Operation And Maintenance Of Wuhan Shelter Hospital: Record Of Edge Construction, Side Reception And Side Treatment

The Wuhan version of the shelter hospital is completing its historic mission.

At 17:00 p.m. on March 10th, with the last batch of shelters, the 16 cabin hospitals were all closed. Patients who have reached the discharge standard have been sent to the rehabilitation isolation point. Patients who have not yet reached the discharge standard are sent to the designated hospitals, while the medical teams are waiting for new orders.

In March 11th, on the first day of the first day of the day, in twenty-first Century, the economic report reporter saw Xu Junmei, the first national emergency medical rescue team (Xiangya No.2 Hospital) leader who arrived in Wuhan. He told the 42 medical personnel of Central South University, who were stationed, operating and finishing in Wuchang shelter hospital.

Xiao Kui, deputy director of the Department of respiratory and critical care medicine, Xiangya No.2 Hospital, Central South University, is communicating with patients. Data picture

Emergency assembly

In February 3rd, Xu Junmei, who was at work, received an urgent notification from the national health and Health Committee: he went to Wuhan to support. After emergency assembly, at 8:00 on the morning of February 4th, Xu Junmei and his team drove 10 emergency vehicles to Wuhan. "On the way again, they were informed that they were waiting for the Hongshan stadium in Wuhan."

At this time in Wuhan, the beds and rescue forces of medical institutions are tense and unable to meet the requirements of receivables.

At the speed of more than 5 hours, Xu Junmei and his party arrived at the destination. The Hongshan gymnasium at that time was named Wuchang shelter hospital. It was the first batch of shelter hospitals in Wuhan. "When we arrived, the infrastructure was not yet built." Xu Junmei recalled that we explored the site and put forward some improvement proposals for the construction and planning of the venues.

In the subsequent arrangement, the Wuchang shelter hospital was divided into 3 districts, and the Xu Junmei team took over 249 beds in the eastern district.

"The patient is required to receive the next day. After the infrastructure is completed, we will immediately enter the stadium for preparation." Xu Junmei said, according to the hospital management regulations, we worked for hours after bedding, labeling and so on, before reaching the standard of patients.

At 23:00 in the evening of February 5th, the first shelter hospital, including the Wuchang shelter hospital, began to treat patients.

"It was very cold that night, the wind and rain, the patients and the medical staff were previewing and triage outside the triage tent," Xu Junmei was especially impressed by that night. "But the temporary renovation of the shelter hospital was not perfect at that time." Xu Junmei said that after the patient entered the cabin, the new environment would inevitably be somewhat lost, or even some complaints.

In response to this, Xu Junmei made a plan ahead of schedule. Xu Junmei asked team members to listen patiently and appease if they encountered such a situation. They could not talk back to their patients. "That night they were admitted to 4 a.m. the next day, and the area we took over was in good order."

The three stage of shelter epidemic

All of Xu Junmei's team came from Xiangya No.2 Hospital, including 12 doctors, 11 nurses, 6 technicians and 13 logistical personnel. "We are from the same building, and the coordination and degree of cooperation from the same hospital are higher and the fighting capacity is stronger." Xu Junmei said that the people's Hospital of Wuhan University is responsible for all administrative management and external connections. The rescue force in each district is composed of a national team and 1-2 provincial teams. Among them, the national team is responsible for the two levels of management, such as the decision of the treatment plan, disease control and so on. The provincial team has more manpower and is mainly responsible for front-line duty, including case writing, doctor's advice and so on.

After the division of labor is clear, the operation of the shelter has gone through three stages: the starting stage, the stationary stage and the ending stage.

The hardest starting period is the opening of the cabin to a week or so. "This is the most difficult period for the shelter to operate." Xu Junmei said that Wuhan's shelter hospital is an emergency measure under the current new crown pneumonia epidemic situation, and all processes and experiences need to be explored. Both medical staff and patients need to adapt.

Xu Junmei led the team to explore. In the treatment, it was found that psychological and emotional management of patients was more important. Xu Junmei asked the rear team to support, and wrote popular science reading materials such as "entering the shelter" and "getting out of the shelter".

"The hardest part is to set up a high quality medical treatment system." Xu Junmei said that there are more than 200 patients in the Wuchang shelter hospital, and more than 200 medical personnel. In the face of the highly contagious new crown virus, restricted by the requirement of protection, all medical personnel can not get in and out at any time under normal working conditions, so as to observe the patient's condition at any time. What should I do? The Xu Junmei team changed the three rounds of doctor rounds system to two grade doctors and rounds rounds at the same time, and set up three rounds of rounds in the morning, afternoon and evening. "Every time point there are doctors in the ward, and every patient will be observed to improve the quality of medical care."

There are too many patients, and the information of the patients will be missed. "Some patients said they didn't prescribe drugs. Some people said they didn't do any tests today." Xu Junmei, they began to prepare information for the case, set up detailed forms of all patients' information, register all the information one by one, and ensure that all patients' information and disease conditions are clear at a glance. "The creation of the form seems to be an easy move, but the pressure is not small at that time."

"We set three goals early: Zero infection of medical staff, zero death of patients and zero return after discharge." Xu Junmei said that most of the patients in the shelter hospital are mild patients. How to ensure the prevention of light illness and turn to severe cases is the top priority. To this end, the team set up plans for emergencies and emergencies. We should promptly identify and identify patients' sudden situations. "For example, some patients may have symptoms such as stroke or myocardial infarction. We must accurately judge and establish a smooth transfer mechanism to avoid emergency rescue."

Fortunately, after a week or so, everything began to work smoothly. At this point, patients begin to discharge and enter a smooth running phase. "There are 29 first discharged patients in Wuchang shelter hospital. There are more than ten people in our ward. The management and process of the shelter were combed out, and about 40 people were admitted to the cabin every day. At the same time, there were still people coming out of the cabin. The speed of the bed transfer was accelerated. Xu Junmei said, at this stage, the physical pressure of medical staff is very large, and often needs to support the shift workers at midnight to deal with the patients' work.

After more than 10 days of "going in and out", the shelter treatment is coming to an end. "The sign is that the number of patients admitted is significantly reduced, and the number of patients is larger than the number of patients admitted." Xu Junmei said that around February 20th, fewer than 10 patients were admitted each day. Before and after the beginning of March, no new patients entered the cabin every day. This situation lasted until the rest of the cabin.

At this time, the number of patients in the cabin was small, and the workload of medical staff was greatly reduced. "About 2%-5% of patients in our ward are transferred to designated hospitals, but patients with long course of disease are positive for nucleic acid testing." Xu Junmei said that for this reason, they once again set up personalized treatment plans for each patient, increasing transfusion, atomization and other treatment methods to speed up their negative progress.

"New crown pneumonia patients with mild disease approaching 70% can be treated in simple condition hospitals. After the construction of the shelter hospital, more than 13000 beds were added, and a total of 12000 were treated. Combined with the number of confirmed patients in Wuhan, about 1/4 of the patients were treated in the shelter hospital. Xu Junmei said that if there is no shelter hospital, the epidemic in Wuhan may extend for 2-3 months.

From February 3rd to February 27th, Wuhan realized "bed and others" and completely changed the situation of "hard bed". By the end of March 10th, the whole cabin was suspended. This short-term expansion of medical resources has become the "Chinese experience" for the treatment of new crown pneumonia.

Ma Xiaowei, director of the national health and Health Committee, said that in the more than 30 days after the operation of the shelter, the way of building, receiving, and treating side by side will create a new model for the rapid expansion of medical resources for China to deal with public health emergencies and cope with major disaster situations in the future.

In March 17th, the Xu Junmei team successfully completed this historic mission and returned to Changsha.

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