Sɔntin de we de mek blɔd nɔ go insay ɛn kɔmɔt na yu at? Dis kin bi (Obstructive Shock)!

we bכdi nכ de sכkכt fayn fayn wan na wi bכdi, we min se wi כgan dεm nכ de gεt di כksijεn we wi nid, wi kin kכl am ‘shכk’. Dis kin apin wantɛm wantɛm. Tide wi go tok abaut wan speshal, bot somtin rare kain ‘shok’. Dɛn kɔl am `(Obstructive Shock)'. Fɔ tɔk am simpul wan, wetin kin apin na dis kes na we sɔntin de blok di blɔd flɔ to wi at ɛn di blɔd we de pɔmp kɔmɔt na di at, dat na, wan `obstruction' de apin. Bikɔs ɔf dis tin we de ambɔg di at, di at nɔ kin ebul fɔ wok fayn, di blɔd prɛshɔn kin go dɔŋ wantɛm wantɛm, ɛn di bɔdi nɔ kin gɛt ɔksijɛn. Dis na tin we rili impɔtant , so i rili impɔtant fɔ gɛt tritmɛnt kwik kwik wan.

So wetin na dis `(Obstructive Shock)`? Wi go ɛksplen am smɔl mɔ?

Imajin, wi at tan lɛk wata pɔmp. Dis pɔmp na in de sɛn blɔd ɔlsay na di bɔdi. Naw, wetin go apin if di wata we de go insay dis pɔmp blok insay di paip, ɔ if di paip we de kɔmɔt na di pɔmp blok? Di wata nɔ de flɔ fayn, nɔto so? Na dat kin apin na `(Obstructive Shock)`.

sכmtin de blכk di fכ fכlכ bכdi tru di big bכdi vεsul dεm (dεn kכl dεm `great vessel`) we de kכnekt di at. Dis kin mek di at nɔ gɛt inof blɔd, ɛn i nɔ kin ebul fɔ pɔmp am kɔmɔt bak. Di rizulyt na dat di ɔgan dɛm we impɔtant pas ɔl na wi bɔdi, di bren, kidni, ɛn lɔng, nɔ kin gɛt inof ɔksijɛn. Dis na imejensi we kin mek pɔsin in layf de pan denja.

Wetin na di difrɛns bitwin `(Cardiogenic Shock)` ɛn `(Obstructive Shock)`?

Dɛn tu tin ya na mɛdikal imejensi, bɔt dɛn kin apin fɔ tu rizin.

Kardiogenic shock kin apin we di at mɔsul dɔn pwɛl, lɛk at atak, ɛn di at nɔ ebul fɔ pɔmp inof blɔd to di bɔdi. Di at kin wik.

bכt insay `(Obstructive Shock),` di hat mכsul kin fayn bכku tεm. Di prɔblɛm nɔr de wit di at, bɔt na ɔda tin wae de ambɔg di at in woke. Tink bɔt dɛn tin ya:

• If yu gɛt big blɔd we de klɔt na wan big blɔd vesel (pulmonary artery) we de go na yu lɔng.
• if dεn sכk di at bay wan sak we fulכp wit wata we de rawnd di at (pericardial tamponade).
• if injuri de na di lכng dεm εn di prεshכn insay di chεst kεviti de inkrεs bכku bכku wan, fכ egzampl, insay wan kכndishכn we dεn kכl ``Tension pneumothorax''.

Obstructive Shock na we di at nɔ ebul fɔ wok fayn bikɔs ɔf sɔntin we kɔmɔt na do lɛk dis.

Aw kכmכn dεn kכl dis kכndyushכn ``Obstructive Shock''? Aw i kin afɛkt di bɔdi?

Obstructive Shock na rili wan tin we nɔ kin apin so ɔltɛm we yu kɔmpia am wit ɔda kayn shɔk. I kin afɛkt ɔl 1% ɔ 2% pan di wan dɛn we gɛt shɔk. Di gud nyus na dat, i kin wɛl pas ɔda kayn shɔk, bɔt na if dɛn trit am kwik kwik wan.

If dɛn nɔ trit am kwik, Obstructive Shock de mek di bɔdi in impɔtant ɔgan dɛn nɔ gɛt ɔksijɛn ɛn it. Dis kin mek di ɔgan dɛn pwɛl ɛn sɔntɛnde i kin ivin day. Na dat mek i impɔtant fɔ go to tritmɛnt ɛn nɔ de te.

Wetin na di sayn dɛm fɔ `(Obstructive Shock)`?

Di sayn dɛm fɔ dis kin tan lɛk di wan dɛm wae gɛt ``Cardiogenic Shock.'' Si if dɛn tin ya kin tan lɛk se yu sabi:

• Di brith rεt de inkrεs abnכmal wan.
• Blɔd prɛshɔn kin drɔp tumɔs (haypɔtɛnshɔn).
• di hat rεt de inkrεs bכku bכku wan (`Tachycardia`). I tan lɛk se yu jɔs dɔn rɔn.
• Di we aw yu de fil kin chenj, sɔntɛm yu kin gɛt pwɛl hat ɔ wɔri.
• Di urine we dɛn kin mek kin ridyus bad bad wan, ɔ i nɔ kin de igen.
• Di skin kin fil kol ɛn i kin swet.
• sכmtεm di briz kin kכmכt כnda di skin (`Subcutaneous emphysema`). Dis min se i kin fil lɛk smɔl smɔl bɔbul dɛn ɔnda di skin.
• Yu kin gɛt pen na yu chɛst ɔ yu bɛlɛ.

If yu gɛt wan ɔ mɔ pan dɛn sik ya, i rili impɔtant fɔ go to dɔktɔ wantɛm wantɛm.

Wetin na di tin dɛm we kin mek pɔsin gɛt `(Obstructive Shock)`?

Bɔku tin dɛn de we kin mek pɔsin gɛt `(Obstructive Shock)`. Lɛ wi si wetin na di men wan dɛn:

• `(Tension pneumothorax)` (di lכng kכlaps): Dis kin apin we di briz de go insay di lכng εn i nכ kin kכmכt, we de mek i trכp insay di lכng. Dɔn di lɔng kin fɔdɔm, we kin mek bɔku prɛshɔn insay di chɛst ɛn mek di at bigin fɔ bit.
• Vena cava compression syndrome: Kכmpreshכn fכ di big vein na wi bכdi (di vena cava). dis kin apin bכku tεm we di bεlε de dכn, we di pikin in wet de kכmprεs dis bכdi vεsul.
• Pulmonary (lung) kכmpreshכn sεndrכm: Pulmonary kכmpreshכn sεndrכm.
• `(High-PEEP ventilation)`: Na kכndyushכn we di prεshכn na di lכng dεm tu hכy fכ pכsin we kכnekt to ventilashכn.
• Tכmכro dεm: sכm kayn tכmכro dεm we de divεlכp insay di chεst kεviti kin bכn bak di at כ big bכdi vεsεl dεm.
• Tromboembolism na di pulmonary artery: Dis kin rili denja. If blɔd we de flɔm na ples lɛk di leg brok ɛn stɔp na blɔd vesel na di lɔng, i de stɔp di blɔd fɔ kɔmɔt na di at to di lɔng.
• di pεricardial tamponade: di tכn sak we de rawnd di at (di pericardium) de fulכp wit wata, we de kכmprεs di at. Dis kin mek di at nɔ kin kɔntrakt ɛn i kin mek i big fayn fayn wan.
• Aortic dissection: Na wata we de kɔmɔt na di aorta, we na di big blɔd vesel we de kɔmɔt na di at.
• di aorta stenosis: di aorta valv na di at de sכmtεm sכmtεm. Dis kin mek i nɔ izi fɔ lɛ blɔd kɔmɔt na di at.
• Hypertrophic cardiomyopathy: Blɔk we di blɔd de flɔ bikɔs di at mɔsul de tik pasmak.
• Constrictive pericarditis: Di sak we de rawnd di at kin tik, we kin mek i nɔ izi fɔ mek di at wok fri wan.

Impɔtant: Ɔl dɛn tin ya we kin mek yu sik na imejensi, so go to dɔktɔ wantɛm wantɛm if yu gɛt sɔm sayn dɛn.

Aw fɔ no `(Obstructive Shock)`?

Yu dɔktɔ go chɛk yu fɔs. Dɛn go lisin to yu at ɛn yu lɔng wit stetɔskɔp. Obstructive shock na wan sik wae kin wɔs kwik, so i impɔtant fɔ gɛt diagnosis kwik kwik wan.

Fɔ no di sik kɔrɛkt wan, dɛn kin du dɛn tɛst ya:

• Ultrasound: Dis kin luk tin dεm lεk di at, big blɔd vesel dεm, εn if wata de rawnd di lכng dεm.
• Echocardiogram (Echo): Dis tan lɛk ɔltra saund fɔ di at. i kin si klia wan aw di at de wok, aw di valv dεm de kכndishכn, εn if wata de rawnd di at.
• Kɔmpyuta tomografi (CT) skan: Dis kin tek ditayla pikchɔ dɛn bɔt di chɛst kaviti. I kin ɛp fɔ no tin dɛn lɛk we blɔd de klɔt, tumbu, ɛn we dɛn kɔt di aorta.
• Ilɛktrokardiogram (ECG ɔ EKG): Dis de tɛst di ilɛktrik wok we di at de du. I kin ɛp fɔ no if sɔntin de we nɔ fayn na yu at.

Aw dɛn kin trit Obstructive Shock?

Fɔs, dɛn go gi yu IV wata (lɛk salin - IV kristaloid wata) ɛn dɛn go chɛk yu blɔd prɛshɔn ɛn ɔksijɛn lɛvɛl ɔltɛm. Dɔn, di tin we impɔtant pas ɔl na fɔ fɛn di tin we mek di Obstructive Shock ɛn trit da kɔz de.

Di we aw dɛn kin trit am kin difrɛn difrɛn wan bay di tin we kin mek i gɛt am. Lɛ wi luk sɔm ɛgzampul dɛn:

• If blɔd klɔt (embolism), dɛn kin pul am bay ɔpreshɔn ɔ bay we dɛn put kanula (kateta).
• if na aorta valv we sכmtεm sכmtεm, dεn go riples am.
• if di hat mכsul tik (hypertrophic cardiomyopathy), dεn kin rεdכks di tik bay we dεn de du כpεrayshכn כ wan spεshal mεtכd we dεn de yuz alkol (catheter-based alcohol ablation).
• Dɛn kin gi yu mɛrɛsin fɔ sɔlv di blɔd we dɔn klɔt.
• If wata de rawnd di at (pericardial tamponade) ɔ tɛnsiɔn nyumotɔraks, dɛn go pul di wata ɔ di briz (sɔntɛm dɛn go yuz smɔl tiub).
• If yu de pan ventilator, yu kin chenj in sɛtin dɛn.
• insay kכndishכn lεk ``Vena cava kכmpreshכn sεndrכm'', di bכdi posishכn de chenj.
• if di prεshכn na di lכng dεm hכy, dεn kin rεdכks di prεshכn wit nidul כ tכb.

Us mɛrɛsin dɛn kin yuz?

Wae dɛn de trit de kɔz, dɛn kin gi yu mɛrɛsin lɛk dis fɔ mek yu sik nɔr de wok tranga wan:

• Fluid dεm lεk `IV` salin (`IV kristalכyd fכluid`).
• Mɛrɛsin fɔ mek blɔd prɛshɔn go ɔp: `(Nɔrepinɛfrin (Levophed®))`, `(Vasopressin (Vasostrict®))`, `(Fɛnilɛfrin (Vazculep® ɔ Biorphen®))`.
• If yu nɔ gɛt bɛtɛ blɔd, dɛn go gi yu blɔd ɔ tin dɛn we dɛn mek wit blɔd (lɛk rɛd blɔd sɛl ɛn plasma).

Aw kwik a go wɛl afta dɛn dɔn trit mi?

Bɔrku pan de tin wae kin mek pɔrsin gɛt Obstructive Shock nid fɔ trit kwik kwik wan , bikɔs na da tɛm de di chans fɔ liv kin pasmak. Bɔt gud tin na dat, dɛn tritmɛnt ya kin wok kwik kwik wan. Bɔt ivin afta dɛn dɔn trit di tin we kin mek i apin, i kin tek tɛm fɔ mek di bɔdi wɛl frɔm di tin dɛn we Obstructive Shock kin du. Yu nɔ go jɔs rɔn rawnd ɛn du yu wok.

Wetin na di lukin-grɔn fɔ `(Obstructive Shock)`?

If dɛn nɔ trit am, ``Obstructive Shock`` na wan sik we kin kil bɔku pipul dɛn. Fɔ wɛl afta yu dɔn gɛt tritmɛnt kin dipen pan sɔm tin dɛm, lɛk:

• Wetin na di kɔz fɔ `(Obstructive Shock)`?
• Aw lɔng i tek fɔ gɛt tritmɛnt?
• Us ɔda sik dɛn yu gɛt?
• Aw di tritmɛnt bin wok fayn fɔ yu?

Bɔt as wi bin dɔn tɔk, di chans fɔ mek yu wɛl frɔm ``Obstructive Shock`` bɛtɛ pas frɔm kɔmɔn kayn ``Shock`` lɛk ``Septic Shock``. So, op de.

Aw a kin kia fɔ misɛf?

Afta di dɔktɔ dɔn pul yu na ɔspitul, yu nid fɔ fala dɛn instrɔkshɔn dɛn di rayt we.

• Yu go nid fɔ rɛst na os fɔ sɔm tɛm bifo yu go bak na wokples.
• Yu fɔ tek di mɛrɛsin we yu dɔktɔ tɛl yu fɔ tek di rayt tɛm . Nɔ stɔp fɔ tek ɛni mɛrɛsin we yu want.
• Go na di fɔs apɔntinmɛnt dɛn ɔltɛm .

Ustɛm a fɔ go to di dɔktɔ bak? Wetin a fɔ du we ɛnitin apin we nɔ izi fɔ mi?

Naw yu no wetin mek yu `(Obstructive Shock)`. Tek tɛm if di sayn dɛn we gɛt fɔ du wit da prɔblɛm de kam bak. If yu gɛt dɛn kayn sik ya bak, ɔ if pɔsin na yu famili notis dis chenj na yu, kɔl di 1990 (Wind) Ambulans Savis wantɛm wantɛm, ɔ go na di imejensi rum na di ɔspitul we de nia yu. Taym na di men tin.

Us kwɛstyɔn dɛn a fɔ aks mi dɔktɔ?

Yu kin aks kwɛstyɔn dɛn lɛk dɛn wan ya:

• Aw lɔŋ a nid fɔ tek di mɛrɛsin we yu gi mi?
• Wetin na di chans fɔ mek a gɛt dis kɔndishɔn bak?
• Yu tink se dis go afɛkt mi kwaliti fɔ liv fɔ lɔng tɛm?
• Us chenj dɛn a fɔ mek to mi it ɛn ɛksesaiz?

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

Obstructive Shock na wan sik wae nɔr kin bɔrku bɔt wae kin rili siriɔs wae kin nid fɔ gɛt tritmɛnt kwik kwik wan. So, e fayn fɔ no bɔt de sik ɛn go to tritmɛnt kwik kwik wan. Wae dɔktɔ dɛn dɔn fɛn di kɔz fɔ Obstructive Shock, dɛn go bigin fɔ gi di rayt tritmɛnt.

Mɛmba se bɔku pipul dɛn kin wɛl frɔm Obstructive Shock, bɔt i kin tek tɛm. Peshɛnt, fala wetin yu dɔktɔ tɛl yu fɔ du, ɛn tek kia ɔf yusɛf. Nɔto yu wan de, ɛn dɔktɔ dɛn, nɔs dɛn, ɛn pipul dɛn we yu lɛk de we go ɛp yu.

` Obstructive Shok, shɔk, at sik, blɔd prɛshɔn, ɔksijɛn, ɔbstrɔkshɔn, imejensi tritmɛnt, lɔng, at