Wake wezwa odokotela bethi, "Sizokhipha isisu esibi" lapho omunye wezihlobo zakho noma abangani bakho ese-ICU (igumbi lokunakekela abagulayo)? Noma ungase ukhumbule igama elithi 'ukukhomba isisu' elalisetshenziswa njalo ngesikhathi sobhubhane lwe-COVID-19. Nakuba lokhu kungase kube kusha kwabaningi, empeleni kuyindlela ebaluleke kakhulu futhi ende esetshenziswa odokotela ukusindisa izimpilo zeziguli ezinezinkinga ezinkulu zokuphefumula. Ngakho-ke, namuhla sizokhuluma ngakho konke ngendlela elula kakhulu, ngendlela ongayiqonda.
Kalula nje, kuyini 'ukuzilungiselela'?
Ukuziphakamisa kuyinto elula kakhulu. Kuwukuguqula isiguli esilele embhedeni sibe nesimo sokuthambekela. Kufana nokujika ngesisu ukuze silale. Kodwa lokhu akuyona into esiyenza ngokunganaki, kuyinto eyenziwa ngokucophelela nangokuhlosiwe ngabasebenzi bezokwelapha esibhedlela.
Lokhu kuvame ukwenziwa ezigulini ezinezinkinga ezinkulu zokuphefumula , ikakhulukazi lezo ezisebenzisa umoya-mpilo. Lokhu kwandisa inani lomoya-mpilo ofinyelela emzimbeni wesiguli.
Nakuba yathandwa kakhulu ngesikhathi sobhubhane lwe-COVID-19, lokhu akuyona into entsha. Odokotela bebelokhu besebenzisa le ndlela amashumi eminyaka. Ucwaningo luye lwabonisa nokuthi ukushesha kwesiguli ezigulini ezinesifo sokuphefumula esinzima ezisebenzisa umshini wokuphefumula kunganciphisa kakhulu ukufa .
Yiziphi izinhlobo zezimo zezokwelapha le ndlela esetshenziselwa zona?
Indlela yokuhlinza isetshenziswa kakhulu ukusiza iziguli ezinezifo zokuphefumula ezinzima lapho umzimba ungatholi khona umoya-mpilo owanele (i-hypoxia). Isimo esivame kakhulu kulezi yi -Acute Respiratory Distress Syndrome (ARDS).
Kalula nje, i-ARDS ukuqongelela koketshezi ezikhwameni zomoya ezincane ngaphakathi kwamaphaphu ethu, i-alveoli. Cabanga ngakho njengesiponji esimunca amanzi bese sivala izikhala. Lapho lezi zikhwameni zomoya zigcwele uketshezi, asikho isikhala somoya sokuphefumula. Lesi yisimo esibi kakhulu. I-ARDS ingenzeka njengecala elibi lezifo ezifana ne-pneumonia kanye ne-COVID-19.
Kungani i-oxygenation ithuthuka uma uphendula isisu sakho?
Lokhu kuyinto ebaluleke kakhulu. Izinga lomoya-mpilo likhuphuka kanjani uma uphenduka ngesisu sakho? Kunezizathu ezimbili eziyinhloko zalokhu. Isizathu ukuthi imizimba yethu ayilingani.
1. Ukuncipha kwesisindo kanye nokucindezeleka emaphashini (Umoya Othuthukisiwe)
Ngenxa yokuma komzimba wethu, sinezicubu zamaphaphu eziningi emhlane wethu kunasesifubeni sethu.Uma silala ngomhlane, isisindo senhliziyo yethu nezinye izitho zesisu siwela ngqo phezu kwamaphaphu ethu. Futhi, ezimweni ezifana ne-ARDS, uketshezi oluqongelela emaphashini luphinde lucindezele amasaka omoya angaphandle ngenxa yamandla adonsela phansi. Lokhu kunciphisa ikhono lamaphaphu lokugcwalisa umoya ngokugcwele.
Cabanga nje unesisindo esifubeni sakho futhi unenkinga yokuphefumula. Kwenzeka into efanayo nasemaphashini akho.
Kodwa-ke, uma isiguli sivulwa ngesisu (isimo esithambekele), isisindo senhliziyo nezinye izitho asiweli emaphashini, kodwa emathanjeni esifuba. Futhi, uketshezi olusemaphashini luqoqana endaweni encane, engaphambili yamaphaphu. Lokhu kukhulula indawo enkulu yamaphaphu ngemuva. Ngemuva kwalokho , umoya ungangena kahle kuleyo ndawo, okuvumela amaphaphu ukuba akhule aze afike ezingeni lawo eliphezulu.
2. Ukusebenza kahle kokushintshana kwegesi emaphashini
Ezimweni ezifana ne-ARDS, kukhona ukungafani phakathi kwenani lomoya ongena emaphashini (umoya ongenisa umoya) kanye nenani lomoya-mpilo omuncwa egazini (ukuphuma kwegazi). Kumuntu ophilile, lezi zinqubo ezimbili zihambisana kahle.
Kunoma yisiphi isimo esikuso, ingemuva lamaphaphu ethu lithola ukugeleza kwegazi okuningi kunangaphambili. Manje cabanga ukuthi kwenzekani lapho isiguli siphendukela esiswini saso.
- Ngokusho kwephuzu lokuqala, amakamelo angaphandle amaphaphu avulekile kahle futhi agcwele umoya.
- Into yesibili ukuthi ingxenye yomhlane egcwele umoya nayo inegazi elingcono kakhulu.
Kalula nje, lapho kunomoya-mpilo omningi khona, ukugeleza kwegazi nakho kuhle. Kufana nokuletha izimpahla lapho kudingeka khona. Lokhu kwenza inqubo yokuphefumula isebenze kahle kakhulu.
| Isikhundla sesiguli | Kwenzekani emaphashini? |
|---|---|
| Ukulala phansi | Amaphaphu ayacindezelwa ngenxa yesisindo senhliziyo nezitho zomzimba. Kunzima ukuthi umoya ufinyelele ezingxenyeni ezingemuva zamaphaphu. |
| Ukuthambekela | Amaphaphu ayakhululeka njengoba isisindo sezitho zomzimba sihamba siye esifubeni. Amakamelo amakhulu amaphaphu angemuva avuleka kahle futhi agcwale umoya. |
Usabela kanjani 'esimeni' sesiguli esibhedlela?
Lokhu kuyinto ehlelwe futhi eyenziwa ngokucophelela okukhulu. Akukhona ukuthi umane uphendule umuntu wonke ngesikhathi esisodwa. Kuhilela ithimba lodokotela, abahlengikazi, kanye nabelaphi bokuphefumula abasebenza ndawonye. Yilokhu okuvame ukwenzeka:
- Okokuqala, wonke amapayipi nezintambo ezixhunywe esigulini (isibonelo, amapayipi e-saline, amapayipi omoya, izintambo ze-ECG) zihlelwe ngokucophelela ukuze zingakhululeki noma zixabane.
- Udokotela wezifo zokuphefumula ubamba ngokuphephile ipayipi le-endotracheal ekhanda nasemlonyeni wesiguli.
- Bese kuthi abanye eqenjini balungiselele isiguli ngokubeka ishidi ngaphansi kwesiguli, babeke imicamelo kanye nelinye ishidi phezu kwesiguli.
- Bese kuthi, wonke umuntu ndawonye, ngesikhathi esifanayo, ngokwesiginali ebekiwe, isiguli siphendukela kolunye uhlangothi lombhede, bese siphendukela kolunye uhlangothi.
- Okwamanje, sihlola kabusha ukuthi wonke amapayipi nezintambo zisendaweni yazo.
- Ekugcineni, isiguli siphendulwa ngokuphelele esiswini saso bese sibekwa kahle emicamelweni eyayibekwe ngaphambili. Imicamelo ibekwa futhi ekhanda nasentanyeni ukuze kwakheke indawo ekhululekile.
Lokhu kungahluka kancane kuye ngesibhedlela, futhi ngezinye izikhathi kusetshenziswa imishini ekhethekile kule njongo.
Kufanele ngiyigcine isikhathi esingakanani kanje?
Amazinga omoya-mpilo kwezinye iziguli aqala ukuthuthuka ngehora elilodwa nje. Kodwa-ke, ukuze kuqinisekiswe ukuthi intuthuko ihlala isikhathi eside, odokotela bavame ukugcina isiguli sigobile amahora angu-12 kuya kwangu-18 ngesikhathi . Uma isimo sesiguli sithuthuka, basigcina kulesi simo okungenani amahora angu-16 ngosuku, bese sibuyela esimweni sokulala isikhathi esisele.
Yiziphi izingozi nezinzuzo zokuhlola?
Njenganoma iyiphi inqubo yezokwelapha, ukusheshisa inqubo kunezingozi ezithile, kodwa izinzuzo zidlula kakhulu lezo zingozi.
| Izinzuzo | Izingozi |
|---|---|
| Kuthuthukisa kakhulu amazinga omoya-mpilo egazini. | Ukuphuma ngengozi kwepayipi le-endotracheal lapho kuphendulwa isiguli. |
| Kwenza kube lula ukukhipha uketshezi olufana ne-mucus emaphashini. | I-catheter yemithambo ekhishwe ekhipha usawoti. |
| Ivula imithambo yegazi emaphashini futhi ithuthukise ukusebenza kwenhliziyo. | Ukuba nezinkinga zomfutho wegazi noma ukushaya kwenhliziyo. |
| Kwandisa ikhono lokususa ngokushesha kumshini wokuphefumula. | Ukuvaleka komoya. |
| Kuye kwafakazelwa ukuthi kunciphisa ukufa kweziguli ezine-ARDS enzima. | Kungenzeka ukuthi kube nezilonda ezicindezelayo esikhumbeni. |
Ukuze kuncishiswe lezi zingozi, odokotela kanye nabasebenzi abahlengikazi basebenza ndawonye njengeqembu ngendlela ehleliwe kakhulu. Le ngozi iphansi kakhulu, ikakhulukazi ezibhedlela ezinolwazi kulokhu.
Kuyini 'Ukuvuka Ukuqaphela'?
Kungenzeka ukuthi nawe uke wezwa ngalokhu. Ukuvuka uqonde phambili kuyinqubo yokufundisa isiguli esiqaphile esingaxhumene nomshini wokuphefumula ukuthi siziphendulele esiswini saso. Lokhu kwenziwa ezimweni ezingembi kangako, ngenhloso yokuvimbela isidingo somshini wokuphefumula.
Kodwa lokhu kubaluleke kakhulu. Lokhu akuyona into ongayenza wedwa. Kufanele ukwenze kuphela uma udokotela wakho ehlole ngokucophelela isimo sesiguli futhi esincoma. Ngisho noma kunjalo, abasebenzi bezokwelapha bazokusiza ufunde ukuthi ungashintshela kanjani ngokuphephile kuleso simo.
Ukubona othandekayo esibhedlela, ikakhulukazi egunjini lokunakekelwa okujulile, esesimweni esibucayi kuyinto eyesabekayo necindezelayo. Njengoba kunezintambo eziningi, amapayipi, kanye nemishini yokukhala, kungaba nzima kakhulu. Singase singaziqondi ezinye zezinto odokotela abazenzayo. Ukuhlikihla ikhanda kungenye yamathuluzi abalulekile odokotela abawasebenzisayo ukusindisa impilo yesiguli. Nakuba kungewona wonke ukwelashwa okusebenza kahle ngo-100%, ucwaningo luye lwabonisa ukuthi ukuhlikihla ikhanda kuyindlela enhle yokusindisa izimpilo zeziguli ezinezifo zokuphefumula ezinzima nokusheshisa ukululama kwazo.
Umlayezo Wokuya Nawe Ekhaya
- Ukuziphakamisa kuyinqubo yokuguqula isiguli esinesifo sokuphefumula esinzima sibe yisisu saso ukuze kwandiswe amazinga omoya-mpilo emzimbeni.
- Lokhu kusetshenziselwa kakhulu izimo ezinzima njenge-ARDS, ikakhulukazi ezigulini ezisebenzisa umshini wokuphefumula.
- Isebenza ngokunciphisa ingcindezi emaphashini kanye nokunikeza igazi elihle endaweni lapho umoya ungena khona.
- Ukuhlikihla imilenze kuyindlela ehlelwe kahle futhi ecophelelayo eyenziwa esibhedlela yithimba lezokwelapha eliqeqeshiwe.
- Naphezu kwezingozi ezithile, ukuhlinza kuye kwafakazelwa ukuthi kusiza kakhulu ekunciphiseni izinga lokufa kweziguli ezimweni ezimbi kakhulu.
- Ungalokothi uzame "Ukuvuka Ekuqapheleni" ekhaya noma esibhedlela ngaphandle kweseluleko sikadokotela. Njalo xhumana nodokotela wakho.
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