Due to the establishment of gas cold storage, a simple cold chain between refrigerated blood and ice boxes and ice cubes has been established in the core area ruled by the Senate. Currently, both blood stations can perform blood collection, refrigeration, cross-matching and routine blood transfusions. operate. The fermentation industry has long been able to provide sufficient amounts of citric acid, which is what health authorities call citric acid. With cold storage, blood outside the body can be stored for nearly a month.
For the Senate industrial system without refrigerants, the invention of refrigerators is still a long way off, and gas cold storage is not suitable for mobile use. Vehicles and ships that only rely on ice boxes and ice cubes cannot cover a large area - this kind of crude blood The support system can basically only guarantee less than half of the chance of survival for the wounded.
In addition to cold chain issues and transportation issues, another important limitation is the lack of blood sources.
Artificial blood collection and transfusion were not only shocking to the world in the 17th century, but even shocking. Almost equated with "demon". Even in "old liberated areas" like Lingao, they mainly rely on blood donations from naturalized citizens, especially those from units such as the military and schools that are instilled with the most new ideas and have strict organizational disciplines. Even naturalized citizens in places like factories and offices would murmur when they hear that blood donations are being organized. Although many people dare not resist, they are quite resistant in their hearts. The regular blood donation system also triggered discussions among some senators about witchcraft.
When we arrived in Guangzhou, the mass base was even worse, and it was almost impossible to find someone to "voluntarily donate blood." In order to encourage blood donation, Lin Motian, who was enthusiastic about establishing a provincial and Hong Kong blood station, launched a "blood donation compensation" mechanism in Guangzhou. Unsurprisingly, it set off another quarrel among the health clinics and some non-health clinic veterans who liked to join in the fun. Force the conference - "Sell blood"! This is a big hit!
"Let the poor be the 'blood gourds' of the rich. This is going backwards in history! A serious setback!"
"We will never allow the human tragedy of 'Xu Sanguan to Sell Blood' to be repeated on our land!"
"Encouraging blood selling will lead to the emergence of 'syphilis villages', which is a serious threat to social stability and the health of the empire's naturalized citizens..."
"You are crazy if you want to make money, this is a real bun that eats human blood!"
Liu San also felt that something was wrong, so he made a special trip to Lin Motian to discuss the matter tactfully.
"Their idea of voluntary blood donation in Guangzhou in the 17th century is simply... naive!" Lin Motian sneered at the objections to starting "blood selling." "Just say that if you donate sub-sperm in the old dimension, the sperm bank will have to give it to you. What about your "transportation subsidy" of several thousand dollars? In this time and space, what does it mean to give some compensation for donating blood? People in this era are generally malnourished. You let them donate blood, but you still don't give them a good meal and subsidies. Is it reasonable to pay for travel expenses? Besides, to promote blood donation and blood transfusion, we must first let them know what this technology is. Based on their knowledge, if they do not regard blood collection and blood transfusion as a magic method, it will give us face. The best publicity is to have A large number of people can survive by relying on blood transfusions! Guangzhou is not Lingao. With such a large population, there are countless people who need blood. But the number of people who understand what blood transfusion is and can voluntarily donate blood for free can be counted on one hand."
"Can't we still encourage the troops to donate blood?" Liu San suggested. Combined with the experience of the old plane, the troops are an important source of blood.
"Yes, of course it is. At this time, the only one who can believe us and know that blood donation and transfusion is not a magic trick is the Fubo Army. But the army only has a few heads, and we can still count on these few people to support the entire army. Is there a demand for blood in Guangzhou? What’s more, I don’t want to keep selling blood like this. Once the people in Guangzhou and Guangxi know what blood donation and blood transfusion are, it won’t be too late to talk about voluntary blood donation.”
Liu San wanted to say something else, but Lin Motian lowered his voice and said: "Commissioner Liu, you also know who I am. The income from the blood bank is not high, but I haven't put a single silver dollar in my pocket." After all - if you make some money, why don't you become the health financial support of the Senate? Our health clinic has only two hospitals in Guangzhou, one provincial and Hong Kong hospital and one infectious disease hospital. Now we can only maintain it by relying on your hard support. To balance the income and expenditure, sometimes we have to complain to Mayor Liu. But we can't always raise difficulties with the organization. Just 'reducing expenditure' is not enough. We have to think about how to 'increase revenue'. This 'blood transfusion compensation' is actually It’s not much money, but the surge in blood supply it brings is real..."
Hearing this, Liu San stopped talking: Lin Motian said it politely. In fact, everyone knows that the health clinic is basically losing money to make money. Guangdong and Guangxi are still at war. Guangzhou's financial situation has always made Liu Xiang grin. , the blood bank generates a lot of revenue, and can fill a hole in the health finance. This is something that everyone in charge likes to see - as for ethical disputes, this discordant voice has no effect at all in a good situation. waves.
"Even if there is a dispute, who can control the Senate? In this era, besides us, who else knows the principles of medical ethics?" Lin Motian was still speaking plausibly: "Just talk about the contributions you have made, Commissioner Liu, and the work of Runshitang Did those Chinese patent medicines go through phase one, two or three clinical trials before they were put on the market? Have animal experiments, human trials, and toxicology tests been done? The first batch of crude sulfonamides trial-produced by the pharmaceutical factory and a lot of "new drugs" were messed up , without even conducting animal experiments, they were used to shelter refugees? According to their logic, this matter is simply intolerable, but no one said anything about such a violation of ethical principles, and now it jumped out, purely It’s just a matter of borrowing a topic and looking for trouble!”
Hearing the words "Runshitang", Liu San's chest moved, and he nodded immediately. He couldn't help thinking: This means that the technical conditions are not met. If he had the ability, Lin Motian would dare to call for the legalization of organ trading. But having said that, in fact, Liu San didn't really have any ethical concerns about selling blood. He just thought that the reputation of this matter in the mouths of other elders was not very good.
Although the demand for blood products is not that large compared to the old plane, blood collection is still not an easy task. Since the technical separation of blood collection and blood transfusion is not possible everywhere, some blood transfusion surgeries that have long been eliminated have to be picked up again. The more popular one is "indirect blood transfusion": using metal or rubber tubes to connect the blood vessels of the blood donor and the blood vessels of the casualty. The more cruel-sounding "direct blood transfusion" is to sew the blood vessels of the blood donor and the blood vessels of the wounded directly together - this is a high-risk and difficult primitive technology that even veteran doctors frown upon, so even if it is done It solves the problem of blood coagulation in the pipeline, and its popularity is still not high.
“What the author would like to remind here is that although our technology is completely incomparable with that of the old plane, even this technology has reached the level of the old plane in the 1920s, and may even be even more advanced than this level. ." Lin Motian wrote in his original report demonstrating the feasibility of frontline blood banks.
However, with the current technical conditions of the Senate, it is impossible to restore the blood bank on the front line, which according to the standards of the old time and space was called "insanely unqualified". There are many limiting factors, the most obvious of which are rubber and cold chain issues: the production of rubber has not increased, and the production of blood transfusion lines cannot be guaranteed; the cold chain is almost non-existent in the front lines and quasi-security areas, and the safety of blood products cannot be guaranteed. Guaranteed - Although Lin Motian used the word "blood products" out of habit when demonstrating the feasibility of blood banks, in fact everyone knows that it is simply impossible to transfuse blood with components such as concentrated red blood cells, platelets, and frozen plasma. It is possible that what the Senate currently calls "blood products" is almost equivalent to fresh whole blood.
Under conditions that cannot be guaranteed by refrigeration, whole blood anticoagulated with citrate can only be stored for a few days, which is even more worrying in the hot Guangdong and Guangxi. For safety reasons, whole blood that has been separated from the body for more than 48 hours must be concentrated in the "spare area" and kept for another 24 hours. It will be used in emergencies and disposed of when it is no longer needed. Therefore, on the front line, we rely more on "blood donors" to draw blood and use it now.
Seeing the stretcher bearer's confused look, Chen Ruihe sighed and ordered the nurse who hurried over: "Let's lie down in the observation room first, but the bleeding can't be stopped. Notify Teacher Xie and the operating room to prepare for emergency surgery." .Find some more blood donors with type B or type O blood!"
However, before the explanation was finished, Xie Yao had already rushed over. He was covered in blood, and the color of his white coat had changed: "Which patient is in hypovolemic shock?"
Before he finished speaking, Xie Yao had already seen Wang Chuyi on the stretcher. He only looked at it and sighed: "Okay, let's lie down in the observation room first, pay attention to maintaining the shock position, hang up the water, and prepare the blood donor. I There is a seriously ill patient over there who has not yet been treated. Over there in the operating room, you say hello and if necessary, disinfect and spread the sheets first. If possible, do it first."
"I can't do it... I'd better wait for you, Teacher Xie." Chen Ruihe waved his hands repeatedly and asked the nurse to find someone to mobilize for blood donation.
Before I could take a breath, I heard the noise again.
"Why is it you again!" Chen Ruihe settled Wang Chuyi down. He turned around and saw that the officer who was about to block the situation was still arguing in front of the water platform. He couldn't help but get angry and rushed forward to ask.
"Just now you said to call the number and show it to the county magistrate first, okay, I'll wait; oh, now this little bitch said to prioritize the treatment, and let me wait behind the wounded person! I've already been waiting. How many are there? Are you still looking down on me? Our squadron leader was injured in the war, and we have to wait in line for such a long time to look down on him. What happened to the county magistrate? If this **** county magistrate hadn’t been fooling around, he wouldn’t have died and been injured. We have lost so many brothers, we all deserve to die!" The officer's voice was not loud, but his face was full of impatience, and he complained with raised eyebrows.
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Next update: Volume 7 - Guangzhou Governance Chapter 430
