Kuyini i-coma? Ake sixoxe ngalesi simo esibucayi sokulahlekelwa ingqondo!

Cishe uke wezwa othile ethi "ungene kwi-coma" noma ubone othile ebhayisikobho enamehlo akhe evaliwe, engashukumi nhlobo. Empeleni lesi yisimo esibi kakhulu, esisongela ukuphila. Ngakho-ke, namuhla sizoxoxa ngokuthi iyini ngempela i-coma, kungani yenzeka, nokuthi yini esingayenza ngayo.

Kuyini ngempela i-coma?

Kalula nje, ukuba se-coma kusho ukuthi awukho mqondo , awazi ukuthi kwenzekani eduze kwakho, futhi awusabeli nganoma iyiphi indlela . Awazi ngomzimba wakho noma izidingo zawo. Kalula nje, i-coma isho ukuthi ubuchopho bakho abusebenzi kahle .

Cabanga ngale ndlela: ubuchopho bufana nesikhungo sokulawula somzimba wethu. Yilokhu okwenzekayo uma bungasebenzi kahle. I-coma ingabangelwa yizimo ezahlukahlukene ezithinta noma ezilimaze kakhulu ubuchopho. Akuzona zonke i-coma ezifanayo. Ezinye zijulile , okusho ukuthi umsebenzi wobuchopho uphazamiseka kakhulu.

I-Coma iyisimo esiphuthumayo sezokwelapha . Uma othile endaweni yakini equlekile futhi engaphenduli, shayela u-911 (noma inombolo yakho yesimo esiphuthumayo yendawo) ngokushesha . Izinto eziningi ezibangela i-coma zidinga ukwelashwa ngokushesha. Ukulibala kungaholela ezinkingeni ezinkulu, ngisho nokufa.

Zivame kangakanani izikhuhlane?

Ngokusho kocwaningo olutholakalayo, emazweni afana ne-United States ne-England, cishe amacala amasha angu-250 e-coma ayenzeka kubantu abayi-100,000 ngonyaka. Kodwa-ke, kukhona ukungaqiniseki ngokuthi lezi zilinganiso zinembile kangakanani. Kunezizathu eziningana zalokhu. Isizathu esisodwa esikhulu ukuthi ezinye zezimo ezibangela i-coma ziyelapheka futhi zingelashwa ngokushesha. Ngezinye izikhathi, lezi zingelashwa ngosizo lokuqala ngaphambi kokuba zifike esibhedlela. Esinye isizathu ukuthi kunezinye izimo ezingase zibukeke njenge-coma, kodwa empeleni zihlukile.

I-coma ingenzeka kunoma ubani onanoma yisiphi isimo sezokwelapha esithinta ukusebenza kobuchopho. Ingathinta noma ubani, kungakhathaliseki ubudala, ubulili, uhlanga, noma inkolo.

Ziyini izimpawu ze-coma?

Kunezimpawu ezintathu eziyinhloko ze-coma:

• Ukungazi: Lokhu kufana nokulala ubuthongo obukhulu kakhulu. Ayikho indlela yokukuvusa .
• Ukuntuleka kokusabela kwamehlo: Lokhu kusho ukuthi amehlo akho avaliwe. Awuphenduli ngisho noma othile ezama ukuvula amehlo akho. Ngezinye izikhathi kungase kube nokunyakaza okuthile okubonakalayo emehlweni. Isibonelo, ukuphendula ekukhanyeni, ukucwayiza, nokujika amehlo akho uma uphendula ikhanda lakho. Kodwa-ke, uma i-coma ijule kakhulu, lokhu kusabela kungase kungenzeki njengoba kulindelekile.
• Ukuntuleka kwempendulo yemoto:Lokho kusho ukuthi awenzi noma yikuphi ukunyakaza okuhlosiwe . Ngezinye izikhathi ungase ube nokusabela okuthile. Kodwa uma i-coma ijule kakhulu, ingase ilahleke. Ungabona futhi ukuthi i-coma ijule kangakanani ngohlobo lokusabela olubonisayo.

Nakuba lezi zimpawu zivame ukubonakala ku-coma, kungase kube nokwehluka okuthile. Abanye abantu bangase babe nokushintsha kwesimo somzimba.

Iyini iGlasgow Coma Scale (GCS)?

I-Glasgow Coma Scale (GCS) iyindlela esetshenziswa kakhulu emhlabeni wonke ukukala ubunzima be-coma. I-GCS inezigaba ezintathu eziyinhloko, futhi isigaba ngasinye sinamaki. Amaphuzu aphezulu angu-15. Lokhu kusho ukuthi uqaphile ngokuphelele, uyazi indawo ekuzungezile, uyakwazi ukuqonda nokuphendula imibuzo, futhi uyakwazi ukulandela imiyalo.

Ngokuvamile, amaphuzu angu-8 noma ngaphansi asho ukuthi use-coma. Uma amaphuzu ephansi, i-coma ijula ​​kakhulu. Amaphuzu aphansi kakhulu angu-3. Izigaba ezintathu ezilinganiswa yi-GCS yilezi:

• Impendulo yamehlo (amaphuzu angu-1-4)
• Impendulo yokunyakaza (amaphuzu angu-1-6)
• Impendulo yokukhuluma (amaphuzu angu-1-5)

Yiziphi izimbangela ezingaba khona ze-coma?

Kunezizathu eziningi ezingadala noma ezingabangela i-coma. Ake sibheke ukuthi ziyini:

• Izinguquko ezingavamile emazingeni kashukela egazini: Lokhu kufaka phakathi ama-coma ahlobene nesifo sikashukela. Kokubili ushukela ophansi egazini (i-hypoglycemia) kanye noshukela ophezulu egazini (i-hyperglycemia) kuyingozi.
• Imithi kanye nezinqubo zezokwelapha: I-anesthesia yokuhlinzwa, kanye nama-coma abangelwa yizokwelapha.
• Ukusetshenziswa kwezidakamizwa zezokwelapha kanye nezidakamizwa ezingezona ezezokwelapha.
• Ukudakwa utshwala kanye noshevu wotshwala.
• Ukulimala ekhanda: Izinto ezifana nokushayisana kwekhanda, okwenzeka lapho ikhanda lishaywa engozini, noma izinto ezimbi kakhulu njengokulimala kobuchopho okubuhlungu (TBI) .
• Ubuchopho buphuma igazi.
• Ukwehla kokugeleza kwegazi kuya ebuchosheni: Kungabangelwa yinoma yiluphi uhlobo lwesifo sohlangothi, ikakhulukazi isifo sohlangothi esibangelwa yi-ischemic .
• Ukuntuleka komoya-mpilo (i-cerebral hypoxia).
• Izinto ezinobuthi: Isibonelo , i-carbon monoxide , izinsimbi ezisindayo, kanye nezinye izibulala-zinambuzane.
• Ukutheleleka: Ikakhulukazi ukutheleleka kobuchopho njenge- encephalitis kanye ne-meningitis , kanye nezimo ezisongela ukuphila njenge -sepsis .
• Ukungasebenzi kahle kwezinso noma isibindi.
• Izimo zokuvuvukala noma izifo ezihlobene nesimiso somzimba sokuzivikela: Isibonelo , 'i-Multiple Sclerosis' (MS) .
• Ukungalingani kwama-electrolyte: Izimo ezifana ne-sodium encane kakhulu (hyponatremia) noma i-calcium eningi kakhulu (hypercalcemia) .
• Izinguquko ezingavamile ekushiseni komzimba: Izinga lokushisa lomzimba eliphansi kakhulu (i-hypothermia) kanye nezinga lokushisa eliphezulu kakhulu (i-hyperthermia) .
• Ukwanda kwengcindezi ngaphakathi kogebhezi (umfutho wegazi ophezulu we-Intracranial): Lokhu kungabangelwa yizimo ezifana ne -hydrocephalus .
• Ukuquleka: Ikakhulukazi 'i-Status Epilepticus', okuyisimo sokuquleka esiqhubekayo.

Ubani osengozini enkulu yokuba ne-coma?

Izimo ezithile zezokwelapha kanye nezici zendlela yokuphila zingandisa ingozi yokuwela kwi-coma. Lokhu kufaka phakathi:

• Izimo ze-Metabolic: Izimo ezithinta amazinga kashukela egazini , njengesifo sikashukela sohlobo 1 kanye nenkinga engavamile yesifo sikashukela sohlobo 2, ebizwa ngokuthi i-Diabetic Ketoacidosis (DKA) .
• Izifo esezinesikhathi eside: Izinto ezifana nomfutho wegazi ophezulu (umfutho wegazi ophakeme) kanye ne-cholesterol ephezulu (i-hyperlipidemia) . Lokhu kungabangela ukopha ebuchosheni noma isifo sohlangothi.
• Ukusetshenziswa kwezidakamizwa notshwala: Ukulutheka kunoma yisiphi isidakamizwa, okuhlanganisa izidakamizwa ezingekho emthethweni, amaphilisi okudambisa izinhlungu e-opioid, amaphilisi okulala, ukulutheka kotshwala, ukulutheka kwe-opioid, kanye nokusebenzisa izidakamizwa ezifuthwayo.
• Ukungazisebenzisi izimpahla zokuphepha: Ukungazisebenzisi izimpahla zokuphepha njengezigqoko zokuzivikela namabhande esihlalo kungaholela ekulimaleni ekhanda nasezimweni ezifana nokuxhuzula noma ama-TBI .
• Izifo ezihlobene nenhliziyo: Izinto ezifana nokungajwayelekile kwenhliziyo.
• Ezinye izimo zesikhathi eside: Izimo ezifana nesifo sokuwa , i-hypothyroidism .

Yiziphi izinkinga ezingaba khona ngenxa ye-coma?

Umuntu okwi-coma akakwazi ukuzinakekela. Akakwazi ukuhambahamba, ukudla, ukugeza, noma ukwenza noma yiziphi zalezi zinto. Lokhu kusho ukuthi udinga ukunakekelwa kwezokwelapha amahora angama-24 ngosuku. Umuntu okwi-coma angadinga i-catheter yomchamo ukuze amsize akhiphe umchamo. Kuvamile futhi ukudinga usizo lokuphefumula, okubizwa ngokuthi ukuphefumula komshini., okungukuthi, zenzelwe ukuphefumula ngosizo lomshini.

Ezinye zezinkinga ezingase zivele ngenxa ye-coma noma ukwelashwa okuhambisana nayo zifaka:

• Izifo ezihlobene nesibhedlela: njenge -ventilator-associated pneumonia (VAP) kanye ne-catheter -associated urinary tract infections (CAUTIs) .
• Ukulimala kwengcindezi/Izilonda Zombhede: Ezinye izingxenye zomzimba zingalimala ngenxa yokuhlala endaweni efanayo.
• Ukondla ngamapayipi.
• Ukuwohloka kwemisipha.
• I-Thrombosis: Ukuvimbela lokhu, kusetshenziswa ama-blood thinner (ama-anticoagulant) kanye namadivayisi okucindezela kwe-pneumatic (IPC) ngezikhathi ezithile . Lokhu kungavimbela izinto ezifana nesifo sohlangothi kanye ne-pulmonary embolism.
• Ukuphambana kwengqondo.
• Ukudala imbobo emphinjeni ukuze uphefumule (Tracheostomy): Lokhu kuvame ukudingeka kuphela uma i-coma ihlala isikhathi esingaphezu kwamasonto amabili.

Uyibona kanjani i-coma?

Ukuthola imbangela ye-coma - okungukuthi, ukuhlonza isimo sezokwelapha esiyisisekelo - kuyinto okudingeka yenzeke ngokushesha . Esinye sezinyathelo zokuqala zokuhlonza i-coma ukwenza ukuhlolwa kwezinzwa . Udokotela angasebenzisa into efana ne -Glasgow Coma Scale ukuthola ubukhali be-coma.

Ngaphezu kokuhlolwa kwezinzwa, odokotela bazokwenza izivivinyo eziningana ukuze bathole imbangela ye-coma nokuthi inkinga ibucayi kangakanani. Isibonelo, uma kube nokulimala ekhanda, kulula ukuthola imbangela. Ngemuva kwalokho izivivinyo zizobheka ubukhulu bomonakalo. Uma imbangela ingaziwa, ukuthola imbangela ye-coma nokunquma ubukhali bembangela cishe kuyinto efanayo.

Yiziphi izivivinyo ezenziwayo ukuze kutholakale lesi simo?

Kunezinhlobo eziningi zokuhlolwa ezingasiza ekuxilongeni i-coma nokunquma ubukhali bayo. Ezinye zazo zifaka:

• Ukuhlolwa kwelabhorethri egazini, emchameni, kanye noketshezi lomgogodla (CSF): Lokhu kuwusizo kakhulu ekutholeni izimbangela eziningi ze-coma. Kungabona izinto eziningi, okuhlanganisa izinkinga zikashukela egazini, ukungalingani kosawoti, ukungasebenzi kahle kwezitho zomzimba, ubuthi, kanye nezimpawu zokutheleleka.
• Ukuthwebula izithombe: Lokhu kuhlolwa kusebenzisa izindlela ezahlukahlukene "ukubona" ​​ukulimala noma umonakalo ngaphakathi kwekhanda lakho. Ukuhlolwa kwezithombe okuvame kakhulu ukuthwebula izithombe nge-computed tomography (CT) kanye nokuthwebula izithombe nge-magnetic resonance (MRI) .
• I-Electroencephalogram (EEG):Lokhu kuhlola kuthola futhi kuqophe umsebenzi kagesi ebuchosheni bakho. Kungasiza ekunqumeni ubukhali be-coma nokubona izimo ezingabangela i-coma, njengesithuthwane.
• I-Electrocardiogram (ECG noma EKG): Lokhu kuhlolwa kungasiza ekuboneni noma ekususeni inkinga yesigqi senhliziyo engase ibangele i-coma.

Ngaphezu kwalokhu, kungase kwenziwe ezinye izivivinyo. Lokhu kuzoncika ohlotsheni lwe-coma, isimo sakho, kanye nomlando wakho wempilo. Uma othile oseduze nawe e-coma, udokotela ungumuntu ongcono kakhulu ukuchaza ukuthi yiziphi izivivinyo ezenziwayo. Uma usuphinde waphaphama, angakutshela ukuthi yiziphi izivivinyo ezenziwe.

Ilashwa kanjani i-coma? Ingabe ingelapheka?

Ukwelashwa kwe-coma kuncike kakhulu embangela eyinhloko . Ngenxa yokuthi kunezimbangela eziningi ze-coma, kungaba nezindlela eziningi zokwelapha. Okusebenza ngesizathu esisodwa kungase kungasebenzi kwesinye (noma kungenza esinye isimo sibe sibi kakhulu).

Ngakho-ke, udokotela ungumuntu ongcono kakhulu ukukutshela ukuthi yiziphi izindlela zokwelapha ezitholakalayo nezinconywayo ngesimo sakho noma somuntu oseduze nawe.

Ukwelashwa okuphuthumayo okuvamile

Ngaphambi kokuba imbangela ye-coma yaziwe, kunezindlela zokwelapha ezithile odokotela noma abanakekeli abangaziqala. Lezi zindlela zokwelapha zivame ukuhlotshaniswa nezimo zezokwelapha ezaziwayo, noma izinto umuntu acabanga ukuthi zingabangela i-coma ngokusekelwe ebufakazini obumzungezile. Lezi zindlela zokwelapha zingasiza ekuqiniseni umuntu, zivimbele i-coma ukuthi ibe yimbi kakhulu, noma ngisho nokumkhipha ngokuphelele ku-coma. Izibonelo zifaka:

• I-glucose noma i-insulin: Lokhu kusiza ukuphakamisa noma ukwehlisa amazinga kashukela egazini. Uma i-glucose inikezwa ngesikhathi, i-coma ingabuyiselwa emuva ngokushesha.
• Imithi yokuguqula ukusetshenziswa kwezidakamizwa ngokweqile: Isibonelo 'yiNaloxone' . Lokhu kungaguqula imiphumela yokusebenzisa i-opioid ngokweqile. I-Naloxone ingaguqula imiphumela yokusebenzisa i-opioid ngokweqile zingakapheli imizuzu emibili kuya kwemihlanu.

Ngokuphathelene nezinkinga/imiphumela emibi yokwelashwa, njengoba kunezindlela eziningi ezahlukene zokwelapha i-coma, kunezinkinga eziningi nemiphumela emibi engenzeka ngenxa yokwelashwa. Udokotela wakho ungumuntu ongcono kakhulu ukuchaza ukuthi yimiphi imiphumela emibi noma izinkinga ezingase zenzeke nokuthi yini engenziwa ngazo.

Kunjani ukuzwa ukuba se-coma?

Ukuba se-coma ngokuvamile kusho ukuthi awukho mqondo , ngakho awazi ukuthi use-coma. Awubonisi ukuqaphela umhlaba okuzungezile. Awuphenduli ngamabomu esimweni sakho, endaweni okuyo, noma ezidingweni zomzimba wakho. Kuye ngokujula kwe-coma, ungase ube nokusabela okuthile, kodwa lokhu kuzohluka kuye ngesimo nesimo.

Uma use-coma, uyazizwa yini izinto ezenzeka eduze kwakho? Uyakhumbula?

LokhuKungenzeka ngezinye izikhathi, kodwa kuncike ohlotsheni lwe-coma kanye nokuthi i-coma yakho ijule kangakanani. Kunobufakazi bokuthi abantu abakwi-coma bangezwa izinto ezenzekayo nxazonke zabo. Abanye abantu abalulame eku-coma bakwazile ukukhumbula izinto ezenzeke eduze, njengezingxoxo. Kodwa-ke, lokhu kungahluka kakhulu. Kunzima ukusho ngqo ukuthi umuntu uzobhekana nini noma kanjani nalokhu.

Kubalulekile futhi ukukhumbula ukuthi i-coma ngezinye izikhathi ingaba nzima ukuyixilonga. Odokotela basebenzisa ukuqeqeshwa kwabo, ulwazi lwabo, kanye nokwahlulela kwabo ukuze baxilonge lesi simo. Kodwa akuwona wonke amacala afanayo. Lokhu kusho ukuthi i-coma ingahlolwa kabi noma ukujula kwayo kuncishiswe ngenxa yezinye izici. Futhi, umuntu angase abe kwi-coma ekuqaleni bese ebuyela ezingeni elithile lokuqwashisa ngaphambi kokuba udokotela aqaphele ushintsho ekuqwashiseni.

Ngenxa yokuthi kunezinto eziningi kangaka, lo mbuzo akulula ukuwuphendula. Udokotela ungumuntu ongcono kakhulu ukukusiza ukuthi uthole ukuthi wena noma othile oseduze nawe ubephapheme futhi ekhumbula okwenzekile ngesikhathi ekwi-coma. Nakuba kungenzeka ukuthi akakwazi ukuphendula lo mbuzo ngokuphelele, okungenani angakusiza ukuthi uqonde ukuthi lolo lwazi luthinta kanjani inqubo yokululama nokuthi kwenzekani ngokulandelayo (uma kukhona).

I-coma ihlala isikhathi esingakanani?

I-coma ingahlala isikhathi esifushane kakhulu, imizuzu embalwa nje . Noma ingahlala isonto elilodwa noma amabili . Ngeshwa, ukufa kungavela futhi ngenkathi use-coma. Lokhu kungenzeka kakhulu uma i-coma ibangelwa ukulimala noma ukugula okubi kakhulu, noma uma umuntu engatholi usizo lwezokwelapha ngokushesha ngemva kokungena e-coma.

Akuvamile ukuthi i-coma ihlale isikhathi esingaphezu kwamasonto ambalwa. Lokhu kungenxa yokuthi umphumela ojwayelekile uwukuthi umuntu avuke e-coma noma umuntu ashintshele kwesinye isimo sokungazi lutho noma sokungazi lutho. Lezi yizi:

• Isimo Sokutshala: Umuntu okulesi simo uphapheme kodwa akaqapheli umhlaba omzungezile. Akabonisi noma yikuphi ukuziphatha okuhlosiwe. Angase avule amehlo akhe futhi enze izinto ezibonakala sengathi zisabela ezweni elimzungezile, kodwa empeleni akaqapheli futhi akenzi lutho ngamabomu. Uma isimo sokutshala sihlala isikhathi eside, sibizwa nangokuthi isimo sokutshala esiqhubekayo (i-PVS) . (Ngokusho kochwepheshe, isimo sokutshala esihlala okungenani izinyanga ezintathu ngaphandle kwengozi, noma izinyanga eziyishumi nambili uma sibangelwa ingozi, sibhekwa njengesiqhubekayo.)
• 'Isimo Esiqonda Kancane': Lesi yisimo lapho umuntu eqaphela khona umhlaba omzungezile futhi ebonisa ukuziphatha okuhlosiwe. Angalandela imiyalo elula futhi akhulume imisho emifushane. Kodwa abakwazi ukwenza lezi zinto njalo. Uma bengakwazi ukwenza lezi zinto, babonakala 'besesimweni sokuhlala bephila'.

Nakuba 'isimo sezitshalo' sifana ne-coma, akuyona neze i-coma. Abantu 'abasesimweni sezitshalo' sebeluleme kwaze kwaba yilapho bengasekho kwi-coma. Kodwa-ke, imisebenzi yabo yobuchopho namakhono abo asalinganiselwe kakhulu.

Amathuba okululama esimweni sokukhula kwezitshalo ayahlukahluka kakhulu. Abanye abantu baphinde bathole ulwazi oluphelele noma oluyingxenye. Kodwa abaningi abalutholi. Abantu bangahlala esimweni sokukhula kwezitshalo amasonto, izinyanga, noma ngisho neminyaka. Kodwa-ke, abakwazi ukuzinakekela futhi badinga ukunakekelwa kwezokwelapha okuqhubekayo. Ngeshwa, basengozini enkulu yezinkinga. Iningi labantu abasesimweni sokukhula kwezitshalo banobude besikhathi sokuphila obulinganiselwe.

Yimaphi amathuba okuphuma kulesi simo?

Amathuba okululama ekukhubazekeni angahluka kakhulu . Ziningi izinto ezithinta lokhu. Umuntu ongcono kakhulu ongakutshela ngesimo esithile udokotela owaziyo isimo. Ezimweni eziningi, lowo ngudokotela owelapha othandekayo wakho.

Uma ungakwazi ukwenza izinqumo, uziveza kanjani izifiso zakho?

Cabanga nje, ukube ubukwi-coma, ubungeke ukwazi ukwenza izinqumo mayelana nokunakekelwa kwakho kwezokwelapha noma ukutshela noma ubani ukuthi ufunani. Ngokuvamile, lezo zinqumo bekuzodingeka zenziwe umndeni noma abathandekayo.

Kungakhathaliseki ukuthi unesifo esingakufaka e-coma noma cha, kuwumqondo omuhle ukukhuluma nabathandekayo bakho ngalokho okufunayo uma ungakwazi ukwenza izinqumo mayelana nokunakekelwa kwakho kwezokwelapha. Le ngxoxo ingase izwakale ingakhululekile futhi inzima. Kodwa, ukuba nalezi zingxoxo ngaphambi kokuba sekwephuzile kuzosiza abathandekayo bakho bazi ukuthi yini oyifisayo uma ungakwazi ukukhuluma.

Kungumqondo omuhle futhi ukubhala phansi izifiso zakho nezinqumo zakho . Lokhu kuvame ukubizwa ngokuthi 'i-Advance Directive' noma 'i-Living Will'. Kumayelana nezindaba zomthetho zalokho okwenzekayo uma ungakwazi ukuzinakekela noma ukwenza izinqumo ngenhlalakahle yakho. Ungathola usizo kummeli ukuze alungiselele la madokhumenti. Kodwa ungazilungiselela nawe eminye yawo (kuye ngemithetho yasendaweni yakini, kungadingeka ukuthi isayinwe ngummeli wezomthetho).

Ingabe ama-coma angavinjelwa?

Izimo eziningi ezibangela i-coma zingavinjelwa - noma ingozi ingancishiswa . Nazi ezinye zezinto ezibaluleke kakhulu ongazenza ukuvimbela noma ukunciphisa ingozi yakho yokuba kwi-coma:

• Ukuphatha izimo zakho ezingamahlalakhona: Ukulandela imiyalelo kadokotela wakho yokuphatha izimo ezifana nesifo sikashukela kanye nesifo sokuwa kunganciphisa amathuba akho okuwela kwi-coma esikhathini esizayo.
• Gqoka izingubo zokuzivikela uma kudingeka: Ukulimala ekhanda, ikakhulukazi ukubhajwa kwemisipha kanye ne-TBI (Traumatic Brain Injuries), kuyizimbangela ezivame kakhulu ze-coma. Zivikele ngokugqoka izingubo zokuzivikela njengezigqoko zokuzivikela namabhande esihlalo uma kufaneleka.
• Yidla ukudla okulinganiselayo: Izimbangela eziningi ze-coma zihlobene nokudla. Isibonelo, ukungalingani kukasawoti, ukuntuleka kokudla okunempilo. Ukudla kwakho kuthinta nempilo yesistimu yakho yokujikeleza kwegazi. Lokhu kungasiza ekuvimbeleni i-coma ebangelwa yizimo ezifana nesifo sohlangothi.
• Hlala umatasa ngokomzimba futhi ulondoloze isisindo esinempilo: Isisindo sakho kanye nezinga lomsebenzi wakho kungasiza ekuvimbeleni noma ekubambezeleni izimo ezithinta ubuchopho bakho, ikakhulukazi lezo eziholela e-coma.
• Ukugwema ukusebenzisa izidakamizwa kanye nemithi engeyona eyezokwelapha, kanye nokuphuza utshwala ngokulinganisela: Ukulutheka kwezidakamizwa kwandisa kakhulu ingozi yokuba ne-coma. Futhi, ukuthatha imithi enikezwe udokotela njengoba nje kuyalelwe kuzonciphisa ingozi yezinkinga kanye nemiphumela emibi efana ne-coma.

Kulabo abanomthandi wakho osekwi-coma, lokhu kungaba yinto eyesabekayo kakhulu. Uma othandekayo wakho esekwi-coma, ungase ube nemibuzo eminingi engaphenduliwe. Ungase uzibuze ukuthi uzolulama yini, kuzothatha isikhathi esingakanani, nokuthi uzolulama ngokugcwele yini. Nakuba kungelula ukuphila nemibuzo nokungaqiniseki, ucwaningo oluqhubekayo lusiza ochwepheshe ukuthi baqonde kangcono ukuthi ama-coma asebenza kanjani nokuthi bawaphatha kanjani. Lokhu kuzovula umnyango wokululama kuma-coma manje nasesikhathini esizayo.

Ngamafuphi, nazi izinto okudingeka sizikhumbule (Umyalezo Wokuya Ekhaya):

Ngiyethemba ukuthi lokhu kukunikeza umbono nge-coma. Izinto ezibaluleke kakhulu okufanele uzikhumbule yilezi:

• I-coma iyisimo esiphuthumayo sezokwelapha. Uma ubona umuntu equlekile futhi engaphenduli , funa usizo lwezokwelapha ngokushesha .
• Kungaba nezimbangela eziningi ze-coma, ezinye zazo ezingavinjelwa.
• Ingozi ye-coma ingancishiswa ngokuvikela ikhanda (isigqoko sokuzivikela, ibhande lesihlalo), ukulawula izifo ezingamahlalakhona (njengesifo sikashukela, umfutho wegazi ophakeme), kanye nokugwema izidakamizwa .
• Uma usesimweni lapho ungakwazi ukwenza izinqumo, kubaluleke kakhulu ukuxoxa ngezifiso zakho zokwelashwa nomndeni wakho, futhi uma kungenzeka, uzibhale phansi .
• Amathuba okululama ngemva kokuquleka ayahlukahluka kuye ngomuntu, futhi udokotela wakho angakunikeza ulwazi olungcono kakhulu ngalokhu.

Sithemba ukuthi lolu lwazi luwusizo kuwe. Hlala uphilile!

` Ukuquleka, ukungazi lutho, ubuchopho, ukwelashwa, isimo esiphuthumayo, izimpawu, impilo