Ua pono anei ʻoe e hana i ke ʻoki kino? A i ʻole ua pono anei ʻoe e hana i kahi hoʻāʻo lapaʻau ma lalo o ka anesthesia ? I kēia lā e kamaʻilio mākou e pili ana i kahi lāʻau lapaʻau kūikawā a nā kauka e hoʻohana ai e pale i kou mau ʻiʻo mai ka neʻe koke ʻana. ʻO Vecuronium ka inoa. He mea weliweli paha ke lohe ʻia e pili ana i ia mea, akā he mea nui loa ia no kou palekana. E kamaʻilio kākou e pili ana i ia mea me nā kikoʻī.
He aha ka Vecuronium?
I ka ʻōlelo maʻalahi, he lāʻau lapaʻau ka vecuronium e hoʻomaha iki i kou mau ʻiʻo . E noʻonoʻo e hana ana ʻoe i kahi ʻoki kino palupalu loa. Inā ʻūlū koke kahi ʻiʻo i loko o kou kino, hiki ke lilo i mea keakea nui no ke kauka ʻoki . A hiki nō hoʻi ke lilo i mea weliweli iā ʻoe.
Hoʻohana ʻia ʻo Vecuronium e hoʻōki i kēia mau neʻe koke. Hoʻopaʻa kēia lāʻau lapaʻau i nā hōʻailona aʻalolo mai kou lolo e haʻi ana i kou mau ʻiʻo e "neʻe." E like me ka hoʻōki ʻana i ka hōʻailona mai kāu kelepona, hoʻōki kēia lāʻau lapaʻau i nā hōʻailona mai kou lolo a i kou mau ʻiʻo. ʻO ia hoʻi, ʻaʻole e ʻoni a neʻe koke paha kou mau ʻiʻo. ʻAe kēia i nā kauka e hana i kā lākou hana me ka palekana a me ka ʻole o ke keakea.
Nā mea e pono ai ʻoe e haʻi i kāu kauka ma mua o ka hāʻawi ʻana i kēia lāʻau lapaʻau
He mea nui loa kēia. No ka mea, he lāʻau ikaika ka vecuronium, he mea nui e ʻike ka hui lapaʻau i nā kikoʻī piha o kou kūlana olakino. Inā nīnau ʻia kēia mau nīnau iā ʻoe, e haʻi i ka ʻoiaʻiʻo me ka hūnā ʻole i kekahi mea. No kou palekana ponoʻī kēia.
| Nā kūlana olakino āu e hōʻike ai | No ke aha he mea nui kēlā? |
|---|---|
| Ka maloʻo ʻana, ʻo ia hoʻi inā ʻaʻole lawa ka wai i loko o ke kino. | Hiki i ka maloʻo ʻana ke hoʻololi i ke ʻano o ka hana ʻana o nā lāʻau lapaʻau i loko o ke kino. |
| Inā he maʻi puʻuwai kou . | Pono nā kauka e makaʻala loa e pili ana i kēia lāʻau lapaʻau, no ka mea, he ʻokoʻa paha kona hopena i ka mea me ka maʻi puʻuwai. |
| Inā he maʻi puʻupaʻa a maʻi akepaʻa paha kou. | ʻO nā puʻupaʻa a me ke akepaʻa nā ʻōkana e wehe i nā lāʻau lapaʻau mai ke kino. Inā ʻaʻole hana pono kēia mau ʻōkana, hiki i ka lāʻau lapaʻau ke noho i loko o ke kino no ka manawa lōʻihi. |
| Nā maʻi o ka māmā (e like me ka hānō, COPD). | ʻOiai hoʻi e pili ana kēia lāʻau lapaʻau i nā ʻiʻo e pili ana i ke kaʻina hana hanu, pono e uku ʻia ka nānā kūikawā i nā poʻe me nā maʻi māmā. |
| Inā loaʻa iā ʻoe kahi maʻi nāwaliwali o nā ʻiʻo e like me myasthenia gravis . | Hiki i ka poʻe me kēia mau kūlana ke hypersensitive i ka vecuronium, ʻo ia hoʻi, hiki i kahi liʻiliʻi loa ke loaʻa ka hopena koʻikoʻi. |
| Nā Allergies : ʻO ia hoʻi inā he allergy kou i ka vecuronium, nā lāʻau lapaʻau ʻē aʻe, nā meaʻai, a i ʻole nā mea hoʻoluʻu. | He mea nui kēia ʻike no ka pale ʻana i kahi hopena alerika koʻikoʻi. |
| Inā hāpai ʻoe a i ʻole e hoʻāʻo nei e hāpai . | He mea nui kēia ʻike e noʻonoʻo ai i nā hopena hiki ke loaʻa i ka pēpē i loko o ka ʻōpū. |
| Inā he makuahine hānai waiū ʻoe . | He mea pono kēia e noʻonoʻo ai inā hele ka lāʻau lapaʻau i ka pēpē ma o ka waiū a i ʻole. |
Pehea ʻoe e hoʻohana ai i kēia lāʻau lapaʻau?
ʻAʻole hiki ke hoʻohana ʻia kēia lāʻau lapaʻau ma ka home. He inikini intravenous ia. Hāʻawi wale ʻia e kahi hui lapaʻau i aʻo ʻia ma kahi haukapila a i ʻole ke keʻena lapaʻau. No laila, ʻaʻole pono ʻoe e hana a noʻonoʻo paha i kekahi mea e pili ana i ia mea.
I kekahi mau hihia kūikawā, hiki ke hoʻohana ʻia kēia lāʻau lapaʻau ma nā keiki ʻōpio, ʻoiai nā pēpē. Akā, pono e hana ʻia me ke akahele nui a ma lalo o ka nānā kūikawā ʻana a ke kauka.
He aha kāu e hana ai inā lawe nui ʻoe i ka lāʻau lapaʻau?
ʻOiai ua hāʻawi ʻia kēia ma kahi haukapila, ua haʻahaʻa loa ka manawa kūpono o ka overdose. No ka mea, hana nā mea āpau ma lalo o ka mana o kahi hui lapaʻau me kahi anesthesiologist. Akā inā loaʻa koke kekahi mea, ua mākaukau lākou e hāʻawi i ka lāʻau lapaʻau e pono ai. No laila, ʻaʻohe ou mea e hopohopo ai. Ma ke ʻano he ʻike, inā ua make ʻoe i kahi lāʻau lapaʻau, pono ʻoe e hoʻokaʻaʻike aku i ke Kikowaena ʻIke Lāʻau Lapaʻau Lahui ma ka Halemai Lahui ʻo Colombo . I kahi pilikia, ua kuhikuhi ʻia ʻoe i ka Emergency Treatment Unit (ETU) kokoke loa.
Nā lāʻau lapaʻau ʻē aʻe e hiki ke launa pū me Vecuronium
Hiki i nā lāʻau lapaʻau ʻē aʻe āu e lawe nei ke hoʻopilikia i ka hana a vecuronium. No laila, he mea nui loa e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe nei, me nā mea kanu, nā huaora, a me nā lāʻau lapaʻau ʻole i kauoha ʻia. Hiki i kekahi mau lāʻau lapaʻau ke hoʻonui i nā hopena o ka vecuronium, aʻo nā mea ʻē aʻe e hiki ke hoʻemi iā ia.
Eia kekahi o nā ʻano lāʻau lapaʻau nui e hiki ai ke hoʻopilikia:
- Kekahi mau lāʻau antibiotic (e laʻa: amikacin, gentamicin, tobramycin, tetracycline, clindamycin, vancomycin, colistin)
- ʻO kekahi mau lāʻau lapaʻau i hāʻawi ʻia no nā maʻi (nā laʻana: carbamazepine, phenytoin)
- Litiuma
- Nā lāʻau hoʻomaʻemaʻe kūloko (e laʻa: lidocaine)
- Nā mea hoʻohui magnesium
- Procainamide
- Kuinidina
E hoʻomanaʻo, ʻaʻole kēia he papa inoa piha, no laila ʻoi aku ka maikaʻi o ka haʻi ʻana i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe ai.
Nā hopena ʻaoʻao e hiki ke loaʻa me kēia lāʻau lapaʻau
E like me nā lāʻau lapaʻau āpau, hiki i ka vecuronium ke hana i nā hopena ʻaoʻao. Akā i ka hapa nui o ka manawa, ʻaʻole kēia mau mea e hana. A no ka mea e nānā mau ana ke kime lapaʻau iā ʻoe i ka wā e hāʻawi ʻia ai kēia lāʻau lapaʻau iā ʻoe, hiki iā lākou ke mālama koke i nā pilikia inā kū mai.
| ʻAno o ka hopena ʻaoʻao | Nā ʻano |
|---|---|
| Nā hopena ʻaoʻao koʻikoʻi e pono e hōʻike koke ʻia i ka hui lapaʻau | |
| Nā hopena alerika | ʻŌhūhū ʻili, maneʻo, pehu o ka maka, nā lehelehe, ke alelo a i ʻole ka puʻu. |
| Nā hōʻailona koʻikoʻi ʻē aʻe | Ke kuni nui, ka hou nui, ka hanu wikiwiki a papau paha, ka puʻuwai wikiwiki a ʻano ʻole paha, ka ʻoʻoleʻa a i ʻole ka ʻūlū ʻana o nā ʻiʻo. |
| ʻAʻohe mea e hopohopo ai, akā inā hoʻomau ia, aia kekahi mau mea e ʻōlelo ai. | |
| Nāwaliwali o nā ʻiʻo | Ke manaʻo nei i kahi nāwaliwali o nā ʻiʻo ma hope o ka pau ʻana o nā hopena o ka lāʻau. |
| ʻO ka ʻoluʻolu ʻole ma kahi i hoʻokomo ʻia | ʻEha, ʻulaʻula, a ʻoluʻolu ʻole paha ma kahi i inikini ʻia. |
ʻAʻole i hoʻokomo ʻia nā hopena ʻaoʻao āpau i kēia papa inoa. Inā ʻike ʻoe i kekahi mea ʻē aʻe i ʻike ʻole ʻia, e kamaʻilio me kāu kauka e pili ana i ia mea.
Ma hea ʻoe e mālama ai i ka lāʻau lapaʻau?
ʻAʻole kēia he pilikia nou. No ka mea, ʻaʻole ʻoe e ʻae ʻia e lawe i kēia lāʻau lapaʻau i ka home. Hoʻohana wale ʻia a mālama ʻia i loko o kahi haukapila a i ʻole keʻena lapaʻau. No laila, ʻaʻole pono ʻoe e noʻonoʻo pehea e mālama ai.
Leka Lawe-Home
- He lāʻau lapaʻau ʻo Vecuronium i hoʻohana ʻia e hoʻomaha i nā ʻiʻo i ka wā o ke ʻoki kino a me nā kaʻina hana lapaʻau. He mea nui loa kēia no kou palekana.
- Hāʻawi wale ʻia kēia lāʻau lapaʻau ma kahi haukapila, e kahi hui lapaʻau i aʻo ʻia, no laila ʻaʻohe ou mea e hopohopo ai.
- He mea nui e haʻi aku i kāu kauka e pili ana i kekahi mau kūlana olakino āu a me nā lāʻau lapaʻau āu e lawe nei (me nā huaora a me nā mea kanu) ma mua o ke ʻoki ʻana.
- I ka wā a ma hope o ka lāʻau lapaʻau, e nānā pono ke kime lapaʻau i kou kūlana. E mākaukau lākou no nā hopena ʻaoʻao e hiki mai ana.
- Inā he mau nīnau kāu e pili ana i kēia lāʻau lapaʻau, mai makaʻu e nīnau i kāu kauka.
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