China News Service, Jinan, October 3 (Reporter Zhao Xiao) During the National Day, there were more dinner parties, changes in diet structure, irregular work and rest, drinking and other factors, resulting in an increase in the number of medical visits for patients with acute abdomen. In view of the characteristics of acute abdomen such as rapid onset and rapid progression, the Emergency General Surgery Department of the Olympic Sports Campus of Shandong First Medical University Affiliated Hospital (Shandong Provincial Hospital) has opened a green treatment channel, which connects the entire chain of emergency assessment, imaging examination, emergency surgery, intensive care, and postoperative rehabilitation. It continues to shorten the waiting time for diagnosis and treatment, improve treatment efficiency, and gain valuable treatment time for emergency patients.
Doctors are on call 24 hours a day to provide emergency treatment windows for patients with acute abdomen
Racing against the disease and against time is the norm for emergency general surgery medical staff. They shuttle between the emergency room, imaging department, operating room and ward, racing against time to protect the safety of patients.
"The National Day holiday coincides with the change of seasons, and is also a period of high incidence of acute abdomen." Lian Guodong, head of the emergency general surgery department, said that there are more gatherings during the holidays. If you consume more high-fat, difficult-to-digest foods in a short period of time, or eat large amounts of persimmons, hawthorns and other foods, it may increase the burden on the gastrointestinal tract of some people. Elderly patients with a history of abdominal surgery, intestinal adhesions, and weak gastrointestinal function should be more vigilant.
Lian Guodong is analyzing the patient's condition. Photo provided by interviewee
"The biggest fear in acute abdomen is delay." Lian Guodong said, "Some diseases may have completely different outcomes if they are treated a few hours earlier or a few hours later. Once a patient is judged to be at risk of intestinal ischemia, perforation, severe abdominal infection or shock, we will immediately activate the green channel and arrange surgery as soon as possible for patients with surgical indications."
Lian Guodong introduced that the emergency general surgery department has established a professional treatment team, with 6 doctors divided into 3 medical groups. A fixed group of personnel is on duty every day during holidays, and other personnel maintain emergency status to ensure that emergency patients are treated, evaluated, and operated around the clock.
The condition of acute abdomen is complex and involves a wide range of disciplines. It is often difficult for a single department to complete a full set of treatment work independently. The hospital has established a collaborative mechanism covering multiple specialties including emergency department, imaging, anesthesia surgery, critical care medicine, and vascular surgery. After the patient is admitted to the hospital, all specialties simultaneously carry out imaging evaluation, circulatory resuscitation, anti-infective treatment and preoperative preparation according to the patient's condition; for patients with abdominal sepsis, severe infection or unstable circulation, they can be quickly transferred between the emergency general surgery department and the ICU; when complex conditions such as mesenteric vascular disease are involved, the emergency general surgery department will jointly develop a plan with vascular surgery and other related specialties.
"There is only one core purpose, which is to allow patients who really need emergency intervention to get effective 'source control' as early as possible." Lian Guodong explained that the so-called "source control" refers to the rapid elimination of perforation, necrosis, obstruction or infection lesions through surgery, drainage and other methods. It is a key link in the treatment of patients with severe abdominal infection and abdominal sepsis.
From the emergency room to the operating room, to the ICU and ward, a treatment network for patients with acute abdomen remains in operation 24 hours a day during the festival.
Emergency general surgeon Xiao Kun examines the patient in the ward. Photo provided by interviewee
Move care forward and identify risks before the patient's condition changes
In the ward, the nursing team carried out various tasks in an orderly manner around dynamic monitoring of the condition, goal-oriented capacity management, meticulous maintenance of drainage lines and perioperative rehabilitation care.
"Emergency general surgery patients generally have severe conditions, change rapidly, and have multiple system problems. Nursing care requires overall assessment and dynamic judgment." Nurse manager Sang Xiaoming said that patients with acute abdomen are often complicated by infection, dehydration, and electrolyte disorders. Some patients are already in a state of pre-shock or even septic shock when they are admitted to the hospital, which places higher demands on nurses' comprehensive abilities such as nursing observation, emergency response, and clinical thinking.
Nursing staff care for patients at the bedside. Photo provided by interviewee
There are currently 20 nursing staff in the emergency ward of Olympic Sports Campus, who are also responsible for the nursing work of two medical units: emergency internal medicine and emergency general surgery. During the National Day holiday, shifts will be implemented, and the on-duty staff will be on call 24 hours a day and can fill their posts at any time.
"We implement specialized disease management and rely on the construction of acute abdomen nursing sub-specialties to identify risks and provide precise intervention for patients as early as possible." Sang Xiaoming said that the nursing team focused on the characteristics of acute abdomen and built a refined management covering the entire process of emergency triage, preoperative evaluation, and postoperative recovery. path, promote the construction of acute abdomen specialty nursing evaluation system, standardized nursing path and specialty quality control indicators, while implementing goal-oriented capacity management and dynamic monitoring of disease conditions, integrating the ERAS concept into nursing practice, and promoting patients to get out of bed early and restore gastrointestinal function as soon as possible.
While promoting specialized and refined care, the team also integrates humanistic care and health education throughout the entire process. It conducts warm pre-operative ceremonies, weekly missionary meetings for ostomy patients and regular social gatherings, shoots popular science videos on special diseases, and produces missionary manuals, etc., to make professional care more warm.
In Sang Xiaoming's view, emergency nursing staff must have both "hard skills" and the ability to quickly judge the condition. The department once received a patient with severe abdominal infection who was transferred from another hospital. The cause of the patient was unknown, the condition was complicated, the general condition was extremely poor, and he had multiple underlying diseases. He was about 1.6 meters tall and weighed less than 70 kilograms. After the operation, the nursing team continued to closely monitor the changes in the condition, and cooperated with the medical team to implement comprehensive plans such as anti-infection intervention, nutritional support, and functional rehabilitation to help the patient overcome multiple risks such as infection, malnutrition, and abnormal cardiopulmonary function, and finally recovered and was discharged.
"Witnessing patients successfully walk out of the ward is the most intuitive professional value of our nursing work." Sang Xiaoming said.
Don’t “carry on” abdominal pain, these are signs that you should seek medical attention as soon as possible
Lian Guodong specifically reminded that during holidays, you should try to maintain moderation and regularity in your diet. It is not advisable to eat a large amount of high-fat, greasy or indigestible food in a short period of time, and you should also drink alcohol in moderation. Especially the elderly, people with a history of abdominal surgery, recurrent intestinal obstruction or weak gastrointestinal function should avoid overeating.
"Common gastrointestinal discomfort and acute abdomen have very similar symptoms in the early stages of the disease and are easily confused." Lian Guodong said that if you have persistent or progressively worsening abdominal pain, obvious abdominal distension, frequent vomiting, stopped defecation and exhaust, or are accompanied by fever, palpitation, cold sweats, changes in consciousness, etc., you should go to the hospital as soon as possible. "Don't think that it will pass after you endure it." He said that for acute abdomen, timely judgment of the cause and seizing the opportunity for treatment are more important than anything else.
The holidays represent reunions and respite, but in emergency wards, emergency rooms and operating rooms, another rhythm of work continues. The beeping sound of the monitor, the transfer bed being pushed hurriedly through the corridor, and the operating lights turning on late at night constitute the daily routine of emergency general surgery medical staff during their holidays. For them, the so-called "persistence" ultimately falls on the same thing - to try to buy as much time and life for every acute abdomen patient as possible.
