So wobɛpɛ sɛ wuhu intubation a sɛ ɛyɛ den ma wo sɛ wobɛhome a, ebetumi aboa wo?

So woasusuw sɛnea yebetumi aboa yɛn ho ma yɛahome sɛ yegyae ahome mpofirim, anaa sɛ wɔreyɛ yɛn oprehyɛn kɛse bi ho pɛn? Ɛno ne bere a nnuruyɛfo de wɔn ho to ɔkwan bi a wɔfrɛ no ``Intubation.'' Ɛwom sɛ eyi yɛ asɛmfua a ɛyɛ hu kakra de, nanso nokwarem no ɛboa ma wogye nnipa pii nkwa. Ma yɛnhwɛ nea ɛyɛ, sɛnea wɔyɛ, ne nea enti a wɔyɛ no mmerɛw.

Dɛn na `(Intubation)` kyerɛ kɛkɛ?

Sɛ yɛbɛka no tiawa a, `(Intubation)` (intubation) yɛ bere a oduruyɛfo de afiri ketewaa bi hyɛ wo mframa afiri (`(trachea)`) mu fa w'ano anaa ɛtɔ mmere bi a ɛfa wo hwene mu. Saa afiri yi ma wo mframa nhama no bue, enti ɛnyɛ den sɛ mframa betumi akɔ mu. Afei wobetumi de saa tube yi abata afiri bi ho. Saa afiri yi de oxygen anaa mframa a ɛwɔ nhyɛso ase kɔ w’ahurututu mu. Yɛfrɛ eyi `(Mfiri a Wɔde Yɛ Mframa)`.

Saa ``(Intubation)`` yi wɔ din afoforo:

• Mframa kwan a wɔde hyɛ nipadua mu
• Endotracheal intubation (ETT) a wɔde hyɛ nipadua no mu .
• Tracheal intubation a wɔde hyɛ nipadua no mu

Eyinom nyinaa yɛ din a wɔde frɛ ade koro.

Adɛn nti na ɛsɛ sɛ woyɛ eyi `(Intubation)`?

Ebia ɛho behia sɛ oduruyɛfo de afiri bɛhyɛ wo mu sɛ wuntumi nhome yiye esiane wo mframa kwan a asiw, asiw kwan, anaa apira nti a. Fa no sɛ, mpofirim ara, wuhyia akwanhyia a emu yɛ den na wo koko ne wo kɔn apira, na ɛma ɛyɛ den sɛ wobɛhome. Anaasɛ, sɛ w’adwene mu yɛ wo naa a, worentumi nni wo home so. Eyi ne bere a eyi ho hia.

Nneɛma afoforo pii nti na ɛsɛ sɛ wɔyɛ `(Intubation)`:

• Sɛ wo yafunu, wo moma so, anaa wo kɔn mu opira bi ka wo mframa kwan a.
• Nhumu a ɛyera (te sɛ nea ɔtotɔ piti) anaasɛ nhumu a ɛso tew. Eyi betumi ama woahwere wo home so tumi.
• Sɛ ɛsɛ sɛ woyɛ oprehyɛn kɛse bi a w’ankasa wuntumi nhome a. Mpɛn pii no, sɛ wɔma yɛn nnuru a wɔde kum nipadua no a, ɛyɛ den ma yɛn sɛ yɛn ankasa bɛhome.
• Ɔhome a entumi nyɛ adwuma yiye. Eyi kyerɛ sɛ w’ahurututu gyae adwumayɛ yiye.
• Asiane wɔ hɔ sɛ nneɛma te sɛ aduan, ɔfe, ne mogya bɛhome na akɔ ahurututu mu (Aspiration) .
• Sɛ biribi kɔhyɛ mframa kwan no mu na ɛma mframa no ntumi nkɔ a, wɔfrɛ no ``Airway obstruction``.
• Koma no gyaee bere a koma no gyae adwumayɛ mpofirim no.
• Sɛ ahome gyae bere tiaa bi a (Apnea).

Ebia ɛho behia sɛ wɔde intubation gu nipadua no mu esiane nneɛma yi mu biara nti.

Eyi abu so dɛn?

Nokwarem no, ``(Intubation)`` yɛ adeyɛ a abu so yiye, a egye nkwa. Wɔ United States nkutoo no, afe biara wɔyɛ oprehyɛn ahorow yi mu bɛyɛ ɔpepem 15 wɔ mmeae a wɔyɛ oprehyɛn. Nea ɛka ho no, wɔyɛ emu ɔpehaha pii wɔ tebea horow a egye ntɛmpɛ mu. Enti wubetumi asusuw mpɛn dodow a wɔyɛ eyi ho. Wɔyɛ no daa nso wɔ Sri Lanka.

Dɛn na ɛba ankasa bere a wɔyɛ Endotracheal Intubation no?

Mpɛn pii no, wɔyɛ saa `(Intubation)` yi wɔ ayaresabea no mu. Nanso, ɛtɔ da bi a, ayaresa a egye ntɛmpɛ (`(EMS)` adwumayɛfo) yɛ no wɔ ayaresabea akyi.

Sɛnea wɔtaa yɛ eyi ni:

1. Nea edi kan no, wɔde kankyee ketewaa bi (IV needle) hyɛ ntini bi a ɛwɔ wo nsa mu mu na wɔfa mu ma wo aduru a wɔde kum wo yare na ama woada na ɛyaw biara nni wo ho.

2. Afei wɔde oxygen akataso bɛhyɛ wo hwene ne w’ano so na ama oxygen foforo akɔ wo nipadua mu.

3. Wo ti bɛdan akɔ akyi kakra na wɔde afiri bi a wɔfrɛ no ``laryngoscope'' bɛhyɛ w'anom (na ɛtɔ da bi a wɔde fa wo hwene mu sɛ ɛho hia a). ``Laryngoscope'' no wɔ nsa, kanea, ne agyan a ɛyɛ mmerɛw. Eyi boa oduruyɛfo no ma ohu sɛnea wɔde ``tracheal tube'' no si hɔ yiye.

4. Afei, wɔfa ``(laryngoscope)`` no fi ano no mu kɔ akyi, na wɔhwɛ yiye sɛ wɔremmɔ sẽ no.

5. Ntini (epiglottis) a ɛsensɛn w’ano akyi no kɔ soro de bɔ wo nne adaka (anom ntini) ho ban.

6. Wɔde `(Laryngoscope)` no ano fa wo `(Larynx)` mu kɔ wo `(Trachea)` (mframa afiri) mu.

7. Afei, wɔde afiri ketewaa bi a ɛte sɛ balloon gu mframa mu twa endotracheal tube no ho hyia. Eyi hwɛ hu sɛ afiri no ntumi nkɔ ahurututu no mu, na mframa a ɛfa afiri no mu nyinaa kɔ ahurututu no mu tẽẽ.

8. Afei yi `(Laryngoscope)` no fi hɔ.

9. Nea ɛbɛyɛ na ahome afiri no ankɔ anim ne akyi no, wɔde plaster gu ano no afã abien no nyinaa anaasɛ wɔde ahama bi twa ti no ho hyia.

10. Awiei koraa no, wɔyɛ X-ray de hwɛ sɛ afiri no wɔ baabi a ɛfata anaa, anaasɛ wɔde bag bi de mframa kɔ afiri no mu na wotie nnyigyei a efi ahurututu no mu ba no.

Eyi begye bere tenten ahe?

Wɔ tebea a egye ntɛmpɛ mu no, oduruyɛfo betumi ayɛ saa ``(Intubation)'' yi wɔ nea ennu simma biako mu. Eyi yɛ biribi a wobetumi ayɛ no ntɛmntɛm saa.

So metumi akasa, adidi, na manom bere a tube no wɔ nea ɛwɔ hɔ no?

Dabi, wuntumi nkasa. Efisɛ saa ɔhome afiri yi fa wo nne nhama mu. Enti sɛ wobɔ mmɔden sɛ wobɛkasa mpo a, nnyigyei biara mpue.

Afei nso, wuntumi nmene bere a tube no wɔ nea ɛwɔ hɔ no. Enti wuntumi nnidi anaa nnom. Nnuruyɛfo bɛma wo aduan a wɔde ma wɔ awotwaa mu (aduan a wɔde fa ntini mu) anaa nkyene (nsu a wɔde IV mu) a egyina bere tenten a ɛsɛ sɛ wotra hɔ saa so. Ɛtɔ mmere bi a, wobetumi de afiri a ɛyɛ tratraa a ɛyɛ soronko afa w’anom anaa wo hwene mu na ama woanya aduannuru akɔ wo yafunu anaa wo dwensɔtwaa ketewaa mu.

Wobɛyɛ dɛn ayi tube no afi hɔ? (Dɛn ne ``(Extubation)``?)

Sɛ nnuruyɛfo no te nka sɛ asiane biara nni ho sɛ wobeyi afiri no afi hɔ a, wobeyi afi hɔ. Wɔfrɛ eyi ``Extubation``. Sɛnea wɔyɛ no ni:

• Woyi plaster anaa teyp a na ɛkura tube no mu no fi hɔ.
• Afiri bi a wɔde twetwe nsu yi nsu ne nneɛma afoforo a asɛe fi wo mframa kwan mu.
• Wɔma mframa fi balloon a wɔde ahyɛ mframa afiri no mu no mu.
• Afei wɔka kyerɛ wo sɛ home denneennen na fa ɔfe anaa yi mframa bere a wɔretwe afiri no afi mu no.

Wo menewa (`(Pharynx)`) betumi ayɛ yaw kakra nna kakraa bi wɔ `(Extubation)` akyi. Ebia ɛbɛyɛ den kakra nso sɛ wobɛkasa. Eyi yɛ ade a ɛfata, mma ɛnhaw wo.

Mfaso bɛn na ɛwɔ intubation so?

Intubation yɛ adeyɛ a wɔtaa yɛ, a mpɛn pii no ahobammɔ nnim a ebetumi aboa ma woagye wo nkwa.

Mfaso kɛse a ɛwɔ eyi so ne sɛ ebetumi agye obi a ne home mu yɛ den no nkwa. Enti, sɛ wɔde toto asiane nketenkete afoforo no ho a, eyi yɛ biribi a mfaso wɔ so kɛse.

Sɛ wɔyɛ intubation a, hokwan bɛn na ɛwɔ hɔ sɛ obenya nkwa?

Eyi gu ahorow ankasa wɔ onipa biara mu. Egyina nneɛma pii so, te sɛ nea enti a wɔde intubation no ahyɛ wo mu, wo mfe a woadi, w’akwahosan nyinaa, ne nea ɛkeka ho Nanso nhwehwɛmu bi daa no adi sɛ nnipa du biara mu bɛyɛ baason a wɔde intubation gu wɔn wɔ dan a wɔhwɛ wɔn a wɔwɔ yare a egye ntɛmpɛ mu no nya nkwa . Enti ɛno kyerɛ sɛnea ɛyɛ nkwagye kɛse.

Asiane bɛn na ɛwɔ intubation mu?

Ɛwom sɛ mpɛn pii no asiane biara nni ho sɛ wɔde intubation bɛhyɛ obi mu de, nanso asiane ahorow bi wɔ hɔ. Nanso kae sɛ nkwa a wubegye no som bo sen asiane ahorow yi.

• Aspiration : Bere a wɔde intubation rekɔ no, ɔfe, mogya, anaa nsu afoforo betumi akɔ ahurututu no mu.
• Endobronchial intubation: Tube a wɔde hyɛ mframa kwan (trachea) mu kɔ mframa kwan atitiriw abien (bronchi) a efi mframa kwan no mu kɔ ahurututu no mu no biako mu.
• Esophageal intubation: Sɛ ɔhome afiri bi kɔ aduan paipu (esophagus) mu sen sɛ ɛbɛkɔ mframa afiri (trachea) mu a, sɛ oduruyɛfo anhwɛ no ntɛm a, ebetumi asɛe amemene no anaasɛ obewu mpo.
• Mframa kwan no a wɔantumi anhyɛ no den: Sɛ wɔantumi anyɛ intubation no yiye a, ebia nnuruyɛfo rentumi nsa wo yare.
• Nyarewa: Mmoawa nyarewa te sɛ sinus mu yare betumi aba bere a wɔde intubation ahyɛ mu akyi.
• Opira: Intubation betumi ama obi apirapira ano, ne sẽ, tɛkrɛma, ɛnne nhama, anaa mframa kwan. Saa apirakuru yi betumi ama mogya atu na wahohoro.
• Ɔhaw ahorow bere a wofi aduru a wɔde kum nipadua no mu ba no: Nnipa dodow no ara ho tɔ wɔn yiye wɔ aduru a wɔde kum nipadua no mu. Nanso, ebia ɛbɛyɛ den ama ebinom sɛ wɔbɛsɔre, anaasɛ wobetumi anya ɔhaw afoforo te sɛ atiridiinini, ntini a ɛtwetwe (malignant hyperthermia), anaa ntini a ɛsɛe bere tiaa bi anaa daa.
• Tension pneumothorax (ahurututu mu a ɛhwe ase): Mframa a ɛkyere wɔ koko mu no betumi ama ahurututu no ahwe ase.

Ɛwom mpo sɛ saa nneɛma yi betumi asi de, nanso nnuruyɛfo dwen eyinom nyinaa ho paa.

Hena na wɔmfa intubation nhyɛ no?

Ɛtɔ mmere bi a, nnuruyɛfo si gyinae sɛ ɛnyɛ nea asiane biara nni ho sɛ wɔbɛyɛ intubation. Eyi betumi aba sɛ obi apira kɛse wɔ mframa kwan no mu, anaasɛ biribi asiw kwan a ɛmma wontumi mfa afiri no nhyɛ mu dwoodwoo a.

Wɔ tebea horow a ɛtete saa mu no, nnuruyɛfo betumi asi gyinae sɛ wɔbɛyɛ oprehyɛn bi wɔ wo kɔn ase de abue wo mframa kwan. Wɔfrɛ eyi `` tracheostomy.`` Wɔtaa yɛ eyi sɛ ɛho hia sɛ wonya ahome afiri bɛboro nna kakraa bi, anaasɛ wususuw sɛ ebia ɛho behia sɛ wonya bi adapɛn pii a.

Bere tenten ahe na egye ansa na asa?

Nnipa dodow no ara ho tɔ wɔn wɔ nnɔnhwerew anaa nna kakraa bi mu wɔ intubation akyi. Nanso, sɛ ɛyɛ den ma wo sɛ wobɛfefe, wobɛmene, anaa wobɛkasa adapɛn kakraa bi mpo wɔ intubation akyi a, kɔ oduruyɛfo nkyɛn. Ebia wɔde wo bɛkɔ aso, hwene, ne menewa ho ɔbenfo (otolaryngologist) nkyɛn.

Bere bɛn na ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn bere a wɔde intubation ahyɛ wo mu awie no?

Sɛ wuhu saa sɛnkyerɛnne ahorow yi bi wɔ intubation akyi , kɔ oduruyɛfo ntɛm ara:

• Koko mu yaw
• Ɔhome a ɛyɛ den, te sɛ ahome a ɛyɛ tiaa
• Ɛyɛ den anaasɛ wontumi nkasa anaasɛ wontumi mene
• Menewa mu yaw a emu yɛ den
• Anim a ɛho ahonhon

Sɛ wowɔ eyinom mu bi a, akyinnye biara nni ho sɛ ka kyerɛ oduruyɛfo.

Intubation yɛ aniberesɛm dɛn?

Eyi gyina nea enti a ɛsɛ sɛ wonya `(Intubation)` so. Ɛtɔ da bi a nnuruyɛfo de `(Intubation)` di dwuma wɔ oprehyɛn a wɔayɛ ho nhyehyɛe mu. Ɛnyɛ asɛm kɛse. Nanso wɔ ntɛmpɛ mu, bere a w'ankasa wuntumi nhome, bere a wɔyɛ `(Intubation)` sɛ nkwagye kwan no, ɛyɛ tebea a anibere wom ankasa.

So ``intubation'' ne ``ventilation'' yɛ nneɛma abien a ɛsono emu biara?

``(Intubation)`` ne ``(Mechanical Ventilation)`` yɛ nea ɛfa wɔn ho wɔn ho ho. Nanso wɔnyɛ pɛ pɛpɛɛpɛ.

• Intubation yɛ ɔkwan a wɔfa so de home afiri bi hyɛ mframa kwan no mu.
• Afei oduruyɛfo no de afiri no bata afiri bi a wɔde home ho. Saa afiri yi betumi ayɛ kotoku a wɔde nsa kura mu a ɛma mframa, anaasɛ ebetumi ayɛ mframa a wɔde ma.
• Mframa afiri yɛ afiri a ɛde mframa pa kɔ wo mframa kwan ne w’ahurututu mu. Ɛtɔ mmere bi a, mframa a wɔde ma mframa fa akataso bi so fa w’anim sen sɛ ɛbɛfa afiri bi mu.

So wote ase? Mpɛn pii no, wɔde mframa afiri no bata ho wɔ ``Intubation'' akyi.

Dɛn ne `(Nasotracheal intubation)`?

Eyi ne baabi a nnuruyɛfo de afiri a wɔde home fa wo hwene mu hyɛ mu. Sɛ wɔreyɛ wo ti, w’ano, anaa wo kɔn mu oprehyɛn a, wɔtaa de eyi di dwuma. Ɛboa nso ma wo kɔn anaa mframa afiri no mpira bio.

Nea etwa to no, nneɛma a ɛsɛ sɛ yɛkae

Sɛ wususuw sɛ oduruyɛfo bi de afiri bi bɛhyɛ wo menewam a, ebetumi ayɛ hu. Nanso intubation yɛ aduruyɛ mu adeyɛ a wɔtaa yɛ wɔ oprehyɛn dan ne mmeae a wɔhwɛ wɔn a wɔwɔ yare a egye ntɛmpɛ mu de boa ma wogye wo nkwa sɛ wuntumi nhome a. Nnipa pii menewam yɛ wɔn yaw anaasɛ ɛyɛ den bi wɔ kasa mu wɔ ɛno akyi. Nanso mpɛn pii no, saa nsunsuanso bɔne yi fi hɔ wɔ dapɛn biako mu. Enti, nya wo nnuruyɛfo mu ahotoso. Wɔbɔ mmɔden bere nyinaa sɛ wɔbɛyɛ nea eye ma wo.

` Intubation, home, ɔhwɛ a egye ntɛmpɛ, ɔhome mmoa, mframa a wɔde ma, oprehyɛn, tracheostomy