Ulawulo oluphambili lwe-airway luyinxalenye ebalulekileyo yokunakekelwa kwangaphambili kwezibhedlele. Ziziphi izinto eziphambili zesigqibo sokwenza intubation?

Ukulandelelana ngokukhawuleza Intubation yindlela yokulawula i-airways nokunciphisa umngcipheko wemisuka kunye namanzi ukuhlaziywa ngokutsha ku1970 (Isityu | Safar) ukusebenzisa iCricoid Pressure ngexesha leenkqubo zolawulo lwe-Airway (Sellick). Ukulandelelana ngokukhawuleza kwe-Intubation yenye yezona zinto zibaluleke kakhulu kwi-ALS kuba kufuneka igcine ukusebenza komoya. Lelona candelo libalulekileyo le- zobungcali bezobugcisa, ngokusebenza kwi ngokukhawuleza esibhedlele. Kodwa ukususela kwi-2010, kukho imibuzo malunga Sellick Maneuver ukuba baphandi baphando.

The Indawo ye-Greater Sydney kwi-HEMS Ngenye yeqela elinamakhono amaninzi malunga neenkqubo ze-ALS zangaphambi kwesibhedlele kwihlabathi. Ba landela #OSAMED protocols ukubonelela wonke umntu ngolwazi ngamava abo, ngokukodwa ngoLawulo lwe-Airway. Bayidale Registry Airway oko kubaluleke kakhulu ukuba ufunde umgangatho ongcono. Zonke iimeko ezibhalisiweyo kwiRejista ye-Airway zixutyushwa ngaphandle kokuxubusha, zingachazwanga kwaye zidibaniswe kwixesha elide ukuze zidibanise kunye ukudibanisa imiyalezo yasekhaya.

The Indawo enkulu yaseSydney HEMS kwi 2010 wenze incwadana yokulandelelana ngokukhawuleza ngokukhawuleza. Le ncwadana ichaza inkqubo ye-anesthesia yangaphambi kwesibhedlele. Yincwadi enomdla ngokwenene yeengcali ezisebenza kuseto olunqongopheleyo kwezakhono apho ukubuyisa iqela izixhobo kunye nobuchule bunokufuneka ukubonelela ngolawulo olukhuselekileyo noluchanekileyo.

Indawo ye-Greater Sydney Indawo ye-HEMS incwadi ichaza iinkqubo ezimele zilandelwe i-anesthhesia yangxamisekileyo yesibhedlele. Uluvo lwase-Australia kukuxhasa isicwangciso se-laryngoscopy esicwangcisiweyo sokuqala sokujonga impumelelo. "Oku kuthintela ukuzama ixesha elide kunye nokulinganisa okuninzi kunye nokulandela okunobunzima. Ijolise ekuqinisekiseni a ubuchule obukhuselekile bokusetyenziswa kwe-anesthesia yangaphambili yezibhedlele Ngelixa uvuma iimeko ezahlukeneyo, imeko kunye ne-pathologies abahlangabezana nayo kulungiselelo lwesibhedlele sangaphambi kwesibhedlele. Ingcebiso ezinikiweyo zithatyathwe kumava adityanisiweyo odidi olukhulu lwee-kliniki zonakekelo lwaphambi kokufika kwasesibhedlele kwaye lusebenza ubungqina apho kunokwenzeka. Incwadana yemigaqo ichaza eyona nto iphambili kuyo kunye nobuchule obunokwenzeka obuvavanywa kwiNgxamali yezeMeko yoNyango oluNgxamisekileyo ". Njengoko kunye nazo zonke iinkqubo, isigqibo sokuqhubeka ne-anesthesia esiphuthumayo yesibhedlele kufuneka sisekelwe kuhlolo oluchanekileyo lomngcipheko wenkqubo ngokumalunga neenzuzo zeklinikhi. Iziboniso i-anesthhesia yangxamisekileyo yesibhedlele zezi:

• Ukungaphumeleli kwendlela yokuhamba ngomoya
• Ukungaphumeleli kokukhuselwa komoya
• Ukungaphumeleli kokungena umoya / oksijini
• Inkqubo yekliniki ekulindeleke
• Izizathu zobuntu
• Ukuququzelela ukuhamba ngokukhuselekileyo

Ulawulo oluphambili lwe-airway, kubandakanya i-anesthesia yongxamiseko, yinto esisiseko senkathalelo yangaphambi kwesibhedlele. Ukhuseleko lobuninzi bomoya kunye nokukhuselwa sisakhono esibalulekileyo sokukhathalela isigulana esenzakeleyo. Ikhulisa i-oxygenation kwizigulana ezenzakala kakhulu, yenza ukuba ukuthutha kwabo kukhuseleke esibhedlela, kuququzelele ukubonwa kwemithambo-luvo kunye nophando olukhawulezileyo esibhedlele kunye nonyango lokuhlinzwa.

Ixesha elongezelelekileyo elichithwe kwindawo yokukhusela i-airway (nkqu noochwephesha abanobuchule) yenye yezona mpikiswano zinkulu kukhathalelo lwangaphambi kokubhedlele. Ixesha elichithelwe ukulawula indlela yomoya liphelile lixesha eligcinwe ngexesha lothutho kunye nezigaba ezibhedlela zokuvuselela ixesha elide njengoko lisenziwa ngokukhuselekileyo nangokukhawuleza. Amaxesha okubulala imeko yongxamiseko ngaphambi kwesibhedlele ixesha elingaphantsi kwe-20min ayafezekiseka kwaye kufanele ibe kukujolisa ngexesha loqeqesho.

I-anesthhesia engxamisekileyo yezibhedlele ingaphambi kokubhedlele ingasengozini kune-anesthesia yezibhedlele ngokubanzi ngenxa yemingeni echazwe yimeko engaphambi kwesibhedlele kwaye ngoko yonke imizamo kufuneka yenziwe ukuze kuqinisekiswe ukhuseleko lwenkqubo. Ukwakheka kwindlela yokukhwela kunye neyezempi kuyamkelwa kakuhle, ukuba ukuphakama kweemeko eziphakamileyo, kukona mfuneko enkulu yokususa inxaxheba kwenkqubo nganye kunye nemfuneko enkulu yokunamathela kwinkqubo yokusebenza esemgangathweni.

Isigqibo sokufakwa: Uluhlu loqwalaselo oluvela eSydney HEMS

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