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Notiuni de baza – urgente pneumologice

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

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  1. Notiuni de baza – urgentepneumologice Conf.Dr.AntigonaTrofor

  2. 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.

  3. 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.

  4. Hemoptizii-conduita/tratament Internare obligatoriu!-in Hemoptizii mari -repaus la pat -punga cu gheata -inventarierea cauzelor- ORL,hematologice, Cardiovasculare,respiratorii. -endoscopia bronsica.

  5. 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.

  6. 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

  7. 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.

  8. 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

  9. Embolia pulmonaraDiagnostic -dispnee instalatabrusc,polipnee, dureri latero-toracice+/-tuse seaca,+/-febra. -hemoptizii/sputehemoptoice -paloare, cianoza,anxietate,oboseala inexplicabila.

  10. Embolia pulmonaraGesturi terapeutice imediate -repaus la pat -oxigenoterapie -combaterea tusei-antitusive -combaterea durerii-antalgice -umplerea patului vascular -tratament anticoagulant-Heparina -tratament antiagregant plachetar.

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