Wakamboona chiremba kana nesi, mushure metsaona kana murwere anorwara zvakanyanya akaunzwa kuchipatara, akabata chigunwe kana chigunwe paruoko kana tsoka yemunhu kwenguva yakati wobva wachisunungura? Vanomirira kuti chigunwe chishanduke ruvara zvakare. Ungave wakambofunga kuti, "Chii ichi chiri kuita?" Bvunzo iri nyore inonzi Capillary Replenishment Time (CRT) . Ingaita sebvunzo iri nyore, asi ibvunzo inokosha kwazvo inopa vanachiremba ruzivo rwakawanda runokosha runogona kuponesa hupenyu hwemunhu.
Zvichitaurwa zviri nyore, chii chinonzi Capillary Refill Time (CRT)?
Tisati tanzwisisa izvi, ngatinzwisisei zvishoma. Tine mitsipa yeropa inotakura ropa mumiviri yedu yese. Mitsipa midiki yeropa iyi, senge tambo dzedandemutande redandemutande, inonzi capillaries . Idzi ndidzo dzinotakura okisijeni nezvinovaka muviri kumasero ese ari mumuviri wedu, kuchikamu chidiki chega chega chayo. Zvakafanana nemigwagwa midiki yemumativi inopararira kubva mumugwagwa mukuru ichienda kudzimba dzese.
Zvino fungidzira uchidzvanya nzara yako kwechinguva. Ipapo nzvimbo iyoyo inoshanduka kupenya, handiti? Unoziva here chikonzero? Paunodzvanya, ropa rinobuda kwenguva pfupi kubva mumasero madiki iwayo. Paunongobvisa ruoko rwako, masero iwayo anozadzwa neropa zvakare uye anodzokera kuruvara rwawo rwekare rwepingi mumasekonzi mashoma.
Ndiyo nguva inoshandiswa neCapillary Refill Time (CRT) . Ndiyo nguva inotora kuti ganda rakapwanywa uye rakabatwa nemusoro rizare neropa zvakare rodzokera kuruvara rwaro rwekare. Nekuyera nguva iyi, chiremba anogona kukurumidza kuona kana ropa riri kuyerera zvakanaka kunzvimbo dziri kure dzemuviri, dzakadai semaoko netsoka, kana kuti kana kuyerera kweropa muropa kwakanaka.
Sei bvunzo iyi ichikosha kudaro? Ngatidzidzei nezvechirwere chine njodzi chinonzi 'Shock'!
Pane chikonzero chikuru chinoita kuti kuongororwa kweCRT kuve kwakakosha zvikuru munguva dzenjodzi. Izvi zvinoreva kuti, kunobatsira kuona kuvhunduka, chirwere chinogona kuisa hupenyu panjodzi.
Chii chinonzi kushamisika uku?
Zvichitaurwa zviri nyore, iyi inyaya yekuti nhengo dzemuviri wedu (dzakadai seuropi, moyo, neitsvo) hadzigamuchire ropa rakakwana rine oxygen. Kungofanana nepanopera simba remagetsi mumba, mwenje, mafeni, nemafiriji zvinomira kushanda, kana ropa rinoenda kunhengo dzedu rikangoerekana radzikira, hazvigone kushanda zvakanaka. Izvi zvine njodzi uye zvinogona kutyisidzira hupenyu hwedu kana zvikasarapwa nekukurumidza.
Panogona kuva nezvikonzero zvakawanda zvinoita kuti munhu avhunduke. Kana paine dambudziko, panogona kusava nenguva yekuita bvunzo dzemurabhoritari kana kuskena. Ndipo panobatsira vanachiremba nebvunzo dzekukurumidza dzakadai seCRT.
| Mamiriro ezvinhu anogona kukonzera kushamisika | |
|---|---|
| Chikonzero | Tsananguro iri nyore |
| Kubuda ropa zvakanyanya (Kubuda ropa zvakanyanya) | Ropa rakawanda richibuda mumuviri, sekunge rabva mutsaona huru. |
| Kupera mvura mumuviri zvakanyanya | Mvura nemunyu zvakaderera zvakanyanya mumuviri nekuda kwemanyoka, kurutsa, kana kudikitira zvakanyanya. |
| Kurwara kwakanyanya (Anaphylaxis) | Kurwara kwakanyanya kunokonzerwa nechikafu, mushonga, kana kurumwa nezvipembenene. |
| Kutsva kwakanyanya | Mvura yakawanda inobviswa mumuviri nekuda kwekutsva kweganda. |
| Kupisa muviri zvakanyanya (Hyperthermia) | Kukwira kwekushisa kwemuviri kune njodzi nekuda kwezvinhu zvakaita sekunyanya kupiswa nezuva. |
| Kupisa muviri zvakanyanya (hypothermia) | Kupisa kwemuviri kunoderera zvine njodzi nekuda kwekutonhora kwakanyanya. |
Bvunzo yeCRT inoitwa sei?
Iyi inzira iri nyore uye isingarwadzi. Kazhinji, chiremba kana nesi vanotevera matanho aya:
1. Kusimudza ruoko kana gumbo: Kutanga, isa rimwe remaoko kana makumbo emurwere pamusoro pemoyo zvishoma.
2.Kudzvanya neminwe: Wobva wadzvanya zvakasimba pamusoro pemunwe kana nzara yechigunwe kwemasekondi angangoita mashanu kusvika gumi. Nzvimbo yacho inozobva yatsvuka.
3. Kuyera nguva: Zvadaro, chigunwe chakadzvanywa chinongoerekana chaburitswa, uye nguva inotora kuti nzvimbo yakachenuruka izare neropa zvakare yodzokera kuruvara rwakafanana neganda rakatenderedza inoyerwa mumasekonzi. Wachi inowanzo shandiswa pakuita izvi.
Chinhu chakakosha ndechekuti nhamba yemasekonzi anowanikwa kubva mubvunzo iyi iri nyore inotaura nyaya huru nezvemamiriro ehurongwa hweropa hwemurwere.
Unogara uchitarisa izvi nemunwe wako here?
Kazhinji, hongu. Asi kune dzimwe nguva dzinokosha apo hazvigoneki kuona izvi nemunwe. Fungidzira kuti munhu anounzwa kuchipatara nemuviri wake uchitonhora, nhengo dzake uye kunyange maoko netsoka dzake zvichichinja kuita bhuruu nekuda kwechando chakanyanya. Sezvo tembiricha yemuviri wemunhu akadaro yakaderera zvikuru (Hypothermia), kutenderera kweropa munhengo kungave kwakadzikira zvakasikwa. Muchiitiko chakadaro, kutarisa CRT nemunwe kunogona kupa pfungwa isiriyo.
Muzviitiko zvakadaro, vanachiremba vanoita bvunzo iyi nekusunga ganda rakatenderedza sternum, pfupa riri pakati pechipfuva, nekuti chikamu chepakati chemuviri chine ropa riri nani kupfuura makumbo nemaoko.
Mhedzisiro yacho inoti chii? Mamiriro ezvinhu akajairika uye asina kujairika
Mhedzisiro yebvunzo iyi inodzoka mumasekonzi mashoma. Mhedzisiro yemunhu ane hutano hwakanaka inogona kusiyana zvishoma nezera.
- Vana vacheche: masekondi maviri kana pasi.
- Vakuru (vana nevechidiki): Masekondi angangoita maviri kusvika matatu.
- Vakuru: Zvinogona kutora masekondi anopfuura matatu.
Ko kana kukosha kwangu kweCRT kuri mukati mehuwandu hwakajairika?
Fungidzira kuti mumwe munhu ari kurwara zvakanyanya, asi CRT yake yakajairika, zvichireva kuti anenge masekonzi maviri. Izvi zvinoreva here kuti haana chirwere? Kwete. Zvinoreva kuti chiremba anonzwisisa kuti parizvino hapana dambudziko guru nehurongwa hweropa hwemurwere, saka chikonzero chechirwere chingave chiri kumwe. Ipapo vanobva vatanga kutsvaga zvimwe zvikonzero.
Ko kana CRT value isina kujairika? (Kana nguva yacho yakareba zvakanyanya)
Apa ndipo paunofanira kuteerera. Kana CRT yemunhu yakakwira kupfuura nguva yakatarwa (semuenzaniso masekondi mana, mashanu, kana kupfuura) , chiratidzo chekusashanda zvakanaka kuna chiremba . Zvinoreva kuti kuyerera kweropa kunhengo dzemuviri kwakanganiswa zvakanyanya, zvichireva kuti kurohwa nehana kuri kuitika kana kuti kwaitika.
Panguva dzakadai, vanachiremba vanokurumidza kuita mimwe miedzo kuti vasimbise chikonzero uye vaone kuoma kwechirwere ichi.
- Pulse Oximetry: Muchina unoyera mwero weokisijeni muropa nekubatanidza mudziyo wakaita seclip pamunwe.
- Yera BP nguva nenguva uye mwero wekurova kwemoyo.
- Kuongorora murwere kuti anoziva sei.
- Kuyera kubuda kweweti: Izvi zvakakosha kuti uzive kana ropa riri kuyerera zvakanaka kuenda kuitsvo.
Vanachiremba vanogona kuumba mufananidzo wakakwana wemamiriro emurwere nekubatanidza ruzivo rwunobva mune izvi zvese.
Inorapwa sei?
Kana CRT iine zviratidzo zvisina kujairika uye shock ikasimbiswa, murwere anofanira kurapwa nekukasika . Kurapwa uku kunoenderana nechikonzero cheshock uye kuoma kwemamiriro emurwere. Aya ndiwo mamwe emarapirwo anowanzo kupiwa muchikamu chekurapa chekukurumidzira (ETU).
- Mvura yemusana (mushonga wemunyu): Mvura nemunyu zvinopinzwa netsinga (kuburikidza ne cannula) kuyedza kudzoreredza BP.
- Okisijeni Yekuwedzera: Okisijeni inopihwa kuburikidza ne cannula yemhino kana mask yekumeso kuti iwedzere mwero weokisijeni muropa.
- Kuisirwa Ropa: Kana ropa rakawanda rakarasika, senge mutsaona, ropa rinopihwa kunze.
- Chubhu yekufema (Intubation): Kana murwere achinetseka kufema ega, chubhu yekufema inoiswa yobatanidzwa nemuchina wekufema .
- Mishonga: Zvichienderana nechikonzero chacho, mishonga yakadai semishonga inorwisa mabhakitiriya inopihwa kana iri hutachiona, uye mishonga inopihwa kana iri allergy.
Chinangwa chekurapa uku kwese ndechekudzorera ropa munhengo dzemuviri nekukurumidza sezvinobvira, kudzivirira kukuvara kwakawanda, uye kuponesa hupenyu.
Mharidzo Yekuenda Nayo Kumba
- Nguva Yokuzadza Capillary (CRT) bvunzo iri nyore yekurapa inogona kuitwa mumasekonzi mashoma, hairwadzi, asi inopa ruzivo rwakakosha.
- Izvi zvinonyanya kuongorora kana kutenderera kweropa kwakanaka kunzvimbo dziri kure dzemuviri, dzakadai semakumbo nemakumbo.
- Kukosha kweCRT kwakakwira kupfuura kwakajairika (kwakareba) kunogona kuva chiratidzo chechirwere chine njodzi senge shock . Iyi inyevero yakakosha kuna vanachiremba.
- Bvunzo iyi ingori chidimbu chidiki chepuzzle hombe. Chiremba anofungisisa zvimwe zvinhu zvakawanda (BP, kurova kwemoyo, zviratidzo) kuti aite sarudzo yakakwana nezvemurwere.
- Nguva inotevera yaunoona chiremba achiita bvunzo iyi, ikozvino wava kuziva kukosha kwemaitiro iwayo ari nyore.
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