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Chapter 1165 Choice
Chapter 1165 Choice
The atmosphere in the red zone is much better than before, and the current number of vacant beds is almost one-third.The biggest hobby of the patients living in the red zone is to guess each other who will be the next batch of "lucky ones" to be discharged.
That is to say, there is no mahjong here in North Fifth District, and the doctors do not encourage everyone to "drop in".Otherwise, among the remaining 60 or so patients, they would probably be able to gather seven or eight tables of poker every day.
The atmosphere is good, on the one hand, because everyone can see that Yunhe's epidemic is only a week or two away from the end.On the other hand, it is more realistic-as the number of patients decreases, the more time doctors and nurses can spend on each patient.
Patients' expectations about their condition are correctly established through continuous communication with doctors and nurses.This process is actually very critical-a patient can only see his attending doctor once three to five days after being hospitalized, and a patient sees the attending doctor every day after being hospitalized and sees upset. The effect obtained is completely different from the expected condition.
We meet and communicate frequently, and we can immediately communicate with the doctor and get feedback if there is any discomfort.Not to mention the early stage of the epidemic, even when you are hospitalized, you can't enjoy this kind of experience.If I had to say it, it was probably the same as those foreign high-end private hospitals that charged extremely expensive fees.
After the manpower comes up, it's not just that the time and frequency of doctors' ward rounds have increased.Various treatments and care are also more adequate.Take the more than 30 critically ill patients as an example. In addition to turning them over and ventilating them in the prone position, the doctors can also perform bronchoscope washing and expectoration at least twice a day.Severely ill patients generally use vibrating vests to assist ventilation, and the expectoration effect is quite good.
With fewer patients, doctors have more time and experience to adjust treatment plans for patients.Although it has been emphasizing thousands of people and thousands of strategies before, refined management.However, in the actual operation process of the five districts in the north and south, the unified treatment plan is still adopted more often.It’s just that the doctors can adjust some specific treatment plans according to the patient’s condition—for example, whether to continue using Arbidol, or to stop the ordinary antiviral regimen and switch to the plasma of recovered patients.
At present, the fifth floor can basically receive about six units of plasma from convalescents every day.If you decide to use it temporarily and the blood type does not match, you can exchange or borrow plasma with other floors.
Convalescent plasma works wonderfully in the vast majority of cases, although there are occasional cases where the response is not particularly good, but it turns out that the probability of this happening is still very low.Judging from the current experience of the fifth floor, about [-]% of patients will improve after using plasma from convalescents.Among them, about [-]% of the patients responded well, about [-]% of the patients responded slightly worse but still improved, and about [-]% of the patients just stopped the progression of the disease.
In the absence of specific drugs, convalescent plasma is indeed the most powerful weapon against the new coronavirus.However, the immune gap in the human body also makes it difficult for the plasma of recovered patients to function stably.
After all, doctors have no way of judging how much specific IgG protein against the new coronavirus is in the plasma of newly sent convalescents, let alone how many of these proteins can make critically ill patients recover.
This treatment method, at best, is "depending on the situation", and at worst, it is "opening the blind box".After all, after using the plasma of convalescents, immunosuppressive treatment and plasma replacement have to be stopped for a while.No one knows whether the patient's condition will slip in a worse direction during the "stop and stop" process.
Sun Lien's current strategy is relatively simple, which is to use the medical resources at hand to kill every patient.The other plans remained unchanged, and the refined chest B-ultrasound diagnosis plan for pulmonary edema that I summarized in the Fourth Hospital was also added.
In fact, the data has revealed such a simple and cruel fact-the new type of coronavirus-infected pneumonia shows a great difference in the degree of brutality between areas with abundant medical resources and places with insufficient medical resources.Even large ones don't seem like the same disease.
As long as medical resources are piled up, the fatality rate of this disease will not be too high.But once it is allowed to spread and develop, a large number of patients with underlying diseases, middle-aged and elderly people will fall into the severe stage - their bodies cannot withstand the attack of the new coronavirus and the successive injuries caused by this virus.
Sufficient medical resources can reduce the probability of mild and ordinary patients transitioning to the severe stage, and at the same time increase their chances of surviving the severe and critical stages.
On the other hand... Although it sounds a bit mysterious, the mood of patients can indeed affect their immunity.
Mood is difficult to quantify, let alone measure.But Sun Lien and other medical team colleagues have the same opinion-most of the current patients are in a better mood, and the speed of recovery seems to be faster than the previous patients.
The speed of recovery is one thing, the effect of recovery is the most important thing.In fact, the death rate of the current patients on the fifth floor is decreasing rapidly. Up to now, it can be regarded as a "critical" patient, and there is only one new patient.
Because the new situation is still not optimistic, with continuous treatment and support, the viral load of hepatitis B in his body began to decrease, and his liver function also improved.But there are still headaches-so far, Yu Xin's nucleic acid test results are still positive. At the same time, his blood picture is still not good, and the levels of white blood cells and platelets continue to decrease, which suggests that he may have myelosuppression.
The inhibitory response of interferon to bone marrow is one of many adverse reactions.For the vast majority of patients, bone marrow suppression induced by interferon is transient.As long as the drug is stopped, the blood picture will return to normal level in a short time.
But for Xin, such bone marrow suppression can be fatal.
A low white blood cell count may allow for a new serious infection, while a lack of platelets may allow blood to flow down the VV ECMO line and the liver replacement system line that keeps him alive, as well as the hemodialysis line.
Once Yu Xin, who lacks platelets, bleeds heavily, he will definitely not be able to recover.
In desperation, Sun Lien stopped all new interferon treatments and started platelet transfusions for him.At present, only nucleotides are the only drugs used to treat hepatitis B, while the drugs used to fight against the new coronavirus are the plasma of convalescents.
Out of personal "intuition", Sun Lien felt that Yu Xin might not be able to survive.But... under the current conditions, it is his job and the duty he has been given to fight for a future for every life.
Don't worry about your personal intuition, and do your best to save the lives of patients. This is all Sun Lien's current working principles.
(End of this chapter)
The atmosphere in the red zone is much better than before, and the current number of vacant beds is almost one-third.The biggest hobby of the patients living in the red zone is to guess each other who will be the next batch of "lucky ones" to be discharged.
That is to say, there is no mahjong here in North Fifth District, and the doctors do not encourage everyone to "drop in".Otherwise, among the remaining 60 or so patients, they would probably be able to gather seven or eight tables of poker every day.
The atmosphere is good, on the one hand, because everyone can see that Yunhe's epidemic is only a week or two away from the end.On the other hand, it is more realistic-as the number of patients decreases, the more time doctors and nurses can spend on each patient.
Patients' expectations about their condition are correctly established through continuous communication with doctors and nurses.This process is actually very critical-a patient can only see his attending doctor once three to five days after being hospitalized, and a patient sees the attending doctor every day after being hospitalized and sees upset. The effect obtained is completely different from the expected condition.
We meet and communicate frequently, and we can immediately communicate with the doctor and get feedback if there is any discomfort.Not to mention the early stage of the epidemic, even when you are hospitalized, you can't enjoy this kind of experience.If I had to say it, it was probably the same as those foreign high-end private hospitals that charged extremely expensive fees.
After the manpower comes up, it's not just that the time and frequency of doctors' ward rounds have increased.Various treatments and care are also more adequate.Take the more than 30 critically ill patients as an example. In addition to turning them over and ventilating them in the prone position, the doctors can also perform bronchoscope washing and expectoration at least twice a day.Severely ill patients generally use vibrating vests to assist ventilation, and the expectoration effect is quite good.
With fewer patients, doctors have more time and experience to adjust treatment plans for patients.Although it has been emphasizing thousands of people and thousands of strategies before, refined management.However, in the actual operation process of the five districts in the north and south, the unified treatment plan is still adopted more often.It’s just that the doctors can adjust some specific treatment plans according to the patient’s condition—for example, whether to continue using Arbidol, or to stop the ordinary antiviral regimen and switch to the plasma of recovered patients.
At present, the fifth floor can basically receive about six units of plasma from convalescents every day.If you decide to use it temporarily and the blood type does not match, you can exchange or borrow plasma with other floors.
Convalescent plasma works wonderfully in the vast majority of cases, although there are occasional cases where the response is not particularly good, but it turns out that the probability of this happening is still very low.Judging from the current experience of the fifth floor, about [-]% of patients will improve after using plasma from convalescents.Among them, about [-]% of the patients responded well, about [-]% of the patients responded slightly worse but still improved, and about [-]% of the patients just stopped the progression of the disease.
In the absence of specific drugs, convalescent plasma is indeed the most powerful weapon against the new coronavirus.However, the immune gap in the human body also makes it difficult for the plasma of recovered patients to function stably.
After all, doctors have no way of judging how much specific IgG protein against the new coronavirus is in the plasma of newly sent convalescents, let alone how many of these proteins can make critically ill patients recover.
This treatment method, at best, is "depending on the situation", and at worst, it is "opening the blind box".After all, after using the plasma of convalescents, immunosuppressive treatment and plasma replacement have to be stopped for a while.No one knows whether the patient's condition will slip in a worse direction during the "stop and stop" process.
Sun Lien's current strategy is relatively simple, which is to use the medical resources at hand to kill every patient.The other plans remained unchanged, and the refined chest B-ultrasound diagnosis plan for pulmonary edema that I summarized in the Fourth Hospital was also added.
In fact, the data has revealed such a simple and cruel fact-the new type of coronavirus-infected pneumonia shows a great difference in the degree of brutality between areas with abundant medical resources and places with insufficient medical resources.Even large ones don't seem like the same disease.
As long as medical resources are piled up, the fatality rate of this disease will not be too high.But once it is allowed to spread and develop, a large number of patients with underlying diseases, middle-aged and elderly people will fall into the severe stage - their bodies cannot withstand the attack of the new coronavirus and the successive injuries caused by this virus.
Sufficient medical resources can reduce the probability of mild and ordinary patients transitioning to the severe stage, and at the same time increase their chances of surviving the severe and critical stages.
On the other hand... Although it sounds a bit mysterious, the mood of patients can indeed affect their immunity.
Mood is difficult to quantify, let alone measure.But Sun Lien and other medical team colleagues have the same opinion-most of the current patients are in a better mood, and the speed of recovery seems to be faster than the previous patients.
The speed of recovery is one thing, the effect of recovery is the most important thing.In fact, the death rate of the current patients on the fifth floor is decreasing rapidly. Up to now, it can be regarded as a "critical" patient, and there is only one new patient.
Because the new situation is still not optimistic, with continuous treatment and support, the viral load of hepatitis B in his body began to decrease, and his liver function also improved.But there are still headaches-so far, Yu Xin's nucleic acid test results are still positive. At the same time, his blood picture is still not good, and the levels of white blood cells and platelets continue to decrease, which suggests that he may have myelosuppression.
The inhibitory response of interferon to bone marrow is one of many adverse reactions.For the vast majority of patients, bone marrow suppression induced by interferon is transient.As long as the drug is stopped, the blood picture will return to normal level in a short time.
But for Xin, such bone marrow suppression can be fatal.
A low white blood cell count may allow for a new serious infection, while a lack of platelets may allow blood to flow down the VV ECMO line and the liver replacement system line that keeps him alive, as well as the hemodialysis line.
Once Yu Xin, who lacks platelets, bleeds heavily, he will definitely not be able to recover.
In desperation, Sun Lien stopped all new interferon treatments and started platelet transfusions for him.At present, only nucleotides are the only drugs used to treat hepatitis B, while the drugs used to fight against the new coronavirus are the plasma of convalescents.
Out of personal "intuition", Sun Lien felt that Yu Xin might not be able to survive.But... under the current conditions, it is his job and the duty he has been given to fight for a future for every life.
Don't worry about your personal intuition, and do your best to save the lives of patients. This is all Sun Lien's current working principles.
(End of this chapter)
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