I can see the status bar

Chapter 1031 D+4 day (6) (blood donation plus 052)

本章是为了感谢书友“书友141230212750325”于2021年7月18日在广州献血而特别加更。单次全血加更三章，今天是Chapter 3加更，已经全部加更完毕。感谢您的善举！
There is no clear imaging evidence and lack of strong nucleic acid test results.It is difficult to prove that a fever patient with a history of living in Yunhe is a patient with new coronavirus pneumonia.

It is even more difficult to prove that he is not, not only in medicine, but also in the actual operation process.

As the current "high-risk group", all passengers with a history of living in Yunhe need to undergo isolation medical observation at their location.After 14 days of isolation without any health problems and symptoms, it is necessary to accept home isolation for different lengths of time according to the "emphasis level" of different regions.

The local policy in Changning is currently relatively strict, requiring all personnel with a history of living in Yunhe to undergo at least two 14-day quarantine observations.Report your body temperature every day, and if you feel unwell, you must be sent to the nearest designated hospital for further examination.And this patient developed symptoms on the third day of isolation, so he was sent to Zhongfu Hospital.

"The patient himself stated that he had never been to the seafood market, nor had he had any contact with the confirmed person before. He came to Changning by car two days before the closure of the city." Mei Ying roughly explained the patient's situation, and then said, " After arriving in Changning, the patient began to be quarantined, and developed fever and cough on the third day of quarantine. According to the principle of proximity, he was sent to our Zhongfu Hospital."

"The CDC and the street have specially sent staff to disinfect the patient's living area, and the entire building where the patient lives is currently under closed control." Mei Ying's voice sounded a little worried, "If this patient is indeed infected If there is a new type of coronavirus, then we have to immediately vacate the entire inpatient department—we use all the five beds in 210 to treat patients, and we don’t know if we can take all the patients in this building.”

"There's no reason to send all the people in the building to the hospital, right?" Sun Lien was a little dazed when he heard this. Because of the shortage of medical resources on Yunhe's side, most of the fever patients had to be isolated at home.The purpose of this is to prevent the possible gathering of fever clinics and large-scale nosocomial transmission before the diagnostic ability can catch up.

Zhongfu Hospital, like many other hospitals, only has a few separate wards for clean treatment or isolation.Generally speaking, their inpatient department is still dominated by multi-person wards.And it is impossible for such a multi-person ward to meet the requirements of isolation and observation—until the accuracy of PCR improves, no one can guarantee that among the patients admitted for observation, there will not be one or two patients who are actually infected with the new coronavirus of patients.

And if there is indeed a carrier of the new coronavirus among the people in centralized isolation, nosocomial infections will appear in the entire ward or even the entire floor.There were big problems with this design from the very beginning.

"It must not be done like this." Mei Ying was also very worried about this problem.But the reality is that Changning City's Health Commission has arranged it this way. "Isolation points need to be remodeled, and medical personnel must also be stationed there. The daily life guarantees of the quarantined people must also be manned... The deployment and coordination of these things will take time. But the problem is... there is no time now."

Therefore, after talking about the topic for a while, I returned to the fundamental question - first of all, it is necessary to determine whether the patient is infected with the new coronavirus.

Sun Li'en was a little worried, if someone else was in Changning, even if he was in Ningyuan, he would know everything if he rushed over to take a look.But the status bar is useless if you don’t see people directly, and the imaging examination is not available for the time being...

People will lose their hair when they are worried, Sun Li'en now has a deep understanding of this - he felt a little itchy on his head, so he scratched it with his hands, and as a result a lot of black hair stubble came down.

It feels like I just went for a haircut, but I didn't wash it because I was in a hurry to go out.Sun Li'en shook the hair sticking to his hands casually, and then said to the phone, "You can send me the detailed information on WeChat, have you checked the peripheral blood lymphocytes of the patient?"

Judging from Sun Lien's experience in the North Fifth District in the past few days, patients who have progressed to the severe stage will start to have an inflammatory storm.Inflammatory storms come sooner or later, but eventually they will come.

The two key indicators for judging the beginning of an inflammatory storm are the interleukin-6 and the total number of peripheral blood lymphocytes that Sun Lien has been emphasizing.Once interleukin-6 levels increased and the total number of peripheral blood lymphocytes began to decline, the patient was likely already developing an inflammatory storm.

"The total number of peripheral blood lymphocytes has been checked, and it is now about 0.7. When I was just admitted to the hospital yesterday, it was 0.9." There was a sound of flipping paper from Meiying's side, and she said after a few seconds, "The value was reported today. Abnormal, but not yet critical."

"It would be strange if his state was critical." Sun Lien asked after thinking for a while, "How much C-reactive protein is there? Is there any cough or sputum?"

"27, I have a cough but it's a dry cough. The inflammation index has risen slightly compared to yesterday." Mei Ying sighed, "This is because I was in a hurry to seek medical treatment. There are no inspection items, and the gods can't figure it out..."

"I personally suggest that it is best to treat this patient according to the standards of a confirmed patient, and start evacuating the patient immediately." Sun Lien said seriously, "This symptom is indeed very similar. In the absence of imaging evidence and nucleic acid positive once, I suggest treating him at least as a highly suspected patient. After evacuating the inpatients as soon as possible, complete the chest CT examination of the patient immediately. And carry out precise management of his intake and output, and use bedside B-ultrasound at any time to judge the pulmonary edema .”

Mei Ying's voice immediately became serious, she stopped Sun Lien's barrage of explanations, and then muttered, "Wait a minute, I'll make a note."

The current national guideline is relatively "rough", and it is more of a directional and framework document.It lists some of the understanding of this new disease during this period of time, as well as the treatment suggestions of many experts for this disease.Of course, this can provide some reference for front-line clinicians, but it is impossible to completely follow the guidelines for treatment.

This is why Sun Lien kept emphasizing the "thousands of people and thousands of strategies" when he was treating patients with pneumonia caused by the new coronavirus in the comprehensive diagnosis center.As a new type of virus, people infected with the new coronavirus show a wide range of symptoms.From viral infection of the lungs causing ARDS, severe diarrhea with electrolyte imbalance, systemic organ damage caused by hypoxemia, to viral myocarditis caused by viruses infecting the heart through the blood... not to mention inflammatory storms and other unknown known damage.The more than 50 patients Sun Lien has seen in Guangbei District [-] can show him so many reasons for "patients dying after rescue", but he doesn't know how many symptoms he can't see.

And of course, these contents will not be put into the guide-this is like a difficult track guide for F1 racers. By the way, it should be written that "the left pedal is the brake, and the right pedal is the accelerator. "It's just as meaningless.

As long as the position and angle of each corner are written, the racers will figure out where to accelerate, where to brake, where to use the offensive line, and where to save the tire.If they can't even understand these things, then they can really consider changing careers to do something else.

But the premise that you can completely let go of it with the help of the guide is that the guide is detailed enough.

If the fight against the new coronavirus is a track, the current guideline at most shows the approximate location of one or two corners.At the same time, the track is still full of thick fog that will reduce visibility to 10 meters.

To race a car in a place like this... would kill someone.

(End of this chapter)