美国伊利诺Assignment代写:室性心律失常

2019-01-15 02:59

血管内容量减少是常见的，继发于肺水肿和腔内液体移位，与吸入的液体类型无关。等渗盐水可指示体积迅速膨胀。室性心律失常(通常是室性心动过速或室颤)、心动过缓和心动过速可能是酸中毒和低氧血症的结果，而不是电解质失衡所致。使用多巴胺或多巴酚丁胺可能需要肌力支持。中央静脉压力监测可能是必要的。大多数的酸中毒是在纠正容量消耗和氧合后恢复的。如果严重的酸中毒患者没有使用上述措施进行纠正，但只有在建立了充分的通气后才能使用碳酸氢钠。大多数浸没的受害者逐渐变得体温过低，有室性颤动和神经损伤的危险。重新加热的方法取决于体温过低的程度和病人的反应。积极地给体温过低的病人重新加热以恢复正常体温。核心与热氧复温,连续膀胱灌洗与流体在40°C,和静脉输液等渗液体在40°C应该开始复苏。对于严重体温过低的患者，可能需要进行温性腹膜灌洗来恢复体温。
美国伊利诺Assignment代写:室性心律失常
Intravascular volume depletion is common, secondary to pulmonary edema and intracompartmental fluid shifts, regardless of the type of fluid aspirated. Rapid volume expansion may be indicated using isotonic saline. Ventricular dysrhythmias (typically, ventricular tachycardia or ventricular fibrillation), bradycardia, and asystole may occur as a result of acidosis and hypoxemia, rather than due to electrolyte imbalances. Inotropic support may be required using dopamine or dobutamine. Central venous pressure monitoring may be warranted.Most acidosis is restored after correction of volume depletion and oxygenation. Sodium bicarbonate may be administered in cases of severe acidosis that do not correct using the above measures, but only administer it after adequate ventilation has been established.Most immersion victims become hypothermic gradually and are at risk for ventricular fibrillation and neurologic injury. Re-warming method is dependent on the degree of hypothermia and the patient’s response. Aggressively rewarm hypothermic patients to restore normal body temperature. Core rewarming with warmed oxygen, continuous bladder lavage with fluid at 40°C, and intravenous infusion of isotonic fluids at 40°C should be initiated during resuscitation. Warm peritoneal lavage may be required for core rewarming in severely hypothermic patients.

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