{"id":33114,"date":"2023-05-11T00:28:18","date_gmt":"2023-05-10T17:28:18","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=33114"},"modified":"2023-05-11T00:28:18","modified_gmt":"2023-05-10T17:28:18","slug":"roi-loan-tri-giac-danh-gia-theo-thang-diem-four-va-xu-tri","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/11\/roi-loan-tri-giac-danh-gia-theo-thang-diem-four-va-xu-tri\/","title":{"rendered":"R\u1ed1i lo\u1ea1n tri gi\u00e1c: \u0111\u00e1nh gi\u00e1 theo thang \u0111i\u1ec3m FOUR v\u00e0 x\u1eed tr\u00ed"},"content":{"rendered":"<div>\n<div class=\"content--kLKAu baseStyles-2133108132--disableImagePointerEventOnTutorial-3958995088--anchorLinkStyles-27620709\">\n<div><strong>R\u1ed1i lo\u1ea1n tri gi\u00e1c (AMS) l\u00e0 m\u1ed9t s\u1ef1 thay \u0111\u1ed5i c\u1ea5p t\u00ednh trong ch\u1ee9c n\u0103ng nh\u1eadn th\u1ee9c, ch\u1ee9c n\u0103ng t\u00e2m th\u1ea7n v\u00e0\/ho\u1eb7c m\u1ee9c \u0111\u1ed9 th\u1ee9c t\u1ec9nh; c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n b\u1edfi l\u00fa l\u1eabn, thay \u0111\u1ed5i h\u00e0nh vi, v\u00e0 c\u00e1c thay \u0111\u1ed5i t\u1eeb k\u00edch th\u00edch cho t\u1edbi ng\u1ee7 g\u00e0, th\u1eadm ch\u00ed h\u00f4n m\u00ea. AMS c\u00f3 th\u1ec3 g\u00e2y ra do c\u00e1c b\u1ec7nh l\u00fd th\u1ea7n kinh trung \u01b0\u01a1ng, c\u00e1c b\u1ec7nh n\u1ed9i khoa to\u00e0n th\u00e2n, nghi\u1ec7n ch\u1ea5t, v\u00e0 c\u00e1c b\u1ec7nh t\u00e2m th\u1ea7n. \u0110\u00e1nh gi\u00e1 r\u1ed1i lo\u1ea1n tri gi\u00e1c kh\u00e1ch quan v\u00e0 \u0111\u1ed3ng nh\u1ea5t c\u1ea7n d\u1ef1a v\u00e0o c\u00e1c thang \u0111i\u1ec3m nh\u01b0 GCS, AVPU v\u00e0 thang \u0111i\u1ec3m FOUR.<\/strong><\/div>\n<div><\/div>\n<h2>1. T\u1ed5ng quan v\u1ec1 c\u00e1c thang \u0111i\u1ec3m trong \u0111\u00e1nh gi\u00e1 r\u1ed1i lo\u1ea1n tri gi\u00e1c.<\/h2>\n<h3 id=\"Y6ec611191c34f254739e4b3dc30fd9da\" class=\"condensed-hidden-step1\"><span id=\"Zfbe2457e09bc58dc26e716103c9c280c\" class=\"api\" data-type=\"anker\">1.1. <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/thang-diem-glasgow-la-gi-y-nghia-thang-diem-glasgow-trong-hon-me\/\">Glasgow coma scale<\/a> (GCS). <\/span><\/h3>\n<ul>\n<li class=\"condensed-hidden-step1\"><span id=\"Zfbe2457e09bc58dc26e716103c9c280c\" class=\"api\" data-type=\"anker\">Ban \u0111\u1ea7u \u0111\u01b0\u1ee3c ph\u00e1t minh \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 b\u1ec7nh nh\u00e2n ch\u1ea5n th\u01b0\u01a1ng n\u00e3o, nh\u01b0ng hi\u1ec7n nay n\u00f3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i trong ph\u00e2n \u0111\u1ed9 h\u00f4n m\u00ea do nhi\u1ec1u nguy\u00ean nh\u00e2n kh\u00e1c nhau. <\/span><\/li>\n<li class=\"condensed-hidden-step1\"><span id=\"Zfbe2457e09bc58dc26e716103c9c280c\" class=\"api\" data-type=\"anker\">L\u00e0 m\u1ed9t thang \u0111i\u1ec3m chu\u1ea9n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 th\u1ee9c t\u1ec9nh v\u00e0 tr\u1ea1ng th\u00e1i th\u1ea7n kinh trong nhi\u1ec1u t\u00ecnh hu\u1ed1ng, nh\u01b0 trong ph\u00e2n lo\u1ea1i ch\u1ea5n th\u01b0\u01a1ng n\u00e3o. <\/span><\/li>\n<li class=\"condensed-hidden-step1\"><span id=\"Zfbe2457e09bc58dc26e716103c9c280c\" class=\"api\" data-type=\"anker\">GCS \u00edt gi\u00e1 tr\u1ecb trong \u0111\u00e1nh gi\u00e1 b\u1ec7nh nh\u00e2n th\u1edf qua n\u1ed9i kh\u00ed qu\u1ea3n v\u00e0 kh\u00f4ng cung c\u1ea5p \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 chi ti\u1ebft ch\u1ee9c n\u0103ng th\u00e2n n\u00e3o.\u00a0<\/span><\/li>\n<\/ul>\n<\/div>\n<div>\n<aside class=\"tooltipContainer-1547484803--filterShadow-3387428294--hidden-661153127\" data-e2e-test-id=\"tooltip-container\">\n<div class=\"triangleContainer-2134543770--generalTooltip-2904566283--up-4192358089\">\n<h3 class=\"table-control-container\">1.2. Thang \u0111i\u1ec3m AVPU.<\/h3>\n<div>L\u00e0 m\u1ed9t thang \u0111i\u1ec3m s\u1eed d\u1ee5ng c\u00e1c ch\u1eef c\u00e1i vi\u1ebft t\u1eaft d\u00f9ng \u0111\u1ec3 ph\u00e2n lo\u1ea1i nhanh v\u00e0 trao \u0111\u1ed5i v\u1ec1 tr\u1ea1ng th\u00e1i th\u1ee9c t\u1ec9nh c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh trong t\u00ecnh hu\u1ed1ng c\u1ea5p c\u1ee9u. <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/nhi\/kham-danh-gia-va-xu-tri-cap-cuu-tre-em\/\">Thang \u0111i\u1ec3m AVPU<\/a> bao g\u1ed3m:<\/div>\n<ul>\n<li>A: alert &#8211; b\u1ec7nh nh\u00e2n t\u1ec9nh th\u1ee9c.<\/li>\n<li>V:\u00a0responsive to\u00a0<span class=\"wichtig\">V<\/span>erbal stimuli &#8211; \u0111\u00e1p \u1ee9ng v\u1edbi l\u1eddi n\u00f3i.<\/li>\n<li>P:\u00a0responsive to\u00a0<span class=\"wichtig\">P<\/span>ainful stimuli &#8211; \u0111\u00e1p \u1ee9ng v\u1edbi k\u00edch th\u00edch \u0111au.<\/li>\n<li>U: Unresponsive &#8211; kh\u00f4ng \u0111\u00e1p \u1ee9ng.<\/li>\n<\/ul>\n<h3>1.3. Thang \u0111i\u1ec3m FOUR:<\/h3>\n<ul>\n<li>L\u00e0 thang \u0111i\u1ec3m \u0111\u00e1nh gi\u00e1 tr\u1ea1ng th\u00e1i th\u1ee9c t\u1ec9nh c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh, \u0111\u1ed3ng th\u1eddi cho ph\u00e9p \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c ch\u1ee9c n\u0103ng th\u00e2n n\u00e3o.<\/li>\n<li>Thang \u0111i\u1ec3m c\u00f3 gi\u00e1 tr\u1ecb s\u1eed d\u1ee5ng trong nhi\u1ec1u t\u00ecnh hu\u1ed1ng l\u00e2m s\u00e0ng kh\u00e1c nhau nh\u01b0 t\u1ea1i khoa c\u1ea5p c\u1ee9u, ICU, ng\u01b0\u1eddi b\u1ec7nh ph\u1eabu thu\u1eadt th\u1ea7n kinh.<\/li>\n<li>C\u00f3 gi\u00e1 tr\u1ecb nh\u01b0 nhau cho b\u1ec7nh nh\u00e2n th\u1edf n\u1ed9i kh\u00ed qu\u1ea3n v\u00e0 kh\u00f4ng th\u1edf n\u1ed9i kh\u00ed qu\u1ea3n. \u0110\u1eb7c hi\u1ec7u h\u01a1n GCS \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n r\u1ed1i lo\u1ea1n tri gi\u00e1c n\u1eb7ng.<\/li>\n<\/ul>\n<h2>2. S\u1eed d\u1ee5ng thang \u0111i\u1ec3m FOUR trong \u0111\u00e1nh gi\u00e1 b\u1ec7nh nh\u00e2n r\u1ed1i lo\u1ea1n tri gi\u00e1c.<\/h2>\n<p>C\u00f3 th\u1ec3 \u01b0u ti\u00ean s\u1eed d\u1ee5ng thang \u0111i\u1ec3m FOUR thay cho GCS trong \u0111\u00e1nh gi\u00e1 tri gi\u00e1c b\u1ec7nh th\u1edf m\u00e1y.<\/p>\n<\/div>\n<\/aside>\n<\/div>\n<\/div>\n<div class=\"css-1x17ya eyueia0\">\n<div class=\"css-1lbpfmz e1tnky2o1\">\n<div class=\"css-139mn3x e1tnky2o0\">\n<div class=\"css-hyaldf e1tnky2o1\">\n<div class=\"css-r8skn2 e1tnky2o0\">\n<div class=\"css-kb7nvz e1vkw3t42\">\n<div class=\"css-rodj39 e1tnky2o1\">\n<div class=\"css-84ablj e1tnky2o0\">\n<div class=\"css-dhmirf e1pr7vjj0\" data-variant=\"inherit\">\n<table class=\"additional api\" data-table=\"L3RkJTNFJTIwJTNDL3RyJTNFJTBBJTNDL3Rib2R5JTNFJTBBJTNDL3RhYmxlJTNF16512\">\n<thead>\n<tr>\n<th scope=\"row\"><span class=\"leitwort\">Ti\u00eau chu\u1ea9n<\/span><\/th>\n<th scope=\"col\"><span class=\"leitwort\">\u0110\u00e1p \u1ee9ng<\/span><\/th>\n<th scope=\"col\"><span class=\"leitwort\">\u0110i\u1ec3m<\/span><\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<th colspan=\"1\" rowspan=\"5\" scope=\"row\">\u0110\u00e1p \u1ee9ng m\u1eaft (E)<\/th>\n<td>\u00c1nh m\u1eaft theo d\u00f5i l\u1eddi n\u00f3i v\u00e0 ch\u1edbp m\u1eaft<\/td>\n<td>4<\/td>\n<\/tr>\n<tr>\n<td>Mi m\u1eaft m\u1edf t\u1ef1 nhi\u00ean ho\u1eb7c khi y\u00eau c\u1ea7u<\/td>\n<td>3<\/td>\n<\/tr>\n<tr>\n<td>Mi m\u1eaft \u0111\u00f3ng nh\u01b0ng m\u1edf khi g\u1ecdi l\u1edbn<\/td>\n<td>2<\/td>\n<\/tr>\n<tr>\n<td>Mi m\u1eaft \u0111\u00f3ng nh\u01b0ng m\u1edf khi k\u00edch th\u00edch \u0111au<\/td>\n<td>1<\/td>\n<\/tr>\n<tr>\n<td>Mi m\u1eaft \u0111\u00f3ng khi k\u00edch th\u00edch \u0111au<\/td>\n<td>0<\/td>\n<\/tr>\n<tr>\n<th colspan=\"1\" rowspan=\"5\" scope=\"row\"><span class=\"leitwort\">V\u1eadn \u0111\u1ed9ng (M)<\/span><\/th>\n<td>C\u00f3 th\u1ec3 ra d\u1ea5u b\u1eb1ng b\u00e0n tay \u0111\u01b0\u1ee3c<\/td>\n<td>4<\/td>\n<\/tr>\n<tr>\n<td>\u0110\u00e1p \u1ee9ng \u0111\u00fang k\u00edch th\u00edch \u0111au<\/td>\n<td>3<\/td>\n<\/tr>\n<tr>\n<td>\u0110\u00e1p \u1ee9ng co l\u1ea1i khi k\u00edch th\u00edch \u0111au<\/td>\n<td>2<\/td>\n<\/tr>\n<tr>\n<td>\u0110\u00e1p \u1ee9ng du\u1ed7i khi k\u00edch th\u00edch \u0111au<\/td>\n<td>1<\/td>\n<\/tr>\n<tr>\n<td>Kh\u00f4ng \u0111\u00e1p \u1ee9ng ho\u1eb7c tr\u1ea1ng th\u00e1i \u0111\u1ed9ng kinh to\u00e0n th\u1ec3 gi\u1eadt c\u01a1<\/td>\n<td>0<\/td>\n<\/tr>\n<tr>\n<th colspan=\"1\" rowspan=\"5\" scope=\"row\"><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/kham-phan-xa-la-kham-gi-cach-kham-nhu-nao\/\">Ph\u1ea3n x\u1ea1 th\u00e2n n\u00e3o<\/a> (B)<\/th>\n<td>C\u00f2n ph\u1ea3n x\u1ea1 gi\u00e1c m\u1ea1c v\u00e0 \u0111\u1ed3ng t\u1eed<\/td>\n<td>4<\/td>\n<\/tr>\n<tr>\n<td>\u0110\u1ed3ng t\u1eed r\u1ed9ng v\u00e0 c\u1ed1 \u0111\u1ecbnh 1 b\u00ean<\/td>\n<td>3<\/td>\n<\/tr>\n<tr>\n<td>M\u1ea5t ph\u1ea3n x\u1ea1 \u0111\u1ed3ng t\u1eed ho\u1eb7c gi\u00e1c m\u1ea1c<\/td>\n<td>2<\/td>\n<\/tr>\n<tr>\n<td>Ph\u1ea3n x\u1ea1 gi\u00e1c m\u1ea1c v\u00e0 \u0111\u1ed3ng t\u1eed m\u1ea5t, ph\u1ea3n x\u1ea1 ho c\u00f2n<\/td>\n<td>1<\/td>\n<\/tr>\n<tr>\n<td>M\u1ea5t c\u1ea3 3 ph\u1ea3n x\u1ea1<\/td>\n<td>0<\/td>\n<\/tr>\n<tr>\n<th colspan=\"1\" rowspan=\"5\" scope=\"row\"><span class=\"leitwort\">H\u00f4 h\u1ea5p (R)<\/span><\/th>\n<td>Kh\u00f4ng \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n, th\u1edf \u0111\u1ec1u<\/td>\n<td>4<\/td>\n<\/tr>\n<tr>\n<td>Kh\u00f4ng \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n, ki\u1ec3u th\u1edf <span class=\"linksuggest\">Cheyne-Stokes<\/span><\/td>\n<td>3<\/td>\n<\/tr>\n<tr>\n<td>Kh\u00f4ng \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n ki\u1ec3u th\u1edf kh\u00f4ng \u0111\u1ec1u<\/td>\n<td>2<\/td>\n<\/tr>\n<tr>\n<td>Th\u1edf qua n\u1ed9i kh\u00ed qu\u1ea3n, th\u1edf &gt;t\u1ea7n s\u1ed1 m\u00e1y th\u1edf<\/td>\n<td>1<\/td>\n<\/tr>\n<tr>\n<td>Th\u1edf qua n\u1ed9i kh\u00ed qu\u1ea3n, th\u1edf&lt;t\u1ea7n s\u1ed1 m\u00e1y th\u1edf ho\u1eb7c ng\u01b0ng th\u1edf<\/td>\n<td>0<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2>3. X\u1eed tr\u00ed ban \u0111\u1ea7u r\u1ed1i lo\u1ea1n tri gi\u00e1c.<\/h2>\n<h3>3.1. Ti\u1ebfp c\u1eadn v\u00e0 \u0111\u00e1nh gi\u00e1 ban \u0111\u1ea7u ng\u01b0\u1eddi b\u1ec7nh r\u1ed1i lo\u1ea1n tri gi\u00e1c.<\/h3>\n<ul>\n<li>Kh\u1ea3o s\u00e1t theo ABCDE.<\/li>\n<li>X\u00e1c \u0111\u1ecbnh \u0111\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng c\u1ee7a c\u00e1c nguy\u00ean nh\u00e2n c\u1ee7a AMS.<\/li>\n<li>T\u00ednh thang \u0111i\u1ec3m h\u00f4n m\u00ea (s\u1eed d\u1ee5ng thang \u0111i\u1ec3m CAM n\u1ebfu nghi ng\u1edd s\u1ea3ng).<\/li>\n<li>Ki\u1ec3m tra glucose m\u00e1u t\u1ea1i gi\u01b0\u1eddng.<\/li>\n<li>B\u1eaft \u0111\u1ea7u theo d\u00f5i tim m\u1ea1ch li\u00ean t\u1ee5c v\u00e0 SpO2.<\/li>\n<li>L\u1eadp \u0111\u01b0\u1eddng truy\u1ec1n t\u0129nh m\u1ea1ch v\u00e0 l\u00e0m c\u00e1c x\u00e9t nghi\u1ec7m th\u01b0\u1eddng quy.<\/li>\n<li>Ch\u1ee5p h\u00ecnh \u1ea3nh h\u1ecdc s\u1ecd n\u00e3o s\u1edbm n\u1ebfu nghi ng\u1edd nguy\u00ean nh\u00e2n th\u1ea7n kinh trung \u01b0\u01a1ng.<\/li>\n<li>Thu th\u1eadp b\u1ec7nh s\u1eed t\u1eeb nh\u1eefng ng\u01b0\u1eddi ch\u1ee9ng ki\u1ebfn.<\/li>\n<li><em><strong>\u1ede b\u1ec7nh nh\u00e2n AMS kh\u1edfi ph\u00e1t \u0111\u1ed9t ng\u1ed9t ho\u1eb7c h\u00f4n m\u00ea, xem x\u00e9t co gi\u1eadt, \u0111\u1ed9t qu\u1ef5, c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch, qu\u00e1 li\u1ec1u thu\u1ed1c, ng\u1ed9 \u0111\u1ed9c.<\/strong><\/em><\/li>\n<\/ul>\n<h3>3.2. Qu\u1ea3n l\u00fd c\u00e1c nguy\u00ean nh\u00e2n quan tr\u1ecdng c\u1ee7a <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/nao-la-roi-loan-tri-giac\/\">r\u1ed1i lo\u1ea1n tri gi\u00e1c.<\/a><\/h3>\n<\/div>\n<p>Th\u1ef1c hi\u1ec7n \u0111\u1ed3ng th\u1eddi c\u00e1c n\u1ed9i dung sau c\u00f9ng v\u1edbi \u0111\u00e1nh gi\u00e1 ban \u0111\u1ea7u, d\u1ef1a tr\u00ean g\u1ee3i \u00fd t\u1eeb l\u00e2m s\u00e0ng.<\/p>\n<div class=\"css-dhmirf e1pr7vjj0\" data-variant=\"inherit\">\n<ul>\n<li style=\"list-style-type: none;\">\n<ul class=\"condensed-hidden\">\n<li>X\u00e1c \u0111\u1ecbnh nhanh c\u00e1c nguy\u00ean nh\u00e2n c\u00f3 th\u1ec3 x\u1eed tr\u00ed \u0111\u1eb7c hi\u1ec7u:\n<ul>\n<li>\u0110i\u1ec1u tr\u1ecb suy h\u00f4 h\u1ea5p b\u1eb1ng <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/lieu-phap-oxy-la-gi\/#:~:text=Li%E1%BB%87u%20ph%C3%A1p%20oxy%20l%C3%A0%20m%E1%BB%99t,nit%C6%A1%20(79%2C02%25).\">li\u1ec7u ph\u00e1p oxy<\/a>, th\u1edf mask-t\u00fai, th\u1edf m\u00e1y.<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb cho\u00e1ng b\u1eb1ng h\u1ed7 tr\u1ee3 huy\u1ebft \u0111\u1ed9ng ngay l\u1eadp t\u1ee9c. H\u1ed3i s\u1ee9c d\u1ecbch, v\u1eadn m\u1ea1ch, thu\u1ed1c t\u0103ng co, v\u00e0\/ho\u1eb7c \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 nh\u01b0 corticosteroid.<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft.<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb c\u1eaft c\u01a1n co gi\u1eadt<\/li>\n<li>Ti\u00eam thu\u1ed1c \u0111\u1ed1i kh\u00e1ng nh\u01b0 naloxone cho qu\u00e1 li\u1ec1u opioid.<\/li>\n<\/ul>\n<\/li>\n<li>Th\u1ef1c hi\u1ec7n c\u00e1c bi\u1ec7n ph\u00e1p b\u1ea3o v\u1ec7:\n<ul>\n<li>B\u1ea3o v\u1ec7 \u0111\u01b0\u1eddng th\u1edf.\n<ul class=\"additional\">\n<li><span class=\"linksuggest\"><a id=\"Lf4ddcaa6fa0a6aab21e37bf667f9484f\" class=\"api\" href=\"https:\/\/next.amboss.com\/us\/article\/hl0c9T#Ze540a7ee2ab1ad12482e411915a0465a\" data-phrasegroup-id=\"PHcWqd0\" data-type=\"link\" data-anker=\"Ze540a7ee2ab1ad12482e411915a0465a\" data-learningcard-id=\"hl0c9T\" data-lxid=\"hl0c9T\" data-section-id=\"4CX3HZ0\" data-sxid=\"4CX3HZ0\" data-title=\"QWlyd2F5IG1hbmFnZW1lbnQg4oaSIEJhc2ljIGFpcndheSBtYW5ldXZlcnM=\" data-source=\"Lf4ddcaa6fa0a6aab21e37bf667f9484f\"><\/a>D\u00f9ng th\u1ee7 thu\u1eadt \u0111\u01b0\u1eddng th\u1edf c\u01a1 b\u1ea3n cho t\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u01b0\u1eddng th\u1edf nguy c\u01a1.<\/span><\/li>\n<li>M\u1edf kh\u00ed qu\u1ea3n khi GCS &lt;8 ho\u1eb7c c\u00f3 d\u1ea5u hi\u1ec7u c\u1ee7a t\u1eafc ngh\u1ebdn ho\u00e0n to\u00e0n \u0111\u01b0\u1eddng th\u1edf.<\/li>\n<\/ul>\n<\/li>\n<li>B\u1ea5t \u0111\u1ed9ng c\u1ed9t s\u1ed1ng ch\u1eef C n\u1ebfu ch\u1ea5n th\u01b0\u01a1ng.<\/li>\n<li>B\u1ea3o v\u1ec7 th\u1ea7n kinh trong ch\u1ea5n th\u01b0\u01a1ng n\u00e3o nh\u01b0 x\u1eed tr\u00ed t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd, h\u1ed9i ch\u1ee9ng tho\u00e1t v\u1ecb n\u00e3o.<\/li>\n<\/ul>\n<\/li>\n<li>B\u1eaft \u0111\u1ea7u c\u00e1c b\u01b0\u1edbc c\u1ea7n x\u1eed tr\u00ed s\u1edbm nh\u01b0 cho kh\u00e1ng sinh trong nhi\u1ec5m tr\u00f9ng huy\u1ebft, t\u00e1i t\u01b0\u1edbi m\u00e1u trong nh\u1ed3i m\u00e1u n\u00e3o.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>H\u01b0\u1edbng d\u1eabn x\u1eed tr\u00ed h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft.<\/p>\n<p>N\u1ebfu b\u1ec7nh nh\u00e2n c\u00f2n t\u1ec9nh:<\/p>\n<ul>\n<li>Cho u\u1ed1ng 15 &#8211; 20g glucose.<\/li>\n<li>D\u00f9ng c\u00e1c carbohydrate t\u00e1c d\u1ee5ng nhanh nh\u01b0 vi\u00ean \u0111\u01b0\u1eddng, k\u1eb9o, n\u01b0\u1edbc tr\u00e1i c\u00e2y.<\/li>\n<\/ul>\n<p>N\u1ebfu b\u1ec7nh nh\u00e2n r\u1ed1i lo\u1ea1n \u00fd th\u1ee9c (ho\u1eb7c kh\u00f4ng th\u1ec3 u\u1ed1ng):<\/p>\n<ul>\n<li>Truy\u1ec1n t\u0129nh m\u1ea1ch dextrose (nh\u01b0 dextrose 50%): Ng\u01b0\u1eddi l\u1edbn IV dextrose 50% 50mL 1 l\u1ea7n, c\u00f3 th\u1ec3 nh\u1eafc l\u1ea1i. Tr\u1ebb em: dextrose 10% 2.5mL\/kg truy\u1ec1n t\u0129nh m\u1ea1ch 1 l\u1ea7n, c\u00f3 th\u1ec3 l\u1eb7p l\u1ea1i ho\u1eb7c dextrose 25% 1mL\/kg.<\/li>\n<li>N\u1ebfu b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 1 h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft v\u00e0 s\u1eed d\u1ee5ng b\u01a1m insulin, kh\u00f4ng \u0111\u01b0\u1ee3c ng\u1eebng b\u01a1m insulin v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft nh\u01b0 b\u00ecnh th\u01b0\u1eddng. D\u1eebng insulin b\u01a1m c\u00f3 th\u1ec3 g\u00e2y toan ceton.\n<div class=\"merke content-box green\"><\/div>\n<div class=\"additional condensed-hidden\">\n<div class=\"cave content-box red\"><strong>T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/strong><\/div>\n<div class=\"cave content-box red\">Altered mental status and coma, Amboss<\/div>\n<div>Hypoglycemia, Amboss.<\/div>\n<\/div>\n<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>R\u1ed1i lo\u1ea1n tri gi\u00e1c (AMS) l\u00e0 m\u1ed9t s\u1ef1 thay \u0111\u1ed5i c\u1ea5p t\u00ednh trong ch\u1ee9c n\u0103ng nh\u1eadn th\u1ee9c, ch\u1ee9c n\u0103ng t\u00e2m th\u1ea7n v\u00e0\/ho\u1eb7c m\u1ee9c \u0111\u1ed9 th\u1ee9c t\u1ec9nh; c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n b\u1edfi l\u00fa l\u1eabn, thay \u0111\u1ed5i h\u00e0nh vi, v\u00e0 c\u00e1c thay \u0111\u1ed5i t\u1eeb k\u00edch th\u00edch cho t\u1edbi ng\u1ee7 g\u00e0, th\u1eadm ch\u00ed h\u00f4n m\u00ea. AMS c\u00f3 th\u1ec3 [&hellip;]<\/p>\n","protected":false},"author":69,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[23,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>R\u1ed1i lo\u1ea1n tri gi\u00e1c: \u0111\u00e1nh gi\u00e1 theo thang \u0111i\u1ec3m FOUR v\u00e0 x\u1eed tr\u00ed - Vinmec<\/title>\n<meta name=\"description\" content=\"C\u1ea7n s\u01a1 c\u1ea5p c\u1ee9u ban \u0111\u1ea7u ABCDE cho b\u1ec7nh nh\u00e2n r\u1ed1i lo\u1ea1n tri gi\u00e1c, l\u1eadp \u0111\u01b0\u1eddng truy\u1ec1n, x\u00e9t nghi\u1ec7m v\u00e0 x\u1eed tr\u00ed c\u00e1c nguy\u00ean nh\u00e2n c\u00f3 \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"R\u1ed1i lo\u1ea1n tri gi\u00e1c: \u0111\u00e1nh gi\u00e1 theo thang \u0111i\u1ec3m FOUR v\u00e0 x\u1eed tr\u00ed - 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