Author: Rong Media reporter Qin Miao
People first! Life is supreme! It is the sonorous sound of this great era! On the occasion of the fifth "Chinese Doctors' Day" on August 19, 2022, in order to further promote the implementation of the work related to the Healthy China Action, the Healthy China Action Promotion Committee formulated the "Key Points of Work of the Healthy China Action in 2022", proposing to organize the "Healthy China Doctor First" activity, widely mobilize medical institutions and medical personnel, and take the lead in practicing the Healthy China Action.
To this end, under the guidance of the Healthy China Action Promotion Committee, jointly sponsored by Physicians' Newspaper, China Medical and Health Culture Association, China Health Promotion and Education Association, China Medical and Health Development Foundation, CCTV, and will unite health administrative departments, medical industry sciences/associations, medical institutions and other colleagues who are interested in the construction of a healthy China, with the help of the "Healthy China, You and I Walk Together" theme public welfare tour exhibition activity held on the Fourth Chinese Doctors Day in 2021, in the fifth" On the occasion of "Chinese Doctors' Day", with the theme of "Healthy China, You and Me Together - Caring for Life and 'Saving' by Our Side", the four-city subway linkage public welfare tour exhibition activity of Beijing, Shanghai, Guangzhou and Hangzhou was launched.
Thirty and standing, forty not confused, in 1983 China officially established the emergency department, so far has been nearly 40 years, emergency medicine from thirty and standing officially into the year of forty not confused, emergency medicine is flourishing at the right time.
In the history of the development of emergency medicine in China, an indispensable force comes from the emergency center of the Second Affiliated Hospital of Zhejiang University School of Medicine (hereinafter referred to as "Zhejiang University Second Hospital"), as one of the first batch of emergency departments established in China, the main initiator and place of establishment of the Emergency Medicine Branch of the Chinese Medical Association, and has written a strong stroke on the journey of emergency medicine development in mainland China.
Located in Building 8 of jiefang Road, Zhejiang Second Hospital, Shangcheng District, Hangzhou, Zhejiang Province, I saw four large glowing red characters of "Emergency Center", which is the Emergency Medicine Department of Zhejiang University Second Hospital (referred to as "Zhejiang Second Emergency Department"), and a row of leafy locust trees next to the building, which together witnessed the growth of China's exemplary emergency medicine department.
On August 19, on China Doctors' Day, the reporter of The Physician Daily walked into Hangzhou, Zhejiang Province, and followed Professor Zhang Mao, the leader of the Emergency Medicine Department of the Second Affiliated Hospital of Zhejiang University School of Medicine, to review this extraordinary road of growth.
The emergency journey explores in the unknown and moves forward in exploration
In 1984, the Department of Emergency Medicine of the Second Affiliated Hospital of Zhejiang University School of Medicine became one of the first emergency departments established in China. In 1985, the national emergency experts held a seminar on urban emergency work in Hangzhou, and in 1987, the Emergency Medicine Branch of the Chinese Medical Association was established.
At the beginning of its creation, it was very difficult. Zhang Mao introduced that in that era, on the one hand, the conditions were limited, and the simple treatment facilities could only meet the most basic rescue needs; On the other hand, because it is a new discipline, there is no experience to refer to in China, and most hospitals are exploring in the unknown and moving forward in exploration. Through the joint efforts of generations of emergency department predecessors, step by step, many pioneering work has been made. In 1987, the first emergency ICU in China was established, which well solved the problem of continuous high-quality treatment of critically ill emergency patients. In 1990, he undertook the society's institutional journal "Emergency Medicine", which actively reported the latest scientific research achievements and clinical diagnosis and treatment experience in the field for medical staff engaged in emergency and critical care clinical work in China. In 1994, it took the lead in establishing an in-hospital trauma treatment model led by emergency departments and multidisciplinary and efficient cooperation in China, which became a distinctive feature of the discipline. In 2005, it took the lead in opening air first aid in China and completed the pioneering work of the initial stage of a number of air first aid.
In 2006, with the overall planning of the hospital, the emergency medicine department relied on a high-level development platform, and the space and facilities of the discipline were greatly improved. Zhang Mao introduced that at that time, the conditions and facilities of the emergency center were the highest in China. Nowadays, walking into the emergency hall on the first floor, you can see that the layout of different emergency function partitions is reasonable and orderly. Functional departments are laid out in order to reduce cross-crossing, reduce nosocomial infections and save time. Emergency pre-screening areas, emergency rooms, emergency resuscitation rooms, etc. are readily available. In the midst of it, people can't help but sigh that in the past 40 years, the development of the state and modern technology has inserted wings into the development of emergency departments. At present, Zhejiang No. 2 Emergency Department integrates clinical, teaching, scientific research, publishing and training, and has become one of the centers of the development of emergency medicine in China, and has entered the top 3 of Fudan's national best specialty rankings.
Do everything in your power to reverse every life-and-death turning point
From the never-ending light of the emergency hall, what makes us feel is the emergency person's protection of life. There are countless stories that have occurred in the emergency department, Zhang Mao said: "The emergency department is a microcosm of society, every day will contact a variety of patients, behind the reflection of the world's cold and warm and sad and happy clutch." ”
In 2016, a boy in Xiaoshan who had just finished the college entrance examination unfortunately suffered a serious car accident and was in a very critical condition. The boy suffered from severe crush injuries, co-infections, and multiple organ failure, and after his family went to two hospitals, he found Professor Zhang Mao because his condition continued to deteriorate.
"Since you trust us, turn around!" From the first time of receiving the patient, the team led by Zhang Mao carried out emergency debridement surgery to win more opportunities for follow-up treatment. Zhang Mao recalled: "In so many days that have not yet been out of danger, whenever I see the mother of the child still wandering outside the ward late at night and looking at me expectantly, I really feel that as an emergency doctor, I must go all out to treat me no matter what." Later, in the multidisciplinary and efficient cooperation mode of treatment in the hospital, after all kinds of difficulties and dangers, after 70 days of long recovery, Zhang Mao finally saw the innocent smile on the face of the boy who was pulled back from the hands of the god of death.
Zhang Mao told the "Physician Daily" reporter that emergency medicine is a discipline that saves lives at a critical juncture, so in order to play a role in the critical moment of patients' lives, the emergency department must do all the available resources, timely, rapid, and in place, and efficiently integrate the limited resources, so that it is possible to turn seemingly impossible things into possibilities, and finally create a miracle of life.
It has to be said that in this treatment, the efficient multidisciplinary collaborative treatment model and rich experience in severe trauma treatment have played a vital role. After years of experience, as the main completion unit, the results of "the establishment and promotion of China's severe trauma treatment norms" won the second prize of the National Science and Technology Progress Award in 2016, and in 2019, it undertook the construction of one of the two domestic "National Trauma Regional Medical Centers", and in 2022, it undertook the construction of the National Emergency Medical Rescue Base.
Do things you don't dare to think about in a pioneering spirit
Since joining the work force in 1996, Zhang Mao has developed a strong interest in emergency medicine, from theory to practice, he has studied hard. In the clinic, in the face of every life in urgent need of treatment, he will devote himself to it. In his spare time, he strives to learn theoretical knowledge, practice various operational skills, is good at observing and summarizing differences, especially for new things, he always maintains an active exploration heart. He has accumulated rich clinical experience relatively quickly, and has successfully treated difficult and critically ill patients for many times, which has been unanimously recognized by the hospital and domestic counterparts.
The development of emergency medicine is closely related to advanced concepts, knowledge, technology and equipment, so it is not possible to develop behind closed doors, but also to actively go out and introduce. In 2003, Zhang Mao had the opportunity to go abroad for a year of further study to see what the gap between China's emergency medicine and Western developed countries was.
"I have to say that this year's further education has broadened my horizons, and the overall level of Western countries has really opened my eyes." At that time, I deeply felt that we still had a big gap. But after a year of study, I knew it was time for us to start there. Zhang Mao said frankly.
After returning to China, from basic research to clinical research, Zhang Mao led the team to actively carry out a number of innovative work, and the discipline also developed rapidly under the background of relying on the high-level development of the hospital.
"Now we're getting more and more afraid to do things we didn't even dare to think about before. Those things that we didn't dare to think about before, now we've all done them. In recent years, with the research and development of domestic equipment, the performance of domestic equipment is not inferior to imported equipment, and even some domestic equipment has technology that Western countries do not have. From the technical level, compared with Western countries, the emergency treatment technology mastered can be equivalent, but due to the great differentiation of the mainland medical level, it is a major problem that we currently have to achieve homogeneous development. ”
In February this year, an elderly man accidentally drowned, and his daughter also suffered a serious drowning and heart arrest during the rescue process. After the daughter was rescued, after the local hospital struggled to rescue, the heartbeat finally returned, but the situation is very critical, and life may end at any time. As patients experience a prolonged period of cardiac arrest, survival becomes nearly impossible, even if resuscitation is successful. After being urgently sent to the Zhejiang Second Emergency Department, Zhang Mao led the team to carry out emergency follow-up treatment, and went all out to use the most advanced treatment measures, and finally pulled her back from the death line, and completely restored brain function, creating a miracle of life.
The future is here, and the emergency department of the future is imperative
With the new hospital area being planned and constructed, the emergency department as a very important unit, Zhang Mao has already planned a blueprint for the "future emergency department" in his heart, which is depicted according to the world's leading level.
First, the idea comes first. Everything revolves around the concept of patients getting more efficient rescue, and the new technology and future new technologies are rationally and scientifically laid out to meet the needs of different patients. Reasonable distribution of areas, before the public health emergency, always stand at the forefront of the emergency is the emergency department. Therefore, whether it is for respiratory-transmitted diseases or other infectious diseases, the future emergency department must pay more attention to the needs of prevention and control, and give more full consideration to the functional partitioning of the emergency department, so as to ensure the effective isolation of ordinary emergency patients related to suspected infectious diseases and avoid the impact on the demand for normal treatment services.
Secondly, for the treatment of critically ill patients, such as patients with severe trauma, the future emergency department will concentrate important rescue instruments and equipment in the same place to form an "emergency hybrid resuscitation unit", and the concept of such a design can shorten the "golden treatment time" as much as possible. Complete all the rescue work in one stop in the same rescue unit, which greatly improves the efficiency and effect of treatment.
In addition, in the future emergency department, there must be no shortage of helicopter rescue services, and the passage between the helicopter rescue site and the emergency department and operating room must be the shortest. With the application of UAV technology, greatly improving the efficiency of medical logistics, in addition to completing emergency tasks, including the delivery of drugs, blood, special instruments and equipment, and even transplanted organs, UAVs can not be affected by road traffic conditions, greatly improving the timeliness of medical distribution, bringing a revolutionary impact to the medical emergency industry.
For the planning of the prototype of "future emergency", Zhang Mao still has a lot of imagination. It can be seen that for the development of the future emergency department, it is ultimately necessary to build a new system, and Zhang Mao is full of confidence in establishing a new emergency system and improving the ability of emergency treatment. The future has come, the future can be expected, through system reshaping and innovative technology application, and finally provide the whole society with more advanced, more efficient, better quality, more fair emergency medical services.
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