At peak visits, 15 hours of pediatrician time were recorded

Chinanews.com, Beijing, December 12 (Shao Meng, Zhang Yuhui) At 16:12 a.m. on December 7, Lu Fang, the attending physician of the Department of Critical Care Medicine of the Capital Institute of Pediatrics (hereinafter referred to as "the Capital Children's Institute"), returned home. In the past day, she worked more than 15 hours in the emergency room. Under the peak of pediatric visits, she has become Xi to such a work state.

With the arrival of autumn and winter, the number of respiratory tract infections continues to rise, and pediatric outpatient and emergency departments in many places are operating at full capacity. As a tertiary children's specialized hospital, the number of outpatient and emergency departments in the first children's hospital has also increased significantly. In order to shorten the waiting time as much as possible, the hospital has taken multiple measures at the same time, and medical staff are racing against time to ensure the medical needs of patients.

Recently, Chinanews.com walked into the first children's institute and recorded the real days and nights of a pediatrician in the emergency room of this big hospital during the surging rush of medical treatment.

December 12th at 6:14 in the Seoulsho lobby. Photo by Shao Meng

"Breathe a sigh of relief"

At 6:16 on the 00th, the emergency waiting area on the first floor of the first floor of the Seoul Children's Center was crowded, and the rows of chairs were full, and many parents brought their own folding chairs and placed their children in campers or strollers covered with plastic film. Anxious and tired, it spreads in bursts of coughing and crying.

Parents for consultation and queuing filled the triage table, and on the calling screen, the children were graded according to the severity of their condition, and most of them were classified into level 24 (emergency) or level <> (non-emergency). "<> hours, you can hang it whenever you come." The medical staff patiently reassured.

Outside the emergency room of the first children's center. Photo by Zhang Yuhui

Lu Fanggang sent a critically ill child to the emergency room, hurried through the waiting crowd and rushed back to the emergency room 1, while calling the inpatient department to make an appointment for the ward, and clicking on the computer to continue to call the number. Since 8:00 a.m., she has hardly stopped to rest.

At 16:10, a mother looked nervous and led her daughter into the consultation room, which was the fifth day of the child's fever. After carefully inquiring about the child's symptoms, test results, and medication, and examining it with a tongue depressor and stethoscope, Lu Fang said: "It is judged that it is a respiratory syncytial virus infection, and it is not recommended to have an infusion, and the fever is generally 5 to 3 days, and it should be almost (feverish)." He also carefully advised him on when he needed to take antipyretics.

The originally worried parents breathed a sigh of relief and said to the child with a smile: "Then we will wait, great baby." ”

Pediatrics is also known as "dumb medicine", and in the face of children who cannot accurately describe their symptoms, doctors need to carefully observe, question, guide, and examine. "What's wrong kid?" "Does your throat hurt?" "Ah, open your mouth and take a look." Lu Fang took the trouble to ask and reassure.

Lu Fang auscultated the child. Photo by Shao Meng

"Both of my children are infected"

At 17:30, Lu Fang was able to take a break from her busy work and have dinner. On her way to the cafeteria, she received a call from her daughter. "What's the matter, kid? I didn't have time to look at WeChat. She asked as she took off her lab coat.

Lu Fang's 11-year-old son and 6-year-old daughter are both infected with RSV and are cared for by their grandmother at home. Due to the special nature of her work, she can't spend much time with them, and sometimes when she gets home from work, the children have fallen asleep. Lu Fang didn't want to mention these too much, "I've seen a lot, and I know if the child is seriously ill." In the face of the children waiting for treatment, she had no choice but to persevere.

Every year, the pediatric department is full of periodic consultations, but Lu Fang feels that this year is particularly busy. "Influenza, respiratory syncytial virus infection, parainfluenza, mycoplasma infection... Since March, the number of visits has not decreased. ”

In response to the increasing number of outpatient and emergency departments, the number of visiting doctors at the first children's clinic has increased by 86.36% and the number of respiratory disease consultations has increased by 30.16%.

Health care workers give fluids to the child. Photo by Shao Meng

This also places higher demands on medical staff. That night, there were seven doctors on duty in four emergency rooms, and Lu Fang said that in the past, three or four doctors usually went out to the emergency room. The infection has also spread to health care workers, and several of her colleagues have fallen ill.

"It's really tiring." Recently, Lu Fang basically has to go to 7 clinics a week, and at least once a night clinic every 3 days. "I can see eighty or ninety patients in the outpatient clinic during the day, and the emergency department will be slower if there are serious cases, about <> people per shift." Lu Fang said. Since March, she has barely had a full break, never taking a double break.

However, Lu Fang said that the situation has improved recently. A parent waiting for the clinic told Chinanews that she brought her child to see Dr. Lu to see the test results, and waited less than two hours that day. "It's fast." She said.

Lu Fang examines the child's examination results. Photo by Shao Meng

"Doctor, are you sure you don't need an infusion?"

At 18:00, Lu Fang, who returned to the consultation room, continued to receive treatment. She has a stainless steel mug on her desk, but for more than 15 hours of work, she has only opened it to drink some water while eating. "If you drink water, you will go to the toilet more, and won't patients wait longer?"

During the long waiting time, parents couldn't help but be anxious. Often, before a patient has finished reading, the parents behind them have already brought their children into the consultation room. During this period, people kept pushing the door in and asking questions about the plus number, dosage, etc. Whenever this happens, Lu Fang will patiently say, "Wait a minute, I'll show them first." ”

There is a "Emergency Request: Must Take a Child" prompt on the triage desk. Photo by Shao Meng

"Just doing nebulization without infusion, what if the condition is delayed and serious?" The father of one of the sick children asked anxiously. He and his wife arrived from a tertiary general hospital with their 3-year-old daughter, who had already had a CT scan and a routine blood test. "Since eight o'clock in the morning, I haven't had an infusion for so long over there, and my hands and head are 'bulging', are you sure that the child doesn't need an infusion?" He hesitated.

In the face of similar situations, Lu Fang will always try to explain clearly. "It's not serious, it doesn't sound like wheezing, the infusion doesn't have much effect on her, I'll teach you to judge her condition, the breathing rate is more than 50 times a minute, you need to come to the hospital." Subsequently, she told parents to do nebulization at home to avoid cross-infection. After receiving the answer, the parents finally showed a smile. "She's actually very lively, I hope she'll get better soon." He said.

Although some parents continue to ask for infusion or CT for peace of mind, Lu Fang insists on a comprehensive study and judgment according to the condition. "Some parents think that their children must be given infusions when they have pneumonia, but this is not the case." She said that many viral infections do not require infusions, and some do not yet have antiviral drugs for the symptoms. Chest x-rays will also have some radiation, and children will only be prescribed this type of examination if there is a high suspicion of pneumonia.

"About 1/3 of the books are not used in major hospitals"

During this period, the children treated by Lu Fang were basically respiratory tract infections, most of which were mild, and the mixed infections were slightly more severe. On the same day, she saw several children with co-infection, and one child tested positive for influenza A, mycoplasma, and adenovirus.

According to Lu Fang, the younger the child, the higher the likelihood of severe disease. On the same day, she saw four seriously ill children, two of whom were infants and young children, all infected with RSV.

Many of the children were brought from the suburbs of Beijing or even Hebei. Lu Fang said that about one-third of the patients she received during this period did not need to come to the tertiary children's specialized hospital for treatment, and could be treated in a primary hospital. However, she can also understand the concerns of parents, "Many children have coughed for a long time and have repeated fevers, and parents will definitely be worried if they do not have this kind of medical knowledge." ”

At 22:57, Lu Fang called the parents of the child to inform them of the examination results. Photo by Shao Meng

In order to shorten the waiting time, the radio in the waiting area of the Seoul Children's Center broadcasts that "peripheral blood tests and other laboratory tests can be prescribed in advance for patients with fever, cough, vomiting, abdominal pain, and diarrhea." According to reports, the hospital has also opened up the second ward of the Department of Respiratory Medicine, and stationed key medical staff to further triage patients.

Chinanews observed that many parents carried CT bags printed with the words of community health service centers and other primary medical and health institutions. "Recently, I have been examined at the grassroots level, and there are indeed more people who come here to prescribe medicine and treatment." Lu Fang said. During the consultation, she also reminded parents many times that nebulization and other treatments can be treated at home or in nearby hospitals to avoid cross-infection.

"Doctor, you've worked hard"

After being a pediatrician for 16 years, recalling the moments of getting along with parents and patients, Lu Fang felt the most "understanding" and "moving".

"The waiting time is long, of course, there are some who are more impatient, but most parents understand us. Recently, I found that many parents come up and say in the first sentence, "Doctor, you have worked hard." It was comforting to hear this. Lu Fang said. Similarly, as a mother of two children, Lu Fang can also understand the feelings of parents, "It's really not easy for them. ”

At 22:13, the emergency waiting area of the Seoul Children's Center was packed. Photo by Shao Meng

23:00, this is Lu Fang's scheduled time for the next visit. Her forehead was already wet with sweat, and the number of "waiting" patients in the list of waiting patients on the computer screen finally became "0". However, there are still 2 children whose examination results are still unavailable. The number in the "Pending" column has been increased to "72", and a new round of shifts has begun.

At 23:10, Lu Fang rushed to the respiratory treatment room to visit her last patient of the day, a 10-year-old child with severe pneumonia. When she first came to the emergency department, her blood oxygen saturation was as low as 88%, and she was still receiving oxygen and fluids.

"Feeling better? Auntie will test you again. Lu Fang said, "Look, it's better, it's 96% now." The girl replied, "Oxygen is cold, and it will be cool when you blow it." The child's mother and Lu Fang both laughed, and the girl blinked and laughed too.

Lu Fang checked the condition of the child in the respiratory treatment room. Photo by Zhang Yuhui

After appeasing the girl and her parents, Lu Fang rushed to the rescue room to communicate. "The patient needs to be kept for observation tonight, and I will print out her case and hand it over to the emergency room later." At this time, it was 23:16, and on the call screen in the emergency waiting hall, the waiting patient arrived at No. 389.

At around 23:30, after everything was done, Lu Fang finally had time to calm down and register to prescribe medicine to her sick children, who had been coughing for more than a month. During the day, as "Dr. Lui", she will continue to race against time for the patients. (ENDS)