He aha inā e pau koke ka puʻuwai? E kamaʻilio kākou e pili ana i ka 'laina pālahalaha' (Asystole)

Ua ʻike paha ʻoe ma ke TV, i ka wā i nalowale koke ai ka ʻike o kekahi a hāʻule i lalo, holo wikiwiki nā kauka, kau i kahi mīkini ma ka umauma a ʻōlelo 'Clear!' a hāʻawi i kahi haʻalulu uila. Akā i kekahi manawa ʻo ka mea āu e ʻike ai ma ka monitor he laina pololei lōʻihi. ʻO ia ka mea a mākou e kapa nei he 'flat-line' a i ʻole asystole. He pilikia olakino koʻikoʻi loa kēia a hoʻoweliweli i ke ola. No laila, he mea nui loa ia iā kākou a pau e ʻike pono i kēia.

He aha maoli ka asystole?

I ka ʻōlelo maʻalahi, ʻo ka asystole ka wā e pani loa ai ka ʻōnaehana uila o kou puʻuwai a oki kou puʻuwai i ke kuʻi ʻana. He ʻano hopu puʻuwai kēia. I kēia manawa, oki loa ka puʻuwai i ka pamu ʻana i ke koko i ke kino. Hiki i kēia ke kumu i ka nalowale koke o ka ʻike, ka pau ʻana o ka hanu ʻana, a i ʻole ka hanu ʻana. Me ka ʻole o ka mālama koke ʻana i ka lāʻau lapaʻau, e like me CPR, hiki ke make i loko o nā minuke.

No ke aha i kapa ʻia ai kēia he 'laina pālahalaha'?

ʻAʻole hiki iā mākou ke ʻike i kēia kūlana mai waho mai. Hiki ke hoʻoholo pololei ʻia me kahi hoʻāʻo ECG (Electrocardiogram). Ua ʻike paha ʻoe ma nā haukapila, ua hoʻopili ʻia kekahi mau sensor i ka umauma e nānā i ka hana o ka puʻuwai. ʻIke kēia mau sensor i ka hana uila maalea o ka puʻuwai a hōʻike iā ia ma ke ʻano he ʻano nalu ma kahi pale.

Hoʻokumu ʻia kēia ʻano nalu ke loaʻa kahi hana uila i loko o ka puʻuwai. I ka asystole, ʻaʻohe hana uila i loko o ka puʻuwai, no laila ma kahi o ka nalu, ʻike wale ʻia kahi laina pololei a pālahalaha ma ka pale. ʻO ia ke kumu i kapa ʻia ai he 'laina pālahalaha'.

Pehea e hana ai ko kākou puʻuwai? He aha ka mea e hana ʻia i ka wā asystole?

I kēlā me kēia manawa e paʻi ai ko kākou puʻuwai, hana ʻia ia ma nā ʻanuʻu nui ʻelua.

1. Systole: ʻO kahi impulse uila liʻiliʻi e kū mai ana i loko o ka puʻuwai e hoʻoulu ai i ka ʻiʻo o ka puʻuwai e ʻūlū ikaika. ʻO kēia ʻūlū ka mea e pamu i ke koko mai ka puʻuwai a puni ke kino.

2. Diastole: Ma hope o hoʻokahi kuʻi ʻana, hoʻomaha ka ʻiʻo o ka puʻuwai. ʻO kēia ka manawa e piha hou ai nā keʻena o ka puʻuwai me ke koko, mākaukau no ka pamu aʻe.

I ka asystole, nalowale loa ke au uila e hoʻokumu ai i ka systole. E like me ka pau ʻana o ka hana a ka motika wai i ka wā e nalowale ai ke au, i ka wā e nalowale ai ke kaʻina hana uila, pau loa ka puʻuwai i ka pamu ʻana. ʻO kēia ka mea a mākou e kapa nei he 'make lapaʻau'.

He aha nā kumu o ka asystole?

Aia kekahi mau kumu e hiki ai i ka puʻuwai ke oki koke i ka hana. ʻO kekahi o nā kumu nui:

• Ke kahe nui ʻana o ke koko mai ke kino mai.
• Haʻahaʻa loa nā pae oxygen i loko o ke kino (Hypoxia).
• ʻO ka paʻakai a me ke kaulike ʻole o ka electrolyte i loko o ke kino.
• He hōʻeha puʻuwai nui.
• ʻO ka embolism pulmonary.
• ʻO nā ʻano puʻuwai maʻamau ʻole (Arrhythmias), ʻoiai nā kūlana e like me Ventricular Fibrillation (VF) a me Ventricular Tachycardia (VT).
• He ulia nui i ka umauma a i ʻole ka puʻuwai.
• Uila haʻalulu.
• Ka ʻai ʻana i kekahi mau lāʻau lapaʻau, nā mea ʻawahia, a i ʻole nā ​​​​lāʻau lapaʻau e like me ka cocaine.

Pehea e hiki ai ke mālama ʻia kēia? Hiki iā ia ke hoʻōla i ke ola?

He pilikia olakino ʻo Asystole kahi e pono ai kēlā me kēia kekona. Inā hana kēia i kekahi ma waho o ka haukapila, ʻo ka mea nui loa a ʻo ka mea wale nō āu e hiki ai ke hana, ʻo ia ke hoʻomaka koke i ka CPR (Cardiopulmonary Resuscitation) a hoʻomau a hiki i ka hōʻea ʻana o ke kōkua lapaʻau. ʻO ka CPR kūpono a hoʻomau ka mea kūpono loa e hoʻopakele i ke ola.

Inā ma loko o ka haukapila, hāʻawi nā hui lapaʻau i nā lāʻau lapaʻau aʻe.

ʻAʻole hiki i ka hoʻohoka (defibrillation) ke hoʻōla hou i ka puʻuwai?

He mea kēia a ka poʻe he nui e kuhihewa nei ma hope o ka nānā ʻana i nā kiʻiʻoniʻoni. ʻAʻole ʻo Asystole kahi mele 'shockable'. ʻO ia hoʻi, ʻaʻohe hopena o ka hāʻawi ʻana i kahi mea me kahi laina pālahalaha i kahi haʻalulu uila (defibrillation). ʻO ka ʻoiaʻiʻo, ʻo ka hana ʻana pēlā e hiki ai ke paʻakikī ke hoʻāla hou i ka puʻuwai.

Hāʻawi wale ʻia nā haʻalulu no nā ʻano mele kūpono ʻole, e like me ka Ventricular Fibrillation (VF), kahi e hoʻopilikia ʻia ai ka hana uila o ka puʻuwai a haʻalulu wale ka puʻuwai. Eia nō naʻe, me ka CPR maikaʻi, i kekahi manawa hiki ke hoʻololi ʻia kahi puʻuwai ma ke kūlana asystole i kahi mele hiki ke haʻalulu. ʻO ia ke kumu ʻo CPR ka lāʻau lapaʻau helu ʻekahi ma ʻaneʻi.

I ka manawa hea ʻoe e ʻimi koke ai i ke kōkua?

Inā loaʻa koke i kekahi kokoke iā ʻoe nā hōʻailona aʻe, he hopu puʻuwai paha ia.

• Ua nalowale koke ka ʻike a hāʻule.
• ʻAʻole hanu a ʻūlū ʻole paha.
• Ka nalowale ʻana o ka pulse ma ka ʻāʻī a i ʻole ka pulima lima.

I loko o ia kūlana, e kāhea koke aku i kahi lawelawe ambulance ulia pōpilikia (no ka laʻana, 1919). A laila, e hoʻomaka i ka CPR i ka hikiwawe loa. ʻOiai inā ʻaʻole ʻoe ʻike pehea e hana ai i ka CPR, mai hopohopo. Hiki i ka luna lawelawe ambulance ke aʻo iā ʻoe pehea e hana ai i ka CPR ma ke kelepona. Loaʻa i kāu mau hana kahi manawa kūpono e hoʻopakele ai i ke ola. Pono e lawe koke ʻia ka mea maʻi i ka Emergency Treatment Unit (ETU) o ka haukapila.

Inā kānalua ʻoe ua hana ʻia kēia ma muli o kahi mea ʻawahia, hiki iā ʻoe ke kāhea koke aku i ke Kikowaena ʻIke Lāʻau Lapaʻau Lahui ma ka Halemai Lahui ʻo Colombo a ʻimi i ka ʻōlelo aʻo.