He āhuatanga ohorere kei te pā mai nā te iti o te toto/wai i roto i te tinana? Kia ako tātou mō tēnei ohorere hypovolemic!

Kua ngaro whakarere tō hinengaro i a koe, kua pōuri, ā, kua uaua ki te manawa? Kua kite rānei koe i tētahi e whara kino ana, ā, e toto nui ana? Ko tētahi o ngā āhuatanga tino morearea ka puta i roto i ēnei āhuatanga ko te hypovolemic shock, ka kōrerohia e tātou i tēnei rā. He āhuatanga tēnei e hiahia ana ki te maimoatanga hauora ohorere, nō reira he mea tino nui kia mōhio koe ki tēnei.

He aha te ohorere hypovolemic? Kia mārama tātou!

Ki te kī ngāwari, ko te ohorere hypovolemic ko te hekenga ohorere o te nui o te toto, o ngā wai rānei i roto i tō tinana, ā, kāore e taea e tō ngākau te pupuhi tika i te toto puta noa i tō tinana. Whakaarohia he rite ki te motuka e pau ana te wahie. He rite te toto ki te wahie ki ō tātou tinana.

Ka puta tēnei āhuatanga ina neke atu i te 20%, arā, te haurima o te toto katoa o te tinana ka ngaro. Ehara i te mea nā te toto nui anake tēnei i puta mai i tētahi whara nui. I ētahi wā, ka puta anō hoki tēnei āhuatanga i te korere nui, te ruaki tonu, te werawera nui rānei, ka ngaro ai te nui o te wai i te tinana.

He āhuatanga ohorere hauora tēnei, nō reira, ki te kite koe i ngā tohu, me waea atu koe ki te 1190, ki te 1990 rānei i taua wā tonu, ka rapu awhina hauora.

He aha te mea e pā ana ki te toto toto i tēnei wā?

Ina puta te ohorere hypovolemic, ka piki ake pea te tau raro o tō toto, e kiia nei ko te pēhanga diastolic, i te tīmatanga. Engari i te haere tonu o te toto, o te wai rānei ki waho o tō tinana, ka tīmata te heke haere o te tau runga, e kiia nei ko te pēhanga systolic.

Ko wai te mea ka nui ake te tūponotanga ka pāngia e tēnei?

Ka pā tēnei āhuatanga ki te tangata katoa, inā koa te tangata kua pāngia e tētahi aituā nui, ā, he nui te toto e ngaro ana. Waihoki, e ai ki tā mātou i kōrero ai i mua ake nei, ka matewai te tangata e ruaki nui ana, e mate korere ana, e werawera nui ana rānei.

He pēhea te noa o tēnei āhuatanga?

I te nuinga o te wā, ka pāngia te tangata e te ohorere i roto i te iti iho i te 1 i roto i te 1,000. Heoi, ko te ohorere hypovolemic te tuarua o ngā momo ohorere tino kitea. I ētahi whenua whakawhanake, he mea tino kitea tēnei i roto i ngā tamariki nohinohi nā te mate korere.

He aha te mea ka pa ki te tinana i te wā o te ohorere hypovolemic?

Ka puta te ohorere hypovolemic ina kore ngā okana tino nui o te tinana (hei tauira, te roro, te ngākau, ngā whatukuhu) e whiwhi i te nui o te toto me te hāora e tika ana. He rite tēnei ki te rākau e mate ana ki te kore he wai. Kāore hoki e taea e ō tātou okana te mahi me te kore he toto.

I tēnei wā, he tino mohio te mahi a tō tātou tinana. Nā te iti o te toto i roto i te tinana, ka arotahi ki te tuku toto ki ngā whekau tino nui e rua hei oranga, arā, te roro me te ngākau . Koia te take ka heke te nui o te toto e haere ana ki ngā peka, ka mātao hoki ngā peka.

I te toharite, ko te tangata e 70 kirokaramu te taumaha, e 5 rita te toto kei roto i tōna tinana. Ko te 7% tēnā o te taumaha o tōna tinana. I roto i te ohorere hypovolemic, ka ngaro tetahi wāhanga nui o tēnei nui.

He aha ngā wāhanga e whā o te ohorere?

E whā ngā āhuatanga matua o tēnei āhuatanga, i runga i te kaha o te pānga.

• Wāhanga 1: Koinei te wā e ngaro ai te 15% o te nui o tō toto (tata ki te 750 miririta (750 mL) – he rite te rahi ki tētahi pounamu wai nui). Tērā pea kei te noa tō toto toto me tō manawa i tēnei wā.
• Wāhanga 2: Koinei te wā ka whakaitihia te nui o te toto mā te 15% ki te 30% (750 mL ki te 1,500 mL – tata ki te rua ngā pounamu wai nui). Ka tīmata te piki haere o te tere o te manawa, ka piki ake hoki te tere o te manawa.
• Wāhanga 3: I waenga i te 30% me te 40% o te nui o te toto o te tinana (1,500 mL ki te 2,000 mL – tata ki te toru pounamu wai nui!) ka ngaro. Ka tino heke te toto toto, ka piki ake te tere o te ngakau me te manawa. Ka tino heke hoki te putanga mimi.
• Wāhanga 4: Koinei te wāhanga tino kino. Neke atu i te 40% o te nui o te toto o te tinana (>2,000 mL) kua ngaro. He tino iti te toto toto, he tere te manawa, ā, tata kore rawa e puta he mimi.

He aha ngā tohu e tika ana kia mōhio tātou?

Ka nui ake te toto, te wai rānei e ngaro ana i te tinana, ka kaha ake ngā tohu. Anei ētahi tohu noa o te ohorere hypovolemic:

• Te tere o te manawa: Te ahua kei te tere ake tō manawa i te mea noa.
• Te pōhēhē, te koretake rānei: He uaua ki te arotahi, ā, ka pōrearea pea koe.
• Te werawera nui: Kātahi ka mātao te tinana, ka tīmata te werawera.
• Te ngaronga o te māramatanga (te hemo): Tērā pea ka ngaro ohorere tō māramatanga me te kore e mahi i tetahi mahi tinana.
• Kiri makariri: Ka mātao ngā peka me ngā waewae ina pā atu.
• Te ngoikore o te tinana: Ka ngoikore rawa, kāore e taea e ia te mahi i tetahi mea.
• Te hekenga o te pāmahana tinana me te toto toto.
• Te pikinga o te tere o te manawa (te pikinga o te tere o te manawa).

Ki te kitea tētahi, neke atu rānei o ēnei tohu i te wā e toto nui ana, he ohorere hypovolemic pea tēnei.

He aha ngā take matua mō tēnei?

Ko te tino take ko te ngaronga o te nui o te toto, o ngā wai rānei i te tinana. Ka puta pea tēnei toto i roto i te tinana (i tētahi ara kāore e kitea) i tētahi patunga e kitea ana rānei. Hei tāpiri,

• Ngā wera
• Te mate pāwera
• Ko ngā take pēnei i te werawera nui, te ruaki, te mate korere rānei he take anō pea.

He aha ngā huarahi ka puta ai te toto?

Ko ngā tino take o te toto e arahi ai ki te hypovolemic shock ko:

• Ngā whara i puta mai i tētahi aituā kino: Ngā mea pēnei i te aituā i te rori, te hinganga mai i te teitei, me ētahi atu.
• I te wā e pokanga ana, i muri rānei i te pokanga: Ka taea e ētahi pokanga te whakanui ake i te toto.
• Hapūtanga ectopic: He āhuatanga tino morearea tēnei, nā te mea ka taea te whakaputa toto i roto i te tinana.
• Pakaru o te aneurysm: Ko te tikanga ka ngoikore te uaua toto, ka pupuhi pērā i te poihau, kātahi ka pakū ohorere.
• Ngā raruraru o te ara nakunaku: Hei tauira, te toto nā te mate puku.

Me pēhea te kite a te tākuta i tēnei?

Ina kawea koe ki te hōhipera, ko te mea tuatahi ka mahia e te tākuta, e te nēhi rānei, ko te tirotiro i a koe. Kātahi ka mahia pea e rātou ētahi whakamātautau hei whakaū i te āhua.

• Ngā whakamātautau toto: Tirohia kia kite i te iti o te tatau toto, me te kite mēnā kua pāngia ngā whekau pēnei i ō whatukuhu.
• Electrocardiogram (ECG): Tirohia te mahi a te ngākau.
• Echocardiogram: He matawai o te ngākau.
• Te whakaurunga o te catheter ki te ngākau matau (Swan-Ganz): He whakamātautau motuhake e ine ana i te pēhanga i roto i te ngākau.
• Matawai CT (Computered tomography - CT) me ētahi atu whakamātautau hihi-X: Hei kimi i te wāhi e turuturu ana te toto i roto i te tinana.
• Endoscopy: Te tirotiro i te ara kai mā te whakamahi i tētahi ngongo me te kāmera.

Me pēhea te rongoā? Ngā mea hei mahi tonu!

I muri i tō kawe mai i a koe ki te hōhipera mā te waka tūroro, mā tētahi atu huarahi rānei, ko te mea tuatahi mā ngā tākuta ko te tuku i a koe ki roto i te raina IV, ka hoatu he wai ki a koe (pērā i te tote) . Kātahi ka hoatu he toto ki a koe mēnā e tika ana. Ka hoatu hoki he rongoā ki a koe hei whakahoki i tō toto ki te noho noa.

Ko te mea nui ko te rongoā i te raruraru i puta ai te ohorere. Hei tauira, te whakamutu i te toto, te pokanga rānei mēnā i whara koe i tētahi aituā. Whai muri i tēnā, ka puritia koe ki te Wāhanga Tiaki Kaha (ICU) hei tirotiro mātakitaki.

He aha ngā momo rongoā e hoatu ana?

Ko ētahi o ngā rongoā matua e hoatu ana mō te ohorere hypovolemic ko:

• Epinephrine (Epinephrine - Adrenalin®)
• Norepinephrine (Norepinephrine - Levophed®)
• Dopamine
• Dobutamine (Dobutamine - Inotrex®)

Ka āwhina ēnei rongoā ki te whakaora i te tere o te ngakau me te toto toto.

He pānga taha kei te rongoā?

I ētahi wā ka pā mai he pānga taha iti noa iho i ēnei rongoā.

• Te pikinga o te toto toto me te tere o te ngakau
• Te uaua ki te manawa
• Mamae upoko (mamae upoko)
• Ngā hapa o te ngakau

He aha tā tātou e taea ai te whakaiti i tēnei mōrearea?

He uaua ki te matapae me te ārai i ngā aituā kino. Heoi, kei reira ētahi mea ka taea e tātou te mahi hei whakaiti i te tūponotanga o te ohorere hypovolemic mai i ētahi atu take:

• Mena kei te tango koe i ngā rongoā whakaheke toto , tangohia kia rite ki te whakahau a tō tākuta. Inumia hoki he nui te wai hei karo i te matewai.
• Ki te pāngia koe e te mate korere, e ruaki ana rānei, inumia he nui te wai, he wai rānei pērā i a Jeevani hei whakakī anō i ngā wai i ngaro i tō tinana.
• Ki te nui tō werawera, inumia he nui te wai hei whakakapi i te wai e ngaro ana i a koe.

Ko te mea nui: Ki te kite koe i te nui o te toto e rere ana, ki te mea rānei he motu tōu kāore e taea te aukati, waea atu ki te 1190, ki te 1990 rānei i taua wā tonu, haere rānei ki te wāhanga whawhati tata o tō hōhipera. Mā te rapu awhina wawe ka āwhina i te whakahaere i te āhuatanga i mua i te ngaronga o te nui o te toto.

Ka aha mēnā ka pāngia koe e te ohorere hypovolemic? Kia pēhea te roa o te wā e ora ai koe?

Ka whakawhirinaki pea ki ētahi āhuatanga te ora o tēnei mate, te ora rānei. Tērā pea he pānga anō hoki ki te nui o te toto, te wai rānei i ngaro, te tere o te tupu, ētahi atu mate hauora kei a koe, me te take o te ohorere.

Ki te tīmata wawe koe i te maimoatanga mō te ohorere, ka taea te whakakore i ōna pānga. Ki te mea he taitamariki koe, ā, kāore i te tino kino te ohorere, he nui te tūponotanga ka ora koe. Heoi, i ētahi wā ka taea e te kino o ngā okana te arahi ki te mate manawa. Ki te kore e ranea te neke atu i te kotahi okana, he nui ake te tūponotanga ka mate te mate. Ahakoa te maimoatanga, i ētahi wā ka mate te ohorere hypovolemic.

Me pēhea taku tiaki i ahau anō kia ora rā anō ahau?

Kia tae atu koe ki te kāinga i te hōhipera, me whai koe i ngā tohutohu a te tākuta kia tika. He maha ngā whara kua pā ki tō tinana, nō reira me okioki koe i te kāinga, me whakaora i a koe anō i mua i te haere ki te mahi. Tangohia te rongoā i tohua e tō tākuta kia tika, ā, tiakina pai ō patunga katoa.

Āhea ahau me toro atu anō ki te tākuta?

Ka tono atu te tākuta kia hoki mai koe mō ngā wā tirotiro whai muri kia kite ai koe kei te pēhea koe. Kaua e mahue ēnei wā tirotiro, nā te mea koinei te wā ka taea e te tākuta te tautuhi wawe i ngā raruraru hou ka puta ake.

Āhea koe me haere ki te Wāhanga Maimoatanga Ohotata (ETU) ?

Ki te kite koe i tētahi e whakaatu ana i ngā tohu o te ohorere hypovolemic, waea atu ki te 1190, ki te 1990 rānei tonu. Ko te tere o te whiwhi āwhina, ko te pai ake. Kia tae mai rā anō te āwhina, whakatakotoria te tangata ki raro me ōna waewae kia teitei ake i te toenga o tōna tinana. Kaua e nekehia te tinana, engari me whakaara ake i ngā waewae. Mēnā kei te toto, ngana ki te whakamutu, me te pupuri kia mahana te tinana.

Mena kua pāngia koe e te ohorere hypovolemic i mua, ki te tīmata anō te toto o ō patunga, ki te āhua nei kei te turuturu, me haere anō ki te rūma whawhati tata.

He aha ngā pātai nui hei pātai atu ki te tākuta?

Ina kite koe i te tākuta, kaua e wareware ki te pātai i ēnei pātai:

• Ka pā mai rānei tēnei ohorere hypovolemic ki ahau mō te wā roa?
• Kia pēhea te roa ka ora katoa ahau?
• Kia pēhea te roa me tango e au te rongoā i whakaritea e koe?

Hei whakamutunga, he karere hei kawe ki te kāinga

He āhuatanga ohorere hauora te ohorere hypovolemic. Heoi, mā te tere o te maimoatanga ka taea te whakaora i tō ora. Ka taea e ngā tākuta te whakakore i te āhua, engari ka roa te wā kia ora ai koe. Ina koa mēnā he aituā nui te hua o te ohorere, tera pea ka roa ake te wā kia ora ai koe. Nō reira, me whai i ngā tohutohu a tō tākuta, ā, kia tiakina koe me ō whara. Kia tūpato tonu!

` te ohorere hypovolemic, te ngaronga toto, te ngaronga wai, te ohorere, te maimoatanga ohorere, te toto toto tiketike, ngā tohu