Medical staff who have been in contact with the Kangshu critical care team once said that if the Kangshu critical care team cannot handle the transport of critical patients, the patient will have no choice but to seek medical treatment at the same place and have no hope of going home! Because they have their own ICU ward, a medical team working in the ICU, professional invasive ventilators, non-invasive ventilators, micro pumps, monitors and other equipment, and an ambulance that can accommodate 180L of oxygen, they can put the ambulance cabin Transform into a mobile ICU ward to provide continuous support to critically ill patients!
Someone has said: If you have not been to a pediatric emergency room late at night, it is not enough to talk about life.
ICU medical staff will also say: If you have not experienced the anxious waiting outside the ICU door, it is not enough to talk about the difference between life and death!
Since the beginning of winter, it has been a season when children's lung infections are most prevalent (as evidenced by the difficulty in finding ventilators in hospitals in Chongqing that can accept little babies). When the family of a child in Chengdu described the child's condition (baby, 100 days old, 4Kg, endotracheal intubation ) to the Kangshu critical care transport team, hoping to be transferred to Chongqing for continued treatment, it can be seen that the child's condition is unusually critical. Transfer treatment means to this family whether the new life can continue.
The prerequisite for transport is a ventilator that matches the baby and medical staff who can control, judge, and deal with the baby's condition. Because the physiology of a baby is very different from that of an adult, the oxygen reserve and hypoxia tolerance time are short. , emergency response measures must be perfected, which is technically demanding, mentally challenging, and precise for medical staff.
There is no challenge without comparison
A 30-year-old is an adult with a weight of 50Kg± or more. For endotracheal intubation (6-8# can be used, the depth can be 21-24cm), you only need to roughly calculate his ventilation volume. ( tidal volume , pressure range) requirements are minimal, maybe a nurse or even a caregiver can handle it.
3 years old is a child, weighing 14±1Kg (age Ventilation volume and airway pressure, in other words, if the ventilator support is higher, the lungs like balloons will burst, which will challenge the ventilation technology and experience of medical staff.
3 months old is a baby with a weight of 4±1Kg. Weight in the first half of the year (KG) = birth weight + age in months Adjusting the depth of the catheter, a difference of a few centimeters can make a difference of a thousand miles), and the ventilator needs to be precise. The experience and skills of medical staff are demanding.
At the same time, the family members also told the Kangshu critical care team that because of the previous failures of two private transport teams, the child's condition became worse after the failure! We cannot try and fail, maybe this failure will be fatal!
Through the introduction of the children’s family members and medical staff, we learned about the first two thrilling experiences:
1. It may have been a patchwork of a nurse holding an adult balloon, an oxygen pillow, and then started transporting the little baby. , as soon as I came downstairs, I vomited, and the baby's pink lips began to change color...! Kang Shu’s summary: The transport personnel are not afraid of dangers if they don’t know the dangers. They transport people even if their airway cannot be maintained. What a nonsense! The parents are in a hurry and seek medical treatment, but if they can return to the ICU alive, the baby is lucky!
2, a XXX transport rescue team that advertised on Baidu, recruited a part-time doctor who could assess the patient's condition, had no professional ventilator support, and had safety awareness, so he automatically gave up the transport. Kang Shu’s summary: This is a doctor with a conscience and medical knowledge, but he is not willing to do anything. Without a matching ventilator, it is difficult for a clever woman to make a meal without rice.
For the Kangshu critical care team, there is no confidence. Even for Dr. Li, who has many experiences in transporting infants and has worked in a pediatric ICU, it is still a difficult challenge, but it may give the family members a new life and health. hope. The distance from Chengdu to Chongqing is 300 kilometers and the time span is 3 hours. No matter how large the ambulance space and medical equipment are, it is insignificant compared to the comprehensive support platform of the hospital ICU ward.How to deal with a series of problems such as BABY's irritability, intolerance to tracheal intubation, vomiting of gastric contents, slippage of tracheal tubes, blockage of venous access, etc. If you want to do your job, you must first sharpen your tools.
The team of medical staff and drivers prepared materials and equipment for one day, as well as the formulation of a transport plan for critically ill children. 1. Doctors and nurses in Kangshu Intensive Care Unit with 5 years of ICU work experience , 2. Emergency response plan after related problems occur; 3. Ensure that the ambulance has 2 ventilators; 4. Visual intubation laryngoscope for infants; 5. Various types of endotracheal tubes; 6. Infant suction tubes; 7. Emergency medicines...
entered the pediatric ICU and after fully communicating the condition with the doctor in charge, he learned that the child's condition fluctuated repeatedly, not only from lung infection, tracheomalacia, but also from pulmonary hypertension mixed with the heart. , possible atrial septal defect. The doctor in charge emphasized that there must be enough ventilators to support ventilation, otherwise you will give up the transportation, and the little baby can't stand the torment.
once again reviewed the changes in the baby's condition, listened to the baby's breath sounds , and checked the ventilator support parameters and ECG monitoring data. Combined with the operational status of the ventilator in supporting infants in the ward and the experience of transferring infants many times in the past. Dr. Li decided to accept this challenge with no retreat, in order to help BABY regain health.
Procedures such as ventilator support, drug pumping, tube fixation, bed-to-bed handover and other procedures are completed with great care. During the three hours from Chengdu to Chongqing Children's Hospital, the people on the bus were highly nervous and worried about the baby's comfort. All procedures were hassle-free and arrived smoothly!
Regarding the safe arrival of the children in this transport, Dr. Li from Kangshu’s critical care team believes that success comes from the assessment of the condition + the practical experience of the ICU medical team’s multiple critical illness transports + the adequate preparation before transport + sudden emergencies during transport response to the situation.
