Isifundo esenziwe nguGqirha Fausto D'Agostino ukuvavanya ukhuseleko lwezifundo ze-BLS-D ezinikezwe ngexesha lobhubhane we-COVID

I-Cardiac pathologies inoxanduva lwe-35% yako konke ukufa kunye neemeko zokufa kwentliziyo ngesiquphe e-Italiya ziqikelelwa phakathi kwama-50,000 kunye nama-70,000 ngonyaka: ukubanjwa kwentliziyo yeyona nto ibangela ukufa kwilizwe lethu.

Ipesenti yokufa ngenxa yokubanjwa kwe-cardiocirculatory arrest khange yehle ngexesha lobhubhane kodwa, ngokuchaseneyo, ukusweleka ngenxa yokubanjwa kwentliziyo kuye kwanda ngenxa yezinto ezininzi, okokuqala uloyiko lokuhlangula isigulana ngesifo esikrokrisayo sokuhlaselwa nguSars-Cov-2 .

Ubhubhane wangoku uphakamise inqanaba lomngcipheko kubo bonke abahlanguli (abalala kunye nonyango) ngenxa yokuba kunokwenzeka ukuba kusasazeke ngokuveliswa kwamathontsi kunye neeerosol ngexesha lokuvuselelwa kwentliziyo.

Ngapha koko, i-WHO iyithathele ingqalelo le ndlela yokusindisa ubomi, nangona ibalulekile kwaye kufuneka yenziwe ngaphandle kokulibazisa, ukuba semngciphekweni omkhulu wongcoliseko lwentsholongwane kubo bonke abahlanguli kwaye ngenxa yoko kufanele ukwenziwa ngononophelo oluthile.

Ngesi sizathu, kuye kwafuneka ukuba kwenziwe utshintsho okwethutyana kwiiprothokholi ezaziwayo zokuvuselela umhlaba (i-BLS-D: Inkxaso yoBomi esisiseko kunye ne-Defibrillation)

Kubantu abane-COVID-19 eqinisekisiweyo okanye ekrokrelwayo, ukulandelelana okuqhelekileyo kokuvuselelwa kwe-cardiopulmonary kugcinwa kunye neengcebiso ezithile, kulandela ukubonakaliswa kwazo zonke i-acronyms zamazwe ngamazwe (ILCOR, AHA, ERC, ILSF):

Umhlanguli oleleyo kufuneka aphephe ukusondela ebusweni bexhoba ukumisela ubukho bokuphefumla kwaye kufuneka aqhubeke ne-CPR yezandla kuphela ngengcebiso yokuvala umlomo neempumlo zexhoba ngesigqubuthelo okanye ngokubeka ingubo phezu kwabo ukunciphisa ukusasazeka kweerosol;

Ngexesha lendyikitya ye-COVID-19 yangoku, abasebenzi bezempilo (kodwa kufanelekile ngokufanelekileyo 'ekubekeni' abahlanguli) kufuneka basebenzise ukhuseleko lwabo buqu izixhobo xa usenza uvuselelo.

Ukuqhambuka kobhubhani we-Sars-Cov-2 kukhokelele ekunqunyanyisweni kwabo bonke Uncedo yokuqala izifundo, ezinokuthi zibuyiselwe kuphela emva kokuba uMphathiswa weZikhokelo zezeMpilo zikhutshiwe.

Iyaqhubeka BLS-D ukuqeqeshwa kwabasebenzi benkonzo ye-112/118 okanye izibhedlele azikwazi ukumiswa okanye ukuhlehliswa ngenxa yezizathu ezicacileyo zokufumana amandla okungenelela xa kwenzeka ukubanjwa kwentliziyo.

Ngapha koko, ngomhla wama-23/06/2020 iSebe lezeMpilo lavelisa isetyhula (prot. No. 21859) “Iimpawu zesizwe zokuqulatha usulelo lwe-SARS-CoV-2 kwimisebenzi yoncedo lokuqala noqeqesho lwabahlanguli”, oludwelisa izikhokelo ezitsha zokwenza iindlela zokusindisa ubomi ngokukhuselekileyo kunye nezikhokelo zokubonelela ngezifundo zoncedo lokuqala ngexesha lobhubhane we-COVID-19.

Ezi mfuno zisisiseko zilandelayo kufuneka zifezekiswe kulungiselelo lwekhosi ye-BLS-D

• Iindawo ezinkulu eziqinisekisa umgama ubuncinci beemitha ezi-2.0 phakathi koqeqesho;
• Izithuba ezineefestile ezinkulu ngokwaneleyo zokuqinisekisa ukutshintshiselana komoya ubuncinci kwimizuzu engama-60 ngekhefu elifutshane;
• Uqheliso oluza kwenziwa kwidummy kwaye kuphela ngoqeqesho olunxibe iiglavu kunye nemask yokuhlinzwa;
• Ekupheleni kwenyathelo ngalinye, ii-simulators (i-dummies, AED abaqeqeshi kunye nezixhobo zokungenisa umoya) ziyakucocwa ngesibulali ntsholongwane esikhethekileyo kunye nephepha elilahlwayo.

Ngenxa yokugula okuphezulu kunye nokusweleka okubangelwa zizifo zentliziyo kunye nokuphefumla kwaye ngenxa yokusebenza okuboniswe ziikhosi ze-BLSD kulawulo lweengxaki zonxunguphalo lomphefumlo, kwakubaluleke kakhulu ukungamisi uqeqesho loBomi boBomi ngexesha lobhubhane, bobabini abasebenzi bezempilo kwaye wabeka abantu.

Ukugcina isigaba soqeqesho kwizakhono zobugcisa kunye nezandla ze-CPR kwimodi 'yomntu' yathathelwa ingqalelo ibalulekile, inikwa isidingo sokuziqhelanisa neenkxaso zoBomi obuSisiseko ngokuthe ngqo kwii-simulators.

Nangona kunjalo, ukuqinisekisa ukhuseleko nokusebenza kweenkqubo ibiyinto ebalulekileyo kwinkqubo yokufundisa.

Injongo yesifundo sokulinga, esenziwa nguGqr Fausto D'Agostino kunye noMphathiswa Wezempilo ngokusebenzisana ne-American Heart Association (AHA) kunye ne-Italian Resuscitation Council (IRC), yayikukuvavanya ukhuseleko lwezifundo ze-BLSD ezinikezwe ngexesha ubhubhane olungxamisekileyo kuyo yonke i-Itali.

Idatha yaqokelelwa kwiphepha lemibuzo elingagunyaziswanga kwaye lalawulwa kubalawuli be-IRC (iBhunga lase-Italiya lokuVusa) kunye namaziko oqeqesho e-AHA ekupheleni kwezifundo ezenziwa nge-1 kaJuni 2020 ukuya kwi-31 kaJanuwari ngo-2021.

Ikhweshine inemibuzo ekhethiweyo ene-14 eyilelwe ukuvavanya inqanaba lokumiliselwa kwesetyhula yabaphathiswa kunye nazo naziphi na iimeko ezigwenxa ekuhlangatyezwane nazo ekuququzeleleni iikhosi ze-BLS-D kwixesha le-COVID-19.

Ikhweshine yayingachazwanga kwaye idatha yayisetyenziswa ngokudibeneyo.

Iphepha lemibuzo laqhutywa ngesicelo se-imeyile kubo bonke abalawuli bamaZiko oQeqesho kwilizwe liphela.

IINKCUKACHA EZIPHAKAMILEYO ZOKUSEBENZA: TYELELA IZOLL BOOTH KWIMiboniso ENGXAMISEKILEYO

Phakathi kwe-398 yase-Italiya i-IRC / i-ERC kunye neZiko loQeqesho lwe-AHA, ama-337 ahambisa izifundo ze-BLS ngexesha lokufunda kwaye bamenywa ukuba baphendule kuvavanyo.

Ireyithi yokuphendula engama-30% yarekhodwa.

Ngexesha, abathathi-nxaxheba abangama-7833 bazama ikhosi ye-BLS; uninzi lwabathathi-nxaxheba (68%) ibingabasebenzi bezempilo, ngelixa abantu abalaleleyo babalelwa kwi-32% kuphela (n = 2499).

Ezona zizathu ziphambili zokuza kule khosi zibonisiwe kumzekeliso 1A.

Umzobo 1A Kwakutheni ukuze abo baqeqeshwayo baye kwikhosi yoqeqesho yoNcedo lokuQala ngexesha loBhubhane weCovid-19?

Ikhosi yathathelwa ingqalelo iluncedo ngama-90% abathathi-nxaxheba, kubandakanya noqeqesho olutsha ekusebenziseni ngokuchanekileyo izixhobo zokhuselo (iipesenti ezingama-94 zeempendulo).

Nangona kunjalo, iipesenti ezingama-80 zabafundi bavakalise uloyiko lokosuleleka ngelixa bebeze kwezi zifundo, ikakhulu ngexesha leseshoni yokusebenza (iipesenti ezingama-69 zeempendulo).

Ngapha koko, i-94% yabathathi-nxaxheba ixele inkxalabo malunga nokhuseleko lwezifundo, ngakumbi ukubulala iintsholongwane kwigumbi kunye ne-manikin (Ikhiwane. 1B).

Umzobo 1B Zeziphi iingongoma ezibalulekileyo?

Ungenelelo oluboniswe kwi Ikhiwane. 1C yathathelwa ingqalelo iluncedo kuthintelo losulelo, oko kukuthi ukuvavanywa kweSab-Cov2 swab, ukusetyenziswa kwemaski kunye nomgama phakathi kwabantu.

Umzobo 1C Ngawaphi amanyathelo ongezelelweyo anokusetyenziswa ukwenza ikhosi yoNcedo lokuQala ikhuseleke?

Amanyathelo athathiweyo ukuthintela usulelo, njengoko kucetyisiwe ngumthetho wase-Itali, athathwa njengoluncedo kwaye kulula ukuwasebenzisa kwi-92% kunye ne-87% yeempendulo ngokwahlukeneyo.

Ukusetyenziswa kweemaski ngexesha lekhosi akuzange kubonwe njengomqobo kunxibelelwano yi-85% yabaphenduli.

Kwakukho iimeko ezi-9 ezichaziweyo zosulelo lwe-COVID-19 emva kwezifundo ezibanjwe ngexesha lokufunda; I-90% yayo yenzeke kwiintsuku ezi-5 ukuya kwezi-14 emva kwekhosi (Ikhiwane. 1D).

Umzobo 1D Ngaba ubunazo naziphi na iingxelo zosulelo lwe-COVID-19 elilandela ikhosi kwiziko lakho?

Iminyaka yabafundi abasulelekileyo yahluka phakathi kweminyaka engama-31 nama-40 (Ikhiwane. 1E).

Umzobo 1E Ingxelo ingene emva kwexesha elingakanani ugqibe izifundo?

Umngcipheko wosulelo kwizifundo ze-BLS yayiyi-0.11%, kunye nenqanaba eliqikelelweyo lezehlo ezingama-54.8 ngabathathi-nxaxheba abayi-100,000.

Le yingxelo yokuqala kwiziganeko zosulelo lwe-Sars-Cov2 olunxulumene nezifundo ze-BLS-D kwaye iseta umlinganiso wokuvavanya ukhuseleko lwezifundo zeCPR ngexesha lobhubhane we-COVID-19

Ngombono wengozi, xa kuthelekiswa nokubanjwa kwentliziyo ka-70,000 / ngonyaka e-Italiya, umngcipheko wosulelo ngexesha lezifundo ze-BLS ubonakala umncinci kakhulu kwaye unokuncitshiswa ngakumbi.

Ukufunda inqaku elipheleleyo: https://www.resuscitationjournal.com/article/S0300-9572(21)00330-0/fulltext

UGqr Fausto D'Agostino

Ingcali kwiAnesthesia, ukuvuselela, ukunyamekela kunye nokunyanga kweentlungu

www. www

Funda kwakhona:

Nguwuphi umahluko phakathi kweCPR kunye ne-BLS?

I-ERC ibonelele nge-BLS kunye nezikhokelo ze-ALS kwii-COVID-19 zezigulana ezinezinye izifo

I-European Resuscitation Council (ERC), Izikhokelo ze-2021: BLS-Inkxaso yoBomi esisiseko