A truly effective network, personally, is the accumulation of value over a long period of time, and your value to others, then others will become your network.

Therefore, when we want to enrich our circle, the first thing we think about is whether we have enough ability to go to a new circle, and whether we can show our personal value in the circle is the most important factor for others to know ourselves.

So brother, I came to the last three conclusions.

1. If you don't have the ability and resources to exchange with others, maybe your connections are a joke.

Second, the essence of networking is the exchange of value, and its two core functions are to reduce information costs and reduce transaction costs.

3. When you have no use value, just imagine, all the connections may not be worthless, don't beg the nobles empty-handed, you have to exchange your own value, you have time to slap others, it is better to shape yourself. ”

Chen Yong lit a cigarette and said, "Do you mean to make me and Tang Xiaoyu close friends?"

"Of course, if you are familiar with her, if it is inconvenient for you to go out, let your sister-in-law go, this may not be a solution. Zuo Mi said confidently.

"It makes sense, then I'll discuss it with Li Hao, she has a set, but it seems to be bigger than Tang Xiaoyu, I don't know if the effect is good, whether the two of them have a common language. ”

"Try it, or I'll come out again. ”

"Why are you out then?"

"Aces are usually the last to come out, haha. ”

......

"Nuo Lan, it's only been two days since the free clinic, are you ready for work?" I asked.

"It's ready, it's all in place. ”

"Okay, have you ever been to Bazhong?"

"I've heard that, I only know that there is Guangwu Mountain, and I don't know anything else. ”

"The scenery of the red maple leaves is good, and it is especially suitable for sightseeing in the summer. ”

"Then let's go to the free clinic this time, and have fun by the way?" Nuo Lan was a little moved.

I looked at Kiki, and Kiki also looked expectant.

"No, you guys go play by yourself, there are some medical staff, I'll go with you to play, what do people think of me, and we are not going to play this time, we are going to work, when Yan Musk comes back, I am on vacation, let's find a better tourist attraction, let's go play together." “

"Okay, listen to the wind director's arrangement. ”

A phone call just came, and I answered it, and my heart beat faster in an instant.

"Damn, there's something wrong with the outpatient clinic, I'm going to get busy first. ”

Nuo Lan and Kiki both looked at me with strange eyes, the call was from Su Lin, which meant that a patient who had been re-examined suddenly fainted and was being rescued, and the situation was not optimistic.

I found Su Lin and said, "What's the matter, why don't you have an ECG and adrenaline yet?"

Seeing that Dr. Pu was still performing cardiopulmonary resuscitation, but the elderly patient did not respond at all, and his son kept crying and stomping his feet on the side, I felt very sad to see this scene.

Su Lin said: "The patient's systolic blood pressure is only 63mmHg, and the electrocardiogram has been used, and norepinephrine has been indicated, but it is ......."

"Then you mean it's already ......"

"Yes, sudden cardiac death, his son was still picking up medicine, and he suddenly lost his beard in the chair, and his heartbeat stopped in less than a minute. ”

There are more and more onlookers, they are ordinary people, I didn't disperse them, let them take a look, this will make them touch their health, what happens to others is called a story, what happens to themselves is called an accident, I asked the doctor to know that the patient Li Guoqing, 74 years old, secondary hypertension, coronary heart disease, diabetes, I once suffered from an old terrier, an old patient, and I was still treating both knee joints in this hospital last year, and the car was driven from Jiangyou, and I didn't have a heartbeat for a minute when I sat on the chair when I got out of the car.

I asked the doctor why the patient came to Chengdu from Jiangyou, and there was no tertiary hospital in Jiangyou? The doctor said that the patient believed in us here, and after treating both knee joints with a small needle knife last year, he still managed it for more than half a year, and he did not go to the big hospital in Jiangyou, because he suspected that he had been sitting in a car for a long time, running at high speed, the air was not good, the car window could not be opened, the lack of oxygen caused insufficient blood supply to the brain, and he himself had heart disease, so it was too sudden, so it was so ......

Li Guoqing's son Li Kai works in the Water Bureau, and when he saw that his father was so motionless, he was motionless, tears flowed out, and he yelled with excitement, which could be seen to be a filial son.

I asked Su Lin, "It's been almost ten minutes, is there really no way?"

"No, cardiopulmonary resuscitation and adrenaline have not worked, it is still an acute heart attack, I can only take care of the aftermath, Li Kai is really not easy, every time I see a doctor, I come to me, easy-going and low-key, and I am also very filial, I have spent a lot of money for my father over the years, Li Guoqing's last words were not left and left, Li Kai felt really uncomfortable. ”

Dr. Pu stared at me and shook his head, I know what it means, Li Guoqing can be declared dead.

But people can't be placed here, Su Lin and I went to communicate, I said to Li Kai: "You are a filial son, this disease is also an acute disease, I can't blame anyone here, including you, it's time for you to be filial, settle your father well, take care of the aftermath, this is what you should do." ”

Li Kai nodded with a handful of snot and tears, and only he knew the grievances of Russia.

Su Lin continued to explain, I dispersed the onlookers, took a white cloth and covered it, birth, old age, sickness and death, there is a providence in the dark, but I died with illness, praying that Li Guoqing will not have any more sickness in another world.

Li Kai's wife and relatives came, and the crying and mourning shouted louder and louder, and I discussed with Su Lin: "This is not good, there are so many people in the hospital, or in the hall, how bad is the impact, let the funeral home car come quickly, discuss it with Li Kai?"

"Okay, leave it to me here, Li Kai is a good person, and he is not the kind of person who pulls off skin, and he won't make trouble for us. ”

"Okay, the fee will not be charged, let the funeral home car come as soon as possible, this is the hospital, if others take photos and post them on the Internet after a long time, it will have an impact." ”

"Got it, Director Wind. ”

When I went back to my office, I heard the sound of artillery shortly after, but fortunately I met someone like Li Kai, and if I met someone else, I might have a lawsuit with us.

Twenty minutes later, Surin was taken care of, and let me come to the emergency department office.

Surin was a little dissatisfied: " Fortunately, Li Kai I know, if it were someone else, we would have to have a lawsuit, we are a tertiary hospital, I don't know what we are usually training, the nurses are not familiar with the rescue measures at all, and there are individual young doctors, I don't know what you are doing, the electrocardiogram is not used, the action is rusty, if I am not in the office, if I am busy, I have met a person who is rippling, it will make our emergency department lose face, of course, there is a reason, acute sudden cardiac death such a heart disease, sudden, such an old patient as Li Guoqing, accompanied by a variety of chronic diseases, has already led to various organ failure, the probability of rescue is too small。

Ladies and gentlemen, take out pens and notebooks, the clinical manifestations and first aid measures of cardiac arrest, I will talk on the spot, and you will record them.

Su Lin said to me: "Director Feng, please let the personnel department notify you later, about the operation of this area, the medical staff of the whole hospital will operate the examination, and record the performance appraisal of the month." ”

"No problem. ”

Su Lin said to everyone again: "Then let's start, this is very important, I hope everyone is serious, the phone is muted for me, if I hear the phone ringing, I'm sorry, please go out, don't blame me for being merciless." ”

Su Lin's words are really good, everyone is very conscious, which can also see Su Lin's status among many medical staff.

"The clinical manifestation, prodromal, occurs days to months before sudden death, and some patients may present with nonspecific symptoms such as chest pain, shortness of breath, fatigue, and palpitations.

In the terminal event stage, typical manifestations are: severe chest pain, acute dyspnea, sudden palpitations or vertigo, etc.

Cardiac arrest: sudden loss of consciousness with local or generalized convulsions. Pale or cyanotic skin, dilated pupils, and incontinence.

Biological death: After cardiac arrest, most patients will begin to develop irreversible brain damage within 4 to 6 minutes, followed by a few minutes of biological death.

Now let's talk about first aid.

1. Primary cardiopulmonary resuscitation, early identification of cardiac arrest and activation of the emergency system: the examination time does not exceed 10 seconds.

2. Chest compression.

3. Open the airway, raise the head to open the airway, and when the head and neck trauma patients are suspected of spinal injury, the method of lifting the jaw should be used to open the airway. When Li Guoqing had a symptom at that time, he couldn't get his breath out directly, and he couldn't change his breath, and he didn't know if the doctor who rescued him noticed this move.

4. Artificial respiration, if there is no breathing, immediate endotracheal intubation to establish artificial ventilation is the best method, and single and two-person cardiopulmonary resuscitation can give 2 consecutive ventilations every 30 chest compressions (30:2).

5. Early defibrillation

The criteria for judging the efficacy of cardiac arrest, whether the pulse of the large arteries (carotid and femoral arteries) is restored to the gold standard, and whether there are heart sounds on auscultation (silver standard).

6. Advanced life support

Pharmacotherapy: epinephrine is preferred for cardiopulmonary resuscitation. Docaine is preferred for patients with ventricular tachycardia or ventricular fibrillation, sodium bicarbonate can be appropriately supplemented for patients with metabolic acidosis and hyperkalemia, and 10% calcium gluconate solution can be used for refractory ventricular fibrillation caused by acute hyperkalemia.

7. Comprehensive post-cardiac arrest treatment

Optimize ventilation and oxygenation: Once the patient has established a high-grade airway, the frequency of ventilation should be titrated to achieve an arterial partial pressure of carbon dioxide to 40 to 45 mmHg. Try to avoid the adverse haemodynamic effects of hyperventilation.

Maintain hemodynamic stability: If the patient's systolic blood pressure is less than 90 mmHg, 1 to 2 L of normal saline or lactated Ringer's solution may be considered, and vasoactive drugs such as epinephrine, dopamine, and norepinephrine can be considered to maintain intravenous infusion to achieve systolic blood pressure greater than or equal to 90 mmHg or mean arterial pressure greater than or equal to 65 mmHg.

Prevention and treatment of central nervous system injury: Brain resuscitation is the key to the final success of cardiopulmonary resuscitation.

Identify and treat acute coronary syndromes: Acute coronary syndromes are an important factor in cardiac arrest.

Finally, correction of metabolic disorders.

I hope you remember it well, memorize, I will ask questions during the exam, I can't answer, I'm sorry, I don't pass the exam, rest assured, the question will not leave what I just said.