【⚠️疫情依舊嚴峻,請大家沒事就待在家,避免非必要外出,戴口罩勤洗手,保護自己也保護別人!】
根據日本《產經新聞》媒體報導,新冠病毒確診者在自家療養時死亡的案例相繼發生。症狀多是無症狀或是輕症,卻突然變成重症。最需要注意的,便是稱為「快樂缺氧」(Happy Hypoxia)的病症。
近期台灣也開始出現不少「快樂缺氧」的案例。明明意識清晰,甚至能通電話,但血氧就是拉不上來😰
一般人血氧95%以上為正常,不足95%則是略微氧氣不足的狀態,若不到90%,則相當危險。
日本麻醉科醫師筒井富美表示,因為受到新冠病毒感染的緣故,快樂缺氧的患者即使已進入血氧濃度僅為70%~80%的重度缺氧狀態,也不會感到呼吸困難,因此發現重症化時往往太遲。
至於發生這個怪異病況的原因究竟為何,麻醉科/疼痛科主治醫師詹廖明義表示,目前並不非常了解,但可能與肺部血栓,血流異常及病毒侵犯到頸動脈體(Carotid Body)有關。
胸腔重症醫師蘇一峰提醒,確診者要注意呼吸和血氧濃度,避免不自覺低血氧造成心肌梗塞猝死;如果是無法住院,只能居家隔離、待在檢疫所的患者,要小心觀察血氧狀況,才能在第一時間就醫。
那麼,我們該怎麼在沒有感覺身體不適的情況下,盡早判斷身體內的氧氣濃度可能已經不足了呢?🚨
使用血氧機進行測量可以說是最簡便的測量方式。
然而,雖然使用血氧機確實可以幫助監控病情,但美國猶太健康醫院(National Jewish Health)重症醫學科主任、胸腔科醫師William Janssen表示,由於COVID-19的疫情讓大家都十分緊張,病患有可能因為擔心疫情,因而不敢進入醫療院所,造成誤判。因此分析結果仍應該要諮詢專業的醫療人員。
民眾若沒有血氧機,也能利用外觀、步行測試、計算呼吸等方式自我監測⏱
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【🔺快樂缺氧自我測試】
#從病人外觀分辨
外媒《DNA India》報導指出,若確診COVID-19病患有快樂缺氧的症狀,他們可能嘴唇顏色會轉藍,皮膚也會變色成紅色或紫色調,或在沒有進行辛苦勞力工作的情況下開始大量流汗。
#步行測試
根據美國胸腔科醫學會提出的6分鐘步行測試(Six minutes walk test),民眾可以按照平時的步行速度連續走6分鐘,若臉色發黑務必就醫
#呼吸測試
在沒運動的狀況下,正常人每分鐘平均呼吸12至20次。若民眾發現自己每分鐘呼吸超過25次以上,就代表有異常,也建議儘速就醫。
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carotid body 在 英國的另類日常 Facebook 的精選貼文
如果你的狗狗超過25kg重,
可以考慮加入捐血行列,拯救更多狗狗的生命!
以下是一隻受惠於輸血的狗狗的故事:
Dodge is a 3 year old cocker spaniel from our Flitwick branch he was bought in in September with a swollen neck, the vet suspected that this was due to a foreign body so dodge was sedated and two grass blades were removed from near his tonsils. There was no other obvious wounds so the vet sent dodge home with antibiotics and anti- inflammatories.
Over the next few days dodge started drooling blood at first this was thought to be an abscess that was draining, but due to the significant amount of blood that started draining dodge was admitted for intensive treatment to our Hendon branch.
A CT scan (hundreds of x-rays are taken at once to build a 3d view of the area) was performed. The CT scan showed two large structures one by the right tonsil and one by the right parotid gland. The vet performed a exploratory surgery and found these structures were pockets of clotted blood. This was removed and packed. After surgery dodge was still bleeding and his blood results showed that his red blood cell count was extremely low. Dodge needed an emergency blood transfusion as he had lost so much.
The practice rang vet blood supplies and ordered a bag of packed cells which were sent to Hendon urgently and the blood transfusion was performed.
A further CT scan was performed and a piece of wood was noticed adjacent to the internal carotid (major artery). Dodge underwent a further surgery to remove this piece of wood. Whilst in recover dodge started to bleed so had to have another anaesthetic at 4am to suture and pack the area. Due to the nature of the wound there was a chance the bleeding would continue.
Dodge then needed another blood transfusion due to the continued blood loss so again vet blood supplies were called this time the packed cells had to be the correct type. (e.g. positive or negative) as only the first transfusion a dog has can be either, the second and subsequent ones have to be correctly typed as there could be a reaction to the blood. Dodge needed positive blood so this was sent urgently to Hendon and another transfusion was performed.
The next day dodge had an endoscopy to look at the area and the bleeding had stopped but there was a small amount of oozing.
Dodge stayed on intravenous fluid therapy and also had a plasma transfusion that was ordered from vet blood supplies this was due to his blood levels being extremely low still.
After a lengthy stay in hospital and a couple of set backs dodge has now been able to go home. He's on some medication and is having regular check ups at Flitwick but currently he is doing very well.
The blood that dodge received was from two of our donors Tommy and Henry, their blood was collected on a donor day at our Welwyn garden city branch. As you can see with dodge, blood donation is a life saving process, dodges owners have now been able to take their baby home due to the blood transfusions he has had.
Currently we are in high demand for blood and have a shortage of donors. Which we are trying to rectify with education and advertisement of our blood donor days.
carotid body 在 史丹福狂想曲 Facebook 的最佳貼文
今天介紹一點基本的酸鹼生理知識。
人體的酶需要在特定的酸鹼值中工作,如果環境太酸或者太鹼,都會影響它們的活動。
人體有幾個很精密的系統把酸鹼值控制在7.35至7.45的範圍。首先,血漿入面有碳酸(carbonic acid)與碳酸氫離子(bicarbonate ions),這個化學系統是一個緩衝溶液(buffer solution),本身就可以對抗酸鹼的變化。當少量的酸被加進溶液中,碳酸氫離子會把它中和掉;當少量的鹼被加進溶液中,碳酸又會把它中和掉,令酸鹼值相對穩定。除了碳酸與碳酸氫離子,血入面還有磷酸、蛋白質等其他緩衝化學系統。
第二,呼吸系統也是一個重要的酸鹼控制機制。當身體的血液變酸,就會刺激化學受體(chemoreceptors)。周邊化學受體位於頸動脈體(carotid body)及主動脈體(aortic body),中央化學受體(central chemoreceptors)則位於延腦(medulla)。當它們偵測到血液變酸,就會透過腦部的呼吸中心刺激肺部加快呼吸,加快排出二氧化碳,減低血液的酸度。反之亦然。
最後,我們的腎臟也會幫助調節酸鹼。當血液的酸度提高,腎臟會減少排出碳酸氫離子,增加排出氫離子,減低血液的酸度。反之亦然。
酸血症(acidosis)或鹼血症(alkalosis)分為呼吸性(respiratory)及代謝性(metabolic)。呼吸性酸鹼失調是由呼吸系統過量或過少換氣,令血液中的二氧化碳含量出現問題引起。代謝性酸鹼失調則是由於腎臟功能失調,或者身體製造或吸收氫離子太多。
要知道人體的酸鹼情況,就要抽動脈的血液做動脈血液氣體分析(arterial blood gas)。如下圖的檢查中,病人有嚴重的呼吸系統問題,令換氣不足,二氧化碳排不部出來。所以血液中二氧化硫非常高,血液也變得很酸。
carotid body 在 Carotid Body and Carotid Sinus -- General Information 的相關結果
Carotid body monitors the blood's pH, pCO2, and pO2 and thereby modulates cardiovascular and respiratory function primarily through ... ... <看更多>
carotid body 在 Anatomy, Head and Neck, Carotid Bodies - StatPearls - NCBI 的相關結果
The carotid body is a 2 to 6 mm, round bilateral sensory organ in the peripheral nervous system located in the adventitia of the bifurcation ... ... <看更多>
carotid body 在 頸動脈體- 維基百科,自由的百科全書 的相關結果
頸動脈體(carotid body)是頸動脈分支附近的一個化學受器(英語:chemoreceptor)暨支持組織。 頸動脈體能偵測動脈血中的氣體分壓,主要是血氧及二氧化碳。 ... <看更多>