Notiuni de baza urgente pneumologice
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Notiuni de baza – urgente pneumologice. Conf.Dr.AntigonaTrofor. Hemoptizia. Def:eliminarea de sange provenit din caile aeriene subglotice prin cavitatea bucala. Dg.diferential cu hematemeza,sfera ORL-laringe, faringe,epistaxis inghitit,cavitatea bucala-vene baza lb, perete jugal)

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Notiuni de baza urgente pneumologice

Notiuni de baza – urgentepneumologice

Conf.Dr.AntigonaTrofor


Hemoptizia
Hemoptizia

Def:eliminarea de sange provenit din caile aeriene subglotice prin cavitatea bucala.

Dg.diferential cu hematemeza,sfera ORL-laringe, faringe,epistaxis inghitit,cavitatea bucala-vene baza lb, perete jugal)

Diagnostic pozitiv-emisiape gurade sange aerat,rosu-deschis,insotita de tuse/epistaxis.

Clasificare-cantitativ-mimima(ml),mica-medie(200-300ml),mare(>/=500ml),masiva.


Hemoptizia conduita terapeutica
Hemoptizia-conduita terapeutica

Gesturi utile imediate

-aprecierea corecta a cantitatii de sange

-semne clinice de detresa respiratorie-care sugereaza gravitatea-insuficienta respiratorie acuta.

-cercetarea semnelor clinice de anemie acuta (paloare,hTA,puls slab,filiform)

-Semne de soc hemodinamic-in Hemoptizii masive.


Hemoptizii conduita tratament
Hemoptizii-conduita/tratament

Internare obligatoriu!-in Hemoptizii mari

-repaus la pat

-punga cu gheata

-inventarierea cauzelor- ORL,hematologice,

Cardiovasculare,respiratorii.

-endoscopia bronsica.


Hemoptizii conduita tratament1
Hemoptizii-conduita/tratament

-oxigenoterapie 2-4 l/min.

-eliberarea cailor respiratorii

-cale de abord venos cu acces permanent

-umplere vasculara pt.corectia hemodinamica

-vasoconstrictoare-vasopresina,sandostatin

-hemostatice i.v./i.m

-trat.chirurgical-embolizare arteriala bronsica,ligatura.


Criza de astm bronsic
Criza de astm bronsic

Diagnostic

-dispnee paroxistica expiratorie,wheezing

-polipnee,cianoza

-agitatie,transpiratii,tahicardie,HTA,puls

paradoxal

-semne de oboseala musculara,respiratie paradoxala

-LINISTE RESPIRATORIE


Criza de astm bronsic1
Criza de astm bronsic

-aerosoli cu bronhodilalatoare cu durata scurta de actiune-salbutamol,corticoizi-flixotide.

-corticosteroizi sistemici (oral,i.m./i.v.)-Metilprednisolon.

-oxigenoterapie,hidratare p.o./sistemic

-antagonisti de leukotriene-Montelukast(Singulair) i.v.

-aminofiline i.v.-Miofilin/Teofilina i.v.

-in exacerbari infectioase-antibioterapie.


Embolia pulmonara
Embolia pulmonara

Def: Obstructia arterelor pulmonare printr-un cheag de sange migrat de la o tromboza.

-sediul trombozei:vene mb.inferioare,

micul bazin,VCS,inima dreapta

-factori favorizanti: staza venoasa,

hipercoagulabilitatea, alterari de perete venos


Embolia pulmonara diagnostic
Embolia pulmonaraDiagnostic

-dispnee instalatabrusc,polipnee, dureri latero-toracice+/-tuse seaca,+/-febra.

-hemoptizii/sputehemoptoice

-paloare, cianoza,anxietate,oboseala

inexplicabila.


Embolia pulmonara gesturi terapeutice imediate
Embolia pulmonaraGesturi terapeutice imediate

-repaus la pat

-oxigenoterapie

-combaterea tusei-antitusive

-combaterea durerii-antalgice

-umplerea patului vascular

-tratament anticoagulant-Heparina

-tratament antiagregant plachetar.