Tshutshisa

Ngenxa yokuphuma kweemvelaphi ezahlukahlukeneyo (umonakalo, ukuhlinzwa, umonakalo wangaphakathi), umthamo wegazi ojikelezayo (BCC) wehla. Ngokuxhomekeke kwintsebenzo yokulahleka kwe-biological fluid, i- oksijini yindlala yanda, kwaye xa ngaphezu kwe-500 ml yokulahleka kwegazi kuvela, ukutshatyalaliswa okukhulu kunokwenzeka. Le yimeko eyingozi kakhulu, echaphazelekayo ngesiphumo esibulalayo ngenxa yokupheliswa kwegazi kwimizimba yengqondo kunye nemiphunga.

Ukwahlula kokutshatyalaliswa okukhulu

Ukongezelela kwintsebenzo, kwimeko yokulahleka kwegazi, izinga lokuhamba kwe-biological fluid libaluleke kakhulu. Kwinqanaba elincinci, ukulahlekelwa kwindleko yegazi (ukuya kuma-1.5 ilitha) akuyona ingozi njengoko kuphuma ngokukhawuleza.

Ngokuhambelana nale nto, izigaba ezilandelayo zokutshatyalaliswa kwamanzi ziyahluka:

1. Isigaba sokuqala siyahlawulwa. Ukuhla kwe-BCC ayikho ngaphezulu kwe-25%. Njengomthetho, ixhoba liyazi, uxinzelelo lwegazi luyancipha, kodwa ngokulinganisela, i-pulse ibuthakathaka, i-tachycardia-ukuya kwi-beat be-110 ngomzuzu. Ikhumba libonakala liphaphazele kwaye libandayo.
2. Isigaba sesibini siyahlawulwa. Ukulahleka kwegazi kufinyelele kwi-40% ye-BCC. Kukhona i-acrocyanosis, ukuphazamiseka kukuphazamiseka, uxinzelelo luyancitshiswa kakhulu, i-pulse yintambo efana nentambo, i- tachycardia- ukuya kwi-140 ngeengqungquthela ngomzuzu. Ukongezelela, i-oliguria, i-dyspnea, i-coldness of ends can be noted.
3. Isigaba sesithathu asinakuguquka. Ukutshatyalaliswa kwamanzi okugqithiseleyo kunempawu ezibonakalisa imeko eyingozi kakhulu kwisigulane: ukulahlekelwa ngokupheleleyo, umbala weempawu zesikhumba (i-pallor eneemvelaphi ezibonakalayo zemithambo yegazi). Ukulahleka kwegazi kudlula i-50% ye-BCC yonke. I-Tachycardia iphumelela nge-160 beats ngomzuzu, uxinzelelo lwe-systolic lingaphantsi kwama-60 mm Hg. I-pulse inzima kakhulu ukuyiqonda.

Isigaba sokugqibela sifaka ukusetyenziswa kweendlela zokuvuselela ngokukhawuleza.

Ukunyamekela ngokukhawuleza ukutshatyalaliswa kwamandla

Emva kwefowuni yeqela lezonyango, kucetyiswa ukuba kuthathe amanyathelo anjalo:

1. Yeka ukuphuma kwegazi, ukuba kubonakala, kuzo zonke iindlela ezikhoyo (ukutshisa, ukuxhoma, ukuxubusha isilonda).
2. Ukupheliswa kwanoma yiyiphi into ephazamisa ukuphefumla okuqhelekileyo. Kubalulekile ukuwusula i-collar eqinisiweyo, ukususa emlonyeni emacaleni amazinyo, ukuhlanza, izidumbu zangaphandle (ngokuphindaphindiweyo emva kwengozi yemoto), thintela ulwimi ukuba luwele kwi-nasopharynx.
3. Ukuba kunokwenzeka, banike abantu imithi yeengxaki ezingenayo i-narcotic pain (Fortral, Lexir, Tramal), ezingathinteli ukujikeleza kwegazi kunye nomsebenzi wokuphefumula.

Akukho cetyiswa ukuhambisa umntu olimele, ngakumbi xa ukuphuma kwamanzi kungaphakathi.

Ukunyangwa kokutshatyalaliswa kwamanzi ngexesha lokubhedlelelwa esibhedlele

Emva kokuvavanya imeko yesigulane, ukulinganisa ingcinezelo yegazi, isantya senhliziyo, ukuphefumula, ukuzinza, ukukhupha ukukhuselwa. Eminye imisebenzi:

1. Ukufuthwa kwe-oxygen ngama-catheters (intranasal) okanye imaski.
2. Ukubonelela ukufikelela kwisitya se-vascular. Kule nto, umvini ophakathi ucocekile. Ngokulahlekelwa okungaphezu kwe-40% ye-bcc, i-vein enkulu ye-femin isetyenziswa.
3. Ukunyangwa kwamachiza kunye nokusungulwa kwezisombululo ze-crystalloid okanye ze-colloidal, ukuba ukuphuma kwamanzi kukhulu kwaye kuninzi-i-erythrocyte.
4. Ukufakwa kwecatheter yeFoley ukulawula ukucima kweeyure kunye nokudibanisa (ukuvavanya ukuphumelela kwe-infusions).
5. Uvavanyo lwegazi.
6. Injongo yokubambisa (inzala) kunye neziyobisi ezihambelanayo.

Xa ukulahleka kwegazi kungaphezu kwama-40% omthamo we-biological fluid, unyango lwe-infusion kufuneka lwenziwe kwiimvini ezange-2-3 ngokufanayo, ngokuhambelana ne-inhalation ye-100% oksijini ngokusebenzisa imaski ye-anesthetic. Kwakhona, iilenki ze-dopamine eziqukethe izidakamizwa okanye i-epinephrin ziyadingeka.