Ƙuntataccen motsi na kashin baya ta amfani da dogon katako na kashin baya da ƙuƙwalwar ƙwayar mahaifa ana aiwatar da shi a cikin lokuta masu rauni, lokacin da aka cika wasu ka'idoji, don taimakawa wajen rage yiwuwar rauni na kashin baya.

Alamomi ga aikace-aikace na kashin baya ƙuntatawa motsi sune a GCS na kasa da 15, shaida na maye, taushi ko zafi a tsakiyar layi na wuyansa ko baya, mai da hankali alamomin jijiya da/ko bayyanar cututtuka, nakasar jiki na kashin baya, da yanayi mai ban sha'awa ko rauni.

Gabatarwa ga raunin kashin baya: yaushe kuma me yasa ake buƙatar katako na kashin baya

Raunin raunin da ya faru shine babban abin da ke haifar da raunin kashin baya a Amurka da sauran ƙasashe da yawa, tare da kusan kusan lokuta 54 a kowace al'umma miliyan kuma kusan kashi 3 cikin 1 na duk asibiti na asibiti don raunin da ya faru.[XNUMX]

Ko da yake raunin kashin baya yana lissafin ƙananan kaso na raunin raunin da ya faru, suna cikin manyan masu ba da gudummawa ga cututtuka da mace-mace.[2][3]

Sakamakon haka, a cikin 1971, Cibiyar Nazarin Orthopedic ta Amurka ta ba da shawarar yin amfani da ƙwayar cuta. ƙwararren mahaifa kuma dogo jirgi don ƙuntata motsi na kashin baya a cikin marasa lafiya da ake zargi da raunin rauni na kashin baya, bisa ga tsarin rauni kawai.

A lokacin, wannan ya dogara ne akan ijma'i maimakon hujja[4].

A cikin shekarun da suka gabata tun lokacin ƙuntatawar motsi na kashin baya, yin amfani da abin wuya na mahaifa da kuma dogon katako na kashin baya ya zama ma'auni a cikin kulawar asibiti.

Ana iya samun shi a cikin jagororin da yawa, gami da Advanced Trauma Life Support (ATLS) da jagororin Tallafin Rayuwa na Prehospital Trauma (PHTLS).

Duk da yawan amfani da su, an yi la'akari da ingancin waɗannan ayyukan.

A cikin binciken daya na kasa da kasa wanda ya kwatanta wadanda suka sami ƙuntataccen motsi na kashin baya ga waɗanda ba su yi ba, binciken ya gano cewa waɗanda ba su sami kulawa ta yau da kullum tare da ƙuntataccen motsi na kashin baya suna da ƙananan raunin neurologic tare da nakasa.

Duk da haka, ya kamata a lura cewa waɗannan marasa lafiya ba a daidaita su ba don tsananin rauni.

Yin amfani da ƙwararrun matasa masu aikin sa kai, wani binciken ya kalli motsin kashin baya a kan wani dogon katako idan aka kwatanta da katifa mai shimfiɗa kuma ya gano cewa doguwar kashin baya ya ba da damar motsi mafi girma.

A cikin 2019, nazari na baya-bayan nan, dubawa, bincike na asibiti da yawa ya bincika ko an sami canji a cikin raunin kashin baya bayan aiwatar da ka'idar EMS wanda ke iyakance ka'idodin kashin baya ga waɗanda ke da manyan abubuwan haɗari ko kuma binciken gwaji mara kyau kuma ya gano cewa akwai babu bambanci a cikin abin da ya faru na raunin kashin baya.[7]

MAFI KWANCIYAR GINDI? ZIYARAR DA KUDIN MAI KUDI A BAYAN GAGGAWA

A halin yanzu babu wani babban matakin bazuwar gwaje-gwajen sarrafawa don ko dai goyan baya ko karyata amfani da ƙuntatawar motsi na kashin baya.

Yana da wuya a sami majiyyaci da zai ba da kansa don nazarin da zai iya haifar da gurguzu na dindindin ya saba wa ƙa'idodin ɗabi'a na yanzu.

Sakamakon waɗannan da sauran karatun, sababbin jagororin sun ba da shawarar iyakance amfani da dogon kashin baya na ƙayyadaddun ƙayyadaddun motsi na kashin baya ga waɗanda ke da tsarin rauni ko game da alamu ko alamun bayyanar kamar yadda aka bayyana a baya a cikin wannan labarin da iyakance tsawon lokacin da mai haƙuri ke ciyarwa ba tare da motsi ba. .

Alamu don amfani da allon kashin baya

A cikin ka'idar Denis, rauni ga ginshiƙai biyu ko fiye ana ɗaukarsa a matsayin karaya mara ƙarfi don cutar da kashin baya da ke cikin ginshiƙin kashin baya.

Amfanin da aka ce na ƙuntata motsi na kashin baya shine cewa ta hanyar rage girman motsi na kashin baya, mutum zai iya rage yiwuwar raunin raunin kashin baya na biyu daga raguwa maras kyau a lokacin cirewa, sufuri, da kuma kimanta marasa lafiya.[9]

Alamu don ƙuntata motsi na kashin baya sun dogara ne akan ƙa'idar da masu kula da sabis na kiwon lafiya na gaggawa suka haɓaka kuma suna iya bambanta daidai da haka.

Duk da haka, Kwamitin Kwaleji na Likita na Amurka akan Trauma (ACS-COT), Kwalejin Likitocin Gaggawa na Amurka (ACEP), da Ƙungiyar Likitocin EMS na ƙasa (NAEMSP) sun haɓaka sanarwar haɗin gwiwa game da ƙuntatawar motsi na kashin baya a cikin tsofaffi marasa lafiya marasa lafiya. a cikin 2018 kuma ya lissafta alamomi kamar haka:[10]

• Canjin matakin sani, alamun maye, GCS <15
• Tausayin kashin baya na tsakiya ko zafi
• Mayar da hankali alamun neurologic ko alamu kamar raunin motsi, tausasawa
• Nakasar kashin baya
• Raunin hankali ko yanayi (misali, karaya, konewa, motsin rai wuya, shingen harshe, da sauransu)

Haka kuma sanarwar haɗin gwiwa ta ba da shawarwari ga marasa lafiya marasa rauni na yara, lura da cewa shekaru da ikon yin magana bai kamata su zama wani abu ba don yanke shawara don kula da kashin baya na asibiti.

Wadannan su ne alamomin shawararsu:[10]

• Kokarin ciwon wuya
• Torticollis
• Ragewar Neurologic
• Canjin yanayin tunani, gami da GCS <15, maye, da sauran alamun (tashin hankali, apnea, hypopnea, rashin bacci, da sauransu)
• Kasancewa cikin haɗarin mota mai hatsarin gaske, babban raunin ruwa mai tasiri, ko yana da rauni mai tsoka

Contraindications a cikin yin amfani da kashin baya allon

Matsakaicin dangi a cikin marasa lafiya tare da raunin rauni zuwa kai, wuyansa, ko gaɓoɓin jiki ba tare da ragi ko gunaguni ba.[11]

A cewar nazarin da aka buga a yankin gabashin gabashin kungiyar na tiyata (gabas) da Jaridar Trauma, marasa lafiya suna da rauni a matsayin marasa lafiya waɗanda ba su yi ba.

Rashin motsin majiyyaci tsari ne mai cin lokaci, tsakanin mintuna 2 zuwa 5, wanda ba wai kawai yana jinkirta sufuri don takamaiman kulawa ba har ma yana jinkirta sauran jiyya kafin asibiti saboda wannan hanya ce ta mutum biyu.[12][13].

RADIO NA MASU Ceto A DUNIYA? ZIYARAR BOTH RADIO EMS A EXPO Gaggawa

Kayan aiki masu mahimmanci don rashin motsi na kashin baya: abin wuya, katako mai tsawo da gajeren kashin baya

The kayan aiki wajibi ne don ƙuntata motsi na kashin baya yana buƙatar katako na kashin baya (ko dai tsayi ko gajere) da kuma abin wuya na mahaifa.

Dogon Kashin baya

An fara aiwatar da allunan kashin baya masu tsayi, tare da haɗin gwiwa tare da ƙwanƙarar mahaifa, don hana kashin baya kamar yadda ake tunanin cewa rashin kulawa da kyau a cikin filin zai iya haifar da rauni ko kuma kara yawan raunin kashin baya.

Dogon katakon kashin baya kuma yana da arha kuma yana aiki azaman hanyar da ta dace don jigilar marasa lafiya da ba su sani ba, rage motsin da ba a so, da kuma rufe ƙasa mara kyau[14].

Gajerun allo na kashin baya

Shortan allunan kashin baya, wanda kuma aka sani da na'urorin cire matakan tsaka-tsaki, yawanci sun fi kunkuntar takwarorinsu.

Gajeren tsayin su yana ba da damar amfani da su a cikin rufaffiyar ko wuraren da aka keɓe, galibi a cikin haɗarin mota.

Gudun gajeriyar kashin baya yana goyan bayan thoracic da kashin mahaifa har sai an iya sanya mai haƙuri a kan katako mai tsayi.

Nau'in gama gari na guntun allo na kashin baya shine Kendrick Extrication Na'urar, wanda ya bambanta da al'ada gajeriyar allon kashin baya a cikin cewa yana da tsattsauran ra'ayi kuma yana shimfidawa a gefe don kewaye gaba da kai.

Kama da dogayen allunan kashin baya, ana kuma amfani da waɗannan tare tare da ƙwanƙolin mahaifa.

Collar Cervical: "C Collar"

Za a iya rarraba kwalaran wuyan mahaifa (ko C Collar) zuwa manyan nau'i biyu: taushi ko m.

A cikin saitunan rauni, ƙwanƙwan wuyan mahaifa sune abubuwan da ba za a iya motsa su ba yayin da suke ba da ingantaccen ƙuntatawa na mahaifa.[15]

An tsara ƙwanƙwasa cervical gabaɗaya don samun yanki na baya wanda ke amfani da tsokoki na trapezius azaman tsarin tallafi da yanki na gaba wanda ke goyan bayan mandible kuma yana amfani da sternum da clavicles azaman tsarin tallafi.

Collars na mahaifa da kansu ba sa bayar da isasshiyar hana motsin mahaifa kuma suna buƙatar ƙarin tsarin tallafi na gefe, sau da yawa a cikin nau'in kumfa na Velcro da aka samu akan dogayen allunan kashin baya.

KOYARWA TA FARKO? ZIYARAR DMC DINAS CONNSULTANTS BOOT A EXPO Gaggawa.

m

Akwai dabaru da yawa don sanya wani a cikin ƙuntatawa na motsi na kashin baya, ɗayan mafi yawan gama gari shine fasahar log-roll da aka zayyana a ƙasa kuma ana yin ta, da kyau, tare da ƙungiyar mutum 5, amma aƙalla, ƙungiyar huɗu.[16] ]

Ga Tawagar ta biyar

Kafin a daina motsi, sa majiyyaci su haye hannuwansu bisa ƙirjin su.

Ya kamata a sanya jagoran tawagar zuwa shugaban majiyyaci wanda zai yi aikin daidaitawa ta hanyar layi ta hanyar kama kafadun majiyyaci tare da yatsunsu a gefen baya na trapezius da babban yatsan yatsa a gefen gaba tare da goshin goshin da aka matse da ƙarfi a kan sassan gefe. shugaban mai haƙuri don iyakance motsi da daidaita kashin mahaifa.

Idan akwai, ya kamata a sanya abin wuya na mahaifa a wannan lokacin ba tare da ɗaga kan mara lafiya daga ƙasa ba. Idan babu ɗaya, kiyaye wannan kwanciyar hankali yayin dabarar jujjuya log ɗin.

Memba na ƙungiyar biyu ya kamata a sanya su a cikin thorax, memba na ƙungiya uku a hips, kuma memba na ƙungiya hudu a kafafu tare da hannayensu a matsayi na nesa na mai haƙuri.

Memba na ƙungiya biyar ya kamata su kasance a shirye don zame dogon allon kashin baya a ƙarƙashin majiyyaci bayan an yi birgima.

A kan umarnin memba na ƙungiyar 1 (yawanci akan ƙidaya uku), membobin ƙungiyar 1 zuwa 4 za su mirgine majiyyaci, a lokacin memba na ƙungiyar biyar za su zame doguwar allon kashin baya ƙarƙashin majiyyaci.

Har yanzu, akan umarnin memba na ƙungiyar, za a mirgina majiyyaci a kan dogon allo na kashin baya.

Tsayar da majiyyaci a kan jirgi kuma ka tsare jikin jiki tare da madauri da ƙashin ƙugu da ƙafafu na sama.

Tsare kan kai ta hanyar sanya tawul ɗin birgima a kowane gefe ko na'urar da aka samo ta kasuwanci sannan a sanya tef a kan goshin kuma a tsare zuwa gefuna na doguwar allon kashin baya.

Ga Tawagar Hudu

Hakanan, yakamata a sanya shugaban ƙungiyar zuwa kan mara lafiya kuma ya bi wannan dabarar da aka zayyana a sama.

Memba na ƙungiyar biyu yakamata a sanya su a thorax tare da hannu ɗaya akan kafada mai nisa ɗayan kuma a kan kwatangwalo mai nisa.

Memba na ƙungiyar uku ya kamata a sanya su a ƙafafu, tare da sanya hannu ɗaya a kan kwatangwalo mai nisa kuma ɗayan a kan ƙafa mai nisa.

Lura cewa ana ba da shawarar cewa hannayen 'yan ƙungiyar su ketare juna a hip.

Memba na ƙungiya hudu zai zame dogon katako na kashin baya a ƙarƙashin majiyyaci, kuma ana bin sauran fasaha kamar yadda aka bayyana a sama.

Matsalolin amfani da allon kashin baya a cikin rashin motsin kashin baya

Ƙunƙarar rauni

Matsala mai yuwuwa a cikin waɗanda ke jurewa dogon katako na kashin baya da ƙuntatawa na kashin baya na mahaifa shine cututtukan matsa lamba, tare da rahoton abin da ya faru har zuwa 30.6%.[17].

A cewar kwamitin ba da shawara kan cutar Ulcer na kasa, yanzu an mayar da ciwon gyambon a matsayin raunin matsatsi.

Suna haifar da matsa lamba, yawanci akan fitattun kasusuwa, na dogon lokaci yana haifar da lalacewar fata da taushi nama.

A farkon matakan, fatar jiki ba ta dawwama amma tana iya ci gaba zuwa gyambo a cikin matakai na gaba.[18]

Adadin lokacin da ake ɗauka don haɓaka rauni na matsa lamba ya bambanta, amma aƙalla bincike ɗaya ya nuna cewa raunin nama zai iya farawa a cikin mintuna 30 kaɗan a cikin masu sa kai masu lafiya[19].

A halin yanzu, matsakaicin lokacin da aka kashe ba tare da motsi ba a kan dogon katako na kashin baya yana kusa da mintuna 54 zuwa 77, kusan mintuna 21 daga cikinsu ana tattara su a cikin ED bayan jigilar kaya.[20][21]

Tare da wannan a zuciya, duk masu samarwa dole ne su yi ƙoƙarin rage lokacin da marasa lafiya ke kashewa ba tare da motsi ba ko dai a kan tsayayyen katako na kashin baya ko tare da ƙwanƙwasa na mahaifa saboda duka biyu na iya haifar da raunin da ya faru.

Ragewar numfashi

Yawancin karatu sun nuna raguwar aikin numfashi saboda madauri da aka yi amfani da su a kan dogayen allunan kashin baya.

A cikin matasa masu aikin sa kai masu lafiya, yin amfani da dogayen madauri na kashin baya a kan ƙirji ya haifar da raguwar sigogin huhu da yawa, gami da ƙarfin ƙarfin tilastawa, ƙarar ƙaƙƙarfan tilastawa, da tilasta kwararar tsaka-tsaki wanda ke haifar da takurawa [22].

A cikin binciken da ya shafi yara, an sami raguwar ƙarfin mahimmancin tilastawa zuwa kashi 80% na asali.[23] A cikin wani binciken kuma, an gano duka tsattsauran jirgi da katifu don hana numfashi da matsakaicin kashi 17% a cikin masu sa kai masu lafiya[24].

Dole ne a kula da hankali lokacin da aka hana marasa lafiya, musamman ga waɗanda ke da cutar huhu da ta rigaya ta kasance da yara da tsofaffi.

Pain

Mafi na kowa, ingantaccen rubuce-rubucen rikitarwa na ƙayyadaddun motsi na kashin baya na kashin baya shine zafi, wanda ya haifar da kadan kamar minti 30.

An fi bayyana ciwo tare da ciwon kai, ciwon baya, da ciwon mandibi[25].

Bugu da ƙari, kuma a yanzu jigo mai maimaitawa, lokacin da aka kashe a kan katako mai tsayi mai tsayi ya kamata a rage shi don rage zafi.

Muhimmancin asibiti na raunin kashin baya: rawar kwala da kashin baya

Rashin ƙarfi mai ƙarfi zai iya haifar da rauni na ginshiƙan kashin baya kuma, saboda haka, lalacewar kashin baya wanda zai iya haifar da mummunar cututtuka da mace-mace.

A cikin 1960s da 1970s, an yi amfani da ƙuntataccen motsi na kashin baya don ragewa ko hana abubuwan da ke tattare da ƙwayoyin cuta da ake tunanin zama na biyu zuwa raunin ginshiƙan kashin baya.

Ko da yake an yarda da shi sosai a matsayin ma'auni na kulawa, wallafe-wallafen ba su da wani babban inganci, bincike-bincike na shaida wanda ke bincika ko ƙuntatawa na kashin baya yana da tasiri akan sakamakon ciwon daji.[26]

Bugu da ƙari, a cikin 'yan shekarun nan an sami ƙararrakin shaida da ke nuna yiwuwar rikitarwa na ƙuntata motsi na kashin baya.[17][22][25][20]

Saboda haka, sababbin jagororin sun ba da shawarar cewa a yi amfani da ƙuntatawa na motsi na kashin baya cikin adalci a cikin takamaiman adadin marasa lafiya.[10]

Kodayake ƙuntatawar motsi na kashin baya na iya zama da amfani a wasu yanayi, mai badawa yana buƙatar sanin duka ka'idoji da matsalolin da za su iya haifar da masu samar da su don samun damar yin amfani da waɗannan fasahohin da kuma inganta sakamakon haƙuri.

Haɓaka Sakamakon Ƙungiyar Kula da Lafiya

Marasa lafiya waɗanda ke da hannu cikin raunin ƙarfi da ƙarfi na iya gabatar da alamu da yawa.

Yana da mahimmanci ga masu sana'a na kiwon lafiya da ke da alhakin kima na farko na waɗannan marasa lafiya don su san alamun, contraindications, matsalolin da za a iya haifar da su, da fasaha mai dacewa na aiwatar da ƙuntatawa na kashin baya.

Sharuɗɗa da yawa na iya zama don taimakawa wajen ƙayyade waɗanne marasa lafiya ne suka cika ka'idojin ƙuntatawa na kashin baya.

Wataƙila mafi sanannun jagororin da aka yarda da su shine na bayanin matsayi na haɗin gwiwa ta Kwamitin Kwalejin Likitoci na Amurka akan Trauma (ACS-COT), Ƙungiyar Ƙungiyar Likitocin EMS (NAEMSP), da Kwalejin Likitocin Gaggawa na Amurka (ACEP). ).[10] Ko da yake waɗannan su ne jagororin da shawarwari na yanzu, babu wani ingantattun gwaje-gwajen sarrafawa bazuwar har zuwa yau, tare da shawarwarin da aka dogara akan nazarin lura, ƙungiyoyi masu juyayi, da nazarin shari'ar.[26].

Bugu da ƙari, sanin alamun alamun da contraindications don ƙuntata motsi na kashin baya, yana da mahimmanci ga masu sana'a na kiwon lafiya su san matsalolin da za su iya zama kamar ciwo, matsa lamba, da rashin daidaituwa na numfashi.

Lokacin aiwatar da ƙuntatawa motsi, duk membobin ƙungiyar masu kiwon lafiya na masu kiwon lafiya dole ne su saba da dabarar da aka fi so da kuma rage sadarwa ta kyau don aiwatar da dabarar da ta dace da rage wuce haddi. Masu sana'a na kiwon lafiya ya kamata su gane cewa lokacin da aka kashe a kan dogon kashin baya ya kamata a rage shi don rage rikitarwa.

Lokacin canja wurin kulawa, ƙungiyar EMS ya kamata ta sadar da jimlar lokacin da aka kashe a kan dogon katako na kashin baya.

Yin amfani da sababbin jagororin, sanin matsalolin da aka sani, iyakance lokacin da aka kashe a kan dogon katako na kashin baya, da kuma yin amfani da kyakkyawan sakamakon sadarwa na sadarwa ga waɗannan marasa lafiya za a iya inganta su. [Mataki na 3]

References:

 

[2]Chen Y,Tang Y,Vogel LC,Devivo MJ, Abubuwan da ke haifar da rauni na kashin baya. Batutuwa a cikin gyaran raunin kashin baya. 2013 lokacin hunturu;     [PubMed PMID: 23678280]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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