I can see the status bar

Chapter 1048 D+6 day (6+7)

In the consulting room, Sun Lien was making a differential diagnosis at an unprecedented speed.

Of course, the basic laws and regulations still have to be met—even if the status column says that this fever is caused by purely psychological factors, Sun Lien has to honestly ask the patient to go to the blood draw center to draw blood first, and then see See the report results.

The blood test process is actually a very helpless standard process.It takes about a minute or two for a skilled nurse to draw a blood sample from a patient.There are currently six nurses working in the blood drawing center of He'an Hospital.It can provide blood test services for more than 2 people in one hour.

Now, Sun Lien has seen more than 70 patients in an hour, and this speed is still increasing.

The current process is that when the patient enters the ward, Sun Lien asks three to four questions, then issues a checklist, and comforts him with a sentence, "I don't think this is a new type of coronavirus infection, but just in case, let's do a checkup." have a look".

Of course, there will be many patients who feel that they have been waiting in line for hours, and the doctor just asked a few words about the process... It seems that they are a bit at a loss.At this time, Sun Lien would point to the paper he had printed next to him, and ask the patient who was not in a good mood to think again.

"Do you want yourself to be healthy and everything is just a false alarm, or is it 'not in vain' if you find out seven or eight diseases after queuing for three hours?" Such a sentence was posted on the wall. If they are not in a good mood, they will point to the sign and let them have a look.Basically all patients can be stunned for a while after seeing this sentence, and then suddenly realize, and honestly cooperate with the doctor to do examinations or prescribe medicines.

However, it was not that Sun Lien did not see infected people during the one-hour political consultation.When he saw the pregnant woman with "new coronavirus infection pneumonia" on her head walk into the room, he was really nervous.

The pregnant woman's name is Mo Zixuan, and the 90-year-old woman with the most classic common name of the post-28s generation is currently 30 weeks pregnant.Since the neighbor to the door is a confirmed case, and I started to have a fever three days ago, the highest body temperature reached 38 degrees Celsius, so I came to He'an Hospital for consultation today.

Sun Lien first asked the patient to sit down, and then took a portable fingertip oximeter from the table. After placing the detector, Sun Lien also handed over a mercury thermometer and asked her to take her temperature again.

From the point of view of intuitive observation, the patient is currently conscious and seems to be in good spirits.She had no cyanotic lips, but was slightly short of breath based on the rate at which her chest rose and fell.

"Dididi, Dididi." Just as Mo Zixuan clamped the thermometer under her arm, the oximeter on her finger started to alarm.According to a preliminary test, her blood oxygen saturation was 90%, which was on the boundary line between hypoxia and normal.

Transcutaneous hemoglobin oxygen saturation and blood oxygen partial pressure (mm Hg) are interrelated but complex indicators.Although clinically checking blood oxygen saturation is the fastest and most direct solution, to determine whether a patient has hypoxemia, the main diagnostic criterion should still be the oxygen partial pressure value in arterial blood gas analysis.

According to the prompt in the status bar, the patient is currently in a state of hypoxemia, but how low it is, this needs to be oxygenated and then an arterial blood gas analysis can be performed before it can be clarified.

After another auscultation, Sun Lien sat in the consulting room and frowned worriedly.Almost all vital signs and reference standards of pregnant women are different from those of nonpregnant women.But one thing is certain - the oxygen consumption of women during pregnancy is a bit higher than that of ordinary people.After all, the level of oxygen needed by two people is definitely not the same as the level of oxygen required by one person.

But no matter how much oxygen the pregnant woman needed, something was wrong and she needed immediate hospital treatment.Then Sun Lien began to worry again.

How do you admit it to the hospital?

"In this way, you first add another layer of this on the outside of your own mask." Sun Lien took out a medical surgical mask from his bag and handed it over. Although the pregnant woman was wearing an N95 mask, the mask was equipped with a breathing valve .The protective performance of this mask is still up to standard, but the existence of the breathing valve means that the mask cannot prevent the transmission of pathogens while wearing it.Therefore, for this pregnant woman who is "diagnosed in the status column", the top priority now is to put a medical surgical mask on her to prevent her from infecting other people.

"Okay." Mo Zixuan nodded, and after putting on the mask she asked, "Where am I going now?"

"You didn't come to the hospital alone, did you?" Sun Lien took out his cell phone and started making a call. He said while typing, "Let your escorts come in together, you all have to do a nucleic acid test."

"I came here alone, I... I got sick? Is it that disease?" I have to say that women are very careful at this time.After hearing Sun Li'en's words, she immediately tasted the difference.The efficient diagnosis style of this "doctor" has left a deep impression on all the patients queuing up at the door.Basically, all the people who come to see the doctor enter the door, sit down, then get up within 40 to 20 seconds, and walk out of the consulting room.A small number of patients will stay in the consulting room for more than ten to 3 seconds.But Mo Zixuan was different, she had already been in the consulting room for at least [-] minutes, and it seemed that this waiting was far from over.

Seeing the cautious look of this pregnant woman, Sun Li'en felt a little uncomfortable.Now in Yunhe, "new coronavirus" has become a topic that everyone talks about.Even the words "new crown virus" seem to have some kind of magical power that can make people sick.Ordinary people living in Yunhe mostly use "that disease" to refer to pneumonia infected by the new coronavirus, and they always look cautious when mentioning this word.

"I'm not sure now, but it's always good to check more." Sun Lien explained, "Your situation is still different from other people. On the one hand, there is someone in your stomach that needs oxygen and nutrients. On the other hand, Your neighbor across the door is positive — that raises your risk."

Sun Lien described a fact in very professional and abstract terms.In human society, all members are always willing to protect pregnant women.Because the safety of one pregnant woman means at least two will survive.From the point of view of income, the "income" of saving a pregnant woman is far greater than that of saving an ordinary person.To use an inappropriate analogy-one penny buys back two lives, this is called a "super high rate of return".

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Sun Li'en finally got through to Liu Pingchuan.Dean Liu seemed to have just come out of the red zone, and he was still out of breath.But he still maintains a very clear line of thought.After hearing Sun Lien's report, Liu Pingchuan's first question was the key, "How many weeks is she pregnant?"

"According to her pregnancy test records, 30 weeks." Sun Lien said.The pregnancy period is an important indicator to measure the safety of a pregnant woman. Before the 26th week, if a pregnant woman has any serious problems, the only way doctors can take is to terminate the pregnancy.There is basically no possibility of the fetus in the womb surviving.But after 26 weeks, every extra day gives the fetus a greater chance of survival.

Although 95 weeks is less than a month, as long as the child has no serious and irreversible congenital deformities, the survival rate of premature infants is almost [-]% under the mature care of premature infants in China, which can be said to be at the advanced level in the world.

30 weeks of pregnancy means that the chances of fetal survival are much higher.It also means that once the mother has a problem, the doctors can quickly start the cesarean section without worrying about whether the mother's situation can be stabilized and give the fetus a few more days to develop.

"Thirty weeks, then you can consider cesarean section." Liu Pingchuan was also thinking about this issue, "How is she doing now?"

"Oxygen at the fingertips is 90%, and the blood gas is to be checked. There are dry rales in the left lung and the middle lobe of the right lung on auscultation. No lower extremity edema was found, and the respiratory rate was slightly faster. No other problems were found in the preliminary examination." Sun Lien replied, "Our inpatient department can Can't accept it?"

"If she is diagnosed with the new crown, she must be admitted if she can't." Liu Pingchuan's attitude is very clear. "The level of treatment for new coronaviruses in designated hospitals is worse than here. Either there are no beds, or they can't admit pregnant women. Those who can admit pregnant women will be treated. Most of the new crowns are not as good as us—if you are counted, they are all worse.” Speaking of this, Liu Pingchuan raised another key question, “Do you think she is diagnosed?”

feel?Sun Li'en glanced at the top of Mo Zixuan's head. The status bar clearly stated that she was an infected person. Does it matter?
"I think the possibility is very high." Sun Lien said, "The patient's self-report and the confirmed patient are neighbors, and the symptoms of fever are indeed present. There is definitely inflammation in the lungs. It is too risky to ask her to observe and then go home. I suggest hospitalization. "

"Then accept it." Liu Pingchuan made a quick decision, "The obstetrics department on the sixth floor is empty now, and there is no problem in giving birth. I will have someone take a positive-pressure clean room right away, and you let her wait in the consulting room." If you need to give her oxygen, then let her go to the emergency room, Xiaotian has already gone to the emergency room."

"Xiao Tian" was probably the person who answered the phone before.Sun Lien finally had a clearer understanding of the colleague from the medical team who had never met but spoke in a very orderly manner—at least he knew that the other party's surname was Tian, ​​and he should be a female doctor in the respiratory department or infection department.

"Okay, I'll let her go now." Sun Lien hung up the phone and asked the pregnant woman, "Can you go now?"

"Yes." She nodded, and then asked a little uneasy, "Can I call home first?"

"You live with your family, right?" Sun Lien nodded, "Then give them a call, and then let them all come to the hospital together for a nucleic acid test."

"I...we don't live together." The woman said hesitantly, "Since I heard about this disease, my husband has let me live alone in this house. He will come to deliver meals to me every day , but leave it at the door and leave..."

Sun Li'en sighed, the family's precautionary awareness and methods were actually considered excellent from the perspective of ordinary people.But... Such a move still failed to stop the cunning and hard-to-see virus from invading.

Not only that, Mo Zixuan's husband who continued to deliver meals during this period, as well as other family members living with her husband, all have a high chance of infection.

Such preventive measures not only failed to prevent Mo Zixuan and her relatives from being infected, but also put her relatives at a higher risk of infection than before.

Sun Li'en nodded, and said helplessly, "You still need to contact them and let them all come for inspection."

"So... do I have this disease?" Mo Zixuan asked the question again, this time she seemed to have guessed the result.

"Until the nucleic acid test is done, no one will know the specific result. But... the probability is indeed very high." Sun Lien sighed, and then said with some sympathy and some active attempts to comfort him, "But your symptoms are very serious. It’s mild. If you maintain the current situation, you may only need to be hospitalized for about a week or two to recover. You can treat this situation as early hospitalization for labor.”

"My child!" Speaking of this, Mo Zixuan suddenly became nervous.She stood up abruptly from her seat, wrapped her hands around her abdomen, and made a protective gesture, "He...he will be okay?"

"At present, there is no evidence to prove that the new coronavirus can cause vertical transmission in the uterus." Sun Lien explained seriously, "Did you feel normal fetal movement recently? The frequency is the same as before?"

"There is no difference. It is around nine o'clock in the morning and ten o'clock in the evening every day." The mother-to-be seemed to relax a little, she sat down slowly and said, "Even if I have a fever these days, the frequency Pretty much the same."

"Then it's not a big problem." Sun Li'en nodded, but the status bar didn't indicate anything abnormal about the fetus.But to be honest, the status bar has never encountered abnormal fetal conditions.He wasn't even sure if the "no prompt" in the status bar was because the fetus was indeed fine, or because he hadn't seen the "top of the head" of the fetus.

Calculated according to the time of pregnancy, under normal circumstances, the fetus should have turned into a head-down state.Of course, the fetal position may not be fixed at this time - there are also lively children turning around in their mother's womb.

"Then it's not a big problem." Sun Li'en reassured the mother-to-be in front of him again, "If you can walk now, go directly to the emergency department. There is a doctor on duty there, and she will give you oxygen first, to ensure that The safety of you and your child. Then take a nucleic acid sample for you, and then arrange for your hospitalization. Let your family members come over and bring you some change of clothes, and ask them to wear masks before entering the hospital—like you Such N95s with breathing valves can no longer be used.”

　Today's work efficiency is low, it took me a whole day to write so much content... This chapter is 4K, everyone, please treat me as two chapters combined into one chapter and post it...

　　
　
(End of this chapter)