Li Yanling didn't speak beside her, and Wu Hao asked, "What is Director Li thinking?"

Li Yanling raised her head and said, "I'm thinking about one of my similar patients. His blood oxygen saturation hadn't fallen below ninety at the time, I remember it very well. But he kept saying that he was uncomfortable and out of breath. But I saw that he was well maintained with a non-invasive ventilator. So I persuaded him to be fine, give your body some time, he is struggling with the disease, it will be fine. ”

As a result, as soon as I finished comforting him, not long after I left his hospital bed, his monitor went on with a loud alarm bell, and if I tried to save him, I couldn't save him, and the person was already dead. I wondered if I had given him an endotracheal tube and put oxygen directly into his lungs when he told me he was having trouble breathing. I don't know because I haven't tried. ”

"There are many roads that you don't know if you can go or not, and no one can say for sure until you go. After hearing what Director Wu said just now, I also felt that I was more inclined to be intubated, and if I had been intubated earlier when I heard him say that he had difficulty breathing, maybe the result would not have been like this. ”

After listening to Li Yanling's example, Director Fu said: "Okay, I personally reserve my opinion. But I agree with this if early intubation can save the patient's life. ”

Seeing that Director Fu had changed his mind, the other doctors who followed him to raise objections also nodded. Isn't it just intubated early? There's no need to oppose it, it's not a big deal, it's all plugged in early and late.

Thinking that if the judgment that early intubation can save lives as soon as possible is true, it is possible to save more lives, in case I insist on not inserting it early, and then insert it when it fails, and later it turns out that this theory is not good and delays the treatment of life, then I will not become a sinner?

After weighing the pros and cons, those doctors who initially felt that they should not be intubated too early agreed to move the intubation forward and intubate it early.

After basically reaching a consensus, Wu Hao was very happy and glanced at Li Yanling approvingly.

Her case is very important and convincing, and it immediately turns the minds of those who do not agree with this view very much.

Wu Hao didn't know whether the decision he made was right or wrong. Perhaps only by looking back in the future and making some statistics on the mortality rate will we come to a clearer understanding of whether it is better to intubate early or late in the face of the new crown.

After leaving the conference room, Director Fu and Dr. Qi of the respiratory department returned to the ward on the third floor where they were responsible.

Dr. Qi said to Director Fu: "I still think Director Wu Hao's statement is a bit alarmist. As Director Li Yanling said, 92% of people die without intubation, I think this is either a case, or she is exaggerating. How can a person with a saturation of 92% die suddenly, unless he has an underlying disease, such as acute myocardial infarction or ultra-high blood pressure, which may lead to sudden death. ”

Director Fu turned his head to look at him and said, "Don't you think that it is precisely because patients often have these underlying diseases that they are admitted to the intensive care unit?" And it is the new crown pneumonia that has caused a qualitative change in the process of these etiological lesions, which will suddenly take the lives of patients. If this is the case, then the new crown pneumonia has made the development of the patient's original underlying disease very strange and uncontrollable. If early intubation can prevent such consequences, it is not unavoidable. Of course, I also think that intubation too early is not necessarily a good thing for patients, unless we find that patients have these underlying diseases, and it is not impossible to be vigilant and intubate in advance to prevent them. ”

Doctor Qi heard Director Fu refute his statement before, and his face was still a little red. Later, when I heard that his words changed and became in agreement with his own statement, I became happy again.

He said, "yes, that's what I mean." It cannot be one-size-fits-all, and depending on the situation, some underlying diseases have a tendency to worsen, and those who cannot control the tendency can choose to intubate early. As they said, the condition does not change or even deteriorate in a short period of time with a non-invasive ventilator, and the tube is immediately intubated. But if there is no underlying disease, the body is very good, and the oxygen saturation has not dropped below 90, why is it intubated so early? Non-invasive breathing can be controlled, and the same can ensure the patient's oxygen saturation, and the sudden death is actually more of an underlying disease, I still think so. ”

Director Fu said: "Okay, let's follow the determined principle first." ”

Dr. Qi nodded, and he returned to the ward he was in charge of for rounds.

One of his patients, a student at an individual school, who was about to graduate, played basketball, was very tall, very athletic, and was lying on a hospital bed, and his feet could only stick out diagonally from the side of the bed, and he took a stool to rest on him, because he had grown a large section, and there was no such long bed.

He had just been admitted to the intensive isolation ward for two days, because his blood oxygen saturation had been hovering around 92% and had not fallen. Mild cough and fever, shadowed lungs, but not too severe, barely a serious patient. Because he was an excellent athlete, his school attached great importance to it and contacted the hospital and asked him to be admitted to intensive care, worried that something would suddenly happen and he would not have time to be rescued. After being assessed by the hospital, he barely met the requirements of intensive care, so he was admitted.

He has been active since he came in, they have four beds in the ward, and two of the other three can't speak because of intubation. One of them, like him, wears a ventilator mask for non-invasive breathing. Blood oxygen saturation will immediately fall below 70 as soon as it leaves the non-invasive ventilator, so it is inseparable for a moment.

And he takes off the oxygen mask from time to time to go to the toilet and do warm-up exercises or something. Dr. Qi tried to dissuade him from strenuous activity at first, but he said it didn't matter, just stretch his legs and lower back or something. Dr. Qi saw that his oxygen saturation did not change significantly after his activity, so he did not stop it again.

After returning from the meeting, Dr. Qi came to check on the ward, and at a glance in the ward, he saw that the basketball player was doing squat and frog jumping.

Dr. Liu was taken aback, this movement is a lot of exercise, but it is not a matter of stretching his legs and bending over. Hurriedly said: "Alas, you can't do this, hurry up to the hospital bed and lie down on the bed." You are a seriously ill patient, if you want to toss like this again, I won't accept you and let you be transferred to a mild ward, how can there be a seriously ill patient like you?"

The athlete jumped twice more before standing up straight, came back and sat on the bed, took the oxygen mask and shone it on his mouth and nose, and said: "Doctor Qi, there is no need to make a fuss, frog jumping is basic training for athletes, and I haven't started high-intensity training yet!" I can't afford to delay that because I'm hospitalized. Otherwise, I will have to play soon, and I will not be able to recover from the hospital and I will not be able to play. ”

"It's your first priority to make sure you're alive now, you don't know that this disease is dangerous, and you must not take it lightly."

These words made the smile on the athlete's face disappear, because in the two days he had been here, he had already seen several patients on their third floor die. One of them also died in the ward, and he was carried away in front of him, and died quietly, without crying or struggling, and just left peacefully. On the contrary, this kind of silence was even more frightening, so he immediately lay down on the bed honestly and did not dare to move again.