Yangtze River ** Wuhan Client, February 8 - A 2-year-old boy fell from his bed and went to a community hospital in a coma a week later. The community hospital relied on the "Maternal and Child Health Community" of the Hubei Provincial Maternal and Child Health Hospital to open a green channel and quickly transferred the child to the Provincial Maternal and Child Street Entrance Hospital for treatment. After investigation, the child had cerebral infarction and cerebral herniation caused by intracranial hemorrhage, and after emergency craniotomy, the child turned critical.
On January 23, 2-year-old Hao Hao (pseudonym) accidentally fell while playing in bed, the child cried bitterly, and the parents hurriedly hugged him to comfort and check, but no obvious injuries were found. For the next few days, the child was always devoid of energy, and on the sixth day he fell into a coma.
On January 30, his parents sensed that something was wrong and sent Haohao to the local community health service center for treatment. The doctor found that the child's response was very poor and he could not call for help, so he quickly contacted the Optics Valley Branch of Hubei Provincial Maternal and Child Health Hospital for quick medical support. Knowing that the child was in critical condition, Lian Hongmei, the person in charge of the hospital's medical office, responded quickly, opened a fast green channel, and sent the child to the Hubei Provincial Maternal and Child Health Hospital for treatment through 120 transfers.
At 3 p.m., the child was transferred to the street entrance yard. "At that time, the child was in a deep coma, with difficulty breathing, cramps and shaking of his limbs, high muscle tone, and unequal pupils on both sides, with a right pupil of 60mm, the reflection of light disappears. Xia Zhi, deputy director of the Department of Pediatric Intensive Care Medicine, according to Haohao's clinical reaction and his family's memories of falling from the bed, initially considered it to be intracranial hemorrhage, and immediately used hemostatic drugs and a ventilator for him, and improved relevant examinations. Sure enough, the CT examination found that Haohao had intracranial hemorrhage, which led to a large cerebral infarction, and the midline of the brain had been deviated.
The child fell and injured his head a week ago, and he has already developed a brain herniation, and his life will be in danger if he continues to delay. Ma Yunfu, director of the Department of Neurosurgery, made a judgment after consultation: craniotomy must be done immediately.
At 5 o'clock in the afternoon, under the strong protection of the surgical anesthesiology department, Ma Yunfu performed subtemporalis decompression of the right bone flap for Haohao. The operation lasted for two hours, which effectively relieved his intracranial hypertension and avoided further damage to his brain cells.
Ma Yunfu, director of the Department of Neurosurgery of Hubei Provincial Maternal and Child Health Hospital, and Xu Hui, director of the Department of Pediatric Intensive Medicine, examined the children.
After the operation, Haohao, who was in a coma, was transferred to the Department of Pediatric Intensive Care Medicine for continuous mechanical ventilation, intracranial drainage, intracranial pressure monitoring, and neurointensive care monitoring. Ma Yunfu came to the joint ward rounds every day, and Xia Zhi led the team to guard the child's bedside day and night, adjusting medication and dressing change at any time according to the intracranial pressure monitoring data.
Forty-eight hours after the operation, Haohao's head CT review showed that the midline deviation had been corrected, the brain herniation had been mostly relieved, and the vital signs such as heart rate, respiration, and blood pressure had gradually stabilized.
Seven days after the operation, Hao Hao yawned and other limb movements, breathed steadily, and was successfully evacuated from the ventilator.
Falls and injuries are a common problem for children, but parents must not be careless. Ma Yunfu reminded parents that if the child hits the head, they should first observe the severity of the head injury, and if there is a laceration on the scalp, they should go to the hospital for debridement and suturing; If the child has headache, vomiting, or head slapping with his hand, or even convulsions, confusion, etc., within 72 hours of the injury, it is likely to be an intracranial hemorrhage and should be sent to the doctor immediately for relevant examinations and**.
Haohao's ability to achieve rapid and effective treatment benefits from the "maternal and child health community" model established by the hospital and primary medical institutions. It is reported that the Provincial Maternal and Child Health Hospital takes the "Maternal and Child Health Community" as the carrier, and helps the community health service center to improve its health care service capacity through technical guidance, clinical teaching, skills training and expert consultation, etc., and promotes the technical improvement and business development of primary medical institutions.
Yangtze River ** reporter Zhang Ming correspondent Luo Huarong Huang Jieying direction **Production Zhang Ming).
Editor: Yu Lina].
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