Medical ArticlesExtraction Of Soft Friable Foreign Bodies From The Tracheobronchial Tree
The difficulties here consist in the liability of crushing or...
See Child-bearing. ...
Foreign Bodies In The Larynx And Tracheobronchial Tree
The protective reflexes preventing the entrance of foreign bo...
A teaspoonful of lemon juice (freshly expressed), along with h...
The first question in any case of sore throat, is, What is the...
This fever assumes two principal forms: Simple or mild, and M...
Diet For The Lean
To a large extent the preceding article will suggest what is s...
How Nuts should be Used. Another form of fat is the meat of ...
Eyes Hazy Sight
Frequently, after inflammation, and even when that has ceased,...
The treatment of a suspected coronary sclerosis is the same a...
Where The Temperature Is Too Low That Is Below 98-2/5 Deg
rub all over with warm olive oil, and clothe in good soft flan...
Of Punctures Etc
In cases of recent punctured wounds the orifice and surroundi...
In most cases of bronchiectasis there are strong indications...
There Is Neither A Specific Nor A Prophylactic To Be Relied On
All these different methods and remedies, and many others, ha...
Punctures Case Xiii
Am old man applied leeches to the instep for inflammation occ...
Angioneurotic edema manifests itself by a pale or red swolle...
Stokes Adams Treatment
The treatment of true Stokes-Adams disease is unsuccessful. I...
Foreign bodies in the pleural cavity should be immediately re...
There is no absolute contraindication to careful esophagosco...
Blood Pressure And Insurance
An epitome of the consensus of opinion of the risk of accepti...
Source: Disturbances Of The Heart
The treatment of shock will probably always be unsatisfactory as the
cause is so varied, and, although circulatory prostration and
vasomotor paresis always constitute the acute condition, the
physiologic health of the heart and blood vessels is so varied. The
patient in shock has low temperature, low blood pressure, and a
pulse either rapid or slow, but excessively feeble; the face is
pale, the surface of the body cold, and there is more or less clammy
perspiration; there may be dyspnea and cardiac anxiety, or the
patient may hardly breathe.
An acute cause, as terrible pain or hemorrhage, must of course be
stopped immediately. There is more or less anemia of the brain, and
therefore the legs and perhaps the lower part of the body should be
elevated. It may even be wise to drive the blood from the legs by
Esmarch bandages into the rest of the circulation. As there is
always more or less paresis and dilatation of the large veins of the
splanchnic system, a tight bandage about the abdomen is of great
advantage in raising the blood pressure to the safety mark.
Strophanthin, given intravenously, is valuable as a quick
restorative of the heart. Digitalis is so slow that it is of little
value in an emergency. Camphor hypodermically, and hot liquids
(nothing is better than black coffee) given by the mouth, are
valuable remedies. The camphor may be repeated frequently.
Strychnin, the long-used stimulant, should generally be given, but
in not too large doses and not too frequently repeated; 1/30 grain
hypodermically is generally a large enough dose; this dose may be
repeated in three or four hours, but should ordinarily not be given
oftener than once in six hours. An aseptic preparation of ergot
given intramuscularly is most efficient in raising the blood
pressure and aiding the heart. One dose of brandy or whisky may do
no harm. Alcohol, however, should not be pushed.
A most important procedure in all kinds of shock is to surround the
patient with dry heat, hot-water bags, and hot flannels; gentle
friction of the arms and legs, unless the patient is too exhausted,
may be of benefit. A hot-water bag to the heart is always a
stimulant. Sometimes friction over the base of the heart in the
region of the auricles is of benefit.
If the collapse is not acute and there is gradual profound
prostration, or if the patient is improved but still in a serious
condition of shock, too energetic measures must not be used; neither
should too many drugs be administered, or drugs in too large doses.
Absolute quiet and the administration of liquid nourishment in but
small amounts at a time are essential.
The hypodermic administration of epinephrin solutions, 1:10,000, or
solutions of pituitary extract, 1:10,000, should be considered; they
are often valuable.
If the shock occurs in ether or chloroform anesthesia, the
vasopressor stimulating effect of inhalations of carbon dioxid gas
may be considered, as advised by Henderson."
If the shock is due to hemorrhage and the hemorrhage has ceased, a
transfusion of physiologic saline solution is generally indicated.
Transfusion of blood under the same conditions is still better.
Rarely is transfusion indicated in shock from other causes; it often
adds to the difficulty rather than improves it. Occasionally if
shock is decided to be due to a toxemia, the toxin may be diluted by
the withdrawal of a small amount of blood and the transfusion of an
equal amount of saline solution.
Next: Acute Dilatation Of The Stomach
Previous: The Heart In Pneumonia