MTLNOVEL I can see the status bar
Chapter 224 Research
Chapter 224 Research
Days are a strange thing.Sometimes every second of a day seems like a year.And sometimes, half a month is just a blink of an eye.
As for Sun Lien's experience these days, it was like turning a glance.
Since the duty time was adjusted to be the same as that of Zhou Jun, Sun Lien had a lot of free time at once.No kidding, the first-line doctors suddenly enjoyed the duty frequency of the third-line doctors.From working six days a week to three days a week, there are no people who can adapt to this change at once.
However, adjusting the order of duty does not mean that Sun Li'en will be able to herd sheep completely.I go to the hospital with Zhou Jun every Monday, Wednesday, and Friday, and I have to go to the laboratory to soak in the second, fourth, and sixth days.Originally, there was one rest day a week, but now it is good, and there is no time to catch a breath.
Of course, Sun Lien was somewhat dissatisfied with this arrangement. No one would like a life of working seven days a week.But Sun Li'en couldn't express his dissatisfaction directly anyway, the reason is very simple - Zhou Jun did the same.
Sun Li'en himself has not given an opening report, and no one has come to tell him what project he should research.As the associate professor in charge of teaching in Liu Tangchun's laboratory, Zhou Jun is also responsible for opening questions.But Sun Lien will only enroll next year, and there are really no projects in the entire laboratory that can be given to him.
After much deliberation, Zhou Jun decided to let Sun Lien participate in a project that was almost completed.At least let Sun Lien get in touch with scientific research projects first, and gradually build up some experience.In this way, when he transferred to other projects later, Sun Li'en would not bump around like a headless chicken.
"So you are mainly engaged in research on cardiopulmonary resuscitation?" In the dormitory, Dr. Cao and Sun Lien were sitting in the living room, with several bottles of beer on the table in front of them.The photo in Sun Lien's circle of friends has been posted for half a month, and the impact it caused cannot be expressed in a few words.Dr. Cao couldn't stand it anymore - everyone in the laboratory knew that he had to kneel down to answer when he provoked his girlfriend.Therefore, Dr. Cao decided to treat Sun Lien to a drink, and then threatened and lured him to delete the photos.It's just that this purpose seems to have been forgotten by him long ago, and he began to be curious about the projects Sun Lien participated in.
"I'm actually a handyman." Sun Lien took a sip of beer. Tomorrow is Sunday, so he doesn't have to go to the hospital on duty.So there is no psychological pressure to drink. "Brother Xu's research data has basically been collected. My main job now is to regularly call and follow up with the family members of the patients who have been treated as research data."
Brother Xu, whose name is Xu Shengyong, is a student of Liu Tangchun.As a postgraduate student in the direction of cardiopulmonary resuscitation in emergency medicine, his research project is very straightforward-"Analysis of the Effect and Influencing Factors of Cardiopulmonary Resuscitation in the Emergency Department".
Cardiac arrest (CA) is the most critical clinical situation. When the cardiac ejection function suddenly stops and the mechanical activity of the heart disappears completely, the blood supply to the whole body will be interrupted immediately.Loss of consciousness occurs when the blood supply to the brain is interrupted for about 10 seconds.It is generally believed that if the heart stops beating for more than 5 minutes, the brain will suffer irreversible damage, and if the heart stops beating for more than 15 minutes, more than 95% of the brain tissue will be damaged.Therefore, in clinical medicine, there is no disease state that is more critical than cardiac arrest, which is also the last common clinical path for many critically ill patients.Cardiopulmonary resuscitation (CPR) is the most important and only emergency medical method for rescuing victims of sudden cardiac arrest.
And cardiac arrest is not simply "heart not beating".From the analysis of ECG, there are four types of cardiac arrest, namely ventricular fibrillation (VF), pulseless ventricular tachycardia (VT), pulseless electrical activity (PEA) and cardiac arrest (ASY).Among them, VF and VT can be treated by defibrillation, so these two types of cardiac arrest are also called shockable heart rates.PEA and ASY are non-shockable heart rates.So, contrary to what most people think, not all CPR sessions involve a defibrillator.
However, modern CPR technology has been developed for almost half a century, but the overall mortality rate of cardiac arrest patients has not been fundamentally improved.According to a multicenter study report in North America, among the 20520 patients with out-of-hospital cardiac arrest (OHCA) they included in the evaluation, the survival rate to hospital discharge ranged from 3.0% to 16.3% in each center.Across all centers, a total of 954 (4.6%) patients survived to discharge.
Yes, in North America, where CPR first aid knowledge is promoted on a large scale, less than 5% of patients with cardiac arrest outside the hospital are able to leave the hospital alive.However, domestic statistics and their prognosis are less optimistic than those in the United States. In 03, 4166 OHCA patients were treated in the Shanghai Emergency Center, and 143 patients had ROSC before hospitalization, and only 1 patients survived and were discharged. 0.02 case ([-]%) only.
In film and television works, the scenes where the heart stops beating, chest compressions and artificial respiration are performed, and finally the handsome electrode plate is placed on the person's chest, and the scene where the person can be rescued by electrification is actually a rare scene.Ventricular fibrillation (VF) due to myocardial infarction is relatively easy to manage.The "chest pain centers" hung in major emergency centers are actually dedicated to treating patients with acute myocardial infarction.
The data that Sun Lien came into contact with during this period is actually very shocking. He has been working in the emergency department for more than two months and almost three months. Not a bad result.Therefore, when seeing the data of 0.02%, Sun Lien's first reaction was "Is this data wrong?"
But the data will not lie. Xu Shengyong's data was collected from the Emergency Department of the Fourth Central Hospital.During the four-and-a-half-year research period, there were 73 emergency patients, more than 4000 people were observed, and 1.9 patients were rescued, accounting for 1936% of the total. Among them, there were 2.6 cases of cardiac arrest, accounting for 13.6%. 597‰ of the patients who visited the doctor, and 59.5% of the patients who were rescued.In the study, a total of 17.9 people were included in the study, with an average age of 103±18 years, the oldest patient was [-] years old, and the youngest was [-] years old.
In the rescue at the Fourth Central Hospital, after cardiopulmonary resuscitation, up to 36.7% of patients were able to achieve spontaneous recovery of circulation, but only 3.2% were able to survive and be discharged. The most valuable effect of CPR, survival and discharge with good neurological function, accounted for only 2.7% of all cases studied.
Only 597 of the 16 people survived and were discharged from the hospital with good neurological function.This is the achievement of the Fourth Central Hospital, the largest emergency center in the region, and a large emergency pilot unit in the past four years.As for those who were not included in the study, except for a dozen who were younger than 18 years old and were excluded because they did not meet the ethical review, most of the patients were voluntarily discharged from the hospital after their family members refused to rescue them or suffered cardiac arrest.It can be speculated that their endings are basically death.That is to say, in the past four years, about 1900 people were sent to the Fourth Central Hospital for emergency treatment due to cardiac arrest, and 16 of them were able to complete activities such as eating, dressing, and going to the toilet without relying on others and were discharged from the hospital. Although the other three survived down, but still with severe nerve damage.
Is CPR really necessary?Sun Lien looked at the data in his hand and fell into another confusion. He did CPR, and Zheng Guoyou was pressed by Sun Lien.The old man probably belonged to one of the very lucky 2.7% who showed hardly any neurological sequelae.
Wu Fenmei, who contracted bird flu, was transferred to the Second Hospital for intensive treatment after her condition stabilized.Sun Lien didn't know the specific situation - when Wu Fenmei was transferred, Sun Lien was still playing with his mobile phone in the isolation room.But at least, Sun Lien can be sure that before he fainted, Wu Fenmei returned to sinus rhythm.She is also lucky, at least luckier than the 63.3% of cardiac arrest patients.Over a long period of time, with a large dose of adrenaline, and multiple electrical defibrillations, he was able to return to a state of sinus rhythm. At first, Sun Lien didn't feel that he was doing so well, but with these data, he couldn't help it. Don't revisit the advantages that the status bar brings.
Is it possible that if there are several reminders, it will definitely allow the patient to recover spontaneous circulation?
·
·
·
After drinking for a short time, Sun Lien opened a total of seven bottles of beer, and Brother Cao couldn't hold it anymore—four of them were drunk by Sun Lien himself.
"You dare to come out and drink with others with only three bottles of beer?" Sun Lien really couldn't bear it when he saw someone drink a bottle of beer for the first time.Brother Cao’s state of vomiting after drinking three bottles of beer in 10 minutes even made Sun Lien wonder if his roommate had taken antibiotics before drinking beer—a disulfiram-like reaction would prevent the body from metabolizing alcohol, causing alcohol to remain in the body Accumulation, and this reaction is potentially fatal.
However, under the double confirmation of the status bar and the inquiry, Sun Lien confirmed that Dr. Cao was simply poor in drinking.This reassured him a lot.
After carrying Dr. Cao into the room, Sun Li'en walked to the balcony.He looked at the moon in the sky, and the white gas from his mouth covered the soft moonlight like a cloud.
Doctors are human too, and frustration and self-doubt are inevitable when the blunt research data seems to vaguely mock him for the futility of everything he does.
The moonlight tended to intensify, and the cold north wind woke up the thinly dressed Sun Li'en.
No, how could it be useless work?Without those 10 minutes of chest compressions, Zheng Guoyou would have become a martyr long ago.Without the eleven times of defibrillation, Wu Fenmei would definitely die on her birthday.Those hard work were not in vain. Even under the research data, 3.2% of patients survived due to cardiopulmonary resuscitation.
If there were no doctors who tried their best to rescue them, these nineteen people would not have survived.
The work of emergency doctors is like this. Not everyone will be saved, but those who are saved will survive because of the doctors' best treatment.
The article "Analysis of Cardiopulmonary Resuscitation Effect and Influencing Factors in Emergency Department" is a postgraduate dissertation from Peking Union Medical College Medical College and Chinese Academy of Medical Sciences in 15.The author is Xu Shengyong, and the instructor is Professor Yu Xuezhong.Mentor Group: Prof. Guo Shubin, Prof. Zhu Huadong
(End of this chapter)
Days are a strange thing.Sometimes every second of a day seems like a year.And sometimes, half a month is just a blink of an eye.
As for Sun Lien's experience these days, it was like turning a glance.
Since the duty time was adjusted to be the same as that of Zhou Jun, Sun Lien had a lot of free time at once.No kidding, the first-line doctors suddenly enjoyed the duty frequency of the third-line doctors.From working six days a week to three days a week, there are no people who can adapt to this change at once.
However, adjusting the order of duty does not mean that Sun Li'en will be able to herd sheep completely.I go to the hospital with Zhou Jun every Monday, Wednesday, and Friday, and I have to go to the laboratory to soak in the second, fourth, and sixth days.Originally, there was one rest day a week, but now it is good, and there is no time to catch a breath.
Of course, Sun Lien was somewhat dissatisfied with this arrangement. No one would like a life of working seven days a week.But Sun Li'en couldn't express his dissatisfaction directly anyway, the reason is very simple - Zhou Jun did the same.
Sun Li'en himself has not given an opening report, and no one has come to tell him what project he should research.As the associate professor in charge of teaching in Liu Tangchun's laboratory, Zhou Jun is also responsible for opening questions.But Sun Lien will only enroll next year, and there are really no projects in the entire laboratory that can be given to him.
After much deliberation, Zhou Jun decided to let Sun Lien participate in a project that was almost completed.At least let Sun Lien get in touch with scientific research projects first, and gradually build up some experience.In this way, when he transferred to other projects later, Sun Li'en would not bump around like a headless chicken.
"So you are mainly engaged in research on cardiopulmonary resuscitation?" In the dormitory, Dr. Cao and Sun Lien were sitting in the living room, with several bottles of beer on the table in front of them.The photo in Sun Lien's circle of friends has been posted for half a month, and the impact it caused cannot be expressed in a few words.Dr. Cao couldn't stand it anymore - everyone in the laboratory knew that he had to kneel down to answer when he provoked his girlfriend.Therefore, Dr. Cao decided to treat Sun Lien to a drink, and then threatened and lured him to delete the photos.It's just that this purpose seems to have been forgotten by him long ago, and he began to be curious about the projects Sun Lien participated in.
"I'm actually a handyman." Sun Lien took a sip of beer. Tomorrow is Sunday, so he doesn't have to go to the hospital on duty.So there is no psychological pressure to drink. "Brother Xu's research data has basically been collected. My main job now is to regularly call and follow up with the family members of the patients who have been treated as research data."
Brother Xu, whose name is Xu Shengyong, is a student of Liu Tangchun.As a postgraduate student in the direction of cardiopulmonary resuscitation in emergency medicine, his research project is very straightforward-"Analysis of the Effect and Influencing Factors of Cardiopulmonary Resuscitation in the Emergency Department".
Cardiac arrest (CA) is the most critical clinical situation. When the cardiac ejection function suddenly stops and the mechanical activity of the heart disappears completely, the blood supply to the whole body will be interrupted immediately.Loss of consciousness occurs when the blood supply to the brain is interrupted for about 10 seconds.It is generally believed that if the heart stops beating for more than 5 minutes, the brain will suffer irreversible damage, and if the heart stops beating for more than 15 minutes, more than 95% of the brain tissue will be damaged.Therefore, in clinical medicine, there is no disease state that is more critical than cardiac arrest, which is also the last common clinical path for many critically ill patients.Cardiopulmonary resuscitation (CPR) is the most important and only emergency medical method for rescuing victims of sudden cardiac arrest.
And cardiac arrest is not simply "heart not beating".From the analysis of ECG, there are four types of cardiac arrest, namely ventricular fibrillation (VF), pulseless ventricular tachycardia (VT), pulseless electrical activity (PEA) and cardiac arrest (ASY).Among them, VF and VT can be treated by defibrillation, so these two types of cardiac arrest are also called shockable heart rates.PEA and ASY are non-shockable heart rates.So, contrary to what most people think, not all CPR sessions involve a defibrillator.
However, modern CPR technology has been developed for almost half a century, but the overall mortality rate of cardiac arrest patients has not been fundamentally improved.According to a multicenter study report in North America, among the 20520 patients with out-of-hospital cardiac arrest (OHCA) they included in the evaluation, the survival rate to hospital discharge ranged from 3.0% to 16.3% in each center.Across all centers, a total of 954 (4.6%) patients survived to discharge.
Yes, in North America, where CPR first aid knowledge is promoted on a large scale, less than 5% of patients with cardiac arrest outside the hospital are able to leave the hospital alive.However, domestic statistics and their prognosis are less optimistic than those in the United States. In 03, 4166 OHCA patients were treated in the Shanghai Emergency Center, and 143 patients had ROSC before hospitalization, and only 1 patients survived and were discharged. 0.02 case ([-]%) only.
In film and television works, the scenes where the heart stops beating, chest compressions and artificial respiration are performed, and finally the handsome electrode plate is placed on the person's chest, and the scene where the person can be rescued by electrification is actually a rare scene.Ventricular fibrillation (VF) due to myocardial infarction is relatively easy to manage.The "chest pain centers" hung in major emergency centers are actually dedicated to treating patients with acute myocardial infarction.
The data that Sun Lien came into contact with during this period is actually very shocking. He has been working in the emergency department for more than two months and almost three months. Not a bad result.Therefore, when seeing the data of 0.02%, Sun Lien's first reaction was "Is this data wrong?"
But the data will not lie. Xu Shengyong's data was collected from the Emergency Department of the Fourth Central Hospital.During the four-and-a-half-year research period, there were 73 emergency patients, more than 4000 people were observed, and 1.9 patients were rescued, accounting for 1936% of the total. Among them, there were 2.6 cases of cardiac arrest, accounting for 13.6%. 597‰ of the patients who visited the doctor, and 59.5% of the patients who were rescued.In the study, a total of 17.9 people were included in the study, with an average age of 103±18 years, the oldest patient was [-] years old, and the youngest was [-] years old.
In the rescue at the Fourth Central Hospital, after cardiopulmonary resuscitation, up to 36.7% of patients were able to achieve spontaneous recovery of circulation, but only 3.2% were able to survive and be discharged. The most valuable effect of CPR, survival and discharge with good neurological function, accounted for only 2.7% of all cases studied.
Only 597 of the 16 people survived and were discharged from the hospital with good neurological function.This is the achievement of the Fourth Central Hospital, the largest emergency center in the region, and a large emergency pilot unit in the past four years.As for those who were not included in the study, except for a dozen who were younger than 18 years old and were excluded because they did not meet the ethical review, most of the patients were voluntarily discharged from the hospital after their family members refused to rescue them or suffered cardiac arrest.It can be speculated that their endings are basically death.That is to say, in the past four years, about 1900 people were sent to the Fourth Central Hospital for emergency treatment due to cardiac arrest, and 16 of them were able to complete activities such as eating, dressing, and going to the toilet without relying on others and were discharged from the hospital. Although the other three survived down, but still with severe nerve damage.
Is CPR really necessary?Sun Lien looked at the data in his hand and fell into another confusion. He did CPR, and Zheng Guoyou was pressed by Sun Lien.The old man probably belonged to one of the very lucky 2.7% who showed hardly any neurological sequelae.
Wu Fenmei, who contracted bird flu, was transferred to the Second Hospital for intensive treatment after her condition stabilized.Sun Lien didn't know the specific situation - when Wu Fenmei was transferred, Sun Lien was still playing with his mobile phone in the isolation room.But at least, Sun Lien can be sure that before he fainted, Wu Fenmei returned to sinus rhythm.She is also lucky, at least luckier than the 63.3% of cardiac arrest patients.Over a long period of time, with a large dose of adrenaline, and multiple electrical defibrillations, he was able to return to a state of sinus rhythm. At first, Sun Lien didn't feel that he was doing so well, but with these data, he couldn't help it. Don't revisit the advantages that the status bar brings.
Is it possible that if there are several reminders, it will definitely allow the patient to recover spontaneous circulation?
·
·
·
After drinking for a short time, Sun Lien opened a total of seven bottles of beer, and Brother Cao couldn't hold it anymore—four of them were drunk by Sun Lien himself.
"You dare to come out and drink with others with only three bottles of beer?" Sun Lien really couldn't bear it when he saw someone drink a bottle of beer for the first time.Brother Cao’s state of vomiting after drinking three bottles of beer in 10 minutes even made Sun Lien wonder if his roommate had taken antibiotics before drinking beer—a disulfiram-like reaction would prevent the body from metabolizing alcohol, causing alcohol to remain in the body Accumulation, and this reaction is potentially fatal.
However, under the double confirmation of the status bar and the inquiry, Sun Lien confirmed that Dr. Cao was simply poor in drinking.This reassured him a lot.
After carrying Dr. Cao into the room, Sun Li'en walked to the balcony.He looked at the moon in the sky, and the white gas from his mouth covered the soft moonlight like a cloud.
Doctors are human too, and frustration and self-doubt are inevitable when the blunt research data seems to vaguely mock him for the futility of everything he does.
The moonlight tended to intensify, and the cold north wind woke up the thinly dressed Sun Li'en.
No, how could it be useless work?Without those 10 minutes of chest compressions, Zheng Guoyou would have become a martyr long ago.Without the eleven times of defibrillation, Wu Fenmei would definitely die on her birthday.Those hard work were not in vain. Even under the research data, 3.2% of patients survived due to cardiopulmonary resuscitation.
If there were no doctors who tried their best to rescue them, these nineteen people would not have survived.
The work of emergency doctors is like this. Not everyone will be saved, but those who are saved will survive because of the doctors' best treatment.
The article "Analysis of Cardiopulmonary Resuscitation Effect and Influencing Factors in Emergency Department" is a postgraduate dissertation from Peking Union Medical College Medical College and Chinese Academy of Medical Sciences in 15.The author is Xu Shengyong, and the instructor is Professor Yu Xuezhong.Mentor Group: Prof. Guo Shubin, Prof. Zhu Huadong
(End of this chapter)
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