MTL - Doctor’s Life Simulator-Chapter 41 Simulation to create the best formula: Hecheng Qin's rehydration formula

For the first time, in the face of such a situation, even if the high-level arrangement made reasonable arrangements as much as possible, due to the fact that too many patients were sent in, everyone still felt urgent pressure, especially some young doctors, who were still a little flustered and nervous.

Wu Youtu said calmly:

"Qin Lang, Cheng Yunfeng, you follow Qian Liang to treat patients, apply analgesics in time, open intravenous channels as soon as possible, and formulate a reasonable rehydration plan to fight shock!"

"Okay, Qin Lang, Cheng Yunfeng, come with me!"

Qian Liang waved his hand and went with the two of them. I have to say that this time there are really many patients with large-area burns. The emergency department and the burn department have treated at least 30 patients so far. Moreover, there are follow-up patients in constant transit.

On the hospital bed, there were patients with severe burns who were frightening all over their bodies. There was a stench in their nostrils, and the smell of coke. Rao Qian Liang, a senior resident physician, was also a little flustered for a while.

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

"...build dual venous access first..."

Qian Liang immediately began to give instructions to rehydrate these patients in the early stage of shock. After thinking about it, he was going 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 why burn shock occurs is due to the symptoms of low blood volume caused by plasma extravasation, and increased vascular permeability, resulting in rapid consumption and loss of body fluids.

The people Qian Liang and Qin Lang faced even suffered extensive burns (>50%). Due to dehydration, electrolyte disturbances, disordered autonomic nervous system and other reasons, they had developed fevers, endocrine disturbances, neurological disturbances to varying degrees. functional impairment, etc.

The situation is very critical, so they urgently need to be rehydrated to improve shock symptoms through rehydration therapy.

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

In this case, it is very important to test the clinical experience of the physician, otherwise it is very easy to cause excessive fluid replacement.

General clinicians tend to tend to be higher and higher, often resulting in patients with acute heart failure, cerebral edema, pulmonary edema, wound deepening and abdominal space syndrome adverse reactions.

In addition, the speed of the infusion during rehydration will also affect the recovery of the patient. Too fast infusion will easily lead to a large increase in the blood concentration of the drug, resulting in a narrowing of the therapeutic index, or due to the toxic effects of some drugs with large toxic effects. treatment effect.

But this time, because of the sudden batch of burn patients, they were divided into many areas, and many groups, respectively, were in charge of different attending physicians or resident physicians with more than five years for rehydration.

Depending on the level of doctors, there will definitely be a situation of transitional rehydration. Therefore, the best way is to first propose an optimal rehydration formula for a short period of time and a large range, and then, in the following follow-up, for Different patients, carry out personalized fluid adjustment!

[Ding, new task: determine the best rehydration formula by simulating the rehydration plan, and promote it in all departments. At the same time, for the patients in their own group, individualized fluid rehydration adjustment is carried out in the follow-up to prevent excessive fluid rehydration and reduce the occurrence of various sequelae. Quest rewards: 1. Life simulation points, 2. Long bear technique, entry-level]

There are simulation points in hand, so don't panic. These days, Qin Lang has accumulated 4 simulation points.

"Consume 1 Life Simulation Point!"

[A large fire broke out in the Hecheng Chemical Plant, and a large number of patients with large-area burns were sent to the emergency department and burn department of the city's first hospital. You were assigned to Wu Youtu's third group. For patients with shock, you started to use the rehydration formula to start rehydration. 】

[Different doctors have given different rehydration formulas, basically using the Jinling burn rehydration formula, or the Third Military Hospital University burn rehydration formula. Very few senior attending physicians adopted a personalized rehydration program. Your group, at your suggestion, Qian Liang adopted your plan. 】

...

[In the subsequent review and summary, in this rescue activity, there are still many patients with some sequelae due to excessive rehydration. According to data statistics, in terms of calculating the collection and calculation time of the rehydration index, the Jinling burn rehydration formula has an objective advantage over the burn rehydration formula of the Third Military Medical University. 】

[Summary conclusion after the event: the Jinling burn fluid formula calculates the fluid reference index only by estimating the burn area, while the Third Military Medical University burn fluid formula needs body mass to estimate the burn area. Due to the characteristics of batch burns, a large number of wounded are burned instantly , The order of the burn scene is chaotic, and it is difficult to achieve timely self-rescue and mutual rescue, resulting in relatively severe burns. Moreover, the admission time is concentrated, the resuscitation is not timely during the transfer process, many patients are in shock, and a large number of wounded cannot be uniformly measured for a limited time after admission. Moreover, Jinling burn fluid rehydration formula to calculate 8h rehydration can significantly shorten the calculation time. 】

[Best plan: Use the Jinling burn rehydration formula at an early stage, and pay attention to a personalized treatment plan in the follow-up. 】

...

[Because of your outstanding performance in this rescue activity, and your opening report successfully guided Wei Guoqiang's preparation in advance. Greatly reduces the casualty rate. At the regular meeting of the hospital, you were highly praised. 】

[Two months later, you signed a contract to stay in the hospital. Wei Guoqiang operates and wants to give you a system, and at the same time let you take his postgraduate exams to make up for the shortcomings in academic qualifications. It is a pity that the number of people in the first hospital of the city is limited, and the rest of the departments are also eyeing them. Therefore, in order to balance the interests of all parties, Dean Hang proposed candidates for each department and secretly assessed the competition to determine the final candidates. 】

[Two months later, you were calculated by the director of the hand surgery and the attending physician, resulting in a medical accident. Since there is no evidence, you are blamed. However, because of Wei Guoqiang's use of connections and the good impression of Director Tian Hua of the Military Hospital, you went to the Military Hospital. 】

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

[At the age of 27, you insisted on going to the burn department of the military hospital, Director Tian Hua agreed. In the burn department, you start to continuously research and improve your personalized burn rehydration program. 】

【At the age of 30, you published "Clinical Application and Nursing Effect of Fluid Rehydration in 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 forty-five, you have accumulated enough data and participated in several batches of first aid for large-scale burns, and proposed: 8h Jinling burn rehydration formula + combined with personalized rehydration plan. The rehydration program was quickly rolled out, and for the first time in the industry, you had such a huge impact. 】

[At the age of 50, you were in the first aid of a sudden burn. At the scene, in order to rescue a firefighter, you encountered an accident and died heroically. In honor of you, your rehydration program is named: Hecheng Qin's Rehydration Formula, which has become the best rehydration formula for sudden large-area burn patients. 】

....

[At the age of fifty, you ended your doctor career]

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

[Because of your lifelong study of the rehydration formula, which has promoted the development of the entire industry, you are rewarded for retaining two of the following abilities]

[1. The skills of a fifty-year-old doctor]

【2. Clinical experience of fifty years old】

[3. The wisdom of practicing medicine at the age of fifty]

Qin Lang naturally chose the second ~www.novelbuddy.com~ three.

[Congratulations to the host, gaining the clinical experience of fifty years old, and the wisdom of practicing medicine at the age of fifty]

[Five-year-old medical wisdom blessing, acquired skills: Blessing to the mind. In the next real or simulated world, you have the opportunity to make breakthroughs in existing medical techniques, improve techniques, or create new ones. 】

[Host: Qin Lang

Rating: Attending Physician 25/40

professional skills:

Room Rounds: Advanced

Tube bed: Advanced

Debridement: Master Class

Basic surgical operations (incision, suturing, exposure, etc.): perfect

Escharotomy: The Master Class

Skin Grafting: Advanced

Rhinoplasty: Advanced

Double Eyelid Surgery: Advanced

Fascial Grafting: Intermediate

Mucosal Transplantation: Intermediate

Tracheostomy: Advanced

Special Skills:

Blessed Mind: A certain chance to create (improve) spells (real or simulated world)

Pain relief: debridement, there is a certain chance to relieve the patient's pain during dressing change

Rehydration for burns: master level, proposed Hecheng Qin's rehydration formula

Special items:

2 bottles of stamina potion

...]

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

You can use the latest domestic and foreign journals and research results of foreign language materials under the guise. Anyway, you have your own reasons and detailed theoretical support. I believe that with the vision of Director Wei, this plan can be adopted.