Novel coronavirus pneumonia was released in February 26th by Zhang and colleagues. 12 middle-aged and old uncle were also in the wheelchair. The 80 year old grandfather was sitting in a wheelchair.
In February 26th, novel coronavirus pneumonia patients were discharged from the Guangdong medical team. Picture provided by interviewee
Novel coronavirus pneumonia is one of the first hospitals in Hankou to receive new crown pneumonia. The situation in Wuhan is serious. On New Years Eve and the fourth day of the lunar new year, Guangdong Province sent the first batch of 127 medical and nursing personnel and the second batch of 148 medical and nursing personnel to form the Guangdong provincial medical team to support Hubei epidemic prevention and control (hereinafter referred to as Guangdong medical team), providing emergency support to the sixth and seventh respiratory districts of Hankou hospital.
Guo yabing, Professor of liver cancer center of infection department of Southern Hospital of Southern Medical University, is the first group leader of Guangdong medical team. In 2003, he was once a member of Xiaotangshan medical team of Southern Hospital of the former First Military Medical University. But compared with 17 years ago, the medical airborne soldiers came from more than 20 hospitals in the province, most of whom did not know each other. How to run in, adapt and cooperate with each other in a short time, and how to deal with the rampant epidemic together in a strange environment is undoubtedly a test for them.
The following is a dialogue between the reporter of the Beijing News and Guo yabing and Zhang.
If a hospital cant do it, the task can only be completed by division of work and cooperation
Beijing News: the medical team went to Wuhan this time, and the personnel organization was very fast.
Guo yabing: Yes. This novel coronavirus pneumonia, our first batch of medical teams came from 9 units, less than half a day to recruit people, starting the night, arrived at 4 oclock in the morning, second days on the shift to ward. Because of the hurry, we found some mistakes in the roster. For example, the people who originally signed up didnt come, or the people who temporarily changed didnt know each other.
Zhang Da Da: I belong to the second group. I will be better with the experience of the first group.
On the plane to Wuhan, the captains of our 18 hospitals met to understand each others personnel composition and material preparation. We found that a single hospital cant do anything. Only when all hospitals unite and work together can we accomplish this task.
For example, the health and Health Commission of Guangdong Province requires the team of each hospital to prepare two weeks of protective materials, but many hospitals are not infectious disease hospitals themselves, so it is impossible to prepare so much at one time. In this way, the hospitals will consult with each other, take out all the materials, and make use of them together.
In terms of personnel, the departments of each hospital are different, including respiratory department, infection department, ICU and endocrine department, so our second batch of 39 doctors were finally separated and divided into three groups.
Beijing News: when you arrived, what was Hankou hospital like?
Guo Yabing: novel coronavirus pneumonia is one of the first batch of designated hospitals in Hankou, and is facing the first wave of the epidemic. Wuhan: It used to be a general hospital, which temporarily vacated the sick room, so when we went, it was basically a mess.
At that time, it was the first day of the lunar new year. There were 80 patients in the ward with 30 people, only 2 doctors and 5 nurses. They ran around, feet down, their heads sweating. So many patients, we are now day shift is 5 doctors, 10 nurses at the same time out of control. So at that time, it was very messy. No one cleaned it. The ground was full of medical garbage.
Generally speaking, the disease is still severe and develops rapidly. I remember that at noon on the second day of the lunar new year, we took over the ward of critically ill patients. Within an hour or two, there were two or three people who couldnt do it. At night, there were two more who couldnt. Another day, a patient was pushed up from the emergency room, and there were no more patients before they arrived at the ward.
There were too many patients in the first few days. During the peak period, the daily outpatient volume of fever clinic was 1500 to 1600.
What is the concept? Our Southern Hospital of Southern Medical University started fever clinic at the earliest time in this epidemic. The number of outpatient clinics was less than 300 a day, and the time of reception was delayed to more than 2:00 at night. But the workload of Hankou hospital is five times that of us. Almost all of our staff have been smashed in, and we have been carrying it for nearly three weeks. I think if we come a little later, they may not be able to carry it, they may collapse.
Guo yabing and his teammates before the expedition. Photo by Zhou Xiaoqi, reporter of Beijing News
Zhang Dacheng: when I first got off the ward, I went to the bedside of the patient, and the patient would be very urgent to tell me where he was uncomfortable, and some patients would cry. This is probably because the original medical staff is not enough, and patients have little access to doctors, so they saw four doctors at once, as if they saw a life-saving straw. The doctor on duty said, this is Guangdong medical team coming to support us. I can feel that the patient is a little excited..
Beijing News: when you went to Hankou hospital, how were the medical staff?
Zhang Da Da: I entered the ward on the sixth day of the lunar new year. I took over the seventh area of breathing. At the time of shift handover, there was only one doctor from Hankou hospital in the whole ward, who was in charge of more than 70 patients. The doctor and we explained the patients situation bed by bed. After a round trip, roughly calculated, about 1 / 3 of the inpatients in the ward were our staff.
After the shift, the doctor left the hospital. Two days later, I heard that he was also hospitalized. On the day of shift handover, we all wore protective clothing and couldnt see our faces. I only knew that he was a middle-aged man called Dr. Liu.
Some people talk, some people quarrel, you have to understand him
Beijing News: when you first arrived in Wuhan, how did you feel?
Zhang Da: I came to Wuhan for a meeting half a year before the outbreak. At that time, I felt that Wuhan was developing rapidly and would catch up with Beijing, Shanghai, Guangzhou and Shenzhen. But this time, I found that the whole city was like falling asleep suddenly. There was almost no one in the street, only a few policemen occasionally. That kind of atmosphere is a little sad and a little desperate, which reminds people of the feeling that birds fly away from thousands of mountains and people trace away from thousands of paths. Under the influence of this kind of atmosphere, people were really depressed at that time.
On the first day when I changed the protective clothing in the ward, I could feel that everyone was very nervous, because I came to a strange hospital and place, and I was not familiar with the whole working process. At that time, we all felt the stones to cross the river, and several patients died in the early stage, which made us very depressed.
This may have a big impact on the doctor. On the one hand, most of the patients in the infection department are hepatitis B patients, and the number of critical diseases is relatively small. On the other hand, the vast majority of doctors and nurses are very kind. He may think that a 37 year old man is the pillar of his family, so there is no one left. He is not satisfied.
Since then, the doctor has become reticent and often stays in his room.
Beijing News: in this case, how do team members adjust their psychological conditions?
Zhang Da Da: one day when there were not many things on duty, I stood by the window with the doctor and chatted. He took the initiative to say that he didnt expect the situation here to be so bad. I said that if we come, we will be safe. If we have come, we will try our best to do something. We dont have to make a big difference. At present, there is no specific medicine or treatment method. A good injection within ones ability is a contribution. The whole epidemic can be gradually improved only if it accumulates little by little.
Another is to distract his attention and tell him about the scenic spots in Wuhan.
I chatted for nearly one night that day. When I went back to the hotel after work, I felt that his driving speed was much faster. I think his mood might be better.
Members of the Guangdong medical team assisted in Hankou hospital. Picture provided by interviewee
Beijing News: psychological pressure, is not the general situation of medical staff?
Guo yabing: it should be said that the situation in front line of Hankou hospital shocked us. After entering the ward on the first day, an old doctor with more than ten years experience told me that he could not sleep and had nightmares that night, and some medical staff would cry in the room. Because limited by the conditions, many of the treatment methods cant go on, our medical staff feel that they have the strength to make it impossible, they feel helpless and cant help seeing the patients.
In this case, the confidence of the team members will be greatly affected. Some people will come to you to talk, and some people will lose their temper and quarrel. You have to understand him in that state.
Beijing News: do you have any disagreements?
Guo yabing: there are still many quarrels. But the quarrel is not for anything else, it is for rescuing the patient, for using more and better methods to treat.
For example, some patients are seriously ill and doctors want to use ICU. We also went to the ICU. There are 16 beds and the hardware conditions are very good. But there is a problem - the ICU of Hankou hospital is for surgery, and the ventilation conditions can not meet the requirements of the infection department. After the scientific assessment, we had to turn it off.
But in this decision-making process, doctors have to quarrel with each other. Many people dont understand that so many experts from Guangdong neither intubate nor use ICU. What are they doing? They are very crazy to want to kill in, sometimes even in order to save people to lose their sense. But the reality is cruel, cant the patient didnt save down, the doctors safety cant guarantee.
Zhang Dacheng: sometimes, there will be disagreements due to different work processes and habits of different hospitals.
For example, when doctors change shifts, some hospitals may have to take a round for patients with mild or severe diseases, while some hospitals may only focus on patients with severe diseases; some hospitals may have to count all the instruments, drugs and even the number of infusion bags for each patient, and some hospitals do not need such trouble. Therefore, the shift handover at the early stage is chaotic, sometimes it takes two hours.
The important thing, the captains voted
Beijing News: the external conditions are so difficult. How can you work together to solve the problem?
Guo yabing: we are a temporary team. To become a fighting team, we need to break in.
On the night of next ward, we had a meeting with the team members. First of all, we need to understand the state of chaos. We do not need to be here without chaos. Our purpose is to control chaos. In the face of these disturbances, we must always be aware of our responsibilities, find ways to adapt, and calm down young people when they panic.
Then, we should do all kinds of basic things. We should be security guards, cleaners and transporters. For example, no one cleans the garbage, no one cleans and disinfects the goggles and protective screens, which is unimaginable at ordinary times. Now we have to pick up all these jobs, and we have to do them. A director is collecting garbage, and a professor level expert is washing and protecting eyeglasses. We are no longer stratified. We can go directly when we need to.
Including the problem of oxygen, we should solve it together. Nowadays, one of the most important treatments for severe patients is oxygen therapy. Some patients even need to use the ventilator for high flow oxygen. However, the oxygen pressure pipeline of Hankou hospital can only supply more than 30 people to take oxygen at the same time. Now, it needs to supply more than 300 patients in the whole hospital. The oxygen pressure is not enough and many equipment cannot be connected.
But doctors still want to save people, so they carry oxygen cylinders by hand every day. One oxygen bottle weighs more than 100 kg, only enough for one hour. A patient should have three or five oxygen bottles around him. We need about 50 or 60 bottles of oxygen every day. Some women doctors run like men carrying steel cylinders. In normal times, they cant carry them at all.
Zhang Da Da: in terms of working mechanism, we have slowly explored, re established a set of processes and habits, and simplified many problems. For example, when the shift is over, the critical patients turn over to the bedside, and the light patients dont have to walk down; in terms of instrument counting, because its in the blocked area, its OK to hand over the valuable drugs and instruments, and its unnecessary to push them all to one place to count.
In case of any disagreement among the team members of each hospital, the problem shall be referred to the team leaders of 18 hospitals for consultation. For important matters, 18 team leaders voted in the group. If there was a flat vote, it was Yao Lin, vice president of the Sixth Affiliated Hospital of Sun Yat sen University.
Beijing News: what have you done to prevent hospital infection?
Guo yabing: first of all, we should straighten out the various processes in the hospital.
Generally speaking, the infectious ward is divided into clean area, buffer area and pollution area, with a whole set of disinfection process. If we want to turn the general ward of the general hospital into the isolation ward, we also need to add many protective facilities and disinfection processes.
When we first arrived at Hankou hospital, we found that only a few doors were temporarily installed in the hospital, and the disinfection and isolation processes were not clear, which could easily cause the whole hospital to be polluted. At that time, it was impossible, because there was a shortage of staff and the process was difficult to implement.
After we arrived, we first carried out the hospital infection training and personal protection training. According to the rules, we wrote all kinds of procedures clearly, put all kinds of articles in order, and put clear signs on the walls.
In addition, every day there should be a supervisor on duty. The medical staff must go through the customs before entering the isolation ward. Everyone should check whether the hat and mask are put on according to the rules.
Beijing News: has the situation in the front line changed?
Guo yabing: in the last two weeks, things have been getting better and better. Its obvious that there is a shift from disorder to order. First of all, under the unified allocation of the headquarters, the beds are in a lot of order. As many patients leave the hospital, they will be allocated as many patients to be admitted.
Moreover, after the construction of the shelter hospital, the light patients have passed, and the treatment of the severe patients can be basically guaranteed. In the past, almost all the patients who stayed in the emergency room and corridor were admitted. There was a lot of quiet and less chaos in the hospital.
Now the patients with mild diseases have turned away, and the patients with severe diseases are more and more, accounting for nearly 70% of the total, and the workload is also increasing. But because the work became orderly, everyone felt less hard, and the team members gradually recovered their confidence, calm and stable. It turns out that we dont have time to work. Now we can work 8 hours.
The novel coronavirus pneumonia patients were discharged from the Guangdong medical team, and the left three was Zhang. Picture provided by interviewee
Zhang Da: we have a patient who is 33 years old, younger than me. When he came here, he had pneumonia, kidney failure, heart failure and metabolic acidosis. He was in a state of drowsiness, almost to the point of dying. We thought it might be out of the question. But for novel coronavirus pneumonia, we treated it for some time. For acidosis, we gave him alkaline substances and improved renal function. Maybe its also because of his youth. In such a bad situation, he was really saved. I still remember when he first came, he had a bad beard. When he got better, he shaved his beard. He was so handsome. Some little nurses took pictures with him.
On February 26, 12 patients in our ward were discharged. I can feel that everyone is very happy. In fact, doctors and nurses are very primitive and simple. The happiest thing is that they can save the patients who thought they could not.