大神棋牌





【收藏版】过敏性休克的抢救程序(三大致命用药错误千万别犯)!

2019/01/23 guanliyuan 53

GUOMINXINGXIUKE 0.1%YANSUANSHENSHANGXIANSU0.5-1.0HAOSHENGJINGZHU、JIYI1HAOSHENGJIZHUHUOPIXIAZHUSHE、BIYAOSHIZHONGFUKANGZUZHIANYAORUFEINEIGEN25~50HAOKEJIZHUBAOZHENGHUXIDAOTONGCHANG,BIYAOSHIQIGUANQIEKAI、XIYANGQINGHUAKEDESONG200~400HAOKEJIARU100HAOSHENGPUTAOTANGYEZHONGJINGDIZHUOQINGXUANYONGXUEGUANHUOXINGYAO。


过敏性休克诊断要点及抢救措施

诊断

1、YOUGUOMINJIECHUSHI;

2、BIAOXIANXIONGMEN、HOUTOUDUSAIGAN、JIERHUXIKUNNAN、ZIGAN、BINSIGAN,YANZHONGZHEKEKECHUFENHONGSEPAOMOYANGTAN;

大神棋牌3、CHANGYOUJULIEDECHANGJIAOTONG,EXIN、OUTU、HUOFUXIE;

大神棋牌4、YISHIZHANGAI,SIZHIMAMU、CHOUCHU、SHIYU、DAXIAOBIANSHIJIN、MAIXIRUO、XUEYAXIAJIANG


抢救

大神棋牌1、LIJIYINGYONGSHENSHANGXIANSU;

2、JINGMAIKUAISUZHURUSHENSHANGXIANPIZHIJISU;

3、KUORONG;

4、XIYANGHUOGAOYAJIYANG;

大神棋牌5、JIYUGAIJIJIKANGZUZHIANYAOWU;

6、JISHICHULIHOUTOUSHUIZHONG、FEISHUIZHONG、NAOSHUIZHONGDENG;


措施

1、0.1%SHENSHANGXIANSU0.5~1.0HAOSHENGJIZHUHUOJINGZHU;

2、QUJIASHENSHANGXIANSU1~4HAOKERONGYU500HAOSHENGRONGYEZHONGJINGDI;

3、DISAIMISONG10~20HAOKEJIA5%PUTAOTANG100HAOSHENG(JINGDI);

大神棋牌4、10%PUTAOTANGSUANGAI20HAOSHENG,JINGMAIHUANZHU;5、ANCHAJIAN0.25KEJIA50%TANG40HAOSHENGJINGMAIHUANZHU;

6、PINGHENGJINGSHUI:500~1000HAOSHENGJINGDI。


肺水肿诊断要点及抢救措施

诊断

1、YANZHONGDEHUXIKUNNAN,DUANZUOHUXI,KOUCHUNFAGAN,DAHANLINLI;

大神棋牌2、ZHENFAXINGKESOU,BANYOUBAISEHUOFENHONGSEPAOMOYANGTAN;

3、FEIBUKEWENJISHIXINGLUOYINYUHANMINGSHENGHUODALIANGTANMINGYIN;


抢救

1、XIYANGHUOGAOYAJIYANG;

2、XUANYONGXUEGUANKUOZHANGJI;

大神棋牌3、XUANYONGQIANGXIN、LINIAOJI;

4、JIJISUYAOWU;

5、SIZHIJIEZHA、BANZUOWEI。


急救

大神棋牌1、MAFEI10HAOKE,PIXIAZHUSHE;

2、XIDILAN0.4~0.6HAOKEJIA50%TANG20HAOSHENGJINGMAIHUANZHU;

3、SUNIAO40HAOKEJIA50%TANG20HAOSHENG(JINGMAIHUANZHU);

4、XIAOSUANGANYOU0.5HAOKEHUOXIAOSUANYISHANLICHUN10HAOKESHEXIAHANFU;

大神棋牌5、XIAOPUNA5~10HAOKEYU5%TANG100HAOSHENG(JINGHUANDI)ZHIZHIZHENGZHUANGTIZHENGXIAOSHI(ZHUYIXUEYA)

大神棋牌6、FENTUOLAMING1.5~3.0HAOKE,50%TANG40HAOSHENG(10FENZHONGJINGZHUWAN)


输液反应和防治

反热反应

症状:

FALENG、HANZHANHEFARE,YANZHONGZHECHUQIJIHANZHAN、JIZHIGAOREDA40-410CBINGYOUEXIN、OUTU、TOUTONG、MAISUDENGZHENGZHUANG。

防治:

大神棋牌JIANMANDIZHUSUDUHUOTINGZHISHUYE,BINGTONGZHIYISHENG。


(肺水肿)循环负荷过量

症状:

大神棋牌TURANCHUXIANHUXIKUNNANQICU、KESOU、PAOMOTANHUOPAOMOXUEXINGTAN、FEIBUCHUXIANSHILUOYIN。

防治:

大神棋牌(1)SHUYEGUOCHENGZHONGZHUYIDIZHUSUDUBUYIGUOKUAI,YELIANGBUKEGUODUO;

大神棋牌(2)RUFAXIANZHENGZHUANGXULIJISHIBINGYUANDUANZUO,LIANGTUIXIACHUI,JIANSHAOJINGMAIHUILIU;

大神棋牌(3)JIAYAJIYANG,SHIYANGQIJING20~30%JIUJINGSHIHUAHOUXIRU;

大神棋牌(4)ANYIZHUJIZHENJINGJIHEKUOXUEGUANYAOWUJIMAODIHUANGDENGQIANGXINJI;

(5)BIYAOSHISIZHILUNLIUJIEZHA;


静脉炎

症状:

大神棋牌CHUXIANTIAOSUOZHUANGHONGXIAN、JUBUZUZHIFAHONG、ZHONGZHANG、ZHUORE、TENGTONG。

防治:

(1)YANGEZHIXINGWUJUNJISHUCAOZUO,DUIXUEGUANCIJIDEYAOWU,YAOYOUJIHUAGENGHUANZHUSHEBUWEI。

(2)HUANZHITAIGAOBINGZHIDONG,JUBUYONG95%JIUJINGHUO50%LIUSUANMEIXINGRESHIFU。


空气栓塞

症状:

BINGYUANXIONGBUGANDAOYICHANGBUSHI,FASHENGHUXIKUNNANHEYANZHONGZIGAN,TINGZHENXINQIANQUKEWENJIXIANGLIANGDE,CHIXUDE“SHUIPAOSHENG”。

防治:

大神棋牌(1)ZHIBINGYOUZUOCEWOWEIHETOUDIZUGAOWEI;

(2)YANGQIXIRU;

大神棋牌(3)JIAYASHUYESHIYANMIGUANCHA;HUSHIBUDELIKAIBINGYUAN。


SHUYEFANYINGYOUWEIXIAN,JINSHENCHULIMOHUANGLUAN。SHUYEFANYINGSHIYILIAOHUODONGZHONGJIWEICHANGJIANDEXIANXIANG,QIBENSHENBINGWUZHISIXING。DANTAKEYOUDAOBINGRENJICHUJIBINGEHUAERDAILAISHENGMINGWEIXIAN。LINCHUANGZHONGYINGZHONGZAIFANGFAN;YIDANFASHENG,PANDUANYAOZHUNQUE,CHUZHIYAOGUODUAN。


输液反应发生的原因和防范

原因

大神棋牌(YI)YETIYUYAOPINZHILIANGBUGUOGUAN:YETIHUOYAOPINZAISHENGCHANGUOCHENGZHONGBAGUANBUYAN,HUNRULEZHIREYUAN。ZHIREYUANJINRURENTIDAOZHIHANZHANFAREFANYING。

大神棋牌(ER)YETIPEIZHICHENGXUBUGUOGUAN:HUSHIZAIYETIPEIZHIGUOCHENGZHONGMABIDAYI,WEINENGLVXING“SANCHAQIDUI”,DUIYETIWAIGUANWEIYUZIXICHAYAN;HUOLAIZUODAO“YIRENYIGUAN”、“YIYEYIGUAN”,YONGTONGYIZHIZHUSHEQIJIDUORENHUODUOZUYETIPEIZHIYAOYE,ZHIYIYUANXINGZHIREYUANSHURURENTI。

(SAN)YETIYUTIWENWENCHAGUODA:LINCHUANGZHONGSHUYEFANYINGCHANGFASHENGYUKUREHUOHANLENGJIJIE。RUGUOCUNFANGYETIDEFANGJIAN,DONGTIANGONGNUANBUZU,XIATIANZHILENGGUODU,DOUHUISHIYETIWENDUGUOLIANG,SHIYETIYURENTIWENCHAJIADA,GUOLIANGDEYETISHURURENTIERDAOZHISHUYEFANYING。

大神棋牌(SI)SHUYESUDUGUOKUAI:LIANGDEYETIKUAISUJINRURENTIERZHISHUYEFANYING。

(WU)YETILUNPEIWUGUOZA:RUGUOYIZUYETIZHONGJIARUYAOWUPINZHONGGUODUO,YAOPINZHIJIANCHANSHENGROUYANBUKEJIANDEHUAXUEFANYING,SHENGCHENGZHIREYUANERZHISHUYEFANYING。RUYOUDEYIZUYETIZHONGJIARUQINGMEISU、BINGDUZUO、SHUANGHUANGLIANHUOCHUANHUNING、DISAIMISONGDENG,JIASHANGYETIBENSHENDEYAOWUCHENGFENGONG5--6ZHONGZHIDUO,SHISHUBUDANG,ZHEIDOUYOULIYUSHUYEFANYINGDEFASHENG。


防范

ZHENDUISHANGSHUYUANYIN,DUIQIFANGFANYINGDANGBUNAN。DANZAIMOUSHI,YIWANGMEINIANDOUYOUYINSHUYEFANYINGZHISISHIJIANFASHENG,ZAIRICHANGGONGZUOZHONGYIDANFASHENGSHUYEFANYINGYISHENGHUSHIDOUHENBEIDONG,WEICIERCHANSHENGDEYILIAOJIUFENYEBUSHAO。SUOYI,HAIBIXUQIANGDIAO:

大神棋牌(YI)BAHAOYAOPINZHILIANGGUAN:XUANGOUZHILIANGBAOZHANGTIXIWANHAODECHANGJIACHANPIN,XUANGOUBUYIFASHENGSHUYEFANYINGDEYETI;

(ER)BAHAOYETIPEIZHIGUAN:MEIYIWEIHUSHIYANGEZHIXING“SANCHAQIDUI”,ZAICAOZUOQIANDOUYANGCHENGXIANBAYETIPINGDAOGUOLAIHUANGYIHUANG、DUIZHECHUANGKOUKANYIKAN(KANYOUWUZAZHIJIHUNZHUO)、BAZHUPINGGAIZHUANYIZHUAN(KANPINGGAISHIFOUSONGDONG)、PEIHAOYETIZAIHUANGYIHUANGKANYIKANDEHAOXIGUAN;

大神棋牌(SAN)JIANCHI“YIRENYIGUAN”、“YIYEYIGUAN”;

(SI)SUOXIAOYETIYUTIWENDEWENCHA:RUOYETIPINGZITAILIANGZEBUYIJIYONG,SHIDANGSHENGWENZUIHAO;

(WU)SHUYESUDUYAOMAN;

大神棋牌(LIU)YETIPEIWUYINGBIFANJIUJIAN,YOUQIZHONGYAOZHENJIZUIHAOBUYUXIYAOPEIWUHUNHE,RUYAOYONG,BIXUYOUWENXIANZILIAOZHICHIZUOYIJU,BUKEPINGJINGYANHUOXIANGDANGRAN。


准确判断

大神棋牌JIANDANSHUO,SHUYEFANYINGJIUSHIREYUANFANYINGSUOZHIDEHANZHANGAORE,YU“SUFAXINGGUOMINFANYING”BUTONG。SUIRANERZHEZAIGANGFASHENGSHIDOUYOUMIANSECANGBAI、XIONGMEN、EXINDENGQIANQUBIAOXIAN,DANQIANZHEFALENGHANZHANGENGTUCHU,YUE10--15FENZHONGHOUMIANSECHAOHONG,HANZHANGUOHOUHUOTONGSHICHUXIANGAORE、CHAOGAORE,LINCHUANGFAZHANYIFENZHONGJI,YUHOUZHEXIANGBIXIANGDUIJIAOPINGWEN;ERHOUZHEDEBENZHISHISUFAXINGGUOMINXINGXIUKE,QIQIANQUZHENGZHUANGFASHENGSHUMIAO、SHUSHIMIAOHOUJICHUXIANMIANSECANGHUI、EXINOUTU、LENGHANLINLI、TANDAOXIAQU、HUXIQIANCU、MAIBOXISU、PINSIGAN、HUNJUE、XINTIAOHUXIZHOUTING,SHIYIZHONGZHOURANAIJIE,QILINCHUANGGUOCHENGYIMIAOJI,YUQIANZHEXIANGBIYAOJIZHOUDEDUO,WUHANZHANGAOREGUOCHENG。


果断处理

YIDANFASHENGSHUYEFANYING

大神棋牌(YI)BUYAOBODIAOJINGMAIZHENTOU,YIDINGBAOLIUHAOJINGMAITONGDAO,YIBEIQIANGJIUYONGYAO。YIDANBODIAOJINGMAITONGDAO,DANGBINGRENXUQIANGJIUSHIZAIJIANJINGMAITONGDAO,HUICUOGUOQIANGJIUSHIJI;

大神棋牌(ER)HUANSHANGYITAOXINDESHUYEQIGUANDAOJIYUYUANYETIXINGZHIBUTONGDEYETI(RUYUANLAISHITANGSHUIZEHUANCHENGSHENGLIYANSHUI),KEZANBUJIAYAO,DAIBINGQINGWENDINGHOUZAIYIJIAYAO;

(SAN)WULIANYONGYAO:

①XIYANG;

大神棋牌②JINGZHUDISAIMISONG10--15mg(XIAOER0.5-1mg/kg.CI)HUOQINGHUAKEDESONG100mg(XIAOER5--10mg/kg.CI);

③JIZHUHUOJINGZHUBENHAILAMING20--40mg(XIAOER0.5--1mg/kg.CI);

④JIZHUFUFANGANJIBILIN2ml(XIAOER0.1ml/kg.CI)HUOKOUFUBULUOFENXUANYE;

⑤RUWEISHAOFALIANGHUOPISECANGBAIKEJIZHUHUOJINGZHU654-2 5mg(XIAOER0.1--0.5mg/kg.CI)。

大神棋牌YIBANZAIYONGYAO30FENZHONGHOUHANCHURETUIERPINGWENXIALAI。

ZHIYUSHUYEFANYINGSHIPIXIAZHUSHESHENSHANGXIANSUZEYINGSHENZHONG。YUANYINSHISHUYEFANYINGBUSHISUFAXINGGUOMINFANYING,YONGSHENSHANGXIANSUWEIBEILESHUYEFANYINGDEBINGLIJIZHI,SHENSHANGXIANSUSHIERCHAFENANLEIYAOWU,YOUKUAISUSHENGYAXIAOYING,YONGYUSUFAXINGGUOMINFANYINGSHIZHENGQUEDE;LINGWAI,SHENSHANGXIANSUDESHENGYAXIAOYINGHUISHIYUANYOUGAOXUEYADEBINGRENBINGQINGEHUA。DANGRAN,ZAIYISHIBUNENGPANDUANCHUSHISHUYEFANYINGHAISHISUFAXINGGUOMINFANYINGSHI,XIAOXINSHIYONGYEWEICHANGBUKE;ZAISHUYEFANYINGYOUHEBINGXUEYAJISUXIAJIANGSHISHIYONGYESHIDUIDE。

大神棋牌ZHIYUFANZAOBUANSHIZHENJINGJIDESHIYONGYEYINGSHENZHONG。SHIJIANZHENGMING,SHUYEFANYINGJINGSHANGSHUCHULIDADUONENGHENKUAIANJINGXIALAI,BUZAIXUYAOYONGZHENJINGJI;DUIZHEIZHONGBINGRENYONGZHENJINGJIYEHUIYANGAIBINGQINGBIANHUA。


3大致命用药错误

YAOWUYINQIDEYANZHONGGUOMINFANYINGSHIYIGEJIXINGDEHEBUKEYUZHIDEYAOYUANXINGJIBING。FANSHIYONGYAOWUDEHUANZHEJUNKEFASHENG,FENBUYUYIYUANGEGELINCHUANGKESHI。GUOWAIYANZHONGGUOMINFANYINGDEBINGSILVXIAOYU0.001%,ERGUONEIDEBINGSILVYUANGAOYUCI。ZUOZHETONGGUODUIJIANSUOFENXIGUOMINXINGXIUKEYINQIDESIWANGBINGLIFAXIAN:GUONEIZAIYANZHONGGUOMINFANYINGQIANGJIUZHONG,CUNZAIZHESANDAYONGYAOCUOWU。


错误一:肾上腺素皮下注射

大神棋牌HUANZHE,NV,52SUI。2015NIAN2YUE27RI,YINZHUANANMEISHENGGAO,ZUNYIZHUYUYIYIGANCAOSUANMEI150mg+10%PUTAOTANGZHUSHEYE500ml,JINGDI。SHUYEYUE2FENZHONGSHI,HUANZHECHUXIANZUICHUNFAGAN、TANXIYANGHUXI、SIZHIFALENG,JINGDONGMAIBODONGBUNENGMENJI。LIJITINGYAO,XIONGWAIXINZANGANYA、XITAN、XIYANG,RUSUANNALINGEZHUSHEYE500ml,JINGDI;SHENSHANGXIANSU1mg,PIXIAZHUSHE。ZUIZHONGQIANGJIUWUXIAOSIWANG。

用药分析

1、SHENSHANGXIANSUWEIZHILIAOYANZHONGGUOMINFANYINGDESHOUXUANYAOWU,MEIYOUJUEDUIJINJIZHENG,DUILAONIANHUANZHEHEJIWANGYOUXINXUEGUANJIBINGDEHUANZHE,LIDAYUBI。

2、SHENSHANGXIANSUJINEIZHUSHEXISHOUJIAOKUAI,PIXIAZHUSHEXISHOUJIAOMAN。YANZHONGGUOMINFANYINGQIANGJIUSHI,SHENSHANGXIANSUZUIJIASHIYONGFANGSHISHITUNBUJIROUZHUSHE。GUOWAIPIXIAZHUSHEFAZAOYISHOUZHONGZHENGQIN,XIWANGGUONEIZAIYEJIANBUDAOZHEIYIYONGFA。

大神棋牌3、SHENSHANGXIANSUYONGFAYONGLIANG:YANZHONGGUOMINFANYINGYIJINGQUEZHEN,JIKEJIROUZHUSHE0.1%SHENSHANGXIANSUZHUSHEYE(1:1000),JILIANGAN0.01mg/kgJISUAN,CHENGRENZUIDAJILIANGWEI0.5ml(0.5mg)。

大神棋牌SHENSHANGXIANSUKEYIZHONGFUYINGYONG,DANSHIYAOZHISHAOJIANGE5FENZHONG。DANGXUYAOFANFUJIZHUSHENSHANGXIANSUDEHUANZHE,YINGGAIJIYUSHENSHANGXIANSUJINGMAIZHUSHE。


错误二:把糖皮质激素作为首选药

大神棋牌HUANZHE,NV,84SUI,ZHENDUANWEI“MANXINGWEIYAN,FEIBUGANRAN”。RUYUANHOUJIYUYISUANHUWEIYAO、KANGGANRANYAO、ZHIKEHUATANYAO、BUYEZHICHIDENGZONGHEZHILIAO。2009NIAN12YUE21RI,JINGMAIDIZHUDIFENZIYOUXUANTANGGANANJISUANZHUSHEYE500ml。ZAISHUYE1FENZHONGZUOYOU,HUANZHETUFAXIONGMEN、QIJI,YANMIANZIGAN,HUXIKUNNAN,XUEYACEBUDAO。LIJITINGYAO,YUQIGUANCHAGUAN,XITAN,HUXIJIFUZHUTONGQI,TONGSHIQIANGXIN、SHENGYA,XINZANGANYA,JINGMAIZHUSHEDISAIMISONG15mgKANGGUOMINZHILIAO,SHUFENZHONGHOUSIWANG。

用药分析

大神棋牌1、YANZHONGGUOMINFANYINGSHIYIYANZHONGDEXITONGXINGFANYING,LEIJIHUXIHEHUOXUNHUANXITONG,BIAOXIANXIANGYINGDEZHENGZHUANGHETIZHENG,RUHOUMING、CHUANXIHUODIXUEYA。KUAISUZHILIAOSHIFAZUOQIZHILIAOFEICHANGGUANJIANDEYINSU。

大神棋牌2、YANZHONGGUOMINFANYINGZHILIAODESHOUXUANYAOWUSHISHENSHANGXIANSU,JISUJIQITAYAOWUJUNWEIFUZHUZHILIAO。JISUQIXIAOMAN,YESHANGWEICHONGFENZHENGSHIQINENGFOUJIANGDICHIFAFANYINGDEWEIXIAN。

3、QINGHUAKEDESONGHUOJIAPONILONGTONGCHANGYONGYUJINGMAITUJING。GUONEILINCHUANGYANJIUZHENGMING,JIAPONILONGYUDISAIMISONGXIANGBI,LINCHUANGJIANXIAOKUAI,BIAOXIANDEBULIANGFANYINGJIAOXIAO。


错误三:静注或滴注10%葡萄糖酸钙注射液

HUANZHE,NV,48SUI。YINXIONGPIANSHIZHIQIGUANYANZHENG,JIYUTOUBAOPAITONG/SHUBATANNA3g+0.9%LVHUANAZHUSHEYE250ml,JINGMAIDIZHU。SHUYEYUE10FENZHONG,HUANZHECHUXIANHUXIKUNNAN、KOUCHUNFAGAN,XUEYAWEICEJI,MAIBOXIAOSHI,YISHISANGSHIDENG。LIJITINGYAO,JIYUXIYANG,SHENSHANGXIANSU1.5mgJINEIZHUSHE,DISAIMISONG10mgHUANMANJINGMAIZHUSHEHE10%PUTAOTANGSUANGAIJIARU5%PUTAOTANGZHUSHEYE250mlJINGMAIDIZHU。ZUIHOUJINGQIANGJIUWUXIAOSIWANG。

用药分析

大神棋牌1、SHENSHANGXIANSU1.5mgJINEIZHUSHE,JILIANGGUODA。RUGUOYINGYONGGUOLIANGKENENGYINQIGAOXUEYA、XINJIQUEXUEYIJIXINLVSHICHANG;YEKENENGCHUXIANDUANZANDEMIANSECANGBAI、XINHUANGHETOUTONGDENGZHENGZHUANG。JISHIZAIXINFEIFUSUZHONG,YOUYUDAJILIANGSHENSHANGXIANSUBULIYUZHANGQISHENGCUN,YEBUZAIBEITUIJIAN。

大神棋牌2、GUONEIWAIZHINANJUNWEITUIJIAN10%PUTANGTANGZHUSHEYEYONGYUYANZHONGGUOMINFANYINGHEXINFEIFUSUDEQIANGJIU。HUIGUXINGHEQIANZHANXINGYANJIUJUNBIAOMING,XINBOZHOUTINGHUANZHEYINGYONGGAIJIZHILIAOSHIWUXIAODE,BUGAIGUODUODAOZHIDEGAOXUEGAIKENENGDUIJITIYOUHAI。ZHIYOUGAOXUEJIA、DIXUEGAIHUOGAITONGDAOZUZHIJIZHONGDUSHI,GAIJIZHILIAOCAIYOUXIAO,QITAQINGKUANGJUNBUYONGGAIJIZHILIAO。

技术支持:

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