ABC, ABCD uye ABCDE mutemo mukurapa kwekukurumidzira: izvo muponesi anofanira kuita

By Cristiano Antonino On Dai 12, 2022

Mutemo we "ABC mutemo" kana kungoti "ABC" mumushonga unoratidza nzira yemnemonic inoyeuchidza vanonunura vose (kwete vanachiremba chete) yezvikamu zvitatu zvinokosha uye zvinoponesa upenyu mukuongorora uye kurapwa kwemurwere, kunyanya kana asina kuziva, mumatambudziko. matanho ekutanga eBasic Life Support

Acronym ABC ichokwadi chidimbu chemazwi matatu echiRungu:

nzira yemhepo: nzira yemhepo;
kufema: mweya;
kutenderera: kutenderera.

Patency yenzira yemhepo (kureva kuti nzira yemhepo haina zvipingamupinyi zvinogona kudzivirira kubuda kwemhepo), kuvapo kwekufema uye kuvapo kwekutenderera kweropa chaizvoizvo zvinhu zvitatu zvakakosha pakurarama kwemurwere.

Mutemo weABC unonyanya kukosha pakuyeuchidza muponesi wezvakakosha pakudzikamisa murwere

Nokudaro, patency yemhepo, kuvapo kwekufema, uye kutenderera kunofanira kuongororwa uye, kana zvichidikanwa, kugadzwa zvakare muhurongwa uhwu chaihwo, zvikasadaro mafambisirwo anotevera anenge asisashande.

Mumashoko akareruka, mununuri anopa rubatsiro rwekutanga kumurwere anofanira:

Kutanga tarisa kuti nzira yemhepo yakachena (kunyanya kana murwere asina chaanoziva);
Wotarisa kana munhu akuvara ari kufema;
wotarisa kutenderera kweropa, semuenzaniso radial kana carotid pulse.

Iyo 'classic' formula yemutemo weABC yakanangana zvakanyanya nevanunuri vese, kureva avo vasiri vashandi vekurapa.

Iyo ABC formula, senge iyo AVPU chikero neGAS maneuvre, inofanira kuzivikanwa nemunhu wese uye kudzidziswa kubva kuchikoro chepuraimari.

Kune nyanzvi (vanachiremba, vanamukoti uye varapi), mamwe maitiro akaoma akagadzirwa, anonzi ABCD uye ABCDE, ayo anonyanya kushandiswa muhutano hwehutano nevanunuri, vanamukoti uye vanachiremba.

Mune zvimwe zviitiko kunyange mafomula akazara anoshandiswa, senge ABCDEF kana ABCDEFG kana ABCDEFGH kana ABCDEFGHI.

ABC inonyanya 'kukosha' pane yekubvisa mudziyo KED

Kana pakaitika tsaona yemumugwagwa nemunhu abatwa netsaona mumotokari, chinhu chekutanga kuita kutarisa nzira yemhepo, kufema nekutenderera, uye ipapo ndipo panogona kuisirwa munhu wetsaona. mutsipa brace uye KED (kunze kwekunge mamiriro acho achida kutorwa nekukurumidza, semuenzaniso kana pasina moto wakanyanya mumotokari).

Pamberi peABC: kuchengetedzwa uye mamiriro ekuziva

Chinhu chekutanga kuita mushure mekuona kana munhu akabatwa ari munzvimbo yakachengetedzeka munjodzi yekurapa ndeyekutarisa mamiriro ekuziva kwemurwere: kana achiziva, njodzi yekufema uye kusungwa kwemoyo inodziviswa.

Kuti utarise kana nyajambwa ari kuziva kana kuti kwete, ingoswedera pedyo naye uchibva kudivi raakatarisa; usamboshevedzera kumunhu nekuti kana pakaita trauma pacervical spine kufamba kwemusoro kamwe kamwe kunogona kutouraya.

Kana munhu akabatwa achipindura zvinokurudzirwa kuzvizivisa uye kubvunza nezvehutano hwake; kana akadaira asi asingakwanisi kutaura, kumbira kubata maoko mununuri. Kana pasina mhinduro, kukurudzira kunorwadza kunofanirwa kuiswa kune akabatwa, kazhinji piniki kuziso repamusoro.

Munhu anenge abatwa nechirwere ichi anogona kuita nekuedza kunzvenga marwadzo asi oramba akarara, asingapinduri kana kuvhura maziso avo: apa munhu anenge afenda asi zvose zviri zviviri kufema uye kushanda kwemwoyo zviripo.

Kuongorora mamiriro ekuziva, chiyero cheAVPU chinogona kushandiswa.

Pamberi peABC: nzvimbo yekuchengetedza

Mukusavapo kwekuita chero kupi zvako, uye nekudaro kwekusaziva, muviri wemurwere unofanirwa kuiswa supine (dumbu kumusoro) panzvimbo yakaoma, zviri nani pasi; musoro nemakumbo zvinofanira kuenderana nemuviri.

Kuti uite izvi, zvinowanzodiwa kutamisa munhu anenge akuvadzwa uye kumuita kuti aite mafambiro akasiyana-siyana emhasuru, izvo zvinofanirwa kuitwa nekuchenjerera, uye chete kana zvichidikanwa, kana paine kukuvadzwa kana kufungidzirwa kukuvadzwa.

Mune zvimwe zviitiko zvakakosha kuisa munhu wacho munzvimbo yekuchengetedzwa kwemashure.

Kuchenjerera kukuru kunofanira kutorwa mukubata muviri kana musoro, mutsipa uye Musipinha kukuvara kwetambo: kana pakakuvara munzvimbo idzi, kufambisa murwere kunogona kungowedzera mamiriro acho ezvinhu uye zvinogona kukonzera kukanganisa kusingagadziriswi kuuropi uye / kana musana (semuenzaniso kuoma kwemuviri wose kana kukuvara kuri pachiyero chechibereko).

Mumamiriro ezvinhu akadaro, kunze kwekunge iwe uchiziva zvauri kuita, zviri nani kusiya munhu anenge akuvadzwa ari munzvimbo yaanenge ari (kunze kwekunge ivo vari munzvimbo isina kuchengetedzeka zvachose, senge imba yekutsva).

Chipfuva chinofanira kufukunurwa uye zvisungo zvipi nezvipi zvinofanira kubviswa sezvo zvichigona kuvharidzira nzira yekufema.

Zvipfeko zvinowanzogurwa nechigero (inonzi Robin's scissors) kuchengetedza nguva.

Iyo "A" yeABC: Airway patency mumurwere asingazive

Njodzi huru kune munhu asina ruzivo ndeyekuvharwa kwemhepo: rurimi pacharwo, nekuda kwekurasikirwa kwenzwi mumasumbu, rinogona kuwira shure uye kudzivirira kufema.

Mufambiro wekutanga unoitwa ndewekuwedzera mwero wemusoro: ruoko rumwe rwunoiswa pahuma uye minwe miviri pasi pechirebvu protuberance, ichiunza musoro kumashure nekusimudza chirebvu.

Iyo yekuwedzera maneuver inotora mutsipa kupfuura iyo yakajairika kuwedzera: chiito, nepo chisingafanirwe kuitwa nechisimba, chinofanira kunge chiri kushanda.

Muchiitiko chekufungidzirwa kushungurudzwa kwekervical, kufambisa kunofanira kudziviswa seimwe nzira ipi zvayo yemurwere: munyaya iyi, chaizvoizvo, inofanira kuitwa chete kana zvichinyatsodiwa (munyaya yemurwere mukusungwa kwekufema, somuenzaniso), uye inofanira kunge ine rusarura chete, kudzivirira kunyange yakakomba uye isingagadzirisiki kukuvara kune spinal column uye naizvozvo kumuzongoza.

Vanunuri uye masevhisi ekukurumidzira vanoshandisa zvishandiso zvakaita seoro-pharyngeal cannulae kana mitsetse yakapfava senge subluxation yeshaya kana intubation kuchengetedza mhepo yakavhurika.

Iyo yemuromo inofanirwa kuongororwa pachishandiswa 'purse maneuvre' iyo inoitwa nekumonyorora chigunwe nechigunwe pamwechete.

Kana zvinhu zviripo zvinovharira nzira yekufema (semuenzaniso mazino), zvinofanirwa kubviswa nemaoko kana nemaforce, uchichenjerera kusasundira mutumbi wekunze kupinda mukati.

Kana mvura kana imwe mvura iripo, sepakunyura, kubuda ropa kana kubuda ropa, musoro wemunhu anenge abatwa unofanirwa kurerekera parutivi kuti mvura ibude.

Kana kushungurudzwa kuchifungidzirwa, muviri wese unofanirwa kutenderedzwa nerubatsiro rwevanhu vakati wandei kuchengetedza mbiru muaxis.

Maturusi anobatsira ekupukuta mvura anogona kunge ari matissue kana mapepi, kana zviri nani zvakadaro, inotakurika kunyanya chikwata.

"A" Airway patency mumurwere anoziva

Kana murwere achiziva, zviratidzo zvekuvharika kwenzira yekufema zvinogona kunge zvisingaite kufamba kwechipfuva, kunetseka kufema, kukuvara kwehuro, ruzha rwekufema uye cyanosis.

Iyo "B" yeABC: Kufema mumurwere asingazive

Mushure memhepo patency phase inofanirwa kutarisa kana munhu akakuvara ari kufema.

Kuti utarise kufema mukusaziva, unogona kushandisa "GAS maneuvre", iyo inomiririra "tarisa, teerera, inzwa".

Izvi zvinosanganisira 'kutarisa' pachipfuva, kureva kutarisa kwemasekonzi maviri kana matatu kuti chipfuva chiri kukura here.

Kuchengetedza kunofanira kutorwa kuti kurege kuvhiringidza kuputika uye gurgles zvinobudiswa muchiitiko chekusungwa kwemwoyo (agonal breathing) nekufema kwemazuva ose: saka zvinokurudzirwa kufunga kusipo kufema kana munhu anenge abatwa asingafemi zvakanaka.

Kana pasina zviratidzo zvekufema zvichave zvakakosha kuti upe mweya wekufema nemuromo kana nerubatsiro rwekudzivirira. midziyo (homwe mask, nhoo yechiso, nezvimwewo) kana, kune vanonunura, bharumu rinozviwedzera (Ambu).

Kana kufema kuripo, inofanirawo kucherechedzwa kana kufema kuri kuita kwakajairika, kwakawedzera kana kuderera.

"B" Kufemera mumurwere anoziva

Kana murwere achiziva, hazvidikanwi kutarisa kufema, asi OPACS (Observe, Palpate, Teerera, Verenga, Saturation) inofanira kuitwa.

OPACS inonyanya kushandiswa kutarisa 'mhando' yekufema (iyo inenge iripo kana munhu achiziva), nepo GAS ichinyanya kushandiswa kutarisa kuti munhu asingazive ari kufema here kana kuti kwete.

Muponesi anozofanira kuongorora kana chipfuva chiri kuwedzera nemazvo, kunzwa kana paine hurema nekupuruzira chipfuva zvishoma, teerera chero ruzha rwekufema (rales, muridzo ...), kuverenga kufema uye kuyera kuzara nemudziyo unonzi saturation mita.

Iwe unofanirwawo kucherechedza kana chiyero chekufema chakajairika, chakawedzera kana kuderera.

"C" muABC: Kutenderera mumurwere asingazive

Tarisa carotid (mutsipa) kana radial pulse.

Kana pasina kufema kana kurova kwemoyo kuripo, pakarepo taura nenhamba yekukurumidzira uye kuraira kuti uri kubata nemurwere mukusungwa kwecardiopulmonary uye tanga CPR nekukurumidza sezvinobvira.

Mune mamwe magadzirirwo, C yakatora zvinoreva Kudzvinyirira, zvichireva kukosha kwakakosha kuita nekukurumidza cardiac massage (chikamu che cardiopulmonary resuscitation) muchiitiko chekufema.

Muchiitiko chemurwere akakuvadzwa, asati aongorora kuvapo uye hutano hwekutenderera, zvakakosha kubhadhara kune chero ipi zvayo huru yekubuda ropa: kurasikirwa kweropa rakawanda kune ngozi kune murwere uye kunopa chero kuedza kwekugadzirisa kusingabatsiri.

"C" Kutenderera mumurwere anoziva

Kana murwere achiziva, kurova kunofanira kuongororwa kungave kuri kweradial, sezvo kutsvaga kwecarotid kuchigona kukonzera kuti munhu wacho awedzere kunetseka.

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Muchiitiko ichi, kuongororwa kwepilse hakuzove kwekuona kuvapo kwepilse (iyo inogona kutorwa zvishoma sezvo murwere ari kuziva) asi kunyanya kuongorora maitiro ayo (bradycardia kana tachycardia), nguva dzose uye hutano (" yakazara. ” kana “kusasimba/kuchinjika”).

Advanced cardiovascular resuscitation support

Advanced cardiovascular life support (ACLS) igadziriro yezvirongwa zvekurapa, nhungamiro uye zvibvumirano, izvo zvinogamuchirwa nevarapi, mukoti uye vashandi vepachipatara kuitira kudzivirira kana kurapa kusungwa kwemwoyo kana kuvandudza mhedzisiro mumamiriro ezvinhu ekudzoka kumhepo inotenderera (ROSC).

Musiyano 'D' muABCD: Kuremara

Tsamba D inoratidza kudikanwa kwekumisikidza mamiriro emurwere wetsinga: vanunuri vanoshandisa iyo iri nyore uye yakatwasuka AVPU sikero, nepo vanachiremba nemanesi vanoshandisa iyo. Glasgow Coma Scale (inonziwo GCS).

Acronym AVPU inomirira Alert, Verbal, Pain, Unresponsive. Alert zvinoreva murwere anoziva uye ane ruzivo; verbal (kutaura) zvinoreva murwere anenge asingazivi anonzwa kudavirwa kwezwi nekazevezeve kana kurohwa; marwadzo zvinoreva murwere anobata chete kune zvinorwadza zvinokurudzira; kusapindura zvinoreva murwere asingazive asingapinduri kune chero rudzi rwekukurudzira.

Sezvo iwe uchifamba kubva kuA (yambiro) uchienda kuU (isingapindure), iyo yekuomarara mamiriro inowedzera.

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"D" Defibrillator

Maererano nemamwe mafomula, vara D chiyeuchidzo icho defibrillation inodiwa muchiitiko chekusungwa kwemwoyo: zviratidzo zve pulseless fibrillation (VF) kana ventricular tachycardia (VT) ichave yakafanana neyekusungwa kwemwoyo.

Vanonunura vane ruzivo vachashandisa semi-automatic defibrillator, nepo vadzidzisi vehutano vakadzidziswa vachashandisa bhuku rekushandisa.

Kunyange zvazvo fibrillation uye ventricular tachycardia inotora 80-90% yezviitiko zvose zvekusungwa kwemwoyo [1] uye VF ndiyo inokonzera rufu (75-80% [2]), zvakakosha kuongorora zvakarurama kana defibrillation ichinyatsodiwa; semi-automatic defibrillators haabvumiri kubuda kana murwere asina VF kana pulseless VT (nekuda kweimwe arrhythmias kana asystole), nepo manual defibrillation, iyo inomiririra yevashandi vehutano vakadzidziswa chete, inogona kumanikidzwa mushure mekuverenga ECG.

“D” Zvimwe zvirevo

Tsamba D inogonawo kushandiswa sechiyeuchidzo:

Tsanangudzo yeCardiac rhythm: kana murwere asiri mu ventricular fibrillation kana tachycardia (uye naizvozvo kwete kusvibiswa), rhythm yakakonzera kusungwa kwemwoyo inofanira kuonekwa nekuverenga ECG (zvinogoneka asystole kana pulseless magetsi).

Zvinodhaka: kurapwa kwemishonga yemurwere, kazhinji kuburikidza nekuwana venous (kurapa / mukoti maitiro).

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"E" Exhibition

Kana mabasa akakosha agadziriswa, kuongororwa kwakadzama kwemamiriro acho kunoitwa, kubvunza murwere (kana hama, kana vasina kuvimbika kana kukwanisa kupindura) kana vane allergies kana zvimwe zvirwere, kana vari pamishonga. uye kana vakambova nezviitiko zvakafanana.

Kuti vayeuke nemnemonically mibvunzo yese yeanamnestic inofanira kubvunzwa munguva dzinowanzo vhunduka dzekununura, vanunuri vanowanzoshandisa acronym AMPIA kana acronym SAMPLE.

Kunyanya munyaya yezviitiko zvinoshungurudza, saka zvakakosha kutarisa kana murwere akakuvara zvakanyanya kana zvishoma, kunyange munzvimbo dzemuviri dzisingaonekwi pakarepo.

Murwere anofanira kubviswa hembe (kucheka hembe kana zvichidiwa) uye kuongororwa kunofanira kuitwa kubva kumusoro kusvika kutsoka, kutarisa chero pakatyoka, maronda kana kubuda ropa kudiki kana kwakavanzika (hematomas).

Kutevera kuongororwa kwemusoro-kugunwe murwere anofukidzwa negumbeze re isothermal kudzivirira hypothermia inogona kuitika.

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“E” Zvimwe zvirevo

Vara E pakupera kwemavara apfuura (ABCDE) rinogonawo kuva chiyeuchidzo:

Electrocardiogram (ECG): kutarisa murwere.
Zvakatipoteredza: Panguva ino chete ndipo apo muponesi angave ane hanya nezvezvinoitika zvidiki zvakatipoteredza, sekutonhora kana kunaya kwemvura.
Escaping Air: Tarisa maronda emuchipfuva akaboora mapapu uye anogona kukonzera kudonha kwepulmonary.

“F” Zvirevo zvakasiyana

Vara F pakupera kwemavara apfuura (ABCDEF) rinogona kureva:

Fetus (munyika dzinotaura Chirungu fundus): kana murwere ari munhukadzi, zvinodikanwa kuona kuti ane pamuviri here kana kuti kwete, uye kana zvakadaro pamwedzi upi wepamuviri.

Mhuri (muFrance): vanunuri vanofanira kuyeuka kubatsira nhengo dzemhuri zvakanyanya sezvinobvira, sezvo vachigona kupa ruzivo rwakakosha rwehutano hwekutarisira kunotevera, sekutaura kweallergies kana kurapa kunoenderera mberi.

Fluids: tarisa kurasikirwa kwemvura (ropa, cerebrospinal fluid, nezvimwewo).

Matanho ekupedzisira: bata nzvimbo iyo yekugamuchira murwere akakosha.

“G” Zvirevo zvakasiyana-siyana

Vara G pakupera kwemavara apfuura (ABCDEFG) rinogona kureva:

Shuga yeropa: inoyeuchidza vanachiremba uye vanamukoti kutarisa mazinga ehuga.

Enda nekukurumidza! (Enda nekukurumidza!): panguva ino murwere anofanira kutakurwa nekukurumidza sezvinobvira kuchipatara (chipinda chekukurumidzira kana DEA).

H uye ini Various zvinoreva

H uye ini pamagumo epamusoro (ABCDEFGHI) anogona kureva

Hypothermia: kudzivirira chando chemurwere nekushandisa gumbeze rinopisa.

Intensive care post resuscitation: kupa rubatsiro rwakanyanya mushure mekumutsidzira kubatsira murwere akaoma.

Variants

AcBC…: diki c pakarepo mushure mechikamu chemhepo chiyeuchidzo chekutarisa zvakanyanya kumusana.

DR ABC… kana SR ABC…: D, S uye R pakutanga chiyeuchidzo

Ngozi kana Kuchengetedzeka: mununuri haafanire kuzviisa iye kana vamwe munjodzi, uye angangofanirwa kuzivisa nyanzvi dzekununura masevhisi (fire brigade, gomo rekununura).

Mhinduro: tanga watarisa mamiriro ekuziva kwemurwere nekudanidzira nenzwi guru.

DRs ABC…: kana ukafenda danidzira kuti ubatsirwe.