Treated SARS patients 17 years ago. Now it is the first new crown pneumonia designated hospital in Dongcheng, Beijing. It has 14 beds and 20 sets of protective clothing.

Outbreak in January at Puren Hospital

From the first patient with new coronary pneumonia to today, the isolation ward of Beijing Puren Hospital has been open for a whole month.

There are no slogans and standpoints here, some are just solid, bit by bit service and dedication. Renovating the ward; finding protective clothing; chatting with patients after work; medical care, cleaners, repairmen, psychological counselors, everyone has become all-rounders; after the isolation is not going to go home, still rushing to the "big emergency"; repeatedly Hospital tests for cured patients ...

New Coronary Pneumonia Patients at Puren Hospital Transfer Channel (Right)

I did n’t expect to treat patients so quickly

Around January 20th, the hospital's leadership had heard that the first designated hospital in Dongcheng might be located in Puren, but the director Zeng Wenjun said frankly, "I didn't expect to really treat patients so soon, at least It feels like there is still time to prepare better. "

Although there is still no negative pressure ward, even though the independent ward building transformed after SARS has already become the hospital's orthopedic ward and rehabilitation area, Puren Hospital has seriously started to prepare for the new crown epidemic. To this end, they referred to SARS and the epidemic in Hubei, and urgently worked out a ward reconstruction plan that required 5 million yuan of investment.

However, within a few days, the plan lost its meaning-"it was too late."

Preparing for emergency medical preparations and setting up emergency teams for the Longtan Temple Fair before the Spring Festival has always been the practice of Puren Hospital. However, in the afternoon of New Year 2020, Beijing announced the cancellation of the temple fair.

Hao Yuhong, deputy director of medical treatment at Puren Hospital, said that at that time, he really realized that things were serious.

WeChat screenshot of medical staff signing up to work in an isolated ward

Sure enough, the hospital's management was recalled to the hospital early in the early morning of the New Year's Day—notice that the hospital should be urgently started to renovate the ward and organize medical staff to enter the isolation ward. The conditions for treating patients should be available at the latest on the sixth day.

On January 30, the first newly diagnosed patient was transferred from the colleagues to the isolation ward of Puren Hospital.

In the morning of this day, the doctors and nurses and the workers and teachers in the hospital just finished using the transparent tape to air-condition the air outlets of the 14 isolation wards one by one.

Realizing that the 5 million yuan renovation plan made recently was impossible to achieve, in the short days from the second day of the new year to the sixth day of the new year, the independent two-story ward building of Puren Hospital was busy.

The original orthopedics were all evacuated, and the passage between the isolation ward and the original orthopedic rehabilitation area was sealed; the original beds were readjusted, and single and double rooms were arranged according to the requirements of the infectious disease ward. Suspected patients were treated in a single room, and confirmed patients could be double rooms. Admission; the door lock of the ward was replaced with "external lock" according to the isolation requirements, and all windows were temporarily installed with fixtures, which could not be fully opened to prevent the patient from losing control and causing safety problems ...

For the new crown epidemic, although the ward building that was remodeled more than ten years ago has become old, in the past few days, the whole hospital concentrated on manpower and wisdom, and still managed to plan and arrange a Pollution-free area, semi-polluted area, clean area and patient access, medical staff access, infectious disease ward containing clean material entrance and exit and medical waste exit.

In the second week of February, all 14 beds in the isolation ward of Puren Hospital were full at one time.

Driving around in ambulance to find protective clothing

Dean Zeng Wenjun talked about the days of initial preparations, and still felt a sense of urgency in his tone. "From the thirtieth year of the New Year, we were nervously laying out the isolation ward, recruiting and urgently training the medical team, and anxious about one thing. That was to see that the patients were about to be admitted. At the time, there were only 20 sets in the hospital. Protective clothing. What can I use to protect our staff in charge? "

On New Year's Eve, New Year's Day and New Year's Day, the most important holiday of each year has become her most anxious days this year. "Since we heard about the epidemic situation in Hubei, we have started to contact the suppliers we have cooperated with throughout the year and ordered a batch of protective supplies, including protective clothing and masks. But I did not expect the critical moment, but I heard that these protective supplies could not be delivered. Arrived, was 'detained' in a certain city outside the city. Our vice president of logistics Wang Xiaoxuan and the head of the equipment department Wang Haijun were anxious. There was no way we decided to go to the city to pick up the goods ourselves. Considering that the traffic was restricted at that time, we Decided to drive an ambulance. Others also broke up and contacted any available channel to find protective supplies. "

"As a result, the ambulance that picked up the goods came halfway, and there was news that another batch of protective supplies was staying at the base of Shunfeng in Pinggu District. As soon as our people discussed it, they went straight to Pinggu. At the SF logistics base, our people were in SF With the help of the personnel, they went directly into the container and rummaged a little, and finally found the protective supplies we ordered. "Then they went to Tianjin overnight and picked up another batch of supplies.

Although the district health committee also tried its best to deploy some protective products for the designated hospitals, it was still a lot worse to meet the needs. "On January 28th, our hospital organized a five-member medical team to assist Hubei. We started to count on two sets of protective clothing per person per day for one month, and we calculated how to bring them 300 protective clothing. However, at that time, all the protective clothing we had gathered together was only 200 sets, which was not enough to bring to the aid team, let alone the need for the isolation ward of our hospital. "

"When it comes to the front line, our medical staff are particularly active and sincere in signing up, but as the dean, my biggest worry is not to provide them with the most important protection."

This anxiety was finally relieved on February 2. "I was suddenly informed that night that the customs had a group of 140 boxes of protective materials donated by the society, which could be allocated to us. We ran that night and gave them all came back."

Communication to "speak" and WeChat to soothe patients

Entering Puren Hospital from the main entrance on the east side of Chongwenmenwai Avenue, you need to pass through the entire outpatient building, enter the hospital's east hospital, and then pass through the parking lot. This is an independent two-story isolation ward building.

This building has two small doors that open directly to the west street of Xihua City outside the hospital. The door on the south side is marked with “Fever Clinic” for people who come to the hot clinic to go in and out; the north side is marked with “Gut Outpatient Clinic”. The door was affixed with black and white paper "Transfer Channel", and the new crown suspected or confirmed patient transferred from the quarantine point or the outer hospital was taken from this ambulance and entered the isolation ward without going through other areas of the hospital.

The first batch of supervising nurses, Jin Li, who signed up to enter the isolation ward to take care of patients with New Coronary Pneumonia, remembers very well. At more than 8 pm on January 30, she put on protective clothing and came to the door of the "entering channel", waiting for Puren. The first patient diagnosed with new coronary pneumonia in the hospital.

"Wearing protective clothing, you must not go outside the door. Ambulances specializing in transporting patients with New Coronary Pneumonia are parked outside the door. The drivers are also wearing protective clothing. We must shout loudly, otherwise we cannot hear." In fact, a few days later Jin Li and her colleagues were dumb. Jin Li remembered that the female patient had almost no obvious symptoms when she first arrived, "a little fever, stuffy nose, there are really no symptoms, it just looks like a cold."

She was from Hubei. She came to Beijing to see her friends on January 22. She developed a fever on the 29th. She went to the Tongren Hospital to see a doctor. She was quickly diagnosed with new coronary pneumonia and was transferred to the Puren Hospital the next day.

Although her symptoms were mild, her friend and her father, who was in their 90s, also entered the isolation ward of Puren Hospital a few days later, and developed into a serious condition, and transferred to You'an Hospital for further treatment.

"The first few days she came in was very anxious. First she kept saying that she was not sick, that is, a common cold. Later, when she realized that she had been diagnosed, she was particularly worried about her friends, her father and her son, and she was particularly guilty. The nanny of the family also lived in, It is confirmed. "

Jin Li saw her anxious day by day, but wearing protective clothing in the ward was inconvenient to communicate with her more, so she asked the patient to add her own WeChat: "We are not allowed to bring mobile phones in the ward, but wait for me to get off work After you get the phone, you can send me a WeChat account and tell me anything ... "

After 24 days of treatment and observation, the patient was finally discharged from the isolation ward of Puren Hospital on February 22.

Don't want to go home, go directly to our emergency

Jin Li officially entered the isolation ward with the same batch of other 9 nurses and 4 doctors on January 30. It lasted 18 days and was withdrawn after handing over to the second batch of medical staff on February 17.

From the 17th to the present, they have been self-isolated in the hotel room requisitioned for the hospital's anti-epidemic in the district, and they can "regain their freedom" by the end of this month.

"Except for taking meals every day, I can only stay in the room by myself. The first day or two is okay, and later ..." Jin Li, who was in a video call with a reporter in the hotel room, smiled very well, reminiscent of the current trend "In SARS in 2003, I signed up to join the medical team supporting Ditan Hospital in our hospital. My hair was cut, but it was not needed anymore. I didn't make it. This time I caught up, but The patient was picked up before the hair was cut. "

In the isolation ward, 6 hours per shift, you need to arrive at the post 1 hour in advance, wear protective clothing for 40 minutes, and then hand over the shift. "People who exercise very well, who go in, all become 'little experts'-medical care, cleaners, repairmen, psychological counselors."

Jin Li is the "top pillar" of the family, but this month, the old mother and 10-year-old daughter of the family can no longer refer to her. "It's okay, they can understand that as long as it is properly operated and protected, there will be no problem."

Dr. Liu Fang

Liu Fang, the former emergency department physician who entered the isolation ward with Jin Li, was born in 1990 and is just 30 years old this year. "I was in junior high school when I was atypical pneumonia, and I didn't expect to see it this time." Liu Fang was "sufficient" when signing up for the isolation ward work-"I am single and have a sister to take care of my parents at home. Understanding and handling of emergency situations will be timely; besides, I am still a party member. "

Speaking of the feeling of self-isolation in the hotel now, Liu Fang said, "I was too panicky. When I was on duty in the isolation ward, I was able to walk outside at work and go to work at 2 o'clock at night. Can step on the side of the road ... Although there are risks in the ward, I know that as long as I operate correctly, it is safe. In fact, I am very quiet in the ward. I do n’t need to consider any other complicated issues. I just think about your patient. Now. "

Liu Fang in the video counted his fingers and said, "We should be able to go out next Monday. I don't plan to go home and go directly to our emergency department." It is said that the pressure and risk of the emergency department in the hospital has always been great. "Emergency patients cannot be rejected, but a variety of potential infections always exist. For example, some patients may have fever, but after taking antipyretics, they came to the emergency department because of other discomforts ..."

Do your best as a doctor

For a whole month from January 25 to February 25, Hao Yuhong, the vice president, did not arrive at the hospital this weekend, February 22-23. On the evening of the 23rd, the hospital also treated Huang Mou, a Hubei women's prison who had caused widespread concern and was released from prison and returned to Beijing with illness.

Hao Yuhong served as the deputy team leader and head of the medical treatment team in the new crown pneumonia prevention and control working group established by Puren Hospital.

Between 1:30 and 2:30 pm on February 25, she was called every few minutes or interrupted by medical staff who hurriedly sought her to deal with the problem during an hour of interview with reporters.

13:45, answer the phone and discuss how to arrange for the suspected patient to be transferred later

14:00, answer the call again to arrange two cases of suspected patients for referral;

14:16. Discuss with the anxious colleagues who came to her to discuss the contents of the epidemiological history in the medical record, the different filling methods of the patient's resident address and the temporary residence address;

14:25, answering the phone to discuss the arrangement of a "marginal patient" (patient with negative throat swab, COPD, chest X-ray showing severe inflammation of the lungs but not like new coronary pneumonia)-cannot be diagnosed, dare not accept in ordinary The ward was sometimes unable to be transferred to a hospital with conditional rescue for severe pneumonia ...

At 14:28, the hospital leaders came to urge the discharge of a cured patient and donation of the information letter of plasma ...

During the busy period, Hao Yuhong talked about the urgency of the initial opening of the isolation ward. "In order to reduce the risk of protection, we require that medical personnel do not bring mobile phones into the isolation ward. The fixed telephone in the isolation ward cannot meet the requirements of internal and external medical staff for communication and consultation. The emergency opening of the isolation ward is not easy to solve this problem. Next, I went to the business hall near my home to apply for a mobile phone card, and registered a micro-signal called 'Isolation Ward' with my own IPAD. The first group of medical staff who entered the ward brought the IPAD in. The initial case consultation The internal and external communication is done by WeChat video phone. "

Later, the internal and external communication in the isolation ward used software such as "Xiaoyu Yilian" and "Tencent Conference". The six core experts of the hospital medical expert group established for this outbreak started with online video consultation in the radiology reading room and isolation ward of the outpatient building, and then converted the conference room into a dedicated space for remote video consultation. Experts The group membership has also expanded to 12.

No matter how busy and chaotic, Hao Yuhong still clearly remembers the first patient diagnosed with new coronary pneumonia. "She was 50 years old, transferred to me on January 30, and was discharged on February 22. In fact, she was a common type of new pneumonia, and she had a fever three days after admission, but the nucleic acid test was always repeated. Usually the patient's temperature was normal for three days. , Even if the nucleic acid test twice (next day) is negative, you can be discharged from the hospital for isolation and observation, but every time the patient performs such a test, it is always the first negative and the second positive (or suspicious). After repeated seven rounds of testing in this way, all of them were finally negative and allowed to be discharged for observation. "

During SARS in 2003, Hao Yuhong, who was in her early 30s, was also the attending doctor of the emergency department of Puren Hospital. "17 years ago, the conditions were far worse than they are now. At that time, people had entered the isolation ward and had not fully responded. Later, they saw that the passage was blocked by wooden boards and the people who came to give us food left the door and ran away. It turned out that I felt something was wrong. The family members called in and burst into tears. "

"Now both the medical conditions and the prevention and control procedures have been standardized a lot. This way, it is really tiring ... To compare, to be honest, I would rather go to the ward like SARS at that time, and do my part as a doctor I feel most at ease in my heart. "

Text / Courtesy of our reporter Zhang Nan / Beijing Puren Hospital