Emergency Live | Airway Management Guidelines could change quickly — Gudanar da hanyar jirgin sama yana da kusanci zuwa wani sabon mataki zuwa nan gaba

Fa'idodi da Hatsarori na Gudanar da Taimakon Magungunan Magunguna na Prehospital (DAAM)

By Cristiano Antonino On Dec 28, 2022

Game da DAAM: Gudanar da hanyar jirgin sama shine shiga tsakani mai mahimmanci a yawancin gaggawa na marasa lafiya - daga daidaitawar hanyar iska zuwa gazawar numfashi da kama zuciya

Duk da haka, dangane da yadda yanayin majiyyaci ya kasance mai tsanani, da kuma cin zarafi na shiga tsakani, kulawar iska yakan haifar da mummunan tasiri ga lafiyar kwakwalwa da lafiyar jiki.

A cikin wasu al'amuran prehospital, marasa lafiya wani lokaci suna amfana daga Drug Assisted Airway Management (DAAM), wanda zai iya ba da ingantaccen laryngoscopy don masu samarwa da sauƙin shigar da bututun endotracheal da hanyoyin iska na supraglottic yayin intubation.

Don samar da mafi inganci da amintaccen magani mai yiwuwa ga marasa lafiya, masu samar da EMS dole ne su san fa'idodin DAAM da yadda za a yi ta yadda ya kamata, da kuma manyan haɗarin da ke tattare da shi.

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Menene DAAM?

Dangane da takaddun albarkatu daga Ƙungiyar Likitocin EMS ta ƙasa (Amurka), Gudanar da Taimakon Jiragen Sama na Drug (DAAM) yana nufin gudanar da magungunan kwantar da hankali kawai, ko a hade tare da masu hana neuromuscular, don fara sanya ci gaba na hanyar iska a cikin marasa lafiya tare da hanyoyin iska ko masu zuwa. gazawar numfashi, wanda kuma yana iya fama da canjin yanayin tunani, tashin hankali ko cikakkiyar amsawar hanyar iska.

Bambance-bambancen DAAM na yanzu waɗanda aka fi amfani da su a cikin saitunan asibiti na asibiti sun haɗa da intubation-taimakawa intubation (SAI), jinkirin intubation (DSI) da intubation mai sauri (RSI).

RSI, wanda ya fi kowa a cikin ukun, ya haɗa da gudanar da maganin kwantar da hankali da kuma gurgunta don intubation na endotracheal a cikin marasa lafiya.

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Yanayin da DAAM zai iya samun garanti

Wasu abubuwan gaggawa waɗanda zasu buƙaci DAAM sun haɗa da bugun jini, raunin kwakwalwa (TBI) da gazawar numfashi daga cututtukan huhu ko na zuciya.

DAAM ya kamata a yi kawai a cikin isassun saitunan da aka dace da albarkatu da jagororin da ke cikin wurin, kuma akwai isasshen horo da kulawar likitan EMS.

Masu bayarwa dole ne su auna a hankali yuwuwar ribar asibiti akan mummunan haɗarin DAAM

Duk da yanayin majiyyaci, kafin yin DAAM, hukumomin EMS dole ne su tabbatar da cewa masu samarwa sun sami cikakkiyar horon da ake buƙata don sarrafa marasa lafiya a cikin yanayin da aka daidaita, gami da lokacin da kuma bayan yuwuwar gazawar DAAM, kuma suna da mahimmanci. kayan aiki a hannu don ba da magani da intubate a cikin aminci da nasara gwargwadon yiwuwa.

Wasu daga cikin kayan aikin da hanyoyin da suka wajaba don yin DAAM sun haɗa da iskar abin rufe fuska na jaka, na'urorin jirgin sama na supraglottic da hanyoyin tiyatar iska.

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Sanin kasada

Matsayin haɗarin da ke tattare da yin DAAM ya dogara da dalilai da yawa da suka danganci bayanin martaba na mai haƙuri, yanayin da bukatun, da kuma matakin ƙwarewa da shirye-shiryen a bangaren masu samarwa.

Kafin shigar da ciki, yana da mahimmanci cewa masu samarwa su gudanar da kima na jiki na majiyyaci don su fahimci haɗarin / fa'ida na yin DAAM, sabanin saurin intubation na tsari ko hanyoyin samun iska.

A yayin tantancewar, masu samar da kayan aiki su nemo duk wata alama da ke nuna yiwuwar shigar da ciki mai wahala, kamar kasancewar hakoran gaba na sama, tarihin shigar da ke da wuya, duk maki Mallampati daban da daya ko daidai da hudu, da bude baki kasa da 4. santimita.

Haɗari mafi girma kuma suna da alaƙa da halayen hanyoyin iska masu wahala, kamar matsanancin girman hanyar iska, wuyansa rashin motsi, ƙuntataccen buɗe baki, gurɓataccen hanyar iska da zubar jini.

Bugu da ƙari, idan aka yi ba daidai ba, DAAM na iya haifar da ƙarin ƙalubale don shigar da hanyar iska saboda saurin da cikakkiyar asarar isar da iskar iska mai karewa da motsin numfashi, da yuwuwar magunguna don cutar da rashin lafiyar physiologic na marasa lafiya.

Yin yanke shawara mai cikakken bayani

Duk da yake akwai yanayi daban-daban na kula da asibiti wanda zai iya ba da garantin amfani da DAAM, kamar yanayin da marasa lafiya ke fama da rikice-rikicen tunani ko kuma suna fama da rikice-rikicen likita wanda zai iya haifar da gazawar numfashi, DAAM kuma yana haifar da babban haɗari ga marasa lafiya.

Yana da mahimmanci cewa masu samar da EMS suna sane da waɗannan haɗari da kuma yadda suke bambanta daga majiyyaci zuwa majiyyaci, da kuma cewa an sanye su da ingantaccen horo da albarkatu don rage haɗari gwargwadon yiwuwa yayin da ake kula da marasa lafiya.