Iwe unotya kukanda kunze kwako musana bhodhi? Yasvika nguva yekuchinja pfungwa dzako pamusoro pekusagadzikana kwemuzongoza

A PAPER KUZIVA ZVAKAWANDA – Dr D Connor, K Porter, M Bloch and I Graves mu“Pre-hospital Mumhara Immobilization: An Initial Consensus Statement ", inoongorora humbowo huripo huripo pamusoro pekuita kwepinal immobilization mumamiriro epamberi echipatara. Ichi chikamu chemhedziso kubva kumusangano wekubvumirana wakaitwa neFaculty of Pre-hospital Care muRoyal College of Surgeons yeEdinburgh muna March 2012. Boka rekubvumirana rakanga rakanyatsojeka kuti kuchinja kunodiwa kubva mumutemo we immobilizing mitsipa se zvakawanda kuitira kudzivirirwa kwechiremba seyemurwere, kune imwe nzira yekusarudza kusafamba kwakagadzirirwa kuderedza njodzi kune akakuvadzwa. Zvakakosha kuyeuka, zvisinei, kuti masangano anobatsira ekuzvipira achange achitsvaga hutungamiri munzvimbo iyi yakaoma. Kune varapi ava, kutungamira kune 'vasiri nyanzvi' yekugadzirisa trauma inofanirwa kukanganisa kuenda kudivi repamusoro. triage. Vanogona nekubatsirwa, zvisinei, kuziviswa kuti cervical collars hadzisi iyo panacea iyo yavanowanzoitwa kuti ive uye kuti inline inline stabilisation (MILS) kazhinji inowanzobetsera uye inogamuchirika modation ichienzaniswa nekatatu kushushikana. Vanofanira zvakare kukurudzirwa kuti vafunge nezvekuenda kure kubva kumuzongoza mabhodhi kuenda kusiri-simbi scoops uye pfungwa yekubata mashoma.

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KUFUNGA KUBVA MUEDEST118 - Sezvaunoziva, spinal immobilization inoitwa mune vese varwere vekutambudzika kubva kune vanonunura muESEM masisitimu epasirese, zvisinei nemabatiro ekukuvara uye zviratidzo zvekiriniki. Iyi nzira yekutaura mazuva ano anga ari rebutted kubva kuhumbowo hwehumbowo uye nhungamiro chaidzo. ACEP, munaJan 2015, yakaburitsa chirevo chemutemo chakanzi: "EMS Management yeVarwere vane Simba Rekukuvara Kwemuzongoza" kujekesa izvo zvakanaka zvinoratidza, uye zvinopesana, zvekusagadzikana kwepelinha mune prehospital marongero. Kushaikwa kwehumbowo hwekushandisa kwakanakisa kwemidziyo yakaita semusana mabhureki, kora yemuromo wechibereko nezvimwewo… zvinopesana nezvakakanganisa mhedzisiro yezviridzwa zvakadai: kufefeterwa nemhepo, kukanganisika kwekufema, kushuvira, tishu ischemia, kuwedzera kusagadzikana kwekumanikidza, uye kurwadziwa, zvichikonzerwa maronda ekumisikidza musana, zvinogona kukonzeresa mukuwedzera kushandiswa kwekuongorora kufungidzira uye kufa. Nechekare muna 2009 a Kudzokorora kweChchrane vakaratidza kusasha kwehupupuriro pamashandisirwo emagunha ekudzivirira maginhi mumatambudziko.

Munguva ichangopfuura kunze kwechipatara kuvimbiswa kwe Nexus chirongwa uye Canada C-spine mitemo, yakanyatsotungamirwa kuenda kune imwe nzira inofanirwa kugadziriswa kumusana wemvura.

Saka mu 2013 American Association of Neurological Surgeons uye Congress of Neurological Surgeons "Mirayiridzo yekutungamirirwa kweAacute Cervical Spine uye Spinal Cord Injurie "  uye Ruzivo rwePre-Chipatara Kuchengeta "Pre-chipatara Spinal Immobilisation: Yekutanga Chibvumirano Chirevo" vakataura izvo zvichishandurwa.

Kubva pane zvataurwa izvi:

1. Kupera kwemvura haifaniri kushandiswa kune varwere vane chirwere chinoputika kunze kweuchapupu hwekukuvara kwepamuviri.
2. Mumhara immobilization inofanira kuonekwa mune zvose zvinotambudza varwere necervical spine or Musipinha tsvimbo yekukuvadzwa kana neine nzira yekukuvara ine simba rekukonzera chibereko chemuviri Musipinha kuipa.
3. Kugadziriswa kwepamuviri haafaniri kuonekwa kune varwere vane chinonyatsonaka chekugadzirisa maitiro ekukuvadza uye chero ipi zvayo inotevera:
   • Murwere ndeye GCS 15 (zvakajairika yevadzidzi)
   • Pane kwete posterior mid-line tenderness
   • Pane hapana kukuvadza kunokanganisa (kumwe kukuvara kunorwadza)
   • Pane kwete focal neurological zviratidzo uye / kana zviratidzo (semuenzaniso, kushaya simba uye / kana kushaya simba)
   • Pane kwete anatomic deformity wepamusoro
   • Pane kwete kudhakwa (doro kana madhiragi, kusanganisira iatrogenic)
4. Muzongoza wakareba bhodhi mudziyo wekubvisa chete.
5. Mabhodhi emabhodhi haafaniri kushandiswa sechirongwa chekurapa kana sekuchengetedzwa kwemukati mukati kana kunze kwechipatara kana kuti kupindira kwemahofisi. Nokuda kwechikonzero ichi, chikwata chekutengesa kana kupisa mateti inofanira kushandiswa.
6. EMS vatambi ahs kuti vave kudzidziswa zvakanaka on kuongorora ngozi nokuda kwekukuvara kwepamuviri uye nyanzvi yekuongorora, uyewo kuita mutambo wevarwere nenzira iyo inogadzirisa mamwe maitiro epasona kune varwere vanokwanisa kukuvara kwepamuviri.

References

1. 2015 ACEP Nheyo dzemitemo: EMS Mutano wevarwere vane Mungozi yeApinal Injury
2. Totten VY, Sugarman DB. Kufuridzirwa kunokonzerwa nekuputika kwepamuviri. Prehosp Emerg Care. Oct-Dec 1999; 3 (4): 347-352.
3. Cochrane Rewiev Spinal immobilisation yevashungurudzi varwere
4. Kuedzwa kwehutachiona hweNXUS hutsika hutachiona hwekuongorora kliniki yepervical spine injury.
5. Kubudiswa kwechipatara kweCanada C-Spine Rule neParamedics
6. Kuongorora kweKuchengetedzwa kweC-Spine Clearance neParamedics
7. 2013 American Association of Neurological Surgeons uye Congress of Neurological Surgeons Mirayiridzo yekutungamirirwa kweAacute Cervical Spine uye Spinal Cord Injurie
8. Ruzivo rwePre-Chipatara Kuchengeta "Pre-chipatara Spinal Immobilisation: Yekutanga Chibvumirano Chirevo"