Pictured: Emergency departments need to face various emergencies Cao Xi photo (the same below)
No. 700 Moyu North Road, Shanghai Oriental Hepatobiliary Surgery Hospital (the Third Affiliated Hospital of naval military medical university) has a separate gate. Behind the door is the emergency department with a construction area of about 5,000 square meters and a total number of beds of 51 beds - on August 1 this year, the emergency department began to operate 24 hours a day, in order to help jiading district all-round, life cycle health security service system construction and efforts.
"We will inherit your spirit and help patients through the 'darkest hours' of life." The first day of full-time operation is the 94th Founding Day, in front of the statue of Wu Mengchao, the "father of Chinese surgical hepatobiliary" in the Anting branch of the hospital, the emergency department owner He Jian led the team to solemnly promise.
Open the door of life for the sick
24 hours a day, the whistles of 120 ambulances echo here from time to time, and the flashing blue police lights remind everyone to tense their nerves at all times. This is the "battlefield" that He Jian and his team insist on, and it is also the "position" at the forefront of this hospital.
Late at night, a young patient in his 30s was sent to the emergency department of the Anting Branch of Shanghai Oriental Hepatobiliary Surgery Hospital, where he had severe abdominal pain for two days. Previously, he was diagnosed with pancreatitis and went to two hospitals for infusion treatment without improving. On the night of being delivered by ambulance, he was even delirious and his family was anxious. The doctor on duty quickly examined, based on the symptoms and results of the examination of the lad, gave the conclusion that "diabetic ketoacidosis" was the main threat. It was another stressful, sleepless night, but the team's efforts paid off in a reassuring way – the patient's consciousness was cleared the next morning and his abdominal pain was relieved.
He Jian expressed the concept of emergency treatment in his heart: "Shoot first and then aim." Because in the team's view, there is hope only if the patient is alive first. "The core of emergency medicine is to buy more time for patients, and then make further judgments and treatments. This requires us to master the ability to quickly diagnose and identify diseases, and remove all factors that endanger the lives of patients first. He said solemnly.
The cultivation of emergency thinking and emergency treatment ability has always been the core of team development. On the basis of summing up years of experience, He Jian has made a lot of innovations in methods. Drawing on the ideas mentioned by Dr. Arthur Gravinde in The List Revolution, he set up a "critical illness screening" module specifically for emergency departments. This small improvement, however, has been proven in clinical practice, greatly improving the diagnosis rate of critical illness.
Pictured: He Jian leads a young doctor on a round
Start with the patient's needs
More than 40 kilometers from the city center, all kinds of accidents and accidents caused by trauma, life-threatening emergencies, etc., can be treated at an appropriate early stage. The emergency team is also constantly exploring how to better adapt to local conditions and carry out treatment work from the needs.
"We are different from other hospitals. Most of the area around the Anting campus is for enterprises and institutions, and there are very few residents. As a result, the need for emergency care is not the same as in mature residential areas. He Jian admitted that this is also an important reason why the emergency department was not running full-time until August this year.
The 24-hour run is just one quarter away. He Jian keenly found that patients admitted to the emergency department began to have some "commonalities" - more than half of the trauma patients sent by 120 were related to electric vehicles. With this discovery, He Jian's daily commute to and from work left a part of his heart. He carefully observed the electric vehicles around him and found that excessive speed and not wearing helmets were two major hidden dangers. "According to the current number of patients admitted, we have to treat hundreds of thousands of traffic accident injuries a year. Everyone may be holding on to the fluke and think that it is a small probability event to do something without a helmet. But what we emergency department physicians see is 100% harm to life. He Jian said. He and the team discussed the next step, the next step is to cooperate with the traffic police department of Jiading District, carry out publicity from the perspective of the emergency department, and unite with surrounding enterprises to organize volunteers at the intersection near the factory area to remind electric vehicle owners to pay attention to safety.
Pictured: He Jian leads a young doctor to read a film during a round
Inherit the spirit of Wu Lao
He Jian has been engaged in emergency work in Changhai Hospital since 1993, and he has also witnessed the growth of Shanghai Oriental Hepatobiliary Surgery Hospital from a department of Changhai Hospital to an independent specialized hospital, and then to a comprehensive hospital. "In Wu Lao's planning, this hospital will be a comprehensive hospital in the future." He Jian said that the patient's situation is ever-changing, and if it is only built with a specialized hospital, there is no comprehensive discipline guarantee, and the life guarantee for the patient is incomplete.
Today, with the overall transformation of the hospital, the emergency department has also been greatly developed. The reporter saw in the emergency department that the rescue area, infusion area, emergency observation and intensive care unit are reasonably partitioned, and equipped with various necessary advanced instruments and equipment, and the support of various professional departments is becoming more and more perfect, and the operation mode of "emergency reception support type, emergency rescue autonomous type, observation and EICU independence" has been realized.
"We have 14 doctors and 20 nurses, a lot of them are very young. Now, the emergency department needs 24 hours to work, if our young nurses encounter rescue patients at night, should have left work at 12 o'clock, they will take the initiative to ask for overtime, after the patients are dealt with, they will leave work at two or three o'clock in the morning to go home. "Usually, everyone will also learn from Elder Wu, do the examination, help the patient to pull the clothes well, put the shoes away." As the "big parent" of the department, He Jian feels that this is the best inheritance of the spirit of Wu Lao.
Xinmin Evening News reporter Gao Yang