Assembling the multi-disciplinary "most powerful brain", Zhejiang Hospital connected to Wuhan by remote consultation and treatment of critically ill patients

On the afternoon of February 27, a connection spanning more than 800 kilometers went smoothly, which brought together a number of heavyweight experts. At the Remote Consultation Center of the Sandun Campus of Zhejiang Hospital, Yan Jing, Zhejiang Hospital’s party committee secretary, led a Zhejiang hospital experts team composed of experts from the Department of Critical Care Medicine, Radiology, Infectious Diseases, and Respiratory Medicine, and connected to Tianyou Hospital affiliated to Wuhan University of Science and Technology.

In two hours, Zhejiang Hospital and the critical illness experts from the first and second teams of Zhejiang Medical who assisted Wuhan and the experts from Tianyou Hospital affiliated to Wuhan University of Science and Technology raced against the clock to analyze and study the difficult problems of each case, and gave full play to their respective problems. Professional advantages, combined with the first-line treatment conditions in Wuhan, proposed a scientific, reasonable, targeted, and highly maneuverable response plan to provide more thoughtful, meticulous and professional services to the first-line patients with acute and critical illness of new coronavirus pneumonia in Wuhan.

Gathering of critically ill experts

Front and back "combination of power"

Yan Jing said that Zhejiang Hospital had always implemented the decisions and deployments of the Party Central Committee, the Provincial Party Committee and the Provincial Government. And the aid to Hubei would be used as an "important battlefield" for hospitals to fight the new coronavirus pneumonia epidemic. In order to win this battle, it is our duty. "We have fully integrated experts, logistics, Internet and other resources. Whether on the front line or the rear, as long as necessary, we will fully mobilize the advantages of the entire team of experts, share treatment experience, and contribute to the fight against the epidemic."

In Wuhan, a large number of critically ill experts gathered and connected to the Sandun District of Zhejiang Hospital through video, including the team of the Critical Care Medicine Department of Tianyou Hospital Affiliated to Wuhan University of Science and Technology, the team leader of the second batch of supporting Wuhan medical team in Zhejiang Province, and the vice hospital of Zhejiang Hospital. Song Baishan, Vice Chairman of the Critical Care Branch of the Zhejiang Medical Association, Huang Liquan, Vice Chairman of the Youth Committee of the Critical Care Branch of the Zhejiang Medical Association, Cai Jing, Chief and Section Director of the Critical Care Team of the Second Zhejiang Medical Team in Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan Science and Technology Zhu Wei, director of the ICU of Tianyou Hospital affiliated to the university, Hu Weihang, assistant to the director of the Department of Critical Care Medicine of Zhejiang Hospital, etc.

In the rear, Yan Jing led the team, including ICU (1) Director Gong Shijin, ICU (2) Director Cai Guolong, ICU (2) Deputy Directors Hu Caibao and Xu Qianghong, Director of the Department of Infectious Diseases Wang Hong, Director of Radiology Department Zhang Jianjun, and Deputy Director Feng Yue, Tang Tingyu, the deputy director of the Department of Respiratory Medicine (in charge of the work), and ICU physician Xu Liang and other 10 experts are on the list.

At 3 pm, the consultation officially began. The large screen of the remote consultation center in the Sandun campus of Zhejiang Hospital was turned on, and real-time transmission of images of the front and rear medical staff, as well as various data of the patient.

Song Baishan first introduced the work of the medical staff of Zhejiang Hospital assisting Hubei on the front line, "Everyone is well, please rest assured. With your care and support, we will be more motivated to contribute all our strength to defeat the Wuhan epidemic."

  Qi Yun, Secretary of the Party Committee of Tianyou Hospital Affiliated to Wuhan University of Science and Technology, expressed his sincere gratitude to Zhejiang Hospital. He said, “It has a positive effect. The patients in this consultation are all critically ill patients with typical clinical characteristics admitted during their stay in Wuhan. It is hoped that through multilateral discussions, the treatment plan can be optimized and the treatment effect can be improved."

Remote Consultation on Measures

Multidisciplinary case discussion of COVID-19 critical illness

Thousands of miles apart,is like close at hand. The critically ill COVID-19 patient in the consultation was a 64-year-old male. Cai Jing first reviewed his situation. It was divided into medical history, diagnosis results, changes in some physiological indicators after admission, and medication, diagnosis and treatment after admission.

"The patient is currently in a state of continuous sedation and analgesia, with a RASS score of -2~-1" "Oxygen concentration 70%" "Respiratory rate 22 times/min" "Obvious diarrhea, watery stools, a total of 7 times, more volume on February 25 " As Cai Jing introduced, the patient's various pathological data and imaging reports appeared on the large screen at the rear at the same time. About 15 minutes later, Cai Jing gave a detailed introduction of the patient's condition and expressed the hope that she would be able to get some advice on the next treatment.

After reviewing the treatment process and a series of imaging data, analyzing laboratory data and a series of ventilator parameters, the expert team of Zhejiang Hospital had a detailed discussion with front-line experts on the follow-up treatment plans, focusing on the patient’s infection, hypoxia, medication and other issues, and combined with the changes in CT images of the lungs.

In the discussion stage, the expert teams from both sides conducted detailed discussions and adjustments on the use of ventilators, antibiotics and the stability of the internal environment based on the details of the discussion. Before the deadline for publication, the patient's condition has improved significantly through the joint efforts of the expert teams of both parties.

“This joint consultation has a long name list and gathered a number of experts in the field of critical illness in China to study and discuss the treatment plan of new coronary patients online. Through the sharing of cases by front and rear medical staff, and the point-to-point discussion of multidisciplinary experts, it not only could provide strong support for the front-line expert medical care, optimized the patient's treatment plan, and at the same time enabled the rear expert medical team to experience "actual combat" and summarized experience. Such remote consultations would also be normalized, appearing in more and wider areas and fields. It was of far-reaching significance for further improving the level of critically ill treatment and saving more lives of critically ill patients. " Yan Jing concluded.

The battlefield for the prevention and control of the new coronary pneumonia epidemic was still severe. In the face of the epidemic, the 14 "white soldiers" in Zhejiang Hospital shouldered their missions and responsibilities to assist Wuhan, Zhe Yi Hospital and Wenzhou. At the forefront, in Wuhan, Zhejiang medical staffs have used their strong combat power and unity and cohesion to participate in the war of epidemic. "You have worked so hard!" "You must protect yourself!" During the remote consultation, Yan Jing also expressed sincere greetings to the frontline medical staff in Wuhan on behalf of all hospital staffs, paid tribute to their hard work and dedication, and urged them to adjust their physical and mental status and protect themselves, and devote their heart and soul to winning the battle against the new coronavirus pneumonia epidemic.