E aʻo kākou e pili ana i ka ʻōmole i hoʻokomo ʻia i ka wā e paʻakikī ai kekahi i ka hanu ʻana? (Intubation)

Ua lohe paha ʻoe i ka huaʻōlelo "ke kau ʻana i loko o kahi paipu" a i ʻole "ke kau ʻana i loko o kahi paipu" ke pilikia kekahi, a i ʻole ma mua o kahi hana nui. He aha ke ʻano o kēia? ʻOiai he mea weliweli iki paha ia, he mea nui loa ia e hiki ke hoʻopakele i ke ola. E kamaʻilio wale kākou e pili ana i ia mea, ʻae?

He aha ka intubation?

I ka ʻōlelo maʻalahi, ʻo ka intubation ka wā e hoʻokomo ai ke kauka a i ʻole ke kauka olakino i aʻo ʻia i kahi ʻōmole lahilahi ma kou waha (a i ʻole kou ihu i kekahi manawa) i loko o kou ʻōpū hanu (ke ala ea nui). Ua kapa ʻia kēia ʻo endotracheal intubation a i ʻole tracheal intubation . Ke hoʻokomo ʻia kēia ʻōmole, ua wehe ʻia ka ʻōpū hanu, e maʻalahi ai ka hanu ʻana. A laila hiki ke hoʻopili ʻia kēia ʻōmole i kahi mīkini (pinepine he ventilator ) hiki ke hanu nou. A laila hāʻawi ka mīkini i ka oxygen a me ka ea e kōkua iā ʻoe e hanu.

No ke aha e pono ai ke hoʻokomo ʻia kekahi i loko o ka tubing e like me kēia?

Pono wale nō kahi ʻōmole inā ʻaʻole hiki i kekahi ke hanu pono iā ia iho, a inā paha ua ālai ʻia a hōʻino ʻia paha ko lākou ala ea. E noʻonoʻo e pili ana i ia mea, he mea nui ka oxygen no ko kākou kino. No laila, inā ʻaʻole mākou e loaʻa pono, hiki ke loaʻa nā pilikia he nui.

Eia nā kūlana e hoʻokomo pinepine ʻia ai kahi paipu:

• Ke ālai ʻia ʻana o ke ala ea : E noʻonoʻo inā ua paʻa kekahi mea i loko o kou ala ea, e like me kahi ʻāpana meaʻai, a ʻaʻole hiki iā ʻoe ke hanu. Pēlā ia.
• Hoʻopau ʻia ka puʻuwai: Inā pau koke ka hana ʻana o ka puʻuwai , ʻaʻole hiki ke komo ka oxygen i ka lolo a me nā ʻōpū ʻē aʻe. Hoʻohana ʻia kēia ʻano hana e hanu koke ai i kēlā manawa.
• Nā ʻeha koʻikoʻi ma ka ʻāʻī, ka umauma, a i ʻole ka ʻōpū: Hiki i kēia mau ʻeha ke hoʻopilikia i ke ala ea a hoʻolilo iā ia i mea paʻakikī ke hanu.
• Ka nalowale ʻana o ka ʻike a i ʻole ka emi ʻana o ka pae o ka ʻike: Ke nalowale kekahi i ka ʻike, ʻaʻole paha lākou e hiki ke kāohi i ko lākou hanu ʻana. ʻO ke ʻano kēia e hāʻule paha ke alelo i hope a ʻūlū.
• I ka wā o ke ʻoki kino nui: I kekahi mau ʻoki kino nui, e noho ʻoe ma lalo o ka anesthesia a ʻaʻole hiki iā ʻoe ke hanu iā ʻoe iho. I kēlā manawa, e hoʻohana ʻia kēia ʻōmole e kōkua iā ʻoe e hanu a hiki i ka pau ʻana o ke ʻoki kino.
• Ka hāʻule ʻana o ka hanu a i ʻole ka pau ʻana o ka hanu ʻana no ka manawa pōkole (Apnea):I nā hihia o nā maʻi ʻeha nui o ka māmā e like me ka niumonia a i ʻole ka hoʻonui ʻia ʻana o ka hānō, ʻaʻole hiki i nā māmā ke hana pono. ʻOiai i kēlā manawa, pono ke kākoʻo ma kēia ʻano.
• Ka pilikia no nā mea e like me ka meaʻai, ka luaʻi, a i ʻole ke koko e komo ana i ke alaloa ka makemake : Inā ʻike ʻole kekahi, hiki i nā mea ke komo i loko o nā māmā ke luaʻi lākou. He mea weliweli loa kēlā. Kōkua kēia paipu i ka pale ʻana i kēlā.

He mea like anei ke hoʻokomo ʻana i kahi ʻōmole a me ka hoʻohui ʻana iā ia i kahi ventilator?

Ua pili kēia mau mea ʻelua, akā ʻaʻole like loa.

ʻO ka intubation, e like me kā mākou i kūkākūkā ai ma mua, e pili ana i ke kaʻina hana o ka hoʻokomo ʻana i kahi ʻōmole (Endotracheal tube - ETT) i loko o ka trachea.

A laila, ma o kēia paipu, ua hoʻopili ʻia ʻoe i kahi mea hanu. I kekahi manawa hiki i kēia ke lilo i ʻeke a ke kauka e ʻomi ai a puhi i ka ea i loko (ua ʻike paha ʻoe iā ia ma nā kiʻiʻoniʻoni). A i ʻole, ua hoʻopili ʻia ʻoe i kahi mīkini i kapa ʻia ʻo `Ventilator` . ʻO kēia mīkini ka mea e hoʻouna i ka oxygen a me ka ea i loko o nā māmā ma ke ʻano i kāohi ʻia.

Eia nō naʻe, i kekahi manawa hāʻawi ka mea hoʻoulu hanu i nā hanu ma o kahi pale maka e uhi ana i ka waha a me ka ihu. A laila ʻaʻole i hoʻokomo ʻia kahi paipu. He mea ʻokoʻa kēlā.

ʻO wai ka mea hiki ʻole ke hoʻokomo ʻia kahi paipu ma kēia ʻano? (Nā Contraindications)

ʻOiai hiki ke hana palekana i kēia ma ka hapa nui o nā hihia, aia kekahi mau manawa e hoʻoholo ai nā kauka ʻaʻole palekana ke hoʻokomo i kahi ʻōmole ma kēia ʻano. Eia kekahi laʻana:

• Inā ua hōʻino nui ʻia ke ala ea.
• Inā he mea keakea nui i loko o ka trachea e pale ai i ke komo ʻana o ka paipu.

E noʻonoʻo, inā he ulia nui ma ka ʻāʻī a ua ʻoki ʻia ka trachea , ʻo ka hoʻāʻo ʻana e hoʻokomo i kahi paipu ma loko e hiki ke hana i ka pōʻino hou aʻe, ʻeā?

I ia mau hihia, hoʻohana nā kauka i kahi ʻano hana ʻokoʻa. ʻO ia hoʻi, hana lākou i kahi lua liʻiliʻi ma ka ʻaoʻao haʻahaʻa o ka ʻāʻī, pololei i loko o ka ʻōpū hanu, a hanu ma o ia mea. Ua kapa ʻia kēia he 'tracheostomy' . He mea pono nō hoʻi kēia 'tracheostomy' ke pono e waiho ʻia kahi ʻōmole ma kahi no nā lā he nui, i kekahi manawa he mau pule paha. ʻO kēia no ka mea ʻo ka loaʻa ʻana o kahi ʻōmole i hoʻokomo ʻia ma ka waha a i ʻole ka ihu no ka manawa lōʻihi hiki ke hana i nā pilikia ʻē aʻe.

Pehea e hana ai kēia kaʻina hana hoʻokomo paipu?

Hana pinepine ʻia kēia ma ka haukapila. I ka wā pilikia, hiki ke hana ʻia kēia ma mua o ka lawe ʻana o ka lawelawe ambulance iā ʻoe i ka haukapila. Eia nō naʻe, hana ʻia kēia e nā kauka i aʻo ʻia a me nā limahana olakino.

Eia ka mea maʻamau e hana ʻia:

1. Hoʻomākaukau: ʻO ka mea mua, hoʻokomo ʻia kahi nila liʻiliʻi (e like me ka `nila IV`) i loko o kahi aa koko ma kou lima a hāʻawi ʻia ka lāʻau lapaʻau e pono ai ma o ia mea. Penei ke ʻano o ka hāʻawi ʻia ʻana o ka anesthesia e hoʻohiamoe ai ʻoe a ʻaʻole e ʻeha.

2. Ke hāʻawi ʻana i ka oxygen hoʻohui:A laila, kau ʻia kahi pale maka oxygen ma luna o kou waha a me kou ihu e hāʻawi i kahi liʻiliʻi o ka oxygen keu i kou kino. Hana ʻia kēia e pale aku i ka emi ʻana o ka oxygen i ka wā pōkole o ka paipu.

3. Hoʻokomo ʻia ʻana o ka hāmeʻa: A laila wehe ʻia ka pale maka oxygen, hoʻohuli iki ʻia kou poʻo i hope, a hoʻokomo ʻia kahi hāmeʻa kūikawā i kapa ʻia he laryngoscope i loko o kou waha (i kekahi manawa ma kou ihu). He kukui liʻiliʻi kona a me kahi ʻāpana e like me ke aniani. ʻAe kēia i ke kauka e ʻike maikaʻi i ka ʻōpū hanu a hoʻokomo i ka ʻōmole.

4. Ke ʻike ʻia nei ka trachea: Hoʻoneʻe mālie ʻia kēia mea hana mai loko mai o ka waha a i ke kua, a me ka hoʻopā ʻole ʻana i nā niho, hāpai ʻia ka ʻāpana o ka puʻu i kapa ʻia ʻo ka epiglottis (ua like kēia me kahi poʻi liʻiliʻi e pani ana i ka trachea i ka wā e moni ai mākou i ka meaʻai), e ʻike maopopo ʻia ai ka waha o ka trachea.

5. Hoʻokomo ʻia ʻana o ka ʻōmole: A laila, hoʻokomo ʻia ka piko o ka laryngoscope ma ka waha o ka trachea i loko o ka trachea, a hoʻokomo ʻia ka ʻōmole hanu (endotracheal tube) ma ia ʻaoʻao.

6. Ke hoʻopaʻa ʻana i ka ʻōmole: Ma hope o ke komo ʻana o ka ʻōmole, ua hoʻopiha ʻia kahi ʻāpana liʻiliʻi e like me ka pōpō e hoʻonui ai. Ma kēia ʻano, noho ka ʻōmole i loko o ka trachea me ka neʻe ʻole, a ʻo nā hanu āpau āu e hanu ai e komo i loko o nā māmā a ʻaʻole e puka i waho.

7. Ka wehe ʻana a me ke kau ʻana i ka hāmeʻa: A laila wehe ʻia ka laryngoscope a hoʻopaʻa ʻia ka ʻōmole ma ka ʻaoʻao o ka waha me kahi plaster a i ʻole ke poʻo i pale ʻia mai ka neʻe ʻana.

8. Ke nānā ʻana i ke kau pololei ʻana: ʻO ka hope loa, ua nānā ʻia ka ʻōmole e ʻike inā aia i loko o ka trachea a ua hele paha i kahi ʻē aʻe. Hiki ke hana ʻia kēia me kahi X-ray umauma, a i ʻole ma ke kau ʻana i kahi ʻeke i ka ʻōmole a hoʻopiha iā ia me ka ea, a hoʻolohe i ka umauma me kahi stethoscope e ʻike inā he leo hanu.

He mau minuke wale nō kēia e lawe ai i kēia mau mea a pau, akā pono e hana ʻia me ke akahele a me ka wikiwiki.

Hiki iā ʻoe ke kamaʻilio a ʻai ʻoiai e hoʻokomo ʻia ana kahi paipu?

He pilikia kēia no nā kānaka he nui.

• ʻAʻole hiki iā ʻoe ke ʻōlelo: No ka mea, hele ka ʻōmole ma waena o kāu mau kaula leo (ka ʻāpana e haʻalulu ai ke ʻōlelo ʻoe), ʻaʻole hiki iā ʻoe ke ʻōlelo ʻoiai he ʻōmole kāu.
• ʻAʻole hiki iā ʻoe ke ʻai a inu paha: Eia kekahi, ʻaʻole hiki iā ʻoe ke ale i ka wā e paʻa ana kahi paipu. No laila, ʻaʻole hiki iā ʻoe ke ʻai a inu paha.

E noʻonoʻo paha ʻoe, "Pehea lā ʻoe e hāʻawi ai i ka meaʻai?"

ʻO ka maʻamau, ma muli o ka lōʻihi o kou noho ʻana ma kēia ʻōmole, e hāʻawi nā kauka iā ʻoe i ka meaʻai āu e pono ai ma o ka saline ('IV fluids') a i ʻole ma ke ʻano he wai ma o kahi ʻōmole lahilahi ʻokoʻa i hoʻokomo ʻia ma kou waha a i ʻole ka ihu i loko o kou ʻōpū.

Pehea e wehe ai i kahi ʻōmole? (Extubation)

Ke hoʻoholo nā kauka hiki iā ʻoe ke hanu maikaʻi iā ʻoe iho a ʻaʻole pono ʻoe i kēia ʻōmole hou, wehe lākou. Ua kapa ʻia kēia ʻo "Extubation ." He hana maʻalahi loa kēia.

Eia ke ʻano:

1. ʻO ka mea mua, e wehe i ka plaster a i ʻole ka lipine e hoʻopaʻa ana i ka paipu ma kahi.

2. A laila, wehe ʻia ka mucus pono ʻole a me nā mea ʻē aʻe i loko o ke ala hanu me kahi ʻōmole lahilahi (suction).

3. Ua hoʻohaʻahaʻa ʻia ka pōpō liʻiliʻi i hoʻopiha ʻia e pale ai i ka paipu mai ke komo ʻana i loko o ka trachea.

4. A laila, e haʻi aku ke kauka iā ʻoe e hanu hohonu , e ʻū me ka leo nui, a e paʻa i kou hanu. I kēlā manawa, e huki mālie lākou i ka ʻōmole i waho.

Ma hope o ka wehe ʻia ʻana o ka ʻōmole, e ʻeha paha kou puʻu no kekahi mau lā. Hiki paha iā ʻoe ke ʻoluʻolu iki i ka wā e kamaʻilio ai. Akā e nalo ana kēlā i loko o kekahi mau lā.

Aia kekahi mau pilikia i kēia? (Nā pilikia o ka Intubation)

He hana maʻamau ka hoʻokomo ʻana i kahi ʻōmole, palekana nui, a he hana hoʻōla ola paha. Hoʻōla ka hapa nui o ka poʻe i loko o kekahi mau hola a i ʻole mau lā. Eia nō naʻe, aia kekahi mau pilikia e hiki ke hana pinepine ʻole ʻia:

• Ka mahuʻi ʻana: Ke hoʻokomo ʻia kahi paipu a waiho ʻia paha ma kahi, i kekahi manawa hiki i nā mea e like me ka luaʻi a me ke koko ke komo i loko o nā māmā.
• Ke hele nei ka paipu ma kahi kūpono ʻole:
• Hoʻokomo ʻana o ka Endobronchial: I kekahi manawa hiki i ka ʻōmole ke komo i loko o kekahi o nā ala ea nui ʻelua e lālā ana mai ka trachea a i loko o nā māmā (i kapa ʻia hoʻi ʻo mainstem intubation). A laila hoʻokahi wale nō māmā e hanu ana.
• Hoʻokomo ʻana i ka esophagus: Inā komo ka paipu i loko o ka paipu meaʻai, ʻo ka esophagus, ma kahi o ka windpipe , hiki iā ia ke hōʻino i ka lolo a me ka make inā ʻaʻole i ʻike koke ʻia. Akā, akahele loa nā kauka e pili ana i kēia.
• ʻAʻole hiki ke hoʻopaʻa i ke ala ea: I kekahi manawa, ʻaʻole paha e holomua nā hoʻāʻo e hoʻokomo i kahi paipu, e hiki ʻole ai ke mālama i ka mea maʻi.
• Nā maʻi: Hiki i nā poʻe me nā ʻōmole ke hoʻomohala i nā mea e like me nā maʻi sinus.
• ʻEha: Ke hoʻokomo ʻia kahi ʻōmole, aia paha he mau ʻeha liʻiliʻi i ka waha, nā niho, ke alelo, nā kaula leo, a i ʻole ke ala ea. Hiki i kēia ke hoʻoulu i ke kahe koko a me ka pehu ʻana.
• Nā pilikia me ka anesthesia: ʻOiai ka hapa nui o ka poʻe e hoʻōla maikaʻi ana mai ka anesthesia, hiki i kekahi ke loaʻa i ka lohi o ka hoʻōla ʻana a i ʻole nā ​​​​pilikia ʻē aʻe.
• ʻO ka pneumothorax tension: ʻO ke ʻano kahi i paʻa ai ka ea i loko o ka lua o ka umauma, e hiolo ai nā māmā.

ʻOiai aia kēia mau pilikia, he mea liʻiliʻi loa ia i ka hoʻohālikelike ʻia me nā pono o ka hoʻokomo ʻia ʻana o kahi paipu, ʻoiai i kahi kūlana e hoʻopakele ai i ke ola.

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)

Ke lana nei koʻu manaʻo ua loaʻa iā ʻoe kahi ʻike maikaʻi o ka Endotracheal intubation , a i ʻole ka endotracheal intubation. He hana lapaʻau koʻikoʻi loa kēia i hana ʻia e hoʻopakele i ke ola o ke kanaka ke hiki ʻole iā lākou ke hanu iā lākou iho.

Mālama kēia ʻōmole i ka ʻōpū hanu e hāmama a ʻae i ka oxygen e komo i loko o nā māmā.

Hana pinepine ʻia kēia ma ka haukapila, i kahi pilikia, a i ʻole ma mua o kahi ʻoki kino nui. ʻOiai he mea weliweli iki paha ia, hana ʻia ia e kōkua iā ʻoe e ho'ōla. E hilinaʻi e hana mau kāu kauka i ka mea maikaʻi loa iā ʻoe. Inā he mau nīnau a hopohopo paha kāu, mai makaʻu e nīnau i kāu kauka a kahu maʻi paha.

intubation , trachea, hoʻokomo ʻana i kahi paipu, ventilator, hanu ʻana, ʻoki kino, mālama ulia pōpilikia