Kodi chingachitike ndi chiyani ngati magetsi akuukira mumzinda?

Mapulogalamu azachipatala ndi magulu opulumutsira oopsa omwe ali ndi vuto lalikulu: amagwiritsanso ntchito "zosaoneka". Monga kuukira kwa zigawenga. Masikiti a gasi, PPE chitetezo ndi atropine. Kodi dipatimenti yowonjezereka ingakonzekere bwanji kuthana ndi nkhondo yachigawenga?

Kuukira kwa mpweya wa mitsempha ku Syria kwatsutsidwa ndi maboma ochokera padziko lonse lapansi, ndipo pali chifukwa champhamvu kwambiri: mpweya wa mitsempha - kuphatikizapo Sarin umodzi-ndizo zida zoopsya zomwe zimayambitsa zotsatira zopweteka za ululu kwa ozunzidwa.

Siyani mayankho a ndale, mayankho a usilikali kapena ziweruzo. Palinso maphunziro omwe angaphunzire ndi kumvetsetsa momwe angagwiritsire ntchito vuto linalake limene mchitidwe wogwiritsa ntchito mankhwala wowonongeka wagwiritsidwa ntchito.

Monga nthawi zonse, ziyenera kukumbukiridwa kuti pakagwidwa ndi mankhwala, othandizira thanzi amayenera kutsatira malamulo apamwamba a malo otetezeka ndipo ayenera kuyesetsa m'njira zonse kukhala otetezeka poyamba. Ayenera kukhala kutali ndi malo owopsa, ngati alibe zida za PPE zoyenera. Nthawi zambiri - momwe ogwiritsira ntchito omwe amalowerera tsiku lililonse pangozi amawadziwa bwino - oyambira omwe amafika pangoziyo amakhala ambulansi, osati Fire Brigade (yomwe ili ndi magalimoto ocheperako pang'ono ndipo amapezeka nthawi zambiri m'malo akutali).

Zoyenera kuchita ngati vuto la gasi?

Kuukira kwamagesi sichinthu chachilendo kwambiri, komabe, chenjezo loyamba ndikuti: musalowe mdera lomwe simunayende popanda chitetezo chokwanira. Ma poizoni am'mitsempha m'magazi amawonongeratu mphamvu yamanjenje, chifukwa amaletsa acetylcholinesterase (AChE) ndipo amakhudza kapena kuipitsa madzi kapena chakudya ndi mpweya. Mitundu ina ya mpweya wamanjenje imathanso kukhudza khungu, ndipo kudzera pakhungu, imayambitsa zotsatira zomwezo koma m'njira yofalikira pamunthu.

Vuto lalikulu ndilakuti onse othandizira mitsempha amakhala ndi kulimbikira kwachilengedwe: samatulutsa ndipo samakwera m'mwamba, koma amalimbikira kumalo komwe adatulutsidwa (pogwiritsa ntchito bomba, migodi, kapenanso ma nebulizer).

Pomwe zikuwonekeratu kuti gasi wafalikira m'derali, ndipo dipatimenti yoyamba yofunikira ya Fire Brigade yazungulira, Maofesi a CBRNE Amayitanidwa. Akatswiri ozimitsa moto awa amalowerera pothana ndi mpweya ndipo amatha kusiyanitsidwa nawo zida ndi zida zogwirira ntchito: masita antigas, ma sensrochemical sensors, zinthu zowopsa ndi zida zina mwazomwe ogwiritsa ntchito a CBRNE ali nazo.

Magulu awa - maofesi a 22 akugwira ntchito ku Italy - ali ndi luso laumisiri ndi luso lothana ndi vutoli popanda kusokonezedwa. Panthawi zovuta, ngakhale magulu apadera a Ankhondo titha kuyitanitsidwa kuti tisowererepo.

Pakadali pano, pali magawo azachipatala omwe ali ndi zida zopangidwa kuti azilowererapo zochitika za CBRNE. Komabe, wogwira ntchito yazaumoyo amayenera kudikirira mpaka pomwe dotolo laikidwiratu ndi Woyang'anira Moto, asanayambe kuloŵerera. Chifukwa pali malo omwe kupeza mwayi kwa ogwira ntchito zaumoyo kungalephereke. Pomwe pali CBRNE chochitika, Ndipotu, Brigade ya Moto, pochita mgwirizano ndi mphamvu zina, imagawaniza derali kukhala magawo ena.

Mu malo ogwira ntchito, anthu okhawo oyenerera ntchito zopulumutsa akhoza kulandira, kupatula ngati ali ndi zenizeni PPE. Mu Red Zone zitha kutanthauzidwanso ngati malo oletsedwa kuchokera kwa aliyense. M'dera la lalanje - lotchedwa decontamination - amangolowa ma gulu oyenera okhaokha.

Pomaliza, malo achikasu, omwe ndi malo opangira zinthu kunja kwambiri, amachitika panthawi yovala owongolera omwe ayenera kulowa malo ofiira, ndipo PMA yoyamba imakhazikitsidwa. Kunja kwa malo achikasu, kwina zadzidzidzi malo oyang'anira zida zokhazikitsidwa akhoza kukhazikitsidwa.

Ku Italy kuli phata la kulowerera kwapadera kwaumoyo, NISS yochokera ku Vicenza: awa ndi madokotala, anamwino ndi SUEM118 antchito okonzekera kukumana ndi chochitika chauchigawenga ndi kuchiza anthu omwe amazunzidwa or ovulala ndi zida. Madokotala, anamwino, madalaivala ndi akatswiri a Suem Operations Center aphunzitsidwa ndikukonzekera kuyang'anira ngozi zadzidzidzi zomwe zimaphatikizapo kuphulika komanso kuvulaza zipolopolo. Ntchitoyi, yomwe ilibe ofanana ku Italy, idabadwa kuchokera kufuna kwa Suem wamkulu, Dr. Federico Politi, yemwe adatsata maphunziro azadzidzidzi ku Israeli ndi United States.

Ndipo, ku Suem of Vicenza, zida zopanga asirikali zafika zomwe zimalola kuti kulowererapo kulepheretse magazi komanso kubaya mabala m'masekondi ochepa. Tsoka ilo palibe gulu linalake lofanana ndi lomwe lidapangidwa ndi English NHS, gulu la HART, pomwe akatswiri othandiza ziwonetserozo amakhala ndi zida ndikuphunzitsidwa ngati ali ozimitsa moto, chifukwa chake amatha kufikira madera otentha kwambiri pobweretsa ukadaulo wawo wasayansi.

Kuukira kwa gasi: momwe mungathandizire kuledzera kwamagesi?

Kuwonjezera pa kupha, zotsatira za mpweya wa mitsempha zimapweteka kwambiri. Kuti mumvetse ngati munthu ali ndi mpweya wa mitsempha, muyenera kumvetsetsa mwa wodwalayo ndi miosis yolimba, kusokonezeka kwakukulu kuti mupeze malo otetezeka (malo ogona), kupitiriza chifuwa ndi kusokonezeka kwa mitsempha, bradycardia, mseru, sialorrhea, kukodza mosadziletsa ndi kutsekemera, asthenia , fasciculations muscular ndi - pamene zotsatira zimakhala zoopsa - ziwalo. Kenaka kukhumudwa, kukomoka ndi imfa zimalowerera.

Muzochitika izi mpulumutsiyo ayenera kuyambitsa kwathunthu kusamba ndi madzi ambiri amthupi la wozunzidwayo, ngati kuli kotheka ndikuchotsa zovalazo chifukwa mpweya wamitsempha, wolowetsedwa mu ulusi, umangokhala pamenepo. Kupereka chithandizo chamankhwala ndi unamwino ndikofunikira pakukhazikitsa milingo iwiri ya atropine.

SIMG (Italy Society of General Medicine) ikuti - kuchokera pazomwe akuchita ndi zomwe adakumana nazo - Mlingo wa atropine woperekedwa kwa odwala omwe akumana ndi vuto la gasi ayenera kukhala "ngwazi" kapena wapamwamba kwambiri kuposa momwe mankhwala a 2mg amalimbikitsira wamba ntchito matenda. Chifukwa chake ndikofunikira kuti mankhwala azachipatala am'deralo azikhala ndi zida zokwanira.

Pali mbali zina za dziko (Israel ndi Iraq) komwe gasi ya magetsi yakhala ikugwiritsidwa ntchito ndipo kulephera kwa poizoni kwachitidwa ndi pridostgmine. Njira yothandiza kupewa matendawa imadziwika ndi zinyama koma osati anthu. Mankhwala amatha kupiritsidwa mobwerezabwereza, pambuyo pa maminiti a 5-10, mpaka kufika poyerekeza ndi mayendedwe (kuyang'ana kwa mydriasis), mpaka kufika pa mlingo wa 100mg mkati mwa maola 24.

Chifukwa chake, kupewa mankhwala sikudali odalirika chifukwa zotsatira za poizoni zili pangozi. Malingaliro omwe ali mu funsowa amachokera ku mayesero opangidwa mu Israeli mu zaka za makumi asanu ndi atatu ndi zisanu ndi zitatu. Komabe, sipadzakhala masitima okwanira okwanira ku Italy kuti athetse anthu osauka, chifukwa chithandizo cha misala sichiri chovomerezeka ndipo chikadali chiopsezo. Choncho, mankhwala opatsirana ndi atropine akulimbikitsidwa, omwe amachititsa kuti pakhale njira zowonongeka za AChE.

Anti-gas KIT: kodi asilikali apangidwa motani?

Popeza kuti magulu a mitsempha ya mitsempha ya mitsempha imakhala yovuta kumenyana ndi nkhondo, ndipo ingagwiritsidwe ntchito motsutsana ndi zida za nkhondo (kugwiritsa ntchito mpweya wa mitsempha waletsedwa ndi misonkhano yapadziko lonse) m'magulu a ku Ulaya muli makatsulo enieni ndi atropine 2mg ndi mankhwala othandizira a AChE (monga pralidoxima). Mwamwayi, kupewa ndi atropine kunasonyeza kuti anthu ambiri ndi achidakwa komanso ana a Israeli ku Gulf War.

Kodi zipatala zakonzekera chochitika ngati kuukira kwa gasi?

Koma ngati ankhondo ali okonzeka kukumana ndi zoopsa zomwezo, kodi zipatala zimapangidwa bwanji? M'zipatala zonse za ku Italy, zida zazikulu za atropine zili mu njira zowonongeka. Malo osokoneza poizoni omwe amwazikana m'dera lonselo ali ndi luso loyenera komanso mankhwala osokoneza bongo. Zimadziwika - kuti zikhale ndi nthawi - ku France kokha kufalitsa kwa 40mg / 20ml yowonongeka kwa atropine sulphate yankho linayambika pambuyo pa kuopsa kwa November 2015. Koma ku Italy, ndibwino, ngati sikutheka kuti pang'onopang'ono zitsulo za atropine zitheke, komanso kugwiritsa ntchito mankhwala osokoneza bongo.

 

 

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