Elephant News Henan Information Radio Reporter Guo Ke
The 41-year-old pregnant woman with confirmed COVID-19 is in urgent condition and requires a cesarean section! In the designated hospital for the treatment of new crown pneumonia in Henan Province - Zhengzhou First People's Hospital Airport District Hospital, an operating room was officially used for the first time, and more than 30 medical staff of Henan Provincial People's Hospital worked together to escort the whole process for 3 consecutive days, and had three multidisciplinary consultations, from the beginning of surgery to the birth of new life, in only 3 minutes!
Caesarean section for pregnant women diagnosed with new crown pneumonia Under layers of protection, the newborn is removed in 3 minutes
At about 17:00 on the afternoon of January 15, obstetrics, pediatrics, anesthesiologists and operating room nurses, midwives and neonatal nurses were fully armed in the negative pressure operating room of the designated hospital for the treatment of new crown pneumonia in Henan Province, waiting for the arrival of a pregnant woman.
This is an elderly pregnant woman who is 38+5 weeks pregnant, accompanied by progressively low platelets, anemia, and may initiate contractions at any time. Because the patient's platelets are less than 50,000 and the function is low, once the contractile weakness, it will face heavy bleeding, endangering the safety of the patient's life, increasing the exposure opportunity of medical staff, and after obstetric evaluation, it is necessary to perform a caesarean section immediately.
At 17:40, the pregnant woman was escorted by Yu Man, the head nurse of the ward, Xue Haina, a nurse, and Wang Qiuming, a doctor, and escorted to the operating room with mobile ultrasound equipment.
Before the anesthesia, the medical staff encouraged her together, "Don't be afraid, there we are." Although she couldn't see everyone's faces clearly, she could hear that there were a lot of familiar voices here.
Preoperative anesthesia begins. Intubation of the endotrachea in patients diagnosed with COVID-19 is a very high risk of exposure, and the anesthesiologist must also wear a positive pressure hood in addition to the protective clothing, which makes the ordinary operation difficult. Anesthesiologists Geng Hongfang and Wang Jie were responsible for endotracheal intubation and anesthesia implementation, and Zhang Jianjian, director of the Department of Anesthesia and Perioperative Medicine, served as the leader of the anesthesia team, and determined the sequence of three drugs of propofol, remifentanil and rocuronium bromide, and the method of rapid induction of tracheal intubation of general anesthesia.
General anesthesia means that once the delivery time is too long, the likelihood of neonatal asphyxia will be greatly increased. This is a challenge for Wang Li, an obstetric expert and assistant Wang Qiuming, a nurse, Zhang Wenling, Wang Yong, Li Xinmei, Mu Xiaochuan, and Yan Jun, Fan Rujia, Chen Guiqin, Liu Baowei, Wu Jiangxia, Zhang Jilu, Wang Yaping, Han Panpan, Yuan Shuhui, Jin Weiwei, etc. on standby.
The three-level protection of the whole process makes the doctor's once unfavorable feel strange. Bulging protective clothing, fogging goggles, and three layers of gloves failed to stop the professionalism and efficiency of the surgical team. With a wealth of surgical experience and surgical procedures that have formed muscle memory, just 3 minutes after the operation officially began, a baby boy was successfully removed.
"Wow..." As a loud baby cry echoed through the room, the dangling heart finally came down.
The baby boy is healthy and thriving, and the newborn is rated 10 points!
To avoid cross-infection, the baby is quickly transferred to a specific room after delivery, where he is cared for by a neonatal team health care worker.
On the operating table, the test faced by medical staff and pregnant women has just begun - to get through the bleeding barrier.
In order to prevent intraoperative bleeding, the expert team made a detailed and perfect plan from intraoperative blood preparation to rescue plan. Fortunately, except for a slight bleeding from the surgical wound, none of the emergency situations in the plan occurred.
At 19:25, the operation was successfully completed. At this time, under the heavy protective clothing, everyone's surgical gowns have long been soaked with sweat.
At present, the situation of the mother is normal and she has been sent back to the isolation ward for further treatment. Knowing that the baby weighed 6 pounds and 6 two, Wang Li said, "What an auspicious number, I hope that he will grow up smoothly and smoothly in the future." ”
Multidisciplinary and multi-departmental repeated drills
"Three minutes on stage", more than 30 medical staff prepared for three consecutive days
Behind the rapid and efficient operation and the safe and healthy mother and child, the strength of multi-departmental and multidisciplinary coordination and cooperation of Henan Provincial People's Hospital is condensed. Among them, it involves the careful deployment of surgery, the transfer of patients and newborns, the purification and preparation of the operating room, the selection and operation of anesthesia methods, the preparation of obstetric surgical personnel, the rescue of newborns, the cooperation of blood transfusion departments and laboratory departments, the design and elimination of transfer routes by hospital sense, the support of logistics departments, and so on.
Shao Fengmin, secretary of the Party Committee of Henan Provincial People's Hospital, attaches great importance to the establishment of a special working group, organizes multidisciplinary consultations, formulates surgical plans, conducts practical exercises, fully considers the high-risk factors of pregnant women, and strengthens the guidance of hospital sense to ensure the safety of medical personnel. President Chen Chuanliang asked all departments and departments to strengthen coordination and cooperation to effectively ensure the safety of pregnant women. The caesarean section operation working group for patients infected with the new crown virus is composed of more than 30 people, including the Medical Department, the Nursing Department, the Surgical Department, the Anesthesia and Perioperative Medicine Department, the Hospital Sense, the Obstetrics Department, the Pediatric Critical Care, and the Logistics Support.
The First People's Hospital of Zhengzhou Sent Senior Nursing Experts to Reinforce, Assist in Surgical Preparation, and Provide Strong Support in Logistical Support. The Medical Administration Office and the Maternal and Child Affairs Department of the Henan Provincial Health Commission also pay close attention to the delivery of pregnant women.
Shen Zhiqiang, vice president of Henan Provincial People's Hospital and executive president of designated hospitals, demanded that the participating experts should talk about the problems, risks and difficulties in the front and must ensure that patients and fetuses are safe and sound.
Wu Haiying, director of the obstetrics department of Henan Provincial People's Hospital, recalled that 3 days ago, she received a call from Wang Li, a doctor who was supporting the airport area hospital, immediately reported the news to the hospital, and led the team to conduct the first consultation with Wang Li and Wang Qiuming through video, and formulated a detailed perioperative plan.
At 5 p.m. on January 14, the last 24 hours before the pregnant woman gave birth. In the conference room of the Airport District Hospital, a three-party remote consultation is being carried out intensively. This is the third consultation conducted by a multidisciplinary team of experts in 3 days.
One group is the members of the airport area new crown pneumonia treatment special class in the conference room of the port area hospital, vice president Shen Zhiqiang, li Yuhong, the leader of the team and deputy director of the education and training department of the port hospital, Hu Bo, deputy director of the medical department, and Kou Jie, deputy director of the nursing department; the other group is Wu Haiying, director of the obstetrics department of Henan Provincial People's Hospital, Sun Kai, director of the department of hematology, and Zhang Jianjian, director of the department of anesthesia and perioperative medicine; the other group is wang Li and Wang Qiuming, obstetricians Wang Li and Wang Qiuming, sun jing in the operating room, Geng Hongfang, anesthesiologist, and Chen Xiangli, a hematologist, who are in the people's hospital of Henan Province. PICU Doctor Cheng Dongliang.
Advanced age, new crown pneumonia, thrombocytopenia, gestational diabetes; epidemic, prevention and control, medical staff... Every difficulty needs to be overcome urgently.
The experts have finally sorted out the surgical methods and procedures to make sure that nothing goes wrong.
After the establishment of the Caesarean Section Operation Working Group for Patients Infected with Covid-19, a number of management plans such as surgical plans, procedures for COVID-19 patients and medical staff to enter and exit the operating room, and a list of emergency abdomen and caesarean section items were produced, so that all work could be based on evidence.
The operating room in the port area has prepared common surgical supplies and protective equipment such as positive pressure hoods and isolation gowns. In order to ensure the safety of medical staff during the operation, the provincial medical headquarters has deployed anti-penetration surgical gowns, caesarean section dressings, and hole towels with pockets (intraoperative amniotic fluid can flow into the pockets to avoid soaking the doctor's clothes). The logistics department of the port hospital deployed newborn incubators, milk powder, and small quilts.
Sun Jing, chief coordinator of the operating room, and Liu Yunhong, the infection prevention and control team, repeatedly designed the process and planned the route to ensure that the pollution surface was minimized.
The team also conducted two on-site drills on the 14th and 15th, carefully considering each link and continuously optimizing the process.
At 15:00 p.m., the relevant personnel entered the operating room according to the drill process. The surgical, anesthesitic, and surgical nurses are divided into 2 groups, one group enters the negative pressure operating room, and one group is on standby in the adjacent operating room.
At 17:50, the pregnant woman arrived at the operating room.
At 18:12, the baby is born.
Subsequently, the medical staff evacuated the operating room in batches and escorted the mother and son to the ward and the intensive care unit respectively.
After the patient left, the nurse in the operating room carried out follow-up work such as instrument disinfection, environmental disinfection, terminal disposal, etc., until 21:18, Sun Jing,18, the head nurse finally left the operating room. At this time, the protective surface screen has been foggy, and the vision is blurred.
Newborns are admitted to intensive care units
Make sure the mother and baby are safe, they have this confidence!
At nearly 22:00 at night, obstetrician Wang Qiuming stepped out of the nervous "frontline", and the first thing he did was to pick up his mobile phone and dial the mother's lover's phone and report to him that he was safe.
Wang Qiuming is the patient's tube bed doctor, he found that the fetal heart rate and intrauterine condition of the fetus are relatively good when examining the patient, but because there are a number of high-risk factors that increase the risk of bleeding, the expert team has consulted many times and prepared a detailed target plan.
In addition, the anxiety and nervousness of pregnant women also made Wang Qiuming pay special attention. "Don't worry too much, there is no evidence that the COVID-19 virus will cause intrauterine infection. In addition, in order to ensure the safe birth of children, we have prepared a very detailed plan and conducted many simulation exercises. After listening to Wang Qiuming's words, the patient's mood was much relieved.
At the same time, Wang Qiuming also took the initiative to talk to the patient's lover on the phone, "Her lover is also isolated, I think he must be very worried about his wife." ”
After the baby was born, a special team composed of PICU doctor Cheng Dongliang, anesthesiologist Wu Jiangxia, midwives Jin Weiwei and Yuan Shuhui, and NICU nurses Zhao Xin and Gao Guangqin was responsible for ensuring the safety of the newborn.
Cheng Dongliang conducted a detailed physical examination of the newborn for the first time to check whether he had deformities and whether his vital signs were stable. Thankfully, the child's check-up was all right.
Next, the newborn will be cared for by professional doctors and neonatal nurses in the one-person, one-room intensive nursing ward prepared for him by the medical staff, who will establish a feeding mechanism for the newborn and continuously monitor various indicators.
"I'm glad that all the rescue preparations I made before were useless!" Cheng Dongliang said that in order to ensure the safe birth of newborns, they have specially formulated detailed plans to ensure effective response to various dangerous situations such as asphyxia in newborns, and have prepared various required equipment such as preheated blankets, scales, neonatal resuscitation sacs (masks), neonatal laryngoscopes, and neonatal ventilators. Even in the event of occupational exposure of frontline personnel, reserve personnel are prepared.
"When the child is well, we are relieved!" Cheng Dongliang said that when they saw the birth of the child, their mood was a little nervous, some expectations, but more confident, "because we are professionals, we are still full of confidence in the task of ensuring the safety of newborns!" ”
yes! With professionalism and dedication, the medical staff confidently declares with this loud baby cry: no winter is insurmountable, and no spring will not come!