E aʻo kākou e pili ana i ke kau ʻana i kahi ʻōmole i loko o ka umauma (Thoracostomy) ma ke ala maʻalahi.

Ua lohe paha ʻoe i kekahi e hoʻokomo ʻia ana kahi ʻōmole umauma ma hope o kahi ulia a i ʻole no ka mea ua pilikia lākou i ka hanu ʻana? Ua ʻike paha ʻoe iā ia ma kahi kiʻiʻoniʻoni. ʻO ka huaʻōlelo lapaʻau no kēia ʻo Thoracostomy. ʻOiai he mea weliweli iki paha ia, he hana hoʻōla ola koʻikoʻi loa ia. ʻAe, no laila e kamaʻilio kākou e pili ana i nā mea āpau ma nā ʻōlelo maʻalahi i kēia lā.

He aha ka Thoracostomy?

I ka ʻōlelo maʻalahi, he hana ka thoracostomy kahi e hana ai ke kauka i kahi ʻoki liʻiliʻi ma ka ʻaoʻao o kou umauma, ma waena o ʻelua mau iwi ʻaoʻao, a hoʻokomo i kahi paipu plastik ma loko. Kāhea pinepine mākou i kēia paipu he 'paipu umauma'.

I kēia manawa, e nānā, aia ʻelua mau membrane lahilahi e hoʻopuni ana i ko kākou mau māmā a e hoʻopuni ana i loko o ko kākou paia umauma. ʻO ka hakahaka ma waena o kēia mau membrane ʻelua ua kapa ʻia ʻo 'pleural space'. Ma muli o kekahi mau kūlana olakino a i ʻole nā ​​​​ulia pōpilikia , hiki i ka ea, ka wai (e like me ka wai), ke koko, a i ʻole ka pus ke hōʻiliʻili i loko o kēia hakahaka. Ke hana ʻia kēia, ʻaʻole hiki i nā māmā ke hoʻopū a hoʻohaʻahaʻa pono, hiki ke pilikia i ka hanu ʻana a me ka ʻeha nui.

I loko o kahi pilikia, ʻoi aku hoʻi i kahi kūlana weliweli e like me ka `Tension Pneumothorax`, kahi hiki iā ʻoe ke hanu i loko akā ʻaʻole hiki ke hanu i waho, hoʻokomo koke nā kauka i kahi nila a hoʻokuʻu i ka ea i waho ma mua o ke kau ʻana i kēia ʻōmole umauma. Ua kapa ʻia kēia ʻo `Needle Thoracostomy`. He hana hoʻōla ola kēia i hana ʻia ma ka Emergency Department (ETU).

He aha nā kūlana e hana ʻia ai ka thoracostomy?

Hana nā kauka i kēia lāʻau no nā kumu like ʻole. E nānā kākou i nā kumu nui.

Pono anei iaʻu e hoʻomākaukau no kēia lāʻau lapaʻau ma mua?

ʻO ka hapa nui o ka manawa, hana ʻia kēia i ka wā e loaʻa ai kahi ulia a i ʻole kahi pilikia, no laila ʻaʻohe manawa e hoʻomākaukau ai ma mua. I ia mau hihia, hana koke nā kauka ma ka Emergency Treatment Unit (ETU) i nā hoʻoholo a hana i kēia.

Eia nō naʻe, i kekahi manawa, ma muli o kahi maʻi mau e like me ke kahe mau ʻana o ka wai i loko o ka umauma, hiki ke hoʻolālā ʻia a kau ʻia kēia ʻōmole. I ia mau hihia, e hāʻawi kāu kauka iā ʻoe i kekahi mau ʻōlelo aʻoaʻo.

• Pono paha e hoʻōki ʻia kekahi mau lāʻau lapaʻau (ʻoiai nā lāʻau hoʻokahe koko) i kekahi mau lā ma mua o ka mālama ʻana.
• E noi ʻia ʻoe e pale i ka ʻai ʻana a i ʻole ka inu ʻana no kekahi mau hola ma mua o ka lāʻau lapaʻau.
• E haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau ʻē aʻe, nā huaora, a i ʻole nā ​​​​mea hoʻopihapiha āu e lawe nei.
• Inā he mau maʻi ʻaleka kou i kekahi lāʻau lapaʻau, e hoʻomaopopo e haʻi aku.
• E hoʻomaopopo pū i kāu kauka inā hāpai ʻoe a inā paha e hāpai ana .

He aha ka mea e hana maoli ai ke hana ʻia kahi thoracostomy?

ʻO ka maʻamau, he 30 mau minuke ka lōʻihi o kēia kaʻina hana. Ua ala ʻoe i ka wā o kēia kaʻina hana. Mai hopohopo, e hana nā kauka i nā mea āpau e hiki ai iā lākou ke hōʻoia ʻaʻole ʻoe e ʻeha.

1. ʻO ka mea mua, hana ʻia kahi X-ray umauma e hōʻoia i ke kau pololei ʻana o ka ʻōmole.

2. A laila e noi ʻia ʻoe e moe i lalo ma luna o kahi moe, e hāpai iki i kou poʻo, a kau i ka lima ma ka ʻaoʻao kahi e hoʻokomo ʻia ai ka ʻōmole ma luna o kou poʻo.

3. Hoʻomaʻemaʻe pono ʻia ka ʻili ma ka umauma kahi e hoʻokomo ʻia ai ka ʻōmole a holoi ʻia me kahi wai hoʻomaʻemaʻe.

4. ʻO ka mea aʻe, ʻo ka mea nui loa. Hoʻokomo ʻia kahi lāʻau hoʻomāno (e like me 'Lidocaine') i loko o ka ʻili. E kōkua kēia iā ʻoe ʻaʻole e ʻeha nui mai kāu hana ma hope.

5. Ma hope o ka mae ʻana o ka ʻili, hana ʻia kahi ʻoki liʻiliʻi ma waena o nā iwi ʻaoʻao ʻelua.

6. Ma o kēlā ʻoki ʻana, ua hoʻokomo pono ʻia kahi ʻōmole palaki (ʻōmole umauma) i loko o ka hakahaka a puni nā māmā.

7. Hoʻopili ʻia ka ʻaoʻao waho o ka paipu i kahi ʻōmole kūikawā a i ʻole ʻeke (pahu hoʻokahe wai) e hōʻiliʻili ana i ka wai a i ʻole ka ea e puka mai ana mai loko mai o ka umauma.

8. ʻO ka hope loa, ua hoʻopili ʻia kahi ʻaila poni antiseptic ma kahi e komo ai ka ʻōmole i loko o ka ʻili a uhi ʻia me kahi ʻaʻahu maʻemaʻe.

He aha nā pōmaikaʻi a me nā pilikia o kēia lāʻau lapaʻau?

E like me nā lāʻau lapaʻau a pau, aia nā pono a me nā pilikia liʻiliʻi loa.

Nā pono nui

• He hana maʻalahi kēia ʻaʻole pono kahi ʻoki nui (minimally invasive).
• He mea nui e hoʻopakele i nā ola i nā wā pilikia.
• ʻAʻole pono kēia i ka anesthesia piha (nalowale o ka ʻike).
• Hāʻawi kēia i ka hōʻoluʻolu nui i kahi mea pilikia i ka hanu ʻana ma muli o ke kahe mau o ka wai i loko o ko lākou umauma.

Nā pilikia liʻiliʻi hiki ke loaʻa

Ke hana nei nā kauka i kā lākou mea maikaʻi loa e hōʻemi i kēia mau pilikia.

• Ua hewa ka paipu a ua hemo paha.
• Ka maʻi ʻeha.
• Ka hōʻiliʻili ʻana o ka ea ma lalo o ka ʻili ('Subcutaneous emphysema').
• Ke kahe ʻana o ke koko.
• ʻAʻole pinepine loa, hōʻino ʻia nā aʻalolo a i ʻole nā ​​​​ʻiʻo a puni.
• Hōʻiliʻili ka wai a puni nā māmā ma hope o ko lākou hoʻopiha hou ʻia ʻana ('Re-expansion pulmonary edema').

He aha ka mea e hana ʻia ma hope o ka lāʻau lapaʻau?

Ma hope o ke komo ʻana o ka ʻōmole, e lawe ʻia kekahi X-ray e hōʻoia i kona wahi. A laila e hāʻawi ke kauka a me nā kahu hānai iā ʻoe i nā kuhikuhi no ka mālama ʻana i ka ʻōmole a me ka ʻeha i kou wā ma ka lumi maʻi.

• Pono e mālama ʻia ka ʻeha i ka maʻemaʻe a maloʻo .
• Pono e mālama ʻia ka paipu mai ke kūlou ʻana a i ʻole ka paʻa ʻana .
• ʻO ka mea nui loa: E mālama mau i ka ipu hoʻokahe wai ma lalo o kou pae umauma . A i ʻole, hiki i nā mea o loko o ka ipu ke liki hou i loko o kou umauma.
• E lawe i nā mea hoʻoluhi ʻeha a me nā lāʻau ʻē aʻe i kauoha ʻia e kāu kauka i ka manawa kūpono.

Pehea ka lōʻihi e waiho ʻia ai kahi ʻōmole umauma?

Aia kēia i ke kumu i hoʻokomo ʻia ai ka ʻōmole. Ke pau ka wai a i ʻole ka ea i loko o ka umauma, e wehe pinepine ʻia ka ʻōmole i loko o kekahi mau lā. Eia nō naʻe, inā hoʻomau ka hōʻiliʻili ʻana o ka wai ma muli o kahi maʻi mau, e like me ke kanesa, pono paha e waiho ʻia ka ʻōmole no nā pule. E nīnau i kāu kauka no ka ʻike hou aku.

Āhea ʻoe e pono ai e ʻike i ke kauka i ka wā hikiwawe loa?

Inā ua hoʻokomo ʻia kahi ʻōmole umauma, e makaʻala loa i nā hōʻailona ma lalo nei. Inā loaʻa iā ʻoe kekahi o kēia mau mea, e haʻi koke aku i kāu kauka a kahu maʻi paha.

Inā ʻike ʻoe i kekahi mea e like me kēia, e hoʻomaopopo koke i ke kauka a i ʻole ke kahu maʻi o ka haukapila. Mai makaʻu e nīnau e pili ana i ia mea.