He mea makaʻu anei ka ventilator? E aʻo kākou i nā mea āpau e pili ana i ia mea (Mechanical Ventilation)

He mea maʻamau ka manaʻo nui i ka makaʻu a me ka hopohopo ke lohe ʻoe ua kau ʻia kekahi āu i ʻike ai ma ka Intensive Care Unit (ICU) ma luna o kahi ventilator. Hoʻonui ʻia kēia makaʻu e ka ʻike ʻole ʻana i ka nui o kēia mīkini. He mea waiwai nui ia e hiki ke kōkua i ke kaua ma waena o ke ola a me ka make. No laila, i kēia lā, e kamaʻilio kākou e pili ana i ke ʻano o ka ventilator, a i ʻole e like me ka mea i kapa ʻia ma ka ʻepekema lapaʻau, a me kāna hana, ma kahi ʻōlelo maʻalahi a maopopo hoʻi.

I ka ʻōlelo maʻalahi, he aha ka ventilator?

He mīkini ka ventilator e kōkua i kekahi e hanu i ka wā e paʻakikī ai lākou i ka hanu ʻana iā lākou iho. E noʻonoʻo e like me ka hoʻohana ʻana i nā crutches i ka wā e haki ai kou wāwae. E like me ke kōkua ʻana o nā crutches iā ʻoe e hele me kou kaumaha, lawe ka ventilator i ka hana hanu no kou mau māmā, ma ke ʻano holoʻokoʻa a i ʻole i kekahi ʻano.

Hana nui ʻia kēia mau mea me kahi ventilator:

• Hāʻawi ia i kou mau māmā i ka oxygen e pono ai lākou.
• Kōkua ia i ka wehe ʻana i ke kinoea kalapona ʻokikene ʻino e hōʻiliʻili ana i loko o nā māmā.
• ʻO nā ʻeke ea liʻiliʻi i loko o nā māmā, i kapa ʻia ʻo alveoli, hāʻawi 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 like me nā pono o ka mea maʻi.

He ʻelua mau mea like ʻole ka Intubation a me ka Ventilation?

ʻAe. ʻO kēia kahi e huikau ai nā kānaka he nui. ʻOiai ke hana pū ʻia nei kēia mau mea ʻelua, he mau kaʻina hana ʻelua kēia.

• Intubation: Ke kaʻina hana e hoʻokomo ai ke kauka i kahi ʻōmole i loko o ka ʻōpū hanu o ka mea maʻi (trachea) ma o ka waha o ka mea maʻi.
• Ka Hoʻoulu ʻana i ka Ea: ʻO ke ʻano kēia o ka hoʻopili ʻana i ka ʻōmole i hoʻokomo ʻia ma kēia ʻano i kahi ventilator e kōkua ai i ka hanu ʻana.

I kekahi mau hihia, hiki ke hoʻohui i ka ventilator i kahi pale maka e kūpono pono ana ma luna o ka maka, me ka ʻole o ke kau ʻana i kahi ʻōmole e like me kēia.

He aha nā ʻano hana ventilator i loaʻa?

Hoʻokuke nā mīkini hanu i ka ea i loko o nā māmā me ka hoʻohana ʻana i ke kaomi maikaʻi. Hiki ke hana ʻia kēia ma nā ʻano nui ʻelua. I mea e maʻalahi ai ka hoʻomaopopo ʻana i kēia ʻike, e hana kākou i kahi papa e like me kēia.

ʻO wai ka mea e pono ai ke kōkua o kahi ventilator?

Hiki ke pono ke kōkua o kahi ventilator i kēlā me kēia manawa ʻaʻole hiki i kekahi ke hanu iā lākou iho, ʻoiai i nā hihia e like me kēia:

• I ka wā o ke ʻoki kino: Hoʻemi ka anesthesia laulā i ko mākou hiki ke hanu. No laila, kōkua kahi ventilator i ka mālama ʻana i ka hanu mau i ka wā o ke ʻoki kino.
• Nā maʻi a i ʻole nā ​​​​maʻi māmā koʻikoʻi: I nā kūlana e like me ka niumonia, COVID-19, acute respiratory distress syndrome (ARDS), a me ka maʻi pulmonary obstructive chronic (COPD).
• Nā ulia pōpilikia a i ʻole nā ​​pilikia olakino: I ka hanana ʻana o kahi ulia e hoʻopilikia ai i ke ala ea a i ʻole ka hāʻule ʻana o ka hanu. No ka laʻana, kahi hopena aleri koʻikoʻi (anaphylaxis).
• Poino lolo: ʻO ka poino o ka lolo, e like me ka hahau ʻana a i ʻole ka coma, hiki ke pale i ka leka mai ka lolo i nā māmā mai ka hele pono ʻana.
• Ke kaulike ʻole o nā pae kinoea koko: Ma nā kūlana e like me ka hoʻonui ʻia o ke kalapona ʻokikene i loko o ke koko (hypercapnia) a i ʻole ka emi ʻana o ka oxygen (hypoxemia).
• I mea e pale ai i ke komo ʻana o ka meaʻai a i ʻole ka lawai i loko o nā māmā: Kāohi i ka hanu ʻana o nā mea (lawa, meaʻai) i loko o ka waha o ke kanaka ʻike ʻole a hiki ai ke hoʻoulu i ka maʻi.

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

No ka mea, pono e nānā pono ʻia kekahi mea i pili i kahi ventilator, mālama pinepine ʻia lākou i loko o ka ʻāpana mālama koʻikoʻi (ICU).Ma laila, mālama kahi hui o nā kauka i hoʻomaʻamaʻa kūikawā ʻia, nā kahu maʻi, a me nā mea hoʻōla hanu i ka mea maʻi.

Ke nānā nei i ka mea maʻi

E ʻike ʻoe he nui nā mīkini ʻē aʻe a kāu mea aloha i hoʻopili ʻia i ko lākou kino. Ke ana mau nei lākou i nā mea e like me ke koko, ka helu o ka puʻuwai, ka helu hanu, a me nā pae oxygen koko. Hana pū lākou i nā kukuna X-ray umauma a me nā hoʻāʻo koko.

Ka omo ʻana

Hiki ke hōʻiliʻili ka huʻa i loko o ke ala ea. No laila, hoʻokomo pinepine nā kahu hānai i kahi ʻōmole lahilahi (catheter) e wehe i ka huʻa. I kēia manawa, hiki i ka mea maʻi ke kuni. He mea ʻoluʻolu ʻole paha kēia iā ʻoe ke nānā aku, akā he mea nui kēia e mālama i ke ala ea i maʻemaʻe.

Lāʻau lapaʻau, meaʻai a me ka hoʻomaʻemaʻe

Hoʻokomo ʻia kekahi mau lāʻau lapaʻau i loko o nā māmā ma o ka ʻōmole hanu. No ka mea, ʻaʻole hiki iā lākou ke ʻai a inu paha, hāʻawi ʻia ka meaʻai wai ma o kahi ʻōmole i hoʻokomo ʻia ma ka ihu i loko o ka ʻōpū. Hāʻawi ʻia nā wai e pono ai ma ke ʻano intravenous ma o ka saline.

Ua ala anei ka mea maʻi?

Hoʻāʻo nā kauka e mālama i ka mea maʻi i ka ʻoluʻolu, mālie, a makaʻala e like me ka hiki. Eia nō naʻe, ma muli o ke kūlana o ka mea maʻi, pono paha e hāʻawi i ka mea maʻi i ka hoʻomaha a ʻae i ke kino e ho'ōla, a i ʻole e hoʻomoe iā lākou i ka hiamoe hohonu (deep sedation). I kekahi manawa, pono paha e kāohi ʻia ka mea maʻi e pale aku iā lākou mai ka hōʻeha ʻana iā lākou iho, no ka laʻana, e pale aku iā lākou mai ka hoʻāʻo ʻana e wehe i ka ʻōmole. Hana ʻia kēia no ka palekana o ka mea maʻi.

He aha nā pono a me nā pilikia?

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

Pehea ʻoe e hoʻokaʻawale ai iā ʻoe iho mai ka ventilator?

Ke hoʻomaikaʻi ke kūlana o ka mea maʻi a maopopo i nā kauka hiki iā lākou ke hanu iā lākou iho, hoʻomaka lākou i ke kaʻina hana o ka "weaning" iā lākou mai ka ventilator. ʻO ka mea mua, hoʻemi mālie lākou i ke kākoʻo mai ka mīkini a nānā inā hiki i ka mea maʻi ke hanu iā lākou iho. Inā maikaʻi nā mea āpau, wehe ʻia ka "ET tube".

Ma hope o ka wehe ʻia ʻana o ka ʻōmole, e loaʻa paha iā ʻoe ka ʻeha o ka puʻu a me ka leo palahalaha no kekahi mau lā. He mea maʻamau kēia.