This article is from the public number: CC Forum (ID: ccjt2014) , author: ZHANG Wen-hong, Huashan hospital, director of infection , Shanghai Medical TreatmentThe head of the expert group, the original title “How to determine whether a child has flu or cold?” Is the vaccine good domestically or imported? Are there all-round antivirals? Teacher Zhang Wenhong’s CC Forum (3rd Season) “, picture from Tencent.
Interactive question one: Pneumonia, Klebsiella, sepsis, sepsis
Q: I would like to ask a question about pneumonia. I may be a bit excited because my father lived in the countryside for a long time. I went home in 2014 to celebrate the New Year, and then my father suddenly had shortness of breath. He died in the hospital on the first day of the first month of the first month. Then he died at the age of 73. I saw the diagnosis certificate as severe pneumonia. Later, I also saw the medical record, saying it was Klebsiella, I have always been particularly guilty and guilty for not taking good care of my father. I would like to ask Dr. Zhang today whether the mortality rate of this bacterium is high? Because my father had been living alone in the countryside at that time, and then he was admitted to the hospital for the last time, which is the third-tier hospital in a fourth-tier city.
Zhang Wenhong answering questions: Okay, thank you, you are actually consulting the medical record. This is generally what happened in our clinic. Of course, we did not charge the registration fee today because our doctor There is a saying that we often do free consultations, right? In fact, no registration fee is charged, and this is the case today.
(1) About Klebsiella:
The Klebsiella pneumoniae you are talking about is actually severe pneumonia. All the death rates today are particularly high. The first is severe pneumonia, so is SARS. The current influenza pneumonia is also 10%.
We have n’t been able to treat it. In fact, they are all severe pneumonia. Sometimes, severe pneumonia can be saved, and sometimes it cannot be saved. The most important thing is whether our doctors can figure out what bacteria or viruses this is the first time. The time required for this judgment is a very big test for our doctors.
(2) About sepsis and sepsis:
Your father left the doctor too short, too short. what is the reason? Because he was ill, he didn’t go to see him. He boiled at home and went to the hospital when he couldn’t get over. In fact, the time window left for our doctor was very narrow. Even though we found the pathogen, when he went, severe pneumonia caused by Klebsiella pneumoniae might have caused sepsis.
What is the mortality rate of sepsis? It depends on the number and age of the organs you have damaged. If you are very old, it is a sepsis caused by a bacterium, which is related to pneumonia, and its mortality rate is basically 80% or more.
This kind of patient, even in the best hospital in Beijing, may not be able to be rescued like Xiehe Hospital. To remind everyone, what is the reminder to everyone in front of the screen? Doctors are not gods. We need time. The earlier you come, the greater the safety space left for me and the larger my time window.
If it ’s all the last minute, the blood pressure ca n’t be measured, and then the person faints, there is already a serious problem in the lungs, and there is no breath. The time window for the doctor is extremely narrow .
(3) Upper medical treatment is not diseased, traditional Chinese medical treatment is minor disease, lower medical treatment is severe disease:
So we think we have a saying in medicine, what does it mean to go to the hospital for treatment? We must think about prevention when you are not sick. Then TCM treats minor illnesses, that is to say, you have just gotten this illness, we have enough time to find its cause, treat it symptomatically, and then go to the doctor to cure serious illness.
When you come to the hospital, when it is very heavy, the patient’s survival time will be very short, so what is your reminder for this case?
(4) Awakening Q & A from Zhang Wenhong:
The first is prevention, and the second is to go to the hospital early. Thirdly, when it is really incurable, we have a large class of diseases. In fact, doctors cannot save them. So I’ll tell you again here that doctors have very limited abilities. What’s the point? Patients need to look after themselves, especially when they are healthy, their own health is the most important.
The Klebsiella pneumoniae you mentioned is very toxic. It is the culprit of sepsis and sepsis that currently causes the most deaths in China. It is Klebsiella pneumoniae. Thank you for your question!
Interactive Q2: Why do not many children get the flu vaccine? Which is better, domestic vaccine or imported vaccine?
Q: I first thank Doctor Zhang for his constant anxiety, and then make us less anxious. Doctor Zhang mentioned a few times before going to the hospital to treat the disease. Although I insist on vaccinating my child every year, I actually do n’t understand it, because according to my personal observation, as the children in the class grow older, the proportion of vaccinations is increasing. It’s getting lower and lower, and every time I see this list, I also wonder if I need to continue to vaccinate my child.
After hearing what you said today, it’s that I’m more determined to give my child a vaccine. But I have a doubt. Whenever I choose, I choose only the expensive ones, so I also hope you can explain to us how to choose between domestic vaccines and imported vaccines. Because I am a child. So I always choose the right one at this time, so I also hope that you explain to us how to choose between domestic and imported vaccines?
Zhang Wenhong answering questions (1):
1. Who is the biggest beneficiary of the vaccine:
The first question you already answered is whether you should be vaccinated. But why is a vaccine like this so badly accepted? In fact, the vaccine is like this. When everyone is vaccinated, it does n’t matter if you do n’t receive the vaccine, because no one is sick, and no one will pass it to you. But when all people are not vaccinated, and only you are vaccinated, your benefit is particularly great. So the vaccine is inWhen a few people get vaccinated, you get the most benefit.
2. About anti-vaccine campaign and torture:
When everyone is vaccinated, it doesn’t matter if you don’t get the vaccine. There is often a discussion abroad whether the vaccine should be vaccinated. So there was a campaign abroad called the Anti-Vaccine Campaign. During a period of anti-vaccination campaigns, many parents resisted vaccination, and then areas like the U.S. would start to spread outbreaks of infectious diseases, like measles and flu.
So every time you have a vaccine, you have to face a torture: When you see everyone being vaccinated, some parents will not be vaccinated, and anyway, they will not be sick anymore, and I won’t plant it. But when more and more people think about it, you suddenly realize that our vaccine can no longer protect all of us. At this time, a small number of people who have been vaccinated will start to benefit, so I think the vaccination is undoubted It’s a very beneficial thing, and this is the first point.
Zhang Wenhong answering questions (2):
Whether you can identify domestic or imported cars, why ca n’t you identify them once you get the vaccine? Let’s talk the simplest. Do you buy domestic cars or not? In fact, they are all the same problem. Of course, I love my motherland, and of course I am full of trust! But if you have to let me judge what kind of car you want to buy, I think this is not a question I should answer. Thank you.
Interactive Q3: How should parents judge whether their child has flu or cold? what should we do?
Q: Hello, Director Zhang, you mentioned the treatment time for flu in colds just now. I am also a mother, and my children are sick quite frequently. Sometimes seeing a doctor, the pediatrician will suggest that if the child has a feverIf so, a minimum observation period of 48 hours is recommended. We are sometimes very nervous. When we are tangled with what symptoms the child has, we have to send her to the hospital to extend to our adults. How should we judge?
Zhang Wenhong answers:
(1) About the common cold:
1. Most of the time, in fact you don’t get flu. If you have a fever, most of the time, you don’t get flu. Because according to our latest data, the number of people in China is the latest and is over 1.4 billion, right? There are 1 million people in the flu in January, and 1 million is not much in 1.4 billion, so in most cases you don’t get the flu.
2. I also tell you clearly that if you have been vaccinated against influenza, then you have a lower probability of getting flu at this time, and you probably do n’t get flu.
3. Why does the common cold suggest that you should take some medicine for colds and observe it at home because it is very difficult to find a doctor abroad. It’s very easy to find a doctor in China, although you’re standing in line right?
4. You find it difficult to line up now. What’s the problem with this? Everyone went to the Beijing Children’s Hospital with their children, that is, the National Children’s Center in China, and then all the people in China drove to the Beijing Children’s Hospital. How crowded?
5, so I hereby tell you clearly that if the common cold and fever, even pneumonia, is in your area, the district central hospital is about the same level as any third-class hospital.
(II) About influenza:
1. When do you have to go to a special top hospital? After seeing it for a month, you still can’t tell, you should take your child there immediately! And youWhen should I run to the hospital with my feverish child without hesitation? In other words, the child’s situation changed. What changed?
2. The average child has a fever, and you will give him some antipyretics, right? Antipyretics. After eating, he burned and then retired. After the burn was retreated, he was alive and could do everything and started playing again. If he started to get upset, he did n’t need to go to the hospital for another 24 hours to observe. I do n’t think problem.
3. If the fever is gone, it is still suffocating, and some breathing is a bit difficult. Do not delay this time for a minute! Go to the hospital immediately!
So what does the child see? It depends on whether he is the same as the original one after the fever, and he is full of vigor, appetite, and begins to blind again. However, if the appetite is still gone and the spirit is getting worse, you should go to the hospital as soon as possible.
4. What will we detect for you when you go to the hospital the first time? The first test is the flu. If the flu is positive, there are a few of all current viral diseases that have drugs. For most viral diseases, we have no drugs and no special drugs because the virus is always changing and we have no special Medicine,
5. Influenza viruses are now effective. Why is testing the first time so important? Because it can be administered one day earlier, it is also good to administer it one day earlier.
(3) Zhang Wenhong’s wake-up Q & A: About children’s colds and flu
The observation point is here. Is the child burned out? Burn the child well, wait a minute; burn the child bad, go to the hospital right away! This point is critical.
Interactive question: Are there all-around antivirals?
Zhang Wenhong’s Awakening Q & A:
If someone says that I can get some antiviral drugs, can I? This logic is wrong, those misleading are all false! I’m not advertising here, I just strongly oppose the so-called antiviral drugs that advertise!
He said that this medicine is antiviral and that medicine is antiviral. The fact is not like this, our anti-virus is only for a specific virus, the doctor knows the future anti-viral drugs will be effective!
This article is from the public number: CC Forum (ID: ccjt2014) < span class = "text-remarks">, author: ZHANG Wen-hong, Huashan hospital, director of infection Shanghai specialized medical treatmentTeam Leader