Shock 1 : Hemoragik

HEMATEMESIS MELENA

- Patofisiologi
Outbreak in the proximal vein ligament The Treitz's esophagus-proximal duodenum.
- Symptoms and Alerts
1. black vomit and excrement
2. dyspepsia, heart aches
3. may be history: cirrhosis, eat medicine analgesic
4. tachycardia, akral cold, pale, low tension

- Handling:
1. ABC, cateter, check: Hb, SGOT, SGPT, electrolyte, blood glucose, routine blood
2. - Infus NaCl 0.9%
- If Hb < 7 transfusion PRC
3. - Place the NGT, the aspirations of stomach contents
- When there is blood, a stomach Rinse water ice (gastrine spooling)
4. Drugs:
- Vitamin K
- Acid Tranexamat
- Antacid, H2 blocker (as stress response, increased stomach acid should be pressed)
5. When the varises: Somatostatin bolus + 259 μg drip μ 250 g / hour
6. In order to purge blood out (that is not absorbed by gut and brain poison)
7. Neomisin 4 X 500 mg to kill intestinal bacteria
8. Klisma each morning and afternoon