Epiglottit, og'ir krup, stridor va yuqori nafas yo'llarining obstruktsiyasi¶

Tomoq to'qimalarining yuqumli shishishi natijasida yuzaga kelgan yuqori nafas yo'llarining o'tkir obstruktsiyasi bolalar va kattalar tibbiyotidagi eng tez harakatlanadigan favqulodda vaziyatlardan biridir. Bir necha daqiqadan bir necha soatgacha epiglottisning bakterial yallig'lanishi (o'tkir epiglottit), ovoz paychalarining ostida kuchli virusli shish (laringotraxeobronxit yoki krup) yoki chuqur bakterial nafas yo'llarining infektsiyasi (bakterial traxeit) nafas yo'llarini chuqurchaga toraytirishi mumkin. Bolaning nafas trubkasi kichik barmog'ining diametriga teng bo'lganligi sababli, hatto 1 millimetr (0,04 dyuym) bolaning nafas olish yo'li ichidagi shilliq qavatning shishishi ko'ndalang kesimdagi nafas olish maydonini 60 foizdan ko'proqqa qisqartiradi va havo oqimining qarshiligini o'n olti barobar oshiradi.

Yallig'langan yuqori nafas yo'llari keskin toraysa, bemor faqat tik o'tirish, oldinga egilish va bo'ynini havoning kichik bo'lagini ochiq ushlab turadigan aniq holatda ushlab turish orqali omon qoladi. Kasalxonaga yotqizilgan birinchi tibbiy yordam ko'rsatish paytida eng katta xavf - bu iatrogenik nafas yo'llarining to'liq yopilishi vahima qo'zg'atgan bolani yoki kattalarni chalqancha yotishga, qoshiq yoki chiroq bilan og'ziga qarashga yoki yig'layotgan bolani bezovta qilishga majburlaydigan yaxshi niyatli qutqaruvchilar tomonidan qo'zg'atilgan. Epiglottitning to'satdan, jim, oqayotgan qo'rquvini virusli krupning guruchli, po'stloq po'stlog'i yo'talidan qanday ajratishni bilish, nima uchun bemorni tanlangan tripod holatida tinchlantirish kerakligini va sovuq tuman yoki namlangan havo yordam berganda, tez tibbiy yordam brigadasi kelgunga qadar havo yo'lini ochiq ushlab turishi mumkin.

Buni hozir qiling¶

1. Agar kimdir tinch holatda shovqinli nafas olayotgan bo‘lsa (stridor), yuta olmaslikdan oqayotgan, bo‘g‘iq “issiq kartoshka” ovozi, uchburchak holati yoki lablari ko‘kargan bo‘lsa, darhol mahalliy tez yordam raqamiga qo‘ng‘iroq qiling. Qo‘shma Shtatlar va Kanadada 911, Yevropa Ittifoqi bo‘ylab 112, Birlashgan Qirollikda 999 yoki Avstraliyada direktor, 00 raqamini tering. favqulodda raqamlar. Request an Advanced Life Support (ALS) ambulance and state clearly that you suspect acute upper airway swelling or epiglottitis so paramedics approach quietly without sirens blaring at the door.
2. Hech qachon stridor, oqayotgan yoki qattiq tomoq shishishi bo'lgan odamni chalqancha yotishga majburlamang. Bemor nafas olish uchun qulay bo'lgan har qanday holatda to'liq tik o'tirsin, odatda iyagini bir oz oldinga egib qo'llari ustiga engashib (shtat yoki hidlash holati). Kichkintoy yoki chaqaloq uchun ota-onasining tizzasida va qo'llarida xotirjam holda tik o'tirishlariga ruxsat bering.
3. NEVER put a tongue depressor, spoon, finger, thermometer, or flashlight inside the mouth to look at the throat. Touching the back of the tongue or forcing the jaw open in suspected epiglottitis triggers an instant vagal laryngospasm or pushes the swollen, cherry-red epiglottis down like a cork into the windpipe, causing immediate and irreversible airway obstruction.
4. Keep a frightened child as calm and quiet as possible in their parent's arms. Crying, screaming, and fighting increase turbulent airflow through the narrowed throat (the Bernoulli effect), which sucks the swollen airway walls inward and worsens hypoxia. Do not separate the child from their caregiver, do not try to pull off their clothes unless necessary, and minimize bright lights or loud noises.
5. Keep the patient strictly NPO (nothing by mouth). Do not offer water, milk, juice, popsicles, honey, or oral fever syrups (such as liquid paracetamol or ibuprofen) to anyone who is drooling, struggling to swallow, or making high-pitched stridor sounds at rest. Attempting to swallow liquid past a swollen epiglottis triggers violent choking and fatal laryngospasm.
6. Agar bolada mumtoz yo'tali (virusli krup) bo'lsa, dimog'i oqmasa, bemalol o'tirsa va faqat yig'layotganida engil stridor bo'lsa, ularni diqqat bilan kuzatib turganda salqin tungi havo yoki hammom tumaniga ta'sir qiling. Tumanli hammomda o'tiring yoki 10-15 daqiqa davomida salqin tashqi havodan nafas oling. engil krupni engillashtiradi, garchi bola tinch va dam olayotganda paydo bo'ladigan har qanday stridor darhol tibbiy ko'rikdan o'tishni va kortikosteroidlarni buyurishni talab qiladi.

O'tkir stridor va yuqori nafas yo'llarining shishishi uchun favqulodda qaror daraxti¶

flowchart TD
    Start["Sudden Noisy Breathing (Stridor), Hoarseness, Barking Cough, or Severe Throat Pain"]
    ChokeCheck{"Did this start INSTANTLY (within seconds)<br/>while eating, playing with small toys, or holding an object in the mouth,<br/>with NO fever or prior illness?"}
    ForeignBody["SUSPECTED FOREIGN-BODY CHOKING / AIRWAY OBSTRUCTION<br/>1. If unable to speak, cough, or breathe: Perform Back Blows & Abdominal Thrusts<br/>   (or Back Blows & Chest Thrusts for infants under 1 year)<br/>2. If coughing forcefully or breathing with stridor: Call EMS immediately;<br/>   do NOT perform blind finger sweeps; keep patient upright"]
    AllergyCheck{"Was the patient exposed to a bee sting, peanut/food allergen,<br/>medication, or has a history of hereditary angioedema,<br/>with swollen lips, tongue, or hives?"}
    Anaphylaxis["ANAPHYLACTIC AIRWAY EDEMA / ANGIOEDEMA<br/>1. Inject Epinephrine Auto-Injector into outer mid-thigh immediately<br/>2. Call EMS (911 / 112 / 999) for urgent transport<br/>3. Keep patient sitting upright if airway/tongue is swollen (unless hypotensive)<br/>4. Give second epinephrine dose at 5 to 15 minutes if no improvement"]
    RedFlagCheck{"Are ANY Epiglottitis or Severe Obstruction Red Flags Present?<br/>- Drooling saliva / unable to swallow own spit<br/>- Sitting upright leaning forward (Tripod / Sniffing posture)<br/>- Muffled 'Hot Potato' voice & absence of barking cough<br/>- High-pitched stridor heard even when resting quietly<br/>- Sternal/rib retractions, lethargy, or bluish/pale skin"}
    EpiglottitisProtocol["CRITICAL UPPER AIRWAY EMERGENCY (EPIGLOTTITIS / SEVERE CROUP / TRACHEITIS)<br/>1. Call EMS (911 / 112 / 999) immediately; request quiet ALS approach<br/>2. Keep patient sitting 100% UPRIGHT (child held in parent's lap)<br/>3. DO NOT look in mouth, DO NOT use tongue blade, DO NOT lay flat<br/>4. Keep strictly NPO (no water, no oral fever medicine)<br/>5. Keep child calm; allow parent to hold blow-by oxygen near face if EMS provides it"]
    MildCroup["LIKELY MILD TO MODERATE VIRAL CROUP (LARYNGOTRACHEOBRONCHITIS)<br/>(Barking seal-like cough, hoarse voice, able to swallow, NO drooling,<br/>NO stridor when resting quietly, alert and drinking fluids)<br/>1. Hold child upright and calm them immediately to stop crying<br/>2. Expose to cool outdoor night air (wrapped warmly) or cool-mist humidifier for 15 min<br/>3. Contact physician or urgent care for single-dose oral Dexamethasone<br/>4. Watch continuously for resting stridor or rib retractions"]

    Start --> ChokeCheck
    ChokeCheck -->|Yes: Sudden Onset, No Fever| ForeignBody
    ChokeCheck -->|No: Preceded by Fever, Cold, or Sore Throat| AllergyCheck
    AllergyCheck -->|Yes: Hives, Lip/Tongue Swelling, Allergen| Anaphylaxis
    AllergyCheck -->|No: Infectious / Inflammatory Pattern| RedFlagCheck
    RedFlagCheck -->|Yes: ANY Red Flag Present| EpiglottitisProtocol
    RedFlagCheck -->|No: Barking Cough Only, Calm at Rest| MildCroup

Hayot uchun xavfli yuqori nafas yo'llarining favqulodda holatlarini taqqoslash¶

Bolada yoki kattalarda shovqinli nafas olish (** stridor **) yoki tomoq og'rig'i paydo bo'lganda, beshta asosiy yuqumli va yuqumli bo'lmagan holatlar tezda ajratilishi kerak. Xirillashdan farqli o'laroq (asosan astmada toraygan pastki bronxial naychalardan **ekshalatsiya paytida eshitiladigan musiqiy, hushtak tovushi), stridor asosan nafas olish paytida eshitiladigan qattiq, baland, qichqiriq yoki arra ovozi (yoki nafas olish va nafas chiqarishda ikkalasi ham) bo'lib, havo oqimining qisman torayishi natijasida paydo bo'ladi. (halqum) yoki nafas trubkasi (traxeya).

Yuqori nafas yo'llarining obstruktsiyasining anatomiyasi va fizikasi¶

Nima uchun 1 millimetrli shish kattalar uchun noqulaylik, lekin bolada falokat¶

Krup yoki epiglottit bilan og'rigan chaqaloq yoki chaqaloq bir necha daqiqada shovqinli nafas olishdan nafas olishni to'xtatishgacha nima uchun yomonlashishi mumkinligini tushunish uchun tez yordam shifokorlari Puazeylning Laminar va turbulent suyuqlik oqimi qonunini qo'llaydilar:

1. Radiusga qarshilik to‘rtinchi quvvat qoidasi (\(R \propto \frac{1}{r^4}\)): Havo oqimi silliq bo'lganda (laminar), havo yo'llarining qarshiligi havo yo'llari radiusining to'rtinchi kuchiga teskari proportsionaldir ** (va yig'lash turbulent havo oqimini keltirib chiqarganda, qarshilik radiusning ** beshinchi kuchi bilan shkalasi).
2. Pediatrik va kattalar havo yo‘li o‘lchovlari:
3. Krikoid xaftaga halqasidagi normal chaqaloq yoki chaqaloqning subglottik havo yo'li ichki diametri bor-yo'g'i 4 millimetr (0,16 dyuym) (radiusi 2 mm) ni tashkil qiladi. Agar virusli krup o'sha qattiq halqa ichida atigi 1 millimetr aylana shilliq qavatining shishishi sabab bo'lsa, ichki diametri 4 mm dan 2 mm gacha tushadi (radius 50 foizga 2 mm dan 1 mm gacha kamayadi). Chunki \(2^4 = 16\), havo yo'li radiusini yarmiga qisqartirish nafas olish maydonini 75 foizga qisqartiradi va nafas olish ishini 1600 foizga (16 marta) oshiradi.
4. Aksincha, oddiy katta traxeyaning ichki diametri taxminan 20 millimetr (0,79 dyuym) (radiusi 10 mm) ni tashkil qiladi. Aynan bir xil 1 millimetrlik aylana shishi kattalar diametrini 20 mm dan 18 mm gacha qisqartiradi, bu esa havo yo'llarining qarshiligini atigi 50 foizga (1,5 barobar) oshiradi.
5. Nega yig'lash havo yo'llarini buzadi (Dinamik Bernoulli effekti): Bolalarda yuqori nafas yo'llari va halqumni qo'llab-quvvatlovchi xaftaga halqalari yumshoq va egiluvchan bo'ladi. Qo'rqib ketgan bola qichqirsa yoki yig'lasa va toraygan tomog'i orqali havoni kuch bilan so'rmoqchi bo'lsa, shishgan devorlardan o'tib ketadigan havoning yuqori tezligi havo yo'li bo'shlig'ida kuchli salbiy vakuum bosimini hosil qiladi (Venturi / Bernoulli effekti). Bu salbiy bosim tom ma'noda nafas olish paytida bolaning tomog'ining yumshoq, egiluvchan devorlarini ichkariga so'radi, qisman to'siqni deyarli to'liq kollapsga aylantiradi. Shuning uchun stridorli bolani tinch va osoyishta tutish nafaqat qulaylik uchun; Bu hayotni saqlab qolish uchun muhim mexanik aralashuvdir.

Supraglottik va subglottik shish o'rtasidagi anatomik farq¶

• Supraglottic Obstruction (Epiglottitis): Occurs above the vocal cords in loose, distensible connective tissue. Because the tissue covering the epiglottis and aryepiglottic folds is loosely attached, bacterial fluid and white blood cells rapidly balloon the epiglottis into a massive swollen sphere that flops over the laryngeal inlet during inspiration. It causes quiet, soft, low-pitched inspiratory stridor, a muffled "hot potato" voice, and drooling because the patient cannot swallow past the swollen mass, but no barking cough.
• Subglottic Obstruction (Viral Croup): Occurs below the vocal cords inside the cricoid cartilage, the only cartilage in the entire human airway that forms a complete, rigid 360-degree signet ring. Because the cricoid ring cannot expand outward when the lining swells, all swelling is forced inward into the breathing tube, stretching the vocal cords above and producing a loud, brassy "barking seal" cough, a hoarse voice, and high-pitched, harsh inspiratory (or biphasic) stridor.

Deep dive: Acute Epiglottitis in children and adults¶

The changing face of Epiglottitis: Why adults are now at high risk¶

Before the routine introduction of the Haemophilus influenzae type b (Hib) conjugate vaccine in the late 1980s and 1990s, acute epiglottitis was predominantly a pediatric disease striking 2-to-7-year-old children. Today, two critical epidemiological realities must be understood by every family and first responder: 1. Pediatric Epiglottitis Still Occurs: It strikes children who are unimmunized or under-immunized against Hib, children in regions without universal Hib vaccination, and even fully vaccinated children when caused by other bacteria such as Streptococcus pneumoniae, Group A beta-hemolytic Streptococcus, or Staphylococcus aureus, or by thermal injury (drinking scalding liquids or inhaling steam). 2. Adult Supraglottitis / Epiglottitis is Rising: The majority of epiglottitis cases in vaccinated countries now occur in adults aged 20 to 65 years. Adult epiglottitis is frequently misdiagnosed at first as a "bad case of strep throat" because the adult throat looks deceptively normal when a doctor looks at the tonsils with a flashlight (since the epiglottis sits lower down, out of direct view).

The "Four Ds" of Acute Epiglottitis¶

Clinicians teach the classic Four Ds to recognize epiglottitis immediately at a glance without ever touching the patient: 1. Drooling (Sialorrhea): Saliva drips continuously from the chin because swallowing triggers agonizing throat pain and threatens to choke the airway. 2. Dysphagia and Severe Odynophagia: Complete inability to swallow liquids or solid food. In adults, the #1 hallmark of epiglottitis is severe, excruciating sore throat pain ("10 out of 10 pain") that is completely out of proportion to a normal-looking oral cavity and tonsils. 3. Dysphonia ("Hot Potato" Voice): The voice sounds thick, muffled, and hollow, as if the person is trying to speak while holding a scalding hot bite of potato in the back of their throat. 4. Distress (Inspiratory Stridor and Tripod Posture): The patient sits motionless, leaning forward with hands braced on their knees (tripod position), neck extended forward and chin tilted up (sniffing position), breathing slowly and carefully so as not to create turbulent airflow that sucks the swollen epiglottis shut.

Step-by-step first aid for suspected Epiglottitis¶

1. Call 911 / 112 / 999 immediately and request an ALS paramedic crew. Tell the dispatcher: "I have a child/adult with suspected epiglottitis who is drooling, sitting in a tripod position, and struggling to breathe."
2. Adopt a strict "Hands-Off, Calm-Environment" protocol:
3. Dim harsh overhead lights and turn off loud televisions or barking pets.
4. If the patient is a child, leave them in their parent's or caregiver's arms. Never try to pry an anxious toddler away from their mother or father to examine them.
5. Let the patient hold a towel or cup near their chin to catch drool so they do not feel an urge to swallow it.
6. Never lay the patient down and never look in the mouth: Do not ask the patient to "open wide and say ahh." Do not shine a phone light down their throat.
7. If the patient loses consciousness and stops breathing completely before paramedics arrive:
8. If the airway closes completely and the patient becomes unresponsive, cyanotic, and apneic, gently lay them supine to begin CPR (yoki pediatric CPR).
9. Rescue Breathing Rule in Complete Epiglottitis Arrest: Even when the swollen epiglottis blocks spontaneous inhalation, firm, slow positive-pressure rescue breaths (mouth-to-mouth or a paramedic's bag-valve-mask) can often force small, life-saving puffs of air past the swollen tissue into the lungs while chest compressions circulate oxygen until paramedics arrive to perform an emergency surgical airway.

Deep dive: Viral Croup (Laryngotracheobronchitis) and Spasmodic Croup¶

Recognizing the classic midnight presentation of Croup¶

Unlike epiglottitis, viral croup accounts for the vast majority of acute stridor cases in children between 6 months and 3 years of age. * Why Croup attacks between 11:00 PM and 4:00 AM: A toddler typically has a mild runny nose, slight hoarseness, and a low-grade fever during the daytime. In the middle of the night, the child wakes up gasping with a loud, metallic, seal-bark cough and a raspy, crowing sound when inhaling (inspiratory stridor). Croup peaks at night because endogenous cortisol (the body's natural anti-inflammatory hormone) drops to its lowest circadian trough between midnight and 4:00 AM, while lying flat in bed increases venous blood pooling in the subglottic lining. * Spasmodic Croup: A closely related variant in which a child goes to bed healthy without any fever and wakes up at 2:00 AM with a barking cough and stridor from sudden subglottic mucosal edema.

Grading Croup severity: The Westley Croup Severity Guide for parents and responders¶

Determining whether a child with a barking cough can be comforted with cool air and taken to a doctor, or requires an immediate 911 / 112 / 999 ambulance, depends on whether stridor and chest retractions are present when the child is calm and resting:

Virusli krup uchun xavfsiz uyda va kasalxonagacha birinchi yordam¶

1. **Bolani ko'taring va darhol tik holatda ushlab turing: ** Tik o'tirish shishgan subglottik shilliq qavatdagi qon to'planishini kamaytiradi va diafragmaga yordam berish uchun tortishish kuchidan foydalanadi.
2. Bolani jimgina ishonch bilan tinchlantiring va tinchlantiring: Bolani tizzangizda ushlab turganda sekin qo‘shiq ayting, sevimli kitobini o‘qing yoki jim video qo‘ying. Bolaning yig'lashini to'xtatish darhol turbulent havo oqimini silliq laminar havo oqimiga aylantiradi, ko'pincha ularning nafas olish kuchini 2 daqiqada yarmiga qisqartiradi.
3. Salqin tungi havo yoki sovuq tumanli hammom protokolini qo'llang (10-15 daqiqa):
4. A varianti (Tungi salqin havo yoki ochiq muzlatkich eshigi): Bolani adyolga issiq tarzda o‘rang va 10-15 daqiqa davomida salqin, nam tungi havodan nafas olish uchun uni ayvonga, ochiq deraza yoniga yoki ochiq muzlatgich/muzlatish kamerasi eshigi oldida olib boring. Sovuq havo subglottik astardagi kengaygan qon tomirlarining vazokonstriksiyasini keltirib chiqaradi, shishishni sezilarli darajada kamaytiradi va qichqiriqli yo'talni engillashtiradi.
5. V varianti (Cool-Mist namlagichi yoki Vanna dumanı): Toza salqin-tumanli namlagichni bolaning yonida ishlating yoki nam tuman hosil qilish uchun dush qabul qilayotganda yopiq hammomda bola bilan tik o‘tiring.
6. KANGIY KUYISH HAQIDA OGOHLANTIRISH: Hech qachon bolani qaynoq suv idishi, issiq pechka yoki issiq bug‘ bug‘latgich ustida ushlab turmang. Issiq bug 'vaporizatorlari va qaynoq suv qozonlari yuz va nafas yo'llarining halokatli kuyishiga olib keladi. kuyadi chayqalayotgan chaqaloqlarda va issiq bug ', aslida shilliq qavatdagi qon oqimini oshirishi va havo yo'llarining shishishini yomonlashtirishi mumkin.
7. Nega krup bilan kasallangan har bir bola klinisyen tomonidan kortikosteroidlar uchun baholanishi kerak:
8. Tungi sovuq havo tungi soat 2:00 da engil krup hujumini to'xtatsa ham, virusli subglottik yallig'lanish 3-5 kun davom etadi va keyingi kechada tez-tez qayta tiklanadi.
9. Amaldagi xalqaro pediatriya ko'rsatmalari (Amerika Pediatriya Akademiyasi, Buyuk Britaniyaning NICE, Kanada Pediatriya Jamiyati, JSST) **krup (hatto engil krup) bo'lgan barcha bolalarga shifokor yoki shoshilinch tibbiy yordam ko'rsatish klinikasidan bir martalik og'iz orqali kortikosteroid (odatda deksametazon) dozasini olishlarini tavsiya qiladi. Deksametazonning bir martalik dozasi nafas yo'llarining shishishini 2-4 soat ichida qisqartirishni boshlaydi, 72 soatgacha davom etadi va tez yordam bo'limiga qayta tashriflar va kasalxonaga yotqizishni 50 foizdan ko'proq qisqartiradi.

Yuqori nafas yo'llarining favqulodda vaziyatlarda oldini olish uchun oltita halokatli xato¶

1. 1-xato: tomoqni qoshiq, barmoq yoki fonar bilan tekshirishga urinish. Hech qachon tilini pastga bosmang yoki stridor bilan oqayotgan bemorni keng ochishni so'ramang. Epiglottitda farenksning minimal mexanik stimulyatsiyasi havo yo'llarining to'liq yopilishiga va vagal bradikardiyani to'xtatishga olib keladi.
2. 2-xato: Tinch holatda stridor yoki oqayotgan bemorga og'iz orqali suyuqlik, asal yoki isitmani tushiruvchi dori berish. Yuqori nafas yo'llari obstruktsiyasi bo'lgan bemorga og'iz orqali biror narsa berish aspiratsiya, kuchli yo'tal spazmlari va laringospazmni keltirib chiqaradi.
3. 3-xato: Yuqumli krup yoki epiglottit bilan og'rigan bolaga qorin bo'shlig'iga zarba berish (Heimlich manevrasi). Qorin bo'shlig'iga zarbalar faqat qattiq mexanik begona jismni chiqarib yuborish uchun mo'ljallangan. Epiglottit yoki krupda obstruktsiya shishgan tirik to'qimalar; qorin bo'shlig'iga zarbalar shishgan to'qimalarni chiqarib yubora olmaydi va faqat bolani vahima qo'zg'atadi va havo yo'lini tezroq yiqitadi.
4. 4-xato: Retseptsiz yo‘talni bostiruvchi, antigistamin yoki sedativ dorilarni berish. Toraygan nafas yo‘li orqali nafas olishga qattiq ishlayotgan bola yoki kattalarni tinchlantirish ularning ongli nafas olish qobiliyatini yo‘qotadi va tomoqni ochiq ushlab turgan faringeal mushaklarni bo‘shashtiradi, bu esa tez nafas olishni tezlashtiradi. Antigistaminlar, shuningdek, virusli krup va bakterial traxeitda nafas yo'llarining sekretsiyasini quritadi va qalinlashtiradi, bu esa tor nafas yo'lida qalin shilliq tiqinlar paydo bo'lishiga olib keladi.
5. 5-xato: Og'ir stridor, oqayotgan yoki orqaga tortilgan bolani shaxsiy avtomobilning orqa o'rindig'ida kasalxonaga haydash. Dam olish paytida stridor, suv oqishi yoki orqaga chekinishlar mavjud bo'lganda, ALS tez yordam xizmati uchun har doim 911/112/999 raqamiga qo'ng'iroq qiling.
6. 6-xato: Yuqori nafas yo‘llarining stridorini astma xuruji bilan chalkashtirib yuborish va inhalerni yig‘layotgan bolaning og‘ziga majburlash. Nafas ekspiratuar xirillashga (pastki o‘pkadan havoni *tashqariga chiqarishda qiyinchilik) sabab bo‘ladi, krup va epiglottit esa **inpiratuar nafas qisilishiga sabab bo‘ladi. yuqori tomoq). Standart ko'k salbutamol yoki albuterol astma inhalerlari pastki o'pkada bronxial silliq mushaklarni bo'shashtiradi; ular tomoqning yuqori qismidagi shishgan xaftaga nol ta'sirga ega va yurak urish tezligini va qo'zg'alishni kuchaytirishi mumkin.

Yuqori nafas yo'llarining favqulodda vaziyatlari tinch harakat qilishni va bemorni qachon bezovta qilmaslik kerakligini bilishni talab qiladi. Milliy Qizil Xoch yoki Qizil Yarim Oy jamiyati, Amerika yurak assotsiatsiyasi yoki Sent-Jon tez yordam mashinasi orqali sertifikatlangan birinchi yordam kursini o'ylab ko'ring.

Tez-tez beriladigan savollar¶

Manbalar tekshirildi¶

• Amerika Pediatriya Akademiyasi (AAP, Qo'shma Shtatlar) va Pediatrik ilg'or hayotni qo'llab-quvvatlash (PALS / AHA): Yuqori havo yo'llari obstruktsiyasi, virusli krup, epiglottit va bakterial traxeitni aniqlash va boshqarish.
• Milliy Sog'liqni saqlash va Xizmat Mukammalligi Instituti (NICE, Buyuk Britaniya) va NHS: Klinik bilimlar haqida qisqacha ma'lumot: Bolalar va kattalardagi krup, o'tkir epiglottit va stridorni baholash.
• Kanada Pediatriya Jamiyati (CPS, Kanada): Favqulodda yordam bo'limida va gospitalgacha bo'lgan sharoitda krupni o'tkir boshqarish.
• Jahon sog'liqni saqlash tashkiloti (JSST, Xalqaro): Bolalar uchun kasalxonada yordam ko'rsatish cho'ntak kitobi: stridor, krup va epiglottit.
• Melburn qirollik bolalar kasalxonasi (RCH, Avstraliya): Klinik amaliyot bo'yicha ko'rsatmalar: Yuqori nafas yo'llarining o'tkir obstruktsiyasi va krup.

Tegishli qo'llanmalar¶

• Pediatrik va chaqaloqlarda yurak urishi va bo'g'ilish
• Kattalar va bolalar uchun bo'g'ilishda birinchi yordam
• Allergik reaktsiyalar va anafilaksi birinchi yordam
• Asthma attack emergency care
• Kattalar CPR va qutqaruv nafasi
• Favqulodda raqamlar va xalqaro jo'natma