Chongqing Formula was founded in 1962 by Southwest Hospital of the Third Military Medical University.

They advocated that the amount of fluid replenishment in the first 24 hours after injury should be 1.5ml per kilogram of body weight and 1.5ml per 1% tbsa (the burn area is calculated based on the actual burn area). The ratio of crystalloid to colloid is 2:1, and 2000ml of water should be added.

In the first 8 hours, 1/2 of the total fluid replacement volume was given, and the other 1/2 was given at a constant rate in the next 16 hours; the fluid replacement volume in the second 24 hours after injury was 1/2 of the actual fluid replacement volume in the first 24 hours.

Shanghai Formula was founded in 1965 by several hospitals including Shanghai Dongshan Hospital.

What they advocate is that the amount of fluid replenishment in the first 24 hours after injury is 1.5 ml of fluid per kilogram of body weight (the burn area is calculated based on the actual burn area), the crystalloid ratio is 1:1, and 3000 to 4000 ml of water is added;

The amount of fluid replacement in the second 24 hours after injury is 1/2 of the actual fluid replacement amount in the first 24 hours, plus 3000 to 4000 ml of water.

The Nanjing formula is mainly suitable for wartime and mass burns, so it has not become the mainstream rehydration formula in China.

Having written so much, the main difference between the Chongqing formula and the Shanghai formula is that the Chongqing formula requires less fluid replenishment, while the Shanghai formula requires more fluid rehydration. In addition, the ratio of crystal gel is also different. One claims 2:1, and the other claims 1:1.

Even though the numbers are only slightly different, the therapeutic effects are vastly different.

The main difference between the Chongqing formula and the Shanghai formula and the mainstream fluid rehydration formula recognized by later generations is that

The Chongqing formula is the most effective for rehydration of patients with small and medium-sized burns of less than 50%, and is also the closest to the rehydration formula of later generations. Later clinical trials have proven that the Chongqing formula is relatively the most scientific.

But the disadvantage is that the rescue effect is not good for large burns with an area exceeding 50% or for severe burns.

The reason is that the Chongqing formula rigidly believes that severe burns only need to be replenished with less than 50% of the infusion volume.

This raises a big question. How can a patient with 30% burns and a patient with 90% burns have the same amount of infusion?

The Chongqing model originally had a small amount of fluid replacement, and now the amount of fluid replacement for patients with severe burns is even less.

Formulas with a small amount of fluid replenishment often fail to maintain circulating blood volume well, resulting in the persistence of ischemic and hypoxic damage, which can lead to patients' death from insufficient blood volume, renal failure, etc.

There is another misunderstanding. It is true that the crystal glue ratio is 2:1, but for patients with severe burns over large areas, the crystal glue ratio should be adjusted to 1:1.

In fact, Southwest Hospital's research is already at the forefront of the country and is much more advanced than the Shanghai formula and the Nanjing formula. But why are there still so many misunderstandings?

This is not because the quality of Southwest Hospital is not good. It is because the domestic conditions in the 1970s and 1980s were too poor. Most medical instruments were lacking, so first-hand experimental data was not available. How to carry out clinical research work?

This is also the reason why in the 1980s, patients with burns exceeding 60% could not be saved.

This chapter is not over yet, please click on the next page to continue reading! The camera continues to return to the burn surgical ward of Vietnam-China Hospital.

Just when Chen Qi was leaning against the door frame, eager to eat melon seeds and watch the excitement, Deng Changle also completed the debridement and walked out of the ward. The two met face to face for the first time.

Chen Qi knew that the other party was an expert from Shanghai, so he smiled and nodded.

Deng Changle had already passed by, then stepped back, and asked with some uncertainty: "Hello, are you Comrade Chen Qi?"

"Uh, yes, I am Chen Qi."

Chen Qi thought he had met another fan of his, so he continued to smile and nodded:

"Are you from Shanghai Dongshan Hospital? May I ask your surname?"

When Deng Changle saw that this legendary "enemy" was so young, he couldn't help but sigh.

"My surname is Deng, Deng Changle. I am the deputy director of the Burn Surgery Department of Dongshan Hospital. Director Chen, what are you..."

Chen Qi thought to himself, Deng Changle? This name sounded familiar to him, but he couldn't remember it for a while, so he said awkwardly:

"Isn't it because I want to see how the experts in Shanghai and Hainan rescue patients? Originally we were responsible for the workers at the Yue Steel Plant, but now that you are here, you are responsible. So I also want to see the treatment methods in Shanghai and Hainan.

What’s the difference with us?”

Deng Changle wanted to laugh in his heart, thinking that young people are really arrogant when they talk, and they actually put Yuezhong Hospital and Dongshan Hospital side by side?

"Well, I heard that there are 38 injured people in the Yue Steel Plant this time. We are responsible for these three seriously injured people, and your Yue Zhong Hospital is responsible for the rest of the lightly injured people. However, the treatment plans for the seriously injured and the lightly injured are different.

Yes, you will learn it in vain if you learn it, it’s too complicated.”

Chen Qi blinked:

"No, no, no, we also have two patients with severe and extremely large area burns. One has 2,3 degree burns covering 83% of the area, and the other has 2,3 degree burns covering 90% of the area. Moreover, they have been burned for a month and were just sent to the hospital.

Come to our hospital."

Deng Changle thought to himself, do you think I'm a fool? I had such a severe burn and lay at home for a month and still didn't die?

"Haha, Dean Chen is really good at joking. How can it be possible that someone with such severe burns has not had an accident for a month? This has never been heard of at home or abroad."

Chen Qi gestured with his mouth:

"No, I'm just lying in the ward. The patient who was just admitted yesterday was covered in pot ash and Chinese herbal medicine when he came. He stayed at home for a month without dying, so his current condition is worse than the Yue Gang you have.

Factory workers are more complicated."

Deng Changle followed Chen Qi's prompts and walked to the door of the other two wards, where he saw two patients, one large and one small, lying on the bed.

He was a professional doctor, and he could tell at a glance that what Chen Qi said was true. The burnt area was indeed very large, but he didn't quite believe it when he said that he was still alive after a month.

Suddenly he thought about why Chen Qi wanted to "peep" at their rescue operations at Dongshan Hospital. Could it be that he wanted to compete?

Thinking of this, Deng Changle was really happy. Fortunately, Liang Jingru was only 11 years old these days and had not debuted, otherwise he would definitely sing a song "Courage" for Chen Qi.

"Dean Chen, are you planning to compete with us on who can save the patient's life? Oh, I understand. It seems that Director Chen is quite dissatisfied with Yue Steel Plant's hiring of doctors from outside hospitals."

The tone of Deng Changle's words was condescending, which Chen Qi disliked very much.

I am a co-director and vice-president of the International Medical Association. What can I do about the deputy director of the burn department? Where does this inexplicable sense of superiority come from?

So Chen Qi stopped being polite and said with a smile:

"Yes, the burn surgery department of Dongshan Hospital is quite famous in China. Otherwise, Yue Steel Plant would not be far away. But I don't think Yue Zhong Hospital is any worse. Now that I have this opportunity, I also want to see Dongshan.

How is the quality of the hospital?"

Deng Changle waved as he walked: "Then let's study hard at Yue Traditional Chinese Medicine Hospital."

Chen Qi thought to himself: This guy is really rude, he is afraid that he will get slapped in the face later.

Deng Changle also thought to himself: This guy is really crazy, so let him use his strength to swell Chen Qi's face.

The two of them whispered to each other inwardly, and then began the rescue work.

After Deng Changxi returned to the ward, his assistant Zeng Chu came over and asked:

"Teacher Deng, what fluid should we add first?"

"First add isotonic saline and 500ml of 0.9% sodium chloride solution."

Dongshan Hospital's fluid replenishment method is to open and close large doses. If you use large doses, you are afraid that the amount of rehydration will be insufficient and the circulating blood volume will be insufficient.

After Chen Qi returned to the ward, he also began to give medical instructions, "Zhang Xing, first give 100ml of 3% sodium chloride solution..."

There was a disagreement between the two during the first round of treatment. Dongshan Hospital used isotonic saline, while Yuezhong Hospital advocated using hypertonic saline.

Who is right and who is wrong?

Needless to say, Chen Qi used a rehydration solution developed by countless medical scientists and verified by numerous clinical trials. How could he be wrong?

Isotonic saline is an infused crystalloid solution based on a + 154 mmol/l each. When the infused amount is too large, it is very easy to produce hypochloremic acidosis or hyponatremia, so it cannot be used as the first choice.

Even if a crystalloid solution is used, it is mainly sodium lactate Ringer's injection, and later sodium pyruvate injection.

Isotonic saline has long been eliminated in later generations, but in 1989, Dongshan Hospital was still using this old prescription. It can only be said that patient rescue was really off to a bad start.

The reason why Chen Qi used hypertonic saline solution was because early use of hypertonic saline solution can reduce the total amount of fluid input and help reduce systemic edema.

At the same time, it can also reduce the occurrence of hyponatremia, reduce the content of inflammatory factors in the blood, and reduce edema and oxidative damage of visceral tissues such as the lungs, intestines, liver, and kidneys.

So if God were to be the referee, in this first round, Chen Qi would score 1 point and Deng Changle -1 point.

Then comes the second round: disinfection.

If such a large area of ​​wound is exposed and the disinfection work is not done well, once infection occurs, it will be completely over. This is why patients with severe burns need a sterile ward.

This chapter is not over yet, please click on the next page to continue reading! The main force of domestic disinfection in the 1980s was alcohol, iodine, and hydrogen peroxide.

These three disinfectants are used to clean wounds. Oh boy, it really hurts like hell.

The first thing that causes pain is alcohol, followed by iodine containing alcohol.

The alcohol content in medical alcohol reaches at least 75% or above, so it is very irritating.

Applying alcohol to a wound will cause the alcohol to quickly enter the body's blood, thereby stimulating the muscles and blood vessels at the wound, inducing contraction and spasm, and causing severe pain.

So when the doctors at Dongshan Hospital started disinfecting the wounds with iodine, the three seriously injured patients were in so much pain that they screamed.

Chen Qi leaned on the door frame, listening to the sounds inside, and made a tut-tut sound:

"It's so cruel and heartless."

Many junior doctors and nurses from the Vietnam Traditional Chinese Medicine Hospital heard the screams and ran out to watch the fun.

"Dean Chen, why are the two female patients able to endure the disinfection when we do it, but why are the three big men at the steel plant shouting when it's their turn? They are too useless, aren't they?"

Chen Qi explained easily:

"We first used hibernation therapy, and the patient's reaction was already very slow. In addition, we used iodophor, which not only has a better effect, but also causes less stimulation because it does not contain alcohol, so the patient suffers less pain.

Look at Dongshan Hospital. They use iodine. After disinfection, they also use alcohol to remove iodine. If you use alcohol on such a large burn area, it will really cost the patient's life. Maybe it will happen again.

You’re going to make a fool of yourself.”

Chen Qi's crow's mouth worked once again.

Unable to withstand the strong stimulation of alcohol, Chi Shanjun once again suffered cardiac and respiratory arrest due to painful shock.
Chapter completed!