-- Report on the Emergency Department of Beijing Hospital of Traditional Chinese Medicine
Source: Beijing Hospital of Traditional Chinese Medicine
The emergency department is a place racing against life at any time in 24 hours every day and 365 days every year. Since the outbreak of Covid-19, the Emergency Department of Beijing Hospital of Traditional Chinese Medicine stood at the outpost of Covid-19 prevention and control, helping each other with other departments and sticking to the safety line of Covid-19 prevention and control.
Hold the first pass of the hospital
The Emergency Department was responsible for the screening of febrile patients and inpatients throughout the hospital, temperature measurement, epidemiological investigation, and screening of Covid-19 patients...This made the Emergency Department which was already overloaded with work even busier. At the beginning of the Covid-19 outbreak, under the leadership of Director Yao Weihai, the department responded quickly, revised the medical treatment procedures, formulated protective measures and carried out training for all staff in the first place. The nursing shift was implemented with the "emergency standby shift" system of leaving the hospital on standby after the night shift at 2:00 am, and the rest of the staff were arranged flexibly, with different levels of protection according to different working areas. From the storage of protective materials to the formulation of procedures, reinforcement of medical personnel, and the opening of pre-examination triage, the advanced warning of emergency department had been strongly supported by the Medical Department, Disease Control Department, Nursing Department, Outpatient Department, Medical and Industrial Department, General Affairs Department, Security Department and other relevant departments.
The quick response halted the spread of the epidemic
On February 3, a man over 60 years old was admitted to the Emergency Department with self-reported cough and general malaise. "Take your temperature first, Uncle. Where have you been lately?" The attending nurse immediately conducted fever screening. "38.5 ℃, hot! Take the patient to the isolation ward, do blood tests, C-Reactive protein, take a throat swab, and tell the Radiology Department to check immediately!"The Emergency Department immediately started the emergency procedure of Covid-19 screening. The Medical Department, CDC and Covid-19 screening expert team rushed to the conference room to receive doctors and report the patient's condition in detail. The Radiology Department promptly issued the CT results of multiple patches of ground glass, combined with the results of blood tests, the expert group unanimously concluded that the patient was a suspected Covid-19 patient. "Uncle, the examination results show that you are likely infected with a novel coronavirus. Where have you been recently? Who else is at home?" In a few words from the uncle, Head Nurse Pei Xiaolu keenly found that the daughter living with the uncle was likely to be infected with pneumonia, and then asked her to drive to the hospital immediately for treatment. After nucleic acid test and CT examination, both father and daughter were Covid-19 patients and were transferred to designated hospitals for treatment. The Emergency Department strictly screened, rapidly responded and timely isolated to avoid the further spread of the epidemic.
Understanding is the most difficult and commendable
Since the outbreak of the epidemic, Pei Xiaolu, the head nurse of the Emergency Department, undertook triage and care of emergency patients, responsible for the arrangement of personnel on duty, materials, personnel protection, psychological counselling... Being asked "what is the biggest difficulty in the epidemic prevention and control", the veteran TCM nurse, who had experienced the SARS epidemic and was fighting on the Covid-19 prevention and control battlefield, replied: "Understanding is the most difficult and commendable." Indeed, understanding between colleagues, between doctors and patients were crucial when materials were available, work flows were smooth, and even heavy work was well prepared and regulated.
At the beginning of the Covid-19 epidemic, Pei Xiaolu conducted "devil style" training for emergency medical workers: wearing protective equipment, masks, hats, goggles, and isolation clothes... Each person practised in turn, over and over again every day. When someone wore a protective suit and made a mistake, she would sternly warn. "I thought people would think it was a waste of time, and they would be impatient and complain, but from the beginning to the end everyone was very cooperative and no one said that it was bored or they were tired." Pei Xiaolu said comfortingly. When restoring emergency shift preparation and flexible scheduling system, no one in the Emergency Department held back. "It's my job," he said, "Firmly obey the arrangement!" "I'm not tired, let the other colleagues have a rest!" We all knew that if we carried it for a while longer, others would have more time to rest and more energy to work.
On Feb. 11, Sun Yiwen, a young nurse, received a phone call from the head nurse: "There is a suspected Covid-19 patient in the Emergency Department. We will activate the emergency plan immediately. We need you to come to work as soon as possible!" Ten minutes later, Sun Yiwen was in place, dressed in protective clothing and entered the isolation room. The patient was a young woman who was very nervous. To ease the atmosphere, Sun Yiwen first introduced herself: "I am Sun Yiwen, a nurse in the Emergency Department. As a large number of aerosols will be generated during the collection process, I need to wear protective clothing. The operation is easy and not painful. Don't worry too much." Gentle and heart-warming words removed the anxiety of the patients, the specimens were successfully retained. When the isolation was lifted, the patient gave a letter of thanks to the Deputy Director Peng Wei, giving full affirmation to the treatment and nursing work of the Emergency Department.
The complex screening process was sometimes criticized by patients and their families. In such a situation, the emergency medical staff patiently explained and comforted them. "When all the tests and treatments were in place, the patients would in turn apologize and thank us. During the epidemic, the psychological pressure on emergency patients and their families would be even greater. We must empathize with them and tried to understand, persuade and tide them over." Deputy Director Peng Wei said.
The young man withstood the test
The average age of the nursing team in the Emergency Department was 25 years old, which was a young team full of vigour and solid work. Qiao Shouang, a male nurse, was one of them. In order to avoid cross-infection caused by manual form filling, Qiao took the lead in making two small procedures "Consent for Nucleic Acid Screening" and "Covid-19 Screening Form", and posted the QR code around the Emergency Department. Patients could fill in the form by scanning the code on their mobile phone before they entered the Emergency Department, which saved time and was conducive to data preservation. During the epidemic, the schedule of nurses was constantly updated. In order to let everyone know the schedule dynamics in a timely manner, Qiao Shouang made a scheduling small program in which the shift changes could be seen on the mobile phone at any time. The nurses could communicate with each other, which was convenient for nurses to arrange work reasonably. Ya Nan, Qiao Shouang's fiancee, is also the nurse of the hospital, since the outbreak of the epidemic, the Emergency Department was busy, Ya Nan often went to the Emergency Department to help after work.
Emergency rooms were full of young doctors and nurses of Mr. Qiao's age who gave up on family visits, cancelled vacations and, in some cases, postponed weddings. These young people withstood the outbreak and became the backbone of the Emergency Department.
Life is above all else
The Emergency Department controlled the green life passage from the front of the hospital to the centre of the hospital. The treatment of critically ill patients was like a relay race. The emergency treatment of the Emergency Department was the first key to win the relay race. On the afternoon of March 4, 120 ambulance brought in a patient with sustained chest pain for 3 hours. An electrocardiogram suggested acute inferior wall myocardial infarction. As Covid-19 should be excluded according to the patient's condition, the screening process might delay the disease and miss the best time for rescue. What to do? Saving lives was the top priority. Yao Weihai, the director of Emergency Department, Peng Wei, the deputy director, decided to take strict protection of the medical staff, Covid-19 screening and the rescue were being carried out at the same time. The chest pain centre was urgently activated! The Emergency Department and Radiology Department quickly screened out the novel coronavirus, and the Cardiovascular Department quickly received emergency interventional therapy. With multidisciplinary cooperation, patients were excluded from Covid-19. It took only one hour from admission to recanalization of blood vessels, realizing the seamless connection of "patient reception + Covid-19 screening + interventional therapy + entry into CCU ward", which gained time and vitality for the rescue.
Having survived SARS and Influenza A, and fighting Covid-19 prevention and control today, the Emergency Department had always been at the forefront of the charge, and emergency workers had never flinched. "The more dangerous it was, the more we should stick to our post!" It was said by young people from the post-90s and post-00s who just started working, as well as doctors who had stayed here for more than 20 years. All the medical staff in the Emergency Department with the best state of "fighting against the epidemic", held the first pass of epidemic prevention and control in the hospital. They conveyed a full of positive energy with confidence, sunshine and positive attitude to colleagues and the community.
