Kwenzekani Ngesikhathi Isikhathi Sokuhlinzwa
Intubation yinkqubo yokufaka ithubhu, ebizwa ngokuthi i- endotracheal tube (ET), ngomlomo bese ehamba emoyeni. Lokhu kwenziwa ukuze isiguli singabekwa ku- ventilator ukuze kusize ngokuphefumula ngesikhathi se- anesthesia , sedation, noma ukugula okukhulu. I-tube isuke ixhunywe ku-ventilator, ephoqa umoya emaphashini ukuletha umoya kumguli.
Le nqubo yenziwa ngoba isiguli asikwazi ukugcina indlela yaso, ayikwazi ukuphefumula eyedwa ngaphandle kosizo, noma kokubili. Lokhu kungaba ngoba banikezwa i-anesthesia futhi ngeke bakwazi ukuphefumula ngokwabo ngesikhathi sokuhlinzwa, noma bangagula kakhulu noma balimala ukuze banikeze oksijini okwanele emzimbeni ngaphandle kosizo.
Indlela Intubation Yenzelwe Ngokwejwayelekile
Ngaphambi kokungenwa kwesiguli isiguli sihlala phansi noma singazi ngenxa yokugula noma ukulimala, okuvumela umlomo nomoya ukuphumula. Isiguli ngokuvamile siyigugu emhlane futhi umuntu ofaka ithubhu emi ekhanda lombhede, ebuka izinyawo zesiguli. Umlomo wesiguli uvuliwe ngobumnene futhi usebenzise ithuluzi elikhanyayo ukuze ugcine ulimi luvule umzila, ukukhanyisa umphimbo, i-tube itholwa kahle emphinjeni futhi iqhubekele emgwaqweni.
Kukhona ibhaluni encane elizungeze ithubhu ehlongozwa ukubamba ithubhu endaweni futhi igcine umoya ubaleke.
Uma leli bhaluni lihlanjululwe, i-tube itholakala ngokuphepha endaweni yomoya futhi iboshwe noma ifakwe endaweni emlonyeni.
Ukubekwa ngokuphumelelayo kuhlolwe kuqala ngokulalela amaphaphu nge-stethoscope futhi kuvame ukuqinisekiswa nge-x-ray yesifuba. Emkhakheni, njengalapho i-911 ivuliwe futhi ithubhu lokuphefumula libekwe ngabasizo lokuqala, kusetshenziswa idivaysi ekhethekile eshintsha umbala lapho ithubhu ibhalwe ngendlela efanele.
Izingozi ze-Intubation
Nakuba ukuhlinzwa okuningi kunengozi kakhulu, futhi ukuzwa kahle kuyingozi kakhulu, kunezimpikiswano ezithile ezingase zivele ikakhulukazi uma isiguli kufanele sihlale esivini isikhathi eside. Izingozi ezivamile zihlanganisa:
- Ukuthungatha amazinyo, umlomo, ulimi, kanye / noma i-larynx
- Intubation engozini engxenyeni yokudla (tube tube) esikhundleni se-trachea (i-air tube)
- I-trauma kuya ku-trachea
- Ukuphuza
- Ukungakwazi ukucutshungulwa kusuka ku-ventilator, okudinga i-tracheostomy.
- Ukuhlambalaza (ukuvuza) ukuhlanza, umathe noma ezinye iziphuzo ngenkathi zifakwa
- I-pneumonia, uma ukufisa kwenzeka
- Umphimbo obuhlungu
- Ukuthuthumela
- Ukwehla kwamathambo athambile (nge-intubation ende)
Ithimba lezokwelapha lizohlola futhi liqaphele lezi zingozi ezingase zibe khona, futhi zenze konke okusemandleni abo ukubhekana nabo.
Kuyini Ukuzwa Ukukhuluma?
Kwezinye izimo, uma umlomo noma umphimbo uqhutshwa noma walimala, ithubhu yokuphefumula ifakwe emakhaleni esikhundleni somlomo, okubizwa ngokuthi intubation yangasese. I-tube nasotracheal (NT) iyangena ekhaleni, phansi emhlane, nasemgwaqweni ongenhla. Lokhu kwenziwa ukugcina umlomo ungenalutho futhi uvumele ukuhlinzwa kwenziwe.
Lolu hlobo lwe-intubation aluvamile, ngoba ngokuvamile kulula ukukhuluma ngokuvula umlomo omkhulu, futhi ngoba akudingekile izinqubo eziningi.
Ngabe Kunesidingo Sokudinga?
Intubation iyadingeka lapho kunikwa i- anesthesia jikelele . Izidakamizwa ze- anesthesia ziphoqa imisipha yomzimba, kufaka phakathi umdwebo , okwenza kube nzima ukuphefumula ngaphandle kweventilator.
Iningi leziguli likhishwa, okusho ukuthi ithubhu lokuphefumula isuswe, ngokushesha ngemuva kokuhlinzwa. Uma bebegula kakhulu noma bebhekene nobunzima bokuphefumula, bangase bahlale e-ventilator isikhathi eside.
Ngemuva kwenqubo eminingi, imithi inikezwa ukuguqula imiphumela ye-anesthesia, evumela isiguli ukuba siphume ngokushesha futhi siqale ukuphefumula sisodwa.
Kweminye inqubo, njengezinqubo zenhliziyo evulekile, isiguli asinikezwa imithi yokuguqula i-anesthesia futhi iyophumula yedwa kancane. Lezi ziguli kuzodingeka zihlale ku-ventilator ize zivuke ngokwanele ukuze zivikele umoya wazo futhi zithinte umoya.
Intubation yenzelwa ukuhluleka ukuphefumula. Kunezizathu eziningi zokuthi kungani isiguli singagula kakhulu ukuphefumula kahle ngokwabo. Bangase babe nokulimala emaphashini, bangase babe ne-pneumonia enzima, noma inkinga yokuphefumula njenge-COPD. Uma isiguli singenakuthola ngokwanele oksijini ngokwanele, i-ventilator ingadingeka kuze kube yilapho iphinda ikwazi ukuphefumula ngaphandle kokusizwa.
Izingane zokwelashwa kanye nenkulumo
Inqubo yokukhulumisana iyafana nabantu abadala kanye nezingane, ngaphandle kobukhulu bemishini esetshenziselwa ngesikhathi senqubo. Ingane encane idinga ithini elincanyana kakhulu kunomuntu omdala, futhi ukubeka ithubhu kungadinga izinga eliphakeme ngoba ukuhamba emoyeni kuncane kakhulu. Kwezinye izimo, i-fibre optic scope, ithuluzi elivumela umuntu ukuthi abeke ithubhu lokuphefumula ukuze abukele inqubo kumqapha, isetshenziselwa ukwenza ukuhumusha kube lula.
Ngenkathi inqubo yangempela yokubeka ithubhu impela iyafana, ukulungiselela ingane ngokuhlinzwa kunzima kakhulu kunabantu abadala. Ngesikhathi umuntu omdala engase abe nemibuzo mayelana nokufakwa komshuwalense, izingozi, izinzuzo nezikhathi zokutakula, ingane izofuna incazelo ehlukile yenqubo ezokwenzeka. Ukuqinisekiswa kuyadingeka, futhi ukulungiswa ngokomzwelo kokuhlinzwa kuyohlukahluka kuye ngokuthi uneminyaka yesiguli.
Ukudla Ngesikhathi Sokungenwa
Isiguli esizobe sisesithombeni senqubo bese sichitha lapho inqubo isuqedile ngeke sidinge ukudla, kodwa singathola uketshezi nge-IV. Uma isiguli kulindeleke ukuba sibe yindlalifa yokuphuza umoya ezinsukwini ezimbili noma ngaphezulu, ukudla kuzovame ukuqaliswa ngosuku noma ezimbili emva kokungenwa.
Akunakwenzeka ukuthatha ukudla noma uketshezi ngomlomo ngenkathi ivuliwe, okungenani hhayi ngendlela ejwayelekile eyenziwa ngokuthatha ukulunywa, ukuhlafuna, ukugwinya.
Ukwenza kube lula ukudla ngokuphephile, imithi kanye namanzi okuphuma emlonyeni, ithubhu ifakwa emphinjeni bese efika esiswini. Le tube ibizwa ngokuthi i-orogastric (OG) uma ifakwa emlonyeni, noma ithubhu elisetshenziswayo (NG) uma lifakwe emmpeni bese phansi emphinjeni. Imithi, uketshezi, kanye nokuxilongwa kwe-tube itholakala ngaphakathi kwipayipi bese isesiswini besebenzisa isiraphu enkulu noma ipompo.
Kwezinye iziguli, ukudla, uketshezi, kanye nemithi kufanele zinikezwe ngaphakathi. Ukudla okune-IV, okubizwa ngokuthi i-TPA noma ukudla okunomzimba wonke, kunikeza ukudla okunomsoco kanye nama-calories ngokuqondile egazini ngendlela eluhlaza. Loluhlobo lokudla luvame ukugwema ngaphandle uma kudingekile, njengoba ukudla kungcono kakhulu kuncike emathunjini.
Ukususa I-Tube Yokuphuza
Ithebhu iyinto elula kakhulu ukususa kunokubeka. Uma sekuyisikhathi sokuba ithubhu isuswe. izibopho noma i-tape eyibambelele endaweni kufanele isuswe kuqala. Khona-ke ibhaluni elithinta ithini emgwaqweni lomoya lihlanjululwa ukuze ithubhu ingasuswa kahle. Uma i-tube iphuma, isiguli kufanele senze umsebenzi wokuphefumula uqobo.
Ungazikhulumi / Ungabuki
Ezinye iziguli zenza izifiso zabo zaziwa ngokusebenzisa isiqondiso esithuthukile, idokhumenti ebonisa ngokucacile izifiso zabo zokunakekelwa kwezempilo. Ezinye iziguli zikhetha ukukhetha "ukungakhethi", okusho ukuthi abafuni ukufakwa efrijini ukuze bathuthukise impilo yabo. Ungabuki kusho ukuthi isiguli sikhetha ukungabi neCPR.
Isiguli sigxile kulokhu kukhetha, ngakho-ke bangakhetha ukushintsha okwesikhashana lokhu kukhetho ukuze babe nokuhlinzwa okudinga umoya, kepha lokhu kuyimibhalo esemthethweni ebophezelayo engakwazi ukuguqulwa abanye ngaphansi kwezimo ezijwayelekile.
Izwi elivela
Isidingo sokuthi singeniswe futhi sibekwe ku-ventilator sivamile nge-anesthesia ejwayelekile, okusho ukuthi ukuhlinzwa okuningi kuzodinga lolu hlobo lokunakekelwa. Nakuba kuyesabeka ukucabanga ukuthi ukhona endaweni yokuphuza umoya, iziguli eziningi zokuhlinzwa ziphefumula zodwa ngaphakathi kwamaminithi ekupheleni kokuhlinzwa. Uma ukhathazekile ngokuba ngomoya wokuhlinza, qiniseka ukuthi uxoxe ngokukhathazeka kwakho nodokotela wakho ohlinzayo noma umuntu ohlinzeka nge-anesthesia yakho.
> Umthombo:
> Endotracheal Intubation. I-Medline Plus. https://medlineplus.gov/ency/article/003449.htm