Whakaarohia, ka ngaro whakarere te mārama o tētahi kei mua i a koe, ka hinga ki te whenua. Ka oma haere koe me te ohorere, ka tirotiro i tōna kaki mō te pā o te manawa, engari kāore he pā o te manawa. Kāore rātou e manawa ana. Ki tō whakaaro he mate manawa tēnei. Engari he mea miharo, i te wā i haria ai rātou ki te hōhipera, ka tangohia e ngā tākuta he ECG, ā, ka whakaatuhia he mahi hiko i roto i te ngākau. He hiko kei reira, engari kāore te ngākau e patupatu ana. Ko tēnei āhuatanga rerekē, morearea ko te mea e kiia nei e mātou i roto i te rongoā ko te "Pulseless Electrical Activity." Ka kiia e mātou ko te PEA mō te poto. He āhuatanga tino ohorere tēnei. Nō reira, me kōrero noa iho tātou mō tēnei.
He aha te PEA?
He momo mate manawa pāwera te PEA. Ko te mea e tupu ana i konei, ahakoa he mahi hiko kei roto i te ngākau, kāore te uaua o te ngākau e kōpiri, e pupuhi toto rānei e ai ki taua tohu hiko. He rite ki te rama e kore e tahuri nā te mea kua pau te taura ahakoa he hiko kei roto.
Ka taea te ine i tēnei ngohe hiko mā te ECG (electrocardiogram). Heoi, ina tirohia tō pā, kāore koe e rongo i te pā nā te mea kāore te ngākau e patupatu ana, e pupuhi ana hoki i te toto huri noa i te tinana.
Ko te mea nui, ko te PEA he tauira manawataki o te ngakau "kāore e taea te wiri". Ko te tikanga tēnei kāore e taea te whakaora mā te wiri mai i te defibrillator, e whakaaturia ana i roto i ngā kiriata. Nō reira, ki te kore e whiwhi wawe i te maimoatanga tika, ka mate pea i roto i ngā meneti.
E rua ngā momo PEA
E wehea ana tēnei e ngā tākuta kia rua ngā momo matua.
1. Pseudo-PEA: I roto i tēnei, ka ngoikore te whakawhāiti o te uaua o te ngākau nā te mahi hiko o te ngākau. Ahakoa he iti noa te toto e pupuhi ana, kāore i te kaha pērā i te pā o te ngakau noa. Nō reira, kāore e ranea te rere o te toto hei rongo i te pā o te tinana.
2. PEA pono: Ahakoa he mahi hiko kei roto i te ngākau, kāore te uaua o te ngākau e aro atu . Ko te tikanga kāore he toto e pupuhihia ana. Kāore he pā o te manawa e rangona ana.
He aha te rerekētanga i waenga i te PEA me te Asystole (papatahi te arai)?
Kua kite pea koe i tēnei i roto i ngā kiriata, ina mate te tangata, ka puta he rārangi tika ki te mata tirotiro me te tangi "pī...". Koinei te mea e kiia nei e tātou ko `(asystole)` ko "flat-lining" rānei.
- PEA: He hiko kei roto i te ngākau, engari kāore te ngākau e mahi. (Pērā i te pouaka whakaata he hiko kei a ia, engari kua pakaru).
- Asystole: Kāore he hiko o te ngākau, ā, kāore te ngākau e patupatu ana. Kāore e tino mārire. (Pērā i te pouaka whakaata kua momotuhia te hiko).
Ahakoa he mate manawa ēnei e rua, ka taea te tautuhi i te rerekētanga i runga i te āhua o te ECG.
He aha ngā tino take o te PEA?
He maha ngā āhuatanga ka puta ai te PEA. Hei whakangāwari ake i te maumahara ki ēnei, ka whakamahia e ngā tākuta tētahi pūnaha whakarāpopototanga e kiia nei ko "H's and T's." Me titiro tātou ki te aha ēnei.
| Kāwai Take | Whakamārama Māmā |
|---|---|
| Te whakahekenga o te nui o te toto (Hypovolemia) | He hekenga o te nui o te toto i roto i te tinana nā tētahi take pēnei i te toto nui i puta mai i tētahi aituā nui, i te matewai nui rānei. |
| Te hekenga o ngā taumata hāora (Hypoxia) | Te korenga o te hāora ki te tinana nā te uaua o te manawa me te toremitanga. |
| Ngā panonitanga o te taurite waikawa/tote o te tinana (Hauora - Waikawa) | Te pikinga o te waikawa i roto i te tinana nā ngā āhuatanga pēnei i te ngoikore o te whatukuhu. Ngā panonitanga nui o ngā taumata electrolyte pēnei i te pāhare pāporo. |
| Te pāmahana tinana iti (hypothermia) | Te hekenga o te pāmahana tinana ki te taumata tino iti. |
| Te horomitanga o ngā paitini | Te nui rawa o te horomanga o ētahi rongoā, raau taero, ētahi atu matū paitini rānei. |
| Te kohikohinga wai huri noa i te ngākau (Tamponade - cardiac) | Ka kī te kōhao huri noa i te ngākau i te toto, i tētahi atu wai rānei, ka pēhia te ngākau. Ka ārai tēnei i te ngākau kia kore e pā noa. |
| Te mate pūkahukahu taumaha | Ka pahū te pukahukahu, ka whakakīia te uma ki te hau, ka pēhi i te ngākau me ngā uaua toto. |
| Ngā toto totoka (Thrombosis) | He āhuatanga pēnei i te whakaeke ngakau (`myocardial infarction`) he toto totoka rānei i roto i ngā pukahukahu (`pulmonary embolism`). |
| Ngā whara tinana (Whara) | Te pakaru o te ngākau nā te aituā kino ki te uma. |
Me pēhea te rongoā mō tēnei?
Ina pāngia te tangata e te PEA, he uaua ki te tautuhi i waho o te hōhipera, nā te mea kāore e taea te tautuhi me te kore he ECG. He waimarie, ko te mea tuatahi me te mea nui rawa atu hei mahi i roto i tētahi take o te hopukanga o te ngakau ko te CPR (Cardiopulmonary Resuscitation).
1. Tīmata tonu te CPR: Ki te kore e mōhio te tangata, kāore he pā o te manawa, kāore hoki he manawa, waea atu ki te waka tūroro, ka pēhi tonu i te uma kia tae mai rā anō. Koinei te huarahi pai ki te whakaora i te ora. Ki te kore koe e mōhio ki te mahi CPR, ka taea e ngā ratonga ohorere te tohutohu i a koe me pēhea te mahi.
2. Te maimoatanga i te hōhipera: Whai muri i te whakaurunga ki te Wāhanga Maimoatanga Ohotata (ETU) o te hōhipera, ka haere tonu ngā tākuta ki te mahi CPR me te tīmata i ētahi atu maimoatanga.
- Epinephrine: Ka kiia hoki tēnei ko te adrenaline. Ka hoatu tēnei rongoā hei ngana ki te whakahoki i te manawataki o te ngākau ki te auau noa.
- Te rongoā i te pūtake: He mea nui kia tere te tautuhi i te pūtake o te PEA (tētahi o ngā pūtake i te ripanga i runga ake nei) me te rongoā. Hei tauira, ki te ngaro te toto, hoatu he toto, ki te kore e ranea te hāora, hoatu he hāora, ki te mea he toto kei te taha o te ngākau, tangohia ki te ngira.
Kia maumahara, he manawataki "kore-ru" te PEA. Ko te tikanga tēnei, kāore e āwhina te ru mai i te defibrillator. Heoi, ki te pai te CPR, i ētahi wā ka huri te manawataki o te ngakau ki te manawataki ru (hei tauira, 'ventricular fibrillation'). I taua wā, ka hoatu e te ru mai i te defibrillator he whai wāhi ki te ngakau ki te tīmata anō. Koia te hiranga o te CPR.
Me aha tātou i roto i tētahi āhuatanga ohorere?
He āhuatanga ohorere hauora tonu te hopukanga o te manawa, nō reira me mahi wawe tonu.
He tangata kei mua i a koe:
- Ki te ngaro whakarere tō māramatanga, ā, ka hinga koe,
- Ki te kore koe e rongo i te pā o te manawa i roto i tō kaki, i tō ringaringa rānei,
- Ki te mutu te manawa, ki te uaua rawa rānei,
Waea atu ki te waka tūroro tonu. Kātahi, tīmatahia te CPR i te wā e taea ai. He mea nui ia hēkona.
Ahakoa he mate tino kino te PEA, kua tino piki ake tō tātou māramatanga mō tēnei mate me te whanaketanga o te rongoā hou. Heoi, ko ngā meneti tuatahi he mea nui ake i ērā katoa. Nō reira, ki te kite koe i tētahi e pāngia ana e tēnei mate, kaua e mataku, tīmata tonu te CPR, ka rapu awhina hauora wawe tonu, ka tino piki ake te tūponotanga ka ora te tangata.
Karere Tangohia ki te Kāinga
- He āhuatanga ohorere hauora tino kino te PEA, e mahi hiko ana te ngākau engari kāore he pā.
- Ki te kore e mōhiotia te ahua o tētahi, tirohia tonutia tōna manawa me tōna manawa.
- Ki te kore e pā te manawa, waea atu ki te waka tūroro, ka tīmata tonu i te CPR (pēhanga uma).
- Ahakoa kāore i te angitu te maimoatanga ru (defibrillation) mō te PEA, mā te CPR tonu ka huri te manawataki o te ngākau ki tētahi manawataki ru.
- Ko te whāinga matua o te maimoatanga i te hōhipera ko te kimi me te rongoā i te pūtake o te PEA i te wā e mahi ana i te CPR.
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