NOVEL WEB I can see the status bar
Chapter 1150 Qualitative Change
Chapter 1150 Qualitative Change
After chatting with his fiancée who agreed to the proposal, Sun Lien left the office contentedly and walked towards the temporary ICU that has been discontinued.
The relevant report of the mNGS test has not yet come out, and Sun Lien is not sure what exactly infected Tian Kang.But as long as some basic scientific principles are followed, it is not difficult to make some general judgments about pathogens.
The first problem to be solved is "where does the pathogen come from?" This problem directly determines whether the temporary ICU ward can continue to be used.
The temporary ICU ward is the original large ward in North Fifth District.According to the original design, eight patients can be hospitalized at the same time.After Yunhe discovered traces of the new coronavirus, Dr. Qi Jing, who was in charge of the entire ward before, quickly decided to renovate the ward.And finally five ICU add-on units were installed in this temporary ICU ward-including life monitoring equipment, oxygen breathing device, integrated lighting and blackout curtains that can surround three sides of the bed.
Coupled with the configuration of three sets of life monitoring equipment and ventilators temporarily sent later, the temporary ICU ward has become a high-level intensive care unit that can accommodate eight critically ill patients with pneumonia infected by the new coronavirus.
From Qi Jing to Sun Li'en, during the two consecutive months of use, this temporary ward has played a huge role.More than a dozen patients have been successfully transferred from here to the general ward to continue receiving treatment, and Mr. Shen, who is in the best condition, has even been sent to the isolation point for isolation observation.
In the past two months, no nosocomial infection has occurred in this ICU.All patients are "safe".
And it was such a safe ICU, but Sun Lien suddenly had a nosocomial infection in his hands, which made him very upset.
If it is in a general ward or even an ordinary ICU ward, it is not too easy for Sun Lien to use the status bar to find the source of the nosocomial sense - look at where the overwhelming warning signs will appear, and you will probably be able to find the source of the nosocomial sense.But in Yunhe, such a skill was suddenly useless—the warning signs were everywhere, and he really couldn't figure out what looked more suspicious.
After entering the ward, Sun Lien began to carefully observe the gaps between the ceiling and the wall of the room.There may be cracks or water seepage in these locations - although in a tertiary hospital of this level, Sun Lien really can't imagine any cracks and leaks in the building itself that would cause the spread of pathogens, but... he really can't think of any other possibility .
It can't be because of a wormhole opened between the ICU upstairs and the North Fifth District, this cunning germ has crossed the North Sixth District, and then directly reached the North Fifth District, right?
Sun Li'en looked over the room carefully, but couldn't find any problems.
This kind of room that can be used as a temporary ICU must be in the best condition.Not only did the room itself not have any mildew stains, cracks or leaks, but even the windows on the side were tightly sealed—three of the six windows in the temporary ward were equipped with exhaust vents for exhaust fans.The other windows were firmly closed, and even the seams of the windows were directly sealed with glass glue.
Only purified air can leave the ward through the window, and anything outside the window, whether it is a leaf or a virus, cannot actively pass through the exhaust vent of the exhaust fan and enter the temporary ICU ward.
Sun Li'en walked around the ward several times, and he vaguely felt a little chill on his trouser legs.This is a main manifestation of the troubles caused by the negative pressure ward to the doctors and nurses—whether sitting in the office or the nurse's station, even in the green area, the negative pressure ward will let the wind flow through the bodies of the doctors and nurses continuously. , and then drilled out along the window.
The wind is not too strong, but the victory is continuous and non-stop.The protective clothing itself is stuffy, but it doesn't keep warm at all.And those little nurses who are not in good health can't survive a night even in the green zone.Sitting in the green zone for an hour or two, their hands and feet would be completely frozen.
The little wind in the red zone also permeates people.Most of the patients were wearing thick clothes, and at the same time they were still lying on the bed, with the electric heater on and covered with thick quilts.Even so, patients often complain of being too cold.
Sun Li'en moved his hands and feet, preparing to give up the inspection and go outside the ICU to have a look.When he passed the bathroom in the temporary ICU ward, he suddenly felt a strange cool wind blowing out along the door of the bathroom.
The temporary ICU ward used to be a room for eight people. Such a large ward must have its own bathroom.Sun Li'en frowned and glanced at the bathroom, then suddenly had an idea, and pushed open the door of the bathroom.
This toilet is not small in size, and there are two shower rooms and three toilet pits inside.There are also two sinks and a mop washbasin.
Since it was used as a temporary ICU, the patients who came in this room were basically comatose patients.Their personal cleaning and excretion work are all done directly on the bed by nursing.
And these cleaning and excretion wastes will be dumped by the nurses into the urinal of the toilet and then flushed away.
There is no problem with this cleaning process, and the nurses have done this kind of thing not once or twice.Relevant aseptic measures must also be done well-even if they are not done so well, drug-resistant bacteria should not be produced in these operations.
The pathogens of hospital-acquired pneumonia are basically drug-resistant bacteria.If it comes from the bacteria excreted by the patient himself, their damage to the human body will not be so great.
In other words, the bacteria that infected Tian Kang should have survived in the hospital a long time ago, and have survived waves of antibiotics and disinfectants.And it’s unlikely that the breed, “bred” by round after round of antibiotics, will suddenly show up in a patient’s feces and urine.
The place where such bacteria are most likely to appear is of course the ICU, which is located on the seventh floor.From the seventh floor to the fifth floor, the only "straight through" pipeline is the sewer.It was a coincidence that the sewer pipe in the temporary ICU on the fifth floor in the north happened to be directly connected to the main sewer pipe in the ICU on the seventh floor.
Of course, Sun Lien didn't know this. He just suddenly thought of the Amoy Garden incident that caused a serious transmission incident in Hong Kong during the SARS period.
The shower room in the temporary ICU has not been used for more than a month, which has caused the trap water seal used to isolate the shower room and the sewer pipe in the sewer pipe that has not been used for a long time to gradually dry up.
A dry water seal can no longer isolate the main sewer pipe from the shower floor drain, and the exhaust in the main sewer pipe ensures that the pressure inside the pipe is greater than that outside the pipe.
Due to continuous pumping and discharging, the pressure of the room in the ward is always lower than the external atmospheric pressure.And the bacteria that remained in the sewer pipe were sucked out of the sewer pipe by the air pressure, and began to spread in the temporary ICU.
It is also very simple to verify whether this conjecture is correct.Sun Lien used two chopsticks to pry open the floor drain of the shower room in the temporary ICU. After taking out the filter, he gently inserted a piece of folded A4 paper into the floor drain.
The length of a piece of A4 paper is 29.7 cm, and the design requirement of the hospital sewer trap is that the height of the water seal is not less than 50mm and not more than 100mm.In other words, if a piece of A4 paper is inserted into the sewer, in theory, it can be directly seen whether there is a water seal in the trap.
The A4 paper that was pulled from the sewer was dry.
Sun Lien took a deep breath, and quickly used the scotch tape on his body to completely seal the three floor drains in the bathroom, then walked out of the room and began to seal all the gaps on the bathroom door with tape.After sticking to every gap, he relaxed a little.
Bacteria are most likely leaking from the water-sealed floor drain.It is not difficult to finally confirm Sun Lien's judgment - let the staff of the hospital's infection department come to the bathroom, and take samples and cultures in the floor drain and the pipe wall.Then compare the culture results with mNGS.
As long as the comparison matches, it can prove the source of the hospital feeling.After that, just pour three to five liters of disinfectant into the floor drain to ensure that there is always water in the trap water seal.
·
·
·
Sun Lien "bathed" his protective clothing with spray equipment outside the room, and the hospital staff who heard the news had already begun to unseal the "seal" he had made on the temporary ICU shower room.
While dismantling it, the hospital staff praised Sun Lien verbally, "Director Sun's judgment is very reasonable, and this emergency handling method is also very good."
Hu Jia smiled and said, "After all, they are emergency doctors. Using tape to stick things is their old profession."
The doctors in the hospital couldn't immediately understand the point of Hu Jia's joke, but this didn't prevent them from continuing to remove the tape.They said while dismantling, "The ward is now in a negative pressure state. In fact, there is no need to worry about the spillage of pollutants in this ward."
"I was mainly worried that the pollutants would get on the protective clothing, which would put patients in other wards at risk." Sun Lien said a little embarrassedly, "At that time, I was busy sticking it with tape, but I didn't bother to think about it."
"Let's do the rest of the work." After tearing off almost all the tape around the bathroom door, the hospital doctor estimated that the door could be opened smoothly, so he said to Sun Li'en and Hu Jia, "Director Sun, you just disappeared Too poisoned, if you continue to stay here... you will have to sterilize again after the meeting opens. One more thing is worse than one less thing, and the rest of the work can be left to us."
Sun Li'en nodded, and then instructed, "There are three floor drains in the shower room, and I tried two of them and they were all dry. If you want to sample, you must collect the two floor drains that have been dried out..."
"All three of us have to take samples." The doctor from the hospital's infection department said, "This is our specialty. Don't worry, Dr. Sun—we will definitely take it seriously."
It took Sun Li'en half an hour to find a possible infection channel in the ICU ward.This made Professor Zhang Zhifu very happy—as long as it is confirmed that the water seal is the source of the germs, the temporary ICU in the North Fifth District can be put into use again in a short time.
At the same time, this discovery also sounded the alarm for other wards-the medical staff in each ward have been notified that all toilets and shower room floor drains must be filled with water every day to ensure that the water seal will not dry up.This discovery not only saved the temporary ICU in North Fifth District, but also reminded the daily work of other wards.
Professor Zhang Zhifu praised Sun Lien emotionally, and then asked, "When will your temporary ICU be put into use again?"
"At least wait until the results of the mNGS comparison come out." Sun Lien thought for a while and said, "It's no small thing to feel hospitalized. The symptoms of the patients in the temporary ICU are very serious. I dare not open the ward immediately until it is safe."
Professor Zhang Zhifu was a little helpless, "This speed must be faster. The current ICU ward is extremely tight. If you have one more bed on your side, we can save one more."
Comrade Zhang was a little flustered by the pressure, but Sun Lien knew very well how much the hospital infection could pose a threat to critically ill patients.Tian Kang's original condition was not good. His Hodgkin's lymphoma finally showed signs of shrinking, and the range of lesions in his lungs was gradually shrinking.As a result, he was suddenly attacked by hospital-acquired pneumonia, and now...whether he can get it back is another matter.
That feeling of frustration is the hardest to swallow for doctors who have nearly beaten the onslaught of the novel coronavirus infection and even seen a shrinkage of Hodgkin's lymphoma.Acquired pneumonia... This disease with a high mortality rate is even more dangerous in Tian Kang.
To save Tian Kang's life from the bacteria, in addition to figuring out the pathogen as soon as possible, the doctors also need the laboratory to start drug susceptibility testing as soon as possible.Look at this kind of bacteria that has survived in the sewer pipes of the hospital for an unknown number of years and has been repeatedly "screened" by countless powerful antibiotics, and which antibiotics still respond to them.
I hope that one or two antibiotics can still be effective... Sun Lien sighed a lot today.The successful marriage proposal itself still made him quite happy, although the degree of happiness was weakened by the anticlimactic process and the relief of various sudden hip-pull problems.But Hu Jia agreed without hesitation, this matter itself is worth being happy.
However, this happiness didn't last long, when Tian Kang's infection suddenly fell on Sun Li'en.The next step is the busy transfer of beds, disinfection, and adjustment of treatment plans.After the busy work was over, Zhang Zhifu tried his best to find a possible infection route, and Zhang Zhifu urged Sun Lien to open the temporary ICU ward again as soon as possible.
These things... It's just bad to separate them.And when all these bad things happen on the same day, at the same time, in the same class, the feeling is not just "bad".
The so-called quantitative change leads to qualitative change, which is probably the case.
(End of this chapter)
After chatting with his fiancée who agreed to the proposal, Sun Lien left the office contentedly and walked towards the temporary ICU that has been discontinued.
The relevant report of the mNGS test has not yet come out, and Sun Lien is not sure what exactly infected Tian Kang.But as long as some basic scientific principles are followed, it is not difficult to make some general judgments about pathogens.
The first problem to be solved is "where does the pathogen come from?" This problem directly determines whether the temporary ICU ward can continue to be used.
The temporary ICU ward is the original large ward in North Fifth District.According to the original design, eight patients can be hospitalized at the same time.After Yunhe discovered traces of the new coronavirus, Dr. Qi Jing, who was in charge of the entire ward before, quickly decided to renovate the ward.And finally five ICU add-on units were installed in this temporary ICU ward-including life monitoring equipment, oxygen breathing device, integrated lighting and blackout curtains that can surround three sides of the bed.
Coupled with the configuration of three sets of life monitoring equipment and ventilators temporarily sent later, the temporary ICU ward has become a high-level intensive care unit that can accommodate eight critically ill patients with pneumonia infected by the new coronavirus.
From Qi Jing to Sun Li'en, during the two consecutive months of use, this temporary ward has played a huge role.More than a dozen patients have been successfully transferred from here to the general ward to continue receiving treatment, and Mr. Shen, who is in the best condition, has even been sent to the isolation point for isolation observation.
In the past two months, no nosocomial infection has occurred in this ICU.All patients are "safe".
And it was such a safe ICU, but Sun Lien suddenly had a nosocomial infection in his hands, which made him very upset.
If it is in a general ward or even an ordinary ICU ward, it is not too easy for Sun Lien to use the status bar to find the source of the nosocomial sense - look at where the overwhelming warning signs will appear, and you will probably be able to find the source of the nosocomial sense.But in Yunhe, such a skill was suddenly useless—the warning signs were everywhere, and he really couldn't figure out what looked more suspicious.
After entering the ward, Sun Lien began to carefully observe the gaps between the ceiling and the wall of the room.There may be cracks or water seepage in these locations - although in a tertiary hospital of this level, Sun Lien really can't imagine any cracks and leaks in the building itself that would cause the spread of pathogens, but... he really can't think of any other possibility .
It can't be because of a wormhole opened between the ICU upstairs and the North Fifth District, this cunning germ has crossed the North Sixth District, and then directly reached the North Fifth District, right?
Sun Li'en looked over the room carefully, but couldn't find any problems.
This kind of room that can be used as a temporary ICU must be in the best condition.Not only did the room itself not have any mildew stains, cracks or leaks, but even the windows on the side were tightly sealed—three of the six windows in the temporary ward were equipped with exhaust vents for exhaust fans.The other windows were firmly closed, and even the seams of the windows were directly sealed with glass glue.
Only purified air can leave the ward through the window, and anything outside the window, whether it is a leaf or a virus, cannot actively pass through the exhaust vent of the exhaust fan and enter the temporary ICU ward.
Sun Li'en walked around the ward several times, and he vaguely felt a little chill on his trouser legs.This is a main manifestation of the troubles caused by the negative pressure ward to the doctors and nurses—whether sitting in the office or the nurse's station, even in the green area, the negative pressure ward will let the wind flow through the bodies of the doctors and nurses continuously. , and then drilled out along the window.
The wind is not too strong, but the victory is continuous and non-stop.The protective clothing itself is stuffy, but it doesn't keep warm at all.And those little nurses who are not in good health can't survive a night even in the green zone.Sitting in the green zone for an hour or two, their hands and feet would be completely frozen.
The little wind in the red zone also permeates people.Most of the patients were wearing thick clothes, and at the same time they were still lying on the bed, with the electric heater on and covered with thick quilts.Even so, patients often complain of being too cold.
Sun Li'en moved his hands and feet, preparing to give up the inspection and go outside the ICU to have a look.When he passed the bathroom in the temporary ICU ward, he suddenly felt a strange cool wind blowing out along the door of the bathroom.
The temporary ICU ward used to be a room for eight people. Such a large ward must have its own bathroom.Sun Li'en frowned and glanced at the bathroom, then suddenly had an idea, and pushed open the door of the bathroom.
This toilet is not small in size, and there are two shower rooms and three toilet pits inside.There are also two sinks and a mop washbasin.
Since it was used as a temporary ICU, the patients who came in this room were basically comatose patients.Their personal cleaning and excretion work are all done directly on the bed by nursing.
And these cleaning and excretion wastes will be dumped by the nurses into the urinal of the toilet and then flushed away.
There is no problem with this cleaning process, and the nurses have done this kind of thing not once or twice.Relevant aseptic measures must also be done well-even if they are not done so well, drug-resistant bacteria should not be produced in these operations.
The pathogens of hospital-acquired pneumonia are basically drug-resistant bacteria.If it comes from the bacteria excreted by the patient himself, their damage to the human body will not be so great.
In other words, the bacteria that infected Tian Kang should have survived in the hospital a long time ago, and have survived waves of antibiotics and disinfectants.And it’s unlikely that the breed, “bred” by round after round of antibiotics, will suddenly show up in a patient’s feces and urine.
The place where such bacteria are most likely to appear is of course the ICU, which is located on the seventh floor.From the seventh floor to the fifth floor, the only "straight through" pipeline is the sewer.It was a coincidence that the sewer pipe in the temporary ICU on the fifth floor in the north happened to be directly connected to the main sewer pipe in the ICU on the seventh floor.
Of course, Sun Lien didn't know this. He just suddenly thought of the Amoy Garden incident that caused a serious transmission incident in Hong Kong during the SARS period.
The shower room in the temporary ICU has not been used for more than a month, which has caused the trap water seal used to isolate the shower room and the sewer pipe in the sewer pipe that has not been used for a long time to gradually dry up.
A dry water seal can no longer isolate the main sewer pipe from the shower floor drain, and the exhaust in the main sewer pipe ensures that the pressure inside the pipe is greater than that outside the pipe.
Due to continuous pumping and discharging, the pressure of the room in the ward is always lower than the external atmospheric pressure.And the bacteria that remained in the sewer pipe were sucked out of the sewer pipe by the air pressure, and began to spread in the temporary ICU.
It is also very simple to verify whether this conjecture is correct.Sun Lien used two chopsticks to pry open the floor drain of the shower room in the temporary ICU. After taking out the filter, he gently inserted a piece of folded A4 paper into the floor drain.
The length of a piece of A4 paper is 29.7 cm, and the design requirement of the hospital sewer trap is that the height of the water seal is not less than 50mm and not more than 100mm.In other words, if a piece of A4 paper is inserted into the sewer, in theory, it can be directly seen whether there is a water seal in the trap.
The A4 paper that was pulled from the sewer was dry.
Sun Lien took a deep breath, and quickly used the scotch tape on his body to completely seal the three floor drains in the bathroom, then walked out of the room and began to seal all the gaps on the bathroom door with tape.After sticking to every gap, he relaxed a little.
Bacteria are most likely leaking from the water-sealed floor drain.It is not difficult to finally confirm Sun Lien's judgment - let the staff of the hospital's infection department come to the bathroom, and take samples and cultures in the floor drain and the pipe wall.Then compare the culture results with mNGS.
As long as the comparison matches, it can prove the source of the hospital feeling.After that, just pour three to five liters of disinfectant into the floor drain to ensure that there is always water in the trap water seal.
·
·
·
Sun Lien "bathed" his protective clothing with spray equipment outside the room, and the hospital staff who heard the news had already begun to unseal the "seal" he had made on the temporary ICU shower room.
While dismantling it, the hospital staff praised Sun Lien verbally, "Director Sun's judgment is very reasonable, and this emergency handling method is also very good."
Hu Jia smiled and said, "After all, they are emergency doctors. Using tape to stick things is their old profession."
The doctors in the hospital couldn't immediately understand the point of Hu Jia's joke, but this didn't prevent them from continuing to remove the tape.They said while dismantling, "The ward is now in a negative pressure state. In fact, there is no need to worry about the spillage of pollutants in this ward."
"I was mainly worried that the pollutants would get on the protective clothing, which would put patients in other wards at risk." Sun Lien said a little embarrassedly, "At that time, I was busy sticking it with tape, but I didn't bother to think about it."
"Let's do the rest of the work." After tearing off almost all the tape around the bathroom door, the hospital doctor estimated that the door could be opened smoothly, so he said to Sun Li'en and Hu Jia, "Director Sun, you just disappeared Too poisoned, if you continue to stay here... you will have to sterilize again after the meeting opens. One more thing is worse than one less thing, and the rest of the work can be left to us."
Sun Li'en nodded, and then instructed, "There are three floor drains in the shower room, and I tried two of them and they were all dry. If you want to sample, you must collect the two floor drains that have been dried out..."
"All three of us have to take samples." The doctor from the hospital's infection department said, "This is our specialty. Don't worry, Dr. Sun—we will definitely take it seriously."
It took Sun Li'en half an hour to find a possible infection channel in the ICU ward.This made Professor Zhang Zhifu very happy—as long as it is confirmed that the water seal is the source of the germs, the temporary ICU in the North Fifth District can be put into use again in a short time.
At the same time, this discovery also sounded the alarm for other wards-the medical staff in each ward have been notified that all toilets and shower room floor drains must be filled with water every day to ensure that the water seal will not dry up.This discovery not only saved the temporary ICU in North Fifth District, but also reminded the daily work of other wards.
Professor Zhang Zhifu praised Sun Lien emotionally, and then asked, "When will your temporary ICU be put into use again?"
"At least wait until the results of the mNGS comparison come out." Sun Lien thought for a while and said, "It's no small thing to feel hospitalized. The symptoms of the patients in the temporary ICU are very serious. I dare not open the ward immediately until it is safe."
Professor Zhang Zhifu was a little helpless, "This speed must be faster. The current ICU ward is extremely tight. If you have one more bed on your side, we can save one more."
Comrade Zhang was a little flustered by the pressure, but Sun Lien knew very well how much the hospital infection could pose a threat to critically ill patients.Tian Kang's original condition was not good. His Hodgkin's lymphoma finally showed signs of shrinking, and the range of lesions in his lungs was gradually shrinking.As a result, he was suddenly attacked by hospital-acquired pneumonia, and now...whether he can get it back is another matter.
That feeling of frustration is the hardest to swallow for doctors who have nearly beaten the onslaught of the novel coronavirus infection and even seen a shrinkage of Hodgkin's lymphoma.Acquired pneumonia... This disease with a high mortality rate is even more dangerous in Tian Kang.
To save Tian Kang's life from the bacteria, in addition to figuring out the pathogen as soon as possible, the doctors also need the laboratory to start drug susceptibility testing as soon as possible.Look at this kind of bacteria that has survived in the sewer pipes of the hospital for an unknown number of years and has been repeatedly "screened" by countless powerful antibiotics, and which antibiotics still respond to them.
I hope that one or two antibiotics can still be effective... Sun Lien sighed a lot today.The successful marriage proposal itself still made him quite happy, although the degree of happiness was weakened by the anticlimactic process and the relief of various sudden hip-pull problems.But Hu Jia agreed without hesitation, this matter itself is worth being happy.
However, this happiness didn't last long, when Tian Kang's infection suddenly fell on Sun Li'en.The next step is the busy transfer of beds, disinfection, and adjustment of treatment plans.After the busy work was over, Zhang Zhifu tried his best to find a possible infection route, and Zhang Zhifu urged Sun Lien to open the temporary ICU ward again as soon as possible.
These things... It's just bad to separate them.And when all these bad things happen on the same day, at the same time, in the same class, the feeling is not just "bad".
The so-called quantitative change leads to qualitative change, which is probably the case.
(End of this chapter)
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