Life is dying requires immediate surgery, what to do if there is no bed in the hospital, the doctor’s practice is commendable

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Life is dying requires immediate surgery, what to do if there is no bed in the hospital, the doctor’s practice is commendable

2018-12-27 10:25:26 21 ℃

A few days ago, I saw a question on the Internet. Someone asked if the patient had to do an emergency operation, but what should the hospital do without a bed? Will the hospital ask patients to transfer? Is this practice reasonable? Seeing this, I think of one thing that happened not long ago. It was an early morning in the morning. The ambulance pulled a patient with a bruise on the abdomen. When he was sent to the hospital, the patient had hemorrhagic shock and was unconscious. Need emergency surgery, no surgery will definitely die. As the second line of general surgery, I was called to go to the consultation. The patient needs urgent surgery and is in critical condition. After completing the operation, I must go to the intensive care unit (ICU). I immediately contacted the doctor at the surgical ICU and was told that the surgical ICU had no bed. What if I don't have a bed? Surgical ICUs live in critically ill patients and it is not possible to have patients who have been hospitalized discharged. The patient with this knife injury needs immediate surgery, and it is impossible to transfer to other hospitals. It is definitely too late. I can't manage it so much. I first contacted the operating room and immediately pushed it to the operating room for emergency laparotomy. At the same time, contact the hospital's total duty, help contact other ICUs in the hospital to have a bed. During the operation, it was found that the mesenteric blood vessels ruptured and there was 3000 ml of bleeding in the abdominal cavity. The patient was rescued due to timely rescue. At this time, the general duty call, the emergency ICU has an empty bed, after the patient can be transferred to the emergency ICU. The patient finally recovered smoothly and was discharged smoothly. When he was discharged from the hospital, he expressed his gratitude to the hospital and the doctor and sent the banner.


With this case, I will come to science, if there is surgery, the hospital has no bed. What should I do? I am a second-line doctor in general surgery. The emergency department of the hospital is my consultation. We often meet patients who need emergency surgery, such as acute appendicitis, acute upper gastrointestinal perforation, intestinal obstruction, abdominal trauma, stomach rupture. Intra-abdominal bleeding and so on. These patients need to have surgery as soon as possible. However, the number of beds in the hospital is limited. Nowadays, there are many patients, and the patients are often full. Because the emergency patients are not every day, it is impossible for Corey to reserve the beds for the emergency patients.


What if the hospital has an emergency patient and there is no bed?

If the hospital has an emergency patient, an emergency department is needed for surgery, but what if the hospital does not have a bed? This is the case, to do emergency surgery, but in many cases, the condition is not urgent enough to race against time, in a short period of time, such as acute appendicitis, in general, only need to complete the surgery within 48 to 72 hours of onset, are Yes. At this time, the patient's condition allows, we can discuss with the patient, you can consider transfer hospital treatment.


Of course, if the patient’s condition is very critical, the infection is toxic shock, intra-abdominal hemorrhage, hemorrhagic shock If you don't have surgery right away, the patient will be in danger. This is extremely urgent. I don't think any hospital will let the patient transfer. In this case, we immediately pushed the patient to the operating room. In some patients, before entering the operating room, the person was already in shock and coma. In the emergency department, the trachea was directly intubated and the cardiopulmonary resuscitation was pushed to the operating room. Especially for patients with trauma, sometimes even the identity information is still unknown, the hospitalization procedures are not done, and the money is not paid. At this time, it is a life-saving, and it is impossible to transfer the patient to the hospital.

The extra bed is at risk

There is no bed in the department, what should I do if I need an extra bed? Many patients and their families say that you can add a bed to us. We can get out of bed and add it to the corridor. Everyone thinks that it is too simple. The extra bed bears a lot of risks for patients and medical staff. The beds in the extra beds are usually from other brothers with empty beds. They borrowed their beds and the patients had to live in the corridors or corridors after the surgery. Extra beds increase the workload of medical staff, and we don't even say that overtime is our normal state. More importantly, patients with extra beds need to connect ECG monitoring, oxygen tanks, gastrointestinal decompression and other equipment in the corridor. In the beds in the ward, these have supporting measures, and the oxygen is a closed line. In the corridor, there is a need for oxygen tanks, as well as various routes. Patients walk around the corridor and there may be various risks.


More importantly, sometimes the patient is in critical condition and cannot be removed after the operation. Tube, postoperative need to be sent to the intensive care unit, now sub-specialization is very fine, there are surgical ICU, neurological ICU, intracardiac ICU and so on. If the surgical patient is sent to the internal medicine ICU or the neurological ICU, the doctor of the internal medicine department is a surgical patient, and the patient is admitted to the profession. This is risky. Although everyone has studied internal and external women when they go to school, after work, everyone Focusing on your major, you may not be familiar with other professional diseases. If the surgeon manages a severely ill surgical patient, there may be cases where the condition is not handled promptly and the treatment is delayed.

In summary, the extra bed is not as simple as everyone thinks. There is a big risk behind it. Every time I will tell the patient and family about the pros and cons, if the patient and family are willing to take on these potentials. The risk, I am not afraid of hard work, I will try my best to treat. It is our duty to cure people and save people, but it is not just about seeing a doctor. There are many things you can't imagine behind.