I hope that you can protect yourself well and persist until the end of the epidemic, so that the hard work of every medical staff will not be "white hard work".
Dictation | Zhang Yijue
Reporter | Huang Qi
A friend asked me a question the other day and asked me if I was busy? He asked himself and said, "The epidemic has nothing to do with you. ”
I said, "I'm in closed-loop management." "To imply that ta is actually busy. But I failed.
Ta hui: "Are you infected or close?" ”
I am an anesthesiologist at the South Branch of Renji Hospital, and our hospital is one of the designated hospitals in Shanghai for the treatment of COVID-19 patients, and we treat infected people with other underlying diseases or infected people with special medical needs, such as positive pregnant women.
On April 7, hospitals began treating COVID-19 infections, and challenges are everywhere. You have also seen reports in the Wuhan epidemic that many high-risk operations such as endotracheal intubation are done by our anesthesiologists. If surgery is encountered, the anesthesia operation under the three-level protection also increases the difficulty for the doctor.
These days, with the efforts of the team of medical staff, we have successfully born a baby here, carried out a surgical operation, and many patients have turned the corner after timely treatment.
Anesthesiologist Zhang Yijue, "stage name" Xiao Hei
In 2003, the year of SARS, I applied for Shanghai Second Medical University (now Shanghai Jiao Tong University School of Medicine) with the mentality of "bottoming out", of course, another reason was due to the influence of the Japanese drama "Looking Back and Seeing Him Again". 19 years later, because of my original choice, I stood on the front line of the fight against the epidemic.
18 years old may not be less than a thing, but now I think the profession of anesthesiologist is very suitable for me; I have opened a public account myself, and in the past I liked to complain, but now I hope to convey more positive messages. At this time, everyone is sticking to their posts, and we are all working hard to get out of the epidemic.
The first baby in the designated hospital cried differently
During the epidemic, everyone is very concerned about the safety of women. Our Rennan Hospital admitted a covid-19-infected woman from another hospital who had her own fever symptoms and signs of fetal distress. Yang Liqun, director of our Department of Anesthesiology, immediately held an online meeting with the doctors in the cabin to prepare the perinatal anesthesia program in special circumstances.
Her condition is the need for caesarean section, this kind of anesthesia is commonly known as "half-body anesthesia", in fact, from the patient's lumbar spine here to administer, professionally called epidural anesthesia or subarachnoid space block. The anesthesiologist in the cabin soothes the anxiety of the mother and uses a variety of ways to locate and confirm the lumbar space of the mother.
On April 15, everything was ready and the surgery began.
Because the mother is infected with the new crown, our doctors wear protective clothing according to the standard of secondary protection. However, the three-layer rubber glove is the biggest difficulty in the operation process for anesthesiologists, because in addition to the standard operation, the epidural puncture depends on the "feel" of the doctor's hand, and the sensitivity of the hand after wearing the three-layer glove must be greatly reduced.
This is the time to have a normal experience and a better mindset. Before entering the operating room, to be honest, I was a little nervous, although I, a post-80s doctor, usually have more than ten surgeries a day and am already very familiar with the technology, I still put the whole process in my head several times.
Happily, the epidural puncture of the mother was smooth and the anesthesia was smooth. At 12 o'clock in the afternoon, a healthy baby was born.
"12:28! Younger sister! In the operating room, deputy director Wang Zhenhong's chimes and the baby's cries sounded together, which was the first new life welcomed by the Renjinan Branch as a designated diagnosis and treatment hospital.
Usually, our anesthesiologists see many babies every month, but it is the first time to do anesthesia in such an environment, and it is indeed different to hear the baby crying.
On the afternoon of April 24, our hospital completed the first surgery after being converted to a designated hospital, and the patient was a patient with COVID-19-positive peritonitis who underwent laparoscopic appendectomy. The patient, who was originally in the Fang Cabin Hospital, was transferred to Renjinan Hospital because of fever and severe abdominal pain, and he had a history of appendicitis in the past.
The situation was still dangerous when I was sent to the hospital, with septic shock, a drop in blood pressure, a heart rate of 142 beats per minute, and surgery was necessary as soon as possible.
The main knife is Wang Zheng, vice president of Renji Hospital and chief physician of gastrointestinal surgery, and general surgeon Liu Dejun assists. Wang Zhenhong, me and I in the department of anesthesiology are responsible for surgical anesthesia, and two surgical nurses, Song Junjing and Lu Yujia, are responsible for surgical assistance. The operation took 30 minutes, and now the patient is recovering well and starting to eat the next day.
Anesthesiologists are also in the first echelon of rescuing patients
As you can see in the news, if a person infected with the new crown virus has other more serious underlying diseases, the risk of becoming serious is much higher than that of ordinary people.
In order to ensure the safety of this part of the infected, Shanghai has opened many designated hospitals, such as our RennanNan Hospital, which treats infected people with tumors, postoperative tumors, cerebral infarction, heart diseases and so on.
If the patient's condition suddenly worsens, our anesthesiologist is part of the rescue team.
For some critically ill patients who are in urgent need of oxygen therapy, endotracheal intubation ventilator support is the most effective method and their most important "lifeline". Usually, the operation of endotracheal intubation is done by anesthesiologist, but the intubation itself is a great risk of spreading the new crown virus.
Because when an anesthesiologist performs intubation, he needs to be very close to the patient's face, open the mouth through the laryngoscope, look for the glottis, and send the tracheal catheter into the airway, which is professionally called "high-risk occupational exposure in direct contact with the patient's respiratory secretions." In such a high-risk environment, it is necessary to wear three levels of protection for all operations. The so-called "three-level protection" is one layer more than the big white that everyone usually sees, with a hood and a ventilation device, and the ventilation equipment is not so hot.
Endotracheal intubation in a COVID-19 ward
Over the past two weeks, our anesthesia team has performed respiratory support operations for a number of high-risk patients, and it has been relatively smooth.
Closed-loop anesthesia team of Renji Hospital South Branch
In fact, every time there is an infectious disease outbreak, anesthesiologists are often in the most risky positions, and the first sacrifice in "SARS" is the anesthesiologist, and the highest proportion of infection is also anesthesiologist.
Epidemic diary
I have a public account myself, usually write something I want to write, and I also have a complaint. To be honest, when I was young, I complained a lot, and after I had children, I was much better.
One day out of the ward, I wrote a scene:
After taking off my protective clothing, it was already 6:30 p.m., and I went to the east gate of the hospital to get dinner. If I had a cell phone at this time, I would have taken this picture.
The east gate of the hospital was locked, and a medical staff sat alone on the cement steps of the green belt to eat. This is common for them, and to avoid cross-infection during meals, they often sit on the floor.
If it's a sunny midday, it may be ridiculed by the people at home as a picnic atmosphere, but after the sun goes down, the scene feels very sad.
Opposite her was a stray dog, sitting up straight, expecting someone to give it some food.
It can be seen that she has just left the cabin and should be very hungry. According to this point in time, she must not have eaten lunch, because 6 hours of backwards, it has not yet reached the meal point, and in order to avoid wearing and taking off the protective clothing for the toilet, she has at most eaten a little breakfast.
She took a little rice from her lunch box and put it in her hand, and the dog understood and ate all the food in her hand, it was so hungry. After eating, the dog did not leave, but sat upright. She took a few bites herself, and then brought out a little more food for it to eat.
Just like that, she ate a whole box lunch with it.
I don't know if anyone could understand how I felt at the time, or maybe I amplified it. In this familiar place, the air you breathe, the person you are facing, are all completely different, just a few days ago, completely different.
From joining the frontline of the fight against the epidemic to now, it has been almost a month since I have not been home, either in the hospital or in the hotel, in fact, there are many people who have been away from home longer than me.
I am grateful for the understanding my family has received from me. Although some people will say that the medical staff in the front line is very hard, the family members of the medical staff have unknown hardships. For example, my parents will always be very worried about my situation, in addition to advice, always put "they will take care of themselves, do not cause me trouble" on the lips.
The wife works from home, struggling with a pile of forms every day, grabbing vegetables, cooking, taking care of a dog, and a mischievous daughter. Everything seems to be difficult to look at separately, but in the current "widowed" life, it is not easy.
Dr. Zhang and daughter
The daughter is actually quite happy, one is not going to school, the other is that the father is not at home - which brings a lot of space for her happiness. Before I left, I kept telling her to protect herself: "Dad worked so hard to save people, in order to protect everyone well, if you don't pay attention to protect yourself, then Dad will work hard in vain." 」 ”
The daughter said: "White hard, not hard." ”
There are also many friends who silently care about me, and I thank you here. I hope that you can protect yourself well and persist until the end of the epidemic, so that the hard work of every medical staff will not be "white hard work".