Imfundo ekude ekhawulezayo ye-ultr-point-of-noncedo lokhathalelo phakathi kwababoneleli bononophelo olungxamisekileyo
Ukufikelela kukhathalelo oluphezulu lwenqanaba eliphantsi kumazwe anengeniso ephantsi kunye nephakathi (i-LMIC) iyasilela. I-Ultra-of-care ultrasound (PoCUS) inamandla okuphucula ngononophelo olungxamisekileyo kwii-LMICs. Eyona nto iphambili kwimfundo ekude.
IXESHA yabandakanywa kwinkqubo yoqeqesho yeqela labantu abalishumi ababoneleli ngeeNkonzo zoNyango oluNgxamisekileyo (i-ECPs) abangahlali abagqirha kwi-Uganda esemaphandleni. Senze uvavanyo olulindelweyo lokujonga malunga nefuthe lokude, uphononongo olukhawulezileyo lwezifundo ze-PoCUS kwinjongo eziphambili zomgangatho we-ECP we-ECP kunye nenjongo yesibini yokusetyenziswa kwe-Ultra. Isifundo malunga nemfundo ekude ekhawulezileyo sahlulwa ngezigaba ezine ngaphezulu kweenyanga ezili-11: inyanga yokuqala yoqeqesho lomntu, iinyanga ezimbini eziphakathi kwiibhloksi apho i-ECPs yenze khona ii-ultrasound ngokuzimeleyo ngaphandle kwengxelo eyi-elektroniki ekude, kunye neenyanga zokugqibela xa i-ECPs yenze i-ultrasound ngokuzimela ngengxelo eyi-elektroniki ekude .
Umgangatho wavavanywa kwisikali esapapashwa ngaphambili samanqaku-manqaku asibhozo yi-sonologist esekwe e-US kunye nengxelo yemigangatho ekhawulezileyo yanikwa i-ECPs ngabasebenzi basekhaya. Ubuntununtunu kunye nokucaciswa kweziphumo zeemvavanyo ze-Ultra zovavanyo oluGxilweyo kunye I-Sonograph ye-Trauma (FAST) zibaliwe.
Imfundo ekude ekhawulezileyo: intshayelelo
Ukufikelela kukhathalelo oluphezulu lwenqanaba eliphantsi kumazwe anengeniso ephantsi kunye nephakathi (i-LMICs) kulinganiselwe, ngaphandle kokona mnxeba wakutsha nje ukuya kwisenzo kwi-2007 yi-WHO. Ukongeza, la mazwe ajongene nenxalenye enkulu yomthwalo wezifo kwihlabathi; amazinga okusweleka kwabantwana, umzekelo, ahlala ene10 ukuya kumaxesha e-20 aphakamileyo kwii-LMICs kunakwimivuzo ephezulu.
Izinto ezininzi zinegalelo koku kungafikeleleki kukhathalelo, kubandakanya nokusilela kwababoneleli abanobuchule. I-Sub-Saharan Africa ijongene ne-25% yomthwalo wezifo kwihlabathi lonke yi-3% yabasebenzi bezempilo. Ukulwa noku kunqongophala, amazwe amaninzi asebenzise isicwangciso esaziwa ngokuba "sokutshintsha umsebenzi" apho izakhono noxanduva zisasazwa ngeendlela ezinqabileyo phakathi kweekhebhu zababoneleli kunye neekhebhu ezintsha zenziwe zafuneka.
Ukunqongophala kwababoneleli abanobuchule kwezi sethingi ezinqongopheleyo zezixhobo kuhlala kuhlanganiswa ngokusebenza kwezinto zobuchwephesha, kubandakanywa itekhnoloji yokucinga yokuqonda. Iphathekayo ethwelwe ngesandla, ayibizi, ayifikeleleki lula kwaye isebenza kakuhle ngokwezonyango apho kufumaneka khona iindlela eziphambili zokuxilonga. Imfundo ekude ekhawulezileyo yecadre ye-non-ogqirha kwi-point-of-care ultrasound (PoCUS) ngendlela engqongqo nogqibeleleyo ke ngoko inokubanempembelelo enkulu ekunikezelweni kononophelo kwii-LMICs.
Uphando lwakwangoko lubonisile ukuba abagqirha abangathathi ntweni banokuqeqeshwa ukuba basebenze ngokuzimeleyo kwizakhono ezifanelekileyo kunonophelo olungxamisekileyo. Ukusetyenziswa kwe-POCUS ngogqirha kwii-LMICs sele kunefuthe eliqinisekisiweyo lolawulo lwesigulana, njengokunyanga unyango lonyango okanye ukutshintsha isicwangciso sononophelo.
Imfundo ekude ekhawulezileyo -Kukho uphando olunqongopheleyo lokuvavanya amandla ogqirha ongekho kugqirha abonelela ngononophelo olungxamisekileyo kwii-LMICs ukuba zifunde i-PoCUS njengesijobelelo sononophelo oluqhelekileyo. URobertson et al. ichaze indlela esekude, yokwenyani yokusetyenziswa kweFaceTime ukufundisa nokubeka iliso kwi-POCUS ngabangengabo ogqirha eHaiti naseLevine et al. Ibonakalise ukuba imifanekiso yeFoTime kuhlolo lwe-tele-ayisiyaphantsi kwabo ifakwe kumatshini we-ultrasound. Ukuza kuthi ga ngoku, akukho datha ipapashiweyo echaza ukusetyenziswa kovavanyo-lwe-telefon ukuxhasa ukusetyenziswa kwe-PoCUS kunye nobuchule ngabangengabo ogqirha kwii-LMICs.
Ngokwemveli, imfundo ye-ultrasound yababoneleli isusela kwiseshoni emfutshane ukuya kwiintsuku ezimbini zoqeqesho olunzulu lweentsuku ezimbini ukuya kwizifundo zemodyuli zonyaka omnye. Amanye amaqela afumanise ukuba ngaphandle kwenkxaso eqhubekayo, iiseshoni zoqeqesho ezimfutshane azivelisi ukugcinwa kwezakhono okuzinzileyo. Nangona kunjalo, uqeqesho lokujonga ngokuthe ngqo ixesha elide, umntu ngamnye, ecaleni kwebhedi, lunokuthintelwa kakhulu ekuboneleleni ngezixhobo kwii-LMICs, ngakumbi ukuba ukongamela kubonelelwa ziingcali ezingezizo ezasekhaya eziya kwii-LMIC ngokukodwa ukubonelela ngemfundo. Apha sichaza isixhobo semfundo yenoveli ukubonelela ngokukhawuleza, "ukuphononongwa komnxeba", ukuqinisekiswa komgangatho kunye nengxelo kwiqela leengcali zonyango ezise-Uganda ezisemaphandleni kunye nefuthe lazo ekuqhubekeni nemfundo kunye nokugcinwa kwezakhono kwi-POCUS ebanzi.
Ukusukela i-2009, abagqirha abangabinakho ogqirha baqeqeshiwe kunyango lwesibhedlele kwisithili sase-Uganda, abanezidanga zenkqubo ababizwa ngokuba zii-Emergency Care Practitioners (ECPs). Inkqubo yokumiselwa kwesibhedlele kunye nenkqubo yoqeqesho zichazwe ngokweenkcukacha kwenye indawo i-PoCUS ibandakanywe kwikharityhulamu inikwa ukufikelela okulinganiselweyo kwiinkonzo ze-radiology. Senze uvavanyo olulindelweyo lokujonga malunga nefuthe lokude, uphononongo olukhawulezileyo lwezifundo ze-PoCUS kusetyenziso lwe-ultrasound kunye nezakhono kwiqela labantu abalishumi le-ECP.
Imfundo ekude ekhawulezayo -Iindlela
Yonke into yokudibana kwezigulana yayingeniswe ngokuchanekileyo kwindawo yedatha yophando ekhompyuter. Idatha eqokelelweyo ibandakanya isikhalazo esiyintloko, ulwazi lwendawo leyo, uvavanyo olwenziweyo okanye olwenziwe (kubandakanya ne-ECP POCUS), iziphumo kunye nokubekeka. I-ECPs ifumene imifanekiso ye-ultrasound ene-Sonosite Micromaxx (Bothell, WA) isebenzisa i-2-5 mHz curvilinear transducer, 6-13 mHz linear transducer, okanye i-1-5 mHz transducer transased.
Ngokuphathelele kwimfundo ekude ekhawulezileyo, njengenxalenye yesifundo sophando, ulwazi malunga ne-ultrasound eyenziweyo, i-sonographic kunye nokutolikwa kokuqala zarekhodwa yi-ECPs emva koko zalayishwa ngabasebenzi kwi-database eyahlukileyo esekwe kwiwebhu eyenzelwe omnye wababhali (* *) isiqinisekiso somgangatho okude. Uhlalutyo lwemifanekiso lwenziwe ukude ngogqirha base-US abaxakekileyo ngoqeqesho lobudlelwane kwi-PoCUS. Ingxelo eneenkcukacha yathunyelwa nge-imeyile kubasebenzi bophando lwasekhaya abaprinte kwaye basasaza ingxelo kwi-ECPs esebenzayo.
Eyona njongo yethu iphambili yayiquka iinguqu kumgangatho wemfundo kwangexesha (ukutolika kunye nokufunyanwa komfanekiso). Injongo yethu yesibini yayiquka ukusetyenziswa kwe-ultrasound. I-Ultrasounds ezenziwe ngokuzimeleyo ngokutyelela ogqirha ngaphandle. Lo msebenzi wamkelwa ziiBhodi zokuPhononongwa kweZiko ze [zaza zachongwa] kunye [zaza zachongwa].