Yaya ake gudanar da bambance-bambance a cikin sashen gaggawa? Hanyoyin START da CESIRA
Triage tsarin ne da aka yi amfani da shi a cikin Sassan Hatsari da Gaggawa (EDAs) don zaɓar waɗanda ke cikin haɗari bisa ga haɓaka nau'ikan gaggawa / gaggawa, dangane da tsananin raunin da aka samu da kuma hoton asibiti.
Yadda za a aiwatar da triage?
Dole ne tsarin tantance masu amfani ya haɗa da tattara bayanai, gano alamun da alamomi, rikodin sigogi da sarrafa bayanan da aka tattara.
Domin gudanar da wannan hadadden tsari na kulawa, ma’aikacin jinya na yin amfani da kwarewarsa ta sana’a, ilimi da basirar da aka samu a lokacin ilimi da horarwa a fannin ilmi da kuma kwarewarsa, da sauran kwararrun da yake tare da su. tana ba da hadin kai da mu'amala.
Ana haɓaka bambance-bambance a cikin manyan matakai guda uku:
- na gani” kima na majiyyaci: wannan kima ne a zahiri bisa yadda majinyacin ya gabatar da kansa kafin a tantance shi da kuma gano dalilin shiga. Wannan lokaci yana ba da damar gano daga lokacin da majiyyaci ya shiga sashin gaggawa yanayin gaggawa na buƙatar gaggawa da gaggawa: mara lafiya wanda ya isa sashen gaggawa a sume, tare da yanke kafa da zubar jini mai yawa, alal misali, baya buƙatar da yawa. ƙarin kimantawa da za a yi la'akari da lambar ja;
- Kima na zahiri da haƙiƙa: da zarar an kawar da yanayin gaggawa, za mu ci gaba zuwa lokacin tattara bayanai. La'akari na farko shine shekarun mai haƙuri: idan batun bai wuce shekaru 16 ba, ana yin jigilar yara. Idan majiyyaci ya haura shekaru 16, ana yin gwajin balagagge. Ƙididdiga na ainihi ya haɗa da ma'aikacin jinya yana bincikar babban alamar, abin da ke faruwa a yanzu, zafi, alamun da ke hade da tarihin likita na baya, duk abin da ya kamata a yi ta hanyar tambayoyin anamnestic da aka yi niyya da sauri. Da zarar an gano dalilin samun dama da bayanan anamnestic, ana gudanar da jarrabawar haƙiƙa (mafi yawan ta hanyar lura da majiyyaci), ana auna alamomi masu mahimmanci kuma ana neman takamaiman bayanai, waɗanda za a iya samo su daga binciken gundumar jiki wanda babban abin ya shafa. alama;
- Yanke yanke shawara: A wannan gaba, triagist yakamata ya sami duk mahimman bayanai don kwatanta majiyyaci tare da lambar launi. Shawarar irin wannan lambar duk da haka tsari ne mai rikitarwa, wanda ya dogara da yanke shawara da sauri da gogewa.
Shawarar mai ƙididdigewa sau da yawa tana dogara ne akan ainihin sigogin kwarara, kamar wanda aka nuna a saman labarin.
Ɗaya daga cikin waɗannan zane-zane yana wakiltar "hanyar START".
Bambance-bambance ta hanyar START
Gagaratun START shine gagaratun kafa ta:
- Sauƙi;
- Bambance-bambance;
- Kuma;
- Mai sauri;
- Jiyya.
Don aiwatar da wannan yarjejeniya, mai triagist dole ne ya yi tambayoyi masu sauƙi guda huɗu kuma ya yi motsi biyu kawai idan ya cancanta, rushewar hanyar iska da dakatar da zubar jini na waje.
Tambayoyin nan guda hudu suna yin ginshiƙi kuma sune:
- mara lafiya yana tafiya? YES= kore kore; idan BA tafiya ba na yi tambaya ta gaba;
- majiyyaci yana numfashi? NO= rugujewar hanyar iska; idan ba za a iya rushe su ba = lambar baƙar fata (mai haƙuri mara lafiya); idan suna numfashi Ina tantance ƙimar numfashi: idan yana da> 30 ayyukan numfashi / minti ko <10/minti = lambar ja
- idan yawan numfashi yana tsakanin numfashi 10 zuwa 30, na ci gaba zuwa tambaya ta gaba:
- bugun bugun radial yana nan? NO= kod ja; idan bugun jini ya kasance, je zuwa tambaya ta gaba:
- majiyyaci yana sane? idan ya aiwatar da umarni masu sauƙi = code yellow
- idan ba aiwatar da umarni masu sauƙi = lambar ja.
Yanzu bari mu kalli tambayoyi guda huɗu na hanyar START daidaiku:
1 MAJIYA ZAI IYA YIN TAFIYA?
Idan majiyyaci yana tafiya, ya kamata a yi la'akari da shi kore, watau tare da ƙarancin fifiko don ceto, kuma ya matsa zuwa ga wanda ya ji rauni na gaba.
Idan ba ya tafiya, matsa zuwa tambaya ta biyu.
2 MAI HAKURI YANA NUFA? MENENE MATSALAR HUKUNCINSA?
Idan babu numfashi, gwada share hanyar iska da jeri cannula na oropharyngeal.
Idan har yanzu babu numfashi, ana ƙoƙarin ɓarna kuma idan wannan ya gaza ana ɗaukar mara lafiya wanda ba shi da tabbas (baƙar fata). Idan, a gefe guda, numfashi ya sake dawowa bayan rashin numfashi na ɗan lokaci, ana la'akari da lambar ja.
Idan ƙimar ya fi numfashi 30/minti, ana ɗaukar shi lamba ja.
Idan ya gaza numfashi 10/minti, ana la'akari da lambar ja.
Idan adadin yana tsakanin numfashi 30 zuwa 10, zan ci gaba zuwa tambaya ta gaba.
3 SHIN RADIAL PULU YANA NAN?
Rashin bugun jini yana nufin hypotension saboda dalilai daban-daban, tare da raguwa na zuciya da jijiyoyin jini, sabili da haka ana daukar mai haƙuri ja, an sanya shi a cikin antishock game da daidaitawar kashin baya.
Idan bugun bugun radial ba ya nan kuma bai sake bayyana ba, ana daukar shi lamba ja. Idan bugun bugun jini ya sake bayyana har yanzu ana daukar ja.
Idan bugun bugun jini ya kasance, matsa lamba na systolic na akalla 80mmHg ana iya danganta shi ga majiyyaci, don haka zan ci gaba zuwa tambaya ta gaba.
4 SHIN MAI HAKURI YANA HANKALI?
Idan majiyyaci ya amsa buƙatun masu sauƙi kamar: buɗe idanunku ko fitar da harshen ku, aikin kwakwalwa yana nan sosai kuma ana ɗaukar rawaya.
Idan mai haƙuri bai amsa buƙatun ba, an rarraba shi azaman ja kuma an sanya shi cikin amintaccen matsayi na gefe dangane da daidaitawar kashin baya.
Hanyar CESIRA
Hanyar CESIRA wata hanya ce ta madadin hanyar START.
Za mu yi karin bayani game da shi a cikin wani labarin dabam.
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