Ua ʻike anei ʻoe i ka wā e loaʻa ai i kāu keiki liʻiliʻi ke anu a i ʻole ke kuni, e komo ana ka ʻili ma waena o nā iwi ʻaoʻao o ka umauma i ka wā e hanu ai lākou? A i ʻole ke ʻano nei e kuʻi ana ko lākou umauma? He mea maʻamau no kekahi makuahine a makuakāne paha ke makaʻu iki i ka wā e ʻike ai lākou i kēia. ʻO kēia ka mea a mākou e kapa nei he Intercostal Retractions i ka lāʻau lapaʻau. He hōʻailona koʻikoʻi kēia o ka paʻakikī o ka hanu ʻana. No laila e kamaʻilio kākou e pili ana i kēia ma ke ʻano maʻalahi a maopopo i kēia lā.
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I ka ʻōlelo maʻalahi, he aha nā Intercostal Retractions?
ʻO ke kuʻi ʻana o ka umauma ma waena o ka ihu (intercostal retractions) ʻo ia ka wā e huki ai nā ʻiʻo a me ka ʻili ma waena o kou mau iwi ʻaoʻao i loko i kou hanu ʻana. ʻO ke ʻano o ka 'Intercostal' he hakahaka ma waena o nā iwi ʻaoʻao ʻelua. ʻO ke kuʻi ʻana o ka umauma, ʻo ia hoʻi, aia ka mumū a i ʻole ke ālai ʻia ʻana o nā māmā, e paʻakikī ai ka hanu ʻana.
E noʻonoʻo i kēia ʻano. Ke hanu maʻamau kākou, huki i lalo ka ʻiʻo ma waena o ko kākou umauma a me ka ʻōpū, i kapa ʻia ʻo ka diaphragm. Hoʻokumu kēia i kahi kaomi maikaʻi ʻole i loko o ka umauma, a huki ʻia ka ea i loko o nā māmā. Ua like kēia me ke huki ʻana i ka lāʻau lapaʻau i loko o kahi syringe. Akā he aha ka mea e hana ai inā ua ālai ʻia a ua hoʻohaiki ʻia paha ke ala ea, ke ala e hele ai ka ea, e ka mucus a i ʻole kekahi mea ʻē aʻe? ʻOiai e huki i lalo ka diaphragm, ʻaʻole lawa ka ea e hiki ke komo i loko o nā māmā.
Me he mea lā e pani ana ʻoe i kekahi wēlau o ka ʻōpala a omo ana i kekahi wēlau. ʻOiai ka ikaika o kou huki ʻana, ʻaʻohe mea e iho mai ana i lalo o ka ʻōpala, akā, e piholo ana nā ʻaoʻao o ka ʻōpala i loko. ʻO ia ka mea e hana ʻia ana i loko o ka umauma. No ka mea, ʻaʻole e komo mai ana ka ea, hoʻomaka nā ʻiʻo a me ka ʻili o ka umauma e huki i loko.
He mea maʻamau paha kēia ma hope o ka holo ʻana a me ka pāʻani ʻana, akā inā ʻike ʻia kēia hōʻailona i ka wā hoʻomaha, me ka ʻole o ka hoʻoikaika kino, he hōʻailona ia o nā pilikia hanu koʻikoʻi.
He aha nā hōʻailona ʻē aʻe o ka pōkole o ka hanu?
ʻO nā retractations intercostal ka ʻike ʻia ʻana o nā lua ma waena o nā iwi ʻaoʻao. Me he mea lā e huki ʻia ana nā iwi ʻaoʻao i loko. ʻIke nui ʻia kēia i nā pēpē a me nā kamaliʻi ʻōpio no ka mea he emi ko lākou momona kino. Ua haʻi aku paha nā kauka iā ʻoe i kekahi manawa e nānā i ka paʻa o ka umauma inā pilikia kāu pēpē i ka hanu ʻana. Ma waho aʻe o kēia hōʻailona, aia kekahi mau hōʻailona ʻē aʻe e ʻike ʻia inā pilikia kāu pēpē i ka hanu ʻana.
| Hōʻailona | Wehewehena |
|---|---|
| Ka puka ʻana o ka ihu | Hoʻonui a hāiki nā puka ihu i kēlā me kēia hanu ʻana. |
| Ka hanu wikiwiki ʻana (Tachypnea) | ʻO ka nui o nā hanu i kēlā me kēia minuke e piʻi nui me ka makahiki. |
| Nā leo ʻē | ʻUmiʻumi a i ʻole ke kani ʻino (stridor) ma ka umauma a i ʻole ka puʻu i ka wā e hanu ana. |
| Pōkole o ka hanu | Ke manaʻo nei a i ʻole ke ʻano o ka hanu ʻole, ʻoiai ke kamaʻilio nei. |
| Ke lōʻihi nei ka hanu ʻana | ʻOi aku ka lōʻihi o ka hanu ʻana ma mua o ka hanu ʻana i loko. |
Inā ʻike ʻoe i kekahi a ʻoi aku paha o kēia mau hōʻailona, ʻoiai me nā retractations intercostal, he pilikia olakino ia. E lawe koke i ke keiki a i ʻole ke kanaka i ka keʻena pilikia haukapila kokoke loa (ETU).
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Check Availability →Aia kekahi mau ʻano hoʻihoʻi like ʻole?
ʻAe, hiki ke hoʻokaʻawale ʻia kēia i kekahi mau ʻano ma muli o kahi i huki ʻia ai ka ʻili ma ka umauma a me ka ʻāʻī. Ma muli o kēlā wahi, hiki i ke kauka ke loaʻa kahi manaʻo maʻamau o kahi i ālai ʻia ai ke ala ea.
| ʻAno hoʻihoʻi | ʻO kahi āu e huki ai i loko | Hōʻike pinepine |
|---|---|---|
| Intercostal | Ma waena o nā iwi ʻaoʻao | Ka ālai ʻana o ke ala hanu haʻahaʻa. |
| ʻO ka ʻaoʻao lalo o ke koʻokoʻo | Ma lalo o ka pā iwi ʻaoʻao, ka ʻōpū | Ka ālai ʻana o ke ala hanu haʻahaʻa. |
| ʻO ka ʻōpū | Ma lalo o ka iwi umauma | Ka ālai ʻana o ke ala hanu haʻahaʻa. |
| ʻO ke kau ʻana ma luna o ka sternum (ʻo ia hoʻi ka huki ʻana o ke alahaka) | Ma waenakonu o ka ʻāʻī, ma luna o ka waena o ka iwi umauma | Ka ālai ʻana o ke alaea o luna. |
| ʻO ke kaʻa ma luna o ka ʻili | Ma luna o ka iwi ʻāʻī | Ka ālai ʻana o ke alaea o luna. |
He aha nā kumu nui o kēia kūlana?
Hoʻokumu ʻia nā retracted intercostal e ka haiki a i ʻole ka paʻa ʻana o ke alaea. Hiki i kēia ke loaʻa i kekahi mau kumu.
- Ka hoʻonui ʻia ʻana o nā maʻi e like me ka hānō a i ʻole COPD: I kēia mau kūlana, ua haiki nā alaloa, e paʻakikī ai ka hanu ʻana.
- Nā maʻi hanu: ʻOi loa aku i nā maʻi e like me ka maʻi 'RSV', 'COVID-19', he mea maʻamau ia i nā keiki.
- ʻO ka mumū o ke ala hanu: Nā kūlana e like me ka 'Bronchiolitis' (ka mumū o nā ala hanu liʻiliʻi), 'Croup' (ka mumū o ka larynx), a me ka 'Pneumonia' (pneumonia).
- Ka ālai ʻana: Ka ālai ʻana o ke ala ea ma muli o kahi mea i paʻa i ka puʻu (e like me kahi ʻāpana meaʻai, kahi mea pāʻani), ka huʻa mānoanoa, a i ʻole kahi puʻupuʻu.
- ʻO ka hopena maʻi ʻaleka koʻikoʻi ('Anaphylaxis'): ʻO ka hopena maʻi ʻaleka koʻikoʻi i ka meaʻai, lāʻau lapaʻau, a i ʻole ke kui ʻana o nā pepeke hiki ke hoʻopūhū i nā alaea a paʻa.
- Nā kumu ʻē aʻe: Ka maʻi lolo o ke kaula leo, ka ketoacidosis diabetic, a me nā maʻi kakaikahi e like me Reye's syndrome.
He aha ka lāʻau lapaʻau a nā kauka e hāʻawi ai no kēia?
Ke lawe ʻia mai kahi kanaka me nā retractions intercostal i ka haukapila, ʻo ka pahuhopu mua a nā kauka ka hōʻemi ʻana i nā pilikia hanu a hāʻawi i ke kino i ka nui o ka oxygen e pono ai. Ma muli o ke kumu, hoʻohana ʻia nā ʻano lapaʻau like ʻole.
- Lapaʻau oxygen: Hāʻawi ʻia ka oxygen ma o ka ʻōmole ihu a i ʻole ka pale maka.
- Nā lāʻau lapaʻau Nebulizer: Ke hanu ʻana i ka mahu o nā lāʻau lapaʻau, e like me nā bronchodilators e wehe ai i nā alaloa a i ʻole corticosteroids e hōʻemi ana i ka mumū.
- Ka wehe ʻana i ke ālai: Ka wehe ʻana i kahi mea i paʻa i ke alaea.
- Ka hoʻoulu ʻana i ke ea ma ke kaomi maikaʻi: Ke paʻakikī loa ka hanu ʻana iā ʻoe iho, hāʻawi ka mīkini i ka ea a i ʻole ka oxygen ma ke kaomi kiʻekiʻe. Hiki ke hana ʻia kēia ma o kahi pale maka e like me CPAP a i ʻole BiPAP a i ʻole, i nā hihia koʻikoʻi loa, ma ka hoʻopili ʻana i kahi mea hanu artificial (mechanical ventilation).
I ka wā o kēia mālama ʻana, hiki i ke kauka ke hana i kekahi mau hoʻokolohua e ʻike ai i ke kumu nui o kēia ʻano.
- ʻO kahi X-ray umauma a i ʻole CT scan.
- Ke lawe ʻana i kahi swab ihu e ʻike ai i nā maʻi viral.
- Nā hoʻāʻo koko.
He aha nā pilikia inā ʻaʻole mālama ʻia?
Inā ʻaʻole mālama ʻia ke kūlana kumu e hoʻoulu ai i nā retractations intercostal, hiki ke ʻoi aku ka ʻino o ke kūlana. I nā hihia koʻikoʻi, paʻakikī ka hanu ʻana,
- Hoʻemi ʻia ka oxygen i nā ʻiʻo o ke kino (hypoxia).
- Hoʻonui ʻia ka nui o ke kalapona dioxide i loko o ke koko (hypercapnia).
- Hiki ke loaʻa nā pilikia e hoʻoweliweli i ke ola e like me ka pau ʻana o ka hanu holoʻokoʻa.
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- ʻO nā retractations intercostal ka huki ʻana o ka ʻili i loko ma waena o nā iwi ʻaoʻao i ka wā e hanu ana. He hōʻailona koʻikoʻi kēia o ka paʻakikī o ka hanu ʻana .
- Hiki ke ʻike maopopo ʻia kēia ʻano ma waena o nā keiki ʻōpio a me nā pēpē.
- Inā ʻike ʻoe i kēia hōʻailona ʻoiai ʻoe e kū wale ana, me ka ʻole o ka hoʻoikaika ʻana, he pilikia ia. E hele koke i ka ʻOihana Pilikia (ETU) o ka haukapila kokoke loa.
- Hiki ke hiki mai kēia ʻano ma muli o nā kumu like ʻole, e like me ka hānō, ka maʻi pneumonia, a i ʻole kekahi mea e ālai ana i ke alaea.
- Hoʻomaka ka lāʻau lapaʻau e wehe i nā ala ea a hāʻawi i ke kino i ka oxygen e pono ai. He mea nui loa ia e hopohopo ʻole ke ʻike ʻoe i kēia ʻano a e ʻimi koke i ke kōkua lapaʻau kūpono.
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