Kugaramira ni iki? Ese kuryama ugaramye bishobora gukiza ubuzima? (Kugaramira)

Ese wigeze wumva abaganga bavuga bati "Tugiye gukomeretsa umurwayi" iyo umwe mu bavandimwe bawe cyangwa inshuti zawe ari mu cyumba cy’indembe (ICU)? Cyangwa ushobora kwibuka ijambo "gukomeretsa" ryakoreshwaga kenshi mu gihe cy’icyorezo cya COVID-19. Nubwo ibi bishobora kuba bishya kuri benshi, mu by’ukuri ni uburyo bw’ingenzi cyane kandi bumaze igihe kirekire abaganga bakoresha kugira ngo barokore ubuzima bw’abarwayi bafite ikibazo gikomeye cyo guhumeka. Rero, uyu munsi turabivugaho byose mu buryo bworoshye cyane, mu buryo ushobora kumva.

Mu magambo make, 'Proning' ni iki?

Guterura ni ikintu cyoroshye cyane. Ni uguhindura umurwayi uri mu buriri aryamye mu mwanya we. Ni nko kwihindukiza inda kugira ngo dusinzira. Ariko iki si ikintu dukora mu buryo busanzwe, ni ikintu gikorwa mu buryo bwitondewe kandi bugambiriwe n'abaganga bo mu bitaro.

Ibi bikunze gukorwa ku barwayi bafite ikibazo gikomeye cyo guhumeka , cyane cyane abahumeka hakoreshejwe ikoranabuhanga. Ibi byongera ingano ya ogisijeni igera ku mubiri w'umurwayi.

Nubwo byamenyekanye cyane mu gihe cy'icyorezo cya COVID-19, ibi si bishya. Abaganga bamaze imyaka ibarirwa muri za mirongo bakoresha ubu buryo. Ubushakashatsi bwagaragaje ko gusohora vuba ku barwayi bafite indwara zikomeye z'ubuhumekero bari ku cyuma gifasha guhumeka bishobora kugabanya cyane impfu .

Ni ubuhe bwoko bw'indwara ubu buryo bukoreshwa?

Uburyo bwo guhanura bukoreshwa cyane cyane mu gufasha abarwayi bafite indwara zikomeye z'ubuhumekero aho umubiri utari kubona umwuka uhagije wa ogisijeni (hypoxia). Indwara ikunze kugaragara muri izi ndwara ni indwara y'ubuhumekero iterwa n'agahinda gakabije (ARDS).

Mu magambo make, ARDS ni ukwirundanya kw'amazi mu dusaho duto tw'umwuka turi mu bihaha byacu, alveoli. Tekereza nk'ikinyugunyugu cyinjiza amazi kigafunga icyuho. Iyo utu dusaho tw'umwuka twuzuyemo amazi, nta mwanya w'umwuka uhumeka. Iyi ni indwara ikomeye cyane. ARDS ishobora kubaho nk'indwara zikomeye nka pneumonia na COVID-19.

Kuki ogisijeni irushaho kuba nziza iyo uhindukije igifu cyawe?

Iki ni cyo kintu cy'ingenzi cyane. Ni gute urugero rwa ogisijeni rwiyongera iyo uhindukiye ku nda yawe? Hari impamvu ebyiri z'ingenzi zibitera. Impamvu ni uko umubiri wacu udahuje imiterere.

1. Kugabanya ibiro n'umuvuduko w'ibihaha (Improved Airtilation)

Bitewe n'imiterere y'umubiri wacu, dufite ibihaha byinshi ku mugongo wacu kuruta ku gituza.Iyo turyamye twugamye, uburemere bw'umutima wacu n'izindi ngingo zo mu nda bugwa hejuru y'ibihaha byacu. Nanone, mu bihe nka ARDS, amazi yirundanya mu bihaha na yo ashyira igitutu ku dusaho tw'umwuka turi hanze bitewe n'imbaraga rukuruzi. Ibi bigabanya ubushobozi bw'ibihaha bwo kuzuza umwuka wose.

Ariko, iyo umurwayi ahindukiye inda ye (aho ahagaze), uburemere bw'umutima n'izindi ngingo ntibwinjira mu bihaha, ahubwo bujya mu magufwa yo mu gituza. Nanone, amazi ari mu bihaha ahurira mu gace gato k'imbere k'ibihaha. Ibi bituma agace kanini k'ibihaha inyuma kabohoka. Hanyuma , umwuka ushobora kwinjira muri ako gace neza, bigatuma ibihaha byaguka kugeza ku bushobozi bwabyo ntarengwa.

2. Kongera ubushobozi bwo guhanahana imyuka mu bihaha

Mu bihe nka ARDS, hari itandukaniro riri hagati y’ingano y’umwuka winjira mu bihaha (guhumeka) n’ingano ya ogisijeni yinjizwa mu maraso (gusohora amaraso). Ku muntu muzima, izi nzira zombi zihuzwa neza.

Uko twaba turi kose, inyuma y'ibihaha byacu hatembera amaraso menshi kurusha imbere. Noneho tekereza uko bigenda iyo umurwayi ahinduriwe inda.

• Dukurikije ingingo ya mbere, ibice byo hanze by'ibihaha bifungutse neza kandi byuzuye umwuka.
• Icya kabiri ni uko igice cy'umugongo cyuzuye umwuka nacyo gifite amaraso meza cyane.

Mu magambo make, aho umwuka wa ogisijeni uri mwinshi, amaraso atembera neza. Ni nko kugeza ibicuruzwa aho bigomba kuba biri. Ibi bituma uburyo bwo guhumeka burushaho kuba bwiza.

Ni gute wakwita ku murwayi uri mu bitaro?

Iki ni ikintu gitegurwa kandi kigakorwa neza cyane. Ntabwo ari nko guhindura umuntu icyarimwe. Bikubiyemo itsinda ry'abaganga, abaforomo, n'abaganga b'imiti ivura indwara z'ubuhumekero bakorana. Ibi nibyo bikunze kubaho:

• Ubwa mbere, imiyoboro yose n'insinga bifatanye n'umurwayi (urugero, imiyoboro ya saline, imiyoboro y'umwuka, insinga za ECG) bitondekwa neza kugira ngo bitavamo cyangwa ngo bihure.
• Umuganga w’indwara zo mu myanya y’ubuhumekero afata neza umuyoboro w’amaraso mu mutwe no mu kanwa k’umurwayi.
• Hanyuma abandi bagize itsinda bategura umurwayi bashyira urupapuro munsi y'umurwayi, bagashyira imisego n'urundi rupapuro hejuru y'umurwayi.
• Hanyuma, bose hamwe, icyarimwe, hakurikijwe ikimenyetso runaka, bahindukiza umurwayi uruhande rumwe rw'igitanda, hanyuma bakajya urundi ruhande.
• Hagati aho, twongera kugenzura ko imiyoboro n'insinga byose biri mu mwanya wabyo.
• Amaherezo, umurwayi ahindurirwa igifu cye cyose maze agashyirwa ku misego yari yashyizwemo mbere. Imisego kandi ishyirwa ku mutwe no ku ijosi kugira ngo imufashe neza.

Ibi bishobora gutandukana gato bitewe n'ibitaro, kandi rimwe na rimwe ibikoresho byihariye bikoreshwa muri ibyo.

Nkwiye kuyigumana imeze gutya igihe kingana iki?

Urugero rwa ogisijeni mu barwayi bamwe rutangira kuzamuka mu isaha imwe gusa. Ariko, kugira ngo bakomeze kunoza ubuzima bwabo, abaganga bakunze kugumana umurwayi mu mwanya we w’imbere amasaha 12 kugeza kuri 18 icyarimwe . Iyo umurwayi amerewe neza, bamugumana muri uwo mwanya nibura amasaha 16 ku munsi, hanyuma bakongera gusubira mu mwanya we w’imbere mu gihe gisigaye.

Ni izihe ngaruka n'inyungu zo gupima imiterere y'umubiri (proning)?

Nk’uko bigenda mu buvuzi ubwo aribwo bwose, kwitegura ubuvuzi bifite ingaruka zimwe na zimwe, ariko inyungu zabyo ziruta kure izo ngaruka.

"Gukanguka" ni iki?

Ushobora kuba warigeze kubyumva. Gukanguka ni uburyo bwo kwigisha umurwayi ufite ubwenge udafite icyuma gihumeka kwihindukiza mu nda. Ibi bikorwa mu bihe bidakomeye cyane, hagamijwe gukumira ko hakenerwa icyuma gihumeka.

Ariko ibi ni ingenzi cyane. Iki si ikintu ushobora gukora wenyine. Ugomba kubikora gusa ari uko muganga wawe yasuzumye neza ikibazo cy'umurwayi kandi akagusaba kubikora. Nubwo bimeze bityo, abakozi b'abaganga bazagufasha kwiga uburyo bwo kwinjira muri iyo myanya mu mutekano.

Kubona umuntu ukunda mu bitaro, cyane cyane mu cyumba cyita ku barwayi barembye, ari mu mimerere ikomeye ni ibintu biteye ubwoba kandi bibabaza cyane. Hamwe n'insinga zose, imiyoboro, n'imashini zivuza, bishobora kugorana cyane. Dushobora kudasobanukirwa bimwe mu bintu abaganga bakora. Guhagarara ni kimwe mu bikoresho by'ingenzi abaganga bakoresha kugira ngo barokore ubuzima bw'umurwayi. Nubwo atari uburyo bwose bwo kuvura butanga umusaruro 100%, ubushakashatsi bwagaragaje ko guhagarara ni uburyo bwiza bwo kurokora ubuzima bw'abarwayi bafite indwara zikomeye z'ubuhumekero no kwihutisha gukira kwabo.

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