Ingabe siyazi ngokugcwele nge-extubation?

Wake wavakashela umuntu osegunjini lokunakekelwa okujulile (ICU)? Noma wake watshelwa udokotela ngenqubo yokuphefumula ngenkathi ulungiselela ukuhlinzwa? Enye yezinto ozizwayo ngezikhathi ezinjalo ukuthi bafaka "ipayipi lokuphefumula." Ngakho-ke, njengokufaka leli payipi, ukulikhipha nakho kuyinqubo ebaluleke kakhulu, ehleliwe. Kwezokwelapha, ukususa lelo payipi yilokho esikubiza ngokuthi "ukukhipha izicubu." Namuhla, ake sixoxe ngalokhu kalula, ngendlela ongayiqonda.

Okokuqala, ake sibone ukuthi kuyini ukufakwa kwe-intubation?

Ngaphambi kokuba sikhulume ngokukhuculula ipayipi, ake sibukeze kafushane ukufakwa kwepayipi. Kalula nje, lokhu kuyinto ithimba lezokwelapha eliyenzayo ukuze lisindise impilo yakho uma unenkinga yokuphefumula wedwa ngesizathu esithile. Bafaka ipayipi lepulasitiki eliguquguqukayo, elibizwa ngokuthi ipayipi le-endotracheal (ETT) , ngomlomo wakho lingene epayipini lakho lomoya (umgudu womoya oyinhloko).

Cabanga ngale ndlela: amaphaphu ethu afana nenjini yemoto. Adinga umoya oqhubekayo (i-oxygen) ukuze asebenze. Njengoba nje imoto ingeke inyakaze uma kukhona ukuminyana kwezimoto, uma indlela yakho yokuphefumula ivaliwe noma ukuphefumula kwakho kubuthakathaka, umoya-mpilo ngeke ufike emaphashini akho. Ngaleso sikhathi, leli payipi liyafakwa, bese kufakwa umshini, umshini wokuphefumula, oxhunywe kuwo, bese unikezwa inani lomoya-mpilo olidingayo. Lokhu kubizwa ngokuthi i-intubation.

Manje cishe usuyaqonda ukuthi kuyini ukukhishwa kwepayipi . Okusho ukuthi, inqubo yokukhipha ngokucophelela ipayipi elalikhona ngemuva kokuba ithimba lezokwelapha liqiniseka ukuthi ungaphefumula kahle wedwa futhi, ngaphandle kosizo.

Kukuziphi izimo lapho kwenziwa khona i-extubation?

Lokhu akwenzeki kuwo wonke umuntu ngesikhathi esifanayo noma ngendlela efanayo. Kuya ngokuthi kungani ufakwe epayipini nokuthi impilo yakho izinzile kangakanani.

Ngemva kokuhlinzwa

Uma uhlinzwa kakhulu, ulaliswa ngokuphelele. Sikubiza ngokuthi i-anesthesia ejwayelekile . Le mithi yokubulala izinzwa ikhubaza okwesikhashana imisipha elawula ukuphefumula kwakho. Ngaleso sikhathi, odokotela bafaka leli payipi lokuphefumula ukuqinisekisa ukuthi uthola inani elifanele lomoya-mpilo phakathi nokuhlinzwa.

Ngemva kokuba ukuhlinzwa sekuqediwe ngempumelelo, ithimba lezokwelapha lizosusa ipayipi ngokushesha nje lapho imiphumela yomuthi wokubulala izinzwa iphela futhi usukwazi ukuphefumula wedwa futhi. Ezimweni eziningi, ipayipi lizobe selisusiwe ngesikhathi ubuyela engqondweni. Ngakho-ke ungase ungalikhumbuli nokulikhumbula. Kulesi simo, ipayipi kungenzeka ukuthi selikhona isikhathi esifushane njengehora noma amabili.

Ngenxa yokugula noma ingozi

Uma umuntu efakwe ipayipi ngoba engakwazi ukuphefumula ngenxa yengozi, ukutheleleka okukhulu (njenge-pneumonia), noma esinye isifo esibi, inqubo yokukhipha ipayipi ihlukile kancane. Lo muntu uvame ukuba segunjini lokunakekelwa okujulile (ICU).

Ngaphambi kokukhipha ipayipi, odokotela kudingeka baqinisekise ukuthi uyakwazi ukuphefumula wedwa. Bazokwenza ukuhlolwa okukhethekile kwalokhu. Kubizwa ngokuthi i-Spontaneous Breathing Test (SBT) .

Ngezinye izikhathi ungase ungaphumeleli lokhu kuhlolwa okokuqala. Lokhu kubizwa ngokuthi "ukwehluleka kokukhumula." Lokhu kuvamile. Uma lokhu kwenzeka, udokotela uzolinda uze ube ngcono kancane bese enza lokhu kuhlolwa futhi ngemva kosuku olulodwa noma ezimbili.

Yiziphi izizathu eziyinhloko zokufakwa kwe-intubation?

Ukuze kwenziwe i-extubation, i-intubation kumele yenziwe kuqala. Nazi ezinye zezizathu ezivamile zalokhu. Ake sizibeke etafuleni elinjengaleli ukuze siziqonde kahle.

Yiziphi izinyathelo ezihilelekile enqubweni yokukhipha izicubu?

Kulungile, manje ake sibone ukuthi udokotela noma umhlengikazi oqeqeshiwe angalikhipha kanjani leli payipi. Lokhu akuyona into engakhishwa konke ngesikhathi esisodwa. Kunezinyathelo ezimbalwa zokulikhipha.

1. Ukulungiselela isiguli: Okokuqala, ikhanda lombhede lizophakanyiswa phezulu. Uzolethwa endaweni yokuhlala. Lokhu kuzosiza umoya ukuthi ungene emaphashini futhi kunciphise ingozi yezinto ezifana namathe angene emaphashini ngemva kokususwa kwepayipi.

2. Ukumunca: Okulandelayo, kusetshenziswa idivayisi ekhethekile (idivayisi yokumunca) ukususa wonke amathe, amathe, nezinye izinto ezingafuneki emlonyeni wakho, emphinjeni, kanye nasepayipini lokuphefumula. Lokhu kubaluleke kakhulu, ngoba ngaphandle kwalokho, lezi zinto zingangena emaphashini akho uma ipayipi likhishwa.

3. Ukukhulula ithubhu: Ibhande noma itheyiphu ebamba ithubhu ebusweni bakho isuswa ngokucophelela.

4. Ukuhlukaniswa ne-ventilator: Ipayipi linqanyuliwe ku-ventilator elixhunywe kuyo.

5. Ukususa ipayipi: Manje yingxenye ebaluleke kakhulu. Udokotela ukutshela ukuthi "thatha umoya ojulile bese ukhwehlela."Njengoba ukhwehlela noma ukhipha umoya, zikhipha ipayipi ngokushesha nangokushelela. Zenza lokhu uma ukhwehlela, okuvula izintambo zakho zezwi, okuvumela ipayipi ukuthi liphume kalula. Futhi ukukhwehlela kukhipha noma yini emphinjeni wakho.

Ingabe uyaphaphama lapho ipayipi likhishwa?

Lona umbuzo abantu abaningi abanawo. Impendulo ithi, ngezinye izikhathi yebo, ngezinye izikhathi cha.

• Ngemva kokuhlinzwa: Ipayipi livame ukukhishwa ngaphambi kokuba ubuye uqonde, ngenkathi usaphethwe yi-anesthesia. Ngakho-ke liyakhishwa uma uvuka.
• Uma usegumbini lokunakekelwa okujulile (ICU): Ipayipi lizokhishwa usaphapheme, njengoba kubalulekile ukuthi uphapheme futhi ulalele lokho okutshelwayo (isibonelo, ukukhwehlela uma utshelwa ukuthi "khwehlela").

Kwenzekani ngemva kokukhipha isisu?

Ukususa ipayipi akusho ukuthi umsebenzi usuphelile. Amahora ambalwa alandelayo abaluleke kakhulu. Ithimba lezokwelapha lizokuqapha ngokucophelela.

• Umoya-mpilo: Ngokuvamile, ngemva kokususwa kwepayipi, uzonikezwa inani elincane lomoya-mpilo nge-cannula yamakhala noma imaski yomoya-mpilo ukusiza umzimba wakho ujwayele isimo esisha.
• Ukuqapha: Izinga le-oxygen egazini lakho (elisebenzisa i-pulse oximeter), izinga lokushaya kwenhliziyo, kanye nomfutho wegazi kuhlolwa njalo.
• Ukukhwehlela: I-mucus ingase iqongeleleke emphinjeni wakho ngenxa yepayipi. Ngakho-ke, uzokwaziswa ukuthi ukhwehlele njalo ukuze uyisuse. Uma kudingeka, kungadingeka ukuthi uphinde uyimunce ukuze usule umphimbo wakho.

Ingabe zikhona izinkinga ezingaba khona ngesikhathi sokukhipha isisu?

Njenganoma iyiphi inqubo yezokwelapha, kunezingozi ezincane ezihilelekile ekukhishweni kwezicubu. Kodwa khumbula, ithimba lezokwelapha likulungele konke lokhu.

Yiziphi izinzuzo zokukhipha i-extubation?

• Isibonakaliso sokululama: Inzuzo enkulu ukuthi ungaphefumula wedwa futhi. Lokho kusho ukuthi amaphaphu akho nomzimba wakho kubuyela esimweni esijwayelekile.
• Ikhono lokukhuluma: Awukwazi ukukhuluma ngenkathi ipayipi likhona. Ngemva kokususwa, uzokwazi ukukhuluma futhi ngesikhathi esifushane. Nakuba umphimbo wakho ungase ube buhlungu ekuqaleni futhi izwi lakho lingase lishintshe kancane, lokhu kuzophela ezinsukwini ezimbalwa. (Kuzophela ezinsukwini ezimbalwa).
• Ikhono lokudla nokuphuza: Ngokufanayo, awukwazi ukudla noma ukuphuza ngomlomo ngenkathi ipayipi likhona. Uma ipayipi selisusiwe futhi ikhono lakho lokugwinya (i-gag reflex) seliqinisekisiwe, ungaqala ukudla futhi.
• Ukugwema izingozi zesikhathi eside: Kunezingozi ezithile ezihlobene nokuba nepayipi lokuphefumula isikhathi eside (isib., ukungasebenzi kahle kwezwi, i-pneumonia, i-tracheomalacia ). Ukukhipha izicubu kusho ukuthi ukhululekile kulezo zingozi.

Uma wena noma othile emndenini wakho kufanele adlule kule nqubo, ungesabi noma ungabaze. Buza udokotela wakho noma yimiphi imibuzo noma ukukhathazeka ongase ube nakho. Bazokuchazela konke.

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