"Comrade, comrade, how are you doing?"

Chen Qi anxiously shouted a few times at the three seriously injured people, but did not get an answer, two people were moaning in pain, and another seriously injured person shouted for a long time and did not respond, probably fainting from pain.

"Uncle Guo, it is estimated that these three people have fallen into shock, or the early stage of shock."

In addition to the cause of the burn itself, patients with large deep burns are constantly washed with cold water, which can not only cause a variety of infections, but also cause a sharp drop in body temperature and blood pressure, causing shock.

Shock is an important cause of early death in burn patients.

Guo Yuanhang's expression was also very serious at this time: "You don't need to send it to the emergency room, you can directly send it to the sterile ward of the burn department for debridement surgery." ”

Fortunately, these workers were burned by molten steel, and the damage to the respiratory tract was not serious, otherwise there would have been a tracheotomy at the scene.

Everyone took action, and even many doctors and nurses passing by saw the situation at the emergency scene and took the initiative to stay and help, especially the three seriously injured people were sent to the burn department as quickly as possible.

Zhu Huoyan and the burn doctor are already preparing and waiting.

When Lao Zhu saw the situation of the wounded, he was also secretly bitter in his heart.

This has just taken over two patients with large-scale burns all over the body in Huangtan, and the experience has not yet been figured out, good guy, three more seriously injured people came in a blink of an eye, and the pressure is huge.

And look at the burn area of this appearance, the burn area is more than 80%, and it is a question whether it can survive.

Death at the beginning of the opening is unlucky, and it will also affect the reputation of the burn surgery department of the People's Hospital.

But Zhu Huoyan is not a person who admits defeat easily, since he has opened a burn department, he will definitely fight for his life.

As the director of surgery, Zhu Huoyan immediately entered the role of a doctor, and gave orders to the two "superiors":

"Xiao Chen, this wounded man is light, you are responsible for debridement. Guo Shuji, the two most serious burn patients, we debride one by one. ”

It's not much lighter, it's the difference between 90% and 80% of burns.

Chen Qi and Lao Guo both nodded, and then took their respective wounded into a separate ward to prepare for first aid.

Then the first problem arose, because the workers were burned all over the body, and the skin was falling down piece by piece, and a lot of the whole body was like coke, and there was no way to monitor vital signs.

Problem: This is an important indicator of treatment evaluation, and without this data, doctors cannot make a step-by-step treatment.

Chen Qi heard that the ward next door was already in chaos, and several nurses were chirping:

"Ah, I can't wear the sleeve of this blood pressure monitor, and there is no way to fix it!"

"This patient's outer lip is broken, there is no way to take the temperature, the anus, the pants are torn and I want to measure the anal temperature!"

"The skin is rotten, and the heartbeat and pulse rate can't be measured, what should I do?"

After a while, Comrade Guo's scolding came:

"Shout, shout what? Now the workers are in danger, so much for you to measure your vital signs? You are so precious, so disgusted and disgusting, so afraid of disgust, all of them are for Lao Tzu to go home and stay, what kind of nurse, what kind of doctor? ”

It seems that Lao Guo Zhen is in a hurry, on the contrary, Zhu Huoyan rarely scolds, he is more ruthless.

Compared with the next door, the rescue in the ward where Chen Qi is located is proceeding in an orderly manner.

With Chen Qi is the deputy head nurse Yang Xiuxiu, she and Chen Li learned a skill from Dean Chen in Africa, and they are more experienced in burn rescue, so they will not panic in case of trouble.

Chen Qi pouted when he heard the scolding next door, thinking that the quality and clinical level of some medical staff were really not improving, which was also a huge difference between the Vietnamese People's Hospital and the top hospitals, and the quality of the medical staff was a big gap.

This people's hospital also has to be evaluated as a third-class hospital, and it seems that the quality of such staff is really not good.

"Xiuxiu, after a while, you will guide and guide them on how to rescue and nurse burned patients, it's really not good, you make a list, and I will transfer them away. Poor technique is understandable, but bad attitude is unacceptable. ”

As the dean, Chen Qi gave her confidant a "Shang Fang Sword", which helped her establish her prestige in the department.

"Okay, Dean Chen, I'll open the venous access for this patient first!"

The first thing to rescue is to open the venous access, that is, where to prick the needle when it is hung?

Patients with extensive injuries and burns on the whole body have little good skin, and the traditional veins in the back of the hand or the vein in the arm will not work at all.

And because of the need for rescue, when rescuing the seriously injured, often one channel is not enough, two or three are very common, so how to choose the needle site is a great test of the nurse's basic skills.

Chen Qi glanced at Yang Xiuxiu, the little girl was wearing a white nurse's hat and mask, only her big eyes were exposed, ignoring the strong odor on the patient's body, her face was close to the skin and looking for a suitable needle point.

Patients with severe burns generally opt for the irregularities of the radial or femoral arteries.

At this time, you can't see the blood vessels, you can only touch them with your hands, to feel the position and direction of the arteries, and finally prick the needle by feeling, which the average little nurse can't bear to do at all.

If it is a little more difficult, it will have to be completed with the guidance of B-ultrasound, which is a great test of skill.

Chen Qi taught Yang Xiuxiu and Chen Li these arterial puncture catheterization in Africa before, and now he just wants to see how Yang Xiuxiu performs?

An unmarried little girl became the deputy head nurse, and if she wants to serve the public, she must show her real skills, otherwise she will be ousted by other nurses sooner or later.

You must know that the palace fight between women is very powerful, not just with him Chen Qi, the "golden father".

Yang Xiuxiu lived up to expectations, opened two channels in three clicks and two clicks, and implanted a hollow needle in the artery of the wrist at the same time, which was connected to the monitor.

A three-channel tube is also implanted in the large vein of the right neck, one channel monitors the patient's intravascular pressure, and the other two channels are given to the patient for intraoperative infusion and drug injection.

The amount of fluid to be given is critically evaluated and is critical to the rescue of patients with burn shock.

Rehydration is not as much as you want to replenish, it needs to be calculated according to the body's needs, so how to know if there is overfilling, then you need to monitor central venous pressure (CVP).

How to monitor and see the data? It's also very simple.

For example, if both central venous pressure and blood pressure are low, it is usually indicated that the blood volume is severely depleted and adequate fluid therapy should be given.

When central venous pressure is low and blood pressure is normal, volume depletion is indicative and appropriate fluid therapy should be given based on central venous pressure.

When the central venous pressure is high and the blood pressure is low, it means cardiac insufficiency, and it is necessary to be careful to prevent the occurrence of heart failure.

When central venous pressure is high and blood pressure is normal, the blood vessel volume is overconstricted and vasodilation therapy should be initiated.

See, isn't it easy? Glance? Some people think they're going to be doctors.

So when technology changes medicine, who is more important, machine or human? All important.

Whether the rehydration is in place, future generations of doctors only need to look at the central venous pressure, pulmonary artery wedge pressure, central venous oxygen saturation and other indicators on the display screen, and can adjust the amount of fluid and drip rate in time.

But what if you don't have these monitoring instruments? For example, Huaguo Hospital in the 80s.

It can only be seen by the patient's urine output, blood pressure, heartbeat, pulse, and mental state.

For example, is it restless or quiet? There is no obvious thirst etc.

These indicators do reflect the state of dehydration and whether rehydration is in place.

But this is only for reference, and you can't accurately monitor your body's rehydration needs.

And often the above judgments are very subjective, for example, if the patient is irritable, is the person not rehydrated enough fluid, blood volume insufficient, or because of the irritability caused by pain? You're too hard to judge.

Often, by the time you notice the abnormality, you have already overfilled it, or you have not done it at all, and then the patient dies.

In the 80s, he couldn't even dynamically observe the changes in blood lactate of patients, and all the treatments were relatively rough in Chen Qi's opinion, but this was the national situation, and Chen Qi had no way.

The only thing he can do is to bring in 10 sets of the most advanced monitoring instruments from abroad, who called the Vietnamese People's Hospital now has at least 10 million US dollars in its account, a standard dog.

Therefore, the equipment of the burn department of the Vietnamese People's Hospital is definitely the leading in China and the world's first-class, but outsiders don't know it yet.

I'm afraid that if I say it, what if all the major hospitals in China come to "borrow"?

Will you lend it out then? If you lend it out, I'm afraid that the meat buns will not be returned, and you must not get rid of the money.

With money, Chen Qi, the dean, has ambitions, either not to build, or to build a world-class burn department, coupled with his experience from later generations, he doesn't believe that he can't play with flowers.

Seeing that Yang Xiuxiu successfully completed so many tasks that should have been done by anesthesiologists, Chen Qi was extremely satisfied:

"Xiuxiu, you hurry up and help Guo Shuji and Director Zhu on the side, don't go again, the old man's scolding is getting louder and louder."

Yang Xiuxiu didn't have time to wipe the sweat from her forehead, nodded, picked up the toolbox and ran out quickly.

Chen Qi looked at Zhang Xing at this time: "Xiao Zhang, come, let's do arithmetic problems again, let's calculate the patient's fluid rehydration amount first......"

Just when Chen Qi and the others were still hurrying to rescue them, burn experts from the provincial capital and Huhai City were on their way to rush over.

The city of West Lake is only 60 kilometers away from Viet Cong, and it takes 1 hour to get there.

Huhai City is also not far away, 260 kilometers, and it doesn't take much time to get there.

Such a major accident occurred in the Yuezhong Iron and Steel Plant this time, and Director Qi also let it go, and truly saved all the workers at all costs, and could not kill a single person.

Although Chen Qi has proven his ability in the field of gastroenterology, he is a burn patient in front of him, and Director Qi does not think that Chen Qi can complete the rescue work well.

In case of a mistake in the Yuezhong Hospital and the death of a few workers, the fun will be great, and he will want the black gauze hat of the people.

Therefore, for the sake of workers' lives and their own interests, it is best to ask for foreign aid.

At that time, the red envelopes of 1,000 yuan and 2,000 yuan will be enough to send the experts.

What is this money to the 30,000-person Vietnamese steel mill? The Vietnamese Iron and Steel Mill sometimes entertains people to eat and drink, and it is more than 1,2000 at the end of a meal.

Huhai Dongshan Hospital.

As one of the best hospitals in Shanghai, Dongshan Hospital has the top burn department in the country.

When the hospital received a rescue call from the Vietnamese and Chinese authorities, Dr. Deng Changle, as the deputy director of the burn department, was designated by the hospital as the person in charge of the rescue team and asked to leave immediately.

Deng Changle has a younger brother named Deng Changxi.

Who is Deng Changxi? He is the director of hand surgery at UBS Hospital in Huhai City, and he and Chen Qi had fought in the ring at the beginning, and the two sides had a very unpleasant quarrel.

Of course, in the follow-up of this ring incident, Wei Cheng of Jisui Tan Hospital, who was the mastermind behind the scenes, immediately stepped down and was removed from the post of president of the Hand Surgery Society and director of the hospital's hand surgery.

Also affected are two main black hands.

One is Wu Jianlin from the First Hospital of Haiyi, and the other is Deng Changxi from UBS Hospital, and the two have also been dismissed from their positions as department directors and demoted to ordinary doctors.

For a doctor to climb to the position of department director, it is decades of hard work, not only to pay a lot of sweat, but also to pay a lot of interpersonal costs and monetary costs.

As a result, he was beaten to dust by Chen Qi, a little doctor in a rural hospital, which was unbearable for everyone.

As Deng Changxi's elder brother, Dr. Deng Changle was a little surprised when he received the notice, and Chen Qilai, who had been in the limelight in the past few years, immediately appeared in his mind.

"Isn't the Vietnamese People's Hospital the hospital where Chen Qi is the president?"

Thinking of this, Deng Changle had the heart to refuse to go to Vietnam to support, but then he thought that since Chen Qi could defeat his younger brother in the field of hand surgery, the Deng family became a laughing stock in the health system.

So today there is such a good opportunity, let him, a burn doctor, defeat Chen Qi, a gastroenterologist, let him know that there are people outside the world, and there is a sky outside the sky, and it is good to help his younger brother export his evil anger.

Thinking of this, Deng Changle led several burn doctors to Yuezhong as fast as possible.

The burn surgeons of the First Hospital of Haiyi were the fastest to arrive in Yuezhong, and when Chen Qi saw several experts from the provincial capital, his mood can be imagined.

Accurate!!!

Lao Tzu is a reborn person, an international double director, and a deputy department-level dean, and still needs to let people from other hospitals come for consultation to see a doctor? To support? To say it is to slap him in the face!

Seeing Chen Qi's face darken, Yang Xingliang, director of the burn surgery department of the First Hospital of Haiyi, who led the team, was a little embarrassed.

Doctors know doctors best, and under normal circumstances, only local hospitals can't bear a patient and take the initiative to ask for help from higher-level hospitals, and higher-level hospitals or other hospitals are famous.

Coming uninvited like this now is the biggest disrespect for the local hospital, and it's strange that people will give a good look.

And Director Yang understands in his heart that don't look at Chen Qi's youth, Chen Qi's level is a dignified deputy department level, which is the same level as Director Yang's immediate boss and the dean of the First Affiliated Hospital of Haidong Medical University.

To be able to climb to such a high position at a young age, which is simple and easy to get along? So I quickly took the initiative to say hello.

"Dean Chen, hehe, hello, hello, let's meet again."

"Director Yang, hello, what are you? ……”

(End of chapter)