"Full Moon" In Wuhan Shelter Hospital: From Emergency Rush To Orderly "Rest Room"

The new crown pneumonia epidemic makes the general public well aware of a medical facility originated from military concepts - shelter hospital. A temporary hospital called "cabin" by the academician of the Chinese Academy of Medical Sciences, academician Wang Chen, is known as "Noah's Ark". It has been undergoing continuous exploration and improvement through emergency transformation, system and process, and is gradually completing its mission.

In March 1st, according to the "Wuhan release" message, 34 patients in Wuhan's Qikou Wu body shelter hospital were recovered and discharged. They will be transferred to the isolation point for 14 days and then home. This is also the last batch of patients discharged from the shelter. The other 76 patients will be referred for treatment, and the Hukou martial arts shelter hospital will be disposed of "no more" and no longer receive patients.

In the thirty-eighth news conference of the Hubei provincial new crown virus pneumonia epidemic prevention and control headquarters held in March 4th, Tu Yuanchao, deputy director of the Hubei health and Health Committee, said, "follow up the actual situation of epidemic prevention and control, and gradually reduce the number of new crown pneumonia admitted to designated hospitals, and orderly shut down the shelter hospitals, in batches and step by step to restore the normal medical order."

The "realistic policy" of non "best practices"

In February 5th, Wang Chen, director of respiratory and critical care medicine, vice president of the Chinese Academy of engineering and President of the Chinese Academy of Medical Sciences, visited the news 1+1 column to talk about the situation in Wuhan: a large number of patients were not admitted to hospital in time. This group of patients in the social mobility, living at home, will cause further social and family infection, which is the most important factor to exacerbate the epidemic.

The key to solving the problem is to centrally diagnose and isolate the cases that have been diagnosed. "In order to expand the capacity of the hospital, we have adopted the method of constructing designated hospitals in the early stage, but the capacity is very limited. If we borrow some large sites to treat patients, although the medical conditions are not perfect, but the capacity is large, we can quickly solve the problem of a large number of beds. Due to the large number of mild patients with high mobility, the shelter hospital can treat these patients to a large extent, so that they can be healed and isolated at the same time, which is a key move. "

Academician Wang Chen defined it as "this is not the best policy, but it is a good policy and a realistic strategy."

Against this background, the shelter hospital relies on 22 national emergency medical rescue teams, 3 mobile P3 laboratories, 2 batches of 30 medical teams, 15 nursing teams and 1 Radiological Technicians teams, and a total of 7000 medical personnel and testing personnel have been put into operation quickly.

The emergency rescue teams from all over the country often undertake the work of multiple shelter hospitals. He Qiang, the head of the Zhejiang national emergency medical rescue team and vice president of Zhejiang Province People's Hospital, said that in February 2nd, the Zhejiang national emergency rescue team was notified by the national health and Health Committee. After completing the recruitment and preparation of materials, it arrived in Wuhan in February 4th. The whole team includes 8 doctors, 9 nurses, 3 technicians and 11 logistics support personnel, and also 6 special rescue emergency vehicles, such as hydroelectric oil tankers, inspection cars and material trucks.

Its working track is also changing along with the construction of Wuhan's shelter hospital. After arriving in Wuhan in February 4th, they immediately put in the construction and medical treatment of Jianghan shelter hospital. Before February 11th, the first shelter hospital in Huangpi was set up in Huangpi district; in February 21st, it was responsible for the construction and management of Wuhan Optics Valley Japan Sea shelter Hospital; later, it was transferred to Caidian shelter hospital to carry out the treatment and management of patients.

According to the data released by Ma Xiaowei, director of the national health and Health Committee, at the news conference held by the Information Office of the State Council in Wuhan, Hubei in February 28th, the first batch of 3 shelter hospitals with 4000 beds was completed in 29 hours. "At present, 16 shelter hospitals have been built in Wuhan, more than 13000 beds are actually opened, and more than 12000 patients have been admitted to the hospital. In Wuhan, 1 of the 4 new crown pneumonia patients were treated in the shelter hospital, and the shelter hospital achieved zero infection, zero death and zero back.

The concept of shelter hospital originated from military field and originated from field shelter hospital. In general, it consists of medical function unit, ward unit and technology guarantee unit. It is a modular medical equipment, which has many functions such as emergency treatment, surgical disposal, clinical examination and so on. In the process of reconstruction of major natural disasters such as earthquakes, there will also be the appearance of a shelter hospital, which is mainly surgical patients.

Unlike wartime, facing the epidemic of infectious diseases, Zhang Kai, director of Johnson's self controlled medical profession, said in an interview with the twenty-first Century economic report, "shelter hospitals need to avoid cross infection between medical staff and patients. Therefore, we must set up five zones according to the space of infectious diseases hospitals, namely, clean areas, semi polluted areas, potentially polluted areas, buffer zones and wards. That is, doctors and nurses enter the different areas in turn and finally reach the ward to treat and care for the patients.

In order to complete the transformation in a short time, challenges come from all aspects. He Qiang said that this is the first time that the state has applied the shelter hospital to the prevention and control of the major infectious disease epidemic situation of the new crown pneumonia, and the various systems and processes of the shelter hospital have also been developing and maturing in the construction and management. "When we were in Jianghan shelter hospital, the process and operation of our medical staff were not very clear, and we were constantly improving in the exploration. Every medical team put forward a lot of rationalization proposals for the construction and management of the shelter hospital. At present, the National Health Protection Commission has issued the third edition of the working manual and patient Handbook of the shelter hospital. All the details in the cockpit hospital have clearly stipulated that there is a mature process for patients entering the cabin, out of the cabin, nucleic acid detection, CT examination and heavy patient transshipment.

Similar to the construction of the fire god Hill Hospital and Raytheon Hill Hospital, the short period of reconstruction and the shortage of labor force during the Spring Festival are the biggest difficulties in the transformation process of the shelter hospital. Zhang Kai said that the transformation facilities of the shelter hospital are usually stadiums, exhibition centers or factories, and the characteristics of these buildings also bring extra difficulty to the construction. For example, during the construction process, the damage to the original buildings should be reduced as much as possible. Most of the reformed stadiums are very high. Therefore, the construction and installation of the site will be more difficult than that of the ordinary hospitals.

Prevent cross infection and sterilize strictly.

In improving the rate of hospitalized treatment, the principle of the new crown pneumonia epidemic is "four early": early detection, early reporting, early diagnosis and early isolation. The shelter hospital has become the key to cure the shift.

The key problem that the shelter hospital has never been able to get around in the process of putting, building and using up to the rest of the cabin is "how to avoid cross infection?"

Zhang Kai said, "because the space of the shelter hospital is very open and there is no strict negative pressure ward setting, the first priority is to protect the medical staff and avoid the risk of cross infection with the patients. To achieve this goal, two points must be achieved: the hospital space should be divided strictly according to the five major divisions to ensure physical isolation. To enhance the level of protection for medical staff, compared with the regular designated hospitals, the doctors in the shelter hospital have higher requirements for wearing equipment. There must be three layers of protection, that is, a separate garment, a protective clothing in the middle, and a layer of protective clothing outside. "

Li Xuewen, vice president of the Shanxi national emergency medical rescue team and Bethune Hospital of Shanxi, said that in the exhibition center, gymnasium, schools and other places, the construction of the shelter hospital was too late to complete the hospital feeling requirement because of the time constraints. "How to make good use of the existing architectural layout and make use of limited space to meet the requirements of infection prevention and control, so as to maintain the medical staff can fight or not reduce the number of personnel, which requires us to find a way to solve it. If there is a larger space, we can use the adjacent buildings to realize the three districts and two passages through the isolation rooms or passageways.

In addition to ensuring supplies, equipped with sensory control trainers, on-site supervision, strict zoning and sub channels, Zhao Song, the head of the Henan national emergency medical rescue team and vice president of the First Affiliated Hospital of Zhengzhou University, listed more specific measures, such as "requiring medical staff to bring their own food boxes, take them back to their rooms after meals, and avoid cross infection during meals."

In terms of psychological and emotional counseling, the shelter hospitals also use the dance of square dance and Tai Chi to enjoy themselves. In addition to the support of professional psychologists, Wang Chen said, "since more than 80 of the shelter hospitals are light patients, they are able to engage in communication and social activities both physically and mentally. Organizing some humanities activities is very helpful for relieving patients' nervousness, improving their living state and quality, and is also very helpful to the illness. So in the shelter hospital, we see many very touching situations, mutual help among patients, and highly coordinated medical and patient relationship. This is the effect of humanistic care in the shelter hospital.

For the next step of "cabin break", Zhang Kai said that the disinfection measures must be strictly in accordance with the requirements of the hospital disinfection and isolation system and the disinfection technical specification of medical institutions, and take different disinfection methods for general wards and infectious diseases wards, such as pressure steam disinfection, wet disinfection, etc. In addition to disinfection in wards, sewage must also be sterilized. The disinfection of the shelter hospital needs to be kept for some time before it can be formally restored to its original functions.

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