Masifunde ngetyhubhu efakwayo xa umntu enengxaki yokuphefumla? (Intubation)

Mhlawumbi ukhe weva ibinzana elithi "ukufaka ityhubhu" okanye "ukufaka ityhubhu" xa umntu ekwimeko embi kakhulu , okanye ngaphambi kotyando olukhulu. Kuthetha ukuthini oku? Nangona kunokuvakala ngathi kuyoyikisa kancinci, yinto ebaluleke kakhulu enokuthi isindise ubomi. Makhe sithethe ngayo, kulungile?

Yintoni i-intubation?

Ngamafutshane, i-intubation kuxa ugqirha okanye ingcali yezempilo eqeqeshiweyo ifaka ityhubhu encinci ngomlomo wakho (okanye ngamanye amaxesha impumlo yakho) kwi-windpipe yakho (umoya ophambili). Oku kukwabizwa ngokuba yi-endotracheal intubation okanye i-tracheal intubation . Xa le tube ifakiwe, i-windpipe ivulekile, okwenza kube lula ukuphefumla. Le tube inokudityaniswa nomatshini (ngokuqhelekileyo i-ventilator ) onokuphefumla. Umatshini emva koko unika i-oxygen nomoya ukukunceda uphefumle.

Kutheni umntu kufuneka afakwe ityhubhu ngolu hlobo?

Ityhubhu ifuneka kuphela xa umntu engakwazi ukuphefumla kakuhle eyedwa, okanye ukuba indlela yakhe yomoya ivaliwe okanye yonakele. Cinga ngayo, ioksijini ibalulekile emizimbeni yethu. Ngoko ke ukuba asiyifumani kakuhle, iingxaki ezininzi zinokubakho.

Ezi ziimeko apho kudla ngokufakwa ityhubhu:

• Ukuvaleka komoya : Khawuthelekelele ukuba kukho into ebambeke kwindlela yakho yomoya, njengokutya, uze ungakwazi ukuphefumla. Yiyo loo nto.
• Ukuma kwentliziyo: Ukuba intliziyo iyeka ukusebenza ngequbuliso , ioksijini ayifiki engqondweni nakwezinye izitho zomzimba. Le ndlela isetyenziselwa ukuphefumla ngokukhawuleza ngelo xesha.
• Ukulimala okukhulu entanyeni, esifubeni, okanye esiswini: Olu kulimala lunokuchaphazela indlela yomoya kwaye kwenze kube nzima ukuphefumla.
• Ukulahlekelwa zingqondo okanye izinga lokuncipha kwengqondo: Xa umntu elahlekelwa zingqondo, usenokungakwazi ukulawula ukuphefumla kwakhe. Oku kuthetha ukuba ulwimi lusenokuwa luze luminxeke.
• Ngexesha lotyando olukhulu: Ngexesha lotyando olukhulu, uya kuba phantsi kwe-anesthesia kwaye awuyi kukwazi ukuphefumla wedwa. Ngelo xesha, le tube iya kusetyenziselwa ukukunceda uphefumle de utyando luphele.
• Ukungaphumeleli kokuphefumla okanye ukuyeka ukuphefumla okwethutyana (i-Apnea):Kwiimeko zosulelo olukhulu lwemiphunga olufana ne-pneumonia okanye ukuqhubela phambili kwesifo sesifuba, imiphunga ayikwazi ukusebenza kakuhle. Nangona kunjalo, inkxaso iyadingeka ngale ndlela.
• Ingozi yezinto ezinje ngokutya, ukuhlanza, okanye igazi elingena kwindlela yomoya ukurhawuzelelwa : Ukuba umntu akazi nto, izinto zinokungena emiphungeni xa ehlanza. Oko kuyingozi kakhulu. Le tube inceda ekuthinteleni oko.

Ngaba ukufaka ityhubhu uze uyidibanise nesixhobo somoya yinto efanayo?

Ezi zimbini zihlobene, kodwa azifani ncam.

Ukufakwa kwetyhubhu, njengoko besitshilo ngaphambili, kubhekisa kwinkqubo yokufaka ityhubhu (ityhubhu ye-Endotracheal - ETT) kwi-trachea.

Emva koko, ngale tube, uqhagamshelwe kwisixhobo sokuphefumla. Ngamanye amaxesha le inokuba yibhegi ecinezelwa ngugqirha aze avuthele umoya kuyo (usenokuba uyibonile kwiimuvi). Okanye, uqhagamshelwe kumatshini obizwa ngokuba yi-'Ventilator' . Lo matshini yiwo othumela ioksijini nomoya emiphungeni ngendlela elawulwayo.

Nangona kunjalo, ngamanye amaxesha i-ventilator inika umoya ngemaski egquma umlomo nempumlo. Emva koko ityhubhu ayifakwa. Yinto eyahlukileyo leyo.

Ngubani ongenakufakwa umbhobho ngolu hlobo? (Iimeko ezingachanekanga)

Nangona oku kungenziwa ngokukhuselekileyo kwiimeko ezininzi, kukho amaxesha apho oogqirha bagqiba kwelokuba akukhuselekanga ukufaka ityhubhu ngale ndlela. Umzekelo:

• Ukuba indlela yomoya yonakele kakhulu.
• Ukuba kukho isithintelo esikhulu kwi-trachea esithintela ukuba ityhubhu ingangeniswa.

Khawucinge nje, ukuba bekukho ingozi enkulu entanyeni kwaye i-trachea inqunyulwe, ukuzama ukufaka ityhubhu kuyo kunokubangela umonakalo ongakumbi, akunjalo?

Kwiimeko ezinjalo, oogqirha basebenzisa indlela eyahlukileyo. Oko kukuthi, benza umngxuma omncinci kwinxalenye esezantsi yentamo, ngqo kwi-windpipe, baze baphefumle ngayo. Oku kubizwa ngokuba yi -'tracheostomy' . Le 'tracheostomy' ikwayimfuneko xa ityhubhu kufuneka ishiywe endaweni yayo kangangeentsuku ezimbalwa, ngamanye amaxesha kwaneeveki. Oku kungenxa yokuba ukufakwa kwetyhubhu ngomlomo okanye empumlweni ixesha elide kunokubangela ezinye iingxaki.

Isebenza njani le nkqubo yokubeka ityhubhu?

Oku kudla ngokwenziwa esibhedlele. Kwimeko engxamisekileyo, oku kungenziwa ngaphambi kokuba inkonzo ye-ambulensi ikuse esibhedlele. Nangona kunjalo, oku kwenziwa ngoogqirha abaqeqeshiweyo kunye nabasebenzi bezempilo.

Nantsi into edla ngokwenzeka:

1. Ukulungiselela: Okokuqala, kufakwa inaliti encinci (njengenaliti ye-IV) emthanjeni osengalweni yakho kwaye amayeza afunekayo anikwa ngayo. Le yindlela enikwa ngayo i-anesthesia ukuze ulale kwaye ungeva ntlungu.

2. Ukunika ioksijini eyongezelelweyo:Okulandelayo, kubekwa imaski yeoksijini phezu komlomo wakho nempumlo ukuze kufumaneke ioksijini encinci emzimbeni wakho. Oku kwenzelwa ukuthintela ukuphelelwa yioksijini ngexesha elifutshane umbhobho ukhona.

3. Ukufakwa kwesixhobo: Emva koko imaski yeoksijini iyasuswa, intloko yakho itsalwe kancinci, kwaye isixhobo esikhethekileyo esibizwa ngokuba yi-laryngoscope sifakwa emlonyeni wakho (ngamanye amaxesha ngempumlo yakho). Sinokukhanya okuncinci kunye nenxalenye efana nesipili. Oku kuvumela ugqirha ukuba abone kakuhle umbhobho womoya aze afake umbhobho.

4. Ukwenza i-trachea ibonakale: Esi sixhobo sisuswa kancinci ukusuka ngaphakathi emlonyeni ukuya ngasemva, kwaye ngaphandle kokuchukumisa amazinyo, inxalenye yomqala ebizwa ngokuba yi-epiglottis (oku kufana nesiciko esincinci esivala i-trachea xa siginya ukutya) iyaphakanyiswa, okwenza umlomo we-trachea ubonakale ngokucacileyo.

5. Ukufakwa kwetyhubhu: Okulandelayo, incam ye-laryngoscope idluliselwa emlonyeni we-trachea iye kwi-trachea, kwaye ityhubhu yokuphefumla (ityhubhu ye-endotracheal) ifakwe ecaleni kwayo.

6. Ukuzinzisa ityhubhu: Emva kokuba ityhubhu ifakiwe, inxalenye encinci efana nebhaluni ejikeleze yona iyavuthelwa ukuze ibe nkulu. Ngale ndlela, ityhubhu ihlala kwi-trachea ingashukumi, kwaye wonke umoya ophefumlayo ungena emiphungeni kwaye awuphumi.

7. Ukususa nokubopha isixhobo: Emva koko i-laryngoscope iyasuswa kwaye ityhubhu ibotshelelwe ecaleni lomlomo ngeplasta okanye ngebhanti yentloko ukuthintela ukuba ingashukumi.

8. Ukujonga indawo eyiyo: Okokugqibela, ityhubhu iyajongwa ukuze kubonwe ukuba ikwi-trachea okanye iye kwenye indawo. Oku kungenziwa nge -X-ray yesifuba, okanye ngokuncamathisela ibhegi kwityhubhu uze uyifutha ngomoya, kwaye umamele isifuba nge-stethoscope ukuze kubonwe ukuba kukho na isandi sokuphefumla.

Konke oku kuya kuthatha imizuzu embalwa kuphela, kodwa kufuneka kwenziwe ngononophelo olukhulu nangokukhawuleza.

Ungathetha utye ngelixa unetyhubhu endaweni yayo?

Le yingxaki kubantu abaninzi.

• Awunakuthetha: Ngenxa yokuba ityhubhu ingena phakathi kweentambo zakho zelizwi (inxalenye engcangcazelayo xa uthetha), awukwazi ukuthetha ngelixa unetyhubhu endaweni yayo.
• Awunakutya okanye usele: Kwakhona, awukwazi ukuginya ngelixa unetyhubhu endaweni yayo. Ngoko ke awunakutya okanye usele.

Usenokuzibuza, "Uza kukubonelela njani ngokutya ke?"

Ngokwesiqhelo, kuxhomekeke ekubeni uza kuhlala ixesha elingakanani kule tube, oogqirha baya kukunika izondlo ozifunayo nokuba nge-saline (`IV fluids`) okanye njengolwelo nge-tube ebhityileyo eyahlukileyo efakwa ngomlomo okanye empumlweni esiswini sakho.

Uyisusa njani ityhubhu? (Extubation)

Xa oogqirha begqiba kwelokuba ungaphefumla kakuhle wedwa kwaye awusayidingi le tube, bayayisusa. Oku kubizwa ngokuba yi- "Extubation ." Le yinkqubo elula kakhulu.

Nantsi indlela yokwenza oku:

1. Okokuqala, susa iplasta okanye iteyiphu ebambe ityhubhu endaweni yayo.

2. Emva koko, i-mucus engeyomfuneko kunye nezinye izinto ezikwindlela yokuphefumla zisuswa ngetyhubhu encinci (i-suction).

3. Ibhaluni encinci eyayivuthelwe umoya ukuze ithintele ityhubhu ukuba ingabambeki ngaphakathi kwi-trachea iyaphuma.

4. Emva koko, ugqirha uza kukuxelela ukuba uphefumle nzulu , ukhohlele kakhulu, uze ubambe umphefumlo wakho. Ngelo xesha, baza kuyikhupha kancinci ityhubhu.

Emva kokuba ityhubhu isusiwe, umqala wakho unokuba buhlungu kangangeentsuku ezimbalwa. Usenokuziva ungakhululekanga xa uthetha. Kodwa oko kuya kuphela kwiintsuku ezimbalwa.

Ngaba kukho naziphi na iingozi koku? (Iingozi zokufunxa)

Ukufakwa kwetyhubhu yindlela eqhelekileyo, ekhuselekileyo kakhulu, kwaye enokusindisa ubomi. Uninzi lwabantu luyaphila kwiiyure okanye iintsuku ezimbalwa. Nangona kunjalo, kukho iingxaki ezithile ezinokwenzeka rhoqo:

• Ukuphefumla: Xa ityhubhu ifakwa okanye ishiywe endaweni yayo, ngamanye amaxesha izinto ezifana nokugabha kunye negazi zinokungena emiphungeni.
• Umbhobho uhamba kwindawo engalunganga:
• Ukufakwa kwe-Endobronchial: Ngamanye amaxesha ityhubhu inokungena kuphela kwenye yeendlela ezimbini eziphambili zomoya ezisuka kwi-trachea ziye emiphungeni (ekwabizwa ngokuba yi-mainstem intubation). Emva koko ngumphunga omnye kuphela ophefumlayo.
• Ukufakwa kwetyhubhu yomlomo: Ukuba ityhubhu ingena kumbhobho wokutya, umqala, endaweni yombhobho womoya , inokubangela umonakalo engqondweni kunye nokufa ukuba ayibonwa ngokukhawuleza. Kodwa oogqirha balumkile kakhulu ngale nto.
• Ukungaphumeleli ukuqinisa indlela yokungena komoya: Ngamanye amaxesha imizamo yokufaka ityhubhu isenokungaphumeleli, nto leyo eyenza kube nzima ukunyanga isigulana.
• Iintsholongwane: Abantu abaneetyhubhu ngamanye amaxesha banokufumana izinto ezifana nosulelo lwe-sinus.
• Ukwenzakala: Xa kufakwa ityhubhu, kunokwenzeka ukwenzakala okuncinci emlonyeni, emazinyweni, elulwimini, kwiintambo zelizwi, okanye kwindlela yomoya. Oku kunokubangela ukopha nokudumba.
• Iingxaki nge-anesthesia: Nangona uninzi lwabantu luchacha kakuhle emva kwe-anesthesia, abanye banokuchacha kade okanye ezinye iimeko ezingxamisekileyo.
• I-Tension pneumothorax: Imeko apho umoya uvaleleke ngaphakathi kwesifuba, nto leyo ebangela ukuba imiphunga idilike.

Nangona ezi ngozi zikhona, zincinci kakhulu xa zithelekiswa neenzuzo zokufakwa kwetyhubhu, ingakumbi kwimeko yokusindisa ubomi.

Okokugqibela, izinto ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Ndiyathemba ukuba ngoku uyiqonda kakuhle i- Endotracheal intubation , okanye i-endotracheal intubation. Le yinkqubo yezonyango ebaluleke kakhulu eyenziwayo ukusindisa ubomi bomntu xa engakwazi ukuphefumla yedwa.

Le tube igcina umbhobho womoya uvulekile kwaye ivumela ioksijini ukuba ingene emiphungeni.

Oku kudla ngokwenziwa esibhedlele, xa kukho imeko engxamisekileyo, okanye ngaphambi kotyando olukhulu. Nangona kunokubonakala ngathi kuyoyikisa kancinci, kwenzelwa ukukunceda uphile. Kholosa ukuba ugqirha wakho uya kuhlala ekwenza okona kulungileyo kuwe. Ukuba unemibuzo okanye iinkxalabo, ungoyiki ukubuza ugqirha wakho okanye umongikazi.

ukufakwa kwetyhubhu , i-trachea, ukufakwa kwetyhubhu, umoya ophefumlayo, ukuphefumla, utyando, unyango olungxamisekileyo