Inā ʻoe a i ʻole kekahi mea kokoke iā ʻoe e hana ʻoki kino, he mea maʻamau ke hoihoi iki, a hopohopo paha, e pili ana i nā lāʻau lapaʻau e hāʻawi ʻia i kēlā manawa. Ma waena o nā lāʻau lapaʻau i hāʻawi ʻia i ka wā anesthesia, he lāʻau lapaʻau koʻikoʻi ʻo Rocuronium. ʻO kekahi o kona mau inoa inoa ʻo Zemuron. No laila i kēia lā, e kamaʻilio wale kākou e pili ana i ke ʻano o Rocuronium, kāna hana, a me nā mea e pono ai mākou e ʻike e pili ana i ia mea.
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He aha ka Rocuronium? He aha kāna hana?
I ka ʻōlelo maʻalahi, he lāʻau lapaʻau ʻo Rocuronium e hoʻomaha ai i nā ʻiʻo iwi i loko o kou kino no kekahi manawa.
E noʻonoʻo i ka wā e hana ana ʻoe i ke ʻoki kino, pono nā kauka e hiki ke hiki maʻalahi i nā ʻōpū i loko o kou kino. No kēlā, ʻaʻole hiki i kou mau ʻiʻo ke ʻūlū, pono lākou e hoʻomaha loa. ʻO ia ka mea a Rocuronium e kōkua ai. Ua like ia me ka hoʻopaʻa ʻana i kou mau ʻiʻo no kekahi manawa. ʻOi aku ka maʻalahi o kēia no ke kauka ʻoki kino e hana i ke ʻoki kino me ka ʻole o ke keakea.
Eia kekahi, i kekahi manawa ke pilikia kekahi i ka hanu ʻana, pono lākou e hoʻopili ʻia i kahi mīkini (ventilator) e hanu ai. I kēlā mau hihia, hoʻohana ʻia kēia lāʻau lapaʻau e hoʻomaha i nā ʻiʻo hanu a kōkua i ka mīkini e hana pono.
He aha kaʻu e haʻi aku ai i ke kauka ma mua o ka hāʻawi ʻana i kēia lāʻau?
He mea nui loa kēia. Ma mua o ka hāʻawi ʻia ʻana iā ʻoe ʻo Rocuronium, he mea nui e ʻike pono kāu hui lapaʻau i kou kūlana olakino. ʻO kēia no ka mea pono kekahi mau kūlana i ka mālama kūikawā i ka wā e hoʻohana ai i kēia lāʻau. No laila, inā loaʻa iā ʻoe kekahi o nā kūlana i helu ʻia ma lalo nei, e hōʻoia e haʻi i kāu kauka.
| Nā kūlana olakino āu e hōʻike ai | No ke aha he mea nui? |
|---|---|
| Dehydration (nele i ka wai i loko o ke kino) | Hoʻopilikia ke kaulike wai i loko o ke kino i ka pono o ka lāʻau lapaʻau. |
| ʻO kēlā me kēia ʻano maʻi puʻuwai | Hiki i kēia lāʻau lapaʻau ke hoʻopilikia i ka helu o ka puʻuwai a me ke koko. |
| Nā ʻano ʻē i ka calcium koko, magnesium, a me ka pae potassium | Pili pono nā pae o kēia mau minelala i ka hana o nā ʻiʻo a me nā hopena o ka lāʻau. |
| Maʻi puʻupaʻa a maʻi akepaʻa paha | Ma muli o ke komo ʻana o kēia mau ʻōkana i ke kaʻina hana o ka wehe ʻana i nā lāʻau lapaʻau mai ke kino, hiki i ko lākou mau kūlana maʻi ke hoʻololi i ka pono o ka lāʻau lapaʻau. |
| Nā maʻi māmā e like me ka hānō | Pono ka mālama kūikawā no ka mea hiki ke hoʻopilikia i ka ʻōnaehana hanu. |
| ʻO Myasthenia Gravis (kahi maʻi e hoʻonāwaliwali ai nā ʻiʻo) | Hiki i kēia mau maʻi ke hypersensitive iā Rocuronium. |
| Nā maʻi ʻaleka i ka rocuronium, bromide, a i ʻole kekahi lāʻau lapaʻau a meaʻai paha | He mea nui kēia e pale aku ai i kahi hopena alerika koʻikoʻi (anaphylaxis). |
| Inā hāpai ʻoe, e hoʻāʻo ana e hāpai, a i ʻole e hānai waiū ana | Pono ke kauka e noʻonoʻo i nā hopena hiki ke loaʻa i ke keiki. |
Pehea e hāʻawi ʻia ai ka inikini Rocuronium?
ʻAʻole hiki iā ʻoe ke hoʻohana i kēia lāʻau lapaʻau ma ka home. Hāʻawi wale ʻia ʻo Rocuronium ma kahi haukapila a i ʻole ke keʻena lapaʻau . E hāʻawi aku kekahi loea mālama ola i aʻo ʻia iā ʻoe ma ke ʻano he injection i loko o kahi aa a i ʻole he infusion i loko o kou kino.
Hiki i nā kauka ke kuhikuhi i kēia lāʻau lapaʻau no nā kamaliʻi ʻōpio, ʻoiai nā pēpē hānau hou, i nā hihia kūikawā. Akā hana ʻia me ke akahele nui a ma lalo o ka nānā kūikawā. Hiki iā ʻoe ke kamaʻilio me kāu kauka pediatric e pili ana i kēia.
ʻOiai ua hāʻawi ʻia kēia lāʻau lapaʻau ma kahi haukapila, ma lalo o ka nānā pono ʻana o ke kauka, ʻaʻole pono ʻoe e hopohopo e pili ana i ka hala ʻana o kahi lāʻau a i ʻole ka lawe ʻana i ka overdose. E hoʻokele pono ke kime lapaʻau i nā mea āpau.
Inā makemake ʻoe i ka ʻike e pili ana i kahi kūlana e like me ka lāʻau make, hiki iā ʻoe ke kelepona i ke Kikowaena ʻIke Lāʻau Lapaʻau Lahui ma ka Halemai Lahui ʻo Colombo . I ka wā o kahi pilikia, e hana ka Emergency Treatment Unit (ETU) o ka haukapila i nā hana e pono ai.
Nā lāʻau ʻē aʻe e launa pū me kēia lāʻau (Nā Hana Lāʻau)
ʻO ka 'Lāʻau Lapaʻau' ʻo ia ka wā e hoʻopilikia ai kekahi lāʻau lapaʻau āu e lawe nei i ka pono o kekahi lāʻau lapaʻau āu e lawe nei. Aia kekahi mau ʻano lāʻau lapaʻau e hiki ke launa pū me Rocuronium. No laila, he mea nui loa e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe nei.
- Kekahi mau lāʻau antibiotic: No ka laʻana, amikacin, gentamicin, tobramycin, vancomycin, tetracyclines, polymyxins.
- ʻO kekahi mau lāʻau lapaʻau i hoʻohana ʻia e mālama i nā kūlana e like me ka maʻi epilepsy (nā hopu ʻana): no ka laʻana, carbamazepine, phenytoin.
- Nā lāʻau lapaʻau ʻē aʻe i hoʻohana ʻia no ka anesthesia: Nā kinoea anesthetic e like me enflurane, isoflurane, halothane.
- Lithium: He lāʻau lapaʻau i hoʻohana ʻia no ka maʻi noʻonoʻo.
- Nā lāʻau anesthetics kūloko: e like me ka lidocaine a me ka tetracaine.
- Makenesium
- Nā mea hoʻomaha ʻiʻo ʻē aʻe no ke ʻoki ʻana
- ʻO Procainamide a me Quinidine (nā lāʻau lapaʻau no ka maʻi puʻuwai)
ʻAʻole piha kēia papa inoa. No laila, he mea nui loa e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe nei (i kauoha ʻia a kūʻai ʻia ma luna o ke kauka), nā huahana lāʻau, nā huaora, a me nā mea hoʻohui āu e lawe nei, a inā ʻoe e puhipaka, inu waiʻona, a hoʻohana paha i nā lāʻau ʻē aʻe, ma mua o kou ʻoki kino.
Nā hopena ʻaoʻao hiki ke loaʻa mai ka lawe ʻana iā Rocuronium
E like me nā lāʻau lapaʻau āpau, hiki i ka Rocuronium ke hana i kekahi mau hopena ʻaoʻao. E nānā pono ke kime lapaʻau iā ʻoe i ka wā e hāʻawi ʻia ai kēia lāʻau lapaʻau iā ʻoe. E hana koke lākou i nā hana inā loaʻa kekahi mau hopena ʻaoʻao. Eia nō naʻe, he mea nui e makaʻala iā lākou.
| Hopena ʻaoʻao | Wehewehena |
|---|---|
| Nā hopena ʻaoʻao e pono e hōʻike koke ʻia i ka hui lapaʻau | |
| Nā hopena alerika koʻikoʻi | ʻŌhūhū ʻili, maneʻo nui, pehu o ka maka, nā lehelehe a i ʻole ke alelo. |
| Paʻakikī ka hanu ʻana | Paʻakikī ka hanu ʻana inā ʻaʻole ʻoe i pili i kahi ventilator. |
| Ka wikiwiki o ka puʻuwai (Tachycardia) | Manaʻo e kuʻi wikiwiki ana kou puʻuwai. |
| Ke koko haʻahaʻa (Hypotension) | Pōniuniu, manaʻo māmā ke poʻo, a me nā maka polū. |
| Nā hōʻailona o ka hōʻino ʻana o nā ʻiʻo | ʻEleʻele ka mimi, paʻakikī ke mimi, luhi loa, a me ka ʻeha pelvic. |
| Nā hopena ʻaoʻao e pono e hōʻike ʻia i ke kauka inā hoʻomau lākou | |
| ʻEha/nāwaliwali o nā ʻiʻo | ʻEhaʻeha a nāwaliwali paha nā ʻiʻo e mau ana ma hope o ka pau ʻana o nā hopena o ka lāʻau. |
| ʻEha ma kahi i hoʻokomo ʻia | ʻEha, ʻulaʻula, a mumū paha kahi i hāʻawi ʻia ai ka inikini. |
ʻAʻole i hoʻokomo ʻia nā hopena ʻaoʻao āpau i loko o kēia papa inoa. Inā loaʻa iā ʻoe kekahi mea ʻē aʻe ma waho aʻe o kēia mau mea, e kamaʻilio me kāu kauka e pili ana i ia mea.
Leka Lawe-Home
- He lāʻau lapaʻau ʻo Rocuronium i hoʻohana ʻia no ka hoʻomaha ʻana i nā ʻiʻo no kekahi manawa i ka wā o ke ʻoki kino a me kekahi mau kaʻina hana lapaʻau.
- Hāʻawi wale ʻia kēia ma kahi haukapila, e kekahi loea lapaʻau i aʻo ʻia.
- He mea nui e hoʻomaopopo i kāu kauka e pili ana i nā pilikia olakino ʻē aʻe āu e loaʻa ai (ʻoiai ka puʻuwai, nā puʻupaʻa, nā maʻi akepaʻa, nā maʻi allergies) a me nā lāʻau lapaʻau ʻē aʻe āu e lawe nei ma mua o ke ʻoki ʻana.
- Inā loaʻa iā ʻoe kekahi mau hopena koʻikoʻi e like me nā hōʻailona maʻi ʻaleka, ka paʻakikī o ka hanu ʻana, a i ʻole ka wikiwiki o ka puʻuwai, e hoʻomaopopo koke i ka hui lapaʻau.
- Inā he mau nīnau kāu e pili ana i kēia lāʻau lapaʻau, mai kānalua e nīnau i kāu kauka.
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