Ua hana ʻia anei ʻoe i ke ʻoki kino? A i ʻole ua noho kekahi āu i ʻike ai i loko o ka ʻāpana mālama koʻikoʻi (ICU) ma kahi ventilator? I ia mau hihia, he mea nui loa ia e hoʻomaha loa i nā ʻiʻo o ke kino o ka mea maʻi a mālama iā lākou. Kōkua kēia i nā kauka e hana maʻalahi i ka wā o ke ʻoki kino a kōkua pū i ke kino o ka mea maʻi ʻaʻole e kuʻi me ka mīkini i ko lākou noho ʻana ma ka ventilator. No laila, i kēia lā ke kamaʻilio nei mākou e pili ana i kahi lāʻau lapaʻau i hoʻohana ʻia i ia mau hihia kūikawā. Ua kapa ʻia ʻo Cisatracurium .
I ka ʻōlelo maʻalahi, he aha ka Cisatracurium?
He mea hoʻomaha ʻiʻo iwi ʻo Cisatracurium. He lāʻau ia e hoʻomaha manawa pōkole a hoʻōki paha i nā ʻiʻo i loko o ko mākou kino a mākou e kāohi ai me ka ʻike (no ka laʻana, nā ʻiʻo i loko o ko mākou mau lālā, nā ʻiʻo i loko o ko mākou ʻāʻī). Hāʻawi ʻia ia i kahi mea maʻi ma ke ʻano he inikini pololei i loko o kahi aʻa a i ʻole he infusion hoʻomau e like me ka saline.
ʻO nā hoʻohana nui ʻelua o kēia:
- I ka wā o ke ʻoki kino: Inā ʻūlū nā ʻiʻo o ka mea maʻi i ka wā o ke ʻoki kino nui, hiki ke paʻakikī i ke kauka ke hana pono i kā lākou hana. Hoʻomaha kēia lāʻau lapaʻau i ke kino holoʻokoʻa, e hoʻolilo ana i ke ʻoki kino i mea palekana a maʻalahi hoʻi.
- Ke hoʻopili ʻia i kahi mīkini hanu/mea hoʻoulu manaʻo: I kekahi mau hihia koʻikoʻi, ʻaʻole hiki i ka mea maʻi ke hanu iā ia iho. I kēlā manawa, hāʻawi ʻia ka hanu ma o kahi mea hoʻoulu manaʻo. Eia nō naʻe, i kekahi manawa hiki i ke kino o ka mea maʻi ke kūʻē i ka hana a kēia mīkini. Kōkua kēia lāʻau lapaʻau e hoʻōki iā ia a ʻae i ka mīkini e hoʻolako i ka ea i nā māmā me ka maʻalahi.
ʻO ka mea nui loa, ʻo ia ka hāʻawi ʻia ʻana o kēia lāʻau lapaʻau i ka mea maʻi ma hope o ka hāʻawi ʻana iā ia i nā lāʻau anesthetic a hoʻolilo iā ia i mea ʻike ʻole loa. No ka mea, hoʻopōʻino wale kēia i nā ʻiʻo, ʻaʻole ia e lilo i mea e nalowale ai ka ʻike. No laila, he mea nui e hoʻolilo i ka mea maʻi i mea ʻike ʻole i ʻole ʻo ia e ʻike i kekahi ʻeha.
Nā mea e pono ai ʻoe e haʻi i kāu kauka ma mua o ka hāʻawi ʻana i kēia lāʻau lapaʻau
Ma mua o ka hāʻawi ʻia ʻana iā ʻoe i ka Cisatracurium, e nīnau ke kauka anesthesiologist iā ʻoe a me kou ʻohana e pili ana i kou olakino. He mea nui loa ia e haʻi iā lākou e pili ana i kou mau kūlana olakino āpau me ka hūnā ʻole i kekahi mea . He mea nui loa ia e haʻi iā lākou e pili ana i kēia mau mea:
| Ke kūlana āu e pono ai e hōʻike | No ke aha wale nō? |
|---|---|
| Nā maʻi ʻaleka i nā lāʻau lapaʻau, nā meaʻai, a i ʻole nā mea ʻē aʻe | Inā ua loaʻa iā ʻoe kahi hopena maʻi i ka cisplatin a i ʻole kekahi mea hoʻomaʻemaʻe ʻē aʻe, hiki ke hoʻoweliweli i ke ola. |
| Maʻi puʻupaʻa a i ʻole ke akepaʻa | Hoʻopau ʻia kēia lāʻau lapaʻau mai ke kino e nā puʻupaʻa a me ke akepaʻa. Inā nāwaliwali kēia mau ʻōkana, e lōʻihi paha ka hopena o ka lāʻau lapaʻau. |
| Nā maʻi hanu e like me ka hānō | Hiki i kēia lāʻau lapaʻau ke hoʻopilikia i ka ʻōnaehana hanu i kekahi manawa, no laila he mea nui e ʻike mua i kēia. |
| ʻO nā maʻi neuromuscular e like me ka myasthenia gravis | Hiki i nā poʻe me kēia mau kūlana ke ʻike i ka hopena nui aʻe o kēia lāʻau lapaʻau, no laila pono e makaʻala loa nā kauka e pili ana i ka nui o ka lāʻau a lākou e kuhikuhi ai. |
| Ka maloʻo ʻana a i ʻole ke kaulike ʻole o ka calcium, potassium, a i ʻole ka magnesium i loko o ke koko | Hoʻopilikia pololei nā loli i ka paʻakai a me ka wai o ke kino i ka hana ʻana o kēia lāʻau. |
| Nā ʻĀʻī (Nā ʻĀʻī Nui) | ʻOkoʻa paha ke ʻano o ka pane ʻana o ke kino i kēia ʻano lāʻau lapaʻau i nā maʻi me nā kuni nui. |
| Ka hāpai ʻana a i ʻole ka hānai ʻana i ka waiū | He mea nui e haʻi i kāu kauka inā ʻoe e hāpai ana, e ho'āʻo ana e hāpai, a e hānai waiū ana paha. |
Pehea e hoʻohana ai i kēia lāʻau lapaʻau a me nā mea nui ʻē aʻe
ʻAʻole kēia he lāʻau lapaʻau hiki iā ʻoe ke lawe i ka home. Hāʻawi wale ʻia ʻo Cisatracurium ma kahi haukapila a i ʻole ke keʻena lapaʻau e ke kauka a kahu maʻi paha i aʻo ʻia. No laila, ʻaʻohe pilikia o ka hala ʻana o kahi mahele lāʻau.
Hāʻawi ʻia kēia lāʻau lapaʻau i nā keiki liʻiliʻi a me nā pēpē i kekahi mau hihia kūikawā. Akā, hana ʻia ia ma lalo o ka nānā pono ʻana a ke kauka pediatric, a me ke akahele nui.
He aha inā hoʻonui ʻia ka nui o ka lāʻau lapaʻau? (Overdosage)
ʻOiai ua hāʻawi ʻia kēia ma kahi haukapila, ua haʻahaʻa loa ka manawa kūpono o ka overdose. Eia nō naʻe, inā hana ʻia kekahi mea e like me kēia, he pilikia ia. I kēlā hihia, e hāʻawi nā kauka ma ka Emergency Treatment Unit (ETU) o ka haukapila i ka lāʻau lapaʻau e pono ai. Inā he kānalua kāu e pili ana i kēia, hiki iā ʻoe ke kelepona i ke National Poisons Information Centre ma ka Colombo National Hospital no ka ʻōlelo aʻoaʻo.
Nā lāʻau lapaʻau ʻē aʻe e launa pū me kēia lāʻau lapaʻau
E haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe nei, me nā lāʻau lapaʻau i kauoha ʻia a me nā lāʻau lapaʻau kūʻai ʻole ʻia, nā huahana lāʻau lapaʻau, nā huaora, a me nā huahana lāʻau lapaʻau. Hiki i kekahi mau lāʻau lapaʻau ke launa pū me Cisplatin a hoʻonui a hoʻemi paha i kona hopena. Eia kekahi laʻana:
- ʻO kekahi mau lāʻau antibiotic - e.g. amikacin, gentamicin, tetracyclines
- Nā lāʻau anticonvulsant (carbamazepine, phenytoin)
- Litiuma
- Nā lāʻau ʻē aʻe i hoʻohana ʻia no ka anesthesia (`isoflurane`, `halothane`)
- Lāʻau hoʻomāmā (lidocaine)
- Makenesium
He aha nā hopena ʻaoʻao i manaʻo ʻia?
E like me nā lāʻau lapaʻau āpau, hiki i ka cisplatin ke hana i nā hopena ʻaoʻao. E nānā pono nā kauka a me nā kahu maʻi iā ʻoe i kou wā e lawe ana i kēia lāʻau lapaʻau. Inā loaʻa iā ʻoe kekahi pilikia, e hoʻomaopopo koke iā lākou.
| Ka hoʻokaʻawale ʻana o nā hopena ʻaoʻao | |
|---|---|
| Nā hopena ʻaoʻao koʻikoʻi e pono e hōʻike koke ʻia i kāu kauka a kahu maʻi paha: | |
| Nā hopena maʻi ʻaleka | ʻŌhūhū ʻili, maneʻo, pehu o ka maka, nā lehelehe a i ʻole ke alelo. |
| Nā pilikia hanu | Paʻakikī ka hanu ʻana. |
| Nā hōʻailona o ke koko haʻahaʻa | Pōniuniu , manaʻo māmā ke poʻo, nā maka polū. |
| Nā hōʻailona o ka hōʻino ʻana o nā ʻiʻo | Mimi ʻeleʻele, paʻakikī ke mimi, luhi loa, ʻeha nā ʻiʻo. |
| ʻĒ aʻe | ʻUlaʻula o ka maka, maneʻo a wela paha o nā maka, nā ʻūlū. |
| Nā hopena ʻaoʻao ʻaʻole i koʻikoʻi pinepine, akā pono e hōʻike i ke kauka inā hoʻomau lākou: | |
| ʻEha a nāwaliwali paha nā ʻiʻo | Ma hope o ka pau ʻana o ka anesthesia a me ka lāʻau lapaʻau, hiki paha iā ʻoe ke manaʻo i kekahi ʻeha a nāwaliwali paha o nā ʻiʻo. |
Leka Lawe-Home
- He inikini kūikawā ʻo Cisatracurium i hāʻawi ʻia e hoʻomaha i nā ʻiʻo i ka wā o ke ʻoki kino a me nā mālama mālama koʻikoʻi.
- Hāʻawi wale ʻia kēia ma ka haukapila, ma lalo o ka nānā ʻana a nā kauka. ʻAʻole kēia he lāʻau lapaʻau e lawe ʻia i ka home.
- He mea nui loa e haʻi aku i kāu kauka e pili ana i kou mau maʻi āpau, nā maʻi allergies, a me nā lāʻau lapaʻau āu e lawe nei ma mua o ke ʻoki ʻana.
- E nānā mau ʻia ʻoe i ka wā e lawe ana i kēia lāʻau lapaʻau, no laila inā loaʻa kekahi hopena ʻaoʻao, e loaʻa koke iā ʻoe ka lāʻau lapaʻau.
- Inā he mau nīnau hou aku kāu e pili ana i kēia lāʻau lapaʻau, mai kānalua e nīnau i kāu kauka.
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