Measures against the refusal to eat
Mental Disorders / / April 27, 2016
refusal to eat are in patients with hallucinatory, delusional and catatonic disorders.Patients may stubbornly refuse to eat under the influence of imperative auditory hallucinations, olfactory and gustatory hallucinations under the influence of delusions of poisoning, self-incrimination, in a state of stupor with symptoms of negativism in depressive states with suicidal tendencies.In order to overcome the failure of the food primarily resorted to persuasion during which discouraged the patient, if he has suspicions about food quality, replace it, or try the food in front of him.Stuporoznyh sick leave them a portion, and sometimes they eat it in the absence of observers.Direct the feeding of patients to those they trust (the number of medical staff or relatives).If all this does not help, the patient is injected subcutaneously with 4-8 units of insulin, which usually evokes the feeling of hunger, but if this is not possible to feed the patient, in 2 hours intravenously administered 20 ml of 40% glucose s
may be trying to feed the patient is able to Barbamyl-release caffeine.To this mixture is injected by slow intravenous barbamyl 5% solution (5.8 mL) and 10% caffeine solution (1.2 mL).Still in the process of infusion of a mixture of patients develop a condition resembles intoxication they become talkative (so you can hold a conversation, clarifying the picture of inner experiences and, in particular, the reasons for not eating), motor recovery, appetite may occur.This state lasts for 15-20 minutes, than you can use for feeding.
When the smell of acetone breath, and in his absence to 3-4th day of persistent non-food and ineffective methods described above, is made artificial feeding of patients through the probe.To perform this procedure, the patient is placed on a couch on her back.Examine the oral cavity, if any dentures, they are removed.The probe end is lubricated with glycerine, introduced a physician or under his supervision - a nurse through the nose, and in violation of patency of the nasal passages - by mouth (gag is introduced into the mouth).The probe should pass through the pharynx and esophagus into the stomach (a distance of about 50 cm, the probe previously a relevant note).If the probe is inserted into the stomach, the patient breathes calmly.If the introduction of the probe in the patient appear shortness of breath, coughing, cyanosis of the skin, the probe must be removed immediately, as these symptoms are evidence of its passage in the respiratory tract - the trachea, and sometimes in the bronchi.Because debilitated patients cough reflex can be lowered and other characteristics may be missing probe inhalation, before introduction into the probe nutrient mixture must again make sure that the end of the probe is in the stomach.In addition to the free breathing, evidenced by the following: the introduction of air into the tube by means of the cylinder causes noises in the stomach, resembling rumbling;flame of a match or a light little piece of fleece, having brought it to the edge of the funnel is inserted into the probe, do not deviate (mean air from the lungs comes out through a tube).After this test are introduced through a funnel 50-200 ml of water or tea, and then warmed nutrient blend containing milk or broth with 2-3 raw eggs, butter, sugar, salt, vegetable or fruit juice in an amount of 500-1000 ml.
After the introduction of the probe mixture quickly recovered.The patient should keep a few minutes lying on your back, that there was no vomiting.Patients who easily vomiting occurs 10-15 minutes prior to the introduction of the probe subcutaneously administered atropine or the tip of the probe is wetted with a 1% solution of novocaine, and 5-10 ml of novocaine flows through the probe before the introduction of the nutrient mixture.
tube feeding is carried out not more than 1 time per day.If necessary, tube feeding for long periods careful attention is drawn to the state of the nasal passages.