Emergency online essay collection

Emergency online essay collection (1): Thoughts on duty

Wang Chunting

It was an ordinary Sunday, the sky was slightly gloomy, accompanied by a slight The north wind is blowing, and for me, it’s another four-day duty day.

That month in the emergency intensive care unit, I listened to the night shift doctor explain the changes in each patient's condition one by one: bed 2 had no fever yesterday, bed 3 had stable hemoglobin, and bed 4 could not sustain non-invasive ventilation and oxygenation in the afternoon yesterday. Intubated... The seemingly calm ward was actually turbulent, and every slight change in the patient seemed to remind me not to be careless.

It was too late, but it was so fast. The handover was not over yet. The oxygenation of a patient with sleep apnea syndrome who was intubated had an "inexplicable" sudden drop, and he could not care about continuing to take over. I ran over and found that the oxygenation dropped and the ventilator waveform also lost its normal state. It was speculated that there might be airway obstruction. I immediately suctioned sputum but it was not effective, so I switched to a simple respirator. I found that the resistance during the air supply process was very large. I took a closer look at the trachea. The depth of intubation is 22cm, which is no problem for normal adults. However, this patient has a small mandible and a short neck. He could not help but adjust the depth of endotracheal intubation to 21cm. The air supply resistance became smaller, oxygenation gradually increased, and the tense atmosphere gradually became tense. Ease. Having said that, the reason why the patient's tracheal intubation depth changed may be related to his restless head position change and frequent coughing. Fortunately, there was no danger.

The sentence that every doctor hears the most when he or she comes into contact with clinical practice is "It's like walking on thin ice when facing an abyss"! Indeed, there is no room for ambiguity in medicine, especially after joining the workforce, I have a deeper understanding of the meaning given by the eight-character motto, and the responsibilities on my shoulders have become increasingly important. Of course, clinical work is not limited to understanding, analyzing and treating diseases. At the same time, the understanding and attitude of each patient and family member also affect the final prognosis of the disease.

Patient A is also a critically ill patient. When he visited, the family members of Patient A smiled and told the patient that all indicators were improving. They reassured the patient that they should cooperate well with the doctor and believe that the doctor will definitely get better from time to time. And tell jokes. When the family members of Patient B visited, their faces were full of sadness, with tears in their eyes. They told the patient to be strong, and then looked at each other as if they were parting from life. In fact, Patient A's condition is far more serious than that of Patient B, and such visits caused Patient B to become depressed after his family members left, and he even had thoughts of leaving this world. It's really sad to think about the same incident. The attitude of the family members can have such a different impact on the patient!

Hospitals are a corner of society, and because they often deal with life, they often reflect the most natural things about human beings. Therefore, in this small place, you can see all kinds of things in the world.

In fact, I want to say that "alive" means lucky; "alive" is also the reason why we continue to live seriously and hard!

Emergency Online Essay Collection (2): A Heart of Gratitude

Yang Weixia

Anyone who knows me knows that I talk fast, walk fast, and do things in a hurry. It's because I'm an emergency room nurse. Facing numerous patients suffering from diseases every day, handling various urgent medical orders, and rushing to work in various areas, I have become a veritable "female man".

Tonight I was on night shift, and I have been immersed in the treatment room since I took over. It was nearly eleven o'clock, and the noisy emergency room gradually became quiet as the night deepened. Listening to the howling north wind outside, I couldn't help but tighten my sweater. An old man in his sixties walked slowly into the hall alone, carrying a handbag. His steps were a bit slow and he looked very weak. I quickly went up to the old man and helped him: "What's wrong with you?" The old man didn't say anything. He raised his right hand and pointed at his left chest with difficulty. My heart skipped a beat, and I quickly helped the old man to sit down on the triage table and asked again. : "Is anyone accompanying you to see a doctor?" The old man took a breath, shook his head at me and said, "The children are busy at work! My wife is not in good health, so I came here on my own." Except for slightly high blood pressure, other physical signs were stable. I asked the old man for his medical insurance card and change, and helped him register. After completing the electrocardiogram and blood tests, the old man sat in the infusion area and breathed oxygen while waiting for the test results.

I chatted with the old man for a while and found out: The old man has been running to the hospital with his wife who has been seriously ill for a long time. He has not had a good rest in the past few days, and he has caught a cold. He couldn't stand it anymore tonight, so he came to the emergency room alone to see a doctor. His children are working They were busy and the old man felt sorry for them, so they kept it secret. The old man saw that our medical staff were busy, so he asked us to take care of other patients while he closed his eyes and rested.

After midnight, the old gentleman asked me when the test results would be available. I saw that he looked better and spoke with more strength, so I comforted him not to worry. It would take 90 minutes for the heart index test results to come out, and I would tell him as soon as the results were available. The old man looked at me, then at the clock on the wall, and murmured: "How can we not be in a hurry? I have to go back early, and I have to send my little granddaughter to school tomorrow morning!" Suddenly my heart was deeply touched. Touched, looking at the old man in front of him, he thought of his father. Since I work three shifts and my wife often travels for business and works overtime, my grandpa is responsible for picking up and dropping off my daughter from school every day, rain or shine, year after year, and has never distracted me. These elderly people just dedicated themselves silently, bearing their own illnesses and difficulties behind their backs... The test results are out! The old man's indicators were basically normal. The doctor told him to get more rest. The old man's energy was much better. He kept thanking our medical care and I sent him to the gate. The old man's figure soon disappeared into the twilight...

After I finished my shift, the north wind hadn’t stopped yet. There were more pedestrians on the road, and the lights of the residential building opposite came on. I seemed to see the old man busy sending his little granddaughter to school regardless of fatigue. I pray silently in my heart, may all the elderly in the world be healthy and safe! In this cold winter, accompanied by the rolling torrent of busy green, let us have more understanding and always be grateful!

A heart of gratitude

Emergency online essay collection (3): I want to send a banner to the patient’s family

Xu Shengyong

There are countless emergencies of critically ill patients have recovered with our help, so we often receive many banners expressing our gratitude. However, if possible, we really want to send pennants to patients and families!

Tell me a story:

There was a young man who was in good health. He developed cold symptoms (later confirmed to be a severe cold virus infection) and soon fell into severe respiratory distress. Failure, endotracheal intubation, ventilator, and admission to the emergency ICU were started. The ventilator support conditions were very high at first, and it took a lot of effort to strengthen the treatment. After 10 days, the lung condition began to slowly improve, but acute kidney disease occurred again. Failure, the patient soon developed anuria and required artificial kidney replacement therapy. At first, the patient was in a hypercoagulable state and needed to use several sets of disposable artificial kidney equipment (very expensive, two to three thousand yuan a set) in one night. After about 10 days, the patient's kidneys began to gradually improve, but he developed intractable diarrhea again, with more than 100 episodes of diarrhea per day, and the amount of diarrhea was about 10,000 ml per day. During the above-mentioned period, the patient also had a high fever of about 40°C every day. After another 20 days, the patient gradually improved in all aspects. The general secretary was hospitalized for nearly 2 months and spent more than 600,000 yuan. Happily, I recovered in the end with almost no sequelae.

The above process sounds simple, but the actual process is extremely arduous and difficult, with difficulties coming from all aspects. The medical staff spent a lot of effort during the whole process. At first, his lungs were in poor condition and he suffered from severe respiratory failure. He was on the verge of death every day. All kinds of treatments and care were done every day, which consumed a lot of manpower and material resources. During artificial kidney replacement therapy, especially in the first few days, severe hypercoagulability accompanied by gastrointestinal bleeding requires medical staff to guard the patient and the machine at all times to handle various alarms and adjust treatment at any time. When you have diarrhea, which occurs every 10 minutes, it is a huge problem just to clean the anus and perineum and prevent secondary infection. In addition, there are many details that cannot be described every day and can only be felt by the doctors and nurses at the time.

Because the patient was infected with a highly contagious virus, the fatigue during the treatment process reduced the immunity of medical staff. During the whole process, more than ten medical staff were infected, including those with high fever and diarrhea. , conjunctivitis, liver damage, pneumonia, etc. Although most of them got better within 10 days, one of the most severe cases almost had respiratory failure and had to be put on a ventilator. But throughout the entire process, no patient was infected.

The above-mentioned arduous and difficult diagnosis and treatment process is far from the most difficult. The most difficult thing is that every day, we don’t know what will happen tomorrow, and we don’t know what the next step of the patient’s condition will be. It is very likely that it will cost a lot of money. A large amount of money is lost in both human and financial resources (the average daily cost of patients during the peak period of the disease is nearly 20,000 yuan, and the family is an ordinary working-class person. They sold their houses in order to treat the disease. Fortunately, the houses in Beijing are valuable). It is very likely that in the end, both human and financial resources will be lost. At that time, family members did not understand the condition, which caused conflicts between doctors and patients, and the consequences were unpredictable. There are many unknowns in medicine, and there are many things that are powerless. No one knows what the outcome will be until the last moment. Therefore, all medical staff are under great psychological pressure every day, worried that the patient's family will not understand the condition and the possible bad outcome.

However, the patients and their families have been very cooperative and understanding of the medical staff from beginning to end. Although they are not medical students, they may not fully understand the patient's condition in detail, but no matter what happens to the patient, no matter what happens, During the treatment process, the family members trust and understand us very much about any treatment plan, treatment risks, etc., and even comfort our medical staff not to have any mental pressure. There is no doubt that as a parent, the pressure on your family members must be huge. Waiting outside the emergency ICU door every day, no one is more anxious than a parent.

Although family members are not the makers of the treatment plan, if the family members do not understand or trust the patient, it will certainly affect the doctor's diagnosis and treatment decisions to some extent. We can’t imagine that if the family members have distrust, for example, when the patient has a fever of around 40°C every day, has diarrhea more than 100 times a day, spends tens of thousands a day but the condition keeps getting worse, what if the family members have no trust in us? I don’t understand whether we can still stick to the established treatment plan without interference from family members. Most likely not.

If family members have some misunderstanding and distrust, and medical staff shrink a little in the face of difficulties, and lack the support of family members in the fight against the disease, the disease is likely to win, and the patient will die in the end. May slip from the edge of death to the abyss of death.

Therefore, one of the biggest contributors to a patient’s recovery is the support and understanding of the patient’s family. In the battle against the disease, our medical staff are in the same trench as the patients and their families!

After discharge, the patient and his family members sent us a banner; however, in fact, if possible, we would also like to send a banner to the patient's family to thank them for their understanding and trust.

Source: "Emergency Online" Editorial Department