Li Rui, Deputy Head Of The Intensive Care Unit Of Chongqing Medical Team, Dictated: Xiaogan, Where The Epidemic Is Serious, Let The Critically Ill See The Hope Of Life.

As of 24 February 23, 2020, Hubei has reported 64287 cases of newly diagnosed pneumonia, 3465 cases diagnosed in Xiaogan, and the most serious epidemic situation in Hubei province except Wuhan.

Xiaogan central hospital is responsible for the most important disease treatment in the local area. Before the arrival of the aid medical team, the local medical staff are under tremendous physical and psychological pressure.

In January 27th, the arrival of the first batch of Chongqing counterparts to Xiaogan new crown pneumonia prevention and treatment counterpart support team (hereinafter referred to as the "Chongqing medical team") eased the pressure of local medical staff, and further improved the cure rate of the patients.

As the deputy head of the intensive care unit of Chongqing medical team, Li Rui, deputy director of the Department of critical care medicine, Affiliated Tumor Hospital of Chongqing University, is involved in the treatment of critically ill patients. In the evening of February 23rd, she accepted an interview with the twenty-first Century economic report reporter, describing the situation of treatment in the past month.

In January 27th, the arrival of the first batch of Chongqing city to Xiaogan new crown pneumonia prevention and treatment counterpart support team eased the pressure of local medical staff, and further improved the cure rate of the patients.

Reconstruction of critical illness treatment system

Our Xiaogan central hospital is the largest hospital in Xiaogan, and is responsible for the designated hospital admission.

As the first batch of medical teams in Chongqing, there are 141 players, including 60 in severe cases, all of whom are experienced in various hospitals in Chongqing.

We arrived in Xiaogan during the day of January 27th. Before the real treatment was put into operation, the sensory control experts of the team first knew about the isolation and protection of the isolation wards in Xiaogan Central Hospital. It can be seen from the scene that the isolation ward of the hospital was established during the SARS period, with pollution zones, buffer zones, working areas and living areas. Although the standard of the top infectious diseases hospitals could not be reached, the protection situation was generally good, and some minor details needed to be adjusted.

Therefore, the first work is to further strengthen the protection conditions of the isolation ward with the colleagues of Xiaogan central hospital. In addition, the Xiaogan central hospital has received a lot of social donations. We have also reclassified these materials, especially excluding some masks, protective clothing and gloves which do not meet the requirements, which strengthens the protection ability of medical staff from one source.

After all our preliminary work was completed, it was already 9 o'clock that evening. Our medical staff did not rest for a moment, and immediately entered the isolation ward to hand over to the colleagues of Xiaogan central hospital.

We should try our best to win time, give patients more chance to cure, and relieve the pressure of local medical staff. Because the number of visits per day in Xiaogan continues to increase, and before we arrive, they have worked for several consecutive days, and the physical and mental fatigue has reached a limit.

I was impressed by the fact that when I entered the isolation ward, I saw a young nurse dispensing. I asked my sister if you had been working for a long time. What was unexpected was that the nurse cried at the time. It was evident that the pressure they had put to the limit was very hard.

In the first batch of aid medical teams in Chongqing, there were 60 players in the intensive care unit. We took over 3 wards of the Xiaogan hospital, 105 beds, all of which were critically ill and critically ill.

In my ward, there are over 20 medical staff responsible for the treatment of more than 30 patients. Although our arrival made the colleagues of Xiaogan central hospital have the opportunity to breathe, and at the same time, the patients had better treatment opportunities. But with the increase of the number of patients, our pressure is still very large.

The number of patients in Xiaogan has increased rapidly since February, especially in many severe cases. However, severe health care professionals are still lacking, such as the lack of medical staff from infectious diseases, Department of respiration and ICU, far from the standard of health care staffing in normal times. A small number of patients will develop from mild to severe. In this process, it is necessary for experienced specialists to identify and intervene early in their development, to move forward to the treatment, to closely observe and monitor vital signs, especially oxygenation, heart rate and blood pressure.

According to the actual situation, we have established a shift system, 4 hours a day, but the shift is not a rest, basically turning the same axis, more than 10 days to say that even the rest of the time is not.

But compared with other hospitals, we feel more fortunate. The first is that the medical supplies in Xiaogan central hospital are relatively adequate. Second, despite the fact that a large number of patients have oxygen demand, there is no shortage of oxygen supply.

I have worked in the Department of critical care medicine of Cancer Hospital Affiliated to Chongqing University for more than 10 years, and I can say that a great deal of experience has been accumulated for the treatment of critically ill patients. But compared with the treatment of critically ill patients in Chongqing, the situation in Xiaogan is indeed different.

In the ICU, we may encounter more serious and complex patients in the ICU. Severe patients in Xiaogan central hospital are mainly respiratory problems and other complications caused by pulmonary infection.

Because we are wearing a full set of protective clothing, our sense of ability will decrease, and the ability to pay attention to some details changes will decrease significantly. For example, in the ICU ward of Chongqing, we will check the skin elasticity of the patients, but because of wearing several gloves, our touch will drop, and also affect our operational sensitivity. Even our voice needs to be increased by several degrees.

From the nursing point of view, under normal circumstances, we can easily get the patient's monitoring data, but in the isolation ward, all data must lag behind. This requires us to rebuild a critical illness treatment system and speed up to familiarize ourselves with the existing treatment environment.

Fortunately, we are very experienced in helping the medical staff in Xiaogan Central Hospital, and the adaptation process has not been long. We soon got better cooperation with our colleagues in Xiaogan central hospital. We are constantly exploring and improving the monitoring process. We try our best to collect the data of the patients with the fastest speed and prepare for the next treatment.

Hope for critically ill patients

Until February 13th, when we worked with local doctors and nurses, more and more patients recovered and discharged. This is the best affirmation for our work.

In February 13th, a new batch of Chongqing medical workers in Xiaogan came to replace us. Now, in retrospect, the mood on the 13 day is still very complicated.

According to the arrangement of the handover work, we have to evacuated the place at 10 a.m. At the 8 point, I joined the other two attending physicians for the first time to enter the ward, hand over the nursing work, and once again understand the patients in the ward.

In the ward, a 47 year old male patient was very excited when we told him that his latest nucleic acid test was negative and should be discharged soon. But when he learned that we were going to rotate and leave the hospital for a while, he suddenly became very excited and cried. At that time, I thought it would be very difficult for a middle-aged man to cry. Maybe it is because of our efforts that we can regain the hope of life.

Before I met him, I felt that after half a month's rotation, I finally got to the first round. But in the face of him, and the patients who need treatment in the ward, I suddenly felt very sad and sad, and felt that my work had not been completed. This is a feeling I never felt since I worked as a doctor.

We recuperate for 9 days and then return to Xiaogan Central Hospital on the 22 th. According to the principle of "all patients should be treated and treated with all kinds of treatment," the Xiaogan hospital has opened up new severe wards, and the patients transferred from the districts and counties of Xiaogan have concentrated treatment here.

I was assigned to intensive care area three, with 30 beds and 60 medical staff. Once again, I feel like I am finally back to myself. Although all the patients in the ward are critically ill, because we have accumulated a lot of experience in clinical treatment and the strengthening of medical care, we are more united. We feel that we have built a very solid wall to stop the spread of the virus.

But the challenge is still at the same time. Our new severe wards began to receive the first batch of severe patients from 22, and by the afternoon of 6, there were 22 patients. Before working in ICU, it is impossible to visit so many critical patients in one day. I also learned that with the increase in the number of patients transferred from districts and counties, we have increased from the original 3 isolation wards to 4 districts and 5 districts of isolation. Altogether 10 isolation wards have been opened up to now, and a large number of patients have received better treatment here.

If the mild patients are mainly treated with conventional treatment, they are really saving lives in our critical wards. Compared with mild patients, there may be drastic changes in the indicators of critically ill patients. We must treat each patient with a very high degree of concentration.

One of my most impressive patients is a patient who has been in a critical ward for two days. At first, because of lung infection and poor breathing, we put him on a noninvasive ventilator. Because of poor physical condition, oxygen inhalation is very tired, he has been very silent, not how to communicate with us.

After treatment, his condition improved, and one day, his noninvasive ventilator was withdrawn. No need for high intensity treatment, maybe the patient saw the hope of survival from the changes in our treatment measures, began to really care about his condition, and asked the medical staff to ask his index data, sometimes he would make some jokes with us. Only then did we realize that he was such a lively person.

It also reflects that it is very important for us to carry out treatment from physiology to psychology. It is very important for us to have a two pronged approach. In particular, psychological counseling is very important, so that patients can see the hope of life, so that patients have stronger motivation to cooperate with treatment.

If we say we used to go to the river, now when the rescue work is at its best, we are resisting big waves, but we are confident that we can accomplish the task.

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