He aha ka ventilator? ʻO nā mea āpau e pili ana i ia mea ma nā huaʻōlelo maʻalahi (Mechanical Ventilation)

Ua hele paha ʻoe e ʻike i kekahi ma ka ʻāpana mālama koʻikoʻi (ICU). A i ʻole ma ka liʻiliʻi ua ʻike ʻoe i kahi kiʻiʻoniʻoni kahi i hoʻopaʻa ʻia ai kahi mea maʻi i kahi mīkini me kahi ʻōmole i loko o ko lākou waha. Ua manaʻo paha ʻoe i kahi makaʻu iki a hoihoi paha i kou ʻike ʻana i kēlā. ʻO kekahi o nā mīkini koʻikoʻi loa ʻo ia ka ventilator. ʻOiai he nui ka poʻe e makaʻu nei iā ia, he mea hoʻōla ola maoli nō ia. No laila i kēia lā, e kamaʻilio kākou e pili ana i ke ʻano o ka ventilator, a i ʻole ma nā ʻōlelo lapaʻau, "Mechanical Ventilation", no ke aha e pono ai, a me nā mea āpau e pili ana iā ia ma ke ʻano maʻalahi loa.

I ka ʻōlelo maʻalahi, he aha ka ventilator?

He mīkini ka mīkini hanu e kōkua iā ʻoe e hanu, a i ʻole e lawe i ka hana holoʻokoʻa, ke hiki ʻole iā ʻoe ke hanu iā ʻoe iho. E like me ke kākoʻo ʻana o nā koʻokoʻo i kou kaumaha ke haki kou wāwae, kākoʻo ka mīkini hanu i kou mau māmā.

Hana kēia mīkini i ʻekolu mau mea nui:

• Hāʻawi ia i kou mau māmā i ka oxygen e pono ai lākou.
• Kōkua ia i kou mau māmā e wehe i ke kalapona ʻokikene i makemake ʻole ʻia e hōʻiliʻili ana i loko o kou kino.
• Hāʻawi nā ʻeke ea liʻiliʻi (alveoli) i loko o kou mau māmā i ke kaomi e pono ai e wehe iā lākou me ka ʻole e hiolo.

Hiki i nā kauka ke hoʻololi i nā hoʻonohonoho o kēia mīkini e kūpono i kou kūlana a hāʻawi iā ʻoe i ke kākoʻo āu e pono ai.

He ʻelua mau mea like ʻole anei ʻo "Intubation" a me "Ventilation"?

ʻAe, ʻoiai e hui pū pinepine ʻia kēia mau mea ʻelua, pili kēia i ʻelua mau kaʻina hana.

• Intubation: ʻO kēia ka manawa e hoʻokomo ai ke kauka i kahi ʻōmole ma kou waha a i ʻole ihu, i lalo o kou ʻōpū hanu (trachea) a i loko o kou mau māmā. Ua kapa ʻia kēia he "endotracheal tube" a i ʻole ET tube.
• Ka Hoʻoulu ʻana i ka Ea Mekanika: Pili kēia i ke kaʻina hana o ka hoʻohui ʻana i ka ʻōmole i hoʻokomo mua ʻia i kahi mīkini ventilator, e kōkua iā ʻoe e hanu.

I kekahi manawa, ma kahi o ke kau ʻana i kahi paipu e like me kēia, hiki iā ʻoe ke hoʻopili i ka ventilator ma o kahi pale maka e pili pono ana ma luna o kou maka. E kamaʻilio mākou e pili ana i kēlā ma hope iki.

He aha nā ʻano nui o ka ventilator therapy?

Hoʻohana nā mīkini hoʻoulu mana i hoʻohana ʻia i kēia lā i ke kaomi maikaʻi e koi i ka ea i loko o nā māmā. Hiki ke hana ʻia kēia ma nā ʻano nui ʻelua.

I ka manawa hea e pono ai kahi ventilator?

Pono paha ʻoe i ke kōkua o kahi mīkini hanu i kekahi kūlana koʻikoʻi kahi hiki ʻole iā ʻoe ke hanu pono iā ʻoe iho. Eia kekahi laʻana:

• I ka wā o ke ʻoki kino nui: Ke noho ʻoe ma lalo o ka anesthesia laulā, ua emi kou hiki ke hanu. No laila, e hāʻawi ʻia ʻoe i ke kōkua o kahi ventilator i ka wā o ke ʻoki kino.
• Nā maʻi a i ʻole nā ​​​​maʻi koʻikoʻi o ka māmā: Pneumonia, COVID-19, Acute Respiratory Distress Syndrome (ARDS), a me ka Chronic Obstructive Pulmonary Disease (COPD) ke ʻoi aʻe ka ʻino o ke kūlana.
• Nā kūlana pilikia a olakino paha: ʻO kēlā me kēia pilikia e ālai ana i ke ala ea a hoʻolilo i ka hanu ʻana i mea paʻakikī. No ka laʻana, kahi hopena aleri koʻikoʻi (anaphylaxis).
• Ka hōʻino ʻana o ka lolo a i ʻole ka maʻi: I nā hihia e like me ka hahau ʻana a me ka ʻeha o ka lolo, ʻaʻole hiki i ka lolo ke hoʻouna pono i nā hōʻailona i nā māmā e hanu.
• Nā loli i ke kaulike o ke kinoea koko: Inā piʻi ka nui o ke kalapona ʻokikene i loko o ke koko (hypercapnia) a emi paha ka nui o ka oxygen (hypoxemia), pono kahi ventilator e kaohi i kēia kūlana.
• E mālama i kou ala ea:Inā luaʻi kekahi i loko o ka coma i ka kuha a i ʻole ka meaʻai mai ko lākou waha, hiki iā ia ke komo i loko o ko lākou mau māmā. I mea e pale ai i kēia, hoʻokomo ʻia kahi ʻōmole hoʻopūʻiwa e pale i ke ala ea.

ʻEhia ka lōʻihi e pono ai ʻoe e kau ma luna o ka ventilator?

Aia wale nō kēia ma ke kūlana i pono ai ʻoe i kahi ventilator. Hiki ke lilo i kekahi mau hola, kekahi mau lā, kekahi mau pule. I nā hihia kakaikahi loa, pono paha ʻoe e noho no nā mahina a i ʻole nā ​​makahiki. ʻO ka pahuhopu o ka hui lapaʻau, ʻo ia ke hoʻokuʻu iā ʻoe mai ka ventilator me ka wikiwiki a me ka palekana . A hiki i kēlā manawa, e nānā mau lākou i kou kūlana.

ʻO ka maʻamau, inā ʻike ʻia e pono ʻoe e kau ma kahi ventilator no nā pule ʻelua a ʻoi aku, e wehe nā kauka i ka ʻōmole i loko o kou waha a hoʻokomo i kahi ʻōmole ma o kahi ʻoki liʻiliʻi ma kou ʻāʻī (tracheostomy). He ʻano ʻoluʻolu a lōʻihi kēia no ka mea maʻi.

He aha ka mea e hana ʻia ke hoʻopili ʻoe iā ia i kahi ventilator?

Hana ʻia kēia kaʻina hana i loko o kahi keʻena mālama koʻikoʻi (ICU).

1. ʻO ka mea mua, e hāʻawi ʻia ʻoe i ka lāʻau hoʻomaha e kōkua iā ʻoe e hoʻomaha a hiamoe. I ka manawa like, e hāʻawi ʻia ʻoe i kahi lāʻau lolo e pale i kou kino mai ka neʻe ʻana i ka wā e hoʻokomo ʻia ai ka ʻōmole.

2. A laila, hoʻokomo ke kauka i kahi ʻōmole (ET tube) ma kou waha i loko o kou ʻōpū hanu.

3. ʻO ka hope loa, ua hoʻopili ʻia ka ʻōmole i ka mīkini ventilator. A laila hoʻomaka ka mīkini e hanu nou.

I kahi pilikia, pono paha e hana ʻia kēia ma kahi ʻano ʻokoʻa iki, me ka wikiwiki loa.

He aha hou aʻe e hana ʻia ke kau ʻoe ma kahi ventilator?

ʻOiai ʻoe e kau ana i ka ventilator, e mālama ʻia ʻoe e kahi hui kauka i aʻo kūikawā ʻia. Aia kekahi mau mea hou aʻe e hana ʻia i loko o kēia manawa.

Ka nānā pono ʻana

E hoʻopili ʻia ʻoe i nā mea nānā ʻē aʻe e nānā i ka hana a kou kino.

• Ke koko
• Ka helu o ka puʻuwai
• Ka helu hanu
• Nā pae oxygen i loko o ke koko

Nānā mau ʻia kēia mau mea. Hana ʻia nā kukuna X-ray o ka umauma e nānā i ke kūlana o nā māmā a hana ʻia nā hoʻāʻo koko e nānā i nā pae oxygen i loko o ke koko.

Ka omo ʻana

Hiki i ka ʻōmole hanu ke hoʻoulu i ka mucus e hōʻiliʻili i loko o kou ala ea. No laila, hoʻokomo pinepine nā kahu maʻi i kahi ʻōmole lahilahi ʻē aʻe (catheter) i loko o ka ʻōmole e wehe i ka mucus e hōʻiliʻili ana. Hiki iā ʻoe ke ʻū iki a ʻoluʻolu ʻole i kēia manawa. Hiki ke lilo kēia i mea ʻoluʻolu ʻole no ka poʻe nānā, akā he mea nui e mālama i kou ala ea i maʻemaʻe.

ʻAi Meaʻai

ʻAʻole hiki iā ʻoe ke ʻai a inu paha no ka mea he paipu kou i loko o kou waha. No laila, e hāʻawi ʻia ʻoe i ka meaʻai wai ma o kahi paipu lahilahi e hele ana mai kou ihu a i kou ʻōpū. E hāʻawi ʻia nā wai ʻē aʻe ma o kahi wai saline i loko o kahi aʻa.

Hoʻoneʻe ʻana

ʻOiai ʻaʻole maikaʻi ka noho mau ʻana ma kahi moe, e hoʻomau ka hui lapaʻau iā ʻoe e neʻe. I kekahi manawa, inā ʻoe i ke kūlana e hana ai pēlā, e hoʻāʻo lākou e hoʻoneʻe iā ʻoe a puni iki.

He aha nā pono a me nā pilikia?

E like me nā lāʻau lapaʻau āpau, loaʻa i ka mālama ʻana i ka ventilator nā pono a me nā pilikia.

He aha nā PEEP a me CPAP?

Ua lohe paha ʻoe i kēia mau huaʻōlelo ʻelua.

• PEEP (Positive End-Expiratory Pressure): He hoʻonohonoho kēia ma kahi mīkini ventilator. I kekahi mau kūlana olakino, ke hanu mākou i waho, pani loa nā ʻeke ea i loko o nā māmā (alveoli). Mālama ka hoʻonohonoho PEEP i kēlā mau ʻeke ea e wehe ma ka hoʻopili ʻana i kahi liʻiliʻi o ke kaomi ʻoiai ke hanu ʻoe. Hoʻonui kēia i ka nui o ka oxygen e komo i loko o ke koko.
• CPAP (Continuous Positive Airway Pressure): Pili kēia i ka hāʻawi mau ʻana i ka nui like o ke kaomi maikaʻi i nā alaea i ka wā e hanu ana i loko a i waho. Hoʻohana pinepine ʻia no nā kūlana e like me ka sleep apnea, ma ke ʻano he ʻano hoʻoulu ea ʻole invasive (ma o kahi mask).

I ka ʻōlelo maʻalahi, ʻo PEEP ke kaomi i kau ʻia i kahi mea maʻi ma luna o kahi ventilator i ko lākou hanu ʻana i waho. ʻO CPAP kahi kaomi mau i kau ʻia i ka wā o ka hanu ʻana a me ka hoʻokuʻu ʻana i waho.

He mea pono ka mīkini hanu e hiki ke hoʻopakele i kou ola i ka wā e loaʻa ai kahi maʻi nui a i ʻole kahi pilikia. ʻOiai ʻaʻole ia e ho'ōla i ka maʻi, hāʻawi ia i kou kino i ka manawa a me ke kākoʻo e pono ai e hakakā i ka maʻi a hoʻōla.