E nānā hohonu kākou i loko o ka puʻuwai! E aʻo e pili ana i ka Swan-Ganz Catheterization!

Ua lohe paha ʻoe e hana ana nā kauka i nā hoʻokolohua like ʻole e ʻimi ai i nā maʻi puʻuwai. I kekahi manawa pono lākou e ʻike pono i ka mea e hana nei i loko o ka puʻuwai, pehea e neʻe ai ke koko, a me ke kaomi. ʻO kahi mea hana kūikawā a me ke kaʻina hana i hoʻohana ʻia i nā manawa e like me kēia ua kapa ʻia ʻo Swan-Garns catheterization. E kamaʻilio kākou e pili ana i kēia ma nā ʻōlelo maʻalahi?

He aha ka Swan-Ganz Catheter?

I ka ʻōlelo maʻalahi, he ʻōmole lahilahi loa ia a kūikawā. Ua like ia me kahi kiu liʻiliʻi a nā kauka e hoʻokomo ai i loko o kou kino e kiʻi i ka ʻike. Ua kapa ʻia hoʻi ia he catheter artery pulmonary no ka mea e pau ana ia i loko o ke aʻa nui (artery) e lawe ana i ke koko i kou mau māmā.

He ʻehā mau paipu liʻiliʻi o kēia catheter, a i ʻole 'nā awa' , e komo ana i loko o ka paipu nui. Ua like lākou me nā alanui ʻaoʻao liʻiliʻi e pili ana i hoʻokahi alanui nui. He ʻokoʻa ka hana a kēlā me kēia o kēia mau awa.

• E hoʻouna i nā wai a i ʻole nā ​​lāʻau lapaʻau i ka puʻuwai. E noʻonoʻo e pili ana i ia mea, aia kekahi mau manawa e pono ai ke hāʻawi pololei ʻia kekahi mau lāʻau lapaʻau i ka puʻuwai, ʻeā? Hiki ke hoʻohana ʻia kēia no kekahi mea e like me ia.
• E ana i ke kaomi koko ma nā wahi like ʻole o ke kino. E nānā pono i ke kaomi i loko o ka puʻuwai a ma nā aa koko e lawe ana i ke koko i nā māmā.
• Ke hoʻopiha ʻana i kahi pōpō liʻiliʻi. Hoʻohana ʻia kēia catheter e kōkua i ke alakaʻi ʻana i ka catheter i kahi kūpono i loko o ke aʻa pulmonary. Kōkua pū ka pōpō i ka lawe ʻana i kekahi mau ana.
• E lawe i kahi hāpana koko mai ke aʻa pulmonary. He mea nui kēia e nānā i nā mea o loko o ke koko e hele ana i nā māmā (no ka laʻana, ka nui o ka oxygen).

He aha kā kākou e aʻo ai mai kēia Swan-Ganz?

E like me ka nānā ʻana o ka mekanika i nā mea āpau i loko o ka ʻenekini o ke kaʻa e ʻike inā he pilikia, hoʻohana nā kauka i kēia catheter e ʻike i ka ʻike he nui e pili ana i ka hana maikaʻi o kou puʻuwai.

Eia nā mea nui e hiki iā ʻoe ke ʻike:

• ʻO ke kaomi i loko o nā keʻena ma ka ʻaoʻao ʻākau o kou puʻuwai (ka "atrium ʻākau" a me ka "ventricle ʻākau") i ka wā e piha ai lākou i ke koko. He mea nui loa ke kaomi i loko o kēia mau keʻena i ka wā e komo ai ke koko i loko o ka puʻuwai a i ka wā e pamu ʻia ana i waho o ka puʻuwai.
• Hiki iā ʻoe ke loaʻa kahi manaʻo maʻamau o ke kaomi i loko o nā keʻena ma ka ʻaoʻao hema o ka puʻuwai (ka "atrium hema" a me ka "ventricle hema"). Ana ʻia kēia ma ke ʻano piʻo.
• Ke kaomi i loko o ke aʻa koko kahi i hoʻokomo ʻia ai ke catheter.
• Ke kaomi o kou aʻa pulmonary. Ke ana kēia i ke kaomi o ke koko i kona hele ʻana i kou mau māmā.
• Pehea kou puʻuwai? ʻO ia hoʻi, ka nui o ke koko e pamu ana kou puʻuwai ma kou kino holoʻokoʻa i kēlā me kēia minuke. He ana koʻikoʻi loa kēia.
• Inā paha e hana pono ana nā valves o kou puʻuwai.

Ke hoʻohana mau ʻia nei ka Swan-Ganz Catheter?

ʻAe, hoʻohana mau nā kauka i kēia ʻano hana no ka mea he nui ka poʻe e manaʻo nei ʻo ia ke ala maikaʻi loa e loaʻa ai ka ʻike pololei e pili ana i nā mea e hana nei i loko o ka puʻuwai a me ke aʻa pulmonary. Ua like ia me kahi ' kūlana gula'.

Akā, ke hoʻohana pinepine ʻole ʻia nei i loko o ka lumi pilikia no nā poʻe maʻi maʻi loa. Akā, ke hoʻohana pinepine ʻia nei kahi mea hana noninvasive i kapa ʻia ʻo echocardiography . ʻO kēia no ka mea, ʻaʻohe pilikia liʻiliʻi o ka echocardiography e hiki ke hana i ka wā e hoʻokomo ai i kahi catheter Swan-Ganz.

ʻO wai ka mea e pono ai i kahi Swan-Ganz Catheter?

E hoʻoholo pinepine ke kauka e hoʻohana i kēia catheter inā manaʻo lākou he loaʻa iā ʻoe, a ʻike paha ua loaʻa iā ʻoe kekahi o kēia mau hōʻailona a i ʻole nā ​​​​kūlana:

• Ka pōkole o ka hanu (inā ʻaʻole maopopo ke kumu)
• Ka hāʻule ʻana o ka puʻuwai
• Nā ʻano puʻuwai maʻamau ʻole
• Ka haʻalulu cardiogenic
• ʻO ka haʻalulu i hoʻokumu ʻia e ka hoʻonui ʻana o nā kīʻaha koko (Distributive shock)
• ʻO ka pericarditis paʻa
• Maʻi hohola
• ʻO ka tamponade cardiac (hōʻiliʻili wai a puni ka puʻuwai )
• ʻO ke koko kiʻekiʻe o ka pulmonary (ke piʻi ʻana o ke kaomi i loko o nā aa o nā māmā)
• ʻO ka embolism pulmonary
• Maʻi puʻuwai hānau makua

ʻAʻole wale ia, hoʻohana ʻia kēia catheter e hōʻiliʻili i ka ʻike ma mua a ma hope o kahi hoʻoili puʻuwai, ma mua a ma hope o ke kau ʻana o kahi mea kōkua ventricular hema, a ma mua a ma hope o kekahi mau ʻoki kino ʻē aʻe.

Pehea ka hana ʻana o ka Swan-Ganz Catheter?

He mea maʻalahi loa ia. E like me kaʻu i ʻōlelo ai ma mua, hoʻohana nā kauka i nā 'puka' like ʻole a i ʻole nā ​​​​ʻōmole liʻiliʻi ma kēia catheter e hōʻiliʻili i ka ʻike mai loko mai o kou kino. Ke hele nei kēia catheter ma waena o nā keʻena ma ka ʻaoʻao ʻākau o ka puʻuwai (ka atrium ʻākau a me ka ventricle ʻākau), ana lākou i ke kaomi i loko o kēlā mau keʻena. A laila, i kona komo ʻana i loko o ke aʻa pulmonary, hoʻohana lākou i kahi pōpō liʻiliʻi ma ka hopena o ke catheter e ana i ke kaomi i loko o kēlā aʻa. Penei lākou e loaʻa ai ka nui o ka ʻike koʻikoʻi e pili ana i ke kahe koko i loko o ka puʻuwai a me nā māmā.

He aha kāu e manaʻo ai ma mua o ka Swan-Ganz Catheterization?

Ma mua o kēia hoʻokolohua, e wehewehe ke kauka iā ʻoe i kēia mau mea:

• E wehewehe lākou iā ʻoe i ka mea a lākou e manaʻo ai e hana me ka hoʻohana ʻana i ke catheter Swan-Ganz. Hiki iā ʻoe ke nīnau i kāu mau nīnau i kēia manawa.
• Inā ʻoe e lawe ana i kekahi mau lāʻau lapaʻau ma mua o ka hoʻāʻo ʻana, e nīnau ʻia ʻoe inā pono ʻoe e hoʻōki i kekahi o lākou. No laila e hōʻoia e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe nei.
• E noi ʻia ʻoe e hoʻōki i ka ʻai ʻana a me ka inu ʻana no kekahi mau hola ma mua o ke kāpili ʻana o ka catheter.
• Ke noi ʻia nei kou ʻae e hana i kēia hoʻokolohua.
• E noi ʻia ʻoe e moe i lalo ma luna o kahi moena kūikawā i loko o kahi keʻena hoʻokolohua catheterization cardiac.
• E hāʻawi ʻia kahi lāʻau lapaʻau e hoʻomaha ai iā ʻoe ma o kahi cannula intravenous (IV). E kōkua kēia iā ʻoe e hōʻemi i ka hopohopo a me ke kaumaha.

He aha ka mea e hana ʻia i ka wā o ka Swan-Ganz Catheterization?

I kēia manawa, ke hana nei ka hui lapaʻau penei:

• Hoʻomaʻemaʻe mua ʻia kahi e hoʻokomo ʻia ai ke catheter (pinepine he aʻa nui ma ka wāwae, ka ʻāʻī, a i ʻole ka umauma) a hoʻomānoanoa ʻia ka ʻāpana (anesthesia) i ʻole ʻoe e ʻeha.
• A laila, hoʻokomo ʻia kahi catheter Swan-Ganz i loko o ke aʻa ma o ka wahi mae.
• Hoʻokomo ʻia ke catheter ma o nā keʻena ma ka ʻaoʻao ʻākau o ka puʻuwai. I kona hele ʻana , nānā mau ʻia nā kiʻi X-ray ma kahi monitor e hōʻike i kahi o ke catheter. Ua like ia me ka GPS e hōʻike ana iā ʻoe i ke ala.
• ʻO ka hope, ua hoʻokomo ʻia ka catheter i loko o ke aʻa pulmonary.
• Ma hope o ka hōʻiliʻili ʻana i nā ʻike āpau e pono ai, wehe pono ʻia ke catheter.

He aha kāu e manaʻo ai ma hope o ka Swan-Ganz Catheterization?

Ma hope o ka wehe ʻana o ke kauka i ka catheter Swan-Ganz, e kaomi ʻo ia i kahi i hoʻokomo ʻia ai ka catheter no kekahi manawa. A laila, e kau ʻia kahi bandage ma ia wahi.

ʻO ka mea nui loa, inā ua hoʻokomo ʻia ke catheter i loko o kou wāwae, e ʻōlelo ʻia ʻoe e moe mālie no ʻelua a ʻeono hola me ka hoʻoneʻe ʻole ʻana i kou wāwae. He mea nui loa kēia, a i ʻole e kahe ke koko.

He mea maʻamau ka loaʻa ʻana o kahi palapū liʻiliʻi ma kahi i hoʻokomo ʻia ai ke catheter. E ho'ōla ia iā ia iho i loko o hoʻokahi pule, ʻelua, a ʻekolu paha pule ma ka lōʻihi.

He aha nā pilikia o ka Swan-Ganz Catheterization?

I kēia manawa, he liʻiliʻi ka pilikia o kekahi hana lapaʻau. Akā, he mea kakaikahi loa nā pilikia mai kahi catheter Swan-Garns - ʻaʻole ma mua o 0.5%. ʻO ia hoʻi, mai loko mai o hoʻokahi haneli kānaka, ʻaʻole paha e hiki i hoʻokahi.

Eia nō naʻe, aia kekahi mau pilikia liʻiliʻi e hiki mai ana. ʻO lākou kēia:

• Maʻi. Inā komo nā germs i kahi catheter.
• He pehu ea i loko o kou kīʻaha koko.
• Pūmāmā hiolo. Hiki ke loaʻa kēia pilikia i kekahi manawa inā hoʻohana ʻia ka aʻa subclavian ma ka ʻāʻī.
• Hiki ke loaʻa kahi ʻano puʻuwai ʻē (arrhythmia). Hiki ke hana ʻia kēia i kekahi manawa ke hoʻokomo ʻia ke catheter ma ka puʻuwai.
• He pōʻino iki i ka paia o ka puʻuwai, ka valve, a i ʻole ke aʻa pulmonary. He mea kākaʻikahi loa kēia.

Ua ʻike maopopo nā kauka i kēia mau pilikia a lawe i nā hana āpau e hiki ai ke hōʻemi iā lākou. No laila , i ka hapa nui o ka manawa, hiki ke hana pono ʻia kēia hoʻāʻo me ka ʻole o nā pilikia.

He aha ka hana a ke kauka me nā hopena o ka Swan-Ganz Catheterization?

ʻO ka ʻike i loaʻa mai ka hoʻāʻo ʻana ua like ia me kahi waihona waiwai o ka ʻike. E hoʻohana kāu kauka i kēia ʻike e hoʻoholo ai i ka lāʻau lapaʻau āu e pono ai.

Hiki i nā hopena hoʻāʻo ke hōʻoia inā he maʻi kou. Hiki iā lākou ke kōkua i ka hui lapaʻau e hoʻoholo i ke koʻikoʻi o kou pilikia.

Ma muli o ke kūlana, hiki ke hana ʻia nā lāʻau lapaʻau penei:

• Nā lāʻau lapaʻau. (Hiki ke hāʻawi ʻia kekahi mau lāʻau lapaʻau ma o kahi 'port' i loko o kahi catheter Swan-Ganz, a i ʻole ma o kahi 'IV' i loko o kahi aa koko ma kou lima.)
• Nā kaʻina hana lapaʻau ʻē aʻe. `(Nā Kaʻina Hana)`
• ʻOki kino. `(ʻOki kino)`

Āhea wau e ʻike hou ai i ke kauka?

Inā loaʻa iā ʻoe kekahi o kēia mau mea ma hope o ka hoʻāʻo ʻana, e hoʻomaopopo koke i kāu kauka:

• Inā pehu kahi i hoʻokomo ʻia ai ke catheter, a inā paha e puka mai ana ke koko a i ʻole kekahi wai ʻē aʻe mai loko mai.
• Inā manaʻo ʻia he mae a pehu paha ka wāwae kahi i hoʻokomo ʻia ai ke catheter.

Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​mai hoʻowahāwahā iā lākou. ʻOi aku ka maikaʻi o ka ʻimi koke ʻana i ke kōkua lapaʻau.

ʻO ka mea nui e hoʻomanaʻo (Leka Lawe-Home)

He hoʻāʻo ka catheter Swan-Ganz e hāʻawi ana i ka ʻike waiwai i nā kauka e kōkua iā lākou e ʻike i kahi pilikia me kou puʻuwai a i ʻole nā ​​māmā. Kōkua kēia ʻike i nā kauka e hāʻawi iā ʻoe i ka lāʻau lapaʻau maikaʻi loa a kūpono hoʻi .

E hōʻoia ka hui lapaʻau e ʻoluʻolu a hoʻomaha ʻoe i ka wā o kēia hoʻokolohua. Eia kekahi, haʻahaʻa loa ka hiki ke loaʻa nā pilikia. No laila, inā manaʻo ke kauka i kēia ʻano hoʻokolohua, ʻaʻohe pono e makaʻu iā ia. E kūkākūkā i nā nīnau a kānalua paha āu me ke kauka a hoʻoponopono iā lākou.

Puʻuwai , catheter Swan-Ganz, aʻa pulmonary, koko, maʻi puʻuwai, māmā, nā hoʻokolohua lapaʻau