After many years of severe science doctors, why did he learn "respiratory treatment"?

In the future, Chinese respiratory therapy practitioners will increase significantly and develop to diversified and specialized.

Written article | Tian Dongliang

Source | "Medical Community" public account

At the end of June, in the 24th National Emergency Medicine "Mechanical Ventilation" Skills Challenge held in the Emergency Medicine of the Chinese Medical Association in Changsha, two young respirators in Wuchang Wuchang Hospital were awarded the second prize of the group.

Xu Liang, director of the Department of Critical Medicine of Wuchang Hospital, is one of the doctors who study and promote respiratory therapy earlier in China. The two award -winning respirators were personally recruited and trained in one hand. A respiratory therapist from the science class.

As early as 70 years ago, the United States took the lead in establishing a respiratory treatment system, which has improved in terms of discipline construction, education and training, and practice systems. The respiratory therapy in China was late. In 1994, the Zhejiang Shaw Run Hospital took the lead in setting up a respiratory therapy department. In 1997, the Huaxi Clinical Medicine College of Sichuan University started the respiratory therapy major, but until now, respiratory therapy is still in its infancy in my country.

Director Xu Liang has learned breathing therapy as a doctor in 2012. In the past 10 years, he has not only continued to study breathing therapy, but also trained the establishment of the respiratory therapy team of Wuchang Hospital. An important responsibility.

Director Xu Liang (right) and Professor Luo Fengming (left), Professor Ge Huiqing (middle)

From learning to promotion

In August 2012, Xu Liang also worked in the intensive medical department of the Third Hospital of Wuhan City. The training of the month is the first time that Director Xu Liang has exposed to respiratory treatment.

Han Xiaotong wrote this training course. In 2007, the Hunan Provincial People's Hospital and the Canadian Ministry of Health Education signed a five -year respiratory therapist training program. Personnel conducts respiratory treatment training. Director Han Xiaotong was also the first student in this training course, and later went to Canada to conduct a two -month clinical visits of respiratory therapy.

Talking about the reasons for the training of respiratory treatment, Director Xu Liang said that mechanical ventilation is the most commonly used technology to save patients' lives in the severe medical department. The details are inconsistent.

"The level of control of mechanical ventilation at that time was very low. In communication with other professional doctors, they even feedback and even had some resistance to the patient's intubation. Because they felt that when they reached this step, the patient's mortality rate would be It will increase significantly. At that time, we thought that except for the progress of the patient's condition, the mortality rate increased. Is there a factors for our doctors in lack of technology? "

Director Xu Liang frankly said that although he knew breathing therapy at that time, his understanding of respiratory therapy was one -sided at that time, and he thought it was an ventilator. At that time he was already the director of the department, and he decided that he went to study first. In the training class of the Hunan Provincial People's Hospital, Xu Liang found that about 1/3 of the students were the same doctors as him. They all had a common confusion and wanted to find a solution through this training.

From 8 am to 8 pm every day, Xu Liang studied for a month. In addition to the training class, there are foreign experts, as well as the most professional professor in the field of respiratory therapy, including Taiwan experts. Through the study of the system, Xu Liang found that his past understanding of respiratory therapy was very narrow. "In the early days, I thought that respiratory treatment was just a technical application of a mechanical ventilation of a ventilator. After studying, I found that not only included mechanical ventilation, but also many severe rehabilitation technology and airway clearing. ","

In this training class, Xu Liang met Professor Zhu Jiacheng, pioneer of Taiwan's respiratory therapy, and studied in the Department of Respiratory therapy, China Medical University, which was traveled to Taiwan in 2014. In November 2018, Xu Liang obtained the qualifications of international visiting scholars from the American Society of Respiratory Therapy. The American Society of Respiratory Therapy went to study 3-5 people every year. Xu Liang was the only Chinese scholar in that year.

After the first training of respiratory therapists was received in 2012, Xu Liang began to carry out the work of popularizing the concept of respiratory therapy in the hospital. After returning from Taiwan in 2014, he began to popularize the concept of respiratory treatment in Wuhan and Hubei Province, and during the popularization of promotion, he met many experts who are interested in this and outside the province. In 2019, Xu Liang was elected as a member of the International Committee of the World Breathing Care Alliance. At that time, the other two Chinese members were Professor Ge Huiqing of Shao Yifu Hospital of Zhejiang University and Professor Luo Fengming of Huaxi Hospital of Sichuan University.

In 2017, Xu Liang was transferred to Wuchang Hospital in Wuhan City. He also brought the concept of respiratory treatment to Wuchang Hospital and began to build a respiratory treatment system at Wuchang Hospital. Xu Liang continued to send doctors and nurse to receive short -term training and training for respiratory therapy. In May 2018, he recruited two respirators who graduated from respiratory therapy. He officially established in Wuchang Hospital for the whole hospital Respiratory treatment group.

This group is centered on medical staff who have received the training of respiratory therapy. In addition to providing the business support for respiratory therapy for the various subjects of the hospital, it also trains the hospital and clinical nurse. The nurses of the hospital can fully understand the concept of respiratory therapy, and can independently deal with common problems related to respiratory therapy. "Let's take the relevant concepts, workflow and clinical specifications of respiratory treatment little by little, first teach the nurses of nursing work to work in nursing work, and then gradually improve the respiratory therapy ability of the entire ward through point of view, and slowly affect the clinician of clinicians. "Director Xu Liang said," Now our respiratory therapy has covered the community, because in addition to acute illnesses, the scope of respiratory therapy also covers the diagnosis and treatment of many chronic diseases. Once the lung function is lost, it will never come back. Therefore Academician Wang Chen has been trying to promote the standardized treatment of primary hospitals to attach great importance to slow pulmonary obstruction. "

Respiratory therapy, far away

According to the "National Vocational Skills Standards for Respiratory Therapists (Draft for Opinions)", the occupation definition of respiratory therapists is: using ventilator, lung function instrument, multi -guided sleep chart, atomized device and other respiratory therapy equipment to engage in cardiopulmonary and Evaluation, diagnosis and treatment, and rehabilitation of related organ functions, as well as personnel such as health education, consulting and guidance.

There are many diseases related to respiratory therapy, including respiratory failure, acute respiratory distress syndrome, heart failure, sleep respiratory disorders, lung infection, obstructive tracting pneumorphic diseases, interstitial pulmonary disease, pulmonary vascular disease, neurotome disease and thicken disease Newborns and children with cardiopulmonary diseases, lung cancer, obesity and other diseases.

In 2020, the new crown epidemic broke out. As the first city in China, Wuhan was the first city that was the most affected by the epidemic. In addition to treatment, the respiratory therapist was very professional in the management of the ventilator and the clearing of the patient's airway, and we joked at the time of the management of the ventilator and the clearing of the patient's airway. "

It is a pity that the number of special soldiers is not large. As of 2020, the Hunan Provincial People's Hospital's respiratory therapist training course has trained more than 1,000 on -the -job medical staff. These students who have received short -term training are basically on -the -job medical staff of various hospitals. They all have their own jobs. In the opinion of Director Xu Liang, short -term respiratory treatment training is not systematic and standardized, and these students can only do respiratory treatment, so all hospitals also need to have the "regular army" of respiratory therapist.

Professional medical institutions are the bases for cultivating respiratory therapists. At present, the United States, Canada and other North America and Taiwan have established a complete respiratory treatment teaching system, and all have a large -scale professional team of respiratory therapists. The professional education of Chinese respiratory therapists not only started late, but also developed very slowly. So far, high schools that have set up respiratory therapy are only Huaxi Clinical Medical College of Sichuan University, Zhejiang University Urban College, Zhengzhou Railway Vocational and Technical College, Sun Yat -sen University A few people such as Xinhua College have far from meeting the needs of respiratory therapists.

"China Tuberculosis and Breathing Magazine" published a signature article "Yang Wei, Liang Guopeng, Liang Zongan and other signed articles" Chinese Respirators Multi -level Professional Training Practice "in 2021. The article states that the top priority of respiratory education is to cultivate a group The professional teachers of regular training have gradually changed most professional courses at this stage.

On the one hand, the lack of respiratory therapists in my country. On the other hand, problems such as academic certification, lack of professional positions, and qualification certification of respiratory therapists have led to the loss of talents. Although the respiratory therapist was included in the national occupation classification catalog in 2020, at present, my country still lacks qualification certification of respiratory therapy. Many hospitals do not have a respiratory therapy department.

In Wuchang Hospital where Director Xu Liang is located, because he did not set up a respiratory therapy department alone, the two full -time respirators they recruited. Although the workboard was written on the workboard, it was a nursing series in terms of work preparation. "In our department, respiratory therapists are higher than the same -level nursing personnel."

If the "SARS" epidemic in 2003 made the Chinese medical community deeply realize that due to the lack of respiratory therapists, my country has a serious deficiency in the technical level of respiratory therapy, then the new crown epidemic in 2020 reveals my country's breathing again. Treatment shortcomings.

The article "Chinese Respiratory Therapist Multi -level Professional Cultivation Practice" predicts that in the future, Chinese respiratory therapy practitioners will definitely increase significantly and develop to diversified and specialized. How to cultivate practitioners in respiratory therapy? The article believes that more conditional colleges and universities should be encouraged to carry out undergraduate education in respiratory therapy. At the same time, in order to quickly expand the team of respiratory and respiratory therapy practitioners, they should also vigorously carry out vocational and technical education to cultivate "practical and technical" talents. In addition, the industry society should also vigorously carry out training classes to provide short -term system training for working doctors and nurses, so that the college can master relevant core knowledge and skills such as the basic knowledge of mechanical ventilation and new progress in respiratory therapy technology.

Director Xu Liang has now completed the transformation from a learner to the promoter trainer. As early as 2013, he launched an academic group called "free breathing" with the same Treaty of the major hospitals in Wuhan. The lectures of courseware and training do tour training on respiratory therapy in Hubei Province. "Now looking at the respiratory treatment in Hubei Province, compared with the rapid development of the past few years." This year, with the support of Professor Hu Bo, deputy director of the Department of Critical Medicine, Wuhan University A member of the Professional Committee of Injury Medicine set up a professional group of respiratory therapy below. Director Xu Liang said that the approval procedure has reached the last step, and the school group is about to be established. "I hope that with the establishment of the school group, we will gather our fellows in Hubei Province to engage in respiratory therapy, study and communicate regularly, and organize the development of respiratory therapy."

Source: Medical Community

Responsible editor: Zheng Huaju

School pair: Zang Hengjia

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