Treatment strategies and emergency care for the common cold: emergency treatment for respiratory distress and management of early hypertensive encephalopathy

Treatment for the common cold primarily focuses on symptomatic relief, aiming to alleviate symptoms and prevent complications. Commonly used medications include antipyretics and analgesics such as aspirin, vitamin C, and chlorpheniramine (Chlorpheniramine), which can significantly reduce symptoms. Intramuscular injection of Bupleurum chinense injection can also be used. For nasal congestion, naphazoline (nasal drops) or compound chlorpheniramine/ephedrine mixture (containing chlorpheniramine and ephedrine) nasal drops can be used. For sore throat, lysozyme or iodine lozenges can be used. Traditional Chinese medicine (TCM) treatment for the common cold generally differentiates between wind-cold, wind-heat, and summer-dampness syndromes, and treats accordingly. In the early stages of a cold, wind-cold syndrome is common, characterized by chills, fever, lack of sweating, headache, limb pain, nasal congestion, runny nose, sore throat, frequent sneezing, thin white tongue coating, and floating pulse. Commonly used herbs include Saposhnikovia divaricata, Perilla frutescens, Schizonepeta tenuifolia, Peucedanum praeruptorum, Platycodon grandiflorus, and fermented soybean. In the middle stage of a cold, symptoms often manifest as wind-heat syndrome, with patients experiencing fever, headache, slight sweating, cough, sore throat, dry mouth, red tongue with a slightly yellow coating, and a floating and rapid pulse. Commonly used herbs include honeysuckle, forsythia, apricot kernel, peppermint, burdock seed, mustard seed, platycodon, chrysanthemum, houttuynia cordata, dryopteris crassirhizoma, isatis leaf, and sophora root. Summer colds are often due to summer-dampness syndrome, with patients experiencing weakness in the limbs, a severe headache, fever, thirst, poor appetite, abdominal distension, sore throat, and cough. Commonly used herbs include agastache, eupatorium, magnolia bark, pinellia, poria cocos, atractylodes macrocephala, honeysuckle, and forsythia. Many preparations and traditional Chinese medicines are also available for treating colds, such as fast-acting cold capsules, cold remedies, strong vitamin C and honeysuckle tablets, honeysuckle and honeysuckle detoxification pills (tablets), antelope and honeysuckle detoxification pills (tablets), agastache and bupleurum soft capsules, and heat-clearing cold granules. Antiviral drugs for influenza include amantadine, moroxydine (Virazole), and triazole nucleoside. For patients with influenza, their condition should be closely monitored, and antibiotics should be used promptly if a secondary bacterial infection is suspected. General treatment for influenza is similar to that for the common cold. Dyspnea refers to difficulty breathing, a feeling of not having enough air, chest tightness, increased respiratory rate, and involvement of accessory respiratory muscles; in severe cases, mouth breathing may be observed. Dyspnea is commonly seen when there is obstruction of the larynx or trachea, obstruction of breathing and airflow, or when pleural or lung lesions affect gas exchange in the lungs. Some neurological disorders (such as hysteria), anemia, and carbon monoxide poisoning can also cause dyspnea. The most common cause of dyspnea in middle-aged men is heart failure due to heart disease, leading to severe respiratory distress. Treating the underlying cause is the primary method of emergency care. Placing the patient in a semi-recumbent or sitting position with their legs dangling over the edge of the bed can reduce the amount of blood returning to the heart, thus temporarily relieving the burden on the heart. Depending on the specific conditions, different forms of oxygen inhalation (nasal cannula, face mask, oxygen tent, etc.) can be administered to relieve breathing difficulties. In emergencies, a tracheotomy can be performed to maintain a clear airway. If sputum production is increased, suctioning should be performed. For bronchospasm, medications such as salbutamol, terbutaline, or chlorpheniramine can be administered. For patients with respiratory failure, central nervous system stimulants such as caffeine benzoate, lobeline, and nikethamide can be given. Assisted ventilation should be provided when necessary, and mechanical ventilation should be used if available. During health checkups, a significant number of middle-aged men are found to have hypertension without any treatment. This is mainly because early symptoms of hypertension are often subtle, sometimes even referred to as an "asymptomatic" disease. By the time obvious symptoms appear, many complications have already developed. Therefore, mild to moderate hypertension should be treated promptly. Deaths in middle-aged men due to hypertension are mostly caused by complications. Emergency room deaths are often due to cerebrovascular and cardiovascular diseases, such as cerebral hemorrhage, cerebral infarction, and congestive heart failure. Hypertension causing kidney damage can lead to death from uremia. Hypertension is closely related to the development of coronary heart disease; deaths from coronary heart disease in hypertensive patients include sudden cardiac death, acute myocardial infarction complicated by heart failure, arrhythmia, and shock, in addition to sudden cardiac death. Early treatment of hypertension should be emphasized to reduce complications and thus lower the mortality rate. Timely treatment of acute cerebrovascular diseases, such as hypertensive intracerebral hemorrhage and hypertensive encephalopathy, and proper treatment of congestive heart failure caused by hypertension in middle-aged men are also important measures to reduce the mortality rate of hypertension. Hypertensive encephalopathy is a syndrome characterized by a sudden increase in blood pressure. It is often triggered by excessive fatigue, mental stress, and emotional excitement. Due to persistent and severe spasm of small arteries in the brain, hypertensive encephalopathy can cause significant cerebral edema and increased intracranial pressure, leading to a series of clinical manifestations. Generally, in middle-aged men, the onset of hypertensive encephalopathy is preceded by a sudden increase in blood pressure, followed by worsening headache, nausea, vomiting, bradycardia or tachycardia, strong pulse, blurred vision, and brief mental confusion. Subsequently, the patient may fall into a coma, often with epileptic-like seizures, weakness in one side of the body, or speech impairment, and respiratory distress may also occur. Hypertensive encephalopathy has a sudden onset, unpredictable symptoms, and is extremely urgent, requiring immediate treatment. The first priority is to urgently lower blood pressure, improve cerebral edema, and prevent excessively high blood pressure from causing cerebral hemorrhage and other serious complications. This can be achieved through deep intramuscular injection of 25% magnesium sulfate, or intravenous injection of sorbitol or mannitol, or hypertonic glucose. Furosemide (Lasix) or ethacrynic acid (ethic acid) can also be used. If conditions permit, antihypertensive drugs such as sodium nitroprusside or alpha-nitroglycerin can also be used. Controlling seizures is also crucial; an enema of 30 ml of 10% chloral hydrate or an intramuscular injection of 0.1–0.2 g of phenobarbital sodium can be administered to quickly control seizures and alleviate the patient's suffering. If the patient cannot be hospitalized, they should be kept quiet and rest in bed. Acupuncture at the Quchi acupoint or massage at the bilateral Quchi acupoints can also be effective.