NOVEL WEB I can see the status bar
Chapter 1149
Chapter 1149
Ten seconds ago, Sun Lien defined himself as a "department director who is gradually shaping a serious and confident personality".Ten seconds later, half kneeling on the ground, the engagement ring and even the box ring were taken away by Hu Jia as if they were "confiscated".Sun Lien began to kneel on the ground and think about life—is there something wrong?
There were so many things that were wrong that he couldn't even point out every one of them for a while.After several failed attempts to organize the language, Sun Li'en could only temporarily give up the attempt to speak.
The other members of the medical team laughed and dragged Sun Lien up from the ground.Hu Jia put the ring box into his locker, while the other team members quickly changed clothes for Sun Lien.
There is no way to deal with the bouquet of 99 red roses for the time being, and it seems to be a bit of a hindrance in the dressing room.Hu Jia thought for a while, and then said to Sun Li'en, "I'll take this flower and share it with everyone."
Sun Li'en nodded in confusion, then stood there, waiting for Hu Jia to check his protective clothing, and wrote his name on his chest and back with a marker.The three isolation doors leading to the red zone opened and closed one by one. Hu Jing looked suspiciously at the niece holding a rose in the passage outside the last isolation door, "What's wrong?"
"I was proposed." Hu Jia walked quickly with a rose in his arms, said in a tone of "cabbage is very cheap in the supermarket next door today", and then entered the ward with the rose in his arms, and began to treat the patients lying on the bed. They handed out flowers, and said while sending out, "This is the flower my boyfriend took when he proposed to me. Share it with everyone for joy—you should get better soon after you take it."
Hu Jing was stunned for a few seconds, and then asked Sun Li'en who walked into the red zone, "Did you propose?"
"Yes." Sun Lien nodded.The shock he suffered just now was really big, and he still hasn't recovered from it yet.
"You young people are really interesting now." Hu Jing pondered for a while, and then decided not to think about such a complicated matter, "Hurry up and take over the shift, the patient's condition has changed a bit."
·
·
·
Yu Xin, Tian Kang and Yang Yifei are currently lying in the intensive care unit.Yang Yifei's situation is slightly better, but the situation is still not optimistic.The CT scan of his lungs showed that the current routine antiviral treatment for him is not effective, and his lung lesions are still progressing.
Tian Kang is better than the day before, and his blood oxygen saturation has risen.But other indicators are still not very good - he started to have a fever this morning, and his current body temperature is 38 degrees Celsius.According to the analysis of blood picture changes, Zhou Jun believed that he might have a secondary lung bacterial infection, but the pathogen that caused the infection is not yet clear.
Yu Xin's situation was the worst. Around noon, his serum bilirubin level had soared to 346mmol/L.Continuing to maintain such high bilirubin levels is likely to lead to new bilirubin encephalopathy.What's more troublesome is that the two life-saving artificial liver support devices still haven't been delivered-it is said to be due to delays in the transportation process.
Fortunately, Zhou Jun, who was born in an emergency department, has long been used to intervening in the vital signs of patients without various high-level life support equipment.If there is no artificial liver, then plasma exchange is performed.
Although doing so may result in the replacement of the antibodies contained in the plasma of the convalescents that were previously infused into the new body, but compared with human life, losing a little antibody at this stage is not unacceptable.The supply of convalescent plasma is getting bigger and bigger. In the past few days, North Fifth District can get at least eight units of frozen convalescent plasma almost every day.Occasionally, the plasma of AB convalescents is not available, but the plasma of convalescents of several other blood types is available every day.
Yu Xin has type B blood. After receiving the plasma exchange at [-] o'clock in the afternoon, Zhou Jun immediately gave him two units of convalescent plasma.
The next task was handed over to Sun Lien.Taking good care of the 96 patients in the two large areas on the fifth floor, and ensuring that they can receive appropriate treatment and be safe in the next ten hours...is Sun Lien's current task.
There is no new "gain" in the status bar during Tian Kang's treatment.Although there was an extra reminder of lung infection, the status bar did not kindly tell Sun Lien what caused the infection.From the time point of view, the infection occurred for about sixteen hours, and Zhou Jun's empirical use of antibiotics seemed to have achieved a partial effect—the writing on the status bar seemed to be... slightly lighter.
Tian Kang has been hospitalized for more than 14 days, and before today, he had no signs of lung bacterial infection.It can be said without hesitation that he suffered from hospital-acquired pneumonia.In other words, the pathogen that infected Tian Kang is likely to be some kind of multi-drug resistant bacteria.
In addition to the MRSA (methicillin-resistant Staphylococcus aureus) that Sun Lien had dealt with before, the common multidrug-resistant bacteria in the ICU also include multidrug-resistant Klebsiella pneumoniae and vancomycin-resistant enterococcus (VRS ), multidrug-resistant Pseudomonas aeruginosa, carbapenem-resistant Acinetobacter baumannii, etc.
Zhou Jun is currently treating Tian Kang with imipenem combined with amoxicillin/clavulanate potassium.At the same time, he also dismissed mNGS's doctor's order, in order to find out what the pathogen that infected Tian Kang was as soon as possible.
"Clear out the three wards." After Sun Li'en completed the succession and sent Zhou Jun away, he immediately issued a new doctor's order, "The original temporary ICU ward will be suspended, and the patient will be transferred back after thorough cleaning and disinfection." ——Patients who grabbed the second bed will not be transferred back for the time being, and will be treated in isolation on the spot.”
Tian Kang, who is currently intubated, has developed a bacterial infection in his lungs—dangerous for the other two patients who are also in the makeshift ICU.Especially for Yu Xin, who is undergoing VV ECMO treatment, the risk is greater.The two venous accesses in his body were themselves openings for bacteria to invade the body, and he also received immunosuppressive treatment.
Tian Kang, who has been attacked by the hepatitis B virus and the new coronavirus, is dying. If he is unfortunate enough to be infected with an all-resistant Klebsiella pneumoniae or a pan-resistant Acinetobacter baumannii... then don't save him, and wait for death up.
Relatively speaking, Yang Yifei faces the lowest risk for patients who are also in the ICU.Despite the bewilderingly rapid progression of the novel coronavirus infection, he is the youngest and the best.What he is currently receiving is only non-invasive ventilator-assisted oxygen inhalation, and he has not undergone a tracheotomy—more importantly, he has not yet received triple therapy for immunosuppression.This means that, compared with Tian Kang who grabbed the second bed and Yu Xin who grabbed the first bed, Yang Yifei who was lying on the third bed should have the most robust immune system.
A healthy immune system is of great significance in defending against extensively drug-resistant bacteria.
After the three wards were cleared out, Hu Jia led two nurses and the staff from the Infection Department who came to support them to thoroughly disinfect the temporary ICU.And this case of acquired pneumonia also made Sun Lien and other doctors in the treatment team sound the alarm.
"Everyone, remember to wear your mask well." This kind of doctor's order has become the most frequently told patients by all doctors and nurses today.Especially for those patients with mild symptoms who receive oxygen therapy through nasal catheter oxygen inhalation, they are required to wear masks all day long and not take them off—the nurses even used adhesive tape to fix the edges of the masks of these patients .
On the one hand, such measures can also reduce the possibility of floating new coronaviruses in the room, but the more important thing is to prevent these patients from being infected by multi-drug resistant bacteria.The medical staff are fully armed, and they are quite safe.But these patients who are about to be discharged from the hospital dare not have anything to do-if they are infected, the subsequent treatment will be troublesome.
Sun Li'en wandered around the ward several times, then returned to the office and called Professor Zhang Zhifu.
After learning about the nosocomial infection in North Fifth District, Zhang Zhifu himself was taken aback, "Is the situation serious? How many people are infected?"
"There is only one patient at the moment. The source of the infection is not clear yet, and samples have been taken and sent to mNGS." Sun Lien replied, "We have invited staff from the hospital to disinfect the room with the nurses. After the disinfection is complete , the source of infection should be detected. At that time, take an environmental sample and do another PCR check to see."
"Environmental disinfection can definitely solve the problem." Zhang Zhifu said very seriously, "But the most urgent task now is to find out where the germ came from."
Zhang Zhifu really couldn't be blamed for making a fuss about this matter.The rooms in the Infectious Disease Hospital have been specially designed. Before becoming the main battleground for the fight against the novel coronavirus, the two wards of North Fifth District and South Fifth District have always been used to receive patients diagnosed with multidrug-resistant pulmonary tuberculosis. ward.Before that, there had never been even a single case of multidrug-resistant bacteria infection in North Fifth District and South Fifth District.
After accepting patients diagnosed with the new coronavirus, both the North Fifth District and the South Fifth District have undergone special renovations.Each ward has a special suction filter machine that works 24 hours a day to ensure that the air pressure in the ward is always lower than that of the outside world.In order to achieve the possibility of blocking the spread of the new coronavirus outside the hospital through aerosol and other means.
In addition to the negative pressure room, routine room disinfection is carried out every day in North Fifth District and South Fifth District.Although the ultraviolet lamp in the room cannot be turned on, the disinfectant mopping the floor three times a day will not be less.All members of the medical team are also actively implementing the principle of red zone operation. Before and after entering and leaving each ward, everyone needs to spray disinfectant on their feet and gloves, and put on a layer after entering the ward New gloves, throw the gloves away immediately after leaving.
When medical staff have raised the awareness of germ prevention and control to this level, hospital-acquired pneumonia still appears in the ward-this is really unreasonable.
Pathogens will not "grow" out of thin air, they must have entered the ward through some channel and infected Tian Kang.This is also what worries Zhang Zhifu the most - if bacteria can enter the ward through a certain channel, it means that the virus in the ward may also leave the ward through the same channel.
"I'll go into the ward to have a look after the disinfection is finished." Sun Lien also felt that something was a little strange, but he really couldn't figure out where this unknown bacteria came from. "I've checked around the ward just now, and I didn't find any problems like water leakage or mold. At least from my rough look, this ward doesn't look like it has any leaks."
"Anyway, you should take a closer look." Zhang Zhifu sighed, "Don't use that temporary ICU for the time being, and don't put patients in it until you figure out the source of the pathogen."
·
·
·
At 11:30 in the evening, Hu Jia walked up to Sun Lien and said, "The room has been disinfected."
"I'll go over and have a look." Sun Li'en, who had been waiting for the disinfection to be completed, suddenly regained his energy. He quickly stood up and prepared to go out, "Is the air extractor in the room not turned off?"
"No." Hu Jia shook her head. Seeing Sun Lien get up, she suddenly asked, "How long have you been planning today's matter?"
Sun Li'en slipped and almost fell, he supported the table and asked in confusion, "What's the matter?"
"Marriage proposal." Hu Jia's glasses covered by the protective goggles were bent into crescent moons, "It's fine if you have a ring, and flowers... Now it's more difficult to get two flowers in Yunhe."
Hu Jia has long been thinking about getting some flowers for the patients to cheer them up.But such a request has never been fulfilled, and the reason is very simple-it is impossible for Yunhe to have flowers in this weather.
At this time in previous years, the flowers of Yunhe had to be transported from the south. If you are closer, you can find Hunan or Guangdong, and if you are farther, you can transport flowers from Yunnan by air.There are not many flower greenhouses in Xiangbei Province, and the supply will not be available until later in April.
And now all the transportation forces that can reach Yunhe are concentrated to ensure the daily needs of tens of millions of residents in this city.Food, medicine, and other materials that can be used to fight the epidemic are the top priority.Delicate and useless things like flowers will not be able to be transported for a while.
As for Sun Li'en's marriage proposal, not only did he have a video camera and a diamond ring, what's more, there were actually 99 roses.
If Hu Jia still can't guess that Sun Li'en has put a lot of thought into this wedding, then I'm really sorry for her usual intelligence and sensitivity.
"Today... the situation is special." Sun Li'en said a little embarrassedly, "I planned to propose at the gate, but I didn't expect the person with the flowers to go to the sixth floor."
"I'm quite satisfied." Hu Jia said with a smile, "If you think the process is not ideal, we can go back and make up another one." She leaned close to Sun Lien's ear and said with a smile, "When the time comes, let's go home and do it, and I will sit on the bed Beside, I will listen for as long as you want."
Sun Li'en rolled his eyes, "I'm afraid my knees can't take it."
"As long as my ears can bear it." Hu Jia chuckled, and lightly kicked Sun Lien's calf with his foot, "Don't worry, I'll prepare a cushion for you in advance."
(End of this chapter)
Ten seconds ago, Sun Lien defined himself as a "department director who is gradually shaping a serious and confident personality".Ten seconds later, half kneeling on the ground, the engagement ring and even the box ring were taken away by Hu Jia as if they were "confiscated".Sun Lien began to kneel on the ground and think about life—is there something wrong?
There were so many things that were wrong that he couldn't even point out every one of them for a while.After several failed attempts to organize the language, Sun Li'en could only temporarily give up the attempt to speak.
The other members of the medical team laughed and dragged Sun Lien up from the ground.Hu Jia put the ring box into his locker, while the other team members quickly changed clothes for Sun Lien.
There is no way to deal with the bouquet of 99 red roses for the time being, and it seems to be a bit of a hindrance in the dressing room.Hu Jia thought for a while, and then said to Sun Li'en, "I'll take this flower and share it with everyone."
Sun Li'en nodded in confusion, then stood there, waiting for Hu Jia to check his protective clothing, and wrote his name on his chest and back with a marker.The three isolation doors leading to the red zone opened and closed one by one. Hu Jing looked suspiciously at the niece holding a rose in the passage outside the last isolation door, "What's wrong?"
"I was proposed." Hu Jia walked quickly with a rose in his arms, said in a tone of "cabbage is very cheap in the supermarket next door today", and then entered the ward with the rose in his arms, and began to treat the patients lying on the bed. They handed out flowers, and said while sending out, "This is the flower my boyfriend took when he proposed to me. Share it with everyone for joy—you should get better soon after you take it."
Hu Jing was stunned for a few seconds, and then asked Sun Li'en who walked into the red zone, "Did you propose?"
"Yes." Sun Lien nodded.The shock he suffered just now was really big, and he still hasn't recovered from it yet.
"You young people are really interesting now." Hu Jing pondered for a while, and then decided not to think about such a complicated matter, "Hurry up and take over the shift, the patient's condition has changed a bit."
·
·
·
Yu Xin, Tian Kang and Yang Yifei are currently lying in the intensive care unit.Yang Yifei's situation is slightly better, but the situation is still not optimistic.The CT scan of his lungs showed that the current routine antiviral treatment for him is not effective, and his lung lesions are still progressing.
Tian Kang is better than the day before, and his blood oxygen saturation has risen.But other indicators are still not very good - he started to have a fever this morning, and his current body temperature is 38 degrees Celsius.According to the analysis of blood picture changes, Zhou Jun believed that he might have a secondary lung bacterial infection, but the pathogen that caused the infection is not yet clear.
Yu Xin's situation was the worst. Around noon, his serum bilirubin level had soared to 346mmol/L.Continuing to maintain such high bilirubin levels is likely to lead to new bilirubin encephalopathy.What's more troublesome is that the two life-saving artificial liver support devices still haven't been delivered-it is said to be due to delays in the transportation process.
Fortunately, Zhou Jun, who was born in an emergency department, has long been used to intervening in the vital signs of patients without various high-level life support equipment.If there is no artificial liver, then plasma exchange is performed.
Although doing so may result in the replacement of the antibodies contained in the plasma of the convalescents that were previously infused into the new body, but compared with human life, losing a little antibody at this stage is not unacceptable.The supply of convalescent plasma is getting bigger and bigger. In the past few days, North Fifth District can get at least eight units of frozen convalescent plasma almost every day.Occasionally, the plasma of AB convalescents is not available, but the plasma of convalescents of several other blood types is available every day.
Yu Xin has type B blood. After receiving the plasma exchange at [-] o'clock in the afternoon, Zhou Jun immediately gave him two units of convalescent plasma.
The next task was handed over to Sun Lien.Taking good care of the 96 patients in the two large areas on the fifth floor, and ensuring that they can receive appropriate treatment and be safe in the next ten hours...is Sun Lien's current task.
There is no new "gain" in the status bar during Tian Kang's treatment.Although there was an extra reminder of lung infection, the status bar did not kindly tell Sun Lien what caused the infection.From the time point of view, the infection occurred for about sixteen hours, and Zhou Jun's empirical use of antibiotics seemed to have achieved a partial effect—the writing on the status bar seemed to be... slightly lighter.
Tian Kang has been hospitalized for more than 14 days, and before today, he had no signs of lung bacterial infection.It can be said without hesitation that he suffered from hospital-acquired pneumonia.In other words, the pathogen that infected Tian Kang is likely to be some kind of multi-drug resistant bacteria.
In addition to the MRSA (methicillin-resistant Staphylococcus aureus) that Sun Lien had dealt with before, the common multidrug-resistant bacteria in the ICU also include multidrug-resistant Klebsiella pneumoniae and vancomycin-resistant enterococcus (VRS ), multidrug-resistant Pseudomonas aeruginosa, carbapenem-resistant Acinetobacter baumannii, etc.
Zhou Jun is currently treating Tian Kang with imipenem combined with amoxicillin/clavulanate potassium.At the same time, he also dismissed mNGS's doctor's order, in order to find out what the pathogen that infected Tian Kang was as soon as possible.
"Clear out the three wards." After Sun Li'en completed the succession and sent Zhou Jun away, he immediately issued a new doctor's order, "The original temporary ICU ward will be suspended, and the patient will be transferred back after thorough cleaning and disinfection." ——Patients who grabbed the second bed will not be transferred back for the time being, and will be treated in isolation on the spot.”
Tian Kang, who is currently intubated, has developed a bacterial infection in his lungs—dangerous for the other two patients who are also in the makeshift ICU.Especially for Yu Xin, who is undergoing VV ECMO treatment, the risk is greater.The two venous accesses in his body were themselves openings for bacteria to invade the body, and he also received immunosuppressive treatment.
Tian Kang, who has been attacked by the hepatitis B virus and the new coronavirus, is dying. If he is unfortunate enough to be infected with an all-resistant Klebsiella pneumoniae or a pan-resistant Acinetobacter baumannii... then don't save him, and wait for death up.
Relatively speaking, Yang Yifei faces the lowest risk for patients who are also in the ICU.Despite the bewilderingly rapid progression of the novel coronavirus infection, he is the youngest and the best.What he is currently receiving is only non-invasive ventilator-assisted oxygen inhalation, and he has not undergone a tracheotomy—more importantly, he has not yet received triple therapy for immunosuppression.This means that, compared with Tian Kang who grabbed the second bed and Yu Xin who grabbed the first bed, Yang Yifei who was lying on the third bed should have the most robust immune system.
A healthy immune system is of great significance in defending against extensively drug-resistant bacteria.
After the three wards were cleared out, Hu Jia led two nurses and the staff from the Infection Department who came to support them to thoroughly disinfect the temporary ICU.And this case of acquired pneumonia also made Sun Lien and other doctors in the treatment team sound the alarm.
"Everyone, remember to wear your mask well." This kind of doctor's order has become the most frequently told patients by all doctors and nurses today.Especially for those patients with mild symptoms who receive oxygen therapy through nasal catheter oxygen inhalation, they are required to wear masks all day long and not take them off—the nurses even used adhesive tape to fix the edges of the masks of these patients .
On the one hand, such measures can also reduce the possibility of floating new coronaviruses in the room, but the more important thing is to prevent these patients from being infected by multi-drug resistant bacteria.The medical staff are fully armed, and they are quite safe.But these patients who are about to be discharged from the hospital dare not have anything to do-if they are infected, the subsequent treatment will be troublesome.
Sun Li'en wandered around the ward several times, then returned to the office and called Professor Zhang Zhifu.
After learning about the nosocomial infection in North Fifth District, Zhang Zhifu himself was taken aback, "Is the situation serious? How many people are infected?"
"There is only one patient at the moment. The source of the infection is not clear yet, and samples have been taken and sent to mNGS." Sun Lien replied, "We have invited staff from the hospital to disinfect the room with the nurses. After the disinfection is complete , the source of infection should be detected. At that time, take an environmental sample and do another PCR check to see."
"Environmental disinfection can definitely solve the problem." Zhang Zhifu said very seriously, "But the most urgent task now is to find out where the germ came from."
Zhang Zhifu really couldn't be blamed for making a fuss about this matter.The rooms in the Infectious Disease Hospital have been specially designed. Before becoming the main battleground for the fight against the novel coronavirus, the two wards of North Fifth District and South Fifth District have always been used to receive patients diagnosed with multidrug-resistant pulmonary tuberculosis. ward.Before that, there had never been even a single case of multidrug-resistant bacteria infection in North Fifth District and South Fifth District.
After accepting patients diagnosed with the new coronavirus, both the North Fifth District and the South Fifth District have undergone special renovations.Each ward has a special suction filter machine that works 24 hours a day to ensure that the air pressure in the ward is always lower than that of the outside world.In order to achieve the possibility of blocking the spread of the new coronavirus outside the hospital through aerosol and other means.
In addition to the negative pressure room, routine room disinfection is carried out every day in North Fifth District and South Fifth District.Although the ultraviolet lamp in the room cannot be turned on, the disinfectant mopping the floor three times a day will not be less.All members of the medical team are also actively implementing the principle of red zone operation. Before and after entering and leaving each ward, everyone needs to spray disinfectant on their feet and gloves, and put on a layer after entering the ward New gloves, throw the gloves away immediately after leaving.
When medical staff have raised the awareness of germ prevention and control to this level, hospital-acquired pneumonia still appears in the ward-this is really unreasonable.
Pathogens will not "grow" out of thin air, they must have entered the ward through some channel and infected Tian Kang.This is also what worries Zhang Zhifu the most - if bacteria can enter the ward through a certain channel, it means that the virus in the ward may also leave the ward through the same channel.
"I'll go into the ward to have a look after the disinfection is finished." Sun Lien also felt that something was a little strange, but he really couldn't figure out where this unknown bacteria came from. "I've checked around the ward just now, and I didn't find any problems like water leakage or mold. At least from my rough look, this ward doesn't look like it has any leaks."
"Anyway, you should take a closer look." Zhang Zhifu sighed, "Don't use that temporary ICU for the time being, and don't put patients in it until you figure out the source of the pathogen."
·
·
·
At 11:30 in the evening, Hu Jia walked up to Sun Lien and said, "The room has been disinfected."
"I'll go over and have a look." Sun Li'en, who had been waiting for the disinfection to be completed, suddenly regained his energy. He quickly stood up and prepared to go out, "Is the air extractor in the room not turned off?"
"No." Hu Jia shook her head. Seeing Sun Lien get up, she suddenly asked, "How long have you been planning today's matter?"
Sun Li'en slipped and almost fell, he supported the table and asked in confusion, "What's the matter?"
"Marriage proposal." Hu Jia's glasses covered by the protective goggles were bent into crescent moons, "It's fine if you have a ring, and flowers... Now it's more difficult to get two flowers in Yunhe."
Hu Jia has long been thinking about getting some flowers for the patients to cheer them up.But such a request has never been fulfilled, and the reason is very simple-it is impossible for Yunhe to have flowers in this weather.
At this time in previous years, the flowers of Yunhe had to be transported from the south. If you are closer, you can find Hunan or Guangdong, and if you are farther, you can transport flowers from Yunnan by air.There are not many flower greenhouses in Xiangbei Province, and the supply will not be available until later in April.
And now all the transportation forces that can reach Yunhe are concentrated to ensure the daily needs of tens of millions of residents in this city.Food, medicine, and other materials that can be used to fight the epidemic are the top priority.Delicate and useless things like flowers will not be able to be transported for a while.
As for Sun Li'en's marriage proposal, not only did he have a video camera and a diamond ring, what's more, there were actually 99 roses.
If Hu Jia still can't guess that Sun Li'en has put a lot of thought into this wedding, then I'm really sorry for her usual intelligence and sensitivity.
"Today... the situation is special." Sun Li'en said a little embarrassedly, "I planned to propose at the gate, but I didn't expect the person with the flowers to go to the sixth floor."
"I'm quite satisfied." Hu Jia said with a smile, "If you think the process is not ideal, we can go back and make up another one." She leaned close to Sun Lien's ear and said with a smile, "When the time comes, let's go home and do it, and I will sit on the bed Beside, I will listen for as long as you want."
Sun Li'en rolled his eyes, "I'm afraid my knees can't take it."
"As long as my ears can bear it." Hu Jia chuckled, and lightly kicked Sun Lien's calf with his foot, "Don't worry, I'll prepare a cushion for you in advance."
(End of this chapter)
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