Yu dɔn ɛva si pɔsin we sik na di intensiv kia yunit (ICU) we gɛt siriɔs prɔblɛm fɔ blo, we di dɔktɔ ɛn di nɔs wokman dɛn tek tɛm tɔn in fes dɔŋ? Yu go dɔn de wɔnda wetin mek dɛn kin du dis, ɛn if i nɔ go fayn fɔ di pɔsin we sik. Dis na rili impɔtant tritmɛnt we kin sev di pɔsin in layf. Tide wi go tɔk bɔt dis spɛshal we we na nyu tin to bɔku pipul dɛn, bɔt dɛn dɔn de yuz am na mɛrɛsin fɔ bɔku bɔku ia. Dɛn kɔl dis "Proning" na mɛrɛsin.
Wetin na jɔs proning?
Fɔ tɔk am simpul wan, proning na di akt fɔ tɔn pɔsin we de ledɔm supine (na dɛn bak) to prone pozishɔn (na dɛn bɛlɛ). insay mεdikal tεm dεm, dεn kכl dis slip posishכn di ``Supine Posishכn''. Di ``Prone Position'' na dכkta dεm de yuz fכ εp di sik pipul dεm we gεt siriכs rεspiretכri kכndyushכn we gεt difrεnt fכ gεt inof כksijεn na dεn bכdi.
Bɔku tɛm dɛn kin yuz dis we fɔ di sik pipul dɛn we de pan mashin we dɛn kin yuz fɔ mek wata kɔmɔt na di bɔdi. Yu go dɔn yɛri dis wɔd di tɛm we COVID-19 pandemik de. Bɔt i nɔto nyu tin. Stɔdi dɔn ivin sho se if dɛn yuz dis we fɔ du tin kwik kwik wan pan pipul dɛn we gɛt siriɔs sik we dɛn kɔl respiratory disease, di risk fɔ day kin ridyus bad bad wan.
Us kayn kɔndishɔn dɛn kin yuz dis we fɔ du tin?
di proning mεtכd na fכ pipul dεm we gεt siriכs rεspiretכri sik dεm we de na stet fכ ``Hypoxia`` usay di bכdi nכ de gεt inof כksijεn. Bɔt dɛn kin yuz dis we fɔ du tin mɔ pan wan sik we dɛn kɔl Acute Respiratory Distress Syndrome (ARDS) .
Fɔ tɔk am simpul wan, ARDS na wan sik we di smɔl smɔl ay sak dɛn (alveoli) we de na wi lɔng dɛn kin ful-ɔp wit wata. Dis kin mek i rili at fɔ blo. ARDS na siriɔs kɔmplikeshɔn fɔ siriɔs sik dɛn we pɔsin kin gɛt we i de blo lɛk nyumonia ɛn COVID-19.
Wetin mek di ɔksijɛn lɛvɛl kin go ɔp we yu tɔn yu ed?
Di rizin fɔ dis rili intrestin. Di men rizin fɔ dis na bikɔs wi bɔdi nɔ kin simetrik ɔl. Proning men wan de du tu tin.
1. Ridyus di wet ɛn prɛshɔn pan di lɔng dɛn
Tink bɔt dis, bikɔs dɛn mek wi bɔdi fɔ gɛt mɔ lɔng tisu na do pas insay wi chɛst. We wi de slip na wi bak, di wet we wi at ɛn ɔda pat dɛn na wi bɛlɛ de fɔdɔm dairekt pan wi lɔng. כlso, di wata we de kכmכt na wi lכng de prεs dכn pan di ay sak dεm na do bikoz fכ di graviti. dis de mek di ples we di lכng dεm fכ fulכp wit briz kכmplit wan.
I tan lɛk spɔnj we gɛt wet pan am. We yu pul di wet, i kin swel fayn fayn wan, nɔto so? Na dat de hapun ya tu.
Bɔt we wi tɔn pɔsin we sik frɔm in fes dɔŋ, di wet we in at ɛn in bɛlɛ ɔgan dɛn gɛt kin kɔmɔt nia di lɔng dɛn ɛn go to di chɛst. Dɔn, di bak sayd we gɛt mɔ lɔng tisu kin fri. So di lכng dεm de εkspכnd bεtεh εn i kin tek mכr briz.
2. Gas Exchange na efyushɔn
insay ARDS, di mismatch de bitwin di כksijεn we de go insay di lכng (ventilashכn) εn di כksijεn we de kכmכt insay di bכdi (pεrfyushכn). I nɔ mata aw wi bɔdi de, di bak pat na di lɔng dɛn kin gɛt di blɔd we pas ɔl.
Naw luk, we wi tɔn di pɔsin in fes dɔŋ, wi de alaw mɔ briz fɔ go insay di lɔng dɛn na wan say. Na di ɔda say, wi de dayrɛkt da ɔksijɛn de to di pat na di lɔng we gɛt mɔ blɔd . Dis kin mek di we aw pɔsin de blo fayn fayn wan. Fɔ tɔk am simpul wan, dis we ya de mek wi ebul fɔ sɛn ɔksijɛn to usay dɛn nid am mɔ.
Aw yu kin tɔn pɔsin we sik in fes dɔŋ?
Dis nɔto sɔntin we wan ɔ tu pipul dɛn kin du. Dis na tim ɛfɔt we dɛn dɔn plan gud gud wan. Wan dɔktɔ we de mɛn pipul dɛn we de blo, dɔktɔ dɛn, ɛn nɔs pipul dɛn, we na at le 5-6 pipul dɛn, kin wok togɛda fɔ du dis.
di fכs tin we yu fכ du na fכ sikyuכr כl di tכb dεm εn waya dεm we kכnekt to di sikman in bכdi (e.g., brith tכb, salin tyub, EKG) so dat dεn nכ go kכmכt. Di dɔktɔ we de mɛn di pɔsin we de blo kin tek tɛm ol di pɔsin in nɛk ɛn di tiub we i de blo. Dɔn, di sem tɛm, akɔdin to di sem kɔmand, di wan ol tim kin tek tɛm tɔn di pɔsin na in sayd, ɛn dɛn kin yuz pilo ɛn klos. Dɛn kin du ɔl dis fɔ mek dɛn nɔ du ɛni bad tin to di pɔsin.
Bɔku tɛm, dɛn kin put pɔsin we sik na dis pozishɔn fɔ bitwin 12 ɛn 18 awa. Bɔku tɛm, dɛn kin spɛn at le 16 awa insay wan sɛshɔn, ɛn di pɔsin kin ledɔm in fes dɔŋ ɛn tɔn am ɔpsayd.
| Advantej dɛn fɔ di Proning we | Simpul ɛksplen |
|---|---|
| Di ɔksijɛn lɛvɛl we de go ɔp | mכr briz de go insay di lכng dεm εn כksijεn de kכmכt insay di bכdi mכr efyushכn. |
| I izi fɔ pul di mכkus | di graviti de ɛp fɔ mek di mכkus ɛn ɔda wata we kin gɛda na di lכng dεm fכ kכmכt izi wan. |
| I de mek di at wok fayn fayn wan | di blɔd vesel dεm na di lכng dεm de opin, we de mek i izi fכ di at fכ pכmp blכd. |
| Di rit we di pipul dɛn we de day de go dɔŋ | Stɔdi dɔn pruv se i de ridyus di rit we pipul dɛn we gɛt ARDS de day bad bad wan. |
Ɛni risk de fɔ dis we?
Jɔs lɛk ɛni ɔda tritmɛnt, sɔm prɔblɛm dɛn de we kin apin we dɛn du dis. Bɔt dɛn kin stɔp dɛn prɔblɛm ya if dɛn gɛt ɛkspiriɛns mɛdikal tim fɔ wach dɛn tin ya gud gud wan.
- Aksidɛntal we dɛn kin pul di ɛndotrakial tiub
- We yu lɔs di venɔs kateshɔn (lɛk salin):
- Prɔblɛm wit blɔd prɛshɔn ɔ at rit: (`Hɛmodaynamik Instability`, `Aritmia`)
- Di ɔksijɛn lɛvɛl fɔ drɔp fɔ sɔm tɛm
- Di we aw di briz de blo
Dɛn risk ya kin rili smɔl na ɔspitul dɛn we gɛt pas 5 ia ɛkspiriɛns wit di Proning we.
Mɛmba se, Proning na tritmɛnt we sayɛns dɔn pruv, we de sev layf fɔ di wan dɛn we de fɛt wit bad bad sik dɛn we dɛn de blo.
Sɔntɛnde, dɛn dɔktɔ kin advays di wan dɛn we gɛt smɔl prɔblɛm wit di we aw dɛn de blo fɔ ledɔm fes dɔŋ (`Awake Proning`). Dis kin mek dɛn nɔ nid fɔ gɛt ventilatɔ.
Mɛsej we dɛn kin kɛr go na os
- Proning na di tritmɛnt fɔ pɔsin we gɛt siriɔs prɔblɛm wit in briz bay we i tɔn dɛn fes dɔŋ.
- Dis kin mek di prɛshɔn pan di lɔng dɛn nɔ bɔku ɛn i kin ɛp di bɔdi fɔ gɛt mɔ ɔksijɛn.
- Dis na mɔ ARDS (Acute Respiratory Distress Syndrome).Wan tritmɛnt wae de sev layf wae dɛn kin yuse fɔ siriɔs sik lɛk.
- Dɛn kin tek tɛm du dis, na wan tim we gɛt dɔktɔ dɛn we dɔn tren.
- If yu si yu pɔsin we yu lɛk de gɛt dis kayn tritmɛnt na ɔspitul, ɔndastand se na rili impɔtant tin fɔ mek dɛn wɛl. If yu gɛt ɛnitin we de mɔna yu, tɔk to di dɔktɔ we de in chaj bɔt am.
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