On July 14, Ning Moumou, a 2023 master's degree student in psychiatry and mental hygiene from the First Affiliated Hospital of China Medical University, suffered a sudden cardiac arrest in the hospital laboratory.
The laboratory is only a few dozen meters away from the emergency department, so why call 120? For the rescue process, many emergency doctors have raised puzzles and questions. The emergency doctor and well-known popular science V "Emergency Nighthawk" pointed out sharply that the emergency process of sudden death in the graduate laboratory reflects the current situation of low-level emergency in some top hospitals.
According to the medical certificate (inference) of the death of the resident issued by the First Affiliated Hospital of China Medical University provided by the family of the deceased, it is stated in the death investigation record column that the patient suddenly fell to the ground 1 hour ago, and the surrounding classmates found that he was unconscious and immediately performed cardiopulmonary resuscitation and called 120. Upon arrival, SCP-120 continued to administer sustained chest compressions and establish an advanced airway with rescue medication, during which spontaneous circulation was not restored. After the patient was transferred to the emergency department, chest compressions were continued in the emergency department, and the final cause of death was respiratory and cardiac arrest.
The family of the deceased said that the laboratory of the First Affiliated Hospital of China Medical University was only a few dozen meters away from the hospital's emergency building. However, the 120 outpatient records on the same day show that there was a gap of 21 minutes between the accident and the ambulance arriving at the scene. In this regard, the family of the deceased questioned and said that it was difficult to accept.
According to "Top News", the first and second floors of the laboratory building are the washing center of the hospital, and the fifth floor is the laboratory.
"The laboratory building belongs to the workplace inside the hospital, and the graduate students belong to the staff of the hospital. When a cardiac arrest event occurs, the hospital's internal plan must be to call the emergency department. "Emergency Nighthawk" wrote on Weibo, "Even if 120 is a doctor, you should ask at the same time, why don't you call the emergency department of your own hospital to save people?" ”
"Emergency Nighthawk" believes that this shows that the implementation of the hospital's in-hospital emergency plan is not in place, the relevant areas lack AED allocation, the lack of personnel first aid training, and the laboratory safety management is not standardized. "Such a response is really not in line with the status of a top local hospital."
"The laboratory is only a few dozen meters away from the emergency room, and it is stupid to call 120." Jia Dacheng, a senior first-aid expert at the Beijing Emergency Center, who is known as "the first person in China's first-aid science popularization", told the "medical community" that the best way is to rescue someone while someone runs to the emergency room of the hospital and asks the emergency doctor to bring professional equipment, instruments, and drugs to the scene for rescue. Another way is that there are always people at the scene who insist on cardiopulmonary resuscitation, and at the same time send someone to the emergency bulldozer, and the doctor in the emergency room follows and puts the patient in the car to the emergency department, and compresses it uninterruptedly. "In this way, the patient may be sent to the emergency room within a few minutes, and it takes him 120 or 21 minutes (car) to arrive, which is too delayed."
In this regard, the First Affiliated Hospital of China Medical University responded to the media that the emergency department is responsible for the emergency diagnosis and treatment services of emergency patients who come to the hospital, while the pre-hospital emergency is responsible for 120, which does not belong to the hospital and is arranged by the Shenyang Emergency Center. Ning suddenly lost consciousness in the laboratory, and there were two students present, one student immediately performed cardiopulmonary resuscitation, and the other student immediately dialed 120. Before 120, the first student had been performing cardiopulmonary resuscitation, and after 120, Ning was sent to the emergency department of our hospital as soon as possible, and the emergency department immediately conducted a multidisciplinary consultation, but unfortunately failed to save Ning's life.
"How to save and whether the treatment can be successful are two different things, sometimes no matter how correct it is, it may not be saved, such as a sudden ventricular rupture, no matter how timely the rescue is, I am afraid it will not be able to be saved. This graduate student is so young and suddenly fell to the ground, it should still be an arrhythmia, as long as there is a defibrillator, it should be able to be saved, so this is really a pity. Jia Dacheng said that more than 80% of cardiac arrests are caused by ventricular fibrillation, and if defibrillation is removed in time, the success rate of rescue will be very high.
In the event of an accident in the non-medical area of the hospital, what should be the correct first aid measures?
Li Ling, attending physician of the Emergency Center of · Sichuan Provincial People's Hospital of Sichuan Academy of Medical Sciences, told the "medical community" that if medical staff find that someone is unconscious in the non-diagnosis and treatment area of the hospital, they must first evaluate according to the standard to confirm the patient's breathing, aortic pulse, etc.
"As long as the patient does not respond and the loss of consciousness is confirmed, the patient's posture should be quickly adjusted to a supine position, cardiopulmonary resuscitation should be done, and the hospital should be contacted at the same time." Li Ling explained that in the stage of loss of spontaneous circulation, cardiopulmonary resuscitation can maintain blood perfusion, which is a very important rescue operation.
At the same time, Li Ling also emphasized that after receiving the request for outpatient visits, the emergency department of the hospital should quickly dispatch doctors and nurses and carts to receive treatment. After receiving the patient, he should remain in the supine position, move the patient to the transfer cart, and rush to the emergency department while doing CPR.
Xu Shengyong, deputy chief physician of the emergency department of Peking Union Medical College Hospital, also said that if someone suddenly suffers cardiac arrest in the non-diagnosis and treatment area of Peking Union Medical College Hospital, the on-site personnel should do cardiopulmonary resuscitation directly on the scene and call the hospital rescue team at the same time. Most of the in-hospital rescue teams are in charge of the emergency department, and after receiving a request for in-hospital rescue, they will immediately follow the process to carry out first aid.
Xu Shengyong emphasized that once 120 receives a request for help for sudden loss of consciousness and cardiac arrest, the faster the better. Li Ling also said that the hospital has a requirement for 120 visiting time, that is, it must be out of the hospital and out of the car within a few minutes after receiving the demand. However, due to many complex and uncontrollable factors such as road conditions, the length of time it takes for the ambulance to arrive at the scene cannot be specified and required.
If an accident occurs in the hospital, Xu Shengyong believes that if 120 knows that it is an incident in the hospital, there is generally no need to send a car. He said that at this time, 120 will generally tell the help-seeker to carry out on-site cardiopulmonary resuscitation, find the nearest doctor for help, etc. However, in the aforementioned incident, the location of the incident is the teaching laboratory of the hospital, although it is very close to the hospital, it is not known whether it belongs to the area of responsibility for in-hospital rescue, and it is not clear whether the in-hospital rescue mode of the hospital is not clear. Of course, even if you are not in the rescue area of the hospital and are very close to the hospital, you can also ask the hospital emergency department for help, and it is generally possible to get emergency help from the hospital before 120 arrives.
According to the "surging news" report, the relevant departments of the First Affiliated Hospital of China Medical University said, "After the incident, the hospital and the school attached great importance to it, immediately set up a special emergency working group, communicated with the family many times, gave spiritual comfort and life care, and actively tried their best to cooperate with the family to deal with the aftermath." However, the two sides have not reached an agreement at present. ”