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哮喘持续状态的急救
原帖由 刘延红大夫 于 2006-10-29 11:33 发表
什么是哮喘持续状态
美国胸科协会将哮喘持续状态定义为:哮喘从发作初期即出现严重的气道阻塞或发作后哮喘病情加重,并且对常规治疗无效的急性发作性哮喘。因此,哮喘严重发作通常称为哮喘持续状态。这种哮喘 ...
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Any is the asthma continues the condition The American chest branch association continues the asthma thecondition definition is: The asthma after manifests suddenly theinitial period namely to appear the serious gas channel to block or tomanifest suddenly the asthma condition to aggravate, and toconventional treatment invalid acute manifesting suddenly asthma.Therefore, the asthma seriously manifests suddenly usually is calledthe asthma to continue the condition. This kind of asthma continuesthe condition only is refers time manifests suddenly the situation tosay, certainly does not represent this patient's basic condition, butoften has Yu Zhongzheng asthma patient, moreover after pre- related,may threaten patient's life. The asthma continues the condition the clinical manifestation is: Theasthma manifests suddenly carries on the nature to aggravate, thechest urgent even has suffocates the feeling, the patient is compelledto sit well, cannot horizontal, bends down to front, two shoulderspeaks get up, two support nearby the knee, the table or the bed, makesan effort to gasp for breath, the breath, the palpitation speed up,speaks off and on, anxious is agitated, sweats profusely, even appearsis addicted to rests, the lips nail cyanosis, then 闻到 the respitesound nearby the patient body. These performance explained the patienthas the obvious gas channel to block, the bodily oxygen deficit, needsurgently to process. The asthma continues the condition the first aid
1. Attracts the oxygen immediately. Generally applies lowcurrent capacity 1~2L/min, along with the low oxygen blood sicknesscorrection, breathes myo- obtains the enough oxygen, the contractionis powerful, the improvement ventilates, simultaneously also avoidsthe oxygen deficit to the bodily important organ harm.
2. Rapid application bronchiectasis medicinal preparation. Beta 2acceptors excited medicinal preparations may rapidly alleviate thebronchial tube contraction, gets up the effect quickly, side effectfew, it generally divides into the persistent effect and the shorteffect two kinds, the asthma continues the condition mainly to applythe short effect preparation, if the sand butylamine is mellow (othername to breathe heavily Le Ninghuo shu Chuanling) 2.5mg to dissolve tothe physiological saline 中雾, from gas channel inspiration, each20min1, altogether 3; Also the coca can the acceptor oppress the anti-medicinal preparation with the choline, if the bromination differentthird 托品 (other name likes happy breathing heavily) 250~500 mu gto add the 2ml physiological saline atomization inspiration. If thetreatment result is not good or the patient stupor, is agitated isunable to use the inspiration treatment, but hypodermic injectionadrenalin (1/1,000) 0.3ml, also may use aminophylline 0.25g to add thephysiological saline or the glucose fluid 50ml vein slowly pushes thenote.
3. Reduces the gas channel acute inflammation as soon as possibleusing the sugar cortical hormone, alleviating which the accelerationacute manifests suddenly, generally applies the succinic acidhydrogenation to be possible pine 100~200mg, or the methyl **2mg/kg body weight, joins in the physiological saline or the grapesolution, each 4~6h vein pushes note 1, after the condition changesfor the better changes to takes orally strongly the pine, every day30~40mg.
4. Has the obvious respiratory tract to infect, the symptom still didnot alleviate, the artery blood oxygen partial pressure still waslower than 60mmHg, realized is unclear perhaps the comatose condition,should consider the machinery ventilated. If has the asthma in the home to continue the condition, when also isunable delivers the hospital immediately, first the patient puts onthe air circulation place, unties the collar, the attention maintainswarmth, if in the family has the oxygen manufacture meter or nei**orthe clinic has the oxygen, should use the nose drive pipe to attractthe oxygen immediately. And the rapid application is loaded with thebronchiectasis medicine the quota manually controlled gas spraymedicinal preparation, if breathes heavily Le Ninghuo to be possibleto have especially (to breathe heavily Le Ningjia to like breathingheavily happy, common asthma patient has), gas channel inspiration 2~4spurts immediately, each 20min may duplicate attracts 1 time; If inthe family has 博利 the Connie pill, may take orally 1 piece(2.5mg). Simultaneously takes orally strong pine 30mg, or pushes note** 5mg to the nei**or clinic vein to add physiologicalsaline 10ml, and the prompt application is loaded with the sugarcortical hormone (for example to have to be possible alkone or PuMick) quota manually controlled atomization medicinal preparationinspiration, each the 20min inspiration 2 spurts. In addition, theasthma continues the condition patient's if once had the fatal asthmato manifest suddenly the history, either passed in for 1 year once tobe hospitalized because of the asthma, the emergency medical treatmentreceives a medical examination, either because the asthma once had thetrachea to insert a tube the history, either at present appears theasthma, purple dark purple carries on the nature to aggravate, thelungs 呼吸音 and the asthma sound gradually weakens and so on thesituation, for the unusual danger signal, should urgently escort tothe hospital. |
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