The Infection-Prone Hospital Patient
The Infection-Prone Hospital Patient
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容易感染的医院病人
DOI：
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发表时间：
1981
影响因子：
17.3
通讯作者：
A. Pollock
中科院分区：
文献类型：
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作者：
A. Pollock
大剂量的F1-肾上腺素能激动剂支气管扩张剂也应该被排除。在给合适的患者使用一个罐进行自我给药之前，应该对他们进行常规调查，以确定他或她需要吸入的剂量，以使脉搏率提高每分钟20到30次。如果患者开始出现血管性水肿时立即吸入该剂量，则足以中止发作的剂量可能被吸收。最好在专科中心确定所需的吸入次数，以排除偶尔吸入小剂量异丙肾上腺素后出现节律障碍的患者。一般认为，对任何过敏反应患者最有效的初始治疗是皮下注射肾上腺素，如果患者严重休克，则肌肉注射肾上腺素（例如，参见Lancet 1980，British Medical Journal 1981，Frankland & Lessof 1980，1981，兰开斯特1980）。刚被蜇过并在过去有过严重反应的患者通常会感到害怕，并且可能会发现自己无法在症状严重程度增加的时候打开注射器并填充注射器然后注射自己。在英国，预充肾上腺素的注射器最近还没有上市（British Medical Journal 1979，Brown 1980），但现在很容易获得（Ackroyd 1980）。强烈建议任何有严重反应的病人，如果他看起来有可能使用这种注射器，应该给他一个，并教他如何使用。病人应该自己注射的肾上腺素剂量应该以类似于确定吸入异丙肾上腺素剂量的方法来确定。J F Ackroyd过敏诊所，St玛丽医院，伦敦W21 NY
large doses of fl-adrenergic agonist bronchodilators should probably also be excluded. Before being given a canister for self-administration, suitable patients should be investigated routinely to discover the dose he or she needs to inhale to raise the pulse rate by twenty to thirty beats per minute. If this dose was inhaled immediately the patient began to develop angioedema, an amount sufficient to abort the attack might be absorbed. The number of inhalations required should preferably be determined in specialist centres in order to exclude from this treatment the occasional patient who develops a dysrhythmia after inhaling quite small doses of isoprenaline. It is generally agreed that the most effective initial treatment for any patient with anaphylaxis is adrenaline by deep subcutaneous or, if the patient is severely shocked, by intramuscular injection (see, for instance, Lancet 1980, British Medical Journal 1981, Frankland & Lessof 1980, 1981, Lancaster 1980). Patients who have just been stung and who have had a severe reaction in the past are usually frightened and may find themselves unable to open an ampoule and fill a syringe and then inject themselves during a time when their symptoms are increasing in severity. Syringes precharged with adrenaline have not recently been available in the UK (British Medical Journal 1979, Brown 1980), but now can be obtained easily (Ackroyd 1980). It is strongly recommended that any patient who has had a severe reaction and who seems likely to be able to use such a syringe should be given one and taught how to use it. The dose of adrenaline with which the patient should inject himself should be determined in a manner similar to that suggested for determining the dose of inhaled isoprenaline. J F Ackroyd Allergy Clinic St Mary's Hospital, London W21NY