Lwaki amalwaliro gakyusa abalwadde? Ka twogere ku nkola eno eya proning!

Wali olabye omulwadde mu kitongole ekijjanjaba abalwadde abayi (ICU) ng’afuna obuzibu obw’amaanyi mu kussa, ng’abasawo n’abakozi ba ba nnamusa bamukyusa n’obwegendereza amaaso wansi? Oyinza okuba nga weebuuzizza lwaki kino bakikola, era oba kyandibadde tekinyuma eri omulwadde. Mu butuufu eno nkola ya bujjanjabi nkulu nnyo esobola okutaasa obulamu bw’omulwadde. Leero tugenda kwogera ku nkola eno ey’enjawulo empya eri abantu bangi, naye nga emaze emyaka mingi ng’ekozesebwa mu busawo. Kino kiyitibwa "Proning" mu busawo.

Kiki ekitegeeza nti omuntu agenda mu maaso?

Mu ngeri ennyangu, okugwa (proning) kye kikolwa eky’okufuula omulwadde agalamidde ng’agalamidde (ku mugongo gwe) n’amufuula mu mbeera ey’okusitama (ku lubuto lwe). Mu ngeri y'obusawo, embeera eno ey'okwebaka eyitibwa ``Supine Position''. ``Prone Position'' ekozesebwa abasawo okuyamba abalwadde abalina embeera z'okussa ez'amaanyi abafuna obuzibu mu kufuna omukka gwa oxygen ogumala mu mibiri gyabwe.

Enkola eno etera okukozesebwa ku balwadde abali ku mpewo ey’ebyuma. Ekisanja kino oyinza okuba nga wakiwulira mu kiseera kino ekya COVID-19 . Naye si kipya. Okunoonyereza kutuuse n’okuzuula nti singa enkola eno ekozesebwa nga bukyali mu balwadde abalina obulwadde obw’amaanyi mu kussa, emikisa gy’okufa giyinza okukendeera ennyo.

Enkola eno ekozesebwa mu mbeera ki?

Enkola ya proning esinga kukozesebwa ku bantu abalina endwadde ez’amaanyi mu kussa abali mu mbeera ya ``Hypoxia`` ng’omubiri tegufuna oxygen emala. Wabula enkola eno esinga kukozesebwa mu mbeera eyitibwa Acute Respiratory Distress Syndrome (ARDS) .

Mu ngeri ennyangu, ARDS mbeera ng’obusawo obutonotono obw’empewo (alveoli) mu mawuggwe gaffe bujjula amazzi. Kino kizibuwalira nnyo okussa. ARDS kizibu kya maanyi ekiva ku ndwadde ez’amaanyi ez’okussa nga ekifuba ne COVID-19.

Lwaki omukka gwa oxygen gweyongera bw’okyusa omutwe?

Ensonga lwaki kino kikoleddwa kinyuma nnyo. Ensonga enkulu lwaki kino kiri bwe kityo eri nti emibiri gyaffe tegikwatagana ddala. Proning okusinga ekola ebintu bibiri.

1. Okukendeeza ku buzito n’okunyigirizibwa ku mawuggwe

Lowooza ku kino, kubanga emibiri gyaffe gyakolebwa okuba n’ebitundu by’amawuggwe bingi ebweru okusinga munda mu kifuba kyaffe. Bwe twebaka ku migongo, obuzito bw’omutima gwaffe n’ebitundu by’olubuto ebirala bugwa butereevu ku mawuggwe gaffe. Ate era, amazzi agakuŋŋaanyizibwa mu mawuggwe gaffe ganyigiriza wansi ku nsawo z’empewo eziri ebweru olw’amaanyi ag’ekisikirize. Kino kikendeeza ku kifo amawuggwe we gajjula ddala empewo.

Naye omulwadde bwe tukyusa okuva mu maaso wansi, obuzito bw’omutima n’ebitundu by’olubuto buva ku mawuggwe ne bugenda mu kifuba. Olwo, oludda olw’emabega, olulina ebitundu by’amawuggwe ebisingawo, lusumululwa. Kale amawuggwe gagaziwa bulungi era gasobola okuyingiza empewo ennyingi.

2. Okuwanyisiganya ggaasi kukola bulungi

Mu ARDS, waliwo obutakwatagana wakati w’obungi bwa oxygen ayingira mu mawuggwe (ventilation) n’obungi bwa oxygen ayingizibwa mu musaayi (perfusion). Ka kibeere nti omubiri gwaffe guli gutya, emabega w’amawuggwe gwe gusinga okufuna omusaayi.

Kati laba, omulwadde bwe tukyusa amaaso wansi, tuba tukkiriza empewo ennyingi okuyingira mu mawuggwe ku ludda olumu. Ku luuyi olulala, tuba tulung’amya omukka ogwo mu kitundu ky’amawuggwe ekisinga okuba n’omusaayi . Kino kifuula enkola y’okussa okukola obulungi ennyo. Mu ngeri ennyangu, enkola eno etusobozesa okusindika omukka gwa oxygen gye gusinga okwetaagisa.

Omulwadde okyusa otya amaaso wansi?

Kino si kintu omuntu omu oba babiri kye basobola okukola. Eno kaweefube wa ttiimu ategekeddwa obulungi. Omusawo w’okussa, abasawo, n’abakozi ba ba nnamusa, waakiri abantu 5-6, bakolera wamu okukola kino.

Omutendera ogusooka kwe kunyweza ttanka zonna ne waya eziyungiddwa ku mubiri gw’omulwadde (e.g., ttanka y’okussa, ttanka y’omunnyo, EKG) zireme kusumululwa. Omusawo w’okussa akwata n’obwegendereza ensingo y’omulwadde n’ekyuma ky’okussa. Olwo, mu kiseera kye kimu, okusinziira ku kiragiro kye kimu, ttiimu yonna n’obwegendereza bungi ekyusa omulwadde ku ludda lwe, nga bakozesa emitto n’engoye. Bino byonna bikolebwa okwewala obulabe bwonna eri omulwadde.

Mu budde obutuufu, omulwadde ateekebwa mu mbeera eno okumala wakati w’essaawa 12 ne 18. Ebiseera ebisinga, waakiri essaawa 16 zimala mu kiseera kimu, ng’omulwadde agalamidde amaaso wansi n’oluvannyuma n’akyuka.

Waliwo akabi konna akali mu nkola eno?

Nga bwe kiri ku bujjanjabi bwonna, waliwo akabi akali mu nkola eno. Kyokka, akabi kano kasobola okukendeezebwa singa wabaawo ttiimu y’abasawo abalina obumanyirivu erondoola ennyo ensonga zino.

• Okuggyawo endotracheal tube mu butanwa
• Okufiirwa omusuwa gw’emisuwa (nga saline):
• Ebizibu bya puleesa oba okukuba kw’omutima: (`Hemodynamic Instability`, `Arrhythmia`)
• Okukendeera kw’omukka gwa oxygen okumala akaseera
• Okuzibikira kw’emikutu gy’empewo

Obulabe buno butono nnyo mu malwaliro agalina obumanyirivu obusukka mu myaka 5 mu nkola ya Proning.

Mu mbeera ezimu, abalwadde abalina obuzibu obutono mu kussa baweebwa amagezi omusawo waabwe okugalamira nga batunudde wansi (`Awake Proning`). Kino kiyinza okubalemesa okwetaaga ekyuma ekiyamba okussa.