Wake wambona udokotela noma umhlengikazi, ngemva kwengozi noma lapho isiguli esigula kakhulu silethwa esibhedlela, ebamba umunwe noma uzwane esandleni noma onyaweni lomuntu isikhashana bese elukhulula? Balinda umunwe uphinde ushintshe umbala. Kungenzeka ukuthi uke wacabanga, "Kwenzenjani lokhu?" Lokho kuhlolwa okulula kubizwa ngokuthi i-Capillary Replenishment Time (CRT) . Kungase kubonakale njengokuhlolwa okulula, kodwa ukuhlolwa okubaluleke kakhulu okunikeza odokotela ulwazi oluningi olubalulekile olungasindisa impilo yomuntu.
Kalula nje, siyini isikhathi sokugcwalisa kabusha i-Capillary (CRT)?
Ngaphambi kokuba sikuqonde lokhu, ake siqonde kancane. Sinemithambo yegazi ethwala igazi emizimbeni yethu yonke. Emincane kakhulu yale mithambo yegazi, njengemicu yewebhu yesicabucabu, ibizwa ngokuthi ama-capillary . Lena yileyo ethwala umoya-mpilo nezakhamzimba kuwo wonke amaseli emzimbeni wethu, kuzo zonke izingxenye zawo ezincane. Kufana nemigwaqo emincane eseceleni ehlukana nomgwaqo omkhulu futhi iholela kuyo yonke indlu.
Manje ake ucabange ucindezela uzipho lwakho isikhashana. Bese lelo phuzu liphenduka libe mhlophe, akunjalo? Uyazi ukuthi kungani? Uma ucindezela, igazi elithile likhishwa okwesikhashana kulawo ma-capillary amancane. Lapho nje usususa isandla sakho, lawo ma-capillary agcwala igazi futhi bese ebuyela embala wawo omdala opinki ngemizuzwana embalwa.
Yilokho okwenziwa yi -Capillary Refill Time (CRT) . Yisikhathi esithathayo ukuthi isikhumba esicindezelwe futhi siphathwe kabi sigcwale igazi futhi sibuyele embala waso ojwayelekile. Ngokulinganisa lesi sikhathi, udokotela angahlola ngokushesha ukuthi igazi ligeleza kahle yini ezindaweni ezikude zomzimba, njengezandla nezinyawo, noma ukuthi uketshezi oluphuma emzimbeni lulungile yini.
Kungani lokhu kuhlolwa kubaluleke kangaka? Ake sifunde ngesimo esiyingozi esibizwa ngokuthi 'Shock'!
Kunesizathu esiyinhloko sokuthi kungani ukuhlolwa kwe-CRT kubaluleke kangaka ezimweni eziphuthumayo. Okusho ukuthi, kusiza ukuthola ukushaqeka, isimo esingaba yingozi empilweni.
Kuyini lokhu kushaqeka ?
Kalula nje, lesi yisimo lapho izitho zomzimba wethu (njengobuchopho, inhliziyo, nezinso) zingatholi igazi elanele elinomoya-mpilo. Njengoba nje ugesi ucima endlini, izibani, amafeni, neziqandisi konke kuyayeka ukusebenza, lapho ukuphakelwa kwegazi ezithweni zethu kuncipha ngokuzumayo, azikwazi ukusebenza kahle. Lokhu kuyingozi kakhulu futhi kungaba yingozi empilweni uma kungelashwa ngokushesha.
Kungaba nezizathu eziningi zesimo sokushaqeka. Esimweni esiphuthumayo, kungase kungabi nesikhathi sokwenza izivivinyo zelebhu noma ukuskena. Yilapho-ke ukuhlolwa okusheshayo okufana ne-CRT kusiza odokotela.
| Izimo ezingaholela ekushaqekeni | |
|---|---|
| Isizathu | Incazelo elula |
| Ukopha kakhulu (Ukopha igazi) | Igazi eliningi liphuma emzimbeni, njengokungathi livela engozini enkulu. |
| Ukuphelelwa amanzi emzimbeni okukhulu | Amazinga amanzi nosawoti aphansi kakhulu emzimbeni ngenxa yohudo, ukuhlanza, noma ukujuluka ngokweqile. |
| Ukungezwani komzimba okukhulu (i-Anaphylaxis) | Ukusabela okubi kakhulu kokungezwani komzimba okubangelwa ukudla, imithi, noma ukulunywa yizinambuzane. |
| Ukusha okukhulu | Inani elikhulu loketshezi likhishwa emzimbeni ngenxa yokusha kwesikhumba. |
| Ukushisa komzimba okuphezulu (i-Hyperthermia) | Ukwenyuka okuyingozi kwezinga lokushisa komzimba ngenxa yezici ezifana nokuchayeka elangeni ngokweqile. |
| I-Hypothermia (izinga lokushisa eliphansi lomzimba) | Izinga lokushisa lomzimba lehla ngengozi ngenxa yokuchayeka emakhazeni amakhulu. |
Ukuhlolwa kwe-CRT kwenziwa kanjani?
Lena inqubo elula kakhulu futhi engenabuhlungu. Ngokuvamile, udokotela noma umhlengikazi uzolandela lezi zinyathelo:
1. Ukuphakamisa ingalo noma umlenze: Okokuqala, beka enye yezingalo noma imilenze yesiguli ngaphezu kancane kwenhliziyo.
2.Ukucindezela iminwe: Bese ucindezela ngokuqinile phezulu komunwe noma uzipho lwezinzwane cishe imizuzwana emi-5-10. Indawo izobe isiba mhlophe.
3. Ukulinganisa isikhathi: Okulandelayo, umunwe ocindezelwe ukhishwa ngokuzumayo, bese isikhathi esithatha indawo ekhanyayo ukuthi igcwale igazi futhi ibuye ibe nombala ofanayo nesikhumba esizungezile silinganiswa ngemizuzwana. Iwashi livame ukusetshenziswa kulokhu.
Into ebalulekile ukuthi inani lemizuzwana etholwe kulolu vivinyo olulula lilandisa indaba enkulu ngesimo sesimiso sokujikeleza kwegazi sesiguli.
Ingabe uhlala ubheka lokhu ngomunwe wakho?
Isikhathi esiningi, yebo. Kodwa kunezimo ezithile ezikhethekile lapho kungenakwenzeka ukubona lokhu ngomunwe. Cabanga ngomuntu olethwa esibhedlela enomzimba obandayo, izitho zakhe ngisho nezandla nezinyawo zakhe ziphenduka zibe luhlaza okwesibhakabhaka ngenxa yomkhuhlane omkhulu. Njengoba izinga lokushisa lomzimba lomuntu onjalo liphansi kakhulu (i-Hypothermia), ukujikeleza kwegazi ezithweni kungenzeka ukuthi kwehle ngokwemvelo. Esimweni esinjalo, ukubheka i-CRT ngomunwe kunganikeza umbono ongalungile.
Ezimweni ezinjalo, odokotela benza lokhu kuhlola ngokuqinisa isikhumba esizungeze i-sternum, ithambo eliphakathi kwesifuba, ngoba leyo ngxenye ephakathi yomzimba inegazi elingcono kunezitho zomzimba.
Imiphumela ithini? Izimo ezijwayelekile nezingavamile
Imiphumela yalolu vivinyo ibuya ngemizuzwana. Imiphumela yomuntu ophilile kahle ingase ihluke kancane ngokweminyaka.
- Izinsana: imizuzwana emi-2 noma ngaphansi.
- Abantu abadala (izingane kanye nentsha): Cishe imizuzwana emi-2-3.
- Abantu abadala: Kungathatha imizuzwana engaphezu kwemithathu.
Kuthiwani uma inani lami le-CRT lingaphakathi kobubanzi obujwayelekile?
Cabanga ngomuntu ogula kakhulu, kodwa i-CRT yakhe ijwayelekile, okusho ukuthi cishe imizuzwana emi-2. Ingabe lokho kusho ukuthi abanaso isifo? Cha. Kusho ukuthi udokotela uyaqonda ukuthi okwamanje akukho nkinga enkulu ngohlelo lokujikeleza kwegazi lwesiguli, ngakho imbangela yalesi sifo ingase ibe kwenye indawo. Bese beqala ukufuna ezinye izimbangela.
Kuthiwani uma inani le-CRT lingajwayelekile? (Uma isikhathi side kakhulu)
Yilapho okudingeka unake khona. Uma i-CRT yomuntu iphakeme kunezinga elijwayelekile (isib. imizuzwana emi-4, emi-5, noma ngaphezulu) , kuyisibonakaliso esibomvu kudokotela . Kusho ukuthi ukugeleza kwegazi ezingxenyeni zomzimba ezingaphandle komzimba kuphazamiseke kakhulu, okusho ukuthi kukhona ukushaqeka noma okwenzekile.
Ngezikhathi ezinjengalezi, odokotela bazokwenza ezinye izivivinyo ngokushesha ukuze baqinisekise imbangela futhi bahlole ubucayi besimo.
- I-Pulse Oximetry: Idivayisi elinganisa izinga le-oxygen egazini ngokunamathisela idivayisi efana ne-clip emunweni.
- Kala njalo umfutho wegazi kanye nesivinini sokushaya kwenhliziyo.
- Ukuhlola izinga lokuqonda kwesiguli.
- Ukulinganisa ukuphuma komchamo: Lokhu kubalulekile ukwazi ukuthi igazi ligeleza kahle yini ezinso.
Ngokuhlanganisa ulwazi oluvela kukho konke lokhu, odokotela bangakha isithombe esiphelele ngesimo sesiguli.
Iphathwa kanjani?
Uma inani le-CRT lingavamile futhi ukushaqeka kuqinisekiswa, isiguli sidinga ukwelashwa ngokushesha . Lokhu kwelashwa kuncike embangela yokushaqeka kanye nobunzima besimo sesiguli. Lezi ezinye zezindlela zokwelapha ezivame ukunikezwa eyunithi yokwelashwa okuphuthumayo (i-ETU).
- Ama-IV Fluids (Saline): Ama-fluids nosawoti kunikezwa ngemithambo yegazi (nge-cannula) ukuzama ukubuyisela umfutho wegazi.
- I-oxygen eyengeziwe: I-oxygen inikezwa nge-cannula yamakhala noma i-mask yobuso ukuze kwandiswe amazinga aphansi e-oxygen egazini.
- Ukufakelwa Igazi: Uma kulahleke igazi eliningi, njengasengozini, igazi likhishwa ngaphandle.
- Ipayipi lokuphefumula (Intubation): Uma isiguli sinenkinga yokuphefumula sodwa, kufakwa ipayipi lokuphefumula bese lixhunywe kumshini wokuphefumula .
- Imithi: Kuye ngembangela, imithi efana nama-antibiotic inikezwa uma kuyisifo, kanti ama-steroid anikezwa uma kuyi-allergy.
Umgomo wazo zonke lezi zindlela zokwelapha ukubuyisela ukuphakelwa kwegazi ezithweni zomzimba ngokushesha okukhulu, ukuvimbela umonakalo owengeziwe, nokusindisa izimpilo.
Umlayezo Wokuya Nawe Ekhaya
- Isikhathi Sokugcwalisa I-Capillary (i-CRT) ukuhlolwa okulula kwezokwelapha okungenziwa ngemizuzwana embalwa, akubuhlungu, kodwa kunikeza ulwazi oluwusizo kakhulu.
- Lokhu kuhlola ikakhulukazi ukuthi ukujikeleza kwegazi kulungile yini ezingxenyeni ezikude zomzimba, njengezitho zomzimba.
- Inani le-CRT eliphakeme kunejwayelekile (elihlala isikhathi eside) lingaba uphawu lwesimo esiyingozi njengokushaqeka . Lesi yisixwayiso esibalulekile kodokotela.
- Lokhu kuhlolwa kumane kuyingcezu encane yephazili enkulu. Udokotela ucabangela ezinye izinto eziningi (umfutho wegazi, ukushaya kwenhliziyo, izimpawu) ukuze enze isinqumo esiphelele ngesiguli.
- Ngesikhathi esilandelayo lapho ubona udokotela enza lokhu kuhlolwa, manje usuyazi ukuthi leyo nqubo elula ingabaluleka kangakanani.
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