Acute cholecystitis: emergency care at the prehospital stage

A serious and at the same time common problem is acute cholecystitis. Emergency care provided correctly and on time, sometimes is a decisive factor in further treatment.

What is acute cholecystitis?

Inflammatory process in the walls of the gallbladder is characterized by acute cholecystitis. Emergency care sometimes plays a crucial role in preserving the patient's life. This disease is primarily classified by such a feature as the presence or absence of stones. So, in the first case it is a question of calculous, and in the second - about noncalculous cholecystitis. Also, the pathology is classified according to the degree of gallbladder damage:

• Catarrhal cholecystitis - the gallbladder is much more than normal, filled with liquid, and the walls are covered with mucus;
• Phlegmonous - inflammation, accompanied by the formation of pus;
• Gangrenous - the most severe form of cholecystitis, which is accompanied by necrosis of tissues.

Causes of the disease

A number of factors can provoke such a problem as acute cholecystitis. Emergency care is largely determined by them. So, the reasons for the problem are:

• The presence of concrements, which complicate the outflow of bile;
• Inflexion of the ducts.

In turn, these factors lead to these problems:

• Operative intervention;
• Mechanical injuries;
• A rigid diet or fasting;
• Problems in the work of the digestive tract;
• atherosclerosis;
• Improper exit from the diet (a sharp increase in the amount of food consumed);
• sepsis;
• Hypertension of bile ducts;
• Started caries;
• overweight;
• Age after 45 years;
• Chronic infections.

Main symptoms

Help identify acute cholecystitis symptoms. Emergency care may be required when there are external manifestations:

• Sharp pains in the right hypochondrium (their intensity and frequency are constantly increasing);
• Dry mouth and white tongue formation;
• Increase in body temperature up to 38 degrees;
• Chills and increased sweating;
• Bloating;
• nausea and vomiting;
• A feeling of bitterness in the mouth;
• Yellow skin;
• Feeling tired and impotent;
• cardiopalmus;
• Difficulties with orientation in space.

It should be noted that these symptoms can also be characteristic of a number of other diseases in acute form (pancreatitis, liver abscess, stomach ulcer, etc.), and not just for such a problem as acute cholecystitis. Emergency care is needed if, with pressure on the gallbladder, pain is greatly increased. A similar reaction is observed when tapping on a painful area during inspiration.

Acute cholecystitis: emergency care at the prehospital stage

The attack occurs absolutely suddenly and proceeds quite hard and long. But do not rely on an independent solution to such problems as acute cholecystitis. "First Aid" should be called immediately when the first signs appear. And before the arrival of doctors it is worth taking such measures:

• First thing you need to help the patient lie down and take a comfortable position (it is better that he lay on his right side);
• It is permissible to give the patient a little non-carbonated mineral (or boiled) water or warm green tea;
• To slightly ease the course of the attack, a packet filled with ice should be placed under the right side.

It is worth noting that first aid for cholecystitis is rather limited. Not only inaction, but also ill-considered manipulations can lead to irreparable consequences.

What can not be done

There are a number of taboos that characterize acute care in acute cholecystitis. The algorithm should in no case include the following items:

• No matter how severe the pain, before the arrival of physicians, exclude the taking of any analgesic drugs (they are unlikely to be able to stop an attack of acute cholecystitis, but it will be more difficult for physicians to make an accurate diagnosis);
• It is unacceptable to give a patient too hot or too cold a drink;
• In no case it is necessary to heat a sore spot (this, of course, can slightly ease the spasm, but, on the other hand, heat can serve as a catalyst for an attack).

Health care

The call of the "First Aid" is necessary for a problem such as acute cholecystitis. Emergency home care is extremely limited. The main task of the medical team is to clarify the diagnosis (by studying the symptoms and palpation), as well as relief of pain. So, a special antispasmodic mixture is injected intravenously. The drug can temporarily facilitate the passage of bile through the ducts, resulting in the symptoms becoming less pronounced. The next stage will be the delivery of the patient to the hospital, where the examination will be performed and the subsequent treatment will be prescribed.

Treatment

After examination in the hospital, the patient is prescribed treatment. In the case of acute cholecystitis, it may include the following items:

• A strict diet (until full starvation), which lasts 1-2 days. Further, the food should be strictly limited and include mainly dairy and vegetable products, as well as low-fat meat.
• Systematic administration of antispasmodic and anesthetics, which are designed to normalize the condition of the biliary tract and eliminate unpleasant symptoms. In especially severe cases, even narcotic drugs can be prescribed.
• With catarrhal cholecystitis, intramuscular administration of antibiotics is prescribed, which often leads to complete recovery. With regard to the destructive form of the disease, this technique may be inconclusive, because of changes in the degenerative nature of blood circulation in the organ is impaired.
• Surgery may involve the removal of part of the gallbladder or the organ completely. Unfortunately, in most cases this is a necessary measure, without which it is impossible to save the patient's life and complete recovery.

Preventive measures

It is difficult to argue with the fact that it is better not to allow the occurrence of diseases than then to deal with their treatment. Despite the fact that the main group at risk of acute cholecystitis is women of large size after 45 years, in fact no one is insured against this problem. Therefore, it is worth paying enough attention to prevention, which implies the following:

• Balanced nutrition, which includes a maximum of useful products;
• Timely treatment of infectious diseases (this applies not only to the digestive tract, but also the respiratory system and other organs);
• Regular dental visits and caries treatment;
• Prevention of infection with intestinal parasites or their immediate elimination in case of problem identification);
• Active lifestyle (be sure to do morning exercises, as well as walk as much as possible);
• Full rest after a day's work;
• A regular medical examination in order to identify the slightest deviations and their immediate elimination.

Conclusion

Acute cholecystitis is a dangerous problem that can manifest itself absolutely suddenly. It is extremely important to be able to provide first aid before the arrival of doctors, because this may depend on the life of the patient. No supernatural medical skills are required, because extraneous intervention is not only inappropriate, but even dangerous.