Ezona mpazamo ziqhelekileyo zabaphenduli bokuqala kwizigulana ezichaphazeleka ngenxa yokothuka?

Ukutshatyalaliswa ngumqathango owenzeka ngenxa yokungakwazi ukuhamba kwegazi emzimbeni. Isimo esongela ubomi esilungisa ukungenelela kwangangoko kunye nobuchule bokugcina ubomi.

Ekuboneleleni ngoncedo lwe-a isigulane esibandezelekayo, iinjongo zonyango zisekelwe kwi IABCDE ukusondela. Kwi umoya kunye nokuphefumla, ukuhambisa i-oksijini kufuneka ikhuliswe ngokuqinisekisa ukunyanzelisa okwaneleyo nokungenakuvinjelwa. Xa kusasazwa, ukuhamba kwegazi kufuneka ibuyiselwe ukuhlaziywa kwamanzi kunye nokulawula okuqhubekayo ukulahlekelwa igazi. Emva koko, ukukhathazeka malunga nokukhubazeka kunye nokuvezwa kuyaphathwa njengezinto eziza kuqala.

In imeko zoxinzelelo, ba phendula ukungenelela okufanelekileyo okuya kunceda ukukhusela ukulimala okungakumbi, nokuthutha ixhoba kwiziko lonyango ngokukhawuleza. Iimpembelelo eziqhelekileyo ukuba umphenduli wokuqala angazibophelela ukunceda isigulane esithintekayo xa sisenokungabikho vavanyo ngokwayo; ngenxa yoko, ukuxilonga nokuphathwa kakuhle akukwazanga kwenziwe ngenxa yoko.

Kukho ezininzi ezibangela ukutshatyalaliswa, inokuba ibangelwa yi-anaphylaxis, hypovolemia, sepsis, neurogenic okanye i-Cardiogenic. Ezinye zeempazamo ezenziwa ngabaphenduli bexesha likaxakeka ekunyangeni abaguli abothukileyo zibandakanya:

Uvavanyo olungapheliyo lweempawu ezibalulekileyo kunye nezinye iimpawu zokutshatyalaliswa

Kukho imeko apho bezempilo kholisa ukujonga uxinzelelo lwegazi lodwa njengesalathiso sokuothusa. Oko kukuthi ukuba xa uxinzelelo lwegazi luqhelekileyo, kukho umntu okrokrayo.

Iimpawu kunye neempawu zokuothusa zihlala zibonakalisa uxinzelelo lwegazi low (hypotension), ukunyuka kwenqanaba lentliziyo (tachycardia), nokunyuka kokuphefumla (tachypnea). Ngamanye amaxesha, uxinzelelo lwegazi lexhoba linokubonakala liqhelekileyo elinokubonakalisa imeko yobugqi.

Udokotela kufuneka ahlolisise ngokubanzi, ngaphandle kwe-pulse kunye neentsholongwane zokuphefumula, kunye nengcinezelo yegazi. Ngokomzekelo, ummangalelwa unokuqwalasela iimpawu zokuphefumula okungonakaliyo kunye nesimo sengqondo esitshintshileyo, esichaza ukulawulwa kweklinikhi enobudlova.

 

Ukungaphumeleli ukubonelela ngamachiza omzimba kwiimeko ezinokuthi unyuke

Akunabo bonke abaphendulayo bokuqala abanokukwazi ukubonelela amayeza angenangxaki kwiindawo. Emva koko, ulawulo lwe-antibiotic luqaliswa kuphela esibhedlele okanye kwanasemva kokuqinisekiswa kokuthuka nge-septic ngovavanyo lokuqonda, oluchanekileyo.

Ukuqhaqhaqhaqhaqhaqhaqhaqhaqheki yintsongelo yobomi efuna ukuphathwa ngokukhawuleza. Njenge-sepsis, ikrokrelwa, kuyimpilo ukuba unyango lwe-antibhaybhi luqaliswe ngaphakathi kweyure okanye ngokukhawuleza. Ukusilela ukubonelela ngee-antibiotics ngokukhawuleza kuthathelwa ingqalelo ngumthetho njengoko ukunonyamekela unyango.

 

Ukuqaliswa kwe-vasopressors, njenge-epinephrin, ngaphandle kokuqinisekisa ubungakanani bemithombo yamanzi

Kwiimeko zokutshatyalaliswa, ukuhla kwegazi kwixhoba kuya kudla ngokukhawuleza ukuphendula abaphenduli bezongxamiseko ukuba banikeze i-vasopressors ukwenzela ukugcina uxinzelelo olunefuthe lomntu. Nangona kunjalo, ukuqaliswa kwe-vasopressure kwisigulane ngokunciphisa umthamo wamanzi akufanelekanga. Ngokutsho kwePulmCCM, ukuvuselelwa okwaneleyo kwamanzi okanye ukunyuka kwe-30ml / kg ye-crystalloids (malunga ne-1500-3000ml) kufuneka yenziwe kwizigulane ezininzi phambi kokulawulwa kwabasopress.

 

 

Umbhali:

UMichael Gerard Sayson

UmNesi oBhalisiweyo onesidanga seNzululwazi kwiDigital Nursing evela kwiYunivesithi yaseSaint Louis kunye ne-Master of Science kwiDigital Nursing, eMkhulu kuLawulo loNesi noLawulo. Amaphepha okubhalwa kwe-2 kunye ne-authored 3. Ukuziqhelanisa nomsebenzi wobongikazi ngaphezulu kweminyaka emi-5 ngoku ngononophelo oluthe ngqo nolungathanga ngqo.

 

 

FUNDA KUNYE

Ukothuka okubanjisiweyo: Zeziphi izisombululo kwiimeko zikaxakeka?

Abaphenduli bexesha likaxakeka kwiiMeko zoLwaphulo-mthetho - ezi-6 ziimpazamo eziQhelekileyo

Ubomi beNqwelo yezigulana, Zeziphi iimpazamo ezinokuthi zenzeke kwiNdlela yokuphendula yokuqala kunye nezihlobo zomguli?

 

 

 

SOURCES

Unyango kunye noLawulo lweHypvovolemic Shock

IiVasopressors zeSkiic Shock (ezivela kwi-Sepsis yokusinda Izikhokelo)

Ngaba ukungcungcutheka kukaSeptic kubangelwa kukuNgcwala kwezonyango?

Imingxunya yokuGwema ukuYazi isifo kunye noLawulo lweNtle 

U no kuthanda