Ua hana ʻia anei ʻoe i kahi ʻoki kino ? A i ʻole ua hana ʻia paha ʻoe i kekahi ʻano hoʻāʻo ma lalo o ka anesthesia ? I kēia lā e kamaʻilio mākou e pili ana i kahi lāʻau lapaʻau kūikawā e kōkua i nā kauka e hoʻomaha i nā ʻiʻo i loko o kou kino a hana i ka hana a i ʻole ka hoʻāʻo me ka palekana a me ka maʻalahi. ʻO Atracurium ka inoa o kēia lāʻau lapaʻau.
I ka ʻōlelo maʻalahi, he aha ʻo Atracurium?
He lāʻau lapaʻau ʻo Atracurium i hāʻawi ʻia e hoʻomaha i nā ʻiʻo i loko o kou kino i ka wā o ke kaʻina hana lapaʻau, e like me ke ʻoki ʻana. Hāʻawi pinepine ʻia ia ma ke ʻano he inikini.
E noʻonoʻo i kahi kauka e hana ana i kahi hana liʻiliʻi ma kou ʻōpū. ʻAʻole anei he mea paʻakikī ke hana i ke hana inā ua ʻūlū kou mau ʻiʻo ʻōpū? I kēlā manawa, ke hāʻawi ʻia kēia lāʻau lapaʻau, pale ia i nā hōʻailona aʻalolo mai ka lolo e haʻi aku i nā ʻiʻo e "ʻaelike". Ua like ia me ka hoʻopau ʻana i ke kuapo ma ke kukui. A laila hoʻomaha loa nā ʻiʻo. ʻO ia hoʻi, ʻaʻole e ʻūlū a neʻe iki kou kino. A laila hiki i ka hui lapaʻau ke hana i kā lākou hana me ka ʻole o ke keakea, me ka palekana loa.
ʻO ka mea nui, ʻaʻole kēia he lāʻau lapaʻau hiki iā ʻoe ke hoʻohana ma ka home. He lāʻau lapaʻau kēia i hāʻawi wale ʻia ma kahi haukapila a i ʻole ke keʻena lapaʻau, e kahi hui lapaʻau i aʻo ʻia .
Nā mea e pono ai ʻoe e haʻi i kāu kauka ma mua o ka lawe ʻana i kēia lāʻau lapaʻau
Ma mua o kou hana ʻana i kekahi ʻoki kino a i ʻole ka anesthesia, e nīnau kāu kauka iā ʻoe i nā nīnau he nui e pili ana i kou olakino. He mea nui loa ia e pane pololei ʻoe iā lākou a pau. ʻOi loa aku ma mua o ka hāʻawi ʻia ʻana iā ʻoe i kahi lāʻau lapaʻau e like me Atracurium, pono ʻoe e haʻi i kāu kauka inā loaʻa iā ʻoe kekahi o nā kūlana i helu ʻia ma lalo nei.
| Ke kūlana paha āu e loaʻa ai | No ke aha he mea nui ka hōʻike? |
|---|---|
| Inā ua maloʻo ke kino (Dehydration) | Ke emi ka nui o ka wai i loko o ke kino, hiki ke loli ke ʻano o ka hana ʻana o nā lāʻau lapaʻau. No laila, he mea nui kēia ʻike e hoʻoponopono i ka nui o nā lāʻau lapaʻau. |
| Inā he maʻi puʻuwai kou | Hiki i kēia lāʻau lapaʻau ke loaʻa kahi hopena liʻiliʻi i ke koko. Pono ka poʻe me ka maʻi puʻuwai e makaʻala loa e pili ana i ia mea. |
| Nā maʻi o ka māmā a i ʻole ka hanu ʻana (e like me ka hānō, COPD) | ʻOiai ʻo Atracurium kekahi e hoʻopilikia nei i ka ʻōnaehana hanu, he mea nui i nā kauka ke ʻike i nā pilikia hanu e kū nei. |
| ʻO nā maʻi neuromuscular e like me ka myasthenia gravis | He mau maʻi kēia e hoʻonāwaliwali ai i nā ʻiʻo. No laila, pono ʻoe e makaʻala loa i ka hāʻawi ʻana i ka mea hoʻomaha ʻiʻo. |
| Inā he maʻi allergy kou i ka atracurium a i ʻole nā lāʻau lapaʻau ʻē aʻe, nā meaʻai, a i ʻole nā mea hoʻoluʻu. | Inā ua loaʻa iā ʻoe kahi maʻi allergies ma mua, ʻo ka haʻi ʻana i kekahi e pili ana i ia mea hiki ke hoʻōla i ke ola. |
| Inā hāpai ʻoe a i ʻole e hoʻāʻo nei e hāpai | He mea nui kēia ʻike e hoʻoholo ai inā he hopena ka lāʻau lapaʻau i ke keiki i hānau ʻole ʻia. |
| Inā hānai ʻia ka pēpē me ka waiū | Pono ke kauka e ʻike i kēia e noʻonoʻo ai inā hiki i kekahi nui o ka lāʻau lapaʻau ke hele i ka pēpē ma o ka waiū umauma. |
Pehea e hāʻawi ʻia ai a mālama ʻia ai kēia lāʻau lapaʻau?
Hoʻokomo ʻia kēia lāʻau lapaʻau i loko o kou aʻa (intravenously). Hana ʻia ia ma kahi haukapila e kekahi kanaka i aʻo ʻia, e like me ke kauka a i ʻole ka anesthesiologist. No laila, ʻaʻole pono ʻoe e hopohopo no ia mea.
- No nā kamaliʻi ʻōpio: I kekahi mau hihia, hāʻawi ʻia kēia lāʻau lapaʻau i nā pēpē e like me hoʻokahi mahina. Akā hana ʻia me ke akahele nui a ma lalo o ka nānā kūikawā.
- Overdose: ʻOiai ua hāʻawi ʻia kēia ma kahi haukapila, ua hoʻoholo ʻia a kāohi ʻia ka nui e ka hui lapaʻau . No laila, ʻaʻole pono ʻoe e hopohopo e pili ana i ka overdose. Inā manaʻo ʻoe ua make ʻoe i kahi lāʻau lapaʻau ma kekahi ʻano, pono ʻoe e hoʻomaopopo koke i ka Emergency Treatment Unit (ETU) o ka haukapila. Ma Sri Lanka, hiki iā ʻoe ke kelepona i ke National Poison Information Center ma ka Colombo National Hospital no ka ʻike kikoʻī e pili ana i ia mau make. Eia nō naʻe, inā ʻoe ma kahi haukapila, na ka hui lapaʻau e mālama i nā mea āpau.
Nā lāʻau lapaʻau ʻē aʻe e hiki ke launa pū me Atracurium
Inā ʻoe e lawe ana i ka lāʻau lapaʻau no nā kūlana ʻē aʻe, he mea nui loa ia e haʻi i kāu kauka e pili ana i ia mea. No ka mea, hiki i kekahi mau lāʻau lapaʻau ke hoʻololi i ke ʻano o ka hana a Atracurium. ʻO ia hoʻi, hiki iā lākou ke hōʻemi a hoʻonui paha i kona hopena.
| Māhele lāʻau lapaʻau | Nā Laʻana |
|---|---|
| Kekahi mau lāʻau antibiotic | ʻAmikacin, gentamicin, tobramycin, tetracycline, clindamycin, vancomycin, colistin |
| ʻO kekahi mau lāʻau lapaʻau no ka migraines | carbamazepine, phenytoin |
| Litiuma | Hoʻohana ʻia no nā maʻi noʻonoʻo. |
| Nā lāʻau hoʻomaʻemaʻe kūloko | lidocaine |
| Nā mea hoʻohui magnesium | Ua hoʻolako ʻia ke kino me ka magnesium. |
| ʻO Procainamide a me Quinidine | Hoʻohana ʻia no nā maʻi o ka arrhythmia o ka puʻuwai. |
ʻAʻole piha kēia papa inoa, no laila e hōʻoia e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe ai (me nā huaora, nā lāʻau lapaʻau lāʻau, a me nā mea hoʻohui ) ma mua o kou ʻoki kino. Eia kekahi, e haʻi i kāu kauka inā ʻoe e puhipaka a inu waiʻona paha.
He aha nā hopena ʻaoʻao e hiki ke loaʻa mai ka lāʻau lapaʻau?
E like me nā lāʻau lapaʻau āpau, hiki iā Atracurium ke loaʻa nā hopena ʻaoʻao . Akā e hoʻomanaʻo, aia ʻoe ma lalo o ka nānā piha ʻana o kahi hui lapaʻau ma ka haukapila. No laila, inā he pilikia, e mālama koke lākou.
| Ka hopena ʻaoʻao | Wehewehena |
|---|---|
| Nā hopena ʻaoʻao koʻikoʻi e pono e hōʻike koke ʻia i kāu hui lapaʻau | |
| Nā hopena alerika | ʻŌhūhū ʻili, maneʻo, pehu o ka maka, lehelehe, alelo a i ʻole ka puʻu, paʻakikī ke hanu. |
| Puʻuwai wikiwiki a ʻano ʻole paha | Ka piʻi koke ʻana o ka helu o ka puʻuwai a i ʻole ka loli ʻana o ka mele. |
| Mahana kino, hou nui, ʻoʻoleʻa o nā ʻiʻo | He mau hōʻailona paha kēia o kahi maʻi laha ʻole akā koʻikoʻi i kapa ʻia ʻo Malignant Hyperthermia. |
| Ke koko haʻahaʻa | Manaʻo poniuniu, poʻo māmā, a i ʻole ka ʻike pohihihi. |
| Nā hopu ʻana | Hoʻomaka ke kino e haʻalulu. |
| Nā hopena ʻaoʻao ʻaʻole i koʻikoʻi pinepine, akā pono e hōʻike ʻia inā hoʻomau lākou | |
| Ka holoi ʻana | ʻUlaʻula, ʻoi aku hoʻi ma ka ʻaoʻao o ka maka a me ka ʻāʻī. |
| Nāwaliwali o nā ʻiʻo | Manaʻo iki ua make iki ma hope o ka pau ʻana o nā hopena o ka lāʻau lapaʻau. |
| ʻEha a ʻulaʻula paha ma kahi i inikini ʻia | ʻEha iki a ʻulaʻula paha kahi i hoʻokomo ʻia ai ke cannula. |
ʻAʻole i hoʻokomo ʻia nā hopena ʻaoʻao āpau i loko o kēia papa inoa. Inā loaʻa iā ʻoe kekahi mea ʻē, e haʻi koke i kāu hui lapaʻau.
Leka Lawe-Home
- He inikini kūikawā ʻo Atracurium i hāʻawi wale ʻia ma ka haukapila e hoʻomaha i nā ʻiʻo i ka wā o nā kaʻina hana lapaʻau e like me ke ʻoki ʻana.
- Ma mua o ka hāʻawi ʻia ʻana o kēia lāʻau lapaʻau iā ʻoe, he mea nui e haʻi aku i kāu kauka e pili ana i kou mōʻaukala olakino piha, nā maʻi allergies āu e loaʻa nei, a me nā lāʻau lapaʻau ʻē aʻe āu e lawe nei.
- E nānā pono ʻia ʻoe e kahi hui lapaʻau i ka wā a ma hope o kēia lāʻau lapaʻau, no laila ʻaʻohe pono e hopohopo.
- Inā loaʻa kahi hopena koʻikoʻi, e like me nā hopena alerika, ka paʻakikī o ka hanu ʻana, a i ʻole nā loli o ka helu o ka puʻuwai, he mea nui e hoʻomaopopo koke i ka hui lapaʻau.
- ʻAʻole i manaʻo ʻia kēia lāʻau lapaʻau e lawe ʻia i ka home a mālama ʻia paha. No laila, mai hopohopo no ia mea. E nīnau i kāu kauka no nā nīnau āu e loaʻa ai.
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