Đang chuẩn bị nút TẢI XUỐNG, xin hãy chờ
Tải xuống
Yếu tố chủ nhà cũng ảnh hưởng đến tiên lượng của chấn thương thoát mạch. Nâng cao tuổi tác, thỏa hiệp miễn dịch, thâm hụt dinh dưỡng, phụ thuộc steroid, và từ trước bệnh mạch máu ngoại vi là tất cả các yếu tố chủ phổ biến mà rất có thể khuếch đại những thiệt hại gây ra bởi bất kỳ sự kiện thoát mạch. | VASCULAR DISORDERS Host factors also influence the prognosis of extravasation injuries. Advanced age immune compromise nutritional deficits steroid dependency and preexisting peripheral vascular disease are all common host factors that can greatly amplify the damage caused by any given extravasation event. Remember that the mainstay of conservative management is elevation use of a cool compress and a loosely wrapped splint to protect and rest the injured part. Although it may seem obvious make sure that the offending intravenous catheter is removed so that no more agent can extravasate and make sure that the affected extremity is not further compromised by tight circumferential items such as jewelry hospital identification bracelets or tight bandages. Application of heat to the affected area often makes the local swelling much worse and should be avoided. Mark the affected area of the limb with an ink marker so that improvement or worsening can be easily noted as time passes. Save whatever intravenous equipment and drug bags are present initially so that the offending agent and circumstances of extravasation can be clearly and thoughtfully assessed. Injection of antidote material into the affected area may be occasionally indicated for specific cases i.e. hydrofluoric acid or powerful vasoconstrictor extravasations but in most cases such injections should be avoided because they will only increase local tissue pressures increase the likelihood of tissue death or vascular compromise and inconsistently reach the offending agent. Surgical intervention is an immediate requirement if compartment syndrome or compromise of a major vessel is present. Surgical drainage and decompression of an extravasation injury is also helpful if large volumes of agent are involved or if the offending agent is a vesicant and the necrosis interval has not yet expired. Once this interval has passed surgical intervention may be better delayed until clear demarcation of dead tissue has .
