Kufambisa kwemafambisi ekufambisa kwemafambisi emhepo ndiyo chinhu chinonyanya kukosha chekufambisa mberi kwechipatara. Ndezvipi zvikonzero zvakakosha zvechisarudzo chekuita intubation?

Rapid Sequence Intubation inzira yekudzora ndege uye kugadzirisa njodzi yemarutsi nemvura regurgitation akaberekwa mu 1970 (Stept | Safar) kushandisa Cricoid Pressure panguva yeAwayway management procedures (Sellick). Rapid Sequence Intubation ndiyo imwe yenzira dzinonyanya kukosha muALS nekuti inofanirwa kuchengetedza kugona kwemweya. Icho chinhu chakakosha chikamu cheiyo chiremba unyanzvi hwokurapa, yekushanda a pre-hospital emergency. Asi kubvira pa2010, pane mibvunzo pamusoro Sellick Maneuver kuti Vatsvakurudzi vari kuongorora.

The Greater Sydney Area HEMS nderimwe remapoka ane unyanzvi pamusoro pehutano hweAIDS husati hwavapo munyika. Vari kutevera #FOAMED zvinyorwa kupa mumwe nomumwe ruzivo pamusoro pezvakaitika kwavari, kunyanya nezveAwayway Management. Vakanga vasika iyo Airway Registry iyo ndiyo chiratidzo chinokosha chekudzidza tsika iri nani. Zvose zviitiko zvakanyoreswa muAirway Registry zvinokurukurwa zvisingafungi, zvisingazivikanwi uye zvinosanganiswa kwenguva yakareba kuti zvinyatsobatanidza kusunganidzwa kwekutora misha.

The Greater Area Area mipendero muna 2010 yakagadzira Rapid Sequence Intubation bhuku. Iri bhuku rinotsanangura system ye pre-chipatara emergency anesthesia. Iri ibhuku rinonakidza kwazvo revashandi vari kushanda mune hunyanzvi-mashoma masetetheni uko kunotora timu midziyo uye hunyanzvi hunogona kudikanwa kuti upe yakachengeteka uye inonyanya kufambisira yepamusoro nzira yekufambisa yemhepo.

Nzvimbo Yepamusoro yeSydney HEMS bhuku rinotsanangura nzira dzinofanira kuteverwa pre-hospital emergency anesthesia. Pfungwa yeAustralia ndeyekutsigira chirongwa chakasarudzika laryngoscopy yekutanga kutarisa kubudirira. "Izvi zvinodzivirira kwenguva refu uye akawanda kuedza uye zvinotevera matambudziko. Inotarisira kuona kuti a nzira yakachengeteka yakagadziriswa yep-pre-hospital emergency anesthesia apo ndichibvuma mamiriro ezvinhu akasiyana-siyana, nharaunda uye pathologies zvakasangana mukutanga-chipatara kurongwa. Zano rakapihwa rinobva pane zvakasangana chiitiko chakakura chevarapi vari muchipatara chisati chiri chipatara kurwara kwekutambudzika uye chiratidzo-chakavakirwa pazvinogoneka. Iri bhuku rinotsanangura kiyi theoretical uye inoshanda kugona kunoongororwa muEmergency Anesthesia Clinical Currency ”. Sezvo nemitemo yose, chisarudzo chekuenderera mberi ne-pre-hospital emergency anesthesia chinofanira kunge chakavakirwa pakuongorora kwakanyatsozivikanwa kwehutano hwehutano hunoenderana nekliniki dzinobatsira. Zviratidzo zve pre-hospital emergency anesthesia vari:

• Kukundikana kwekufamba kwemafirimu
• Kukundikana kwekuchengetedzwa kwemhepo
• Kukundikana kwemavheni / oxygenation
• Anotarisira kliniki yekodhi
• Zvikonzero zvebatsiri
• Kuita kuti pave nekufambisa kwakachengeteka

Nhandare yekufambisa kwepamhepo, inosanganisira emergency anesthesia, chinhu chakakosha chekurapa kwepamberi kwepachipatara. Kuchengetedza airway patency uye kuchengetedza hunyanzvi hwakakosha pakuchengeta murwere akawandisa akakuvara. Iyo inowedzera oxygenation yevarwere vakakuvara zvakanyanya, inogonesa kutakura kwavo kwakachengeteka kuchipatara, inofambisa neuroprotection pamwe nekukurumidza mu-chipatara kuferefetwa nekutarisirwa kwekuvhiya.

Iyo nguva yakawedzerwa inoshandiswa pachiitiko kuchengetedza airway (kunyangwe nevarapi vane hunyanzvi) ndeimwe yemakakatanwa makuru mukutarisirwa kuchipatara. Iyo nguva inoshandiswa kuronga mugwagwa wemhepo yakabviswa nenguva yakachengetwa panguva yekufambisa uye muzvipatara zvikamu zvekudzoreredzwa chero bedzi zvichinge zvaitwa zvakachengeteka uye zvichikurumidza. Pre-chipatara emergency emergency anesthesia scene nguva dzisingasviki 20min dzinogoneka uye dzinofanira kuve dzinotarisirwa panguva yekudzidziswa.

Pre-hospital emergency anesthesia inogona kunge inotyisa kupinda mune-chipatara mukuru anesthesia nekuda kwezvinetso zvinowanikwa nehutachiona hwepamberi uye naizvozvo kuedza kwose kunofanira kuitwa kuti kuve nekuchengeteka kwehutano. Mukufambisa kwemauto uye zvechiuto zvinogamuchirwa zvakanaka, kuti iyo yakakwirira yehutano hwemamiriro acho ezvinhu, zvakanyanya kudikanwa kubvisa imwe nzira yekutarisa uye zvakanyanya kudiwa kwekutevedzera kune imwe nzira yekushanda nzira.

Chisarudzo chekunyisa: rondedzero yekuongorora kubva kuSydney HEMS

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