Mene ne agonal jihar?

A karshe mataki ne ake kira mutuwa azaba. Agonal yanayin ne halin da cewa sun fara yin aiki na rayayye compensatory sunadaran. Wannan yaki da nau'i nau'i na karshe da muhimmanci sojojin na jiki.

m jihohin

Komowar canje-canje a cikin kwakwalwa nama da fara saboda hypoxia da kuma canje-canje a cikin acid-balance tushe ake kira m jihohi. Suna halin da cewa da ayyuka na jiki suna Fading, amma shi ba ya faru instantaneously, amma sannu a hankali. Saboda haka, a wasu lokuta, likitoci iya mayar da su ta amfani da farfado da.

Don m yanayi hada da wadannan:

• mai tsanani buga (shi ne tura na IV digiri).
• IV coma digiri (wanda kuma ake kira prohibitive).
• durkushe.
• predagoniya.
• lõkacin fatara daga numfashi ƙungiyoyi - ɗan hutu m.
• azabar.
• Clinical mutuwa.

Mutuwa a matsayin mataki na wani m yanayin halin da gaskiya cewa haƙuri ta matsa dukan muhimmanci ayyuka, ko da yake shi ne har yanzu yiwu don taimaka. Amma za a iya yi a lokuta inda jiki ya ba tukuna m ta yiwuwa. Alal misali, za ka iya mayar da lamarinsa, idan mutuwa ta auku a sakamakon jini hasara, buga, ko shaƙa.

All cututtuka suna classified bisa ga ICD. Agonal jihar nufin da code R57. Yana da wani tura, wanda aka ba a tsare sauran wurare. A karkashin wannan code a ICD ƙayyade yawan thermal yanayi, ciki har da predagoniyu, azabar da kusa mutuwa.

Predagoniya

The matsaloli fara da warwarewarsu na tsakiya m tsarin. A haƙuri da dama a cikin unconsciousness. A wasu lokuta, sani ne kiyaye, amma shi confusedly. Wannan muhimmanci rage-rage hawan jini - shi iya fada a kasa 60 mm Hg. Art. Layi daya ga wannan, bugun jini rãyar, shi ya zama thready. Yana iya kawai gwada femoral da carotid arteries, na gefe zuwa shi ne ba ya nan.

Numfashin iya predagonii surface, shi ne wuya. Kodadde fata na haƙuri. Agonal jihar iya fara nan da nan bayan ƙarshen zamani, ko bayan wani da ake kira thermal hutu.

A tsawon lokaci da wannan lokaci ya dogara da dalilin da ya sa aka farko na ce cuta tsari. Idan haƙuri akwai kwatsam bugun zuciya, to, wannan lokaci shi ne kusan ƙarancin. Amma hemorrhage, numfashi gazawar, traumatic buga iya sa da ci gaban predagonalnogo jihar, wadda za ta karshe 'yan sa'o'i.

m Dakatawa

Ba ko da yaushe preagonic da agonal jihar ne rabuwa. Alal misali, lokacin da jini da asarar a mafi yawan lokuta akwai wani sauyin lokaci - m hutu. Yana iya dauka daga 5 seconds zuwa 4 da minti. An halin kwatsam lõkacin fatara daga numfashi. Ya fara bradycardia. Wannan shi ne yanayin a cikin abin da zuciya rate, a wasu lokuta akwai asystole rage-rage markedly. Don haka ya kira sakamakon bugun zuciya. Almajirin kasa don amsa ga haske, da suka bazu, reflexes bace.

A wannan yanayin, a cikin electroencephalogram bioelectrical aiki vuya, da kuma nuna ectopic hasken dake fitowa. A kan aiwatar da m karya ne Littafi glycolytic matakai da hadawan abu da iskar shaka - hana.

Jihar azabar

Saboda kaifi rashin oxygen, wanda ya auku a lokacin da jihar predagonii da m hutu, duk jiki ayyuka ne hana. Its main alama ne a numfashi rashin lafiya.

Agonal yanayin halin da babu zafi ƙwarai, Fading na asali reflexes (pupillary, fata, agara, corneal). A karshen Tashoshi da kuma na ayyuka na zuciya. Wannan tsari na iya bambanta dangane da abin da ya sa aka mutuwa.

Tare da daban-daban na mutuwa azabar da duration iya bambanta muhimmanci. Alal misali, traumatic buga, ko jini da asarar take kaiwa zuwa gaskiya cewa karshen mutuwa mataki na iya wuce daga 2 zuwa 20 minutes. Lokacin inji asphyxia (throttling), shi ne ba fiye da minti 10. A lokacin sakamakon bugun zuciya, agonal numfashi na iya dage domin minti 10 ko da bayan wurare dabam dabam tsaya a nan ba.

A mafi tsawo azabar lura a mutuwa a sakamakon shafe tsawon maye. Yana iya zama a peritonitis, sepsis, ciwon daji cachexia. Yawancin lokaci, a kuma waɗannan lokuta, bãbu m hutu. A azabar kanta iya wuce domin da yawa hours. A wasu lokuta, shi yana zuwa kwanaki uku.

A halayyar asibiti hoto

A matakin farko, da yawa kunna kwakwalwa Tsarin. Haƙuri ƴan dilate, zuciya rate zai karu, ya bayyana motor ruri. vasospasm iya haifar da ƙara jini. Idan wannan yanayin yana dogon, hypoxia ƙaruwa. A sakamakon haka, kunna subcortical kwakwalwa Tsarin - da kuma wannan take kaiwa zuwa wani karuwa a cikin zumudi mutuwa. Wannan yana bayyana convulsions, involuntary hanji motsi da kuma mafitsara.

A a layi daya, agonal yanayin haƙuri ne halin da cewa rage-rage adadin jini a cikin jijiyoyinmu, wanda ya koma zuwa ga zuciya tsoka. Wannan yanayi ya taso daga gaskiya cewa total girma na jini da aka raba wa gefe tasoshin. Wannan ya sa shi wuya a ƙayyade da matsa lamba ne na al'ada. Pulse za a iya ji a cikin carotid arteries, zuciya sautuna biyayya ba.

Karsh a Jihar azabar

Yana iya zama mai rauni tare da low mawadãta ƙungiyoyi. Amma wani lokacin marasa lafiya sharply sha taba da kuma exhale. A wani lokaci, za su iya yin daga 2 zuwa 6 irin na numfashi ƙungiyoyi. Kafin mutuwa a matakai suna amfani da tsokoki na akwati, kuma wuyansa. Outwardly, ga alama cewa wannan numfashi ne sosai tasiri. Bayan duk, da mãsu haƙuri inhales warai da kuma gaba daya ta saki dukkan iska. Amma a gaskiya, irin wannan numfashin a lokacin da agonal jihar damar sosai dan kadan don bar iska ta shiga cikin huhu. A girma daga iska ba ya wuce kashi 15% na al'ada.

Rashin sani da kowane numfashin da haƙuri jefa kansa baya, bakinsa a bude. Daga gefe alama kamar yadda idan ya ke kokarin hadiye matsakaicin adadin iska.

Amma agonal jihar ne tare da wani m na huhu edema. Wannan shi ne saboda gaskiyar cewa haƙuri ne a Jihar m hypoxia, a cikin abin da ya karu permeability na capillary katangu. Bugu da kari ya na huhu wurare dabam dabam kudi ne ma rage, akwai wani hargitsi na microcirculation tafiyar matakai.

Definition na IBC

Sanin cewa duk cututtuka suna tsare ta kasa da kasa Nau'in Cututtuka (ICD), da yawa ban sha'awa code agonal jihar. Suna da aka jera a karkashin R00-R99. Ga duk da bayyanar cututtuka da kuma ãyõyinSa, kazalika da sabawa daga na kullum, ba a hada a cikin wasu kan magana da. A subgroup na R50-R69 ne janar alamu da bayyanar cututtuka.

R57 hadawa duk wani nau'i na tunkaro, ba classified sauran wurare. Daga gare su ne thermal jihar. Amma shi ya kamata a lura dabam, idan mutuwa ta auku daga duk wani sauran dalili, sa'an nan, domin wannan akwai wasu iri rarrabuwa. Domin R57 hada kwatsam da hana jini wurare dabam dabam da kuma numfashi, wadda ta zo a ƙarƙashin rinjayar waje ko ciki dalilai. A wannan yanayin, na asibiti mutuwa kuma koma zuwa wannan sashe.

Saboda haka wajibi ne a fahimci dalilan da raya agonal jihar. ICD 10 ya nuna cewa domin sanin thermal halaye muhimmanci domin sanin jini. Idan shi ne mafi girma fiye da 70 mm Hg. Art., Da muhimmanci gabobin ne a zumunta aminci. Amma lokacin da shi saukad da ke ƙasa 50 mm Hg. Art. fara mutuwa matakai, da farko shi rinjayar da zuciya tsoka da kuma kwakwalwa.

A siffofin bayyana a cikin index

Medical rarrabuwa damar gano alamun gane asali thermal da kuma agonal jihar. ICD 10 code R57 nuna cewa yayin da akwai da wadannan siffofin:

• janar lethargy.
• illa sani.
• matsa lamba drop kasa 50 mm Hg. Mataki na ashirin da.;
• fitowan na tsanani shortness na numfashi;
• babu wani bugun jini a gefe jijiyoyi.

Kamar yadda muka gani da sauran asibiti ãyõyin azaba. Bayan su zo da ãyõyin asibiti mutuwa. A nasa guda sashe a matsayin agonal jihar. Code ICD R57 kayyade duk da bayyanar cututtuka ya zama sane da likita domin sanin nau'i nau'i na rayuwa.

bayyana mutuwar

Primary bayyanar cututtuka faruwa a cikin 10 seconds bayan sakamakon bugun zuciya. A haƙuri hasarar sani, ya bugun jini Fading ko da a kan manyan jijiyoyi, convulsions.

Secondary cututtuka iya fara a lokacin da 20-60 seconds:

• ƴan gushe amsa zuwa ga haske.
• tsaya a nan ba numfashi.
• fuska fata ne fentin a earthy-m.
• Yana hūta tsokoki, ciki har da sphincters.

A sakamakon haka, da matakai na iya fara involuntary defecation kuma urination.

resuscitative matakan

Ya kamata ka san cewa thermal jihar, wanda sun hada da azabar da karshe mataki - asibiti mutuwa suna dauke su reversible. The jiki iya taimaka a shawo kan wannan jiha, idan ba ta riga ta m duk da ayyuka. Alal misali, za a yi wannan a mutuwa daga asphyxia, hemorrhage ko traumatic buga.

CPR Hanyar kunshi a yin kirji compressions da kuma wucin gadi numfasawa. Mutumin bada irin wannan taimako na iya zama m m numfashi ƙungiyoyi daga mãsu haƙuri kuma bayyanar cututtuka na sababbu zuciya aiki. Ci gaba da yin resuscitative matakan ya zama har da mutum kau na jihar azabar har da cikakken karfafawa.

Idan wadannan matakan bai isa ba, za su iya amfani da tsoka relaxants da kuma rike intubation. Idan wannan shi ne ba zai yiwu, yi wucin gadi numfasawa bakin-to-hanci ko bakin. A lokuta inda riga fara thermal na huhu edema, ba zai iya yi ba tare da intubation.

A wasu lokuta, a kan backdrop na kirji compressions ci gaba agonal jihar. Ãyõyin shi ne kamar yadda na ramin zuciya fibrillation na jiki. A wannan yanayin, dole ne ka yi amfani da elektrodefibrillyator. Yana da muhimmanci a gudanar da ciki-jijiya jini da kuma dole ruwaye jini musanya idan mutuwa ta zo a sakamakon jini hasara, traumatic buga.

Yanayin bayan farfado

Godiya ga dace da kammala matakan dauka don mayar da haƙuri da harshen damo, sau da yawa ta ci gaba agonal jihar. Bayan nan, da mãsu haƙuri yana bukatar wani dogon lokacin da lura da kuma m kula. Da bukatar wadannan matakan ne kiyaye ko da idan dalili na sama thermal yanayin, aka sauri shafe ta. Domin jiki na haƙuri ne yiwuwa ga maimaitawa na azaba.

Yana da muhimmanci a cikakken kashe hypoxia, Sistem sakulasan cuta da kuma rayuwa cuta. Wajibi ne su hana yiwu ci gaban sepsis da kwamin na tara rikitarwa. Samun iska da kuma transfussion far kamata ci gaba har irin wannan lokaci har sai dukan alamu na numfashi gazawar an shafe ta, da kuma girma na zagawa da jini zo a mayar da al'ada.

A azabar dabbobi

A cikin matasa, 'yan'uwa ma, akwai sau lokacin da su ne a kan iyakar da ke tsakanin rai da mutuwa. Agonal yanayin dabba a asibiti, ãyõyi ba musamman daban-daban daga abin da ya faru a irin wannan halin da ake ciki tare da wani mutum.

Da gwaje-gwaje a kan berayen ya nuna cewa bayan da tsayawa zukãtansu kwakwalwa aiki ya karu da 30 seconds. A daidai wannan lokaci da muke zama mafi m zuwa daga high-mita tãguwar ruwa, fitaccen neurotransmitters. Yana yiwuwa a kafa ta kimantawa kwakwalwa aiki tare da wani electroencephalograph da electrocardiograph. A mutuwa na berayen faruwa a sakamakon shaƙa.

Af, wannan ne na ayyuka na kwakwalwa, masana kimiyya bayyana wahayi, wanda son gaya mutanen da suka samu na asibiti mutuwa. Sun bayyana shi dai kawai wani feverish aiki na jiki.