Kua kite koe i tētahi i roto i te wāhanga tiaki nui (ICU) i tētahi rānei kua haria ki te rūma ohorere (ETU) me te uaua ki te manawa, ā, ka hohoro te kī atu a ngā tākuta kia "mahi i tētahi ABG"? He whakamātautau toto tino nui tēnei, ā, he āhua motuhake. I tēnei rā, ka kōrerohia ngāwaritia e tātou, i roto i tētahi huarahi e mārama ai koe.
He aha te tikanga o tēnei whakamātautau ABG?
Ko te ABG (Arterial Blood Gas) he whakamātautau e tango ana i te iti o te toto mai i te uaua o roto i tō tātou tinana. Inaianei pea kei te whakaaro koe, "Ko ētahi atu whakamātautau toto e tango ana i te toto mai i te uaua, he aha te rerekētanga?"
Whakaarohia pēnei. He rite tō tātou tinana ki tētahi tāone.
- He rite ngā uaua toto ki ngā huarahi nui e kawe mai ana i ngā mea nui pēnei i te hāora me te kai totika ki te tāone.
- He rite ngā uaua ki ngā rori tawhito o te tāone e kawe ana i ngā para pēnei i te hauhā waro ki te tāone.
Nō reira, ki te hiahia tātou ki te mōhio ki te nui o te hāora e tae atu ana ki ngā whekau o tō tātou tinana, inā koa te roro me te ngākau, me whakamātautau tātou i te toto kei runga i taua "huarahi", tika? Koia te take i tangohia ai te toto mai i te uaua mō te whakamātautau ABG.
Ko te nuinga o tēnei whakamātautau ka ine i ngā taumata o te hāora me te hauhā waro i roto i ō toto. Ka ine anō hoki i te taurite waikawa-pūtake, te pH rānei, o ō toto. He mea nui tēnei taurite mō ngā tukanga katoa o roto i ō tātou tinana.
He aha tonu te ine a te whakamātautau ABG?
Ina tirohia e koe tētahi pūrongo ABG, ka kite koe i ētahi reta he uaua ki te mārama. Engari he tino māmā te tikanga. Me titiro tātou ki te tikanga o ia uara.
| Ine | Te tikanga māmā |
|---|---|
| pH | Mā tēnei ka kitea te waikawa o tō toto. Me noho tēnei uara i waenga i te 7.35 me te 7.45. Ki te iti iho i tēnā, he waikawa tō toto, ā, ki te teitei ake, he kawakore. |
| PaO2 (Pēhanga wāhanga o te hāora) | Te nui o te hāora e rewa ana i roto i te toto. E whakaatu ana tēnei i te pai o te urunga o te hāora ki roto i te toto mai i ō pūkahukahu. |
| PaCO2 (Pēhanga wāhanga o te hauhā waro) | Te nui o te hauhā waro i roto i tō toto. E whakaatu ana tēnei i te pai o te tango a tō tinana i te hauhā. |
| HCO3 (Paikāponate) | He pūtake tēnei i roto i ō tātou toto. Kei ngā whatukuhu te mana whakahaere. He mea tino nui mō te whakataurite i te pH o te toto. |
| O2Sat (Te mākū o te hāora) | E whakaatu ana i te nui o te pūmua hemoglobin i roto i te toto e kawe ana i te hāora, hei ōrau. Ka inehia te uara ōrite e te pulse oximeter ka whakanohoia e koe ki tō maihao. |
Āhea te wā e hiahiatia ai he whakamātautau ABG?
Ehara tēnei i te whakamātautau e mahia ana mō te tirotiro noa. He maha ngā wā ka mahia i ngā wā ohorere , hei aroturuki hoki i te āhua o ngā tūroro kua noho kē ki te hōhipera . Anei ētahi o ngā take matua ka tonoa ai tēnei whakamātautau e te tākuta:
- Ngā uauatanga nui o te manawa: I roto i ngā take pēnei i te kaha haere o te mate huango me te kohikohinga wai i roto i ngā pukahukahu (te ngoikore o te manawa whakapeka).
- Ngā āhuatanga pangia kino: I roto i ngā mate urutā e morearea ana ki te ora pērā i te sepsis, te ru septic rānei.
- Ngā raruraru e pā ana ki te mate huka: I ngā āhuatanga ka waikawa te toto, pērā i te ketoacidosis mate huka (DKA).
- Te whakaeke ngakau, te ngoikore rānei o te ngakau: Ina mutu ohorere te mahi a te ngakau (Te ngoikore ohorere o te ngakau) ina mutu rānei te mahi a te ngakau (Te hopukanga o te ngakau).
- Te ngoikore o te whatukuhu: Ina kore e taea e ngā whatukuhu te tango tika i ngā waikawa mai i te toto, ka waikawa te toto. Akohia tēnei āhuatanga.
- Te paitini: Ina horomia ētahi paitini, ka rerekē te pH o te toto.
- I mua me muri i ngā pokanga nui: Aroturukihia te āhua o te manawa o te tūroro i te wā e rongoātia ana te mate whakamoe me muri i te pokanga.
- Ngā mate pūkahukahu mau tonu: Tirohia mēnā kei te angitu te maimoatanga mō te hunga whai mate pēnei i te COPD (mate pūkahukahu aukati mau tonu).
Me pēhea te whakahaere i tēnei whakamātautau? He mamae?
He rerekē te whakamātautau ABG i te whakamātautau toto noa.
I mua i te whakamātautau
I ētahi wā, ki te hoatu he hāora tāpiri ki a koe, ka mutu pea te whakamahi i te 20 meneti i mua i te whakamātautau. Hei tirotiro i te mahi a tō tinana me te kore hāora. Engari ki te kore rawa e taea e koe te mahi me te kore hāora, kāore pea koe e mahi pēnā. Ki te tangohia he toto mai i tō ringaringa, ka mahi pea te tākuta, te āpiha rānei kua whakangungua i tētahi whakamātautau māmā e kiia nei ko te 'whakamātautau Allen' hei tirotiro mēnā he pai te rere o te toto i roto i tō ringaringa.
I te wā e mahi ana i te whakamātautau
1. Ka kitea e te tākuta, e te tohunga rānei he uaua kei roto i tō ringaringa (radial artery), e tata ana ki tō tuke (brachial artery), kei roto rānei i tō hope (femoral artery).
2. Horoia rawatia te wāhi, kātahi ka pania he paturopi.
3. Kātahi ka werohia he ngira iti rawa ki roto i te uaua toto, ā, ka mimitihia he toto iti ki roto i te ngira werohanga.
4. Ki te pono , he mamae ake tēnei i te tango toto mai i te uaua. Nā te mea kei raro iho i te kiri te uaua, ā, he nui ake ngā io e karapoti ana. Engari ko te mamae ka pā mai i te wā e werohia ai te ngira.
5. Kia kohia te nui o te toto e hiahiatia ana, tangohia te ngira ka pēhi i te wāhi ki te miro, ki te kākahu rānei hei whakamutu i te toto mō te 5 ki te 10 meneti pea . Mena kei te tango koe i te rongoā whakaiti toto, me pēhi pea koe mō te wā roa.
I muri i te whakamātautau
Tērā pea he paku maru, he kikorangi rānei te wāhi i werohia ai te ngira. He mea noa tēnei. Ka kī atu tō tākuta kia kaua e hiki i ngā mea taumaha ki taua ringa mō ngā haora 24 i muri i te tango toto.
Ka tere te puta mai o ngā hua o te whakamātautau ABG, i roto i te 10-15 meneti te nuinga. He mea nui ēnei hua mō te whakatau tere i ngā wā ohorere.
He pēhea te āhua o ngā uara toharite i roto i te pūrongo?
Tērā pea he rerekē ngā uara nei i ia taiwhanga, engari koinei ngā uara toharite mō te pakeke hauora i te taumata moana. He pai ake te pātai atu ki tō tākuta mō tētahi whakamārama katoa mō ngā uara kei roto i tō pūrongo.
| Ine | Awhe Noa |
|---|---|
| pH | 7.35 - 7.45 |
| PaO2 | 75 - 100 mmHg |
| PaCO2 | 35 - 45 mmHg |
| HCO3 | 22 - 26 mEq/L |
| O2Sat | 95% - 100% |
Mena kei waho atu ēnei uara i te awhe noa, tera pea he tohu kāore tō tinana e whiwhi ana i te nui o te hāora , kāore rānei te hauhā waro e puta tika ana i roto i tō pūnaha , kāore rānei i te taurite te taurite waikawa/pūtake o tō toto . Ka whakamahia e tō tākuta tēnei pūrongo, ō tohumate, me ētahi atu whakamātautau hei whakatau i te āhua o tō mate.
Karere Tangohia ki te Kāinga
- Ehara te ABG i te whakamātautau toto noa e tangohia ana mai i te uaua, engari he whakamātautau motuhake e tangohia ana mai i te uaua toto, he uaua toto nui e whakarato ana i te hāora ki te tinana.
- Ko te nuinga o tēnei ka ine i te hāora, te hauhā waro, me te waikawa (pH) i roto i te toto.
- He mea nui tēnei mō te kitenga wawe i ngā āhuatanga hauora i ngā wā ohorere me ngā āhuatanga nui pērā i te uauatanga o te manawa, ngā mate urutā kino, me te mate ngakau.
- Ahakoa he mamae ake pea i te whakamātautau toto noa, mā ngā mōhiotanga e homai ana e ia ka āwhina i te whakaora i te ora.
- Me kōrero tonu ki tō tākuta e rongoā ana mō ngā hua o tō whakamātautau ABG me tōna tikanga.











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