Mina míasrɔ̃ nu tso mɔ̃ si wotsɔ dea eme ne gbɔgbɔ sesẽ na ame aɖe ŋua? (Intubation) .

Ðewohĩ èse nyagbɔgblɔ "tube dede" alo "tube dede" ne ame aɖe le nɔnɔme sesẽ aɖe me, alo hafi woawɔ dɔ gã aɖe nɛ . Nuka tututue esia fia? Togbɔ be aɖi vɔvɔ̃ vie hã la, enye nu vevi aɖe ŋutɔ si ate ŋu axɔ ame aɖe ɖe agbe zi geɖe. Mina míaƒo nu tso eŋu ko, enyoa?

Nukae nye intubation?

Kpuie ko la, yaƒoƒomɔ̃e nye ne ɖɔkta alo lãmesẽdɔwɔla si wona hehee tsɔ mɔ̃ tsɛ aɖe to wò nu me (alo ɣeaɖewoɣi wò ŋɔti me) de wò yaƒoƒomɔ̃ (yaƒoƒomɔ̃ vevitɔ) me. Wogayɔa esia be endotracheal intubation alo tracheal intubation . Ne wotsɔ mɔ̃ sia de eme la, yaƒoƒomɔ̃a ʋuna, si wɔnɛ be gbɔgbɔ nɔa bɔbɔe. Emegbe woate ŋu atsɔ mɔ̃ sia aƒo ka na mɔ̃ aɖe (zi geɖe la , yagbɔgbɔmɔ̃ ) si ate ŋu agbɔ ya na wò. Emegbe mɔ̃a naa oxygen kple ya be wòakpe ɖe ŋuwò nàgbɔ ya.

Nukatae ahiã be woado ʋu na ame aɖe alea?

Ne ame aɖe mete ŋu le gbɔgbɔm nyuie le eɖokui si o, alo ne eƒe yaƒoƒomɔ̃ xe alo gblẽ. Bu eŋu kpɔ, oxygen hiã vevie na míaƒe ŋutilã. Eyata ne míese egɔme nyuie o la, kuxi geɖe ate ŋu ado mo ɖa.

Esiawoe nye nɔnɔme siwo me wotsɔa mɔ̃ dea mɔ̃ me zi geɖe:

• Yaƒoƒo ƒe mɔxexe: Bu eŋu kpɔ ne nane tsi wò yaƒoƒomɔ̃ me, abe nuɖuɖu kakɛ aɖe ene, eye mète ŋu le gbɔgbɔm o. Aleae wòle.
• Dzi ƒe dɔmawɔmawɔ nyuie: Ne dzia dzudzɔ dɔwɔwɔ kpata , oxygen mele gegem ɖe ahɔhɔ̃a kple ŋutinu bubuwo gbɔ o. Wozãa mɔnu sia tsɔ gbɔa ya kabakaba le ɣeyiɣi ma me.
• Nuveviwɔame sesẽwo le kɔ, akɔta, alo ƒodo ŋu: Abi siawo ate ŋu agblẽ nu le yaƒoƒomɔ̃a ŋu eye wòana gbɔgbɔ nasesẽ.
• Ame aɖe ƒe susu meganɔa nu ŋu o alo eƒe susu ƒe dɔwɔwɔ dzi ɖe kpɔtɔ: Ne ame aɖe ƒe tagbɔ bu la, ate ŋu adzɔ be mate ŋu aɖu eƒe gbɔgbɔ dzi o. Esia fia be aɖe ate ŋu adze anyi ɖe megbe eye wòatsi.
• Le amekoko gã aɖe wɔɣi: Le amekoko gã aɖewo me la, woatsɔ atike si naa alɔ̃dɔdɔ wò eye màte ŋu agbɔ le ɖokuiwò si o. Ɣemaɣi la, woazã mɔ̃ sia atsɔ akpe ɖe ŋuwò nàgbɔ ya vaseɖe esime amekokoa nawu enu.
• Yagbɔgbɔ ƒe dɔmawɔmawɔ nyuie alo gbɔgbɔtsixetsixe hena ɣeyiɣi aɖe (Apnea):Le lãkusi me dɔlékui sesẽwo abe aklãdɔ alo asrã ƒe sesẽ ene me la, lãkusiwo mate ŋu awɔ dɔ nyuie o. Ɣemaɣi gɔ̃ hã la, kpekpeɖeŋu hiã le mɔ sia nu.
• Afɔku le nusiwo abe nuɖuɖu, ʋuʋudedi, alo ʋu ƒe gege ɖe yaƒoƒomɔ̃a me ŋu aspiration : Ne ame aɖe ƒe susu megale dɔ wɔm o la, nuwo ate ŋu ayi ɖe lãkusi me ne eɖe aɖuɖɔ. Ema nye afɔku gã aɖe. Tube sia kpena ɖe ame ŋu be wòaxe mɔ ɖe ema nu.

Ðe mɔ̃ aɖe dede eme kple etsɔtsɔ do ka kple yagbɔgbɔmɔ̃ nye nu ɖeka?

Ame eve siawo do ƒome, gake menye nu ɖeka tututu o.

Intubation, abe alesi míeƒo nu tsoe va yi ene la, fia alesi wotsɔa mɔ̃ (Endotracheal tube - ETT) dea yaƒoƒo me.

Emegbe, to mɔ̃ sia dzi la, wotsɔa wò doa ka kple gbɔgbɔmɔ̃ aɖe. Esia ate ŋu anye akplo si me ɖɔkta ƒoa ya ɖe eme ɣeaɖewoɣi (ɖewohĩ èkpɔe le sinimawo me kpɔ). Alo, wodo ka kple mɔ̃ aɖe si woyɔna be `Ventilator` . Mɔ̃ siae ɖoa ɔksidzin kple ya ɖe lãkusiwo me le mɔ si dzi wokpɔna nu.

Gake ɣeaɖewoɣi la, yagbɔgbɔmɔ̃a naa gbɔgbɔ toa ametakpɔnu si tsyɔa nu kple ŋɔti dzi. Emegbe womedea pɔmpi aɖeke eme o. Ema nye nu bubu.

Amekae mate ŋu ana woatsɔ mɔ̃ aɖe ade eme alea o? (Amesiwo tsi tre ɖe eŋu) .

Togbɔ be woate ŋu awɔ esia dedie le go geɖe me hã la, ɣeyiɣi aɖewo li siwo me ɖɔktawo tsoa nya me be mele dedie be woade mɔ̃ me alea o. Le kpɔɖeŋu me:

• Ne yaƒoƒomɔ̃a gblẽ vevie.
• Ne mɔxenu gã aɖe le yaƒoƒomɔ̃a me si xea mɔ na mɔ̃a be womate ŋu ade eme o.

Bu eŋu kpɔ, ne afɔku gã aɖe dzɔ le kɔa ƒe akpa si wotso eye wotso yaƒoƒomɔ̃a la , agbagbadzedze be woatsɔ mɔ̃ aɖe ato eme ate ŋu agblẽ nu geɖe wu, alo?

Le nɔnɔme mawo me la, ɖɔktawo zãa mɔnu bubu. Eyae nye be wowɔa do sue aɖe ɖe kɔa ƒe akpa si le anyime, yia yaƒoƒomɔ̃a me tẽ, eye wogbɔa ya to eme. Woyɔa esia be `tracheostomy` . `Tracheostomy` sia hã hiã ne ehiã be woagblẽ mɔ̃ aɖe ɖe teƒe si wu ŋkeke ʋee aɖewo, ɣeaɖewoɣi kwasiɖa geɖe gɔ̃ hã. Esia le alea elabena ne wotsɔ mɔ̃ aɖe de nu me alo ŋɔti me ɣeyiɣi didi aɖe la, ate ŋu ahe kuxi bubuwo vɛ.

Aleke tube dede ƒe ɖoɖo sia wɔa dɔe?

Zi geɖe la, wowɔa esia le kɔdzi. Le nɔnɔme kpata aɖe me la, woate ŋu awɔ esia hafi dɔnɔdzikpɔƒea nakplɔ wò ayi kɔdzi. Gake ɖɔkta siwo wona hehee kple lãmesẽdɔwɔlawoe wɔa esia.

Nusiwo dzɔna zi geɖee nye esi:

1. Dzadzraɖo: Gbã la, wotsɔa aŋe sue aɖe (abe `IV aŋe` ene) dea ʋuka aɖe me le wò alɔnu eye wonaa atike si hiã la to edzi. Aleae wonaa atike si naa alɔ̃dɔdɔ wò be nàdɔ alɔ̃ eye màse veve aɖeke o.

2. Oxygen kpeɖeŋutɔ nana:Eyome wotsɔa oxygen-nutsyɔnu dana wò nu kple ŋɔti dzi be wòana oxygen vi aɖe si sɔ gbɔ ɖe wò ŋutilã me. Wowɔa esia be woaxe mɔ na oxygen ƒe vɔvɔ le ɣeyiɣi kpui si me mɔ̃a le teƒea.

3. Mɔ̃a dede eme: Emegbe woɖea oxygen-nutsyɔnu la ɖa, wotsɔa wò ta trɔna ɖe megbe vie, eye wotsɔa mɔ̃ tɔxɛ aɖe si woyɔna be laryngoscope dea wò nu me (ɣeaɖewoɣi to wò ŋɔti me). Kekeli sue aɖe le eŋu eye eƒe akpa aɖe le abe ahuhɔ̃e ene. Esia wɔnɛ be ɖɔktaa kpɔa yaƒoƒomɔ̃a nyuie wu eye wòdea mɔ̃a me.

4. Nana be yaƒoƒoa nadze: Woɖea mɔ̃ sia blewuu tso nu me yia megbe, eye ne womeka asi aɖuawo ŋu o la, wokɔa ŋɔti ƒe akpa si woyɔna be epiglottis (esia le abe nutsyɔnu sue aɖe si xea yagbɔgbɔ ne míemi nuɖuɖu ene) ɖe dzi, si wɔnɛ be yaƒoƒoa ƒe nu dzena nyuie.

5. Mɔ̃a dede eme: Eyome wotsɔa yaƒoƒomɔ̃a ƒe nugbɔ toa yaƒoƒomɔ̃a ƒe nu me yia yagbɔgbɔ me, eye wotsɔa yagbɔgbɔmɔ̃a (endotracheal tube) dea eme.

6. Tube la ƒe liƒolili: Ne wotsɔ mɔ̃a de eme vɔ la, wodoa ya ɖe akpa sue aɖe si le abe balloon ene si ƒo xlãe be wòalolo wu. To mɔ sia dzi la, mɔ̃a nɔa yagbɔgbɔ me evɔ meʋãna o, eye gbɔgbɔ si katã nègbɔna la yia lãkusi me eye medoa go o.

7. Mɔ̃a ɖeɖe kple etsɔtsɔ blae: Emegbe woɖea lãkusia eye wotsɔa aŋɔ alo taɖa blaa mɔ̃a ɖe nu ƒe axadzi be wòagaʋuʋu o.

8. Kpɔkpɔ be wodae nyuie hã: Mlɔeba la, woléa ŋku ɖe mɔ̃a ŋu be ele yaƒoƒomɔ̃a me alo yi teƒe bubu hã. Woate ŋu awɔ esia to akɔta ƒe X-ray , alo to akplo aɖe dede mɔ̃a ŋu kple ya dodo ɖe eme, kple toɖoɖo akɔta kple nuƒomɔ̃ be woakpɔe ɖa be gbɔgbɔ ƒe gbeɖiɖi aɖe le eme hã.

Aɖabaƒoƒo ʋɛ aɖewo koe esiawo katã axɔ, gake ehiã be woawɔe nyuie ŋutɔ eye woawɔe kaba.

Ðe nàte ŋu aƒo nu ahaɖu nu esime mɔ̃ aɖe le asiwòa?

Esia nye kuxi na ame geɖe.

• Màte ŋu aƒo nu o: Esi wònye be mɔ̃a yia wò gbeɖiɖikawo (afã si ʋuʋuna ne èle nu ƒom) dome ta la, màte ŋu aƒo nu esime mɔ̃ aɖe le asiwò o.
• Màte ŋu aɖu nu alo ano nu o: Azɔ hã, màte ŋu ami nu esime mɔ̃ aɖe le asiwò o. Eyata màte ŋu aɖu nu alo ano nu o.

Ðewohĩ àbia ɖokuiwò be, "Aleke nàwɔ ana nuɖuɖu ɣemaɣi?"

Zi geɖe la, le ɣeyiɣi didi si nànɔ mɔ̃ sia dzi nu la, ɖɔktawo ana nunyiame si nèhiã la wò to saline (`IV fluids`) dzi alo abe tsi ene to mɔ̃ tsɛ aɖe si le vovo si wotsɔ to wò nu alo ŋɔti me dea wò dɔgbo me.

Aleke nàwɔ aɖe mɔ̃ aɖe ɖa? (Tɔdzinu si woɖena le lãme na ame) .

Ne ɖɔktawo tso nya me be àte ŋu agbɔ ya nyuie le ɖokuiwò si eye be mègahiã mɔ̃ sia o la, woɖenɛ ɖa. Woyɔa esia be ``Extubation .'' Esia hã nye dɔwɔwɔ bɔbɔe ŋutɔ.

Ale si nàwɔe nye esi:

1. Gbã la, ɖe aŋɔ alo kasɛt si léa mɔ̃a ɖe teƒea la ɖa.

2. Emegbe, wotsɔa mɔ̃ nyui aɖe (nunono) ɖea ʋuʋudedi kple nu bubu siwo mehiã o le gbɔgbɔtsixe me.

3. Woɖea ya le ʋuƒo sue si wodo ɖe ya me be mɔ̃a nagage ɖe yaƒoƒomɔ̃a me o la me.

4. Emegbe, ɖɔkta la agblɔ na wò be nàgbɔ ya sesĩe , akɔ kɔdzi sesĩe, eye nàlé gbɔgbɔ ɖe te. Le ɣeyiɣi ma me la, woahe mɔ̃a vivivi ado goe.

Ne woɖe mɔ̃a ɖa vɔ la, wò ŋɔti ate ŋu anɔ veve sem ŋkeke ʋɛ aɖewo. Ðewohĩ àse le ɖokuiwò me be yemevo vie ne èle nu ƒom hã o. Gake ema nu ayi le ŋkeke ʋɛ aɖewo megbe.

Ðe afɔku aɖewo le esia mea? (Afɔku Siwo Le Intubation Me) .

Tube dede nye dɔ si bɔ, si ƒe akpa gãtɔ le dedie, eye ate ŋu axɔ ame ɖe agbe. Ame akpa gãtɔ hayana le gaƒoƒo alo ŋkeke ʋɛ aɖewo megbe. Gake kuxi aɖewo li siwo ate ŋu adzɔ ƒã ŋutɔ:

• Yagbɔgbɔ: Ne wotsɔ mɔ̃ aɖe de eme alo gblẽe ɖe teƒea la, ɣeaɖewoɣi la, nuwo abe ʋuʋudedi kple ʋu ene ate ŋu age ɖe lãkusiwo me.
• Pɔmpi si le yiyim le teƒe si mesɔ o:
• Endobronchial intubation: Ɣeaɖewoɣi la, yaƒoƒomɔ̃ gã eve siwo dona tso yaƒoƒomɔ̃a me yia lãkusi me (si woyɔna hã be mainstem intubation) dometɔ ɖeka me koe mɔ̃a ate ŋu ayi. Ekema lãkusi ɖeka koe le gbɔgbɔm.
• Esophageal intubation: Ne mɔ̃a yi ɖe nuɖuɖu ƒe pɔmpi, si nye nuɖuɖutome, me ɖe yaƒoƒomɔ̃a teƒe , ate ŋu agblẽ nu le ahɔhɔ̃a ŋu eye wòaku gɔ̃ hã ne womekpɔe dze sii kaba o. Gake ɖɔktawo léa ŋku ɖe esia ŋu ŋutɔ.
• Yaƒoƒomɔ̃a ƒe kpododonu: Ɣeaɖewoɣi la, agbagba siwo wodzena be woade yaƒoƒomɔ̃a me la mate ŋu adze edzi o, si wɔnɛ be manya wɔ be woada dɔ na dɔnɔa o.
• Dɔlékuiwo: Amesiwo ŋu tube le ate ŋu axɔ nuwo abe sinus dɔlékuiwo ene ɣeaɖewoɣi.
• Nuveviwɔame: Ne wotsɔ mɔ̃ aɖe de eme la, abi suesuesuewo ate ŋu anɔ nu, aɖu, aɖe, gbeɖiɖikawo, alo yaƒoƒomɔ̃ me. Esia ate ŋu ana ʋu nado eye wòavuvu.
• Kuxi siwo le atike si naa alɔ̃dɔdɔ ame ŋu: Togbɔ be ame akpa gãtɔ hayana nyuie le atike si wua alɔ̃dɔdɔ me hã la, ame aɖewo ate ŋu akpɔ hayahaya megbe alo nɔnɔme kpata bubuwo ate ŋu adzɔ.
• Tension pneumothorax: Nɔnɔme si me ya gena ɖe akɔta ƒe do me, si wɔnɛ be lãkusiwo mu.

Togbɔ be afɔku siawo li hã la, wole sue ŋutɔ ne wotsɔ wo sɔ kple viɖe siwo dona tso mɔ̃ aɖe dede eme me, vevietɔ le nɔnɔme si me woaɖe ame ƒe agbe le me.

Mlɔeba la, nusiwo dzi wòle be woaɖo ŋkui (Take-Home Message) .

Mele mɔ kpɔm be èse Endotracheal intubation , alo endotracheal intubation gɔme nyuie azɔ. Esia nye atikewɔwɔ ƒe ɖoɖo vevi aɖe ŋutɔ si wowɔna tsɔ ɖea ame ƒe agbe ne womete ŋu le gbɔgbɔm le wo ɖokui si o.

Mɔ̃ sia nana yaƒoƒomɔ̃a nɔa ʋuʋu ɖi eye wònana ya si woyɔna be oxygen gena ɖe lãkusiwo me.

Zi geɖe la, wowɔa esia le kɔdzi, le nɔnɔme kpata aɖe me, alo do ŋgɔ na amekoko gã aɖe. Togbɔ be adze nu dziŋɔ vie hã la, wowɔe be wòakpe ɖe ŋuwò nàhaya. Ka ɖe edzi be wò ɖɔkta awɔ nusi nyo na wò ɣesiaɣi. Ne nyabiase alo dzimaɖitsitsi aɖe le asiwò la, mègavɔ̃ be yeabia wò ɖɔkta alo dɔnɔdzikpɔla o.

` intubation, trachea, tube dede eme, yagbɔgbɔmɔ̃, gbɔgbɔ, amekoko, atikewɔwɔ kpata