Ungathanda ukwazi nge-intubation, engakusiza uma unenkinga yokuphefumula?

Wake wazibuza ukuthi singazisiza kanjani ngokuphefumula uma singaphefumuli ngokuzumayo, noma uma sihlinzwa kakhulu? Yilapho odokotela besebenzisa inqubo ebizwa ngokuthi "Intubation." Nakuba leli gama liyesabeka kancane, empeleni liyasiza ekusindiseni izimpilo eziningi. Ake sibone ukuthi liyini, ukuthi lenziwa kanjani, nokuthi kungani lenziwa kalula.

Kusho ukuthini nje ukuthi `(Intubation)`?

Kalula nje, `(Intubation)` (intubation) yilapho udokotela efaka ipayipi elincane epayipini lakho lomoya (`(trachea)`) ngomlomo wakho noma ngezinye izikhathi ngekhala lakho. Leli payipi ligcina ipayipi lakho lomoya livulekile, ukuze umoya ungene kalula. Leli payipi lingaxhunywa emshinini. Lo mshini uthumela umoya-mpilo noma umoya ngaphansi kwengcindezi emaphashini akho. Lokhu sikubiza ngokuthi `(Mechanical Ventilation)`.

Le ``(Intubation)`` inamanye amagama:

• Ukufakwa komoya
• Ukufakwa kwe-Endotracheal intubation (ETT)
• Ukufakwa kwepayipi lomoya ophuma emphinjeni

Lawa wonke amagama ento efanayo.

Kungani udinga ukwenza lokhu `(Intubation)`?

Udokotela kungadingeka akufake i-tube uma ungakwazi ukuphefumula kahle ngenxa yokuvaleka, ukuvaleka, noma ukulimala kwendlela yakho yokuphefumula. Cabanga nje, ngokuzumayo, uba nengozi enkulu futhi isifuba nentamo yakho kulimele, okwenza kube nzima ukuphefumula. Noma, uma ulahlekelwa ingqondo, ngeke ukwazi ukulawula ukuphefumula kwakho. Yilapho lokhu kudingeka khona.

Kunezinye izizathu eziningana zokwenza `(Intubation)`:

• Uma indlela yakho yokuphefumula ithintwa ukulimala esiswini, esifubeni, noma entanyeni.
• Ukulahlekelwa ukwazi (njengokuquleka) noma izinga eliphansi lokuqwasha. Lokhu kungabangela ukuthi ulahlekelwe ukulawula ukuphefumula kwakho.
• Uma kufanele wenze ukuhlinzwa okukhulu lapho ungakwazi ukuphefumula wedwa. Ngokuvamile, uma sinikezwa i-anesthesia, kuba nzima ngathi ukuphefumula wedwa.
• Ukwehluleka kokuphefumula. Lokhu kusho ukuthi amaphaphu akho ayayeka ukusebenza kahle.
• Kukhona ingozi yokuthi izinto ezifana nokudla, ukuhlanza, kanye negazi ziphefumulwe bese zingena emaphashini (Aspiration) .
• Uma into ibambeka endleleni yomoya futhi ivimba umoya ukuthi ungagelezi, ibizwa ngokuthi ``ukuvinjelwa komoya``.
• Ukuma kwenhliziyo kwenzeka lapho inhliziyo iyeka ukusebenza ngokuzumayo.
• Uma ukuphefumula kuyeka okwesikhashana (i-Apnea).

Ukufakwa kwepayipi kungadingeka nganoma yisiphi salezi zizathu.

Kuvamile kangakanani lokhu?

Eqinisweni, "(Intubation)" inqubo evamile kakhulu, esindisa impilo. E-United States kuphela, cishe izigidi ezingu-15 zalezi zinqubo zenziwa emakamelweni okuhlinzwa minyaka yonke. Ngaphezu kwalokho, amakhulu ezinkulungwane zazo zenziwa ezimweni eziphuthumayo. Ngakho ungacabanga ukuthi lokhu kwenziwa kangaki. Kwenziwa njalo naseSri Lanka.

Kwenzekani ngempela uma kwenziwa i-Endotracheal Intubation?

Esikhathini esiningi, lokhu `(Intubation)` kwenziwa ngaphakathi esibhedlela. Kodwa-ke, ngezinye izikhathi, abasebenzi bezokwelapha eziphuthumayo (`(EMS)`) bakwenza ngaphandle kwesibhedlela.

Nansi indlela lokhu okwenziwa ngayo ngokuvamile:

1. Okokuqala, i-cannula encane (inaliti ye-IV) ifakwa emthanjeni ongalweni yakho bese kunikezwa umuthi wokubulala izinzwa ngayo ukuze ulale futhi ungabi nobuhlungu.

2. Ngemuva kwalokho kuzobekwa imaski yomoya-mpilo phezu kwekhala lakho nomlomo wakho ukuze kunikezwe umoya-mpilo owengeziwe emzimbeni wakho.

3. Ikhanda lakho lizohlehliswa kancane bese kufakwa ithuluzi elibizwa ngokuthi ``i-laryngoscope'' emlonyeni wakho (futhi ngezinye izikhathi lidlule ekhaleni lakho uma kudingeka). ``i-laryngoscope'' inesibambo, ukukhanya, kanye nensingo ebukhali. Lokhu kusiza udokotela ukubona indawo efanele ``ithubhu yomgudu wokuphefumula''.

4. Okulandelayo, i-``(laryngoscope)`` ithathwa ngaphakathi emlonyeni iye ngemuva, iqaphe ukuthi ayishayi amazinyo.

5. I-flap yezicubu (i-epiglottis) elenga ngemuva komlomo wakho iyaphakama ukuze ivikele ibhokisi lakho lezwi (i-larynx).

6. Iphuzu le-`(Laryngoscope)` lidlula nge-`(Larynx)` yakho liye kwi-`(Trachea)` yakho (umphimbo womoya).

7. Bese kuba khona idivayisi encane efana nebhaluni evuvukele eduze kwepayipi le-endotracheal. Lokhu kuqinisekisa ukuthi ipayipi alihambi ku-trachea, futhi wonke umoya onikezwa ngepayipi uya ngqo emaphashini.

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

9. Ukuze kuvinjelwe ipayipi lokuphefumula ukuthi lingahambi liye phambili nangemuva, kufakwa iplasta kuzo zombili izinhlangothi zomlomo noma kufakwa ibhande elizungeze ikhanda.

10. Ekugcineni, kuthathwa i-X-ray ukuze kuhlolwe ukuthi ithubhu isendaweni efanele yini, noma isikhwama sisetshenziselwa ukupompa umoya ungene ethubhu futhi silalele imisindo evela emaphashini.

Kuthatha isikhathi esingakanani lokhu?

Esimweni esiphuthumayo, udokotela angenza lokhu "(Intubation)" esikhathini esingaphansi komzuzu. Lokhu kuyinto engenziwa ngokushesha okukhulu.

Ngingakwazi yini ukukhuluma, ukudla, nokuphuza ipayipi lisekhona?

Cha. Awukwazi ukukhuluma. Ngoba le payipi yokuphefumula idlula ezintanjeni zakho zezwi. Ngakho-ke noma uzama ukukhuluma, akukho msindo ophumayo.

Futhi, awukwazi ukugwinya ngenkathi ipayipi likhona. Ngakho awukwazi ukudla noma ukuphuza. Kuye ngokuthi kufanele uhlale isikhathi esingakanani kanje, odokotela bazokunikeza ukudla okunomsoco kwangaphakathi (ukudla okunomsoco ngaphakathi kwemithambo yegazi) noma usawoti (uketshezi lwe-IV). Ngezinye izikhathi ipayipi elincane elihlukile lingafakwa ngomlomo noma ekhaleni lakho ukuze likunike ukudla okunomsoco esiswini sakho noma emathunjini amancane.

Ulisusa kanjani ithubhu? (Kuyini ``(Extubation)``?)

Uma odokotela sebebona ukuthi kuphephile ukususa ipayipi, bazolikhipha. Lokhu kubizwa ngokuthi "i-Extubation". Nansi indlela okwenziwa ngayo:

• I-plaster noma i-tape ebibambe ipayipi endaweni yayo iyasuswa.
• Idivayisi yokumunca isusa amafinyila kanye nezinye izinsalela emigudwini yakho yomoya.
• Ibhaluni elivuvukele ngaphakathi kompompi womoya liyancibilika.
• Bese utshelwa ukuthi uphefumule kakhulu bese ukhwehlela noma ukhiphe umoya njengoba bekhipha ipayipi.

Umphimbo wakho (`(Pharynx)`) ungase ube buhlungu kancane izinsuku ezimbalwa ngemva kwe-`(Extubation)`. Kungase kube nzima nokukhuluma. Lokhu kuvamile, ungakhathazeki.

Yiziphi izinzuzo zokufakwa kwe-intubation?

Ukufakwa kwepayipi kuyindlela evamile, ephephile ngokuvamile engasiza ekusindiseni impilo yakho.

Inzuzo enkulu yalokhu ukuthi kungasindisa impilo yomuntu onenkinga yokuphefumula. Ngakho-ke, uma kuqhathaniswa nezinye izingozi ezincane, lokhu kuyinto ewusizo kakhulu.

Angakanani amathuba okusinda uma kwenziwa i-intubation?

Lokhu kuyahlukahluka ngempela kuye ngomuntu nomuntu. Kuncike ezintweni eziningi, njengesizathu sokufakwa kwepayipi, iminyaka yakho, impilo yakho jikelele, njll. Kodwa olunye ucwaningo luthole ukuthi cishe abantu abayisikhombisa kwabayishumi abafakwa epayipini egumbini lezimo eziphuthumayo bayasinda . Ngakho lokho kukhombisa ukuthi kusindisa impilo kangakanani.

Ziyini izingozi zokufakwa kwepayipi?

Nakuba ukufakwa kwepayipi ngokuvamile kuphephile, kunezingozi ezithile. Kodwa khumbula, ukusindisa impilo kubaluleke kakhulu kunezingozi ezinjalo.

• Ukuphefumula : Ngesikhathi sokufakwa kwepayipi, ukuhlanza, igazi, noma olunye uketshezi kungangena emaphashini.
• Ukufakwa kwe-Endobronchial: Ipayipi elifakwa ku-windpipe (trachea) kwenye yezindlela ezimbili zomoya eziyinhloko (i-bronchi) ezisuka ku-windpipe ziye emaphashini.
• Ukufakwa kwepayipi lokuphefumula: Uma ipayipi lokuphefumula lingena epayipini lokudla (umphimbo) esikhundleni sepayipi lomoya (umphimbo), lingabangela ukulimala kobuchopho noma ngisho nokufa uma lingelashwa ngokushesha udokotela.
• Ukwehluleka ukuvikela indlela yokuphefumula: Uma ukufakelwa kwepayipi kungenziwa kahle, odokotela bangase bangakwazi ukukwelapha.
• Ukutheleleka: Ukutheleleka ngamagciwane, njengokutheleleka kwama-sinus, kungavela ngemva kokufakwa kwepayipi.
• Ukulimala: Ukufakwa kwepayipi kungabangela ukulimala emlonyeni, emazinyweni, olimini, ezintanjeni zezwi, noma endleleni yokuphefumula. Lokhu kulimala kungabangela ukopha nokuvuvukala.
• Izinkinga lapho uphuma ekubulaweni yizinzwa: Iningi labantu lilulama kahle ekubulaweni yizinzwa. Kodwa-ke, abanye bangase babe nobunzima bokuvuka, noma bangase babe nezinye izinkinga ezifana nomkhuhlane, ukudikiza kwemisipha (i-hyperthermia embi), noma ukulimala kwemizwa okwesikhashana noma okuhlala njalo.
• I-Tension pneumothorax (ukuwa kwamaphaphu): Umoya ovaleleke esifubeni ungabangela ukuba amaphaphu awe.

Ngisho noma lezi zinto zingenzeka, odokotela bakhathazekile kakhulu ngakho konke lokhu.

Ubani ongafakwanga ipayipi?

Ngezinye izikhathi, odokotela banquma ukuthi akuphephile ukwenza i-intube. Lokhu kungenzeka uma kukhona ukulimala okukhulu endleleni yokuphefumula, noma uma kukhona ukuvaleka okuvimbela i-tube ukuthi ingafakwa ngokuphephile.

Ezimweni ezinjalo, odokotela bangase banqume ukwenza inqubo yokuhlinzwa entanyeni yakho engezansi ukuze kuvuleke indlela yakho yokuphefumula. Lokhu kubizwa ngokuthi "i- tracheostomy." Lokhu kuvame ukwenziwa uma udinga ipayipi lokuphefumula isikhathi esingaphezu kwezinsuku ezimbalwa, noma uma ucabanga ukuthi kungadingeka ukuthi ulisebenzise amasonto ambalwa.

Kuthatha isikhathi esingakanani ukuphulukiswa?

Iningi labantu liyalulama zingakapheli amahora noma izinsuku ezimbalwa ngemva kokufakwa kwepayipi. Kodwa-ke, uma unenkinga yokukhwehlela, ukugwinya, noma ukukhuluma ngisho namasonto ambalwa ngemva kokufakwa kwepayipi, bona udokotela. Bangase bakuthumele kuchwepheshe wezindlebe, impumulo, kanye nomphimbo (otolaryngologist).

Kufanele ubonane nini nodokotela ngemva kokufakwa kwepayipi?

Uma uhlangabezana nanoma yiziphi zalezi zimpawu ngemva kokufakwa kwepayipi , xhumana nodokotela ngokushesha:

• Ubuhlungu besifuba
• Ubunzima bokuphefumula, njengokushoda kokuphefumula
• Ubunzima noma ukungakwazi ukukhuluma noma ukugwinya
• Umphimbo obuhlungu kakhulu
• Ukuvuvukala kobuso

Uma unanoma yikuphi kwalokhu, tshela udokotela.

Kubaluleke kangakanani ukufakwa kwepayipi?

Lokhu kuncike ekutheni kungani udinga ukwenza i-`(Intubation)`. Ngezinye izikhathi odokotela basebenzisa i-`(Intubation)` ngesikhathi sokuhlinzwa okuhleliwe. Akuyona into enkulu. Kodwa esimweni esiphuthumayo, lapho ungakwazi ukuphefumula wedwa, lapho i-`(Intubation)` yenziwa njengendlela yokusindisa impilo, kuyisimo esibucayi ngempela.

Ingabe "ukufakwa kwepayipi" kanye "nokungena komoya" kuyizinto ezihlukene?

``(Intubation)`` kanye ``(Mechanical Ventilation)`` zihlobene. Kodwa azifani ncamashi.

• Ukufakwa kwepayipi lokuphefumula inqubo yokufaka ipayipi lokuphefumula endaweni yokuphefumula.
• Udokotela ube esexhuma ipayipi kudivayisi esetshenziselwa ukuphefumula. Le divayisi ingaba yisikhwama esiphathwa ngesandla esipompa umoya, noma ingaba umshini wokuphefumula.
• I-ventilator umshini opompa umoya-mpilo emigudwini yakho yomoya nasemaphashini. Ngezinye izikhathi i-ventilator ikhipha umoya ngemaski ebusweni bakho esikhundleni sepayipi.

Uyaqonda? Isikhathi esiningi, umshini wokuphefumula uxhunywe ngemuva kokuthi "Ukufakwa kwentuba".

Kuyini `(Nasotracheal intubation)`?

Yilapho odokotela befaka khona ipayipi lokuphefumula ngekhala lakho. Lokhu kuvame ukusetshenziswa uma uhlinzwa ekhanda, emlonyeni, noma entanyeni. Kuphinde kusize ekuvimbeleni ukulimala okwengeziwe entanyeni noma emphinjeni wakho.

Okokugcina, izinto okufanele uzikhumbule

Umcabango wokuthi udokotela afake ipayipi emphinjeni wakho ungethusa. Kodwa ukufakwa kwepayipi kuyindlela yezokwelapha evame ukwenziwa emakamelweni okuhlinzwa nasemakamelweni ezimo eziphuthumayo ukusiza ekusindiseni impilo yakho uma ungakwazi ukuphefumula. Abantu abaningi bazwa ubuhlungu bomphimbo noma ubunzima bokukhuluma ngemva kwalokho. Kodwa leyo miphumela emibi ivame ukuphela phakathi nesonto. Ngakho-ke, thembela odokotela bakho. Bahlala bezama ukwenza okungcono kakhulu kuwe.

Ukufakwa kwepayipi , ukuphefumula, ukunakekelwa okuphuthumayo, ukwesekwa kokuphefumula, umoya opholile, ukuhlinzwa, i-tracheostomy