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標題:
舌頭被割斷, ABC有問題, 出現缺氧和休克, 該怎樣處理呢?
發問:
如果舌頭被割斷, 傷者大量出血, 血液流進氣道, ABC未能維持, 並已出現缺氧和休克徵狀, 請問一個專業同偉大的醫生在欠缺助手的情況下會怎樣處理呢?
最佳解答:
A large portion of the tongue - up to 3/4 of it - remains after it has been cut. Reasonable speech can be restored even when half of it is removed. So in most cases, giving the short time span and the torrential bleeding from the tongue would, saving life by simple suture is more important than meticulos stitching of the cut tongue piece back onto the tongue proper. Particularly when the resutured tongue might not heal after surgery. Maintaining the airway is important in any patient with cut tongue, as blood tends to be profusely flooding the trachea, and the patient is either comatose or stuporous from the trauma and shock. The problem is worsened by the patient's clenched jaws because of pain in the throat from the cut tongue. This means it is impossible to gain access to the airway without relaxing the patient's jaws. After intravenous access with wide bore saline, succinylcholine is injected to paralyze the patient's musculature. Pain is relieved with IV pethidine. When the jaw is relaxed ( in less than 1/2 minute), orotracheal suction begins immediately, followed by endotracheal intubation and manual ventilation with 100% oxygen. Having secured the airway, the tongue, now paralyzed, tends to fall back into the pharynx. In the emergency department, surgical apparatus is in short supply, so it might be necessary to grasp the tongue out by stitching the tongue tip with a 2/0 large suture needle. When the suture is pulled, the tongue comes out with it. Suture is then possible.
其他解答:
舌頭被割斷, ABC有問題, 出現缺氧和休克, 該怎樣處理呢?
發問:
如果舌頭被割斷, 傷者大量出血, 血液流進氣道, ABC未能維持, 並已出現缺氧和休克徵狀, 請問一個專業同偉大的醫生在欠缺助手的情況下會怎樣處理呢?
最佳解答:
A large portion of the tongue - up to 3/4 of it - remains after it has been cut. Reasonable speech can be restored even when half of it is removed. So in most cases, giving the short time span and the torrential bleeding from the tongue would, saving life by simple suture is more important than meticulos stitching of the cut tongue piece back onto the tongue proper. Particularly when the resutured tongue might not heal after surgery. Maintaining the airway is important in any patient with cut tongue, as blood tends to be profusely flooding the trachea, and the patient is either comatose or stuporous from the trauma and shock. The problem is worsened by the patient's clenched jaws because of pain in the throat from the cut tongue. This means it is impossible to gain access to the airway without relaxing the patient's jaws. After intravenous access with wide bore saline, succinylcholine is injected to paralyze the patient's musculature. Pain is relieved with IV pethidine. When the jaw is relaxed ( in less than 1/2 minute), orotracheal suction begins immediately, followed by endotracheal intubation and manual ventilation with 100% oxygen. Having secured the airway, the tongue, now paralyzed, tends to fall back into the pharynx. In the emergency department, surgical apparatus is in short supply, so it might be necessary to grasp the tongue out by stitching the tongue tip with a 2/0 large suture needle. When the suture is pulled, the tongue comes out with it. Suture is then possible.
其他解答:
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一個專業同偉大的問者應自己都知道老人既問題 係神先至可以答到佢既 2008-08-28 08:28:00 補充： 一個專業同偉大的問者應自己都知道老作既問題 係神先至可以答到佢既
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