Khola lachiberekero: tiwone omwe ali abwino kwambiri kuti akhale nawo mu ambulansi kuti muwone ma protocol.

• Kodi kusayenda bwino ndikuti ndi zida ziti?
• Kukula: kofunika?
• Kodi khola lachiberekero limagwiritsidwa ntchito bwanji mwadzidzidzi?
• Kodi khola lachiberekero limagwira ntchito liti?
• Zomwe zimawonongeka zimatha kuchokera ku ntchito yoyipa ya khola lachiberekero?
• Kanemayo wokhudza kola ya khomo lachiberekero malinga ndi WAU

Kodi mukudziwa zomwe mukugwiritsa ntchito kukhosi lanu odwala matenda opweteka? Carsical kolala sizofanana, choncho tiyeni tiwone kusiyana pakati gawo limodzi (kapena mono-valavu) ndi bi-valavu kolala. Monga mukudziwira, m'zaka zapitazi mkangano waukulu udabuka pa mutu wa kusokoneza. Kumbali imodzi, pali omwe amaziwona ngati zatha ndipo - nthawi zina - ngakhale zimakhala zovulaza kwa wodwalayo. Kumbali ina, pali ena omwe akupitiliza ndi kukhudzika kosinthasintha komanso kusokoneza wodwala monga njira yosamala. Pakati pali ma protocol apano - omwe ayenela zizisamalidwa nthawi zonse. Zipangizo zamankhwala othandizira ayenera kupanga zinthu zomwe ndizochulukirapo bwino, yogwira mtima komanso yopangidwa kuti ithe kusintha wodwala mikhalidwe. Ndipo ayenera kugwiranso ntchito mogwirizana ndi makumi (ngakhale mazana) a ma protocol osiyanasiyana ochitapo kanthu. Zogulitsa zoterezi zimayesetsa kuchepetsa kulemera kwa mutu pamlomo wam'mimba komanso kuteteza malowa kuti asavulazidwe komanso kusuntha kosavuta. Mpaka lero kuli bwino kwamankhwala othandizira zachipatala - M'mayiko omwe ali ndi EMT ndi odzipereka pa ambulansi - ndi: "Khola lachiberekero liyenera kugwiritsidwa ntchito kwa onse odwala matenda ovulala mwanjira mpaka chivomerezo cha khomo lachiberekero chitaperekedwa." M'malo mwake, kolala yamchiberekero imagwiritsidwa ntchito chifukwa - malinga ndi kafukufuku wina wasayansi - M'pofunika kuchepetsa kayendedwe kaumodzi kokha ngati wodwala ali ndi vuto lachiberekero. Zomwe zimafanana ndi 2-4% ya odwala onse ovulala, omwe pakati pawo mwinamwake 20% ali ndi a Msana chingwe kuvulala.

Kodi kukhazikika kwa khomo pachiberekero ndi chiyani?

Ndibwino kuti mufufuze mwatsatanetsatane zipangizo zamankhwala zomwe zimagwiritsidwa ntchito popanga immobilization, kuyambira pazomwe zimadziwika bwino komanso zogwiritsidwa ntchito, osati pazochitika zadzidzidzi komanso zokhudzana ndi thanzi labwino: kolala ya chiberekero. Zomwe zimatchedwanso "khosi la khosi", chipangizochi chimagwiritsidwa ntchito kuchepetsa kusuntha kwa chiberekero cha chiberekero chomwe chili pakhosi. Chifukwa chake, chipangizochi chokha sichikwanira kuti chiwonongeko chonse cha rachis. M'malo mwake, m'maprotocol ambiri ntchito yake imaphatikizidwa ndi zida zina zotsekereza, monga msana bolodi, ndi Kendrick Extrication Chipangizo kapena matiresi a vacuum.

Ndi mitundu yanji yama kolala yachiberekero yomwe imapezeka pa malonda?

Khola la khomo lachiberekero limagwiritsidwa ntchito pochiza gawo lofunika kwambiri komanso losakhwima la thupi. Pachifukwa ichi, pali mayankho osiyanasiyana omwe amapezeka pazamalonda omwe amakwanira kapena kuchepera chithandizo choyambira ntchito, kugona m'chipatala kwa nthawi yayitali kapena zolinga zina. M'munda wadzidzidzi ndizofala kugwiritsa ntchito makola okhwima a khomo lachiberekero. Tsopano titha kusiyanitsa mitundu iwiri ya kolala:

• Gawo limodzi - Ndi kolala yosavuta kwambiri, yopanga chipolopolo chimodzi chosinthika chopangidwa ndi pulasitiki wokhala ndi pulasitiki. Pakakhala kuti saigwiritsidwa ntchito ndi lathyathyathya, zomwe zimapangitsa kukhala kosavuta kwambiri kuti isunge mu ambulansi ngakhale yayikulu. Ndikofunika kukumbukira kuti makola awa adapangira a kugwiritsa ntchito kamodzi. Nthawi zambiri, ndikamtundu kakang'ono kumakhala kokhotakhota kutsogolo theka, yoyenera kuyika pansi pa chibwano. M'malo mwake, kumbuyo theka Iyenera kuyikidwa pansi pa mutu wa wodwala mwa njira inayake yopangidwira kupewa ngozi kuvulaza msana wa wodwala.
• Pikanani or  zidutswa ziwiri - Imapangidwa ndi magawo awiri ophatikizika palimodzi pogwiritsa ntchito zingwe ziwiri za Velcro, ndikupanga ntchito mosavuta, chifukwa ndizotheka kuyika hafu yakutsogolo ndi theka lakumbuyo panthawi zosiyanasiyana.

Mitundu yonse ya kolala yachiberekero yomwe imagwiritsidwa ntchito pakagwa mwadzidzidzi iyenera kukhala ndi mipata yakutsogolo yolola ogwira ntchito pachipatalacho kuti ayang'anire kayendedwe ka carotid ndikuwongolera zoyendetsa zina, monga tracheotomy.

Kukula kwa khola lachiberekero: chifukwa chiyani kuli kofunikira?

Kukula kwa khola lachiberekero ndikofunikira kwambiri. Kulowetsa munthu khola lomwe limakwana kwambiri kapena laling'ono kwambiri kumatha kumabweretsa mavuto awiri osiyana: mbali imodzi pali ngozi ya kupindika mutu / khosi, chifukwa cha kutalika kwa minofu ndi kapangidwe ka rachis. Kumbali ina, pali chiopsezo kuti khola lachiberekero sikumakwaniritsa cholinga chake kapena - zoyipitsitsa - kuti zimalepheretsa mayendedwe ena azaumoyo. Mapeto ake ndiwakuti kukula kwake kumakhala kambiri, zimakhala zosavuta kupeza woyenera. M'malo mwake, othandizira akuyandikira a kuchuluka kwakukulu kapena - nthawi zina - cha makola achiberekero zitha kukhala takambiranazi musanayambe kudwala. Tiyeni tinene kuti kolala iyenera kusinthidwa nthawi zonse isanayambe; ndizofunikira kwambiri. Choyamba, munthu ayenera kuyeza dera la khosi la wodwalayo kuti asankhe khola lomwe angagwiritse ntchito. Kenako kolala imagwiritsidwa ntchito. Vutoli litha kukhala zovuta pamiyeso ingapo, kutengera mtundu wa wodwala. Koma ziyenera kukumbukiridwa nthawi zonse khola lachiberekero likugwiritsidwa ntchito payenera kukhala awiri ogwira ntchito azaumoyo, osati m'modzi yekha.

Kodi khola lachiberekero limagwiritsidwa ntchito bwanji mwadzidzidzi?

Asanayambe kugwiritsa ntchito kolala, ayenera onani ngati alipo mphete, khosi kapena zovala zomwe zingalepheretse pulogalamu yoyenera. Ndikwabwino nthawi zonse kuchotsa zotengerazi. Tanena kale kuti nthawi zonse payenera kukhala antchito azaumoyo a 2 (ma protocol ena amafunikira ngakhale ogwira ntchito azaumoyo a 3). Woyambayo amadzikhazika kumbuyo kwa wodwala ndikugwira ndikuwongolera mutu ndi khosi ndi manja ake, kuti akhale osatenga nawo mbali. M'malo oterowo mutu umakhala woloza kumapewa ndi mmbali zonse. Izi zimachepetsa chiopsezo cha kuvulala kwa msana ndikukulitsa malo omwe amapezeka kuti msana ukhale mu rachis.

Wodwala amayenera kuyang'ana m'mwamba, osati pansi. Nkhope - yowoneka bwino ndikuyang'ana kutsogolo - idzayang'aniridwa mosalekeza ndi yachiwiri zamalonda, yemwe ayenera kudziika patsogolo pa wodwalayo kuti ayike kolala. Ngakhale wothandizapo wachiwiri amamuthandiza kolala, woyamba sayenera kutaya mphamvu pamutu. Ngakhale kolala itagwiritsidwa ntchito, mutu umafunika kusungunuka manja, popeza ndi chipangizo chosasiyanitsa. Khola lachiberekero lomwe limayikidwa mbali ziwiri limayikidwa kwa wodwalayo kuti apange dzenje kuti wodwalayo azikhala ndi chibwano. Choyamba, theka lakutsogolo limayikidwa, ndiye kuti zingwe za Velcro zimaperekedwa kumbuyo kwa khosi kuti ateteze kolala mozungulira mozungulira wodwala. Izi zimalepheretsa kusintha kwamutu uliwonse komanso kulola ma paramedics kuwonjezera theka la kolala. Zingwe zakunja za Velcro zakunja zitasungidwa, palibe kuwonjezera komwe kungatheke. Ngati kukula kuli koyenera ndipo ngati ntchitoyo idachitidwa moyenera, wodwalayo samva vuto, komanso sipangakhale choletsa kupumira ndi kumeza.

Kodi khola lachiberekero limagwira ntchito liti?

Khola litatha, munthu ayenera kuonetsetsa kuti ntchitoyo idachitidwa bwino. Muyenera kuwonetsetsa kuti kolala ikualumikizana ndi ziwalo zina zamthupi motere:

• Mbali yakutsogolo iyenera kulumikizana ndi sternum manubrium, ndi gawo lotsika la zovomerezeka, ndipo pambuyo pake ziyenera kulumikizana ndi kolala ndi gawo lotsika la ramus yopingasa yovomerezeka.
• Gawo lakumbuyo liyenera kulumikizana ndi dera la kumbuyo pakati pa scapulae, pomwe malo a occipital a mutu ndi zingwe ziwiri za Velcro ziyenera kufanana ndi malo othamangira kutsogolo kwa kolala.

Kodi chingandichititse mantha ndikamagwiritsa ntchito kolala yachiberekero ndi chiyani?

Wodwala akhoza kukhala ndi vuto lachiberekero lomwe limayambitsidwa ndi a kusokonezeka ndipo othandizira matendawa sangazindikire mpaka atayamba kuyendetsa ntchito kolala. Chifukwa chake, wina ayenera kuyang'ana - kuyambira pachiwonetsero cha kuyika mutuwo m'malo osalowerera ndale - zotheka kuti ma spasms a minofu kapena khosi komanso kupweteka kumbuyo. Komanso, ngati kupuma ntchito kumangidwa Kusokoneza momwe misewu imakhalira, ngati wodwalayo akhazikika mutu pamalo ena kapena ngati pali zotupa zowoneka bwino ku trachea kapena kumitsempha yamagazi, dokotala ayenera kuthandizidwa asanapite.

Mwachiwonekere, ngati pali matupi achilendo mu minofu yofewa ya khosi, kapena ngati kuli kotheka kusalowerera ndale, wodwalayo ayenera kulimbikitsidwa m'malo omwe amagonekamo, kuwonetsetsa kuti kupuma konse komanso kufalikira kwa magazi kumakhala kosasunthika.

Kodi ndizowonongeka ziti zomwe zingachitike chifukwa chogwiritsa ntchito kolala yachiberekero?

Kupatula kuwonongeka kwa msana, kuwonongeka koipa kwa khomo lachiberekero kungayambitsenso mavuto ena. Sikuti timangoika pachiwopsezo chopanga munthu kukhala paraplegic; timakhalanso pachiwopsezo kupanga ntchito ya madokotala ndi anamwino zovuta kapena ngakhale kosatheka. Khola lachiberekero loyipa lingagwiritsidwe ntchito limalepheretsa kugwira ntchito kwa tracheotomy kapena kubisala pang'ono tracheostomies. Zimatha kubweretsa mavuto kupuma kapena kupangitsa kumeza kukhala kovuta. Pomaliza - koma osati chomaliza - kumatha kudwalitsa wodwala komanso kumamupweteka.

Ndi khola lachiberekero liti lomwe limalimbikitsa kwambiri?

Palibe kolala yovomerezeka yamchiberekero kwambiri. Chilichonse chazadzidzidzi ndi chithandizo chilichonse chachipatala chimachitika mosiyanasiyana ndikutsatira ma protocol osiyanasiyana. Ndikofunika kukumbukira kuti kolala yokhala ndi mbali imodzi, ngakhale ndiyosavuta kuyitsatira ndikuigwiritsa ntchito, nthawi zambiri imakhala yokhazikika kuposa chinthu chachiwiri, chomwe ntchito yake - m'malo mwake - imafuna kuwongolera kowonjezera koma imalola kuwongolera kwambiri. Mukamawerengera mtengo womwe mungagule ndikuyenera kuganizira mbiri yakale ya gulu lake: Kodi mumakumana ndi mavuto angati mwezi uliwonse? Kodi ndizotheka bwanji kutenga nawo mbali pothandizira pazachipatala kupita ku ngozi zapamsewu kapena pangozi zapangozi? Kodi anu osowa mankhwala wophunzitsidwa ndi chidutswa chimodzi kapena mbali ziwiri? Ndipo limodzi ndi mafunso amenewa munthu ayenera kuganiza kuti: Kodi ndili ndi malo angati osungirako khola lachiberekero?

Kugwiritsa ntchito kolala yokhala ndi mbali ziwiri zokha

• Paramedic yomwe imatsogolera opareshoniyo imagwira ndikuyendetsa mutu wa wodwalayo ndi manja ake kuti isagwire nawo ntchito. Wothandizapo wachiwiri, yemwe akugwiritsa ntchito kolala ayenera:
• Khalani pafupi ndi wodwalayo m'malo osavuta ndikuchotsa zovala zomwe zimazungulira khosi la wodwalayo, pamodzi ndi mphete, khosi kapena china chilichonse;
• Onani khungu lanu kuti mupeze mabala kapena kuvulala ndipo mulibe cholakwika chilichonse pakugwiritsa ntchito kolala;
• Paramedic imayeza khosi la wodwalayo. (Muyeso umayamba kuchokera kuvomerezedwa mpaka kumapeto kwa minofu ya trapezius);
• Tsimikizani kukula kwa kolala (kuyesa theka la kolala, kuyambira chingwe cha Velcro mpaka m'munsi mwa kolala);
• Paramedic amagwira mbali yakutsogolo ya kolala ndikuigwada pang'ono. Kenako, amaika kolala pansi pazovulaza za munthu wovulalayo, ndikuyiyika pakhosi kufikira ataloledwa.
• Pambuyo pakugwiritsa ntchito gawo lakumwambalo, paramedic imasunthira zingwe zolumikizira pansi pa khosi ndikuzikonza. Tsopano wamkulu wa paramedic amasuntha akuwongolera ake kuti agwire chipangizocho mwamphamvu;
• Pomwe mtsogoleri wagululo amagwirizira theka la kutsogolo, omutsatira amatenga theka ndikukhala pansi kumbuyo kwa khosi;
• Mukakhuta pamalo, kolala imayenera kutetezedwa ndi zingwe ziwiri za Velcro, kusamala kuti isavutike, koma nthawi zonse modekha;
• Pakadali pano othandizira amafunsira ndikuwatsimikizira kuti wodwalayo amalekerera kolala popanda mavuto, kuti kupuma kwakeko sikunasokonezedwe, kuti atha kutsegula pakamwa komanso kuti kugunda kuli bwino.
• Pomaliza, pakatha zovuta, mutha kuyendetsa wodwala pamtanda, mkati mwa ambulansi.

Kanemayo wokhudza kugwiritsa ntchito kolala ya khomo lachiberekero malinga ndi WAU (chidule cha ku Italy cha Emergency and Urgency Regional Agency). Kanemayo akuwonetsa momwe angagwiritsire ntchito Collical Collar m'njira yoyenera.