Kusokoneza maganizo

Kugwedezeka kwamankhwala ndi vuto ladzidzidzi momwe magazi kapena kutayika kwamadzimadzi kumapangitsa mtima kusapopera magazi okwanira mthupi. Kudandaula kotereku kumatha kupangitsa ziwalo zambiri kusiya kugwira ntchito.

Kutaya gawo limodzi mwa magawo asanu kapena kupitirirapo mwa magazi abwinobwino mthupi lanu kumadzetsa mantha.

Kutaya magazi kumatha kukhala chifukwa cha:

• Magazi kuchokera mabala
• Magazi kuchokera kuvulala kwina
• Kutuluka magazi mkati, monga m'mimba

Kuchuluka kwa magazi oyenda mthupi lanu amathanso kutsika mukataya madzi amthupi ochulukirapo pazifukwa zina. Izi zitha kuchitika chifukwa cha:

• Kutentha
• Kutsekula m'mimba
• Kutuluka thukuta kwambiri
• Kusanza

Zizindikiro zimaphatikizapo:

• Kuda nkhawa kapena kusokonezeka
• Khungu lozizira, losalala
• Kusokonezeka
• Kuchepetsa kapena kusatulutsa mkodzo
• Kufooka kwakukulu
• Mtundu wa khungu wotumbululuka (pallor)
• Kupuma mofulumira
• Thukuta, khungu lonyowa
• Kusadziŵa (kusayankha)

Kutaya magazi kwambiri ndikofulumira, kumawonjezera zizindikilo zakukhumudwa.

Kuyezetsa thupi kudzawonetsa zodabwitsa, kuphatikiza:

• Kuthamanga kwa magazi
• Kutentha kwa thupi
• Kuthamanga kwachangu, nthawi zambiri kofooka komanso kozizira

Mayeso omwe angachitike ndi awa:

• Umagwirira wamagazi, kuphatikiza kuyesa kwa impso ndi mayeserowo kufunafuna umboni wa kuwonongeka kwa minofu yamtima
• Kuwerengera kwathunthu kwa magazi (CBC)
• CT scan, ultrasound, kapena x-ray ya madera okayikira
• Echocardiogram - kuyesa kwa mawonekedwe amachitidwe amtima
• Electrocardiogram
• Endoscopy - chubu chomwe chimayikidwa mkamwa mpaka m'mimba (chapamwamba cha endoscopy) kapena colonoscopy (chubu choyikidwa kudzera mu anus mpaka matumbo akulu)
• Mtima wamanja (Swan-Ganz) catheterization
• Catheterization yamikodzo (chubu choyikidwa mu chikhodzodzo kuti muyese mkodzo)

Nthawi zina, mayeso ena atha kuchitidwanso.

Pezani chithandizo chamankhwala nthawi yomweyo. Pakadali pano, tsatirani izi:

• Khalani omasuka komanso otentha (kupewa hypothermia).
• Muuzeni munthuyo kuti agone pansi miyendo itakwezedwa pafupifupi mainchesi 12 (30 cm) kuti muwonjezere kufalikira. Komabe, ngati munthuyo wavulala mutu, khosi, msana, kapena mwendo, musasinthe mawonekedwe ake pokhapokha atakhala pachiwopsezo.
• Osapereka madzi pakamwa.
• Ngati munthu akukumana ndi vuto linalake, thandizirani zovuta, ngati mukudziwa.
• Ngati munthuyo akuyenera kunyamulidwa, yesetsani kuwakhazika pansi, mutu pansi ndi mapazi. Limbikitsani mutu ndi khosi musanasunthire munthu yemwe akuwoneka kuti wavulala msana.

Cholinga cha chithandizo chamankhwala ndikubwezeretsa magazi ndi madzi. Mzere wolowa mkati (IV) udzaikidwa m'manja mwa munthuyo kuti alole magazi kapena zinthu zamagazi.

Mankhwala monga dopamine, dobutamine, epinephrine, ndi norepinephrine angafunikire kuwonjezera kuthamanga kwa magazi komanso kuchuluka kwa magazi otuluka mumtima (zotulutsa mtima).

Zizindikiro ndi zotsatira zake zimatha kusiyanasiyana, kutengera:

• Kuchuluka kwa magazi / madzi amadzimadzi atayika
• Mlingo wa kutayika kwa magazi / madzimadzi
• Kudwala kapena kuvulala komwe kumayambitsa kutayika
• Zomwe zimayambitsa matenda aakulu, monga matenda a shuga ndi mtima, mapapo, ndi matenda a impso, kapena zokhudzana ndi kuvulala

Kawirikawiri, anthu omwe ali ndi mantha ochepa amatha kuchita bwino kuposa omwe ali ndi mantha aakulu. Kugwedezeka kwakukulu kungayambitse imfa, ngakhale mutalandira chithandizo chamankhwala mwachangu. Okalamba nthawi zambiri amakhala ndi zotsatira zoyipa chifukwa chodzidzimutsa.

Zovuta zingaphatikizepo:

• Kuwonongeka kwa impso (kungafune kugwiritsidwa ntchito kwakanthawi kapena kosatha kwa makina a impso)
• Kuwonongeka kwa ubongo
• Kuphulika kwa mikono kapena miyendo, nthawi zina kumabweretsa kudulidwa
• Matenda amtima
• Zowonongeka zina
• Imfa

Kuthamangitsidwa kwadzidzidzi ndizadzidzidzi zamankhwala. Imbani nambala yadzidzidzi yakomweko (monga 911) kapena mutengereni munthuyo kuchipatala.

Kupewa mantha ndikosavuta kuposa kuyesera kuchitira izi zikachitika. Kuthetsa vutoli mwachangu kumachepetsa chiopsezo chodwala kwambiri. Chithandizo choyamba choyambirira chingathandize kuchepetsa mantha.

Kusokonezeka - zachinyengo

Angus DC. Yandikirani wodwalayo ndi mantha. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 98.

Dries DJ. Hypovolemia ndi mantha owopsa: kasamalidwe ka opaleshoni. Mu: Parrillo JE, Dellinger RP, olemba. Zovuta Zosamalira Mankhwala: Mfundo Zazidziwitso ndi Kuwongolera Kwa Akuluakulu. 5th ed. Philadelphia, PA: Elsevier; 2019: chaputala 26.

Mtsikana MJ, Peake SL. Chidule cha mantha. Mu: Bersten AD, Handy JM, eds. Buku Lopatsa Chidwi la Oh. 8th ed. Philadelphia, PA: Elsevier; 2019: mutu 15.

Puskarich MA, Jones AE. Chodabwitsa. Mu: Makoma RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: mutu 6.