Nezve DAAM: Kutungamira kwendege ndiko kupindira kwakakosha mune dzakawanda dzemurwere dzekukurumidzira - kubva kumhepo yekukanganisa kusvika pakutadza kufema uye kusungwa kwemoyo.

Zvisinei, zvichienderana nekuoma kwehutano hwemurwere, uye kupindira kwekupindira, kutungamirirwa kwemhepo kunowanzokonzera migumisiro yakaipa kuhutano hwepfungwa nemuviri wevarwere.

Mune zvimwe zviitiko zveprehospital, varwere dzimwe nguva vanobatsirwa kubva kuDrug Assisted Airway Management (DAAM), iyo inogona kupa yakagadziridzwa laryngoscopy yevanopa uye kuisa nyore endotracheal machubhu uye supraglottic airways panguva yekupinda.

Kuti vape kurapwa kwakanyanya uye kwakachengeteka kunogoneka kune varwere, vanopa EMS vanofanirwa kuziva mabhenefiti eDAAM uye maitiro ekuita nemazvo, pamwe nenjodzi dzakakura dzine chekuita nazvo.

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Chii chinonzi DAAM?

Zvinoenderana negwaro rekushandisa kubva kuNational Association of EMS Physicians (USA), Drug Assisted Airway Management (DAAM) inoreva kutungamirirwa kwezvidhori zvega, kana pamwe chete neuromuscular blockers, kutanga kuiswa kwepamusoro kwemhepo kune varwere vane mhepo yakakanganiswa kana iri kuuya. kutadza kufema, uyo anogonawo kutambura nekuchinjwa kwechimiro chepfungwa, kushushikana kana kuti intact inodzivirira airway reflexes.

Ikozvino misiyano yeDAAM iyo inowanzoshandiswa mumakiriniki prehospital marongero anosanganisira sedation-assisted intubation (SAI), kunonoka kutevedzana intubation (DSI) uye nekukurumidza sequence intubation (RSI).

RSI, iyo inonyanya kuzivikanwa yevatatu, inosanganisira kutungamirirwa kwekunyaradza uye mutezo we endotracheal intubation muvarwere.

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Mamiriro ezvinhu umo DAAM inogona kutenderwa

Zvimwe zvekukurumidzira zvingada DAAM zvinosanganisira sitiroko, kukuvara kwehuropi (TBI) uye kutadza kufema kubva kuchirwere chepulmonary kana chemoyo.

DAAM inofanira kungoitwa munzvimbo dzakakwana umo zvigadziro zvakakodzera uye mirayiridzo iripo, uye kudzidziswa kwakakwana uye EMS kutariswa kwechiremba kunowanikwa.

Vanopa rubatsiro vanofanira kunyatsoongorora zvingangoitika zvekiriniki zvichienzaniswa nenjodzi dzakaipa dzeDAAM

Pasinei nemamiriro emurwere, asati aita DAAM, masangano eEMS anofanirwa kuve nechokwadi kuti vatapi vakawana kudzidziswa kwakakwana kunodiwa kutarisira varwere mumamiriro ezvinhu akanganisa, kusanganisira panguva uye shure kwekukundikana kweDAAM, uye kuti vane zvinodiwa. midziyo pa-ruoko kupa mushonga uye intubate zvakachengeteka uye zvinobudirira sezvinobvira.

Zvimwe zvezvishandiso uye nzira dzinodiwa kuita DAAM dzinosanganisira bag mask ventilation, supraglottic airway zvishandiso uye nzira dzekuvhiya dzemhepo.

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Kuziva njodzi

Nhamba yengozi inobatanidza nekuita DAAM inotsamira pane zvinhu zvakawanda zvine chokuita nehuwandu hwemurwere, mamiriro uye zvaanoda, pamwe chete nehuwandu hwechiitiko uye kugadzirira kune chikamu chevanopa.

Isati yatanga intubation, zvakakosha kuti vapeji vaite ongororo yemuviri wemurwere kuti vanyatsonzwisisa njodzi / bhenefiti reshiyo yekuita DAAM, kusiyana nekukurumidza kutevedzana intubation kana isiri-invasive ventilation dzimwe nzira.

Munguva yekuongorora, vapeji vanofanirwa kutarisa chero zviratidzo zvinoratidza mukana wekunetsa intubation, sekuvapo kwemazino ekumusoro epamberi, nhoroondo yekuomerwa intubation, chero chibodzwa cheMallampati chakasiyana kubva kune chimwe kana chakaenzana nechina, uye muromo unovhura isingasviki 4. masendimita.

Njodzi dzepamusoro dzinobatanidzwawo neakaomerwa nemurwere hunhu hwemhepo, hwakadai sekunyanyisa kwesaizi yemhepo, mutsipa kutadza kufamba, kushama muromo, nzira yekufema ine tsvina uye kubuda ropa.

Uyezve, kana ikaitwa zvisiri izvo, DAAM inogona kukonzera mamwe matambudziko ekuiswa kwemhepo nekuda kwekukurumidza uye kurasikirwa kwakakwana kwekudzivirira airway reflexes uye kufema kwekufema, uye kukwanisa kwemishonga kukuvadza varwere varipo physiologic abnormalities.

Kuita sarudzo ine ruzivo

Kunyange paine akasiyana prehospital care scenarios anogona kubvumidza kushandiswa kweDAAM, senge mamiriro ezvinhu umo varwere vari kusangana nemamiriro epfungwa akakanganisika kana vari kutambura nematambudziko ekurapa anogona kukonzera kutadza kufema, DAAM inoisawo njodzi huru kune varwere.

Zvakakosha kuti vanopa EMS vazive nezvenjodzi idzi uye kuti dzinosiyana sei kubva kumurwere kune murwere, uye kuti vakashongedzerwa nekudzidziswa kwakakodzera uye zviwanikwa zvekudzikisa njodzi zvakanyanya sezvinobvira pakurapa varwere.

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