Ngaba wakha watyelela umntu okwiyunithi yokhathalelo olunzulu (ICU)? Okanye wakha wacelwa ngugqirha ukuba akuchazele ngenkqubo yokuphefumla ngelixa ulungiselela utyando? Enye yezinto ozivayo ngamaxesha anjalo kukuba bafaka "ityhubhu yokuphefumla." Ngoko ke, njengokufaka le tyhubhu, ukuyisusa kukwayindlela ebaluleke kakhulu necwangcisiweyo. Kwizonyango, ukususa loo tyhubhu yinto esiyibiza ngokuba yi "extubation." Namhlanje, masithethe ngale nto ngokulula, ngendlela onokuyiqonda.
Okokuqala, masibone ukuba yintoni i-intubation?
Ngaphambi kokuba sithethe nge-extubation, makhe sihlolisise ngokufutshane i-intubation. Ngamafutshane, le yinto eyenziwa liqela lezonyango ukusindisa ubomi bakho xa unengxaki yokuphefumla wedwa ngesizathu esithile. Bafaka ityhubhu yeplastiki eguquguqukayo, ebizwa ngokuba yi-endotracheal tube (ETT) , ngomlomo wakho iye kwi-windpipe yakho (umoya ophambili).
Cinga ngale ndlela: imiphunga yethu ifana nenjini yemoto. Ifuna umoya ohlala uhleli (ioksijini) ukuze isebenze. Kanye njengokuba imoto ingashukumi ukuba kukho ukuxinana kwezithuthi, ukuba indlela yakho yomoya ivaliwe okanye ukuphefumla kwakho kubuthathaka, ioksijini ayizukufikelela emiphungeni yakho. Ngelo xesha, le tube ifakwa, kwaye umatshini, i-ventilator, uqhagamshelwe kuyo, kwaye unikwa ubungakanani beoksijini oyifunayo. Oku kubizwa ngokuba yi-intubation.
Ngoku mhlawumbi uyaqonda ukuba yintoni i-extubation . Oko kukuthi, inkqubo yokususa ngononophelo ityhubhu ebikhona emva kokuba iqela lezonyango liqinisekile ukuba ungaphefumla kakuhle wedwa kwakhona, ngaphandle koncedo.
Kukweziphi iimeko apho kwenziwa khona i-extubation?
Oku akwenzeki kuwo wonke umntu ngaxeshanye okanye ngendlela efanayo. Kuxhomekeke kwisizathu sokuba ufakwe kwityhubhu kunye nokuba impilo yakho izinzile kangakanani.
Emva kotyando
Xa utyando olukhulu, ulala ngokupheleleyo. Silubiza ngokuba yi -anesthesia eqhelekileyo . La mayeza okubulala iintlungu ayenzakalisa okwethutyana imisipha elawula ukuphefumla kwakho. Ngelo xesha, oogqirha bafaka le tube yokuphefumla ukuqinisekisa ukuba ufumana ioksijini eyaneleyo kulo lonke utyando.
Emva kokuba utyando lugqityiwe ngempumelelo, iqela lezonyango liza kuyisusa ityhubhu ngokukhawuleza nje ukuba iziphumo ze-anesthetic ziphele kwaye ukwazi ukuphefumla ngokwakho kwakhona. Kwiimeko ezininzi, ityhubhu iya kuba isusiwe ngexesha lokubuyela kwengqondo. Ngoko usenokungayikhumbuli. Kwimeko enjalo, ityhubhu isenokuba ibikho ixesha elifutshane njengeyure okanye ezimbini.
Ngenxa yokugula okanye ingozi
Xa umntu efakwe ityhubhu kuba engakwazi ukuphefumla ngenxa yengozi, usulelo olunzima (njenge-pneumonia), okanye esinye isifo esinzima, inkqubo yokukhupha ityhubhu yahlukile kancinci. Lo mntu uhlala ekwiyunithi yokhathalelo oluphezulu (ICU).
Ngaphambi kokuba ukhuphe ityhubhu, oogqirha kufuneka baqinisekise ukuba uyakwazi ukuphefumla wedwa. Baza kwenza uvavanyo olukhethekileyo loku. Lubizwa ngokuba yiSpontaneous Breathing Test (SBT) .
Ngamafutshane, oku kufana noqeqesho oluncinci. Ugqirha uya kunciphisa kancinci inkxaso evela kwi-ventilator aze akuvavanye imizuzu embalwa ukuze abone ukuba unokuphefumla kakuhle kangakanani wedwa. Amanqanaba akho eoksijini, izinga lokubetha kwentliziyo, kunye nezinga lokuphefumla kuya kuhlolwa ngokusondeleyo ngeli xesha. Kuphela xa uphumelele olu vavanyo apho ugqirha uya kugqiba ekubeni asuse ityhubhu.
Ngamanye amaxesha usenokungaluphumeleli olu vavanyo okokuqala. Oku kubizwa ngokuba "kukusilela kokulumla." Oku kuqhelekile. Ukuba oku kuyenzeka, ugqirha uya kulinda ude uphile kakuhle aze aphinde enze olu vavanyo kwakhona emva kosuku olunye okanye ezimbini.
Ziziphi izizathu eziphambili zokufakwa kwetyhubhu?
Ukuze kwenziwe i-extubation, kufuneka kuqala kwenziwe i-intubation. Nazi ezinye zezizathu eziqhelekileyo zale nto. Masizibeke ezi zinto kwitheyibhile efana nale ukuze siziqonde kakuhle.
| Isizathu sokufunxa | Ngamagama alula... |
|---|---|
| Ukuvalwa kwendlela yomoya | Ukuvaleka ngokupheleleyo kwendlela yomoya ngenxa yesizathu esifana nokunamathela kokutya emlonyeni okanye i-allergy enzima. |
| Ukubanjwa kwe-cardiac | Kuba xa intliziyo iyeka ngequbuliso, kubalulekile ukubonelela ngeoksijini engqondweni nasemzimbeni. |
| Ukonzakala Okukhulu | Ukonakala kwendlela yomoya okanye ukungakwazi ukuphefumla ngenxa yokwenzakala okukhulu entanyeni, esifubeni, okanye esiswini. |
| Ukulahlekelwa yingqondo | Kwiimeko ezinzima zokungazi nto, ulwimi kufuneka lubuyiselwe umva ukuze kuthintelwe ukuvaleka kwendlela yomoya nokulawula ukuphefumla. |
| Utyando | Ukulawula ngokupheleleyo ukuphefumla ngelixa uphantsi kwe-anesthesia. |
| Ukungaphumeleli kokuphefumla | Ngenxa yesifo esibi esifana ne-pneumonia, imiphunga ayikwazi ukufumana umlinganiselo weoksijini ofunekayo ngumzimba ngokwayo. |
| Umngcipheko Wokuphefumla | Ukuthintela izinto ezisesiswini (ukutya, ukuhlanza, igazi) zomntu ongazi nto ukuba zingangeni emiphungeni. |
Ngawaphi amanyathelo abandakanyekayo kwinkqubo yokukhupha izicubu zomzimba?
Kulungile, ngoku makhe sibone ukuba ugqirha okanye umongikazi oqeqeshiweyo angawususa njani lo mbhobho. Le ayisiyonto inokutsalwa yonke ngaxeshanye. Kukho amanyathelo ambalwa okuya kuyo.
1. Ukulungiselela isigulana: Okokuqala, intloko yebhedi iya kuphakanyiswa phezulu. Uza kuziswa kwindawo yokuhlala. Oku kuya kunceda umoya ungene emiphungeni kwaye kunciphise umngcipheko wezinto ezifana namathe angene emiphungeni emva kokuba ityhubhu isusiwe.
2. Ukufunxa: Okulandelayo, kusetyenziswa isixhobo esikhethekileyo (isixhobo sokufunxa) ukususa yonke i-mucus, amathe, kunye nezinye izinto ezingafunekiyo emlonyeni wakho, emqaleni, nakwityhubhu yokuphefumla. Oku kubaluleke kakhulu, kuba kungenjalo, ezi zinto zinokungena emiphungeni yakho xa ityhubhu isusiwe.
3. Ukukhulula ityhubhu: Intambo okanye iteyipu ebamba ityhubhu ebusweni bakho isuswa ngononophelo.
4. Ukwahlulwa kwi-ventilator: Ityhubhu isusiwe kwi-ventilator eqhagamshelwe kuyo.
5. Ukususa ityhubhu: Eyona nto ibalulekileyo ngoku. Ugqirha ukuxelela ukuba "phefumla nzulu uze ukhohlele."Njengoko ukhohlela okanye ukhupha umoya, bayawukhupha umbhobho ngokukhawuleza nangokuthe tye. Benza oku xa ukhohlela, nto leyo evula imibhobho yakho yelizwi, ivumela umbhobho ukuba uphume lula. Kwaye ukukhohlela kukwakhupha nantoni na esemqaleni wakho.
Ngaba uziva uphaphile xa ityhubhu isuswa?
Lo ngumbuzo abantu abaninzi abanawo. Impendulo ithi, ngamanye amaxesha ewe, ngamanye amaxesha hayi.
- Emva kotyando: Ityhubhu idla ngokususwa ngaphambi kokuba ubuyele ezingqondweni, ngelixa usephantsi kwe-anesthesia. Ngoko ke ikhutshwa xa uvuka.
- Ukuba ukwiyunithi yokhathalelo oluphezulu (ICU): Ityhubhu iya kususwa ngelixa usesengqondweni, njengoko kubalulekile ukuba uhlale usengqondweni kwaye umamele oko ukuxelelwayo (umzekelo, ukukhwehlela xa uxelelwa ukuba "khwehlela").
Kwenzeka ntoni emva kokukhupha isisu?
Ukususa ityhubhu akuthethi ukuba umsebenzi ugqityiwe. Iiyure ezimbalwa ezilandelayo zibaluleke kakhulu. Iqela lezonyango liza kukubeka esweni ngokusondeleyo.
- Ioksijini: Rhoqo, emva kokuba ityhubhu isusiwe, uya kunikwa ioksijini encinci nge-cannula yempumlo okanye imaski yeoksijini ukunceda umzimba wakho uqhelane nemeko entsha.
- Ukubeka esweni: Inqanaba le-oksijini egazini lakho (elisebenzisa i-pulse oximeter), izinga lokubetha kwentliziyo, kunye noxinzelelo lwegazi zihlala zijongwa.
- Ukukhwehlela: I-mucus isenokuqokelelana emqaleni wakho ngenxa yombhobho. Ngoko ke, uya kucetyiswa ukuba ukhwehlele rhoqo ukuze uyisuse. Ukuba kuyimfuneko, ungadinga ukufunxa kwakhona ukuze usule umqala wakho.
Ngaba kukho naziphi na iingxaki ezinokwenzeka ngexesha lokukhupha isisu?
Njengakwezinye iinkqubo zonyango, kukho iingozi ezincinci ezibandakanyekayo ekukhutshweni kwetyhubhu. Kodwa khumbula, iqela lezonyango likulungele konke oku.
| Ingxaki | Kwenzeka ntoni ngale nto? |
|---|---|
| Ukungaphumeleli kokukhupha ityhubhu | Emva kokuba ityhubhu isusiwe, isigulane asisakwazi ukuphefumla ngokwaso njengoko bekulindelwe. Ukuba oku kuyenzeka, ityhubhu kufuneka ibuyiselwe ukuze kukhuseleke isigulane (ukufakwa kwakhona kwetyhubhu).Kuyenzeka. Oku kunokwenzeka kubantu abayi-10%-15%. Umngcipheko uphezulu kancinci kubantu abangaphezu kweminyaka engama-65 ubudala kunye nabo banesifo sentliziyo okanye sokuphefumla. |
| Ukuphefumla okunomsindo (iStridor) | Le tube inokubangela ukudumba okuncinci kwindlela yomoya ephezulu, ingakumbi ejikeleze iintambo zelizwi. Oku kunokubangela isandi esirhabaxa nesivakala phezulu xa uphefumla emva kokuba ityhubhu isusiwe. Oku kunokulawulwa ngamayeza. |
| Ukonakala kwimisonto yelizwi | Kunqabile kakhulu ukuba kubekho umonakalo omncinci kwiintambo zelizwi xa kufakwa okanye kususwa umbhobho. Oku kunokubangela utshintsho kwilizwi (ukurhawuzelela) okwethutyana. |
| Ukukhohlela kakhulu kunye nokuxinana komoya (i-laryngospasm) | Abanye abantu banokufumana ukuqina ngequbuliso kwemithambo yelizwi ngenxa yokuva umqala xa ityhubhu isusiwe. Oku kuya kubuyela esiqhelweni kwimizuzwana embalwa. |
Ziziphi iingenelo zokukhupha i-extubation?
Le yinto entle kakhulu. Ukuphefumla umntu kuthetha ukuba udlule kwinqanaba elibalulekileyo kuhambo lwakhe lokuchacha.
- Uphawu lokuchacha: Eyona nzuzo inkulu kukuba ungaphefumla wedwa kwakhona. Oko kuthetha ukuba imiphunga yakho nomzimba wakho zibuyela esiqhelweni.
- Ubuchule bokuthetha: Awunakuthetha ngelixa ityhubhu ikwindawo yayo. Emva kokuba isusiwe, uya kukwazi ukuthetha kwakhona ngexesha elifutshane. Nangona umqala wakho usenokuba buhlungu ekuqaleni kwaye ilizwi lakho lisenokutshintsha kancinci, oku kuya kuphela kwiintsuku ezimbalwa. (Kuya kuphela kwiintsuku ezimbalwa).
- Ubuchule bokutya nokusela: Ngokufanayo, awunakutya okanye usele ngomlomo ngelixa ityhubhu ikwindawo yayo. Nje ukuba ityhubhu isusiwe kwaye amandla akho okuginya (gag reflex) aqinisekisiwe, ungaqala ukutya kwakhona.
- Ukuphepha iingozi zexesha elide: Kukho iingozi ezithile ezinxulumene nokuba nombhobho wokuphefumla ixesha elide (umz., ukungasebenzi kakuhle kwelizwi, i-pneumonia, i-tracheomalacia ). Ukukhupha i-extubation kuthetha ukuba ukhululekile kwezo ngozi.
Ukuba wena okanye umntu kusapho lwakho kufuneka adlule kule nkqubo, ungoyiki okanye ungathandabuzi. Buza ugqirha wakho nayiphi na imibuzo okanye iinkxalabo onokuba nazo. Baza kukuchazela yonke into.
Umyalezo Wokuya Ekhaya
- Ukukhupha i-extubation yinkqubo yokususa i-endotracheal tube (ETT) efakwa kwi-trachea yakho emva kokuba ukwazi ukuphefumla kakuhle wedwa.
- Oku akuyonto eyenziwa ngaxeshanye. Yinto eza kwenziwa liqela lezonyango emva kokuyihlola ngononophelo imeko yakho kunye nocwangciso lwakho.
- Kuqhelekile ukuba nomphimbo obuhlungu kunye nokurhawuzelela kwelizwi lakho kangangeentsuku ezimbalwa emva kokuba ityhubhu isusiwe.
- Nangona ngamanye amaxesha kunokuvela iingxaki (ezifana nokungaphumeleli kokukhupha ityhubhu), iqela lezonyango lihlala likulungele ukujongana nazo.
- Ukukhupha i-extubation kuthetha ukuba uthathe inyathelo elikhulu nelibalulekileyo kuhambo lwakho lokuchacha. Yinto ekufuneka uyivuyele leyo!
- Ukuba unenkxalabo malunga nenkqubo yezonyango kuwe okanye kumntu omthandayo, thetha ngayo rhoqo nogqirha wakho.
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