Doctor's Life Simulator

Chapter 43 Simulating to Create the Best Formula: Hecheng Qin's Rehydration Formula
For the first time, in the face of such a situation, even though the top management tried to arrange it as reasonably as possible, everyone still felt the urgent pressure due to the fact that there were too many patients, especially some small doctors, who were still a little flustered and nervous.

Wu Youtu's tone was calm:

"Qin Lang, Cheng Yunfeng, follow Qian Liang to treat patients, apply analgesic drugs in time, open intravenous access as soon as possible, formulate a reasonable rehydration plan, and resist shock!"

"Alright, Qin Lang, Cheng Yunfeng, follow me!"

Qian Liang waved his hand and took the two of them there. I have to say that there are really a lot of patients with extensive burns this time. The emergency department and the burn department have admitted and treated at least [-] patients so far. Moreover, there are follow-up patients on the way of continuous transfer.

On the hospital bed, there were shockingly severely burned patients lying one after another. Their noses were full of stench and scorching. Even a senior resident like Qian Liang was a little flustered for a while.

However, at such a moment, the doctors couldn't allow themselves to think too much, so they threw themselves into the rescue immediately.

". First establish a double vein channel"

Qian Liang started to issue orders immediately, and began to rehydrate these patients in the early stages of shock. After thinking about it, he planned to use the most traditional rehydration formula for rehydration.

Shock is one of the common clinical symptoms in patients with moderate and moderate burns.

The reason for burn shock is the symptoms of low blood volume caused by the extravasation of the patient's plasma. The permeability of blood vessels increases, resulting in the rapid consumption and loss of body fluids.

However, the few people Qian Liang and Qin Lang faced had extensive burns (>50%). Due to dehydration, electrolyte imbalance, autonomic nervous dysfunction and other reasons, they had already developed varying degrees of fever, endocrine disorders, neurological disorders, etc. functional impairment, etc.

The situation is very critical, so it is urgent to rehydrate them, and through rehydration therapy, the symptoms of shock can be improved.

However, there are various formulas for calculating the amount of fluid infusion in clinical practice. Moreover, there are large individual differences among different patients, and the clinical indicators are somewhat lagging.

In this case, it is a test of the doctor's clinical experience, otherwise it is very easy to cause excessive fluid replacement.

General clinicians often have a tendency to increase and increase, which often causes adverse reactions in patients with acute heart failure, cerebral edema, pulmonary edema, wound deepening and abdominal compartment syndrome.

In addition, the speed of infusion during rehydration will also affect the patient's recovery. Too fast infusion can easily cause the blood concentration of the drug to increase rapidly, resulting in a narrowing of the therapeutic index, or due to the toxic effect of some drugs with high toxicity, affecting the patient's recovery. treatment effect.

But this time, due to the sudden batch of burn patients, they were divided into many areas and many groups, each of which was in charge of different attending physicians, or resident physicians who had been in residence for more than five years, for rehydration.

Doctors with different levels will definitely have transitional rehydration. Therefore, the best way is to propose an optimal rehydration formula in a short period of time and in a large area, and then, in the follow-up, for Different patients, individualized fluid adjustments!
[Ding, new task: determine the best formula for rehydration through simulated rehydration plan, and promote it in all departments.At the same time, for patients in their own group, individualized fluid replacement adjustments will be made in the follow-up to prevent excessive fluid replacement and reduce the occurrence of various sequelae.Task rewards: 1. Life simulation points, 2. Bear dragon technique, entry level]

With the simulation points in hand, don't panic. These days, Qin Lang has accumulated 4 simulation points.

"Consume 1 life simulation point!"

[A major fire broke out at the Hecheng Chemical Plant, and batches of patients with extensive burns were sent to the emergency department and burn department of the No. [-] Hospital of the city.You are assigned to the third group of Wu Youtu. For patients with shock, you start to use the formula of rehydration to start rehydration. 】

[Different physicians gave different rehydration formulas, and basically used the Jinling burn rehydration formula, or the third military hospital university burn rehydration formula.A very small number of senior attending physicians adopted a personalized fluid replacement plan.Your group, under your suggestion, Qian Liang adopted your plan. 】

[In the subsequent review and summary, during this rescue operation, many patients still had some sequelae due to excessive fluid replacement.According to the data statistics, in terms of the collection and calculation time of calculating the fluid replacement index, the time of using Jinling burn fluid fluid formula has an objective advantage compared with the burn fluid fluid formula of the Third Military Medical University. 】

[Summary and conclusion afterward: Calculating the reference index of fluid replacement by the Jinling formula for rehydration for burns only needs to estimate the burn area, while the formula for fluid replacement for burns by the Third Military Medical University also needs body mass when estimating the area of ​​burns. , The order of the burn scene was chaotic, and it was difficult to achieve timely self-rescue and mutual rescue, resulting in relatively severe burns.Moreover, the admission time is concentrated, the recovery is not timely during the transfer, many patients are in shock, and a large number of wounded cannot be uniformly measured in a limited time after admission, and it is not suitable to measure the body weight of severely burned patients in the early stage.Moreover, the Jinling formula for rehydration for burns can significantly shorten the calculation time for 8h rehydration. 】

[Best solution: use Jinling burn rehydration formula early, and pay attention to the personalized treatment plan in the follow-up. 】

[Because of your excellent performance in this rescue operation, and your opening report successfully guided Wei Guoqiang's preparations in advance.Greatly reduced the casualty rate.At the court meeting, you were highly praised. 】

[Two months later, you signed a contract to stay in the hospital.Wei Guoqiang's operation wants to give you a system, and at the same time let you take his postgraduate entrance examination to make up for the shortcomings in academic qualifications.It's a pity that the number of places in the city's first hospital is limited, and the rest of the departments are also eyeing.Therefore, in order to balance the interests of all parties, Dean Hang proposed candidates from various departments, and secretly assessed and competed to determine the final candidate. 】

[Two months later, you were calculated by the director and attending physician of the hand surgery department, leading to medical malpractice.Because there is no evidence, you are wronged.However, Wei Guoqiang used his connections, and director Tian Hua of the military hospital favored you, so you went to the military hospital. 】

[In the next few years, you will stay peacefully in the military hospital as a resident physician.At the same time, I went to Shuguang Beauty Hospital part-time. 】

[27 years old, you insist on going to the burn department of the military hospital, Director Tian Hua agreed.In the burn department, you began to continuously research and improve your own personalized burn rehydration plan. 】

[At the age of 30, you published "Clinical Application and Nursing Effects of PICC in Rehydration Therapy for Patients with Large Area Burns", which greatly improved the nursing efficiency of nursing staff, and the clinical value was recognized by the industry. 】

[At the age of 45, you have accumulated enough data and participated in several batches of first aid for large-area burns, and proposed: 8h Jinling burn rehydration formula + combined with PICC personalized rehydration program.The rehydration solution was quickly promoted, and you had such a huge impact in the entire industry for the first time. 】

[50 years old, you were in the midst of a sudden burn emergency. At the scene, in order to save a firefighter, you encountered an accident and died heroically.To commemorate you, your rehydration solution is named: Hecheng Qin's Rehydration Formula, which has become the best formula for rehydration of patients with sudden large-area burns. 】

[At 50, you end your career as a doctor]

[Simulation ends, doctor career evaluation, attending physician 25/40]

[Because you have studied the formula of rehydration all your life and promoted the development of the entire industry, you are rewarded for retaining two of the following abilities]

[1.50-year-old doctor skills]

[2.50-year-old clinical experience]

[3.50-year-old medical wisdom]

Qin Lang naturally chose the second and third items.

[Congratulations to the host, gaining 50-year-old clinical experience and 50-year-old medical wisdom]

[50-year-old practicing medical wisdom blessing, acquired skill: Blessing to the soul.In the next real or simulated world, you have the opportunity to make breakthroughs in existing medical procedures, improve them, or create new ones. 】

[Host: Qin Lang
Level: Attending Physician 25/40
professional skills:
Rounds: Advanced

Tube Bed: Advanced

Debridement: Master Class

Basic surgical operations (cutting, suturing, exposure, etc.): perfect level
Escharotomy: Master Class

Skin Grafting: Advanced
Rhinoplasty: Advanced
Double Eyelid Surgery: Advanced
Fascia Grafting: Intermediate
Mucosal Grafting: Intermediate
Tracheostomy: Advanced
Special Skills:
Blessing to the Mind: There is a chance to create (improved) spells (real or simulated world)
Pain Relief: Debridement, there is a chance to reduce the pain of patients during dressing changes

Burn rehydration: master level, proposed Hecheng Qin's rehydration formula

Special items:

2 bottles of stamina potion

】

After the simulation was completed, Qin Lang was the first to go to Director Wei, and just in the name of the previous research project, he proposed the Hecheng Qin's rehydration formula that he created.

You can use the latest journals at home and abroad, and in the name of the research results of foreign language materials. Anyway, I have good reasons and detailed theoretical support. I believe that Director Wei can adopt this plan with his eyesight.

(End of this chapter)