Is still lying at home? Under the ravages of the
virus, free breathing has become a luxury in China with a population of 1.4 billion. People would rather stay stupid at home than go outside to ruin their lives.
In desperation, he can only use his mobile phone and watch TV. And if you love TV dramas, then American dramas must be a big IP that cannot be bypassed.
Many of my friends are not very good at English, so watching American dramas can’t concentrate on appreciating the actors’ acting skills, and it takes a lot of effort to read the Chinese subtitles on the screen.
Therefore, in the selection of American and domestic dramas, some people firmly lead to domestic dramas. It is true that the production level of domestic dramas is getting higher and higher, but compared with the quality of American dramas in screenwriting, actors' acting skills and props, domestic dramas still lag far behind.
famous screenwriter Wang Hailin once bombarded some domestic dramas, believing that the current degeneration of social morality is the current extremely hot men and women who are fueling the flames.
The female film buyers who David regards have become additives that affect social morality. In Wang Hailin's words: "These women buy dramas with small fresh meat. Sex mania! Why did the party’s literary and artistic position fall into the hands of a group of pornographic fans? "It's really hardcore. In today's entertainment industry, only Wang Hailin dares to tell the truth.
Since domestic dramas are all degenerate into this, anyway, I'm free to watch ABC TV dramas. It is very important to develop a good habit. Go to Douban to check the score.
In this era when data determines quality, the higher the value, the higher the quality. At least, you won't be too disappointed!
Perhaps, the hand typing on the keyboard once dreamed of becoming a surgeon's surgeon. Therefore, I did not hesitate to open the American TV series called "The Good Doctor" in English and "Good Doctor" in Chinese. The
story starts from the perspective of an autistic surgeon. It tells the story of doctors treating patients one after another. There is an intriguing story behind each case. As the plot progressed, the image of multiple doctors in the hospital team began to be full.
sounds unfamiliar at first, but the background is not small. David Shaw, the creator of the drama "Doctor House" and the screenwriter for the entire eight seasons and even the special episode, developed this drama.
Although we can look forward to a better medical drama than "Doctor House", it is difficult for us to find one that is more complicated and more attractive than House in terms of the character of the doctor. On the Douban score, the score of "Good Doctor" has never been lower than 9 points for three consecutive seasons.
If you watch it for the first time, congratulations, you will be attracted by this drama as soon as possible. Because Sean, the protagonist with autism, will hold your eyes tightly within a very short time of his appearance.
With the advancement of the whole plot, you will find that the drama "Good Doctor" is simply a promotional film about surgical medicine.
Look carefully at the actor of this show. He interprets Sean’s autistic state extremely well, especially the nervousness and unnaturalness that dare not communicate when encountering people, and insists on his attitude towards disease. For sure, and the cuteness who can't distinguish between love and love, etc., he has all acted.
But autism makes it difficult for Sean to communicate with the people around him normally. He doesn't like being asked why, everything around him, even the sound of water dripping from the tap.
Most people with autism have social problems, language problems, intellectual problems, and difficulty understanding concepts. Therefore, they live in their own space. disease occurs in infants and young children. A small number of children show symptoms when they are 4-5 years old. The incidence of boys is several times that of girls.
Unfortunately, the cause of autism is currently unknown. It may be genetically related (some populations have chromosomal problems); organic brain disease (2/3 of children with mental retardation of varying degrees); Neurobiochemical factors (abnormal serotonin levels), etc. In the
play, Sean is withdrawn, likes to live alone, communicates and acts rigidly, and will avoid others' eyes unconsciously, but he is very capable of memory, abstraction, and spatial imagination. In the
story, Sean’s personality is a scholar’s syndrome in autism, manifested in a certain artistic or academic ability that is beyond ordinary people. With such abilities as
, Sean can easily use his powerful abstract space imaging capabilities to analyze the patient's condition without any technical assistance. The development of the plot of
is true from the very beginning. An 8-year-old boy was accidentally hit by glass. Sean was in danger. His brain was like a computer with abundant reserves and fast calculations. He quickly concluded that the jugular vein was cut off and his left lung was injured.
The external jugular vein is the largest branch of the superficial cervical vein, usually formed by the confluence of the posterior branch of the posterior mandibular vein with the posterior auricular vein and the occipital vein at the angle of the mandible. It runs obliquely back to this muscle along the surface of the pectoralis muscle On the posterior edge, pass through the cervical fascia propria at 2.5 cm above the midpoint of the clavicle and inject into the internal jugular vein (type I), the venous angle (type II) or the subclavian vein (type III).
Severe neck injuries are mostly compound. In addition to neck soft tissue injuries, they are often accompanied by pharynx, larynx, trachea, esophagus, thyroid and large blood vessels.
The mortality rate of open neck injuries can reach 17%. The causes of death are mostly upper airway obstruction, severe hemorrhagic shock and hemopneumothorax. First aid for neck trauma should put life-saving in the first place, and restore the function of the larynx and trachea as much as possible to prevent complications. In the
drama, the location of bleeding is behind the surface of the sternocleidomastoid muscle. The bleeding appears as dark venous blood. Therefore, Sean pointed out that the vein presses the distal end of the blood vessel to avoid pressing the proximal end to cause suffocation.
In addition, Sean examined the whole body of the injured boy and found an abdominal trauma. Multiple injuries often miss some traumatic parts because of clothing covering. The details of this action are highly praised.
During the overall examination, Sean found that the injured boy had the following clinical manifestations: abnormal expansion of the peripheral veins (indicating the obstruction of the return to the heart and vein), abnormal chest movement (indicating flail chest, or abnormal fullness of one side of the chest), left side Pulmonary abnormalities (low breath sounds in the lungs, drum sounds on percussion), so that the child has a traumatic tension pneumothorax.
Traumatic pneumothorax is divided into closed pneumothorax, tension pneumothorax, and open pneumothorax. The incidence of traumatic tension pneumothorax is relatively low. But compared with closed pneumothorax and open pneumothorax, tension pneumothorax is more dangerous.
Traumatic tension pneumothorax develops rapidly. The main points of on-site first aid include: history of trauma; severe symptoms: dyspnea, cyanosis, etc.; physical examination may show rapid breathing rate, tracheal shift, chest asymmetry, abnormal peripheral vein filling, and the patient has The ipsilateral chest is full, the intercostal space is widened, the breath sounds are weakened, and the percussion shows drum sounds.
quickly exhausting the chest is the most critical first aid step. Generally, there are two ways: puncture, the position is generally in the second intercostal space of the midclavicular line; closed drainage of the thoracic cavity, when the pneumothorax cannot be effectively controlled, a drainage tube is placed in the second or sixth intercostal space of the midclavicular line to connect the water-sealed bottle to the flail. The chest and hemothorax have the effect of exhaust and fluid.
Therefore, in an emergency, Sean made a simple one-way valve with a wine bottle and plastic hose to allow the injured boy's chest to vent quickly.
So, Sean wants to do breathing assistance with his colleagues, he immediately began to do closed chest drainage, he chose the sixth intercostal part (the detail in the play is that he counts 2 ribs from the nipple line down, the details are well received). The
device is simple, but sufficient. The tube is inserted into the pleural cavity to make a one-way valve, and the gas enters the liquid in the bottle from the tube, but cannot flow back into the chest cavity.
After the on-site rescue was completed, Sean found a low-voltage change in the injured boy’s ECG while he was accompanying him, and then suspected pericardial effusion, and asked to improve cardiac color Doppler ultrasound.
pericardial effusion, as its name implies, is the accumulation of fluid in the pericardium. There are many causes, such as infection, trauma, etc., but the three most common causes are tumors, idiopathic pericarditis and renal failure.
A small amount of pericardial effusion does not affect hemodynamic changes, and physical examination will not find abnormalities. However, the pericardial fluid increases rapidly, and the pressure in the pericardium rises sharply due to the inability of the pericardium to expand quickly, which causes the heart to be compressed, which leads to a significant decrease in the ejection function of the heart, a drop in blood pressure, and acute pericardial tamponade, life-threatening and urgent treatment .
The current methods for checking pericardial effusion include X-ray examination, electrocardiogram, echocardiography, cardiac CT, MRI and pericardiocentesis.
Despite the cardiac color Doppler ultrasound, Dr. Melendez ruled out pericardial effusion 100%. However, Sean was obsessed with the unexplainable changes in the electrocardiogram, and carefully identified the heart color Doppler ultrasound and found a defect in the right atrium.
There is a detail here that the heart beat (the process of depolarization and repolarization) and the electrocardiogram are displayed together. The details are well received.
Dr. Brown believes that it may be a hypothesis that a traumatic foreign body in the heart causes abnormalities in the electrocardiogram and heart color Doppler ultrasound.
In the end, Sean insisted that the operation be carried out in time, and by opening the chest cavity, he accurately found the cause of the abnormal heart beat-a piece of glass slag. Of course, other heart injuries can also cause abnormal heart beats.
Surgery includes preparation of the operating staff, surgical hand washing, surgical disinfection, surgical lay-ups, etc. There is too much content to elaborate on one by one. The play "Good Doctor" is excellent.
If you watch this drama carefully, you will find that the preparation of the surgical staff is very standardized. From changing the special clothes in the operating room, to trousers, shoes, and wearing sterile hats and masks, every detail is professional. The
hat should completely cover the hair, and the mask must cover the mouth and nostrils. Roll the sleeves on both sides to the upper 1/3 of the upper arm, and tuck the hem of the shirt inside the waistband.
Note that after doctors wear surgical gowns, hats, masks, and goggles are in compliance.
Surgical hand washing: After surgical hand washing and disinfection, keep the hands arched. Keep your hands 30cm away from the chest, upwards should not be higher than the shoulders, downwards should not be lower than the xiphoid process, and the arms should not droop.
When entering the operating room, use your back to open the door or use the induction door. Do not touch the unsterilized items with your arms, otherwise you need to re-soak and sterilize.
Pay attention to the position of Sean's hands. Everyone in the play washes their hands and enters the operating room with their hands raised as required, which is in compliance.
such as the provisions of the aseptic area of the operator, including the operator's shoulder below the waist, the front area above the waist, and both arms belong to the personal aseptic space. After the sterile sheet is laid on the operating table and the instrument cart, the area of the tabletop belongs to the sterile area.
Pay attention to Sean's left hand. When he is not holding anything, he is close to himself and placed in a reasonable sterile area, which is compliant.
only needs to watch the first episode to get an evaluation: the medical production level of this drama is very high. I wear masks and hats honestly during the operation, and every detail of the action follows the medical principles. It can be said that "Good Doctor" is really very conscientious.
In the second season of "The Good Doctor", a sudden and acute infectious disease broke out in the hospital. By coincidence, the outbreak happened on Christmas Eve.
is similar to the Chinese New Year. On this most important holiday in the United States, many medical staff in the hospital also take vacations. The two patients who came suddenly broke the festival that was supposed to be happy.
One of the men became unconscious after arriving at the airport lobby, and the other woman, Marianne, developed a high fever. The doctors in the play subconsciously think that Christmas is the peak time for travel, so they didn't take it too seriously, and treated Marianne with the initial diagnosis of pulmonary embolism.
The male patient who was first sent to the clinic was quickly declared dead due to hypoxia in the chest and heart. At this time, resident Sean noticed that both patients had obvious rashes, and asked Marianne if they had been in contact.
After learning that the two had returned from Malaysia on the same plane, considered that there may be acute infectious diseases, the hospital immediately established a negative pressure isolation room to prevent the spread of bacteria.
During the isolation consultation, Marianne said that she had not had close contact with the deceased on the plane-if they were really affected by an airborne virus, it would mean everyone on the plane and in the emergency room Are all infected.
Soon, Marianne died due to ineffective rescue. From this point of view, it is very likely that this is a highly infectious and highly fatal infectious disease.
In order to effectively control the spread of the virus, the hospital soon implemented preliminary isolation measures. This detail of really does not require association, after all, we are suffering from the new coronavirus. It is also highly infectious and has a high fatality rate.
, the first responder's younger brother Taylor, who had brought the patient from the airport before, also showed a similar rash on his body, which made people suspect that he was also infected. Taylor was puzzled: Why did he still get infected when he was wearing a face mask and a mask when he was carrying out emergency transportation?
Not long after, Taylor also developed fever and other symptoms, and the approval to isolate the hospital emergency room was also approved. On one side of
, hospital staff urgently blocked the emergency room. On the other side, Lim brought the two remaining residents, Sean and Morgan, to explain the situation to all the people stranded in the quarantine area.
obtained through preliminary information sharing and laboratory analysis. This is an unknown acute infectious disease originating in Malaysia. The symptoms of patients are similar to those of SARS, but the virus spreads faster.
For the attending physician Melendez, this is simply bad news-he is preparing for a bone marrow transplant, and the bone marrow donor was also isolated in the emergency room by accident, but he cannot enter now. quarantine area.
Melendez has another unspoken worry, but he is afraid of what comes from it: his colleague Lim, who just had a "spark" with him, was also infected.
Lim immediately put himself in the isolation room after discovering the rash on his body. In a blink of an eye, the first aid brother Taylor also died in front of her.
As the "top commander" in the isolation area at this stage, Lim's self-isolation has undoubtedly increased the haze of the remaining medical staff in the emergency room. Sean and Morgan can only perform abdominal surgery on patients under the guidance of Lim's partition window under crude conditions. What's worse is that Lim passed out in a coma during the operation, and Morgan and the others had to complete the operation in a panic and deal with the unstable situation on the scene.
This is a crisis and a test. Morgan found that Taylor's mask was broken when he touched Taylor's body. From this, it was judged that the virus was probably drop-like , rather than airborne. It may be that the patient's saliva or blood passed through the mask to cause Taylor to be infected.
This is of course a guess, but the quarantine area must remain locked down until it is confirmed. Soon after, the quarantine of the hospital was lifted because the mode of transmission of the virus was confirmed and there were no new infections in the emergency room.
viewers have no way of knowing the investigations of other passengers on the plane, but the small emergency epidemic that occurred in the hospital was successfully resolved within 24 hours after three people died.
"Good Doctor" is a TV series after all, it contains a lot of dramatic artistic processing, can not be taken too seriously, and there is a difference between China and the United States. The small epidemic in the
plot is even more incomparable with the current domestic new coronavirus epidemic. However, for whenUnder the circumstances, this story still has a lot of reference and inspiration.
is the first to isolate . The emergency room area is isolated with the highest efficiency inside and outside the hospital. Whether it is a patient or not, for whatever reason, they are not allowed to go out after the isolation. Although
is out of protection, as soon as the news of the emergency closure is announced, there will be a high probability of fleeing due to panic in the isolation area-in fact, after Lim finished speaking, there will be one A panicked man raised his chair and tried to smash the door to escape.
Fortunately, Lim was prepared and hid a tranquilizer on his body. He looked at the timing and brought down the man to avoid losing control of the situation in a moment, and other people in the emergency room also quickly calmed down because of this scene.
When dealing with acute infectious diseases, especially unknown viruses that are not yet known how to be infected, effective isolation in the quarantine area is the most basic requirement for prevention and control , which is not transferred by people’s subjective wishes, even the so-called "human rights" ", you have to step aside when necessary.
Now the work of "clearing fields and reducing transportation" is in full swing all over the country. From Wuhan and Hubei to small villages and streets, the state machinery has been turned at full speed. In fact, the whole country is treated as a huge isolation. Area.
The incubation period of the new coronavirus is generally 3-7 days, and the longest is no more than 14 days. The infectivity is high, the incubation period is long, and the fatality rate is low. It is quite tricky to handle (like the high infectious, short The latent and highly lethal virus may seem fierce at the beginning, but it is actually easy to deal with. Those who have played "Plague Company" should understand). If the isolation at this stage is effective, normal social order can be gradually restored in more places. Therefore, please understand and cooperate with "Reduce going out and avoid gatherings" during this period.
After all, the chance of "squatting at home during such a long vacation" may not necessarily happen again in this life, please cherish it!
Panic is an inevitable part of the outbreak, and there is a typical supporting role in the story. Although the hospital who came to the hospital because of high blood sugar did not make any excessive behaviors when being isolated, he said the most. greatly contributed to the anxiety in the emergency room.
This buddy is anxious because of panic. In order to relieve his psychological pressure, he pesters Sean to inject insulin. It is estimated that the dose is not enough, and the dose must be increased.
Although Sean seemed a little weird when communicating, his words and deeds were not wrong, but the flustered buddies gradually began to speak bad words (did not dare to move their hands), and finally fainted temporarily because of nervousness and blood sugar imbalance.
At this moment, another patient developed asthma. Since no one was helping to treat him, Dr. Park, who was outside the isolation area, rushed in for treatment at all costs. Everyone saw other doctors coming in and couldn’t help raising their concerns and requests. , A large-scale panic reappeared in the crowd.
Everyone’s worries are understandable, and what they have said is meaningful, because once these questions and needs are not answered or fed back in time, rumors and riots will follow.
Under the weight of the chaos, Dr. Park, who became a monk, yelled to stop everyone's chattering (this buddy was a policeman before practicing medicine), and the commotion in the crowd lowered again.
In fact, none of the other people in the emergency room have been infected with the virus. If you wait patiently for the isolation to be lifted, everyone will be fine. In the face of the new coronavirus epidemic, we must maintain a serious attitude of fear, but we must not panic.
Don’t think you must be recruited in the quarantine area, and don’t scare yourself all day outside the quarantine area. The simplest is that a fever does not necessarily mean you will be infected with the new coronavirus. Winter and spring are the period when the flu is high. There are also common colds and other diseases that can cause fever.
If you have a fever, you may wish to dry yourself first, and immediately go to the designated hospital to queue up for examination, which will increase the possibility of infection (it is another matter if you suspect that you have a contact history).
As for nowIn the endless rumors, everyone can only work hard to improve their ability to discern. Whether it is blindly optimistic or blindly panic rumors, it is useless except to add confusion and chaos.
suggests that everyone should watch less of the epidemic-related things every day. If you have to watch it, official news shall prevail.
In the epidemic of "Good Doctor", there are many embarrassing emotional stories.
Tyler, the first responder, has always had a crush on Morgan, paying attention to everything about the other party but never said it. He didn’t dare to speak to Morgan until he was infected and isolated. Xueba, pragmatic, indifferent, few friends around, let alone boyfriends. Suddenly, a young man who seemed to know herself well, and his life was not long before appeared, her mood was mixed.
However, before Morgan could speak, the first responder went to heaven.
Some people are happy and some are worried. Dr. Park and his estranged son Karen reconciled. Melendez said affectionately "Merry Christmas" to Lim. The Viola family of three shared a happy time. The quarantined people let go of their worries. After Sean was discharged from the hospital Also hugged with his best friend Glassman.
"Love" has always been the background color in all our lives, regardless of time or location, it gives us the warmth when we are in the cold, and it also gives us the courage to face hardship.
In view of the continued impact of the new coronavirus epidemic, each of us will inevitably have anxious negative emotions, and some people even engage in regional attacks to vent.
If you want to ease these uneasiness and blindness, you must arouse more empathy that compares the heart to the heart, and the key is precisely "love".
Don't think "isolate virus, not isolate love" is just a simple slogan, it is the simplest and most correct truth today, because love is the bridge connecting everything.
author | young doctor
picture source | internet
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