ʻO ke alakaʻi wikiwiki a me ka lepo i ka haʻalulu: nā ʻokoʻa ma waena o ka uku, decompensated a me ka hiki ʻole ke hoʻohuli
I kēlā me kēia manawa e make ai ka maʻi, pili ka haʻalulu. ʻO ka haʻalulu ka nalo ʻana o ke kahe ʻana e kākoʻo i nā kino koʻikoʻi. ʻO ke kumu o nā ʻano haʻalulu a pau he hypotension ka hopena i ka hypoxia
Hiki i kēia hypotension ke hopena ma muli o ka hemahema o kekahi ʻāpana o ka ʻōnaehana kaʻa, a hiki ke hoʻokaʻawale ʻia ka hopena ma nā ʻano like ʻole ma muli o kona paʻakikī.
Nā ʻano o ka haʻalulu
ʻO ka ʻōnaehana holo kaʻa he mea ʻē aʻe ma mua o kahi loop paʻakikī o ka wai i hoʻoneʻe ʻia e kahi pamu.
E haʻihaʻi ka hopena inā poino/nalo ka pamu, ka paipu, a i ʻole ka wai.
AʻO: E kipa aku i ka BOOTH o DMC DINAS MEDICAL CONSULTANTS MA EMERGENCY EXPO
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He kumu like ʻole ko kēlā me kēia ʻano haʻalulu ʻekolu
ʻO ka pau ʻole o ka pauma (naʻau) ʻike ʻia ʻo "Cardiogenic Shock" he nui nā ala e hiki ai i ka puʻuwai ke hāʻule, akā ʻo ka hōʻike maʻamau a hoʻāʻo nui ʻia ʻo ia ka congestive heart failure (CHF).
ʻO ka CHF ka emi mau o ka puka o ka naʻau ma muli o ka pōʻino o nā ʻiʻo.
ʻO ka poʻe maʻi i ka haʻalulu cardiogenic e loaʻa i ka ʻili maʻalili/puʻupuʻu/ʻeleʻele a pehu i ko lākou mau wēlau haʻahaʻa a loaʻa paha ka haʻahaʻa o ka oxygen saturation inā koʻikoʻi ko lākou maʻi.
ʻEkolu mau ʻano kumu no ka hāʻule ʻana o ka paipu (nā aʻa koko).
ʻO ka haʻalulu anaphylactic kahi e hoʻoulu ai kahi allergen i kahi pane maʻi nui; neurogenic shock kahi e poino ai ka spinal pale ke kaula i nā hōʻailona aʻalolo mai ka hiki ʻana i nā kīʻaha koko; a me ka sepsis kahi e hoʻoulu ai nā microbes i loko o ke kahe koko i ka overrection o ka ʻōnaehana pale.
Hana ʻia ka haʻalulu anaphylactic i ka wā o ka nā pūnaewele keʻokeʻo hoʻokuʻu i ka nui o nā ʻelele kemika e hoʻoheheʻe i nā kīʻaha koko a hoʻoheheʻe i ka wai i loko o nā ʻiʻo me ke kūpono ʻole.
E loaʻa i kēia mau maʻi ka ʻili wela/ʻulaʻula, hiki ke loaʻa i ka ʻūhū, tachycardia, a me ka pehu ʻana o ka maka/lehelehe.
Hiki iā lākou ke pilikia i ka hanu ʻana a/a i ʻole ke ala ea mai kēia pehu ʻana.
Hiki mai ka ha'alulu neurogenic ke pi'i ka 'eha o ka iwi kuamo'o ma ka 'ā'ī ʻoki ʻo ia i ke kino mai ka ʻōnaehana sympathetic nerve, pale kēia i nā kīʻaha koko mai ka vasoconstricting a me ka puʻuwai mai ka hoʻonui ʻana i kona wikiwiki.
He bradycardic kēia mau maʻi a i ʻole ka puʻuwai maʻamau ʻoiai he hypotensive.
ʻO ka lolo kino o nā wāwae a me nā lima ʻaneʻane mau.
ʻO Sepsis ke kumu maʻamau o ka "container failure," ʻo nā microbes i loko o ke kahe koko e hoʻoulu i kahi pane kūʻokoʻa ikaika a inā aia lākou i nā helu nui hiki ke hopena i ka leakage o nā kīʻaha koko a me ka vasodilation i ka hopena e like me ka anaphylaxis.
E loaʻa i kēia mau maʻi ka ʻili wela/ʻulaʻula a me ka tachycardia, loaʻa iā lākou nā hōʻailona e like me ke anuanu, ke kuni, a me ka diaphoresis.
ʻO ka nalowale o ka wai (ke koko) ke kumu hope loa o ka haʻalulu, i kapa ʻia ʻo "Hypovolemic Shock"
Hiki ke nalowale ke koko ma nā ʻano he nui, inā ma muli o ka trauma a i ʻole ka maʻi maʻi / acute bleeding i loko o ka ʻōpū ʻo ia nā kumu maʻamau i ka hoʻonohonoho EMS.
ʻO kēia mau maʻi he ʻili anuanu/ʻeleʻele/ʻeleʻele a he tachycardic.
Loaʻa iā lākou kahi moʻolelo o ke koko a i ʻole kahi hōʻeha traumatic hou.
Nā Māhele o ka Haʻalulu
Hiki ke hoʻokomo ʻia ka haʻalulu o kēlā me kēia ʻano i loko o kekahi o nā ʻano ʻekolu, uku ʻia, decompensated, a i ʻole hiki ke hoʻololi ʻia ma muli o nā hōʻailona a me nā hōʻailona e ʻike nei ka mea maʻi.
Hoʻomaka ka haʻalulu i ka wā i uhi ʻia ai ka hana ʻino o ka puʻuwai, nā kīʻaha koko, a i ʻole ka nui o ke koko e kekahi o nā ʻōnaehana ʻē aʻe.
Hana ka naʻau i kēia ma ka hoʻonui ʻana i ka wikiwiki o ka paila ʻana i ke koko a hiki i nā kīʻaha koko ke hoʻopaʻa i lalo (vasoconstriction) a hoʻonui i ka nui o ke kaomi e hiki i nā ʻōpū.
ʻO nā hōʻailona o ka haʻalulu i uku ʻia he puʻuwai kiʻekiʻe, ke koko systolic ma mua o 90, a me ke kūlana noʻonoʻo maʻamau.
ʻAʻohe hōʻailona o ka haʻalulu i uku ʻia, hiki i kekahi poʻe maʻi ke ʻike i ka palpitations, pōkole o ka hanu, luhi, a i ʻole nā hōʻailona ʻē aʻe.
Hoʻomaka ka haʻalulu decompensated inā ʻaʻole hiki i nā ʻōnaehana ʻē aʻe o ke kino ke uhi piha no ka ʻōnaehana hana ʻino, hiki pinepine kēia ma muli o ka nalowale ʻana o ka hana o ka ʻōnaehana pōʻino a i ʻole e hoʻomaka ana ka ʻōnaehana e uhi ana i ka ʻōnaehana hana ʻino.
ʻO Hypotension ka hōʻailona koʻikoʻi o ka haʻalulu decompensated, ʻaʻole i hoʻokaʻawale ʻia ka haʻalulu a hiki i ka hypotension a i ʻole ke ʻano o ke kino, ma ka hoʻonohonoho EMS i hoʻololi ʻia ke kūlana noʻonoʻo ʻo ia ka hōʻailona maikaʻi loa o ke kino kino.
ʻO nā hōʻailona o ka haʻalulu decompensated ka huikau, ka hou ʻana, ke anuanu, ka loli ʻana o ka ʻike, a me ka hiamoe nui / luhi.
Hiki ke ho'iho'i 'ole i ka wā e kokoke mai ana ka make, 'a'ole 'ike 'ia ka mea ma'i, 'o ke ko'iko'i o ka hypotension, a ho'omaka ka emi 'ana o ka pu'uwai ke loa'a ka tachycardia ma mua.
AʻO: E kipa aku i ka BOOTH o DMC DINAS MEDICAL CONSULTANTS MA EMERGENCY EXPO
Ka Lapaau ana i ka Haalulu
Hoʻopili ʻia ka mālama EMT o nā ʻano a me nā ʻano haʻalulu a puni nā ABC.
Hoʻopili pinepine ʻia ke ala ea ma hope i ka wā o ka haʻalulu ʻoiai lākou e decompensate a hoʻomohala i ke kūlana noʻonoʻo i hoʻololi ʻia, hiki i kēia ke hopena i ka ʻae ʻana o ka hanu ʻana a pono paha kēia mau maʻi i ka hoʻoheheʻe ʻana i ke kaomi maikaʻi a me kahi hoʻohui ea.
ʻO ka haʻalulu neurogenic ka hihia kakaʻikahi kahi e ulu mua ai ke kuʻikahi o ka hanu ma muli o ka lolo o nā ʻiʻo hanu.
ʻO ka mālama ʻana i ke kahe ʻana i hoʻohālikelike ʻia i ke kikowaena o ka haʻalulu, ʻo ka hapa nui o nā maʻi i ka haʻalulu e koi i nā wai IV e lohi a pale paha iā lākou mai ka holomua ʻana i ka haʻalulu decompensated a hiki ʻole ke hoʻihoʻi ʻia.
ʻO ka haʻalulu Septic a me ka haʻalulu hypovolemic e koi mau i nā wai IV, neurogenic a me anaphylactic shock i kekahi manawa e koi i nā wai IV, a ʻaʻole pono e hāʻawi ʻia nā mea maʻi i ka haʻalulu cardiogenic.
Loaʻa nā lāʻau lapaʻau kūikawā anaphylactic a me neurogenic shock; Hoʻoponoponoʻia ka anaphylaxis me ka epinephrine,ʻo ka "Epi-Pen" he 0.3mg dose o 1mg / ml epinephrine aʻo ia ka lāʻau EMS maʻamau no ka anaphylaxis, hiki i kēia mau maʻi ke koi hou i nā kau o ka epinephrine inā hoʻomau lākou i ka decompensate.
Hoʻoponopono pū ʻia ka haʻalulu neurogenic me ka epinephrine me ka wai o IV inā loaʻa ka hypotension.
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Poison Mushroom Poisoning: He aha ka hana? Pehea e hōʻike ʻia ai ka lāʻau ʻawaʻawa iā ia iho?
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Kōkua Mua: He aha kāu e hana ai ma hope o ka ʻai ʻana a i ʻole ke kahe ʻana i ka pilahi ma kou ʻili
Nā hōʻailona a me nā hōʻailona o ka haʻalulu: pehea a me ka wā e komo ai
Wasp Sting and Anaphylactic Shock: He aha ka mea e hana ai ma mua o ka hiki ʻana mai o ka Ambulance?
KED Extrication Device No Trauma Extraction: He aha ia a pehea e hoʻohana ai
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