HOSPITAL STAGE:

4.Semi-radical methods:

Application of artificial pneumothorax or pneumoperitoneum. The effectiveness of the methods is very controversial. Endovascular embolization of bronchial artery branches.

Endobronchial manipulations: drug or other effects on the bleeding area through the bronchoscope;

Aspiration of blood through the endoscope (especially rigid), lavage with cold saline solutions, irrigation with hemostatic agents, injection of vasoconstrictors into the bleeding bronchus (adrenaline 0.1% 1 ml or more).

Obturation (filling) of bleeding bronchi. Material: more often sterile foam rubber sponge in the form of a ball, bronchial diameter (tamponade must be tight) - obturator must not be in the mouth of the bronchus for more than 3 days.

5. Radical methods (surgery). Determine the optimal volume of surgical intervention (lung resection, pneumonectomy, etc.)

THERE ARE THREE MAIN STEPS IN THE MANAGEMENT OF PATIENTS WITH PROFUSE PULMONARY BLEEDING:

1.Resuscitation and airway protection.

2.Determining the location of bleeding and its cause.

3.Stopping bleeding and preventing its recurrence.

DIFFERENTIAL DIAGNOSIS:

1.Gastrointestinal bleeding (bloody vomiting).

2.Nasal bleeding.

3.Bleeding from the mouth and throat.

ANAPHYLACTIC SHOCK -

an acute, life-threatening process occurring as a severe manifestation of anaphylaxis and characterized by severe disorders of the central nervous system, circulation, respiration and metabolism.

THE CLINIC OF ANAPHYLACTIC SHOCK:

1.It is manifested by feelings of fear, anxiety, dizziness, tinnitus, fever, shortness of breath, tightness behind the chest, nausea, vomiting.

2.Hives and soft tissue edema may occur.

3.Acute vascular failure is manifested by clammy cold sweat, sharp pallor of visible mucous membranes and skin, thready pulse, sharp drop in blood pressure.

4.Depressed consciousness, disturbed breathing.

5.Further deterioration of the clinical picture is characteristic of the developing coma due to cerebral hypoxia.

TREATMENT:

1.Stop administering the allergen.

2.Apply a tourniquet above the injection site for 25-40 minutes.

3.Provide airway patency; conicotomy if tracheal intubation is impossible.

4.Raise legs.

5.Apply cold - ice to the place of introduction of allergen.Inhalation of 100% oxygen (no more than 30 minutes); provide access to the vein.Intravenous jet injection of fluids (polyglucin, reopolyglucin, sodium chloride, glucose).

6.Adrenaline IV.

7.Glucocorticoid hormones IV (prednisolone, hydrocortisone hemisuccinate).

8.Intravenous dimedrol or suprastin intramuscularly.

:

11.Intravenously slow eufillin (for bronchospasm), strophantine.

12.In severe collapse: norepinephrine intravenously.

13.In severe condition, fix tongue to prevent asphyxiation.

14.In anaphylactic shock from penicillin: penicillinase intramuscularly.

15.Mesaton, ephedrine, cordiamine intravenously.External heart massage, artificial lung ventilation, intracardiac adrenaline

16.After the stabilization of the condition - transportation to the hospital. In the hospital - transfer the patient to the intensive care ward with the period of hospitalization not less than 7 - 8 days (late complications are possible).

17.Continuous control of hemodynamics, ICE and electrolyte metabolism.

SPONTANEOUS

PNEUMOTHORAX (SP) -

Is an a condition characterized by the entry of air into the pleural cavity, which occurs spontaneously, as if spontaneously, without damage to the chest wall or lung, resulting in the collapse of the lung. However, in most cases of spontaneous pneumothorax, both a particular form of lung pathology and the factors that contributed to its occurrence may well be established.

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