Isikhokelo esikhawulezayo nesimdaka sokothuka: iyantlukwano phakathi kwembuyekezo, imbuyekezo kunye nengenakurhoxiswa
Nanini na isigulana sisifa, kubandakanyeke umothuko. Ukothuka kukulahleka kokujikeleza okwaneleyo ukuxhasa amalungu abalulekileyo. Isiseko sazo zonke iintlobo zomothuko yi-hypotension ekhokelela kwi-hypoxia
Le hypotension inokubangelwa ukungaphumeleli kwayo nayiphi na inxalenye yenkqubo yokujikeleza, kwaye ukungaphumeleli okubangelwayo kunokuhlelwa ngeendlela ezahlukeneyo kuxhomekeke kubunzima bayo.
Iintlobo Zokothuka
Inkqubo yokujikeleza kwegazi ayikho enye into ngaphandle kwe-loop eyinkimbinkimbi yolwelo olushukunyiswa yimpompo.
Ukothuka kuya kubangela ukuba impompo, ityhubhu, okanye ulwelo lonakele/lulahlekile.
UQEQESHO: TYELELA I-BOOTH YE-DMC DINAS MEDICAL CONSULTANTS KWI-EXPO EXPO.
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Nganye kwezi ntlobo zintathu zomothuko zinezizathu ezahlukahlukeneyo
Ukungaphumeleli kwempompo (intliziyo) kwaziwa ngokuba yi "Cardiogenic Shock" kukho iindlela ezininzi apho intliziyo inokungaphumeleli khona, kodwa eyona nto ixhaphakileyo kwaye ivavanywa kakhulu yintetho ye-congestive heart failure (CHF).
I-CHF kukuhla okungapheliyo kwisiphumo sentliziyo ngenxa yomonakalo kwiiseli zemisipha.
Izigulana kwi-cardiogenic shock ziya kuba nesikhumba esipholileyo / i-clammy / ekhanyayo kunye nokudumba kwiindawo eziphantsi kwaye zinokuba ne-oksijini ephantsi ukuba imeko yabo inzima.
Ukungaphumeleli kwe-tubing (imithambo yegazi) kuthatha iifom ezintathu eziphambili:
I-anaphylactic shock apho i-allergen ibangela impendulo enkulu; ukothuka kwe-neurogenic apho umonakalo kwi Umgudu intambo ikhusela imiqondiso yemithambo-luvo ukuba ifike kwimithambo yegazi; kunye ne-sepsis apho ii-microbes kwi-bloodstream zibangela ukugqithiswa kwe-immune system.
Umothuko we-Anaphylactic lwenzeka xa i- iiseli ezimhlophe zegazi ukukhulula inani elikhulu lezithunywa zeekhemikhali ezenza imithambo yegazi i-vasodilate kwaye ivuze ulwelo kwiithishu ngokungafanelekanga.
Ezi zigulana ziya kuba nesikhumba esishushu / esibomvu, esinokuthi sibe ne-rash, tachycardia, kwaye sinokudumba kobuso / imilebe.
Basenokuba nobunzima bokuphefumla kunye/okanye ukuthomalalisa kwindlela yomoya ngenxa yoku kudumba.
Ukutshatyalaliswa kwe-neurogenic kwenzeka xa ukulimala komgogodla kuphezulu entanyeni Unqumla umzimba kwinkqubo yemithambo-luvo enovelwano, oku kuthintela imithambo yegazi kwi-vasoconstricting kunye nentliziyo ekunyuseni izinga layo.
Ezi zigulana ziya kuba ne-bradycardic okanye zibe nesantya sentliziyo esiqhelekileyo nangona sine-hypotensive.
Ukukhubazeka ngokomzimba kwemilenze kunye neengalo phantse kukho rhoqo.
I-Sepsis iyona nto ibangela ukuba "ukungaphumeleli kwesiqulatho," i-microbes egazini ivuselela impendulo ye-immune eyingozi kwaye ukuba ikhona ngamanani amaninzi oku kunokubangela ukuvuza kwemithambo yegazi kunye ne-vasodilation ekuphenduleni okufana ne-anaphylaxis.
Ezi zigulana ziya kuba nesikhumba esishushu / esibomvu kunye ne-tachycardia, zihlala zineempawu ezinje ngokubanda, umkhuhlane, kunye ne-diaphoresis.
Ukulahleka kolwelo (igazi) ngunobangela wokugqibela womothuko, owaziwa ngokuba yi “Hypovolemic Shock”
Igazi liyakwazi ukulahleka ngeendlela ezininzi, nokuba kungenxa yokwenzakala okanye ukuphuma kwegazi okungapheliyo / okukrakra emathunjini kuba yizona zizathu eziqhelekileyo kwi-EMS setting.
Ezi zigulana ngokubanzi zinesikhumba esipholileyo/esimthukuthezi/esikhumbene kwaye sine-tachycardic.
Bahlala benembali yokopha okanye ukwenzakala okubuhlungu okutsha nje.
Iindidi zokothuka
Umothuko walo naluphi na uhlobo lunokufakwa kwelinye leendidi ezintathu, imbuyekezo, intlawulo, okanye ingenakuguquleka ngokusekelwe kwiimpawu kunye neempawu isigulane esifumanayo.
Umothuko ohlawulelwayo lwenzeka xa ukungasebenzi kwentliziyo, imithambo yegazi, okanye umthamo wegazi unokugqunywa yenye yezinye iinkqubo.
Intliziyo yenza oku ngokunyusa izinga apho impompa igazi kwaye imithambo yegazi inokubamba (vasoconstriction) kwaye yandise umthamo woxinzelelo olufikelela kumalungu.
Iimpawu zomothuko ohlawulelwayo kukubetha kwentliziyo okuphakamileyo, uxinzelelo lwegazi lwe-systolic ngaphezulu kwe-90, kunye nesimo sengqondo esiqhelekileyo.
Umothuko ohlawulelwayo usenokungabi nazimpawu, ezinye izigulana zinokuziva ukubetha kwentliziyo, ukuphefumla nzima, ukudinwa, okanye ezinye iimpawu ezingacacanga/ ezingacacanga.
Umothuko othotyiweyo wenziwa xa ezinye iinkqubo zomzimba zingasakwazi ukuyigubungela ngokupheleleyo inkqubo engasebenzi kakuhle, oku kudla ngokukwenzeka ngokuthe ngcembe njengoko inkqubo eyonakeleyo ngokuthe ngcembe iphelelwa ngumsebenzi okanye inkqubo egquma inkqubo engasebenziyo iqalisa “ukonakala.”
I-Hypotension luphawu oluphambili lokutshitshiswa kwe-decompensated, ukutshitshiswa akunyanzelwanga kuze kube yilapho i-hypotension okanye i-organ dysfunction ikhona, kwisimo se-EMS ukuguqulwa kwesimo sengqondo sisona sibonakaliso esihle sokungasebenzi kakuhle kwamalungu.
Iimpawu zomothuko othotyiweyo kukubhideka, ukubila, ukubanda, ukutshintsha kombono, ukozela/ukudinwa kakhulu.
Umothuko ongenakulungiseka kwenzeka xa ukufa kusondele, isigulana siya kuhlala singekho zingqondweni, i-hypotension inokuba nzima, kwaye ukubetha kwentliziyo kunokuqala ukwehla ukuba i-tachycardia ibikho ngaphambili.
UQEQESHO: TYELELA I-BOOTH YE-DMC DINAS MEDICAL CONSULTANTS KWI-EXPO EXPO.
Unyango Lomothuko
Unyango lwe-EMT yazo zonke iintlobo/amacandelo othuko lugxile kwii-ABCs.
Umzila womoya udla ngokuba sengozini kamva ngexesha lokothuka njengoko zinciphisa kwaye ziphuhlise isimo sengqondo esitshintshileyo, oku kunokubangela ukuthomalalisa ukuphefumla kunye kwaye ezi zigulana zinokufuna umoya opholileyo wokuphefumla kunye ne-adjunct yomoya.
Ukutshatyalaliswa kwe-neurogenic yimeko enqabileyo apho ukulungelelaniswa kokuphefumula kunokuphuhlisa kuqala ngenxa yokukhubazeka kwemisipha yokuphefumula.
Unyango lokujikeleza okuchetyiweyo lusembindini womothuko, uninzi lwezigulana ezothukileyo zifuna ulwelo lwe-IV ukuze lucothe okanye lubathintele ekuqhubeleni phambili ukuya kumothuko othotyiweyo okanye ongabuyisekiyo.
I-septic shock kunye ne-hypovolemic shock ihlala ifuna ulwelo lwe-IV, ukothuka kwe-neurogenic kunye ne-anaphylactic ngamanye amaxesha kufuna ulwelo lwe-IV, kwaye izigulane ezikwi-cardiogenic shock akufuneki zinikwe ulwelo lwe-IV.
I-Anaphylactic kunye ne-neurogenic shock inonyango olukhethekileyo olukhoyo; i-anaphylaxis ilawulwa nge-epinephrine, i-"Epi-Pen" yi-0.3mg i-dose ye-1mg / ml epinephrine kwaye iyona nto ixhaphakileyo yonyango lwe-EMS ye-anaphylaxis, ezi zi gulane zingadinga ukuphindaphinda iidosi ze-epinephrine ukuba ziqhubeka zichitha.
Umothuko weNeurogenic nawo ulawulwa nge-epinephrine ukongeza kulwelo lwe-IV ukuba kukho i-hypotension.
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