Raunin Wutar Lantarki: Duk da cewa hatsarurran lantarki da ke faruwa a cikin gida ba da gangan ba (misali, taɓa tashar wutar lantarki ko ƙaramar na'ura ta gigice) ba kasafai ke haifar da munanan raunuka ko abubuwan da suka biyo baya ba, haɗarin haɗari ga igiyoyin wutar lantarki yana haifar da mutuwar kusan 300 kowace shekara a cikin Amurka

Akwai> 30 000 da ba sa mutuwa hadurran lantarki / shekara a cikin Amurka kuma ƙonewar wutar lantarki ya kai kusan kashi 5% na shigar da raka'a a cikin Amurka.

Raunin lantarki, pathophysiology

A al'ada, an koyar da cewa tsananin rauni daga wutar lantarki ya dogara da abubuwan Kouwenhoven:

• Nau'in halin yanzu (kai tsaye [DC] ko madaidaicin [AC])
• Voltage da amperage (ma'auni na ƙarfin halin yanzu)
• Tsawon bayyanarwa (tsawon bayyanarwa yana ƙara tsananin rauni)
• Juriya na jiki
• Hanya na yanzu (wanda ke ƙayyade takamaiman ƙwayoyin kyallen takarda sun lalace)

Duk da haka, ƙarfin filin lantarki, adadin da aka yi la'akari da shi kwanan nan, yana da alama yana hasashen raunin rauni daidai.

Wutar Lantarki: Abubuwan Kouwenhoven

Madadin halin yanzu yana canza shugabanci akai-akai; nau'in halin yanzu ne wanda galibi ake bayarwa ga gidaje a Amurka da Turai.

Direct halin yanzu yana gudana akai-akai a hanya guda; nau'in halin yanzu ne wanda batura ke bayarwa.

Defibrillators da na'urorin cardioversion yawanci suna isar da halin yanzu kai tsaye.

DEFIBRILLATORS, NUNA KALLON, NA'URAR RUWAN KIRJI: ZIYARAR KWALLON MAGANIN PRAGETI A EXPO na Gaggawa

Hanyar canza yanayin halin yanzu yana lalata jiki ya dogara da yawa akan mita.

Ana amfani da madaidaicin ƙananan mitoci (50-60 Hertz) a cikin tsarin gida a cikin Amurka (60 Hertz) da Turai (50 Hertz).

Saboda ƙananan mitar canjin halin yanzu yana haifar da matsananciyar tsokar tsoka (tetany), wanda zai iya kulle hannaye a kan tushen yanzu kuma ya tsawaita bayyanarwa, yana iya zama mafi haɗari fiye da madaidaicin halin yanzu kuma sau 3 zuwa 5 ya fi haɗari fiye da halin yanzu na kai tsaye. irin ƙarfin lantarki da amperage.

Fuskantar kai tsaye yana ƙoƙarin haifar da ƙanƙara guda ɗaya cikin sauƙi, wanda sau da yawa yana jefa batun daga tushen yanzu.

DEFIBRILLATORS, ZIYAR BUTH EMD112 A BAYAN GAGGAWA.

Konewar wutar lantarki: tasirin wutar lantarki da amperage akan tsananin rauni

Domin duka masu canzawa da na yanzu kai tsaye, mafi girman ƙarfin lantarki (V) da amperage (A), mafi girma sakamakon raunin wutar lantarki (don bayyanar iri ɗaya).

Gidan na yanzu a cikin Amurka yana daga 110 V (daidaitattun kantunan lantarki) zuwa 220 V (amfani da manyan na'urori, misali firiji, na'urar bushewa).

Matsakaicin ƙarfin wutar lantarki (> 500 V) yana haifar da ƙonawa mai zurfi, yayin da ƙananan wutar lantarki (110 zuwa 220 V) sukan haifar da tetany na tsoka da rashin motsi a tushen yanzu.

Matsakaicin amperage wanda zai iya haifar da raguwar tsokoki na hannu, amma har yanzu yana ba da damar batun sakin hannunsu daga tushen yanzu, ana kiransa bari-tafi na yanzu.

A halin yanzu bari-go ya bambanta bisa ga nauyin jiki da yawan tsoka.

Don matsakaita 70 kg mutum, bari-go halin yanzu yana da kusan milliamperes 75 (mA) don halin yanzu kai tsaye da kuma kusan 15 mA don canjin halin yanzu.

Ƙarƙashin ƙarfin wutar lantarki na 60 Hz na yanzu yana wucewa ta cikin kirji har ma da kashi na biyu na iya haifar da fibrillation na ventricular, ko da a amperages kamar 60-100 mA; tare da halin yanzu kai tsaye, ana buƙatar kusan 300-500 mA.

Idan halin yanzu ya kai ga zuciya kai tsaye (misali ta hanyar catheter na zuciya ko na'urorin lantarki na na'urar bugun zuciya), ko da amperage na <1 mA na iya haifar da fibrillation (a cikin madaidaicin halin yanzu da kai tsaye).

Lalacewar nama a sanadiyyar fallasa wutar lantarki ya fi faruwa ne ta hanyar sauya makamashin lantarki zuwa zafi, wanda ke haifar da lalacewar yanayin zafi.

Adadin zafi da aka watsar yana daidai da amperage2 × juriya × lokaci; don haka, don halin yanzu da tsawon lokaci, nama tare da mafi girman juriya yana kula da mafi yawan lalacewa. Juriya na jiki (wanda aka auna a ohms/cm2) yafi samar da fata, saboda duk kyallen takarda na ciki (sai kashi) suna da juriya mara kyau.

Kaurin fata da bushewa suna ƙara juriya; busassun, keratinized mai kyau da fata mara kyau yana da matsakaicin ƙimar 20 000-30 000 ohm/cm2.

Dabbobi mai kauri, mai kauri ko shuka na iya samun juriya na 2-3 miliyan ohms / cm2; akasin haka, sirara, damshin fata yana da juriya kusan 500 ohms/cm2.

Juriya na fata da aka ji rauni (misali daga yanke, abrasions, sandunan allura) ko m membranes mucous (misali baki, dubura, farji) na iya zama ƙasa da 200-300 ohms/cm2.

Idan juriyar fata ta yi girma, ƙarin ƙarfin lantarki za a iya bazuwa ta cikin fata, yana haifar da ƙonewa mai yawa, amma ƙarancin rauni na ciki.

Idan juriyar fata ta yi ƙasa, ƙonewar fata ba ta da yawa ko ba ta nan, kuma ana watsa ƙarin ƙarfin lantarki zuwa tsarin ciki.

Don haka, rashin ƙonawa na waje baya nuna rashin raunin wutar lantarki, kuma tsananin ƙonawar waje baya nuna tsananin lalacewar lantarki.

Lalacewa ga kyallen takarda na ciki ya dogara da juriya da yawa na yanzu (a halin yanzu kowane yanki na yanki; makamashi ya fi maida hankali lokacin da ƙarfin halin yanzu ya wuce ta ƙaramin yanki).

Misali, lokacin da makamashin lantarki ya ratsa ta hannu (musamman ta ƙananan ƙwayoyin juriya, misali, tsokoki, tasoshin ruwa, jijiyoyi), ƙarfin halin yanzu yana ƙaruwa a cikin gidajen abinci saboda babban kaso na ɓangaren ɓangaren haɗin gwiwa ya ƙunshi mafi girma. juriya kyallen takarda (misali, kasusuwa, tendons), wanda ke rage ƙananan juriya na nama; don haka, lalacewa ga ƙananan juriya na kyallen takarda yakan zama mafi tsanani a cikin gidajen abinci.

Hanyar halin yanzu ta cikin jiki yana ƙayyade wane tsarin zai lalace.

Saboda alternating current yana jujjuya alkibla, kalmomin da aka saba amfani da su na 'shigarwa' da 'fitarwa' basu dace ba; 'source' da 'ƙasa' sun fi dacewa.

Hannu shine tushen tushen da aka fi sani, sannan kuma kai.

Ƙafa ita ce mafi yawan wuraren duniya. Tafiya na yanzu tsakanin hannuwa ko tsakanin hannu da ƙafa yana yiwuwa ya ratsa cikin zuciya, mai yuwuwar haifar da arrhythmia.

Wannan halin yanzu yana da haɗari fiye da tafiya na yanzu daga ƙafa ɗaya zuwa wancan.

Abin da ake nufi da kai na yanzu yana iya lalata tsarin juyayi na tsakiya.

Ƙarfin filin lantarki

Ƙarfin wutar lantarki shine ƙarfin wutar lantarki a fadin yankin da ake amfani da shi.

Tare da abubuwan Kouwenhoven, yana kuma ƙayyade matakin raunin nama.

Alal misali, 20 000 volts (20 kV) da aka rarraba ta cikin jikin mutum kimanin 2 m tsayi yana haifar da ƙarfin filin kusan 10 kV / m.

Hakazalika, 110 volts, idan aka yi amfani da shi fiye da 1 cm kawai (misali, leɓun yaro), yana haifar da irin wannan ƙarfin filin 11 kV/m; Wannan rabo ya bayyana dalilin da ya sa irin wannan ƙananan lalacewar wutar lantarki na iya haifar da lalacewar nama mai tsanani kamar yadda wasu manyan ƙarfin lantarki da ake amfani da su a kan manyan wurare.

Sabanin haka, lokacin da ake la'akari da ƙarfin lantarki maimakon ƙarfin filin lantarki, ƙananan raunin wutar lantarki ko ƙananan rauni za'a iya ƙididdige su azaman babban ƙarfin lantarki.

Misali, girgiza da kuke samu daga rarrafe ƙafafunku akan kafet a cikin hunturu ya ƙunshi dubban volts, amma yana haifar da raunin da ba a iya gani ba.

Tasirin filin lantarki zai iya haifar da lalacewa ga membrane cell (electroporation) ko da lokacin da makamashi bai isa ya haifar da lalacewar thermal ba.

Raunin wutar lantarki: ilimin halittar jiki

Aiwatar da filin lantarki mai ƙarancin ƙarfi yana haifar da rashin jin daɗi nan da nan ('shock'), amma da wuya yana haifar da mummunan rauni ko dindindin.

Aikace-aikacen filin lantarki mai ƙarfi yana haifar da lalacewar zafi ko electrochemical ga kyallen takarda na ciki.

Lalacewar na iya haɗawa da

• Haemolysis
• Coagulation na sunadarai
• Coagulation necrosis na tsoka da sauran kyallen takarda
• Thrombosis
• dehydration
• Ƙaunar tsokoki da tendons

Lalacewa daga filin lantarki mai ƙarfi na iya haifar da kumburi mai mahimmanci, wanda, yayin da zubar jini a cikin jijiyoyi da tsokoki suka kumbura, yana haifar da ciwo na yanki.

Har ila yau, ƙananan edema na iya haifar da hypovolemia da hypotension.

Rushewar tsoka zai iya haifar da rhabdomyolysis da myoglobinuria, da rashin daidaituwa na electrolyte.

Myoglobinuria, hypovolaemia da hypotension suna ƙara haɗarin lalacewar koda.

Sakamakon rashin aikin gabobin ba koyaushe yana da alaƙa da adadin nama da aka lalata ba (misali fibrillation na ventricular zai iya faruwa tare da lalata nama kaɗan).

Symptomatology

Ana iya rarrabe konewa a fata a fili ko da lokacin da halin yanzu ya shiga cikin kyallen takarda ba bisa ka'ida ba.

Ƙunƙarar ƙwayar tsoka mai tsanani ba da son rai ba, jujjuyawa, fibrillation na ventricular ko kama numfashi na iya faruwa saboda lalacewa ga tsarin juyayi na tsakiya ko tsokoki.

Lalacewa ga kwakwalwa, kashin baya igiya ko jijiyoyi na gefe na iya haifar da raunin jijiya iri-iri.

Kamewar zuciya na iya faruwa idan babu konewa, kamar yadda yake faruwa a cikin hatsarori a cikin gidan wanka (lokacin da mai jika [wanda yake hulɗa da ƙasa] ya karɓi wutar lantarki 110 V, misali daga na'urar bushewa ko rediyo).

Yaran da suka ciji ko tsotse igiyoyin wutar lantarki na iya fuskantar kunar baki da lebe.

Irin wannan ƙonawa na iya haifar da nakasar kayan kwalliya da kuma lalata ci gaban hakora, muƙamuƙi da muƙamuƙi.

Hemorrhage na jini na Labial artery, wanda ke fitowa daga faɗuwar eschar kwanaki 5-10 bayan rauni, yana faruwa a kusan kashi 10% na waɗannan yara.

Girgizar wutar lantarki na iya haifar da raunin tsoka mai ƙarfi ko faɗuwa (misali daga tsani ko rufin), yana haifar da tarwatsewa (girgiza wutar lantarki ɗaya ce daga cikin ƴan abubuwan da ke haifar da ɓarnawar kafaɗa ta baya), kashin baya ko wasu karaya, rauni ga gabobin ciki da sauran tasiri. raunuka.

Matsalolin jiki mai laushi ko rashin ƙarfi na jiki, tunani da jijiya na iya haɓaka shekaru 1-5 bayan rauni kuma yana haifar da rashin lafiya mai mahimmanci.

Wutar lantarki: ganewar asali

• Cikakken gwajin likita
• Wani lokaci ECG, bugun zuciya enzyme titration da fitsari bincike

Da zarar an cire majiyyaci daga halin yanzu, ana tantance kamawar zuciya da kamun numfashi.

Ana aiwatar da farfadowar da ya dace.

Bayan farfadowa na farko, ana bincika marasa lafiya daga kai zuwa ƙafa don raunin da ya faru, musamman ma idan mai haƙuri ya fadi ko aka jefa.

Marasa lafiyan asymptomatic waɗanda ba su da ciki, ba su da cututtukan zuciya da aka sani, kuma waɗanda suka ɗan ɗanɗana bayyanar da gida a halin yanzu yawanci ba su da mugun rauni na ciki ko na waje, kuma babu buƙatar ƙarin gwaji ko saka idanu.

Ga sauran marasa lafiya, ya kamata a yi la'akari da ECG, CBC tare da dabara, titration enzyme na zuciya da fitsari (don bincika myoglobin). Marasa lafiya tare da asarar sani na iya buƙatar CT scan ko MRI.

Jiyya

• Kashe wutar
• Tsanakewa
• Analgesia
• Wani lokaci lura da zuciya na 6-12 h
• Raunin kulawa

Magani kafin asibiti

Abu na farko shine karya lamba tsakanin majiyyaci da tushen wutar lantarki ta hanyar kashe wutar lantarki (misali ta hanyar tarwatsa na'urar kashe wutar lantarki ko kashe na'urar, ko cire haɗin na'urar daga fitilun lantarki).

High-voltage da low-voltage Lines ba koyaushe ake iya bambanta ba, musamman a waje.

HANKALI: Idan ana zargin manyan layukan wutar lantarki, don gujewa girgiza mai ceto, kada a yi ƙoƙarin 'yantar da majiyyaci har sai an cire haɗin wutar.

Tsanakewa

An sake farfado da marasa lafiya kuma a lokaci guda ana kimanta su.

Shock, wanda zai iya haifar da rauni ko kuma mai yawa konewa, ana kula da shi.

Formula don ƙididdige ruwan da za a ba su don farfado da ƙonawa na gargajiya, waɗanda suka dogara da girman konewar fata, na iya yin la'akari da buƙatun ruwa don ƙonewar wutar lantarki; don haka, ba a amfani da waɗannan hanyoyin.

Madadin haka, ana yin tit ɗin ruwa don kula da isasshen diuresis (kimanin 100 ml / h a cikin manya da 1.5 ml / kg / h a cikin yara).

A cikin yanayin myoglobinuria, kiyaye isasshen diuresis yana da mahimmanci musamman, yayin da alkalinisation na fitsari yana taimakawa rage haɗarin gazawar koda.

Rashin aikin tiyata na yawan ƙwayar tsoka zai iya taimakawa wajen rage gazawar myoglobinuric renal.

Ya kamata a kula da zafi mai tsanani daga kunar wuta tare da amfani da EV opioids.

MAGANIN KONA A CIKIN AYYUKAN CETO: ZIYARAR BINCIKIN FINA -FINA A BAYAN GAGGAWA.

Hadarin lantarki: wasu matakan

Marasa lafiya masu asymptomatic waɗanda ba su da ciki, ba su da cututtukan zuciya da aka sani, kuma waɗanda suka ɗan ɗanɗana ga wutar lantarki a gida yawanci ba su da mugun rauni na ciki ko na waje da ke buƙatar asibiti kuma ana iya sallame su.

Ana nuna kulawar zuciya na zuciya don 6-12 h ga marasa lafiya tare da waɗannan yanayi:

• Arrhythmias
• Ƙunƙun zuma
• Lalacewar zuciya da ake zargin
• Mai yiwuwa ciki
• Duk wasu cututtukan zuciya da aka sani

Ana buƙatar rigakafin tetanus da ya dace da kuma maganin rauni na cikin gida.

Ana kula da ciwo tare da NSAIDs ko wasu abubuwan analgesics.

Duk majinyata da ke da babban kuna ya kamata a tura su zuwa cibiyar ƙwararrun ƙwararrun.

Ya kamata a tura yaran da ke da kunar lebe zuwa ga ƙwararrun likitocin likitancin yara ko kuma likitan tiyata na maxillofacial da ya samu raunuka.

rigakafin

Na'urorin lantarkin da suke taɓawa ko mai yuwuwa jiki ya taɓa su dole ne a sanya su a rufe da kyau, da ƙasa kuma a saka su cikin da'irar da ke ɗauke da na'urori masu karya da'ira.

Masu watsewar da'ira masu ceton rai, waɗanda ke tafiya idan an gano ɗigon ruwa na ko da 5 milliamperes (mA), suna da tasiri kuma a shirye suke.

Rufin aminci yana rage haɗari a cikin gidaje tare da ƙananan yara.

Don guje wa raunuka daga tsalle-tsalle na yanzu (rauni), bai kamata a yi amfani da sanduna da tsani kusa da manyan layukan wutar lantarki ba.

Karanta Har ila yau:

Patrick Hardison, Labarin Fuskantar Fuskantarwa Akan Wutar Gobara Tare da Konewa

Yanke da raunuka: Yaushe Zaku Kira Motar Ambulance Ko Kuje Dakin Gaggawa?

Hyperbaric Oxygen A cikin Tsarin Warkar da Rauni

Ta yaya za a yi sauri da kuma gane mai haƙuri mai saurin ciwo a cikin tsarin asibiti?

Source:

MSD