ʻO ka mea e pono ai ʻoe e ʻike e pili ana i ka extubation

Malia paha ua manaʻo ʻoe i kahi ʻūpā iki a ʻoluʻolu ʻole paha i kou puʻu i kou ala ʻana ma hope o ke ʻoki ʻana. A i ʻole ua ʻike paha ʻoe i kekahi mea kokoke iā ʻoe ma ka ʻāpana mālama koʻikoʻi (ICU) me kahi paipu i loko o ko lākou waha. I kēia lā, ke kamaʻilio nei mākou e pili ana i ka wehe ʻana i ka paipu e kōkua iā lākou e hanu. Ua kapa ʻia kēia he extubation ma nā huaʻōlelo lapaʻau. ʻOiai paha he huaʻōlelo weliweli kēia, he hōʻailona maikaʻi loa ia no kāu huakaʻi hoʻōla.

ʻO ka mea mua, e nānā kākou, he aha ka Intubation a me ka Extubation?

He mea maʻalahi loa kēia.

• Intubation: E noʻonoʻo ʻaʻole hiki iā ʻoe ke hanu iā ʻoe iho ma muli o kahi maʻi, kahi ulia, a i ʻole ke ʻoki kino nui. I kēlā manawa, e hoʻokomo nā kauka i kahi ʻōmole palupalu ma kou waha i loko o kou ʻōpū hanu. Ua kapa ʻia kēia ʻōmole he Endotracheal Tube (ETT) . Hoʻopili ʻia kēia ʻōmole i kahi ventilator a hāʻawi i ka oxygen i kou mau māmā. ʻO ka Intubation ke kaʻina hana o ke komo ʻana i kēia ʻōmole.

• Extubation: Ke holomua kou olakino a ua hilinaʻi nā kauka hiki iā ʻoe ke hanu maikaʻi hou iā ʻoe iho, me ke kōkua ʻole, e wehe pono lākou i ka ʻōmole i hoʻokomo mua ʻia (ETT). ʻO kēia ke kaʻina hana a mākou e kapa nei he extubation .

No ke aha e pono ai ke hoʻokomo ʻia kekahi i loko o ka tubing penei?

Aia kekahi mau kumu e hiki ʻole ai i kekahi ke hanu iā lākou iho. Eia kekahi o nā kumu nui e pono ai ka intubation ma mua o ka extubation.

Pehea e hana ʻia ai ka extubation? He aha ke kaʻina hana?

ʻAʻole kēia he mea wale nō o ka wehe ʻana i kahi ʻōmole a hoʻihoʻi iā ia i loko. Hana ke kime lapaʻau i kēia me ka hoʻolālā maikaʻi a me ka mālama pono.

Pehea e hoʻoholo ai nā kauka i ka manawa e wehe ai i ka ʻōmole?

Hana lākou i kahi hoʻāʻo kūikawā no kēia. Ua kapa ʻia ʻo ia ʻo ka Hoʻāʻo Hanu Kūlohelohe (SBT) . I ka ʻōlelo maʻalahi, hoʻāʻo kēia inā hiki iā ʻoe ke hanu iā ʻoe iho me ke kōkua liʻiliʻi mai ka ventilator. Ua like ia me ka lawe ʻana i kahi 'hoʻāʻo hoʻokele' liʻiliʻi i kou wā e aʻo ana e hoʻokele kaʻa. Inā ʻoe e hala i kēia hoʻāʻo, ʻo ia hoʻi ua lawa ka ikaika o kou mau māmā e hana hou.

E nānā pū lākou i kou hiki ke ʻū a hoʻomaʻemaʻe i kou puʻu (gag reflex). He mea nui kēia e hōʻoia i hiki iā ʻoe ke mālama i nā mea e like me ka meaʻai a me ka mea inu mai loko mai o kou mau māmā.

Nā hana e wehe ai i ka paipu

Ma hope o kou hala ʻana i ka SBT, e hahai ke kauka a i ʻole nā ​​limahana kahu hānai i aʻo ʻia i kēia mau ʻanuʻu:

1. Hoʻomākaukau moe: E lawe ʻia ʻoe i kahi kūlana pololei ma luna o kahi moe.

2. Hoʻomaʻemaʻe: Hoʻohana ʻia kahi mea omo kūikawā e wehe i ka mucus a me nā ʻōpala mai kou waha, puʻu, a ma loko o ka ʻōmole.

3. Ke wehe ʻana i ka lipine: Ua wehe ʻia ka plaster a i ʻole ka lipine e hoʻopaʻa ana i ka ʻōmole i ka maka.

4. Ke hāʻawi nei i nā ʻōlelo aʻoaʻo hanu: Ke haʻi aku nei ke kauka iā ʻoe e "hanu hohonu a ʻū." I kou ʻū ʻana, wehe lākou i ka ʻōmole me kahi neʻe wikiwiki a laumania.

He aha ka mea e hana ʻia ma hope o ka extubation? He aha ka mea e manaʻo ai?

ʻO ka mea mua āu e ʻike ai ma hope o ka wehe ʻia ʻana o ka ʻōmole he hōʻoluʻolu nui! Eia nō naʻe, hiki iā ʻoe ke ʻike i kekahi ʻeha ma kou puʻu a me ka leo palahalaha no kekahi mau lā. He mea maʻamau loa kēia. Ua like ia me ka ʻeha o ka puʻu mai ka uē ʻana no ka manawa lōʻihi.

Ma hope o ka wehe ʻia ʻana o ka ʻōmole, e hoʻomau ke kime lapaʻau e nānā iā ʻoe.

• Hoʻopaʻa pinepine ʻia kou pae oxygen koko .
• E makaʻala i ka helu o kou puʻuwai a me ke ʻano hanu.
• I kekahi manawa, ma ke ʻano he kōkua iki i ka wā mua, hiki ke hāʻawi ʻia kahi oxygen liʻiliʻi ma o ka cannula nasal a i ʻole kahi pale maka oxygen.

Ua ʻike anei ʻoe i kou wā e wehe ai i ka ʻōmole?

Aia kēia i ke kumu i kau ʻia ai ʻoe ma luna o ka ʻōmole.

• No ke ʻoki kino: I ka manawa pinepine, wehe ʻia ka ʻōmole ma hope koke o ke ʻoki kino, ma mua o kou ala ʻana mai ka anesthesia. Ke ala ʻoe, ua nalowale ka ʻōmole.
• Ma ka Hale Mālama Koʻikoʻi (ICU): Inā e mālama ʻia ana ʻoe no kahi maʻi a ulia paha, e wehe ʻia ka ʻōmole i kou wā e ʻike ana. Akā, mai hopohopo, e wehewehe ke kime lapaʻau i nā mea āpau iā ʻoe a e hōʻoluʻolu iā ʻoe.

Aia kekahi mau pilikia a me nā pilikia o ka extubation?

E like me nā hana lapaʻau āpau, aia kekahi mau pilikia liʻiliʻi loa. Akā, ʻaʻole pinepine kēia mau mea. Ua ʻike maopopo nā kauka i kēia, no laila ua mākaukau mau lākou e hoʻoponopono i ia mau kūlana.

ʻO ka pilikia nui ka hāʻule ʻana o ka extubation . ʻO ke ʻano kēia ma hope o ka wehe ʻia ʻana o ka paipu, ʻaʻole hiki iā ʻoe ke hanu pono hou a pono e hoʻokomo hou ʻia i loko o ka tube.

• He hapa liʻiliʻi wale nō kēia o ka poʻe, ma kahi o 10% -14%, ka poʻe i wehe ʻia kā lākou mau paipu ma ke ʻano hoʻolālā.
• He kiʻekiʻe iki kēia pilikia no ka poʻe ma luna o 65 mau makahiki, a me ka poʻe me ka maʻi puʻuwai a i ʻole ka maʻi māmā mau loa.

Nā pilikia liʻiliʻi ʻē aʻe:

• Nā loli leo a me ka ʻeha ʻāʻī: He kūlana maʻamau kēia i ʻike ʻia e ka poʻe he nui a e hoʻomaikaʻi iā lākou iho i loko o kekahi mau lā.
• Stridor: I kekahi manawa, hiki ke lohe ʻia kahi leo hū iki i ka wā e hanu ana ma muli o ka pehu ʻana o ka puʻu. Ua ʻike nā kauka pehea e mālama ai i kēia.
• ʻUmi nui: ʻO ke ʻūmi e kū mai ana i ka wā e wehe ʻia ai ka ʻōmole hiki ke hoʻopaʻa i nā ʻiʻo o ka puʻu (laryngospasm).