There is an essential difference between whether a newborn is born with full term or not. (1)

Daisy's son does not have a name yet, but the various organs in his body are basically mature and have corresponding functions, so he can fully adapt to survival outside the uterus. Even if he encounters the h1n1 influenza virus, he can still use his lungs to fight.

The h1n1 test report was placed in front of Robert and Qi Jing, ""it was particularly eye-catching.

The bizarre h1n1 virus infection three months ago also made Robert remember it. At that time, two patients in the pediatric department were infected with h1n1, and finally they were isolated from the custody room to avoid spreading. However, the few wards downstairs were not so lucky, especially the heart, respiratory and geriatric wards, which spread very quickly.

"Give oseltamivir first." Qi Jing touched the child's skin, "the body temperature is coming."

Robert had also used oseltamivir before, but the newborn is different from a three or five-year-old child. He was unsure: "Can you use that young?"

"Oseltamivir is quite gentle to children, and it may have some side effects if used." Qi Jing looked at the breasts on the bedside in the video reader again, "If not, his lungs will be done! You should know the lethality of severe pneumonia to newborns better than me."

With the advice of a respiratory doctor, I had an H1n1 test report and a chest radiograph report in my hand, so there was really nothing to hesitate. Because the treatment recommendation for CDC at that time was to actively antivirals, the drug used was oseltamivir, and the earlier the medication, the better the effect.

The results of use are also obvious.

Robert quickly made a decision: "This is the drug, hoping to suppress the inflammation."

The mature two lungs allow children to still get a lot of oxygen when they are attacked by the virus. Although they have mild suffocation, they are still within a controllable range. This makes pediatric treatment much easier. You only need to control your body temperature and dosage, and monitor vital signs at the same time.

All that remains is oxygen absorption.

Of course, this patient is a newborn after all, and Robert is not completely relieved now. What he fears most is that viral pneumonia will further aggravate. Severe viral pneumonia will often cause the lungs to become more solid and deprive both lungs of their natural ability to resist microorganisms.

At this time, bacteria with more lethality will invade.

Viral pneumonia combined with bacterial infection is not a good thing. Treatment with oseltamivir and antibiotics will have great side effects on the young body of newborns. The results are often not much better. Even if it can be cured, their kidneys will be scrapped.

However, it is Robert's job to prevent Yu Weiran, and Qi Jing just wants to know the h1n1 report.

Now that he has obtained the report, Qi Jing's focus has shifted from the child's physical condition to the source of the virus.

The range of h1n1 transmission was very wide at that time, but there were few reports on vertical transmission of maternal and infants. There were no more than ten cases in Qi Jing's memory. These newborn h1n1 cases were not completely mother-to-child transmission, and a few cases were actually infected after birth.

So who has never obtained evidence of vertical transmission, but the phenomenon of vertical transmission actually exists, and there are situations like Daisy and her son.

For Qi Jing, it is not important to how the virus penetrates the placenta or how it attacks the fetus' body. What is important is that since such an extremely accidental chance occurs, front-line doctors need to use this to try to find out the source of the infection.

Among a lot of uncertainties, the only thing that can be confirmed is that if the child has h1n1 at birth, the mother must have it. If the mother does not have it now, she must have it before.

But strangely, the H1n1 case in Lehn Town was cleared a month ago. If it was infected before, how could it be lurking for so long after the virus spreads along the mother-to-child system? If it were infected at the beginning, it might have exploded long ago, further affecting the pregnancy course, and it would have been prematurely born in the early 30s.

From this point of view, Daisy should have just been infected recently.

So where did her infection come from?

The so-called clearance of cdc cases should not be so casual...

Qi Jing sat at the desk in the custody room and looked at the child's chest radiograph, but what he was thinking about was Daisy who had experienced heavy postpartum bleeding on the first floor. Robert, who was standing next to him, tapping the tabletop with one hand and holding the phone receiver in the other, with a serious expression.

A confirmed case appeared in his ward. Considering that his mother is also very likely to be a confirmed patient, he must report to CDC as soon as possible.

"It's finally done, thank goodness...hey, is it cdc?"

"Len County's disease control...yes, here is cdc, what's wrong?"

"I am a doctor at Lehn Hospital. There is a patient with H1n1 flu here." Robert subconsciously tightened his mask. "There are severe lung inflammation. I hope you can guide the treatment and come here to carry out traceability work."

"I know, I know you have a suspected case of h1n1. Has the test result been released?"

Know???

Robert's doubt flashed through his mind and immediately answered the other party's question: "Well, the result was positive."

"You are too inefficient. You said you need to have a test at 10 o'clock. Why did you get the result now?" The doctor on the other end of the phone yawned and suggested, "Talk to him more and don't make him panic too much. Just say that h1n1 is similar to influenza."

Talk???

Robert wanted to explain, but the other party kept talking and didn't give him a chance to speak: "If you guide the treatment... By the way, have you used oseltamivir? oseltamivir still has a certain effect on h1n1."

"Feed, I used the oseltamivir phosphate granules left last time."

This time the question mark moved to the other side of the phone.

Feed? Granules?

Granules of melted water are for children and the elderly who cannot take pills. Who should take granules for normal people?

"Why do you need granules? Are there no pills?"

"The patient is a newborn, so he must use granules." Robert finally gave the answer, "Now the child has lung inflammation, his body temperature is 38.3 degrees, and his nucleic acid test is positive."

"You just said that the patient is a middle-aged man, why has he become a newborn again..."

"Mid-aged man?" Robert heard it for no reason, "I am a pediatrician. I am a newborn here. I was born two hours ago. Because of mild asphyxiation and pneumonia, we checked nucleic acid and the nucleic acid test result was positive. I think his mother must have h1n1!"

I was indeed a middle-aged man just now, and now there is another mother and son. It was not until then that doctor cdc realized the seriousness of the problem: "Okay, I understand, I'll send someone here soon."

Robert finally breathed a sigh of relief when he heard this.

Fortunately, Dr. Magna specifically reminded himself that h1n1 would have been missed like this.

Once he missed, the child could not receive targeted antiviral treatment within 48 hours, and it is very likely that he could not even defend the first wave of pneumonia. When he really reacted, his lungs, which were eroded by inflammation, might have collapsed long ago.

If the child is not kept, there will be a chain reaction on the eighth floor. Not to mention medical staff, more than a dozen hospitalized children will suffer.

Robert hung up the phone, still scared, and wanted to turn around and have a good chat with Dr. Magna just now. But unexpectedly, the person disappeared in just two or three minutes.

"Where are people?"

He searched in the ward for a while, and even ran out of the ward and searched back and forth, unable to even see his figure.

Seeing him like this, the nurse couldn't help but ask, "What's wrong?"

"Did you see that doctor?" Robert quickly described the other person's appearance, "I am shorter than me, thinner..."

"Oh, I know, Dr. Magna." The nurse smiled, "It's not long since."

Robert stood by the nurse's table and hesitated for a while, looked at the elevator entrance in the distance, shook his head and sighed: "Forget it, h1n1 is under greater pressure on respiratory departments, he needs to be busy for a while..."

"Doctor, what did you say just now?"

"H1n1 is back, it's the newborn I just brought up." Robert said, "First disinfect the entire ward according to the method three months ago. I guess all the staff in the hospital will have to undergo nucleic acid tests tomorrow morning. I hope the situation will not be too bad this time..."

......

Dr. Magna, in Robert's eyes, had just left the elevator and was standing at the door of Clinic 106 on the first floor. It was 2:43 am.

Morton, who was originally lying on the bed of a first aid stretcher, had been taken back by his son, and Daisy, who was deeply involved in postpartum bleeding, also left here. As early as 20 minutes ago, her condition worsened, and Xu Jiakang asked Miller to call the transfer car to go to the nearest Stitz General Hospital.

The hospital there is much better than Lehn, at least they have their own obstetric rescue team and obstetric operating room.

In just twenty minutes, Qi Jing missed a highly suspected case. Although there was a signal after the phone number, the noise was too heavy, so Qi Jing could only contact Xu Jiakang, who had gotten into the car through text messages.

【The result of the child is positive, and the mother must be positive】

【knew】

[When you arrive, please communicate with the local hospital and try to isolate it as much as possible]

【Um】

Seeing that the number of words replied was getting smaller and smaller, Qi Jing knew that the mother had a big problem, and Xu Jiakang had no time to communicate anymore.

In fact, the development of things was worse than he expected. Since taking over the rescue power, Xu Jiakang's heart has been hanging in the air. Daisy's body is like a water bottle with a leaking bottom. The hang red and crystal colloid that had just entered the body turned into the blood vessel for half a circle and had to flow out of the uterus.

A simple subclavian vein was not enough at one point, so the nurse could only rely on pressurized blood transfusions.

Daisy's husband was more willing to stay in the hospital in the face of the high transfer fee and the uncertainty of long-distance transfer. However, Xu Jiakang still helped Miller make a decision. The opportunity for the transfer was the coagulation function report he repeatedly asked for, that is, the four coagulation items.

pt:14.6s, aptt:47.8s, tt:17s, fib:1.5g/l(2)

Only PT time is still acceptable, and the other three items have already indicated that the patient's coagulation function has decreased significantly. Daisy's uterus is like an exploded fire hydrant, with water flowing everywhere, and it can no longer be stopped by stopping the bleeding alone.

At this time, in order to block the bleeding, it is obviously unwise to repair the fire hydrant on the spot. The best way is to remove the broken fire hydrant as soon as possible and block the blood vessels. Therefore, staying at Lehn Hospital, which has no ability to open the laparotomy, is waiting to die.

Lehn Town is located in a remote location, and the hospital has insufficient capacity and emergency response. It took more than an hour to wait for the coagulation report and transfer to the hospital.

When the doctor on the transfer bus saw the emergency record sheet, his hands couldn't help but tremble: "The total bleeding volume actually exceeded 3,000ml, and the blood in the whole body has been replaced by more than half. Why did he delay it for so long?"

"The patient has no insurance and didn't want to give it to him before, but now it's useless to say this. Let's stabilize the vital signs first."

"The blood pressure and heart rate are quite reasonable, but dic can't stop it." The doctor with the car looked at his husband sitting at the back door, "Are you a family member?"

"Um......"

"I must tell you that the patient is in a bad condition and there may be accidents on the way. Please cooperate with us at that time."

"Um......"

"Check the transfer intention form as well."

"Um......"

Xu Jiakang, who was standing by, sighed, pulled out the paper and pen around him, and carefully calculated Daisy's total inlet and exit in the past four hours: "Total bleeding is 3300, urine is 200, crystal 1500, colloid 350, hanging red 1200, plasma 400, prothrombin complex 300, fibrinogen 1g......input 3450, almost..."

"Have you contacted Statz General Hospital?"

"I made a call before and it has explained the general situation."

Dr. Che nodded, looking at the shocking amount of bleeding, he called the place again in accordance with the principle of being on the safe side: "Hey, I am Dr. Che from the emergency center. I just received a patient with severe postpartum bleeding from Lehn Hospital..."

“,,,,,”
To be continued...