Kuyendetsa galimoto yopita patsogolo ndi gawo lalikulu la chisamaliro chisanafike kuchipatala. Kodi ndi zifukwa zikuluzikulu ziti zomwe zimapanga chisankho?

Kuthamanga Kwambiri Mwachangu ndi njira yowonongolera mpweya wa airways ndi kuchepetsa chiopsezo cha masanzi ndi madzi regurgitation wobadwa mu 1970 (Kutentha | Safar) kugwiritsira ntchito Cricoid Pressure mu njira zoyendetsera ndege (Sellick). Rapid Sequence Intubation ndichimodzi mwazinthu zofunikira kwambiri mu ALS chifukwa ziyenera kusunga njira zapaulendo. Ndiye gawo lofunikira la maluso azachipatala, chifukwa chogwira ntchito chithandizo chambiri chisanachitike. Koma kuyambira 2010, pali mafunso okhudza Sellick Maneuver kuti ofufuza akufufuza.

The Malo a Greater Sydney HEMS ndi mmodzi mwa magulu odziwa zambiri pa njira za ALS zisanafike kuchipatala. Akutsatira #FOAMED ndondomeko kuti apatse aliyense chidziwitso chokhudza zomwe anakumana nazo, makamaka za Airway Management. Iwo adalenga Kulembera kwa Airway ndicho choyimira chofunikira kwambiri pophunzira chizoloŵezi chabwinoko. Malamulo onse omwe amalembedwa ku Airway Registry akukambidwa osati mwachindunji, osadziwitsidwa ndi kugwirizanitsidwa panthawi yomwe akugwirizanitsa kuphatikiza mauthenga a kunyumba.

The Malo Aakulu a Sydney HEMS mu 2010 adapanga buku la Rapid Sequence Intubation. Bukuli limalongosola njira yothandizira odwala asanachitike kuchipatala. Ndi buku losangalatsadi kwa akatswiri omwe akugwiritsa ntchito maluso ochepa pomwe gulu lobwezeretsa zida ndipo ukadaulo ukhoza kufunidwa kuti upereke njira zotetezeka komanso zotetezeka kwambiri zapamtunda.

Chigawo cha Great Sydney Chigawo cha HEMS chikufotokozera njira zoyenera kutsatira pre-hospital emergency anesthesia. Lingaliro la Australia ndikuthandizira njira yokonzedweratu ya laryngoscopy yoyamba kuyang'ana bwino. "Izi zimapewa kuyesa kwakanthawi komanso kangapo komanso zovuta zina. Cholinga chake ndikuonetsetsa kuti a Njira yodalirika yoyenera kuchipatala chisanafike ndikuvomereza zovuta zosiyanasiyana, mapangidwe ndi mapangidwe omwe adakumana nawo mchipatala chisanachitike. Upangiri womwe waperekedwa udachokera ku zomwe opeza ambiri azachipatala amazisamalira asanachitike kuchipatala ndipo zimawonekera ngati kungatheke. Bukuli likufotokoza zofunikira zakuganiza komanso njira zomwe zimayesedwa mu Emergency Anesthesia Clinical Currency ”. Monga momwe ziliri ndi ndondomeko yonse, chigamulo choyendera ndi chithandizo choyambitsanso chithandizo choyamba chisanafike kuchipatala chiyenera kukhazikitsidwa pozindikira momwe chiopsezo cha njirayi chidzathandizira. Zisonyezo pre-hospital emergency anesthesia ndi:

• Kulephera kwa patency airway
• Kulephera kwa chitetezo cha ndege
• Kulephera kwa mpweya wabwino / oxygenation
• Maphunziro a kachipatala
• Zifukwa zaumulungu
• Kuti atsogolere kuyenda bwino

Kutha kwa kayendetsedwe kabwino ka ndege, kuphatikiza chithandizo chodzidzimutsa, ndichinthu chofunikira kwambiri pakuchipatala. Kuteteza chitetezo chamtundu wapaulendo ndi chitetezo ndi luso lofunikira posamalira wodwalayo wambiri. Imakulitsa oxygenation ya odwala ovulala kwambiri, imathandizira kuyendetsa bwino kupita kuchipatala, imathandizira ma neuroprotection komanso kufufuza mwachangu kuchipatala ndi chisamaliro cha opaleshoni.

Nthawi yowonjezera yomwe imagwiritsidwa ntchito pachitetezo chapa airway (ngakhale azachipatala aluso) ndi imodzi mwamikangano yayikulu pakuchipatala. Nthawi yomwe idagwiritsidwa ntchito poyang'anira msewu wa ndege imachotsedwa ndi nthawi yomwe yasungidwa nthawi yoyendera ndi mu chipatala nthawi yayitali ngati imachitidwa mosamala komanso mwachangu. Nthawi yovutikira kuchipatala isanakwane mphindi 20min imatheka ndipo imayenera kukhala chandamale pophunzitsidwa.

Nthendayi yam'chipatala yowonjezera chithandizo cha Pre-hospitali imatha kukhala yoopsa kwambiri kuposa chipatala chachikulu cha anesthesia chifukwa cha zovuta zomwe zimayambitsidwa ndi chipatala chisanafike. Choncho, khama lililonse liyenera kuchitidwa pofuna kuteteza njirayi. Zokonzekera ndege ndi zankhondo zimavomerezedwa bwino, kuti kukwera kwa chikhalidwe, ndikofunika kwambiri kuchotsa aliyense payekha ndikukonzekera kufunika kotsatira ndondomeko yoyendetsera ntchito.

Lingaliro la makulidwe: mndandanda wowunikira kuchokera ku Sydney HEMS

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