醫者仁心！5小時，30000次心臟按壓，30名醫生輪流搶救8歲男孩
03-19
醫者仁心！5小時，30000次心臟按壓，30名醫生輪流搶救8歲男孩
林立豐 BUMBLEBEE英語課堂 今天
人民日報
9月21日，中秋節前的最後一個工作日，很多人沉浸在團圓節日的喜悅中。 但對於江蘇常州市兒童醫院的許多醫護人員來說，卻是又一次與死神交鋒的不眠之夜。
醫護人員輪流為小雨做胸外心臟按壓病危！8歲男孩暴發性心肌炎 9月20日晚，常州市兒童醫院重症監護室收治了一名患有暴發性心肌炎的8歲男孩小雨（化名），床邊心臟彩超提示，左心收縮功能下降，心臟跳動乏力，情況十分危急。經過一系列對症治療，孩子的情況有所改善。 21日上午，小雨病情突發變化，心律紊亂、血壓下降、室顫，隨後出現抽搐、阿斯發作、心跳驟停。經過搶救，小雨的心跳恢復了，但心率始終不穩定，血壓偏低。
暴發性心肌炎的起病急、發病凶、進展迅速，死亡率很高，如不及時救治，後果不堪設想。憑藉多年工作經驗，兒童醫院重症醫學科主任鄒國錦判斷這個孩子需要採用國際頂尖的體外膜肺（ECMO）技術來救治。
他立即聯繫了上海復旦兒科醫院PICU，決定聯合開展ECMO轉運，為孩子的生命奮力一搏。 然而，下午兩點多，就在轉運車剛從上海出發不久，小雨的病情急劇惡化，血壓直線下降至無法測出，心跳呼吸停止。全科醫護人員隨即投入緊張的搶救當中，大家輪流不停地進行心臟按壓。聽聞這一消息，小雨媽媽一度暈厥過去。等待上海的救護車過來還需要幾個小時，孩子能撐到那個時候嗎？ 床位醫生倪永成與小雨父親進行了溝通，小雨爸爸表示，只要有一絲生的希望，就決不放棄。搶救！30名醫護輪流按壓超3萬次 於是，醫務人員組織力量為小雨進行了長達數小時的搶救。胸外心臟按壓對醫務人員的體力是個極大的考驗，每分鐘100-120次的按壓，並且按壓的深度、手法都必須到位，一般按壓1-2分鐘就要換人，才能保證按壓效果。
可是，上海到常州，光路上就要三個小時，那得按壓多少次呢？ 家長的信任和支持給了全科醫務人員極大的鼓舞，在重症監護室的戰場上，向來如此，只要有一線生機，就要付出百分之百的努力。為了確保胸外心臟按壓的質量，院長薛鵬、副院長王秋偉坐鎮，醫務科調集了全院近30名醫護人員輪流進行不間斷胸外心臟按壓，接力為小雨續寫生命的長度。 一直到上海復旦兒科醫院ECMO團隊到來，ECMO設備正常運轉起來，按壓時長達5個多小時，300多分鐘，累計超30000次！今天我們一起來看相關的新聞報道。
新聞來源：1 China Daily Medical team saves boys life with 30,000 chest compressions
A number of health workers from Changzhou Childrens Hospital, East Chinas Jiangsu province, wait to take a turn performing chest compressions in a relayto keep alive an eight-year-old boy who went into sudden cardiac arrest, Sept 21, 2018. [Photo provided to http://chinadaily.com.cn]
Thirty medical professionals took turns performing more than 30,000 chest compressions over five hours to save an 8-year-old boy who went into sudden cardiac arrest on last Friday at Changzhou Childrens Hospital, East Chinas Jiangsu province, the http://thepaper.cn reported.The boy, suffering severe stomach pain and fever, was placed in the pediatric ICU (PICU) immediately after being diagnosed with fulminant myocarditis last Thursday evening. The illness is an inflammatory process that occurs in themyocardium, the muscular tissue of the heart, and causes acute-onset heart failure.After receiving initial treatment, he was in stable condition in the early morning of the next day. However, the situation deteriorated suddenly at around 8:30 am, with development of an irregular heartbeat, with his heart rate slowing down, thenconvulsions and cardiac arrest occurred.First aid was given but twice more the boy stopped breathing. Though the patients condition stabilized later, his life was still at high risk."Fulminant myocarditis features quick onset, severe symptoms, rapid progress and high mortality. The result is unbearable if the patient does not receive timely treatment," said Zou Guojin, a doctor from the Changzhou Childrens Hospital.
Life-saving ECMO equipment is wheeled into Changzhou Childrens Hospital in East Chinas Jiangsu province, Sept 21, 2018. [Photoprovided to http://chinadaily.com.cn]Given the demanding situation, the doctors in the PICU decided to apply ECMO (extracorporeal membrane oxygenation), an advanced technique of providing cardiac and respiratory support, to the boy.
PICU at the Changzhou Childrens Hospital did not have the equipment to perform ECMO so they contacted their counterpart at Children』s Hospital of Fudan University in Shanghai, and asked to borrow the ECMO machine.
At around 1:30 pm, a transport team bringing the machine set out from Shanghai. Just 20 minutes or so later, the boys condition was deteriorating rapidly.His blood pressure decreased to such an extent that it could not be detected. Cardiac arrest and breathlessness frequently reemerged. It would take over three hours for the equipment to be brought to Changzhou and no one knew whether the boy would make it through.The boys mother fell down in a faint when she heard the news. His father stayed rather calm and was determined to save his son."So long as there is a glimmer of hope, we will never give up," the father said.
Doctors and nurses from Changzhou Childrens Hospital in East Chinas Jiangsu province who participated in the chest compression relay to save a boys life rest in the hospital, Sept 21, 2018. [Photo provided http://tochinadaily.com.cn]At 2:50 pm, the boys heart completely stopped beating while the ECMO machine was still on the way. From this moment on, continuous chest compression was needed to keep him alive.For such an emergency, the hospital organized 30-odd professionals to perform the task. To guarantee the efficacy of the action, relays were set up, with each person performing the chest compressions for one to two minutes and then resting while another did a set of compressions. Otherwise, a person would tire and the compressions would not be powerful enough.
In this way, the 30-odd professionals tried hard to save the boy until the machine arrived and started working.
By the time the machine was operable at 7:30 pm, health workers had performed over 30,000 chest compressions."We are desperate to save every young life that is at risk with all our efforts. The world is not that terrible because we love you in silence," one staff member who participated in the relay posted on WeChat, a popular social networking platform in China.The boys heart started beating again in a very weak way and he is still under treatment at the time of this writing.【注釋】
1 pediatric：兒科的； paediatrics：兒科學； 2 fulminant myocarditis：爆發性心肌炎；3 inflammatory：炎症的；發炎的； inflammation；4 myocardium： 心肌（層）；
5 deteriorate：惡化；變壞；衰退； If sth deteriorates, it becomes worse in some way； 6 convulsion：（可數名詞） 抽搐；痙攣； If someone has convulsions, they suffer uncontrollable movements of their muscles； 7 cardiac arrest：心臟停搏； 8 respiratory：呼吸的；推薦閱讀：