Human blood is to maintain the most basic material of life, if the accident caused the bleeding body of a site to how to do » Very often we have no players put on the necessary equipment to stop bleeding, then try our hands.
Started bleeding from his hands
Means of pressure to stop bleeding artery bleeding is the most rapidly a temporary stop bleeding, is a finger or hand injuries in the top of the force, arterial pressure deflated in the bone, blocking blood through in order to immediately stop bleeding, but only in the body more Superficial location, easy to oppression of the artery.
1. Brachial artery bleeding oppression of the law applicable to the hand, forearm and the lower part of the upper arm bleeding. Bleeding or with the thumb is that the remaining four in the upper arm medial arterial pulse, blood pressure will be to the humerus, to stop bleeding purposes.
2. Femoral artery to stop bleeding oppression of the law applicable to the lower limbs bleeding. Haemostasis in the groin (thigh roots) midpoint of partial, artery beating, with two-handed thumb overlap oppression shares in the femoral artery, to stop bleeding.
3. Oppression of oppression head bleeding ears before the carotid artery, apply to the front of the head bleeding. Facial bleeding, the oppression of mandibular angle of the jaw before the concave artery. The larger head and face bleeding, airway pressure on both sides of the neck carotid artery, but not on both sides of oppression.
4. Hand oppression hemostasis such as palm bleeding, oppression and radial artery ulnar artery. Fingers bleeding, bleeding finger pressure on both sides of the artery.
5. Foot oppression hemostasis foot bleeding, oppression and the anterior tibial artery posterior tibial artery.
Aug 1, 2008
After the psychological shock of the elderly care characteristics
The elderly shock is clear, it may accept to give nurses a good psychological impact.
(A) of the patients for psychological comfort
The sense of shock patients is clear, the sudden change in the condition have a different psychological effects, such as fear, fear, anxiety and so on, these reactions and shock will be formed between the vicious cycle of negative feedback. Nurses to select the appropriate language to comfort patients, patience to explain the changes in condition, to stabilize the patient mood, reduce patient suffering. Nurses in the implementation of the rescue, to speak softly and carefully, to lightweight and elegant manners, work should be prudent and orderly manner, to influence a mental patient, calm and strengthen their confidence.
(B) to patients for safe and comfortable position
Patients can take to the semi-Zuowo place (bedside elevation 30), and lower limb pick up high 30, to reduce the abdominal organs of cardiopulmonary oppression, to breathe and the promotion of coronary circulation, and conducive to the lower extremity venous reflux, this will not only promote Shock of recovery, and patients can feel comfortable.
(C) to the loving care of the patient
Retaining should always observe the patient's pulse, blood pressure, breathing and urine, and so on, and keep records. To care for patients, asking patients what not, what is required, patience to answer questions and timely solutions to the reasonable demands of patients, so that patients feel comfortable, with better treatment and care.
(D) to observe the particular patient's symptoms
Reflects the spirit of symptoms the patient's central nervous system, particularly the brain's blood perfusion and the amount of oxygen, the disease is the overall significance of the judgement. In mild hypoxia, mainly patients performance of excitement, anxiety, irritability, even manic. If this view is correct hypoxia, the patient's emotions, awareness and behaviour could resume normal. However, the shock continues to increase, the brain function by inhibiting exciting turn, expressed as indifferent, slow and sluggish, to be followed for all absurd, coma, it is dangerous signal. If the brain and other organs to improve the blood supply, hypoxia corrected, the patient's awareness will be followed sober.
(E) of nurses to patients should be accompanied by friends and relatives or the comfort of work
Advise them not to show the patient before the emotional fluctuations interfere with the patient Xinxu quiet. And guide them to some simple life care technology, to meet the medical staff do a good job.
(A) of the patients for psychological comfort
The sense of shock patients is clear, the sudden change in the condition have a different psychological effects, such as fear, fear, anxiety and so on, these reactions and shock will be formed between the vicious cycle of negative feedback. Nurses to select the appropriate language to comfort patients, patience to explain the changes in condition, to stabilize the patient mood, reduce patient suffering. Nurses in the implementation of the rescue, to speak softly and carefully, to lightweight and elegant manners, work should be prudent and orderly manner, to influence a mental patient, calm and strengthen their confidence.
(B) to patients for safe and comfortable position
Patients can take to the semi-Zuowo place (bedside elevation 30), and lower limb pick up high 30, to reduce the abdominal organs of cardiopulmonary oppression, to breathe and the promotion of coronary circulation, and conducive to the lower extremity venous reflux, this will not only promote Shock of recovery, and patients can feel comfortable.
(C) to the loving care of the patient
Retaining should always observe the patient's pulse, blood pressure, breathing and urine, and so on, and keep records. To care for patients, asking patients what not, what is required, patience to answer questions and timely solutions to the reasonable demands of patients, so that patients feel comfortable, with better treatment and care.
(D) to observe the particular patient's symptoms
Reflects the spirit of symptoms the patient's central nervous system, particularly the brain's blood perfusion and the amount of oxygen, the disease is the overall significance of the judgement. In mild hypoxia, mainly patients performance of excitement, anxiety, irritability, even manic. If this view is correct hypoxia, the patient's emotions, awareness and behaviour could resume normal. However, the shock continues to increase, the brain function by inhibiting exciting turn, expressed as indifferent, slow and sluggish, to be followed for all absurd, coma, it is dangerous signal. If the brain and other organs to improve the blood supply, hypoxia corrected, the patient's awareness will be followed sober.
(E) of nurses to patients should be accompanied by friends and relatives or the comfort of work
Advise them not to show the patient before the emotional fluctuations interfere with the patient Xinxu quiet. And guide them to some simple life care technology, to meet the medical staff do a good job.
Burn after eating Conditioning
The fire in the first first-aid measures are "fire", that is, removal of the source injured, as far as possible "burn less, burning shallow point." But after the burn care can not be ignored.
First, the importance of diet
1. Supplementary diet is the most important means of nutrients.
2. Dietary supplements of the nutrient more comprehensive, convenient and economical.
3. A reasonable diet, is conducive to wound healing, improving the general situation, shortening the length of stay.
Second, restaurants with the allocation of time:
1. Morning, evening meals by the staple food rice and pasta, vegetables and meat (including fish, chicken, ducks, rabbits, cattle, pork, etc.).
You Su Hun meals shall have to ensure that the human body daily for most of the nutrients added.
2. Meals and before bed can increase between milk, soy milk, eggs, Oufen, cakes, and so on.
3. Meal after meal supplemented with fruits, to stimulate the appetite and help digestion, multi-vitamin supplement.
4. ① injury after 1-2 days or less consumption of fasting, began three days to test a small meal, such as Mi Tang, such as 3-of-6 / day, each 50-100 ml, after the gradual increase in milk , Broth, and so on, into 3-8 meals a day to talk, Yi Xiaohua suitable diet. ② 1 week after eating can be changed to a half-juice-juice diet, eating Roumo porridge, fish watery gruel, Steaming, noodles, and so on. ③ if patients digestive function well, catering to gradually restore patients with general.
Third, the diet Attention
1. More consumption, particularly more fresh eggs, beans and its products easy to absorb the high-quality protein.
2. Shaoshi provocative spicy food, such as pepper, ginger, garlic, and so on.
First, the importance of diet
1. Supplementary diet is the most important means of nutrients.
2. Dietary supplements of the nutrient more comprehensive, convenient and economical.
3. A reasonable diet, is conducive to wound healing, improving the general situation, shortening the length of stay.
Second, restaurants with the allocation of time:
1. Morning, evening meals by the staple food rice and pasta, vegetables and meat (including fish, chicken, ducks, rabbits, cattle, pork, etc.).
You Su Hun meals shall have to ensure that the human body daily for most of the nutrients added.
2. Meals and before bed can increase between milk, soy milk, eggs, Oufen, cakes, and so on.
3. Meal after meal supplemented with fruits, to stimulate the appetite and help digestion, multi-vitamin supplement.
4. ① injury after 1-2 days or less consumption of fasting, began three days to test a small meal, such as Mi Tang, such as 3-of-6 / day, each 50-100 ml, after the gradual increase in milk , Broth, and so on, into 3-8 meals a day to talk, Yi Xiaohua suitable diet. ② 1 week after eating can be changed to a half-juice-juice diet, eating Roumo porridge, fish watery gruel, Steaming, noodles, and so on. ③ if patients digestive function well, catering to gradually restore patients with general.
Third, the diet Attention
1. More consumption, particularly more fresh eggs, beans and its products easy to absorb the high-quality protein.
2. Shaoshi provocative spicy food, such as pepper, ginger, garlic, and so on.
The use of health sliver will cause toxic shock?
I was a young woman. Menstrual line, often using health sliver. However, the sliver of the Manual of Health wrote: To guard against toxic shock syndrome occurred. Does the existence of such a situation »
Miss Wu in Nanjing, Jiangsu Miss Wu:
Health sliver (or health suppository) such as the finger-shaped, about 4 centimeters, when inserted in the vagina passing through. Health sliver can absorb blood so that the perineum maintain a clean dry after use without discomfort, but action free, popular President of all ages. However, health sliver is not perfect, and sometimes lead to toxic shock syndrome. This is because the intestinal bacteria into the vagina almost all. Women per milliliter of normal vaginal fluid contains about 100 million the number of bacteria, Staphylococcus aureus menstrual period the detection rate can be as high as 17%. Originally a vaginal self-purification, menstrual blood, the brain drain is also a kind of self-purification. The use of health sliver, the menstrual blood was adsorbed on the sliver of Staphylococcus aureus that is, in the health sliver of the large number of breeding and release toxins. The experts also observed that the health sliver can absorb vaginal epithelium of mucus and water so that it becomes dry, and there can not be observed by the naked eye to the minor ulcers, to absorb toxins created the conditions.
Once the toxins into the blood, in the near future disease, manifested as high fever, accompanied by headache, malaise, vomiting, diarrhea, blood pressure dropped, leading to toxic shock and a heart, liver, kidney and other multiple organ failure and even death . Toxic shock syndrome Although the incidence rate of only 10,000, but with the health sliver number of users increased, the incidence of will of a rising trend.
Therefore, you should use every four to six hours to replace a night to sleep, the best use toilet paper or Weisheng Mian, in order to reduce the incidence of toxic shock syndrome.
Miss Wu in Nanjing, Jiangsu Miss Wu:
Health sliver (or health suppository) such as the finger-shaped, about 4 centimeters, when inserted in the vagina passing through. Health sliver can absorb blood so that the perineum maintain a clean dry after use without discomfort, but action free, popular President of all ages. However, health sliver is not perfect, and sometimes lead to toxic shock syndrome. This is because the intestinal bacteria into the vagina almost all. Women per milliliter of normal vaginal fluid contains about 100 million the number of bacteria, Staphylococcus aureus menstrual period the detection rate can be as high as 17%. Originally a vaginal self-purification, menstrual blood, the brain drain is also a kind of self-purification. The use of health sliver, the menstrual blood was adsorbed on the sliver of Staphylococcus aureus that is, in the health sliver of the large number of breeding and release toxins. The experts also observed that the health sliver can absorb vaginal epithelium of mucus and water so that it becomes dry, and there can not be observed by the naked eye to the minor ulcers, to absorb toxins created the conditions.
Once the toxins into the blood, in the near future disease, manifested as high fever, accompanied by headache, malaise, vomiting, diarrhea, blood pressure dropped, leading to toxic shock and a heart, liver, kidney and other multiple organ failure and even death . Toxic shock syndrome Although the incidence rate of only 10,000, but with the health sliver number of users increased, the incidence of will of a rising trend.
Therefore, you should use every four to six hours to replace a night to sleep, the best use toilet paper or Weisheng Mian, in order to reduce the incidence of toxic shock syndrome.
Aprotinin agents can cause serious adverse reactions
State Food and Drug Administration on November 9 release of information: the National Adverse Drug Reaction Monitoring Center monitoring, received a total of some domestic pharmaceutical production and production of aprotinin agents report cases of adverse reactions 229 cases, including cases of serious adverse reaction report 49 cases, the main adverse reaction to allergy-like reaction, anaphylactic shock, hemoglobin urine, nausea, chills, vomiting, chest tightness, difficulty in breathing, urticaria, hypotension, and so on.
State Food and Drug Administration are organizing the relevant departments and experts, on China's aprotinin in clinical use and to evaluate security issues, and will take corresponding measures.
Aprotinin is a broad-spectrum protease inhibitors, can be used to regulate heart pump (CPB) surgery caused by the body inflammatory response (SIR). SIR can activate the relevant bleeding, fibrinolysis, and inflammation system cells and body fluids. Aprotinin and through its effect on a variety of media (such as vascular-Shu, plasmin enzyme) can reduce the inflammatory response, fibrinolytic response and the formation of thrombin. Manual indications for the prevention of drug use, for the implementation of pump coronary artery bypass surgery patients to reduce bleeding during surgery, and the corresponding reduced demand for blood transfusion.
National Adverse Drug Reaction Monitoring Centre in November 2004, "Adverse Drug Reaction communications" section 7, issued a safety of the drugs information, suggesting that the drugs can cause serious adverse reactions, the proposed clinicians strictly indications , To strengthen monitoring of medication.
It is learnt that recently the U.S. Food and Drug Administration (FDA) announced that, should the FDA request, Bayer pharmaceutical companies agreed to suspend aprotinin injection (aprotinin, trade names: Trasylol) go on sale in the United States. The suspension stems from the Canadian patients with a clinical trial (BART), test results showed that the use of aprotinin in patients with increased risk of death. At present, China's market has not approved the import aprotinin drug sales.
State Food and Drug Administration are organizing the relevant departments and experts, on China's aprotinin in clinical use and to evaluate security issues, and will take corresponding measures.
Aprotinin is a broad-spectrum protease inhibitors, can be used to regulate heart pump (CPB) surgery caused by the body inflammatory response (SIR). SIR can activate the relevant bleeding, fibrinolysis, and inflammation system cells and body fluids. Aprotinin and through its effect on a variety of media (such as vascular-Shu, plasmin enzyme) can reduce the inflammatory response, fibrinolytic response and the formation of thrombin. Manual indications for the prevention of drug use, for the implementation of pump coronary artery bypass surgery patients to reduce bleeding during surgery, and the corresponding reduced demand for blood transfusion.
National Adverse Drug Reaction Monitoring Centre in November 2004, "Adverse Drug Reaction communications" section 7, issued a safety of the drugs information, suggesting that the drugs can cause serious adverse reactions, the proposed clinicians strictly indications , To strengthen monitoring of medication.
It is learnt that recently the U.S. Food and Drug Administration (FDA) announced that, should the FDA request, Bayer pharmaceutical companies agreed to suspend aprotinin injection (aprotinin, trade names: Trasylol) go on sale in the United States. The suspension stems from the Canadian patients with a clinical trial (BART), test results showed that the use of aprotinin in patients with increased risk of death. At present, China's market has not approved the import aprotinin drug sales.
What are allergic shock performance
Anaphylactic shock (anaphylaxis, anaphylactic shock) is outside of certain substances into the antigen has sensitized the body, through the immune mechanism in a short period of time in a strong involvement of multiple organ group. Anaphylactic shock performance and level of response by the body, antigen into the volume and channels and are very different. Are usually sudden and very dramatic, if not timely treatment, often life-threatening.
Most of Curan anaphylactic shock occurred about half of patients in the cause of antigen (such as the injection of penicillin G, etc.) within five minutes symptoms, only 10% of patients with symptoms starting in half an hour later, a very small number of patients in the continuous treatment in the process of the Disease.
Anaphylactic shock has two main characteristics: First performance of a shock that the rapid blood pressure dropped to 10.6/6.6 kPa (80/50mmHg) below, a consciousness disorder patients, ranging from dim, then re-coma. The second is in shock before or at the same time, often some of the symptoms associated with allergies. Are as follows.
(A) skin mucosa performance anaphylactic shock is often the earliest and most often the symptoms, including skin Chaohong, itching, followed by extensive and urticaria (or) vessels and nerves of edema; can appear sneeze, water samples nose, Music Dumb, and even affect breathing.
(B) symptoms of obstructive airway disease is the most common performance, but also the main cause of death. As airway edema, secretions increase, coupled with jets and (or) bronchial spasms, plug flu patients throat, chest tightness, short breath, wheezing, Bieqi, cyanosis, resulting from suffocation and death.
(C) performance of circulatory failure patients to have palpitations, sweating, looking pale and weak pulse rate and then developed into Zhileng, cyanosis, the rapid decline in blood pressure, pulse disappeared, and even less than measuring blood pressure, leading to cardiac arrest. A small number of patients with existing coronary atherosclerosis may be complicated by myocardial infarction.
(D) awareness of the changes are often first appear fear, irritability and dizziness; with cerebral edema and cerebral hypoxia intensified, in unclear or complete loss of consciousness; can also issued five-stroke type convulsions, limb rigidity, and so on.
(5) Other more common symptoms are irritating cough, for a Ti, nausea, vomiting, abdominal pain, diarrhea, incontinence can occur final.
Most of Curan anaphylactic shock occurred about half of patients in the cause of antigen (such as the injection of penicillin G, etc.) within five minutes symptoms, only 10% of patients with symptoms starting in half an hour later, a very small number of patients in the continuous treatment in the process of the Disease.
Anaphylactic shock has two main characteristics: First performance of a shock that the rapid blood pressure dropped to 10.6/6.6 kPa (80/50mmHg) below, a consciousness disorder patients, ranging from dim, then re-coma. The second is in shock before or at the same time, often some of the symptoms associated with allergies. Are as follows.
(A) skin mucosa performance anaphylactic shock is often the earliest and most often the symptoms, including skin Chaohong, itching, followed by extensive and urticaria (or) vessels and nerves of edema; can appear sneeze, water samples nose, Music Dumb, and even affect breathing.
(B) symptoms of obstructive airway disease is the most common performance, but also the main cause of death. As airway edema, secretions increase, coupled with jets and (or) bronchial spasms, plug flu patients throat, chest tightness, short breath, wheezing, Bieqi, cyanosis, resulting from suffocation and death.
(C) performance of circulatory failure patients to have palpitations, sweating, looking pale and weak pulse rate and then developed into Zhileng, cyanosis, the rapid decline in blood pressure, pulse disappeared, and even less than measuring blood pressure, leading to cardiac arrest. A small number of patients with existing coronary atherosclerosis may be complicated by myocardial infarction.
(D) awareness of the changes are often first appear fear, irritability and dizziness; with cerebral edema and cerebral hypoxia intensified, in unclear or complete loss of consciousness; can also issued five-stroke type convulsions, limb rigidity, and so on.
(5) Other more common symptoms are irritating cough, for a Ti, nausea, vomiting, abdominal pain, diarrhea, incontinence can occur final.
How to anaphylactic shock diagnosis
Anaphylactic shock (anaphylaxis, anaphylactic shock) are Antigenicity outside of certain substances into the body has been sensitized, in a short period of time through the immune mechanism in a strong involvement of multiple organ group. Anaphylactic shock performance and level of response by the body, antigen into the volume and channels and are very different. Are usually sudden and very dramatic, if not timely treatment, often life-threatening.
1. Rapid blood pressure dropped to the level of shock, 10.7/6.7 KPa (80/50mmHg) below. If the original patients suffering from hypertension, systolic blood pressure in the original level Meng fell to 10.7 KPa (80mmHg), can also be considered to have access to state of shock.
2. Fear, flustered, irritability, dizziness or loud shouts and a visually-impaired, as Huang, Huan Shi, diplopia; then dim awareness, and even complete loss of consciousness, reflection and other light reflection weakening or loss.
3. Precursor of allergy symptoms: Chaohong, including the skin or the skin of a pale, chills, etc.; Zhoushen itchy skin or palm itching, skin and mucous membrane Ma flu, the majority of the lips and limbs, Ma flu. Next, with a variety of skin rashes, mostly college-like high winds, heavy to see a large vessels and nerves of subcutaneous edema, or swelling both skin. In addition, the nasal cavity, throat mucous membrane can also occur edema, and a sneeze, the flow of water like the nose, the sound dumb, breathing difficulties and throat spasms, and so on. Many patients with esophageal and the blocking, abdominal discomfort, accompanied by nausea, vomiting, and so on.
4. Allergen exposure history: before there was shock treatment, in particular the history of drug injection, and other specific history of exposure to allergens, including food, inhalation of, of contacts, such as insect sting thorn.
Benbingfasheng soon, it is necessary to make timely diagnosis. Where in the (especially after injection) antigen of the substance or a drug, or bees bites occur immediately after the general reaction, drugs and difficult to explain their pharmacological effects, they should immediately take into account the possibility of this disease, the diagnosis in Not on the general difficulties.
1. Rapid blood pressure dropped to the level of shock, 10.7/6.7 KPa (80/50mmHg) below. If the original patients suffering from hypertension, systolic blood pressure in the original level Meng fell to 10.7 KPa (80mmHg), can also be considered to have access to state of shock.
2. Fear, flustered, irritability, dizziness or loud shouts and a visually-impaired, as Huang, Huan Shi, diplopia; then dim awareness, and even complete loss of consciousness, reflection and other light reflection weakening or loss.
3. Precursor of allergy symptoms: Chaohong, including the skin or the skin of a pale, chills, etc.; Zhoushen itchy skin or palm itching, skin and mucous membrane Ma flu, the majority of the lips and limbs, Ma flu. Next, with a variety of skin rashes, mostly college-like high winds, heavy to see a large vessels and nerves of subcutaneous edema, or swelling both skin. In addition, the nasal cavity, throat mucous membrane can also occur edema, and a sneeze, the flow of water like the nose, the sound dumb, breathing difficulties and throat spasms, and so on. Many patients with esophageal and the blocking, abdominal discomfort, accompanied by nausea, vomiting, and so on.
4. Allergen exposure history: before there was shock treatment, in particular the history of drug injection, and other specific history of exposure to allergens, including food, inhalation of, of contacts, such as insect sting thorn.
Benbingfasheng soon, it is necessary to make timely diagnosis. Where in the (especially after injection) antigen of the substance or a drug, or bees bites occur immediately after the general reaction, drugs and difficult to explain their pharmacological effects, they should immediately take into account the possibility of this disease, the diagnosis in Not on the general difficulties.
Anaphylactic shock easily confused with which disease
Anaphylactic shock (anaphylaxis, anaphylactic shock) is outside of certain substances into the antigen has sensitized the body, through the immune mechanism in a short period of time in a strong involvement of multiple organ group. Anaphylactic shock performance and level of response by the body, antigen into the volume and channels and are very different. Are usually sudden and very dramatic, if not timely treatment, often life-threatening.
Benbingfasheng soon, it is necessary to make timely diagnosis. Where in the (especially after injection) antigen of the substance or a drug, or bees bites occur immediately after the general reaction, drugs and difficult to explain their pharmacological effects, they should immediately be taken into account the possibility of this disease, it was General little difficult diagnosis. However, it should be except for the following circumstances.
(A) vagus vascular syncope (or vagus vascular collapse, vasovagal collapse) occurred after the injection, in particular, the patients have fever, low blood sugar or the tendency of water loss when. Patients Changcheng looking pale, nausea, a cold sweat, could then syncope, it is easily misdiagnosed as anaphylactic shock. However, this disease no itching or rash, syncope sits flat immediately after the turn for the better, although low blood pressure but slow pulse, and these different anaphylactic shock. Vagal syncope vascular Atropine can be used in the treatment.
(B) edema hereditary vascular disease (hereditary angioedema) This is a regular chromosomes from the lack of genetic complement C1 esterase inhibitor of the disease. In some patients may be non-specific factors (such as infection, trauma, etc.) stimulated a sudden onset, for the performance of the skin and mucous membrane of respiratory vascular edema. As the airway obstruction, patients also often wheezing, short breath and extreme difficulty in breathing, and anaphylactic shock is quite similar. However, the onset of slower, and many patients have family history or history of seizures since childhood, when the disease is usually no blood pressure dropped and no urticaria, which can be differentiated from anaphylactic shock.
Anaphylactic shock of the diagnosis of this specific disease prevention is of great significance, the only test for allergens should be lifted after ① In shock; ② the disabled and Kangguominyao grams of antibody after; ③ such as a skin test, the best necessary Anti-shock drug. A small number of patients with negative skin test is still the possibility of occurrence of this disease.
Benbingfasheng soon, it is necessary to make timely diagnosis. Where in the (especially after injection) antigen of the substance or a drug, or bees bites occur immediately after the general reaction, drugs and difficult to explain their pharmacological effects, they should immediately be taken into account the possibility of this disease, it was General little difficult diagnosis. However, it should be except for the following circumstances.
(A) vagus vascular syncope (or vagus vascular collapse, vasovagal collapse) occurred after the injection, in particular, the patients have fever, low blood sugar or the tendency of water loss when. Patients Changcheng looking pale, nausea, a cold sweat, could then syncope, it is easily misdiagnosed as anaphylactic shock. However, this disease no itching or rash, syncope sits flat immediately after the turn for the better, although low blood pressure but slow pulse, and these different anaphylactic shock. Vagal syncope vascular Atropine can be used in the treatment.
(B) edema hereditary vascular disease (hereditary angioedema) This is a regular chromosomes from the lack of genetic complement C1 esterase inhibitor of the disease. In some patients may be non-specific factors (such as infection, trauma, etc.) stimulated a sudden onset, for the performance of the skin and mucous membrane of respiratory vascular edema. As the airway obstruction, patients also often wheezing, short breath and extreme difficulty in breathing, and anaphylactic shock is quite similar. However, the onset of slower, and many patients have family history or history of seizures since childhood, when the disease is usually no blood pressure dropped and no urticaria, which can be differentiated from anaphylactic shock.
Anaphylactic shock of the diagnosis of this specific disease prevention is of great significance, the only test for allergens should be lifted after ① In shock; ② the disabled and Kangguominyao grams of antibody after; ③ such as a skin test, the best necessary Anti-shock drug. A small number of patients with negative skin test is still the possibility of occurrence of this disease.
Australian researchers found that the new toxic shock therapy
Australia's Monash Institute researchers have found a potential treatment of toxic shock and other inflammatory diseases of the new therapy.
1 year 28 million cases of toxic shock, resulting in 500,000 deaths. However, this body has not been excessive immune response and effective treatment methods.
Melbourne, Australia's Monash Institute of Medical Research, Dr Kristian Jones said: "A few years ago, we found another body inflammatory response when the protein activin, it was considered to help stimulate inflammation. We found that in mice in the experiment also follistatin Be the release of activin and combining, but also in and activin. When we give the mice more follistatin, an increase of toxaemia mice on the survival chance. "
Jones said: "We believe that follistatin eased the activin and defeat the inflammatory response."
Toxic shock is the intensive care unit after the heart attack death of the main reasons, need 1 billion U.S. dollars annually for health care. These findings stirred up by the hope of follistatin to save lives.
Human infection by the constant threat, but have adapted to such a threat. Human normal use it to the defense or the immune system to control infection and inflammation.
Sometimes escape the infection defense system and quickly spread to many organs and blood lead to toxic shock. This is a very serious infection and the body needs to control the fierce reaction to it. Sometimes the body quickly over-react strongly, the whole body have been infected and damage their own.
It is precisely because of this toxic shock out of control led to the excessive inflammatory response was damage vital organs and in many cases lead to death.
Jones said: "We are further exploring how follistatin is the interaction with activin, is also looking for business partners, we have found in patients with the toxaemia have a high level of follistatin and activin. If follistatin's role in controlling inflammation was Confirmed, then its rheumatoid arthritis, asthma and other diseases is also helpful. "
1 year 28 million cases of toxic shock, resulting in 500,000 deaths. However, this body has not been excessive immune response and effective treatment methods.
Melbourne, Australia's Monash Institute of Medical Research, Dr Kristian Jones said: "A few years ago, we found another body inflammatory response when the protein activin, it was considered to help stimulate inflammation. We found that in mice in the experiment also follistatin Be the release of activin and combining, but also in and activin. When we give the mice more follistatin, an increase of toxaemia mice on the survival chance. "
Jones said: "We believe that follistatin eased the activin and defeat the inflammatory response."
Toxic shock is the intensive care unit after the heart attack death of the main reasons, need 1 billion U.S. dollars annually for health care. These findings stirred up by the hope of follistatin to save lives.
Human infection by the constant threat, but have adapted to such a threat. Human normal use it to the defense or the immune system to control infection and inflammation.
Sometimes escape the infection defense system and quickly spread to many organs and blood lead to toxic shock. This is a very serious infection and the body needs to control the fierce reaction to it. Sometimes the body quickly over-react strongly, the whole body have been infected and damage their own.
It is precisely because of this toxic shock out of control led to the excessive inflammatory response was damage vital organs and in many cases lead to death.
Jones said: "We are further exploring how follistatin is the interaction with activin, is also looking for business partners, we have found in patients with the toxaemia have a high level of follistatin and activin. If follistatin's role in controlling inflammation was Confirmed, then its rheumatoid arthritis, asthma and other diseases is also helpful. "
Children with septic shock
Overview
Septic shock is the variety of pathogens and toxins from the body after the invasion caused to the microcirculation, tissue perfusion of blood shortage, leading to an important organ of life of acute dysfunction syndrome, and often occur in toxic bacillary dysentery, and the outbreak of ECM, hemorrhagic necrotizing enterocolitis, sepsis, severe pneumonia and acute biliary tract infection and other infectious diseases on the basis of clinical to looking pale and limbs of the cooler skin Fahua, reduce the amount of urine, blood pressure dropped as the main performance. Pediatrics is one of the common critical illnesses.
Clinical performance
1. Or looking pale lips, Zhizhi cyanosis, skin Fahua.
2. Hand, Foot and a cooler filled capillaries to extend the time.
3. Thin-speed pulse, blood pressure measuring less than even decline, the narrow pulse pressure.
4. Urine output reduction.
5. Fuzzy consciousness, a coma or indifferent expression.
6. Anal toe temperature> 6 ℃.
Diagnosis
1. Are the primary infection.
2. Looking pale, peripheral and mucosal cyanosis, skin-like patterns change, peripheral cold.
3. Pulse of small-speed, filling time again capillary> = 2 seconds.
4. Urine output reduction, mild shock five babies per hour ￣ 10 ml, children 10 ￣ 20 ml, severe shock babies per hour less than 5 ml, children less than 10 ml.
5. Measurement of blood pressure dropped to less than, pulse pressure <4 Kpa (30mmHg), early mild shock to normal blood pressure.
6. Make them apathetic, fuzzy consciousness, respiratory markedly accelerated.
Treatment principle
1. Expansion of blood volume, correct acid poisoning.
2. Microcirculation to lift the vessel spasm.
3. Cardiac treatment.
4. Anti-infection.
5. Application of adrenal glucocorticoid.
6. The protection of critical organ function, prevention and treatment of brain edema, heart failure, acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation (DIC) and acute renal failure.
Treatment principle
1. Septic shock, according to the incidence of bacteria on the choice of at least two sensitive to antibiotics, intravenous injection, the dose should be enough, treatment should be enough. Pathogens do not know, the choice of two broad-spectrum, highly effective microbicides, and take into account cocci bacteria, identify pathogens, according to drug sensitivity.
2. Shock patients with various degrees of cardiac function decline in the first batch of quick infusion should be used cardiac drugs, with heart failure, it is necessary to appropriately control the speed and the infusion of liquid aggregate limit Hanna hypertonic dehydration solution and the application of .
3. Fulminant ECM with shock, often disseminated intravascular coagulation and fibrinolysis hyperthyroidism exist, the rescue without waiting for laboratory results when, according to clinical signs and symptoms of immediate treatment, while heparin and 6 -- Amino acid.
4. Shock with acute renal failure, should be accurate calculation of access and maintain water and electrolyte balance, improve the application of dopamine and 654-2 renal microcirculation.
5. Naloxone for morphine receptor antagonist, the antagonism of β-brown Fei's role in reversing the shock when low blood pressure, often used in refractory shock will be good effect, when the shock treatment with traditional methods fails And the timely use of naloxone.
Septic shock is the variety of pathogens and toxins from the body after the invasion caused to the microcirculation, tissue perfusion of blood shortage, leading to an important organ of life of acute dysfunction syndrome, and often occur in toxic bacillary dysentery, and the outbreak of ECM, hemorrhagic necrotizing enterocolitis, sepsis, severe pneumonia and acute biliary tract infection and other infectious diseases on the basis of clinical to looking pale and limbs of the cooler skin Fahua, reduce the amount of urine, blood pressure dropped as the main performance. Pediatrics is one of the common critical illnesses.
Clinical performance
1. Or looking pale lips, Zhizhi cyanosis, skin Fahua.
2. Hand, Foot and a cooler filled capillaries to extend the time.
3. Thin-speed pulse, blood pressure measuring less than even decline, the narrow pulse pressure.
4. Urine output reduction.
5. Fuzzy consciousness, a coma or indifferent expression.
6. Anal toe temperature> 6 ℃.
Diagnosis
1. Are the primary infection.
2. Looking pale, peripheral and mucosal cyanosis, skin-like patterns change, peripheral cold.
3. Pulse of small-speed, filling time again capillary> = 2 seconds.
4. Urine output reduction, mild shock five babies per hour ￣ 10 ml, children 10 ￣ 20 ml, severe shock babies per hour less than 5 ml, children less than 10 ml.
5. Measurement of blood pressure dropped to less than, pulse pressure <4 Kpa (30mmHg), early mild shock to normal blood pressure.
6. Make them apathetic, fuzzy consciousness, respiratory markedly accelerated.
Treatment principle
1. Expansion of blood volume, correct acid poisoning.
2. Microcirculation to lift the vessel spasm.
3. Cardiac treatment.
4. Anti-infection.
5. Application of adrenal glucocorticoid.
6. The protection of critical organ function, prevention and treatment of brain edema, heart failure, acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation (DIC) and acute renal failure.
Treatment principle
1. Septic shock, according to the incidence of bacteria on the choice of at least two sensitive to antibiotics, intravenous injection, the dose should be enough, treatment should be enough. Pathogens do not know, the choice of two broad-spectrum, highly effective microbicides, and take into account cocci bacteria, identify pathogens, according to drug sensitivity.
2. Shock patients with various degrees of cardiac function decline in the first batch of quick infusion should be used cardiac drugs, with heart failure, it is necessary to appropriately control the speed and the infusion of liquid aggregate limit Hanna hypertonic dehydration solution and the application of .
3. Fulminant ECM with shock, often disseminated intravascular coagulation and fibrinolysis hyperthyroidism exist, the rescue without waiting for laboratory results when, according to clinical signs and symptoms of immediate treatment, while heparin and 6 -- Amino acid.
4. Shock with acute renal failure, should be accurate calculation of access and maintain water and electrolyte balance, improve the application of dopamine and 654-2 renal microcirculation.
5. Naloxone for morphine receptor antagonist, the antagonism of β-brown Fei's role in reversing the shock when low blood pressure, often used in refractory shock will be good effect, when the shock treatment with traditional methods fails And the timely use of naloxone.
Children shock
Shock is common in pediatric critical severe, according to the cause can be divided into different reasons: septic shock, anaphylactic shock, cardiogenic shock, hemorrhagic shock, neurogenic shock, and its effective cycle output reduction, Is a common pathophysiological basis. Reduce blood volume, cardiac output and reduce the microcirculation, the shock is the key to the development.
Cause
① septic shock is a serious infection on the basis of the results of interaction between a variety of factors, both humoral factors and the role of cell damage, but also the changes in microcirculation, together form the complicated process of the pathophysiology.
② hemorrhagic shock due to blood loss and more, the loss of so sharp decrease in blood volume.
③ cardiogenic shock due to heart Bengxue dysfunction, cardiac output caused a sharp decrease.
④ anaphylactic shock outsiders antigen enters the body of material generated by the strong reaction of the body, leading to expansion of blood vessels, increased permeability, plasma leakage, the result of sharp decline in blood circulation.
⑤ neurogenic shock occurred in severe pain caused vascular expansion, microcirculation congestion, effective when the sharp decline in circulating blood volume, due to trauma Most of it is also called traumatic shock.
Diagnosis
Primarily on the basis of clinical manifestations, various types of shock is a common feature: looking pale and limbs Jueleng, shortness of breath, Xiruo pulse, blood pressure dropped, urine output reduction, the spirit of Weimi or irritability, and so on.
Infection in infants and young children on the basis of a fever or body temperature or not, looking pale and limbs Jueleng, anorexia, lethargy or irritability, staring eyes, irregular breathing, heart rate> 160 / points, consideration should be given shock.
Older children, after repeated chills high fever, or rectal means (toe) temperature> 6 ℃ above, Jingshenbuzhen, no significant loss of body fluids circumstances orbital depression, body temperature and pulse out of proportion, sweat Lin Li, pulse pressure on the poor, There should also consider the shock.
Advanced disease has become more severe, breathing rhythm is not the whole, skin mucosa cyanosis, limbs Jueleng, Zhoushen a pattern, no palpable pulse or breakdown, measurement of blood pressure lowering or not, reduce the amount of urine, unclear or consciousness to seizures, And frequently have organ failure.
Monitoring
In a simple principle, the following items through the monitoring of the estimated illness and prognosis help:
① drastic changes in temperature: T> 40 ℃ or not or, or anus that (toe) temperature> 6 ℃;
② consciousness change: indifferent, irritability, semi-conscious or unconscious;
③ blood pressure: pulse pressure <2 6kPa (20mmHg), or decreased blood pressure than the original 4 kPa (30mmHg), close to the pulse and blood pressure, pulse if the rules effectively, is also quite normal blood pressure, pulse Xiruo if they fail, blood pressure is also the majority Reduced or no measurement;
④ urine or decreased urine: urine monitoring cycle is an important indicator of the situation, oliguria means school-age children <400 ml / d, pre-school children <300 ml / d, baby <200 ml / d, 24 hours of urine <30 ~ 50m1 said no urine;
⑤ edema, usually with albumin concentrations decrease.
Cause
① septic shock is a serious infection on the basis of the results of interaction between a variety of factors, both humoral factors and the role of cell damage, but also the changes in microcirculation, together form the complicated process of the pathophysiology.
② hemorrhagic shock due to blood loss and more, the loss of so sharp decrease in blood volume.
③ cardiogenic shock due to heart Bengxue dysfunction, cardiac output caused a sharp decrease.
④ anaphylactic shock outsiders antigen enters the body of material generated by the strong reaction of the body, leading to expansion of blood vessels, increased permeability, plasma leakage, the result of sharp decline in blood circulation.
⑤ neurogenic shock occurred in severe pain caused vascular expansion, microcirculation congestion, effective when the sharp decline in circulating blood volume, due to trauma Most of it is also called traumatic shock.
Diagnosis
Primarily on the basis of clinical manifestations, various types of shock is a common feature: looking pale and limbs Jueleng, shortness of breath, Xiruo pulse, blood pressure dropped, urine output reduction, the spirit of Weimi or irritability, and so on.
Infection in infants and young children on the basis of a fever or body temperature or not, looking pale and limbs Jueleng, anorexia, lethargy or irritability, staring eyes, irregular breathing, heart rate> 160 / points, consideration should be given shock.
Older children, after repeated chills high fever, or rectal means (toe) temperature> 6 ℃ above, Jingshenbuzhen, no significant loss of body fluids circumstances orbital depression, body temperature and pulse out of proportion, sweat Lin Li, pulse pressure on the poor, There should also consider the shock.
Advanced disease has become more severe, breathing rhythm is not the whole, skin mucosa cyanosis, limbs Jueleng, Zhoushen a pattern, no palpable pulse or breakdown, measurement of blood pressure lowering or not, reduce the amount of urine, unclear or consciousness to seizures, And frequently have organ failure.
Monitoring
In a simple principle, the following items through the monitoring of the estimated illness and prognosis help:
① drastic changes in temperature: T> 40 ℃ or not or, or anus that (toe) temperature> 6 ℃;
② consciousness change: indifferent, irritability, semi-conscious or unconscious;
③ blood pressure: pulse pressure <2 6kPa (20mmHg), or decreased blood pressure than the original 4 kPa (30mmHg), close to the pulse and blood pressure, pulse if the rules effectively, is also quite normal blood pressure, pulse Xiruo if they fail, blood pressure is also the majority Reduced or no measurement;
④ urine or decreased urine: urine monitoring cycle is an important indicator of the situation, oliguria means school-age children <400 ml / d, pre-school children <300 ml / d, baby <200 ml / d, 24 hours of urine <30 ~ 50m1 said no urine;
⑤ edema, usually with albumin concentrations decrease.
Anaphylactic shock
[Outlined]
Anaphylactic shock (anaphylaxis, anaphylactic shock) is outside of certain substances into the antigen has sensitized the body, through the immune mechanism in a short period of time in a strong involvement of multiple organ group. Anaphylactic shock performance and level of response by the body, antigen into the volume and channels and are very different. Are usually sudden and very dramatic, if not timely treatment, often life-threatening.
[Treatment]
Must act quickly, seize the opportunity to actively address. ① immediately stop and shift into the branch of suspicious allergens, pathogens or drugs. Ligation injection Chong Yao site or over the limb to slow the absorption can also be injected or sting to 0.005 percent of the local adrenaline 2 ~ 5 ml closed injection. ② immediately to 0.1 percent adrenaline, the first subcutaneous injection of 0.3 ~ 0.5 ml, then injected into a vein puncture 0.1 ~ 0.2 ml, followed by 5 percent drop glucose injection, to maintain smooth flow of intravenous injection. Adrenergic receptor β effect through the rapid relaxation of bronchial spasms, through α receptor effect on the peripheral vascular contraction. It can also confront some of the media allergic Ⅰ-release, so this is where the first choice of drug, in the course of the applications can be repeated several times. General after 1 or 2 times epinephrine injection, most of the patients symptoms of shock in a half-hour can be recovered. Conversely, if not shock sustained improvement is a serious case of early intravenous dexamethasone 10 ~ 20 mg, the acid test-hydride 200 ~ 400 mg. Has the discretion to choose a group of more lasting effect, the side effects of smaller anti-shock drugs such as norepinephrine, Ala Ming (between hydroxylamine). At the same time to vasoactive drugs, blood volume and promptly added, the first infusion of 500 ml can quickly infusion, adult general of the first day of rehydration up to 400 ml. ③ anti-allergic and symptomatic treatment, commonly used is 10 mg or chlorpheniramine promethazine 25 ~ 50 mg, intramuscular, sits flat, oxygen and maintain respiratory smooth.
As in allergic diseases shock when the patient's allergy threshold very low, some of the original may not allergic to the drug allergens. Therefore, the treatment of this medication must not excessive.
[ET]
As allergens cause the disease antigen substances are:
(A) of xenotransplantation (of) the secretion of protein (insulin, vasopressin), the enzyme (chymotrypsin, penicillin-), pollen extract (pig grass, trees, grass), food (egg white, milk, hard shell Fruits, dried seafood, chocolate), anti-serum (anti-serum or anti-lymphocyte IVIG), occupational exposure to the protein (rubber products), the bees toxin.
(B) polysaccharides such as iron dextran.
(C) many commonly used drugs such as antibiotics (penicillin, cephalosporins adriamycin, amphotericin B, nitro furans properly due to taste), local anesthetic (procaine, lidocaine), vitamins (thiamin, folic acid ), Diagnostic agents (iodized X-ray contrast agent, iodine bromide phthalate), the occupational exposure to chemical agents (ethylene oxide).
The vast majority of allergic shock is a typical type Ⅰ multi-organ allergic reaction in the body, especially the cycle of the performance. Outside the antigen of substances (antigens certain drugs is incomplete, but after entering the body with a combination of protein Chengquan antigen) enters the body can stimulate the immune system to produce antibodies, IgE production, due to physical varies widely. These specific IgE cells have a stronger pro-nature, with the skin, bronchial, the vessel walls, and so the "target cells" combination. When the same again after the antigen has been sensitized with the individual contacts, we can inspire much of the allergic type Ⅰ, the process of release of histamine and platelet activating factor, such as edema is caused by multiple organ, such as clinical exudation The direct cause of performance.
In blood, plasma or immunoglobulin in the process of occasionally can be seen rapid onset of anaphylactic shock, they are the cause of three: ① donors with the specific IgE who are receiving treatment by drugs (such as penicillin G) from the reaction . ② selective IgA to the lack of multiple infusion of IgA blood products, can produce the anti-IgA IgG antibody category. When the re-injection of IgA products, it is possible IgA-anti-IgA antibody immune complex, a type Ⅲ allergy caused by anaphylactic shock. ③ for intravenous infusion of gamma globulin (C-) formulations contain high molecular weight of the C-polymer, can activate complement, a C3a, C4a, C5a, and other allergic toxin; then the activation of mast cells produce anaphylactic shock. A small number of patients in the use of drugs such as opium tincture, dextran, a high degree of ionizing X-ray contrast agent or antibiotics (such as polymyxin B), mainly through to the mast cell degranulation, also have allergic shock of clinical manifestations. In recent years, people would not exist allergens and the antibody response, that is through non-immune mechanisms of allergic symptoms and signs called shock-like allergic reaction (anaphylactoid reaction).
[Pathological changes:
Because of this disease and the main features of sudden death: acute pulmonary bleeding and excessive inflation, throat swelling, visceral congestion, pulmonary edema and bleeding. Endoscopic airway submucosal foreseeable edema extremely small airway secretions increase, bronchial and lung stromal vascular congestion associated with eosinophil infiltration, about 80 percent of deaths and myocardial necrosis, or the focal lesions. Spleen, liver and mesenteric vascular also more associated with congestive eosinophil infiltration. There are also a few cases, such as gastrointestinal bleeding.
[Clinical]
Most of Curan of the disease occurred in about half of patients receive cause antigen (such as the injection of penicillin G, etc.) within five minutes symptoms, only 10% of patients with symptoms starting in half an hour later, a very small number of patients in the continuous treatment in the process of this disease .
Anaphylactic shock has two main characteristics: First performance of a shock that the rapid blood pressure dropped to 10.6/6.6 kPa (80/50mmHg) below, a consciousness disorder patients, ranging from dim, then re-coma. The second is in shock before or at the same time, often some of the symptoms associated with allergies. Are as follows.
(A) skin mucosa performance anaphylactic shock is often the earliest and most often the symptoms, including skin Chaohong, itching, followed by extensive and urticaria (or) vessels and nerves of edema; can appear sneeze, water samples nose, Music Dumb, and even affect breathing.
(B) symptoms of obstructive airway disease is the most common performance, but also the main cause of death. As airway edema, secretions increase, coupled with jets and (or) bronchial spasms, plug flu patients throat, chest tightness, short breath, wheezing, Bieqi, cyanosis, resulting from suffocation and death.
(C) performance of circulatory failure patients to have palpitations, sweating, looking pale and weak pulse rate and then developed into Zhileng, cyanosis, the rapid decline in blood pressure, pulse disappeared, and even less than measuring blood pressure, leading to cardiac arrest. A small number of patients with existing coronary atherosclerosis may be complicated by myocardial infarction.
(D) awareness of the changes are often first appear fear, irritability and dizziness; with cerebral edema and cerebral hypoxia intensified, in unclear or complete loss of consciousness; can also issued five-stroke type convulsions, limb rigidity, and so on.
(5) Other more common symptoms are irritating cough, for a Ti, nausea, vomiting, abdominal pain, diarrhea, incontinence can occur final.
[Diagnosis]
Benbingfasheng soon, it is necessary to make timely diagnosis. Where in the (especially after injection) antigen of the substance or a drug, or bees bites occur immediately after the general reaction, drugs and difficult to explain their pharmacological effects, they should immediately be taken into account the possibility of this disease, it was General little difficult diagnosis. However, it should be except for the following circumstances.
(A) vagus vascular syncope (or vagus vascular collapse, vasovagal collapse) occurred after the injection, in particular, the patients have fever, low blood sugar or the tendency of water loss when. Patients Changcheng looking pale, nausea, a cold sweat, could then syncope, it is easily misdiagnosed as anaphylactic shock. However, this disease no itching or rashes, syncope sits flat immediately after the turn for the better, although low blood pressure but slow pulse, and these different anaphylactic shock. Vagal syncope vascular Atropine can be used in the treatment.
(B) edema hereditary vascular disease (hereditary angioedema) This is a regular chromosomes from the lack of genetic complement C1 esterase inhibitor of the disease. In some patients may be non-specific factors (such as infection, trauma, etc.) stimulated a sudden onset, for the performance of the skin and mucous membrane of respiratory vascular edema. As the airway obstruction, patients also often wheezing, short breath and extreme difficulty in breathing, and anaphylactic shock is quite similar. However, the onset of slower, and many patients have family history or history of seizures since childhood, when the disease is usually no blood pressure dropped and no urticaria, which can be differentiated from anaphylactic shock.
Anaphylactic shock of the diagnosis of this specific disease prevention is of great significance, but the test should be conducted allergens ① in shock after lifting; ② in grams and Kangguominyao out of antibodies after; ③ such as a skin test, the best necessary Anti-shock drug. A small number of patients with negative skin test is still the possibility of occurrence of this disease.
[Prevention]
The most fundamental way to clear the cause of the allergens, and the lack of effective anti-avoidance. However, the clinical often difficult to make a specific diagnosis of allergens Furthermore, many patients are not immune from the mechanisms of allergic-like reaction. To this end should be noted: ① long before the allergy medication history, the positive patients should be eye-catching in the history of Home and detailed records. ② minimize do not have to use radio, the widespread use of oral agents. ③ of allergic patients in physical observation of injecting drug use after 15 to 20 minutes, must accept that this disease may be induced by drugs (such as methyl contrast agent), Yixian use of antihistamines or prednisone 20 ~ 30 mg. ④ skin test for the first pick of skin prick test as far as possible without a positive drug, as required, can be tried "by-test" or "desensitization test." Its principles in the anti-histamine drugs under the protection of patients from the very small dose was gradually increased by the amount of drug-min, until the patients have tolerated far. In the process of desensitization, there must be close observation of medical staff, water and ready to adrenaline, oxygen, intubation and intravenous injection can be a corticosteroid and all other emergency rescue measures.
[Prognosis]
Normally receive after the antigen of the symptoms of the late, the better the prognosis. Certain height in case of allergy, "like lightning" anaphylactic shock, often poor prognosis. Coronary heart disease have occurred in the context of the present time because of the concentration of plasma and blood pressure drop, often associated with myocardial infarction easy. Nervous system symptoms are also easy to resume after the residue after the hypoxic brain complications.
Since the overwhelming majority of the intermediary for the specific IgE allergic. Each from the corresponding allergens caused by the increase in delivery of IgE production, that is, once again contact occurred when the possibility of more severe reactions. For this reason, patients should be warned never to accept a similar allergen, and taboo in the medical records of drug registration card Home.
Anaphylactic shock (anaphylaxis, anaphylactic shock) is outside of certain substances into the antigen has sensitized the body, through the immune mechanism in a short period of time in a strong involvement of multiple organ group. Anaphylactic shock performance and level of response by the body, antigen into the volume and channels and are very different. Are usually sudden and very dramatic, if not timely treatment, often life-threatening.
[Treatment]
Must act quickly, seize the opportunity to actively address. ① immediately stop and shift into the branch of suspicious allergens, pathogens or drugs. Ligation injection Chong Yao site or over the limb to slow the absorption can also be injected or sting to 0.005 percent of the local adrenaline 2 ~ 5 ml closed injection. ② immediately to 0.1 percent adrenaline, the first subcutaneous injection of 0.3 ~ 0.5 ml, then injected into a vein puncture 0.1 ~ 0.2 ml, followed by 5 percent drop glucose injection, to maintain smooth flow of intravenous injection. Adrenergic receptor β effect through the rapid relaxation of bronchial spasms, through α receptor effect on the peripheral vascular contraction. It can also confront some of the media allergic Ⅰ-release, so this is where the first choice of drug, in the course of the applications can be repeated several times. General after 1 or 2 times epinephrine injection, most of the patients symptoms of shock in a half-hour can be recovered. Conversely, if not shock sustained improvement is a serious case of early intravenous dexamethasone 10 ~ 20 mg, the acid test-hydride 200 ~ 400 mg. Has the discretion to choose a group of more lasting effect, the side effects of smaller anti-shock drugs such as norepinephrine, Ala Ming (between hydroxylamine). At the same time to vasoactive drugs, blood volume and promptly added, the first infusion of 500 ml can quickly infusion, adult general of the first day of rehydration up to 400 ml. ③ anti-allergic and symptomatic treatment, commonly used is 10 mg or chlorpheniramine promethazine 25 ~ 50 mg, intramuscular, sits flat, oxygen and maintain respiratory smooth.
As in allergic diseases shock when the patient's allergy threshold very low, some of the original may not allergic to the drug allergens. Therefore, the treatment of this medication must not excessive.
[ET]
As allergens cause the disease antigen substances are:
(A) of xenotransplantation (of) the secretion of protein (insulin, vasopressin), the enzyme (chymotrypsin, penicillin-), pollen extract (pig grass, trees, grass), food (egg white, milk, hard shell Fruits, dried seafood, chocolate), anti-serum (anti-serum or anti-lymphocyte IVIG), occupational exposure to the protein (rubber products), the bees toxin.
(B) polysaccharides such as iron dextran.
(C) many commonly used drugs such as antibiotics (penicillin, cephalosporins adriamycin, amphotericin B, nitro furans properly due to taste), local anesthetic (procaine, lidocaine), vitamins (thiamin, folic acid ), Diagnostic agents (iodized X-ray contrast agent, iodine bromide phthalate), the occupational exposure to chemical agents (ethylene oxide).
The vast majority of allergic shock is a typical type Ⅰ multi-organ allergic reaction in the body, especially the cycle of the performance. Outside the antigen of substances (antigens certain drugs is incomplete, but after entering the body with a combination of protein Chengquan antigen) enters the body can stimulate the immune system to produce antibodies, IgE production, due to physical varies widely. These specific IgE cells have a stronger pro-nature, with the skin, bronchial, the vessel walls, and so the "target cells" combination. When the same again after the antigen has been sensitized with the individual contacts, we can inspire much of the allergic type Ⅰ, the process of release of histamine and platelet activating factor, such as edema is caused by multiple organ, such as clinical exudation The direct cause of performance.
In blood, plasma or immunoglobulin in the process of occasionally can be seen rapid onset of anaphylactic shock, they are the cause of three: ① donors with the specific IgE who are receiving treatment by drugs (such as penicillin G) from the reaction . ② selective IgA to the lack of multiple infusion of IgA blood products, can produce the anti-IgA IgG antibody category. When the re-injection of IgA products, it is possible IgA-anti-IgA antibody immune complex, a type Ⅲ allergy caused by anaphylactic shock. ③ for intravenous infusion of gamma globulin (C-) formulations contain high molecular weight of the C-polymer, can activate complement, a C3a, C4a, C5a, and other allergic toxin; then the activation of mast cells produce anaphylactic shock. A small number of patients in the use of drugs such as opium tincture, dextran, a high degree of ionizing X-ray contrast agent or antibiotics (such as polymyxin B), mainly through to the mast cell degranulation, also have allergic shock of clinical manifestations. In recent years, people would not exist allergens and the antibody response, that is through non-immune mechanisms of allergic symptoms and signs called shock-like allergic reaction (anaphylactoid reaction).
[Pathological changes:
Because of this disease and the main features of sudden death: acute pulmonary bleeding and excessive inflation, throat swelling, visceral congestion, pulmonary edema and bleeding. Endoscopic airway submucosal foreseeable edema extremely small airway secretions increase, bronchial and lung stromal vascular congestion associated with eosinophil infiltration, about 80 percent of deaths and myocardial necrosis, or the focal lesions. Spleen, liver and mesenteric vascular also more associated with congestive eosinophil infiltration. There are also a few cases, such as gastrointestinal bleeding.
[Clinical]
Most of Curan of the disease occurred in about half of patients receive cause antigen (such as the injection of penicillin G, etc.) within five minutes symptoms, only 10% of patients with symptoms starting in half an hour later, a very small number of patients in the continuous treatment in the process of this disease .
Anaphylactic shock has two main characteristics: First performance of a shock that the rapid blood pressure dropped to 10.6/6.6 kPa (80/50mmHg) below, a consciousness disorder patients, ranging from dim, then re-coma. The second is in shock before or at the same time, often some of the symptoms associated with allergies. Are as follows.
(A) skin mucosa performance anaphylactic shock is often the earliest and most often the symptoms, including skin Chaohong, itching, followed by extensive and urticaria (or) vessels and nerves of edema; can appear sneeze, water samples nose, Music Dumb, and even affect breathing.
(B) symptoms of obstructive airway disease is the most common performance, but also the main cause of death. As airway edema, secretions increase, coupled with jets and (or) bronchial spasms, plug flu patients throat, chest tightness, short breath, wheezing, Bieqi, cyanosis, resulting from suffocation and death.
(C) performance of circulatory failure patients to have palpitations, sweating, looking pale and weak pulse rate and then developed into Zhileng, cyanosis, the rapid decline in blood pressure, pulse disappeared, and even less than measuring blood pressure, leading to cardiac arrest. A small number of patients with existing coronary atherosclerosis may be complicated by myocardial infarction.
(D) awareness of the changes are often first appear fear, irritability and dizziness; with cerebral edema and cerebral hypoxia intensified, in unclear or complete loss of consciousness; can also issued five-stroke type convulsions, limb rigidity, and so on.
(5) Other more common symptoms are irritating cough, for a Ti, nausea, vomiting, abdominal pain, diarrhea, incontinence can occur final.
[Diagnosis]
Benbingfasheng soon, it is necessary to make timely diagnosis. Where in the (especially after injection) antigen of the substance or a drug, or bees bites occur immediately after the general reaction, drugs and difficult to explain their pharmacological effects, they should immediately be taken into account the possibility of this disease, it was General little difficult diagnosis. However, it should be except for the following circumstances.
(A) vagus vascular syncope (or vagus vascular collapse, vasovagal collapse) occurred after the injection, in particular, the patients have fever, low blood sugar or the tendency of water loss when. Patients Changcheng looking pale, nausea, a cold sweat, could then syncope, it is easily misdiagnosed as anaphylactic shock. However, this disease no itching or rashes, syncope sits flat immediately after the turn for the better, although low blood pressure but slow pulse, and these different anaphylactic shock. Vagal syncope vascular Atropine can be used in the treatment.
(B) edema hereditary vascular disease (hereditary angioedema) This is a regular chromosomes from the lack of genetic complement C1 esterase inhibitor of the disease. In some patients may be non-specific factors (such as infection, trauma, etc.) stimulated a sudden onset, for the performance of the skin and mucous membrane of respiratory vascular edema. As the airway obstruction, patients also often wheezing, short breath and extreme difficulty in breathing, and anaphylactic shock is quite similar. However, the onset of slower, and many patients have family history or history of seizures since childhood, when the disease is usually no blood pressure dropped and no urticaria, which can be differentiated from anaphylactic shock.
Anaphylactic shock of the diagnosis of this specific disease prevention is of great significance, but the test should be conducted allergens ① in shock after lifting; ② in grams and Kangguominyao out of antibodies after; ③ such as a skin test, the best necessary Anti-shock drug. A small number of patients with negative skin test is still the possibility of occurrence of this disease.
[Prevention]
The most fundamental way to clear the cause of the allergens, and the lack of effective anti-avoidance. However, the clinical often difficult to make a specific diagnosis of allergens Furthermore, many patients are not immune from the mechanisms of allergic-like reaction. To this end should be noted: ① long before the allergy medication history, the positive patients should be eye-catching in the history of Home and detailed records. ② minimize do not have to use radio, the widespread use of oral agents. ③ of allergic patients in physical observation of injecting drug use after 15 to 20 minutes, must accept that this disease may be induced by drugs (such as methyl contrast agent), Yixian use of antihistamines or prednisone 20 ~ 30 mg. ④ skin test for the first pick of skin prick test as far as possible without a positive drug, as required, can be tried "by-test" or "desensitization test." Its principles in the anti-histamine drugs under the protection of patients from the very small dose was gradually increased by the amount of drug-min, until the patients have tolerated far. In the process of desensitization, there must be close observation of medical staff, water and ready to adrenaline, oxygen, intubation and intravenous injection can be a corticosteroid and all other emergency rescue measures.
[Prognosis]
Normally receive after the antigen of the symptoms of the late, the better the prognosis. Certain height in case of allergy, "like lightning" anaphylactic shock, often poor prognosis. Coronary heart disease have occurred in the context of the present time because of the concentration of plasma and blood pressure drop, often associated with myocardial infarction easy. Nervous system symptoms are also easy to resume after the residue after the hypoxic brain complications.
Since the overwhelming majority of the intermediary for the specific IgE allergic. Each from the corresponding allergens caused by the increase in delivery of IgE production, that is, once again contact occurred when the possibility of more severe reactions. For this reason, patients should be warned never to accept a similar allergen, and taboo in the medical records of drug registration card Home.
Two injection may cause shock death
"Can not oral vaccination, can not intravenous injection." Experts advise patients, people sick after more than take medicine that intravenous infusion and intramuscular quick. "I medication through the stomach, the liver detoxification, in general more secure. Intravenous drug directly into the blood because, in the relative risk of allergic reaction to a greater and faster, even fatal allergic reaction, is one of the most The use of unsafe manner. "
Zibo City State Food and Drug Authority Adverse Drug Reaction Monitoring Centre has released the first 12 ADR communications. Communications to remind doctors, patients and pharmaceutical companies, tiopronin injections and thymosin injection may cause patients with anaphylactic shock. Drug experts reminded the public sector, general administration should minimize the intravenous drip, to the best oral oral drugs.
It is learnt that tiopronin injection is a sulfhydryl drugs used to improve various kinds of acute and chronic hepatitis liver function, fatty liver, drug-induced liver damage and heavy metal detoxification, radiotherapy and chemotherapy to reduce the adverse reaction, due to the prevention of radiotherapy and chemotherapy The peripheral leukocyte reduction and senile for early treatment of cataract and vitreoretinal turbidity. Adverse reactions are rash, itching, nausea, vomiting, dizziness, flustered, chest tightness and throat swelling, breathing difficulties, allergic-like reactions. In view of tiopronin injection can induce anaphylactic shock, severe cases can lead to death, reminded medical staff strictly indications, and in strict accordance with the special requirements specification storage and preparation, but also strengthen the monitoring of medication. Tiopronin injection of trade names including Tiopronin, Heinonen, Victoria spring, 100 of Connaught, Hainuo Xin, with Darragon, Culture and Sport-cable, Dingshu, cut Lingbao, such as e Jigme.
Thymosin as a thymus hormone, for various cells of the immune function of the lower disease treatment. Thymosin injection of the other major side effects are rash, fever, chills, chills, chest tightness, palpitations, difficulty in breathing, headaches, cyanosis, and other allergic-like reactions. In addition, the route of administration with anaphylactic shock on the incidence, 95 percent of anaphylactic shock are intravenous drug delivery. In view of thymosin injection may cause anaphylactic shock, and other serious adverse reactions, and extensive clinical application of the drug, communications reminded medical staff to use the drug to strictly control indications, according to illness need to select route of administration, and in accordance with the statement recommended dose use. Paper used to be done before the sensitivity test, skin test negative, should the need to enhance the monitoring of medication.
"Can not oral vaccination, can not intravenous injection." Experts advise patients, people sick after more than take medicine that intravenous infusion and intramuscular quick. In particular, the current season when the turn, a cold fever patients increased dramatically, major hospitals infusion room overcrowding. "I medication through the stomach, the liver detoxification, in general more secure. Intravenous drug directly into the blood because, in the relative risk of allergic reaction to a greater and faster, even fatal allergic reaction, is one of the most The use of unsafe manner. "
Zibo City State Food and Drug Authority Adverse Drug Reaction Monitoring Centre has released the first 12 ADR communications. Communications to remind doctors, patients and pharmaceutical companies, tiopronin injections and thymosin injection may cause patients with anaphylactic shock. Drug experts reminded the public sector, general administration should minimize the intravenous drip, to the best oral oral drugs.
It is learnt that tiopronin injection is a sulfhydryl drugs used to improve various kinds of acute and chronic hepatitis liver function, fatty liver, drug-induced liver damage and heavy metal detoxification, radiotherapy and chemotherapy to reduce the adverse reaction, due to the prevention of radiotherapy and chemotherapy The peripheral leukocyte reduction and senile for early treatment of cataract and vitreoretinal turbidity. Adverse reactions are rash, itching, nausea, vomiting, dizziness, flustered, chest tightness and throat swelling, breathing difficulties, allergic-like reactions. In view of tiopronin injection can induce anaphylactic shock, severe cases can lead to death, reminded medical staff strictly indications, and in strict accordance with the special requirements specification storage and preparation, but also strengthen the monitoring of medication. Tiopronin injection of trade names including Tiopronin, Heinonen, Victoria spring, 100 of Connaught, Hainuo Xin, with Darragon, Culture and Sport-cable, Dingshu, cut Lingbao, such as e Jigme.
Thymosin as a thymus hormone, for various cells of the immune function of the lower disease treatment. Thymosin injection of the other major side effects are rash, fever, chills, chills, chest tightness, palpitations, difficulty in breathing, headaches, cyanosis, and other allergic-like reactions. In addition, the route of administration with anaphylactic shock on the incidence, 95 percent of anaphylactic shock are intravenous drug delivery. In view of thymosin injection may cause anaphylactic shock, and other serious adverse reactions, and extensive clinical application of the drug, communications reminded medical staff to use the drug to strictly control indications, according to illness need to select route of administration, and in accordance with the statement recommended dose use. Paper used to be done before the sensitivity test, skin test negative, should the need to enhance the monitoring of medication.
"Can not oral vaccination, can not intravenous injection." Experts advise patients, people sick after more than take medicine that intravenous infusion and intramuscular quick. In particular, the current season when the turn, a cold fever patients increased dramatically, major hospitals infusion room overcrowding. "I medication through the stomach, the liver detoxification, in general more secure. Intravenous drug directly into the blood because, in the relative risk of allergic reaction to a greater and faster, even fatal allergic reaction, is one of the most The use of unsafe manner. "
Rape 14-year-old orphan girls shock to the lower body bleeding suspects were arrested yesterday
14-year-old orphan girls for the small Guangzhou He was cheated twice raped by bleeding off Gulbuddin roadside. This shocking case Tianhe Interpol has been breaking speed. Yesterday, the 31-year-old criminal suspects to help in Tianhe District, a refuse collection point near the Huangcun, plainclothes police were arrested.
Police:
Reports on the trial results and basically consistent with the
18:00 yesterday, the reporter received a report rushed to the Tianhe District Battalion Interpol, arrested the suspects are on trial. -- Cai police officers on the case, the trial results and this basically consistent with the reports, another girl Xiao Wu Xiao Wu has confirmed that the guardian of safe home.
Police have identified the evening of July 13, Ho Fogang small girls (14 years old) and Xiao Wu students in the streets looking for work, a self-proclaimed "week of" the man told them to the car on the 14th morning Conghua. 14, and Xiao Wu Ho small as about Upon arrival, the "Week of" They will be taken to Guangzhou. He and Xiao Wu night on the arrangements for the owner of the "quarters" in sleep a night, peaceful night. On the 15th afternoon, the "Week of" small to Huangcun near Ho "Towards Longqiao" Park, after the disappearance.
An hour later, a "to 20-year-old, standing about 1.6 meters," the young men there. He is going to help a suspect. Supporting an their Xingwang, the small Ho said: "go home with me, tomorrow I give you the money to go home."
Subsequently, a small He came to help and Huangcun rental of a house. According to testimony with the help of small DR a confession, entered the house after a hurry to help small to Dr Chong Liang, after supporting a sleep over one hour, Peter Ho will hold down the small violations, small Ho resistance, to help open the A hands will be forced to help a small bed in the implementation of what the rape. Around the middle of the night, raped again to help a small Ho, Ho lower body at this time on the bloodshed, rape suspension.
July 16 morning, when they wake up what no small help of a certain, therefore intend to go to the "Week of." In the staircase, small He met a help, she then go Xialou. Go , small lower body Ho bloodshed, the whole of the pants were blood soaked, then hiding near the small Ho Gongjiaozhanpai, put on clean clothes.
But blood is still not ended. He ran into a small panic Nvce Suo. A see Cijing, worried about what the small Abai Jiaozhu Nvce Suo out from the masses, another woman, she carefully watching this girl. The woman asked the masses into the Chushenmeshi » He never wanted to ask small. July 16 noon, small excessive bleeding He fainted.
Good intentions of the people immediately call 120, and at the same time the police. Tianhe District, the Red Cross Hospital maternity ward timely He admitted a small, it is learnt that dangerous circumstances at the time: "At that time, Ho has small shock, severe vaginal tears, not blood, the hospital immediately to her side while blood transfusion surgery to repair, at least keep the children A life. "
Arresting:
He identified four small holding at the scene
July 16 at 1 pm, 110 Jiejing and quickly rushed to the scene. The police station to verify the nature of the case, 16:00, Tianhe involved in the investigation by Interpol.
Interpol do-the first victims of what the small, with Police say the suspect characteristics: "Ping head, forehead, a handful of hair longer……" What is the small police inspired, Ding Xiaxin to slowly memories The case to the surrounding environment, including in a park in which direction » What characteristics of the surrounding » According to Interpol immediate clues, in the village started a comprehensive search.
At the same time, the police also sought the views of the hospital, in a small body Ho basic restored, she will bring to the hospital, with trolley pushed by Shoubao, holding small He left the village several places, and at noon yesterday, and finally Will be locked in at the scene Huangcun temple per Hengjie the fifth floor of a rented rooms!
Although found at the scene, police discovered the suspect had in the afternoon of July 16th move! After investigation, police determine how far the suspects did not escape, then launched a search in the surrounding, many of the people has provided powerful evidence and clues. Yesterday afternoon, when the help of a garbage station in the neighboring Huangcun, plainclothes police arrested Pushang, supported by the firm resistance of a desperately Andao.
Reminder:
Sheshiweishen the prevention of juvenile raise awareness
To help a criminal suspect confessed to the facts. Currently the case is still further investigation. According to case-handling department was informed that the help of a notorious record in Yingde Zuoguo in jail for robbery, also in Guangzhou for possession of controlled knives Kyrgyz police station-were dealt with, many times whoring experience.
Police passed on to remind the general public, especially teenagers Sheshiweishen, away from home, especially alert to strangers, in order to raise their awareness of prevention, and you take the initiative on the lines of strangers or Taojin Hu to remain vigilant attitude and found themselves After being illegal infringement, we must promptly report to the public security organs. (Xiang Chen's correspondent days)
A dialogue to help
Small eyes, triangular nose and thick lips. Zhuangshi body, face indifference. This is the case of a criminal suspects to help.
Reporter: You are where people » Read the book years » When the Guangzhou »
Supporting a certain: I was in Sichuan Gulin Xian, was born in 1976. I have read the 2003 primary, did not have been at home reading on the dry farm work. I…… 1995 to the Guangzhou.
Reporter: At that time you went to a park to find that girl, for what is the purpose of «
Supporting a certain: the girls in a meal, I have seen in the restaurant on her. I live from the park where only about 100 meters, just at the event, she would have to speak.
Reporter: What it says »
Supporting a certain: say something. I said to you I live in it, tomorrow I will give you a few hundred yuan to return home.
Reporter: You told that girl home? »
Supporting a certain: right.
Reporter: Are you for whatever purpose, to take her home »
Supporting a certain: there is no purpose. I was kind. Sleep the night before that idea.
Reporter: Do you and girls in a relationship, she said that is how the » How resistance »
Supporting a certain: She pushed open my hand and said that she would also like to study and to go home. I put pressure on her hand.
All members of the public to lend a helping hand to small Ho
Police:
Reports on the trial results and basically consistent with the
18:00 yesterday, the reporter received a report rushed to the Tianhe District Battalion Interpol, arrested the suspects are on trial. -- Cai police officers on the case, the trial results and this basically consistent with the reports, another girl Xiao Wu Xiao Wu has confirmed that the guardian of safe home.
Police have identified the evening of July 13, Ho Fogang small girls (14 years old) and Xiao Wu students in the streets looking for work, a self-proclaimed "week of" the man told them to the car on the 14th morning Conghua. 14, and Xiao Wu Ho small as about Upon arrival, the "Week of" They will be taken to Guangzhou. He and Xiao Wu night on the arrangements for the owner of the "quarters" in sleep a night, peaceful night. On the 15th afternoon, the "Week of" small to Huangcun near Ho "Towards Longqiao" Park, after the disappearance.
An hour later, a "to 20-year-old, standing about 1.6 meters," the young men there. He is going to help a suspect. Supporting an their Xingwang, the small Ho said: "go home with me, tomorrow I give you the money to go home."
Subsequently, a small He came to help and Huangcun rental of a house. According to testimony with the help of small DR a confession, entered the house after a hurry to help small to Dr Chong Liang, after supporting a sleep over one hour, Peter Ho will hold down the small violations, small Ho resistance, to help open the A hands will be forced to help a small bed in the implementation of what the rape. Around the middle of the night, raped again to help a small Ho, Ho lower body at this time on the bloodshed, rape suspension.
July 16 morning, when they wake up what no small help of a certain, therefore intend to go to the "Week of." In the staircase, small He met a help, she then go Xialou. Go , small lower body Ho bloodshed, the whole of the pants were blood soaked, then hiding near the small Ho Gongjiaozhanpai, put on clean clothes.
But blood is still not ended. He ran into a small panic Nvce Suo. A see Cijing, worried about what the small Abai Jiaozhu Nvce Suo out from the masses, another woman, she carefully watching this girl. The woman asked the masses into the Chushenmeshi » He never wanted to ask small. July 16 noon, small excessive bleeding He fainted.
Good intentions of the people immediately call 120, and at the same time the police. Tianhe District, the Red Cross Hospital maternity ward timely He admitted a small, it is learnt that dangerous circumstances at the time: "At that time, Ho has small shock, severe vaginal tears, not blood, the hospital immediately to her side while blood transfusion surgery to repair, at least keep the children A life. "
Arresting:
He identified four small holding at the scene
July 16 at 1 pm, 110 Jiejing and quickly rushed to the scene. The police station to verify the nature of the case, 16:00, Tianhe involved in the investigation by Interpol.
Interpol do-the first victims of what the small, with Police say the suspect characteristics: "Ping head, forehead, a handful of hair longer……" What is the small police inspired, Ding Xiaxin to slowly memories The case to the surrounding environment, including in a park in which direction » What characteristics of the surrounding » According to Interpol immediate clues, in the village started a comprehensive search.
At the same time, the police also sought the views of the hospital, in a small body Ho basic restored, she will bring to the hospital, with trolley pushed by Shoubao, holding small He left the village several places, and at noon yesterday, and finally Will be locked in at the scene Huangcun temple per Hengjie the fifth floor of a rented rooms!
Although found at the scene, police discovered the suspect had in the afternoon of July 16th move! After investigation, police determine how far the suspects did not escape, then launched a search in the surrounding, many of the people has provided powerful evidence and clues. Yesterday afternoon, when the help of a garbage station in the neighboring Huangcun, plainclothes police arrested Pushang, supported by the firm resistance of a desperately Andao.
Reminder:
Sheshiweishen the prevention of juvenile raise awareness
To help a criminal suspect confessed to the facts. Currently the case is still further investigation. According to case-handling department was informed that the help of a notorious record in Yingde Zuoguo in jail for robbery, also in Guangzhou for possession of controlled knives Kyrgyz police station-were dealt with, many times whoring experience.
Police passed on to remind the general public, especially teenagers Sheshiweishen, away from home, especially alert to strangers, in order to raise their awareness of prevention, and you take the initiative on the lines of strangers or Taojin Hu to remain vigilant attitude and found themselves After being illegal infringement, we must promptly report to the public security organs. (Xiang Chen's correspondent days)
A dialogue to help
Small eyes, triangular nose and thick lips. Zhuangshi body, face indifference. This is the case of a criminal suspects to help.
Reporter: You are where people » Read the book years » When the Guangzhou »
Supporting a certain: I was in Sichuan Gulin Xian, was born in 1976. I have read the 2003 primary, did not have been at home reading on the dry farm work. I…… 1995 to the Guangzhou.
Reporter: At that time you went to a park to find that girl, for what is the purpose of «
Supporting a certain: the girls in a meal, I have seen in the restaurant on her. I live from the park where only about 100 meters, just at the event, she would have to speak.
Reporter: What it says »
Supporting a certain: say something. I said to you I live in it, tomorrow I will give you a few hundred yuan to return home.
Reporter: You told that girl home? »
Supporting a certain: right.
Reporter: Are you for whatever purpose, to take her home »
Supporting a certain: there is no purpose. I was kind. Sleep the night before that idea.
Reporter: Do you and girls in a relationship, she said that is how the » How resistance »
Supporting a certain: She pushed open my hand and said that she would also like to study and to go home. I put pressure on her hand.
All members of the public to lend a helping hand to small Ho
Teach children to the earthquake Protection Manual
Brain injury casualties in the earthquake is the highest mortality rates, early mortality rate of 30 percent. Maxillofacial, facial features will cause serious injury dysfunction, blood clots and organizations can shift, causing suffocation. Squeeze the body muscles strong, or weight of more than six hours, local muscle necrosis, the release of large amounts of protein decomposition substances into the blood circulation, leading to shock and renal failure, which is squeezed syndrome, a high mortality rate.
7. Vehicle on-street parking, closed to control the region
A major earthquake, automobile tires will be like a gas like China, unable to grasp the steering wheel, driving difficult. Must pay full attention to avoiding the crossroads of the car will stop by the roadside. In order not to hinder the evacuation of asylum and passage of emergency vehicles, to make the road to the middle part.
Urban centres in the vast majority of roads will be a total ban on access. Full attention to the car radio broadcasting, the vicinity of the police, should act in accordance with their instructions.
The need for evacuation, not for involvement in the fire, the Commissioner of the windows, and car keys inserted in the car, do not lock the doors, and the local people and act together.
8. Be sure to pay attention to landslides, rock-drop or bluffs overlooking the tsunami
In the hillside, a steep tilt lots, in landslides, rock-drop bluffs overlooking the risk, should prompt evacuation to a safe place.
The coast, a tsunami risk. Perception earthquake or a tsunami warning, then, please note that radio, TV, and other information quickly to a safe place of asylum.
9. To evacuate on foot, carrying goods should at least limit
Due to a fire caused by the earthquake, the spread of burning, a crisis of life, personal safety, and so, the measures taken refuge. Evacuation methods, in principle, to disaster prevention and public organizations, such as street as a unit, in charge and led police to take refuge on foot, carrying the items should be at least limit. Absolutely can not use cars, bicycles asylum.
For patients such as asylum, local residents and cooperation and mutual assistance is indispensable. From peacetime, the neighbours on the need for asylum prior to the agreed mode.
10. Do not listen to rumors, do not act rashly
In the event of major earthquake, people psychologically easily shaken. To prevent confusion, each person based on correct information, to act calmly, very important.
From the portable radios, etc., to the correct information. I believe from the government, police, fire prevention, such as the message directly and not rely on the Liuyanfeiyu irresponsible not to act rashly.
6, earthquake survival
The disasters, including earthquakes causing the collapse of buildings, fires and earthquakes after the plague, can cause a large number of casualties.
When the earthquake and to suddenly, if at the beginning of magnitude is not high, people should quickly left the complex, decentralized boost to open the venue. There was no time to leave the buildings often collapse of the housing will be buried or injured.
Judging from China's Tangshan Earthquake information, the reason why some people can be buried in the rubble to survive is because: 1. Not the deadly visceral injury, 2. Try to find a way out moral ventilation I find, and find export, and nephew from the rapid collapse of the housing ruins, 3. Mining did not hear the voice and paging sound, no shouting or claimed unnecessary disruption to the roller, panic, Luanhanluanjiao will speed up the metabolism, increase oxygen consumption, but also a result of smoke inhalation a large number of suffocation.
This shows that the earthquake, although not completely avoid human and control, but as long as needed to save each other self-help skills, so that disasters can be reduced to a minimum. Summed up the following points:
1. To remain calm.
In the quake, it was observed that many innocent people is not because of the collapse were injured or died of crush injury, but because of a nervous breakdown, lost hope of survival, Luanhan, Luanjiao, in extreme fear of "kill "Themselves. This is because, Luanhanluanjiao will speed up the metabolism, increase oxygen consumption, physical decline, lower tolerance at the same time, screaming, a lot will be inhalation of dust and easy to suffocation caused unnecessary casualties. Is the correct attitude in any adverse environment, should always remain calm, analysis of their environment, looking for a way out, waiting for rescue.
2. Bleeding, injured and fixed crush injury is common in earthquake damage.
Open wounds, the bleeding should first stop bleeding Taigaohuanzhi, for help. The open fracture, should not be reset to the scene to prevent the re-organization were injured, most with a clean gauze covering the wound, then fixed for a simple operation. Different parts of fractures, according to different requirements of fixed. And in the light different injury, wound classification, grading, taken to hospital to further treatment.
3. Properly handle the crush injury wound
, Should try to lift heavy pressure as soon as possible, the trauma experienced large area, to keep the wound clean, with a clean gauze bandaging wounds, suspected tetanus infection and gas production, they should immediately contact with the hospital, timely diagnosis and treatment. Large area of trauma and severe trauma, can be oral glucose drip to prevent shock.
4. Often prevent the fire from many earthquakes, "the disaster", is a common fire.
In the fire as soon as possible from the scene of the fire, burning off the Yimao, or covered with wet clothes on, or lying to roll, can also be directly poured water poured fire. Puda flames must not use his hands, otherwise they will burn from his hands. Disinfection clean cloth or gauze bandaging evacuation hospitals further processing.
5. At the same time to prevent tetanus and gas gangrene
And to the bodies buried as soon as possible, attention to diet water sanitation to prevent the disaster of the epidemic.
7. Vehicle on-street parking, closed to control the region
A major earthquake, automobile tires will be like a gas like China, unable to grasp the steering wheel, driving difficult. Must pay full attention to avoiding the crossroads of the car will stop by the roadside. In order not to hinder the evacuation of asylum and passage of emergency vehicles, to make the road to the middle part.
Urban centres in the vast majority of roads will be a total ban on access. Full attention to the car radio broadcasting, the vicinity of the police, should act in accordance with their instructions.
The need for evacuation, not for involvement in the fire, the Commissioner of the windows, and car keys inserted in the car, do not lock the doors, and the local people and act together.
8. Be sure to pay attention to landslides, rock-drop or bluffs overlooking the tsunami
In the hillside, a steep tilt lots, in landslides, rock-drop bluffs overlooking the risk, should prompt evacuation to a safe place.
The coast, a tsunami risk. Perception earthquake or a tsunami warning, then, please note that radio, TV, and other information quickly to a safe place of asylum.
9. To evacuate on foot, carrying goods should at least limit
Due to a fire caused by the earthquake, the spread of burning, a crisis of life, personal safety, and so, the measures taken refuge. Evacuation methods, in principle, to disaster prevention and public organizations, such as street as a unit, in charge and led police to take refuge on foot, carrying the items should be at least limit. Absolutely can not use cars, bicycles asylum.
For patients such as asylum, local residents and cooperation and mutual assistance is indispensable. From peacetime, the neighbours on the need for asylum prior to the agreed mode.
10. Do not listen to rumors, do not act rashly
In the event of major earthquake, people psychologically easily shaken. To prevent confusion, each person based on correct information, to act calmly, very important.
From the portable radios, etc., to the correct information. I believe from the government, police, fire prevention, such as the message directly and not rely on the Liuyanfeiyu irresponsible not to act rashly.
6, earthquake survival
The disasters, including earthquakes causing the collapse of buildings, fires and earthquakes after the plague, can cause a large number of casualties.
When the earthquake and to suddenly, if at the beginning of magnitude is not high, people should quickly left the complex, decentralized boost to open the venue. There was no time to leave the buildings often collapse of the housing will be buried or injured.
Judging from China's Tangshan Earthquake information, the reason why some people can be buried in the rubble to survive is because: 1. Not the deadly visceral injury, 2. Try to find a way out moral ventilation I find, and find export, and nephew from the rapid collapse of the housing ruins, 3. Mining did not hear the voice and paging sound, no shouting or claimed unnecessary disruption to the roller, panic, Luanhanluanjiao will speed up the metabolism, increase oxygen consumption, but also a result of smoke inhalation a large number of suffocation.
This shows that the earthquake, although not completely avoid human and control, but as long as needed to save each other self-help skills, so that disasters can be reduced to a minimum. Summed up the following points:
1. To remain calm.
In the quake, it was observed that many innocent people is not because of the collapse were injured or died of crush injury, but because of a nervous breakdown, lost hope of survival, Luanhan, Luanjiao, in extreme fear of "kill "Themselves. This is because, Luanhanluanjiao will speed up the metabolism, increase oxygen consumption, physical decline, lower tolerance at the same time, screaming, a lot will be inhalation of dust and easy to suffocation caused unnecessary casualties. Is the correct attitude in any adverse environment, should always remain calm, analysis of their environment, looking for a way out, waiting for rescue.
2. Bleeding, injured and fixed crush injury is common in earthquake damage.
Open wounds, the bleeding should first stop bleeding Taigaohuanzhi, for help. The open fracture, should not be reset to the scene to prevent the re-organization were injured, most with a clean gauze covering the wound, then fixed for a simple operation. Different parts of fractures, according to different requirements of fixed. And in the light different injury, wound classification, grading, taken to hospital to further treatment.
3. Properly handle the crush injury wound
, Should try to lift heavy pressure as soon as possible, the trauma experienced large area, to keep the wound clean, with a clean gauze bandaging wounds, suspected tetanus infection and gas production, they should immediately contact with the hospital, timely diagnosis and treatment. Large area of trauma and severe trauma, can be oral glucose drip to prevent shock.
4. Often prevent the fire from many earthquakes, "the disaster", is a common fire.
In the fire as soon as possible from the scene of the fire, burning off the Yimao, or covered with wet clothes on, or lying to roll, can also be directly poured water poured fire. Puda flames must not use his hands, otherwise they will burn from his hands. Disinfection clean cloth or gauze bandaging evacuation hospitals further processing.
5. At the same time to prevent tetanus and gas gangrene
And to the bodies buried as soon as possible, attention to diet water sanitation to prevent the disaster of the epidemic.
Teach children to the earthquake Protection Manual
Brain injury casualties in the earthquake is the highest mortality rates, early mortality rate of 30 percent. Maxillofacial, facial features will cause serious injury dysfunction, blood clots and organizations can shift, causing suffocation. Squeeze the body muscles strong, or weight of more than six hours, local muscle necrosis, the release of large amounts of protein decomposition substances into the blood circulation, leading to shock and renal failure, which is squeezed syndrome, a high mortality rate.
Squeeze the body muscles strong, or weight of more than six hours, local muscle necrosis, the release of large amounts of protein decomposition substances into the blood circulation, leading to shock and renal failure, which is squeezed syndrome, a high mortality rate. The little light will affect the function of the muscles.
Traumatic shock and infection is the leading cause of death. Hunger and water shortage is one of the reasons for the earthquake killed.
First aid in the mutual self-help save the very important
After the earthquake the first thing is self-help and mutual help, so to win precious time, the general self-help each other save rate of 40 to 80 percent. Excavated in the ruins of the wounded first to identify the head, fast, lightweight head exposed, remove lime-soil, exposed thoracoabdominal, if asphyxia, should immediately go out. Can not be forced Yingla.
First-aid principles
1, ruled out suffocation and respiratory obstruction.
2, dealing with traumatic shock.
3, complete address hunger.
4, traumatic bleeding, bandaging, fixed.
5, rule 10 earthquake escape
1. Hiding in the table below, and other solid furniture
Big sloshing around time is about one minute. This is the first to take into account is your own family's personal safety. First, in the center of gravity low and strong to firmly avoid the table below, and closely Zhualao table legs. In the absence of the table, such as hiding for the occasion, in any case, but also with a good cushion, such as the protection of the head.
2. Fire Commissioner shaking immediately, as soon as the fire extinguishing
Earthquake, will have to fight the fire engines can not depend on the circumstances. Therefore, each of us clearance fire, the fire-fighting efforts, is the possibility of earthquake disaster control in the smallest degree of important factors.
From peacetime to develop even a small earthquake also the habit of fire Commissioner of it.
In order not to fire lead to Dahuo, family members since Needless to say, between the neighbors help each other, enforce fire early is extremely important.
The earthquake, the Commissioner has the opportunity to fire three times
In the first opportunity before the advent of the sloshing of a small shaking when
In the perception of small shaking moment, immediately notify each other: "Earthquake! Faster clearance fire!", Is using the closure of heating stoves, gas heaters.
A second chance in the shaking stopped when the
In a major shaking when the fire to the Commissioner, on the gas stove, heater above the kettle and other fall down, it is very dangerous.
Big sloshing stopped, once again shouting: "Fire Commissioner! Commissioner of Fire!" And related to the fire.
In the third opportunity after fire
Even where the fire occurred in 1-2 minutes, or can the fight. In order to rapidly fire, please fire extinguishers, fire buckets placed in the regular use of fire from local establishments close.
3. Do not panic ran to the outdoor
After the earthquake, Huanghuangzhangzhang to run out, broken glass, brick and tile on the roof, falling billboards, and other Laiza body, is very dangerous. In addition, the precast concrete wall, vending machines, and so has the danger of collapse, not around these objects.
4. Qiangmendakai to ensure that exports
Reinforced concrete structure of the housing, because of the earthquake will cause shaking windows and doors dislocation, trying to open doors, have been closed in some instances in the room. Please Jiangmendakai to ensure that the exports.
Usually better to advance to the event being held in the house, how to escape the way, ready for a ladder, rope, and so on.
5. Outdoor occasions, to protect your head and avoid the danger of
When violent shaking the earth, standing instability, people will have help on, to seize what the psychological. Close to the post, the walls will be supported by most of the targets. However, these seem quite strong solid things, in fact it is dangerous.
In 1987 Japan's Miyagi Prefecture undersea earthquake, the precast concrete wall, the collapse of the post, has caused too many casualties. Must not close to cement prefabricated wall, post, and so avoid.
In the bustling Street, floor area, is the most dangerous windows, billboards, and other injured people were falling down. Attention should be paid to hand such as handbags or the protection of your head.
In addition, attention should also be overturned wounding vending machines.
In floor area, according to the situation, avoid entering the building in the relatively safe.
6. In department stores, theatres, according to the instructions of the staff of Action
In department stores, such as the Mass Transit Street and more places, the most frightening thing is chaos. Please follow the store staff, security personnel's instructions to action.
On the earthquake, said the Mass Transit Street is relatively safe. Even if a power failure, emergency lighting, will instantly lights up, please be calm and take action.
In case of fire, will be immediately filled with smoke. To suppress the body's posture asylum, and do absolutely non-smokers.
Take the escalator words
In the event of earthquake, fire, can not use the elevator. Take the lift in the event encountered earthquakes, will operate on each floor-all by pressing the button, once stopped, quickly left the elevator, to confirm the safety of asylum.
Recent high-rise buildings and buildings in the lift, are equipped with operational control of the device. When the earthquake occurred, automatically moves, the last stop in the floor.
The event was held in the elevator, please lift of a dedicated telephone contact with the management room, for help.
Squeeze the body muscles strong, or weight of more than six hours, local muscle necrosis, the release of large amounts of protein decomposition substances into the blood circulation, leading to shock and renal failure, which is squeezed syndrome, a high mortality rate. The little light will affect the function of the muscles.
Traumatic shock and infection is the leading cause of death. Hunger and water shortage is one of the reasons for the earthquake killed.
First aid in the mutual self-help save the very important
After the earthquake the first thing is self-help and mutual help, so to win precious time, the general self-help each other save rate of 40 to 80 percent. Excavated in the ruins of the wounded first to identify the head, fast, lightweight head exposed, remove lime-soil, exposed thoracoabdominal, if asphyxia, should immediately go out. Can not be forced Yingla.
First-aid principles
1, ruled out suffocation and respiratory obstruction.
2, dealing with traumatic shock.
3, complete address hunger.
4, traumatic bleeding, bandaging, fixed.
5, rule 10 earthquake escape
1. Hiding in the table below, and other solid furniture
Big sloshing around time is about one minute. This is the first to take into account is your own family's personal safety. First, in the center of gravity low and strong to firmly avoid the table below, and closely Zhualao table legs. In the absence of the table, such as hiding for the occasion, in any case, but also with a good cushion, such as the protection of the head.
2. Fire Commissioner shaking immediately, as soon as the fire extinguishing
Earthquake, will have to fight the fire engines can not depend on the circumstances. Therefore, each of us clearance fire, the fire-fighting efforts, is the possibility of earthquake disaster control in the smallest degree of important factors.
From peacetime to develop even a small earthquake also the habit of fire Commissioner of it.
In order not to fire lead to Dahuo, family members since Needless to say, between the neighbors help each other, enforce fire early is extremely important.
The earthquake, the Commissioner has the opportunity to fire three times
In the first opportunity before the advent of the sloshing of a small shaking when
In the perception of small shaking moment, immediately notify each other: "Earthquake! Faster clearance fire!", Is using the closure of heating stoves, gas heaters.
A second chance in the shaking stopped when the
In a major shaking when the fire to the Commissioner, on the gas stove, heater above the kettle and other fall down, it is very dangerous.
Big sloshing stopped, once again shouting: "Fire Commissioner! Commissioner of Fire!" And related to the fire.
In the third opportunity after fire
Even where the fire occurred in 1-2 minutes, or can the fight. In order to rapidly fire, please fire extinguishers, fire buckets placed in the regular use of fire from local establishments close.
3. Do not panic ran to the outdoor
After the earthquake, Huanghuangzhangzhang to run out, broken glass, brick and tile on the roof, falling billboards, and other Laiza body, is very dangerous. In addition, the precast concrete wall, vending machines, and so has the danger of collapse, not around these objects.
4. Qiangmendakai to ensure that exports
Reinforced concrete structure of the housing, because of the earthquake will cause shaking windows and doors dislocation, trying to open doors, have been closed in some instances in the room. Please Jiangmendakai to ensure that the exports.
Usually better to advance to the event being held in the house, how to escape the way, ready for a ladder, rope, and so on.
5. Outdoor occasions, to protect your head and avoid the danger of
When violent shaking the earth, standing instability, people will have help on, to seize what the psychological. Close to the post, the walls will be supported by most of the targets. However, these seem quite strong solid things, in fact it is dangerous.
In 1987 Japan's Miyagi Prefecture undersea earthquake, the precast concrete wall, the collapse of the post, has caused too many casualties. Must not close to cement prefabricated wall, post, and so avoid.
In the bustling Street, floor area, is the most dangerous windows, billboards, and other injured people were falling down. Attention should be paid to hand such as handbags or the protection of your head.
In addition, attention should also be overturned wounding vending machines.
In floor area, according to the situation, avoid entering the building in the relatively safe.
6. In department stores, theatres, according to the instructions of the staff of Action
In department stores, such as the Mass Transit Street and more places, the most frightening thing is chaos. Please follow the store staff, security personnel's instructions to action.
On the earthquake, said the Mass Transit Street is relatively safe. Even if a power failure, emergency lighting, will instantly lights up, please be calm and take action.
In case of fire, will be immediately filled with smoke. To suppress the body's posture asylum, and do absolutely non-smokers.
Take the escalator words
In the event of earthquake, fire, can not use the elevator. Take the lift in the event encountered earthquakes, will operate on each floor-all by pressing the button, once stopped, quickly left the elevator, to confirm the safety of asylum.
Recent high-rise buildings and buildings in the lift, are equipped with operational control of the device. When the earthquake occurred, automatically moves, the last stop in the floor.
The event was held in the elevator, please lift of a dedicated telephone contact with the management room, for help.
Teach children to the earthquake Protection Manual
Brain injury casualties in the earthquake is the highest mortality rates, early mortality rate of 30 percent. Maxillofacial, facial features will cause serious injury dysfunction, blood clots and organizations can shift, causing suffocation. Squeeze the body muscles strong, or weight of more than six hours, local muscle necrosis, the release of large amounts of protein decomposition substances into the blood circulation, leading to shock and renal failure, which is squeezed syndrome, a high mortality rate.
Teach children to the earthquake Protection Manual
Although the earthquake was unable to prevent and control human beings, but as long as the master some skills, but also from the disaster will be to minimize the damage.
First, principles: the withdrawal as soon as possible to the most safe place
Chun-when the nearest escape, post-earthquake rapid evacuation to a safe place contingency protection is a better way. The so-called nearest escape, according to local conditions and in accordance with the different situations of different countermeasures.
Second, different guidance: the earthquake occurred at how to do
School staff
In the schools, the earthquake is most in need of school leaders and teachers of calm and resolute. Medium and long-term earthquake prediction is the region, usually to combine teaching and learning activities to students about the earthquake and defense, shock absorbers knowledge. Zhen former students to make good arrangements for the transfer, withdrawal routes and venues; post-earthquake calmly directing the orderly withdrawal of students. In relatively strong, secure housing, can escape the desk, next to the podium, teaching students to the building of the small hall, a pipeline support room, and never allows students to span or jumping from buildings.
In the streets
When the earthquake occurred, high-rise buildings of glass and concrete building lateral fragments, and advertising signs, tinplate board, Nihong Deng-, may fall wounding, walking in the street, will be the best side of the bag or Top soft goods in the head, no item can also be in the head with their hands for as much as possible for self-defense preparations to be calm, should quickly leave the poles and the wall, toward a broader regional escape.
Shop workers
Can hide in cars, machine tools and equipment under the higher, not to panic span, the special status of workers should be the first closure of inflammable, explosive, toxic gas valves, reduce the time high-temperature, high pressure pipeline temperature and pressure, running off equipment. Most staff can work from the scene, where security protection under the premise of a small number of staff to remain at the scene surveillance danger at any time, the timely processing of the accidents may occur, to prevent the occurrence of secondary disasters.
Vehicles on the
(1) drivers should slow down as soon as possible, and gradually brake gate;
(2) passengers (especially on trains) Application hands firmly seize the handle, or pillars, such as seats and pay attention to preventing baggage fell from the shelves wounding, facing the direction of traffic, to the seats before the arm Upholstery, Huzhu face, tend to channel the body, two-handed Huzhu head; Beichao directions of traffic of people, two-handed Huzhu after brain and abdominal carrying nursing knee, tightening the body, for defensive posture.
Building within the staff
Once the earthquake occurred, we must first maintain a clear, cool head and promptly determine shock situation, must not in jumping from buildings in panic, it is extremely important. Secondly, can escape in a solid furniture, or in a corner, can also be transferred to the load-bearing walls more, the small hall in the kitchen, toilets to take shelter 1:00. Because these areas with strong, especially after handling pipeline, with the support of better, more seismic coefficient. In short, when the earthquake under the layout of buildings and indoor conditions, size up the situation, find safe space and access to avoid and reduce casualties.
Shops in case of earthquake
In department stores experienced the earthquake, it is necessary to maintain calm. As staff panic, the whereabouts of goods, may be blocking access to asylum. At this point, should be hiding near the major pillars of goods and the next (to avoid commodity display cabinet), or no obstacle to the passage in the escape, and then Qushen squat, waiting for the earthquake subsided. In the upstairs location, in principle, to the bottom of the transfer is better. However, anti-seismic building stairs is often the weak parts, so to escape identified the right time. Attendants to organize the masses to the nearest escape, post-earthquake safety evacuation.
Third, self-help after earthquake
If pressure earthquake buried under the rubble, the surrounding is a dark, only a very small space, you must not panic, we should calmly and establish the survival of confidence that someone will Laijiu you, to do everything possible to protect themselves.
After the earthquake, there are often several aftershocks occurred, the situation may continue to deteriorate, in order to avoid new damage to their environment as much as possible to improve their own. At this point, if emergency kits in the side, you will be out of danger from the great role.
In this extremely unfavorable environment, we must first protect the respiratory unimpeded, Nuekai the head, chest of debris, and smelled the gas, poison gas, such as wet clothes of Wuzhu mouth, nose, not at the top of the body to avoid the collapse of the firm And other easily lead to falling objects; expansion and stability of living space, with bricks, sticks and other support for Canyuanduanbi to prevent the aftershocks occurred after the further deterioration of the environment.
To danger from. If you can not find the channel from the danger, the physical preservation of as much as possible, with stones can be audible percussion objects, sent out SOS signals, do not cry, impatient and blind action, which will consume large energy and stamina, as much as possible Control their emotions or Bimu rest and wait for rescue personnel arrived. If injured, it is necessary to think dressing, to avoid excessive bleeding.
Life-sustaining. If buried under the ruins of the relatively long time, rescue workers less, or have not heard SOS signals on finding ways to maintain their own lives, preventing earthquakes packets of water and food must be savings, as much as possible to find food and drinking water, if necessary When their urine can also play a role quench their thirst.
Fourth, where the earthquake damage to the human body's largest
Brain injury casualties in the earthquake is the highest mortality rates, early mortality rate of 30 percent. Maxillofacial, facial features will cause serious injury dysfunction, blood clots and organizations can shift, causing suffocation. Squeeze the body muscles strong, or weight of more than six hours, local muscle necrosis, the release of large amounts of protein decomposition substances into the blood circulation, leading to shock and renal failure, which is squeezed syndrome, a high mortality rate.
Brain injury casualties in the earthquake is the highest mortality rates, early mortality rate of 30 percent. Maxillofacial, facial features will cause serious injury dysfunction, blood clots and organizations can shift, causing suffocation.
Summary of casualties
Brain injury casualties in the earthquake is the highest mortality rates, early mortality rate of 30 percent. Maxillofacial, facial features will cause serious injury dysfunction, blood clots and organizations can shift, causing suffocation. Limbs, injuries account for about different parts of the body injured 50 percent, and frequently have peripheral vascular and nerve injury. Abdominal injury rate low. Most of a pelvic injury urinary system injury.
Hurt in all kinds of fractures of the first, soft tissue injury ranked second, is third in the extrusion of SARS.
Fractures of the spine fractures account for about 1 / 4, of which 30% to 40% with paraplegia. A considerable number is increasing in the handling of paraplegia. Closed to the main limb fracture. Rib fractures stump stabbed pneumothorax or blood can cause chest.
Teach children to the earthquake Protection Manual
Although the earthquake was unable to prevent and control human beings, but as long as the master some skills, but also from the disaster will be to minimize the damage.
First, principles: the withdrawal as soon as possible to the most safe place
Chun-when the nearest escape, post-earthquake rapid evacuation to a safe place contingency protection is a better way. The so-called nearest escape, according to local conditions and in accordance with the different situations of different countermeasures.
Second, different guidance: the earthquake occurred at how to do
School staff
In the schools, the earthquake is most in need of school leaders and teachers of calm and resolute. Medium and long-term earthquake prediction is the region, usually to combine teaching and learning activities to students about the earthquake and defense, shock absorbers knowledge. Zhen former students to make good arrangements for the transfer, withdrawal routes and venues; post-earthquake calmly directing the orderly withdrawal of students. In relatively strong, secure housing, can escape the desk, next to the podium, teaching students to the building of the small hall, a pipeline support room, and never allows students to span or jumping from buildings.
In the streets
When the earthquake occurred, high-rise buildings of glass and concrete building lateral fragments, and advertising signs, tinplate board, Nihong Deng-, may fall wounding, walking in the street, will be the best side of the bag or Top soft goods in the head, no item can also be in the head with their hands for as much as possible for self-defense preparations to be calm, should quickly leave the poles and the wall, toward a broader regional escape.
Shop workers
Can hide in cars, machine tools and equipment under the higher, not to panic span, the special status of workers should be the first closure of inflammable, explosive, toxic gas valves, reduce the time high-temperature, high pressure pipeline temperature and pressure, running off equipment. Most staff can work from the scene, where security protection under the premise of a small number of staff to remain at the scene surveillance danger at any time, the timely processing of the accidents may occur, to prevent the occurrence of secondary disasters.
Vehicles on the
(1) drivers should slow down as soon as possible, and gradually brake gate;
(2) passengers (especially on trains) Application hands firmly seize the handle, or pillars, such as seats and pay attention to preventing baggage fell from the shelves wounding, facing the direction of traffic, to the seats before the arm Upholstery, Huzhu face, tend to channel the body, two-handed Huzhu head; Beichao directions of traffic of people, two-handed Huzhu after brain and abdominal carrying nursing knee, tightening the body, for defensive posture.
Building within the staff
Once the earthquake occurred, we must first maintain a clear, cool head and promptly determine shock situation, must not in jumping from buildings in panic, it is extremely important. Secondly, can escape in a solid furniture, or in a corner, can also be transferred to the load-bearing walls more, the small hall in the kitchen, toilets to take shelter 1:00. Because these areas with strong, especially after handling pipeline, with the support of better, more seismic coefficient. In short, when the earthquake under the layout of buildings and indoor conditions, size up the situation, find safe space and access to avoid and reduce casualties.
Shops in case of earthquake
In department stores experienced the earthquake, it is necessary to maintain calm. As staff panic, the whereabouts of goods, may be blocking access to asylum. At this point, should be hiding near the major pillars of goods and the next (to avoid commodity display cabinet), or no obstacle to the passage in the escape, and then Qushen squat, waiting for the earthquake subsided. In the upstairs location, in principle, to the bottom of the transfer is better. However, anti-seismic building stairs is often the weak parts, so to escape identified the right time. Attendants to organize the masses to the nearest escape, post-earthquake safety evacuation.
Third, self-help after earthquake
If pressure earthquake buried under the rubble, the surrounding is a dark, only a very small space, you must not panic, we should calmly and establish the survival of confidence that someone will Laijiu you, to do everything possible to protect themselves.
After the earthquake, there are often several aftershocks occurred, the situation may continue to deteriorate, in order to avoid new damage to their environment as much as possible to improve their own. At this point, if emergency kits in the side, you will be out of danger from the great role.
In this extremely unfavorable environment, we must first protect the respiratory unimpeded, Nuekai the head, chest of debris, and smelled the gas, poison gas, such as wet clothes of Wuzhu mouth, nose, not at the top of the body to avoid the collapse of the firm And other easily lead to falling objects; expansion and stability of living space, with bricks, sticks and other support for Canyuanduanbi to prevent the aftershocks occurred after the further deterioration of the environment.
To danger from. If you can not find the channel from the danger, the physical preservation of as much as possible, with stones can be audible percussion objects, sent out SOS signals, do not cry, impatient and blind action, which will consume large energy and stamina, as much as possible Control their emotions or Bimu rest and wait for rescue personnel arrived. If injured, it is necessary to think dressing, to avoid excessive bleeding.
Life-sustaining. If buried under the ruins of the relatively long time, rescue workers less, or have not heard SOS signals on finding ways to maintain their own lives, preventing earthquakes packets of water and food must be savings, as much as possible to find food and drinking water, if necessary When their urine can also play a role quench their thirst.
Fourth, where the earthquake damage to the human body's largest
Brain injury casualties in the earthquake is the highest mortality rates, early mortality rate of 30 percent. Maxillofacial, facial features will cause serious injury dysfunction, blood clots and organizations can shift, causing suffocation. Squeeze the body muscles strong, or weight of more than six hours, local muscle necrosis, the release of large amounts of protein decomposition substances into the blood circulation, leading to shock and renal failure, which is squeezed syndrome, a high mortality rate.
Brain injury casualties in the earthquake is the highest mortality rates, early mortality rate of 30 percent. Maxillofacial, facial features will cause serious injury dysfunction, blood clots and organizations can shift, causing suffocation.
Summary of casualties
Brain injury casualties in the earthquake is the highest mortality rates, early mortality rate of 30 percent. Maxillofacial, facial features will cause serious injury dysfunction, blood clots and organizations can shift, causing suffocation. Limbs, injuries account for about different parts of the body injured 50 percent, and frequently have peripheral vascular and nerve injury. Abdominal injury rate low. Most of a pelvic injury urinary system injury.
Hurt in all kinds of fractures of the first, soft tissue injury ranked second, is third in the extrusion of SARS.
Fractures of the spine fractures account for about 1 / 4, of which 30% to 40% with paraplegia. A considerable number is increasing in the handling of paraplegia. Closed to the main limb fracture. Rib fractures stump stabbed pneumothorax or blood can cause chest.
From gastric ulcer caused by a "homicide"
Gastric ulcer is a common digestive disease, hunger does not apply to typical performance, Baozhangaiqi, pantothenic acid, or postprandial timing of the chronic abdominal pain, serious when they have black and hematemesis that occurred gastrorrhagia. Clinical performance as the number of bleeding can be a very serious consequences.
Sally from the north to Guangzhou Chuang world had gone more than a year. With his own smart-minded, hard-working hands, Lingli the Kouchi, by the company of her boss and Tixie. This past year, from his blue-collar to white-collar workers, the median wage from 3 to 4 digits, smooth sailing. The lucky ones dark determined: "efforts, in order to house the car and future wife!" Unfortunately, he has a problem, the money life is also important, is, after all, the hard-earned them. He dry all day long fight ah ah, Qizaotanhei, hunger meal full meal. There was several Tongde Zhibuqiyao stomach pain, he did not mind. His experience, his Nianqinglizhuang, "small wound on the disease" do not have to take medicine or have injections, a Ting, carrying a carry, all will be the last.
One day, he found that from the stool was black, like eating pig blood, and then look like asphalt, was simply a dark red water will be. He also disagreed with Yirenzairen, until the last appeared flustered shortness of breath, every cold sweat, Wodao in bed. His companions rushed to the hospital.
In the hospital, doctors quickly made a diagnosis: gastric ulcer bleeding, hemorrhagic shock. Doctors warned that another , even life may be lost . Sally and blood transfusion in the hospital and rehydration, and traditional Chinese medicine and western medicine, a full two weeks before they recovered and discharged. And his regret, so spending money and to alert Wu Gong, more than usual care of the body, or early discovery and treatment of this issue. He, however, where that chain reaction is yet to come.
To work a few days later, Sally feel that two wrong. As of the original clear eyes become blurred, not only far unclear, even to speak in front of the boss face also appears dim Meng, what seems missing. He had to keep turning her eyes. Boss asked him how this pair of strange way, he said pushed eyes itch. Later, the computer can write even feel the strain. Sally accepted the lessons of last time, not neglect, Ganjin Wang hospitals running, to find the last of Dr. Li Jie Zhen.
Dr. Li very good memory, a Jiu Renchu the youngster. After hearing the statement, he checked the eyelid Sally, as a pupil, said: "The vision is a problem, and may last gastrorrhagia on." Sally can not help confused, the last hospital learned Is: overworked - gastric ulcer - hemorrhage - shock - a life-threatening. This is how bad eyesight, and gastrorrhagia Gua Shanggou «
Sally also too late to ask clear, it was Dr. Li led to Professor Wang, ophthalmic clinics run. Professor Wang after listening to Dr. Li's briefing, to Sally has done some very professional inspection. Go to the binocular vision, and then as eyes-eyes, and then use two search-vision inspection vision. Finally, he pointed to plans to tell Sally vision: "have two eyes can not see a place, it is vision defects, seems to defects in the optic nerve head on."
Sally also committed confused: "nipple is not long in the chest?« How went to the eye where »"
Professor Wang said with a smile: "Human Anatomy, known as the site of more than nipple in the chest, which is also available in several places.'s Eyes can see things, depending on the nipple played a major role. Optic nerve head in the back of the eyeball from the optic fiber From merging, slightly prominent, and there are blood vessels and out the middle. Fundus-use observation, it is like the moon You Yuanyou-15. Optic nerve is responsible for the feeling of light into the brain, depending on the nipple but the only visual access Ah, you said that it was important not important », as the nipple is very delicate, vulnerable to injury. Gastric hemorrhage, due to blood loss, blood pressure will lead to decline. As the water pressure enough, the floors of the high-water supply on the same. Blood pressure Low blood supply to the nipple as inadequate, resulting in hypoxic damage, thus affecting visual function, which in medicine known as the 'ischemic optic nerve head disease'. "
Sally hear the origin of this disease, this know why only a pair of big eyes are turning a blind eye. Professor Wang ranging from under doctor's orders, he immediately insists that hospital. This time, he knows that small things to spend money, but the loss of vision thing, not a good treatment, house car, the wife will go down the drain.
After a period of combining traditional Chinese and western medicine treatment, Sally finally can clearly see .
The two "ordeal Pocai" Let Sally Taichedawu, he no longer "money is king." He finally understand "the body is the capital of revolution," the real meaning of this statement: health is the foundation, is priceless, with it, can a house and car of the future wife. This time, really, this is Sally Feibi Sally!
Sally from the north to Guangzhou Chuang world had gone more than a year. With his own smart-minded, hard-working hands, Lingli the Kouchi, by the company of her boss and Tixie. This past year, from his blue-collar to white-collar workers, the median wage from 3 to 4 digits, smooth sailing. The lucky ones dark determined: "efforts, in order to house the car and future wife!" Unfortunately, he has a problem, the money life is also important, is, after all, the hard-earned them. He dry all day long fight ah ah, Qizaotanhei, hunger meal full meal. There was several Tongde Zhibuqiyao stomach pain, he did not mind. His experience, his Nianqinglizhuang, "small wound on the disease" do not have to take medicine or have injections, a Ting, carrying a carry, all will be the last.
One day, he found that from the stool was black, like eating pig blood, and then look like asphalt, was simply a dark red water will be. He also disagreed with Yirenzairen, until the last appeared flustered shortness of breath, every cold sweat, Wodao in bed. His companions rushed to the hospital.
In the hospital, doctors quickly made a diagnosis: gastric ulcer bleeding, hemorrhagic shock. Doctors warned that another , even life may be lost . Sally and blood transfusion in the hospital and rehydration, and traditional Chinese medicine and western medicine, a full two weeks before they recovered and discharged. And his regret, so spending money and to alert Wu Gong, more than usual care of the body, or early discovery and treatment of this issue. He, however, where that chain reaction is yet to come.
To work a few days later, Sally feel that two wrong. As of the original clear eyes become blurred, not only far unclear, even to speak in front of the boss face also appears dim Meng, what seems missing. He had to keep turning her eyes. Boss asked him how this pair of strange way, he said pushed eyes itch. Later, the computer can write even feel the strain. Sally accepted the lessons of last time, not neglect, Ganjin Wang hospitals running, to find the last of Dr. Li Jie Zhen.
Dr. Li very good memory, a Jiu Renchu the youngster. After hearing the statement, he checked the eyelid Sally, as a pupil, said: "The vision is a problem, and may last gastrorrhagia on." Sally can not help confused, the last hospital learned Is: overworked - gastric ulcer - hemorrhage - shock - a life-threatening. This is how bad eyesight, and gastrorrhagia Gua Shanggou «
Sally also too late to ask clear, it was Dr. Li led to Professor Wang, ophthalmic clinics run. Professor Wang after listening to Dr. Li's briefing, to Sally has done some very professional inspection. Go to the binocular vision, and then as eyes-eyes, and then use two search-vision inspection vision. Finally, he pointed to plans to tell Sally vision: "have two eyes can not see a place, it is vision defects, seems to defects in the optic nerve head on."
Sally also committed confused: "nipple is not long in the chest?« How went to the eye where »"
Professor Wang said with a smile: "Human Anatomy, known as the site of more than nipple in the chest, which is also available in several places.'s Eyes can see things, depending on the nipple played a major role. Optic nerve head in the back of the eyeball from the optic fiber From merging, slightly prominent, and there are blood vessels and out the middle. Fundus-use observation, it is like the moon You Yuanyou-15. Optic nerve is responsible for the feeling of light into the brain, depending on the nipple but the only visual access Ah, you said that it was important not important », as the nipple is very delicate, vulnerable to injury. Gastric hemorrhage, due to blood loss, blood pressure will lead to decline. As the water pressure enough, the floors of the high-water supply on the same. Blood pressure Low blood supply to the nipple as inadequate, resulting in hypoxic damage, thus affecting visual function, which in medicine known as the 'ischemic optic nerve head disease'. "
Sally hear the origin of this disease, this know why only a pair of big eyes are turning a blind eye. Professor Wang ranging from under doctor's orders, he immediately insists that hospital. This time, he knows that small things to spend money, but the loss of vision thing, not a good treatment, house car, the wife will go down the drain.
After a period of combining traditional Chinese and western medicine treatment, Sally finally can clearly see .
The two "ordeal Pocai" Let Sally Taichedawu, he no longer "money is king." He finally understand "the body is the capital of revolution," the real meaning of this statement: health is the foundation, is priceless, with it, can a house and car of the future wife. This time, really, this is Sally Feibi Sally!
Hemorrhagic shock should be on how to prevent
1. Active infection control
2. Traumatic to the scene in time to stop bleeding such as insulation, and other analgesic
3. Excessive bleeding or fluid loss (such as diarrhea and vomiting hemoptysis gastrointestinal bleeding sweat a lot, and so on), as appropriate, patients should be timely rehydration or blood transfusion
2. Traumatic to the scene in time to stop bleeding such as insulation, and other analgesic
3. Excessive bleeding or fluid loss (such as diarrhea and vomiting hemoptysis gastrointestinal bleeding sweat a lot, and so on), as appropriate, patients should be timely rehydration or blood transfusion
How should hemorrhagic shock treatment
Hemorrhagic shock treatment in the first procedures to ensure that the airway open and bleeding airway patency is effective ventilation and oxygen should be the basic conditions for the effective guarantee of a serious shock and circulatory failure patients should also be given to intubation and mechanical Ventilation is to stop bleeding and shock in the development of oppressive measures to stop bleeding is feasible and effective emergency measures; tourniquet should be applied is also very effective as soon as possible to establish a two-channel intravenous infusion
With the establishment of an immediate infusion access to a large number of serious shock rapid rehydration should quickly enter the 1 ~ 2 L isotonic balanced salt solution then added the best cross-matching blood transfusion can to help with the type or the type O red blood cells particularly in the application of balance After the salt solution in restoring the capacity can not meet the requirements of the recovery should be lost with the red blood cell hemoglobin to 10 g / dl above but not the bleeding of the above-mentioned method of rehydration blood transfusion is defective because of a strong recovery in the liquid will increase Chongdiao thrombosis Hemorrhagic lower survival rate in the hospital for first aid in particular the use of high-salt solution to achieve rapid expansion of the practice still controversial
In the absence of central venous catheter or through the pulmonary artery catheterization test will be the case with the following clinical indicators to grasp that the urine treatment required to achieve 0.5 ~ 1.0 ml / (kg.h) normal heart rate normal blood pressure normal capillary filling good perception
Worth of tips in response to massive blood loss is a recovery after that is to compensate for blood loss and blood transfusion should be in addition to re-supply a certain amount of liquid crystal and colloidal liquid in order to adapt to fluid separation needs to understand this need not only to limit rehydration And the inappropriate treatment of its consequences will increase shock lead metabolic acidosis-induced multiple organ failure and even cause death of about 1 d after the body fluids from the separation of the shift to the diuretic phase from the vessel, through the accumulation of fluid that is to increase the diuretic was superfluous body fluids Turn out to mobilize the body fluids gap gradually restored to normal level before the injury
With the establishment of an immediate infusion access to a large number of serious shock rapid rehydration should quickly enter the 1 ~ 2 L isotonic balanced salt solution then added the best cross-matching blood transfusion can to help with the type or the type O red blood cells particularly in the application of balance After the salt solution in restoring the capacity can not meet the requirements of the recovery should be lost with the red blood cell hemoglobin to 10 g / dl above but not the bleeding of the above-mentioned method of rehydration blood transfusion is defective because of a strong recovery in the liquid will increase Chongdiao thrombosis Hemorrhagic lower survival rate in the hospital for first aid in particular the use of high-salt solution to achieve rapid expansion of the practice still controversial
In the absence of central venous catheter or through the pulmonary artery catheterization test will be the case with the following clinical indicators to grasp that the urine treatment required to achieve 0.5 ~ 1.0 ml / (kg.h) normal heart rate normal blood pressure normal capillary filling good perception
Worth of tips in response to massive blood loss is a recovery after that is to compensate for blood loss and blood transfusion should be in addition to re-supply a certain amount of liquid crystal and colloidal liquid in order to adapt to fluid separation needs to understand this need not only to limit rehydration And the inappropriate treatment of its consequences will increase shock lead metabolic acidosis-induced multiple organ failure and even cause death of about 1 d after the body fluids from the separation of the shift to the diuretic phase from the vessel, through the accumulation of fluid that is to increase the diuretic was superfluous body fluids Turn out to mobilize the body fluids gap gradually restored to normal level before the injury
Hemorrhagic shock can be complicated by the diseases
And traumatic shock the same hemorrhagic shock easily with DIC (disseminated intravascular coagulation) can cause serious shock death of the patients therefore need to timely rescue
Disseminated intravascular coagulation (disseminated intravascular coagulation, DIC) is a syndrome, not an independent disease, in the role of various pathogenic factors, in the capillaries, arteries, veins within the broader small fibrin deposition and platelet Gathered to form a wide range of micro-thrombosis, resulting in circulation and other internal organs dysfunction, consumption of clotting disease, secondary fibrinolysis, a shock, hemorrhage, embolism, hemolysis, and other clinical manifestations. Has in the past referred to as low blood fibrinogen Of (defibrination), consumption of clotting disease (comsumptive coagulopathy), have recently been considered expendable to thrombosis hemorrhagic disease (comsumptive thrombohemorrhagic disordors) as well, but still the most commonly used disseminated intravascular coagulation. Acute onset of DIC Jizhou Rapid development. Common symptoms are the following:
1 bleeding: Light skin can be only a few points of severe bleeding, that a wide range of skin or mucous membrane Yuban hematoma typical for large areas of skin Yuban visceral bleeding wound bleeding more than parts
2 thrombosis related to performance:
(1) skin thromboembolism: the most common nasal tip-toe ear fingertip skin cyanosis Ban Kuaizhuang bleeding skin necrosis stem necrosis, etc.
(2) renal thrombosis: oliguria no urine azotemia, and other manifestations of acute renal failure the most common
(3) pulmonary thrombosis: breathing difficulties cyanotic hemoptysis severe acute pulmonary failure can occur
(4) gastrointestinal thrombosis: gastrointestinal bleeding nausea and vomiting and abdominal pain
(5) cerebral thrombosis: irritable sense of lethargy obstacles coma convulsions cranial nerve palsy and paralysis of limbs
3 shock: acromegaly cold bluish violet oliguria and blood pressure dropped to vascular endothelial damage caused by DIC more
4 hemolytic: red blood cells through a result of microvascular disease, injury suffered mechanical deformation and rupture occurred on the clinical hemolytic anemia hemoglobin may have jaundice
5 original-like symptoms.
Disseminated intravascular coagulation (disseminated intravascular coagulation, DIC) is a syndrome, not an independent disease, in the role of various pathogenic factors, in the capillaries, arteries, veins within the broader small fibrin deposition and platelet Gathered to form a wide range of micro-thrombosis, resulting in circulation and other internal organs dysfunction, consumption of clotting disease, secondary fibrinolysis, a shock, hemorrhage, embolism, hemolysis, and other clinical manifestations. Has in the past referred to as low blood fibrinogen Of (defibrination), consumption of clotting disease (comsumptive coagulopathy), have recently been considered expendable to thrombosis hemorrhagic disease (comsumptive thrombohemorrhagic disordors) as well, but still the most commonly used disseminated intravascular coagulation. Acute onset of DIC Jizhou Rapid development. Common symptoms are the following:
1 bleeding: Light skin can be only a few points of severe bleeding, that a wide range of skin or mucous membrane Yuban hematoma typical for large areas of skin Yuban visceral bleeding wound bleeding more than parts
2 thrombosis related to performance:
(1) skin thromboembolism: the most common nasal tip-toe ear fingertip skin cyanosis Ban Kuaizhuang bleeding skin necrosis stem necrosis, etc.
(2) renal thrombosis: oliguria no urine azotemia, and other manifestations of acute renal failure the most common
(3) pulmonary thrombosis: breathing difficulties cyanotic hemoptysis severe acute pulmonary failure can occur
(4) gastrointestinal thrombosis: gastrointestinal bleeding nausea and vomiting and abdominal pain
(5) cerebral thrombosis: irritable sense of lethargy obstacles coma convulsions cranial nerve palsy and paralysis of limbs
3 shock: acromegaly cold bluish violet oliguria and blood pressure dropped to vascular endothelial damage caused by DIC more
4 hemolytic: red blood cells through a result of microvascular disease, injury suffered mechanical deformation and rupture occurred on the clinical hemolytic anemia hemoglobin may have jaundice
5 original-like symptoms.
Hemorrhagic shock easily confused with the diseases
Inadequate capacity beyond compensatory function will show symptoms of heart from the shock integrated output to reduce systolic blood pressure despite the peripheral vascular perfusion still fell organizations to reduce the formation of lactic acid in anaerobic metabolism and increased metabolic acidosis re-distribution of blood flow to the brain and heart blood supply to To maintain the vessel will lead to further contraction of vascular endothelial cell damage caused damage to the loss of body fluids and low blood volume will eventually increase the occurrence of multiple organ failure on the intestinal mucosa hemorrhagic shock caused by intestinal antibodies from the defense capabilities have been Damage is likely to pneumonia and other infectious complications in the pathogenesis of the important loss of blood endotoxin Zhi Siliang the attacks have the ability to cross-tolerance that is the loss of blood, Zhisi Liang Zhi Siliang, toxins can attack the protective effect of a
Hemorrhagic shock should do what checks
Of the disease in check mainly rely on physical examination with the experimental inspection:
A medical examination
Asked in detail about the patient history and medical examination carried out strictly in general and vascular content of less than the compensatory adrenal response to these indexes reflect
2 experimental inspection
Experimental Detection and different medical examination because of acute blood loss in a short period of time after the body fluids also can not move through the blood is obviously difficult to detect indicators reflected the process longer if bleeding body fluids moving gradually increased so that blood will be present for the performance of hemoglobin higher concentration of blood cells Specific volume increased urea nitrogen and creatinine increase the proportion of the process longer if the hemorrhagic bleeding is particularly large amount of free water loss will occur gradually increased serum sodium therefore be increased in accordance with the laboratory blood test accurate estimate of blood loss
A medical examination
Asked in detail about the patient history and medical examination carried out strictly in general and vascular content of less than the compensatory adrenal response to these indexes reflect
2 experimental inspection
Experimental Detection and different medical examination because of acute blood loss in a short period of time after the body fluids also can not move through the blood is obviously difficult to detect indicators reflected the process longer if bleeding body fluids moving gradually increased so that blood will be present for the performance of hemoglobin higher concentration of blood cells Specific volume increased urea nitrogen and creatinine increase the proportion of the process longer if the hemorrhagic bleeding is particularly large amount of free water loss will occur gradually increased serum sodium therefore be increased in accordance with the laboratory blood test accurate estimate of blood loss
What are the hemorrhagic shock performance and how to diagnosis
In many cases the bleeding is not difficult to diagnose and can reflect the history and signs of vascular content and lack of adrenal compensatory reaction to the experimental test, however not entirely the case because of acute blood loss in a short period of time after the body fluids also move Obviously it is impossible not through blood tests indicators reflected the process longer if bleeding body fluids moving gradually increased so that blood will be present for the performance of hemoglobin concentration increased blood cells specific volume increased urea nitrogen and creatinine increase the proportion of loss of blood if the process longer hemorrhagic In particular the large amount of free water loss will occur gradually increased serum sodium increased sum up the shock of blood loss should be a full estimate of the often underestimated noteworthy
When the larger cause severe hemorrhagic low capacity in clinical shock and also difficult to grasp living practical changes in laws and in particular the recovery rehydration therapy is also difficult to show positive results should be considered at central venous catheter or conduct a pulmonary artery catheter Hemodynamic monitoring pressure through the centre can be observed CVP (CVP) and pulmonary artery wedge pressure (PCWP) from the heart to reduce output to reduce venous oxygen saturation (SVO2) and reduced systemic vascular resistance increased
When the larger cause severe hemorrhagic low capacity in clinical shock and also difficult to grasp living practical changes in laws and in particular the recovery rehydration therapy is also difficult to show positive results should be considered at central venous catheter or conduct a pulmonary artery catheter Hemodynamic monitoring pressure through the centre can be observed CVP (CVP) and pulmonary artery wedge pressure (PCWP) from the heart to reduce output to reduce venous oxygen saturation (SVO2) and reduced systemic vascular resistance increased
Hemorrhagic shock is what causes
Microcirculation (ischemia congestion disseminated intravascular coagulation) of microcirculation blood perfusion less than the life of an important organ because of asphyxia and metabolic functions in various types of obstacles is the common shock of shock-cycle changes can be broadly That is, for the three-cycle ischemia microcirculation congestion period and the microcirculation of blood coagulation
(A) of micro-circulation ischemia (hypoxic ischemic period)
Micro-cycle changes in this period was characterized by: ① after the micro-micro-artery artery and capillary sphincter contraction before the micro-irrigation cycle dramatically reduce traffic pressure on the lower; ② micro-and small vein vein of catecholamine less sensitive contraction lighter; ③ arteriovenous anastomosis Support may have different degrees of blood from the open-artery anastomosis with the arteriovenous directly into the small veins
Microcirculation ischemia caused a critical change is sympathetic - adrenomedullin system strongly excited different types of shock can be caused by different mechanisms sympathetic - adrenomedullin shock and cardiac shock when cardiac output and reduce arterial blood pressure Can be reduced through the arch sinus reflex sympathetic to - excited adrenomedullin system in the majority of endotoxin shock endotoxin can directly stimulate the sympathetic - adrenomedullin system make it a strong excitement
Sympathetic excited about the release of catecholamines on the cardiovascular system to increase the overall effect is to make the total peripheral resistance and increased cardiac output increase but different organs of the reaction vessel by a difference in the skin of the abdominal organs and kidney is rich in blood vessels due to sympathetic shrink Vascular and disposable fiber α receptor and thus take advantage of the sympathetic catecholamine more excited when these parts of the arteries-arteries and veins of small capillaries including former Red muscle contraction which have taken place in the artery because of micro-fiber sympathetic vasoconstrictor distribution of the capillary Vascular before catecholamines sphincter of the response of the strongest so that they contracted the most strong resistance before the result was significantly higher capillary micro-irrigation cycle of capillary flow dramatically reduced the average blood pressure decreased by only a small amount of blood straight Jie Tong Road and a few really into the capillaries Micro-vein small vein organizations so serious hypoxic ischemic brain vascular sympathetic vasoconstrictor fiber distribution of at least α-density low-calibre can be no significant changes in coronary Although there are also sympathetic innervation and β receptor α sympathetic but excited And catecholamines are more activities to strengthen the heart by raising the level of metabolism that vasodilative metabolites in particular the increase in adenosine coronary expansion
Sympathetic excited and can reduce blood volume activation of the renin - angiotensin - Ⅱ angiotensin-aldosterone system and have a stronger role in the vasoconstrictor, including the contraction of the coronary
Besides the increase in catecholamine stimulation can produce more platelet thromboxane A2 (thromboxane A2, TXA2) and TXA2 also have a strong role in the vasoconstrictor
Hemorrhagic shock
Figure 1 microcirculation model of the development process
1. Normal circumstances
⑴ arteriovenous anastomosis with the closure of the
⑵ only 20% of capillary blood perfusion rotation and opening up
⑶ capillaries open and close the capillaries before sphincter contraction and relaxation of the regulation
2. Microcirculation ischemia
⑴ sympathetic excitement and adrenaline secretion of norepinephrine increase in small arteries after artery-artery-capillary before sphincter contraction
⑵ arteriovenous anastomosis with blood by the open-artery directly into the small veins
⑶ capillary blood perfusion less than hypoxia
3. Microcirculation of blood stasis
⑴ small and micro-artery contraction artery anastomosis with arteriovenous still in the open state of the capillary into the blood is still very small
⑵ due to hypoxia histamine bradykinin hydrogen ions and other substances increased after Shu-vascular arteries and capillaries sphincter relaxation before the opening capillary blood vessels to expand into the volume of capillary blood flow is slow
⑶ sympathetic excited because epinephrine and norepinephrine secretion increased (and possibly the role of histamine) to enable small and micro-vein capillary veins shrink after the results of increased resistance to blood stasis telangiectasia
4. Microcirculation of blood coagulation
⑴ due to hypoxia organizations serious acid poisoning capillary wall damage and increased permeability of capillary blood flow stasis concentrated other blood coagulation results in increased microcirculation produced disseminated intravascular coagulation
⑵ due to more heavy-thrombosis hypoxia and metabolic barriers lysosomal rupture cells from the tissue necrosis serious organ dysfunction
⑶ because of clotting blood coagulation factor (such as the prothrombin fibrinogen, etc.) and platelet consumption by a large number of fibrin degradation products also increased to reduce blood coagulation; damaged vessel wall and then extensive bleeding occurred
And TXA2 also have a strong role in the vasoconstrictor
There are lysosomal enzyme - myocardial inhibitor system in the shock stage Ⅰ microcirculation in the incidence of ischemic also played a role mainly due to shock when the pancreas reduced blood flow caused by irrigation of ischemia and hypoxia and acidosis can pancreatic Exocrine cells rupture and release of lysosomal cathepsin decomposition of the latter to generate protein and myocardial inhibitory factor (myocardial depressant factor, MDF) MDF small peptides into the blood after contraction in addition to cause myocardial weakened inhibition mononuclear phagocytes Phagocytosis outside the system can make visceral abdominal contraction of the small blood vessels so as to further increase the weight of these parts microcirculation of ischemic
This issue's main clinical manifestations are: skin pale limbs Jueleng a cold sweat urine output decreased because of peripheral resistance can not increase significantly reduce systolic blood pressure and diastolic blood pressure has increased the pulse of small-speed pulse pressure decreases; clear consciousness, such as irritability
Micro-cycle changes in this period have a certain significance of compensatory skin and abdominal organs, and other small artery contraction can increase peripheral resistance in order to maintain blood pressure can reduce the number of tissues and organs of blood flow to ensure that the heart and brain and other vital organs of the blood supply; capillary ago Resistance increased capillary fluid pressure to reduce tissue fluid entered the blood plasma to increase the capacity of other arteriovenous open vein anastomosis with the contraction capacity of narrow vein (some 70% of normal blood in the veins) can speed up and increase output but also conducive to Huixin blood pressure The maintenance of heart and brain and the blood supply because most of tissues and organs because of microcirculation to lack of blood perfusion in hypoxia will lead to the further development of shock if early detection of positive timely rescue added output to reduce the drama of the stress response can be quickly Improve microcirculation and restore blood pressure to prevent further deterioration of shock and Turning the Tide
At this time the mechanism of micro-cycle changes can be summarized as follows (Figure 2):
(B) microcirculation congestion period (congestion period of hypoxia)
In a shock through the cycle of ischemia such as failure to improve microcirculation early for emergency treatment due to the ongoing and serious vascular Shu hypoxia local materials (such as histamine bradykinin acid adenosine, etc.) after the number of arterioles and capillaries Sphincter relaxation before expand micro-cycle capacity to shock the development of congestion-congestion period of this cycle of micro-circulation is characterized by: ① after the arteries and capillaries-before sphincter relaxation (a result of local acidosis catecholamine response to lower) open a large number of capillaries Was not the side of the capsule-shaped expansion (pool of blood-forming) expansion of micro-circulation volume; ② micro-and small vein vein of local acidosis catecholamine still greater tolerance to shrink (histamine can make hepatopulmonary Vein, such as micro-and small vein shrinkage) after the resistance increased capillary blood flow -slow; ③ microvascular wall of plasma leakage increased permeability of blood stasis; ④ concentrated blood cells as blood pressure increases red blood cell plot of platelet aggregation interleukin impaction Adhesion and aggregation, and other changes in hemorheology microcirculation blood flow can slow down or even stop the ⑤ microcirculation congestion due to increased pressure on Circulating the blood into the micro-less (At this point small and micro-artery artery is still in effect due to sympathetic Contraction) due to massive siltation in the blood-circulating Huixin output to reduce cardiac output further reduce the shock of increased development
Hemorrhagic shock
Figure 2 hypoxic ischemic mechanism of micro-cycle changes
As a result of these micro-cycle changes in the microcirculation Although the plot but a large number of arterial blood flow irrigation will be reduced even more patients from the pale skin color gradually cyanosis especially because I-chen and fingertip vein to flow and cardiac output decrease more patients intravenous wilt depression Filling slow arterial pressure decreased pulse pressure on the small clock speed; heart and brain due to insufficient supply of blood and reduce the ATP generation performance for the weakening of the heart contraction (lower heart sounds) or indifferent expression of consciousness can occur unclear serious heart and kidney failure that lung function Is the critical state of shock should immediately lift the rescue of small vasospasm rehydration of oxygen to correct acid poisoning to clear the microcirculation and prevent disseminated intravascular coagulation when the mechanism of micro-cycle changes can be summarized as follows (Figure 3):
Hemorrhagic shock
Figure 3 congestion period of hypoxia-cycle changes in the mechanism
(C) microcirculation of blood coagulation (disseminated intravascular coagulation)
Microcirculation from the congestion phase of the development cycle for the micro-coagulation is the shock of the deteriorating performance of its features are: microcirculation congestion on the basis of the microcirculation (especially micro-capillary veins vein small vein) fibrin thrombosis And often focal or diffuse bleeding due to severe hypoxic cells caused necrosis
Disseminated intravascular coagulation and the shock of the extremely close contact on disseminated intravascular coagulation caused pathological changes and how it can cause shock or add to the development of in shock, "disseminated intravascular coagulation," a chapter here again discussed the outline How to summarize the shock caused disseminated intravascular coagulation
1. Stress response to increased blood coagulation of the cause of shock (such as burn wounds bleeding, etc.) and the shock itself is a strong stimulus can cause stress and excitement of pituitary sympathetic - adrenal cortex activities to strengthen the blood Platelet and clotting factor in the increase of platelet aggregation and adhesion to strengthen the capacity of blood coagulation provide the necessary material foundation
2. Clotting factor and the activation of the release of some cause shock (such as trauma burns, etc.) can make their own clotting factor release and activation of the damage such as the organization can release a large number of organizations thromboplastin start of exogenous clotting process; large Burned large number of red blood cells to destroy the red blood cell membrane phospholipid destruction of red blood cells and release of the ADP process to promote blood coagulation
3. Microcirculation hypoxia local histamine bradykinin, such as lactic acid number of these substances on the one hand telangiectasia congestion caused increased permeability of the slow flow of blood viscosity increase red blood cell concentration is conducive to thrombosis; On the other hand damage capillary Vascular endothelial cells exposed collagen activate clotting factor Ⅻ and the platelet adhesion and aggregation
4. Hypoxia engulfed the single-cell nuclear systems can not function timely removal of thrombin and thrombin yuan fibrin results in the role of these factors caused disseminated intravascular coagulation
Disseminated intravascular coagulation event will microcirculation more serious shock condition further deteriorated this is because: ① wide range of microvascular obstruction microcirculation to further increase output further reduce Huixin; ② clotting substances that Deplete the secondary fibrinolysis activation And other factors cause bleeding so that reduced blood volume; ③ soluble fibrin polymer and its products, such as cracking can be swallowed up by the closed-cell system so that the toxins from the intestine can not be fully cleared
As disseminated intravascular coagulation and the occurrence of microcirculation congestion due to the continuous increase of blood pressure lowering of the body caused by micro-irrigation cycle of the severe shortage of general flow of hypoxia and acidosis will also become increasingly serious; serious acid poisoning also can Cell membrane rupture within the lysosomes release of lysosomal enzyme (such as hydrolyzed protein Meideng) and cause some shock (such as endotoxin, etc.) so that cells can be serious and irreversible damage to the heart and brain, including the The various metabolic functions of vital organs are more serious obstacles (in detail later) that gave cause great difficulties for the current period is also known as the refractory period of shock
(A) of micro-circulation ischemia (hypoxic ischemic period)
Micro-cycle changes in this period was characterized by: ① after the micro-micro-artery artery and capillary sphincter contraction before the micro-irrigation cycle dramatically reduce traffic pressure on the lower; ② micro-and small vein vein of catecholamine less sensitive contraction lighter; ③ arteriovenous anastomosis Support may have different degrees of blood from the open-artery anastomosis with the arteriovenous directly into the small veins
Microcirculation ischemia caused a critical change is sympathetic - adrenomedullin system strongly excited different types of shock can be caused by different mechanisms sympathetic - adrenomedullin shock and cardiac shock when cardiac output and reduce arterial blood pressure Can be reduced through the arch sinus reflex sympathetic to - excited adrenomedullin system in the majority of endotoxin shock endotoxin can directly stimulate the sympathetic - adrenomedullin system make it a strong excitement
Sympathetic excited about the release of catecholamines on the cardiovascular system to increase the overall effect is to make the total peripheral resistance and increased cardiac output increase but different organs of the reaction vessel by a difference in the skin of the abdominal organs and kidney is rich in blood vessels due to sympathetic shrink Vascular and disposable fiber α receptor and thus take advantage of the sympathetic catecholamine more excited when these parts of the arteries-arteries and veins of small capillaries including former Red muscle contraction which have taken place in the artery because of micro-fiber sympathetic vasoconstrictor distribution of the capillary Vascular before catecholamines sphincter of the response of the strongest so that they contracted the most strong resistance before the result was significantly higher capillary micro-irrigation cycle of capillary flow dramatically reduced the average blood pressure decreased by only a small amount of blood straight Jie Tong Road and a few really into the capillaries Micro-vein small vein organizations so serious hypoxic ischemic brain vascular sympathetic vasoconstrictor fiber distribution of at least α-density low-calibre can be no significant changes in coronary Although there are also sympathetic innervation and β receptor α sympathetic but excited And catecholamines are more activities to strengthen the heart by raising the level of metabolism that vasodilative metabolites in particular the increase in adenosine coronary expansion
Sympathetic excited and can reduce blood volume activation of the renin - angiotensin - Ⅱ angiotensin-aldosterone system and have a stronger role in the vasoconstrictor, including the contraction of the coronary
Besides the increase in catecholamine stimulation can produce more platelet thromboxane A2 (thromboxane A2, TXA2) and TXA2 also have a strong role in the vasoconstrictor
Hemorrhagic shock
Figure 1 microcirculation model of the development process
1. Normal circumstances
⑴ arteriovenous anastomosis with the closure of the
⑵ only 20% of capillary blood perfusion rotation and opening up
⑶ capillaries open and close the capillaries before sphincter contraction and relaxation of the regulation
2. Microcirculation ischemia
⑴ sympathetic excitement and adrenaline secretion of norepinephrine increase in small arteries after artery-artery-capillary before sphincter contraction
⑵ arteriovenous anastomosis with blood by the open-artery directly into the small veins
⑶ capillary blood perfusion less than hypoxia
3. Microcirculation of blood stasis
⑴ small and micro-artery contraction artery anastomosis with arteriovenous still in the open state of the capillary into the blood is still very small
⑵ due to hypoxia histamine bradykinin hydrogen ions and other substances increased after Shu-vascular arteries and capillaries sphincter relaxation before the opening capillary blood vessels to expand into the volume of capillary blood flow is slow
⑶ sympathetic excited because epinephrine and norepinephrine secretion increased (and possibly the role of histamine) to enable small and micro-vein capillary veins shrink after the results of increased resistance to blood stasis telangiectasia
4. Microcirculation of blood coagulation
⑴ due to hypoxia organizations serious acid poisoning capillary wall damage and increased permeability of capillary blood flow stasis concentrated other blood coagulation results in increased microcirculation produced disseminated intravascular coagulation
⑵ due to more heavy-thrombosis hypoxia and metabolic barriers lysosomal rupture cells from the tissue necrosis serious organ dysfunction
⑶ because of clotting blood coagulation factor (such as the prothrombin fibrinogen, etc.) and platelet consumption by a large number of fibrin degradation products also increased to reduce blood coagulation; damaged vessel wall and then extensive bleeding occurred
And TXA2 also have a strong role in the vasoconstrictor
There are lysosomal enzyme - myocardial inhibitor system in the shock stage Ⅰ microcirculation in the incidence of ischemic also played a role mainly due to shock when the pancreas reduced blood flow caused by irrigation of ischemia and hypoxia and acidosis can pancreatic Exocrine cells rupture and release of lysosomal cathepsin decomposition of the latter to generate protein and myocardial inhibitory factor (myocardial depressant factor, MDF) MDF small peptides into the blood after contraction in addition to cause myocardial weakened inhibition mononuclear phagocytes Phagocytosis outside the system can make visceral abdominal contraction of the small blood vessels so as to further increase the weight of these parts microcirculation of ischemic
This issue's main clinical manifestations are: skin pale limbs Jueleng a cold sweat urine output decreased because of peripheral resistance can not increase significantly reduce systolic blood pressure and diastolic blood pressure has increased the pulse of small-speed pulse pressure decreases; clear consciousness, such as irritability
Micro-cycle changes in this period have a certain significance of compensatory skin and abdominal organs, and other small artery contraction can increase peripheral resistance in order to maintain blood pressure can reduce the number of tissues and organs of blood flow to ensure that the heart and brain and other vital organs of the blood supply; capillary ago Resistance increased capillary fluid pressure to reduce tissue fluid entered the blood plasma to increase the capacity of other arteriovenous open vein anastomosis with the contraction capacity of narrow vein (some 70% of normal blood in the veins) can speed up and increase output but also conducive to Huixin blood pressure The maintenance of heart and brain and the blood supply because most of tissues and organs because of microcirculation to lack of blood perfusion in hypoxia will lead to the further development of shock if early detection of positive timely rescue added output to reduce the drama of the stress response can be quickly Improve microcirculation and restore blood pressure to prevent further deterioration of shock and Turning the Tide
At this time the mechanism of micro-cycle changes can be summarized as follows (Figure 2):
(B) microcirculation congestion period (congestion period of hypoxia)
In a shock through the cycle of ischemia such as failure to improve microcirculation early for emergency treatment due to the ongoing and serious vascular Shu hypoxia local materials (such as histamine bradykinin acid adenosine, etc.) after the number of arterioles and capillaries Sphincter relaxation before expand micro-cycle capacity to shock the development of congestion-congestion period of this cycle of micro-circulation is characterized by: ① after the arteries and capillaries-before sphincter relaxation (a result of local acidosis catecholamine response to lower) open a large number of capillaries Was not the side of the capsule-shaped expansion (pool of blood-forming) expansion of micro-circulation volume; ② micro-and small vein vein of local acidosis catecholamine still greater tolerance to shrink (histamine can make hepatopulmonary Vein, such as micro-and small vein shrinkage) after the resistance increased capillary blood flow -slow; ③ microvascular wall of plasma leakage increased permeability of blood stasis; ④ concentrated blood cells as blood pressure increases red blood cell plot of platelet aggregation interleukin impaction Adhesion and aggregation, and other changes in hemorheology microcirculation blood flow can slow down or even stop the ⑤ microcirculation congestion due to increased pressure on Circulating the blood into the micro-less (At this point small and micro-artery artery is still in effect due to sympathetic Contraction) due to massive siltation in the blood-circulating Huixin output to reduce cardiac output further reduce the shock of increased development
Hemorrhagic shock
Figure 2 hypoxic ischemic mechanism of micro-cycle changes
As a result of these micro-cycle changes in the microcirculation Although the plot but a large number of arterial blood flow irrigation will be reduced even more patients from the pale skin color gradually cyanosis especially because I-chen and fingertip vein to flow and cardiac output decrease more patients intravenous wilt depression Filling slow arterial pressure decreased pulse pressure on the small clock speed; heart and brain due to insufficient supply of blood and reduce the ATP generation performance for the weakening of the heart contraction (lower heart sounds) or indifferent expression of consciousness can occur unclear serious heart and kidney failure that lung function Is the critical state of shock should immediately lift the rescue of small vasospasm rehydration of oxygen to correct acid poisoning to clear the microcirculation and prevent disseminated intravascular coagulation when the mechanism of micro-cycle changes can be summarized as follows (Figure 3):
Hemorrhagic shock
Figure 3 congestion period of hypoxia-cycle changes in the mechanism
(C) microcirculation of blood coagulation (disseminated intravascular coagulation)
Microcirculation from the congestion phase of the development cycle for the micro-coagulation is the shock of the deteriorating performance of its features are: microcirculation congestion on the basis of the microcirculation (especially micro-capillary veins vein small vein) fibrin thrombosis And often focal or diffuse bleeding due to severe hypoxic cells caused necrosis
Disseminated intravascular coagulation and the shock of the extremely close contact on disseminated intravascular coagulation caused pathological changes and how it can cause shock or add to the development of in shock, "disseminated intravascular coagulation," a chapter here again discussed the outline How to summarize the shock caused disseminated intravascular coagulation
1. Stress response to increased blood coagulation of the cause of shock (such as burn wounds bleeding, etc.) and the shock itself is a strong stimulus can cause stress and excitement of pituitary sympathetic - adrenal cortex activities to strengthen the blood Platelet and clotting factor in the increase of platelet aggregation and adhesion to strengthen the capacity of blood coagulation provide the necessary material foundation
2. Clotting factor and the activation of the release of some cause shock (such as trauma burns, etc.) can make their own clotting factor release and activation of the damage such as the organization can release a large number of organizations thromboplastin start of exogenous clotting process; large Burned large number of red blood cells to destroy the red blood cell membrane phospholipid destruction of red blood cells and release of the ADP process to promote blood coagulation
3. Microcirculation hypoxia local histamine bradykinin, such as lactic acid number of these substances on the one hand telangiectasia congestion caused increased permeability of the slow flow of blood viscosity increase red blood cell concentration is conducive to thrombosis; On the other hand damage capillary Vascular endothelial cells exposed collagen activate clotting factor Ⅻ and the platelet adhesion and aggregation
4. Hypoxia engulfed the single-cell nuclear systems can not function timely removal of thrombin and thrombin yuan fibrin results in the role of these factors caused disseminated intravascular coagulation
Disseminated intravascular coagulation event will microcirculation more serious shock condition further deteriorated this is because: ① wide range of microvascular obstruction microcirculation to further increase output further reduce Huixin; ② clotting substances that Deplete the secondary fibrinolysis activation And other factors cause bleeding so that reduced blood volume; ③ soluble fibrin polymer and its products, such as cracking can be swallowed up by the closed-cell system so that the toxins from the intestine can not be fully cleared
As disseminated intravascular coagulation and the occurrence of microcirculation congestion due to the continuous increase of blood pressure lowering of the body caused by micro-irrigation cycle of the severe shortage of general flow of hypoxia and acidosis will also become increasingly serious; serious acid poisoning also can Cell membrane rupture within the lysosomes release of lysosomal enzyme (such as hydrolyzed protein Meideng) and cause some shock (such as endotoxin, etc.) so that cells can be serious and irreversible damage to the heart and brain, including the The various metabolic functions of vital organs are more serious obstacles (in detail later) that gave cause great difficulties for the current period is also known as the refractory period of shock
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