Hospital blood is never enough, both in the past and now.

Even if you can buy blood, you have to have someone to sell it!

Vietnam and China are economically developed areas in China, and the common people are far from the point of selling blood to make a living, so the inventory of the hematology department in the Vietnamese Central People's Hospital has been empty for a long time.

In these years, there is no central blood station, and other hospitals have to reach out to the people's hospital if they don't have enough blood, so where does the people's hospital go to "borrow blood"?

As for free blood donations, no kidding.

Ordinary people have two major concerns, one is that blood donation is harmful to the body, and this scruple has not been eliminated even if the information is so developed decades later.

Second, Lao Tzu donates blood for free, why do your blood stations and hospitals sell such expensive blood? Why is the income of your central blood bank staff so high?

Those blood product pharmaceutical companies, where do they get so many blood raw materials to produce albumin injections, immunoglobulins, human coagulation factor VIII., human prothrombin complex, human fibrinogen and so on.

You received the blood for free, shouldn't it be given to the patient for free? Why is it so expensive? Far more than your cost of work?

Donating blood is definitely a good thing and should be encouraged and supported.

However, just like charity, the finances are not disclosed, the whereabouts of the blood are not transparent, and it is difficult to gain the trust of the people.

There are even a few areas that clearly say that good family members have donated blood, and they or their immediate family members can use blood for free.

However, when the blood donor himself or his family members urgently need blood, they say that it cannot be free, or that the blood donation time is too long and expired, unless they donate blood again.

This dishonest behavior is undoubtedly a devastating blow to the free blood donation policy.

Many patients who want to use blood and should use blood are not rescued in time, and finally have no choice but to miss the best rescue time.

This is the biggest evil consequence brought about by the high cost of social creditworthiness, especially state institutions, which should be based on integrity, and must have the spirit of contract and the spirit of the legal system.

Viet Chung People's Hospital

When generations of blood were drawn from the workers and masters of the Yuegang Plant, and then sent to the hematology department in bags, Chen Qi didn't even care about the patient.

Looking at the mountains of blood in front of me, I was overjoyed, not only was there enough for the patients in front of me, but there was no shortage of blood in the people's hospital for a long time in the future.

"Hurry up, hurry up and test, get me 1000cc of whole blood first, I have an emergency."

The staff of the hematology department was quite strange: "Dean, why do you want whole blood." ”

"What can you do? Of course, it's to save people, there is still a poor mother and daughter lying in my ward, and there is no good skin with burns all over the body. ”

"Hey, even if a burn patient needs a blood transfusion, the first choice is plasma, you can't be mistaken, dean?"

The staff is ready to remind them, for fear that their own dean will make a mistake and it will be over if someone dies.

Doctors used to think that the plasma of burn patients was the first choice, followed by some plasma substitute products, such as hydroxyethyl starch.

In the past, scholars and doctors generally believed that the replenishment of whole blood or red blood cells during the shock period would aggravate hemoconcentration, increase blood viscosity, block microcirculation, and form blood clots.

However, later scholars and doctors found that the early supplementation of whole blood in shock is beneficial to correct anemia, improve hypoproteinemia, reduce tissue hypoxia and edema, restore hemodynamic stability, protect internal organs, and improve immune function.

Especially for patients with large, severe and severe burns, whole blood supplementation is preferable to the use of plasma or plasma substitute.

Medicine is constantly advancing, and the old ideas of the past are constantly being overturned and replaced by new ones.

For example, French hepatobiliary surgeon Thierry Pollard and his colleagues started in their own areas of medicine.

They collected more than 500 papers on cirrhosis and hepatitis over 50 years and submitted them to a panel of experts for examination. Each expert is responsible for pointing out whether the paper is genuine, outdated, or has been overturned.

What they found was striking: the number of papers that remained correct was clearly declining.

The unambiguous figure of the "half-life" of the facts in this area: 45 years. Half of the medical knowledge of cirrhosis or hepatitis expires or is overturned every 45 years.

This means that most of the opinions published in the papers published in the past 45 years are wrong and have been overturned.

Another example is a very simple CPR resuscitation, the ratio of chest compressions to rescue breaths, which has changed over the years.

5:1 from the beginning; Later it was 15:1; Then he says that 15:2 is correct;

Finally, the guide tells us that 30:2 is perfect.

God knows if in a few years, or the 30:2 ratio will be "proven" to be unscientific again, and then changed to 30:3? Or to put it bluntly, artificial respiration can be done without it.

Therefore, being a doctor is tiring, because doctors not only have to take many exams, but also have to read a large number of medical journals and periodicals, so as not to fall behind and ensure clinical safety.

Not only are doctors suffering, but they are also very hard during their studies at medical universities.

In the first half of this year, all college students across the country went for a "walk", but all medical students were forced to sit in classrooms with thick textbooks on their backs, and their ears did not listen to what was going on outside the window.

Chen Qi is a reborn person, so he takes advantage of this point, and belongs to God's perspective.

And the doctors in the 80s, including Deng Changle, a top burn specialist, still have their knowledge points stuck in 1989, so it is inevitable to make mistakes.

For example, Deng Changle has now made a very big clinical mistake, he used hydroxyethyl starch as a substitute for plasma.

Later studies have shown that the tissue residue after the application of hydroxyethyl starch is heavier, and may increase the renal impairment and mortality of patients.

Therefore, in 2013, the European Medicines Agency and the U.S. Food and Drug Administration recommended that hydroxyethyl starch be withdrawn from the market.

Deng Changle used it, and used it as a matter of course, thinking that it was saving his life, but the result was ......

Chi Shanjun went into cardiac and respiratory arrest again.

When Zeng Chu, who had been paying close attention to the patient at the bedside, found that the patient's heartbeat and breathing were gone, he immediately began to call his colleagues.

It was 2 a.m.

The doctors of Dongshan Hospital were resting in the next ward, and when they heard the emergency order, they all ran out of their clothes and ran to the 10 beds one by one.

The family members and the people from the Viet Steel Mill were all working in the corridor, and they all woke up when they heard the noise.

Everyone is not stupid, and in the middle of the night, when all the doctors are dispatched, it must be very auspicious, and many family members began to fold their hands and pray to the Bodhisattva.

Poor factory director Qi, the director of a large factory of 30,000 people, also slept on the floor, and when he heard the shouts in the ward, he chuckled in his heart, and he felt a strong sense of uneasiness in his heart.

What can he do in the middle of the night to organize a rescue, he has accumulated virtue by thinking about it with his toes, what is he afraid of? Aren't you afraid that your workers will die?

"Nurse, what happened to the nurse 10 bed patient? In the middle of the night. ”

Director Qi grabbed a nurse and asked eagerly.

The little nurse knew the big boss of the Vietnam Steel Mill, so she didn't hide it from him:

"The 10-bed Chi Shanjun's heartbeat is gone, and Dr. Huhai is rescuing."

As soon as the words fell, Chi Shanjun's family members cried loudly, and it was particularly miserable in the ward in the middle of the night.

Qi Guomin also muttered to himself: "This is the first time, and the fourth time is no heartbeat, right?" Chi Shanjun, you have to resist it......"

In the ward, the doctors of Huhai Hospital have been resuscitating for more than 20 minutes, and everyone's hearts have sunk to the bottom, and everyone understands that the patient is really going to die this time.

Because the gold rescue time is only 5 minutes, the longer the time, the less likely it is to be rescued.

Chen Qi also ran into the ward at this time.

He was sleeping in the duty room, and when he heard that the 10-bed Chi Shanjun had another cardiac and respiratory arrest, he decided to come over to see if he could help.

When Chen Qi entered the ward, there was a strong smell of disinfectant water and Chinese herbs in the room.

On the hospital bed, patients with burns all over their bodies look miserable, and doctors are constantly replacing chest compressions and artificial balloons instead of artificial respiration, with a ratio of 5:1

Press 5 times on the chest and 1 more time on the balloon.

Chen Qi wanted to endure it, but he couldn't help but remind: "Everyone, do you want to try the frequency of 30:2." ”

Deng Changle saw that Chen Qi had come to "make trouble" again, and his already bad mood was even worse:

"Dean Chen, take care of your own patients, we have our own rescue plan for Dongshan Hospital here, don't worry about it."

Chen Qi was also unhappy at this time, he was a dignified deputy department-level dean, and an international double director was always despised by others, where could he bear it.

"Director Deng, I want to remind you that you are now rescuing patients in the Vietnamese Central Hospital, although I do not have the authorization of the factory and your family to participate in the rescue, but as the host, it is still necessary for me to know your rescue process and medication specifications, you can rest assured, I am not here to snatch any dominance, I just play a supervisory role."

Chen Qi's words still make sense.

Dozens of burn-injured workers at the Viet Cong Iron and Steel Plant are living in the Viet Central People's Hospital, especially the three seriously injured.

Although the doctors are from Dongshan Hospital, the nurses, tests, medicines, machinery and equipment used are all provided by the hospital.

It is better to say that people do not die, but if people die, the responsibility can be clearly divided at that time.

The local snake of the Yue Iron and Steel Mill will not be reasonable, let them go to Shanghai to quarrel, and they will not dare to borrow a few of their guts.

However, it is very possible for them to turn their heads to deal with the Vietnamese Central People's Hospital, and put the responsibility on the head of the People's Hospital.

Therefore, Chen Qi can not participate in the rescue, but he must be aware of it, and he can't be a substitute for the dead in vain.

Deng Changle obviously understood Chen Qi's thoughts, so he gritted his teeth and snorted coldly:

"Okay, you want to check, check it yourself, please don't disturb our rescue!"

Chen Qi was not polite, he took the iron clip containing the medical records and looked at it, and was startled when he saw it.

In the past 12 hours, both crystalloid and colloidal fluids have been transfused to 9,000 ml.

In comparison, Ding Xinjuan, who has the same burn area, has only 3700ml of infusion in 12 hours.

Moreover, the crystalline gel ratio of Chi Shanjun's infusion is still 2:1, and the plasma hydroxyethyl starch is also used, which is really a mistake after a mistake.

As a consequence of the flooding, the pumping function of the heart of the patient with severe burns has been reduced, and now it has been given too much pressure, so that the heart is overwhelmed, and finally it strikes directly.

If you're tired, don't jump, let's destroy.

Left and right heart failure occur at the same time, which not only causes edema throughout the body, but also causes blood stasis and edema in the lungs.

When heart failure and lung failure occur at the same time, can the patient survive?

Chen Qi looked at Chi Shanjun on the hospital bed, his eyes were full of sympathy;

looked at Deng Changle, who was sweating profusely on the side, and there was strong dissatisfaction and contempt in his eyes.

Chen Qi didn't know where this Huhai expert's hostility came from to him?

Is it because they are Huhai doctors and look down on country doctors? Or did he Chen Qi eat his Deng family's rice, or molested his daughter-in-law?

But in any case, medicine should be a team and cooperate with each other, and no matter what personal grievances should give way to clinical practice, rather than self-righteousness.

Just when Chen Qi and Deng Changle clashed, Director Qi also got the news and rushed to the ward.

"Dean Chen, you are also here, Director Deng, how are my workers doing now? Can it be saved? ”

Deng Changle shook his head lightly while pressing hard:

"Director Qi, you have to be mentally prepared, this worker is estimated to not be able to be saved, we will rescue for another 10 minutes, if it doesn't work, we can only give up."

"Ahh Director Qi stomped his foot in annoyance.

Then he suddenly remembered that there was a legendary miracle doctor beside him, so he asked as a dead horse doctor:

"Dean Chen, why don't you help Chi Shanjun take a look at it again? Maybe there's still a chance to save it? ”

陈棋白了一眼这个齐国民，要不是看在他年龄大了，陈棋真想一巴掌扇过去。

But the anger still couldn't be suppressed, and he scolded with a calm face:

"Before, my mother's Lao Tzu said that she would take over the treatment, but you fucking looked down on me, thinking that the level of our Vietnamese Traditional Chinese Medicine Hospital was not good, and I was superstitious about the big hospitals in big cities. Now that everyone is dead, let me try, what are you and me Chen Qi? What are you Qi Guo? ”

Chen Qi kicked a stool next to him, and continued to point at the Dongshan Medical Group and scolded:

"This worker is dead, your Dongshan Hospital has a lot of responsibility, he could not have died, but he was killed alive by you fools. Deng Changle, take a look at your prescription yourself, damn the 12-hour infusion of more than 9,000ml, have you considered the patient's cardiopulmonary endurance?

Water and electrolyte imbalances are also counted, don't you know that a large amount of fluid replacement can cause cerebral edema, pulmonary edema, and heart failure caused by severe lack of circulating blood volume? Didn't you know that overhydration can cause abdominal space syndrome and coagulopathy?

You don't even monitor the basic CVP, PAWP, CO, or CI, CFI, ITBV, ITBVI, EVLW, or EVLWI indicators when you fucking rehydrate, so you just close your eyes and start rehydration, are you scientific? Do you have a basis?

What about Dongshan Hospital, bullshit, no wonder your level has not been able to go up, more than 60% of burn patients can't be rescued, thinking that this is the death line, at this level, it is only in the country to show off your might, do you know how ridiculous you are? ”

Chen Qi began to flutter, Deng Changle and Qi Guomin looked surprised and surprised, and their brains couldn't react at once.

The other little doctors and nurses were also trembling with fright, after all, Chen Qi rarely got angry in public.

Chen Qiyao slammed the door and left, and after a while, the door opened again:

"Either hand over the patient to our Vietnamese Hospital for treatment, or you all get out of the way at dawn and send the patient to Huhai, and the three-knife doctor will stop disgusting me in front of me, Lao Tzu will not serve anymore!"

(End of chapter)