Ingaba kukho imeko engxamisekileyo ngenxa yamanqanaba aphantsi egazi/ulwelo emzimbeni? Masifunde ngale ngxaki yokungonwabi kakuhle kwegazi!

Ngaba wakha waphelelwa zingqondo ngequbuliso, waziva isiyezi, waza waba nobunzima bokuphefumla? Okanye wakha wambona umntu onzakele kakhulu waza wopha kakhulu? Enye yezona meko ziyingozi kakhulu ezinokwenzeka kwiimeko ezinjalo yi-hypovolemic shock, esiza kuthetha ngayo namhlanje. Le yimeko efuna unyango olungxamisekileyo, ngoko ke kubaluleke kakhulu ukuba uyiqaphele.

Yintoni i-hypovolemic shock? Masiyiqonde ngokulula!

Ngamafutshane, i-hypovolemic shock iyenzeka xa inani legazi okanye ulwelo emzimbeni wakho lincipha ngequbuliso kangangokuba intliziyo yakho ayikwazi ukupompa igazi emzimbeni wakho ngokufanelekileyo. Cinga ngayo njengemoto ephelelwa yipetroli. Igazi lifana nepetroli emizimbeni yethu.

Le meko idla ngokuvela xa ngaphezulu kwe-20%, okanye isinye kwisihlanu, somthamo wegazi uphela emzimbeni wethu ulahlekile. Oku akunakwenzeka kuphela ngenxa yokopha kakhulu ngenxa yokwenzakala okukhulu. Ngamanye amaxesha, urhudo olunzima, ukuhlanza okungapheliyo, okanye ukubila kakhulu nako kunokubangela le meko, okubangela ukuba kulahleke ulwelo oluninzi emzimbeni.

Le yingxamiseko yezonyango, ngoko ke ukuba ubona iimpawu, kubalulekile ukufowunela ku-1190 okanye ku-1990 ngokukhawuleza kwaye ufumane uncedo lwezonyango.

Kwenzeka ntoni kuxinzelelo lwegazi ngeli xesha?

Xa kukho i-hypovolemic shock, inani elisezantsi loxinzelelo lwakho lwegazi, olubizwa ngokuba yi-diastolic pressure, ekuqaleni lisenokunyuka kancinci. Kodwa njengoko igazi okanye ulwelo luqhubeka luphuma emzimbeni wakho, inani eliphezulu, elibizwa ngokuba yi-systolic pressure, liya kuqala ukwehla kancinci kancinci.

Ngubani onokuthi aphuhlise oku ngakumbi?

Le meko inokwenzeka nakubani na, ingakumbi umntu oye wehlelwa yingozi enkulu waza walahlekelwa ligazi elininzi. Kwakhona, njengoko besitshilo ngaphambili, umntu ohlanza kakhulu, orhudayo, okanye obila kakhulu naye unokuphelelwa ngamanzi emzimbeni.

Ixhaphake kangakanani le meko?

Lilonke, naluphi na uhlobo lomothuko lwenzeka kubantu abangaphantsi kwe-1 kwi-1,000. Nangona kunjalo, umothuko we-hypovolemic lolona hlobo lwesibini oluqhelekileyo lomothuko. Kwamanye amazwe asakhasayo, luxhaphake kakhulu kubantwana abancinci ngenxa yorhudo.

Kwenzeka ntoni emzimbeni xa kukho i-hypovolemic shock?

I-Hypovolemic Shock yenzeka xa amalungu abalulekileyo emzimbeni wethu (umzekelo, ingqondo, intliziyo, izintso) engafumani umlinganiselo ofunekayo wegazi kunye neoksijini. Oku kufana nomthi ofayo ngaphandle kwamanzi. Amalungu ethu nawo awakwazi ukusebenza ngaphandle kwegazi.

Ngeli xesha, imizimba yethu isebenza ngobulumko kakhulu. Ngenxa yokuba igazi lincinci emzimbeni, ibeka phambili ukunikezelwa kwegazi kumalungu amabini abalulekileyo ukuze aphile, ingqondo nentliziyo . Yiyo loo nto inani legazi eliya kumalungu lincipha, kwaye amalungu abandayo.

Ngokomyinge, umntu obunzima obumalunga neekhilogram ezingama-70 uneelitha ezi-5 zegazi emzimbeni wakhe. Oko kuthetha malunga ne-7% yobunzima bomzimba wakhe. Xa umntu enesifo soxinzelelo lwegazi oluphantsi, inxalenye enkulu yalo mali iyalahleka.

Ngawaphi amanqanaba amane omothuko?

Kukho iimeko ezine eziphambili kule meko, kuxhomekeke kubunzima bayo.

• Inqanaba loku-1: Kulapho ulahlekelwa malunga ne-15% yomthamo wegazi lakho (malunga ne-750 milliliters (750 mL) – loo nto ilingana nebhotile enkulu yamanzi). Uxinzelelo lwegazi kunye nesantya sentliziyo yakho zisenokuba zesiqhelo ngeli xesha.
• Inqanaba lesi-2: Kulapho umthamo wegazi wehla nge-15% ukuya kwi-30% (750 mL ukuya kwi-1,500 mL – malunga neebhotile ezimbini ezinkulu zamanzi). Isantya sentliziyo siqala ukwanda, kwaye isantya sokuphefumla siyanda.
• Inqanaba lesi-3: Phakathi kwama-30% nama-40% omthamo wegazi lomzimba (1,500 mL ukuya kuma-2,000 mL – malunga neebhotile ezintathu ezinkulu zamanzi!) ziyalahleka. Uxinzelelo lwegazi luyehla kakhulu, isantya sentliziyo kunye nesantya sokuphefumla siyanda. Ukuphuma komchamo nako kwehla kakhulu.
• Inqanaba lesi-4: Eli lelona nqanaba linzima kakhulu. Ngaphezulu kwama-40% omthamo wegazi lomzimba (>2,000 mL) ulahlekile. Uxinzelelo lwegazi luphantsi kakhulu, isantya sentliziyo siphezulu, kwaye umchamo awubonakali.

Zeziphi iimpawu esifanele siziqaphele?

Okukhona igazi okanye ulwelo luphuma emzimbeni, kokukhona iimpawu ziba mandundu ngakumbi. Nazi ezinye zeempawu eziqhelekileyo zokothuka kwe-hypovolemic:

• Ukwanda kwesantya sokuphefumla: Ukuziva ngathi uphefumla ngokukhawuleza kunesiqhelo.
• Ukuziva udidekile okanye ungaphumli: Kunzima ukugxila, kwaye ungaziva uphazamisekile.
• Ukubila okugqithisileyo: Ngequbuliso, umzimba uyabanda uze uqalise ukubila.
• Ukulahlekelwa yingqondo (ukutyhafa): Ungalahlekelwa yingqondo ngequbuliso ngaphandle kokwenza nayiphi na imisebenzi yomzimba.
• Ulusu olubandayo: Amalungu omzimba aziva ebanda xa echukunyiswa.
• Ukuziva ubuthathaka: Umzimba uba buthathaka kangangokuba awukwazi ukwenza nantoni na.
• Ukwehla kobushushu bomzimba kunye noxinzelelo lwegazi.
• Ukwanda kwesantya sentliziyo (ukwanda kwesantya sentliziyo).

Ukuba enye okanye ezingaphezulu kwezi mpawu zibonakala xa kuphuma igazi elininzi, isenokuba yi-hypovolemic shock.

Ziziphi izizathu eziphambili zoku?

Eyona nto iphambili kukulahleka kwegazi elininzi okanye ulwelo oluphuma emzimbeni. Oku kuphuma kwegazi kungenziwa ngaphakathi (ngendlela esingenakuyibona) okanye kwinxeba elibonakalayo. Ukongeza,

• Ukutsha
• I-Pancreatitis
• Izinto ezibangela ukubila kakhulu, ukuhlanza, okanye urhudo nazo zinokuba negalelo.

Ziziphi iindlela ezinokwenzeka apho ukopha kunokwenzeka khona?

Iziganeko eziphambili zokopha ezinokubangela ukothuka kwe-hypovolemic zezi:

• Ukulimala okubangelwe yingozi enkulu: Izinto ezifana nengozi endleleni, ukuwa kwindawo ephakamileyo, njl.
• Ngexesha okanye emva kotyando (utyando): Ezinye iintlobo zotyando zinokubangela ukopha kancinci.
• Ukukhulelwa kwesisu: Le yimeko eyingozi kakhulu, kuba inokubangela ukopha emzimbeni.
• Ukuqhekeka kwe-Aneurysm: Oku kuthetha ukuba umthambo wegazi uyabuthathaka, uvuvukale njengebhaluni, uze uqhume ngequbuliso.
• Iingxaki zendlela yokugaya ukutya: Umzekelo, ukopha ngenxa yesilonda esiswini.

Ugqirha uyibona njani le nto?

Xa uziswa esibhedlele, into yokuqala ugqirha okanye umongikazi aya kuyenza kukuxilonga, emva koko, banokwenza uvavanyo olumbalwa ukuqinisekisa imeko.

• Uvavanyo lwegazi: Jonga ukuba inani legazi lakho liphantsi kangakanani na kwaye nokuba amalungu omzimba afana nezintso zakho achaphazelekile na.
• I-Electrocardiogram (ECG): Jonga ukusebenza kwentliziyo.
• I-Echocardiogram: Iskeni sentliziyo.
• Ukufakwa kwe-catheter kwintliziyo yasekunene (Swan-Ganz): Uvavanyo olukhethekileyo olulinganisa uxinzelelo entliziyweni.
• I-CT scan (i-computed tomography - CT) okanye ezinye iimvavanyo ze-radiological: Ukufumanisa apho igazi livuza khona emzimbeni.
• I-Endoscopy: Uvavanyo lomgudu wokugaya ukutya kusetyenziswa ityhubhu enekhamera.

Ungayinyanga njani? Izinto ekufuneka zenziwe ngoko nangoko!

Emva kokuba usiwe esibhedlele nge-ambulensi okanye ngenye indlela, into yokuqala eyenziwa ngoogqirha kukufaka kumgca we-IV baze bakunike ulwelo (njenge-saline) . Emva koko bakunika igazi ukuba kuyimfuneko. Bakunika namayeza okubuyisela uxinzelelo lwakho lwegazi esiqhelweni.

Eyona nto ibalulekileyo kukulungisa ingxaki ebangele ukothuka. Umzekelo, ukuyeka ukopha, okanye ukwenza utyando ukuba wenzekele kwingozi. Emva koko, uza kugcinwa kwiYunithi yoKhathalelo oluPhezulu (ICU) ukuze ujongwe.

Zeziphi iintlobo zamayeza ezinikwayo?

Amanye amayeza aphambili anikwayo kwi-hypovolemic shock ngala:

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

La mayeza anceda ukubuyisela izinga lentliziyo kunye noxinzelelo lwegazi.

Ngaba kukho naziphi na iziphumo ebezingalindelekanga zonyango?

La mayeza ngamanye amaxesha anokubangela iziphumo ebezingalindelekanga ezincinci.

• Uxinzelelo lwegazi oluphezulu kunye nesantya sentliziyo
• Ubunzima bokuphefumla
• Intloko ebuhlungu (intloko ebuhlungu)
• Ukungahambi kakuhle kwentliziyo

Singenza ntoni ukunciphisa lo mngcipheko?

Kunzima ukuqikelela nokuthintela iingozi ezinkulu. Nangona kunjalo, kukho izinto esinokuzenza ukunciphisa umngcipheko wokothuka ngenxa ye-hypovolemic shock evela kwezinye izizathu:

• Ukuba usela amayeza okukhupha isisu (diuretics) , thatha kanye njengoko ugqirha wakho ekuyalele. Kwakhona, sela amanzi amaninzi ukuze ungaphelelwa ngamanzi emzimbeni.
• Ukuba unesifo sorhudo okanye uyahlanza, sela amanzi amaninzi okanye ulwelo olufana noJeevani ukuze uzalise ulwelo olulahlekileyo emzimbeni wakho.
• Ukuba ubila kakhulu, sela amanzi amaninzi ukuze ubuyisele ulwelo olulahlekayo.

Okubaluleke kakhulu: Ukuba ubona ukopha kakhulu, okanye ukuba unenxeba elingenakunqandwa, fowunela ku-1190 okanye ku-1990 ngoko nangoko, okanye uye kwicandelo likaxakeka lesibhedlele esikufutshane nawe. Ukufumana uncedo ngokukhawuleza kunokunceda ukulawula imeko ngaphambi kokuba kulahleke igazi elininzi.

Kwenzeka ntoni ukuba ufumana i-hypovolemic shock? Kuthatha ixesha elingakanani ukuba uphile?

Ukuba uyasinda kule meko kwaye uyaphila kuxhomekeke kwizinto ezininzi. Ukuba igazi okanye ulwelo lulahlekile kangakanani, ukuba kwenzeke ngokukhawuleza kangakanani, ezinye iimeko zempilo onazo, kunye nokuba yintoni ebangele ukothuka nazo zinokudlala indima.

Ukuba uqala unyango lomothuko kwangethuba, iziphumo zalo zinokuguqulwa. Ukuba usemncinci kwaye umothuko awunzima kakhulu, unethuba elihle lokusinda. Nangona kunjalo, ngamanye amaxesha umonakalo wamalungu omzimba unokukhokelela ekuhlaselweni yintliziyo. Ukuba amalungu angaphezu kwelinye ayasilela, imeko inokuba yingozi. Nokuba unyango lukhona, umothuko we-hypovolemic ngamanye amaxesha unokubulala.

Ndingazinyamekela njani ndide ndiphile?

Emva kokuba ufikile ekhaya uvela esibhedlele, kufuneka ulandele imiyalelo kagqirha ngqo. Umzimba wakho udlule kwiintlungu ezininzi, ngoko ke kufuneka uphumle kwaye uphile ekhaya ngaphambi kokuba uye emsebenzini. Sela amayeza owanikwe ngugqirha wakho ngqo, kwaye unyamekele kakuhle nawaphi na amanxeba.

Kufuneka ndiphinde ndibone ugqirha kwakhona nini?

Ugqirha uza kukucela ukuba ubuye kwintlanganiso zokulandelela ukuze abone ukuba unjani. Ungaphoswa zezi ntlanganiso, kuba kulapho ugqirha anokukwazi khona ukubona ngokukhawuleza naziphi na iingxaki ezintsha ezinokuvela.

Ufanele uye nini kwiYunithi yoNyango oluNgxamisekileyo (i-ETU) ?

Ukuba ubona umntu ebonisa iimpawu zokothuka ngenxa ye-hypovolemic shock, fowunela ku-1190 okanye ku-1990 ngoko nangoko. Okukhona umntu efumana uncedo ngokukhawuleza, kokukhona kungcono. De kufike uncedo, mlalise phantsi umntu imilenze yakhe iphakame malunga nonyawo ngaphezu komzimba wonke. Musa ukuwushukumisa umzimba, ngaphandle kokuphakamisa imilenze. Ukuba kukho ukopha, zama ukuwumisa, kwaye ugcine umzimba ufudumele.

Ukuba ukhe waba nomothuko we-hypovolemic ngaphambili, ukuba amanxeba akho aqala ukopha kwakhona, okanye ukuba abonakala ngathi ayaphuma, yiya kwigumbi likaxakeka kwakhona.

Yeyiphi imibuzo ebalulekileyo ekufuneka uyibuze ugqirha?

Xa ubona ugqirha, ungalibali ukubuza le mibuzo:

• Ngaba le ngxaki yokungakwazi ukuphumla iza kundichaphazela ixesha elide?
• Kuza kuthatha ixesha elingakanani ukuba ndiphile ngokupheleleyo?
• Kufuneka ndithathe amayeza owandinike wona ixesha elingakanani?

Okokugqibela, umyalezo oya ekhaya

Ukothuka ngenxa ye-Hypovolemic yingxamiseko yezonyango. Nangona kunjalo, ukufumana unyango ngokukhawuleza kunokusindisa ubomi bakho. Oogqirha banokuyiguqula le meko, kodwa kuya kuthatha ixesha ukuba uphile. Ingakumbi ukuba ukothuka kungenxa yengozi enkulu, kungathatha ixesha elide ukuba uphile. Ngoko ke, landela imiyalelo kagqirha wakho ngokuchanekileyo kwaye uzinyamekele kakuhle wena kunye nokwenzakala kwakho. Hlala ulumkile!

` ukothuka kwe-hypovolemic, ukulahleka kwegazi, ukulahleka kolwelo, ukothuka, unyango olungxamisekileyo, uxinzelelo lwegazi, iimpawu