At present, in order to fight the epidemic prevention and control defense war, Shanghai has carried out nucleic acid testing round by round. However, for the majority of pregnant women, they are facing unprecedented uneasiness: the implementation of sealing and control in the residential community, what should be done about the obstetric examination? Jianka Hospital is assisting in the investigation, what should I do if I am about to give birth? If it is an isolated pregnant woman, what should I do if I have an emergency? The nucleic acid report is not within the validity period, but the condition is very urgent, what to do? Epidemic prevention and control is becoming increasingly severe, but the safety of mothers and babies cannot be lost.
As the oldest obstetrics and gynecology hospital, how can the Obstetrics and Gynecology Hospital affiliated to Fudan University break through the siege of the epidemic and make every effort to build a dual-track parallel "prevention and control safety line" and "maternal and infant lifeline"?
Optimize emergency closed-loop transit processes
It is urgent to save lives
"Ultrasound B reported it: intra-abdominal bleeding. Estimated 1,000 ml. It is too late to wait for the nucleic acid to be reported, and immediate surgery, otherwise once hemorrhagic shock, it is life-threatening at any time. ”
In the early morning of March 29, He Xiaoping, an emergency doctor at the Yangpu Branch of the Obstetrics and Gynecology Hospital affiliated to Fudan University, received a patient with sudden abdominal pain. Xiao An (pseudonym), a 22-year-old white-collar worker, recently had an HCG blood test near her home and was clearly pregnant. On March 28, she worked from home as usual, but her abdominal pain became more and more obvious, accompanied by vaginal bleeding, until the early morning, Xiao An, who had unbearable abdominal pain, accompanied by her family, went to the emergency department of Yangpu Branch of Fudan University Affiliated Obstetrics and Gynecology Hospital. Dr. Ho believes from experience that the possibility of ectopic pregnancy in Xiao'an is extremely high and requires immediate surgery.
But Xiaoan does not have a recent effective nucleic acid report, what to do? Safety of life first! The hospital immediately launched a plan, placed Xiaoan in the isolation clinic, completed a series of emergency examinations including B ultrasound, and as expected, Xiaoan had serious intraperitoneal bleeding, estimated to be 1,000 milliliters. At the same time, the negative pressure operating room entered a state of preparation, and the anesthesia department and blood transfusion department were waiting. According to the closed-loop transfer process, the emergency personnel transferred Xiaoan from the negative pressure transfer chamber to the isolation ward.
But the next situation made everyone unexpected. Preoperative examination showed that Xiao'an's blood type was RH-negative blood, which is often referred to as the "panda" blood type. Under the epidemic situation, the blood bank is in emergency, and the blood source is in short supply. At this time, the abdominal pain on the bed was severe, and the positive signs appeared one by one, indicating that the amount of intra-abdominal bleeding was further increasing. The atmosphere in the operating room suddenly became solemn. In an emergency, the anesthesiology department decided to solve this problem by using autologous blood transfusion technology.
This emergency laparoscopic surgery, which is racing against time, is carried out in an orderly manner amid the buzzing of the instruments, and under the endoscopy, the rupture and bleeding caused by tubal pregnancy are nearly 1000 ml, but 300 ml of autologous blood is slowly returned to the patient's body, ensuring the smooth progress of the operation. Director Luo Xuezhen and Dr. Shen Haoran calmly completed the operation, and the patient's vital signs recovered smoothly.
During the extraordinary period of epidemic prevention and control, multi-departmental collaboration, reasonable diagnosis and treatment procedures, and orderly cooperation and collaboration have ensured the dual safety of medical treatment and infection control, and enabled patients to turn the crisis into safety.
That's the speed of the Red House!
Alternate turns are formal and seamless
The "life channel" is unimpeded
On the evening of March 28, the Yangpu Campus implemented screening measures for relevant personnel and the environment, and some areas were temporarily closed-loop management. The place is closed, but the childbirth cannot be suspended, and the obstetric safety is no small matter!
"Make every effort to ensure the safety of pregnant women!" The hospital immediately launched a plan, urgently adjusted medical resources, adjusted the Yangpu outpatient operating room into a backup delivery room, and opened a green channel for emergency pregnant women.
Just as important as the alternate premises are the medical staff!
"Life is supreme, the epidemic is the order!" There is no one vague, the midwife who just got off the morning shift, the obstetrician who only took a night off, the neonatologist who insisted on working consecutive shifts, the anesthesia doctor who just unsealed the community, everyone was ordered to move, and went directly to the hospital from all sides of the city.
The place is there, the personnel are in place, and the facilities and equipment are not a problem. Under the coordination of various functional departments, Quan Peiqing, the head nurse of the outpatient operating room, completed the use of obstetrics and neonatal instruments and emergency equipment, and the information department Xu Chengjie actively helped solve the information system problem, and in less than 1 hour, a delivery room with 2 obstetric operating rooms, 1 waiting room, and 1 delivery room was quickly ready.
At about the same time, the emergency department called: "37 weeks pregnant, twins with preeclampsia, elevated urine protein, urgent cesarean section required!" "The well-trained Red House medical team, seamless and orderly cooperation, perfectly realizes the rapid switching of "combination of epidemic prevention" at the moment of epidemic prevention, so as to keep the responsibility of the land and guard the door. In the long night, the temporary delivery room is brightly lit, and the two new lives who "fall to the ground" and the new mother who have turned the crisis into safety witness the wisdom of the people in the red house. Let the "life channel" be unimpeded, and the red house will not hesitate!
"Emergency care does not stop" is a commitment to the life of the people. When the epidemic hit, the number of emergency departments has increased exponentially, and the risks are everywhere! But it is difficult not to fall the red house people. What should I do if I need a temporary closed loop in the emergency treatment area? What should I do if the patient comes to the emergency department and cannot provide a valid nucleic acid report, but the condition urgently needs immediate surgery? The hospital lists every risk that may arise and invites them to resolve them. Reasonably enable an idle area next to the emergency diagnosis and treatment area, build a "temporary emergency point", copy the relevant facilities and equipment without deviation, copy the "emergency" workflow, ensure that when the emergency department is temporarily closed-loop, you can immediately mobilize and convert medical resources to the standby emergency point, realize the comprehensive "big transfer" of personnel, places, processes, and facilities, and ensure that you can return to the original place again after rapid elimination, achieve flexible conversion, and start with one key...
Wards 21 and 27 are model "isolation wards" for gynecology and obstetrics in hospitals. When the epidemic suddenly broke out, these two military wards only needed to install a "one-panel wall" on this floor to quickly meet the requirements of the new crown wards that met the "three districts and two passages". Once the epidemic appears, close this door, the ordinary ward can be quickly switched to a new crown ward, and the ward immediately enters a state of isolation. In the absence of a major outbreak, the wards returned to normal operations. The "one-panel wall" comprehensively solves the embarrassing situation of "the supply of beds is in short supply during the epidemic, and the resources are innocent and wasted in peacetime", and through this "board wall", the ideal model of "win-win situation against the epidemic" is skillfully transformed, and the efficient coordination and seamless connection between public health services and medical services are realized.
Behind the flexible conversion and seamless connection is the normalized and modular emergency drill, the sufficient reserve material support, and the continuous optimization of the hospital infection prevention and control process. The most valuable thing is that the "New Crown Epidemic Prevention Knowledge Manual" updated by the hospital and the new crown epidemic is easy to understand, from experts and professors to the work security guards, everyone knows, everyone assesses, and everyone is a sensory control practitioner... All these provide full protection for the 24-hour green code "life channel".
That's the height of the Red House!
Phone contact, SMS notification...
Pamper the "softest" crowd
"Doctor, I made an appointment to do a large row of deformities on April 3, but Puxi sealed it, what should I do?" On the other end of the phone, the voice of the pregnant woman Xiao Song was already crying. "Don't worry, I'll help you change your contract now." On the other end of the phone, the staff patiently told Xiao Song that the examination time could be adjusted for him within the corresponding gestational week, and when he heard this, Xiao Song's anxious heart immediately settled down.
Obstetric examination during pregnancy is a just need of every pregnant woman, of which the screening and diagnosis of birth defects is an important item. From April 1 to April 5, Puxi will carry out a new round of nucleic acid screening. What should I do if I make an appointment for a major deformity or N T test during this period? To this end, the hospital's ultrasound department solved the problem in the front, they carefully sorted out the list of pregnant women, and then contacted the information department to notify each pregnant woman of the relevant adjustment information through the information system point-to-point TEXT message, and reminded them to ensure that there is a 48-hour nucleic acid report, so that the uneasy mood of pregnant mothers to be tested has been alleviated.
At present, there are more than 6,000 pregnant women in the hospital. Gu Weirong, director of the obstetrics department of the hospital, told us: "The WeChat group of the obstetrics department has been established for two years, and pregnant women can find their own attending doctor for communication and consultation for the first time in the group, which is a normal work in the past two years. "During the epidemic, the WeChat group of the special disease group played a key role. It is understood that there are six specialized disease groups in the obstetrics department of the hospital, and the WeChat group of each special disease group has a special group director, deputy director, clinical backbone physicians, as well as nurse leaders and responsible nurses online.
So what conveniences can pregnant women get in the group? It is understood that in addition to ensuring that the patient's questions are replied to in a timely manner 24 hours a day, the medical staff in the group also regularly classify the consultation questions and answers, and hang the questions in the self-service system of the hospital's official service account through intelligent robots, which is convenient for pregnant women to review and learn and find. During the epidemic period, in order to facilitate pregnant women to understand the relevant management policies of the epidemic in a timely manner and help everyone arrange obstetric examinations and hospitalizations in advance, the medical team will also regularly update and push popular science articles and real-time information.
That's the temperature of the Red House!
The persistence of the "retrograde"
Ensuring the safety of mothers and babies "non-stop"
On the evening of March 27, not long after the news of the sealing of the area bounded by the Huangpu River was announced, the hospital welcomed many red house people with suitcases, who came from all directions of the city retrograde and voluntarily stayed in the hospital to take on the responsibility of guarding patients.
Gynecology ward nurse Xiao Gu has been sticking to the post for ten days, from the gynecological ward to the support obstetric ward and then into the isolation ward, Xiao Gu and her "comrades-in-arms" not only do a good job of medical care, but also help the mothers wipe themselves, carry water, do a good job of life care, when asked why WeChat avatar is an Ultraman, she smiled and said, "This is my son's idol, before going out he asked me, is it also like Ultraman to defeat the monster?" I replied to him that Mom would come back after defeating the monster. Now, I have become an idol of my son. "Their tireless efforts have been exchanged for the praise of the women in the ward."
In fact, they are no longer the first "stranded people" in the hospital. As early as the beginning of the epidemic, there have been countless voluntary hospital personnel in the hospital. The sweaty white in the screening ward, the round after round of killing, the diligent logistics workers, the security guards with great bodies, the canteen staff who get up early and greedily..." In addition to the sick leave employees, all the canteen employees lived in the hospital, although the canteen in the middle was suspended due to the epidemic, but the Yangpu canteen was on top in time to support the three meals supply in the two hospitals. Fu Wenduo, the manager of the canteen, said, "The accommodation conditions are difficult, but I have not heard a single complaint, we only know that we must do our job conscientiously, there is no way back in front of the big right and wrong, we will definitely stick to it." "It is their perseverance that ensures the catering of all patients and medical staff in the two hospitals, so that everyone can avoid worries."
In order to ensure the normal operation of the hospital, the hospital implements the "full bubble management" model, the different areas of the two campuses are cut according to the functional division, and a team is formed according to the personnel situation in each area, and the team includes a series of closed-loop management of all personnel who can complete the work in the area, such as medical care and work, and rotates them as a team. From the initial two-day round to the dynamic adjustment to the seven-day round, bubble management ensures effective medical strength and ensures the steady progress of work during the epidemic.
That's the power of the Red House!
At present, the hospital party members are also charging forward, and actively set up the 'Spark Cohesion' party member anti-epidemic vanguard team and the youth anti-epidemic commando team, doing their best to fight in the same direction, and the hospital will certainly exert its full strength to exert effective medical strength, build a solid lifeline, and ensure that the safety of mothers and babies will never "stop".
Author: Wang Jue, Li Min, Shen Yan
Editor: Li Miaoran