Intensive care unit (ICU)-ah mi i tlawh tawh em? A nih loh leh, operation atana inbuatsaih laiin thawk dan tur doctor-in a hrilhfiah che ngai em? Chutiang huna i hriat thin pakhat chu "breathing tube" an dah tih hi a ni. Chuvangin, he tube hi dah ang bawkin, lakchhuah pawh hi thil pawimawh tak, ruahmanna fel tak siam a ni. Damdawi lamah chuan chu tube chu lakchhuah chu "extubation" kan tih chu a ni. Vawiin hian he thu hi awlsam takin, i hriatthiam theih dan tur angin sawi ila.
A hmasain intubation tih hi eng nge ni?
Extubation chungchang kan sawi hmain intubation chungchang tawi te tein han thlir leh ila. A awlsam zawngin, hei hi eng emaw chhan vanga mahni chauha thawk harsatna i neih laiin medical team-in i nunna chhanhimna atana an tih thin a ni. I hmui kaltlangin plastic tube flexible tak, endotracheal tube (ETT) an tih chu i thlipui (thlipui kawngpui)-ah an dah lut a.
Hetiang hian han ngaihtuah teh: kan lung hi motor engine ang a ni. Hnathawh tur hian boruak (oxygen) awm reng an mamawh a ni. Traffic jam a awm chuan car a che lo ang bawkin, i thawkna kawng a inkhar emaw, i thawk a chak lo emaw a nih chuan oxygen hian i lung a thleng lovang. Chutih lai chuan he tube hi dah a ni a, chutah chuan machine, ventilator chu an inzawm a, oxygen i mamawh zat an pe che a ni. Hei hi intubation an ti a.
Tunah chuan extubation tih hi i hrethiam tawh mai thei. Chu chu, medical team-te’n mahni chauha thawk tha leh thei tura rinna an neih hnua uluk taka lakchhuah dan tur chu, engmah tanpuina awm lovin.
Eng case-ah nge extubation hi tih thin?
Hei hi mi zawng zawng chungah a rualin emaw, a inang emaw a thleng lo. Tube-a i dah chhan leh i hriselna a nghet danah a innghat.
Operation hnuah
Surgery lian tak i neih chuan i muhil vek a ni. General anesthesia kan ti a . Heng anesthetic drugs te hian i thawk dan tur control tu muscle te chu rei lo te chhung atan a titawp thin. Chutih lai chuan doctor-te chuan he thawkna tube hi an dah lut a, chu chu operation chhung zawnga oxygen dik tak i hmuh theih nan an dah a ni.
Surgery hlawhtling taka zawh a nih hnuah medical team chuan anesthetic-in a nghawng a tihchhiat veleh tube chu an la chhuak nghal ang a, nangmah chauhin i thawk leh thei tawh ang. A tam zawkah chuan i hriatna i neih leh hunah chuan tube chu lakchhuah a ni tawh ang. Chuvangin i hre reng lo pawh a ni thei. Chutiang a nih chuan tube chu darkar khat emaw darkar hnih emaw vel chauh a awm tawh mai thei.
Natna emaw accident vang emaw a ni
Mi pakhat chu accident emaw, natna khirh tak (pneumonia ang chi) avanga thawk thei lo vanga intubate a nih chuan, a tube lakchhuah dan chu a danglam deuh hlek a ni. He mi hi intensive care unit (ICU)-ah a awm tlangpui.
Tube hi lakchhuah hmain doctor-te chuan nangmah chauhin i thawk thei tih an hriat chian a ngai a ni. Hemi atan hian test bik an nei dawn a ni. Spontaneous Breathing Test (SBT) tih a ni.
A awlsam zawngin, hei hi training tlemte ang mai a ni. Doctor chuan ventilator atanga support chu a tihtlem zauh zauh ang a, minute engemaw zat a test ang che a, nangmah chauhin i thawk tha thei ang em tih a enfiah ang. Hemi chhung hian i oxygen level, heart rate leh thawk dan te uluk takin an enfiah ang. He test hi i pass chauhvin doctor chuan tube chu lakchhuah a rel ang.
A châng chuan he test hi a vawi khatnaah i pass lo mai thei. Hei hi "weaning failure" an ti a. Hei hi thil pangngai a ni. Chutiang a nih chuan doctor chuan i dam rei hma chu a nghak ang a, ni khat emaw ni hnih emaw hnuah he test hi a ti leh ang.
Intubation tih chhan berte chu engte nge ni?
Extubation tih tur chuan intubation tih hmasak a ngai a ni. A chhan tlangpui thenkhat chu hetiang hi a ni. Hengte hi chiang taka hriatthiam theih nan hetiang table -ah hian dah ila.
| Intubation tih chhan | A awlsam zawngin... |
|---|---|
| Thli kawng a tikhawlo | Chaw ei tur ka chhunga a tlakbuak emaw, allergy na tak emaw avanga boruak kawngkhar a khar vek. |
| Cardiac Arrest a ni | A chhan chu thinlung hi a tawp thut chuan thluak leh taksaah oxygen supply a pawimawh hle a ni. |
| Trauma na tak a ni | Thli kawng chhiatna emaw, kawr, rilru emaw, pum emaw a hliam na tak avanga thawk theih lohna. |
| Thil hriatna hloh | Hriat lohna na tak takah chuan thawkna kawng inkharkhip loh nan leh thawk dan tur thunun nan lei chu hnungtawlh tur a ni. |
| Inzai | Anesthesia hnuaia thawk lak dan tur control kim neih theih nan. |
| Thluak lama harsatna nei | Pneumonia ang chi natna khirh tak avang hian lung hian taksain oxygen a mamawh zat chu a mah chauhin a hmu thei lo. |
| Risk for Aspiration tih hi a ni | Mi hriat lohna pum chhunga thil awm (ei tur, luak chhuak, thisen) chu lung chhunga a luh loh nan. |
Extubation process-a step hrang hrangte chu engte nge ni?
Okay, tunah chuan doctor emaw trained nurse emaw hian he tube hi engtin nge a lak chhuah ang tih kan en ang. Hei hi vawi khata lak chhuah theih thil a ni lo. Step tlemte a awm a.
1. Damlo buatsaih dan: A hmasa berin khum lu chu sang takin a chawi ang. Thutnaah hruai i ni ang. Hei hian lung chhunga boruak a luh theih nan a pui ang a, tube lakchhuah hnua lung chhunga hmui ang chi thil a luh theihna tur a ti tlem bawk ang.
2. Suctioning: A dawtah chuan special device (suction device) hmangin i ka, i kawr leh i thawkna kawngkhar atanga mucus, saliva leh thil dang duh loh zawng zawng te chu paih vek a ni. Hei hi a pawimawh hle a, a chhan chu chutiang a nih loh chuan heng thilte hi tube lakchhuah hunah i lung chhungah a lut thei a ni.
3. Tube chhuah tir: Tube chu i hmaiah a vawn tlat thin strap emaw tape emaw chu uluk takin lakchhuah a ni.
4. Ventilator atanga inthen: Tube hi a inzawmna ventilator atanga tihtawp a ni.
5. Tube lakchhuah: Tunah hi a pawimawh ber a ni. Doctor chuan "thâwk la la, khuh rawh" a ti che a.I khuh emaw, i thawk chhuah emaw chuan tube chu rang tak leh awlsam takin an chhuah chhuak thin. Chutiang chuan i khuh laiin an ti a, chu chuan i vocal cord a hawng a, tube chu awlsam zawkin a chhuak thei a ni. Tin, khuh hian i rilru chhunga awm eng pawh a hnawtchhuak bawk.
Tube lakchhuah hian i conscious em?
Hei hi mi tam takin zawhna an neih a ni. A chhanna chu, a chang chuan a ni, a chang chuan ni lo tih hi a ni.
- Operation hnuah: Tube hi i hriat leh hmain lakchhuah a ni fo a, chutih lai chuan anesthesia i la nei bawk. Chuvangin i harh chuan a paih chhuak thin.
- Intensive care unit (ICU)-a i awm a nih chuan: I hriatna i la neih laiin tube chu lakchhuah a ni ang, i tan chuan hriatna neia i thusawi ngaihthlak a pawimawh avangin (entir nan, "khuh" tura tih a nih chuan khuh).
Extubation hnuah eng nge thleng?
Tube lakchhuah hian hna chu a zo tawh tihna a ni lo. Darkar engemaw zat lo awm tur hi a pawimawh hle. Medical team ten uluk takin an lo vil reng ang che.
- Oxygen: Vawi tam tak chu, tube lakchhuah hnuah, i taksa chu dinhmun thara a insiamrem theih nan nasal cannula emaw oxygen mask emaw hmangin oxygen tlemte pek i ni ang.
- Monitoring: I thisen oxygen level (pulse oximeter hmangin), heart rate, leh thisen sang te chu enfiah chhunzawm zel a ni.
- Khuh: Tube vang hian i rilruah mucus a awm thei. Chuvangin, a tihfai nan khuh fo thin turin a fuih ang che. A tul chuan i rilru tihfai nan i suction leh a ngai mai thei bawk.
Extubation neih lai hian harsatna a awm thei em?
Damdawi lam thil dang ang bawkin, extubation-ah hian hlauhawmna tenau tak tak a awm a. Mahse, heng zawng zawng atan hian medical team hi an inpeih reng tih hre reng ang che.
| Complication awm thei | Hei hi eng nge thleng? |
|---|---|
| Extubation a hlawhchham | Tube an lakchhuah hnuah chuan damlo chuan beisei angin a mah chauhin a thawk thei tawh lo. Chutiang a nih chuan damlo himna atan tube chu dah leh tur a ni (re-intubation).A thleng thin. Hei hi mi 10%-15% ah a thleng thei. Kum 65 chunglam leh thinlung emaw thawkna lam natna nei tan chuan a hlauhawmna a sang deuh hlek a ni. |
| Thâwk ri nasa tak (Stridor) . | Tube hian thawkna kawng chunglam, a bik takin vocal cord vel ah hian a hring tlem thei hle. Hei hian tube lakchhuah hnua i thawk chhuah hian thawm ri nasa tak, ri sang tak a siam thei a ni. Hei hi damdawi hmanga control theih a ni fo. |
| Vocal cords tihchhiat | A tlem hle a, tube dah emaw, lakchhuah emaw lai hian vocal cords tihchhiat tenau te a awm thei. Hei hian hun rei lote chhung chu aw a tidanglam thei (a hoarseness) a thlen thei a ni. |
| Khuh na tak leh thawkna kawng (laryngospasm) . | Mi thenkhat chuan tube lakchhuah a nih chuan an rilruah hriatna a awm avangin vocal cords a tikhauh nghal mai thei. Hei hi second tlemte chhungin a normal leh ang. |
Extubation hian eng nge a thatna?
Hei hi thil tha tak a ni. Mi pakhat extubating tih hian a dam lehna kawngah thil pawimawh tak a paltlang tihna a ni.
- Damna chhinchhiahna: A hlawkna lian ber chu mahni chauha thawk leh thei hi a ni. Chu chu i lung leh taksa chu a pangngaiin a lo awm leh tawh tihna a ni.
- Thusawi thiamna: Tube a awm lai hian i tawng thei lo. A lak chhuah hnu chuan hun rei lote chhungin i tawng leh thei tawh ang. A tirah chuan i beng a na thei a, i aw pawh a danglam deuh thei a, mahse hei hi ni engemaw zat hnuah a reh mai ang. (Ni engemaw zat hnuah a bo mai ang).
- Ei leh in thiamna: Chutiang bawkin tube a awm laiin ka ei leh in theih loh. Tube chu lakchhuah a nih hnuah leh i ei theihna (gag reflex) a finfiah hnuah chuan ei leh in i ei tan thei tawh ang.
- Hun rei tak chhunga hlauhawm laka invenna: Thâwk chhuahna kawng (breathing tube) rei tak awmnaah hian hlauhawmna ṭhenkhat a awm (e.g., vocal cord dysfunction, pneumonia, tracheomalacia ). Extubation tih awmzia chu chutiang risk lakah chuan i fihlim tihna a ni.
Nangmah emaw, i chhungte zinga tu emaw hian hetiang kalphung hi i paltlang a ngai a nih chuan hlau lo la, hreh suh. Zawhna emaw, ngaihtuahna emaw i neih chuan i doctor hnenah zawt rawh. Engkim an hrilhfiah ang che.
Take-Home Thuchah a ni
- Extubation tih hi mahni chauha thawk tha thei tura i trachea chhunga dah endotracheal tube (ETT) lakchhuahna a ni.
- Hei hi vawi khata tih vek a ni lo. I dinhmun uluk taka an enfiah hnu leh ruahmanna an siam hnua medical team-in an tih tur a ni.
- Tube lakchhuah hnu ni engemaw zat chhung chu i rilru na leh i aw a ri chhuak hi thil pangngai tak a ni.
- A chang chuan harsatna (extubation failure ang chi) lo awm thei mah se, medical team chuan chu chu hmachhawn turin an inpeih reng a ni.
- Extubation tih awmzia chu i dam lehna kawngah hmasawnna lian tak leh pawimawh tak i la tawh tihna a ni. Chu chu thil phurawm tak a ni!
- I tan emaw, i hmangaih tak emaw tan damdawi lam kalphung chungchangah ngaihtuahna i neih chuan i doctor nen sawiho fo ang che .
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