Wake wasibona isiguli egunjini lokunakekelwa okujulile (ICU) esinobunzima obukhulu bokuphefumula, siphendulwa ngobuso phansi ngodokotela kanye nabasebenzi abahlengikazi? Kungenzeka ukuthi uke wazibuza ukuthi kungani benza lokhu, nokuthi ngabe bekungeke yini kube buhlungu esigulini. Empeleni lena indlela yokwelapha ebaluleke kakhulu engasindisa impilo yesiguli. Namuhla sizokhuluma ngale ndlela ekhethekile entsha kubantu abaningi, kodwa ebilokhu isetshenziswa kwezokwelapha amashumi eminyaka. Lokhu kubizwa ngokuthi "Proning" kwezokwelapha.
Kuyini ukumane ukhulume?
Kalula nje, ukukhothama kuyisenzo sokuguqula isiguli esilele sibheke phezulu (ngomhlane) sibe sesimweni sokuthambekela (ngesisu). Ngokwezokwelapha, lesi simo sokulala sibizwa ngokuthi "Isimo Sokukhothama". "Isimo Sokukhothama" sisetshenziswa odokotela ukusiza iziguli ezinezimo ezinzima zokuphefumula ezinenkinga yokuthola umoya-mpilo owanele emizimbeni yazo.
Le ndlela ivame ukusetshenziswa ezigulini ezisebenzisa umoya ophefumulayo ngomshini. Kungenzeka ukuthi uke wezwa leli gama ngesikhathi sobhubhane lwe-COVID-19 . Kodwa akuyona into entsha. Izifundo zithole nokuthi uma le ndlela isetshenziswa kusenesikhathi ezigulini ezinezifo zokuphefumula ezinzima, ingozi yokufa ingancishiswa kakhulu.
Yiziphi izinhlobo zezimo zezokwelapha le ndlela esetshenziselwa zona?
Indlela yokukhomba isetshenziswa kakhulu kubantu abanezifo zokuphefumula ezinzima abasesimweni "se-Hypoxia" lapho umzimba ungatholi khona umoya-mpilo owanele. Kodwa-ke, le ndlela isetshenziswa kakhulu esimweni esibizwa ngokuthi i-Acute Respiratory Distress Syndrome (ARDS) .
Kalula nje, i-ARDS yisimo lapho amasaka amancane omoya (i-alveoli) emaphashini ethu egcwala khona uketshezi. Lokhu kwenza kube nzima kakhulu ukuphefumula. I-ARDS iyinkinga enkulu yezifo ezinzima zokuphefumula njenge-pneumonia kanye ne-COVID-19.
Kungani amazinga omoya-mpilo enyuka uma uphendula ikhanda lakho?
Isizathu salokhu siyathakazelisa kakhulu. Isizathu esiyinhloko salokhu ukuthi imizimba yethu ayilingani ngokuphelele. Ukuziphakamisa kwenza izinto ezimbili.
1. Ukuncipha kwesisindo kanye nokucindezeleka emaphashini
Cabanga ngakho, ngoba imizimba yethu yenzelwe ukuba nezicubu zamaphaphu eziningi ngaphandle kunengaphakathi kwesifuba sethu. Uma silala ngomhlane, isisindo senhliziyo yethu nezinye izitho zesisu ziwela ngqo emaphashini ethu. Futhi, uketshezi oluqongelela emaphashini ethu lucindezela phansi ezikhwameni zomoya ngaphandle ngenxa yamandla adonsela phansi. Lokhu kunciphisa isikhala sokuba amaphaphu agcwale umoya ngokuphelele.
Kufana nesiponji esinesisindo. Uma ususa isisindo, sivuvukala kahle, akunjalo? Yilokho okwenzekayo nalapha.
Kodwa uma siphendula isiguli sibheke phansi, isisindo senhliziyo nesesisu siyasuka emaphashini siye esifubeni. Ngemuva kwalokho, uhlangothi olungemuva, olunezicubu eziningi zamaphaphu, luyakhululwa. Ngakho amaphaphu akhula kangcono futhi angangenisa umoya omningi.
2. Ukushintshaniswa Kwegesi Kusebenza kahle
Ku-ARDS, kukhona ukungafani phakathi kwenani lomoya-mpilo ongena emaphashini (umoya-mpilo) kanye nenani lomoya-mpilo omuncwa egazini (umoya-mpilo). Kungakhathaliseki ukuthi umzimba wethu umi kanjani, ingemuva lamaphaphu lithola igazi eliningi kakhulu.
Manje bheka, uma siphendula ubuso besiguli phansi, sivumela umoya omningi ukuthi ungene emaphashini ngakolunye uhlangothi. Ngakolunye uhlangothi, siqondisa lowo moya engxenyeni yamaphaphu enegazi eliningi kakhulu . Lokhu kwenza inqubo yokuphefumula isebenze kahle kakhulu. Kalula nje, le ndlela isivumela ukuthi sithumele umoya-mpilo lapho udingeka khona kakhulu.
Uphendula kanjani isiguli sibheke phansi?
Lokhu akuyona into engenziwa umuntu oyedwa noma ababili. Lokhu kuwumzamo weqembu ohlelwe kahle. Uchwepheshe wezokwelapha ukuphefumula, odokotela, kanye nabasebenzi abahlengikazi, okungenani abantu aba-5-6, basebenzisana ukwenza lokhu.
Isinyathelo sokuqala ukubopha wonke amapayipi nezintambo ezixhunywe emzimbeni wesiguli (isib. ipayipi lokuphefumula, ipayipi le-saline, i-EKG) ukuze zingakhululeki. Umelaphi wokuphefumula ubamba ngokucophelela intamo yesiguli kanye nepayipi lokuphefumula. Bese, ngesikhathi esifanayo, ngokomyalo ofanayo, lonke ithimba liphendula ngokucophelela isiguli ohlangothini lwaso, besebenzisa imicamelo nezindwangu. Konke lokhu kwenziwa ukuze kugwenywe noma yikuphi ukulimala kwesiguli.
Ngokuvamile, isiguli sibekwa kulesi sikhundla amahora aphakathi kuka-12 no-18. Ngokuvamile, kuchithwa okungenani amahora angu-16 ngesikhathi esisodwa, isiguli silele sibheke phansi bese siphendukezelwa phansi.
| Izinzuzo zendlela ye-Proning | Incazelo elula |
|---|---|
| Amazinga e-oxygen akhuphukile | Umoya omningi ungena emaphashini bese umoya-mpilo umuncwa egazini ngendlela ephumelela kakhulu. |
| Ukususwa kalula kwe-mucus | Amandla adonsela phansi asiza ukuthi amafinyila kanye nolunye uketshezi oluqongelela emaphashini luphume kalula. |
| Ukusebenza kwenhliziyo okuthuthukisiwe | Imithambo yegazi emaphashini iyavuleka, okwenza kube lula ngenhliziyo ukupompa igazi. |
| Ukwehla kwezinga lokufa | Izifundo zibonise ukuthi kunciphisa kakhulu izinga lokufa kweziguli ze-ARDS. |
Ingabe zikhona izingozi kule ndlela?
Njenganoma yikuphi ukwelashwa kwezokwelapha, kunezingozi ezithile ezihilelekile kule nqubo. Kodwa-ke, lezi zingozi zingancishiswa ngokuba nethimba lezokwelapha elinolwazi eliqapha ngokucophelela lezi zici.
- Ukususwa ngengozi kwepayipi le-endotracheal
- Ukulahlekelwa yi-catheter yemithambo yegazi (njenge-saline):
- Izinkinga zomfutho wegazi noma izinga lokushaya kwenhliziyo: (`Hemodynamic Instability`, `Arrhythmia`)
- Ukwehla kwesikhashana kwamazinga omoya-mpilo
- Ukuvinjelwa komoya
Lezi zingozi ziphansi kakhulu ezibhedlela ezinolwazi olungaphezu kweminyaka emihlanu ngendlela ye-Proning.
Khumbula, i-Proning iyindlela yokwelapha eqinisekisiwe ngokwesayensi, esindisa impilo yeziguli ezibhekene nezimo zokuphefumula ezinzima.
Kwezinye izimo, iziguli ezinenkinga yokuphefumula encane zelulekwa udokotela wazo ukuba zilale zibheke phansi (`Phaphama Ukuziphakamisa`). Lokhu kungabavimbela ekudingeni umshini wokuphefumula.
Umlayezo Wokuya Nawe Ekhaya
- Ukuhlikihla imilenze kuyindlela yokwelapha isiguli esinenkinga enkulu yokuphefumula ngokusiphendula sibheke phansi.
- Lokhu kunciphisa ingcindezi emaphashini futhi kusiza umzimba ukuthi uthole umoya-mpilo owengeziwe.
- Lokhu ikakhulukazi yi -ARDS (i-Acute Respiratory Distress Syndrome).Ukwelashwa okusindisa impilo okusetshenziselwa izimo ezinzima ezifana.
- Lokhu kwenziwa ngokucophelela okukhulu, yiqembu lodokotela abaqeqeshiwe.
- Uma ubona othandekayo wakho ethola lolu hlobo lokwelashwa esibhedlela, qonda ukuthi kuyisinyathelo esibaluleke kakhulu ekululameni kwakhe. Uma unenkinga, khuluma nodokotela ophethe ngakho.
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