Tekereza, umuntu uri imbere yawe ahita atakaza ubwenge maze agwa hasi. Uriruka cyane, ureba ijosi rye niba hari umutima uhagaze, ariko nta mutima uhumeka. Utekereza ko ibi ari uguhagarara k'umutima. Ariko igitangaje ni uko iyo babajyanye kwa muganga, abaganga bafata ECG maze igaragaza imikorere y'amashanyarazi mu mutima. Hari amashanyarazi, ariko umutima ntukubita. Iyi ndwara idasanzwe kandi iteje akaga ni yo mu buvuzi twita "Ibikorwa by'amashanyarazi bitagira umuvuduko." Tuyita PEA mu magambo ahinnye. Iki ni ikibazo cyihutirwa cyane. Reka tubiganireho mu buryo bworoshye.
Mu magambo make, PEA ni iki?
PEA ni ubwoko bw'umutima uhagarara. Ikibaho hano ni uko, nubwo hari amashanyarazi mu mutima, imitsi y'umutima ntikora ngo ikore amaraso hakurikijwe icyo kimenyetso cy'amashanyarazi. Ni nk'aho itara ritacana kuko umugozi washize nubwo hari amashanyarazi .
Iki gikorwa cy'amashanyarazi gishobora gupimwa hifashishijwe ECG (electrocardiogram). Ariko, iyo urebye imitsi y'umutima wawe, ntuzumva imitsi y'umutima kuko umutima udakubita kandi ntutera amaraso hirya no hino mu mubiri.
Icy'ingenzi kurushaho, PEA ni uburyo umutima utera "gutigita" mu buryo "budatindiganywa". Ibi bivuze ko idashobora kugarurwa n'ihungabana riturutse kuri defibrillator, nk'uko bigaragara muri filime. Kubwibyo, iyo ubuvuzi bukwiye budakiriwe vuba, urupfu rushobora kubaho mu minota mike.
Hari ubwoko bubiri bwa PEA
Abaganga babigabanyamo ubwoko bubiri bw'ingenzi.
1. Pseudo-PEA: Muri ibi, imitsi y'umutima iragabanuka cyane bitewe n'imikorere y'amashanyarazi y'umutima. Nubwo yakwinjiza amaraso make, ntabwo ikomeye nk'umutima usanzwe utera. Kubwibyo, nta maraso ahagije atembera kugira ngo wumve umuvuduko w'amaraso mu mubiri.
2. PEA nyayo: Muri ibi, nubwo hari imikorere y'amashanyarazi mu mutima, imitsi y'umutima ntikora na gato . Ibyo bivuze ko nta maraso atangwa na gato. Nta guhagarara k'umutima kumvikana na gato.
Ni irihe tandukaniro riri hagati ya PEA na Asystole (Flat-lining)?
Ushobora kuba warabibonye muri filime, iyo umuntu apfuye, umurongo ugororotse ugaragara kuri ecran irimo ijwi rya "beep...". Ibyo ni byo twita `(asystole)` cyangwa "flat-lining."
- PEA: Hari amashanyarazi mu mutima, ariko umutima ntukora. (Nk'uko televiziyo ifite amashanyarazi , ariko ikaba yangiritse).
- Asystole: Umutima nta mashanyarazi ugira, kandi umutima ntutera. Utuje rwose. (Nk'uko televiziyo yafunguwe).
Nubwo byombi ari indwara zo guhagarara k'umutima, itandukaniro rishobora kumenyekana hashingiwe ku ishusho ya ECG.
Ni izihe mpamvu nyamukuru zitera PEA?
Hari ibintu byinshi bishobora gutera PEA. Kugira ngo byoroshye kwibuka ibi, abaganga bakoresha uburyo bwo kugabanya umubare w'abantu buzwi nka "H na T." Reka turebe ibyo ari byo.
| Icyiciro cy'impamvu | Ibisobanuro byoroshye |
|---|---|
| Kugabanuka k'umuvuduko w'amaraso (Hypovolemia) | Kugabanuka k'umubare w'amaraso mu mubiri bitewe n'impamvu nko kuva amaraso menshi bitewe n'impanuka ikomeye cyangwa kubura amazi mu mubiri cyane. |
| Kugabanuka k'urugero rwa ogisijeni (Hypoxia) | Kubura umwuka wa ogisijeni mu mubiri bitewe no kugorwa no guhumeka no kurohama. |
| Impinduka mu kuringaniza aside/umunyu mu mubiri (Hydrogen iyoni - Acidosis) | Ubwiyongere bw'aside mu mubiri buterwa n'impamvu nko kunanirwa kw'impyiko. Impinduka zikomeye mu rugero rwa electrolyte nka potasiyumu. |
| Hypothermia (ubushyuhe buke bw'umubiri) | Ubushyuhe bw'umubiri buragabanuka bukagera ku rwego rwo hasi cyane. |
| Kurya uburozi | Kunywa imiti imwe n'imwe, imiti cyangwa ibindi bintu by'uburozi birenze urugero. |
| Ubwinshi bw'amazi mu mutima (Tamponade - umutima) | Umwobo ukikije umutima wuzura amaraso cyangwa andi mazi, bigatera umutima gukandagira. Ibi bibuza umutima gutera neza. |
| Pneumothorax yo mu muvuduko | Ibihaha biraturika, byuzuza umwuka mu gituza, umutima n'imitsi y'amaraso bikandagira. |
| Kuziba kw'amaraso (Trombose) | Indwara nk'indwara y'umutima (`myocardial infarction`) cyangwa amaraso afunganye mu bihaha (`pulmonary embolism`). |
| Ibikomere by'umubiri (Ihungabana) | Kwangirika k'umutima bitewe n'impanuka ikomeye yabereye mu gituza. |
Ibi bivurwa bite?
Iyo umuntu afite PEA, bishobora kugorana kuyisuzuma hanze y'ibitaro, kuko bidashoboka kubimenya nta ECG. Ku bw'amahirwe, ikintu cya mbere kandi cy'ingenzi cyo gukora mu gihe cyose umutima uhagaze ni kimwe: CPR (Cardiopulmonary Resuscitation).
1. Tangira CPR ako kanya: Niba umuntu atazi ubwenge, nta mutima we cyangwa umwuka afite, hamagara imbangukiragutabara ako kanya kandi ukomeze gukanda igituza kugeza igihe azahagera. Aya ni yo mahirwe meza yo kurokora ubuzima. Niba utazi uburyo bwo gukora CPR, ikigo gishinzwe ubutabazi bwihuse gishobora kukwereka uburyo bwo kubikora.
2. Kuvurirwa mu bitaro: Nyuma yo kwakirwa mu ishami ryita ku barwayi barwaye indwara zihutirwa (ETU) ry’ibitaro, abaganga bazakomeza gukora CPR no gutangira ubundi buryo bwo kuvura.
- Epinephrine: Iyi nanone yitwa adrenaline. Uyu muti utangwa kugira ngo ugerageze gusubiza umutima ku murongo usanzwe.
- Kuvura icyateye: Ni ngombwa kumenya vuba icyateye PEA (imwe mu mpamvu ziri mu mbonerahamwe iri hejuru) no kuyivura. Urugero, niba amaraso yatakaye, tanga amaraso, niba nta mwuka uhagije wa ogisijeni, tanga ogisijeni, niba hari amaraso hafi y'umutima, uyakuremo ukoresheje syringe.
Wibuke ko PEA ari injyana "idahindagurika". Ibi bivuze ko guhungabana bivuye kuri defibrillator ntacyo bizafasha. Ariko, iyo CPR imeze neza, rimwe na rimwe injyana y'umutima ishobora guhinduka injyana ihindagurika (urugero: `ventricular fibrillation`). Muri icyo gihe, guhungabana bivuye kuri defibrillator biha umutima amahirwe yo kongera gutangira. Niyo mpamvu CPR ari ingenzi cyane.
Ni iki twakora mu gihe cy'ubutabazi bwihutirwa?
Guhagarara k'umutima buri gihe ni ikibazo cyihutirwa cy'ubuvuzi, bityo rero ni ngombwa gufata ingamba zihuse.
Umuntu uri imbere yawe:
- Iyo utakaje ubwenge mu buryo butunguranye ukagwa,
- Niba udashobora kumva umuvuduko w'amaraso mu ijosi cyangwa ku kuboko,
- Iyo guhumeka bihagaze cyangwa bikagorana bidasanzwe,
Hamagara imbangukiragutabara ako kanya. Hanyuma, tangira CPR vuba bishoboka. Buri segonda rigira agaciro.
Nubwo PEA ari indwara ikomeye cyane, kuyisobanukirwa kwacu kwariyongereye cyane bitewe n’iterambere ry’ubuvuzi bwa none. Ariko, iminota mike ya mbere ni ingenzi cyane kurusha ibyo byose. Bityo rero, niba ubonye umuntu uhuye n’ibi, ntugatinye, tangira CPR ako kanya, kandi usange ubufasha bwihuse kwa muganga, ibyo bishobora kongera amahirwe yo kurokora ubuzima.
Ubutumwa bwo kujyana mu rugo
- PEA ni ikibazo gikomeye cyane cy’uburwayi aho umutima ugira amashanyarazi ariko nta guhagarara kw’umutima.
- Iyo umuntu aguye mu gituza, banza urebe uko umutima we utera n'uko ahumeka ako kanya.
- Niba nta guhumeka cyangwa umutima urimo gutera, hamagara imbangukiragutabara vuba kandi utangire CPR (gukanda igituza) ako kanya.
- Nubwo kuvura indwara ya shock (defibrillation) kuri PEA akenshi bitagenda neza, CPR ihoraho ishobora guhindura umutima ukagira shock ritrium.
- Intego nyamukuru yo kuvurwa mu bitaro ni ukumenya no kuvura impamvu nyamukuru ya PEA mu gihe bakora CPR.
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