Ungathanda ukwazi nge-intubation, enokukunceda ukuba unengxaki yokuphefumla?

Ngaba wakha wazibuza ukuba singazinceda njani ukuba siphefumle ukuba ngequbuliso siyeka ukuphefumla, okanye ukuba senza utyando olukhulu? Kulapho oogqirha basebenzise khona inkqubo ebizwa ngokuba yi-"Intubation." Nangona eli ligama eloyikisayo, linceda ekusindiseni ubomi babantu abaninzi. Makhe sibone ukuba yintoni, yenziwa njani, kwaye kutheni yenziwa ngokulula.

Kuthetha ukuthini nje ukuthi `(Intubation)`?

Ngamafutshane, `(Intubation)` (intubation) kuxa ugqirha efaka ityhubhu encinci kumbhobho wakho womoya (`(trachea)`) nokuba ngomlomo wakho okanye ngamanye amaxesha ngempumlo yakho. Le tyhubhu igcina umbhobho wakho womoya uvulekile, ukuze umoya ungene lula. Le tyhubhu inokudityaniswa nomatshini. Lo matshini uthumela ioksijini okanye umoya phantsi koxinzelelo emiphungeni yakho. Oku sikubiza ngokuba yi`(Mechanical Ventilation)`.

Le ``(Intubation)`` inamanye amagama:

• Ukufakwa komoya
• Ukufakwa kwe-Endotracheal intubation (ETT)
• Ukufunxwa kwe-trachea

La magama onke athetha into enye.

Kutheni kufuneka wenze oku `(Intubation)`?

Ugqirha usenokufuna ukukufaka ityhubhu ukuba awukwazi ukuphefumla kakuhle ngenxa yokuvaleka, ukuvaleka, okanye ukwenzakala kwindlela yakho yomoya. Khawuthelekelele, ngequbuliso, ufumana ingozi enkulu kwaye isifuba nentamo yakho zonzakele, nto leyo eyenza kube nzima ukuphefumla. Okanye, ukuba ulahlekelwa zingqondo, awuyi kukwazi ukulawula ukuphefumla kwakho. Kulapho ke oku kufuneka khona.

Kukho ezinye izizathu ezininzi zokwenza `(Intubation)`:

• Ukuba indlela yakho yomoya ichatshazelwe kukwenzakala esiswini, esifubeni, okanye entanyeni.
• Ukulahlekelwa zingqondo (njengokuquleka) okanye izinga lokungabi nangqondo liphantsi. Oku kunokubangela ukuba uphulukane nolawulo lokuphefumla kwakho.
• Ukuba kufuneka wenze utyando olukhulu apho ungakwaziyo ukuphefumla wedwa. Ngokwesiqhelo, xa sinikwa i-anesthesia, kuba nzima kuthi ukuphefumla wedwa.
• Ukungasebenzi kakuhle kokuphefumla. Oku kuthetha ukuba imiphunga yakho ayisebenzi kakuhle.
• Kukho umngcipheko wokuba izinto ezinje ngokutya, ukuhlanza, kunye negazi zifuthwe zingene emiphungeni (Aspiration) .
• Ukuba into ibambeka kwindlela yomoya ize ithintele umoya ukuba ungaphumi, ibizwa ngokuba yi-``Airway obstruction``.
• Ukubanjwa kwentliziyo kwenzeka xa intliziyo iyeka ukusebenza ngequbuliso.
• Ukuba ukuphefumla kuyeka okwethutyana (i-Apnea).

Ukufakwa kwetyhubhu kungafuneka ngenxa yezi zizathu.

Kuqheleke kangakanani oku?

Enyanisweni, "(Intubation)" yinkqubo eqhelekileyo kakhulu, esindisa ubomi. E-United States kuphela, malunga nezigidi ezili-15 zezi nkqubo zenziwa kumagumbi otyando minyaka le. Ukongeza, amakhulu amawaka azo zenziwa kwiimeko ezingxamisekileyo. Ngoko unokucinga ukuba oku kwenziwa kangaphi. Kwenziwa rhoqo eSri Lanka.

Kwenzeka ntoni ngokwenene xa kusenziwa i-Endotracheal Intubation?

Uninzi lwexesha, olu `(Intubation)` lwenziwa ngaphakathi esibhedlele. Nangona kunjalo, ngamanye amaxesha, abasebenzi beenkonzo zonyango ezingxamisekileyo (`(EMS)`) balwenza ngaphandle kwesibhedlele.

Nantsi indlela oku kwenziwa ngayo rhoqo:

1. Okokuqala, kufakwa inaliti encinci (inaliti ye-IV) emthanjeni osengalweni yakho kwaye kunikwa isithomalalisi sokudambisa iintlungu ngayo ukuze ulale kwaye ungabi nantlungu.

2. Emva koko kuya kubekwa imaski yeoksijini phezu kwempumlo yakho nomlomo wakho ukuze kufumaneke ioksijini eyongezelelweyo emzimbeni wakho.

3. Intloko yakho iya kujika kancinci kwaye isixhobo esibizwa ngokuba yi-"laryngoscope" siya kufakwa emlonyeni wakho (kwaye ngamanye amaxesha singene empumlweni yakho ukuba kuyimfuneko). I-"laryngoscope" inesiphatho, ukukhanya, kunye nencakuba ecacileyo. Oku kunceda ugqirha ukuba abone indawo efanelekileyo ye-"tracheal tube".

4. Okulandelayo, i-``(laryngoscope)`` ithathwa ngaphakathi emlonyeni iye ngasemva, ilumke ingabetheki emazinyweni.

5. I-flap yethishu (i-epiglottis) exhonywe ngasemva komlomo wakho iyaphakama ukuze ikhusele ibhokisi yakho yelizwi (i-larynx).

6. Incam ye-`(Laryngoscope)` idluliselwa kwi-`(Larynx)` yakho iye kwi-`(Trachea)` yakho (umphimbo womoya).

7. Emva koko, isixhobo esincinci esifana nebhaluni siyafuthwa sijikeleze ityhubhu ye-endotracheal. Oku kuqinisekisa ukuba ityhubhu ayishukumi kwi-trachea, kwaye wonke umoya okhutshwa yityhubhu uya ngqo emiphungeni.

8. Ngoku susa i-`(Laryngoscope)`.

9. Ukuthintela ukuba umbhobho wokuphefumla ungahambi usiya phambili nangasemva, kufakwa iplasta kumacala omabini omlomo okanye kufakwe ibhande elijikeleze intloko.

10. Okokugqibela, kuthathwa i-X-ray ukujonga ukuba ityhubhu ikwindawo eyiyo na, okanye ibhegi isetyenziselwa ukupompa umoya kwityhubhu nokumamela izandi ezivela emiphungeni.

Kuza kuthatha ixesha elingakanani oku?

Kwimeko engxamisekileyo, ugqirha angenza le "(Intubation)" ngaphantsi komzuzu omnye. Le yinto enokwenziwa ngokukhawuleza.

Ndingathetha, nditye, ndize ndisele ngelixa ityhubhu ikwindawo yayo?

Hayi. Awukwazi ukuthetha. Kuba le mbhobho yokuphefumla idlula kwiintambo zakho zelizwi. Ngoko ke nokuba uzama ukuthetha, akukho sandi siphumayo.

Kwakhona, awukwazi ukuginya ngelixa ityhubhu ikwindawo yayo. Ngoko ke awukwazi ukutya okanye ukusela. Ngokuxhomekeke ekubeni kufuneka uhlale ixesha elingakanani ngolu hlobo, oogqirha baya kukunika isondlo sokutya (isondlo se-intravenous) okanye i-saline (i-IV fluids). Ngamanye amaxesha ityhubhu eyahlukileyo encinci inokufakwa ngomlomo okanye empumlweni ukuze ikunike isondlo esiswini sakho okanye emathunjini amancinci.

Uyisusa njani ityhubhu? (Yintoni ``(Extubation)``?)

Xa oogqirha bebona ukuba kukhuselekile ukususa ityhubhu, baya kuyisusa. Oku kubizwa ngokuba yi-"Extubation". Nantsi indlela eyenziwa ngayo:

• Iplasta okanye iteyipu ebibambe ityhubhu endaweni yayo iyasuswa.
• Isixhobo sokufunxa sisusa i-mucus kunye nezinye izinto ezimdaka kwimigudu yakho yomoya.
• Ibhaluni evuvukele ngaphakathi kwi-windpipe iyathotywa.
• Emva koko uxelelwa ukuba uphefumle nzulu uze ukhohlele okanye ukhuphe umoya njengoko bekhupha umbhobho.

Umqala wakho (`(Pharynx)`) usenokuba buhlungu kancinci kangangeentsuku ezimbalwa emva kwe`(Extubation)`. Kusenokuba nzima nokuthetha. Oku kuqhelekile, ungakhathazeki.

Zithini iingenelo zokufakelwa ityhubhu?

Ukufakwa kwetyhubhu yindlela eqhelekileyo, ekhuselekileyo ngokubanzi enokukunceda usindise ubomi bakho.

Eyona nzuzo inkulu yoku kukuba inokusindisa ubomi bomntu onengxaki yokuphefumla. Ngoko ke, xa kuthelekiswa nezinye iingozi ezincinci, le yinto exabisekileyo kakhulu.

Zithini amathuba okusinda ukuba kufakwe ityhubhu?

Oku kuyahluka ngokwenene kumntu nomntu. Kuxhomekeke kwizinto ezininzi, njengesizathu sokufunxwa, ubudala bakho, impilo yakho ngokubanzi, njl. Kodwa olunye uphando lufumanise ukuba malunga nabantu abasixhenxe kwabalishumi abafunxwa kwigumbi likaxakeka bayasinda . Oko kubonisa ukuba oko kusindisa ubomi kangakanani.

Zithini iingozi zokufakwa kwetyhubhu?

Nangona ukufunxa ngetyhubhu kukhuselekile ngokubanzi, kukho iingozi ezithile. Kodwa khumbula, ukusindisa ubomi kubaluleke ngaphezu kwezi ngozi.

• Ukuphefumla : Ngexesha lokufaka umbhobho, ukuhlanza, igazi, okanye olunye ulwelo lunokungena emiphungeni.
• Ukufakwa kwe-Endobronchial intubation: Ityhubhu efakwe kwi-windpipe (trachea) kwenye yeendlela ezimbini eziphambili zomoya (i-bronchi) ezisuka kwi-windpipe ziye emiphungeni.
• Ukufakwa kwetyhubhu yomlomo: Ukuba ityhubhu yokuphefumla ingena kumbhobho wokutya (umlomo womlomo) endaweni yombhobho womoya (umlomo womlomo), inokubangela umonakalo engqondweni okanye nokufa ukuba ayinyangwa ngokukhawuleza ngugqirha.
• Ukungaphumeleli ukuqinisa indlela yokungena komoya: Ukuba ukufakelwa kwetyhubhu akukwazi ukwenziwa ngokufanelekileyo, oogqirha basenokungakwazi ukukunyanga.
• Iintsholongwane: Iintsholongwane ezinje ngeentsholongwane ze-sinus, zinokuvela emva kokufakwa kwetyhubhu.
• Ukulimala: Ukufunxa ityhubhu kunokubangela ukwenzakala emlonyeni, emazinyweni, elulwimini, kwiintambo zelizwi, okanye kwindlela yomoya. Ezi nzakala zinokubangela ukopha nokudumba.
• Iingxaki xa uphuma kwi-anesthesia: Uninzi lwabantu luyaphola kakuhle emva kwe-anesthesia. Nangona kunjalo, abanye banokuba nobunzima bokuvuka, okanye banokufumana ezinye iingxaki ezifana nomkhuhlane, ukuxhuzula kwemisipha (i-hyperthermia embi), okanye umonakalo wexeshana okanye osisigxina wemithambo-luvo.
• I-Tinsion pneumothorax (ukuwa kwepulmonary): Umoya ovaleleke esifubeni unokubangela ukuba imiphunga iwe.

Nangona ezi zinto zinokwenzeka, oogqirha baxhalabile kakhulu ngako konke oku.

Ngubani ongafakwanga ityhubhu?

Ngamanye amaxesha, oogqirha bagqiba kwelokuba akukhuselekanga ukwenza i-intubation. Oku kunokwenzeka ukuba kukho ukwenzakala okukhulu kwindlela yomoya, okanye ukuba kukho ukuvaleka okuthintela i-tube ukuba ingafakwa ngokukhuselekileyo.

Kwiimeko ezinjalo, oogqirha banokugqiba ekubeni benze utyando entanyeni yakho engezantsi ukuze kuvuleke indlela yomoya. Oku kubizwa ngokuba yi-" tracheostomy." Oku kwenziwa rhoqo ukuba kufuneka ube netyhubhu yokuphefumla kangangeentsuku ezimbalwa, okanye ukuba ucinga ukuba unokufuna ukuyenza kangangeeveki ezimbalwa.

Kuthatha ixesha elingakanani ukuphiliswa?

Uninzi lwabantu luyaphola emva kweeyure okanye iintsuku ezimbalwa emva kokufakwa kwetyhubhu. Nangona kunjalo, ukuba unengxaki yokukhohlela, ukuginya, okanye ukuthetha nokuba ziiveki ezimbalwa emva kokufakwa kwetyhubhu, bona ugqirha. Banokukuthumela kwingcali yendlebe, impumlo, kunye nomqala (otolaryngologist).

Ufanele uye nini kugqirha emva kokufakelwa ityhubhu?

Ukuba ufumana naziphi na ezi mpawu emva kokufakwa kwetyhubhu , bona ugqirha ngokukhawuleza:

• Iintlungu zesifuba
• Ubunzima bokuphefumla, njengokuphefumla kancinci
• Ubunzima okanye ukungakwazi ukuthetha okanye ukuginya
• Umphimbo obuhlungu kakhulu
• Ukudumba kobuso

Ukuba unayo nayiphi na kwezi, xelela ugqirha ngokuqinisekileyo.

Inzulu kangakanani i-intubation?

Oku kuxhomekeke ekubeni kutheni kufuneka wenze i-`(Intubation)`. Ngamanye amaxesha oogqirha basebenzisa i-`(Intubation)` ngexesha lotyando olucwangcisiweyo. Ayisiyonto inkulu leyo. Kodwa kwimeko kaxakeka, xa ungakwazi ukuphefumla wedwa, xa i-`(Intubation)` yenziwe njengendlela yokusindisa ubomi, yimeko enzima kakhulu.

Ingaba ``intubation'' kunye ``nomoya'' zizinto ezahlukeneyo?

``(Intubation)`` kunye ``(Mechanical Ventilation)`` zihlobene. Kodwa azifani ncam.

• Ukufakwa kwetyhubhu yindlela yokufaka ityhubhu yokuphefumla kwindlela yomoya.
• Emva koko ugqirha uqhagamshela ityhubhu kwisixhobo esisetyenziselwa ukuphefumla. Esi sixhobo sisenokuba yibhegi ephathwa ngesandla epompa umoya, okanye sisenokuba yi-ventilator.
• I-ventilator ngumatshini opompa ioksijini kwimigudu yakho yomoya nasemiphungeni. Ngamanye amaxesha i-ventilator ihambisa umoya ngemaski ebusweni bakho endaweni yetyhubhu.

Uyaqonda? Uninzi lwexesha, i-ventilator iqhagamshelwe emva kwe-"Intubation".

Yintoni `(Nasotracheal intubation)`?

Kulapho oogqirha bafaka khona umbhobho wokuphefumla ngempumlo yakho. Oku kudla ngokusetyenziswa ukuba wenza utyando entloko, emlonyeni, okanye entanyeni. Kwakhona kunceda ukuthintela ukwenzakala okungakumbi entanyeni okanye kumbhobho womoya.

Okokugqibela, izinto ekufuneka uzikhumbule

Ingcinga yokuba ugqirha abeke ityhubhu emqaleni wakho inokuba yinto eyoyikisayo. Kodwa ityhubhu yindlela yezonyango edla ngokwenziwa kumagumbi otyando nakwiindawo zongxamiseko ukunceda ukusindisa ubomi bakho ukuba awukwazi ukuphefumla. Abantu abaninzi bafumana umphimbo obuhlungu okanye ubunzima bokuthetha emva koko. Kodwa ezo ziphumo bezihlala ziphela kwiveki. Ngoko ke, bathembe oogqirha bakho. Basoloko bezama ukwenza okulungileyo kuwe.

Ukufakwa kwetyhubhu , ukuphefumla, ukhathalelo olungxamisekileyo, inkxaso yokuphefumla, umoya ophefumlayo, utyando, i-tracheostomy