Dɛn ne ‘extravasation’ yi? Momma yɛnte ase kɛkɛ!

So woate asɛmfua ‘extravasation’ pɛn? Ebia woate afi wo duruyɛfo hɔ, anaasɛ ebia woate bere a woreyɛ nhwehwɛmu wɔ kokoram ayaresa ho no . Ɛwom sɛ nokwarem no ɛyɛ aduruyɛ mu asɛmfua kakra de, nanso ɛwɔ ntease abien. Biako ne sɛ ɛyɛ abɔde mu adeyɛ a ɛkɔ so wɔ yɛn nipadua mu. Ɔfoforo no ne sɛ ɛyɛ ɔhaw ketewaa bi a ɛtɔ mmere bi a ebetumi aba bere a yɛma nnuru no, titiriw bere a yɛresa kokoram (chemotherapy). Yɛbɛka eyinom abien no nyinaa ho asɛm nnɛ, tiawa koraa, sɛnea ɛbɛyɛ a wobɛte ase.

Dɛn ne adeyɛ a wɔfrɛ no ‘extravasation’?

Sɛ yɛbɛka no tiawa a, ‘extravasation’ yɛ ɔkwan a nkwammoaa a ɛwɔ yɛn nipadua mu no fi mogya ntini mu (baabi a mogya sen) kɔ ntini a atwa yɛn ho ahyia no mu. Latin nsɛmfua abien na ɛka bom yɛ. 'extra' kyerɛ "akyi" na 'vas' kyerɛ "anwenne." Enti ɛkyerɛ biribi te sɛ "nea efi anwenne mu ba."

Susuw ho saa kwan yi so. Sɛ wunya kuru ketewaa bi, anaa sɛ ɔyare mmoawa bi hyɛn wo nipadua mu a, ade a edi kan a ɛbɛboa wo ne wo mogya mu nkwammoaa fitaa no. Wɔte sɛ polisifo a wɔwɔ wo nipadua mu. Saa mogya mu nkwammoaa fitaa yi fa wo mogya ntini mu, huruw fi saa ntini no mu, na ɛkɔ kuru no anaa ɔyare mmoawa no ho. Yɛfrɛ saa adeyɛ a ɛne sɛ wobehuruw afi mu yi ‘extravasation.’ Eyi yɛ wo nipadua no ahobammɔ nhyehyɛe no fã titiriw .

Afei nso, awerɛhosɛm ne sɛ, saa ‘extravasation’ adeyɛ koro yi ara na kokoram nkwammoaa de di dwuma de trɛw wɔ nipadua no mu nyinaa, kyerɛ sɛ, efi beae biako kɔ foforo (a yɛsan frɛ no `metastasis`).

Ɔkwan bɛn so na kokoram nkwammoaa yɛ eyi?

Kokoram nkwammoaa di kan tetew fi mfitiase akisikuru a efi mu bae no ho. Afei saa nkwammoaa yi fa mogya ntini nketenkete a ɛwɔ yɛn nipadua mu a wɔfrɛ no capillaries , mu kɔ mogya no mu. Bere a wɔretu kwan no, kokoram nkwammoaa yi bata ntini a ɛyɛ tratraa bi a wɔfrɛ no endothelium , a ɛyɛ mogya ntini no ho.

Mfiase no, saa kokoram nkwammoaa yi fa endothelium no mu. Bere bi akyi no, wɔbata endothelium no ho denneennen. (Yɛn mogya mu nkwammoaa fitaa no bi boa eyi, nkwammoaa bi a wɔfrɛ no platelets . Aduruyɛ mu nhwehwɛmufo resua adeyɛ yi ho ade pii, efisɛ wosusuw sɛ sɛ yetumi siw ano a, yebetumi ama kokoram no atrɛw brɛoo.) Awiei koraa no, kokoram nkwammoaa yi bubu fa mogya ntini no afasu mu na wotu kwan kɔ ntini no mu. Ɛno akyi no, kokoram nkwammoaa no betumi ada, awuwu, anaasɛ afi ase ayɛ akisikuru foforo wɔ beae foforo.

Ebia woresusuw sɛ, "Sɛ mewɔ 'extravasation' a ɛte sɛɛ wɔ me nipadua mu a, anka mɛte nka?" Sɛ mogya mu nkwammoaa fitaa reko atia ɔyare mmoawa bi a, ebia wobɛte biribi te sɛ wo hohoro ne kɔkɔɔ. Nanso wɔ ‘extravasation’ a ɛba bere a kokoram trɛw mu no , ebia worenhu sɛnkyerɛnne atitiriw a ɛte saa mfiase no . Ɛwom sɛ aduruyɛ mu nhwehwɛmu nkyerɛ saa ‘nsu a wɔtwe fi nipadua no mu’ yi tẽẽ de, nanso wobetumi de mogya mu nhwehwɛmu ahwɛ nneɛma te sɛ mogya mu nkwammoaa fitaa dodow a ɛwɔ mogya no mu ne kokoram agyiraehyɛde ahorow.

Ayaresa tebea a wɔfrɛ no ‘extravasation’ no.

Afei momma yɛnka ntease foforo a ɛwɔ nea nnuruyɛfo frɛ no ‘extravasation’ no ho asɛm. Eyi te saa titiriw bere a wɔma kokoram ayarefo nnuru a wɔde sa yare wɔ ntini mu (IV) , a ɛyɛ aduru bi a wɔde fa afiri (cannula) mu kɔ ntini mu no.

Ebia woahyɛ no nsow sɛ wɔde nnuru bi gu ntini bi mu tẽẽ. Wɔ kokoram ayaresa mu no, wɔde aduru yi fa IV afiri mu kɔ mogya no mu tẽẽ. Mpɛn pii no, wɔde saa IV afiri yi bata ntini bi a ɛwɔ wo nsa anaa wo nsateaa mu ho. Afei wɔde aduru no fa afiri bi mu fi plastic bag mu kɔ wo mogya mu. Ɛtɔ mmere bi a wɔde kankyee bi di dwuma, na ɛde nnuru no gu wo nipadua mu nkakrankakra wɔ bere bi mu.

Afei, nnuru bi wɔ hɔ a ɛko tia kokoram a wɔfrɛ no ``vesicants.'' Asɛmfua no kyerɛ ``a ɛde vesicants ba.'' Sɛ saa ``vesicants'' nnuru yi pue fi IV line anaa ``cannula,'' mu a, ebetumi asɛe ntini a ɛwɔ apɔwmuden a atwa ho ahyia no. Ɛno ne nea yɛfrɛ no wɔ aduruyɛ mu ``extravasation,'' bere a aduru no pue fi ntini no mu na ɛsɛe ntini no .

Sɛ eyi ba a, ebia onipa a ɔrema no aduru no bɛte ɔhyew ne ɛyaw nka wɔ baabi a wɔde IV no ahyɛ no. Sɛ aduru no fa kankyee mu pue a, ebia beae no bɛte nka sɛ ɛyɛ den, ɛho ahonhon, na ɛyɛ kɔkɔɔ.

Nanso biribi a ɛho hia yiye a ɛsɛ sɛ yɛkae ni . Sɛ wɔrema wo kokoram aduru bi a ɛyɛ ‘vesicant’ a, wo nnuruyɛfo ne ayarehwɛfo nim no yiye. Ayaresabea ahorow wɔ nhyehyɛe ne akwankyerɛ a emu da hɔ a wɔde besiw ‘extravasation’ yi ano. Wɔhwɛ wo yiye bere a wɔde aduru no rema wo no, na sɛ wohu ɔhaw bi a, wosiesie ntɛm.

So ‘ntini a wɔtwe fi nipadua mu’ yi abu so wɔ kokoram ayaresa mu?

Dabi, eyi nyɛ nea abu so saa., nanso ɛnyɛ nea entumi nyɛ yiye. Nhwehwɛmu bi kyerɛe sɛ kokoram ayaresa bɛyɛ 6% wɔ ‘extravasation’ ketewaa bi. Wɔatete nnuruyɛfo a wɔnam IV so ma kokoram nnuru no titiriw sɛnea ɛbɛyɛ a wobesiw eyi ano na sɛ ɛba a, wɔbɛsa no ntɛm.

So eyi yɛ ɔhaw a anibere wom?

Yiw, ɛtɔ mmere bi a eyi betumi ayɛ aniberesɛm . Susuw ho hwɛ, nnuru a ano yɛ den a ebetumi akum kokoram nkwammoaa no nso betumi asɛe ntini a ɛte apɔw, ɛnte saa? Enti sɛ aduru no fi IV no mu a, ebetumi ama obi ayɛ yaw na asɛe ntini ahorow. Ebia yare no ho sɛnkyerɛnne bɛda adi ntɛm ara, anaasɛ ɛbɛda adi nna kakraa bi akyi.

Dɛn ne sɛnkyerɛnne ahorow a ɛkyerɛ sɛ obi ayɛ ‘extravasation’?

• Ɛyaw a ɛba mpofirim wɔ baabi a wɔde IV anaa kankyee no hyɛ mu.
• Nkate a ɛyɛ hyew anaasɛ ɛyɛ yaw .
• Wora no yɛ kɔkɔɔ wɔ saa beae no.
• Pockmarks anaasɛ akisikuru .
• Opira .
• Wora a ɛyɛ fitaa (eyi betumi ayɛ sɛnkyerɛnne a ɛkyerɛ sɛ ntini asɛe).

So nneɛma bi wɔ hɔ a ɛma asiane a ɛwɔ hɔ sɛ obi bɛkɔ mogya no mu no yɛ kɛse?

Yiw, nneɛma bi betumi ama asiane yi ayɛ kɛse kakra. Nanso nnuruyɛfo nim asiane ahorow yi, enti wɔyɛ nneɛma bi de tew asiane yi so.

• Wɔn a wɔn ntini nketenkete anaa ɛyɛ mmerɛw no fam no .
• Wɔn a wɔn mogya ntini pae ntɛmntɛm sen sɛnea ɛte daa no fam no .
• Wɔ nnipa a wɔn mogya ntini ayɛ den anaasɛ ayɛ den esiane kokoram ayaresa nti no fam.
• Wɔn a mogya ntini a ɛretu bere a wɔrebɔ mmɔden sɛ wɔde IV bɛhyɛ wɔn mu no fam no.

Ɔkwan bɛn so na wɔyɛ ‘extravasation’ yi?

Aduruyɛ adwumayɛfo a wɔde kokoram nnuru ma no de yɛ wɔn ade titiriw sɛ wobesiw ‘extravasation’ yi ano. Nanso, sɛ awerɛhosɛm ne sɛ ɛba a, wɔtete wɔn nso ma wosiesie ɔhaw biara a ɛbɛsɔre ntɛm. Anamɔn bi a wɔtaa tu ni:

• Wobegyae nnuru a wɔde fa IV no so no ntɛm ara.
• Sɛnea wubetumi biara no, yi nnuru biara a ahwie agu afi baabi a ɛwɔ hɔ no.
• Woyi IV no na wɔtow gu.
• Basa a ɛka no no kɔ soro kakra (ɛma so).
• Fa cream bi gu so na ama yare no ho sɛnkyerɛnne so atew.
• Wɔde nnuru a wɔde hyɛ nsu mu a ɛyɛ nwini na ɛyɛ adwuma. Cold compress no brɛ ɛyaw ase. Ɛsan nso twetwe mogya ntini no, na ɛmma nnuru biara a aka no ntrɛw.
• Wɔ tebea horow bi mu no , wɔde compress ahorow a ɛyɛ hyew na ɛyɛ adwuma.Nnuru a wɔde mia mogya a ɛyɛ hyew ma mogya no kɔ soro, na ebetumi aboa ma wɔayi nnuru a ɛwɔ baabi a wɔde IV no ahyia no afi hɔ anaasɛ ɛbɛtew so. (Wo duruyɛfo na obesi gyinae sɛ ebia ɛfata sɛ wode aduru a ɛyɛ hyew anaa awɔw bɛhyɛ wo nsa).

Dɛn na ɛba bere a wɔayɛ ‘extravasation’ akyi?

Ebetumi ayɛ soronko a egyina wo tebea no so. W’aduruyɛfo kuw no bɛsa ɔhaw ahorow a efi ntini a wɔtwe fi nipadua no mu no de ba no. Ɛno akyi no, wɔbɛhwɛ wo tebea no so ahwɛ sɛ ɔhaw foforo bi sɔre anaa tebea no mu yɛ den anaa.

Ɛtɔ da bi a, wubetumi akɔ so ayɛ ayaresa denam IV beae foforo a wode bedi dwuma no so. Mmere foforo nso, ebia wo duruyɛfo bɛkamfo akyerɛ sɛ mfa ayaresa no nkɔ akyiri nna kakraa bi kosi sɛ wo ho bɛtɔ wo. Nanso, wɔbɛma wo akwankyerɛ a ɛkɔ akyiri a ɛfa sɛnea wobɛhwɛ wo ho wɔ fie. Nhwɛsoɔ:

• Sɛ wɔayiyi wo nsa akyi a, wobetumi aka akyerɛ wo sɛ fa aduru a ɛyɛ nwini anaa ɛyɛ hyew bɛhyɛ wo nsa so anyɛ yiye koraa no da koro (bɛyɛ simma 15-20, mpɛn anan kosi asia da biara). Wo duruyɛfo bɛkyerɛ wo sɛnea wobɛyɛ eyi pɛpɛɛpɛ.
• Wubetumi aka akyerɛ wɔn sɛ wɔmma nsa a ɛka no no nkɔ soro .

So metumi akɔ so ayɛ ayaresa?

Egyina wo tebea no nso so. Nhwehwɛmu ahorow kyerɛ sɛ nnipa dodow no ara betumi akɔ so ayɛ ayaresa . Ɛtɔ mmere bi a, wobetumi de IV no asi ananmu na wɔafi ase ayɛ ayaresa wɔ ntini a wɔayi afi mu no akyi bere tiaa bi. Mmere foforo nso, wobetumi atwe ayaresa no akyɛ kosi sɛ ntini a wɔde kɔ nipadua no mu no ho sɛnkyerɛnne no befi hɔ koraa.

Bere bɛn na ɛsɛ sɛ mebɔ oduruyɛfo no amanneɛ?

Sɛ mogya a ɛkɔ nipadua no mu no ho sɛnkyerɛnne kɔ so kyɛ sen sɛnea na wohwɛ kwan a, hwɛ hu sɛ wobɛbɔ wo duruyɛfo amanneɛ .

Sɛ yɛbɛbɔ no mua a, nneɛma a ɛsɛ sɛ yɛkae ni (Take-Home Message):

Seesei wunim sɛ asɛmfua ‘extravasation’ no wɔ ntease abien. Biako ne abɔde mu adeyɛ a kokoram nkwammoaa fa so trɛw kɔ nipadua no mu nyinaa. Ɔfoforo no yɛ aduruyɛ mu tebea a ebetumi aba bere a nnuru a wɔde sa yare no pue fi IV no mu no.

Nea ɛho hia no, saa ɔhaw a wɔfrɛ no ‘extravasation’ yi nyɛ nea ɛntaa nsi wɔ kokoram ayaresa mu. Wɔatete nnuruyɛfo titiriw sɛnea ɛbɛyɛ a wobesiw ano na sɛ ɛba a, wɔbɛsa no ntɛm.

Sɛ worekɔyɛ nnuru a wɔde sa kokoram a, wo ne wo duruyɛfo anaa ɔyarehwɛfo nkasa mfa nea wobɛhwɛ kwan bere a wɔreyɛ ayaresa no ne nea ɛtaa de ba no ho asɛm. Saa kwan no so no, sɛ wuhu biribi soronko bi a, wubetumi ahu sɛ ɛyɛ ade a ɛfata anaa biribi a ɛsɛ sɛ wobɔ ho amanneɛ ntɛm ara. Mma ɛnhaw wo, w’aduruyɛ kuw no wɔ ha sɛ wɔbɛboa.

` Extravasation, kokoram ayaresa, chemotherapy, IV leak, nnuru a ɛtwetwe fi ntini no mu, kokoram a ɛtrɛw, nkwammoaa a ɛkɔ baabi foforo