Chapter 329
Chapter 327: Chapter 161: Goodwill from Vice Director Ye, Corpse Carrying Gate_2
“The second type is high-risk patients. These patients usually have underlying diseases with potential dangers and may be preparing for invasive surgeries that carry higher risks. Examples include severe pancreatitis, severe asthma, organ failure, severe obstetrics complications, and so on. The principle of admitting these patients is to effectively prevent and treat their complications, reduce medical expenses, and shorten hospital stays.”
Many patients, if not admitted to the ICU during the waiting period for surgery, may never meet the criteria to be taken to the operating table.
In such cases, it is a good choice to decisively opt for admission to the ICU to save lives first, and then schedule surgery later.
Many people think that being admitted to the ICU is just burning money, but actually, it’s quite the opposite.
Sometimes it may even save on medical expenses.
Imagine when various complications explode, the cost of emergency treatments is incredibly high.
And it will greatly prolong the discharge time.
“The third kind is patients who experience an acute exacerbation of chronic diseases. The Intensive Care Unit can help them get through the acute phase and strive to return patients to their previous chronic disease state. For example, patients with an exacerbation period of chronic respiratory diseases fall into this category.”
These types of patients are very common.
The saying that money can buy life often refers to these patients.
By being admitted to the ICU, they can really escape death from King Yan.
Once they pull through, they can live well again.
“The fourth type is patients whose diseases have become irreversibly malignant. For instance, patients with massive hemorrhage that cannot be effectively controlled by hemostasis, or patients with terminal malignant tumors. There are also elderly patients awaiting natural death. The greater meaning of admitting these patients lies in demonstrating respect for life and reverence for life.”
The last type of patients are mostly from wealthy families, with too much money and no place to spend it.
Generally speaking, as long as family members do not consent to the disconnection of life support, these patients can stay in the ICU for quite a long time.
Basically, as long as they don’t suffer brain death, they can be allowed to stay on.
It’s worth mentioning that for the fourth type of patients admitted to the ICU, very few can make it out alive.
They already know this outcome before entering the ICU.
It’s purely about extending life for as long as possible, nothing more.
Of course, we must realize that the relatives of these patients are willing to pay expensive medical costs as an expression of their inextricable affection.
For example, as children, they do not want to watch the parents who raised them to die, even if it means spending all they have for the sake of just an extra second of their parents’ presence in this world.
“The sources of patients in the Intensive Care Medicine Department are roughly these four types. I introduce them in such detail so that you can have a clear understanding when you start working, and have a clear idea of the treatment direction and purpose for each type of patient.”
The person in charge spoke out loud.
The treatment focus differs for each of the four types of patients.
If it’s for preparation before surgery, we must try to reduce complications and provide the patient with the best nutritional support possible.
To extend life, we must find ways to ensure that the patient does not die.
Zhou Can, after listening, had already begun to feel the intense atmosphere of the Intensive Care Medicine Department.
“When admitting patients in the Intensive Care Medicine Department, in addition to the above-mentioned four criteria, there is also a very important indicator, which is the death rate score. For example, take the Acute Physiology And Chronic Health Evaluation (APACHE) scoring system as an example, which scores based on various physiological indicators of the patient, used to predict mortality. A score of 15 to 35 points, meaning the mortality rate is higher than 15% but lower than 85%, is most suitable for staying in the ICU.”
This scoring standard is basically the golden criterion for admission in all ICUs.
If the mortality rate is less than 15%, it is generally treated in a specialized ICU or in a general ward.
If the mortality rate is higher than 85%, unless the family is extremely wealthy, out of conscience, doctors will suggest that the patient spend the last moments of life in the emergency room.
Of course, this standard cannot be doctrinaire.
There are patients whose predicted mortality is higher than 85%, but if the attending physician believes that being admitted to the ICU could save them, as long as they get through the most difficult time, there might be a chance of improvement, they should definitely be admitted.
To lower the hospital’s patient mortality rate, that’s the fundamental purpose of establishing the Intensive Care Medicine Department.
“Next, let’s talk about division into groups. Clinical medical teams are divided into three groups, with a three-shift system, eight hours each. The nursing team has five groups, working on a 12-hour system. The Intensive Care Medicine Department is a high-intensity job, you must be mentally prepared.”
The doctor to nurse ratio is roughly one to three.
One doctor for every three nurses.
Each patient in a bed receives one-on-one service.
A doctor is responsible for up to three patient beds.
It’s like a battlefield; where there’s a need, there’s where you charge.
“Alright, that’s about all the introductions. If you have questions, you can take the opportunity to consult with senior doctors. But I must tell you that when working in the ICU, it’s better to speak less and do more. Your senior doctors need to concentrate and deal with every emergency, and if you ask questions at inappropriate times and interrupt their train of thought, at best you’ll be scolded, at worst sent to me, and I’ll teach you the rules.”
The person in charge first explained the rules to the thirty-two standardized training students.
It’s a completely different concept from the ordinary departments.
In specialized wards, doctors are more relaxed. Not to mention asking questions, even casual chatting is common.
“Next, we will assign senior doctors to mentor you. Currently, only Resident Doctors can be arranged to guide you, and those who perform well may get the chance to be promoted to attending physicians.”