临床上的各种危象（Clinical crises）.docVIP

临床上的各种危象（Clinical crises） Send out a summary of the various clinical crises that I hope will help you when youre on night shift and out of the emergency department!! Clinical crisis summary Clinical crisis, the critical sign of disease, is found in clinical departments. Identification and treatment of crisis is an important part of critical care medicine. 1 endocrine and metabolic system 1.1 pituitary crisis: this crisis is a variety of metabolic disorder and dysfunction of organ dysfunction caused by hypopituitarism and normal hormone replacement therapy. It is one of the life-threatening and severe cases. Diagnostic points: Patients with hypopituitarism suffer from severe stress, such as infection, trauma, surgery, and severe metabolic disorder (hyponatremia, hypoglycemia), mental symptoms (mental disorders, unconsciousness, delirium), coma. Rescue measures: Most of them are caused by hypoglycemia and / or hyponatremia. It emphasizes the rapid correction of hypoglycemia, water electrolyte disorders, rapid supplementation of related hormones, and active control of predisposing factors and treatment of complications. 1.2 thyroid crisis Referred to as hyperthyroidism crisis, or thyroid storm, hyperthyroidism is an acute exacerbation of the disease, often dangerous and patient life Diagnostic points: Graves disease, thyroid adenoma or nodular goiter patients, sudden high fever ( 39 C), sweating, tachycardia ( 160 /min), frequent vomiting and diarrhea, anxiety, tremor, delirium, coma. Rescue measures: Rapid inhibition of thyroid hormone synthesis and secretion (by anti thyroid drugs, iodine), thyroid hormone levels decreased rapidly in circulating blood (plasma exchange, dialysis), reduce the reaction around the organization of thyroxine (beta 2 adrenergic blocking agent, reserpine or guanethidine), protection of vital organs, prevention and treatment failure (be antipyretic, sugar corticosteroids or artificial hibernation) 1.3 hypothyroidism crisis Hypothyroidism cris