Izikhungo zokushaya izidakamizwa eziyinhloko izibhedlela eziye zaqinisekiswa yi-Joint Commission, inhlangano eyamukela izinhlelo zokunakekelwa kwezempilo e-United States. I-Joint Commission yaqala ukuqinisekiswa kwezikhungo zokunakekelwa kwezifo eziphambili ngoDisemba 2003.
Imigomo Yesikhungo Esiyisisekelo Sesivinini
Izikhungo zokuhlaselwa eziyinhloko kufanele zifeze izinqubo ezithile ukuze zivunyelwe ngokusemthethweni futhi ziqinisekiswe yilowo mbono.
Ezinye zalezi zidingo zifaka:
- Ukuba neyunithi yesifo esinqunyiwe yokuqapha okuqhubekayo kwesiguli.
- Kubonisa ukuhambisana nemikhombandlela yokwenza umtholampilo eyakhiwe ngesifo sohlangothi.
- Ukuqinisekisa ulwazi olusemthethweni lomnyango oluphuthumayo lwezinhlelo eziphuthumayo.
- Ukusungula inqubo yokwamukela nokudlulisela iziguli ezihlaselwa.
- Ukuqoqa nokubika idatha eqinisekisiwe mayelana nemiphumela yesifo.
Ama-Stroke Centers ahlinzeka ngokunakekelwa kwesifo sohlangothi oluhlelekile nokuhlelekile
Umgomo ovamile wesikhungo ngasinye sokushaya isifo ukuhambisa, ukuhlola, ukuxilonga, nokwelapha isiguli ngasinye ngesifo sohlangothi phakathi kwamahora amathathu ukuqala kwezibonakaliso zabo. Ukwengamela ukwelapha okufanelekile kwesidakamizwa kudinga ithimba lezokwelapha elinolwazi nangolwazi.
Imithi yokwelapha ishicilelo ihlanganisa ukuphathwa kwegazi elinamandla kakhulu njenge- IV TPA kanye ne -thrombolysis yangaphakathi. Lezi mithi kumele ziphathwe ngaphakathi kwefasitela elifushane lesikhathi ngemuva kokuba izimpawu zesifo sokuqala ziqale, noma ngabe zibangele izinkinga ezinkulu, futhi kungenzeka zibulale.
Eminye yemisebenzi emikhulu isikhungo sokushaywa yisifo sokuqala kumele sikwazi ukufeza phakathi nale festi yesikhathi samahora amathathu kufaka:
- Ukuthutha isiguli esibhedlela
- Yenza ukuhlolwa okuphelele ngudokotela - ngokuvamile i-neurologist
- Thola futhi ufunde, i- CT scan of the brain
- Dweba igazi, uhlaziye, futhi ubike imiphumela
- Khipha ukwelashwa okufanele
Ukuphathwa kwezigubhu ngabachwepheshe beStroke
Izikhungo eziningi eziphazamiseka zinezifo ze-neurologists, noma izinzwa ze-neurologists (izazi ze-neurologists ezisebenzayo ngokuzikhandla) kubasebenzi, futhi ngokuvamile zikhona endlini, ngehora. Laba odokotela basebenza ngaphansi kwesiqubulo esithi "isikhathi ubuchopho." Ngakho-ke, ziyasheshisa kakhulu, kodwa zinembile kakhulu, lapho zibona izibhamu eziyingozi ngokungavamile. Uma lokhu kwenzeka, laba odokotela baqeqeshwe ukuhlela ukuhlinza okuvela ngokushesha, nokuhlela ukuhanjiswa okusheshayo kwunithi yokunakekelwa okukhulu, noma esibhedlela esithile esikhethekile.
Ukuqashelwa Nokuphathwa Okufanelekile Kwezinkinga Ze-Stroke
Odokotela nabahlengikazi abayingxenye yesikhungo sokushaya isifo baqeqeshwe ukuthola izinkinga zezokwelapha ezingase zivele kumuntu oye wahlaselwa isifo. Lokhu kubaluleke kakhulu, njengoba iziguli ezihlukunyezwayo zivame ukulimaza ngokushesha phakathi kwamahora ambalwa okuqala noma izinsuku emva kokushaywa yisifo. Eqinisweni, ngisho nemivimbo ephansi kakhulu ingozi engama-10% yokuguqula emikhulu emahoreni angu-48 okuqala.
Ezinye zezinkinga ezivame ngemuva kokushaywa komzimba zihlanganisa:
- I-stroke entsha, noma ikhula
- Ukukhipha igazi, ikakhulukazi uma uphathwa nge-t-PA
- Ukuzizwa
- Ukuvuvukala kwebongo
- Izinkinga zezokwelapha ezifana ne- pneumonia nezinye izifo
Abasebenzi base-Ancillary bajwayele izidingo zeziguli zesisu
Inzuzo ebalulekile yezikhungo zokushaywa yisifo ukuxhunywa kwabo nabasebenzi bezenhlalakahle kanye nezinye izisebenzi ezisekelayo ezijwayele izidingo ezincane nezesikhathi eside zeziguli ezihlukunyezwayo. Labaqeqeshi abaqeqeshiwe bavame ukunikeza usizo olukhulu ekuxazululeni izinkinga ezihlobene nomshuwalense wezempilo , ekutholeni ukuqashwa kwabagulayo ngesifo sohlangothi, odokotela bezengqondo, noma abahlinzeki bezisebenzi, nasekukhethweni kwezinhlelo ezinhle zokuvuselela izifo ukuze kutholakale ukuphumula nokulula ngemva kokushaywa yisifo.
Imiphumela Yesikhungo Esiyisisekelo Sesivinini
Ngokuhlaziywa kwedatha eyanyatheliswa yi-Journal of the American Heart Association, iziguli ezithola ukwelashwa kwesifo sohlangothi ezikhungweni eziyinhloko zithinteka ukwelashwa nge-T-PA kuneziguli ezingaphathwa ngezikhungo eziphambili zezintambo.
Esinye isampula sesiguli esasifunda iziguli ezingaphezu kuka-120 000 ezamukelwa futhi zelashwa ngesifo sohlangothi sanyatheliswa kuyi-Journal of Stroke and Cerebrovascular Disease. Iziguli zazibandakanya iziguli ezihlaselwe yisifo sohlangothi olwaluvunyelwe ezikhungweni zokushaya izidakamizwa kanye neziguli ezazingeniswa ezibhedlela ezingazange zikhethwe njengezikhungo zokushaya izidakamizwa eziyinhloko.
Ababhali abathintekayo bathi iziguli eziphazamisekile eziphethwe izikhungo zokushaya izidakamizwa eziyisisekelo zazingenakwenzeka ukuba zibe nezibhedlela ezingenasifo futhi zibe nemiphumela engcono yokukhishwa esibhedlela.
Ukwelapha isisu kuLobubanzi
Indlela entsha yokuthola iziguli eziphazamiseka ziphathwa amanga ngokushesha kunesikhungo sokunakekelwa kwesifo esibizwa ngokuthi i-Mobile Stroke Unit. Njengoba kunabantu abambalwa emhlabeni futhi ababili e-United States, ama-Unity Stroke Units asebenza njengoba nje igama lisho, ukuqala ukuhlolwa kwesifo, futhi ngezinye izikhathi ngisho nokwelashwa, endleleni eya esibhedlela, ukulondoloza isikhathi esiyigugu.
> Imithombo:
> Amakilasi ama-Joint Commission Primary Stroke asebenzisa i-Rt-PA eSiphakamisweni Sonke Sokugula Isiguli, uMellen MT, Kasner SE, Kallan MJ, Kleindorfer DO, Albright KC, Carr BG, Journal of the American Heart Association , 2013 Mar 26; 2 (2) : e000071
> Izinga lezehlakalo ezimbi nezimpikiswano phakathi kweziguli zesifo sofuba esivumelwaneni esivumelwaneni. Chaudhry SA, Afzal MR, Chaudhry BZ, Zafar TT, Safdar A, Kassab MY, Hussain SI, Qureshi A, Journal of Stroke and Cerebrovascular Disease, 2016 Aug; 25 (8): 1960-5
Ihlelwe nguHeidi Moawad MD