Yu blɔd flɔ kin pwɛl ɛn yu de go insay ‘shɔk’? Mek wi tok abaut ‘distributive shock’!

Oh, sɔntɛnde wi kin gɛt big trɔbul wantɛm wantɛm, nɔto so? Sɔmtɛm wi kin fil lɛk se wi de lɔs wi layf ɛn i kin at fɔ blo. Sɔntɛnde lɛk dis, sɔntin we siriɔs kin de apin insay wi bɔdi. Tide wi go tɔk bɔt wan pan dɛn kayn tin ya we kin apin wantɛm wantɛm ɛn we kin mek pɔsin in layf de pan denja. Dat na wan kɔndishɔn we dɛn kɔl ‘Distributive Shock’ .

Wetin na dis ‘distributiv shɔk’? Fɔ tɔk am simpul wan...

Fɔ tɔk am simpul wan, distributiv shɔk na mɛdikal imejensi. Wetin kin apin ya na dat di blɔd vesel dɛn na yu bɔdi (we blɔd de flɔ) kin tu big wantɛm wantɛm, lɛk we dɛn de strɛch rɔba tiub. Sɔntɛnde dɛn kin kɔl dis bak vasodilatory shock . So, we di blɔd vesel dɛn big lɛk dis, di blɔd prɛshɔn kin go dɔŋ bad bad wan wantɛm wantɛm. Tink bɔt am lɛk se if wata paip big, di wata go flɔ sloslo.

Wetin kin apin we dis kin apin? Yu men ɔgan dɛn lɛk yu at, bren, ɛn kidni dɛn nɔ kin gɛt inof blɔd . Nɔto dat nɔmɔ, bɔt sɔntɛnde sɔm pan di blɔd kin bigin fɔ lik kɔmɔt na dɛn smɔl smɔl blɔd vesel dɛn ya (kapilari dɛn). Dis kin mek di blɔd we de na yu bɔdi nɔ bɔku. Dis na tin we rili denja, bikɔs wi ɔgan dɛn nid blɔd ɔltɛm fɔ mek dɛn ebul fɔ wok.

I rili impɔtant: If yu gɛt ‘shɔk’ lɛk dis, i impɔtant fɔ go to tritmɛnt kwik kwik wan. If nɔto dat, i kin mek pɔsin in layf de pan denja.

Wetin na di men kayn ‘distributive shocks’?

Tri men kayn ‘distributive shock’ de, ɛn ɛni wan pan dɛn kin apin fɔ difrɛn rizin.

1. Septic Shock: Dis na di kayn we we pipul dɛn kin gɛt mɔ. Na baktri infekshɔn kin kam wit am. Imajin, yu gɛt wund, i kin rili bad, di jem dɛn kin skata ɔlsay na yu bɔdi, ɛn i kin bi wan stet we dɛn kɔl ``Sepsis'', ɛn yu nɔ kin ebul fɔ kɔntrol am. Sɔmtɛm, ivin sɔmtin lɛk nyumonia kin mek dis sik.

2. Anaphylactic Shock: Dis kin kam bikɔs yu gɛt siriɔs alɛji. Fɔ ɛgzampul, sɔm pipul dɛn kin gɛt bad bad alɛji fɔ sɔntin lɛk pinat, nɔto so? Ɔ i kin apin we sɔm insɛkt dɛn bit dɛn. Pɔrsin wae gɛt asma kin gɛt dis sik bak, ivin if i nɔr kin izi fɔ blo.

3. Nyurojɛnik Shɔk: Dis kin kam bikɔs yu spɛnal kɔd dɔn pwɛl. fכ egzampl, if yu hit yu ed we yu de jomp insay wata εn inju yu spεnal kכd, כ if yu gεt siriכs aksidεnt we de pwεl yu spayna, dis ‘nyurojenik shכk’ kin apin bikoz fכ di ifekt pan di nεv sεstem.

Wetin na di difrɛns bitwin ‘Distributive Shock’ ɛn ‘Hypovolemic Shock’?

Dɛn tu na kayn ‘shɔk’. Dat min se pan ɔl tu di kes dɛn, wi impɔtant pat dɛn nɔ de gɛt inof blɔd ɛn ɔksijɛn. Bɔt, di tin we kin mek i apin difrɛn.

• Distributive shock , lɛk aw wi bin dɔn tɔk, kin kam bikɔs di blɔd vesel dɛn kin tu big. Bɔrku tɛm dis kin kam wit wan infekshɔn wae dɛn kɔl sɛpsis ɔr wan siriɔs alɛji.
• Hypovolemic shock na we di blɔd ɔ ɔda wata we de na di bɔdi tu smɔl. Fɔ ɛgzampul, dis kin apin if yu lɔs bɔku blɔd bikɔs yu gɛt big injuri, ɔ if yu lɔs bɔku wata bikɔs yu gɛt bad bad dayarɛa ɔ yu vɔmit.

fכ simpul wan, insay ‘distributiv’ di bכdi vεsul dεm de bi big, insay ‘hypovolemic’ di bכdi/fluid na di bכdi de dכn. Dɔn gɛt am?

Aw kɔmɔn dis ‘distributiv shɔk’?

fכ kayn shכk de we wi no bכt (`Hypovolemic`, `Cardiogenic Shock`, `Obstructive Shock` εn `Distributive Shock`). Fɔ dɛn 4 ya , di wan we kɔmɔn pas ɔl na `Distributive Shock` . Ɛspɛshali di kayn we dɛn kɔl `Septic Shock`. Ivin na kɔntri lɛk Amɛrika, na lɛk wan milyɔn pipul dɛn kin gɛt `Septic Shock` ɛvri ia. I kin apin to ɛnibɔdi.

Wetin kin apin to di bɔdi wit ‘distributive shock’?

As a bin dɔn tɔk, we di blɔd vesel dɛn kin big pasmak, di blɔd prɛshɔn kin go dɔŋ. Dɔn di blɔd we de go na di ɔgan dɛn nɔ kin du fɔ am. Wi ɔgan dɛn tan lɛk mashin. Dɛn nid fɔ gɛt di rayt fiul (i.e. blɔd ɛn ɔksijɛn) fɔ wok. We dɛn nɔ gɛt inof blɔd, ɔksijɛn, ɛn tin dɛn we dɛn nid, di ɔgan dɛn kin bigin fɔ wok smɔl smɔl. Wi kin kɔl dis ‘ɔgan we nɔ de wok fayn’ . If di ɔgan dɛn nɔ wok lɛk dis, i kin bi big prɔblɛm fɔ layf.

Wetin na di sayn dɛm fɔ dis?

Di simptom dɛm fɔ distributiv shɔk kin difrɛn smɔl dipen pan di kɔz. Bɔt sɔm sayn dɛn de we kin apin:

• Rash na di skin
• Hat de bit kwik kwik wan ɛn we i de blo
• Lɔw blɔd prɛshɔn (dis na di men sayn) .
• Fɔs, di an ɛn fut kin wam, dɔn dɛn kin kol ɛn swet.
• Fiva
• Chil (fɔ fil kol ɛn shek shek) .
• Bɛlɛ de at
• Kɔnfyushɔn, fil lɛk se yu de lɔs kɔnshɛns
• Kɔf
• Shot we yu de blo
• Vɔmit
• Fɔ vɔmit
• Pen we yu de pis

If wan ɔ mɔ pan dɛn sayn ya apin wantɛm wantɛm, i go fayn fɔ mek yu nɔ tek am layt, nɔto so?

Wetin na di tin dɛm we kin mek pɔsin gɛt ‘Distributive Shock’?

Apat frɔm di tri kayn we dɛn we wi bin dɔn tɔk bɔt, bɔku ɔda rizin dɛn de we kin mek dis kayn tin apin.

• Sepsis we kin kam wit baktriyal infεkshכn (dis na di men tin) .
• Anafylaksis, we kin kam wit siriɔs alɛji (e.g., it lɛk pinat, insɛkt sting, sɔm mɛrɛsin, asma exacerbations)
• Bɔn dɛn
• Pankriaytis we gɛt sik
• Toxic Shock Syndrome (we kin apin, mɔ pan uman dɛn, bikɔs dɛn de yuz tampon) .
• Spinal kɔd injuri
• Dizayd dɛn we de na di ɛndɔkrin
• Adrenal insufficiency (dis nɔ kin apin smɔl) .
• Capillary leak syndrome ( wata we de lik frɔm di blɔd vesel, dis bak nɔ kin apin smɔl) .
• Fɔ tek tumɔs mɛrɛsin we de mek yu blɔd vesel big (Drug overdose) (dis nɔ kin apin bak) .

Aw dɔktɔ dɛn kin no dis?

We yu gɛt dɛn sik ya, di fɔs tin we dɔktɔ go du na fɔ chɛk yu gud gud wan ɛn aks yu bɔt yu mɛdikal istri. Bɔt pɔsin we shɔk nɔ go ebul fɔ gi yu ɛni infɔmeshɔn. If dis kayn tin apin, pɔsin we de wit yu kin tɛl di dɔktɔ bɔt yu alɛji, if yu dɔn gɛt anafylaksis bifo, ɛn us mɛrɛsin yu de tek. Dis infɔmeshɔn kin rili ɛp fɔ no di sik.

Afta dat, di dɔktɔ go ɔda fɔ du sɔm tɛst dɛn, lɛk:

• Blɔd tɛst: Chɛk fɔ si if yu gɛt infɛkshɔn ɛn aw di ɔgan dɛn de wok.
• ECG (Electrocardiogram - EKG): I de chɛk aw di at de wok.
• Chɛst X-ray: Chɛk aw di lɔng dɛn de.
• Ultrasound scan: Luk di at, di lכng dεm, εn di כgan dεm na di bεlε. Sɔm pan dɛn tin ya kin apin nia di bed.

Aw dɛn kin trit am?

Bikɔs dis na imejensi, bɔku tɛm dɛn kin bigin fɔ trit am na di Imejɛnsi Rum. Afta dat, dɛn kin transfa yu to di Intensiv Keya Yunit (ICU).

1. Di fɔs tin we yu de du na fɔ gi IV wata. Dɛn kin gi wata lɛk salin insay wan vein. Dɛn kin du dis fɔ mek yu blɔd prɛshɔn go dɔŋ smɔl.

2. Neks, wi go no wetin mek di ‘shɔk’ ɛn gi di rayt mɛrɛsin.

3. Sɔntɛnde , dɛn kin yuz tiub fidin , bikɔs di bɔdi nid ɛnaji.

Insay di intensiv kia yunit, dɔktɔ ɛn nɔs dɛn go kɔntinyu fɔ wach yu impɔtant sayn dɛn (at rit, blɔd prɛshɔn, brith, tɛmpracha). Dɛn go chɛk bak fɔ di sayd ɛfɛkt dɛn we di tritmɛnt gɛt. If i nɔ izi fɔ yu fɔ blo yusɛf, dɛn kin kɔnɛkt yu to mashin fɔ blo (ventilator) .

Us kayn mɛrɛsin dɛn kin yuz?

Di mɛrɛsin we dɛn kin gi fɔ ‘Distributive Shock’ kin difrɛn difrɛn wan fɔ di kɔz:

• Vasopreshɔn dɛn: .Dɛn kin gi dɛn tin ya fɔ mek blɔd prɛshɔn go ɔp. fכ egzampl, mεdisin dεm lεk `epinephrine`, `vasopressin`, `norepinephrine` כ `phenylephrine`.
• Antibayɔtik : If infekshɔn de.
• Antihistamines: If na bikɔs ɔf alɛji.
• Stɛroyd: Fɔ alɛji ɔ fɔ siriɔs sɛpsis.
• Albuterol inhaler (lɛk Accuneb® ɔ Proair®HFA): If di shɔk na bikɔs ɔf asma.

Ɛni bad tin de we di tritmɛnt kin du?

Yɛs, sɔm mɛrɛsin dɛn kin mek yu gɛt smɔl smɔl sayd ɛfɛkt dɛn.

• Vasopressors: at bit we nɔ de bit ɔltɛm (arrhythmia), nɔ de rɛst, pulmonary edema, chɛst de pen, di korona at dɛn na di at de smɔl (dis kin mek yu gɛt at atak).
• Antibayɔtik : Nɔs, vɔmit.
• Albuterol: Wɔri, diziz, nɔs.
• Antihistamines: I kin slip, diziz, ed kin at, at kin bit kwik kwik wan.

Bɔt, dɔktɔ dɛn go luk ɔl dis ɛn gi yu di tritmɛnt we fit pas ɔl. Di tin we impɔtant pas ɔl na fɔ sev yu layf.

Aw wi go ridyus dis risk?

Wi nɔ go ebul fɔ avɔyd ɔltin we de mek wi gɛt distribyushɔn shɔk. Fɔ ɛgzampul, infɛkshɔn ɛn bɔn. Bɔt sɔm tin dɛn de we wi kin du fɔ ridyus di risk fɔ dis shɔk bikɔs ɔf sɔm tin dɛn we wi no:

• If yu gɛt siriɔs alɛji fɔ it , lɛk pinat, kin kɛr wan epinephrine ɔto-injɛkta (lɛk EpiPen® Ɔto-Injɛkta ɔ Adrenalin®) wit yu ɔltɛm. No gud gud wan aw fɔ yuz am.
• If yu gɛt asma flawa ɔltɛm , kip yu albuterol ɔ salbutamol inhala wit yu ɔltɛm. Nɔ mek i dɔn.
• If yu yuz tampon, nɔ lɛf am fɔ lɔng tɛm, bikɔs dis kin mek yu gɛt Toxic Shock Syndrome, we kin go bifo to Distributive Shock.
• Nɔ jomp insay wata we shalo ɔ wata we yu nɔ no dip. I kin mek di spaynal kɔd pwɛl.
• If yu de tek mɛrɛsin we de mek yu blɔd vesel dɛn big (opin), nɔ tek am tumɔs. Tek di mɔni nɔmɔ we yu dɔktɔ tɛl yu fɔ tek.

Wetin kin apin if ‘distributive shock’ apin?

If de tin wae de mek yu shɔk na sepsis, yu kin gɛt prɔblɛm fɔ lɔng tɛm. Tin dɛn lɛk taya, bad drim, ɛn nɔ want fɔ it. Ilɛk wetin mek yu du dat, yu fɔ kɔntinyu fɔ go to yu dɔktɔ fɔ mek dɛn go fala yu. Yu fɔ tek di mɛrɛsin dɛn bak we yu dɔktɔ gi yu di rayt we.

Di tɛm we i kin tek fɔ wɛl frɔm distribyushɔn shɔk kin dipen pan aw i bin siriɔs. Yu kin nid fɔ de na ɔspitul fɔ sɔm dez to sɔm wiks.

di rεt fכ dis kכndyushכn kin difrεn frכm 20% to 80%, dipכnt pan di kכz. If dɛn nɔ trit am, bɔku tɛm i kin mek pɔsin day. Fɔ no di sik kwik kwik wan ɛn fɔ trit am na di bɛst we fɔ sev pɔsin in layf. Di wan dɛn we dɔn ol, di wan dɛn we de drink rɔm, ɛn di wan dɛn we gɛt bɔku prɔblɛm wit dɛn ɔgan dɛn kin gɛt mɔ prɔblɛm.

If yu bɔdi de ansa fayn to IV wata ɛn yu ɔgan dɛn kɔntinyu fɔ wok, yu gɛt gud chans fɔ wɛl.

Aw a kin kia fɔ misɛf afta a dɔn rich na os?

Afta yu kam bak na os frɔm ɔspitul, tek kia ɔf yusɛf lɛk aw yu dɔktɔ tɛl yu. Yu kin nid fɔ de na os fɔ sɔm dez ɔ sɔm wiks fɔ rɛst fayn bifo yu go bak na wokples. Kip yu fɔlɔp apɔntinmɛnt dɛn. Tek yu mɛrɛsin dɛn jɔs lɛk aw dɛn tɛl yu fɔ tek.

If yu fil se yu de gɛt prɔblɛm bak we yu de na os, kɔl yu dɔktɔ wantɛm wantɛm.

Insay imejensi: Dɛn fɔ kɛr ɛnibɔdi we gɛt di sayn dɛn fɔ distribyushɔn shɔk go na di imejensi rum wantɛm wantɛm. Te di ambulans kam, mek di pɔsin we shɔk ledɔm. Kɔba dɛn wit blankit fɔ mek dɛn wam, ɛn es dɛn leg ɔp lɛk wan fut fɔ mek blɔd go fayn.

Us kwɛstyɔn dɛn yu fɔ aks di dɔktɔ?

If yu gɛt dis sik, i go fayn fɔ aks yu dɔktɔ bɔt tin dɛn lɛk:

• A de pan risk fɔ gɛt ‘distributive shock’ bak?
• Aw ɔltɛm a nid fɔ kam fɔ fala-ap apɔntinmɛnt?
• A go gɛt lɔng tɛm ifɛkt frɔm di ‘Distributive Shock’?

Fɔ dɔn, wetin fɔ mɛmba (Take-Home Message) .

Distributive Shock na mɛdikal imejensi we nid fɔ gɛt tritmɛnt kwik kwik wan. Fɔ gɛt ɛp kwik kwik wan na yu bɛst chans fɔ sev yu layf. I kin tek tɛm fɔ mek yu wɛl, so peshɛnt wit yusɛf. We yu de na os, tek yu mɛrɛsin dɛn jɔs lɛk aw yu dɔktɔ tɛl yu fɔ tek, ɛn go to pipul dɛn we de fala yu ɔltɛm. As yu si, dis na wan sik we rili siriɔs. So i impɔtant fɔ no bɔt dis.

` Distributiv shɔk, sɛptik shɔk, anafylaktik shɔk, nyurojɛnik shɔk, lɔw blɔd prɛshɔn, shɔk tritmɛnt, sɛpsis Sinhala