The Godfather of Surgery

Even though antibiotics were used according to experience, Lu Jiangbei's high fever never went away, and her body temperature fluctuated. She relied entirely on antipyretics and physical cooling to suppress her body temperature. This showed that the lung infection was not under control at all, and empirical antibiotics were ineffective.

Three days later, the results of the bacterial culture of the sputum came out. Yang Ping turned on the computer screen and called up the test results: MRSA. The abbreviations of several English letters were very eye-catching.

MRSA - methicillin-resistant Staphylococcus aureus, one of the superbugs.

The so-called superbugs are resistant to almost all antibiotics due to genetic mutations. They have become invulnerable and cannot be killed by antibiotics.

Because of their strong drug resistance, doctors have almost no weapons at their disposal against these bacteria, making them very difficult to treat.

To deal with MRSA, only vancomycin can be used.

The drug susceptibility test sheet also showed that, except for vancomycin, all other listed antibiotics were resistant.

What a careless guy, Yang Ping cursed in his heart!

The whole treatment process is extremely hard and full of twists and turns. If you make any mistake in one step, all your efforts will be wasted.

Director Pan didn't want to make this call, but there was no way. Facts were facts. They were really afraid of what would come. Almost all clinicians would be frightened when encountering superbugs.

Professor Yang——

I have seen the inspection report and am coming over now. Let's meet and discuss it.

After a few words of communication, Yang Ping rushed to the trauma ICU again. Since it was not in the same building, it took some time to rush back and forth.

When Yang Ping arrived, temporary ICU workers August and Robert were already standing at the door to greet him.

After swiping the card to open the door, Yang Ping went straight to the doctor's office.

At this time, there were already people inside, including Director Pan, the doctor in charge, Dr. Zhou, the head nurse, and several colleagues from the Department of Respiratory Medicine, the Hospital's Infectious Diseases Department, the Laboratory Department, and the Blood Transfusion Department.

The emergence of super bacteria has put everyone at risk.

MRSA infection itself is not an infectious disease, but as long as there is infection with the pathogen, there is a possibility of cross-infection.

Once this superbug spreads due to cross-infection, the consequences will be very serious.

When Yang Ping came in, everyone stood up to show courtesy, and Director Pan personally welcomed Yang Ping to his seat.

The patient has been transferred to the isolation ward. The chest X-ray was reviewed and the infection area is expanding. Director Pan sat down and was the first to speak.

The director of respiratory medicine took a sip of water: What should we do now?

What else can I do? Prescribe vancomycin! Xiao Zhou, use my work number to prescribe vancomycin. Use it now.

Director Pan was scolding his mother in his heart. Of course, he was not scolding others, but scolding this bacteria. He hadn't had such bad luck in a long time, and this time he was actually infected.

Vancomycin is a new type of antibiotic. It is known as the nuclear bomb among antibiotics. It will not be used unless it is a last resort. It is the last weapon of doctors to deal with infections.

The originator of antibiotics was penicillin, which at that time was called a life-saving miracle drug.

Since the beginning of penicillin, mankind has entered the era of antibiotics. Many bacterial infections that were incurable in the pre-antibiotic era were easily cured by penicillin. Since then, many types of antibiotics have entered clinical medicine.

If bacteria are the shield, antibiotics are the spear.

There will naturally be a struggle between spears and shields. Bacteria are smart and will not sit still and wait for death. In order to survive, they will find ways to avoid the attack of antibiotics.

As drugs are used for extended periods of time, bacteria have accumulated rich experience in dealing with antibiotics. They pass this experience on from generation to generation and continuously optimize, making some antibiotics ineffective.

So-called drug-resistant bacteria have emerged. These drug-resistant bacteria can use some methods to render antibiotics ineffective and thus survive.

The principle of survival of the fittest also applies to the bacterial world. Resistant bacteria survive and reproduce, while bacteria without resistance die from antibiotics and eventually become extinct.

Methicillin-resistant Staphylococcus aureus is the leader among these drug-resistant bacteria and has taken the crown of superbug.

Against this background, scientists had to invent new weapons to deal with drug-resistant bacteria, so vancomycin, the “King of Antibiotics”, was finally put into clinical use in 1972.

Vancomycin can be called a nuclear weapon among antibiotics. Since it was put into clinical use, it has been invincible and sterile. In the 16 years since its use, it has created an unbeatable record - not a single resistant strain has emerged.

It was not until 1988 that vancomycin's unbeatable golden status was broken. In 1988, the first vancomycin-resistant strain appeared. This type of bacteria was enterococci.

Since then, vancomycin has been somewhat powerless. In 2002, the first case of vancomycin-resistant Staphylococcus aureus (VRSA) appeared. Of course, this kind of bacteria is very rare at present, but once a VRSA infection is diagnosed, it is likely to be disastrous.

Fortunately, Lu Jiangbei was infected with MRSA, not VRSA.

Even if MRSA bacteria are enough to kill Lu Jiangbei, he is not a patient with only lung infection. His entire body, including limbs and trunk, is in a state of paralysis. There are fractures in many places in the pelvis and body, and he is severely injured due to excessive blood loss. With anemia, the entire person's immune system is in a state of near collapse.

If the lung infection cannot be controlled in time, once a certain critical point is exceeded, respiratory failure will occur from the sky. In the end, he will have to slowly die with the support of ECMO.

Dr. Zhou got the oral doctor's order from Director Pan, temporarily left the meeting table, and turned to the computer to issue the doctor's order. Once the decision was made, he didn't want to waste a second.

That's the only way. The director of the Department of Respiratory Medicine nodded.

In the face of this superbug, vancomycin has become the only choice, without any controversy, no need to discuss.

Can you blood transfusion department be quicker and give more blood, the hemoglobin will not go up, and the immune system will collapse sooner or later. Director Pan went straight to the point, no nonsense, now that Yang Ping is present, the blood transfusion department is afraid and will be more cooperative, Director Pan's tone Also sharper.

Director Yuan of the blood transfusion department was very embarrassed: It's not that we don't give it. The blood bank is very short of blood now. This patient has already replenished more than 70. It is a bit difficult to ask for more blood, but we will try our best.

Director Pan was very angry: Don't always look at the rules and regulations, but look at the specific situation.

I can't help it. It's not that you need blood in one department. Gastroenterology, general surgery, obstetrics and gynecology. I can't count which department is not urging us every day. The director of the general surgery department scolded me on the phone yesterday, and it was useless. , I can’t bleed, if you can, you can draw my blood now.” Director Yuan stretched out his arm.

Old Pan, let's understand each other. Professor Yang is here today. I promise to give you blood as a priority and try to meet your needs, but I really can't guarantee enough. You have already ordered more than 10 units of red blood cells. This time you open your mouth and want another 10 units, what do you want me to do? Use 6 units first, and talk about it later.”

Six units? Director Pan sneered, you sent beggars away.

Indeed, now Lu Jiangbei desperately needs to continue blood transfusions. When the hemoglobin is raised, the immunity will also be improved, and if the operation is performed, more than 70 hemoglobin is not enough.

8 units! Director Pan argued hard.

Director Yuan didn't agree at all: Impossible, a patient with a ruptured liver and spleen in the General Surgery Department yesterday was also waiting for my blood supply.

Director Yuan is also in a dilemma, resources are limited, and everyone is eagerly waiting for his blood. What to do can only be strictly controlled.

Give 10 units! Yang Ping finally spoke.

Lu Jiangbei's current situation is in urgent need of blood transfusion, and several units of red blood cells are really not enough.

Director Yuan had just fought vigorously with Director Pan, but he was at a loss for words, and said slowly, Okay, 10 units!

The debate was over, the director of the Infection Department of the hospital rubbed his brows, he wanted to speak.

The Hospital Infection Department is a group of hated guys in the hospital. Their job is to try to find the loopholes in the Hospital Infection and make up for it in time.

The investigation is still an investigation. We will investigate the cause of this infection. I hope it will not interfere with your work. Please wash your hands carefully. We will focus on monitoring the trauma ICU these days. The director of the hospital's infection department obviously lacked confidence and said very modestly .

Hmm! Director Pan hummed in a low voice.

——

Because of the drastic changes in her condition, Lu Jiangbei's mother was once again pushed to the consultation room of the trauma ICU. In the past few days, Dr. Zhou of the ICU has talked to her several times.

She could have entrusted the family's diagnosis and treatment activities to relatives, such as his brother or sister, but she was worried and felt that she was competent, so she came to play the role of family members herself, and her brother and sister took turns to accompany and take care of her.

When will the operation be? asked the middle-aged mother.

Yang Ping shook his head: I can't operate yet, let Dr. Zhou tell you about it.

Lu Jiangbei has been having a high fever for the past few days, and has been diagnosed with a lung infection. The bacterial culture results have come out. It is methicillin-resistant Staphylococcus aureus, which is one of the super bacteria. We have now used the super antibiotic—Wan Gu Mycin, but there is no guarantee that the infection can be suppressed, his life will be in danger at any time, and he will stop breathing at any time, you must be mentally prepared. Dr. Zhou led the conversation as the doctor in charge, and Yang Ping and Director Pan sat beside him.

This is the medical condition notification? If there is respiratory failure, do you need to use ECMO? The cost of ECMO is very high, and the self-payment part is very large. Dr. Zhou handed over several pages of informed consent.

Be mentally prepared!

When the middle-aged mother heard the last few words and looked at the pages of the informed consent form, her head went blank and buzzed. In the previous conversations, every time the doctor talked about the danger of life, she always took it seriously. She always felt that such things far away from myself.

But this time was different. For some reason, she felt the pressure of death coming to her face, like a huge rock that made her unable to breathe, because she knew that not long ago, a patient with respiratory failure passed away here, and she saw the family members with her own eyes. Crying in the hallway.

Originally he was not out of danger, but now a new danger has been added. Once the lung infection cannot be controlled, respiratory failure will occur, and then --- then it will lead to death. Dr. Zhou continued.

His mother's eyes were dull. At this time, the word college entrance examination no longer appeared in her mind. He had completely forgotten the existence of the college entrance examination, and his mind was occupied by the word death.

Doctor, help, save him—

After a long time, my mother squeezed out these words in a pleading tone.

We will try our best, but many things are beyond our control. Director Pan added.

The mother was very heartbroken, and nodded mechanically: Can I go in and see the child?

Director Pan took the words: He is infected with super bacteria now, so he is not suitable for visiting. If you want to visit, you can look through the glass in the visiting corridor outside.

Sometimes it's really hard to say, but in this situation, he may die from respiratory failure at any time. Director Pan has also experienced many battles, and has seen many life and death partings.

Under Director Pan's arrangement, Lu Jiangbei's mother, sitting in a wheelchair, saw her son through the glass. He was lying on a hospital bed, connected to various tubes, and most of his upper body was covered by a brace. Unclear face.

Mother couldn't help lowering her head, covering her eyes, and began to cry loudly.

Her head is very messy now, filled with regret, those auxiliary machines, those pipelines, made her truly realize that the child might leave her.

Ever since she was a child, she has been complaining and scolding her child, comparing him with other children, never really considering his feelings, and always squeezing all the space for him with studies and college entrance examinations. Every time her child's grades decline, she will After being insulted by her, every time her child's grades improved, she would always say lightly that she still needs to work hard. It is impossible to pass 211 or 985 with such grades.

The more she thought about it, the more guilty Lu Jiangbei's mother felt. She felt that she had never really cared about her child.

If he can survive, no matter whether he can go to university or not, no matter what occupation he does, as long as he is alive and healthy, she will accept everything, as long as he is healthy.

Doctor, save him, save him no matter what. The mother repeated this sentence.

We'll do our best. We've already used vancomycin. Wait a few days to see what happens. If vancomycin doesn't work— Director Pan didn't continue.