huge problems, and some doctors need to take it very seriously, and even the injuries that may be helpless, sometimes can be "perfunctory" under the compensatory function of the human body.
But such "perfunctory" comes at a price.
Sun Lien is dealing with such a patient. It has to be said that his body is indeed trying very hard to keep him alive.But the situation is really beyond the scope of the body's ability.
Repair and compensatory functions, especially the compensatory function, have three major deficiencies, which make it difficult for doctors and patients to use compensation as the main means of fighting diseases.
The first flaw is that it only "sometimes" solves huge problems.In the face of those traumas and lesions that may take the patient's life in a short period of time, compensation is often ineffective.
The second defect is "perfunctory".The compensatory function can never really solve the problem, it can only maintain the patient's normal physiological signs for a period of time after it works.The patient's physiological signs may remain normal or nearly normal under this compensatory effect.
The third flaw is "compensation" itself.The human body is a very efficient tissue, and it tends to use as little energy as possible to perform major actions.In other words, everyone's body is a living Grandet.It is a basic operation to not pull out a penny, and it is an average level to throw it away if you don’t pick it up when you go out.
And such a "stingy level" determines that even if the human body's metabolism is efficient, it still cannot last.
Taking the current patient's situation as an example, his problem lies in the compensation of the heart.
As an obese middle-aged man with high blood pressure for a long time, Zhuang Xinhao himself is of course a high-risk group for cardiovascular diseases.Although the hospitalization was due to a new type of coronavirus infection, Sun Lien discovered something was wrong the first time he saw him.
There is a blue status bar prompt on this patient's head, and the content is "a small number of myocardial ischemic infarctions".
Sun Lien has always been concerned about what the blue status bar means. According to Sun Lien's previous inference, it may mean symptoms that are "highly related to the primary disease and difficult to ignore, but will not cause further danger".The reappearance of the blue status bar this time may also be an important reminder.
This patient currently has some mild arrhythmia, and this is one of the important reasons why he was sent to the North Fifth District for treatment-Chen Xuerong, who was born in the Department of Cardiology, is in the North Fifth District, as a senior attending doctor , he also has emergency PCI access qualifications.
The Infectious Disease Hospital has the conditions for PCI intervention. As a confirmed patient with pneumonia caused by a new type of coronavirus infection, when the circulatory system is severely affected, arrhythmia may only be a transient symptom, but it may also be a more dangerous malignant disease. A precursor to arrhythmia.Insufficient oxygen supply in the body is likely to lead to the rapid deterioration of the existing mild arrhythmia, which is a very risky factor for patients with underlying heart diseases and a history of coronary heart disease.
And Zhuang Xinhao in front of Sun Lien had such a problem.
Although Zhuang Xinhao resolutely denied that he had a history of coronary heart disease or pain in the chest area, whether it was a medical history inquiry or a patient's self-report.But the blue handwriting on the status bar was still hanging above his head brightly, which distracted Sun Lien very much.
"How about this." Sun Li'en thought for a while and said, "Your heart rate is really not right. Since you have already moved in, why don't you just check it all at once?"
"You are a doctor, I will listen to you." Fortunately, Zhuang Xinhao is Sun Lien's favorite type of patient - he is very obedient to the doctor's advice. "Do you need me to sign something?"
"Let's do a radiography. There will be some corresponding informed letters that you need to sign." Sun Lien replied, "If you have no objections, then I will send you the notification and permission of the radiography later."
·
·
·
In Sun Li'en's view, Zhuang Xinhao's problem should actually be relatively simple - this is a matter of compensation.
There must be a problem with myocardial infarction, otherwise the prompt on the status bar would be very unreasonable.And there are patients who have never felt the precordial pain caused by myocardial infarction. Painless myocardial infarction is not a rare thing.
And Zhuang Xinhao's electrocardiogram did not prompt, which led to the possibility of "compensation".
When he suffered from small-scale or chronic myocardial insufficiency, the body's compensatory ability caused his coronary arteries to rapidly grow "branches".And this may be the cause of compensation.
In order to obtain sufficient oxygen supply from the coronary arteries, the myocardium generally has two compensatory modes.One is compensatory thickening of the coronary arteries - which allows more blood to flow through the arteries.The other is compensatory hyperplasia, that is, many tiny blood vessels extend from the coronary arteries, and then extend to the hypoxic place.
From the perspective of no medical conditions and simply prolonging life, this is probably the "optimal solution" that the human body can achieve.But the problem is that these tiny extensions are essentially a "perfunctory" move.
The originally blocked coronary artery has not been dredged, and the myocardium that has died of hypoxia cannot regenerate.The patient's own living habits have not improved, and the cause of the original coronary artery blockage still exists-he still has a high probability of recurrent myocardial infarction.
The situation is even more troublesome now that the main pathways supplying blood to the rest of the myocardium are regenerated, unidentified arterioles.
The diameter of the new small coronary arteries is thinner, and the blood flow that can be accommodated is also limited.They have difficulty meeting the heart's demands for blood flow.Especially when the demand suddenly increases, these new nameless coronary arteries do not have the ability to increase the supply at all.
At the same time, new arterioles are often twisted and twisted—under the principle of "Grantai" in the human body, the blood supply range of each of them needs to cover as much heart muscle as possible.The twisted and twisted blood vessels themselves have "huge defects" in hemodynamics.In addition, the diameter of the neonatal artery is very small, and the cause of coronary artery blockage has not yet been eliminated, which undoubtedly greatly increases the probability of the patient's recurrence of myocardial infarction.
For doctors, such a thin new arteriole has no possibility of coronary artery stent placement.
Therefore, Sun Lien's first step in dealing with Zhuang Xinhao is to perform a coronary angiography on him first, and then judge how these new arteries are doing, and whether they can persist until Zhuang Xinhao defeats the new coronavirus.
If the evaluation of the condition of the blood vessels is okay, the next step is to continue to maintain antiviral treatment and strengthen monitoring.If the situation is not good, it may be necessary to decide whether to do thrombolysis, stent, or simply perform bypass surgery according to the consultation opinion of the cardiology department.
(End of this chapter)
Tip: You can use left, right, A and D keyboard keys to browse between chapters.