Weak pulse that can't even be clearly palpated
Introduction
Introduction Obstetric shock is divided into shock compensation period, shock inhibition period, and shock failure period. A weak pulse or even a clear failure is a symptom of the shock inhibition period. Although the causes of various shocks are different, there are relative and absolute insufficient effective circulation. The pathophysiological changes of microcirculation have different obstacles along with the process of shock. Therefore, the treatment principle of shock should be removed as soon as possible. The cause of shock, supplement blood volume, correct microcirculatory disorders, improve heart function, and restore normal body metabolism.
Cause
Cause
The main cause of the condition is shock. Obstetric shock is mainly caused by hemorrhagic shock, followed by shock caused by septic shock and other special causes. Skin, mucous membrane bleeding point or gastrointestinal bleeding, indicating that the disease has progressed to the disseminated intravascular coagulation stage, if active treatment still no progress, secondary dyspnea, if the arterial blood pressure drops below 8kPa (60mmHg), although pressurized Oxygenation symptoms can not be improved, oxygen partial pressure can not be improved, suggesting that dyspnea syndrome and other organ damage will enter the stage of failure.
Examine
an examination
Related inspection
Pulse pulse wave velocity
The patient's expression was indifferent, the reaction was slow, the lips and limbs were cyanotic, the cold sweat, the pulse speed, and the pulse pressure difference was lower. In severe cases, the mind is unclear or coma, the skin mucous membrane is obviously hypoxic and cyanotic, the limbs are cold, the pulse is weak and even can not be clearly touched, the blood pressure drops even 0, oliguria or no urine, CO2 binding reduces acidosis. Skin, mucous membrane bleeding point or gastrointestinal bleeding, indicating that the disease has progressed to the disseminated intravascular coagulation stage, if active treatment still no progress, secondary dyspnea, if the arterial blood pressure drops below 8kPa (60mmHg), although pressurized Oxygenation symptoms can not be improved, oxygen partial pressure can not be improved, suggesting that dyspnea syndrome and other organ damage will enter the stage of failure.
Diagnosis
Differential diagnosis
Differential diagnosis that is weak or even unclear:
1, slow pulse: slow pulse, four breaths, to relax and relax the pulse. Chinese medicine believes that if the pulse is even and gentle, it is a normal pulse. The slow pulse is more common in wet syndrome or spleen and stomach weakness.
2, weak pulse: sinking soft and soft like a weak pulse, lightly looking for no board to regain knowledge, vitality loss and blood deficiency, juveniles can be considered white-headed.
3, micro-pulse: the pulse is very fine and soft, according to the desire, it seems to have nothing.
4, Shenmai: Shenmai is one of the pulse. The pulse position is low, and the light should not be referred to, and the original pulse is re-pressed. "Pulse": "The lack of sinking pulse, more than enough."
5, small pulse pressure: blood pressure is divided into systolic pressure and diastolic blood pressure, the difference between systolic blood pressure and diastolic blood pressure is called "pulse pressure difference". For example, the systolic blood pressure is 120 mm Hg, the diastolic blood pressure is 75 mm Hg, and the pulse pressure difference is 45 mm Hg. Under normal circumstances, the pulse pressure difference of normal people is 20-60 mmHg (2.67-8.0 Kpa). If the pulse is more than 60 mmHg, the pulse pressure difference is too large, and if it is less than 20 mmHg, it is too small.
6. Odd pulse: refers to the phenomenon that the pulse is obviously weakened or even disappeared during inhalation, and appears or recovers when exhaled. Observing odd veins with a sphygmomanometer is often more noticeable than finger palpation.
