I dam chhung tawp lamah i duh ang enkawlna i hmu thei ang em? (DNR) chungchang hi han sawi ila!

Nun hi kan hmangaih vek a ni lawm ni? Mahse, ni khat chu kan damlo nasa hle a, kan nun tawp dawn hnaihah pawh hian eng ang damdawi lam enkawlna nge kan duh leh duh loh tih ngaihtuah a ngai hun a lo thleng dawn a ni. He thupui hi thupui sensitive leh sawi harsa tak ni mah se, kan dikna leh duhdan kan hriat chian a pawimawh hle. Chu chu vawiinah kan sawi dawn a, chu chu `(DNR)` a ni.

`(DNR)` tih awmzia chu eng nge ni? A awlsam zawngin i zawng chhuak ang u?

A awlsam zawngin, `(DNR)` tih hi English tawng "Do-Not-Resuscitate" tih tawifelna a ni. Sinhala tawng chuan "resuscitate suh" tih kan hriattir lawk tawh tihna a ni. Hei hi advance directive chi khat a ni . `(DNR)` order i siam a, chu chu i thinlung a na a chawlhsan emaw, i thawk a tawp emaw chuan `(CPR)` (cardiopulmonary resuscitation) hmanga enkawl i duh lo tihna a ni.

A tlangpuiin doctor te, nurse te, leh health care worker dangte chuan i nunna chhanhim turin theihtawp an chhuah thin. Hei hian ``CPR'' tih a huam a, chu chu i thinlung leh lung hnathawh leh theihna tura i rilru tihbuai leh hmui atanga hmui atanga thawk chhuah a ni. Leh:

• Thâwk a harsat chuan thawkna tube (`Intubation`) dahin artificial breathing machine (`Ventilator` / `Mechanical Ventilation`) nen an thlunzawm a.
• Thinlung hnathawh dan a dik lo a nih chuan , machine bik (`defibrillator` hmangin) atanga electric shock (`shock`) pek hmangin thinlung chu a pangngaia siam leh tum a ni.

Mahse, i damlo nasa tawh a, a nih loh leh natna hlauhawm tak i neih chuan engtin nge ni ang? Chutah chuan `(DNR)` order a lo lut a, `(DNR)` hi hetiang thil i duh chuan a tangkai thei ang:

• I nun tawp lama i hrehawmna leh hrehawm tawrhna chu tihtlem rawh.
• I thih lai hian i zahawmna humhim rawh.

``DNR'' order hi doctor-in a ziak tlangpui a, nangmah leh/ emaw i dan anga thutlukna siamtute, i duh chuan, leh i chhungte nen uluk taka an sawiho hnuah. I state chhunga dan azirin ``DNR'' order chu doctor (MD emaw DO emaw) emaw, health care professional ruat emaw ziah a nih chauhvin a hman theih.

Emergency a thlen hmain ``DNR'' order buatsaih hmasak a tha ber. He thupek hian health care worker-te chu i thinlung emaw, thawk emaw a tawp chuan ``CPR'' ti lo turin a hrilh a ni. He thupek ziaktu doctor hian midangte hmuh theih nan i medical record (``Medical Chart'') ah a dah tel ang.

`(DNR)` chi hrang hrang a awm em?

A tam zawkah chuan `(DNR)` kan tih hian `(CPR)` leh a kaihhnawih enkawlna `(Defibrillator)` hman ang chi te kan sawina a ni. Mahse, chutiang bawka order dang, chiang zawka sawi a awm bawk. A châng chuan, heng `(DNR)` chi hrang hrangte hi i ram/region-a dan a zirin a danglam thei bawk. Entirna thenkhat han en ila.

• Resuscitation tih tum suh (DNAR): Hei hi DNR nen a inang. Hmun thenkhatah chuan health care facility thenkhatah chuan he hming hi an hmang thin.
• Allow Natural Death (AND): Hei hian a theih ang anga i hlim theih nan a mamawh enkawlna chauh pek tihna a ni. Hetah hian tum ber chu i thih huna hrehawm i tawrh loh nan a ni.
• Do not intubate (DNI): Hei hian doctor hnenah mahni chauha thawk thei lo i nih chuan intubate emaw ventilator nena inzawm emaw i duh loh thu a hrilh a ni.
• DNR order bik: Hengte hi mimal ang zela siam theih order a ni. Entîr nân, CPR chu i duh lo mai thei a, mahse nunna chhanhim thei damdawi dang, defibrillator ang chi chu i nei duh lo mai thei.
• Comfort care order: Hengte hian i dam chhung tawp lamah eng ang enkawlna nge i dawn theih tih a hrilh thei che a ni. I nun tawp lamah pawh a nuam thei ang bera awm tura tanpui che duhna an sawi thei bawk.

I awmna hmun leh i dinhmun a zirin ``DNR'' chi hrang hrang a awm thei. I doctor chuan i duhthlan turte a hrilh belh thei che a ni.

CPR hian nunna a chhanhim a nih chuan engvangin nge tu pawhin DNR order an siam ang?

Hei hi mi tam takin an hmachhawn thin zawhna a ni. Natna hlauhawm tak nei emaw, hriselna lama harsatna nasa tak nei emaw ṭhenkhat chuan CPR hi an dawng duh lo va, chu chuan an thihna a thlen thei a nih pawhin an dawng duh lo. DNR order siam tura thutlukna siam hian i nun thunun theihna a pe thei che a, chakna engemaw chen a pe thei bawk.

CPR hian nunna a chhanhim thei a, mahse 100% a hlawk lo. Tin, CPR hi damlo nasa tak emaw, damdawi lam harsatna engemaw nei emaw tan chuan a hlawk lo zawk thei bawk. CPR neih lai hian hliam na tak tak, ruh tliak leh sternum tliak te pawh a awm fo bawk.

Ngaihtuah teh, mi pakhat chu a upa tawh hle a, tihdam theih loh cancer a vei tawh a ni. An thinlung a na a chawlhsan a, hun engemaw chen kaihthawh nan CPR pek pawh ni se, chu chuan natna a thlen belh zel dawn chauh a, hahdamna a awm lo ang, DNR neih an thlang mai thei. Chu chu an thutlukna a ni.

Engtin nge ka duhzawng (DNR) hi ka hrilhfiah ang?

Hemi chungchangah hian i primary care provider emaw, team leader emaw, enkawltu che nen inbiakna neihpui rawh. I doctor chuan CPR leh a kaihhnawih enkawlnate thatna leh that lohna a sawipui ang che. Hei hi i duh tak tak chungchanga rinawm taka inbiakna a ni. Heng sawihona neih chhung hian informed consent pek a pawimawh hle. Hei hian i tih theih zawng zawng i hriat theih nan leh i mimal duhzawng a zirin thutlukna siam turin a pui ang che. Ngaihtuah belh i duh emaw, i chhungte i biak duh emaw chuan i doctor hrilh chu a pawi lo . Doctor office i tlawh lai emaw, damdawi ina admit i nih lai emawa DNR order chungchang hriat hi thil awmze nei tak a ni.

`(DNR)` i hmuh hnuah i doctor chuan i ``Medical Record`` ah a record thei ang. I hnena dah turin copy a pe thei che a ni. Emergency responder ten ``DNR`` i nei tih an hriat theih nan i bun ``Medical ID Bracelets`` pawh i hmu thei.

Keimah ngeiin `(DNR)` chungchangah thutlukna ka siam thei lo a nih chuan eng nge thleng ang?

Natna emaw, accident emaw avanga hriat lohna i neih chuan, emaw, a dangin thutlukna dik siam thei lo i nih chuan, ``DNR'' chungchangah i duhzawng i sawi thei lo mai thei. ``DNR'' order i neih tawh chuan, chu chu i medical record-ah a awm a, i chhungte chuan an thlak thei lo.

`(DNR)` i neih loh chuan i aiawha thu sawi tur mi hming i sawi thei ang. Entirnan, i dan anga palai (`Power of Attorney`) emaw, damdawi lam thutlukna dang siam tura thuneihna petu che (`Healthcare Proxy`) emaw Mi hming i sawi loh chuan a chang chuan i chhungte pakhatin i tan damdawi lam thutlukna a siamsak thei che a, thutlukna i siam thei lo a nih chuan. I tana thutlukna siamtu chhungkaw member-te chu ram hrang hrangah leh bial hrang hrangah an inang lo thei.

DNR order ziah a, min pek hnua ka ngaihdan ka thlak a nih chuan engtin nge ni ang?

I ``(DNR)`` chungchangah hian i ngaihdan thlak danglam theihna i nei reng a ni. I ngaihdan i thlak chuan doctor hnenah hrilh nghal rawh. Chumi hnuah chuan i medical record-ah a danglamna chu a record thei ang. I kutphahah i bun thin identification card ang chi thil te pawh i hmang tawh lo tur a ni a, copy i neih zawng zawng pawh i tichhia tur a ni.

I chhungte leh enkawltu dangte hnenah i rilru i thlak tih leh i `(DNR)` i duh tawh loh thu hrilh rawh.

`(DNR)`-a awm mi i tihnun leh chuan eng nge thleng ang?

``(DNR)`` order hian a chungchang hretu (a nih loh leh a dik taka hriat tur) medical professional-te chauh a nghawng a ni. Doctor-in i ``(DNR)`` chungchang a hriat loh chuan, emaw, inbiakpawhna dik lo a awm chuan harsatna an tawk hauh lo vang.

Mahse, i doctor-in i `(DNR)` chungchang a hriat a, a la tiharh che a nih chuan dan anga nghawng an tawk thei a ni. An ngaihsak lo a, i `(DNR)` chungchang an hriat loh chuan chutiang a nih avang chuan a rah chhuah pawh an tawk thei bawk.

Nonmedical professional-te chuan dan angin DNR nei mi pakhat chu CPR tihsak an ni lo. Heart attack nei mi pakhat CPR tih tura training i nih chuan tih tum tur a ni. Amaherawhchu, mi pakhatin DNR a nei tih i hriat chuan kaihthawh loh nan an duhdan chu zahsak tur a ni.

Surgery ka neih chuan ``DNR'' hian ka enkawlna a nghawng dawn em?

`(DNR)` i neih a, zai tur i nih chuan i `(DNR)` chungchang hi i surgeon leh anesthesiologist nen sawipui ngei ang che. I `(DNR)` hian i surgery hmun eng pawh a nghawng dan tur an hrilh belh thei che a ni.

Thil engemaw takah chuan i anesthesiologist, surgeon emaw, an pahnih hian i ``DNR'' chu operation neih laiin rei lo te chhung tihtawp turin an ti thei che a ni. Hei hi a chhan chu surgery-a thil awm tlangpui thenkhat, a bik takin general anesthesia te hi i ``DNR'' nen a inrem lo thei a ni. Hemi chungchanga zawhna i neih chuan i surgeon emaw anesthesiologist emaw zawt hreh suh. I mamawh leh duhzawng phuhruk thei tur enkawlna i dawn theih nan i ngaihtuahnate hrilhfiah a pawimawh hle.

Hriat reng tur pawimawh ber (Take-Home Message) .

I nun tawp i hnaih lai pawhin i enkawlna chungchangah thutlukna siam turin dikna i nei a ni. ``Do Not Resuscitate'' (DNR) order hian thiltihtheihna a pe che a, enkawlna chi hrang hrang i dawn tur thlan theihna hun remchang a pe bawk.

I nun tawp lam enkawlna chungchang hi i mamawh hun tur hriat lawk lawk khan i doctor nen inbiakna neih hmasak phawt a tha ber. Thil ruahman lawk hian i healthcare team leh i hmangaih tak takte chu i duhzawng an hriat theih nan a pui thin. Chutiang chuan, i nun tâwp thlengin i mamawh leh i ngaih pawimawh berte tlâka enkawlna i hmu thei a ni. Hemi chungchang hi sawi hlau suh, i dikna a ni.

` DNR, tihnun loh, thupek hmasa ber, CPR, nunna humhim thei enkawlna, duhthlanna hnuhnung ber, damdawi chungchanga thutlukna siam, natna thi thei lo, thlamuanna enkawlna