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“救治危重病人,我们拼尽全力”——记四川大学华西医院援鄂重症救治医疗队

2020-09-18 董小红 新华网

全力救治重症患者,不顾一切与死神“赛跑”,“一人一方案、精准施治”……作为医疗界的“百年老店”,在支

全力救治重症患者,不顾一切与死神“赛跑”,“一人一方案、精准施治”……作为医疗界的“百年老店”,在支援武汉期间,四川大学华西医院援鄂重症救治医疗队抓住重症患者这一关键,不辱使命、不负重托,用一系列严谨、扎实的流程和制度,齐心协力、并肩奋战,圆满完成了重症救治任务。

一人一方案、精准施治

在支援武汉期间,康焰作为华西医院第三批援鄂重症救治医疗队队长,带领131名医护人员,于2月7日抵达武汉,受命援助武汉大学人民医院东院区,整建制接管两个危重症病区、共计80张床位。

“到达武汉后,我们发现一些病情相对稳定的病人与危重病人没能及时分级管理,重症病人的治疗效果也欠佳。我们立即进行了相关流程的梳理,及时对不同程度的重症病人进行分级管理,盯住危重症病人全力救治。”康焰说。

医疗队把病区细分为红区、黄区和绿区。红区收治危重病人,黄区收治可能从重症转向危重症的病人,绿区收治症状相对较轻的病人,有针对性地分配救治力量。

“一人一方案,精准施治。”康焰说,他们集中全力对重症病人早筛查、早集中、早治疗,尤其是对危重症病人进行每天会诊,每天都要对每一个病例进行治疗方案的优化。

新冠肺炎疫情发生以来,华西医院援鄂重症救治医疗队一共派出175名医务人员紧急驰援武汉,共接管7个危重症病区,负责259张床位的危重症患者救治,收治了667名患者。

与死神赛跑,提高护理质量也是重要环节。作为医疗队队员,到达武汉市红十字会医院时,护士长冯梅发现他们将与来自11个不同医院的护士合作,但来自呼吸、重症、感染等科室的人员很不足。

“为了提高护理质量,统一管理标准势在必行。”冯梅把专业的华西护理模式带到了武汉前线:成立病房临时护理管理小组,实行“护士长-专科护士-责任护士”三级责任制管理。在人员安排上,尽量保证每一班次都有当地医院本院护士在岗,每一班次都有呼吸、感染或重症专业且临床经验丰富的高年资护士在岗,治疗护理密集时段安排“华西护士+其他医院护士”组合,病房护理工作井然有序、安全高效。

收治危重病人,一刻都不能放松

“我不上前线,谁上前线!”大年初一,华西医院呼吸与危重症医学科教授罗凤鸣,带着21人的队伍奔赴武汉,进入距华南海鲜市场最近的武汉市红十字会医院,全力抗击疫情。

罗凤鸣按照华西医院的科室管理制定了相应的制度,科室主任和护士长负责,各个病区主任负责其病区的医疗和管理,病人的治疗效果得到很大提升。

“我们每天都要在群里讨论危重病人的情况。”医疗队队员徐原宁说,“没有特效药,每一位危重症患者的救治都是一场拉锯战,我们一刻都不能放松。”

有一位李婆婆曾是情况最危重的病人。“我们刚来时,她就住在这里了,情况很严重。”徐原宁说,这位婆婆年纪大,自身抵抗力不足,病情一直非常危险。

医护团队一直密切关注李婆婆的情况,想尽各种办法救治,保证氧气供应,持续补充营养,加强心理安抚,经过团队一周多的努力,李婆婆的各项指标才慢慢好转,后来顺利出院。

医疗队队员、华西医院应急办副主任晏会说,在接管病区后,他们团队立即成立了“华西-武大新冠肺炎重症救治中心”,针对传染病治疗的特点,建立了远程医学会诊模式,实现了不同医院、病区之间的危重症病人无缝床旁会诊,远程多学科病例讨论,大大提升了重症患者救治水平。

竭尽全力让患者顺畅呼吸

新冠肺炎会引起呼吸衰竭,大多数重症患者必须吸氧,才能开展后续治疗。在医疗队中,呼吸治疗师非常重要,可以说是前线隐形的“氧气医生”。

“前线收治的都是重型和危重型患者,基本上都需要呼吸支持——从普通氧疗到经鼻高流量氧疗。”在武汉大学人民医院东院区支援的华西医院呼吸治疗师倪忠说。

医疗队刚到武汉时,病房里有个67岁的患者,有20年的抽烟史,基础肺功能本来就比较差,感染病毒后,缺氧明显,情况危险。

“我们立即想办法改善他低氧的情况,先是用无创呼吸机,发现氧气压力和浓度都不够。后面又用床头的氧源接鼻塞供氧,同时再搬来一个大氧气钢瓶接上储氧面罩,给患者双重供氧,才让患者氧饱和度不断上升,缓解了明显缺氧的表现。”倪忠说。

在前线,呼吸治疗师往往要想尽办法解决患者的缺氧难题,同时,还要面临插管可能造成的被感染风险。

“有个病人情况很危急,需要紧急插管帮助他呼吸,但当时条件有限,不能完全达到应具备的防护标准,为了减少暴露风险,同事就紧急找了一个大塑料袋,在我的防护面屏下缠了一圈当成‘围脖’,就这样给病人插了管。”倪忠说。

“竭尽全力让患者顺畅呼吸是我们的使命!”倪忠说。

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    2020-10-05 日月
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  4. 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    2021-05-02 zll0635
  5. 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  6. 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    2021-09-03 xugc
  7. 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    2020-10-16 是魔是仙我说了算

    学习

    0

  8. 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authenticateStatus=null, createdAvatar=null, createdBy=53bc12401014, createdName=listen322, createdTime=Sun Sep 20 13:46:20 CST 2020, time=2020-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=886634, encodeId=ec73886634e4, content=尽力就好, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200924/7bd206330bbb4109818f49196c8e1710/dd483f19ecb749dfb0a975cd098bbddc.jpg, createdBy=58ee2077721, createdName=1591f17e2fm, createdTime=Sat Sep 19 13:02:53 CST 2020, time=2020-09-19, status=1, ipAttribution=)]
    2020-09-20 fengyqf
  9. 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    2020-09-19 1591f17e2fm

    尽力就好

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