Ka pāngia tātou katoa e ngā wā ka pāngia tātou e te mate ohorere, kāore? He tino whakamataku te ngoikore, te pōuriuri o te mahunga, te uaua rānei ki te hopu manawa. Tērā pea he tohu ēnei kare ā-roto kei te pāngia tō tinana e tētahi raruraru nui, e takoto ana i raro i te mahunga. I tēnei rā, e hiahia ana a Nirogi Lanka ki te āwhina i a koe ki te mārama ki tētahi āhuatanga ohorere hauora nui, e morearea ana ki te ora e mōhiotia ana ko te 'Distributive Shock' . Mēnā ka pāngia koe e ēnei tohu, tēnā rapua he awhina hauora tonu mā te waea atu ki te 911, ki ō ratonga ohorere rānei o te rohe.
He aha te 'Distributive Shock'? He māmā noa iho…
He whakarāpopototanga noa iho, he āhuatanga hauora nui te Distributive Shock. Ka puta mai ina whānui rawa ō uaua toto, pērā i te ngongo rapa kua totoro rawa. I ētahi wā ka kiia tēnei ko te 'Vasodilatory Shock' . Ina whānui ēnei uaua toto, ka tino heke tō toto. Whakaarohia he rite ki te ngongo māra: ina nui rawa te whānui, ka heke te pēhanga wai i roto, ā, ka kore e pai te rere.
He aha te hua? Kāore ō whekau nui, pērā i tō ngākau, tō roro, me ō whatukuhu, e whiwhi i te rere o te toto e hiahiatia ana hei mahi . Hei tāpiri, i ētahi wā, ka tīmata te turuturu o te wai i roto i ēnei oko toto iti (ngā capillary), ka whakaiti ake i te nui o te toto katoa. He āhuatanga morearea tēnei nā te mea ka whakawhirinaki ō whekau ki te rere tonu o te toto hei oranga.
He mea tino nui: Ki te whakapae koe kei te pāngia koe e te ohorere, rapua tonutia he awhina hauora ohorere. Waea atu ki te 911, toro atu rānei ki tō rūma ohorere tata tonu, nā te mea ka mate pea koe i ngā whakaroa.
He aha ngā momo matua o te Runga Tohatoha?
E toru ngā momo matua o te Distributive Shock, ia momo e puta mai ana i tētahi take matua rerekē:
1. Te Mate Pūkahukahu: Koinei te momo tino noa. Ka puta mai i te mate huakita kino. Hei tauira, ki te pangia te patunga, ā, ka horapa ngā iroriki puta noa i tō tinana (he āhuatanga e kiia nei ko te Sepsis), ā, ka kore e taea te whakahaere i te urupare a te tinana, ka pāngia pea koe e te Mate Pūkahukahu. Ka taea hoki e te niumōnia kino, e ētahi atu mate pūnaha rānei te whakaoho i tēnei.
2. Te Ohorere Anaphylactic: Ka puta tēnei i te mate pāwera kino, e morearea ana ki te ora. Hei tauira, ka pāngia ētahi tāngata e tēnei mate i muri i te kai pīnati, i te ngaua rānei e ētahi pepeke. Mena ka pāngia tētahi tangata he mate huango kino e ngā uauatanga manawa ohorere, ohorere, ka pāngia hoki e tēnei momo ohorere.
3. Te ohorere o te roro:Ka puta tēnei nā te kino o tō taurakira. Mēnā ka whara tō upoko, tō tuaiwi rānei, pērā i te aituā ruku, i te hinganga nui rānei/i te tukinga waka, ka ārai pea te kino o tō pūnaha io i te tinana ki te pupuri i te kaha o ngā oko toto, ka hua ake ai te Neurogenic Shock.
He aha te rerekētanga i waenga i te Rua Tohatoha me te Rua Hypovolemic?
He momo ohorere e rua, arā, ka ngaro te hāora me ngā matūkai nui i ngā whekau ora. Heoi, he rerekē ngā pūtake.
- Ka puta te Distributive Shock nā te mea ka ngaro te kaha o ō uaua toto, ka whānui rawa atu, he maha ngā wā ka puta mai i te Sepsis, i tētahi mate pāwera kino rānei.
- Ka puta te ohorere hypovolemic nā te mea kua ngaro te nui o te wai—nā te toto nui, te ngaronga nui rānei o te wai, pērā i te mate korere tonu, te ruaki rānei, ka maroke ai tō tinana.
Hei whakarāpopototanga: Ko te ru tohatoha e pā ana ki te whakawhānui i ngā oko toto; ko te ru hypovolemic e pā ana ki te ngaronga o te toto, o ngā wai tinana rānei. E mārama ana koe ki te rerekētanga?
He pēhea te noa o te Distributive Shock?
E whā ngā momo matua o te ru: Hypovolemic, Cardiogenic, Obstructive, me Distributive. Ko te Distributive Shock te mea tino kitea, inā koa ko te Septic Shock. I ngā whenua pēnei i te US, tata ki te kotahi miriona tāngata e pāngia ana e te Sepsis/Septic Shock ia tau. He mate tēnei ka pā ki te tangata katoa, ahakoa te pakeke.
He aha ngā pānga o te Distributive Shock ki tō tinana?
E ai ki te kōrero i mua ake nei, ina whānui haere ngā uaua toto, ka heke tō toto toto. Nō reira, kāore ō whekau e whiwhi toto nui. Whakaarohia ō whekau he mīhini; me whai wahie tonu rātou—te toto me te hāora—kia mahi ai. Ina motuhia tēnei puna, ka tīmata te kati o ngā whekau takitahi. E mōhiotia ana tēnei ko te ngoikore o te whekau , he tūmomo mōrearea tonu tēnei ki tō ora.
He aha ngā tohu?
Ka rerekē pea ngā tohu o te Distributive Shock i runga i te pūtake. Heoi, ko ngā tohu whakatūpato noa ko:
- He kiri mākūkū, he whero rānei
- Te tere o te manawa me te tere o te manawa
- Te toto toto iti (he tohu nui)
- I te tīmatanga he kiri mahana, ā, i muri mai ka huri hei makariri, ka kirikiri hoki
- Kirika
- Te makariri me te wiri
- Mamae puku
- Te pōhēhē, te koretake rānei o te hinengaro
- Te maremare
- Te poto o te manawa
- Whakapairuaki
- Ruaki
- Te mamae i te wā e mimi ana
Ki te pāngia koe e tētahi, e ētahi rānei o ēnei tohumate, kaua e whakahawea.
He aha te take o te Runga Tohatoha?
Haunga ngā momo e toru i kōrerotia i mua ake nei, he maha atu anō ngā āhuatanga ka arahi pea ki tēnei āhuatanga:
- Te mate pāwera i puta mai i te mate huakita (koinei te tino take).
- Te anaphylaxis nā ngā mate pāwera kino (hei tauira, te pīnati, te wero pepeke, ētahi rongoā, ngā whakaekenga huango kino rānei).
- Ngā wera nui.
- Pancreatitis (mumura o te pancreas).
- Te Mate Pūngāwerewere Toxic (ka puta pea tēnei, hei tauira, mai i te whakamahinga roa o te tampon).
- Te whara o te taurakira.
- Ko ētahi mate endocrine.
- Te ngoikore o te adrenal (he take kāore i te tino kitea).
- Te mate turuturu o te capillary (te turuturu o te wai mai i ngā oko toto; he onge hoki).
- Te nui rawa o te rongoā e whakamahia ana ngā rongoā whakawhanui i ngā toto (kāore i te tino kitea).
Me pēhea te tautuhi a ngā tākuta i tēnei mate?
Ina puta mai ēnei tohu ki a koe, ka tirotirohia tonutia koe e te tākuta, ka tangohia he hītori taipitopito. Nā te mea kāore pea e taea e te tangata ohorere te kōrero, he mea nui kia whakamōhiotia e te whānau, e ngā hoa rānei, te tīma hauora ō mate pāwera e mōhiotia ana, tō hītori anaphylaxis, ngā rongoā rānei e tangohia ana e koe i tēnei wā. He mea nui ēnei mōhiohio hei tautuhi i te mate.
Whai muri i tēnei, ka taea e tō tākuta te tono i ētahi whakamātautau:
- Ngā whakamātautau toto: Hei tirotiro mō ngā mate pāwera me te aromatawai i te mahi a ngā okana.
- Te hiko o te manawa (EKG/ECG): Hei aroturuki i ngā mahi hiko o tō ngākau.
- X-ray o te uma: Hei aromatawai i ō pukahukahu.
- Ultrasound: Hei tiro i te ngākau, ngā pukahukahu, me ngā whekau o te puku; he maha ngā wā ka whakamahia ngā waeine kawe i te taha tonu o tō moenga.
Me pēhea te rongoā?
Nā te mea he āhuatanga ohorere hauora tēnei, ka tīmata te maimoatanga i te Rūma Ohotata, ā, ka haere tonu i te Wāhanga Tiaki Kaha (ICU).
1. Ko te mahi tonu ko te hoatu wai IV: Ka hoatu he wai tote, he wai rānei mā roto i te uaua hei āwhina i te pumau o tō toto toto.
2. Maimoatanga kua whakaritea: Ka tautuhia e ngā tākuta te pūtake motuhake o te ohorere, ā, ka whakaratohia he rongoā hei whakatika.
3. Tautoko kai: I ētahi wā, me whāngai ki te ngongo kia whiwhi ai tō tinana i te pūngao e hiahiatia ana hei whakaora.
I roto i te ICU, ka aroturuki tonu te tīma hauora i ō tohu ora (te tere o te manawa, te toto toto, ngā taumata hāora, me te pāmahana). Ka whakahaerea hoki e rātou ngā pānga taha o te maimoatanga. Mena kei te uaua koe ki te manawa, ka whakanohoia pea koe ki runga i te mīhini manawa.
He aha ngā rongoā e whakamahia ana?
Ko te maimoatanga e whakawhirinaki ana ki te pūtake o tō ohorere tohatoha:
- Ngā Vasopressors: Ngā rongoā pēnei i te epinephrine, vasopressin, norepinephrine, phenylephrine rānei hei whakaara i te toto toto.
- Ngā rongoā paturopi: Hei rongoā i ngā mate urutā.
- Ngā rongoā ārai mate pāwera: Hei whakahaere i ngā uruparenga mate pāwera.
- Ngā steroids: Whakamahia mō ngā mate pāwera, ngā take kino rānei o te sepsis.
- Ngā rongoā whakapūngao albuterol: (hei tauira, Accuneb®, Proair®HFA rānei) mēnā i puta te ohorere i te mate huango kino.
He pānga taha kei te maimoatanga?
Ae, ka pāngia pea ētahi rongoā e ngā pānga taha, tae atu ki:
- Ngā Vasopressors: Ngā koretake o te manawa o te ngakau (arrhythmia), te manukanuka, te wai i roto i ngā pukahukahu (te edema pūkahukahu), te mamae o te uma, te whakawhāiti rānei o ngā uaua coronary.
- Ngā rongoā paturopi: Whakapairuaki, korere rānei.
- Albuterol: Te wiri, te whanoke, te whakapairuaki rānei.
- Ngā rongoā ārai mate pāwera: Te hiamoe, te whanoke, te ānini, te tere o te manawa rānei.
Kia māia koe, ka ata paunatia e ō tākuta ēnei mōrearea me te hiahia ki te whakaora i tō ora, ā, ka whakaratohia e rātou te maimoatanga tino haumaru, tino whai hua hoki ki Nirogi Lanka.
Me pēhea e taea ai e koe te whakaiti i te mōrearea?
Ahakoa kāore e taea te ārai i ngā take katoa o te ohorere tohatoha, pērā i ētahi mate, ka taea e koe te mahi i ngā mahi hei whakahaere i ngā mōrearea e mōhiotia ana:
- Mena he mate pāwera kai nui tōu, me mau tonu he epinephrine auto-injector (pēnei i a EpiPen®, Adrenalin® rānei) me te mōhio ki te whakamahi tika.
- Ki te pāngia koe e te mate huango auau, me pupuri tonu tō horomanga Albuterol, Salbutamol rānei. Kaua e tukua kia pau.
- Ki te whakamahi koe i ngā tampon, whakawhitia pinepinetia hei ārai i te tūponotanga o te Toxic Shock Syndrome.
- Āta karohia te ruku ki te wai pāpaku, ki te wai kāore e mōhiotia ana, nā te mea ka pā he whara ki te taurakira.
- Me tango tonu ngā rongoā kia rite ki te mea i whakaritea e tō tākuta.
Ka aha mēnā ka pāngia koe e te Distributive Shock?
Mena ko te sepsis te take o tō 'oho', tera pea ka pāngia koe e ngā wero roa pēnei i te ngenge, te moemoeā whakararuraru, te ngaro rānei o te hiahia kai. Ahakoa te take matua, he mea nui kia haere koe ki ō wā tirotiro katoa, me te piri tonu ki te mahere rongoā kua tohua e tō tākuta.
Ko te roanga o tō whakaoranga mai i te Distributive Shock e whakawhirinaki ana ki te kaha o tō wheako. Tērā pea me noho koe ki te hōhipera mai i ētahi rā ki ētahi wiki.
Kei waenganui i te 20% me te 80% te tūponotanga o te ora katoa, i runga i te pūtake. Ki te kore he wawaotanga hauora, he maha ngā wā ka mate tēnei mate. Ko te kitenga wawe me te maimoatanga tere ko tō parepare pai rawa atu mō te oranga.He nui ake te mōrearea mō ngā kaumātua, ngā tāngata e whakamahi waipiro mau tonu ana, me te hunga e pāngia ana e ngā raruraru maha-ōkana.
Ki te pai te urupare a tō tinana ki ngā wai werohanga ā-uaua (IV) ā, ka mau tonu te mahi a ō whekau, ka kaha ake te tūponotanga ka ora ake koe.
Me pēhea taku tiaki i ahau anō i muri i taku hokinga ki te kāinga ?
Kia tukuna koe i te hōhipera, me whai i ngā tohutohu a tō tākuta kia tika. Me okioki pea koe i te kāinga mō ētahi rā, wiki rānei i mua i tō hokinga atu ki te mahi. Kia mahara kia tae atu koe ki ngā haerenga tirotiro katoa, ā, kia oti katoa te tango i tō rongoā.
Ki te mea kei te kino haere tō āhua i te kāinga, whakapā atu ki tō tākuta tonu atu.
I roto i tētahi āhuatanga ohorere: Me tere te kawe i te tangata e whakaatu ana i ngā tohu o te Distributive Shock ki te tari ohorere tata. I a koe e tatari ana mō ngā ratonga ohorere (waea atu ki te 911), me takoto te tangata kia papatahi, me whakamahana ia ia ki te paraikete, ā, me whakaara ake ōna waewae kia 12 inihi te teitei hei akiaki i te rere o te toto.
Ngā pātai hei pātai atu ki tō tākuta
Mena kua pāngia koe e tēnei āhuatanga, he mea pai kia kōrero koe ki tō tākuta mō ēnei mea e whai ake nei:
- Kei te tūpono anō ahau ki te pāngia e te Distributive Shock ?
- Kia pēhea te auau o taku haere ki ngā hui whai muri mai?
- Ka pāngia tōku hauora e te Distributive Shock mō te wā roa?
Karere Hira mō te Hokona ki te Kāinga
He āhuatanga ohorere hauora nui te ohorere tohatoha e hiahia ana kia arohia tonutia. Mā te rapu āwhina i te wā e taea ai ka puta te tūponotanga pai rawa atu kia ora. He roa te wā e hiahiatia ana hei whakaora, nō reira kia manawanui ki tō tinana. I te kāinga, whai i tō tikanga rongoā me te haere ki ngā tirotiro katoa. I Nirogi Lanka, e hiahia ana mātou kia mōhio pai koe nā te mea he kaupapa hauora nui tēnei.
👩🏽⚕️ Ngā Pātai Auau (FAQs)
💬 He rite tonu te Ru Whakahāngai ki te ru hiko?
Kāo. I roto i ngā kupu hauora, ko te 'oho ohorere' e pā ana ki tētahi āhua e morearea ai te ora, ka tino heke te rere o te toto ki ngā whekau nui (pērā i te roro me ngā whatukuhu). I tēnei take, i te wā e pupuhi ana te ngākau, ka whānui haere ngā oko toto, ka heke te toto ki ngā taumata tino iti.
💬 He aha i whānui ai ngā uaua toto, i heke ai hoki te toto toto?
E toru ngā tino take: 1. He mate pāwera kino (Anaphylaxis, pērā i te ngau a te pī), 2. He mate toto kino (Sepsis/Septic shock), 3. Te kino o ngā io ki te tuaiwi nā te whara (Neurogenic shock).
💬 Me pēhea te tautuhi i tētahi e mōrearea ana?
Ko ngā tohu ko te ngoikore, te tere o te ngakau (tachycardia), te kiri mā, me te uaua ki te manawa. Nā te mea ka mate pea i roto i ngā meneti, me whakauru te tūroro ki te ICU mō ngā rongoā ohorere (pērā i ngā vasopressors pēnei i te epinephrine).
Ngā Kupumatua: Te ohorere tohatoha, te ohorere septic, te ohorere anaphylactic, te ohorere neurogenic, te toto toto iti, te maimoatanga ohorere, te whakaoranga sepsis
