Iningi lethu libone othile egunjini lokunakekelwa okujulile (ICU) esibhedlela, exhunywe emishinini ehlukahlukene, ephefumula ngamapayipi, futhi edla ngamanye amapayipi. Uma sibona lezi zinto, sizizwa sesaba futhi sikhathazekile. Sivame ukubhekisela kulesi simo ngokuthi 'ukusekelwa kokuphila'. Uma sizwa leli gama, sicabanga ngokushesha ngesimo esibucayi kakhulu. Kuyiqiniso lokho. Kodwa siyini ngempela lesi 'sisekelo sokuphila'? Kwenzekani ngaso? Kungani sisetshenziswa? Namuhla, ake sixoxe kalula nangokufudumele ngalesi sihloko esibucayi abantu abaningi abanemibuzo ngaso.
Kalula nje, iyini i-life support?
Cabanga ngemizimba yethu njengomshini oyinkimbinkimbi onezingxenye eziningi ezahlukene ezisebenzisanayo. Amaphaphu ethu ayaphefumula, inhliziyo yethu ipompa igazi, futhi izinso zethu ziyalihlanza. Kodwa kwenzekani uma esinye noma ngaphezulu salezi zitho siyeka ukusebenza kahle, njengokuthi ngenxa yokugula okukhulu noma ingozi? Lonke uhlelo lomzimba lungawohloka.
Ukusekela impilo ukusetshenziswa kwedivayisi yangaphandle, umshini, noma inqubo yezokwelapha ukugcina umsebenzi womzimba oyekile ukusebenza. Kalula nje, kuyindlela 'yokusiza' umzimba ukuthi wenze into ongakwazi ukuyenza wedwa. Lokhu kufana nokunikeza imoto 'isiqalo' kusuka kwelinye ibhethri lapho ibhethri selifile. Lokhu kusiza umzimba ukuthi ululame futhi ululame.
Into ebalulekile ukuthi i-life support akuyona 'umuthi' owelapha isifo. 'Iwuhlelo lokusekela' olugcina imisebenzi yomzimba ngokwenziwa.
Lokhu kuvame ukuba okwesikhashana. Isibonelo, uma amaphaphu engakwazi ukuphefumula kahle ngenxa ye-pneumonia enzima, umshini wokuphefumula ungasetshenziswa izinsuku ezimbalwa. Phakathi nalesi sikhathi, kuzonikezwa ama-antibiotic ukusiza amaphaphu ukuba alulame futhi amaphaphu azoqala ukusebenza ewodwa futhi. Umshini wokuphefumula uzobe usususwa.
Kodwa ngezinye izikhathi, umzimba ungase ungakwazi ukusebenza wodwa futhi. Khona-ke kufanele uthembele ekusekelweni kokuphila isikhathi eside. Ukwenza izinqumo ngalokhu kuyinto ebucayi kakhulu futhi enzima.
Kunini lapho ukusekelwa kokuphila kuqala futhi kumiswe khona?
Lona umbuzo abantu abaningi abanawo. Lezi zinqumo zenziwa kanjani? Ubani onegunya lokuzenza?
Ukuqala ukwesekwa kokuphila
Odokotela baqala ukwelashwa ngokusekela impilo kuphela uma bebona ukuthi kuyadingeka ngempela emzimbeni wesiguli. Okusho ukuthi, uma impilo yesiguli ingase ilimale uma lokho kusekelwa kunganikezwa ngaleso sikhathi.
Kodwa-ke, ukwesekwa kokuphila ngeke kuqalwe ezimweni ezinjengalezi:
- Uma isiguli senqabe:Abanye abantu bangase babe nesiqondiso kusengaphambili lapho betshelwa khona kusengaphambili ukuthi ngeke bathole ukwelashwa okuthile uma bequleka. Nakuba lokhu kungavamile kakhulu ezweni lakithi, odokotela bayakuhlonipha uma isiguli senze isitatimende esinjalo ngesikhathi siqaphile.
- Uma umndeni wenqaba egameni lesiguli: Uma isiguli sisesimweni esibucayi lapho singenakukwazi ukwenza isinqumo, izihlobo zaso eziseduze zingasenza leso sinqumo.
- Uma kungekho nzuzo yezokwelapha: Ngezinye izikhathi, uma isiguli sigula kakhulu, ukunikeza ukwesekwa kokuphila kungase kwandise inqubo yokufa izinsuku ezimbalwa ezengeziwe. Uma kubangela isiguli ubuhlungu nokuhlupheka okwengeziwe, futhi kungekho themba lokululama, odokotela nomndeni bangase banqume ukungaselapha isiguli.
Ukuyeka ukusekela impilo
Lesi yisinqumo esinzima nesibucayi kakhulu kunoma ubani. Umuntu angaba sesimweni sokusekela impilo amasonto, ngisho nezinyanga. Odokotela bahlala beqapha isimo sesiguli futhi bachazele umndeni ukuthi likhona yini ithemba lokululama.
Ngezinye izikhathi umzimba ungase ungalulami ngokugcwele, kodwa uma kungenzeka ukuthi uzobuyela ezingeni lapho ungaphila khona impilo enenjongo (isibonelo, ukuphila impilo evamile ngenkathi usebenzisa i-dialysis), odokotela batusa ukuqhubeka nokwelashwa.
Kodwa-ke, ezimweni lapho ubuchopho bonakaliswe kakhulu futhi kungekho thuba lokuthola ulwazi (ukufa kobuchopho), odokotela bangase batuse ukuthi akunasizathu sokuqhubeka nokugcina umzimba uphila ngemishini.
Ukwenza isinqumo sokuyeka ukwelashwa ngesikhathi esinjengalesi kuyinto yomuntu siqu kakhulu. Ngokomthetho nangokokuziphatha, akukubi ukuyeka ukwelashwa okungasizi ngalutho isiguli futhi okwandisa ukuhlupheka kwaso.
Khumbula lokhu: Uma i-life support ihoxiswa, akukhona ukuyeka ukwelashwa okubangela ukufa. Yisimo esiyisisekelo sesiguli, esingelapheki esibangela ukufa. Ukususa i-support kuvumela nje lokho okufanele kwenzeke ngokwemvelo.
Yiziphi izinhlobo eziyinhloko zokusekela impilo?
Uma sicabanga 'ngesisekelo sokuphila', sivame ukucabanga ngomshini osisiza ukuphefumula, kodwa ubanzi kakhulu kunalokho. Noma yini esiza inqubo emzimbeni ngaphandle ingaba yisisekelo sokuphila. Ake sibheke ezinye zezinhlobo eziyinhloko.
| Indlela Yokusekela | Kuchazwe kalula |
|---|---|
| Umoya Wokusebenza Ngomshini | Lokhu yilokho esikubiza ngokuthi umshini wokuphefumula. Uma amaphaphu engasebenzi kahle, lo mshini upompa umoya ungene futhi uphume emaphashini. Lokhu kuhilela ukufaka ipayipi ngomlomo noma ekhaleni ungene epayipini lomoya (intubation). Isetshenziswa okwesikhashana ngemva kokuhlinzwa okukhulu noma ezimweni zokutheleleka okukhulu kwamaphaphu. |
| I-ECMO (i-Extracorporeal Membrane Oxygenation) | Lena indlela ethuthuke kakhulu kune-ventilator. Ihilela ukukhipha igazi lesiguli emzimbeni, ukusebenzisa umshini wokufaka umoya-mpilo kulo, ukususa i-carbon dioxide, bese ulibuyisela emzimbeni. Isetshenziswa ezimweni ezimbi kakhulu lapho kokubili amaphaphu nenhliziyo kuye kwahluleka khona. |
| Ukuvuselelwa Kwenhliziyo Nezinhliziyo (CPR) | I-CPR inqubo yokuzama ukuqala kabusha inhliziyo yomuntu nokuphefumula lapho eseyekile. Ihilela ukucindezelwa kwesifuba, ukususwa kwe-fibrillation, kanye nemithi. Ezimweni zokumiswa kwenhliziyo ngokuzumayo noma ukuminza, ukunikeza i-CPR ngokushesha kungasindisa impilo. |
| Ukudla Okunomsoco Nokumanzisa Okwenziwa | Ukondla iziguli ezingakwazi ukudla noma ukuphuza ngomlomo ngepayipi. Leli payipi linganikezwa ngekhala liye esiswini (ukudla ngepayipi) noma ngezinye izikhathi lingene ngqo emthanjeni (TPN - Total Parenteral Nutrition). Lokhu kubalulekile ukuze kuqhubeke nokuphila kuze kube yilapho umzimba uphola. |
| Ukuhlolwa Kwezinso | Uma izinso zihluleka, azikwazi ukususa ubuthi kanye noketshezi oluningi emzimbeni. Umshini wokuhlanza igazi ususa igazi, ulihlanze, bese ulibuyisela emzimbeni. Usebenza njengesikhundla sezinso. Awulaphi isifo sezinso, kodwa uyasiza ekulondolozeni impilo. |
Kuyini i-BLS ne-ALS?
Cishe uke wezwa la magama amabili. Ahlobene futhi nokusekela impilo.
Ukusekelwa Kokuphila Okuyisisekelo (i-BLS)
Lezi izindlela eziyisisekelo zokusindisa impilo ezingaqeqeshwa noma ubani ukuba azenze esimweni esiphuthumayo. Isibonelo:
- Ukwenza i-CPR uma othile ehlaselwa yinhliziyo futhi ewa equlekile.
- Ukusiza umuntu onenkinga ethile emphinjeni wakhe.
Noma ubani angathola ukuqeqeshwa kulezi zinto. Kunezikhathi lapho lolu lwazi lungasindisa impilo.
Ukusekelwa Kokuphila Okuthuthukisiwe (i-ALS)
Lokhu kuyisinyathelo esikhuphukayo kusukela ku-BLS. Kwenziwa kuphela ochwepheshe bezempilo abaqeqeshwe kahle, njengodokotela nabahlengikazi. Ngaphezu kwezinto ezifana ne-CPR,
- Ukufakwa kwepayipi lokusiza ekuphefumuleni
- Ukunikeza imithi ekhethekile yokubuyisela ukusebenza kwenhliziyo
- Ukwelashwa ngokuqapha isigqi senhliziyo
Kwenziwa izinto eziyinkimbinkimbi ezifana nalezi. Le ndlela yokwelapha izinsana nezingane ezincane ibizwa ngokuthi i-Pediatric Advanced Life Support (PALS) .
Ekuphetheni, asikho isidingo sokwesaba ukwesekwa kokuphila. Ngokuthuthuka kwesayensi yezokwelapha, kuyinto esiza ekusindiseni izimpilo eziningi. Futhi, ngezinye izikhathi kungandisa inqubo yokufa kuphela. Into ebaluleke kakhulu ukukhuluma ngokukhululekile nodokotela wakho ngesimo sakho noma somuntu omthandayo, ukwelashwa okunikezwayo, kanye nezinzuzo nezingozi zako. Zonke izinqumo kufanele zenziwe ngokuqonda okugcwele kanye nemvume yomndeni.
Umlayezo Wokuya Nawe Ekhaya
- Ukusekelwa kokuphila akuyona ikhambi lesifo, kodwa uhlelo lokusekela olusiza okwesikhashana inqubo engasebenzi kahle emzimbeni.
- Lokhu kunikeza umzimba isikhathi osidingayo sokuphulukiswa, futhi ngezinye izikhathi kungasiza ekusindiseni impilo.
- Kodwa-ke, ezimweni lapho kungekho themba lokululama, kungandisa inqubo yokufa ngokungadingekile.
- Izinqumo mayelana nokuqala, ukuqhubeka, noma ukuyeka ukusekelwa kokuphila ziyimfihlo kakhulu futhi zibucayi.
- Ngaphambi kokwenza noma yiziphi izinqumo mayelana nesimo sakho noma somuntu omthandayo, khuluma nodokotela wakho kahle bese uthola ukuqonda okugcwele ngezinzuzo, amaphutha kanye nezinketho.
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