Management of sudden cerebral hemorrhage
Cerebral hemorrhage is a common occurrence among middle-aged and elderly people, which is caused by the sudden increase of blood pressure, resulting in the rupture of microvessels in the brain and causing bleeding. At the site of the hemorrhagic focus, blood can directly compress the brain tissue, causing cerebral edema around it, and in severe cases, secondary brain displacement and brain herniation.
The typical manifestations of cerebral hemorrhage include sudden numbness, weakness or paralysis of one of the limbs, when the patient often falls unprepared, or suddenly drops the objects in his hands; at the same time, the patient also has distorted corners of the mouth, drooling, slurred speech or aphasia, and some have headache, vomiting, blurred vision, impaired consciousness, incontinence and other phenomena. When a patient has a cerebral hemorrhage, the family should provide emergency care.
1. Keep calm and lay the patient down immediately. Never rush the patient to the hospital to avoid road shock. You can tilt his head to the side to prevent sputum and vomit from being inhaled into the trachea.
2, quickly loosen the patient’s collar and belt, keep indoor air circulation, pay attention to warmth when it is cold and cooling when it is hot.
3.If the patient is unconscious and makes a strong snoring sound, it means that his tongue root has fallen down, use a handkerchief or gauze to wrap the patient’s tongue and gently pull it outward.
4.Cold towel can be used to cover the patient’s head, because the blood vessels contract when they are cold, which can reduce the amount of bleeding.
5.When the patient is incontinent, he/she should be treated in place and not move the patient’s body at will to prevent aggravation of cerebral hemorrhage.
6. When the patient’s condition is stable, the vehicle should be driven as smoothly as possible to reduce bumps and vibrations; at the same time, the patient’s head should be slightly elevated and kept at an angle of 20 degrees to the ground, and changes in condition should be noted at all times.
Precautions
1.Patients need a quiet and comfortable environment, especially within 2 weeks of onset, visits should be minimized, maintain a calm and stable mood, and avoid various adverse emotional effects.
2, absolute bed rest for 2 weeks, the head can be gently turned to the left and right, should avoid excessive lifting or elevation of the head, limbs can be turned in bed in a small range, once every 2 hours, do not have to be overly nervous. Urination and defecation must be carried out in bed, do not get out of bed to relieve themselves, to prevent the occurrence of re-bleeding accidents.
3.Some patients may become restless and agitated. We will take protective measures such as restraint belt and bed stall for such patients, which can prevent unnecessary accidents such as removal of infusion tube or gastric tube and falling out of bed by the patients themselves. Some family members may not be able to bear it, but we understand their feelings. Once the condition is stable and no longer irritable, we will immediately withdraw the restraint on the torso, but the bed stall still needs extra protection from time to time, especially for patients with air beds, to strictly prevent falling out of bed. We hope you can cooperate with us.
4. Different degrees of headache may also occur during the course of the disease, such as head distension, pins and needles-like pain and severe pain, which are the most common symptoms. We will give reasonable treatment. As the disease improves, the headache will gradually disappear, so you do not need to be overly nervous and learn to distract yourself. If you still feel painful and cannot tolerate it during the treatment, please inform us in time so that the doctor can take more effective treatment methods.
5. Elderly patients, with aging and high degree of brittleness of the heart and brain vessels, are prone to induce diseases due to seasonal changes. Long-term bed-ridden patients are prone to lung infections, and sputum is not easily coughed out. Drugs are used to expectorate sputum and strengthen turning and back patting to loosen and cough up sputum and reduce lung infections. For those who are unable to cough up sputum, take sputum aspiration measures and expect to cooperate.
6.Long-term bed rest, skin pressure for more than 2 hours, prone to bedsores, should strengthen turning. Massage the pressurized area to keep the skin clean and dry. Place the limb in a functional position to prevent deformity.
7, diet: to be nutritious, low-fat, light and soft food, such as eggs, soy products, etc.. For those who have difficulty in eating, head can be tilted to the side, feed slowly, avoid talking, prevent choking and suffocation.
8, keep the stool smooth, can eat bananas, honey, more water, strengthen moderate turning, massage the abdomen, reduce the occurrence of constipation. Patients who have not relieved stool for several days or have poor bowel movement can use a slow defecator to induce bowel movement. Do not hold your breath to prevent brain hemorrhage again.
9.Shake the head of the bed 10~15○ during the recovery period according to medical advice, and then gradually shake the head of the bed to semi-recumbent position according to the degree of tolerance and adaptation, ranging from 30 minutes to 1~2 hours per day.
10. Hypertension is a common cause of this disease. Take antihypertensive drugs on time and in quantity, and do not increase or decrease the dosage at will to prevent sudden rise and fall of blood pressure and aggravate the disease.
11.After discharge from the hospital, regular outpatient follow-up, monitoring blood pressure and blood lipids, and appropriate physical activities, such as walking, tai chi, etc.
Diet for patients with cerebral hemorrhage
In addition to medication, a reasonable diet also plays an important role in the recovery of patients.
If the stroke patient’s condition has been stabilized, but there are different degrees of impaired consciousness, swallowing difficulties, nasal feeding diet should be used, easy to digest flowing juice diet, such as thick rice soup, soy milk, milk, fresh vegetable juice, fruit juice, etc. in several instillations, or 5-6 instillations of mixed milk 1000-2000 ml, the infusion of food should not be too hot and cold, at 37 ℃-39 ℃. 37℃-39℃ is appropriate. The ingredients required for the preparation of mixed milk are 600 ml of fresh milk, 350 ml of thick rice soup, 2 eggs, 50 g of sugar, 10 g of sesame oil, and 3 g of salt.
The preparation is done in three steps.
(1) Crack open the cleaned eggs, put them in a clean container, add sugar, salt and oil, and stir well with chopsticks.
(2) Mix 600 ml of fresh milk and 350 ml of rice broth and bring to a boil.
(3) Pour the egg mixture into the boiled milk and rice broth, stirring with chopsticks while pouring, to make 1000 ml of mixed milk. This 1000 ml milk mixture contains 40 grams of egg white, 40 grams of fat, 120 grams of sugar and 4184 kJ (1000 kcal) of calories. If the patient is diabetic, sugar is not added.
If the stroke patient is lucid but sometimes chokes and coughs when eating, he should be given a paste diet, which consists of steamed egg custard, thick porridge with minced meat and vegetables, rotten noodles with minced meat and vegetables, milk with lotus root powder, fruit puree or rice mashed with a masher and given to the patient.
For stroke patients without swallowing difficulties during the recovery period, it is advisable to have a soft and balanced diet that is light, less oily and easy to digest.
First of all, animal fats, such as lard, butter, cream, etc., and foods containing high cholesterol, such as egg yolk, fish roe, animal offal, fatty meat, etc., should be restricted because saturated fatty acids contained in these foods can significantly increase the concentration of cholesterol in blood and promote atherosclerosis; vegetable oils, such as soybean oil, tea oil, sesame oil, peanut oil, etc., can be used because the unsaturated fats contained in them can promote cholesterol excretion and conversion into The unsaturated fats contained in them can promote cholesterol excretion and conversion into bile acids, thus lowering the cholesterol content in the blood and delaying and reducing the purpose of atherosclerosis.
Secondly, there should be appropriate protein in the diet, often eat some egg whites, lean meat, fish and various beans and soy products to supply the body with the ammoniacal acid it needs. Generally, drink one glass of milk and one glass of sour milk each day, because milk contains milk factor and whey acid, which can inhibit the synthesis of cholesterol in the body and reduce the content of blood fat and cholesterol. When drinking milk, you can remove the milk skin. Beans contain soy sterols, which also have the effect of promoting cholesterol discharge.
You should eat more fresh vegetables and fruits because they contain vitamin C and potassium and magnesium. Vitamin C can lower cholesterol, enhance the denseness of blood vessels, to prevent bleeding, potassium, magnesium on and because the tube has a protective effect.
Can eat more on the knot of iodine-rich food, such as kelp, nori, shrimp, etc., iodine can reduce cholesterol deposition in the arterial wall, to prevent the occurrence of atherosclerosis.
Daily salt in less than 6 grams is appropriate, because salt contains a lot of sodium ions, the body intake of sodium ions too much, can increase blood volume and heart burden, and can increase blood viscosity, thus making blood pressure rise, unfavorable to stroke patients.
Avoid foods that excite the nervous system, such as wine, strong tea, coffee and stimulating condiments. In addition, eating less chicken soup and broth is beneficial to protect the cardiovascular system and the nervous system, and overeating needs to be avoided.
If you have a stroke patient, you can choose the following dietary supplements: 1. 6 grams of black fungus, soaked in water, added to dishes or steamed food. It can lower blood lipids, anti-thrombotic and anti-platelet aggregation. 2. 5 celery root, 10 red dates, decoction, eat dates and drink soup, can play a role in lowering blood cholesterol. 3. eat fresh hawthorn or hawthorn bubble boiling water, add appropriate amount of honey, after cooling as tea. If the stroke is complicated by diabetes, it is not suitable to add honey. 4. 10-15 grams of raw garlic or onion can lower blood lipids and enhance fibrin activity and anti-vascular sclerosis. 5. 5-10 ml of vinegar for diet after meal for stroke patients has the effect of softening blood vessels.
Brain hemorrhage patient’s home care methods
1.Psychological care
Patients with cerebral hemorrhage often have emotional reactions such as depression, frustration, irritability, irritability, pessimism and disappointment. Therefore, family members should care for the patient psychologically, talk with the patient more often, comfort and encourage the patient, create a good family atmosphere, explain the condition patiently, eliminate the patient’s doubts and pessimism, make them understand their condition, and establish and consolidate confidence and determination in functional rehabilitation training.
2.Care for prevention of complications
(1) Help patients turn and pat their backs 4~6 times a day regularly, for about 10 minutes each time. Once you find that the patient is coughing yellow sputum, fever, shortness of breath and blue lips, you should immediately consult a doctor.
(2) Encourage the patient to drink more water for the purpose of cleaning the urinary tract. And pay attention to the cleanliness of the perineum to prevent cross-infection. If cloudy urine and fever are found, they are signs of urinary tract infection and should be treated early.
(3) Most of the paralyzed patients have constipation, and some of them may have cerebral hemorrhage again due to forceful defecation. Therefore, it is necessary to pay attention to the diet structure, and give the patient more low-fat, high-protein, high-energy diet and vegetables and fruits with coarse fiber, and give enough water. Give regular bowel movements and apply laxative drugs and enemas when necessary.
(4) When the patient is paralyzed in bed, decubitus ulcers are prone to occur in the occipital ridge, scapula, hip, sacrococcygeal, heel and other bony prominences. Soft pillows or sea surface pads should be used to protect the bony ridge, turning every 2-3 hours, avoiding dragging and pushing, keeping the bed dry and clean, taking warm water baths and massaging regularly to improve local blood circulation and local nutrition.
(5) Daily centripetal massage of the extremities, 10-15 minutes each time, to promote venous blood flow back and prevent deep vein thrombosis. Once unexplained fever, swelling and pain in the lower limbs are found, they should be quickly treated.