Aia kekahi mea e ālai ana i ke kahe ʻana o ke koko i loko a i waho o kou puʻuwai? Hiki paha kēia ke lilo i (Obstructive Shock)!

Ke holo pono ʻole ke koko ma loko o ko kākou kino, ʻo ia hoʻi, ʻaʻole i loaʻa i ko kākou mau kino ka nui o ka oxygen e pono ai, kapa pinepine mākou ia he 'shock'. Hiki koke kēia. I kēia lā, e kamaʻilio mākou e pili ana i kahi ʻano kūikawā, akā he ʻano kakaikahi o ka 'shock'. Ua kapa ʻia ʻo ia he '(Obstructive Shock)'. I ka ʻōlelo maʻalahi, ʻo ka mea e hana ʻia ma kēia hihia, ʻo ia ka mea e ālai ana i ke kahe o ke koko i ko kākou puʻuwai a me ke koko e pume ana i waho o ka puʻuwai, ʻo ia hoʻi, he 'ala'. Ma muli o kēia ālai ʻana, ʻaʻole hiki i ka puʻuwai ke hana pono, hiki ke hāʻule koke ke koko, a hiki i ke kino ke nele i ka oxygen. He kūlana wikiwiki loa kēia, no laila he mea nui loa ka loaʻa koke ʻana o ka lāʻau lapaʻau.

No laila he aha kēia `(Obstructive Shock)`? E wehewehe iki aku kākou?

E noʻonoʻo, ua like ko kākou puʻuwai me ka pamu wai. ʻO kēia pamu ka mea e hoʻouna i ke koko ma ke kino holoʻokoʻa. I kēia manawa, he aha ka mea e hana ai inā e ālai ʻia ka wai e komo ana i loko o kēia pamu i loko o ka paipu, a i ʻole inā e ālai ʻia ka paipu e puka ana mai ka pamu? ʻAʻole kahe pono ka wai, ʻeā? ʻO ia ka mea e hana ai ma ka `(Obstructive Shock)`.

Ke ālai nei kekahi mea i ke kahe o ke koko ma o nā kīʻaha koko nui (i kapa ʻia ʻo "nā kīʻaha koko nui") e hoʻopili ana i ka puʻuwai. Pale kēia i ka puʻuwai mai ka loaʻa ʻana o ke koko lawa, a ʻaʻole hiki iā ia ke pamu iā ia i waho. ʻO ka hopena, ʻaʻole lawa ka oxygen i nā ʻāpana koʻikoʻi loa o ko kākou kino, ka lolo, nā puʻupaʻa, a me nā māmā. He pilikia weliweli kēia e ola ai.

He aha ka ʻokoʻa ma waena o ka `(Cardiogenic Shock)` a me ka `(Obstructive Shock)`?

He mau pilikia olakino kēia mau mea ʻelua, akā ʻelua mau kumu e kū mai ai.

Hiki mai ka haʻalulu cardiogenic ke hōʻino ʻia ka ʻiʻo o ka puʻuwai, e like me ka hōʻeha puʻuwai, a ʻaʻole hiki i ka puʻuwai ke pamu i ke koko kūpono i ke kino. Lilo ka puʻuwai i nāwaliwali.

Akā i loko o ka `(Obstructive Shock),` hiki i ka ʻiʻo puʻuwai ke maikaʻi pinepine. ʻAʻole ka pilikia me ka puʻuwai, akā me kahi mea ʻē aʻe e hoʻopilikia nei i ka hana o ka puʻuwai. E noʻonoʻo i kēia mau mea:

• Inā he ʻūpā koko nui kou i loko o kahi kīʻaha koko nui (ʻaʻa pulmonary) e alakaʻi ana i kou mau māmā.
• Inā ua ʻūmiʻi ʻia ka puʻuwai e kahi ʻeke piha i ka wai a puni ka puʻuwai (pericardial tamponade).
• Inā he ʻeha i nā māmā a piʻi nui ke kaomi i loko o ka lua umauma, no ka laʻana, ma ke ʻano i kapa ʻia ʻo "Tension pneumothorax".

ʻO ka Obstructive Shock ka hiki ʻole i ka puʻuwai ke hana pono ma muli o kahi kumu o waho e like me kēia.

Pehea ka maʻamau o kēia kūlana i kapa ʻia ʻo "Obstructive Shock"? Pehea kona hopena i ke kino?

He ʻano laha ʻole ka Obstructive Shock i hoʻohālikelike ʻia me nā ʻano haʻalulu ʻē aʻe. Hoʻopilikia pinepine ia i 1% a i ʻole 2% wale nō o nā maʻi haʻalulu. ʻO ka nūhou maikaʻi, ʻoi aku ka maʻalahi o ka hoʻōla ʻia ma mua o nā ʻano haʻalulu ʻē aʻe, akā inā mālama koke ʻia.

Inā ʻaʻole e mālama koke ʻia, hoʻonele ka Obstructive Shock i nā ʻōkana koʻikoʻi o ke kino i ka oxygen a me nā meaʻai. Hiki i kēia ke alakaʻi i ka hōʻino ʻana o nā ʻōkana a i kekahi manawa make. No laila he mea nui e ʻimi koke i ka lāʻau lapaʻau.

He aha nā hōʻailona o ka `(Obstructive Shock)`?

ʻO nā hōʻailona o kēia paha e like iki me nā hōʻailona o ka "Cardiogenic Shock." E nānā inā kamaʻāina kēia mau mea iā ʻoe:

• Piʻi nui ka hanu ʻana ma ke ʻano ʻē.
• Hāʻule haʻahaʻa loa ke koko (hypotension).
• Piʻi nui ka helu o ka puʻuwai (`Tachycardia`). Me he mea lā ua holo wale ʻoe.
• Loli ka naʻau, malia paha he kaumaha a hopohopo paha.
• Ua emi nui ka nui o ka mimi i hana ʻia, a ʻaʻole loa paha.
• Anu a hou ka ʻili.
• I kekahi manawa hiki ke hōʻiliʻili ka ea ma lalo o ka ʻili (`Subcutaneous emphysema`). ʻO ke ʻano kēia, ua like ia me nā pehu liʻiliʻi ma lalo o ka ʻili.
• Hiki paha iā ʻoe ke ʻeha i ka umauma a i ʻole ka ʻōpū.

Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, ​​​​he mea nui loa e ʻimi koke i ke kōkua lapaʻau.

He aha nā kumu o ka `(Obstructive Shock)`?

Aia kekahi mau kumu o ka `(Obstructive Shock)`. E nānā kākou i nā mea nui:

• `(Tension pneumothorax)` (hiolo ʻana o ka māmā): Hana ʻia kēia ke komo ka ea i loko o ka māmā a ʻaʻole hiki ke puka i waho, e hoʻopaʻa ʻia ai i loko o ka māmā. A laila hiolo ka māmā, e hana ana i ka nui o ke kaomi i loko o ka umauma a e hoʻomaka ai ka puʻuwai e kuʻi.
• ʻO ka maʻi hoʻopili ʻana o Vena cava: ʻO ke kaomi ʻana o ke aʻa koko nui loa i loko o ko mākou kino (ka vena cava). Hiki ke hana pinepine kēia i ka hopena o ka hāpai ʻana, i ka wā e hoʻopili ai ke kaumaha o ka pēpē i kēia aʻa koko.
• ʻO ka maʻi hoʻopili ʻana o ka puʻuwai (mama): ʻO ka maʻi hoʻopili ʻana o ka puʻuwai.
• `(High-PEEP ventilation)`: He kūlana kahi i kiʻekiʻe loa ai ke kaomi i loko o nā māmā no kekahi mea i pili i kahi ventilator.
• Nā Tumors: ʻO kekahi ʻano o nā tumors e ulu ana i loko o ka lua o ka umauma hiki ke ālai i ka puʻuwai a i ʻole nā ​​​​kīʻaha koko nui.
• ʻO ka Thromboembolism i loko o ke aʻa pulmonary: He mea weliweli loa kēia. Inā haki kahi ʻūpā koko i hana ʻia ma kahi e like me ka wāwae a paʻa i loko o kahi kīʻaha koko i loko o nā māmā, e hoʻōki ia i ke koko mai ke kahe ʻana mai ka puʻuwai a i nā māmā.
• ʻO ka tamponade Pericardial: Hoʻopiha ʻia ka ʻeke lahilahi a puni ka puʻuwai (ka pericardium) me ka wai, e ʻomi ana i ka puʻuwai. Pale kēia i ka puʻuwai mai ka ʻūlū ʻana a me ka hoʻonui pono ʻana.
• ʻO ka dissection Aortic: He haehae i loko o ka aorta, ke kīʻaha koko nui loa e puka ana mai ka puʻuwai.
• ʻO ka stenosis aortic: Ka hāiki ʻana o ka valve aortic i loko o ka puʻuwai. ʻO kēia ka mea e paʻakikī ai ke kahe ʻana o ke koko mai loko mai o ka puʻuwai.
• Hypertrophic cardiomyopathy: Ke ālai ʻia ʻana o ke kahe koko ma muli o ka mānoanoa nui o ka ʻiʻo o ka puʻuwai.
• ʻO ka pericarditis constrictive: Hoʻomānoanoa ʻia ka ʻeke a puni ka puʻuwai, e paʻakikī ai i ka puʻuwai ke hana manuahi.

Mea nui: He mau pilikia kēia mau kumu a pau, no laila e ʻike koke i ke kauka inā loaʻa iā ʻoe nā hōʻailona.

Pehea e ʻike ai i ka `(Obstructive Shock)`?

E nānā mua kāu kauka iā ʻoe. E hoʻolohe lākou i kou puʻuwai a me kou māmā me ka stethoscope. ʻO ke ʻano obstructive shock kahi maʻi e hiki ke ʻoi aku ka ʻino, no laila he mea nui e loaʻa koke kahi hōʻailona.

No ka hoʻomaopopo pololei ʻana i ka maʻi, hiki ke hana ʻia nā hoʻokolohua penei:

• Ultrasound: Hiki i kēia ke nānā i nā mea e like me ka puʻuwai, nā kīʻaha koko nui, a inā he wai a puni nā māmā.
• ʻEchocardiogram (Echo): Ua like kēia me ka ultrasound o ka puʻuwai. Hiki iā ia ke ʻike maopopo i ka hana o ka puʻuwai, ke kūlana o nā valves, a inā he wai a puni ka puʻuwai.
• ʻO ke kiʻi ʻana o ka tomography computed (CT): Hiki i kēia ke kiʻi i nā kiʻi kikoʻī o ka lua o ka umauma. Hiki iā ia ke kōkua i ka ʻike ʻana i nā mea e like me nā ʻōpū koko, nā puʻupuʻu, a me ka dissection aortic.
• Electrocardiogram (ECG a i ʻole EKG): Hoʻāʻo kēia i ka hana uila o ka puʻuwai. Hiki iā ia ke kōkua i ka hoʻoholo ʻana inā he hewa kekahi mea me kou puʻuwai.

Pehea e mālama ʻia ai ka Obstructive Shock?

ʻO ka mea mua, e hāʻawi ʻia ʻoe i nā wai IV (e like me ka saline - IV crystalloid fluids) a e nānā mau ʻia kou koko a me nā pae oxygen. A laila, ʻo ka mea nui loa, ʻo ia ka ʻimi ʻana i ke kumu o ka Obstructive Shock a mālama i kēlā kumu.

ʻOkoʻa nā ʻano lapaʻau ma muli o ke kumu. E nānā kākou i kekahi mau laʻana:

• Inā he ʻūpē koko (embolism), e wehe ʻia ma ke ʻoki ʻana a i ʻole ma ke hoʻokomo ʻana i kahi cannula (catheter).
• Inā he valve aortic i hoʻohaiki nui ʻia, e pani ʻia.
• I nā hihia o ka mānoanoa o ka ʻiʻo puʻuwai (hypertrophic cardiomyopathy), hiki ke hoʻemi ʻia ka mānoanoa ma o ke ʻoki ʻana a i ʻole kahi hana kūikawā e hoʻohana ana i ka waiʻona (catheter-based alcohol ablation).
• Hāʻawi lākou iā ʻoe i ka lāʻau lapaʻau e hoʻoheheʻe i nā ʻūpā koko.
• Inā he wai a puni ka puʻuwai (pericardial tamponade) a i ʻole he tension pneumothorax, e wehe ʻia ka wai a i ʻole ka ea (malia paha me ka hoʻohana ʻana i kahi ʻōmole liʻiliʻi).
• Inā ʻoe ma luna o kahi ventilator, hiki iā ʻoe ke hoʻololi i kāna mau hoʻonohonoho.
• I ke kūlana e like me ka "Vena cava compression syndrome", ua loli ke kūlana o ke kino.
• Inā kiʻekiʻe ke kaomi i loko o nā māmā, hoʻemi ʻia ke kaomi me kahi nila a i ʻole ka paipu.

He aha nā lāʻau lapaʻau i hoʻohana ʻia?

ʻOiai e mālama ʻia ana ke kumu, hiki ke hāʻawi ʻia iā ʻoe nā lāʻau lapaʻau e like me kēia e hoʻopaʻa ai i kou kūlana:

• Nā wai e like me ka 'IV' saline ('IV crystalloid fluids').
• Nā lāʻau lapaʻau e hoʻonui ai i ke koko: `(Norepinephrine (Levophed®))`, `(Vasopressin (Vasostrict®))`, `(Phenylephrine (Vazculep® a i ʻole Biorphen®))`.
• Inā haʻahaʻa kou helu koko, e hāʻawi ʻia ʻoe i ke koko a i ʻole nā ​​​​​​huahana koko (e like me nā hunaola koko ʻulaʻula a me ka plasma).

Pehea ka wikiwiki o koʻu ho'ōla ʻana ma hope o ka lāʻau lapaʻau?

Pono e mālama koke ʻia nā kumu he nui o ka Obstructive Shock, ʻoiai ʻo ia ka manawa e ola nui ai. ʻO ka mea pōmaikaʻi, hana koke kēia mau lāʻau lapaʻau. Eia naʻe, ma hope o ka mālama ʻana i ke kumu, pono ka manawa no ke kino e hoʻōla mai nā hopena o ka Obstructive Shock. ʻAʻole hiki iā ʻoe ke holo wale a hana i kāu hana.

He aha ka manaʻo no ka `(Obstructive Shock)`?

Inā ʻaʻole mālama ʻia, ʻo ka "Obstructive Shock" kahi maʻi e hiki ke make no nā kānaka he nui. ʻO kou hoʻōla ʻana ma hope o ka mālama ʻana e pili ana i kekahi mau kumu, e like me:

• He aha ke kumu o ka `(Obstructive Shock)`?
• ʻEhia ka lōʻihi o ka loaʻa ʻana o ka lāʻau lapaʻau?
• He aha nā maʻi ʻē aʻe āu e loaʻa nei?
• Pehea ka holomua o ka lāʻau lapaʻau iā ʻoe?

Eia nō naʻe, e like me ka mea i ʻōlelo ʻia ma mua, ʻoi aku ka kiʻekiʻe o nā manawa e hoʻōla ai mai ka "Obstructive Shock" ma mua o nā ʻano maʻamau o ka "Shock" e like me ka "Septic Shock". No laila, aia ka manaʻolana.

Pehea wau e mālama ai iaʻu iho?

Ma hope o ka hoʻokuʻu ʻana o ke kauka iā ʻoe mai ka haukapila, pono ʻoe e hahai pololei i kā lākou mau kuhikuhi.

• Pono ʻoe e hoʻomaha ma ka home no kekahi manawa ma mua o kou hoʻi ʻana i ka hana.
• Pono ʻoe e lawe i ka lāʻau lapaʻau i kuhikuhi ʻia e kāu kauka i ka manawa kūpono . Mai ho'ōki i ka lawe ʻana i kekahi lāʻau lapaʻau i ka manawa e makemake ai.
• E hele pinepine i nā hālāwai hoʻomaʻamaʻa .

Āhea wau e ʻike hou ai i ke kauka? He aha kaʻu e hana ai i ka wā pilikia?

I kēia manawa ua ʻike ʻoe i ke kumu o kou `(Obstructive Shock)`. E makaʻala inā e hoʻi hou mai nā hōʻailona e pili ana i kēlā pilikia. Inā loaʻa hou iā ʻoe kēlā mau hōʻailona, ​​a inā paha e ʻike kekahi o kou ʻohana i kēia loli iā ʻoe, e kāhea koke i ka 1990 (Wind) Ambulance Service, a i ʻole e hele i ka lumi pilikia o ka haukapila kokoke loa. He mea nui ka manawa.

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

Hiki iā ʻoe ke nīnau i nā nīnau e like me kēia:

• Pehea ka lōʻihi e pono ai iaʻu e lawe i ka lāʻau lapaʻau āu i kauoha mai ai?
• He aha nā manawa kūpono e loaʻa hou ai iaʻu kēia maʻi?
• E loaʻa anei kēia i ka hopena lōʻihi i koʻu kūlana ola?
• He aha nā hoʻololi e pono iaʻu e hana i kaʻu ʻai a me ka hoʻoikaika kino?

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)

He kūlana kakaikahi ka Obstructive Shock akā he kūlana koʻikoʻi loa ia e pono ai ka mālama koke ʻana. No laila, he mea nui e makaʻala i nā hōʻailona a e ʻimi koke i ka mālama ʻana. Ke loaʻa i nā kauka ke kumu o Obstructive Shock, e hoʻomaka lākou i ka mālama kūpono.

E hoʻomanaʻo, hiki i ka hapa nui o ka poʻe ke ho'ōla mai ka Obstructive Shock, akā he manawa ka lōʻihi. E hoʻomanawanui, e hahai i nā ʻōlelo a kāu kauka, a e mālama iā ʻoe iho. ʻAʻole ʻoe hoʻokahi, a aia nā kauka, nā kahu maʻi, a me kāu poʻe aloha e hiki ke kōkua iā ʻoe.

ʻO ke kūpikipikiʻō, ke kūpikipikiʻō, maʻi puʻuwai, ke koko, ka oxygen, ke kūpikipikiʻō, ka mālama ʻana i ka pilikia, nā māmā, ka puʻuwai