{"id":62,"date":"2025-08-17T09:48:59","date_gmt":"2025-08-17T09:48:59","guid":{"rendered":"https:\/\/huedao.com.vn\/?p=62"},"modified":"2025-08-17T09:49:02","modified_gmt":"2025-08-17T09:49:02","slug":"hanh-trinh-vuot-qua-ngat-chia-se-kinh-nghiem-va-kien-thuc-y-hoc-toan-dien-ve-ngat-ngung-tim-ngung-tho","status":"publish","type":"post","link":"https:\/\/huedao.com.vn\/index.php\/2025\/08\/17\/hanh-trinh-vuot-qua-ngat-chia-se-kinh-nghiem-va-kien-thuc-y-hoc-toan-dien-ve-ngat-ngung-tim-ngung-tho\/","title":{"rendered":"H\u00e0nh Tr\u00ecnh V\u01b0\u1ee3t Qua Ng\u1ea5t: Chia S\u1ebb Kinh Nghi\u1ec7m v\u00e0 Ki\u1ebfn Th\u1ee9c Y H\u1ecdc To\u00e0n Di\u1ec7n V\u1ec1 Ng\u1ea5t, Ng\u1eebng Tim, Ng\u1eebng Th\u1edf."},"content":{"rendered":"\n

I. T\u1eeb C\u00e2u Chuy\u1ec7n C\u00e1 Nh\u00e2n \u0110\u1ebfn B\u00e0i H\u1ecdc S\u1ee9c Kh\u1ecfe C\u1ed9ng \u0110\u1ed3ng<\/strong><\/p>\n\n\n\n

Nh\u1eefng c\u00e1i ch\u1ebft \u0111\u1ed9t ng\u1ed9t g\u1ea7n \u0111\u00e2y c\u1ee7a \u00f4ng HNT, tr\u1ecdng t\u00e0i T\u0110T hay tr\u01b0\u1eddng h\u1ee3p c\u1ee7a thanh ni\u00ean 20t \u0111\u00e3 \u0111\u01b0\u1ee3c c\u1ee9u k\u1ecbp th\u1eddi \u0111\u00e3 g\u00e2y ch\u1ea5n \u0111\u1ed9ng d\u01b0 lu\u1eadn, khi\u1ebfn nhi\u1ec1u ng\u01b0\u1eddi kh\u00f4ng kh\u1ecfi b\u0103n kho\u0103n v\u1ec1 s\u1ee9c kh\u1ecfe tim m\u1ea1ch, \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00e1c hi\u1ec7n t\u01b0\u1ee3ng \u0111\u1ed9t t\u1eed v\u00e0 \u0111\u1ed9t qu\u1ef5. Trong b\u1ed1i c\u1ea3nh \u0111\u00f3, t\u00f4i xin chia s\u1ebb c\u00e2u chuy\u1ec7n c\u1ee7a m\u00ecnh, t\u00f4i l\u00e0 m\u1ed9t qu\u1ea3n l\u00fd l\u00e0m vi\u1ec7c trong doanh nghi\u1ec7p nh\u00e0 n\u01b0\u1edbc, ng\u01b0\u1eddi th\u01b0\u1eddng xuy\u00ean ph\u1ea3i \u0111i ti\u1ebfp kh\u00e1ch v\u00e0 u\u1ed1ng nhi\u1ec1u r\u01b0\u1ee3u bia, tr\u1edf th\u00e0nh m\u1ed9t l\u1eddi c\u1ea3nh t\u1ec9nh \u0111\u00e1ng suy ng\u1eabm.<\/p>\n\n\n\n

V\u00e0o m\u1ed9t chi\u1ec1u th\u00e1ng 7\/2021, khi \u0111ang t\u01b0\u1edbi c\u00e2y c\u1ea3nh t\u1ea1i nh\u00e0, t\u00f4i \u0111\u1ed9t nhi\u00ean c\u1ea3m th\u1ea5y h\u1ed3i h\u1ed9p, tim \u0111\u1eadp nhanh, m\u1ec7t m\u1ecfi v\u00e0 ph\u1ea3i v\u1ecbn v\u00e0o ch\u1eadu c\u00e2y \u0111\u1ec3 gi\u1eef th\u0103ng b\u1eb1ng. Sau \u0111\u00f3, t\u00f4i b\u1ea5t ng\u1edd t\u00e9 ng\u00e3, b\u1ea5t t\u1ec9nh m\u00e0 kh\u00f4ng h\u1ec1 hay bi\u1ebft. Ch\u1ec9 khi tr\u00edch xu\u1ea5t camera an ninh, m\u1edbi nh\u1eadn ra m\u00ecnh \u0111\u00e3 b\u1ecb ng\u1ea5t. Th\u1eddi \u0111i\u1ec3m \u0111\u00f3, \u0111\u1ea1i d\u1ecbch COVID-19 \u0111ang ho\u00e0nh h\u00e0nh, n\u1ed7i lo s\u1ee3 b\u1ecb c\u00e1ch ly \u0111\u00e3 khi\u1ebfn t\u00f4i kh\u00f4ng d\u00e1m \u0111\u1ebfn b\u1ec7nh vi\u1ec7n l\u1edbn. S\u00e1ng h\u00f4m sau, t\u00f4i \u0111\u1ebfn m\u1ed9t ph\u00f2ng kh\u00e1m nh\u1ecf v\u00e0 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n “thi\u1ebfu m\u00e1u n\u00e3o c\u1ee5c b\u1ed9”, sau \u0111\u00f3 \u0111\u01b0\u1ee3c k\u00ea thu\u1ed1c u\u1ed1ng.<\/p>\n\n\n\n

\u0110\u1ebfn \u0111\u1ea7u th\u00e1ng 01 n\u0103m 2022, khi TP.HCM c\u01a1 b\u1ea3n ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c d\u1ecbch COVID-19, t\u00f4i m\u1edbi c\u00f3 th\u1ec3 ti\u1ebfp c\u1eadn c\u00e1c c\u01a1 s\u1edf y t\u1ebf chuy\u00ean s\u00e2u h\u01a1n. T\u00f4i \u0111\u00e3 \u0111\u1ebfn B\u1ec7nh vi\u1ec7n \u0110\u1ea1i h\u1ecdc Y D\u01b0\u1ee3c, B\u1ec7nh vi\u1ec7n Tim T\u00e2m \u0110\u1ee9c, B\u1ec7nh vi\u1ec7n Ch\u1ee3 R\u1eaby, v\u00e0 th\u1eadm ch\u00ed t\u00ecm ki\u1ebfm t\u01b0 v\u1ea5n t\u1eeb c\u00e1c b\u1ec7nh vi\u1ec7n \u1edf Th\u00e1i Lan, Singapore. M\u1eb7c d\u00f9 \u0111\u00e3 th\u1ef1c hi\u1ec7n “t\u1ea5t c\u1ea3 c\u00e1c x\u00e9t nghi\u1ec7m li\u00ean quan \u0111\u1ebfn tim m\u1ea1ch, th\u1ea7n kinh v\u00e0 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh x\u00e9t nghi\u1ec7m x\u1ea1 h\u00ecnh t\u01b0\u1edbi m\u00e1u c\u01a1 tim,” nh\u01b0ng nguy\u00ean nh\u00e2n b\u1ec7nh t\u00ecnh v\u1eabn kh\u00f4ng \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh r\u00f5 r\u00e0ng, ch\u1ec9 ghi nh\u1eadn l\u00e0 “Ng\u1ea5t kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n”.<\/p>\n\n\n\n

Qu\u00e1 tr\u00ecnh ch\u1ea9n \u0111o\u00e1n n\u00e0y cho th\u1ea5y m\u1ed9t th\u1ef1c t\u1ebf y khoa ph\u1ee9c t\u1ea1p: vi\u1ec7c x\u00e1c \u0111\u1ecbnh nguy\u00ean nh\u00e2n ng\u1ea5t, \u0111\u1eb7c bi\u1ec7t l\u00e0 ng\u1ea5t do tim m\u1ea1ch, c\u00f3 th\u1ec3 r\u1ea5t kh\u00f3 kh\u0103n do t\u00ednh ch\u1ea5t tho\u00e1ng qua v\u00e0 kh\u00f4ng th\u01b0\u1eddng xuy\u00ean c\u1ee7a c\u00e1c s\u1ef1 ki\u1ec7n. Ngay c\u1ea3 khi \u0111\u00e3 th\u1ef1c hi\u1ec7n nhi\u1ec1u x\u00e9t nghi\u1ec7m chuy\u00ean s\u00e2u v\u00e0 to\u00e0n di\u1ec7n, nguy\u00ean nh\u00e2n v\u1eabn c\u00f3 th\u1ec3 kh\u00f4ng r\u00f5 r\u00e0ng. M\u1ed9t y\u1ebfu t\u1ed1 kh\u00e1c \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u00e0nh tr\u00ecnh t\u00ecm ki\u1ebfm ch\u1ea9n \u0111o\u00e1n l\u00e0 do b\u1ed1i c\u1ea3nh \u0111\u1ea1i d\u1ecbch COVID-19. Ban \u0111\u1ea7u, t\u00f4i ng\u1ea7n ng\u1ea1i \u0111\u1ebfn b\u1ec7nh vi\u1ec7n v\u00ec lo s\u1ee3 b\u1ecb c\u00e1ch ly, v\u00e0 sau \u0111\u00f3, vi\u1ec7c \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb l\u00e0m x\u00e9t nghi\u1ec7m x\u1ea1 h\u00ecnh t\u01b0\u1edbi m\u00e1u c\u01a1 tim c\u0169ng b\u1ecb \u1ea3nh h\u01b0\u1edfng do “kh\u00f4ng c\u00f3 h\u00f3a ch\u1ea5t”.<\/p>\n\n\n\n

May m\u1eafn thay, t\u00f4i tr\u00edch xu\u1ea5t \u0111\u01b0\u1ee3c \u0111o\u1ea1n clip ghi l\u1ea1i c\u01a1n ng\u1ea5t c\u1ee7a m\u00ecnh \u0111\u00e3 tr\u1edf th\u00e0nh m\u1ed9t manh m\u1ed1i v\u00f4 c\u00f9ng qu\u00fd gi\u00e1. Khi b\u00e1c s\u0129 khai th\u00e1c ti\u1ec1n s\u1eed b\u1ec7nh d\u1ef1a tr\u00ean \u0111o\u1ea1n clip, t\u00f4i nh\u1eadn ra r\u1eb1ng m\u00ecnh \u0111\u00e3 t\u1eebng c\u00f3 nh\u1eefng tri\u1ec7u ch\u1ee9ng t\u01b0\u01a1ng t\u1ef1 m\u1ed9t v\u00e0i l\u1ea7n tr\u01b0\u1edbc \u0111\u00f3 nh\u01b0ng l\u1ea1i b\u1ecf qua, ngh\u0129 r\u1eb1ng \u0111\u00f3 ch\u1ec9 l\u00e0 do \u1ea3nh h\u01b0\u1edfng c\u1ee7a r\u01b0\u1ee3u bia. “r\u1ea5t may h\u00f4m b\u1ecb ng\u1ea5t t\u00e9 ng\u00e3 v\u00e0 m\u1ea5y ng\u00e0y tr\u01b0\u1edbc \u0111\u00f3 kh\u00f4ng u\u1ed1ng r\u01b0\u1ee3u bia g\u00ec n\u00ean m\u1edbi nghi ng\u1edd m\u00ecnh c\u00f3 b\u1ec7nh n\u00ean \u0111i kh\u00e1m v\u00e0 c\u0169ng t\u1eeb h\u00f4m \u0111\u00f3 \u0111\u1ebfn nay m\u00ecnh kh\u00f4ng u\u1ed1ng b\u1ea5t k\u1ef3 1 gi\u1ecdt r\u01b0\u1ee3u bia n\u00e0o”. Nh\u1eadn th\u1ee9c s\u00e2u s\u1eafc v\u1ec1 t\u1ea7m quan tr\u1ecdng c\u1ee7a s\u1ee9c kh\u1ecfe, t\u00f4i \u0111\u00e3 \u0111\u01b0a ra m\u1ed9t quy\u1ebft \u0111\u1ecbnh t\u00e1o b\u1ea1o: “v\u00ec m\u00ecnh l\u00e0 ng\u01b0\u1eddi c\u1ee7a c\u00f4ng vi\u1ec7c, ng\u01b0\u1eddi tham c\u00f4ng ti\u1ebfc vi\u1ec7c n\u00ean \u0111\u1ec3 to\u00e0n t\u00e2m to\u00e0n \u00fd ch\u1eefa b\u1ec7nh m\u00ecnh bu\u1ed9c ph\u1ea3i ngh\u1ec9 vi\u1ec7c, m\u00ecnh suy ngh\u0129 r\u1ea5t nhi\u1ec1u l\u00e0 ch\u1ecdn s\u1ee9c kh\u1ecfe, t\u00ednh m\u1ea1ng hay \u0111\u1ecba v\u1ecb ti\u1ec1n b\u1ea1c, c\u00e1i n\u00e0o c\u0169ng c\u1ea7n, c\u0169ng qu\u00ed nh\u01b0ng s\u1ee9c kh\u1ecfe l\u00e0 tr\u00ean h\u1ebft v\u00e0 quy\u1ebft \u0111\u1ecbnh ngh\u1ec9 vi\u1ec7c”. Sau nhi\u1ec1u l\u1ea7n \u0111i kh\u00e1m ch\u1eefa b\u1ec7nh t\u1ea1i nhi\u1ec1u b\u1ec7nh vi\u1ec7n nh\u01b0ng v\u1eabn kh\u00f4ng x\u00e1c \u0111\u1ecbnh r\u00f5 r\u00e0ng nguy\u00ean nh\u00e2n Ng\u1ea5t. \u0110\u1ebfn gi\u1eefa n\u0103m 2023, t\u00f4i kh\u00f4ng \u0111i kh\u00e1m b\u1ec7nh vi\u1ec7n m\u00e0 ch\u1ec9 u\u1ed1ng thu\u1ed1c theo toa c\u1ee7a B\u1ec7nh vi\u1ec7n Tim T\u00e2m \u0110\u1ee9c v\u00e0 duy tr\u00ec l\u1ed1i s\u1ed1ng l\u00e0nh m\u1ea1nh, kh\u00f4ng r\u01b0\u1ee3u bia, t\u1eadp th\u1ec3 d\u1ee5c \u0111i\u1ec1u \u0111\u1ed9. K\u1ebft qu\u1ea3 l\u00e0 “s\u1ee9c kh\u1ecfe c\u1ea3i thi\u1ec7n \u0111\u00e1ng k\u1ec3 cho \u0111\u1ebfn b\u00e2y gi\u1edd”.<\/p>\n\n\n\n

C\u00e2u chuy\u1ec7n c\u1ee7a t\u00f4i l\u00e0 m\u1ed9t minh ch\u1ee9ng s\u1ed1ng \u0111\u1ed9ng cho nh\u1eefng c\u1ea3nh b\u00e1o v\u1ec1 t\u00e1c \u0111\u1ed9ng c\u1ee7a l\u1ed1i s\u1ed1ng hi\u1ec7n \u0111\u1ea1i \u0111\u1ebfn s\u1ee9c kh\u1ecfe. T\u00f4i “t\u00e2m \u0111\u1eafc b\u00e0i b\u00e1o \u201cNh\u1eefng y\u1ebfu t\u1ed1 d\u1eabn \u0111\u1ebfn t\u1eed vong do \u0111\u1ed9t t\u01b0, \u0111\u1ed9t qu\u1ef5\u201d c\u1ee7a B\u00e1c s\u0129 \u201cTr\u1ea7n V\u0103n Ph\u00fac”, \u0111i\u1ec1u n\u00e0y c\u00e0ng c\u1ee7ng c\u1ed1 th\u00eam ni\u1ec1m tin v\u00e0o quy\u1ebft \u0111\u1ecbnh thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng c\u1ee7a m\u00ecnh.<\/p>\n\n\n\n

M\u1ee5c \u0111\u00edch c\u1ee7a b\u00e0i vi\u1ebft n\u00e0y l\u00e0 t\u1ed5ng h\u1ee3p kinh nghi\u1ec7m v\u00e0 g\u00f3c nh\u00ecn c\u00e1 nh\u00e2n c\u1ee7a m\u00ecnh \u0111\u1ec3 cung c\u1ea5p m\u1ed9t c\u00e1i nh\u00ecn logic, t\u1ed5ng th\u1ec3, to\u00e0n di\u1ec7n v\u1ec1 ng\u1ea5t, ng\u01b0ng tim v\u00e0 ng\u01b0ng th\u1edf.<\/p>\n\n\n\n

T\u1eeb tr\u1ea3i nghi\u1ec7m c\u1ee7a ch\u00ednh m\u00ecnh, t\u00f4i ti\u1ebfn h\u00e0nh nghi\u00ean c\u1ee9u, t\u00ecm hi\u1ec3u v\u1ec1 Ng\u1ea5t. B\u00e0i vi\u1ebft s\u1ebd \u0111i s\u00e2u v\u00e0o \u0111\u1ecbnh ngh\u0129a, c\u01a1 ch\u1ebf, nguy\u00ean nh\u00e2n, y\u1ebfu t\u1ed1 nguy c\u01a1, quy tr\u00ecnh ch\u1ea9n \u0111o\u00e1n, c\u0169ng nh\u01b0 c\u00e1c chi\u1ebfn l\u01b0\u1ee3c ph\u00f2ng ng\u1eeba v\u00e0 \u0111i\u1ec1u tr\u1ecb. Qua \u0111\u00f3, t\u00f4i hy v\u1ecdng c\u00f3 th\u1ec3 n\u00e2ng cao nh\u1eadn th\u1ee9c c\u1ed9ng \u0111\u1ed3ng v\u1ec1 t\u1ea7m quan tr\u1ecdng c\u1ee7a vi\u1ec7c l\u1eafng nghe c\u01a1 th\u1ec3, ch\u1ee7 \u0111\u1ed9ng b\u1ea3o v\u1ec7 s\u1ee9c kh\u1ecfe, v\u00e0 \u0111\u01b0a ra nh\u1eefng l\u1ef1a ch\u1ecdn l\u1ed1i s\u1ed1ng t\u00edch c\u1ef1c \u0111\u1ec3 ph\u00f2ng tr\u00e1nh nh\u1eefng bi\u1ebfn c\u1ed1 s\u1ee9c kho\u1ebb nghi\u00eam tr\u1ecdng.<\/p>\n\n\n\n

II. Ng\u1ea5t (Syncope) \u2013 Hi\u1ec7n T\u01b0\u1ee3ng M\u1ea5t \u00dd Th\u1ee9c Tho\u00e1ng Qua<\/strong><\/p>\n\n\n\n

\u0110\u1ecbnh ngh\u0129a v\u00e0 c\u01a1 ch\u1ebf sinh l\u00fd c\u1ee7a ng\u1ea5t<\/strong><\/p>\n\n\n\n

Ng\u1ea5t, hay c\u00f2n g\u1ecdi l\u00e0 ng\u1ea5t x\u1ec9u ho\u1eb7c b\u1ea5t t\u1ec9nh, l\u00e0 t\u00ecnh tr\u1ea1ng m\u1ea5t \u00fd th\u1ee9c v\u00e0 tr\u01b0\u01a1ng l\u1ef1c t\u01b0 th\u1ebf \u0111\u1ed9t ng\u1ed9t, tho\u00e1ng qua, th\u01b0\u1eddng t\u1ef1 h\u1ed3i ph\u1ee5c ho\u00e0n to\u00e0n. C\u01a1 ch\u1ebf ch\u00ednh g\u00e2y ng\u1ea5t l\u00e0 do s\u1ef1 suy gi\u1ea3m t\u1ea1m th\u1eddi v\u00e0 to\u00e0n b\u1ed9 l\u01b0u l\u01b0\u1ee3ng m\u00e1u \u0111\u1ebfn n\u00e3o (thi\u1ebfu m\u00e1u n\u00e3o c\u1ee5c b\u1ed9 to\u00e0n b\u1ed9). Khi n\u00e3o kh\u00f4ng nh\u1eadn \u0111\u1ee7 oxy v\u00e0 glucose c\u1ea7n thi\u1ebft, c\u00e1c ch\u1ee9c n\u0103ng th\u1ea7n kinh t\u1ea1m th\u1eddi b\u1ecb r\u1ed1i lo\u1ea1n, d\u1eabn \u0111\u1ebfn m\u1ea5t \u00fd th\u1ee9c. S\u1ef1 h\u1ed3i ph\u1ee5c \u00fd th\u1ee9c th\u01b0\u1eddng di\u1ec5n ra nhanh ch\u00f3ng, trong v\u00f2ng 1-2 ph\u00fat, khi l\u01b0u l\u01b0\u1ee3ng m\u00e1u n\u00e3o \u0111\u01b0\u1ee3c ph\u1ee5c h\u1ed3i.<\/p>\n\n\n\n

Ph\u00e2n bi\u1ec7t ng\u1ea5t v\u1edbi ng\u01b0ng tim v\u00e0 ng\u01b0ng th\u1edf<\/strong><\/p>\n\n\n\n

\u0110\u1ec3 c\u00f3 c\u00e1i nh\u00ecn t\u1ed5ng th\u1ec3 v\u00e0 ch\u00ednh x\u00e1c, vi\u1ec7c ph\u00e2n bi\u1ec7t ng\u1ea5t v\u1edbi ng\u1eebng tim v\u00e0 ng\u1eebng th\u1edf l\u00e0 r\u1ea5t quan tr\u1ecdng, v\u00ec m\u1ed7i t\u00ecnh tr\u1ea1ng \u0111\u00f2i h\u1ecfi c\u00e1ch x\u1eed tr\u00ed kh\u00e1c nhau:<\/p>\n\n\n\n

\u25cf      Ng\u1ea5t (Syncope): L\u00e0 v\u1ea5n \u0111\u1ec1 v\u1ec1 l\u01b0u l\u01b0\u1ee3ng m\u00e1u \u0111\u1ebfn n\u00e3o b\u1ecb gi\u00e1n \u0111o\u1ea1n t\u1ea1m th\u1eddi. Trong c\u01a1n ng\u1ea5t, tim v\u1eabn \u0111\u1eadp (c\u00f3 th\u1ec3 ch\u1eadm ho\u1eb7c nhanh), c\u00f3 m\u1ea1ch, v\u00e0 ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng b\u00e1o tr\u01b0\u1edbc nh\u01b0 ch\u00f3ng m\u1eb7t, bu\u1ed3n n\u00f4n, v\u00e3 m\u1ed3 h\u00f4i. H\u1ed3i ph\u1ee5c th\u01b0\u1eddng nhanh v\u00e0 ho\u00e0n to\u00e0n.<\/p>\n\n\n\n

\u25cf      Ng\u1eebng tim (Cardiac Arrest): L\u00e0 v\u1ea5n \u0111\u1ec1 v\u1ec1 h\u1ec7 th\u1ed1ng \u0111i\u1ec7n h\u1ecdc c\u1ee7a tim, khi\u1ebfn tim \u0111\u1ed9t ng\u1ed9t ng\u1eebng \u0111\u1eadp ho\u1eb7c \u0111\u1eadp lo\u1ea1n x\u1ea1, kh\u00f4ng b\u01a1m m\u00e1u hi\u1ec7u qu\u1ea3. T\u00ecnh tr\u1ea1ng n\u00e0y d\u1eabn \u0111\u1ebfn m\u1ea5t \u00fd th\u1ee9c, ng\u1eebng th\u1edf, v\u00e0 kh\u00f4ng c\u00f3 m\u1ea1ch. \u0110\u00e2y l\u00e0 m\u1ed9t t\u00ecnh hu\u1ed1ng c\u1ea5p c\u1ee9u y t\u1ebf c\u1ef1c k\u1ef3 nguy hi\u1ec3m, t\u00ednh m\u1ea1ng ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c t\u00ednh b\u1eb1ng ph\u00fat. C\u1ea7n l\u01b0u \u00fd r\u1eb1ng ng\u1eebng tim kh\u00e1c v\u1edbi \u0111au tim (nh\u1ed3i m\u00e1u c\u01a1 tim), v\u1ed1n l\u00e0 do t\u1eafc ngh\u1ebdn m\u1ea1ch m\u00e1u nu\u00f4i tim nh\u01b0ng tim v\u1eabn ti\u1ebfp t\u1ee5c \u0111\u1eadp.<\/p>\n\n\n\n

\u25cf      Ng\u1eebng th\u1edf (Respiratory Arrest): L\u00e0 t\u00ecnh tr\u1ea1ng ng\u1eebng h\u00f4 h\u1ea5p. Ban \u0111\u1ea7u, tim v\u1eabn c\u00f3 th\u1ec3 \u0111\u1eadp (v\u1eabn c\u00f3 m\u1ea1ch). Tuy nhi\u00ean, n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c c\u1ea5p c\u1ee9u k\u1ecbp th\u1eddi, t\u00ecnh tr\u1ea1ng thi\u1ebfu oxy nghi\u00eam tr\u1ecdng v\u00e0 t\u00edch t\u1ee5 carbon dioxide s\u1ebd \u1ea3nh h\u01b0\u1edfng tr\u1ef1c ti\u1ebfp \u0111\u1ebfn n\u00e3o v\u00e0 tim, d\u1eabn \u0111\u1ebfn ng\u1eebng tim.<\/p>\n\n\n\n

\u25cf      M\u1ed1i li\u00ean h\u1ec7: Ng\u1eebng h\u00f4 h\u1ea5p c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn ng\u1eebng tim. Ng\u01b0\u1ee3c l\u1ea1i, khi tim ng\u1eebng \u0111\u1eadp, m\u00e1u kh\u00f4ng c\u00f2n ch\u1ea3y \u0111\u1ebfn c\u00e1c c\u01a1 quan, bao g\u1ed3m c\u1ea3 trung t\u00e2m h\u00f4 h\u1ea5p c\u1ee7a n\u00e3o, khi\u1ebfn nh\u1ecbp th\u1edf c\u0169ng ng\u01b0ng theo, th\u01b0\u1eddng trong v\u00f2ng m\u1ed9t ph\u00fat ho\u1eb7c \u00edt h\u01a1n.<\/p>\n\n\n\n

C\u00e1c nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn g\u00e2y ng\u1ea5t<\/strong><\/p>\n\n\n\n

Ng\u1ea5t c\u00f3 th\u1ec3 do nhi\u1ec1u nguy\u00ean nh\u00e2n kh\u00e1c nhau, t\u1eeb nh\u1eefng y\u1ebfu t\u1ed1 l\u00e0nh t\u00ednh \u0111\u1ebfn c\u00e1c t\u00ecnh tr\u1ea1ng y t\u1ebf nghi\u00eam tr\u1ecdng:<\/p>\n\n\n\n

\u25cf      Ng\u1ea5t do ph\u1ea3n x\u1ea1 th\u1ea7n kinh (Vasovagal\/Neurocardiogenic Syncope): \u0110\u00e2y l\u00e0 lo\u1ea1i ng\u1ea5t ph\u1ed5 bi\u1ebfn nh\u1ea5t v\u00e0 th\u01b0\u1eddng kh\u00f4ng nguy hi\u1ec3m. N\u00f3 x\u1ea3y ra khi c\u01a1 th\u1ec3 ph\u1ea3n \u1ee9ng qu\u00e1 m\u1ee9c v\u1edbi c\u00e1c y\u1ebfu t\u1ed1 k\u00edch th\u00edch nh\u01b0 s\u1ee3 h\u00e3i, \u0111au \u0111\u1edbn, c\u0103ng th\u1eb3ng c\u1ea3m x\u00fac, \u0111\u1ee9ng l\u00e2u, m\u1ec7t m\u1ecfi, m\u00f4i tr\u01b0\u1eddng n\u00f3ng b\u1ee9c, m\u1ea5t n\u01b0\u1edbc, ho, ho\u1eb7c \u0111i ti\u1ec3u. Ph\u1ea3n \u1ee9ng n\u00e0y l\u00e0m tim \u0111\u1eadp ch\u1eadm l\u1ea1i ho\u1eb7c m\u1ea1ch m\u00e1u gi\u00e3n n\u1edf (ho\u1eb7c c\u1ea3 hai), d\u1eabn \u0111\u1ebfn gi\u1ea3m huy\u1ebft \u00e1p v\u00e0 l\u01b0u l\u01b0\u1ee3ng m\u00e1u l\u00ean n\u00e3o.<\/p>\n\n\n\n

\u25cf      Ng\u1ea5t do tim m\u1ea1ch (Cardiac Syncope): \u0110\u00e2y l\u00e0 nguy\u00ean nh\u00e2n nghi\u00eam tr\u1ecdng v\u00e0 c\u00f3 th\u1ec3 \u0111e d\u1ecda t\u00ednh m\u1ea1ng. C\u00e1c nguy\u00ean nh\u00e2n bao g\u1ed3m:<\/p>\n\n\n\n

\u25cb      R\u1ed1i lo\u1ea1n nh\u1ecbp tim: Tim \u0111\u1eadp qu\u00e1 nhanh (nh\u1ecbp nhanh th\u1ea5t, rung th\u1ea5t, nh\u1ecbp nhanh tr\u00ean th\u1ea5t) ho\u1eb7c qu\u00e1 ch\u1eadm (nh\u1ecbp ch\u1eadm xoang, block nh\u0129 th\u1ea5t) khi\u1ebfn cung l\u01b0\u1ee3ng tim kh\u00f4ng \u0111\u1ee7 \u0111\u1ec3 cung c\u1ea5p m\u00e1u l\u00ean n\u00e3o.<\/p>\n\n\n\n

\u25cb      B\u1ec7nh tim c\u1ea5u tr\u00fac: C\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 c\u1ea5u tr\u00fac tim nh\u01b0 h\u1eb9p van tim (v\u00ed d\u1ee5: h\u1eb9p \u0111\u1ed9ng m\u1ea1ch ch\u1ee7), b\u1ec7nh c\u01a1 tim (ph\u00ec \u0111\u1ea1i, gi\u00e3n n\u1edf, thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9), kh\u1ed1i u tim, ho\u1eb7c b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh c\u00f3 th\u1ec3 c\u1ea3n tr\u1edf d\u00f2ng m\u00e1u ra kh\u1ecfi tim.<\/p>\n\n\n\n

\u25cb      Gi\u1ea3m cung l\u01b0\u1ee3ng tim: Do c\u00e1c b\u1ec7nh l\u00fd g\u00e2y t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng t\u1ed1ng m\u00e1u.<\/p>\n\n\n\n

\u25cf      Ng\u1ea5t do huy\u1ebft \u00e1p t\u01b0 th\u1ebf (Orthostatic Hypotension): X\u1ea3y ra khi huy\u1ebft \u00e1p gi\u1ea3m \u0111\u1ed9t ng\u1ed9t l\u00fac \u0111\u1ee9ng ho\u1eb7c ng\u1ed3i d\u1eady nhanh. Nguy\u00ean nh\u00e2n c\u00f3 th\u1ec3 do m\u1ea5t n\u01b0\u1edbc, s\u1eed d\u1ee5ng m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c l\u00e0m gi\u1ea3m huy\u1ebft \u00e1p, ho\u1eb7c u\u1ed1ng r\u01b0\u1ee3u bia.<\/p>\n\n\n\n

\u25cf      Ng\u1ea5t do nguy\u00ean nh\u00e2n th\u1ea7n kinh (Neurologic Syncope): \u00cdt ph\u1ed5 bi\u1ebfn h\u01a1n, c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn c\u00e1c t\u00ecnh tr\u1ea1ng nh\u01b0 co gi\u1eadt, \u0111\u1ed9t qu\u1ef5, ho\u1eb7c thi\u1ebfu m\u00e1u n\u00e3o tho\u00e1ng qua (TIA).<\/p>\n\n\n\n

\u25cf      C\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c: Thi\u1ebfu m\u00e1u, h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft, ng\u1ed9 \u0111\u1ed9c carbon monoxide, ho\u1eb7c t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c.<\/p>\n\n\n\n

Tri\u1ec7u ch\u1ee9ng \u0111i\u1ec3n h\u00ecnh v\u00e0 d\u1ea5u hi\u1ec7u c\u1ea3nh b\u00e1o c\u1ee7a ng\u1ea5t<\/strong><\/p>\n\n\n\n

Ng\u01b0\u1eddi tr\u1ea3i qua c\u01a1n ng\u1ea5t th\u01b0\u1eddng c\u00f3 th\u1ec3 nh\u1eadn th\u1ea5y m\u1ed9t s\u1ed1 tri\u1ec7u ch\u1ee9ng b\u00e1o tr\u01b0\u1edbc, m\u1eb7c d\u00f9 \u0111\u00f4i khi ng\u1ea5t c\u00f3 th\u1ec3 x\u1ea3y ra m\u00e0 kh\u00f4ng c\u00f3 c\u1ea3nh b\u00e1o.<\/p>\n\n\n\n

\u25cf      Tri\u1ec7u ch\u1ee9ng b\u00e1o tr\u01b0\u1edbc (Prodromal symptoms): Tr\u01b0\u1edbc khi ng\u1ea5t, ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 c\u1ea3m th\u1ea5y ch\u00f3ng m\u1eb7t, cho\u00e1ng v\u00e1ng, bu\u1ed3n n\u00f4n, v\u00e3 m\u1ed3 h\u00f4i, da t\u00e1i nh\u1ee3t, thay \u0111\u1ed5i th\u1ecb gi\u00e1c (nh\u01b0 nh\u00ecn m\u1edd ho\u1eb7c nh\u00ecn \u0111\u01b0\u1eddng h\u1ea7m), h\u1ed3i h\u1ed9p tim \u0111\u1eadp nhanh, ho\u1eb7c c\u1ea3m th\u1ea5y m\u1ec7t m\u1ecfi. Trong c\u00e2u chuy\u1ec7n c\u1ee7a m\u00ecnh, t\u00f4i \u0111\u00e3 c\u00f3 c\u1ea3m gi\u00e1c “h\u1ed3i h\u1ed9p tim \u0111\u1eadp nhanh” v\u00e0 “th\u1ea5y m\u1ec7t” tr\u01b0\u1edbc khi ng\u00e3.<\/p>\n\n\n\n

\u25cf      Trong c\u01a1n ng\u1ea5t: M\u1ea5t \u00fd th\u1ee9c \u0111\u1ed9t ng\u1ed9t v\u00e0 ng\u00e3 qu\u1ef5 l\u00e0 nh\u1eefng d\u1ea5u hi\u1ec7u ch\u00ednh. \u0110\u00f4i khi, ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 c\u00f3 c\u00e1c c\u1eed \u0111\u1ed9ng gi\u1eadt c\u01a1 kh\u00f4ng ch\u1ee7 \u00fd, \u0111i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 b\u1ecb nh\u1ea7m l\u1eabn v\u1edbi co gi\u1eadt.<\/p>\n\n\n\n

\u25cf      Sau c\u01a1n ng\u1ea5t: Ng\u01b0\u1eddi b\u1ec7nh th\u01b0\u1eddng h\u1ed3i ph\u1ee5c \u00fd th\u1ee9c nhanh ch\u00f3ng v\u00e0 ho\u00e0n to\u00e0n, kh\u00f4ng c\u00f3 t\u00ecnh tr\u1ea1ng l\u1eabn l\u1ed9n k\u00e9o d\u00e0i nh\u01b0 sau c\u01a1n \u0111\u1ed9ng kinh. Tuy nhi\u00ean, c\u1ea3m gi\u00e1c m\u1ec7t m\u1ecfi ho\u1eb7c cho\u00e1ng v\u00e1ng c\u00f3 th\u1ec3 k\u00e9o d\u00e0i m\u1ed9t th\u1eddi gian.<\/p>\n\n\n\n

\u0110i\u1ec1u quan tr\u1ecdng l\u00e0 ph\u1ea3i nh\u1eadn bi\u1ebft c\u00e1c d\u1ea5u hi\u1ec7u c\u1ea3nh b\u00e1o nguy hi\u1ec3m c\u1ea7n \u0111\u01b0\u1ee3c th\u0103m kh\u00e1m y t\u1ebf ngay l\u1eadp t\u1ee9c: ng\u1ea5t khi \u0111ang t\u1eadp luy\u1ec7n ho\u1eb7c g\u1eafng s\u1ee9c, ng\u1ea5t khi \u0111ang n\u1eb1m, ng\u1ea5t kh\u00f4ng c\u00f3 d\u1ea5u hi\u1ec7u b\u00e1o tr\u01b0\u1edbc, ng\u1ea5t nhi\u1ec1u l\u1ea7n trong th\u1eddi gian ng\u1eafn, ng\u1ea5t k\u00e8m theo \u0111au ng\u1ef1c, kh\u00f3 th\u1edf, tim \u0111\u1eadp nhanh b\u1ea5t th\u01b0\u1eddng, ho\u1eb7c c\u00f3 ti\u1ec1n s\u1eed gia \u0111\u00ecnh m\u1eafc b\u1ec7nh tim hay \u0111\u1ed9t t\u1eed kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n.<\/p>\n\n\n\n

B\u1ea3ng 1: So S\u00e1nh Ng\u1ea5t, Ng\u1eebng Tim v\u00e0 Ng\u1eebng Th\u1edf<\/strong><\/p>\n\n\n\n

Vi\u1ec7c hi\u1ec3u r\u00f5 s\u1ef1 kh\u00e1c bi\u1ec7t gi\u1eefa ng\u1ea5t, ng\u1eebng tim v\u00e0 ng\u1eebng th\u1edf l\u00e0 c\u1ef1c k\u1ef3 quan tr\u1ecdng \u0111\u1ec3 c\u00f3 th\u1ec3 ph\u1ea3n \u1ee9ng \u0111\u00fang \u0111\u1eafn trong c\u00e1c t\u00ecnh hu\u1ed1ng kh\u1ea9n c\u1ea5p. B\u1ea3ng d\u01b0\u1edbi \u0111\u00e2y t\u00f3m t\u1eaft c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m ch\u00ednh gi\u00fap ph\u00e2n bi\u1ec7t ba t\u00ecnh tr\u1ea1ng n\u00e0y:<\/p>\n\n\n\n

Ti\u00eau ch\u00ed<\/strong><\/td>Ng\u1ea5t (Syncope)<\/strong><\/td>Ng\u1eebng Tim (Cardiac Arrest)<\/strong><\/td>Ng\u1eebng Th\u1edf (Respiratory Arrest)<\/strong><\/td><\/tr>
\u00dd th\u1ee9c<\/td>M\u1ea5t \u00fd th\u1ee9c tho\u00e1ng qua, th\u01b0\u1eddng t\u1ef1 h\u1ed3i ph\u1ee5c<\/td>M\u1ea5t \u00fd th\u1ee9c \u0111\u1ed9t ng\u1ed9t, ho\u00e0n to\u00e0n<\/td>M\u1ea5t \u00fd th\u1ee9c (do thi\u1ebfu oxy n\u00e3o)<\/td><\/tr>
Nh\u1ecbp tim<\/td>Tim v\u1eabn \u0111\u1eadp, c\u00f3 th\u1ec3 ch\u1eadm ho\u1eb7c nhanh<\/td>Tim ng\u1eebng \u0111\u1eadp ho\u1eb7c \u0111\u1eadp r\u1ea5t y\u1ebfu\/lo\u1ea1n x\u1ea1<\/td>Tim v\u1eabn \u0111\u1eadp (ban \u0111\u1ea7u)<\/td><\/tr>
Nh\u1ecbp th\u1edf<\/td>Th\u1edf b\u00ecnh th\u01b0\u1eddng<\/td>Ng\u1eebng th\u1edf ho\u1eb7c th\u1edf ng\u00e1p c\u00e1<\/td>Ng\u1eebng th\u1edf ho\u00e0n to\u00e0n<\/td><\/tr>
M\u1ea1ch<\/td>C\u00f3 m\u1ea1ch<\/td>Kh\u00f4ng c\u00f3 m\u1ea1ch<\/td>C\u00f3 m\u1ea1ch (ban \u0111\u1ea7u)<\/td><\/tr>
Nguy\u00ean nh\u00e2n ch\u00ednh<\/td>Ph\u1ea3n x\u1ea1 th\u1ea7n kinh, tim m\u1ea1ch, huy\u1ebft \u00e1p t\u01b0 th\u1ebf, th\u1ea7n kinh<\/td>R\u1ed1i lo\u1ea1n \u0111i\u1ec7n tim, b\u1ec7nh tim c\u1ea5u tr\u00fac, nh\u1ed3i m\u00e1u c\u01a1 tim<\/td>T\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng th\u1edf, suy h\u00f4 h\u1ea5p, ng\u1ed9 \u0111\u1ed9c<\/td><\/tr>
M\u1ee9c \u0111\u1ed9 nguy hi\u1ec3m<\/td>Th\u01b0\u1eddng l\u00e0nh t\u00ednh (tr\u1eeb ng\u1ea5t do tim)<\/td>C\u1ef1c k\u1ef3 nguy hi\u1ec3m, t\u1eed vong nhanh<\/td>R\u1ea5t nguy hi\u1ec3m, c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn ng\u1eebng tim<\/td><\/tr>
H\u00e0nh \u0111\u1ed9ng c\u1ea5p c\u1ee9u ban \u0111\u1ea7u<\/td>N\u1eb1m xu\u1ed1ng, n\u00e2ng ch\u00e2n, n\u1edbi l\u1ecfng qu\u1ea7n \u00e1o<\/td>G\u1ecdi c\u1ea5p c\u1ee9u, \u00e9p tim ngo\u00e0i l\u1ed3ng ng\u1ef1c (CPR), s\u1eed d\u1ee5ng AED (n\u1ebfu c\u00f3)<\/td>G\u1ecdi c\u1ea5p c\u1ee9u, khai th\u00f4ng \u0111\u01b0\u1eddng th\u1edf, h\u00f4 h\u1ea5p nh\u00e2n t\u1ea1o, Heimlich (n\u1ebfu d\u1ecb v\u1eadt)<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Ng\u1ea5t l\u00e0 m\u1ed9t tri\u1ec7u ch\u1ee9ng, kh\u00f4ng ph\u1ea3i l\u00e0 m\u1ed9t b\u1ec7nh. \u0110i\u1ec1u n\u00e0y c\u00f3 ngh\u0129a l\u00e0 m\u1ecdi tr\u01b0\u1eddng h\u1ee3p ng\u1ea5t \u0111\u1ec1u c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 y t\u1ebf k\u1ef9 l\u01b0\u1ee1ng \u0111\u1ec3 lo\u1ea1i tr\u1eeb c\u00e1c nguy\u00ean nh\u00e2n nguy hi\u1ec3m ti\u1ec1m \u1ea9n, \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim m\u1ea1ch. Thay v\u00ec ch\u1ec9 \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng, tr\u1ecdng t\u00e2m ph\u1ea3i l\u00e0 t\u00ecm ra nguy\u00ean nh\u00e2n g\u1ed1c r\u1ec5 g\u00e2y ng\u1ea5t \u0111\u1ec3 c\u00f3 bi\u1ec7n ph\u00e1p ph\u00f2ng ng\u1eeba v\u00e0 \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3, tr\u00e1nh nh\u1eefng h\u1eadu qu\u1ea3 nghi\u00eam tr\u1ecdng h\u01a1n nh\u01b0 \u0111\u1ed9t t\u1eed.<\/p>\n\n\n\n

M\u1ed9t \u0111i\u1ec3m th\u01b0\u1eddng g\u00e2y nh\u1ea7m l\u1eabn trong c\u1ed9ng \u0111\u1ed3ng l\u00e0 s\u1ef1 kh\u00e1c bi\u1ec7t gi\u1eefa \u0111au tim v\u00e0 ng\u1eebng tim. \u0110au tim (hay nh\u1ed3i m\u00e1u c\u01a1 tim) x\u1ea3y ra do t\u1eafc ngh\u1ebdn m\u1ea1ch m\u00e1u nu\u00f4i tim, nh\u01b0ng tim v\u1eabn \u0111\u1eadp. Ng\u1eebng tim, nh\u01b0 \u0111\u00e3 \u0111\u1ec1 c\u1eadp, l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 v\u1ec1 \u0111i\u1ec7n h\u1ecdc c\u1ee7a tim khi\u1ebfn tim ng\u1eebng b\u01a1m m\u00e1u. S\u1ef1 nh\u1ea7m l\u1eabn n\u00e0y c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn ph\u1ea3n \u1ee9ng c\u1ea5p c\u1ee9u kh\u00f4ng ph\u00f9 h\u1ee3p. V\u00ed d\u1ee5, m\u1ed9t ng\u01b0\u1eddi b\u1ecb \u0111au tim v\u1eabn c\u00f3 \u00fd th\u1ee9c v\u00e0 m\u1ea1ch, c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u01b0a \u0111\u1ebfn b\u1ec7nh vi\u1ec7n ngay. Trong khi \u0111\u00f3, m\u1ed9t ng\u01b0\u1eddi b\u1ecb ng\u1eebng tim c\u1ea7n \u0111\u01b0\u1ee3c \u00e9p tim ngo\u00e0i l\u1ed3ng ng\u1ef1c (CPR) v\u00e0 s\u1ed1c \u0111i\u1ec7n b\u1eb1ng AED ngay l\u1eadp t\u1ee9c \u0111\u1ec3 duy tr\u00ec s\u1ef1 s\u1ed1ng. N\u00e2ng cao nh\u1eadn th\u1ee9c v\u1ec1 s\u1ef1 kh\u00e1c bi\u1ec7t n\u00e0y c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n \u0111\u00e1ng k\u1ec3 t\u1ef7 l\u1ec7 s\u1ed1ng s\u00f3t cho n\u1ea1n nh\u00e2n ng\u1eebng tim \u0111\u1ed9t ng\u1ed9t.<\/p>\n\n\n\n

III. Ng\u1eebng Tim (Cardiac Arrest) v\u00e0 Ng\u1eebng Th\u1edf (Respiratory Arrest) \u2013 T\u00ecnh Hu\u1ed1ng C\u1ea5p C\u1ee9u Nguy Hi\u1ec3m<\/strong><\/p>\n\n\n\n

\u0110\u1ecbnh ngh\u0129a v\u00e0 c\u01a1 ch\u1ebf sinh l\u00fd c\u1ee7a ng\u1eebng tim<\/strong><\/p>\n\n\n\n

Ng\u1eebng tim, hay c\u00f2n g\u1ecdi l\u00e0 ng\u1eebng tu\u1ea7n ho\u00e0n, l\u00e0 t\u00ecnh tr\u1ea1ng m\u1ea5t \u0111\u1ed9t ng\u1ed9t c\u00e1c ch\u1ee9c n\u0103ng c\u1ee7a tim, khi\u1ebfn tim b\u1ea5t ng\u1edd ng\u1eebng \u0111\u1eadp do r\u1ed1i lo\u1ea1n ho\u1ea1t \u0111\u1ed9ng \u0111i\u1ec7n c\u1ee7a tim. Khi tim ng\u1eebng \u0111\u1eadp, n\u00f3 kh\u00f4ng c\u00f2n c\u00f3 th\u1ec3 b\u01a1m m\u00e1u hi\u1ec7u qu\u1ea3 \u0111\u1ebfn n\u00e3o, ph\u1ed5i v\u00e0 c\u00e1c c\u01a1 quan kh\u00e1c trong c\u01a1 th\u1ec3. \u0110i\u1ec1u n\u00e0y d\u1eabn \u0111\u1ebfn m\u1ea5t tri gi\u00e1c, ng\u1eebng th\u1edf v\u00e0 kh\u00f4ng b\u1eaft \u0111\u01b0\u1ee3c m\u1ea1ch.<\/p>\n\n\n\n

Ng\u1eebng tim \u0111\u1ed9t ng\u1ed9t c\u00f3 th\u1ec3 x\u1ea3y ra ngay c\u1ea3 tr\u00ean m\u1ed9t tr\u00e1i tim ho\u00e0n to\u00e0n kh\u1ecfe m\u1ea1nh ho\u1eb7c l\u00e0 h\u1eadu qu\u1ea3 c\u1ee7a c\u00e1c tai n\u1ea1n nh\u01b0 \u0111i\u1ec7n gi\u1eadt, \u0111u\u1ed1i n\u01b0\u1edbc, s\u1ed1c ph\u1ea3n v\u1ec7, ho\u1eb7c \u0111a ch\u1ea5n th\u01b0\u01a1ng. Tuy nhi\u00ean, nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn nh\u1ea5t g\u00e2y ng\u1eebng tim l\u00e0 do c\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp tim nguy hi\u1ec3m, \u0111\u1eb7c bi\u1ec7t l\u00e0 rung th\u1ea5t, n\u01a1i c\u00e1c bu\u1ed3ng tim d\u01b0\u1edbi rung l\u00ean m\u1ed9t c\u00e1ch h\u1ed7n lo\u1ea1n thay v\u00ec b\u01a1m m\u00e1u hi\u1ec7u qu\u1ea3.<\/p>\n\n\n\n

\u0110\u1ecbnh ngh\u0129a v\u00e0 c\u01a1 ch\u1ebf sinh l\u00fd c\u1ee7a ng\u1eebng th\u1edf<\/strong><\/p>\n\n\n\n

Ng\u1eebng th\u1edf l\u00e0 t\u00ecnh tr\u1ea1ng h\u00f4 h\u1ea5p b\u1ecb gi\u00e1n \u0111o\u1ea1n ho\u1eb7c ng\u1eebng ho\u00e0n to\u00e0n, trong khi ho\u1ea1t \u0111\u1ed9ng tim m\u1ea1ch hi\u1ec7u qu\u1ea3 v\u1eabn c\u00f3 th\u1ec3 duy tr\u00ec ban \u0111\u1ea7u. C\u00e1c nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn g\u00e2y ng\u1eebng th\u1edf bao g\u1ed3m hen suy\u1ec5n, vi\u00eam ph\u1ed5i, b\u1ec7nh ph\u1ed5i m\u1ea1n t\u00ednh, qu\u00e1 li\u1ec1u thu\u1ed1c, ng\u1ed9 \u0111\u1ed9c, ho\u1eb7c t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng th\u1edf do d\u1ecb v\u1eadt, m\u00e1u, ch\u1ea5t n\u00f4n, ho\u1eb7c vi\u00eam.<\/p>\n\n\n\n

Khi ng\u1eebng th\u1edf x\u1ea3y ra, c\u01a1 th\u1ec3 kh\u00f4ng lo\u1ea1i b\u1ecf \u0111\u01b0\u1ee3c carbon dioxide kh\u1ecfi m\u00e1u, d\u1eabn \u0111\u1ebfn s\u1ef1 t\u00edch t\u1ee5 axit carbonic. \u0110\u1ed3ng th\u1eddi, n\u1ed3ng \u0111\u1ed9 oxy trong m\u00e1u s\u1ebd gi\u1ea3m \u0111i. C\u1ea3 hai t\u00ecnh tr\u1ea1ng n\u00e0y, n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c x\u1eed l\u00fd, \u0111\u1ec1u c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng tr\u1ef1c ti\u1ebfp \u0111\u1ebfn n\u00e3o v\u00e0 tim, d\u1eabn \u0111\u1ebfn h\u00f4n m\u00ea v\u00e0 cu\u1ed1i c\u00f9ng l\u00e0 ng\u1eebng tim.<\/p>\n\n\n\n

M\u1ed1i li\u00ean h\u1ec7 ch\u1eb7t ch\u1ebd gi\u1eefa ng\u1eebng tim v\u00e0 ng\u1eebng th\u1edf<\/strong><\/p>\n\n\n\n

Ng\u1eebng tim v\u00e0 ng\u1eebng th\u1edf c\u00f3 m\u1ed1i li\u00ean h\u1ec7 m\u1eadt thi\u1ebft v\u00e0 c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng l\u1eabn nhau m\u1ed9t c\u00e1ch nhanh ch\u00f3ng. N\u1ebfu t\u00ecnh tr\u1ea1ng ng\u1eebng h\u00f4 h\u1ea5p x\u1ea3y ra v\u00e0 kh\u00f4ng \u0111\u01b0\u1ee3c c\u1ea5p c\u1ee9u k\u1ecbp th\u1eddi, n\u00f3 s\u1ebd d\u1eabn \u0111\u1ebfn ng\u1eebng tim trong v\u00f2ng v\u00e0i ph\u00fat do thi\u1ebfu oxy nghi\u00eam tr\u1ecdng v\u00e0 t\u00edch t\u1ee5 CO2 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ch\u1ee9c n\u0103ng n\u00e3o v\u00e0 tim. Ng\u01b0\u1ee3c l\u1ea1i, khi tim ng\u1eebng \u0111\u1eadp, m\u00e1u kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c b\u01a1m \u0111\u1ebfn c\u00e1c c\u01a1 quan, bao g\u1ed3m c\u1ea3 n\u00e3o. Trung t\u00e2m h\u00f4 h\u1ea5p c\u1ee7a n\u00e3o s\u1ebd ng\u1eebng ho\u1ea1t \u0111\u1ed9ng, khi\u1ebfn nh\u1ecbp th\u1edf c\u0169ng ng\u01b0ng theo, qu\u00e1 tr\u00ecnh n\u00e0y th\u01b0\u1eddng di\u1ec5n ra trong v\u00f2ng m\u1ed9t ph\u00fat ho\u1eb7c \u00edt h\u01a1n.<\/p>\n\n\n\n

Tri\u1ec7u ch\u1ee9ng \u0111i\u1ec3n h\u00ecnh v\u00e0 d\u1ea5u hi\u1ec7u c\u1ea3nh b\u00e1o c\u1ea7n nh\u1eadn bi\u1ebft<\/strong><\/p>\n\n\n\n

Vi\u1ec7c nh\u1eadn bi\u1ebft nhanh ch\u00f3ng c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a ng\u1eebng tim v\u00e0 ng\u1eebng th\u1edf l\u00e0 y\u1ebfu t\u1ed1 then ch\u1ed1t \u0111\u1ec3 c\u1ee9u s\u1ed1ng ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n\n\n\n

\u25cf      D\u1ea5u hi\u1ec7u ng\u1eebng tim:<\/p>\n\n\n\n

\u25cb      \u0110\u1ed9t ng\u1ed9t ng\u00e3 qu\u1ef5 v\u00e0 m\u1ea5t \u00fd th\u1ee9c: Ng\u01b0\u1eddi b\u1ec7nh s\u1ebd b\u1ea5t t\u1ec9nh ngay l\u1eadp t\u1ee9c, kh\u00f4ng ph\u1ea3n \u1ee9ng v\u1edbi lay g\u1ecdi ho\u1eb7c k\u00edch th\u00edch.<\/p>\n\n\n\n

\u25cb      Kh\u00f4ng th\u1edf ho\u1eb7c th\u1edf b\u1ea5t th\u01b0\u1eddng: Ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng c\u00f3 h\u01a1i th\u1edf ho\u1eb7c ch\u1ec9 th\u1edf ng\u00e1p c\u00e1 (th\u1edf h\u1ed5n h\u1ec3n, kh\u00f4ng hi\u1ec7u qu\u1ea3). L\u1ed3ng ng\u1ef1c kh\u00f4ng di \u0111\u1ed9ng.<\/p>\n\n\n\n

\u25cb      Kh\u00f4ng b\u1eaft \u0111\u01b0\u1ee3c m\u1ea1ch: Kh\u00f4ng c\u1ea3m nh\u1eadn \u0111\u01b0\u1ee3c m\u1ea1ch \u1edf c\u00e1c v\u1ecb tr\u00ed m\u1ea1ch l\u1edbn nh\u01b0 m\u1ea1ch c\u1ea3nh \u1edf c\u1ed5 ho\u1eb7c m\u1ea1ch b\u1eb9n.<\/p>\n\n\n\n

\u25cb      D\u1ea5u hi\u1ec7u c\u1ea3nh b\u00e1o s\u1edbm (c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n tr\u01b0\u1edbc khi ng\u1eebng tim \u0111\u1ed9t ng\u1ed9t): \u0110au ng\u1ef1c ho\u1eb7c c\u1ea3m gi\u00e1c kh\u00f3 ch\u1ecbu v\u00f9ng ng\u1ef1c, h\u1ed3i h\u1ed9p, \u0111\u00e1nh tr\u1ed1ng ng\u1ef1c, th\u1edf kh\u00f2 kh\u00e8, c\u1ea3m gi\u00e1c h\u1ee5t h\u01a1i, ch\u00f3ng m\u1eb7t, cho\u00e1ng v\u00e1ng ho\u1eb7c x\u1ec9u.<\/p>\n\n\n\n

\u25cf      D\u1ea5u hi\u1ec7u ng\u1eebng th\u1edf:<\/p>\n\n\n\n

\u25cb      Kh\u00f3 th\u1edf ho\u1eb7c th\u1edf nhanh b\u1ea5t th\u01b0\u1eddng: \u0110\u00e2y l\u00e0 nh\u1eefng d\u1ea5u hi\u1ec7u s\u1edbm c\u1ee7a suy h\u00f4 h\u1ea5p.<\/p>\n\n\n\n

\u25cb      Da xanh t\u00edm: \u0110\u1eb7c bi\u1ec7t quanh mi\u1ec7ng ho\u1eb7c m\u00f3ng tay (cyanosis), do thi\u1ebfu oxy trong m\u00e1u.<\/p>\n\n\n\n

\u25cb      Ho c\u00f3 \u0111\u1eddm v\u00e0 co k\u00e9o l\u1ed3ng ng\u1ef1c: L\u1ed3ng ng\u1ef1c c\u00f3 th\u1ec3 l\u00f5m v\u00e0o d\u01b0\u1edbi c\u1ed5 ho\u1eb7c x\u01b0\u01a1ng \u1ee9c v\u1edbi m\u1ed7i nh\u1ecbp th\u1edf.<\/p>\n\n\n\n

\u25cb      \u0110au ng\u1ef1c c\u00f3 th\u1ec3 n\u1eb7ng h\u01a1n khi th\u1edf ho\u1eb7c ho:.<\/p>\n\n\n\n

\u25cb      \u0110\u1ed5 m\u1ed3 h\u00f4i nhi\u1ec1u \u1edf \u0111\u1ea7u: Ngay c\u1ea3 khi da kh\u00f4ng \u1ea5m.<\/p>\n\n\n\n

Ch\u1ea9n \u0111o\u00e1n c\u1ea5p c\u1ee9u ng\u1eebng tim v\u00e0 ng\u1eebng th\u1edf t\u1ea1i hi\u1ec7n tr\u01b0\u1eddng<\/strong><\/p>\n\n\n\n

Trong t\u00ecnh hu\u1ed1ng kh\u1ea9n c\u1ea5p, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n nhanh ch\u00f3ng v\u00e0 ch\u00ednh x\u00e1c l\u00e0 c\u1ef1c k\u1ef3 quan tr\u1ecdng \u0111\u1ec3 b\u1eaft \u0111\u1ea7u c\u00e1c bi\u1ec7n ph\u00e1p c\u1ea5p c\u1ee9u k\u1ecbp th\u1eddi.<\/p>\n\n\n\n

\u25cf      Ch\u1ea9n \u0111o\u00e1n ng\u1eebng tim: D\u1ef1a v\u00e0o ba d\u1ea5u hi\u1ec7u ch\u00ednh: ng\u01b0\u1eddi b\u1ec7nh \u0111\u1ed9t ng\u1ed9t m\u1ea5t \u00fd th\u1ee9c, kh\u00f4ng th\u1edf ho\u1eb7c ch\u1ec9 th\u1edf ng\u00e1p c\u00e1, v\u00e0 kh\u00f4ng b\u1eaft \u0111\u01b0\u1ee3c m\u1ea1ch trung t\u00e2m (m\u1ea1ch c\u1ea3nh \u1edf c\u1ed5) trong v\u00f2ng 10 gi\u00e2y. N\u1ebfu ph\u00e1t hi\u1ec7n b\u1ea5t k\u1ef3 d\u1ea5u hi\u1ec7u n\u00e0o trong s\u1ed1 n\u00e0y, c\u1ea7n h\u00e0nh \u0111\u1ed9ng ngay l\u1eadp t\u1ee9c.<\/p>\n\n\n\n

\u25cf      Ch\u1ea9n \u0111o\u00e1n ng\u1eebng th\u1edf: Ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng ph\u1ea3n \u1ee9ng khi lay g\u1ecdi, kh\u00f4ng c\u00f3 d\u1ea5u hi\u1ec7u th\u1edf (kh\u00f4ng nh\u00ecn th\u1ea5y l\u1ed3ng ng\u1ef1c di \u0111\u1ed9ng, kh\u00f4ng nghe ti\u1ebfng th\u1edf, kh\u00f4ng c\u1ea3m nh\u1eadn h\u01a1i th\u1edf), nh\u01b0ng \u0111i\u1ec1u quan tr\u1ecdng l\u00e0 v\u1eabn c\u00f3 m\u1ea1ch. N\u1ebfu ng\u1eebng th\u1edf kh\u00f4ng \u0111\u01b0\u1ee3c x\u1eed l\u00fd, ng\u1eebng tim s\u1ebd x\u1ea3y ra trong v\u00f2ng v\u00e0i ph\u00fat.<\/p>\n\n\n\n

T\u1ea7m quan tr\u1ecdng t\u1ed1i cao c\u1ee7a vi\u1ec7c nh\u1eadn bi\u1ebft nhanh ch\u00f3ng v\u00e0 ch\u00ednh x\u00e1c t\u00ecnh tr\u1ea1ng ng\u1eebng tim ho\u1eb7c ng\u1eebng th\u1edf kh\u00f4ng th\u1ec3 b\u1ecb ph\u00f3ng \u0111\u1ea1i. Khi tim ng\u1eebng \u0111\u1eadp, t\u00ednh m\u1ea1ng n\u1ea1n nh\u00e2n \u0111\u01b0\u1ee3c t\u00ednh b\u1eb1ng ph\u00fat. T\u1ef7 l\u1ec7 s\u1ed1ng s\u00f3t gi\u1ea3m kho\u1ea3ng 10% sau m\u1ed7i ph\u00fat ch\u1eadm tr\u1ec5 trong vi\u1ec7c h\u1ed3i s\u1ee9c. N\u00e3o c\u00f3 th\u1ec3 b\u1ecb t\u1ed5n th\u01b0\u01a1ng v\u0129nh vi\u1ec5n ch\u1ec9 sau 4-5 ph\u00fat thi\u1ebfu oxy. \u0110i\u1ec1u n\u00e0y \u0111\u1eb7t ra y\u00eau c\u1ea7u c\u1ea5p b\u00e1ch v\u1ec1 vi\u1ec7c gi\u00e1o d\u1ee5c c\u1ed9ng \u0111\u1ed3ng c\u00e1c k\u1ef9 n\u0103ng s\u01a1 c\u1ee9u c\u01a1 b\u1ea3n nh\u01b0 nh\u1eadn bi\u1ebft d\u1ea5u hi\u1ec7u ng\u1eebng tim\/ng\u1eebng th\u1edf v\u00e0 th\u1ef1c hi\u1ec7n h\u1ed3i s\u1ee9c tim ph\u1ed5i (CPR) ho\u1eb7c th\u1ed5i ng\u1ea1t. Ng\u01b0\u1eddi \u0111\u1ea7u ti\u00ean ph\u00e1t hi\u1ec7n n\u1ea1n nh\u00e2n th\u01b0\u1eddng l\u00e0 ng\u01b0\u1eddi th\u00e2n ho\u1eb7c ng\u01b0\u1eddi qua \u0111\u01b0\u1eddng, v\u00e0 h\u00e0nh \u0111\u1ed9ng c\u1ee7a h\u1ecd trong nh\u1eefng ph\u00fat \u0111\u1ea7u ti\u00ean c\u00f3 \u00fd ngh\u0129a quy\u1ebft \u0111\u1ecbnh \u0111\u1ebfn kh\u1ea3 n\u0103ng s\u1ed1ng s\u00f3t v\u00e0 ph\u1ee5c h\u1ed3i c\u1ee7a n\u1ea1n nh\u00e2n.<\/p>\n\n\n\n

M\u1ed9t s\u1ef1 hi\u1ec3u l\u1ea7m ph\u1ed5 bi\u1ebfn l\u00e0 vi\u1ec7c \u0111\u00e1nh \u0111\u1ed3ng “\u0111au tim” v\u1edbi “ng\u1eebng tim”. Nhi\u1ec1u ng\u01b0\u1eddi c\u00f3 th\u1ec3 ngh\u0129 r\u1eb1ng n\u1ea1n nh\u00e2n \u0111ang b\u1ecb \u0111au tim v\u00e0 tim v\u1eabn \u0111\u1eadp, d\u1eabn \u0111\u1ebfn vi\u1ec7c ch\u1ec9 g\u1ecdi c\u1ea5p c\u1ee9u m\u00e0 kh\u00f4ng th\u1ef1c hi\u1ec7n c\u00e1c bi\u1ec7n ph\u00e1p s\u01a1 c\u1ee9u ngay l\u1eadp t\u1ee9c. S\u1ef1 hi\u1ec3u l\u1ea7m n\u00e0y c\u00f3 th\u1ec3 c\u1ea3n tr\u1edf h\u00e0nh \u0111\u1ed9ng c\u1ee9u ng\u01b0\u1eddi k\u1ecbp th\u1eddi. Vi\u1ec7c gi\u00e1o d\u1ee5c r\u00f5 r\u00e0ng v\u1ec1 s\u1ef1 kh\u00e1c bi\u1ec7t n\u00e0y l\u00e0 t\u1ed1i quan tr\u1ecdng \u0111\u1ec3 th\u00fac \u0111\u1ea9y h\u00e0nh \u0111\u1ed9ng CPR v\u00e0 s\u1eed d\u1ee5ng m\u00e1y kh\u1eed rung tim ngo\u00e0i t\u1ef1 \u0111\u1ed9ng (AED) k\u1ecbp th\u1eddi, v\u1ed1n l\u00e0 y\u1ebfu t\u1ed1 then ch\u1ed1t \u0111\u1ec3 c\u1ee9u s\u1ed1ng ng\u01b0\u1eddi b\u1ecb ng\u1eebng tim.<\/p>\n\n\n\n

IV. H\u00e0nh Tr\u00ecnh Ch\u1ea9n \u0110o\u00e1n v\u00e0 Th\u00e1ch Th\u1ee9c “Ng\u1ea5t Kh\u00f4ng R\u00f5 Nguy\u00ean Nh\u00e2n”<\/strong><\/p>\n\n\n\n

Quy tr\u00ecnh ch\u1ea9n \u0111o\u00e1n ng\u1ea5t: t\u1eeb kh\u00e1m l\u00e2m s\u00e0ng \u0111\u1ebfn c\u00e1c x\u00e9t nghi\u1ec7m chuy\u00ean s\u00e2u<\/strong><\/p>\n\n\n\n

Khi m\u1ed9t ng\u01b0\u1eddi b\u1ecb ng\u1ea5t, quy tr\u00ecnh ch\u1ea9n \u0111o\u00e1n th\u01b0\u1eddng b\u1eaft \u0111\u1ea7u b\u1eb1ng vi\u1ec7c thu th\u1eadp th\u00f4ng tin chi ti\u1ebft v\u00e0 kh\u00e1m l\u00e2m s\u00e0ng k\u1ef9 l\u01b0\u1ee1ng, sau \u0111\u00f3 m\u1edbi \u0111\u1ebfn c\u00e1c x\u00e9t nghi\u1ec7m chuy\u00ean s\u00e2u.<\/p>\n\n\n\n

\u25cf      \u0110\u00e1nh gi\u00e1 ban \u0111\u1ea7u: B\u00e1c s\u0129 s\u1ebd khai th\u00e1c ti\u1ec1n s\u1eed b\u1ec7nh m\u1ed9t c\u00e1ch chi ti\u1ebft, bao g\u1ed3m ho\u00e0n c\u1ea3nh x\u1ea3y ra c\u01a1n ng\u1ea5t, c\u00e1c tri\u1ec7u ch\u1ee9ng b\u00e1o tr\u01b0\u1edbc (n\u1ebfu c\u00f3), ti\u1ec1n s\u1eed b\u1ec7nh l\u00fd c\u00e1 nh\u00e2n v\u00e0 gia \u0111\u00ecnh (\u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00e1c b\u1ec7nh tim m\u1ea1ch ho\u1eb7c \u0111\u1ed9t t\u1eed kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n), v\u00e0 c\u00e1c lo\u1ea1i thu\u1ed1c \u0111ang s\u1eed d\u1ee5ng. Kh\u00e1m th\u1ef1c th\u1ec3 to\u00e0n di\u1ec7n bao g\u1ed3m \u0111o huy\u1ebft \u00e1p v\u00e0 nh\u1ecbp tim \u1edf c\u1ea3 t\u01b0 th\u1ebf n\u1eb1m v\u00e0 sau 3 ph\u00fat \u0111\u1ee9ng \u0111\u1ec3 ki\u1ec3m tra h\u1ea1 huy\u1ebft \u00e1p t\u01b0 th\u1ebf, ki\u1ec3m tra m\u1ea1ch, nghe tim \u0111\u1ec3 ph\u00e1t hi\u1ec7n ti\u1ebfng th\u1ed5i ho\u1eb7c c\u00e1c d\u1ea5u hi\u1ec7u b\u1ea5t th\u01b0\u1eddng, v\u00e0 kh\u00e1m th\u1ea7n kinh \u0111\u1ec3 lo\u1ea1i tr\u1eeb c\u00e1c nguy\u00ean nh\u00e2n th\u1ea7n kinh.<\/p>\n\n\n\n

\u25cf      \u0110i\u1ec7n t\u00e2m \u0111\u1ed3 (ECG): \u0110\u00e2y l\u00e0 x\u00e9t nghi\u1ec7m \u0111\u1ea7u ti\u00ean v\u00e0 quan tr\u1ecdng, ghi l\u1ea1i ho\u1ea1t \u0111\u1ed9ng \u0111i\u1ec7n c\u1ee7a tim. ECG c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n c\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp tim (nh\u1ecbp nhanh ho\u1eb7c nh\u1ecbp ch\u1eadm) ho\u1eb7c c\u00e1c b\u1ec7nh l\u00fd tim c\u1ea5u tr\u00fac c\u00f3 th\u1ec3 g\u00e2y ng\u1ea5t.<\/p>\n\n\n\n

\u25cf      Si\u00eau \u00e2m tim (Echocardiogram): S\u1eed d\u1ee5ng s\u00f3ng si\u00eau \u00e2m \u0111\u1ec3 t\u1ea1o h\u00ecnh \u1ea3nh chuy\u1ec3n \u0111\u1ed9ng c\u1ee7a tim, gi\u00fap \u0111\u00e1nh gi\u00e1 c\u1ea5u tr\u00fac, k\u00edch th\u01b0\u1edbc, ch\u1ee9c n\u0103ng b\u01a1m m\u00e1u c\u1ee7a tim v\u00e0 ph\u00e1t hi\u1ec7n c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 van tim, c\u01a1 tim, t\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i, ho\u1eb7c thuy\u00ean t\u1eafc ph\u1ed5i.<\/p>\n\n\n\n

\u25cf      Nghi\u1ec7m ph\u00e1p b\u00e0n nghi\u00eang (Tilt Table Test): \u0110\u01b0\u1ee3c th\u1ef1c hi\u1ec7n khi kh\u00f4ng t\u00ecm th\u1ea5y nguy\u00ean nh\u00e2n tim m\u1ea1ch r\u00f5 r\u00e0ng. B\u1ec7nh nh\u00e2n n\u1eb1m tr\u00ean m\u1ed9t b\u00e0n \u0111\u1eb7c bi\u1ec7t v\u00e0 \u0111\u01b0\u1ee3c nghi\u00eang l\u00ean c\u00e1c g\u00f3c kh\u00e1c nhau trong khi nh\u1ecbp tim v\u00e0 huy\u1ebft \u00e1p \u0111\u01b0\u1ee3c theo d\u00f5i li\u00ean t\u1ee5c. X\u00e9t nghi\u1ec7m n\u00e0y gi\u00fap \u0111\u00e1nh gi\u00e1 ph\u1ea3n \u1ee9ng c\u1ee7a c\u01a1 th\u1ec3 v\u1edbi thay \u0111\u1ed5i t\u01b0 th\u1ebf, \u0111\u1eb7c bi\u1ec7t h\u1eefu \u00edch trong ch\u1ea9n \u0111o\u00e1n ng\u1ea5t ph\u1ea3n x\u1ea1 ph\u1ebf v\u1ecb ho\u1eb7c h\u1ea1 huy\u1ebft \u00e1p t\u01b0 th\u1ebf.<\/p>\n\n\n\n

\u25cf      M\u00e1y theo d\u00f5i tim l\u01b0u \u0111\u1ed9ng (Holter monitor\/Event monitor\/Implantable Loop Recorder – ILR): C\u00e1c thi\u1ebft b\u1ecb n\u00e0y \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 theo d\u00f5i nh\u1ecbp tim trong th\u1eddi gian d\u00e0i (t\u1eeb 24 gi\u1edd \u0111\u1ebfn v\u00e0i tu\u1ea7n \u0111\u1ed1i v\u1edbi Holter\/Event monitor, ho\u1eb7c c\u1ea5y gh\u00e9p d\u01b0\u1edbi da \u0111\u1ec3 theo d\u00f5i \u0111\u1ebfn v\u00e0i n\u0103m \u0111\u1ed1i v\u1edbi ILR) nh\u1eb1m ph\u00e1t hi\u1ec7n c\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp tim kh\u00f4ng th\u01b0\u1eddng xuy\u00ean g\u00e2y ng\u1ea5t, v\u1ed1n c\u00f3 th\u1ec3 kh\u00f4ng xu\u1ea5t hi\u1ec7n trong th\u1eddi gian kh\u00e1m ng\u1eafn t\u1ea1i b\u1ec7nh vi\u1ec7n.<\/p>\n\n\n\n

\u25cf      X\u00e9t nghi\u1ec7m m\u00e1u: C\u00e1c x\u00e9t nghi\u1ec7m m\u00e1u c\u01a1 b\u1ea3n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 t\u00ecm ki\u1ebfm c\u00e1c nguy\u00ean nh\u00e2n nh\u01b0 thi\u1ebfu m\u00e1u, h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft, ho\u1eb7c r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i.<\/p>\n\n\n\n

Th\u1ea3o lu\u1eadn v\u1ec1 X\u1ea1 h\u00ecnh t\u01b0\u1edbi m\u00e1u c\u01a1 tim (Myocardial Perfusion Imaging – MPI): m\u1ee5c \u0111\u00edch v\u00e0 \u00fd ngh\u0129a trong ch\u1ea9n \u0111o\u00e1n<\/strong><\/p>\n\n\n\n

X\u1ea1 h\u00ecnh t\u01b0\u1edbi m\u00e1u c\u01a1 tim (MPI), c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 x\u1ea1 h\u00ecnh “thallium” ho\u1eb7c nuclear stress test, l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n kh\u00f4ng x\u00e2m l\u1ea5n, c\u00f3 \u0111\u1ed9 nh\u1ea1y v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u cao \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 l\u01b0u l\u01b0\u1ee3ng m\u00e1u nu\u00f4i c\u01a1 tim. M\u1ee5c \u0111\u00edch ch\u00ednh c\u1ee7a MPI l\u00e0 x\u00e1c \u0111\u1ecbnh xem c\u01a1 tim c\u00f3 nh\u1eadn \u0111\u1ee7 m\u00e1u hay kh\u00f4ng, c\u1ea3 khi ngh\u1ec9 ng\u01a1i v\u00e0 khi g\u1eafng s\u1ee9c. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 t\u00ecm nguy\u00ean nh\u00e2n g\u00e2y \u0111au ng\u1ef1c, x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 h\u1eb9p c\u1ee7a \u0111\u1ed9ng m\u1ea1ch v\u00e0nh, \u0111\u00e1nh gi\u00e1 nguy c\u01a1 sau nh\u1ed3i m\u00e1u c\u01a1 tim, v\u00e0 theo d\u00f5i hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh.<\/p>\n\n\n\n

Trong tr\u01b0\u1eddng h\u1ee3p c\u1ee7a m\u00ecnh, \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb th\u1ef1c hi\u1ec7n x\u00e9t nghi\u1ec7m n\u00e0y nh\u01b0ng do \u1ea3nh h\u01b0\u1edfng d\u1ecbch Covid-19 n\u00ean thi\u1ebfu ho\u00e1 ch\u1ea5t kh\u00f4ng th\u1ef1c hi\u1ec7n h\u1eb9n l\u1ea1i v\u00e0 m\u00ecnh t\u1ea1m d\u1eebng kh\u00f4ng th\u1ef1c hi\u1ec7n n\u1eefa.<\/p>\n\n\n\n

Vai tr\u00f2 c\u1ee7a \u0110i\u1ec7n n\u00e3o \u0111\u1ed3 (EEG) v\u00e0 Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh n\u00e3o (CT\/MRI) trong ph\u00e2n bi\u1ec7t ng\u1ea5t v\u00e0 c\u00e1c t\u00ecnh tr\u1ea1ng th\u1ea7n kinh kh\u00e1c<\/strong><\/p>\n\n\n\n

\u25cf      \u0110i\u1ec7n n\u00e3o \u0111\u1ed3 (EEG): Ghi l\u1ea1i ho\u1ea1t \u0111\u1ed9ng \u0111i\u1ec7n c\u1ee7a n\u00e3o. Trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p ng\u1ea5t, c\u00e1c ph\u00e1t hi\u1ec7n tr\u00ean EEG th\u01b0\u1eddng ph\u1ea3n \u00e1nh t\u00ecnh tr\u1ea1ng thi\u1ebfu m\u00e1u n\u00e3o c\u1ee5c b\u1ed9 to\u00e0n b\u1ed9: ban \u0111\u1ea7u c\u00f3 th\u1ec3 c\u00f3 s\u1ef1 ch\u1eadm l\u1ea1i c\u1ee7a s\u00f3ng n\u1ec1n, sau \u0111\u00f3 l\u00e0 ho\u1ea1t \u0111\u1ed9ng s\u00f3ng delta bi\u00ean \u0111\u1ed9 cao, v\u00e0 c\u00f3 th\u1ec3 l\u00e0m ph\u1eb3ng EEG n\u1ebfu t\u00ecnh tr\u1ea1ng thi\u1ebfu m\u00e1u k\u00e9o d\u00e0i. M\u1eb7c d\u00f9 nh\u1eefng thay \u0111\u1ed5i n\u00e0y c\u00f3 th\u1ec3 gi\u1ed1ng v\u1edbi \u0111\u1ed9ng kinh, nh\u01b0ng ch\u00fang kh\u00f4ng ph\u1ea3i l\u00e0 hi\u1ec7n t\u01b0\u1ee3ng \u0111\u1ed9ng kinh th\u1ef1c s\u1ef1. EEG kh\u00f4ng ph\u1ea3i l\u00e0 x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n ch\u00ednh cho ng\u1ea5t, nh\u01b0ng n\u00f3 r\u1ea5t h\u1eefu \u00edch \u0111\u1ec3 ph\u00e2n bi\u1ec7t ng\u1ea5t v\u1edbi co gi\u1eadt, \u0111\u1eb7c bi\u1ec7t khi c\u00f3 c\u00e1c c\u1eed \u0111\u1ed9ng kh\u00f4ng ch\u1ee7 \u00fd trong c\u01a1n m\u1ea5t \u00fd th\u1ee9c. \u0110\u1ec3 c\u00f3 ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c, c\u1ea7n k\u1ebft h\u1ee3p EEG v\u1edbi ECG \u0111\u1ed3ng th\u1eddi.<\/p>\n\n\n\n

\u25cf      Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh n\u00e3o (CT\/MRI): Nh\u00ecn chung, ch\u1ee5p CT ho\u1eb7c MRI n\u00e3o kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb th\u01b0\u1eddng quy cho c\u00e1c tr\u01b0\u1eddng h\u1ee3p ng\u1ea5t \u0111\u01a1n gi\u1ea3n v\u1edbi kh\u00e1m th\u1ea7n kinh b\u00ecnh th\u01b0\u1eddng. L\u00fd do l\u00e0 kh\u1ea3 n\u0103ng nguy\u00ean nh\u00e2n ng\u1ea5t xu\u1ea5t ph\u00e1t t\u1eeb h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng l\u00e0 r\u1ea5t th\u1ea5p, v\u00e0 vi\u1ec7c ch\u1ee5p chi\u1ebfu th\u01b0\u1eddng kh\u00f4ng c\u1ea3i thi\u1ec7n k\u1ebft qu\u1ea3 ch\u1ea9n \u0111o\u00e1n ho\u1eb7c \u0111i\u1ec1u tr\u1ecb cho b\u1ec7nh nh\u00e2n. C\u00e1c nghi\u00ean c\u1ee9u cho th\u1ea5y t\u1ef7 l\u1ec7 b\u1ea5t th\u01b0\u1eddng tr\u00ean CT n\u00e3o \u1edf b\u1ec7nh nh\u00e2n ng\u1ea5t l\u00e0 th\u1ea5p, tr\u1eeb khi c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u c\u1ea3nh b\u00e1o kh\u00e1c. C\u00e1c x\u00e9t nghi\u1ec7m h\u00ecnh \u1ea3nh n\u00e3o ch\u1ec9 n\u00ean \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh khi c\u00f3 nghi ng\u1edd co gi\u1eadt, c\u00f3 d\u1ea5u hi\u1ec7u th\u1ea7n kinh khu tr\u00fa (v\u00ed d\u1ee5: y\u1ebfu li\u1ec7t m\u1ed9t b\u00ean), ho\u1eb7c ti\u1ec1n s\u1eed ch\u1ea5n th\u01b0\u01a1ng \u0111\u1ea7u g\u1ea7n \u0111\u00e2y. Vi\u1ec7c ban \u0111\u1ea7u \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n “thi\u1ebfu m\u00e1u n\u00e3o c\u1ee5c b\u1ed9” c\u00f3 th\u1ec3 \u0111\u00e3 th\u00fac \u0111\u1ea9y vi\u1ec7c ch\u1ec9 \u0111\u1ecbnh c\u00e1c x\u00e9t nghi\u1ec7m h\u00ecnh \u1ea3nh n\u00e3o, m\u1eb7c d\u00f9 cu\u1ed1i c\u00f9ng nguy\u00ean nh\u00e2n v\u1eabn kh\u00f4ng \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh r\u00f5 r\u00e0ng.<\/p>\n\n\n\n

Ph\u00e2n t\u00edch tr\u01b0\u1eddng h\u1ee3p c\u1ee7a m\u00ecnh: t\u1ea1i sao l\u1ea1i l\u00e0 “ng\u1ea5t kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n” d\u00f9 \u0111\u00e3 l\u00e0m nhi\u1ec1u x\u00e9t nghi\u1ec7m, v\u00e0 t\u1ea7m quan tr\u1ecdng c\u1ee7a video ghi l\u1ea1i c\u01a1n ng\u1ea5t<\/strong><\/p>\n\n\n\n

Ch\u1ea9n \u0111o\u00e1n “ng\u1ea5t kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n” kh\u00f4ng ph\u1ea3i l\u00e0 hi\u1ebfm g\u1eb7p, ngay c\u1ea3 sau khi \u0111\u00e3 th\u1ef1c hi\u1ec7n nhi\u1ec1u x\u00e9t nghi\u1ec7m chuy\u00ean s\u00e2u. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 do t\u00ednh ch\u1ea5t tho\u00e1ng qua c\u1ee7a c\u00e1c r\u1ed1i lo\u1ea1n g\u00e2y ng\u1ea5t, khi\u1ebfn ch\u00fang kh\u00f3 b\u1ecb ghi nh\u1eadn trong th\u1eddi gian kh\u00e1m b\u1ec7nh ho\u1eb7c c\u00e1c x\u00e9t nghi\u1ec7m ng\u1eafn h\u1ea1n. Ho\u1eb7c \u0111\u00f4i khi, nguy\u00ean nh\u00e2n c\u00f3 th\u1ec3 l\u00e0 s\u1ef1 k\u1ebft h\u1ee3p c\u1ee7a nhi\u1ec1u y\u1ebfu t\u1ed1 nh\u1ecf, kh\u00f4ng \u0111i\u1ec3n h\u00ecnh, ho\u1eb7c kh\u00f4ng th\u1ec3 ph\u00e1t hi\u1ec7n b\u1eb1ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p hi\u1ec7n c\u00f3. Trong tr\u01b0\u1eddng h\u1ee3p c\u1ee7a m\u00ecnh, vi\u1ec7c \u0111\u00e3 l\u00e0m “t\u1ea5t c\u1ea3 c\u00e1c x\u00e9t nghi\u1ec7m li\u00ean quan \u0111\u1ebfn tim m\u1ea1ch, th\u1ea7n kinh\u201d nh\u01b0ng v\u1eabn kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n cho th\u1ea5y s\u1ef1 ph\u1ee9c t\u1ea1p c\u1ee7a ca b\u1ec7nh.<\/p>\n\n\n\n

T\u1ea7m quan tr\u1ecdng c\u1ee7a video ghi l\u1ea1i c\u01a1n ng\u1ea5t l\u00e0 m\u1ed9t \u0111i\u1ec3m nh\u1ea5n \u0111\u1eb7c bi\u1ec7t trong c\u00e2u chuy\u1ec7n n\u00e0y. “R\u1ea5t may l\u00e0 m\u00ecnh tr\u00edch xu\u1ea5t \u0111\u01b0\u1ee3c clip ng\u1ea5t c\u1ee7a m\u00ecnh n\u00ean khi B\u00e1c s\u0129 khai th\u00e1c ti\u1ec1n s\u1eed b\u1ec7nh th\u00ec ra n\u00f3 \u0111\u00e3 c\u00f3 tri\u1ec7u ch\u1ee9ng m\u1ed9t v\u00e0i l\u1ea7n nh\u01b0ng c\u1ee9 ngh\u0129 do u\u1ed1ng r\u01b0\u1ee3u bia \u1ea3nh h\u01b0\u1edfng n\u00ean c\u1ee9 b\u1ecf qua”. \u0110o\u1ea1n video n\u00e0y cung c\u1ea5p b\u1eb1ng ch\u1ee9ng kh\u00e1ch quan hi\u1ebfm c\u00f3, gi\u00fap b\u00e1c s\u0129 t\u00e1i hi\u1ec7n l\u1ea1i s\u1ef1 ki\u1ec7n m\u1ed9t c\u00e1ch ch\u00ednh x\u00e1c, x\u00e1c \u0111\u1ecbnh c\u00e1c tri\u1ec7u ch\u1ee9ng b\u00e1o tr\u01b0\u1edbc (prodrome) m\u00e0 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 \u0111\u00e3 b\u1ecf qua ho\u1eb7c nh\u1ea7m l\u1eabn v\u1edbi t\u00e1c \u0111\u1ed9ng c\u1ee7a r\u01b0\u1ee3u bia. \u0110\u00e2y l\u00e0 y\u1ebfu t\u1ed1 then ch\u1ed1t gi\u00fap \u0111\u1ecbnh h\u01b0\u1edbng ch\u1ea9n \u0111o\u00e1n, ngay c\u1ea3 khi c\u00e1c x\u00e9t nghi\u1ec7m c\u1eadn l\u00e2m s\u00e0ng kh\u00f4ng \u0111\u01b0a ra k\u1ebft qu\u1ea3 r\u00f5 r\u00e0ng. N\u00f3 minh h\u1ecda t\u1ea7m quan tr\u1ecdng c\u1ee7a vi\u1ec7c b\u1ec7nh nh\u00e2n t\u1ef1 ghi nh\u1eadn chi ti\u1ebft c\u00e1c tri\u1ec7u ch\u1ee9ng, ho\u00e0n c\u1ea3nh x\u1ea3y ra, v\u00e0 th\u1eadm ch\u00ed l\u00e0 quay video (n\u1ebfu c\u00f3 th\u1ec3) trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p m\u1ea5t \u00fd th\u1ee9c kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n. Th\u00f4ng tin ch\u1ee7 quan v\u00e0 kh\u00e1ch quan t\u1eeb ng\u01b0\u1eddi b\u1ec7nh ho\u1eb7c ng\u01b0\u1eddi ch\u1ee9ng ki\u1ebfn c\u00f3 th\u1ec3 l\u00e0 ch\u00eca kh\u00f3a \u0111\u1ec3 b\u00e1c s\u0129 x\u00e2u chu\u1ed7i c\u00e1c manh m\u1ed1i, \u0111\u1eb7c bi\u1ec7t khi c\u00e1c x\u00e9t nghi\u1ec7m c\u1eadn l\u00e2m s\u00e0ng kh\u00f4ng \u0111\u01b0a ra k\u1ebft qu\u1ea3 r\u00f5 r\u00e0ng.<\/p>\n\n\n\n

Ch\u1ea9n \u0111o\u00e1n ng\u1ea5t l\u00e0 m\u1ed9t qu\u00e1 tr\u00ecnh lo\u1ea1i tr\u1eeb v\u00e0 t\u00edch h\u1ee3p th\u00f4ng tin, kh\u00f4ng ph\u1ea3i l\u00e0 m\u1ed9t x\u00e9t nghi\u1ec7m \u0111\u01a1n l\u1ebb. Vi\u1ec7c c\u1ee7a m\u00ecnh \u0111\u00e3 th\u1ef1c hi\u1ec7n nhi\u1ec1u x\u00e9t nghi\u1ec7m nh\u01b0ng v\u1eabn kh\u00f4ng t\u00ecm ra nguy\u00ean nh\u00e2n r\u00f5 r\u00e0ng cho th\u1ea5y s\u1ef1 ph\u1ee9c t\u1ea1p c\u1ee7a vi\u1ec7c ch\u1ea9n \u0111o\u00e1n ng\u1ea5t. Kh\u00f4ng c\u00f3 m\u1ed9t “x\u00e9t nghi\u1ec7m v\u00e0ng” n\u00e0o c\u00f3 th\u1ec3 ch\u1ea9n \u0111o\u00e1n t\u1ea5t c\u1ea3 c\u00e1c nguy\u00ean nh\u00e2n. Thay v\u00e0o \u0111\u00f3, b\u00e1c s\u0129 ph\u1ea3i t\u1ed5ng h\u1ee3p th\u00f4ng tin t\u1eeb ti\u1ec1n s\u1eed, kh\u00e1m l\u00e2m s\u00e0ng, v\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a nhi\u1ec1u x\u00e9t nghi\u1ec7m kh\u00e1c nhau \u0111\u1ec3 \u0111\u01b0a ra ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c nh\u1ea5t. Khi nguy\u00ean nh\u00e2n v\u1eabn kh\u00f4ng r\u00f5 r\u00e0ng, vi\u1ec7c theo d\u00f5i l\u00e2u d\u00e0i v\u00e0 qu\u1ea3n l\u00fd c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 tr\u1edf n\u00ean c\u1ef1c k\u1ef3 quan tr\u1ecdng.<\/p>\n\n\n\n

M\u1ed9t \u0111i\u1ec1u c\u1ea7n l\u01b0u \u00fd l\u00e0 s\u1ef1 h\u1eefu \u00edch h\u1ea1n ch\u1ebf c\u1ee7a c\u00e1c x\u00e9t nghi\u1ec7m h\u00ecnh \u1ea3nh n\u00e3o trong ch\u1ea9n \u0111o\u00e1n ng\u1ea5t th\u00f4ng th\u01b0\u1eddng. C\u00e1c h\u01b0\u1edbng d\u1eabn y t\u1ebf v\u00e0 nghi\u00ean c\u1ee9u ch\u1ec9 ra r\u1eb1ng ch\u1ee5p CT\/MRI n\u00e3o th\u01b0\u1eddng kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb cho ng\u1ea5t \u0111\u01a1n thu\u1ea7n n\u1ebfu kh\u00f4ng c\u00f3 d\u1ea5u hi\u1ec7u th\u1ea7n kinh khu tr\u00fa ho\u1eb7c nghi ng\u1edd co gi\u1eadt. M\u1eb7c d\u00f9 ban \u0111\u1ea7u \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n “thi\u1ebfu m\u00e1u n\u00e3o c\u1ee5c b\u1ed9” c\u00f3 th\u1ec3 \u0111\u00e3 th\u00fac \u0111\u1ea9y vi\u1ec7c ch\u1ee5p chi\u1ebfu, nh\u01b0ng cu\u1ed1i c\u00f9ng nguy\u00ean nh\u00e2n v\u1eabn kh\u00f4ng r\u00f5 r\u00e0ng. \u0110i\u1ec1u n\u00e0y gi\u00fap ng\u01b0\u1eddi b\u1ec7nh hi\u1ec3u r\u1eb1ng kh\u00f4ng ph\u1ea3i m\u1ecdi t\u00ecnh tr\u1ea1ng m\u1ea5t \u00fd th\u1ee9c \u0111\u1ec1u c\u1ea7n ch\u1ee5p n\u00e3o, v\u00e0 vi\u1ec7c l\u1ea1m d\u1ee5ng c\u00e1c x\u00e9t nghi\u1ec7m n\u00e0y c\u00f3 th\u1ec3 kh\u00f4ng mang l\u1ea1i l\u1ee3i \u00edch ch\u1ea9n \u0111o\u00e1n m\u00e0 c\u00f2n g\u00e2y t\u1ed1n k\u00e9m v\u00e0 ph\u01a1i nhi\u1ec5m kh\u00f4ng c\u1ea7n thi\u1ebft. N\u00f3 c\u1ee7ng c\u1ed1 vai tr\u00f2 trung t\u00e2m c\u1ee7a vi\u1ec7c khai th\u00e1c ti\u1ec1n s\u1eed v\u00e0 kh\u00e1m l\u00e2m s\u00e0ng k\u1ef9 l\u01b0\u1ee1ng trong vi\u1ec7c \u0111\u1ecbnh h\u01b0\u1edbng c\u00e1c x\u00e9t nghi\u1ec7m c\u1ea7n thi\u1ebft.<\/p>\n\n\n\n

B\u1ea3ng 2: C\u00e1c X\u00e9t Nghi\u1ec7m Ch\u1ea9n \u0110o\u00e1n Ng\u1ea5t v\u00e0 M\u1ee5c \u0110\u00edch<\/strong><\/p>\n\n\n\n

\u0110\u1ec3 gi\u00fap m\u1ecdi ng\u01b0\u1eddi hi\u1ec3u r\u00f5 h\u01a1n v\u1ec1 qu\u00e1 tr\u00ecnh ch\u1ea9n \u0111o\u00e1n ng\u1ea5t, b\u1ea3ng d\u01b0\u1edbi \u0111\u00e2y t\u00f3m t\u1eaft c\u00e1c x\u00e9t nghi\u1ec7m y t\u1ebf ph\u1ed5 bi\u1ebfn v\u00e0 m\u1ee5c \u0111\u00edch ch\u00ednh c\u1ee7a ch\u00fang:<\/p>\n\n\n\n

X\u00e9t nghi\u1ec7m<\/strong><\/td>M\u1ee5c \u0111\u00edch ch\u00ednh<\/strong><\/td><\/tr>
Khai th\u00e1c ti\u1ec1n s\u1eed & Kh\u00e1m l\u00e2m s\u00e0ng<\/td>\u0110\u00e1nh gi\u00e1 t\u1ed5ng th\u1ec3, t\u00ecm manh m\u1ed1i v\u1ec1 ho\u00e0n c\u1ea3nh, tri\u1ec7u ch\u1ee9ng b\u00e1o tr\u01b0\u1edbc, ti\u1ec1n s\u1eed b\u1ec7nh l\u00fd v\u00e0 gia \u0111\u00ecnh.<\/td><\/tr>
\u0110i\u1ec7n t\u00e2m \u0111\u1ed3 (ECG)<\/td>Ph\u00e1t hi\u1ec7n r\u1ed1i lo\u1ea1n nh\u1ecbp tim, b\u1ec7nh tim c\u1ea5u tr\u00fac li\u00ean quan \u0111i\u1ec7n h\u1ecdc.<\/td><\/tr>
Si\u00eau \u00e2m tim<\/td>\u0110\u00e1nh gi\u00e1 c\u1ea5u tr\u00fac, ch\u1ee9c n\u0103ng tim, van tim, c\u01a1 tim.<\/td><\/tr>
Nghi\u1ec7m ph\u00e1p b\u00e0n nghi\u00eang<\/td>Ch\u1ea9n \u0111o\u00e1n ng\u1ea5t ph\u1ea3n x\u1ea1 ph\u1ebf v\u1ecb, h\u1ea1 huy\u1ebft \u00e1p t\u01b0 th\u1ebf.<\/td><\/tr>
M\u00e1y theo d\u00f5i tim l\u01b0u \u0111\u1ed9ng (Holter\/Event\/ILR)<\/td>Ghi nh\u1eadn r\u1ed1i lo\u1ea1n nh\u1ecbp tim kh\u00f4ng th\u01b0\u1eddng xuy\u00ean trong th\u1eddi gian d\u00e0i.<\/td><\/tr>
X\u00e9t nghi\u1ec7m m\u00e1u<\/td>Ph\u00e1t hi\u1ec7n thi\u1ebfu m\u00e1u, h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft, r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i, ch\u1ee9c n\u0103ng gan th\u1eadn.<\/td><\/tr>
X\u1ea1 h\u00ecnh t\u01b0\u1edbi m\u00e1u c\u01a1 tim (MPI)<\/td>\u0110\u00e1nh gi\u00e1 l\u01b0u l\u01b0\u1ee3ng m\u00e1u nu\u00f4i c\u01a1 tim, ph\u00e1t hi\u1ec7n thi\u1ebfu m\u00e1u c\u01a1 tim c\u1ee5c b\u1ed9, b\u1ec7nh m\u1ea1ch v\u00e0nh.<\/td><\/tr>
\u0110i\u1ec7n n\u00e3o \u0111\u1ed3 (EEG)<\/td>Ph\u00e2n bi\u1ec7t ng\u1ea5t v\u1edbi co gi\u1eadt, \u0111\u00e1nh gi\u00e1 ho\u1ea1t \u0111\u1ed9ng \u0111i\u1ec7n n\u00e3o.<\/td><\/tr>
Ch\u1ee5p CT\/MRI n\u00e3o<\/td>Lo\u1ea1i tr\u1eeb c\u00e1c nguy\u00ean nh\u00e2n th\u1ea7n kinh c\u1ea5u tr\u00fac (ch\u1ec9 khi c\u00f3 ch\u1ec9 \u0111\u1ecbnh r\u00f5 r\u00e0ng).<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

V. C\u00e1c Y\u1ebfu T\u1ed1 Nguy C\u01a1 v\u00e0 T\u00e1c \u0110\u1ed9ng T\u1eeb L\u1ed1i S\u1ed1ng<\/strong><\/p>\n\n\n\n

S\u1ee9c kh\u1ecfe tim m\u1ea1ch v\u00e0 th\u1ea7n kinh ch\u1ecbu \u1ea3nh h\u01b0\u1edfng s\u00e2u s\u1eafc t\u1eeb nhi\u1ec1u y\u1ebfu t\u1ed1, t\u1eeb di truy\u1ec1n \u0111\u1ebfn l\u1ed1i s\u1ed1ng h\u00e0ng ng\u00e0y. Vi\u1ec7c hi\u1ec3u r\u00f5 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 n\u00e0y l\u00e0 b\u01b0\u1edbc \u0111\u1ea7u ti\u00ean \u0111\u1ec3 ch\u1ee7 \u0111\u1ed9ng ph\u00f2ng ng\u1eeba v\u00e0 b\u1ea3o v\u1ec7 b\u1ea3n th\u00e2n.<\/p>\n\n\n\n

C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 chung c\u1ee7a ng\u1ea5t, ng\u1eebng tim, ng\u1eebng th\u1edf<\/strong><\/p>\n\n\n\n

\u25cf      B\u1ec7nh tim m\u1ea1ch: L\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1 h\u00e0ng \u0111\u1ea7u d\u1eabn \u0111\u1ebfn ng\u1ea5t, ng\u1eebng tim, v\u00e0 ng\u1eebng th\u1edf. C\u00e1c t\u00ecnh tr\u1ea1ng nh\u01b0 b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh, b\u1ec7nh c\u01a1 tim, suy tim, v\u00e0 c\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp tim (nh\u1ecbp nhanh ho\u1eb7c nh\u1ecbp ch\u1eadm) \u0111\u1ec1u c\u00f3 th\u1ec3 t\u1ea1o \u0111i\u1ec1u ki\u1ec7n cho c\u00e1c bi\u1ebfn c\u1ed1 nguy hi\u1ec3m. Nh\u1ed3i m\u00e1u c\u01a1 tim c\u0169ng l\u00e0 m\u1ed9t nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn d\u1eabn \u0111\u1ebfn ng\u1eebng tim \u0111\u1ed9t ng\u1ed9t.<\/p>\n\n\n\n

\u25cf      Y\u1ebfu t\u1ed1 di truy\u1ec1n: M\u1ed9t s\u1ed1 t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd di truy\u1ec1n c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 ng\u1eebng tim \u0111\u1ed9t ng\u1ed9t, bao g\u1ed3m c\u00e1c d\u1ecb t\u1eadt tim b\u1ea9m sinh v\u00e0 r\u1ed1i lo\u1ea1n nh\u1ecbp tim di truy\u1ec1n. Ti\u1ec1n s\u1eed gia \u0111\u00ecnh c\u00f3 ng\u01b0\u1eddi b\u1ecb ng\u1eebng tim ho\u1eb7c \u0111\u1ed9t t\u1eed kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n c\u0169ng l\u00e0 m\u1ed9t d\u1ea5u hi\u1ec7u c\u1ea3nh b\u00e1o quan tr\u1ecdng.<\/p>\n\n\n\n

\u25cf      Tu\u1ed5i t\u00e1c v\u00e0 gi\u1edbi t\u00ednh: Nguy c\u01a1 ng\u1eebng tim \u0111\u1ed9t ng\u1ed9t t\u0103ng l\u00ean theo tu\u1ed5i t\u00e1c. Ng\u1ea5t do tim m\u1ea1ch ph\u1ed5 bi\u1ebfn h\u01a1n \u1edf nam gi\u1edbi v\u00e0 nh\u1eefng ng\u01b0\u1eddi tr\u00ean 60 tu\u1ed5i. \u0110\u1eb7c bi\u1ec7t, n\u1ebfu m\u1ed9t ng\u01b0\u1eddi b\u1ecb ng\u1ea5t l\u1ea7n \u0111\u1ea7u ti\u00ean sau 40 tu\u1ed5i, kh\u1ea3 n\u0103ng li\u00ean quan \u0111\u1ebfn b\u1ec7nh l\u00fd tim m\u1ea1ch s\u1ebd cao h\u01a1n.<\/p>\n\n\n\n

\u25cf      C\u00e1c b\u1ec7nh m\u1ea1n t\u00ednh: T\u0103ng huy\u1ebft \u00e1p, cholesterol cao, b\u00e9o ph\u00ec, ti\u1ec3u \u0111\u01b0\u1eddng, b\u1ec7nh th\u1eadn m\u1ea1n t\u00ednh, v\u00e0 ng\u01b0ng th\u1edf khi ng\u1ee7 \u0111\u1ec1u l\u00e0 nh\u1eefng y\u1ebfu t\u1ed1 nguy c\u01a1 \u0111\u00e1ng k\u1ec3, g\u00f3p ph\u1ea7n l\u00e0m t\u0103ng kh\u1ea3 n\u0103ng m\u1eafc c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch v\u00e0 th\u1ea7n kinh.<\/p>\n\n\n\n

T\u00e1c \u0111\u1ed9ng c\u1ee7a r\u01b0\u1ee3u bia \u0111\u1ebfn s\u1ee9c kh\u1ecfe tim m\u1ea1ch v\u00e0 th\u1ea7n kinh<\/strong><\/p>\n\n\n\n

C\u00e2u chuy\u1ec7n c\u1ee7a m\u00ecnh \u0111\u00e3 c\u00f3 ti\u1ec1n s\u1eed “th\u01b0\u1eddng xuy\u00ean \u0111i ti\u1ebfp kh\u00e1ch u\u1ed1ng nhi\u1ec1u r\u01b0\u1ee3u bia” v\u00e0 ban \u0111\u1ea7u \u0111\u00e3 b\u1ecf qua c\u00e1c tri\u1ec7u ch\u1ee9ng b\u1ea5t th\u01b0\u1eddng v\u00ec “c\u1ee9 ngh\u0129 do u\u1ed1ng r\u01b0\u1ee3u bia \u1ea3nh h\u01b0\u1edfng”. Th\u1ef1c t\u1ebf, r\u01b0\u1ee3u bia c\u00f3 t\u00e1c \u0111\u1ed9ng s\u00e2u r\u1ed9ng v\u00e0 ti\u00eau c\u1ef1c \u0111\u1ebfn c\u1ea3 h\u1ec7 tim m\u1ea1ch v\u00e0 th\u1ea7n kinh.<\/p>\n\n\n\n

\u25cf      Tim m\u1ea1ch: U\u1ed1ng nhi\u1ec1u r\u01b0\u1ee3u bia th\u01b0\u1eddng xuy\u00ean l\u00e0m t\u0103ng nh\u1ecbp tim, t\u0103ng huy\u1ebft \u00e1p, suy y\u1ebfu c\u01a1 tim, v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp tim nh\u01b0 nh\u1ecbp nhanh k\u1ecbch ph\u00e1t. T\u00ecnh tr\u1ea1ng nh\u1ecbp tim nhanh k\u00e9o d\u00e0i c\u00f3 th\u1ec3 l\u00e0m suy y\u1ebfu c\u01a1 tim v\u00e0 t\u0103ng nguy c\u01a1 h\u00ecnh th\u00e0nh c\u1ee5c m\u00e1u \u0111\u00f4ng, d\u1eabn \u0111\u1ebfn nh\u1ed3i m\u00e1u c\u01a1 tim ho\u1eb7c \u0111\u1ed9t qu\u1ef5. R\u01b0\u1ee3u c\u0169ng c\u00f3 th\u1ec3 g\u00e2y t\u0103ng huy\u1ebft \u00e1p t\u1ea1m th\u1eddi ho\u1eb7c m\u1ea1n t\u00ednh, l\u00e0m c\u1ee9ng v\u00e0 d\u00e0y th\u00e0nh \u0111\u1ed9ng m\u1ea1ch, t\u0103ng nguy c\u01a1 \u0111au th\u1eaft ng\u1ef1c v\u00e0 nh\u1ed3i m\u00e1u n\u00e3o.<\/p>\n\n\n\n

\u25cf      Th\u1ea7n kinh: L\u01b0\u1ee3ng c\u1ed3n l\u1edbn \u0111i v\u00e0o c\u01a1 th\u1ec3 c\u00f3 th\u1ec3 g\u00e2y r\u1ed1i lo\u1ea1n n\u00e3o b\u1ed9, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn kh\u1ea3 n\u0103ng ki\u1ec3m so\u00e1t v\u1eadn \u0111\u1ed9ng, l\u00e0m ch\u1eadm ph\u1ea3n \u1ee9ng, v\u00e0 g\u00e2y m\u1ea5t ki\u1ec3m so\u00e1t h\u00e0nh vi. R\u01b0\u1ee3u c\u0169ng c\u00f3 th\u1ec3 tr\u1ef1c ti\u1ebfp g\u00e2y ng\u1ea5t do h\u1ea1 huy\u1ebft \u00e1p t\u01b0 th\u1ebf ho\u1eb7c \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u1ec7 th\u1ea7n kinh. U\u1ed1ng r\u01b0\u1ee3u khi \u0111\u00f3i ho\u1eb7c u\u1ed1ng qu\u00e1 nhanh l\u00e0m t\u0103ng nguy c\u01a1 m\u1ea5t tr\u00ed nh\u1edb t\u1ea1m th\u1eddi (blackout).<\/p>\n\n\n\n

Vi\u1ec7c m\u00ecnh nh\u1eadn ra t\u00e1c h\u1ea1i c\u1ee7a r\u01b0\u1ee3u bia v\u00e0 ho\u00e0n to\u00e0n t\u1eeb b\u1ecf th\u00f3i quen n\u00e0y l\u00e0 m\u1ed9t b\u01b0\u1edbc thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng quan tr\u1ecdng v\u00e0 t\u00edch c\u1ef1c, g\u00f3p ph\u1ea7n \u0111\u00e1ng k\u1ec3 v\u00e0o s\u1ef1 c\u1ea3i thi\u1ec7n s\u1ee9c kh\u1ecfe c\u1ee7a m\u00ecnh.<\/p>\n\n\n\n

\u1ea2nh h\u01b0\u1edfng c\u1ee7a c\u0103ng th\u1eb3ng v\u00e0 l\u00e0m vi\u1ec7c qu\u00e1 s\u1ee9c \u0111\u1ebfn s\u1ee9c kh\u1ecfe<\/strong><\/p>\n\n\n\n

M\u00ecnh t\u1ef1 nh\u1eadn m\u00ecnh l\u00e0 “ng\u01b0\u1eddi c\u1ee7a c\u00f4ng vi\u1ec7c, ng\u01b0\u1eddi tham c\u00f4ng ti\u1ebfc vi\u1ec7c”, \u0111i\u1ec1u n\u00e0y li\u00ean quan tr\u1ef1c ti\u1ebfp \u0111\u1ebfn c\u00e1c y\u1ebfu t\u1ed1 \u0111\u01b0\u1ee3c B\u00e1c s\u0129 Tr\u1ea7n V\u0103n Ph\u00fac nh\u1ea5n m\u1ea1nh trong b\u00e0i b\u00e1o “Nh\u1eefng y\u1ebfu t\u1ed1 d\u1eabn \u0111\u1ebfn t\u1eed vong do \u0111\u1ed9t t\u1eed, \u0111\u1ed9t qu\u1ef5”. B\u00e1c s\u0129 Ph\u00fac c\u1ea3nh b\u00e1o r\u1eb1ng nhi\u1ec1u c\u00e1i ch\u1ebft \u0111\u1ed9t ng\u1ed9t th\u1ef1c ch\u1ea5t l\u00e0 “nh\u1eefng c\u00e1i ch\u1ebft \u0111\u1ed9t ng\u1ed9t \u0111\u01b0\u1ee3c l\u00ean k\u1ebf ho\u1ea1ch” do g\u00e1nh n\u1eb7ng v\u00e0 c\u0103ng th\u1eb3ng t\u00edch t\u1ee5 qu\u00e1 l\u1edbn tr\u00ean c\u01a1 th\u1ec3.<\/p>\n\n\n\n

\u25cf      K\u00edch \u0111\u1ed9ng c\u1ea3m x\u00fac: Khi con ng\u01b0\u1eddi b\u1ecb c\u0103ng th\u1eb3ng ho\u1eb7c k\u00edch \u0111\u1ed9ng c\u1ea3m x\u00fac, c\u01a1 th\u1ec3 s\u1ebd ph\u1ea3n \u1ee9ng b\u1eb1ng c\u00e1ch gi\u1ea3i ph\u00f3ng c\u00e1c hormone nh\u01b0 adrenaline v\u00e0 cortisol. \u0110i\u1ec1u n\u00e0y l\u00e0m t\u0103ng nh\u1ecbp tim, huy\u1ebft \u00e1p, v\u00e0 nhu c\u1ea7u oxy c\u1ee7a c\u01a1 tim, d\u1ec5 g\u00e2y r\u1ed1i lo\u1ea1n nh\u1ecbp tim nghi\u00eam tr\u1ecdng, nh\u1ed3i m\u00e1u c\u01a1 tim, v\u00e0 \u0111\u1ed9t qu\u1ef5. Nghi\u00ean c\u1ee9u tr\u00ean T\u1ea1p ch\u00ed Tim m\u1ea1ch Ch\u00e2u \u00c2u ch\u1ec9 ra r\u1eb1ng nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 n\u00e3o t\u0103ng g\u1ea5p 3 l\u1ea7n trong v\u00f2ng 2 gi\u1edd sau khi n\u1ed5i gi\u1eadn.<\/p>\n\n\n\n

\u25cf      M\u1ec7t m\u1ecfi v\u00e0 thi\u1ebfu ng\u1ee7: M\u1ec7t m\u1ecfi m\u00e3n t\u00ednh v\u00e0 thi\u1ebfu ng\u1ee7 l\u00e0 nh\u1eefng y\u1ebfu t\u1ed1 nguy c\u01a1 \u0111\u00e1ng k\u1ec3. B\u00e1c s\u0129 Ph\u00fac ch\u1ec9 ra r\u1eb1ng nh\u1eefng ng\u01b0\u1eddi ng\u1ee7 d\u01b0\u1edbi 5 gi\u1edd m\u1ed7i \u0111\u00eam c\u00f3 nguy c\u01a1 nh\u1ed3i m\u00e1u c\u01a1 tim cao g\u1ea5p 2,3 l\u1ea7n so v\u1edbi nh\u1eefng ng\u01b0\u1eddi ng\u1ee7 \u0111\u1ee7 6-8 gi\u1edd. Thi\u1ebfu ng\u1ee7 c\u00f3 m\u1ed1i t\u01b0\u01a1ng quan \u0111\u00e1ng k\u1ec3 v\u1edbi c\u00e1c v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe nh\u01b0 vi\u00eam nhi\u1ec5m, huy\u1ebft \u00e1p cao, ti\u1ec3u \u0111\u01b0\u1eddng, v\u00e0 tr\u1ea7m c\u1ea3m. N\u00e3o b\u1ed9 l\u00e0 c\u01a1 quan \u0111i\u1ec1u h\u00f2a gi\u1ea5c ng\u1ee7, v\u00e0 c\u0103ng th\u1eb3ng k\u00e9o d\u00e0i c\u00f3 th\u1ec3 g\u00e2y suy nh\u01b0\u1ee3c th\u1ea7n kinh v\u00e0 m\u1ea5t ng\u1ee7.<\/p>\n\n\n\n

\u25cf      L\u00e0m vi\u1ec7c qu\u00e1 s\u1ee9c: B\u00e1c s\u0129 Ph\u00fac nh\u1ea5n m\u1ea1nh r\u1eb1ng l\u00e0m vi\u1ec7c qu\u00e1 s\u1ee9c l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y ra “nh\u1eefng c\u00e1i ch\u1ebft \u0111\u1ed9t ng\u1ed9t \u0111\u01b0\u1ee3c l\u00ean k\u1ebf ho\u1ea1ch” do g\u00e1nh n\u1eb7ng v\u00e0 c\u0103ng th\u1eb3ng t\u00edch t\u1ee5. Th\u1ed1ng k\u00ea c\u1ee7a WHO v\u00e0 T\u1ed5 ch\u1ee9c Lao \u0111\u1ed9ng Qu\u1ed1c t\u1ebf (ILO) cho th\u1ea5y trung b\u00ecnh m\u1ed7i n\u0103m c\u00f3 h\u01a1n 745.000 ng\u01b0\u1eddi ch\u1ebft \u0111\u1ed9t ng\u1ed9t v\u00ec l\u00e0m vi\u1ec7c h\u01a1n 55 gi\u1edd m\u1ed9t tu\u1ea7n. T\u00ecnh tr\u1ea1ng n\u00e0y t\u1eadp trung nhi\u1ec1u \u1edf c\u00e1c n\u01b0\u1edbc \u0110\u00f4ng Nam \u00c1 v\u00e0 T\u00e2y Th\u00e1i B\u00ecnh D\u01b0\u01a1ng.<\/p>\n\n\n\n

C\u00e2u chuy\u1ec7n c\u1ee7a m\u00ecnh l\u00e0 m\u1ed9t minh ch\u1ee9ng s\u1ed1ng \u0111\u1ed9ng cho nh\u1eefng c\u1ea3nh b\u00e1o n\u00e0y. Vi\u1ec7c m\u00ecnh quy\u1ebft \u0111\u1ecbnh “bu\u1ed9c ph\u1ea3i ngh\u1ec9 vi\u1ec7c” \u0111\u1ec3 “to\u00e0n t\u00e2m to\u00e0n \u00fd ch\u1eefa b\u1ec7nh” cho th\u1ea5y m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng c\u1ee7a t\u00e1c \u0111\u1ed9ng t\u1eeb l\u1ed1i s\u1ed1ng v\u00e0 s\u1ef1 \u01b0u ti\u00ean s\u1ee9c kh\u1ecfe tuy\u1ec7t \u0111\u1ed1i. \u0110i\u1ec1u n\u00e0y c\u0169ng ph\u1ea3n \u00e1nh m\u1ed9t v\u1ea5n \u0111\u1ec1 x\u00e3 h\u1ed9i l\u1edbn v\u1ec1 \u00e1p l\u1ef1c c\u00f4ng vi\u1ec7c v\u00e0 v\u0103n h\u00f3a “tham c\u00f4ng ti\u1ebfc vi\u1ec7c” c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn h\u1eadu qu\u1ea3 s\u1ee9c kh\u1ecfe nghi\u00eam tr\u1ecdng.<\/p>\n\n\n\n

C\u00e1c y\u1ebfu t\u1ed1 l\u1ed1i s\u1ed1ng nh\u01b0 u\u1ed1ng r\u01b0\u1ee3u bia, c\u0103ng th\u1eb3ng, v\u00e0 l\u00e0m vi\u1ec7c qu\u00e1 s\u1ee9c kh\u00f4ng ho\u1ea1t \u0111\u1ed9ng \u0111\u1ed9c l\u1eadp m\u00e0 t\u01b0\u01a1ng t\u00e1c v\u00e0 c\u1ed9ng h\u01b0\u1edfng, t\u1ea1o th\u00e0nh m\u1ed9t v\u00f2ng xo\u00e1y nguy c\u01a1 cho s\u1ee9c kh\u1ecfe tim m\u1ea1ch v\u00e0 th\u1ea7n kinh. V\u00ed d\u1ee5, c\u0103ng th\u1eb3ng c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn vi\u1ec7c u\u1ed1ng r\u01b0\u1ee3u nhi\u1ec1u h\u01a1n, v\u00e0 c\u1ea3 hai \u0111\u1ec1u l\u00e0m t\u0103ng huy\u1ebft \u00e1p v\u00e0 nguy c\u01a1 \u0111\u1ed9t qu\u1ef5. Vi\u1ec7c nh\u1eadn di\u1ec7n v\u00e0 can thi\u1ec7p v\u00e0o nhi\u1ec1u y\u1ebfu t\u1ed1 nguy c\u01a1 c\u00f9ng l\u00fac, nh\u01b0 m\u00ecnh \u0111\u00e3 l\u00e0m l\u00e0 t\u1eeb b\u1ecf r\u01b0\u1ee3u bia v\u00e0 ngh\u1ec9 vi\u1ec7c, l\u00e0 chi\u1ebfn l\u01b0\u1ee3c hi\u1ec7u qu\u1ea3 nh\u1ea5t \u0111\u1ec3 b\u1ea3o v\u1ec7 s\u1ee9c kh\u1ecfe t\u1ed5ng th\u1ec3. Kh\u00e1i ni\u1ec7m “c\u00e1i ch\u1ebft \u0111\u1ed9t ng\u1ed9t \u0111\u01b0\u1ee3c l\u00ean k\u1ebf ho\u1ea1ch” c\u1ee7a B\u00e1c s\u0129 Tr\u1ea7n V\u0103n Ph\u00fac chuy\u1ec3n tr\u00e1ch nhi\u1ec7m t\u1eeb “s\u1ed1 ph\u1eadn” sang “l\u1ed1i s\u1ed1ng v\u00e0 qu\u1ea3n l\u00fd s\u1ee9c kh\u1ecfe c\u00e1 nh\u00e2n”. N\u00f3 c\u1ea3nh b\u00e1o v\u1ec1 m\u1ed9t “c\u0103n b\u1ec7nh th\u1eddi hi\u1ec7n \u0111\u1ea1i” m\u00e0 nhi\u1ec1u ng\u01b0\u1eddi \u0111ang \u0111\u1ed1i m\u1eb7t do \u00e1p l\u1ef1c c\u00f4ng vi\u1ec7c v\u00e0 x\u00e3 h\u1ed9i. \u0110i\u1ec1u n\u00e0y th\u00fac \u0111\u1ea9y m\u1ed9t cu\u1ed9c \u0111\u1ed1i tho\u1ea1i quan tr\u1ecdng v\u1ec1 c\u00e2n b\u1eb1ng gi\u1eefa c\u00f4ng vi\u1ec7c v\u00e0 cu\u1ed9c s\u1ed1ng, t\u1ea7m quan tr\u1ecdng c\u1ee7a vi\u1ec7c ngh\u1ec9 ng\u01a1i \u0111\u1ea7y \u0111\u1ee7, v\u00e0 s\u1ef1 c\u1ea7n thi\u1ebft c\u1ee7a c\u00e1c ch\u00ednh s\u00e1ch h\u1ed7 tr\u1ee3 s\u1ee9c kh\u1ecfe tinh th\u1ea7n v\u00e0 th\u1ec3 ch\u1ea5t t\u1ea1i n\u01a1i l\u00e0m vi\u1ec7c \u0111\u1ec3 ng\u0103n ng\u1eeba nh\u1eefng c\u00e1i ch\u1ebft kh\u00f4ng \u0111\u00e1ng c\u00f3.<\/p>\n\n\n\n

Vai tr\u00f2 c\u1ee7a ho\u1ea1t \u0111\u1ed9ng th\u1ec3 ch\u1ea5t \u0111\u1ed1i v\u1edbi s\u1ee9c kh\u1ecfe tim m\u1ea1ch v\u00e0 th\u1ea7n kinh<\/strong><\/p>\n\n\n\n

Ho\u1ea1t \u0111\u1ed9ng th\u1ec3 ch\u1ea5t \u0111\u1ec1u \u0111\u1eb7n l\u00e0 m\u1ed9t trong nh\u1eefng “m\u00f3n qu\u00e0 tuy\u1ec7t v\u1eddi nh\u1ea5t” m\u00e0 m\u1ed9t ng\u01b0\u1eddi c\u00f3 th\u1ec3 d\u00e0nh cho tr\u00e1i tim v\u00e0 s\u1ee9c kh\u1ecfe t\u1ed5ng th\u1ec3.<\/p>\n\n\n\n

\u25cf      Tim m\u1ea1ch: T\u1eadp th\u1ec3 d\u1ee5c c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng tim m\u1ea1ch v\u00e0 h\u00f4 h\u1ea5p, gi\u1ea3m nh\u1ecbp tim l\u00fac ngh\u1ec9 ng\u01a1i, v\u00e0 t\u0103ng kh\u1ea3 n\u0103ng ch\u1ecbu \u0111\u1ef1ng c\u1ee7a c\u01a1 th\u1ec3. N\u00f3 c\u0169ng gi\u00fap gi\u1ea3m c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 b\u1ec7nh tim m\u1ea1ch nh\u01b0 huy\u1ebft \u00e1p cao, cholesterol x\u1ea5u, b\u00e9o ph\u00ec, v\u00e0 ti\u1ec3u \u0111\u01b0\u1eddng.<\/p>\n\n\n\n

\u25cf      Th\u1ea7n kinh v\u00e0 tinh th\u1ea7n: Ho\u1ea1t \u0111\u1ed9ng th\u1ec3 ch\u1ea5t c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng nh\u1eadn th\u1ee9c, gi\u1ea3m lo l\u1eafng v\u00e0 tr\u1ea7m c\u1ea3m, t\u0103ng c\u01b0\u1eddng c\u1ea3m gi\u00e1c h\u1ea1nh ph\u00fac, v\u00e0 l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p hi\u1ec7u qu\u1ea3 \u0111\u1ec3 gi\u1ea3m stress.<\/p>\n\n\n\n

Vi\u1ec7c m\u00ecnh “t\u1eadp th\u1ec3 d\u1ee5c \u0111i\u1ec1u \u0111\u1ed9 s\u1ee9c kh\u1ecfe c\u1ea3i thi\u1ec7n \u0111\u00e1ng k\u1ec3” sau khi ngh\u1ec9 vi\u1ec7c v\u00e0 thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng \u0111\u00e3 ch\u1ee9ng minh hi\u1ec7u qu\u1ea3 r\u00f5 r\u1ec7t c\u1ee7a ho\u1ea1t \u0111\u1ed9ng th\u1ec3 ch\u1ea5t trong vi\u1ec7c ph\u1ee5c h\u1ed3i v\u00e0 duy tr\u00ec s\u1ee9c kh\u1ecfe. \u0110\u00e2y l\u00e0 m\u1ed9t th\u00f4ng \u0111i\u1ec7p t\u00edch c\u1ef1c v\u00e0 khuy\u1ebfn kh\u00edch cho m\u1ecdi ng\u01b0\u1eddi v\u1ec1 t\u1ea7m quan tr\u1ecdng c\u1ee7a vi\u1ec7c duy tr\u00ec m\u1ed9t l\u1ed1i s\u1ed1ng n\u0103ng \u0111\u1ed9ng.<\/p>\n\n\n\n

VI. Ph\u00f2ng Ng\u1eeba v\u00e0 \u0110i\u1ec1u Tr\u1ecb \u2013 Nh\u1eefng B\u01b0\u1edbc \u0110i Quan Tr\u1ecdng \u0110\u1ec3 B\u1ea3o V\u1ec7 S\u1ee9c Kh\u1ecfe<\/strong><\/p>\n\n\n\n

Vi\u1ec7c ch\u1ee7 \u0111\u1ed9ng ph\u00f2ng ng\u1eeba v\u00e0 bi\u1ebft c\u00e1ch x\u1eed tr\u00ed khi c\u00f3 bi\u1ebfn c\u1ed1 l\u00e0 ch\u00eca kh\u00f3a \u0111\u1ec3 b\u1ea3o v\u1ec7 s\u1ee9c kh\u1ecfe v\u00e0 t\u00ednh m\u1ea1ng. C\u00e1c chi\u1ebfn l\u01b0\u1ee3c ph\u00f2ng ng\u1eeba v\u00e0 \u0111i\u1ec1u tr\u1ecb kh\u00e1c nhau t\u00f9y thu\u1ed9c v\u00e0o t\u1eebng t\u00ecnh tr\u1ea1ng c\u1ee5 th\u1ec3.<\/p>\n\n\n\n

Chi\u1ebfn l\u01b0\u1ee3c ph\u00f2ng ng\u1eeba ng\u1ea5t t\u00e1i ph\u00e1t<\/strong><\/p>\n\n\n\n

\u0110\u1ec3 gi\u1ea3m nguy c\u01a1 ng\u1ea5t t\u00e1i ph\u00e1t, vi\u1ec7c \u0111i\u1ec1u ch\u1ec9nh l\u1ed1i s\u1ed1ng v\u00e0 qu\u1ea3n l\u00fd c\u00e1c y\u1ebfu t\u1ed1 k\u00edch th\u00edch l\u00e0 r\u1ea5t quan tr\u1ecdng:<\/p>\n\n\n\n

\u25cf      Thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng: Tr\u00e1nh c\u00e1c y\u1ebfu t\u1ed1 k\u00edch th\u00edch \u0111\u00e3 bi\u1ebft nh\u01b0 \u0111\u1ee9ng l\u00e2u, \u1edf trong m\u00f4i tr\u01b0\u1eddng n\u00f3ng b\u1ee9c, c\u0103ng th\u1eb3ng c\u1ea3m x\u00fac m\u1ea1nh, \u0111au \u0111\u1edbn, ho\u1eb7c nh\u00ecn th\u1ea5y m\u00e1u. \u0110\u1ea3m b\u1ea3o u\u1ed1ng \u0111\u1ee7 n\u01b0\u1edbc v\u00e0 \u0103n \u0111\u1ee7 b\u1eefa, kh\u00f4ng nh\u1ecbn \u0111\u00f3i. M\u00ecnh \u0111\u00e3 t\u1eeb b\u1ecf r\u01b0\u1ee3u bia v\u00e0 s\u1ed1ng l\u00e0nh m\u1ea1nh, \u0111i\u1ec1u n\u00e0y l\u00e0 m\u1ed9t v\u00ed d\u1ee5 \u0111i\u1ec3n h\u00ecnh c\u1ee7a vi\u1ec7c thay \u0111\u1ed5i t\u00edch c\u1ef1c.<\/p>\n\n\n\n

\u25cf      T\u0103ng c\u01b0\u1eddng s\u1ee9c kh\u1ecfe t\u1ed5ng th\u1ec3: T\u1eadp th\u1ec3 d\u1ee5c \u0111i\u1ec1u \u0111\u1ed9 gi\u00fap c\u1ea3i thi\u1ec7n tu\u1ea7n ho\u00e0n v\u00e0 gi\u1ea3m c\u0103ng th\u1eb3ng. Duy tr\u00ec c\u00e2n n\u1eb7ng ph\u00f9 h\u1ee3p c\u0169ng g\u00f3p ph\u1ea7n v\u00e0o s\u1ee9c kh\u1ecfe tim m\u1ea1ch t\u1ed5ng th\u1ec3.<\/p>\n\n\n\n

\u25cf      Qu\u1ea3n l\u00fd thu\u1ed1c: N\u1ebfu \u0111ang s\u1eed d\u1ee5ng c\u00e1c lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m huy\u1ebft \u00e1p (v\u00ed d\u1ee5: thu\u1ed1c l\u1ee3i ti\u1ec3u), c\u1ea7n tham kh\u1ea3o \u00fd ki\u1ebfn b\u00e1c s\u0129 \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u l\u01b0\u1ee3ng ho\u1eb7c thay \u0111\u1ed5i thu\u1ed1c.<\/p>\n\n\n\n

\u25cf      H\u00e0nh \u0111\u1ed9ng khi c\u00f3 d\u1ea5u hi\u1ec7u b\u00e1o tr\u01b0\u1edbc: N\u1ebfu c\u1ea3m th\u1ea5y ch\u00f3ng m\u1eb7t, hoa m\u1eaft, ho\u1eb7c c\u00e1c tri\u1ec7u ch\u1ee9ng b\u00e1o tr\u01b0\u1edbc kh\u00e1c, h\u00e3y nhanh ch\u00f3ng n\u1eb1m xu\u1ed1ng v\u00e0 k\u00ea cao ch\u00e2n (cao h\u01a1n tim kho\u1ea3ng 25-30cm) \u0111\u1ec3 t\u0103ng c\u01b0\u1eddng l\u01b0u l\u01b0\u1ee3ng m\u00e1u v\u1ec1 n\u00e3o. N\u1edbi l\u1ecfng qu\u1ea7n \u00e1o b\u00f3 s\u00e1t v\u00e0 h\u00edt th\u1edf s\u00e2u, gi\u1eef b\u00ecnh t\u0129nh c\u0169ng c\u00f3 th\u1ec3 gi\u00fap ng\u0103n ng\u1eeba ng\u1ea5t.<\/p>\n\n\n\n

Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ng\u1ea5t<\/strong><\/p>\n\n\n\n

Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ng\u1ea5t t\u1eadp trung v\u00e0o vi\u1ec7c x\u1eed l\u00fd nguy\u00ean nh\u00e2n c\u01a1 b\u1ea3n:<\/p>\n\n\n\n

\u25cf      \u0110i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n: \u0110\u00e2y l\u00e0 y\u1ebfu t\u1ed1 quan tr\u1ecdng nh\u1ea5t. N\u1ebfu ng\u1ea5t do r\u1ed1i lo\u1ea1n nh\u1ecbp tim, b\u00e1c s\u0129 s\u1ebd \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n nh\u1ecbp. N\u1ebfu do b\u1ec7nh van tim, c\u00f3 th\u1ec3 c\u1ea7n ph\u1eabu thu\u1eadt. N\u1ebfu do h\u1ea1 huy\u1ebft \u00e1p t\u01b0 th\u1ebf, vi\u1ec7c qu\u1ea3n l\u00fd huy\u1ebft \u00e1p v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 li\u00ean quan l\u00e0 c\u1ea7n thi\u1ebft.<\/p>\n\n\n\n

\u25cf      Thu\u1ed1c: T\u00f9y thu\u1ed9c v\u00e0o nguy\u00ean nh\u00e2n, b\u00e1c s\u0129 c\u00f3 th\u1ec3 k\u00ea m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c. V\u00ed d\u1ee5, Fludrocortisone acetate c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 t\u0103ng huy\u1ebft \u00e1p, ho\u1eb7c c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu serotonin ch\u1ecdn l\u1ecdc (SSRIs) \u0111\u1ec3 \u0111i\u1ec1u h\u00f2a ph\u1ea3n \u1ee9ng h\u1ec7 th\u1ea7n kinh. Beta-blockers c\u0169ng c\u00f3 th\u1ec3 h\u1eefu \u00edch cho b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i m\u1eafc ng\u1ea5t do tim m\u1ea1ch.<\/p>\n\n\n\n

\u25cf      Can thi\u1ec7p y t\u1ebf: Trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p ng\u1ea5t do tim m\u1ea1ch nghi\u00eam tr\u1ecdng v\u00e0 kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00e1c, vi\u1ec7c c\u1ea5y m\u00e1y t\u1ea1o nh\u1ecbp tim (pacemaker) c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u0111\u1ec3 \u0111i\u1ec1u h\u00f2a nh\u1ecbp tim.<\/p>\n\n\n\n

Ph\u00f2ng ng\u1eeba v\u00e0 \u0111i\u1ec1u tr\u1ecb ng\u1eebng tim<\/strong><\/p>\n\n\n\n

Ng\u1eebng tim l\u00e0 m\u1ed9t t\u00ecnh hu\u1ed1ng c\u1ea5p c\u1ee9u y t\u1ebf t\u1ed1i kh\u1ea9n c\u1ea5p, \u0111\u00f2i h\u1ecfi h\u00e0nh \u0111\u1ed9ng nhanh ch\u00f3ng v\u00e0 ph\u1ed1i h\u1ee3p gi\u1eefa ph\u00f2ng ng\u1eeba v\u00e0 \u0111i\u1ec1u tr\u1ecb.<\/p>\n\n\n\n

\u25cf      Ph\u00f2ng ng\u1eeba:<\/p>\n\n\n\n

\u25cb      Ki\u1ec3m so\u00e1t c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1: \u0110i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 c\u00e1c b\u1ec7nh tim m\u1ea1ch n\u1ec1n nh\u01b0 b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh, suy tim, ho\u1eb7c r\u1ed1i lo\u1ea1n nh\u1ecbp tim. Qu\u1ea3n l\u00fd ch\u1eb7t ch\u1ebd huy\u1ebft \u00e1p cao, cholesterol cao, ti\u1ec3u \u0111\u01b0\u1eddng, v\u00e0 b\u00e9o ph\u00ec.<\/p>\n\n\n\n

\u25cb      L\u1ed1i s\u1ed1ng l\u00e0nh m\u1ea1nh: Kh\u00f4ng h\u00fat thu\u1ed1c l\u00e1, duy tr\u00ec ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng khoa h\u1ecdc, \u0111\u1ea1t v\u00e0 duy tr\u00ec c\u00e2n n\u1eb7ng ph\u00f9 h\u1ee3p, ho\u1ea1t \u0111\u1ed9ng th\u1ec3 ch\u1ea5t th\u01b0\u1eddng xuy\u00ean, v\u00e0 h\u1ecdc c\u00e1ch qu\u1ea3n l\u00fd c\u0103ng th\u1eb3ng hi\u1ec7u qu\u1ea3.<\/p>\n\n\n\n

\u25cb      Th\u0103m kh\u00e1m \u0111\u1ecbnh k\u1ef3: \u0110\u1eb7c bi\u1ec7t quan tr\u1ecdng \u0111\u1ed1i v\u1edbi nh\u1eefng ng\u01b0\u1eddi c\u00f3 nguy c\u01a1 cao ho\u1eb7c ti\u1ec1n s\u1eed gia \u0111\u00ecnh m\u1eafc b\u1ec7nh tim m\u1ea1ch.<\/p>\n\n\n\n

\u25cb      C\u1ea5y m\u00e1y kh\u1eed rung tim (ICD): \u0110\u1ed1i v\u1edbi nh\u1eefng ng\u01b0\u1eddi c\u00f3 nguy c\u01a1 cao b\u1ecb \u0111\u1ed9t t\u1eed do r\u1ed1i lo\u1ea1n nh\u1ecbp th\u1ea5t nguy hi\u1ec3m, m\u00e1y kh\u1eed rung tim c\u1ea5y gh\u00e9p (ICD) c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 ng\u0103n ng\u1eeba c\u00e1c bi\u1ebfn c\u1ed1 trong t\u01b0\u01a1ng lai.<\/p>\n\n\n\n

\u25cf      \u0110i\u1ec1u tr\u1ecb c\u1ea5p c\u1ee9u (t\u1ea1i hi\u1ec7n tr\u01b0\u1eddng):<\/p>\n\n\n\n

\u25cb      G\u1ecdi ngay c\u1ea5p c\u1ee9u: G\u1ecdi 115 (t\u1ea1i Vi\u1ec7t Nam) ho\u1eb7c s\u1ed1 kh\u1ea9n c\u1ea5p \u0111\u1ecba ph\u01b0\u01a1ng ngay khi ph\u00e1t hi\u1ec7n ng\u01b0\u1eddi b\u1ec7nh c\u00f3 d\u1ea5u hi\u1ec7u ng\u1eebng tim.<\/p>\n\n\n\n

\u25cb      \u0110\u1ea3m b\u1ea3o an to\u00e0n hi\u1ec7n tr\u01b0\u1eddng v\u00e0 n\u1ea1n nh\u00e2n: \u0110\u1eb7t n\u1ea1n nh\u00e2n n\u1eb1m ng\u1eeda tr\u00ean n\u1ec1n c\u1ee9ng.<\/p>\n\n\n\n

\u25cb      Ki\u1ec3m tra ph\u1ea3n \u1ee9ng, h\u00f4 h\u1ea5p v\u00e0 m\u1ea1ch: Lay g\u1ecdi, h\u1ecfi l\u1edbn, ki\u1ec3m tra xem n\u1ea1n nh\u00e2n c\u00f3 th\u1edf hay kh\u00f4ng v\u00e0 c\u00f3 m\u1ea1ch \u0111\u1eadp hay kh\u00f4ng.<\/p>\n\n\n\n

\u25cb      Th\u1ef1c hi\u1ec7n H\u1ed3i s\u1ee9c tim ph\u1ed5i (CPR) ch\u1ea5t l\u01b0\u1ee3ng cao ngay l\u1eadp t\u1ee9c: \u00c9p m\u1ea1nh v\u00e0 nhanh v\u00e0o gi\u1eefa l\u1ed3ng ng\u1ef1c (\u00edt nh\u1ea5t 5cm, t\u1ed1c \u0111\u1ed9 100-120 l\u1ea7n\/ph\u00fat), cho ph\u00e9p l\u1ed3ng ng\u1ef1c tr\u1edf l\u1ea1i v\u1ecb tr\u00ed ban \u0111\u1ea7u sau m\u1ed7i l\u1ea7n \u00e9p.<\/p>\n\n\n\n

\u25cb      S\u1eed d\u1ee5ng M\u00e1y kh\u1eed rung tim ngo\u00e0i t\u1ef1 \u0111\u1ed9ng (AED) n\u1ebfu c\u00f3: B\u1eadt m\u00e1y v\u00e0 l\u00e0m theo h\u01b0\u1edbng d\u1eabn b\u1eb1ng gi\u1ecdng n\u00f3i c\u1ee7a thi\u1ebft b\u1ecb.<\/p>\n\n\n\n

\u25cb      Ti\u1ebfp t\u1ee5c CPR: Duy tr\u00ec CPR cho \u0111\u1ebfn khi n\u1ea1n nh\u00e2n b\u1eaft \u0111\u1ea7u th\u1edf l\u1ea1i ho\u1eb7c c\u1eed \u0111\u1ed9ng, ho\u1eb7c cho \u0111\u1ebfn khi c\u00f3 nh\u00e2n vi\u00ean y t\u1ebf chuy\u00ean nghi\u1ec7p \u0111\u1ebfn h\u1ed7 tr\u1ee3.<\/p>\n\n\n\n

\u25cf      \u0110i\u1ec1u tr\u1ecb t\u1ea1i b\u1ec7nh vi\u1ec7n:<\/p>\n\n\n\n

\u25cb      Ki\u1ec3m tra v\u00e0 x\u00e1c \u0111\u1ecbnh nguy\u00ean nh\u00e2n: B\u00e1c s\u0129 s\u1ebd th\u1ef1c hi\u1ec7n c\u00e1c x\u00e9t nghi\u1ec7m nh\u01b0 x\u00e9t nghi\u1ec7m m\u00e1u, stress test, ch\u1ee5p chi\u1ebfu tim, th\u00f4ng tim, nghi\u00ean c\u1ee9u \u0111i\u1ec7n sinh l\u00fd (EP study), v\u00e0 x\u00e9t nghi\u1ec7m gen \u0111\u1ec3 t\u00ecm ra nguy\u00ean nh\u00e2n g\u1ed1c r\u1ec5 c\u1ee7a ng\u1eebng tim.<\/p>\n\n\n\n

\u25cb      C\u00e1c li\u1ec7u ph\u00e1p chuy\u00ean s\u00e2u: Bao g\u1ed3m h\u1ea1 th\u00e2n nhi\u1ec7t \u0111\u00edch (TTM) \u0111\u1ec3 b\u1ea3o v\u1ec7 n\u00e3o, li\u1ec7u ph\u00e1p oxy, v\u00e0 ECMO (tu\u1ea7n ho\u00e0n ngo\u00e0i c\u01a1 th\u1ec3) \u0111\u1ec3 h\u1ed7 tr\u1ee3 ch\u1ee9c n\u0103ng tim v\u00e0 ph\u1ed5i.<\/p>\n\n\n\n

\u25cb      \u0110i\u1ec1u tr\u1ecb b\u1ec7nh n\u1ec1n: D\u1ef1a tr\u00ean ch\u1ea9n \u0111o\u00e1n, c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb nh\u01b0 d\u00f9ng thu\u1ed1c, can thi\u1ec7p m\u1ea1ch v\u00e0nh (\u0111\u1eb7t stent, ph\u1eabu thu\u1eadt b\u1eafc c\u1ea7u) s\u1ebd \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng \u0111\u1ec3 ph\u1ee5c h\u1ed3i l\u01b0u l\u01b0\u1ee3ng m\u00e1u v\u00e0 ch\u1ee9c n\u0103ng tim.<\/p>\n\n\n\n

Ph\u00f2ng ng\u1eeba v\u00e0 \u0111i\u1ec1u tr\u1ecb ng\u1eebng th\u1edf<\/strong><\/p>\n\n\n\n

Ph\u00f2ng ng\u1eeba v\u00e0 \u0111i\u1ec1u tr\u1ecb ng\u1eebng th\u1edf c\u0169ng \u0111\u00f2i h\u1ecfi s\u1ef1 ch\u00fa \u00fd \u0111\u1ebfn c\u1ea3 l\u1ed1i s\u1ed1ng v\u00e0 can thi\u1ec7p y t\u1ebf.<\/p>\n\n\n\n

\u25cf      Ph\u00f2ng ng\u1eeba:<\/p>\n\n\n\n

\u25cb      Duy tr\u00ec l\u1ed1i s\u1ed1ng l\u00e0nh m\u1ea1nh: \u0102n u\u1ed1ng \u0111\u1ee7 ch\u1ea5t, v\u1eadn \u0111\u1ed9ng t\u00edch c\u1ef1c, tr\u00e1nh xa thu\u1ed1c l\u00e1, r\u01b0\u1ee3u bia, v\u00e0 c\u00e1c ch\u1ea5t k\u00edch th\u00edch.<\/p>\n\n\n\n

\u25cb      V\u1ec7 sinh m\u0169i h\u1ecdng th\u01b0\u1eddng xuy\u00ean: Gi\u00fap \u0111\u01b0\u1eddng th\u1edf lu\u00f4n s\u1ea1ch s\u1ebd v\u00e0 th\u00f4ng tho\u00e1ng, ng\u0103n ng\u1eeba vi\u00eam nhi\u1ec5m.<\/p>\n\n\n\n

\u25cb      Ch\u1ecdn t\u01b0 th\u1ebf ng\u1ee7 ph\u00f9 h\u1ee3p: Ng\u1ee7 nghi\u00eang c\u00f3 th\u1ec3 gi\u00fap tr\u00e1nh t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng th\u1edf do m\u00f4 m\u1ec1m \u1edf h\u1ecdng v\u00e0 l\u01b0\u1ee1i.<\/p>\n\n\n\n

\u25cb      Qu\u1ea3n l\u00fd thu\u1ed1c: Kh\u00f4ng s\u1eed d\u1ee5ng c\u00e1c lo\u1ea1i thu\u1ed1c an th\u1ea7n ho\u1eb7c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh tr\u01b0\u1edbc khi ng\u1ee7 n\u1ebfu kh\u00f4ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh c\u1ee7a b\u00e1c s\u0129.<\/p>\n\n\n\n

\u25cb      Gi\u1ea3m c\u00e2n: N\u1ebfu th\u1eeba c\u00e2n ho\u1eb7c b\u00e9o ph\u00ec, vi\u1ec7c gi\u1ea3m c\u00e2n t\u00edch c\u1ef1c s\u1ebd l\u00e0m gi\u1ea3m c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 bi\u1ebfn ch\u1ee9ng c\u1ee7a ng\u01b0ng th\u1edf t\u1eafc ngh\u1ebdn khi ng\u1ee7.<\/p>\n\n\n\n

\u25cf      \u0110i\u1ec1u tr\u1ecb c\u1ea5p c\u1ee9u (t\u1ea1i hi\u1ec7n tr\u01b0\u1eddng):<\/p>\n\n\n\n

\u25cb      G\u1ecdi c\u1ea5p c\u1ee9u: G\u1ecdi s\u1ed1 kh\u1ea9n c\u1ea5p ngay l\u1eadp t\u1ee9c.<\/p>\n\n\n\n

\u25cb      Khai th\u00f4ng \u0111\u01b0\u1eddng th\u1edf: Ng\u1eeda \u0111\u1ea7u n\u00e2ng c\u1eb1m ho\u1eb7c \u1ea5n h\u00e0m (n\u1ebfu nghi ng\u1edd ch\u1ea5n th\u01b0\u01a1ng c\u1ed9t s\u1ed1ng c\u1ed5), nhanh ch\u00f3ng lo\u1ea1i b\u1ecf d\u1ecb v\u1eadt, \u0111\u00e0m nh\u1edbt trong h\u1ecdng mi\u1ec7ng.<\/p>\n\n\n\n

\u25cb      H\u00f4 h\u1ea5p nh\u00e2n t\u1ea1o (th\u1ed5i ng\u1ea1t): Cung c\u1ea5p oxy cho n\u1ea1n nh\u00e2n b\u1eb1ng c\u00e1ch th\u1ed5i h\u01a1i v\u00e0o mi\u1ec7ng.<\/p>\n\n\n\n

\u25cb      Nghi\u1ec7m ph\u00e1p Heimlich: Th\u1ef1c hi\u1ec7n n\u1ebfu nghi ng\u1edd d\u1ecb v\u1eadt \u0111\u01b0\u1eddng th\u1edf.<\/p>\n\n\n\n

\u25cf      \u0110i\u1ec1u tr\u1ecb t\u1ea1i b\u1ec7nh vi\u1ec7n:<\/p>\n\n\n\n

\u25cb      Thi\u1ebft b\u1ecb h\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p: S\u1eed d\u1ee5ng m\u00e1y th\u1edf \u00e1p l\u1ef1c d\u01b0\u01a1ng li\u00ean t\u1ee5c (CPAP) ho\u1eb7c thi\u1ebft b\u1ecb h\u1ed7 tr\u1ee3 mi\u1ec7ng cho c\u00e1c tr\u01b0\u1eddng h\u1ee3p ng\u01b0ng th\u1edf t\u1eafc ngh\u1ebdn khi ng\u1ee7.<\/p>\n\n\n\n

\u25cb      Ph\u1eabu thu\u1eadt: N\u1ebfu nguy\u00ean nh\u00e2n do d\u1ecb t\u1eadt c\u1ea5u tr\u00fac, c\u00f3 th\u1ec3 c\u1ea7n ph\u1eabu thu\u1eadt tai m\u0169i h\u1ecdng (n\u1ea1o amidan, VA, ch\u1ec9nh h\u00ecnh v\u00e1ch ng\u0103n m\u0169i, can thi\u1ec7p h\u00e0m).<\/p>\n\n\n\n

\u25cb      K\u00edch th\u00edch th\u1ea7n kinh: S\u1eed d\u1ee5ng m\u00e1y k\u00edch th\u00edch th\u1ea7n kinh \u0111\u1ec3 c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng c\u01a1 ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng th\u1edf tr\u00ean.<\/p>\n\n\n\n

\u25cb      Thu\u1ed1c: C\u00e1c lo\u1ea1i thu\u1ed1c nh\u01b0 Naloxone cho tr\u01b0\u1eddng h\u1ee3p qu\u00e1 li\u1ec1u opioid , kh\u00e1ng sinh cho nhi\u1ec5m tr\u00f9ng ph\u1ed5i, thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n, ho\u1eb7c corticosteroid c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n.<\/p>\n\n\n\n

\u25cb      Th\u00f4ng kh\u00ed c\u01a1 h\u1ecdc v\u00e0 m\u1edf kh\u00ed qu\u1ea3n: Trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng, ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 c\u1ea7n \u0111\u01b0\u1ee3c h\u1ed7 tr\u1ee3 b\u1eb1ng m\u00e1y th\u1edf (mechanical ventilator) ho\u1eb7c th\u1ef1c hi\u1ec7n m\u1edf kh\u00ed qu\u1ea3n (tracheostomy) \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o \u0111\u01b0\u1eddng th\u1edf th\u00f4ng tho\u00e1ng.<\/p>\n\n\n\n

B\u1ea3ng 3: Chi\u1ebfn L\u01b0\u1ee3c Ph\u00f2ng Ng\u1eeba v\u00e0 \u0110i\u1ec1u Tr\u1ecb Ch\u00ednh<\/strong><\/p>\n\n\n\n

B\u1ea3ng d\u01b0\u1edbi \u0111\u00e2y t\u00f3m t\u1eaft c\u00e1c chi\u1ebfn l\u01b0\u1ee3c ph\u00f2ng ng\u1eeba v\u00e0 \u0111i\u1ec1u tr\u1ecb quan tr\u1ecdng cho ng\u1ea5t, ng\u1eebng tim v\u00e0 ng\u1eebng th\u1edf, cung c\u1ea5p m\u1ed9t h\u01b0\u1edbng d\u1eabn th\u1ef1c t\u1ebf cho m\u1ecdi ng\u01b0\u1eddi :<\/p>\n\n\n\n

T\u00ecnh tr\u1ea1ng<\/strong><\/td>Ph\u00f2ng ng\u1eeba<\/strong><\/td>\u0110i\u1ec1u tr\u1ecb c\u1ea5p c\u1ee9u (t\u1ea1i hi\u1ec7n tr\u01b0\u1eddng)<\/strong><\/td>\u0110i\u1ec1u tr\u1ecb y t\u1ebf (t\u1ea1i b\u1ec7nh vi\u1ec7n)<\/strong><\/td><\/tr>
Ng\u1ea5t (Syncope)<\/td>Tr\u00e1nh y\u1ebfu t\u1ed1 k\u00edch th\u00edch (\u0111\u1ee9ng l\u00e2u, n\u00f3ng, c\u0103ng th\u1eb3ng), u\u1ed1ng \u0111\u1ee7 n\u01b0\u1edbc, \u0103n \u0111\u1ee7 b\u1eefa, t\u1eadp th\u1ec3 d\u1ee5c, qu\u1ea3n l\u00fd thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p. Khi c\u00f3 d\u1ea5u hi\u1ec7u: n\u1eb1m xu\u1ed1ng, k\u00ea cao ch\u00e2n, n\u1edbi l\u1ecfng qu\u1ea7n \u00e1o.<\/td>N\u1eb1m ng\u1eeda, n\u00e2ng ch\u00e2n cao h\u01a1n tim, n\u1edbi l\u1ecfng qu\u1ea7n \u00e1o, \u0111\u1ea3m b\u1ea3o th\u00f4ng tho\u00e1ng.<\/td>\u0110i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n n\u1ec1n (r\u1ed1i lo\u1ea1n nh\u1ecbp, b\u1ec7nh van tim), thu\u1ed1c (fludrocortisone, SSRIs), c\u1ea5y m\u00e1y t\u1ea1o nh\u1ecbp (hi\u1ebfm).<\/td><\/tr>
Ng\u1eebng Tim (Cardiac Arrest)<\/td>Ki\u1ec3m so\u00e1t b\u1ec7nh tim m\u1ea1ch (huy\u1ebft \u00e1p, cholesterol, ti\u1ec3u \u0111\u01b0\u1eddng), l\u1ed1i s\u1ed1ng l\u00e0nh m\u1ea1nh (kh\u00f4ng thu\u1ed1c l\u00e1, \u0103n u\u1ed1ng khoa h\u1ecdc, t\u1eadp th\u1ec3 d\u1ee5c, qu\u1ea3n l\u00fd stress), th\u0103m kh\u00e1m \u0111\u1ecbnh k\u1ef3, c\u1ea5y ICD (n\u1ebfu nguy c\u01a1 cao).<\/td>G\u1ecdi c\u1ea5p c\u1ee9u 115, \u0111\u1ea3m b\u1ea3o an to\u00e0n, ki\u1ec3m tra ph\u1ea3n \u1ee9ng\/th\u1edf\/m\u1ea1ch. Th\u1ef1c hi\u1ec7n CPR ch\u1ea5t l\u01b0\u1ee3ng cao (\u00e9p tim 100-120 l\u1ea7n\/ph\u00fat, s\u00e2u 5cm), s\u1eed d\u1ee5ng AED (n\u1ebfu c\u00f3).<\/td>X\u00e1c \u0111\u1ecbnh nguy\u00ean nh\u00e2n, h\u1ea1 th\u00e2n nhi\u1ec7t \u0111\u00edch (TTM), li\u1ec7u ph\u00e1p oxy, ECMO, \u0111i\u1ec1u tr\u1ecb b\u1ec7nh n\u1ec1n (thu\u1ed1c, can thi\u1ec7p m\u1ea1ch v\u00e0nh, ph\u1eabu thu\u1eadt).<\/td><\/tr>
Ng\u1eebng Th\u1edf (Respiratory Arrest)<\/td>L\u1ed1i s\u1ed1ng l\u00e0nh m\u1ea1nh (\u0103n u\u1ed1ng, v\u1eadn \u0111\u1ed9ng, tr\u00e1nh ch\u1ea5t k\u00edch th\u00edch), v\u1ec7 sinh m\u0169i h\u1ecdng, t\u01b0 th\u1ebf ng\u1ee7 nghi\u00eang, gi\u1ea3m c\u00e2n, kh\u00f4ng l\u1ea1m d\u1ee5ng thu\u1ed1c an th\u1ea7n.<\/td>G\u1ecdi c\u1ea5p c\u1ee9u, khai th\u00f4ng \u0111\u01b0\u1eddng th\u1edf (ng\u1eeda \u0111\u1ea7u n\u00e2ng c\u1eb1m\/\u1ea5n h\u00e0m, lo\u1ea1i b\u1ecf d\u1ecb v\u1eadt), h\u00f4 h\u1ea5p nh\u00e2n t\u1ea1o (th\u1ed5i ng\u1ea1t), Heimlich (n\u1ebfu d\u1ecb v\u1eadt).<\/td>CPAP, thi\u1ebft b\u1ecb h\u1ed7 tr\u1ee3 mi\u1ec7ng, ph\u1eabu thu\u1eadt tai m\u0169i h\u1ecdng, k\u00edch th\u00edch th\u1ea7n kinh, thu\u1ed1c (naloxone, kh\u00e1ng sinh), th\u00f4ng kh\u00ed c\u01a1 h\u1ecdc, m\u1edf kh\u00ed qu\u1ea3n.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Vai tr\u00f2 k\u00e9p c\u1ee7a l\u1ed1i s\u1ed1ng l\u00e0nh m\u1ea1nh l\u00e0 m\u1ed9t \u0111i\u1ec3m c\u1ea7n \u0111\u01b0\u1ee3c nh\u1ea5n m\u1ea1nh: n\u00f3 v\u1eeba l\u00e0 y\u1ebfu t\u1ed1 ph\u00f2ng ng\u1eeba hi\u1ec7u qu\u1ea3, v\u1eeba l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 quan tr\u1ecdng. C\u00e1c th\u00f3i quen h\u00e0ng ng\u00e0y nh\u01b0 \u0103n u\u1ed1ng c\u00e2n b\u1eb1ng, t\u1eadp th\u1ec3 d\u1ee5c \u0111\u1ec1u \u0111\u1eb7n, tr\u00e1nh r\u01b0\u1ee3u bia, v\u00e0 qu\u1ea3n l\u00fd c\u0103ng th\u1eb3ng c\u00f3 t\u00e1c \u0111\u1ed9ng s\u00e2u s\u1eafc \u0111\u1ebfn kh\u1ea3 n\u0103ng ph\u00f2ng ng\u1eeba v\u00e0 ph\u1ee5c h\u1ed3i b\u1ec7nh t\u1eadt. C\u00e2u chuy\u1ec7n c\u1ee7a m\u00ecnh, v\u1edbi vi\u1ec7c s\u1ee9c kh\u1ecfe c\u1ea3i thi\u1ec7n \u0111\u00e1ng k\u1ec3 sau khi thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng, l\u00e0 minh ch\u1ee9ng r\u00f5 r\u00e0ng cho \u0111i\u1ec1u n\u00e0y. L\u1ed1i s\u1ed1ng l\u00e0nh m\u1ea1nh kh\u00f4ng ch\u1ec9 gi\u00fap ng\u0103n ng\u1eeba b\u1ec7nh m\u00e0 c\u00f2n l\u00e0 n\u1ec1n t\u1ea3ng quan tr\u1ecdng \u0111\u1ec3 h\u1ed7 tr\u1ee3 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb y t\u1ebf, gi\u00fap c\u01a1 th\u1ec3 ph\u1ee5c h\u1ed3i t\u1ed1t h\u01a1n v\u00e0 gi\u1ea3m nguy c\u01a1 t\u00e1i ph\u00e1t.<\/p>\n\n\n\n

B\u00ean c\u1ea1nh \u0111\u00f3, vi\u1ec7c gi\u00e1o d\u1ee5c c\u1ed9ng \u0111\u1ed3ng v\u1ec1 s\u01a1 c\u1ee9u kh\u1ea9n c\u1ea5p l\u00e0 v\u00f4 c\u00f9ng c\u1ea7n thi\u1ebft. \u0110\u1ed1i v\u1edbi ng\u1eebng tim v\u00e0 ng\u1eebng th\u1edf, c\u00e1c t\u00e0i li\u1ec7u y t\u1ebf \u0111\u1ec1u nh\u1ea5n m\u1ea1nh s\u1ef1 c\u1ea7n thi\u1ebft c\u1ee7a h\u00e0nh \u0111\u1ed9ng ngay l\u1eadp t\u1ee9c t\u1eeb ng\u01b0\u1eddi ch\u1ee9ng ki\u1ebfn. T\u1ef7 l\u1ec7 s\u1ed1ng s\u00f3t gi\u1ea3m nhanh ch\u00f3ng theo t\u1eebng ph\u00fat ch\u1eadm tr\u1ec5. \u0110i\u1ec1u n\u00e0y cho th\u1ea5y r\u1eb1ng h\u1ec7 th\u1ed1ng y t\u1ebf kh\u00f4ng th\u1ec3 m\u1ed9t m\u00ecnh g\u00e1nh v\u00e1c to\u00e0n b\u1ed9 g\u00e1nh n\u1eb7ng c\u1ea5p c\u1ee9u. Vi\u1ec7c trang b\u1ecb ki\u1ebfn th\u1ee9c v\u00e0 k\u1ef9 n\u0103ng s\u01a1 c\u1ee9u c\u01a1 b\u1ea3n cho ng\u01b0\u1eddi d\u00e2n l\u00e0 m\u1ed9t chi\u1ebfn l\u01b0\u1ee3c y t\u1ebf c\u00f4ng c\u1ed9ng hi\u1ec7u qu\u1ea3, bi\u1ebfn m\u1ed7i c\u00e1 nh\u00e2n th\u00e0nh m\u1ed9t m\u1eaft x\u00edch quan tr\u1ecdng trong chu\u1ed7i ph\u1ea3n \u1ee9ng c\u1ea5p c\u1ee9u, t\u1eeb \u0111\u00f3 c\u1ea3i thi\u1ec7n \u0111\u00e1ng k\u1ec3 t\u1ef7 l\u1ec7 s\u1ed1ng s\u00f3t v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng cho n\u1ea1n nh\u00e2n.<\/p>\n\n\n\n

VII. L\u1eddi Khuy\u00ean T\u1eeb Kinh Nghi\u1ec7m Th\u1ef1c T\u1ebf v\u00e0 K\u1ebft Lu\u1eadn<\/strong><\/p>\n\n\n\n

B\u00e0i h\u1ecdc r\u00fat ra t\u1eeb c\u00e2u chuy\u1ec7n c\u1ee7a m\u00ecnh<\/strong><\/p>\n\n\n\n

C\u00e2u chuy\u1ec7n c\u1ee7a m\u00ecnh l\u00e0 m\u1ed9t l\u1eddi nh\u1eafc nh\u1edf m\u1ea1nh m\u1ebd v\u1ec1 t\u1ea7m quan tr\u1ecdng c\u1ee7a s\u1ee9c kh\u1ecfe trong cu\u1ed9c s\u1ed1ng hi\u1ec7n \u0111\u1ea1i.<\/p>\n\n\n\n

\u25cf      \u01afu ti\u00ean s\u1ee9c kh\u1ecfe l\u00e0 tr\u00ean h\u1ebft: Quy\u1ebft \u0111\u1ecbnh “ch\u1ecdn s\u1ee9c kh\u1ecfe, t\u00ednh m\u1ea1ng hay \u0111\u1ecba v\u1ecb ti\u1ec1n b\u1ea1c” v\u00e0 “quy\u1ebft \u0111\u1ecbnh ngh\u1ec9 vi\u1ec7c” l\u00e0 m\u1ed9t b\u00e0i h\u1ecdc \u0111\u1eaft gi\u00e1 v\u1ec1 vi\u1ec7c \u0111\u1eb7t s\u1ee9c kh\u1ecfe l\u00ean h\u00e0ng \u0111\u1ea7u, \u0111\u1eb7c bi\u1ec7t khi c\u01a1 th\u1ec3 \u0111\u00e3 ph\u00e1t \u0111i t\u00edn hi\u1ec7u c\u1ea3nh b\u00e1o nghi\u00eam tr\u1ecdng. N\u00f3 cho th\u1ea5y r\u1eb1ng kh\u00f4ng c\u00f3 th\u00e0nh c\u00f4ng hay t\u00e0i s\u1ea3n n\u00e0o c\u00f3 \u00fd ngh\u0129a n\u1ebfu kh\u00f4ng c\u00f3 s\u1ee9c kh\u1ecfe \u0111\u1ec3 t\u1eadn h\u01b0\u1edfng.<\/p>\n\n\n\n

\u25cf      T\u1ea7m quan tr\u1ecdng c\u1ee7a l\u1ed1i s\u1ed1ng l\u00e0nh m\u1ea1nh: Vi\u1ec7c t\u1eeb b\u1ecf r\u01b0\u1ee3u bia v\u00e0 t\u1eadp th\u1ec3 d\u1ee5c \u0111i\u1ec1u \u0111\u1ed9 \u0111\u00e3 gi\u00fap “s\u1ee9c kh\u1ecfe c\u1ea3i thi\u1ec7n \u0111\u00e1ng k\u1ec3”. \u0110i\u1ec1u n\u00e0y ch\u1ee9ng minh r\u1eb1ng nh\u1eefng thay \u0111\u1ed5i t\u00edch c\u1ef1c trong l\u1ed1i s\u1ed1ng c\u00f3 th\u1ec3 mang l\u1ea1i hi\u1ec7u qu\u1ea3 r\u00f5 r\u1ec7t trong vi\u1ec7c ph\u1ee5c h\u1ed3i v\u00e0 duy tr\u00ec s\u1ee9c kh\u1ecfe, ngay c\u1ea3 khi nguy\u00ean nh\u00e2n b\u1ec7nh l\u00fd ban \u0111\u1ea7u ch\u01b0a \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh r\u00f5 r\u00e0ng.<\/p>\n\n\n\n

\u25cf      L\u1eafng nghe c\u01a1 th\u1ec3 v\u00e0 kh\u00f4ng b\u1ecf qua c\u00e1c tri\u1ec7u ch\u1ee9ng: Ban \u0111\u1ea7u, m\u00ecnh \u0111\u00e3 b\u1ecf qua c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00ec ngh\u0129 \u0111\u00f3 ch\u1ec9 l\u00e0 do r\u01b0\u1ee3u bia. C\u00e2u chuy\u1ec7n nh\u1ea5n m\u1ea1nh t\u1ea7m quan tr\u1ecdng c\u1ee7a vi\u1ec7c nh\u1eadn bi\u1ebft s\u1edbm c\u00e1c d\u1ea5u hi\u1ec7u b\u1ea5t th\u01b0\u1eddng, d\u00f9 l\u00e0 nh\u1ecf nh\u1ea5t, v\u00e0 t\u00ecm ki\u1ebfm s\u1ef1 tr\u1ee3 gi\u00fap y t\u1ebf k\u1ecbp th\u1eddi. Vi\u1ec7c tr\u00ec ho\u00e3n c\u00f3 th\u1ec3 khi\u1ebfn t\u00ecnh tr\u1ea1ng tr\u1edf n\u00ean nghi\u00eam tr\u1ecdng h\u01a1n.<\/p>\n\n\n\n

\u25cf      S\u1ef1 ki\u00ean tr\u00ec trong ch\u1ea9n \u0111o\u00e1n: D\u00f9 g\u1eb7p nhi\u1ec1u kh\u00f3 kh\u0103n trong vi\u1ec7c t\u00ecm ra nguy\u00ean nh\u00e2n v\u00e0 nh\u1eadn ch\u1ea9n \u0111o\u00e1n “ng\u1ea5t kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n,” vi\u1ec7c ti\u1ebfp t\u1ee5c t\u00ecm ki\u1ebfm v\u00e0 theo d\u00f5i l\u00e0 c\u1ea7n thi\u1ebft. \u0110o\u1ea1n video ghi l\u1ea1i c\u01a1n ng\u1ea5t l\u00e0 m\u1ed9t v\u00ed d\u1ee5 \u0111i\u1ec3n h\u00ecnh v\u1ec1 vi\u1ec7c th\u00f4ng tin kh\u00e1ch quan t\u1eeb ch\u00ednh m\u00ecnh c\u00f3 th\u1ec3 h\u1ed7 tr\u1ee3 ch\u1ea9n \u0111o\u00e1n nh\u01b0 th\u1ebf n\u00e0o, gi\u00fap b\u00e1c s\u0129 c\u00f3 c\u00e1i nh\u00ecn to\u00e0n di\u1ec7n h\u01a1n v\u1ec1 ti\u1ec1n s\u1eed b\u1ec7nh.<\/p>\n\n\n\n

T\u1ea7m quan tr\u1ecdng c\u1ee7a vi\u1ec7c l\u1eafng nghe c\u01a1 th\u1ec3, nh\u1eadn bi\u1ebft d\u1ea5u hi\u1ec7u c\u1ea3nh b\u00e1o, v\u00e0 th\u0103m kh\u00e1m \u0111\u1ecbnh k\u1ef3<\/strong><\/p>\n\n\n\n

M\u1ed7i ng\u01b0\u1eddi c\u1ea7n ch\u1ee7 \u0111\u1ed9ng theo d\u00f5i s\u1ee9c kh\u1ecfe c\u1ee7a m\u00ecnh. \u0110i\u1ec1u n\u00e0y bao g\u1ed3m vi\u1ec7c nh\u1eadn bi\u1ebft c\u00e1c d\u1ea5u hi\u1ec7u c\u1ea3nh b\u00e1o c\u1ee7a ng\u1ea5t, ng\u1eebng tim, ng\u1eebng th\u1edf \u0111\u00e3 \u0111\u01b0\u1ee3c tr\u00ecnh b\u00e0y trong b\u00e0i vi\u1ebft n\u00e0y. Vi\u1ec7c th\u0103m kh\u00e1m s\u1ee9c kh\u1ecfe \u0111\u1ecbnh k\u1ef3 gi\u00fap ph\u00e1t hi\u1ec7n s\u1edbm c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 v\u00e0 b\u1ec7nh l\u00fd ti\u1ec1m \u1ea9n, \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00e1c b\u1ec7nh tim m\u1ea1ch, ngay c\u1ea3 khi ch\u01b0a c\u00f3 tri\u1ec7u ch\u1ee9ng r\u00f5 r\u00e0ng. N\u1ebfu c\u1ea3m th\u1ea5y ch\u1ea9n \u0111o\u00e1n ban \u0111\u1ea7u ch\u01b0a r\u00f5 r\u00e0ng ho\u1eb7c kh\u00f4ng y\u00ean t\u00e2m, vi\u1ec7c t\u00ecm ki\u1ebfm \u00fd ki\u1ebfn y t\u1ebf th\u1ee9 hai ho\u1eb7c th\u1ee9 ba l\u00e0 m\u1ed9t quy\u1ec1n l\u1ee3i v\u00e0 n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n.<\/p>\n\n\n\n

Khuy\u1ebfn ngh\u1ecb chung cho c\u1ed9ng \u0111\u1ed3ng \u0111\u1ec3 n\u00e2ng cao nh\u1eadn th\u1ee9c v\u00e0 ch\u1ee7 \u0111\u1ed9ng b\u1ea3o v\u1ec7 s\u1ee9c kh\u1ecfe<\/strong><\/p>\n\n\n\n

\u0110\u1ec3 x\u00e2y d\u1ef1ng m\u1ed9t c\u1ed9ng \u0111\u1ed3ng kh\u1ecfe m\u1ea1nh v\u00e0 gi\u1ea3m thi\u1ec3u c\u00e1c bi\u1ebfn c\u1ed1 y t\u1ebf nghi\u00eam tr\u1ecdng, nh\u1eefng khuy\u1ebfn ngh\u1ecb sau \u0111\u00e2y l\u00e0 c\u1ea7n thi\u1ebft:<\/p>\n\n\n\n

\u25cf      N\u00e2ng cao ki\u1ebfn th\u1ee9c y t\u1ebf c\u01a1 b\u1ea3n: M\u1ed7i c\u00e1 nh\u00e2n n\u00ean t\u00ecm hi\u1ec3u v\u00e0 hi\u1ec3u r\u00f5 v\u1ec1 c\u00e1c t\u00ecnh tr\u1ea1ng nh\u01b0 ng\u1ea5t, ng\u1eebng tim, ng\u1eebng th\u1edf, c\u0169ng nh\u01b0 c\u00e1ch ph\u00e2n bi\u1ec7t ch\u00fang. Ki\u1ebfn th\u1ee9c n\u00e0y l\u00e0 n\u1ec1n t\u1ea3ng \u0111\u1ec3 ph\u1ea3n \u1ee9ng \u0111\u00fang \u0111\u1eafn trong t\u00ecnh hu\u1ed1ng kh\u1ea9n c\u1ea5p.<\/p>\n\n\n\n

\u25cf      H\u1ecdc k\u1ef9 n\u0103ng s\u01a1 c\u1ee9u: Tham gia c\u00e1c kh\u00f3a h\u1ecdc v\u1ec1 h\u1ed3i s\u1ee9c tim ph\u1ed5i (CPR) v\u00e0 c\u00e1ch s\u1eed d\u1ee5ng m\u00e1y kh\u1eed rung tim ngo\u00e0i t\u1ef1 \u0111\u1ed9ng (AED). Vi\u1ec7c trang b\u1ecb nh\u1eefng k\u1ef9 n\u0103ng n\u00e0y c\u00f3 th\u1ec3 bi\u1ebfn m\u1ed7i ng\u01b0\u1eddi th\u00e0nh m\u1ed9t ng\u01b0\u1eddi h\u00f9ng, c\u00f3 kh\u1ea3 n\u0103ng c\u1ee9u s\u1ed1ng ng\u01b0\u1eddi kh\u00e1c trong nh\u1eefng ph\u00fat v\u00e0ng.<\/p>\n\n\n\n

\u25cf      \u01afu ti\u00ean c\u00e2n b\u1eb1ng cu\u1ed9c s\u1ed1ng: Tr\u00e1nh l\u00e0m vi\u1ec7c qu\u00e1 s\u1ee9c, \u0111\u1ea3m b\u1ea3o ng\u1ee7 \u0111\u1ee7 gi\u1ea5c v\u00e0 qu\u1ea3n l\u00fd c\u0103ng th\u1eb3ng hi\u1ec7u qu\u1ea3. L\u1eddi c\u1ea3nh b\u00e1o c\u1ee7a B\u00e1c s\u0129 Tr\u1ea7n V\u0103n Ph\u00fac v\u1ec1 “c\u00e1i ch\u1ebft \u0111\u1ed9t ng\u1ed9t \u0111\u01b0\u1ee3c l\u00ean k\u1ebf ho\u1ea1ch” l\u00e0 m\u1ed9t l\u1eddi nh\u1eafc nh\u1edf nghi\u00eam t\u00fac v\u1ec1 h\u1eadu qu\u1ea3 c\u1ee7a l\u1ed1i s\u1ed1ng m\u1ea5t c\u00e2n b\u1eb1ng.<\/p>\n\n\n\n

\u25cf      Duy tr\u00ec l\u1ed1i s\u1ed1ng l\u00e0nh m\u1ea1nh: Th\u1ef1c h\u00e0nh \u0103n u\u1ed1ng c\u00e2n b\u1eb1ng, t\u1eadp th\u1ec3 d\u1ee5c \u0111\u1ec1u \u0111\u1eb7n, v\u00e0 h\u1ea1n ch\u1ebf t\u1ed1i \u0111a r\u01b0\u1ee3u bia c\u00f9ng c\u00e1c ch\u1ea5t k\u00edch th\u00edch. \u0110\u00e2y l\u00e0 nh\u1eefng n\u1ec1n t\u1ea3ng v\u1eefng ch\u1eafc cho m\u1ed9t tr\u00e1i tim kh\u1ecfe m\u1ea1nh v\u00e0 m\u1ed9t h\u1ec7 th\u1ea7n kinh \u1ed5n \u0111\u1ecbnh.<\/p>\n\n\n\n

\u25cf      Th\u0103m kh\u00e1m s\u1ee9c kh\u1ecfe \u0111\u1ecbnh k\u1ef3: \u0110\u00e2y l\u00e0 bi\u1ec7n ph\u00e1p ph\u00f2ng ng\u1eeba ch\u1ee7 \u0111\u1ed9ng quan tr\u1ecdng, \u0111\u1eb7c bi\u1ec7t v\u1edbi nh\u1eefng ng\u01b0\u1eddi c\u00f3 ti\u1ec1n s\u1eed b\u1ec7nh l\u00fd ho\u1eb7c y\u1ebfu t\u1ed1 nguy c\u01a1.<\/p>\n\n\n\n

K\u1ebft lu\u1eadn<\/strong><\/p>\n\n\n\n

C\u00e2u chuy\u1ec7n c\u1ee7a m\u00ecnh l\u00e0 m\u1ed9t minh ch\u1ee9ng m\u1ea1nh m\u1ebd r\u1eb1ng s\u1ee9c kh\u1ecfe l\u00e0 t\u00e0i s\u1ea3n qu\u00fd gi\u00e1 nh\u1ea5t, v\u00e0 vi\u1ec7c \u01b0u ti\u00ean n\u00f3 l\u00e0 m\u1ed9t quy\u1ebft \u0111\u1ecbnh s\u00e1ng su\u1ed1t. D\u00f9 ph\u1ea3i \u0111\u1ed1i m\u1eb7t v\u1edbi ch\u1ea9n \u0111o\u00e1n “ng\u1ea5t kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n” v\u00e0 nh\u1eefng th\u00e1ch th\u1ee9c trong qu\u00e1 tr\u00ecnh t\u00ecm ki\u1ebfm, s\u1ef1 ki\u00ean tr\u00ec v\u00e0 quy\u1ebft t\u00e2m thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng \u0111\u00e3 mang l\u1ea1i k\u1ebft qu\u1ea3 t\u00edch c\u1ef1c.<\/p>\n\n\n\n

B\u00e0i vi\u1ebft n\u00e0y kh\u00f4ng ch\u1ec9 chia s\u1ebb m\u1ed9t h\u00e0nh tr\u00ecnh c\u00e1 nh\u00e2n m\u00e0 c\u00f2n cung c\u1ea5p ki\u1ebfn th\u1ee9c y h\u1ecdc to\u00e0n di\u1ec7n v\u1ec1 ng\u1ea5t, ng\u1eebng tim, v\u00e0 ng\u1eebng th\u1edf. Vi\u1ec7c ch\u1ee7 \u0111\u1ed9ng ph\u00f2ng ng\u1eeba, nh\u1eadn bi\u1ebft s\u1edbm c\u00e1c d\u1ea5u hi\u1ec7u c\u1ea3nh b\u00e1o, v\u00e0 t\u00ecm ki\u1ebfm s\u1ef1 can thi\u1ec7p y t\u1ebf k\u1ecbp th\u1eddi, c\u00f9ng v\u1edbi vi\u1ec7c thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng t\u00edch c\u1ef1c, c\u00f3 th\u1ec3 t\u1ea1o ra s\u1ef1 kh\u00e1c bi\u1ec7t l\u1edbn trong vi\u1ec7c b\u1ea3o v\u1ec7 t\u00ednh m\u1ea1ng v\u00e0 n\u00e2ng cao ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng. H\u00e3y l\u1eafng nghe c\u01a1 th\u1ec3 m\u00ecnh, v\u00ec \u0111\u00f4i khi, nh\u1eefng t\u00edn hi\u1ec7u nh\u1ecf nh\u1ea5t l\u1ea1i l\u00e0 l\u1eddi c\u1ea3nh b\u00e1o quan tr\u1ecdng nh\u1ea5t.<\/p>\n","protected":false},"excerpt":{"rendered":"

I. T\u1eeb C\u00e2u Chuy\u1ec7n C\u00e1 Nh\u00e2n \u0110\u1ebfn B\u00e0i H\u1ecdc S\u1ee9c Kh\u1ecfe C\u1ed9ng \u0110\u1ed3ng Nh\u1eefng c\u00e1i ch\u1ebft \u0111\u1ed9t ng\u1ed9t g\u1ea7n \u0111\u00e2y c\u1ee7a \u00f4ng HNT, tr\u1ecdng t\u00e0i T\u0110T hay tr\u01b0\u1eddng h\u1ee3p c\u1ee7a thanh ni\u00ean 20t \u0111\u00e3 \u0111\u01b0\u1ee3c c\u1ee9u k\u1ecbp th\u1eddi \u0111\u00e3 g\u00e2y ch\u1ea5n \u0111\u1ed9ng d\u01b0 lu\u1eadn, khi\u1ebfn nhi\u1ec1u ng\u01b0\u1eddi kh\u00f4ng kh\u1ecfi b\u0103n kho\u0103n v\u1ec1 s\u1ee9c kh\u1ecfe tim […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[],"class_list":["post-62","post","type-post","status-publish","format-standard","hentry","category-chua-phan-loai"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/huedao.com.vn\/index.php\/wp-json\/wp\/v2\/posts\/62","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/huedao.com.vn\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/huedao.com.vn\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/huedao.com.vn\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/huedao.com.vn\/index.php\/wp-json\/wp\/v2\/comments?post=62"}],"version-history":[{"count":1,"href":"https:\/\/huedao.com.vn\/index.php\/wp-json\/wp\/v2\/posts\/62\/revisions"}],"predecessor-version":[{"id":63,"href":"https:\/\/huedao.com.vn\/index.php\/wp-json\/wp\/v2\/posts\/62\/revisions\/63"}],"wp:attachment":[{"href":"https:\/\/huedao.com.vn\/index.php\/wp-json\/wp\/v2\/media?parent=62"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/huedao.com.vn\/index.php\/wp-json\/wp\/v2\/categories?post=62"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/huedao.com.vn\/index.php\/wp-json\/wp\/v2\/tags?post=62"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}