"Lamulo la ABC" kapena kungoti "ABC" muzamankhwala likuwonetsa njira yopumira yomwe imakumbutsa opulumutsa ambiri (osati madokotala okha) za magawo atatu ofunikira komanso opulumutsa moyo pakuwunika ndi kuchiza wodwala, makamaka ngati atakomoka, magawo oyambirira a Basic Life Support

Mawu akuti ABC ndi chidule cha mawu atatu achingerezi:

• njira ya mpweya: mpweya;
• kupuma: kupuma;
• kuzungulira: kuzungulira.

Patency ya njira ya mpweya (kutanthauza kuti njira ya mpweya ndi yopanda zopinga zomwe zingalepheretse kutuluka kwa mpweya), kukhalapo kwa mpweya ndi kupezeka kwa magazi ndi zigawo zitatu zofunika kwambiri kuti wodwalayo akhalebe ndi moyo.

Ulamuliro wa ABC ndiwothandiza makamaka kukumbutsa wopulumutsa zomwe ndizofunikira pakukhazikika kwa wodwalayo

Choncho, patency ya airway, kukhalapo kwa mpweya, ndi kuyendayenda kuyenera kufufuzidwa ndipo, ngati kuli kofunikira, kukhazikitsidwanso motsatira ndondomekoyi, apo ayi kuwongolera kotsatira sikudzakhala kothandiza.

M'mawu osavuta, wopulumutsa akupereka chithandizo choyambira kwa wodwala ayenera:

• Choyamba fufuzani kuti njira ya mpweya ndi yoyera (makamaka ngati wodwalayo ali chikomokere);
• Kenako fufuzani ngati wovulalayo akupuma;
• Kenako yang'anani kuthamanga kwa magazi, mwachitsanzo, kugunda kwa radial kapena carotid.

Njira ya 'kale' ya malamulo a ABC imayang'ana kwambiri opulumutsa ambiri, mwachitsanzo, omwe sali ogwira ntchito zachipatala.

Fomula ya ABC, monga Kutumiza sikelo ndi kachitidwe ka GAS, ziyenera kudziwika ndi aliyense ndikuphunzitsidwa kuyambira kusukulu ya pulaimale.

Kwa akatswiri (madokotala, anamwino ndi othandizira), njira zovuta kwambiri zapangidwa, zotchedwa ABCD ndi ABCDE, zomwe zimagwiritsidwa ntchito kwambiri pazachipatala ndi opulumutsa, anamwino ndi madokotala.

Nthawi zina mafomula owonjezera amagwiritsidwa ntchito, monga ABCDEF kapena ABCDEFG kapena ABCDEFGH kapena ABCDEFGHI.

ABC ndi 'yofunika' kuposa chipangizo cha KED

Pakachitika ngozi yapamsewu ndi wovulalayo m'galimoto, chinthu choyamba kuchita ndikuyang'ana njira ya mpweya, kupuma ndi kuzungulira, ndipo pokhapokha pomwe wovulalayo atha kuikidwa khosi brace ndi KED (pokhapokha ngati vuto likufuna kuchotsa mwachangu, mwachitsanzo ngati mgalimoto mulibe lawi lamoto).

Pamaso pa ABC: chitetezo ndi chidziwitso

Chinthu choyamba kuchita mutatsimikizira ngati wovulalayo ali pamalo otetezeka panthawi yachipatala ndikuwunika momwe wodwalayo alili: ngati akudziwa, chiopsezo cha kupuma ndi kumangidwa kwa mtima chimapewedwa.

Kuti muwone ngati wozunzidwayo akudziwa kapena ayi, ingofikirani iye kuchokera kumbali yomwe maso ake akuyang'ana; musamafuule kwa munthuyo chifukwa ngati pakhala kuvulala kwa khomo lachiberekero kusuntha kwadzidzidzi kwa mutu kumatha kufa.

Ngati wozunzidwayo ayankha ndi bwino kuti adzidziwitse yekha ndikufunsa za thanzi lake; ngati achitapo kanthu koma satha kulankhula, pemphani kugwirana chanza ndi wopulumutsayo. Ngati palibe yankho, chokondolera chowawa chiyenera kuperekedwa kwa wozunzidwayo, makamaka kutsina kumtunda kwa chikope.

Wozunzidwayo amatha kuchitapo kanthu poyesa kuthawa ululu koma amakhalabe pafupi ndi tulo, osayankha kapena kutsegula maso awo: pamenepa munthuyo sakudziwa koma kupuma ndi ntchito ya mtima ilipo.

Kuti muwone momwe chidziwitso, sikelo ya AVPU ingagwiritsidwe ntchito.

Pamaso pa ABC: malo otetezeka

Ngati palibe chomwe chingachitike, ndipo chifukwa chake chikomokere, thupi la wodwalayo liyenera kuikidwa chapamwamba (mimba mmwamba) pamalo olimba, makamaka pansi; mutu ndi miyendo ziyenera kugwirizana ndi thupi.

Kuti tichite izi, nthawi zambiri pamafunika kusuntha wovulalayo ndikumupangitsa kuti azisuntha mosiyanasiyana, zomwe ziyenera kuchitidwa mosamala, pokhapokha ngati kuli kofunikira, pakakhala kuvulala kapena kupwetekedwa mtima.

Nthawi zina ndikofunikira kuyika munthuyo pamalo otetezedwa.

Kusamala kwambiri kuyenera kuchitidwa pogwira thupi ngati mutu, khosi ndi Msana Kuvulala kwa zingwe: ngati kuvulala m'maderawa, kusuntha wodwalayo kumangowonjezera vutoli ndipo kungayambitse kuwonongeka kosasinthika ku ubongo ndi / kapena msana (mwachitsanzo, kufooka kwathunthu kwa thupi ngati chovulalacho chili pamtunda wa khomo lachiberekero).

Zikatero, pokhapokha mutadziwa zomwe mukuchita, ndi bwino kusiya wovulalayo pamalo omwe ali (pokhapokha ngati ali pamalo opanda chitetezo, monga chipinda choyaka moto).

Chifuwa chiyenera kutsekedwa ndipo zomangira zilizonse ziyenera kuchotsedwa chifukwa zingatseke njira yodutsa mpweya.

Zovala nthawi zambiri zimadulidwa ndi lumo (otchedwa Robin's scissors) kuti asunge nthawi.

"A" ya ABC: Patency ya Airway mwa wodwala yemwe sakudziwa

Choopsa chachikulu kwa munthu wosazindikira ndicho kutsekeka kwa mpweya: lilime palokha, chifukwa cha kutayika kwa mawu mu minofu, limatha kugwa chagada ndikuletsa kupuma.

Kuwongolera koyamba komwe kumayenera kuchitidwa ndikotambasula pang'ono kwa mutu: dzanja limodzi limayikidwa pamphumi ndi zala ziwiri pansi pa chibwano protuberance, kubweretsa mutu kumbuyo ndi kukweza chibwano.

Kuwongolera kowonjezera kumatenga khosi kupitilira kukulitsa kwake: zomwe zimachitika, ngakhale siziyenera kuchitidwa mwankhanza, ziyenera kukhala zogwira mtima.

Ngati akukayikira kuvulala kwa khomo lachiberekero, kuwongolera kuyenera kupewedwa ngati kusuntha kwina kulikonse kwa wodwalayo: Pankhaniyi, ziyenera kuchitika pokhapokha ngati kuli kofunikira (panthawi ya wodwala kupuma kupuma, mwachitsanzo), ndipo akuyenera kukhala atsankho, kupeŵa kuwonongeka koopsa komanso kosasinthika msana ndi chifukwa chake ku msana.

Opulumutsa ndi ogwira ntchito zadzidzidzi amagwiritsa ntchito zipangizo monga oro-pharyngeal cannulae kapena zoyendetsa bwino monga subluxation ya nsagwada kapena intubation kuti mpweya ukhale wotseguka.

Khomo la mkamwa liwunikidwe pogwiritsa ntchito njira ya 'purse maneuvre' yomwe imachitika popotoza chala ndi chala chachikulu.

Ngati pali zinthu zomwe zimatsekereza njira yolowera mpweya (monga mano opangira mano), zichotsedwe ndi dzanja kapena ndi zikwapu, kusamala kuti asapitirire kulowa.

Ngati madzi kapena madzi ena alipo, monga ngati amira, kutuluka magazi kapena kutuluka magazi, mutu wa wovulalayo uyenera kupendekera kumbali kuti madziwo atuluke.

Ngati akukayikira kuti zavulala, thupi lonse liyenera kuzunguliridwa mothandizidwa ndi anthu angapo kuti mzerewo ukhale wozungulira.

Zida zothandiza zopukutira zamadzimadzi zitha kukhala minyewa kapena zopukuta, kapenanso bwino, zonyamula gawo loyamwa.

"A" Airway patency mu odwala ozindikira

Ngati wodwala akudziwa, zizindikiro za kutsekeka kwa mpweya kungakhale mayendedwe asymmetrical pachifuwa, kupuma movutikira, kuvulala pakhosi, phokoso la kupuma ndi cyanosis.

"B" ya ABC: Kupuma kwa wodwala yemwe sakudziwa

Pambuyo pa airway patency gawo m'pofunika kufufuza ngati wovulalayo akupuma.

Kuti muwone ngati mukupuma mu chikomokere, mungagwiritse ntchito "GAS maneuvre", yomwe imayimira "yang'anani, mverani, mverani".

Izi zimaphatikizapo kuyang'ana pachifuwa, mwachitsanzo, kuyang'ana kwa masekondi 2-3 ngati chifuwa chikukula.

Chisamaliro chiyenera kutengedwa kuti zisasokoneze mpweya ndi ma gurgles omwe amatuluka ngati kumangidwa kwa mtima (kupuma kwa agonal) ndi kupuma kwabwino: choncho ndi bwino kuganizira kupuma komwe kulibe ngati wovulalayo sakupuma bwinobwino.

Ngati palibe zizindikiro za kupuma, m'pofunika kupereka kupuma kwapakamwa kapena mothandizidwa ndi chitetezo. zida (chigoba cha mthumba, chishango cha nkhope, ndi zina zotero) kapena, kwa opulumutsa, baluni yodzikulitsa (Ambu).

Ngati kupuma kulipo, ziyenera kudziwidwanso ngati kupuma kwabwinoko, kuwonjezeka kapena kuchepa.

"B" Kupuma kwa wodwala wozindikira

Ngati wodwalayo akudziwa, sikoyenera kufufuza kupuma, koma OPACS (Observe, Palpate, Listen, Count, Saturation) iyenera kuchitidwa.

OPACS imagwiritsidwa ntchito makamaka poyang'ana 'khalidwe' la kupuma (lomwe limakhalapo ngati phunziro likudziwa), pamene GAS imagwiritsidwa ntchito makamaka kufufuza ngati munthu amene alibe chidziwitso akupuma kapena ayi.

Wopulumutsayo adzayenera kuona ngati chifuwa chikukula bwino, kumva ngati pali zopunduka pogwedeza chifuwa mopepuka, mvetserani phokoso lililonse la kupuma (rales, whistles ...), kuwerengera kupuma kwa kupuma ndikuyesa kukhutitsidwa ndi chipangizo chotchedwa saturation mita.

Muyeneranso kuzindikira ngati kupuma kwa mpweya ndi kwachibadwa, kuwonjezeka kapena kuchepa.

"C" mu ABC: Kuzungulira kwa wodwala wosazindikira

Yang'anani carotid (khosi) kapena kugunda kwa radial.

Ngati palibe kupuma kapena kugunda kwa mtima kulibe, funsani mwamsanga nambala yachangu ndikulangizani kuti mukuchita ndi wodwala kumangidwa kwa mtima ndi kuyamba CPR mwamsanga.

M'mapangidwe ena, C yatenga tanthauzo la Kuponderezedwa, ponena za kufunikira kofunikira kuti nthawi yomweyo achite kutikita minofu ya mtima (gawo la cardiopulmonary resuscitation) pakachitika kupuma.

Pankhani ya wodwala wopwetekedwa mtima, musanayambe kuyesa kukhalapo ndi ubwino wa kayendedwe kake, m'pofunika kumvetsera ku kutaya magazi kwakukulu: kutaya magazi ochuluka kumakhala koopsa kwa wodwalayo ndipo kungapangitse kuyesa kulikonse kobwezeretsa kukhala kopanda ntchito.

"C" Kuzungulira kwa wodwalayo

Ngati wodwala akudziwa, kugunda kwa mtima koyenera kuyezedwa makamaka kumakhala kokulirapo, chifukwa kufunafuna carotid kungapangitse wovulalayo kuda nkhawa kwambiri.

Pankhaniyi, kuwunika kwa kugunda sikudzakhala kutsimikizira kukhalapo kwa kugunda (komwe kungatengedwe mopepuka ngati wodwala akudziwa) koma makamaka kuyesa pafupipafupi (bradycardia kapena tachycardia), kukhazikika ndi mtundu ("zambiri ” kapena “ofooka/osinthasintha”).

Thandizo lapamwamba la mtima wotsitsimutsa mtima

Advanced cardiovascular life Thandizo (ACLS) ndi ndondomeko yachipatala, malangizo ndi ndondomeko, zomwe zimatengedwa ndi ogwira ntchito zachipatala, unamwino ndi othandizira kuti ateteze kapena kuchiza kumangidwa kwa mtima kapena kupititsa patsogolo zotsatira muzochitika zobwerera ku circulation modzidzimutsa (ROSC).

Kusintha kwa 'D' mu ABCD: Kulemala

Kalata D ikuwonetsa kufunikira kokhazikitsa minyewa ya wodwalayo: opulumutsa amagwiritsa ntchito sikelo yosavuta komanso yowongoka ya AVPU, pomwe madokotala ndi anamwino amagwiritsa ntchito Glasgow Coma Scale (yomwe imatchedwanso GCS).

Acronym AVPU imayimira Alert, Verbal, Pain, Unreaction. Chenjezo limatanthauza wodwala wozindikira komanso wozindikira; mawu amatanthauza wodwala theka-chikumbukiro amene amalabadira kukopa mawu ndi kunong'ona kapena sitiroko; kupweteka kumatanthauza wodwala amene amangochita zowawa; wosayankhidwa amatanthauza wodwala wosadziwa yemwe sayankha kumtundu uliwonse wa kusonkhezera.

Pamene mukuchoka ku A (chenjezo) kupita ku U (osayankha), kuuma kumawonjezeka.

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"D" Defibrillator

Malinga ndi njira zina, chilembo D ndi chikumbutso kuti kutsekemera ndikofunikira pakachitika kumangidwa kwa mtima: zizindikiro za pulseless fibrillation (VF) kapena ventricular tachycardia (VT) zidzakhala zofanana ndi za kumangidwa kwa mtima.

Opulumutsa odziwa bwino adzagwiritsa ntchito semi-automatic defibrillator, pomwe akatswiri azachipatala ophunzitsidwa bwino adzagwiritsa ntchito buku limodzi.

Ngakhale kuti fibrillation ndi ventricular tachycardia imakhala ndi 80-90% ya milandu yonse ya kumangidwa kwa mtima [1] ndipo VF ndiyo yomwe imayambitsa imfa (75-80% [2]), ndikofunika kufufuza molondola pamene kutayika kwa mtima kumafunikadi; semi-automatic defibrillators samalola kutulutsa ngati wodwalayo alibe VF kapena pulseless VT (chifukwa cha arrhythmias ena kapena asystole), pomwe defibrillation yamanja, yomwe ili yoyenera kwa akatswiri azaumoyo ophunzitsidwa bwino okha, amatha kukakamizidwa atawerenga ECG.

“D” Matanthauzo ena

Chilembo cha D chingagwiritsidwenso ntchito ngati chikumbutso:

Tanthauzo la kayimbidwe ka mtima: ngati wodwalayo sali mu ventricular fibrillation kapena tachycardia (ndipo chifukwa chake alibe defibrillated), nyimbo yomwe inachititsa kuti mtima wamtima umangidwe uyenera kudziwika powerenga ECG (zotheka asystole kapena pulseless magetsi).

Mankhwala: chithandizo chamankhwala cha wodwalayo, makamaka kudzera munjira ya venous (mankhwala / unamwino).

MAPHUNZIRO WOYAMBA WOYAMBA? ENDWENI KU DMC DINAS MEDICAL CONSULTANTS BOOTH PA EMERGENCY EXPO

Chiwonetsero cha "E".

Ntchito zofunika zikakhazikika, kusanthula mozama kwa zochitikazo kumachitika, kufunsa wodwalayo (kapena achibale, ngati sali odalirika kapena okhoza kuyankha) ngati ali ndi chifuwa kapena matenda ena, ngati ali ndi mankhwala. ndipo ngati adakhalapo ndi zochitika zofanana.

Pofuna kukumbukira mwamnemonically mafunso onse a anamnestic omwe amafunsidwa nthawi zambiri zopulumutsira, opulumutsa nthawi zambiri amagwiritsa ntchito mawu akuti AMPIA kapena acronym SAMPLE.

Makamaka pazochitika zowopsya, kotero ndikofunikira kuyang'ana ngati wodwalayo wavulala kwambiri kapena pang'ono, ngakhale m'madera a thupi omwe samawoneka nthawi yomweyo.

Wodwala ayenera kuvula (kudula zovala ngati kuli kofunikira) ndikuwunika kupangidwa kuchokera kumutu mpaka kumapazi, kuyang'ana ngati pali zothyoka, mabala kapena magazi ochepa kapena obisika (hematomas).

Pambuyo pakuwunika kwa mutu ndi chala wodwalayo amaphimbidwa ndi bulangeti la isothermal kuti apewe hypothermia yomwe ingatheke.

MAKOLO WA chiberekero, KEDS NDI PATIENT IMMOBILISATION AIDS? ENDWENI KU BOOTH YA SPENCER PA EMERGENCY EXPO

“E” Matanthauzo ena

Chilembo E kumapeto kwa zilembo zam'mbuyomo (ABCDE) zithanso kukhala chikumbutso:

• Electrocardiogram (ECG): kuwunika kwa wodwala.
• Chilengedwe: Ndi nthawi iyi yokha yomwe wopulumutsa angakhudzidwe ndi zochitika zazing'ono zachilengedwe, monga kuzizira kapena mvula.
• Kuthawa Mpweya: Yang'anani zilonda zam'chifuwa zomwe zaboola mapapu ndipo zingayambitse kugwa kwa m'mapapo.

"F" Matanthauzo osiyanasiyana

Chilembo F kumapeto kwa zilembo zam'mbuyomo (ABCDEF) zitha kutanthauza:

Fetus (m'mayiko olankhula Chingerezi fundus): ngati wodwalayo ndi wamkazi, m'pofunika kudziwa ngati ali ndi pakati kapena ayi, ndipo ngati ali ndi pakati pa mwezi wanji.

Banja (ku France): opulumutsa ayenera kukumbukira kuthandiza achibale awo momwe angathere, chifukwa amatha kupereka chidziwitso chofunikira chaumoyo pa chisamaliro chotsatira, monga kupereka lipoti la chifuwa kapena chithandizo chopitilira.

Madzi: fufuzani kuti madzi atayika (magazi, cerebrospinal fluid, etc.).

Njira zomaliza: funsani malo omwe akuyenera kulandira wodwalayo.

"G" Matanthauzo osiyanasiyana

Chilembo G kumapeto kwa zilembo zam'mbuyomo (ABCDEFG) zitha kutanthauza:

Shuga wa m'magazi: amakumbutsa madokotala ndi anamwino kuti awone kuchuluka kwa shuga m'magazi.

Pitani msanga! (Pitani mwachangu!): panthawiyi wodwalayo akuyenera kutengedwa msangamsanga kupita kumalo osamalira anthu (chipinda changozi kapena DEA).

H ndi ine Matanthauzo osiyanasiyana

H ndi ine kumapeto kwa pamwambapa (ABCDEFGHI) angatanthauze

Hypothermia: kuteteza wodwala kuzizira pogwiritsa ntchito bulangeti lotentha.

Chisamaliro chachikulu pambuyo potsitsimula: kupereka chithandizo champhamvu pambuyo potsitsimutsa kuti athandize wodwala wovuta.

mitundu

AcBC…: yaing'ono c itangotha ​​​​gawo la airways ndi chikumbutso kuti mupereke chidwi chapadera ku msana.

DR ABC… kapena SR ABC…: D, S ndi R poyambirira kumbutsani

Ngozi kapena Chitetezo: Wopulumutsa sayenera kudziyika yekha kapena ena pachiwopsezo, ndipo angafunikire kuchenjeza zachitetezo chapadera (gulu la ozimitsa moto, kupulumutsa mapiri).

Yankho: choyamba yang'anani mkhalidwe wa chidziwitso cha wodwalayo mwa kuyitana mokweza.

DRs ABC…: ngati wakomoka fuulani kuti akuthandizeni.

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Source:

Medicina pa intaneti