Ese wowe cyangwa umuntu uzi wigeze kwakirwa muri ICU? Reka tubiganireho! (ICU)

Nta n'umwe muri twe ukunda kuba mu bitaro. Ariko hari igihe dukenera ubufasha bwa muganga kugira ngo turokore ubuzima bwacu, cyangwa ngo turekure mu bihe bikomeye cyane. Muri ibyo bihe, ushobora kuba warumvise "ICU". Abantu benshi bagira ubwoba kandi bagahangayika iyo bumvise ijambo ICU. None rero uyu munsi, reka tuganire ku cyo ICU ari cyo, ibibera aho, n'impamvu ari ingenzi.

ICU ni iki? Kuki ari umwihariko cyane?

Mu magambo make, Ishami ryita ku barwayi barembye (ICU) ni ishami ridasanzwe mu bitaro. Mu by'ukuri, ni ahantu havurirwa abarwayi barembye cyane cyangwa abarwaye cyane cyangwa abagize impanuka ikomeye. Yego, kuba bari mu cyumba cy'indembe bivuze ko ikibazo gikomeye gato . Kuko abarwayi hano bakeneye kwitabwaho, gukurikiranwa no kuvurwa by'umwihariko n'abaganga b'inzobere n'abaforomo amasaha yose.

Hari igihe yitwa andi mazina, ushobora kuba warumvise:

• `Ishami ryita ku barwayi barembye`
• `Ishami rishinzwe kuvura indwara zikomeye`
• `Ishami rivura indwara zikomeye`

Uko wabivuga kose, igitekerezo ni kimwe. Ni ukuvuga ahantu hatanga ubuvuzi bwihariye kandi bwimbitse .

Ni gute abaganga bafata icyemezo niba nkeneye kuvurwa muri ICU?

Ubu ushobora kuba wibaza uti "Ni gute wafata icyemezo cyo gushyira umuntu muri ICU ?" Abaganga bareba ibintu byinshi iyo bafata icyo cyemezo. Tekereza ku bintu nk'ibi:

• Isuzuma ryawe : Ibi bivuze indwara ufite.
• Ukira ute ubuvuzi wahawe kugeza ubu?: Hari igihe ubuvuzi butangwa mu cyumba gisanzwe cy’abarwayi bushobora kuba budahagije.
• Izindi ndwara ufite (`Comorbidities`) : Urugero, niba ufite izindi ndwara nka diyabete cyangwa umuvuduko ukabije w'amaraso , indwara nyamukuru ishobora kugorana kurushaho.
• Uburemere bw'indwara cyangwa impanuka : Turareba kandi uburyo ibintu bikomeye.

Nanone, abaganga bazasuzuma ibyo ukunda. Hari abantu bashobora kudashaka kuvurwa muri ICU mu gihe babona ko bizagira ingaruka mbi ku mibereho yabo cyangwa niba amahirwe yabo yo gukira ari make cyane.

Ni izihe mpamvu nyamukuru zo kwinjira muri ICU?

Hari indwara zitandukanye n'ibikomere bisaba kuvurirwa muri ICU. Reka turebe zimwe mu mpamvu zikunze kugaragara :

• Igihe cyo gukira nyuma yo kubagwa bikomeye : Nyuma yo kubagwa bimwe na bimwe bikomeye, umurwayi yoherezwa mu cyumba cy’indembe gikuru (ICU) agakurikiranwa neza.
• Aneurysm yo mu bwonko yacitse: Iki ni ikibazo gikomeye cyane.
• Sepsis : Iyi ni indwara ikomeye ikwirakwira mu mubiri wose.
• Indwara zikomeye za bagiteri cyangwa virusi : Hari igihe izi ndwara zishobora gushyira ubuzima mu kaga.
• Indwara yo mu bwonko : Indwara iterwa no kuziba kw'amaraso ajya mu bwonko .
• Gucika intege gutunguranye k'urugingo rw'ingenzi mu mubiri : Urugero, umutima, impyiko, umwijima, cyangwa ibihaha (`(gucika intege mu guhumeka)`) bihita bihagarara gukora.
• Ingorane nyuma yo kubagwa .
• Impanuka zikomeye : Ibintu nk'ibikomere by'amasasu, impanuka zikomeye z'imodoka.
• Ibikomere bikomeye byo mu mutwe (Ibikomere byo mu bwonko bikomeretsa cyane) .
• Gutungurwa : Iyi ni indwara aho umubiri utakaza amaraso ahagije, bigatuma ingingo zibura ogisijeni n'intungamubiri.
• Indwara zimwe na zimwe zikomeye n'uburyo bwo kuvura bujyanye na kanseri .

Mu bihe nk'ibi, serivisi z'inzobere zitangwa muri ICU ni ingenzi kugira ngo umurwayi arokore ubuzima bwe kandi akire vuba.

Ni ubuhe bwoko bw'ubuvuzi butangwa muri ICU? Ni nde utanga ubwo buvuzi?

Mu cyumba cy’indembe , abarwayi bakurikiranwa kandi bakavurwa amasaha yose . Hakoreshwa ibikoresho byinshi byihariye byo kwa muganga .

ICU itanga "ubuvuzi bw'inzobere nyinshi ". Ni ukuvuga itsinda ry'abaganga, abaforomo, n'abandi bakozi bo mu rwego rw'ubuzima bafite uburambe mu nzego zitandukanye bakorana mu kwita ku murwayi umwe. Tekereza itsinda nk'iri:

• Abaganga b'inzobere mu by'ubuvuzi bw'ibanze / intensivists : Aba ni bo baganga bakomeye mu cyumba cy'indembe.
• Abaganga b'ihungabana : Abaganga bavura abantu bakomeretse bikomeye.
• Abaforomo n'abafasha b'abaganga bahuguwe byihariye (`Abatanga serivisi z'ubuvuzi zigezweho cyangwa porogaramu`) .
• Abaforomo : Abakozi b'abaforomo ni bo bamara igihe kinini bita ku murwayi.
• Abavuzi b'indwara zo guhumeka : Abafasha abarwayi bafite ibibazo byo guhumeka.
• Abavuzi b'akazi : Abafasha abarwayi gusubira ku kazi kabo.
• Abaganga bari mu mahugurwa (`Abaturage`) : Abarangije impamyabumenyi yabo y'ubuganga kandi bakaba barimo guhabwa andi mahugurwa yihariye.
• Abaganga bari mu mahugurwa y'inzobere (`Fellows`): Ni ukuvuga abaganga barangije amahugurwa yabo y'ibanze kandi bakaba bahabwa amahugurwa yimbitse y'inzobere.
• Abahanga mu by'imiti : Abantu bafite ubumenyi bwihariye ku miti ihabwa abarwayi.
• Abavuzi b'umubiri : Abantu bafasha kugarura imigendere y'umubiri, imitsi, n'ibindi.
• Abahanga mu by'imirire : Abakora ibishoboka byose kugira ngo umurwayi abone indyo yuzuye akeneye.
• Abakozi b'imibereho myiza y'abaturage : Abatanga ubufasha bwo mu mutwe n'ubundi bufasha ku murwayi n'umuryango.
• Abashinzwe gukurikirana ubuvuzi bw'abarwayi: Abahuza ibikorwa byo kwita ku barwayi.

Reba ukuntu itsinda rikorera umurwayi umwe! Intego ya buri wese ni ukuvura umurwayi vuba bishoboka.

Ni ibihe bikoresho bikunze kuboneka mu cyumba cy’indembe?

Iyo ugiye kwa muganga wita ku barwayi barembye cyane (ICU), uzabona imashini zitandukanye n'ibikoresho byo kugenzura uburwayi. Ibi bikoreshwa mu gukurikirana buri gihe uko umurwayi amerewe no gutanga ubuvuzi bukenewe. Reka turebe bimwe mu bikoresho by'ingenzi bikoreshwa:

• Imashini zigabanya ububabare : Izi zikoreshwa mu gutanga ububabare mu gihe cyo kubagwa cyangwa mu gihe cyo kubabara.
• Imiti yo hagati n'iy'inyuma : Iyi ikoreshwa mu gutanga imiti, nka saline, mu mubiri. Ikoreshwa kandi mu gutanga imiti igabanya ububabare n'imihangayiko.
• Defibrillators : Iyo umutima uhagaze mu buryo butunguranye (Cardiac arrest), iyi mashini ikoreshwa mu gutanga amashanyarazi kugira ngo wongere utangizwe.
• Ibikoresho byo gufata amashusho : Ibintu nka X-ray na ultrasound birakenewe kugira ngo umuntu abone imbere mu mubiri.
• Imashini zifasha mu buzima : Izi zikoreshwa mu gushyigikira ingingo zidakora neza, cyangwa mu gukora by'agateganyo imirimo y'izo ngingo.
• Guhumeka hakoreshejwe ikoranabuhanga : Iyi mashini ifasha abarwayi badashobora guhumeka bonyine.
• ECMO (Extracorporeal membrane oxygenation) : Imashini yihariye ishyigikira umutima n'ibihaha.
• Uburyo bwo kuvura impyiko mu buryo buhoraho : Ubu ni uburyo bwo gukora akazi iyo impyiko zidakora neza, kimwe na dialyse.
• Imiyoboro ya IV yo mu mpande : Iyi ni imiyoboro mito ya pulasitiki ikoreshwa mu gutanga umunyu, intungamubiri zo mu nda (rimwe na rimwe itangwa binyuze mu muyoboro unyuze mu mazuru), imiti, no guterwa amaraso.
• Katheteri zo mu nkari : Izi zikoreshwa mu gusohora inkari mu ruhago.
• Igenzura ry'ibimenyetso by'ingenzi : Ibi bipima kandi bikagaragaza ibintu nk'ubushyuhe bw'umubiri, umuvuduko w'amaraso, umuvuduko w'umutima, n'umuvuduko w'ubuhumekero .

Ntugatinye iyo ubonye ibi bikoresho. Ibi byose ni ukugira ngo umurwayi ahabwe ubuvuzi bwiza.

Ni iyihe miti ikoreshwa cyane muri ICU?

Mu cyumba cy’indembe (ICU), imiti itandukanye ikoreshwa bitewe n’uko umurwayi ameze. Dore ingero zimwe na zimwe:

• Imiti ivura indwara z'umutima (`Antiarrhythmics`) .
• Antibiyotike : Kuvura indwara zandura.
• Imiti igabanya ubukana bw'indwara zo mu mutwe: Ku ndwara zimwe na zimwe zo mu mutwe.
• Imiti igabanya ubukana bw'indwara nk'igicuri cyangwa ibicurane .
• Beta-blockers : Ku ndwara zimwe na zimwe z’urusobe rw’amaraso.
• Imiti igabanya umuvuduko ukabije w'amaraso .
• Ibikoresho bifunga imiyoboro ya kalisiyumu : Ku ndwara nk'indwara z'umutima, umuvuduko ukabije w'amaraso, n'umutima utera vuba (tachycardia).
• Imikorobe : Imiti itera inkari nyinshi ku ndwara nk'iz'umutima no kubyimba.
• Imiti igabanya ububabare : Kugenzura ububabare buri hagati kugeza ku bunini.
• Imiti itera ubwonko gutera ubwoba : Ifasha mu kuvura imvune zo mu bwonko no mu gucika kw'imitsi.
• Imiti igabanya ububabare, kubabara, no gutuma umurwayi atuza.
• Vasopressors : Iyo ufite umuvuduko muke w'amaraso (hypotension).

Iyi miti yose itangwa munsi y’ubugenzuzi bukomeye bw’abaganga, kandi ijyanye n’uko umurwayi amerewe.

Ni iki wakwitega mu gihe winjiye muri ICU?

Icyumba cyita ku barwayi barembye ni ahantu hakorerwa cyane. Kuko, ugomba kwitondera umurwayi wese uhari igihe cyose. Abaganga bakora uko bashoboye kose kugira ngo umurwayi agire ibyiyumvo byiza. Ariko, kuri bamwe, akazi kenshi kaho, urusaku rw'imashini, hamwe n'impumuro zimwe na zimwe bishobora kugorana kwihanganira, kandi bashobora kumva bafite stress.

Bitandukanye n'ibindi byumba by'abarwayi, hari ibitanda bike gusa muri ICU. Ubusanzwe umuforomo yita ku murwayi umwe cyangwa babiri gusa. Nanone, hari amabwiriza ku bashobora gusura abarwayi . Umubare w'abantu bashobora gusura ni muto, bashobora kutemererwa gukoresha telefoni zigendanwa, kandi bashobora gusabwa kutazana ibiryo, ibinyobwa, indabyo, nibindi. Nanone, niba umushyitsi afite ibicurane cyangwa indi ndwara, ni byiza kuguma mu rugo. Ibi byose bikorwa ku bw'umutekano w'abarwayi.

Iyo umuntu afite indwara yandura, ashobora gushyirwa ahantu hihariye muri ICU kugira ngo hirindwe ko iyi ndwara yakwirakwira mu bandi. Muri iki gihe, abakozi bo kwa muganga bazakenera kandi gukoresha ibikoresho by'inyongera byo kwirinda indwara (PPE). Ibi bishobora kuba birimo:

• Indorerwamo z'umutekano
• Udukingirizo two mu maso
• Uturindantoki
• Amakanzu yihariye
• Gupfuka umutwe
• Udupfukamunwa two mu maso (`Udupfukamunwa`)
• Udukoresho two guhumeka
• Ibipfukisho by'inkweto

Iyo umurwayi atazi cyangwa afite ikiruhuko kandi adashobora kugaragaza ibyifuzo bye, umuryango ni wo ugomba gufata ibyemezo ku bijyanye no kwita ku murwayi. Mu gihe cy’impanuka, abaganga bashobora no gufata ibyemezo ku murwayi.

Ni ryari nshobora kuva muri ICU?

Ibi biterwa cyane n'uburemere bw'uburwayi bw'umurwayi . Abantu benshi baguma mu cyumba cy'indembe bakira bakava mu bitaro. Ariko, indwara zisaba ubuvuzi bwa ICU ziragoye cyane kandi rimwe na rimwe zishobora guhinduka mu buryo butunguranye. Ushobora gukenera kuguma mu cyumba cy'indembe amasaha make gusa, cyangwa ushobora gukenera kuguma mu byumweru cyangwa amezi. Muganga wawe azaguha igitekerezo gifatika kuri ibi.

Ese hari ubwoko butandukanye bwa ICU? Ese buri ICU ifite umwihariko wayo?

Yego, hari ibitaro bimwe bifite ubwoko bwihariye bwa ICU. Ni ukuvuga, ibitaro byita ku barwayi barembye byihariye mu matsinda amwe n'amwe y'abarwayi cyangwa indwara zimwe na zimwe. Ingero zimwe ni izi:

• Ivuriro ryihariye ry’umutima (CICU) : Rivura abantu bafite indwara z’umutima.
• Icyicaro cyita ku barwayi barembye cyane mu gifu (CTICU): Ku bantu bafite indwara z'umutima n'ibihaha .
• Icyicaro cyita ku bana bavutse vuba (NICU): Ku bana bavutse vuba , cyane cyane abana bavutse mbere y'igihe n'abarwaye.
• Ivuriro ryimbitse (MICU) : Ku bibazo bikomeye by’uburwayi, indwara zikomeye, n’ibibazo by’ubuhumekero.
• Ivuriro ryimbitse ry'abana (PICU) : Kuvura abana.
• Ishami rishinzwe kwita ku barwayi bakomeretse n'abarwaye indwara z'ihungabana (STICU) : Ku barwayi nyuma yo kubagwa n'impanuka zikomeye.

Kugira ICU yihariye nk'iyi bizadufasha gutanga serivisi zihariye zikenewe na buri murwayi.

Ese ICU bivuze ko umuntu ahora ari mu bikoresho byo gufasha umuntu gufashwa igihe cyose?

Ibi si ko bigenda buri gihe. Ariko, abantu benshi bari mu cyumba cy’indembe bakenera uburyo bwo kwa muganga kugira ngo ingingo zabo zikomeze gukora neza. Urugero, ibintu nk'imashini zihumeka, dialyse, na defibrillators. Ibi bikoreshwa mu gufasha umubiri gukora ibintu utagishoboye gukora wonyine.

Ese ICU ni ubuvuzi bw'ibanze gusa?

Hari igihe bishobora kubaho, ariko si buri gihe. ICU yagenewe gutanga ubuvuzi bwihariye ku bantu barwaye cyane cyangwa bakomeretse. Ariko, hari igihe umurwayi adashobora gukira indwara nubwo yaba afite ubuvuzi bwa ICU .Muri icyo gihe, niba wowe, itsinda ry’abaganga bawe, cyangwa abakunzi bawe mufashe icyemezo cy’uko ubuvuzi bwa ICU butagikenewe, ushobora kwimurirwa mu cyumba gisanzwe mu bitaro. Cyangwa, niba bishoboka, ushobora koherezwa mu rugo, cyangwa woherezwa mu kigo cyita ku barwayi barembye gitanga ububabare n’ihumure mu mpera z’ubuzima bwawe.

Ikirenze byose, abakozi bo muri ICU bumva uko umerewe n'uko umuryango wawe umerewe. Bahora bagerageza gutanga umusaruro mwiza ushoboka no kuguhumuriza muri iki gihe kigoye.

Amaherezo, ibintu by'ingenzi cyane ugomba kwibuka

Noneho twaganiriye cyane kuri ICU. Dore ibintu by'ingenzi ugomba kwibuka:

• Icyumba cyita ku barwayi barembye cyane (ICU) ni ahantu hihariye havurirwa indwara zikomeye cyane.
• Kwinjira muri ICU bivuze ko ari ibisanzwe ko umurwayi n'umuryango we bumva bafite ubwoba, imihangayiko, kandi bafite stress. Ibyo ni ibisanzwe cyane.
• Abakozi bose, barimo abaganga n'abaforomo, bari muri ICU kugira ngo bafashe umurwayi, batange ubuvuzi bwiza, kandi bahumurize muri iki gihe kigoye.

Niba wowe cyangwa undi muntu uzi akeneye kuvurwa muri ICU, ntutinye. Tega amatwi witonze ibyo abaganga bavuga, kandi ubaze ikibazo icyo ari cyo cyose ufite. Bazagufasha.

Ishami ryita ku barwaye indwara ikomeye, ICU, Ibitaro, Ubuvuzi bwihutirwa, Inkunga y'ubuzima, Abaganga b'inzobere, Ibikoresho by'ubuvuzi