"Breath like learning to swim, I successfully made it"
——Cure experience of a critically ill patient
Hubei Daily News correspondent Longhua correspondent Tong Xuan
From high-flow oxygen inhalation, to non-invasive ventilator, to tracheal intubation, until the most serious ECMO, for new patients with severe coronary pneumonia, learning to adapt to non-invasive ventilator is a turning point. Mr. Zhang, who had been treated in the severe ICU, was one of them. On March 30, he told the Hubei Daily News reporter how he successfully "passed through a ventilator and learned to swim" under the leadership of a nurse.
Mr. Zhang, 54, has a history of hypertension. When he came to the Tongji Sino-French New City campus on February 9, he was diagnosed with severe new pneumonia. At first, the doctor and nurse gave him a mask to inhale oxygen. Since oxygen saturation has not been improved, it was replaced with a non-invasive ventilator on February 13.
"Using non-invasive ventilator requires patient cooperation." Xia Zhipeng is Mr. Zhang's responsible nurse. He said that for some patients, non-invasive ventilator was very uncomfortable at the beginning, and the mouth and nose were suddenly blocked by the mask, which caused fear in itself, not to mention the lack of security. "If the oxygen flow into the mask is not inhaled in time, the patient will feel a freshness bag on his head, which is breathless and has a suffocating sense of dying."
"Take it away!" Sure enough, like many patients, Mr. Zhang, because he was not adapted to the ventilator, had a choking cough, and grabbed his hands and feet in a subconscious way, trying to pull out the tube. However, his body immediately experienced a chain reaction. Due to his impatience, after removing the oxygen mask, his hypoxic reaction worsened and his breathing became more rapid.
"Mild patients generally have a better state of mind and are more likely to cooperate with treatment; critically ill patients, after using sedative drugs, will not have such a reaction." Xia Zhipeng introduced, critical patients have relatively clear thinking and their reactions when using ventilator And coordination directly affects the therapeutic effect.
"If the patient can improve the level of non-invasive ventilator and assist breathing through the mask, there is no need for intubation. Because once intubation, especially for older patients, it will face a series of complications Risk. Therefore, we must help patients to keep this level. "Said Zhao Jianping, director of the Department of Respiratory and Intensive Medicine of Tongji Hospital.
Helping patients adapt to non-invasive ventilator tests the patience of nurses.
Xiong Jie, head nurse of the ICU in the Sino-French New City Campus, came up with an idea. One day, he came to the bed and said to Mr. Zhang: "It's like learning to swim, raise your head to inhale, and exhale your head. As long as you maintain the rhythm of the ventilator, you can effectively promote lung recruitment and improve breathing. After that, all the nurses in the ward began to teach the patients to learn to "swim with a ventilator".
"Okay, follow me, exhale, inhale ..." Xia Zhipeng taught over and over again, as Mr. Zhang's "swimming coach".
"I didn't expect it to be so easy." After two visits, Mr. Zhang quickly mastered the trick, and the whole person felt much easier. I was in a good mood, and Mr. Zhang's coordination was much better. Every time I saw the nurse, I began to sign and said, "Learn to swim."
After 13 days, Mr. Zhang removed the non-invasive ventilator and replaced it with a nasal catheter for oxygen. On March 19, he stopped taking oxygen again. Subsequently, the nucleic acid test was negative and the lung CT improved, and he was discharged from the hospital on March 22.
It is reported that at present, most of the 48 patients in the ward of Professor Zhao Jianping, except for a few patients with underlying diseases, have been discharged.