Ingabe ukuhamba kwegazi lakho kungaphazamiseka bese uqala 'ukushaqeka'? Ake sixoxe 'ngokushaqeka okusabalalisa'!

O, ngezinye izikhathi singangena enkingeni enkulu ngokuzumayo, akunjalo? Kunezikhathi lapho sizizwa sengathi silahlekelwa yimpilo yethu futhi kunzima ukuphefumula. Ngezikhathi ezinjengalezi, kungenzeka ukuthi kukhona into enkulu eyenzeka emizimbeni yethu. Namuhla sizokhuluma ngesimo esinjalo esisheshayo, esisongela ukuphila. Leso yisimo esibizwa ngokuthi 'Distributive Shock' .

Kuyini lokhu 'ukwethuka kokusabalalisa'? Kalula nje...

Kalula nje, ukushaqeka kokusabalalisa kuyisimo esiphuthumayo sezokwelapha. Okwenzekayo lapha ukuthi imithambo yegazi emzimbeni wakho (lapho igazi ligeleza khona) ngokuzumayo iba mikhulu kakhulu, njengepayipi lerabha elinwetshwayo. Ngezinye izikhathi lokhu kubizwa nangokuthi ukushaqeka kwe-vasodilatory . Ngakho-ke, lapho imithambo yegazi iba mikhulu kanje, umfutho wegazi wehla kakhulu ngokuzumayo. Cabanga ngakho njengokuthi uma ipayipi lamanzi likhula, amanzi azohamba kancane.

Kwenzekani uma lokhu kwenzeka? Izitho zakho ezinkulu, njengenhliziyo yakho, ubuchopho, nezinso, azitholi igazi elanele . Hhayi lokho kuphela, kodwa ngezinye izikhathi elinye igazi liqala ukuvuza kule mithambo yegazi emincane (ama-capillaries). Lokhu kungabangela ukuthi inani legazi emzimbeni wakho lehle. Lesi yisimo esiyingozi kakhulu, ngoba izitho zethu zidinga ukunikezwa kwegazi njalo ukuze zisebenze.

Kubaluleke kakhulu: Uma uhlangabezana 'nokushaqeka' okunje, kubalulekile ukufuna ukwelashwa ngokushesha okukhulu. Ngaphandle kwalokho, kungaba yingozi empilweni.

Yiziphi izinhlobo eziyinhloko 'zokwethuka kokusabalalisa'?

Kunezinhlobo ezintathu eziyinhloko 'zokwethuka kokusabalalisa', ngayinye yazo eyenzeka ngesizathu esihlukile.

1. Ukushaqeka Okubangelwa Yigciwane: Lolu uhlobo oluvame kakhulu. Lubangelwa ukutheleleka ngamagciwane. Cabanga nje, unesilonda, siba sibi kakhulu, amagciwane asakazeka emzimbeni wakho wonke, bese kuba yisimo esibizwa ngokuthi "i-Sepsis", futhi awukwazi ukusilawula. Ngezinye izikhathi, ngisho nento efana ne-pneumonia ingabangela lesi simo.

2. Ukushaqeka Okubangelwa I-Anaphylactic: Lokhu kubangelwa ukusabela okukhulu kokungezwani komzimba. Isibonelo, abanye abantu basabela kakhulu kokungezwani komzimba entweni efana nama-peanut, akunjalo? Noma kwenzeka lapho belunywa yizinambuzane ezithile. Umuntu one-asthma angaba nalesi simo, noma ngabe unobunzima obukhulu bokuphefumula.

3. Ukushaqeka Kwezinzwa: Lokhu kubangelwa ukulimala komgogodla wakho. Isibonelo, uma ushaya ikhanda lakho ngenkathi ugxumela emanzini bese ulimala umgogodla wakho, noma uma unengozi enkulu elimaza umgogodla wakho, lokhu 'kushaqeka kwemizwa' kungenzeka ngenxa yomphumela ohlelweni lwezinzwa.

Uyini umehluko phakathi kwe-'Distributive Shock' kanye ne-'Hypovolemic Shock'?

Zombili ziyizinhlobo 'zokwethuka'. Lokho kusho ukuthi kuzo zombili izimo, izitho zethu ezibalulekile azitholi igazi nomoya-mpilo owanele. Kodwa-ke, imbangela ihlukile.

• Ukushaqeka kokusabalalisa , njengoba kushiwo ngaphambili, kubangelwa ukuthi imithambo yegazi iba mikhulu kakhulu. Lokhu kuvame ukubangelwa ukutheleleka okubizwa ngokuthi i-sepsis noma ukusabela okukhulu kokungezwani komzimba.
• Ukushaqeka kwe-Hypovolemic kwenzeka lapho inani legazi noma olunye uketshezi emzimbeni liphansi kakhulu. Isibonelo, lokhu kungenzeka uma ulahlekelwa igazi eliningi ngenxa yokulimala okukhulu, noma uma ulahlekelwa uketshezi oluningi ngenxa yohudo olubi noma ukuhlanza.

Kalula nje, 'ekusabalaliseni' imithambo yegazi iba mikhulu, 'ekunciphiseni imithambo yegazi' igazi/uketshezi emzimbeni luyancipha. Uyaqonda?

Kuvame kangakanani lokhu 'kushaqeka kokusabalalisa'?

Kunezinhlobo ezine zokushaqeka esizaziyo (`Hypovolemic`, `Cardiogenic Shock`, `Obstructive Shock` kanye `Distributive Shock`). Kulezi ezine , ezivame kakhulu yi-`Distributive Shock` . Ikakhulukazi uhlobo olubizwa nge-`Septic Shock`. Ngisho nasezweni elifana neMelika, cishe abantu abayisigidi baba ne-`Septic Shock` minyaka yonke. Kungenzeka kunoma ubani.

Kwenzekani emzimbeni 'ngokuphazamiseka kokusabalalisa'?

Njengoba ngishilo ngaphambili, lapho imithambo yegazi iba mikhulu kakhulu, umfutho wegazi uyancipha. Bese inani legazi eliya ezithweni zomzimba liba lisanele. Izitho zethu zomzimba zifana nemishini. Zidinga ukuthola inani elifanele likaphethiloli (okungukuthi igazi nomoya-mpilo) ukuze zisebenze. Uma zingatholi igazi elanele, umoya-mpilo, kanye nezakhamzimba, izitho zomzimba ziyayeka ukusebenza kancane kancane. Lokhu sikubiza ngokuthi 'ukwehluleka kwezitho zomzimba' . Uma izitho zomzimba zehluleka kanje, kuba usongo olukhulu empilweni.

Ziyini izimpawu zalokhu?

Izimpawu zokushaqeka kokusabalalisa zingahluka kancane kuye ngokuthi imbangela ikuphi. Kodwa-ke, kunezimpawu ezithile ezivamile:

• Ukuqhuma kwesikhumba
• Ukushaya kwenhliziyo okusheshayo nokuphefumula
• Umfutho wegazi ophansi (lesi yisibonakaliso esiyinhloko)
• Izandla nezinyawo ziqala zifudumele, bese kubanda futhi kujuluke.
• Imfiva
• Ukugodola (ukuzizwa ubanda futhi uthuthumela)
• Isisu esibuhlungu
• Ukudideka, uzizwa sengathi ulahlekelwa ingqondo
• Ukukhwehlela
• Ukuphelelwa umoya
• Isicanucanu
• Ukuhlanza
• Ubuhlungu lapho uchama

Uma kuvela uphawu olulodwa noma ngaphezulu kwalezi ngokuzumayo, kungcono ukungaluthathi kalula, akunjalo?

Yiziphi izimbangela 'zokwethuka kokusabalalisa'?

Ngaphezu kwezinhlobo ezintathu esixoxe ngazo ekuqaleni, kunezinye izizathu eziningana eziholela kulesi simo.

• I-Sepsis ebangelwa ukutheleleka ngamagciwane (lena imbangela eyinhloko)
• I-Anaphylaxis, ebangelwa ukungezwani komzimba okukhulu (isib. ukudla okufana namakinati, ukulunywa yizinambuzane, imithi ethile, ukubhebhetheka kwe-asthma)
• Ukusha
• I-Pancreatitis
• I-Toxic Shock Syndrome (engenzeka, ikakhulukazi kwabesifazane, ngenxa yokusebenzisa ama-tampon)
• Ukulimala komgogodla
• Izinkinga ze-endocrine
• Ukungasebenzi kahle kwezinso (lokhu akuvamile kakhulu)
• I-Capillary leak syndrome ( ukuvuza koketshezi oluvela emithanjeni yegazi, lokhu nakho akuvamile kakhulu)
• Ukuthatha imithi ekhulisa imithambo yegazi kakhulu (Ukusebenzisa izidakamizwa ngokweqile) (lokhu nakho akuvamile)

Odokotela bakubona kanjani lokhu?

Uma unalezi zimpawu, into yokuqala udokotela azokwenza ukukuhlola kahle bese ekubuza ngomlando wakho wezokwelapha. Kodwa-ke, umuntu oshaqekile angase angakwazi ukukunikeza noma yiluphi ulwazi. Esimweni esinjalo, othile ohamba nawe angatshela udokotela nge-allergies yakho, ukuthi uke waba ne-anaphylaxis yini ngaphambili, nokuthi imiphi imithi oyiphuzayo. Lolu lwazi lungaba usizo kakhulu ekuxilongeni lesi simo.

Ngemva kwalokho, udokotela uzoyala izivivinyo eziningana, njengokuthi:

• Ukuhlolwa kwegazi: Hlola izifo nokuthi izitho zomzimba zisebenza kanjani.
• I-ECG (i-Electrocardiogram - EKG): Ihlola ukusebenza kwenhliziyo.
• I-X-ray yesifuba: Hlola isimo samaphaphu.
• Ukuskena kwe-Ultrasound: Bheka inhliziyo, amaphaphu, kanye nezitho ezisesiswini. Ezinye zalezi zingenziwa eceleni kombhede.

Iphathwa kanjani?

Ngenxa yokuthi lesi yisimo esiphuthumayo, ukwelashwa kuvame ukuqala eGumbini Lesimo Esiphuthumayo. Ngemva kwalokho, ungadluliselwa eYunithi Yokunakekelwa Okujulile (ICU).

1. Into yokuqala oyenzayo ukunikeza uketshezi lwe-IV. Uketshezi olufana nosawoti lufakwa emthanjeni. Lokhu kwenzelwa ukwehlisa kancane umfutho wegazi lakho.

2. Okulandelayo, sizonquma imbangela 'yokwethuka' bese sinikeza umuthi ofanele.

3. Ngezinye izikhathi , ukudla ngamapayipi kungasetshenziswa , ngoba umzimba udinga amandla.

Egumbini lokunakekelwa okujulile, odokotela nabahlengikazi bazoqhubeka nokuqapha izimpawu zakho ezibalulekile (ukushaya kwenhliziyo, umfutho wegazi, ukuphefumula, izinga lokushisa). Bazohlola nemiphumela emibi evela ekwelashweni. Uma unenkinga yokuphefumula wedwa, ungase uxhunywe emshinini wokuphefumula (i-ventilator) .

Yimiphi imithi esetshenziswayo?

Umuthi onikezwa 'i-Distributive Shock' uyahlukahluka kuye ngembangela:

• Ama-Vasopressor:Lezi zinikezwa ukwandisa umfutho wegazi. Isibonelo, imithi efana ne-`epinephrine`, `vasopressin`, `norepinephrine` noma `phenylephrine`.
• Ama-antibiotic : Uma kukhona ukutheleleka.
• Ama-Antihistamine: Uma kungenxa yokusabela kokungezwani komzimba.
• Ama-Steroids: Ekwelapheni ukungezwani komzimba noma i-sepsis enzima.
• I-Albuterol inhaler (njenge-Accuneb® noma i-Proair®HFA): Uma ukushaqeka kubangelwa yi-asthma.

Ingabe ikhona imiphumela emibi yokwelashwa?

Yebo, eminye imithi ingabangela imiphumela emibi emincane.

• Ama-Vasopressor: ukushaya kwenhliziyo okungajwayelekile (i-arrhythmia), ukungaphumuli, ukuvuvukala kwamaphaphu, ubuhlungu besifuba, ukuncipha kwemithambo yenhliziyo (lokhu kungaholela ekuhlaselweni yinhliziyo).
• Ama-antibiotic : Isicanucanu, ukuhlanza.
• I-Albuterol: Ukukhathazeka, isiyezi, isicanucanu.
• Ama-Antihistamine: Ukozela, isiyezi, ikhanda elibuhlungu, ukushaya kwenhliziyo okusheshayo.

Kodwa, odokotela bazobheka konke lokhu futhi bakunikeze ukwelashwa okufanele kakhulu. Into ebaluleke kakhulu ukusindisa impilo yakho.

Singayinciphisa kanjani le ngozi?

Singase singakwazi ukugwema konke okubangela ukushaqeka kokusabalalisa. Isibonelo, ukutheleleka nokusha. Kodwa-ke, kunezinto ezithile esingazenza ukunciphisa ingozi yalokhu kushaqeka ngenxa yezinkinga ezithile ezaziwayo:

• Uma une-allergy enkulu yokudla , njenge-peanut, hlala uphethe i-epinephrine auto-injector (njenge-EpiPen® Auto-Injector noma i-Adrenalin®). Yazi kahle ukuthi uyisebenzisa kanjani.
• Uma uvame ukuzizwa ukhwehlela yi-asthma , hlala unaso i-albuterol noma i-salbutamol inhaler yakho. Ungavumeli ukuthi iphele.
• Uma usebenzisa ama-tampon, ungawashiyi isikhathi eside kakhulu, ngoba lokhu kungabangela i-Toxic Shock Syndrome, engaqhubekela ku-Distributive Shock.
• Ungagxumeli emanzini angajulile noma emanzini anokujula okungaziwa. Kungabangela umonakalo emgogodleni.
• Uma uthatha imithi evula imithambo yegazi yakho, ungayithathi kakhulu. Thatha kuphela inani udokotela wakho akutshele ukuthi ulithathe.

Kwenzekani uma kwenzeka 'ukushaqeka kokusabalalisa'?

Uma imbangela yokushaqeka kuyi-sepsis, ungase ube nezinkinga zesikhathi eside. Izinto ezifana nokukhathala, amaphupho amabi, nokulahlekelwa yisifiso sokudla. Kungakhathaliseki ukuthi imbangela iyini, kufanele uqhubeke ubona udokotela wakho ukuze uthole ama-aphoyintimenti okulandelela. Kufanele futhi uphuze imithi udokotela wakho ayinikezayo ngqo.

Isikhathi esithathayo ukuze ululame ekushaqekeni okusabalalisa sincike ekutheni bekukubi kangakanani. Kungase kudingeke uhlale esibhedlela izinsuku ezimbalwa kuya emavikini ambalwa.

Izinga lokusinda kwalesi simo lingahluka kusuka ku-20% kuya ku-80%, kuye ngokuthi imbangela ikuphi. Uma singelashwa, singaholela ekufeni. Ukuxilongwa kusenesikhathi kanye nokwelashwa kuyindlela engcono kakhulu yokusindisa impilo. Asebekhulile, labo abaphuza utshwala, kanye nalabo abanezinkinga eziningi zezitho zomzimba basengozini enkulu.

Uma umzimba wakho usabela kahle eziwuketshezini ze-IV futhi izitho zakho ziqhubeka nokusebenza, unethuba elihle lokululama.

Ngizinakekela kanjani ngemva kokufika ekhaya?

Ngemva kokufika ekhaya uvela esibhedlela, zinakekele njengoba udokotela wakho ekutshelile. Kungase kudingeke uhlale ekhaya izinsuku ezimbalwa noma amasonto ukuze uphumule kahle ngaphambi kokuba ubuyele emsebenzini. Gcina ama-aphoyintimenti akho okulandelela. Thatha imithi yakho njengoba uyalelwe.

Uma uzizwa sengathi unenkinga futhi ngesikhathi usekhaya, shayela udokotela wakho ngokushesha.

Esimweni esiphuthumayo: Noma ubani onezimpawu zokushaqeka okusabalalayo kufanele ayiswe ekamelweni lezimo eziphuthumayo ngokushesha. Kuze kufike i-ambulensi, cela umuntu oshaqekile alale phansi. Mmboze ngengubo ukuze ahlale efudumele, bese uphakamisa imilenze yakhe cishe ngonyawo ukuze uthuthukise ukujikeleza kwegazi.

Yimiphi imibuzo okufanele uyibuze udokotela?

Uma ubhekene nalesi simo, kuwumqondo omuhle ukubuza udokotela wakho ngezinto ezifana nalezi:

• Ingabe ngisengozini yokuthola 'ukushaqeka kokusabalalisa' futhi?
• Kukangaki ngidinga ukuza ngezikhathi zokulandelela?
• Ingabe ngizoba nemiphumela yesikhathi eside evela ku-'Distributive Shock'?

Okokugcina, okufanele ukukhumbule (Umyalezo Wokuya Ekhaya)

I-Distributive Shock iyisimo esiphuthumayo sezokwelapha esidinga ukwelashwa okusheshayo. Ukuthola usizo ngokushesha okukhulu kuyithuba lakho elihle kakhulu lokusindisa impilo yakho. Kuthatha isikhathi ukululama, ngakho-ke yiba nesineke. Ngesikhathi usekhaya, thatha imithi yakho njengoba nje udokotela wakho ekuyalele, bese uya kodokotela njalo. Njengoba ubona, lesi yisimo esibi kakhulu. Ngakho-ke kubalulekile ukuqaphela lokhu.

Ukushaqeka okusabalalisa, ukushaqeka kwe-septic, ukushaqeka kwe-anaphylactic, ukushaqeka kwe-neurogenic, umfutho wegazi ophansi, ukwelashwa kokushaqeka, i-sepsis