Emergency Live | 10 Steps to perform a Correct Spinal Immobilization of a Trauma Patient image 4 — Layliska degdega ah: codsiga madaxa idha-dhaqaaqa iyo qoorta ilmagaleenka

Farsamooyinka ka-hortagga ilmo-galeenka iyo laf-dhabarta: dulmar

By Cristiano Antonino On Feb 24, 2023

Farsamooyinka dhaqaajinta ilmo-galeenka iyo laf-dhabarta: Shaqaalaha adeegyada caafimaadka degdegga ah (EMS) waxay sii ahaanayaan daryeel-bixiyeyaasha aasaasiga ah ee maaraynta inta badan xaaladaha degdegga ah ee ka baxsan isbitaalka, oo ay ku jiraan xaaladaha dhaawacyada.

Tilmaamaha ATLS (taageerada nolosha dhaawaca sareeysa), ee la sameeyay 1980-meeyadii, waxay sii ahaanayaan heerka dahabka ee qiimeynta iyo kala hormarinta maareynta dhaawacyada nafta halis gelinaya si macquul ah oo hufan, inkastoo ay jirtay dood dheer oo ku saabsan hababka isticmaalka gargaarkan.

Dhaqdhaqaaq la'aanta laf dhabarta waxay ahayd qayb muhiim ah oo waxbarid ah, marka lagu daro xirmooyinka miskaha iyo kabyada jabka lafaha dheer

Noocyada kala duwan ee caafimaadka qalab waxaa loo sameeyay si loo suurtageliyo waxtarka iyo fududaynta codsiga, iyo sidoo kale u oggolaanshaha dabacsanaanta iyo helitaanka muhiimka ah ee maaraynta marin-haweedka iyo hababka kale.

Baahida loo qabo in la dhaqdhaqaajiyo laf dhabarta waxaa lagu go'aamiyaa goobta iyo qiimeynta bukaanka.

FARXIYAYAYAASHA, BOARAHA LAFAFARKA, CUNTADA SAmbabada, Kuraasta daad-gureynta: Alaabooyinka Spencer ee ku yaal BOOTH labanlaaban ee Bandhigga Degdegga ah

Tixgeli dhaqdhaqaaqa laf dhabarta marka habka dhaawaca uu abuuro tuhun sare oo shaki ah madaxa, qoorta ama dhaawac laf dhabarta

Xaaladda maskaxeed ee daciifka ah iyo yaraanta neerfaha ayaa sidoo kale tilmaamaya in dhaqdhaqaaqa laf dhabarta la tixgeliyo.[1][2][3][4]

Dhaqdhaqaaqa ATLS ee caadiga ah ee loogu talagalay dhaqdhaqaaq-la'aanta laf-dhabarka ee ku habboon bukaanka ku jira xaalad dhaawac weyn ayaa ah mid adag oo si fiican loo rakibay. dabka oo leh baloogyo iyo cajalad si loo sugo laf-dhabarta ilmo-galeenka, iyo sidoo kale sabuurad si loo ilaaliyo inta kale ee laf dhabarta.

The Qalabka soo saarista Kendrick waxay u ogolaataa laf dhabarta in lagu ilaaliyo qofka dhaawaca ah oo fadhiya meel fadhiya inta lagu jiro degdega ah ee gaariga ama xaaladaha kale ee helitaanka xaddidan si loogu oggolaado isticmaalka dhabarka buuxa.

Si kastaba ha ahaatee, qalabkani wuxuu u baahan yahay in shaqaalaha samatabbixintu ay taxaddaraan si ay u xaddidaan dhaqdhaqaaqa laf-dhabarka ilmo-galeenka iyaga oo isticmaalaya abaabulka khadka ilaa inta la isugu yimaado [5].

Daabacaadda 10-aad ee tilmaamaha ATLS iyo bayaanka la isku raacsan yahay ee Kulliyada Maraykanka ee Dhakhaatiirta Degdegga ah (ACEP), Kulliyada Maraykanka ee Dhakhaatiirta Qalliinka ee Dhaawaca (ACS-COT), iyo Ururka Qaranka ee Dhakhaatiirta EMS (NAEMSP) ayaa sheegaya in, in kiiska dhaawaca gasha ma jirto wax calaamad u ah xaddidaadda dhaqdhaqaaqa laf-dhabarka [6], iyada oo la raacayo daraasad dib-u-eegis ah oo laga helay Xogta Dhaawaca Maraykanka oo muujisay tiro aad u yar oo dhaawacyo laf-dhabar ah oo aan degganayn oo u baahan qalliin marka la eego xaaladda dhaawaca. Daraasaddu waxay sidoo kale muujinaysaa in tirada bukaannada la daweynayo si loo helo faa'iido suurtagal ah ay aad uga badan tahay tirada bukaannada lagu daweynayo si loo helo dhaawac, 1032/66.

Si kastaba ha ahaatee, xaalada dhaawac ba'an oo muuqda, xannibaado ayaa lagu sii muujinayaa xaaladaha soo socda:

Low GCS ama caddaynta khamriga iyo maandooriyaha
Jilicsanaanta laf dhabarta ilmo-galeenka ee khadka dhexe ama dambe
Naafonimada laf dhabarta oo cad
Jiritaanka nabarrada kale ee leexinta

Talada xaddidaadda wax ku oolka ah waxay ku sii socotaa inay noqoto qoorta ilmagaleenka oo leh ilaalin buuxda oo lafdhabarta ah, taas oo ah in laga saaro sida ugu dhakhsaha badan.

Tani waxay sabab u tahay khatarta dhaawacyada lakabyada badan.

Si kastaba ha noqotee, dadka bukaanka ah ee carruurta, khatarta dhaawacyada heerarka kala duwan ayaa hooseeya sidaas darteed kaliya taxaddarrada laf-dhabarka ilmo-galeenka oo aan la sheegin taxadar buuxa oo lafdhabarta ah (haddii aan calaamadaha ama calaamadaha dhaawacyada kale ee laf-dhabarka la heli karo mooyaane).

Dhaqdhaqaaqa ilmo-galeenka iyo qoorta adag ee bukaanka carruurta

Neck xanuun
Beddelka neerfaha addimada oo aan lagu sharaxin dhaawaca addimada
Muruqyada qoorta (torticollis)
Hooseysa GCS
Dhaawac halis ah oo halis ah (tusaale shil baabuur oo tamar badan leh, dhaawaca qoorta iyo dhaawaca sare ee jirka)

Meelaha walaaca laga qabo

Waxa jira caddayn isa soo taraya iyo welwelka goobtaas kala-soocid ayaa keentay in si xad dhaaf ah loo isticmaalo hababka dhaq-dhaqaaqa laf-dhabarta iyo in bukaanada qaarkood ay suurtagal tahay inay halis galaan [7] [8] [9] [10].

Dhibaatooyinka suurtagalka ah ee dhaqdhaqaaqa laf dhabarta:

Raaxo iyo cidhiidhi ku jira bukaanka[11].
Kordhinta wakhtiga isbitaalka ka hor oo leh dib u dhac ku iman kara baadhitaanada iyo daawaynta muhiimka ah, iyo sidoo kale faragelinta waxqabadyada kale[11].
Xayiraadda neefsashada ee xargaha, iyo sidoo kale shaqada neefsashada ee ka sii daraysa ee booska sare marka loo eego booska toosan. Tani waxay si gaar ah muhiim ugu tahay xaaladaha dhaawac-maskaxeed, ha ahaato mid badheedh ah ama ha ahaato mid gasha[12]
Kiiska bukaanada qaba ankylosing spondylitis ama qallafsanaanta laf dhabarta ee horay u jirtay, halkaas oo waxyeelada dhabta ah ay sababi karto ku qasbitaanka bukaanka inuu u hoggaansamo booska hore loo go'aamiyay ee qoorta ilmo-galeenka adag iyo dhabarka dambe[15].

Dib-u-eegis cusub oo ku saabsan suugaanta Scandinavian-ka, oo loo sameeyay si loo baaro caddaynta la heli karo ee xaddidaadda dhaqdhaqaaqa laf-dhabarka [16], waxay bixisaa aragtiyo aad u qiimo badan marka la barbardhigo hababka xasilinta laf-dhabarka ee isbitaalka kahor iyadoo la qiimeynayo xoogga caddaynta.

Collar adag

Qoorta adag ayaa loo isticmaalay tan iyo bartamihii 1960-meeyadii sida habka xasilinta laf-dhabarka ilmo-galeenka, oo leh caddayn tayo hoose leh oo taageeraya saamaynta togan ee natiijada neerfaha ee dhaawaca laf-dhabarka ilmo-galeenka, oo leh saameyn taban oo suurtagal ah sababtoo ah korodhka weyn ee cadaadiska intracranial iyo dysphagia [17].

Maqaalku waxa kale oo uu soo jeedinayaa in bukaanka feejignaanta iyo iskaashiga leh ee leh murqaha murqaha ee uu sababay dhaawaca aysan u badnayn in uu yeesho barokac weyn, sida lagu xusay daraasadaha cadaver ee isku dayay in ay bartaan saameynta dhaawaca.

Maqaalku wuxuu soo jeedinayaa in la isku dheellitiro khataraha iyo faa'iidooyinka qalliinkan.

Si kastaba ha ahaatee, Ururka Maraykanka ee Dhakhaatiirta Dhakhaatiirta Neerfaha waxay sii wadaan inay soo jeediyaan cufan adag oo ah habka lagu xasilinayo laf-dhabarka ilmo-galeenka ee xaaladda isbitaalka ka hor[18].

Looxa adag: Goorma ayaa looxa dheer ee laf dhabarta la isticmaalaa?

Saxiixa dheer ee laf dhabarta ee asalka ah ayaa lala isticmaalay qoor adag, baloogyo iyo xargaha si loo gaaro dhaqdhaqaaq la'aanta laf dhabarta.

Dhaawaca suurtagalka ah, gaar ahaan nabarrada cadaadiska ee sacrum, [19] [20] ayaa hadda la muujiyay, gaar ahaan haddii ay dhacdo dhaawacyada laf-dhabarka iyada oo aan la dareemin ilaalin.

Furaash vacuum ah oo jilicsan wuxuu bixiyaa oog dabacsan oo ka ilaaliya saamaynta nabarrada cadaadiska isla markaana bixiya taageero ku filan marka la kordhiyo heerka madaxa[16].

blocks

Blocks waa qayb ka mid ah istaraatiijiyada abaabulida khadka ee lagu xasilinayo laf dhabarta waxayna u muuqdaan kuwo waxtar leh marka bukaanka lagu dhejiyo laf dhabarta guddiga si loo gaaro heer go'an oo dhaqdhaqaaq-la'aan ah, iyada oo aan faa'iido dheeraad ah laga helin isticmaalka koodhka adag ee la isku daray [21].

Furaash nadiif ah

Isbarbardhigga joodariga faakuumka iyo sabuurada adag oo keliya, furaashku wuxuu bixiyaa kontorool badan iyo dhaqdhaqaaq yar inta lagu jiro codsiga iyo qaadista marka loo eego looxa adag [22].

Iyadoo la tixgelinayo khatarta nabarrada cadaadiska, furaashku wuxuu u muuqdaa inuu bixiyo ikhtiyaar ka wanaagsan gaadiidka bukaanka.

Xoraynta lafdhabarta: habaynta laf-dhabarta iyo dhaqdhaqaaqa ilmo-galeenka

Shuruudaha NEXUS: feejignaan, qof aan sakhraan ahayn oo aan lahayn dhaawacyo soo jiidasho leh ayaa leh suurtogalnimada dhaawac aad u hooseeya marka ay maqan tahay xiisadda khadka dhexe iyo yaraanta neerfaha.

Tani waxay u muuqataa inay tahay qalab baadhiseed xasaasi ah oo leh dareen 99% iyo qiime saadaalineed taban oo ah 99.8%[23].

Si kastaba ha ahaatee, cilmi-baarisyo kale oo indho-indhayn ah ayaa soo jeediyay in bukaanka heeganka ah ee dhaawaca laf-dhabarka ilmo-galeenka uu isku dayi doono inuu dejiyo laf-dhabarka iyo in joogitaanka nabarrada qallafsan (marka laga reebo dhuunta) aysan saameyn ku yeelan natiijooyinka baaritaanka kiliinikada ee laf-dhabarka ilmo-galeenka iyo sidaas darteed laf dhabarta waxaa lagu sifeyn karaa kiliinikada iyadoon sawir kale laga qaadin[24]. Daraasado kale ayaa soo jeedinaya natiijooyin isku mid ah laf-dhabarka thoracolumbar [25] [24].

RAADIYAHA SHAQAALAHA EE ADUUNKA? BOOQO EMS RADIO BOOTH EE EXPO Gurmadka Degdegga ah

Muhiimadda bukaanka

Inkasta oo dhaqdhaqaaqa laf-dhabarka ka-hor-isbitaalka la sameeyay muddo tobanaan sano ah, xogta hadda jirta ayaa muujinaysa in dhammaan bukaannada aan loo baahnayn in la dhaqaajiyo.

Hadda Ururka Qaranka ee Dhakhaatiirta Degdegga ah ee Maraykanka iyo Kulliyada Maraykanka ee Dhakhaatiirta Qalliinka ee Ku-xigeenka Trauma waxay soo jeedinayaan codsi xaddidan oo dhaqdhaqaaqa laf dhabarta ah.

Tilmaamahan ugu dambeeyay waxay muujinayaan in tirada bukaannada ka faa'iideysan kara dhaqdhaqaaq la'aanta ay aad u yar yihiin

Guddigu wuxuu sii waday inuu sheego in isticmaalka macquulka ah ee xakameynta laf-dhabarka inta lagu jiro gaadiidka ay tahay in si taxadar leh loo isticmaalo, maadaama xaaladaha qaarkood khatarta suurtagalka ah ay ka badan tahay faa'iidooyinkooda.

Intaa waxaa dheer, bukaanada ay soo gaareen jug dhexda ah oo aan lahayn cillad maskaxeed oo muuqda, isticmaalka xakameynta laf dhabarta laguma talinayo.

Gudaha USA hawlwadeenka EMS waa inuu isticmaalo acumen bukaan kahor intuusan go'aansan inuu isticmaalo looxa laf dhabarta.[26]

Ugu dambeyntii, dhaqdhaqaaq la'aanta laf-dhabarka ayaa lala xiriiriyay xanuunka dhabarka, xanuunka qoorta oo aad u adag in la sameeyo hababka qaarkood, oo ay ku jiraan sawir-qaadista.

Dhaqdhaqaaq la'aanta laf dhabarta ayaa sidoo kale lala xiriiriyay dhibaatooyinka neefsashada, gaar ahaan marka xarkaha waaweyn lagu dhejiyo laabta.

Inkasta oo ururo badan oo EMS ah oo Maraykan ah ay qaateen tilmaamahan cusub ee dhaqdhaqaaqa laf dhabarta, tani maaha mid caalami ah.

Qaar ka mid ah nidaamyada EMS ayaa ka baqaya dacwad haddii aysan kicin bukaannada.

Bukaanka ay tahay in laga guuro laf dhabarta waxaa ka mid ah kuwan soo socda:

Sawir-qaadista ku-shaqeynta hawo-mareenka: maxaan ugu baahanahay…

Mar 24, 2023

Sida loo doorto oo loo isticmaalo oximeter garaaca wadnaha?

Mar 21, 2023

Qalabka caafimaadka: Sida loo akhriyo Kormeeraha Calaamadaha Muhiimka ah

Mar 18, 2023

Hawo-mareeneyaasha, waxa kaliya ee aad u baahan tahay inaad ogaato: farqiga u dhexeeya…

Mar 18, 2023

trauma blunt
laf dhabarta xanuun
bukaanka qaba heerka miyirka oo bedelay
cilladaha neerfaha
qallafsanaan cad oo anatomical ah ee tiirka laf dhabarta
Dhaawac aad u sarreeya oo ku dhaca bukaanka sakhraansan daroogada, khamriga.

Tixraacyada buugaagta

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[4] Lacey CM, Finkelstein M, Thygeson MV, Saamaynta meelaynta cabsida marka la tallaalayo: dhabarka iyo fadhiga. Joornaalka kalkaalisada carruurta. 2008 Jun; [PubMed PMID: 18492548]

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[22]Prasarn ML,Hyldmo PK,Zdziarski LA,Loewy E,Dubose D,Horodyski M,Rechtine GR,Isbarbardhigga Furaash Vacuum ah iyo Guddiga Laf-dhabarta oo Keli ah Dhaqdhaqaaqa Laf-dhabarta ilmo-galeenka ee Dhaawacan Bukaan-socodka: Daraasad Biyomechanical Cadveric ah. Laf dhabarta 2017 Dec 15 [PubMed PMID: 28591075]

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