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izk.kog L=ksrl L=ksRkl O;k[;kL=ksrkafl [kyq ifj.kkevkin;ekukuak /kkrquka vfÒokghuh ÒofUr v;u vFksZua A ¼p-fo- 5½ izk.kog L=ksrl eqyLFkku Ák.kogkuk L=ksrlka g`n; eqya egkL=ksr’pA ¼p-fo- 5½
'olu izfØ;k ukfÒLFk izk.kiou% Li`"Vok àRdeykUrjeA d.Bkn~ cfgfoZfu;kZfr ikrqa fo".kq inke`reAA ihRok pakcjih;q"ka iqujk;kfr osxr%A izh.k;u nsgef[kya tho;u~ tkBjkuye~AA ¼’kk-iw- 5½
vfÒO;fDr LFkku ¼LFkwy½ fØ;k LFkku ¼Lkq{e½ Ukklk Xkzlfudk 'okliz.kkyh oke oke nf{k.k Qq¶Qql}; àn; egkL=ksrl o n’k izk.kk;rus laiw.kZ 'kjhjns[khy viLraÒ Ák.kog L=ksrl
Izkk.kog L=ksrl nqf"V gsrq% {k;kr~ la/kkj.kkr~ jkS{;kr~ O;k;kekr~ {kqf/kr~L; pA Izkk.kokfguh nq";fUr L=ksrkaL;kU;S’p nk:.kS%A ¼p-fo- 5@10½ Izkk.kog L=ksrl nqf"V y{k.ks %& ^^vfrl`"Vaefrc)a dqfireYikIya vHkh{.ka ok l’kCn 'kqyeqPN~olUra n``"Vok izk.kogkuL; L=ksrkafl iznq"Vkuhrh fo/kkr~A ¼p-fo- 5½
1½ vfrl`"V’olu & vfr’k; tyn 'oklksPNokl (Hyperapnoea ) eg ’oklO;k/kh 2½ vfrc)a & 'okl ?ks.ks vkf.k lksM.sk ;k fØ;k vM[kGr gks.ks- 3½ dqihra & tyn 'oklksPNokl iajrq mPNokl vkf.k fu%’okl ;kaP;k izkd`r Ratio e/;s cny 4½ vYikIya ’olu & Shallow respiration 5½ vfHk{.ka & fu%’okl gk mPNoklkis{kk iznh?kZ-
L=ksrksn`f"V izdkj L=ksrksn`f"V 4 izdkjs gksrs- ^^vfrizo`Rrh laxks ok fljk.kka xazFk;skM~fi okA foekxZxeua pkfi L=ksrlka nqf"Vy{k.ke~A ¼p-fo- 5@23½ vfrizo`Rrh & L=ksrksckg~; jlknh /kkarqps vf/kd izek.kkr oguA fuxZeu mnk- 'okl 2½ lax & a½ vizo`Rrh b½ fdaphr izo`Rrh 3½ fljkxazFkh & mnk- v’kZ 4½ foekxZeu & foijhr ekxkZus /kkrqps ogu mnk-jkt;{ek
Ák.kog L=ksrl nqf"Vph laizkfIr %& Ák.kog L=ksrlkr eq[;r% okr dQkph nq"Vh vlrs- ok;qP;k ekxkZr dQkus vojks/k fuekZ.k gskrs- R;keqGs ok;qps foekxZxeu gksmu ok;q nqf"kr gksrs- gk ok;q izk.kog rlsp vU; vUuog] mndog vkfn L=ksrlauk nq"khr d:u mj%fLFkr gksÅu izk.kog L=ksrlkP;k fujfujkG;k O;ka/khph fuehZrh gksrs- pjdkpk;kZauh fgDdkÜokl ;kaph laizkfIr lkaxrkauk] ^^ ek:r% izk.kokfguh L=ksrkaL;fo’; dqI;frA mj%LFk% dQeqn/kq; fgDdkÜoklkUdjksfr l%A** ¼p-fp- 17@15½ dQksi:)xeu% iouks foÜoxfLFkr%A izk.kksndkUuokfguh nq"Vk L=ksrkafl nq"V;uA mj%LFk% dq:rs Üokla vkek’k;leqnHkoe~A ¼v-g-fu½
^^dQokrkRedkosrkS fiRrLFkku leqnHkokSA g~n;L; jlknhuka /kkrquka pksi’kks"k.kkSA rLekr~ la/kkjukosrkS erkS ijenqtZ;ksA feF;ksipfjrksS dqR/kkS∙gr vkf’kfo"kehoA** ¼p- fp- 17@8½ ^^fiRrLFkkuleqRFkHkofoR;usus fiRrL;ks/oZ LFkkulaca/k ,o] Rkrq okrdQonkjEHkdRofefr n’kZ;fr] fiRRkLFkku’kCnsukek’k;ks∙fHkizsr%A lk/kkj.kfofr izk;LrqY;fpfdRL;Rokr~A** ¼pØnRr fVdk½
izk.kog o jlog L=ksrl & vU;ksU; laca/k ewyLFkkukuq:Ik ¼p-½ g`n;] egkL=ksrl ¼lq-½ g`n;] jlokgh@ izk.kokgh /keU;k izk.kog ¼p-½ ân;] n’k/keU;k ¼lq-½ ân;] jlokgh /keU;k jlog
ân; xksikulhuke~ vkxkjdf.kZdsokFkZA ¼p-lw- 30@5½ ;f) rr~ Li’kZfoKkua /kkfj rRr= lafJre~A Rkr~ ijL;kStl% LFkkua r= pSrU;laxzg%AA ¼p-lw- 30@6]7½ ân; ân;kfHk?kkr ¼p-½ dkl] Üokl mi?kkr&ewPNkZ Hksn&e`R;q vkst ¼’kjhjLFk jl/kkrwpk Lusg½ 10 izk.kk;rukaiSdh ,d R;keqGs ân;kps j{k.k dj.ks vR;ko’;d vkgs-
nq"Vh gsrq %& izk.kog L=ksrkaL;U;S% p nk:.kS%A vU; L=ksrlkaP;k fod`rheqGs fdaok fod`rhtU; O;k/khaeqGs fdaok minzo Lo:Ik gsk.kkjh izk.kog L=ksrlkph nq"Vh mnk- 1½ fgDdk o Üokl funku vkenks"k] vkukg] Toj] PNnhZ] vfrlkj] folwfpdk] ik.Mw] mnkorZ] vyld 2½ ik.Mw :Ik&Üokl] "Bhou] âæo 3½ :)iFkdkeyk & g`n;xkSjo] ikÜoZ’kwy] fgDdk] Üokl 4½ Eksnksjksx & {kqnzÜokl 5½ eyko`r ok;q & vLoLFk g`n; 6½ vko`rRo minzo & g`nzksx 7½ mnj minzo & red Üokl] dkl] fgDdk] ikÜoZ’kwy] LojHksn
jlog & fpUR;kuke~ pkfrfpUrukr~ vUUke; iq:"k eu lq)k vUue; eukps LFkku g`n; izk.kkps LFkku â| vkgkj lsou mRd`"V vkgkjjl mRrjksRrj /kkrw iks"k.k o mRre /kkrq fuekZ.k ;k myV fud`”V vkgkjjl fod`r /kkRokfXu ghu /kkrq fufeZrh
izk.kog L=skrl egk=ksrl dk ijLij lac/k 1½ r= izk.kogkuka L=ksrlka g`n; ewya egkL=ksr’p iznq"Vuka rq [kYos"kfena fo’ks"k foKkua Hkofr r|Fkk vfrl`"Vefrc)a dqfireYikYieHkh{.ak ok l’kCn’kwya mPNolUra n`"Vok izk.kogkU;L; L=ksrkafl iznq"Vkuhrh fo|kr~ A p-fo- 5@8 2½ vfrek=L; pkdkys pkfgrL; p Hkkstukr~A vUuokfguh nq";fUr oSxq.;kRk~ ikodL; p AA p- fo- 5@12 3½ vUuog L=ksrl eqy LFkku o nq"Vh y{k.ks vUuogkuka L=ksrlkaek’k;ks ewya okea p ik’oZ Ikznq"Vkuka rq [kYos"kfena fo’ks"k foKku Hkofr r|Fkk vuUukfHkyk"k.kejkspd foikdkS PNfnZ p n`"Vok∙UuogkU;L; L=ksrkafl iznq"Vkuhfr fo|kr~A
Ikqjh"kogL=ksrl n`"Vh gsrq%& 4½ la/kkj.kknR;’kuknth.kZ/;’kukr~ rFkkA opksZokghuh nq";fUr nqcZykXus% d`’kL;pA p-fo- 5@21 Ikqfj"kog L=ksrl eqy LFkku nq"Vh y{k.ks%& 5½ iqjh"kogkuka L=ksrlka iDok’k;ks ewya LFkwy xqna pA iznq"Vkuka rq [kYos"kkfena fo’ks"k foKkua HkofrA r|/kk d`PNs.kkYikYIka l’kCn’kwya vfrnzoefrxzfFkre vfrcgq pksifo’kaURka n`"Vok iqjh"kogkfu vL; L=ksrkafl iznq"Vkfurh fo|kr~A 6½ fiRrLFkkus"kq vkek’k; bfr %& vkek’k;ks v/kks Hkkx% 'ys"e LFkkus"kq vkek’k; vkek’k; m/oZHkkx%A pØik.kh vkek’k;kpk vFkksHkkx fiRrkps LFkku o vkek’k;kpk m/oZHkkx gs dQkps LFkku lkafxrysys vkgs-
7½ ^^dQksi:)xeu% iouks fo’oxkfLFkr%A Ák.kksndk·Uuokghuh nq"V% L=ksrkfl nq"Vkr~ mj%LFk% dq:rs Üokl vkek’k;leqn~HkoeA ok-fu-4@3- ¼v:.knRrVhdk½ 8½ ^^rs"kka izdksikr~ LFkkuLFkkÜpSo ekxZ’p’kjhj/kkro% izdksieki|rs] brjs"kka izdksifnr L=ksrkafl L=ksrkafLk ,o /kkroÜp /kkrwuso iznq";fUr iznq";%Ars"kak losZ"kkeso okrfiR’ys"ek.k% iznq"; nw"kf;rkjks HkofUr nks"kLokHkkofnrh AA p- fo- 5@9
izk.kog L=ksrl fpfdRlk Ák.kksndkUuogk.ka nq"Vkuka 'okfldh fØ;kAA Ák.kog L=ksrl fpfdRlk v½ funkuifjotZuc½ ’kks/ku fpfdRlk d½ 'keu fpfdRlkM½ jlk;u fpfdRlk b½ IkF;kiF; dkea izk.kgjk jksxk cg~oks u rq rs rFkkA ;Fkk ‘okl’p fgDdk p izk.kkuk’kq fud`Urr%AA p-fp- 17
v½ funkuifjotZu %& fgDdk’oklfodkjk.kka funkua ;r~ izdhfrZre~ A oT;ZekjksX;dkeS% rn fgDdk’oklfodkfjfHk%AA p-fp-17 vfXulaj{k.k 1½ vk;qo.kkZs cya -------izk.kk’pksDRrk----AA p-fp-15 2½ ;{ekihulesgknhu dQtku----AA 3½ dQokrkRedkosrkS fiRrLFkkuleqnHkokSA p-fp-17
fgDdk’oklk·e;h g;sdks cyokuks nqcZyks∙ij%AdQkf/kLr/kSosdks :{ks cg~ofuyksij%AAcyoku & dQkf/kd nqcZy & :{k & okrkf/kD; dQkf/kds cyLFks oeua ls fojspue~A dq;kZr~ IkF;kf’kus /kweysgkfn’keua rr%AA p-fp-17
Lusgu ¼yo.k rSy½ ukMh izLrjladj Losn fLuX/k]’kkrh ]ekaljl] nf/klj vkgkj ¼’ys“ekf.k lao`)s½ oeu ¼fiIirh laSa/ko{kkSnz;qDra okrkfojksf/k ;r~A½fo’ks.kkr dkl oe;qFkqgrxz’’oklkfnus &&v-g`- fp- 4 /kweiku ¼gjhnzknh euf’kykfn b-½v’kkUrkS d`rla’kq)s% /kweSyhua era gjsr~AA v-g`- fp- 4
e`nq Losn Lusg lsd]’kdZjk nqX/k ck"i] mRdkfjdk] miukg u Los|k% fiRrnkgkrkZ jDr Losn vfrorhZr%A {kh.k/kkrq cyk :{kk xfHkZ.;’pfi fiRryk%AA p-fp-17fojspu dkflus PNnZua n|kr LojHkaxs p cqf)eku~ Aokr’ys"e gjS%;qDra reds rq fojspuaAA p-fp-17uL; & xqM 'kaqBh uL; b-vuqfRDy"V dQkfLoUUka nqcZykuka fo’kks/kukr~Aok;q% yC/kkLinks eeZ la’kks";k’kq gjsnlwuAA p-fp-17 oeu & okrizdksi & vH;ax] ekaljl] okrgjHkkstu fgDdk’okl $ mnkorZ] vk/eku & ekrqyqqax] vkEyosrl] fcMyo.k] fgaxq
'keu fpfdRlkokfrdku nqcZyku ckyku o`)k’pfuylwnuS%AriZ;snso ‘’keuS% Lusg;q"kjlkfnfHk%AAfiRrkuqca/kh ’okl Lojf{k.kfrlkj vl`dfiRrnkgkuqcU/ktku~ e/kqj fLuX/kf’krk|S% fgDdk’oklkuqikpjsr~AA p-fp-17’oklgj egkd"kk;&{kkjiz;ksx &?k`riz;ksx fgDdk’oklkuqcU/kk ;s ’kq"dksj % d.Brkyqdk%A izd`R;k :{kLosn’p lfiZfHk% rkuqikpjsr~%AA p-fp-17
Okkrd`)k dQgja dQd`)kfuykige~A dk;ZuSdkfUrda rkH;ka izk;% Js;kss∙ fuykige~AA p-fp-17okrdQuk’kd & okrdkjd dQuk’kd & dQ vf/kd r;kj & okrkus ckgsj dk<.ks dQgkjd okruk’kd & dQkyk ‘kq”drk vlrs & dQ oeukus ckgsj dk<.ks LkoS”kka ca`g.ks g;Yia ‘kD;’p izk;’kks Hkosr~A ukR;FkZ ‘keus·ik;ks Hk`’kks·’kD;P; d’kZusAA p-fp-17 ca`g.ka dQdj oeu Js”B ‘keu okrdQgj] okrd`r xkS.k d”kZ.k vlk/; v’kD;
jlk;u fpfdRlk nzO; :Ik%& P;ouizk’k o/kZeku fiIiyh jlk;u ;f”Be/kq QakV HkYykrd jlk;u b- vnzO; :i%& ;ksx] izk.kk;ke b- iF;kiF;& ;fRdafpr dQokr?ueq”.ka okrkuqykseue~A Hks.kta pkikuea~ vUue p rn fgra ‘oklfgfDdukSAA p-fp-17 vkgkj % fogkj % ekulHkko
Modern line of Treatment • Nebulisation • Mechanical Ventilation • O2 inhalation • Bronchodilator • Dieuretics • Steroids • Anti-inflamatory Drug • Broad spectrum antibiotics