Shanghai 120 front-line personnel: 14 trips in 7 hours, with dry food and water on duty every day

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“From 7:30 am this morning out of the car, to 2 pm, we have been out of 14 cars, the basic interval of 3-5 seconds, the next car out of the command came!” On the afternoon of December 25, Ruan Sheng, a 120 driver from the South District Center of Shanghai Medical Emergency Center, told the Punch News.

The 36-year-old Ruan Sheng is a party member and has also had experience in fighting the epidemic in Wuhan. 2020, he supported Wuhan 120 and was responsible for the local transfer of the new crown of critically ill patients within 42 days. This time in Shanghai, Ruan Sheng, together with EMT Li Zhu and EMT Wang Xiaodong, formed a temporary strike team that has been under closed-loop management since Dec. 19 to fully ensure front-line emergency work.

“They don’t have a fixed time off work, nor do they have a double weekend off, often resting for three or four hours and going out again.” In the eyes of Chen Yi-jie, director of the South District Center of Shanghai Medical Emergency Center, this three-member assault team, are tough guys, “As a 120 emergency person, life comes first. Recently there is more demand for emergency care from the public, and 120 trips are very busy, so each of us is working overtime, with a maximum of 20 trips in a day shift, basically receiving patients with fever, or patients with underlying diseases.”

Currently, Shanghai is ushering in the first wave of peak infections, and the city’s pre-hospital emergency work has been put to a huge test. Statistics from the Shanghai Health Care Commission show that on December 23, the city’s 120 calls in were 51,852, up 4.7% from the previous day, and the city’s 120 trips were 5,101, up 2.2% from the previous day, and up 33.5% in the last week from the previous week.

Chen Yi-jie, director of the South District Center of Shanghai Medical Emergency Center, is coordinating the first-line emergency work.

The number of trips is increasing day by day, and the dynamic scheduling taps the emergency power

There are 11 stations in the South District Center of Shanghai Medical Emergency Center, mainly responsible for receiving pre-hospital emergency services from Xuhui and Changning districts. In the past few days, with the increasing volume of emergency calls, the number of trips is rising day by day. Chen Yi-jie, the director of the sub-center, has a hoarse voice and can only leave work at 9 or 10 pm almost every day, and has to arrive at work at 7 am.

“Currently, we have people with physical conditions every day, and we may face ‘attrition’ at any time, so we need dynamic scheduling every day to tap all the emergency power.” Chen Yi-jie said that the protection of front-line emergency personnel is very important. Currently, the vast majority of our 120 cases are fever patients, basically positive patients, and we also need to protect the protection of all front-line emergency personnel by equipping them with protective masks, face screens, isolation suits, hand sanitizer, etc., so that they can avoid infection as much as possible.”

Recently, a group of social volunteers who serve as 120 drivers has also come to the South District Center. “We are also training them so that they can be familiar with the performance of the vehicle, the way of driving as soon as possible, and master how to operate the safety belt and liftable stretcher on the emergency vehicle, etc.” Chen Yi-jie said. Currently, the sub-center has added 9 daily vehicles despite the limited emergency resources. From 12:00 noon to 2:30 p.m., she made 200 calls to coordinate the first-line emergency work of all sub-stations.

“In order to protect our first-line emergency work, from December 19, we also set up a special southern district center assault team, consisting of 2 party members and 1 party activist, and the three of them received mostly elderly groups over 80 years old with fever and underlying diseases.” Chen Yi-jae said.

Ruan Sheng is the backbone member of this commando team. At 7:30 a.m. that day, he was in charge of the trip along with EMT Li Zhu and EMT Wang Xiaodong.

Wearing protective caps, N95 masks with face screens and blue isolation suits, the three sat on a 120 ambulance. On that day, most of the patients they saw had fevers above 38 degrees Celsius.

There was an elderly man with underlying disease, over 80 years old, who had had a cerebral infarction. The old man, who had been paralyzed in bed for a long time and infected with a new crown, not only had a high fever, but also had a significantly lower oxygen saturation measured at the scene, accompanied by shortness of breath. First responders feared that the elderly would develop complications such as pneumonia and used the fastest speed to get him into the 120 ambulance.

There was also an 82-year-old man with diabetes and hypertension who had a fever of over 38 degrees Celsius at home for three days. Luckily, when the three EMTs arrived, the basic condition of the old man was quite stable, his body temperature had dropped to 37.1 degrees Celsius, and his blood pressure, blood sugar and oxygen saturation were normal.

“In the case of the elderly vital signs stable, we communicated with his family, suggesting that the elderly can first home, temporarily do not go to the hospital, but also to avoid the risk of cross-infection, the family also expressed understanding.” Ruan Sheng said, “We will also remind the family in particular, once the elderly oxygen saturation downward, there is shortness of breath, chest tightness, the need to send the hospital for treatment at the first time, in order to avoid the elderly to the development of severe disease.”

120 driver Ruan Sheng (middle), together with emergency doctor Li Zhu (first from right) and EMT Wang Xiaodong (first from left), formed a temporary strike team for the South District Center.

EMTs bring dry food and water on duty and take a bite without affecting emergency care

Throughout the day, the three EMTs did not even have time to have a bite of hot food, almost just after completing the last task, followed by the next outgoing task, without a single moment of rest.

“As an EMT, we understand the meaning of the phrase ‘life comes first’.” Ruan Sheng said, “Every day before we go out, we will buy dry food such as cookies and bread in advance, and in our premises, there is ‘Ton Ton Cup’ to guarantee our drinking water for the day …… under the premise of ensuring that the emergency work is not affected. We will choose a relatively open place, take off the mask to eat a little, drink a little to ensure that our physical strength can last.”

Compared to the experience in Wuhan in 2020 when fighting the epidemic, Ruan Sheng confessed, “In the past, when we were in Wuhan, we still needed four hours to transfer in ‘dabai’ and could not drink or go to the toilet. Now that the virus is not as pathogenic, we can avoid becoming infected as long as we follow the relevant epidemic prevention norms and put every detail in place. Moreover, our understanding of the new coronavirus has gradually deepened, and we do not have the initial fear and panic. Most of the patients and their families also understand our work, and there are many people expressing their gratitude to us.”

At 7 p.m. on December 25, after a short break of four hours, Ruan Sheng, along with EMT Li Zhu and EMT Wang Xiaodong, went on duty again, ready for the 120 to go out. On that day, they would work until the early morning.

“We are working in a closed loop this time, now there is no way to go home, sleep and rest are only in the unit.” Ruan Sheng said, he also often think of his parents at home, “my father is not well, lumbar disc protrusion, slow hands and feet, but the good thing is that life can take care of themselves, cooking vegetables and cooking is not much of a problem. My mother has high blood pressure, diabetes and mild depression. Although she has also recently contracted a new crown, she is in a good frame of mind and has no more fever today, just some dry cough. They are both alone in one room and are carrying out self-health monitoring every day.”

“New crown infection is really not terrible, I hope that those who have elderly people at home can do a good job of self-health monitoring, especially to take more care of those who have underlying diseases at home, observe the changes in their condition and ensure their nutritional intake as well as their blood pressure, oxygen saturation, breathing and heart rate. Also, make sure to read more news from authoritative sources, don’t listen to rumors on the internet, and keep a good mindset to cope. I believe we can all work together to beat the virus.” Ruan Sheng said.

Emergency physician Li Zhu opens a vein for a patient. Among his recent emergency patients, most of them are fever patients and elderly people with underlying diseases.

Shanghai 120: Use 120 wisely and give emergency resources to critically ill patients

According to the data from Shanghai Health Care Commission, Shanghai’s pre-hospital emergency system consists of the city emergency center and nine suburban emergency centers (“1+9”), with 1,251 emergency vehicles and 4,046 employees. On December 23, there were 51,852 incoming 120 calls, up 4.7% from the previous day, and 5,101 trips, up 2.2% from the previous day, and up 33.5% in the last week. The personnel on duty rate was 70.3%.

In order to better ensure the development of emergency work, Shanghai Health and Health Commission has organized 7 central urban areas such as Huangpu, Xuhui, Jing’an, Changning, Hongkou, Putuo and Yangpu to send 191 doctors to support Shanghai Medical Emergency Center, 15 tertiary hospitals such as Zhongshan, Huashan, Ruijin, Renji, City Six, City One, City Ten, Oncology and Ichimoku Hospital to support the city’s medical emergency center, and each The suburban health care committee organized 56 physicians from district hospitals to support the suburban medical emergency centers.

As early as December 19, the Shanghai Municipal Health Care Commission also issued work tips to guide medical institutions to further accelerate pre-hospital and in-hospital connections, clearly requiring: first, the Municipal Health Care Commission will monitor the 120 pressure situation in real time, and for hospitals with serious backlogs, immediately contact the main leaders of the hospitals, requesting to speed up coordination and give priority to patients transferred by 120 vehicles; second, additional medical forces, expanded venues and other measures to enhance the emergency department Third, mobilize stable inpatients to speed up their discharge and reserve certain beds in wards to give priority to emergency patients with inpatient and observation needs.

The Shanghai Medical Emergency Center also calls for the rational use of “120” and the reservation of limited emergency resources for the elderly and seriously ill patients with serious underlying diseases.

In case of six conditions, such as difficulty in breathing or shortness of breath that cannot be relieved, persistent inability to eat or drink, or diarrhea for more than 2 days, a temperature above 38.5°C or heart rate over 100 beats per minute for more than 3 days after medication, a significant aggravation of an existing underlying disease that cannot be controlled, drowsiness, persistent refusal to eat, feeding difficulties, or persistent diarrhea or vomiting in children, headache, dizziness, panic attacks, breath-holding in pregnant women, or abdominal pain, vomiting, etc. and other symptoms, or abdominal pain, vaginal bleeding or fluid flow, abnormal fetal movement, etc. In these cases, 120 dispatchers will quickly obtain the relevant conditions and send emergency vehicles to protect patients with acute and critical illnesses on a priority basis.