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1、藥物過敏試驗及過敏反應的處理 Medicationallergytest andmanagementofallergicreactionTracyZhaoContentPenicillinallergytestStreptomycinallergytestTetanusallergytestCephalosporinallergytestIodineallergytestProcaineallergytest學習目標掌握青霉素過敏試驗方法、結果判斷、過敏反應的臨床表現(xiàn)、預防和急救處理原則。掌握TAT脫敏注射法。熟悉青霉素過敏反應的原因。熟悉鏈霉素、破傷風抗毒素、普魯卡因、碘過敏試驗的方
2、法及結果判斷。Casestudy：Onepatienthasgotpenicillinskintest5minbefore,nowhesuddenlyfeelschesttightness,shortnessofbreathwithpale,coldsweat,hisbloodpressureisat10/7.0Kpa(75/52mmHg),pulseisweak.Whatisthisphenomenon?Howdoyoumanageitifyouareanurseonduty？.MnagementofAllergicshockThemostseverealergicreactioni
3、salsocalledanaphylaxisoranaphylacticshock1.stopmedicine.2.give0.1%adrenaline(epinephrine)viasubcutaneousinjection.3.oxygeninhalation.4.anti-allergy5.correctionofacidosis.6.expandbloodvolume.7.resuscitation.8.closeobservationofdiseaseThesoonerthatepinephrineisgiven,thegreaterthechanceforsurvival過
4、敏反應的處理過敏反應的處理Thetreatmentonanaphylacticshockmustbeprompt,graspeveryminuteandsecond,startrescuewithoumoving,adopteffectivemeasuresandcloseobservationHavethepersonlieflat,raisehisfeet,andcoverhimorherwithawarmblanket.giveoxygenGiveinjectionof0.1%epinephrine0.5~1mlatonceIfsymptomsisnotremission,giv
5、e0.1%epinephrine0.5mleveryhalfhour.Ifcardiacarrestisoccurred,startCPRimmediately腎上腺素是搶救過敏性休克的首選藥物，具有收縮血管、增加外周阻力、提升血壓、興奮心肌、增加心輸出量以及松弛支氣管平滑肌等作用Giveoxygentoimprovehypoxia.conductmouth-to-mouthartificialrespirationifRespiratoryarrest,giverespiratorystimulantNikethamide,lobelineviaintramuscularinject
6、ionasphyxiainducedbyLaryngealedema,shouldperformendotrachealintubationortracheotomyandconnectartificialrespiratorassoonaspossibleAntiallergytreatment.Givedexamethasone5~10mgorhydrocortisonesodiumsuccinate200~400mgin5%~10%glucosesolution500mlviaintravenousinfusionGiveantihistaminedrugs,promethazi
7、nehydrochloride25~50mgordiphenhydramine40mgviaintramuscularinjectionsGiveintravenousinfusionof10%dextroseorRinger'ssolution.accordingtodoctor'sordersgivedopamineornorepinephrineviaintrvenousinfusionCorrectionofacidosisAcupun
