Kei te tere haere te pao o tō ngākau i ētahi wā, kāore he take e kitea ana? Kei te rite koe ki te manu e papaki ana i ōna parirau i roto i tō uma? He wheako tino whakamataku tēnei. Ko te pikinga ohorere o te tere o te ngākau e kiia ana ko te Supraventricular Tachycardia (SVT). I ngā wā penei, i mua i te whakamahi i te rongoā, he tikanga māmā engari he tino whai hua hei āwhina i a koe ki te whakataurite i te tere o tō ngākau. I tēnei rā kei te kōrero tātou mō ngā 'Vagal Maneuvers'.
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He aha ngā 'Vagal Maneuvers'?
Whakaarohia he 'pēra' tūturu tō tinana e whakahaere ana i te tere o tō ngākau. Ko te 'Nerve Vagus' te ingoa o taua pēra. He io roa tēnei e rere ana mai i tō tātou roro ki tō tātou puku. He maha ngā mea e āwhina ana tēnei io ki te whakahaere, tae atu ki te tere o te pao o tō tātou ngākau me te manawa.
Ko ngā 'vegal maneuvers' he mahi ā-tinana e mahia ana e tātou me te āta whakaaro. Ka whakaoho i te 'vagas nerve', e tuku tohu ana ki te pacemaker tūturu o te ngākau, e whakaroa ana i te tere o te ngākau. He māmā noa iho, koinei ētahi huarahi hei whakamahi i te 'pēhi' tūturu o tō tātou tinana hei whakamarie i te ngākau e tere ana te patu. He mahi tēnei e mahia ana i raro i te tirotiro a te tākuta. Kaua e whakamātau i ēnei māu ake me te kore e kōrero ki tō tākuta.
He aha te hiranga o ēnei tikanga?
I te wā e rongoatia ana te tangata he tere te tere o te manawa (SVT), ka whakamahia e ngā tākuta ēnei 'tikanga huawhenua' hei whiringa tuatahi mā rātou. He maha ngā take mō tēnei:
- He iti te mōrearea: He iti ake te mōrearea o ēnei tikanga i te hoatu rongoā, i te hoatu rānei i ngā ru hiko (ngā nekehanga ngākau).
- He iti te utu: Kāore e hiahiatia he taputapu motuhake, he rongoā rānei, nō reira he iti te utu.
- Ngā hua tere: Ki te angitu, ka hoki te tere o te manawa ki te āhua noa i roto i ētahi meneti. Ko te auau angitu kei waenganui i te 20% me te 40%.
- Āwhina tātaritanga: I ētahi wā, mā te tirotiro i te urupare a tō ngākau ki ēnei tikanga, ka taea e tō tākuta te whakatau tika i te momo mate manawataki ngākau (arrhythmia) kei a koe.
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Check Availability →Ngā momo matua o ngā 'tikanga huawhenua' e whakamahia ana e ngā tākuta
He maha ngā tikanga pēnei. Kei te ripanga i raro nei ētahi o ngā tikanga e whakamahia whānuitia ana e ngā tākuta.
| Ingoa Tikanga | He whakamārama ngāwari noa iho |
|---|---|
| Te Whakawhitiwhiti a Valsalva | Te pupuri i tō manawa me te whakamātau me te mea kei te tūtae koe. |
| Te Whakaata Ruku | Te ruku ohorere i te mata ki roto i te peihana wai hukapapa. |
| Mirimiri Sinus Carotid | (Nā te tākuta anake) Mirimiri mārire i tētahi wāhi motuhake i te taha o te kaki. |
| Te pūkahukahu | Te whakaoho i te korokoro kia ruaki. |
| Te maremare | Te maremare nui, te kaha. |
Me pēhea te mahi i ēnei tikanga?
Anei me pēhea te mahi i ngā tikanga e toru e tino kitea ana. Kia maumahara, ka mahia ēnei i raro i te tirotiro a te tākuta.
- Te Mahi a Valsalva: Ka tonoa koe kia takoto ki runga i te moenga, kia manawa hōhonu, kia katia tō ihu me tō waha, ka whakapūha mō te 10-30 hēkona, me te mea kei te ngana koe ki te pupuhi ki roto i tētahi paipa kua āraia. I ētahi wā, ka piko pea te tākuta i te upoko o te moenga ki raro, ka hiki ake i ō waewae i a koe e whakapūha ana.
- Te Whakaoho Ruku: I a koe e noho ana, puritia tō manawa, ka rumakina tō mata katoa ki roto i tētahi peihana wai hukapapa. Puritia tō mata ki roto i te wai mō te roa e taea ana. Tērā atu rānei, ka taea e koe te pupuri i tētahi kete hukapapa, i tētahi tauera mākū makariri rānei ki runga i tō mata.
- Mirimiri i te Carotid Sinus: He mahi tēnei mā te tākuta anake. Ka takoto koe ki runga i te moenga, ka tahuri tō māhunga ki tetahi taha, ā, ka pēhi mārire te tākuta i te wāhi e kiia nei ko te 'Carotid Sinus' i te taha o tō kaki ki ōna maihao mō te 5-10 hēkona.
Kāore e tika ana tēnei tikanga mā wai? (Ngā āhuatanga mōrearea)
Kāore ēnei tikanga e pai mō te katoa. Kāore ngā tākuta e whakamahi i ēnei tikanga mēnā he 'kore pumau' te āhua o te tūroro, arā, mēnā kei a rātou ēnei tohu e whai ake nei:
- Toto toto tino iti(Toto toto iti)
- Mamae o te uma
- Te poto o te manawa
- Kāore e nui te hāora e whiwhi ana te tinana
- He āhuatanga e kore ai e nui te toto e whiwhihia ana e ngā whekau
Mō tēnei tangata kāore i te pumau, ka whakamahia te cardioversion, e whakahaere ana i te manawa o te ngakau mā te rongoā, mā te ru hiko rānei, hei utu mō ngā 'maneuver vagal'.
He mea nui: Ki te pāngia koe e ngā tohu pēnei i te mamae o te uma, te poto o te manawa, te tere rānei o te ngakau, he āhuatanga ohorere tēnei. Haere tonu ki te Tari Ohorere o te hōhipera (ETU) .
He tūponotanga kei roto i ēnei tikanga?
I te nuinga o te wā, he onge ngā raruraru ina whakahaerehia tēnei tikanga e te tākuta ki tētahi tangata e tika ana. Mēnā ka puta, he wā poto noa iho te nuinga.
- Te toto toto iti (hypotension)
- Te puhoi rawa o te ngakau (Bradycardia)
- Ko ētahi atu mate manawataki o te ngakau kāore e tino onge te puta ko te Atrial Fibrillation, te Ventricular Fibrillation, me te Ventricular Tachycardia.
Tērā pea kāore e taea e te katoa te mahi i te tikanga e kīia nei ko te 'Carotid Sinus Massage'. Kaua e mahia e te hunga whai hītori e whai ake nei:
- Mō te hunga kua pāngia e te whiu, e te TIA rānei (transient ischemic attack) o mua
- Mō te hunga e mate ana i te uaua carotid
- Mō te hunga kua pāngia e te mate ngakau i ngā wā tata nei
- Mō ngā tamariki kei raro iho i te 10 tau te pakeke
Koia mātou e kī atu anō, kaua rawa e whakamātau i ēnei tikanga, inā koa te tikanga mirimiri kaki, me te kore he tohutohu a te tākuta.
Karere Tangohia ki te Kāinga
- He mahi whakakori tinana māmā ngā 'vegal maneuvers' e whakamahia ana hei whakahaere i te atrial fibrillation (SVT).
- Ka whakamahia ēnei e ngā tākuta hei rongoā tuatahi nā te mea he iti ake te mōrearea.
- Kaua e whakamātau i ēnei ki te kāinga ki te kore e tohua e tō tākuta. Ko te Mirimiri Sinus Carotid, ina koa, me mahi e te tākuta anake.
- Ki te mamae tō uma, ki te whanoke, ki te uaua rānei te manawa i te wā e tere ana te pao o tō ngākau, haere tonu ki te Tari Urupare (ETU) o te hōhipera.
- Ki te kore ēnei tikanga e whakahaere i tō tere manawa, kaua e manukanuka. Tērā pea he rongoā, he maimoatanga rānei kei tō tākuta (hei tauira, te tango i te catheter). Me whai tonu i ana tohutohu.
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