Ukutshatyalaliswa kwe-Hypovolemic

Ukutshatyalaliswa kwe-Hypovolemic yimeko engxamisekileyo apho igazi elibi okanye enye ilahleko yamanzi yenza intliziyo ingakwazi ukupompa igazi elaneleyo emzimbeni. Olu hlobo lokothuka lunokubangela ukuba amalungu amaninzi ayeke ukusebenza.

Ukuphulukana nesiqingatha segazi okanye isixa esiqhelekileyo segazi emzimbeni wakho kubangela ukothuka.

Ukuphulukana negazi kunokuba ngenxa:

• Ukopha ukusuka ekusikeni
• Ukopha ekonzakaleni
• Ukopha ngaphakathi, njengakwiphepha lesisu

Inani lokujikeleza kwegazi emzimbeni wakho nalo linokuhla xa ulahlekelwa lulwelo oluninzi lomzimba kwezinye izizathu. Oku kunokuba ngenxa:

• Ukutsha
• Urhudo
• Umbilo ogqithisileyo
• Ukuhlanza

Iimpawu zingabandakanya:

• Ixhala okanye ukuphazamiseka
• Epholileyo, ulusu olushushu
• Ukudideka
• Ukwehla okanye ukungabikho kwemveliso yomchamo
• Ubuthathaka ngokubanzi
• Umbala wesikhumba omdaka (pallor)
• Ukuphefumla ngokukhawuleza
• Ukubila, ulusu olumanzi
• Ukungazi (ukungabikho kokuphendula)

Ukwanda kokulahleka kwegazi okukhula ngokukhawuleza, kokukhona zisiba qatha iimpawu zokothuka.

Uvavanyo lomzimba luya kubonisa iimpawu zokothuka, kubandakanya:

• Uxinzelelo lwegazi oluphantsi
• Ubushushu obuphantsi bomzimba
• Ukubetha ngokukhawuleza, kuhlala kubuthathaka kwaye sele kulungile

Uvavanyo olunokwenziwa lunokubandakanya:

• I-chemistry yegazi, kubandakanya novavanyo lomsebenzi wezintso kunye nolo vavanyo lufuna ubungqina bomonakalo wentliziyo
• Gcwalisa ubalo lwegazi (CBC)
• Ukuskena i-CT, i-ultrasound, okanye i-x-reyi yemimandla ekrokrelwayo
• Uvavanyo lwe-Echocardiogram - isandi sokuvavanywa kwentliziyo kunye nokusebenza
• Electrocardiogram
• I-Endoscopy - ityhubhu ebekwe emlonyeni ukuya esiswini (i-endoscopy ephezulu) okanye i-colonoscopy (ityhubhu ebekwe nge-anus ukuya kwisisu esikhulu)
• Intliziyo yasekunene (Swan-Ganz) catheterization
• I-catheterization ye-Urinary (ityhubhu ibekwe kwisinyi ukulinganisa ukuphuma komchamo)

Ngamanye amaxesha, olunye uvavanyo lunokwenziwa ngokunjalo.

Fumana uncedo lwezonyango kwangoko. Okwangoku, landela la manyathelo:

• Gcina umntu ekhululekile kwaye eshushu (ukuthintela i-hypothermia).
• Makhe umntu alale ethe tywa iinyawo eziphakanyiswe malunga nee-intshi ezili-12 (iisentimitha ezingama-30) ukwandisa ukujikeleza. Nangona kunjalo, ukuba umntu unentloko, intamo, umqolo, okanye ukulimala emlenzeni, ungatshintshi indawo yomntu ngaphandle kokuba usengozini kwangoko.
• Musa ukunika ulwelo ngomlomo.
• Ukuba umntu unesifo sokungaziphathi kakuhle, phatha ukusabela okungafunekiyo, ukuba uyazi njani.
• Ukuba umntu kufuneka ethwelwe, zama ukumgcina ethe tyaba, intloko ijonge phantsi kwaye iinyawo ziphakanyisiwe. Zinzisa intloko nentamo ngaphambi kokuba uhambise umntu owonzakeleyo omqolo.

Injongo yonyango esibhedlele kukubuyisela igazi kunye neencindi. Umgca otofelweyo (IV) uya kufakwa engalweni yomntu ukuvumela ukuba kunikwe igazi okanye iimveliso zegazi.

Amayeza afana ne-dopamine, i-dobutamine, i-epinephrine, kunye ne-norepinephrin inokufuneka ukuze inyuse uxinzelelo lwegazi kunye nenani legazi elikhutshwe entliziyweni (ukuphuma kwentliziyo).

Iimpawu kunye neziphumo ziyahluka, kuxhomekeke:

• Isixa segazi / umthamo wamanzi ulahlekile
• Ireyithi yokulahleka kwegazi / ulwelo
• Ukugula okanye ukwenzakala okubangela ilahleko
• Iimeko zonyango ezingapheliyo, ezinje ngeswekile kunye nentliziyo, imiphunga, kunye nesifo sezintso, okanye ezinxulumene nokwenzakala

Ngokubanzi, abantu abaneedigri ezothusayo badla ngokwenza ngcono kunabo bothuka kakhulu. Ukothuka kakhulu kunokukhokelela ekufeni, nokuba unganikwa unyango kwangoko. Abantu abadala abadala banamathuba okuba neziphumo ezibi ngenxa yokothuka.

Iingxaki zinokubandakanya:

• Ukonakala kwezintso (kunokufuna ukusetyenziswa kwethutyana okanye okusisigxina ngomatshini we-dialysis)
• Umonakalo wobuchopho
• Ukudanjiswa kweengalo okanye imilenze, ngamanye amaxesha kukhokelela ekunqunyulweni
• Ukuhlaselwa yintliziyo
• Omnye umonakalo kumalungu
• Ukufa

Ukutshatyalaliswa kwe-Hypovolemic yimeko engxamisekileyo yezonyango. Fowunela inombolo yongxamiseko yendawo (enje ngo-911) okanye uthathe umntu lowo umse kwigumbi likaxakeka.

Ukuthintela ukothuka kulula kunokuzama ukuyinyanga yakuba yenzekile. Ukunyanga ngokukhawuleza unobangela kuya kunciphisa umngcipheko wokuba nomothuko omkhulu. Uncedo lokuqala kwangoko lunokunceda ekulawuleni ukothuka.

Umothuko - uhanahaniso

I-Angus DC. Sondela kwisigulana ngokothuka. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 98.

UDries DJ. I-Hypovolemia kunye nokothuka okwenzekileyo: ulawulo lwezonyango. Ku: Parrillo JE, Dellinger RP, ii-eds. Unyango oluKhathalelayo oluBalulekileyo: Imigaqo yokuchongwa kunye noLawulo kuLuntu oluDala. Umhla we-5. IPhiladelphia, PA: Elsevier; I-2019: isahluko 26.

Intombazana enguMJ, i-Peake SL. Ushwankathelo lokothuka. Ku: Bersten AD, Handy JM, ii-eds. Incwadana yoKhathalelo oluKhulu. Ngomhla we-8. IPhiladelphia, PA: Elsevier; I-2019: isahl. 15.

IPuskarich MA, uJones AE. Umothuko. Ku: Iindonga RM, iHockberger RS, iGausche-Hill M, ii-eds. Unyango lukaRosen oluNgxamisekileyo: iikhonsepthi kunye nokuziqhelanisa neklinikhi. Umhla we-9. IPhiladelphia, PA: Elsevier; I-2018: isahluko 6.