Tērā pea kua ngoikore te rere o tō toto, ā, kei te pāngia koe e te 'oho ohorere'? Me kōrero tātou mō te 'oho ohorere'!

Āe, i ētahi wā ka pā mai he raruraru nui ki a tātou, tika? He wā anō ka rite tātou ki te ngaro o te ora, ā, he uaua ki te manawa. I ēnei wā, tera pea he mea nui kei roto i ō tātou tinana. I tēnei rā ka kōrero tātou mō tētahi āhuatanga ohorere, e morearea ana ki te ora. Koia tētahi āhuatanga e kiia nei ko te 'Distributive Shock' .

He aha tēnei 'oho tohatoha'? He māmā noa iho...

He ngāwari noa iho, he āhuatanga hauora ohorere te ru tohatoha. Ko te mea e tupu ana i konei, ka nui rawa ngā oko toto i roto i tō tinana (te wāhi e rere ai te toto), pērā i te ngongo rapa e totorohia ana. I ētahi wā ka kiia hoki tēnei ko te ru whakawhanui i te toto . Nō reira, ina nui haere ngā oko toto pēnei, ka tino heke te toto toto. Whakaarohia mēnā ka nui haere te paipa wai, ka pōturi ake te rere o te wai.

Ka aha mēnā ka puta tēnei? Kāore e nui te toto e tukuna ana ki ō whekau nui, pērā i tō ngākau, tō roro, me ō whatukuhu . Ehara i te mea koinā anake, engari i ētahi wā ka tīmata te turuturu o ētahi o te toto mai i ēnei oko toto iti (ngā capillary). Ka taea e tēnei te whakaiti i te nui o te toto i roto i tō tinana. He āhuatanga tino morearea tēnei, nā te mea me whai toto tonu ō tātou whekau kia mahi ai.

He mea tino nui: Ki te pāngia koe e te 'ohorere' pēnei, he mea nui kia rapua he maimoatanga i te wā e taea ai. Ki te kore, ka mate pea koe.

He aha ngā momo matua o ngā 'rūrū tohatoha'?

E toru ngā momo matua o te 'oho tohatoha', ā, he rerekē te take o ia momo.

1. Te Mate Pūkahukahu: Koinei te momo tino noa. Ka puta mai i te mate huakita. Whakaarohia, he patunga tōu, ka tino kino, ka horapa ngā iroriki puta noa i tō tinana, ā, ka puta he āhua e kiia nei ko te "Sepsis", ā, kāore e taea te whakahaere. I ētahi wā, ka puta pea tēnei āhuatanga i te mea pērā i te niumōnia.

2. Te Āhua Anaphylactic: Ka puta tēnei i te mate pāwera nui. Hei tauira, he nui te mate pāwera o ētahi tāngata ki tētahi mea pērā i te pīnati, tika? Ka puta rānei tēnei ina ngaua rātou e ētahi pepeke. Ka pāngia hoki te tangata mate huango e tēnei mate, ahakoa he tino uaua ki te manawa.

3. Te Ohorere Neurogenic: Ka puta tēnei i te pakaru o tō taurakira. Hei tauira, ki te pā tō mahunga i a koe e peke ana ki te wai, ā, ka whara tō taurakira, ki te pāngia rānei koe e tētahi aituā kino e pakaru ai tō tuaiwi, ka puta pea tēnei 'ohorere neurogenic' nā te pānga ki te pūnaha io.

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He aha te rerekētanga i waenga i te 'Distributive Shock' me te 'Hypovolemic Shock'?

He momo 'ohorere' e rua. Ko te tikanga o tēnei, i ngā āhuatanga e rua, kāore e nui te toto me te hāora e whiwhi ana ō tātou whekau nui. Heoi, he rerekē te take.

• Ko te ohorere tohatoha , e ai ki te kōrero i mua ake nei, ka puta mai i te nui rawa o ngā oko toto. He maha ngā wā ka puta mai tēnei i te mate e kiia nei ko te sepsis, i te mate pāwera kino rānei.
• Ko te ohorere hypovolemic ko te iti rawa o te toto, o ētahi atu wai rānei i roto i te tinana. Hei tauira, ka pā tēnei mena ka ngaro te nui o te toto i tētahi whara nui, ka ngaro rānei te nui o te wai i te mate korere nui, i te ruaki rānei.

Ki te kī māmā noa, i roto i te 'tohatoha' ka nui haere ngā uaua toto, i roto i te 'hypovolemic' ka heke te toto/wai i roto i te tinana. Kei te mārama koe?

He pēhea te auau o tēnei 'oho tohatoha'?

E whā ngā momo ohorere e mōhiotia ana e tātou ('Hypovolemic', 'Cardiogenic Shock', 'Obstructive Shock' me te 'Distributive Shock'). O ēnei e whā , ko te mea tino kitea ko te 'Distributive Shock' . Ina koa ko te momo e kiia nei ko te 'Septic Shock'. Ahakoa i roto i tētahi whenua pēnei i a Amerika, tata ki te miriona tāngata ka pāngia e te 'Septic Shock' i ia tau. Ka taea e te tangata katoa te pāngia e tēnei āhuatanga.

He aha ngā mea ka pā ki te tinana me te 'oho tohatoha'?

E ai ki taku kōrero i mua, ina nui rawa ngā uaua toto, ka heke te toto toto. Kātahi ka kore e ranea te nui o te toto e haere ana ki ngā whekau. He rite ā tātou whekau ki ngā mīhini. Me whiwhi rātou i te nui o te wahie e tika ana (arā, te toto me te hāora) hei mahi. Ina kore e ranea te toto, te hāora, me ngā matūkai e whiwhi, ka tīmata te mutu haere o te mahi a ngā whekau. Ka kiia tēnei he 'ngoikore o te whekau' . Ki te pēnei te ngoikore o ngā whekau, ka noho hei tūponotanga nui ki te ora.

He aha ngā tohu o tēnei?

Ka rerekē pea ngā tohu o te ohorere tohatoha i runga i te pūtake. Heoi, kei reira ētahi tohu noa:

• Ponana kiri
• Te tere o te manawa me te ngakau
• Te toto toto iti (koinei te tohu matua)
• I te tīmatanga ka mahana ngā ringa me ngā waewae, kātahi ka mātao, ka werawera.
• Kirika
• Te makariri (te mātao me te wiri)
• Mamae puku
• Pōhēhē, te āhua nei kei te ngaro tō māramatanga
• Maremare
• Te poto o te manawa
• Whakapairuaki
• Ruaki
• Te mamae i te wā e mimi ana

Ki te puta ohorere mai tētahi, ētahi rānei o ēnei tohu, he pai ake kia kaua e whakahaweatia, tika?

He aha ngā take o te 'Distributive Shock'?

Haunga ngā momo e toru i kōrerotia i mua ake nei, he maha atu anō ngā take e hua ai tēnei āhuatanga.

• Te mate pāwera i puta mai i te mate huakita (koinei te tino take)
• Ko te anaphylaxis, e puta mai ana i ngā mate pāwera kino (hei tauira, ngā kai pēnei i te pīnati, ngā wero pepeke, ētahi rongoā, ngā whakaekenga huango)
• Ngā wera
• Te mate pāwera
• Te Mate Pūngāwerewere Toxic (ka pā mai pea tēnei, inā koa i roto i ngā wāhine, nā te whakamahinga o te tampon)
• Te whara o te taurakira
• Ngā mate endocrine
• Te ngoikore o te adrenal (he iti ake te kitea o tēnei)
• Te mate turuturu o te capillary ( te turuturu o te wai mai i ngā oko toto, he iti ake te kitea o tēnei)
• Te tango nui rawa i te rongoā whakanui toto (te nui rawa o te rongoā) (he onge hoki tēnei)

Me pēhea te mōhio o ngā tākuta ki tēnei?

Ina pāngia koe e ēnei tohu, ko te mea tuatahi ka mahia e te tākuta ko te tirotiro i a koe me te pātai atu mō tō hītori hauora. Heoi, kāore pea e taea e te tangata ohorere te hoatu i tētahi kōrero ki a koe. I roto i tēnei āhuatanga, ka taea e tētahi atu te kōrero ki te tākuta mō ō mate pāwera, mēnā kua pāngia koe e te anaphylaxis i mua, me ngā rongoā e tangohia ana e koe. He tino āwhina ēnei kōrero ki te tautuhi i te mate.

I muri i tēnā, ka tohua e te tākuta ētahi whakamātautau, pēnei i:

• Ngā whakamātautau toto: Tirohia mēnā he mate pāwera me te mahi a ngā whekau.
• ECG (Electrocardiogram - EKG): Ka tirohia te mahi a te ngākau.
• X-ray o te uma: Tirohia te āhua o ngā pukahukahu.
• Matawai ira-oro: Tirohia te ngākau, ngā pukahukahu, me ngā whekau i roto i te puku. Ka taea ētahi o ēnei te mahi i te taha o te moenga.

Me pēhea te rongoā?

Nā te mea he āhuatanga ohorere tēnei, ka tīmata te maimoatanga i te Rūma Ohorere. Whai muri i tēnā, ka taea te whakawhiti i a koe ki te Wāhanga Tiaki Kaha (ICU).

1. Ko te mea tuatahi ka mahia e koe ko te hoatu wai ki roto i te uaua. Ka hoatu he wai pēnei i te tote ki roto i te uaua. Ka mahia tēnei hei whakaiti i te toto toto.

2. Muri iho, ka whakatauhia e mātou te pūtake o te 'ohorere', ā, ka hoatu te rongoā e tika ana.

3. I ētahi wā , ka whakamahia pea te whāngai mā te ngongo , nā te mea e hiahia ana te tinana ki te pūngao.

I roto i te wāhanga tiaki nui, ka aroturuki tonu ngā tākuta me ngā nēhi i ō tohu ora (te tere o te manawa, te toto toto, te manawa, te pāmahana). Ka tirohia hoki e rātou ngā pānga taha o te maimoatanga. Mena he uaua ki a koe te manawa ko koe anake, tera pea ka honoa koe ki tētahi mīhini manawa (he mīhini manawa) .

He aha ngā momo rongoā e whakamahia ana?

Ka rerekē te rongoā e hoatu ana mō te 'Distributive Shock' i runga i te pūtake:

• Ngā Vasopressors:Ka hoatu ēnei hei whakanui i te toto toto. Hei tauira, ko ngā rongoā pēnei i te epinephrine, vasopressin, norepinephrine, phenylephrine rānei.
• Ngā rongoā paturopi : Mena he mate pāwera.
• Ngā rongoā ārai mate pāwera: Mena nā te mate pāwera i puta.
• Steroids: Mō ngā mate pāwera, mō te sepsis kino rānei.
• He rongoā whakangote albuterol (pēnei i te Accuneb®, Proair®HFA rānei): Mēnā ko te huango te take o te ohorere.

He pānga taha kei te rongoā?

Ae, ka pā mai pea ētahi rongoā i ngā pānga taha iti noa iho.

• Ngā Vasopressors: te ngakau pākiki (arrhythmia), te kore okiokinga, te pupuhi pūkahukahu, te mamae o te uma, te whaiti o ngā uaua coronary o te ngakau (ka arahi pea tēnei ki te whakaeke ngakau).
• Ngā rongoā paturopi : Whakapairuaki, ruaki.
• Albuterol: Manukanuka, whanoke, whakapairuaki.
• Ngā rongoā ātete histamines: Te hiamoe, te whanoke, te ānini, te tere o te ngakau.

Engari, ka tirohia ēnei mea katoa e ngā tākuta, ā, ka hoatu ki a koe te maimoatanga tino tika. Ko te mea nui ko te whakaora i tōu ora.

Me pēhea tātou e whakaiti ai i tēnei mōrearea?

Kāore pea e taea e tātou te karo i ngā mea katoa e puta ai te ohorere tohatoha. Hei tauira, ko ngā mate me ngā wera. Heoi, kei reira ētahi mea ka taea e tātou te mahi hei whakaiti i te mōrearea o tēnei ohorere nā ētahi take e mōhiotia ana:

• Mena he mate pāwera kai nui tōu , pērā i te pīnati, me mau tonu he werohanga epinephrine aunoa (pērā i te EpiPen® Auto-Injector, Adrenalin® rānei). Kia mōhio koe ki te whakamahinga.
• Ki te pāngia koe e te mate huango , me pupuri tonu tō rongoā manawa albuterol, salbutamol rānei. Kaua e tukua kia pau.
• Ki te whakamahi koe i ngā tampon, kaua e waiho kia roa rawa, nā te mea ka pā mai te Toxic Shock Syndrome, ka taea ai te whanake hei Distributive Shock.
• Kaua e peke ki te wai pāpaku, ki te wai rānei kāore i te mōhiotia te hohonu. Ka pā kino pea tēnei ki te taurakira.
• Mena kei te tango koe i ngā rongoā hei whakawhanui (whakatuwhera) i ō uaua toto, kaua e nui rawa te tango. Tangohia noa te nui e tohutohu ana tō tākuta ki a koe.

Ka aha mēnā ka puta he 'oho tohatoha'?

Mena ko te sepsis te pūtake o te ohorere, tera pea ka pāngia koe e ngā raruraru roa. Ngā mea pēnei i te ngenge, ngā moemoeā kino, me te ngaro o te hiahia kai. Ahakoa te take, me haere tonu koe ki te kite i tō tākuta mō ngā wā tirotiro. Me tango hoki e koe ngā rongoā kua tohua e tō tākuta.

Ko te roa o te wā e ora ai koe i te ohorere tohatoha ka whakawhirinaki ki te kaha o tōna pānga. Me noho pea koe ki te hōhipera mō ētahi rā ki ētahi wiki.

Ka rerekē te ōrau oranga mō tēnei mate mai i te 20% ki te 80%, i runga i te pūtake. Mēnā kāore e rongoatia, ka mate pea. Ko te tātaritanga me te maimoatanga wawe te huarahi pai ki te whakaora i te ora. Ko te hunga kaumātua, te hunga inu waipiro, me te hunga he maha ngā raruraru okana kei roto i te mōrearea.

Ki te pai te urupare a tō tinana ki ngā wai werohanga IV, ā, ka mahi tonu ō whekau, he nui te tūponotanga ka ora koe.

Me pēhea taku tiaki i ahau anō i muri i taku taenga ki te kāinga?

Kia tae atu koe ki te kāinga i te hōhipera, tiakina koe kia rite ki tā te tākuta e tohutohu ana. Me noho pea koe ki te kāinga mō ētahi rā, wiki rānei hei okioki pai i mua i tō hokinga atu ki te mahi. Puritia ō wā tirotiro. Tangohia ō rongoā kia rite ki te mea i whakaritea.

Ki te mea kei te raru anō koe i te kāinga, waea atu ki tō tākuta tonu atu.

I roto i tētahi āhuatanga ohorere: Me hari tonu te tangata e pāngia ana e ngā tohu o te ohorere tohatoha ki te rūma ohorere. Kia tae mai rā anō te waka tūroro, me takoto te tangata e pāngia ana e te ohorere. Taupokina ki te paraikete hei pupuri i te mahana, me te hiki ake i ō rātou waewae kia tata ki te putu te teitei hei whakapai ake i te rere o te toto.

He aha ngā pātai me pātai atu koe ki te tākuta?

Mena ka pāngia koe e tēnei āhuatanga, he mea pai kia pātai atu koe ki tō tākuta mō ngā mea penei:

• Kei te tūpono anō ahau ki te pāngia e te 'oho tohatoha'?
• Kia pēhea te auau o taku haerenga atu mō ngā wā whakarite whai muri?
• Ka pā mai ngā pānga roa ki ahau mai i te 'Distributive Shock'?

Hei whakamutunga, ngā mea hei maumahara (Karere hei tango ki te kāinga)

He āhuatanga ohorere hauora te Distributive Shock e hiahia ana kia rongoatia tonutia. Ko te rapu awhina i te wā e taea ai te whakaora i tō oranga te huarahi pai rawa atu ki te whakaora i a koe. He roa te wā e ora ai koe, nō reira kia manawanui ki a koe anō. I a koe e noho ana i te kāinga, me tango ō rongoā kia rite ki te whakahau a tō tākuta, ā, me haere ki ngā tirotiro i ia wā. E kite ana koe, he mate tino kino tēnei. Nō reira he mea nui kia mōhio koe ki tēnei.