What is the end-of-life status of critically ill patients?
Some doctors describe a lot of water, into the lungs, oxygen can not get in, the lungs are full of virus caused by the jelly-like secretions, they awake and accompanied by intense struggle, until the last breath...
For the vast majority of severely ill patients, "breathing difficulties" are their biggest enemy. Once the blood oxygen saturation "high on low off", the condition will rapidly deteriorate within a few hours, very soon will be life-threatening. For the treatment of severe and critical cases, the seventh edition (trial edition) of the national covid-19 protocol states that in cases where respiratory distress and/or hypoxemia cannot be relieved after standard oxygen therapy, high-flow nasal catheter oxygen therapy or noninvasive ventilation may be considered. If the condition does not improve or even worsen within a short period of time (1-2 hours), endotracheal intubation and invasive mechanical ventilation should be performed promptly.
For critically ill patients requiring mechanical ventilation, pulmonary function assessment and nutritional support programs are critical treatment contents.
Professor zhan qingyuan from china-japan friendship hospital emphasized three points of treatment experience:
1. It is recommended not to use muscle relaxant as much as possible, and to use less tranquilizer to keep the patient relatively awake and able to maintain spontaneous breathing
2. Most patients have good ventilation effect on prone position, which can be considered as appropriate during treatment
3. For severe and critically ill patients, early tracheotomy is recommended if there are relevant indications
In addition, according to professor zhan qingyuan, the other biggest difficulty encountered in the treatment of severe and critically ill patients is endotracheal intubation, which has a very high risk and great effect. At present, doctors from the laryngology and anesthesiology departments are appointed to intubate the patients in the zhongfrance-xincheng hospital of tongji hospital. This requires the intubator to be available at any time, and any delay may affect the success rate of the intubation. In order to improve the success rate of intubation, they focused on two aspects of work, one is once the comprehensive decision of patients may need intubation, they asked the family to sign in advance, reduce the waiting time. The second is to communicate well with tongji hospital in xincheng district of China and France, and ask the anesthesiologist to make preparations in advance. "Most of the patients who were intubated early survived." This is the happiest thing for professor zhan qingyuan.
After nearly three months of efforts, China's COVID - 19 epidemic has basically won the initial victory, only five days before wuhan "unblocked"! But COVID - 19 international situation is increasingly serious, in the face of the global epidemic prevention and control, China will not hesitate to take big bear responsibility, share information, the promotion of successful treatment experience, to provide advanced technical support, with the rest of the world hand in hand to build a resist, dike and dam against disaster risk, common to protect the earth to the survival of humans.
One breath, one destiny! At the beginning of April, we firmly believe that the war of all mankind VS virus will usher in the dawn of victory in this sunny season.