Makemake ʻoe e ʻike e pili ana i ka intubation, hiki ke kōkua iā ʻoe inā pilikia ʻoe i ka hanu ʻana?

Ua noʻonoʻo paha ʻoe pehea e hiki ai iā mākou ke kōkua iā mākou iho e hanu inā e pau koke kā mākou hanu ʻana, a inā paha e hana ʻia ana mākou i kahi hana nui? ʻO ia ka manawa e hoʻohana ai nā kauka i kahi hana i kapa ʻia ʻo "Intubation." ʻOiai he huaʻōlelo weliweli kēia, kōkua maoli ia i ka hoʻopakele ʻana i nā ola he nui. E nānā kākou i ke ʻano o ia mea, pehea e hana ʻia ai, a no ke aha e hana maʻalahi ʻia ai.

He aha ka manaʻo maʻalahi o ka ʻōlelo `(Intubation)`?

I ka ʻōlelo maʻalahi, ʻo ka `(Intubation)` (intubation) ke kau nei ke kauka i kahi ʻōmole liʻiliʻi i loko o kou ʻōpū hanu (`(trachea)`) ma o kou waha a i ʻole i kekahi manawa ma o kou ihu. Mālama kēia ʻōmole i kou ʻōpū hanu e wehe, i hiki ai i ka ea ke komo maʻalahi. A laila hiki ke hoʻopili ʻia kēia ʻōmole i kahi mīkini. Hoʻouna kēia mīkini i ka oxygen a i ʻole ka ea ma lalo o ke kaomi i loko o kou mau māmā. Kāhea mākou i kēia `(Mechanical Ventilation)`.

He mau inoa ʻē aʻe ko kēia ``(Intubation)``:

• Hoʻokomo ʻana i ke ala ea
• ʻO ka hoʻokomo ʻana o ka Endotracheal (ETT)
• Hoʻokomo ʻana o ka trachea

He mau inoa kēia a pau no ka mea hoʻokahi.

No ke aha ʻoe e pono ai e hana i kēia `(Intubation)`?

Pono paha ke kauka e hoʻokomo i ka ʻōpū ma loko o kou kino inā ʻaʻole hiki iā ʻoe ke hanu pono ma muli o kahi ālai ʻia, kahi ʻūlū, a i ʻole ka ʻeha ʻana i kou ala ea. E noʻonoʻo, i ka manawa koke, ua loaʻa iā ʻoe kahi ulia koʻikoʻi a ua ʻeha kou umauma a me kou ʻāʻī, e paʻakikī ai ka hanu ʻana. A i ʻole, inā nalowale kou ʻike, ʻaʻole hiki iā ʻoe ke kaohi i kou hanu ʻana. ʻO kēia ka manawa e pono ai kēia.

Aia kekahi mau kumu ʻē aʻe e hana ai i ka `(Intubation)`:

• Inā pilikia kou ala ea i kahi hōʻeha i kou ʻōpū, umauma, a ʻāʻī paha.
• Ka nalowale ʻana o ka ʻike (e like me ka hāʻule ʻana) a i ʻole ka emi ʻana o ka ʻike. Hiki paha i kēia ke lilo i kou mana o kou hanu ʻana.
• Inā pono ʻoe e hana i kahi ʻoki kino nui kahi hiki ʻole iā ʻoe ke hanu iā ʻoe iho. ʻO ka maʻamau, ke hāʻawi ʻia iā mākou ka anesthesia, he mea paʻakikī iā mākou ke hanu iā mākou iho.
• Ka hāʻule ʻana o ka hanu. ʻO ke ʻano kēia ua pau ka hana pono ʻana o kou mau māmā.
• Aia kahi pilikia o ka hanu ʻia ʻana o nā mea e like me ka meaʻai, ka luaʻi, a me ke koko a komo i loko o nā māmā (Aspiration) .
• Inā paʻa kekahi mea i loko o ke ala ea a kāohi i ke kahe ʻana o ka ea, ua kapa ʻia ia he "Airway Obstruction".
• Hana ʻia ka hopu ʻana o ka puʻuwai ke pau koke ka hana a ka puʻuwai.
• Inā pau ka hanu ʻana no kekahi manawa (Apnea).

Pono paha ka intubation no kekahi o kēia mau kumu.

Pehea ka maʻamau o kēia?

ʻO ka ʻoiaʻiʻo, he hana maʻamau loa ka "(Intubation)" a he hana hoʻōla ola. Ma ʻAmelika Hui Pū ʻIa wale nō, ma kahi o 15 miliona o kēia mau hana e hana ʻia ana i loko o nā lumi hana i kēlā me kēia makahiki. Eia kekahi, he mau haneli haneli o lākou e hana ʻia ana i nā kūlana pilikia. No laila hiki iā ʻoe ke noʻonoʻo i ka pinepine o ka hana ʻia ʻana o kēia. Hana mau ʻia hoʻi ia ma Sri Lanka.

He aha ka mea e hana maoli ana i ka wā e hana ʻia ai kahi Endotracheal Intubation?

ʻO ka hapa nui o ka manawa, hana ʻia kēia `(Intubation)` i loko o ka haukapila. Eia nō naʻe, i kekahi manawa, hana nā lawelawe lapaʻau ulia pōpilikia (`(EMS)` limahana) ma waho o ka haukapila.

Eia ke ʻano o ka hana maʻamau ʻana o kēia:

1. ʻO ka mea mua, hoʻokomo ʻia kahi cannula liʻiliʻi (nila IV) i loko o kahi aa koko ma kou lima a hāʻawi ʻia kahi anesthetic ma o ia mea e hoʻohiamoe ai ʻoe a ʻaʻohe ʻeha.

2. A laila e kau ʻia kahi pale maka oxygen ma luna o kou ihu a me kou waha e hāʻawi i ka oxygen keu i kou kino.

3. E hoʻokiʻekiʻe iki ʻia kou poʻo i hope a e hoʻokomo ʻia kahi mea i kapa ʻia he "laryngoscope" i loko o kou waha (a i kekahi manawa ma kou ihu inā pono). Loaʻa i ka "laryngoscope" kahi lima, kahi kukui, a me kahi pahi ʻoi. Kōkua kēia i ke kauka e ʻike i ke kau kūpono o ka "tracheal tube".

4. A laila, lawe ʻia ka ``(laryngoscope)`` mai loko mai o ka waha a i ke kua, me ka makaʻala ʻaʻole e pa i nā niho.

5. ʻO ka ʻili o ka ʻiʻo (ka epiglottis) e kau ana ma ke kua o kou waha e hāpai i luna e pale i kou pahu leo ​​(ka larynx).

6. Hoʻokomo ʻia ka piko o ka `(Laryngoscope)` ma o kou `(Larynx)` i loko o kou `(Trachea)` (ʻōpū hanu).

7. A laila, ua hoʻopiha ʻia kahi mea liʻiliʻi e like me ka pōpō pehu a puni ka ʻōmole endotracheal. Hōʻoia kēia ʻaʻole e neʻe ka ʻōmole i loko o ka trachea, a ʻo ka ea a pau i hāʻawi ʻia ma o ka ʻōmole e hele pololei i loko o nā māmā.

8. I kēia manawa e wehe i ka `(Laryngoscope)`.

9. I mea e pale ai i ka neʻe ʻana o ka ʻōmole hanu i mua a i mua, ua kau ʻia kahi plaster ma nā ʻaoʻao ʻelua o ka waha a i ʻole ua kau ʻia kahi kāʻei a puni ke poʻo.

10. ʻO ka hope loa, lawe ʻia kahi X-ray e nānā i ke kūlana kūpono o ka ʻōmole, a i ʻole e hoʻohana ʻia kahi ʻeke e pamu i ka ea i loko o ka ʻōmole a hoʻolohe i nā leo e puka mai ana mai nā māmā.

Pehea ka lōʻihi o kēia?

I loko o kahi pilikia, hiki i ke kauka ke hana i kēia "(Intubation)" i loko o ka manawa emi ma mua o hoʻokahi minuke. He mea kēia e hiki ke hana koke ʻia.

Hiki iaʻu ke kamaʻilio, ʻai, a inu i ka wā e waiho ana ka ʻōmole?

ʻAʻole. ʻAʻole hiki iā ʻoe ke ʻōlelo. No ka mea, hele kēia ʻōmole hanu ma o kou mau kaula leo. No laila, inā ʻoe e hoʻāʻo e ʻōlelo, ʻaʻohe leo e puka mai.

Eia kekahi, ʻaʻole hiki iā ʻoe ke ale i ka wā e paʻa ana ka ʻōmole. No laila, ʻaʻole hiki iā ʻoe ke ʻai a inu paha. Ma muli o ka lōʻihi o kou noho ʻana penei, e hāʻawi nā kauka iā ʻoe i ka meaʻai enteral (meaʻai intravenous) a i ʻole ka saline (nā wai IV). I kekahi manawa e hoʻokomo ʻia kahi ʻōmole lahilahi ʻokoʻa ma kou waha a i ʻole ka ihu e hāʻawi iā ʻoe i ka meaʻai i loko o kou ʻōpū a i ʻole ka ʻōpū liʻiliʻi.

Pehea ʻoe e wehe ai i ka ʻōmole? (He aha ka ``(Extubation)``?)

Ke manaʻo nā kauka ua palekana ka wehe ʻana i ka ʻōmole, e wehe lākou. Ua kapa ʻia kēia he "Extubation". Eia ke ʻano o ka hana ʻana:

• Hoʻohemo ʻia ka plaster a i ʻole ka lipine e hoʻopaʻa ana i ka paipu ma kahi.
• Hoʻopau kahi mea omo i ka mucus a me nā ʻōpala ʻē aʻe mai kou mau ala ea.
• Ua emi ka pōpō i hoʻopiha ʻia i loko o ka ʻōpū makani.
• A laila ua ʻōlelo ʻia ʻoe e hanu hohonu a ʻūlū a hanu paha i waho i ko lākou huki ʻana i ka ʻōmole i waho.

E ʻeha iki paha kou puʻu (`(Pharynx)`) no kekahi mau lā ma hope o ka `(Extubation)`. He mea paʻakikī iki paha ke ʻōlelo. He mea maʻamau kēia, mai hopohopo.

He aha nā pōmaikaʻi o ka intubation?

He hana maʻamau ka intubation a palekana hoʻi e hiki ke kōkua i ka hoʻopakele ʻana i kou ola.

ʻO ka pōmaikaʻi nui o kēia, ʻo ia ka hiki ke hoʻopakele i ke ola o kekahi e pilikia ana i ka hanu ʻana. No laila, i ka hoʻohālikelike ʻia me nā pilikia liʻiliʻi ʻē aʻe, he mea kūpono loa kēia.

He aha nā manawa e ola ai inā hana ʻia ka intubation?

ʻOkoʻa maoli kēia mai kēlā kanaka a kēia kanaka. Aia ia i nā mea he nui, e like me ke kumu o ka intubation, kou makahiki, kou olakino laulā, a pēlā aku. Akā ua ʻike ʻia kekahi noiʻi he ʻehiku o ka ʻumi o ka poʻe i hoʻokomo ʻia i loko o kahi lumi pilikia e ola ana . No laila ke hōʻike nei kēlā i ka nui o ka hoʻopakele ola.

He aha nā pilikia o ka intubation?

ʻOiai palekana ka intubation ma ke ʻano laulā, aia kekahi mau pilikia. Akā e hoʻomanaʻo, ʻoi aku ka waiwai o ka hoʻopakele ʻana i ke ola ma mua o kēia mau pilikia.

• Ka hanu ʻana : I ka wā o ka intubation, hiki i ka luaʻi, ke koko, a i ʻole nā ​​​​wai ʻē aʻe ke komo i loko o nā māmā.
• Hoʻokomo ʻia ʻana o ka endobronchial intubation: He paipu i hoʻokomo ʻia i loko o ka windpipe (trachea) i loko o kekahi o nā ala ea nui ʻelua (bronchi) e lālā ana mai ka windpipe i loko o nā māmā.
• Hoʻokomo ʻana i ka esophageal: Inā komo kahi ʻōmole hanu i loko o ka paipu meaʻai (esophagus) ma kahi o ka windpipe (trachea), hiki iā ia ke hōʻino i ka lolo a i ʻole ka make inā ʻaʻole mālama koke ʻia e ke kauka.
• ʻO ka hiki ʻole ke hoʻopaʻa i ke ala ea: Inā ʻaʻole hiki ke hana pono ʻia ka intubation, ʻaʻole hiki i nā kauka ke mālama iā ʻoe.
• Nā maʻi: Hiki ke ulu nā maʻi bacteria, e like me nā maʻi sinus, ma hope o ka intubation.
• Nā ʻeha: Hiki i ka intubation ke hōʻeha i ka waha, nā niho, ke alelo, nā kaula leo, a i ʻole ke ala ea. Hiki i kēia mau ʻeha ke hoʻokahe i ke koko a me ka pehu.
• Nā pilikia i ka wā e puka ai mai ka anesthesia: Hoʻōla maikaʻi ka hapa nui o ka poʻe mai ka anesthesia. Eia nō naʻe, paʻakikī paha kekahi i ke ala ʻana, a i ʻole e loaʻa paha nā pilikia ʻē aʻe e like me ke kuni, ka ʻūlū ʻana o nā ʻiʻo (malignant hyperthermia), a i ʻole ka hōʻino ʻana o ke aʻalolo no ka manawa pōkole a mau loa paha.
• ʻO ka pneumothorax tension (ka hiolo ʻana o ka pulmonary): ʻO ka ea i paʻa i loko o ka lua umauma e hiki ai ke hiolo nā māmā.

ʻOiai paha e hiki ke hana ʻia kēia mau mea, hopohopo nui nā kauka no kēia mau mea a pau.

ʻO wai ka mea ʻaʻole i hoʻokomo ʻia i loko o ka tubing?

I kekahi manawa, hoʻoholo nā kauka ʻaʻole palekana ka hana ʻana i ka intubation. Hiki ke hana ʻia kēia inā he ʻeha nui i ke ala ea, a inā he mea keakea e pale ai i ka ʻōmole mai ke komo palekana ʻana.

I ia mau hihia, hiki i nā kauka ke hoʻoholo e hana i kahi hana ʻoki ma kou ʻāʻī haʻahaʻa e wehe i kou ala ea. Ua kapa ʻia kēia he " tracheostomy." Hana pinepine ʻia kēia inā pono ʻoe e loaʻa kahi ʻōmole hanu no nā lā he nui, a inā manaʻo ʻoe e pono ʻoe e loaʻa i hoʻokahi no kekahi mau pule.

ʻEhia ka lōʻihi e ho'ōla ai?

Hoʻōla ka hapa nui o ka poʻe i loko o kekahi mau hola a i ʻole mau lā ma hope o ka intubation. Eia nō naʻe, inā pilikia ʻoe i ka ʻū ʻana, ka moni ʻana, a i ʻole ka ʻōlelo ʻana i kekahi mau pule ma hope o ka intubation, e ʻike i ke kauka. Hiki iā lākou ke kuhikuhi iā ʻoe i kahi loea pepeiao, ihu, a me ka ʻāʻī (otolaryngologist).

I ka manawa hea ʻoe e ʻike ai i ke kauka ma hope o ka intubation?

Inā ʻike ʻoe i kekahi o kēia mau hōʻailona ma hope o ka intubation , e ʻike koke i ke kauka:

• ʻEha umauma
• Ka pilikia o ka hanu ʻana, e like me ka pōkole o ka hanu
• Paʻakikī a hiki ʻole paha ke ʻōlelo a ale paha
• ʻEha nui ka ʻāʻī
• Pehu maka

Inā loaʻa iā ʻoe kekahi o kēia mau mea, e haʻi pono i ke kauka.

Pehea ke koʻikoʻi o ka intubation?

Aia kēia i ke kumu e pono ai ʻoe e loaʻa i kahi `(Intubation)`. I kekahi manawa hoʻohana nā kauka i ka `(Intubation)` i ka wā o nā ʻokiʻoki i hoʻolālā ʻia. ʻAʻole ia he mea nui. Akā i kahi pilikia, i ka wā hiki ʻole iā ʻoe ke hanu iā ʻoe iho, i ka wā e hana ʻia ai ka `(Intubation)` ma ke ʻano he hana hoʻopakele ola, he kūlana koʻikoʻi loa ia.

He ʻelua mau mea ʻokoʻa anei ka "intubation" a me ka "ventilation"?

Pili ka ``(Intubation)`` a me ka ``(Mechanical Ventilation)`` kekahi i kekahi. Akā, ʻaʻole like loa lāua.

• ʻO ka intubation ke kaʻina hana o ka hoʻokomo ʻana i kahi ʻōmole hanu i loko o ke alaea.
• A laila hoʻopili ke kauka i ka ʻōmole i kahi mea hana e hanu ai. Hiki i kēia mea hana ke lilo i ʻeke lima e pamu i ka ea, a i ʻole he ventilator paha.
• He mīkini ka ventilator e pamu i ka oxygen i loko o kou mau ala ea a me nā māmā. I kekahi manawa, hāʻawi ka ventilator i ka ea ma o kahi pale maka ma luna o kou maka ma kahi o kahi ʻōmole.

Maopopo iā ʻoe? ʻO ka hapa nui o ka manawa, ua hoʻopili ʻia ka ventilator ma hope o ka "Intubation".

He aha ka `(Nasotracheal intubation)`?

ʻO kēia kahi e hoʻokomo ai nā kauka i kahi ʻōmole hanu ma kou ihu. Hoʻohana pinepine ʻia kēia inā ʻoe e hana ana i ke ʻoki ma kou poʻo, waha, a ʻāʻī paha. Kōkua nō hoʻi ia i ka pale ʻana i ka ʻeha hou aʻe i kou ʻāʻī a i ʻole ka ʻōpū hanu.

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai

Hiki ke hopohopo ka manaʻo o ke kauka e kau ana i kahi ʻōmole i lalo o kou puʻu. Akā, ʻo ka intubation kahi hana lapaʻau i hana pinepine ʻia i loko o nā lumi hana a me nā lumi pilikia e kōkua i ka hoʻopakele ʻana i kou ola inā ʻaʻole hiki iā ʻoe ke hanu. Nui ka poʻe e ʻeha ana ka puʻu a i ʻole kekahi pilikia i ka ʻōlelo ʻana ma hope. Akā, e nalowale kēlā mau hopena ʻaoʻao i loko o hoʻokahi pule. No laila, e hilinaʻi i kāu mau kauka. Ke ho'āʻo mau nei lākou e hana i ka mea maikaʻi loa iā ʻoe.

ʻO ka hoʻokomo ʻana i ka tubing, ka hanu ʻana, ka mālama pilikia, ke kākoʻo hanu, ka mīkini hanu, ke ʻoki kino, ka tracheostomy