Kodi mukuwopa kutaya bolodi lanu la msana? Yakwana nthawi yosintha malingaliro anu za kuchepa kwa msana

PAPA KUTI MUKUDZIWA ZAMBIRI - Dr D Connor, K Porter, M Bloch ndi I Graves mu "Pre-hospital M'mimba Kusavomerezeka: Ndemanga Yoyamba Yogwirizana ", imayang'ana umboni wamakono womwe ulipo pa mchitidwe wa kusasunthika kwa msana m'malo omwe asanakhale chipatala. Ichi ndi mbali ya ziganizo kuchokera ku msonkhano wogwirizana womwe unachitikira ndi Faculty of Pre-hospital Care ku Royal College of Surgeons of Edinburgh mu March 2012. Gulu logwirizana linali lomveka bwino kuti kusintha kumafunika kuchokera ku ndondomeko ya immobilizing makosi monga zambiri kaamba ka chitetezo cha dokotala monga cha wodwalayo, ku dongosolo losasunthika losasunthika lokonzedwa kuti lichepetse kuopsa kwa wovulalayo. Ndikofunikira kukumbukira, komabe, kuti mabungwe othandiza mwaufulu adzakhala akuyang'ana chitsogozo pa gawo lovutali. Kwa ochita izi, chitsogozo cha 'omwe si akatswiri' oyang'anira zoopsa akuyenera kulowera mbali yopitilira. kuyendera. Iwo akanakhoza kupindula, komabe, kudziwitsidwa kuti makola achiberekero Kodi siwoti zomwe zimapangidwa kuti zikhalepo komanso kuti zolemba zam'manja (MILS) nthawi zambiri zimakhala zopindulitsa ndi zovomerezeka poyerekeza ndi kuvutitsidwa kwatatu. Ayeneranso kulimbikitsidwa kuti azilingalira kuchoka pamatumba a spinal kupita kumalo osakhala zitsulo ndi lingaliro lazogwirira ntchito pang'ono.

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ZOYENERA KU MEDEST118 - Monga mukudziwa, kuperewera kwa msana kumachitika mwa odwala onse opwetekedwa ndi opulumutsa m'machitidwe a EMS padziko lonse lapansi, mosasamala kanthu za kuvulala ndi zizindikilo zamankhwala. Njira imeneyi masiku ano yakhala ikuchitika adakanidwa kuchokera ku maumboni aposachedwa komanso malangizo omwe aperekedwe. ACEP, mu Jan 2015, idatulutsa chikalata chalamulo chotchedwa: "EMS Management of Patients with Potential Spinal Injury" kumveketsa zisonyezo zolondola, komanso zotsutsana, zakulephera kwa msana m'malo opita kuchipatala. Kuperewera kwaumboni wogwiritsa ntchito bwino zida monga msana wam'mbuyo, makola amtundu wa khomo lachiberekero ndi zina zambiri ... zikusiyana ndi kuwonongeka kwa zida zotere: kusokonekera kwa njira yapaulendo, kuwonongeka kwa kupuma, kulakalaka, minofu ischemia, kupanikizika kopitilira muyeso, ndi ululu, chifukwa cha zida zosokoneza msana, zitha kuchititsa kuti anthu azigwiritsa ntchito kwambiri kulingalira ndi kufa. Kale mu 2009 a Kupenda kwa Cochrane adawonetsa kusowa kwa maumboni pogwiritsa ntchito njira zoletsera msana m'masautso.

Posachedwa kutuluka kwa chipatala chotsimikiziridwa Njira ya Nexus ndi Malamulo a Canada C-spine, kuyendetsedwa kwambiri ku njira yowonongeka kwa msana.

Kotero mu 2013 A Association of American Neurological Surgeon and Congress of Neurological Surgeons "Malangizo Othandizira Kulamulira Kachilombo ka Cervical Spine and Spinal Cord Kusokoneza "  ndi Gulu La Chithandizo Chisanafike Kuchipatala "Kuperewera kwa Spinal Pre-hospital Spinal Immobilisation: Chigwirizano Choyamba ' adanena kusintha kumeneko.

Malingana ndi mawu awa:

1. Kutha kwa msana sayenera kugwiritsidwa ntchito kwa odwala omwe ali ndi vuto lalikulu lopweteka popanda umboni wa kuvulala kwa msana.
2. M'mimba kusokoneza ziyenera kuganiziridwa onse odwala matendawakhola lachiberekero kapena Msana kuvulaza chingwe kapena njira yovulaza yomwe ingayambitse chiberekero Msana kuvulala.
3. Kuletsedwa kwa msana sayenera kuganiziridwa kwa odwala omwe ali ndi vuto lopweteka kwambiri ndi zotsatirazi:
   • Wodwala ali Mtengo wa GCS 15 (zachizoloŵezi za kuchenjeza)
   • Pali palibe kutsika kwapakati pa mzere wamkati
   • Pali palibe chovulaza chosokoneza (kuvulala kwina kowawa)
   • Pali palibe zizindikiro zenizeni zamaganizo ndi / kapena zizindikiro (mwachitsanzo, kufooka ndi / kapena kufooka kwa magalimoto)
   • Pali palibe kuwonongeka kwa anatomic za msana
   • Pali palibe kuledzera (mowa kapena mankhwala, kuphatikizapo iatrogenic)
4. Msana wautali bolodi ndi extrication chipangizo yekha.
5. Zojambulajambula sayenera kugwiritsidwa ntchito monga chithandizo chochizira kapena ngati kutchinjiriza kumakhala mkati kapena kunja kwa chipatala kapena kumalo osungirako malo. Pachifukwa ichi, gwiritsirani ntchito mateti otsekemera kapena otsekemera ayenera kugwiritsa ntchito.
6. Omwe a EMS amafunika kukhala ophunzitsidwa bwino on kuwona ngozi kuvulala kwa msana ndi kafukufuku wamaganizo, komanso kuchita mchitidwe wodwala mwa njira yomwe imalepheretsa kuwonjezeka kwina kwa msana kwa odwala omwe angapweteke msana.

Zothandizira

1. 2015 ACEP Ndondomeko ya ndondomeko: EMS Management of Odwala ndi Pothaŵira Pakuvulaza Kwambiri
2. Totten VY, Sugarman DB. Zotsatira za kupuma kwa msana. Prehosp Emerg Care. Oct-Dec 1999; 3 (4): 347-352.
3. Cochrane Rewiev Chimake chokha chifukwa cha odwala matendawa
4. Kuyesera kwa munthu aliyense payekha pa NEXUS njira zochepetsera ma kachipatala zowonongeka msana.
5. Kuvomerezeka kwapadera kwa chipatala cha Canada C-Spine Rule ndi Paramedics
6. Kufufuza kwa Chitetezo cha Kusintha kwa C-Spine ndi Paramedics
7. 2013 A Association of American Neurological Surgeon and Congress of Neurological Surgeons Malangizo Othandizira Kutsogoleredwa kwa Mthenda Yamtundu wa Cervical Spine and Spinal Cord Injurie
8. Gulu La Chithandizo Chisanafike Kuchipatala "Kuperewera kwa Spinal Pre-hospital Spinal Immobilisation: Chigwirizano Choyamba '