What should we do in the face of the ICU in the face of the ICU?

Although it has been established, the city has continued to be high temperature, and patients with fever have appeared from time to time. The Department of Critical Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, has received several patients with heat -ray disease, one of which is a 13 -year -old girl Xiaoxue (pseudonym).

Xiaoxue is the school's basketball player. According to the children's parents: "Xiaoxue is usually healthy and does not delay physical to learn sports. The outdoor temperature of Xi'an a week ago reached more than 40 degrees. Xiaoxue and his teammates were training outdoors as usual." It didn't take long for Mi to start, Xiaoxue felt that her skin was hot, and she was dizzy and vomited, and she kept sweating, but the child had always insisted on training. After 1 hour, his teammates found that Xiaoxue suddenly fainted. The crowd raised Xiaoxue to the cool place with seven -handed foot, thinking that it was heat stroke, they bought popsicles and put them on the child's head, and then dial 120.

After being sent to a local hospital by an emergency car, the body temperature of Xiaoxue was 39.8 ° C, and the blood pressure decreased to 96/48mmHg. When the child was doing CT examination, he also appeared in the body.

In addition, blood drawing also reminds Xiaoxue that has severe acid -alkali balance disorders, damage to liver and kidney and cardiac function, horizontal muscle dissolving, coagulation fiber -soluble balance, lung infection, and pneumothorax. Multi -organ dysfunction of the whole body. After the hospital gave symptomatic treatment such as cooling, liquid rectification shock, tracheal intubation connection ventilator auxiliary breathing support to stabilize the internal environment of the body, Xiaoxue had irritability and unclear consciousness. The functions of each organs did not improve significantly compared with the previous, and the condition was critical. Xiaoxue's parents were anxious and transferred their children to the intensive medical department of the First Affiliated Hospital of Jiaotong University.

As soon as I entered the department, a lot of sputum and consciousness were inflated in the small snow trachea intubation. The blood drawing test reminded that the function of each organs was still poor. Under the guidance of Chief Physicians of Liu Yu and Zhang Lei, the chief physician of severe medical medicine, immediately opened the vein pathway after admission, and there were arterial pressure monitoring of life signs. At the same time, in order to prevent the transverse muscle dissolving products from destroying the kidneys, blood purification therapy began to start bed. Because the small snow platelets are low, the anticoagulant drugs in the blood purification process need to be particularly cautious. After treatment, the child's platelets gradually came up, and the functions of each organs gradually developed in a good direction. Slowly, Xiaoxue woke up. On the 4th day after admission, Xiaoxue said happily to the doctor: "Sister, the tube is finally removed, it is too comfortable."

At present, after active treatment, the child's condition has improved, and he can be discharged home in one or two days.

According to Director Liu Yu, thermal radiation disease is severe heat stroke, because the body temperature adjustment function is exposed in a high -temperature and high humidity environment. Obstacles (such as delirium, convulsions, coma), and severe acute and hot diseases of multi -organ dysfunction are the most serious types of heat stroke.

● Why does thermal irritation cause such serious consequences?

Thermal radiation disease is divided into class typical thermal radiation and laborer fever. For patients with unknown thermal causes and have a weak or chronic disease in a closed environment, if symptoms such as conscious disorders (possibilities for strokes) occur, medical staff should first consider the classic thermal radiation disease. When patients have high temperature (high humidity) environmental operations or high -strength physical exercise experiences, and symptoms such as high fever and consciousness disorder occur, medical staff should first consider labor -type fever.

In recent years, the "dual -channel mechanism" of thermal ejection disease has been gradually recognized by most scholars. The first channel is the direct damage to the organ system caused by the increase in the core temperature; the second passage is the heat stress and endotoxemia caused by thermal exposure. Syndrome (SIRS), immune dysfunction, this pathological process is defined as a "refuel -like reaction" of thermal ejection disease, causing patients with multi -organ dysfunction. If it is not treated in time and effective treatment, the mortality rate can be as high as 60%.

At present, it is believed that thermal radiation disease is the process of complex interaction between direct cell damage caused by heat exposure and systemic inflammation reactions, which in turn leads to the process of organ damage or multi -organ dysfunction syndrome (MODS).

Most patients with fever radiosis change the symptoms of high fever with a conscious state. The core temperature of the patient (anal temperature, often 0.8-1.0 ℃ higher than the axillary temperature) exceeds 40 ° C. , Behavior abnormalities, etc.).

Here, doctors remind that the masses should be aware of the cognitive level of typical thermal radiation diseases. The key to reducing the mortality of thermal radiation disease is prevention. The most effective prevention measures are to avoid high temperature (high humidity) and non -ventilation environment, reducing and avoiding the risk factors of heat stroke, ensuring adequate rest time, timely supplementation of water to avoid dehydration to avoid dehydration The occurrence and gradually increase the intensity of exercise to achieve the hot habits, thereby reducing the incidence and mortality of thermal irritation.

Wang Chaona, a reporter from Xi'an Newspaper all -media reporter Wang Chaona interviewed the hospital for pictures of the hospital

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