Hemorrhagic shock

Nemhaka yekubuda ropa zvakasiyana-siyana (kushungurudzika, kuvhiyiwa, kuparadzwa kwemukati), simba rekupararira ropa (BCC) rinoderera. Zvichienderana nehuwandu hwekurasikirwa kwehupenyu hwehupenyu, oxygen inowedzera nzara inowedzera, uye kana inopfuura 500 ml yeropa kurasikirwa, kutyisa kunokonzera kunoitika. Ichi chiitiko chakaipisisa, chakazara nemugumisiro unouraya nekuda kwekuguma kwekupararira kweropa mumakumbo europi nemapapu.

Kuenzanisa kwekushungurudzika kwakanyanya

Mukuwedzera kumanikidziro, munyaya yeropa kurasikirwa, mutengo wekuyerera kwehupenyu hwehutachiwana hunokosha zvikuru. Nenguva pfupi, kurasikirwa kwepamusoro pehuwandu hwemari (hunosvika 1.5 litita) hahuna ngozi sekubuda ropa nokukurumidza.

Maererano neizvi, zvikamu zvinotevera zvekushungurudzika kwemhepo zvakasiyana:

1. Nharaunda yekutanga inobhadharwa. Kupera kweBBCC hakusi kupfuura 25%. Sezvo mutemo, munhu anenge atambudzwa anoziva, kuwedzerwa kweropa kunoderedzwa, asi zvine mwero, kupisa kunenge kusina simba, tachycardia - kusvika kusvika ku 110 kurova paminiti. Ganda rinotaridzika uye rinotonhora.
2. Chikamu chechipiri chinorambidzwa. Kurasikirwa neropa kunosvika 40% yeBCC. Ikoko kune acrocyanosis, pfungwa inovhiringidzika, mhirizhonga inoderedzwa zvikuru, iyo inotyisa ishinda yakafanana, tachycardia - kusvika pamakumbo 140 paminiti. Uyezve, oliguria, dyspnea, kutonhora kwemigumo kunogona kuonekwa.
3. Chikamu chechitatu hachikwanisiki. Hemorrhagic shock of degree severe ine zviratidzo zvinoratidza chirwere chinotyisa zvikuru chemu murwere: kukanganiswa kwakakwana kwekuziva, marble ruvara rweganda (pallor ine mavara anooneka zvakanaka emidziyo yeropa). Kurasikirwa kweropa kudarika 50% yeBCC yose. Tachycardia inopera 160 kubata paminiti, systolic mhepo inopfuura 60 mm Hg. Iko kusvuta kunonetsa zvikuru kuziva.

Chikamu chekupedzisira chinosanganisira kushandiswa kwekukurumidza kudzorera nzira.

Emergency care for hemorrhagic shock

Mushure mekudanwa kweboka rezvechiremba, zvinokurudzirwa kutora matanho akadaro:

1. Rega kubuda ropa, kana zvichionekwa, nezvose zvinowanikwa (kutsva, kuisa, kuvhara ronda).
2. Kugadziriswa kwezvinhu zvipi zvinopesana nekufema kwemazuva ose. Zvakakosha kusunungura iyo yakasimba collar, kubvisa kubva pamuromo mazamu emeno, marutsi, miviri yekunze (kazhinji mushure mekuitika kwegwazi yemotokari), kudzivirira rurimi kuti rurege kupinda mumasopharynx.
3. Kana zvichikwanisika, ipai vanhu vasina marwadzo marwadzo emishonga (Fortral, Lexir, Tramal), iyo isingabatsiri kupararira kweropa uye mabasa ekufema.

Hazvibvumirwi kutamisa munhu akakuvara, kunyanya kana kubuda ropa mukati.

Kurapa kwekutyisa kukuru panguva yekurapwa

Mushure mokuongorora chirwere chemu murwere, kuyera ropa, kupisa kwemwoyo, kufema, kuchengetedza pfungwa, kubuda ropa kunodzivirirwa. Zvimwe mabasa:

1. Inhalation ye oksijeni ne catheters (intranasal) kana mask.
2. Kupa kukwanisa kumubhedha wemavhesi. Nokuda kweizvi, mutezo wepakati inonzi catheterized. Nekurasikirwa kwemazana makumi mana ezana ezana bcc, chirwere chikuru chevakadzi chinoshandiswa.
3. Kuvharapa remishonga pamwe nekuiswa kwekriststalloid kana colloidal solutions, kana kubuda ropa kwakanyanya uye kwakawanda - masiteri eerythrocyte.
4. Kuiswa kwaFeley catheter kuti utungamirire nguva yeawa neyekutengesa (kutarisa kubudirira kwevhirwere).
5. Kuongorora ropa.
6. Chinangwa sedative (sedative) uye analgesic zvinodhaka.

Apo kurasikirwa kweropa kunopfuura 40% yehuwandu hwehupenyu hwehutachiona, kupirisa kwekodzero kunofanira kuitwa mu 2-3 maronda pamwechete panguva imwechete, pamwe chete nekuputika kwe 100% oksijeni kuburikidza nechirwere chekushaya masimba. Uyezve, majekiseni eDopamine-ane zvinodhaka kana epinephrine anodiwa.