Since 1981 Health School

There will never be enough blood in hospitals, neither in the past nor in the present.

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

Vietnam is an economically developed area in China, and the common people are far from selling blood to survive. Therefore, the blood department inventory in Vietnam People's Hospital has been empty for a long time.

There is no central blood station these days, and other hospitals have to reach out to the People's Hospital if they don't have enough blood. Where can the People's Hospital "borrow blood" in turn?

As for free blood donations, no kidding.

Common people have two concerns. One is that blood donation will be harmful to the body. This concern has not been eliminated even after decades of information development.

Second, I donate blood for free, why do your blood banks 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 blood for free, shouldn't it be given to patients for free? Why is the fee still so expensive? Far more than your cost?

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

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

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

But when the blood donors or their family members are in urgent need of 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.

The common people don’t actively donate blood, so there is less clinical use of blood. Many patients who want to use blood, but should use blood, cannot get timely rescue, and finally miss the best rescue time.

This is the biggest evil result brought about by the high cost of honesty in society, especially state institutions, should be based on honesty, have the spirit of contract, and the spirit of the rule of law.

Vietnam People's Hospital

Chen Qi didn't even care about the patients when generations of blood were drawn from the master workers of the Yue Steel Plant and sent to the hematology department in bags.

Looking at the blood piled up in front of my eyes, I was very happy. Not only is there enough for the patients in front of me, but the People's Hospital will not be short of blood for a long time to come.

"Hurry up, hurry up, test it quickly, get me 1000cc of whole blood first, I need it urgently."

The staff in the hematology department were quite strange: "Dean, why do you want whole blood?"

"What can I do? Of course it's saving people. There's still a poor mother and daughter lying in my ward, with burns all over their bodies and no good skin, tsk tsk tsk."

"Hey, even if a burn patient needs a blood transfusion, plasma is the first choice. Dean, you can't make a mistake, right?"

The staff was ready to remind me kindly, because they were afraid that if the dean made a mistake, someone would be killed and it would be over.

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

In the past, researchers and doctors generally believed that supplementing whole blood or red blood cells during the shock period would aggravate blood concentration, increase blood viscosity, block microcirculation, and form thrombus.

However, some scholars and doctors later discovered that 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 extensive severe burns, supplementing with whole blood is better than using plasma or plasma substitutes.

Medicine is constantly advancing, and old views in the past are constantly being overthrown and replaced by new ones.

Thierry Pollard, a French hepatobiliary surgeon, and his colleagues, for example, started with their own specialized field of medicine.

They collected 500 papers on cirrhosis and hepatitis over five decades and sent them to a panel of experts for review. Each expert is responsible for indicating whether the paper is true, outdated or disproved.

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

A definite figure for the "half-life" of facts in this field: 45 years. Half of medical knowledge about cirrhosis or hepatitis is outdated or disproved every 45 years.

It means that more than half of the opinions published in the papers 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 artificial respiration has been changing over the years.

From 5:1 at the beginning; to 15:1 later; and then said 15:2 is correct;

In the end, the guide told us that 30:2 is perfect.

God knows in a few years, or will the ratio of 30:2 be "proved" not scientific enough, and then changed to 30:3? Or directly say that artificial respiration does not need to be done.

So being a doctor is tiring, because doctors not only take many exams, but also read a lot of medical journals and periodicals, so as not to be outdated and to ensure clinical safety.

Not only is it hard for doctors, but it is also very hard for me when I was studying in a medical university.

In the first half of this year, college students all over the country went for "walks". Only medical students were forced to sit in the classroom with thick textbooks on their backs, keeping their ears shut.

Chen Qi is a reborn person, so he has an advantage in this regard, which belongs to God's perspective.

However, doctors in the 1980s, including Deng Changle, a top burn specialist, still had their knowledge in 1989, so it was inevitable to make mistakes.

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

Studies in later generations have shown that the tissue residue after the application of hydroxyethyl starch is relatively heavy, and may increase renal function damage and mortality in patients.

Therefore, in 2013, the European Medicines Agency and the US Food and Drug Administration suggested that hydroxyethyl starch should be withdrawn from the market, and it would not be used in foreign countries. The country lags behind, but it is still in a state of caution.

Deng Changle used it, and used it as a matter of course, thinking that it was saving lives, but in the end...

Chi Shanjun suffered 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 had stopped, he immediately called his colleagues.

It was 2 o'clock in the morning.

The doctors of Dongshan Hospital were resting in the nearby ward. When they heard the first aid order, they all ran out with their clothes casually, and ran to bed 10 one by one.

The family members and people from the Yuegang Plant were all laying the floor in the corridor, and they all woke up when they heard the noise.

We are all not fools. It must be bad luck if all the doctors are dispatched in the middle of the night. Many family members began to pray to the Bodhisattva with their hands clasped together.

Poor director Qi, the director of a large factory with 30,000 people, was also sleeping on the floor. When he heard the shouts in the ward, his heart skipped a beat, with a strong sense of uneasiness in his heart.

What's the matter with organizing rescue in the middle of the night? If you think about it with your toes, it's good deeds. What is he afraid of? Isn't it because they are afraid that their workers will die?

"Nurse, what happened to the patient in bed 10? It was in the middle of the night."

Director Qi grabbed a nurse and asked eagerly.

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

"Chi Shanjun's heartbeat disappeared again on bed 10, and doctors from Shanghai are trying to rescue him."

As soon as the words fell, Chi Shanjun's family members burst into tears, and it was extremely miserable in the ward in the middle of the night.

Qi Guomin also murmured to himself: "How many times is this, is it the fourth time that you have lost your heartbeat? Chi Shanjun, you have to hold on..."

In the ward, the doctors from Shanghai Hospital had been rescuing the patient for more than 20 minutes, and everyone's heart sank to the bottom. Everyone knew that the patient was 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. When he heard that Chi Shanjun had another cardiac and respiratory arrest on the 10th bed, he decided to come over to see if he could help.

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

On the hospital bed, the appearance of the patient with burns all over his body was horrible. The doctors were constantly replacing people with chest compressions and artificial balloons instead of artificial respiration. The ratio was 5:1.

Press 5 times outside the chest, and then press the balloon once more.

Chen Qi wanted to bear it, but couldn't help reminding: "Everyone, do you want to try the frequency of 30:2?"

When Deng Changle saw that Chen Qi was "making trouble" again, his bad mood got even worse:

"President Chen, take care of your own patients. There is our Dongshan Hospital's rescue plan here, so don't worry about it."

Chen Qi is not feeling well at this time, he is a dignified deputy dean and an international double director who is always despised by others, how can he bear it.

"Director Deng, I want to remind you that you are rescuing patients in Yuezhong Hospital. Although I am not authorized by the factory and family members to participate in the rescue, as the host, I still need to know your rescue process and medication regulations. You Don't worry, I'm not here to grab some dominance, I'm just playing a supervisory role."

Chen Qi's words still made sense.

Dozens of burnt workers from the Yue Steel Plant lived in the Yuezhong People's Hospital, especially the three seriously injured.

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

It's good to say that people don't die, but if people die, then the responsibility can be clearly divided.

Local snakes like the Yue Steel Factory don't know how to reason. If they were asked to go to Shanghai to quarrel, they would not dare to borrow their courage.

But it is very possible for them to turn their heads to deal with the Yuezhong People's Hospital, put all the responsibility on the People's Hospital, cry, make trouble, and hang themselves.

So Chen Qi doesn't need to participate in the rescue, but he must be aware of it, and he can't be a scapegoat for others.

Deng Changle obviously understood what Chen Qi was thinking, 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 either, and took the iron folder containing the medical records to look through it, and was startled when he saw it.

In the past 12 hours, whether it is crystal fluid or colloid fluid, 9000ml has been infused to the patient.

In comparison, Ding Xinjuan, who suffered from the same burn area, received only 3700ml of fluid infusion in 12 hours.

Moreover, the crystal gel ratio of Chi Shanjun's infusion was still 2:1, and hetastarch was used instead of plasma. This was really one mistake after another.

The consequence of flooding with flooding is that the pumping function of the heart of patients with severe burns has already declined, but now it is put too much pressure on it, which makes the heart overwhelmed and finally goes on strike.

Tired, stop jumping, destroy it.

Left and right heart failure occurs at the same time, which not only causes edema of the whole 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;

Looking at Deng Changle, who was sweating profusely while rescuing him, there was strong dissatisfaction and contempt in his eyes.

Chen Qi didn't know where the hostility of this Shanghai expert towards him came from?

Is it because they are doctors from Shanghai and look down on doctors from the countryside? Or did Chen Qi eat rice from his Deng family, or molested his wife?

But in any case, medicine should be a teamwork and mutual cooperation, no matter what personal grievances or grievances must give way to the clinic, rather than self-willed.

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

"Dean Chen, you are here, Director Deng, how is the situation of my workers now? Can they be rescued?"

Deng Changle shook his head gently while pressing hard:

"Director Qi, you have to be mentally prepared. This worker probably won't be rescued. Let's rescue him for another 10 minutes. If it doesn't work, we have to give up."

"Ah!" Director Qi stomped his feet angrily.

Then he suddenly remembered that there was a legendary miracle doctor by his side, so he asked like a living doctor:

"Dean Chen, why don't you help Chi Shanjun take a look? Maybe there is still a chance of rescue?"

Chen Qi gave this Qi Guomin a blank look. If it wasn't for his age, Chen Qi really wanted to slap him.

But he still couldn't suppress his anger, and cursed with a sullen face:

"Before I said that I would take over the treatment, you fucking looked down on me, thinking that our Yuezhong Hospital is not good enough, and superstitious about big hospitals in big cities. Now that everyone is dead, let me try it. What do you think I am Chen Qi? ? What do you think you are a Qi citizen?"

Chen Qi kicked a stool next to him away, continued pointing at the Dongshan Medical Team and cursed:

"This worker is dead, and you Dongshan Hospital have a great responsibility. He could have survived, but he was put to death by you idiots. Deng Changle, look at your prescription yourself, damn it, more than 9,000 infusions in 12 hours ml, have you considered the patient's cardiopulmonary capacity?

Forget about water and electrolyte disorders. Didn’t you know that a large amount of fluid replacement can cause cerebral edema, pulmonary edema, and severe insufficient circulating blood volume to cause heart failure? Didn't you know that overhydration can cause abdominal compartment syndrome and coagulation disorders?

You don’t even monitor the basic CVP, PAWP, and CO during your bloody rehydration, and don’t care about CI, CFI, ITBV, ITBVI, EVLW, EVLWI indicators, just close your eyes and start rehydration, are you scientific? Do you have a basis?

Back to Dongshan Hospital, bullshit, no wonder your level has been unable to improve, more than 60% of burn patients can not be rescued, think this is the death line, at this level, you can only show your power in the country, do you know that you have How ridiculous? "

Chen Qi started to go crazy, Deng Changle and Qi Guomin looked surprised and astonished, 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 Qi slammed the door and left, and the door opened again after a while:

"Either hand over the patient to our Yuezhong Hospital for treatment, or you all get out at dawn and send the patient to Shanghai. The three-knife doctor will stop disgusting me in front of me. I won't serve you anymore!"