冬天是心脑血管、哮喘等疾病的高发期。家有老人和慢病患者更要注意,疾病突发时,除了第一时间拨打急救电话,还要掌握一些急救知识。
心脏病“动不得”
心脏病突发一般有心绞痛和心肌梗死两种情况。心肌梗死是严重的心绞痛发作。如果已经确诊为冠心病的人发生胸闷、气短或胸部压榨性疼痛等症状时,在急救人员没到之前,先让病人保持一个舒服的体位,比如半卧位,一定不要乱动。如果有条件,可以让其吸氧。心绞痛病人发病时可舌下含服一片硝酸甘油,一般30秒到1分钟就能见效。如果无效,3—5分钟后可再含服1片,最多3片。倘若心绞痛15分钟以上不减轻,排除了消化道溃疡和其他出血情况,可一次口服阿司匹林3片(150—300毫克)。
在等待急救车时,如果病人突然倒地,意识不清,面部、四肢抽搐,脸色难看,说明可能要发生心脏骤停了。此时电击除颤是挽救生命的关键措施。如果没有专业的除颤器,家属可以迅速让病人仰卧,给其进行一次胸部叩击(拳头距胸部正中上方二三十厘米,用力向下叩击一次)。接着进行心肺复苏,先做心脏按压,再做人工呼吸。
脑出血“颠不得”
患有高血压的人,容易发生脑出血,一旦发生,死亡率很高。一开始,患者会出现嘴歪眼斜,说话大舌头。随后,大多患者会出现突发性昏迷,喷射状呕吐。等待急救时,可以先让患者侧卧,保持不动,避免呕吐物堵塞气道,千万不要灌药或喝水。为了避免加重脑出血,搬运过程中要尽量少颠簸,最好就近治疗,待病情稳定后再转院。在车辆、担架上时,要保持病人头高位,不要晃动(可以用手固定)。同时,还应将患者的头歪向一侧,以便呕吐物流出。
脑血栓“慢不得”
对于缺血性脑中风(俗称脑血栓),发病后的6小时尤其重要,一旦超过6小时,就失去了药物治疗的最佳时机,脑组织可能因为缺血时间过长,而发生各种中风后遗症。所以,发现病人有言语不清、肢体轻瘫或发麻的症状,一定要第一时间打急救电话,去医院进行详细诊断,看是不是有脑出血情况。在等待救护车来的时候,家属可以让病人平躺,别枕枕头,更不要贸然用药。如血压太高(高压超过200毫米汞柱),可以吃一些降压药。
哮喘“背不得”
哮喘也是冬季多发的一种凶险疾病,病情进展很快。支气管哮喘病人发病时,首先服用平时用来缓解病情的药物,比如气喘喷雾剂,同时半坐位吸氧。如果发生心脏性哮喘,发病时血压高,可服用硝酸甘油1片,无效可再服1次。然后,采取坐位,最好让双脚垂下来。同时,解开病人衣领扣、放松裤带,及时清除口腔痰液,有条件的可以吸氧。搬运患者时,不要用背的方式,以免引起呼吸、心跳骤停。
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