Ngaba wakha wambona umguli kwigumbi lokhathalelo oluphezulu (ICU) onengxaki yokuphefumla kakhulu, ejikwa ngononophelo ngobuso phantsi ngoogqirha kunye nabasebenzi bonyango? Usenokuba ukhe wazibuza ukuba kutheni besenza oku, kwaye ingaba bekungayi kuba buhlungu na kumguli. Le yindlela yonyango ebaluleke kakhulu enokusindisa ubomi bomguli. Namhlanje siza kuthetha ngale ndlela ikhethekileyo intsha kubantu abaninzi, kodwa ibisetyenziswa kwezonyango amashumi eminyaka. Oku kubizwa ngokuba yi "Proning" kwezonyango.
Yintoni nje ukuhla unyuka?
Ngamafutshane, ukugoba sisenzo sokujika isigulane esilele phantsi (ngomqolo) sibe kwindawo ethe nkqo (ngesisu). Ngokwezonyango, le ndawo yokulala ibizwa ngokuba yi-"Supine Position". "Prone Position" isetyenziswa ngoogqirha ukunceda izigulane ezineengxaki zokuphefumla ezinzima ezinengxaki yokufumana ioksijini eyaneleyo emizimbeni yazo.
Le ndlela idla ngokusetyenziswa kwizigulana ezisebenzisa umoya ongeniswa ngoomatshini. Usenokuba ukhe weva eli gama ngexesha lobhubhane we-COVID-19 . Kodwa ayisiyonto intsha. Izifundo zifumanise nokuba ukuba le ndlela isetyenziswa kwangethuba kwizigulana ezinezifo zokuphefumla ezinzima, umngcipheko wokufa unokuncipha kakhulu.
Zeziphi iintlobo zeemeko ezisetyenziselwa le ndlela?
Indlela yokuphembelela isetyenziswa kakhulu kubantu abanezifo ezinzima zokuphefumla abakwimeko ethi "Hypoxia" apho umzimba ungafumani ioksijini eyaneleyo. Nangona kunjalo, le ndlela isetyenziswa kakhulu kwimeko ebizwa ngokuba yi -Acute Respiratory Distress Syndrome (ARDS) .
Ngamafutshane, i-ARDS yimeko apho iingxowa zomoya ezincinci (i-alveoli) ezikwimiphunga yethu zizaliswa lulwelo. Oku kwenza kube nzima kakhulu ukuphefumla. I-ARDS yingxaki enkulu yezifo ezinzima zokuphefumla ezifana ne-pneumonia kunye ne-COVID-19.
Kutheni amanqanaba eoksijini enyuka xa ujika intloko yakho?
Isizathu soku sinomdla kakhulu. Isizathu esiphambili soku kukuba imizimba yethu ayilingani ngokupheleleyo. Ukuziphakamisa ikakhulu kwenza izinto ezimbini.
1. Ukunciphisa ubunzima kunye noxinzelelo emiphungeni
Cinga ngako oku, kuba imizimba yethu yenzelwe ukuba ibe nezicubu ezininzi zemiphunga ngaphandle kunangaphakathi esifubeni sethu. Xa silala ngomqolo, ubunzima bentliziyo yethu kunye nezinye izitho zesisu buwela ngqo emiphungeni yethu. Kwakhona, ulwelo oluqokelelana emiphungeni yethu lucinezela iingxowa zomoya ngaphandle ngenxa yomxhuzulane. Oku kunciphisa indawo yokuba imiphunga izaliseke ngokupheleleyo ngumoya.
Kufana nesiponji esinobunzima. Xa ususa ubunzima, budumba kakuhle, akunjalo? Yiloo nto eyenzekayo apha.
Kodwa xa sijika isigulane sijonge phantsi, ubunzima bentliziyo kunye nezitho zesisu busuka emiphungeni siye esifubeni. Emva koko, icala elingasemva, elinezicubu ezininzi zemiphunga, liyakhululwa. Ngoko imiphunga iyanda ngcono kwaye ingathatha umoya omninzi.
2. Utshintshiselwano lweGesi lusebenza kakuhle
Kwi-ARDS, kukho ukungalingani phakathi kobungakanani beoksijini engena emiphungeni (umoya) kunye nobungakanani beoksijini efunxwa egazini (ukukhupha igazi). Nokuba umzimba wethu umi njani, umva wemiphunga ufumana igazi elininzi.
Ngoku khangela, xa sijika ubuso besigulana bujonge phantsi, sivumela umoya omninzi ukuba ungene emiphungeni kwelinye icala. Kwelinye icala, siqondisa loo moya kwindawo yomphunga enegazi elininzi . Oku kwenza inkqubo yokuphefumla isebenze ngakumbi. Ngamafutshane, le ndlela isenza sikwazi ukuthumela ioksijini apho ifuneka khona kakhulu.
Ujika njani ubuso bomntu onesigulana bujonge phantsi?
Oku akuyonto enokwenziwa ngumntu omnye okanye ababini. Lo ngumzamo weqela ocwangcisiweyo kakuhle. Ingcali yokuphefumla, oogqirha, kunye nabasebenzi bokonga, ubuncinane abantu aba-5-6, benza oku kunye.
Inyathelo lokuqala kukubopha zonke iityhubhu kunye neengcingo ezidityaniswe emzimbeni wesigulana (umz., ityhubhu yokuphefumla, ityhubhu yesaline, i-EKG) ukuze zingakhululeki. Ingcali yokuphefumla ibamba ngononophelo intamo yesigulana kunye netyhubhu yokuphefumla. Emva koko, ngaxeshanye, ngokomyalelo ofanayo, lonke iqela lijika ngononophelo isigulana ecaleni laso, lisebenzisa imiqamelo kunye namalaphu. Konke oku kwenziwa ukuze kuthintelwe nayiphi na ingozi kwisigulana.
Ngokwesiqhelo, isigulana sibekwa kule ndawo kangangeeyure ezili-12 ukuya kwezili-18. Ngokuqhelekileyo, ubuncinane iiyure ezili-16 zichithwa kwiseshoni enye, isigulana silele sijonge phantsi size sijonge phantsi.
| Iingenelo zendlela yeProning | Ingcaciso elula |
|---|---|
| Amanqanaba omoya-mpilo anyukileyo | Umoya omninzi ungena emiphungeni kwaye ioksijini ifunxwa egazini ngokufanelekileyo. |
| Ukususwa kwe-mucus ngokulula | Amandla adonsela phantsi komhlaba anceda ukuba i-mucus kunye nezinye izinto eziqokelelana emiphungeni ziphume lula. |
| Ukuphucula ukusebenza kwentliziyo | Imithambo yegazi emiphungeni iyavuleka, nto leyo eyenza kube lula ukuba intliziyo ipompe igazi. |
| Ukwehla kwezinga lokufa | Izifundo zibonakalise ukuba iyanciphisa kakhulu izinga lokufa kwizigulane ze-ARDS. |
Ngaba kukho naziphi na iingozi kule ndlela?
Njengakwezinye iindlela zonyango, kukho iingozi ezithile ezibandakanyekayo kule nkqubo. Nangona kunjalo, ezi ngozi zingancitshiswa ngokuba neqela lezonyango elinamava eliza kujonga ngokusondeleyo ezi zinto.
- Ukususwa ngengozi kombhobho we-endotracheal
- Ukulahlekelwa yi-catheter yemithambo yegazi (njenge-saline):
- Iingxaki zoxinzelelo lwegazi okanye izinga lokubetha kwentliziyo: (`Hemodynamic Instability`, `Arrhythmia`)
- Ukuhla okwethutyana kwamanqanaba eoksijini
- Ukuvalwa kwendlela yomoya
Ezi ngozi ziphantsi kakhulu kwizibhedlele ezinamava angaphezu kweminyaka emihlanu ngokusebenzisa indlela yeProning.
Khumbula, iProning lunyango oluqinisekisiweyo ngokwesayensi, olusindisa ubomi kwizigulane ezijongene neemeko ezinzima zokuphefumla.
Kwezinye iimeko, izigulane ezinengxaki yokuphefumla kancinci ziyacetyiswa ngugqirha wazo ukuba zilale zijonge phantsi (`Awake Proning`). Oku kunokubangela ukuba zingadingi i-ventilator.
Umyalezo Wokuya Ekhaya
- Ukuzibamba ngesandla kunyango lwesigulana esinengxaki yokuphefumla ngokusijika sijonge phantsi.
- Oku kunciphisa uxinzelelo emiphungeni kwaye kunceda umzimba ufumane ioksijini engaphezulu.
- Oku ikakhulu yi-ARDS (i-Acute Respiratory Distress Syndrome).Unyango olusindisa ubomi olusetyenziswa kwiimeko ezinzima ezifana.
- Oku kwenziwa ngononophelo olukhulu, liqela loogqirha abaqeqeshiweyo.
- Ukuba ubona umntu omthandayo efumana olu hlobo lonyango esibhedlele, qonda ukuba linyathelo elibaluleke kakhulu ekuchacheni kwakhe. Ukuba uneengxaki, thetha nogqirha ophetheyo ngalo mba.
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