Usizo lokuqala kanye ne-BLS (Basic Life Support): kuyini nokuthi kwenziwa kanjani

By UCristiano Antonino On Kwangathi 11, 2022

Ukubhucungwa kwenhliziyo kuyindlela yezokwelapha, kanye namanye amasu, okwenza i-BLS, emele i-Basic Life Support, isethi yezenzo ezihlinzeka ngosizo lokuqala kubantu abaye bahlukumezeka, njengengozi yemoto, ukuboshwa kwenhliziyo noma ukushaywa ugesi.

I-BLS ihlanganisa izingxenye eziningana

ukuhlolwa kwendawo yesigameko
ukuhlolwa kwesimo sokwazi koxoxwayo
ukucela usizo ngocingo;
ABC (ukuhlolwa kwe-patency yomoya, ukuba khona kokuphefumula kanye nomsebenzi wenhliziyo);
ukuvuselelwa kwe-cardiopulmonary (CPR): okuhlanganisa ukubhucungwa kwenhliziyo nokuphefumula komlomo kuya emlonyeni;
ezinye izenzo eziyisisekelo zokusekela ukuphila.

Ukuhlola ukwazi

Ezimeni eziphuthumayo, into yokuqala okufanele yenziwe - ngemva kokuhlola ukuthi indawo ayisethuli ubungozi ku-opharetha noma olimele - ukuhlola isimo somuntu sokwazi:

zibeke eduze nomzimba;
umuntu kufanele anyakaziswe amahlombe ngobumnene (ukugwema ukulimala okwengeziwe);
umuntu kufanele abizwe ngokuzwakalayo (khumbula ukuthi umuntu, uma engaziwa, angase abe yisithulu);
uma umuntu engaphenduli, kusho ukuthi uqulekile: kulokhu akufanele kumoshwe isikhathi futhi kufanele kwenziwe isicelo esisheshayo kulabo abasondelene nawe ukuthi bashayele inombolo yocingo oluphuthumayo lwezokwelapha u-118 kanye/noma u-112;

Okwamanje qala ama-ABC, okungukuthi:

hlola ukuthi indlela yokuphefumula ayinazo yini izinto ezithikameza ukuphefumula;
hlola ukuthi ukuphefumula kukhona yini;
hlola ukuthi umsebenzi wenhliziyo ukhona yini nge-carotid (intamo) noma i-radial (ishayela) ishayela;
ngokungabikho kokuphefumula nokusebenza kwenhliziyo, qalisa ukuvuselelwa kwe-cardiopulmonary (CPR).

Ukuvuselelwa kweCardiopulmonary (CPR)

Inqubo ye-CPR kufanele yenziwe ngesiguli esibekwe endaweni eqinile (indawo ethambile noma evuzayo yenza ukucindezelwa kungenasidingo ngokuphelele).

Uma ikhona, sebenzisa i-automatic/semiautomatic i-defibrillator, ekwazi ukuhlola ukuguqulwa kwenhliziyo kanye nekhono lokuletha umfutho kagesi ukwenza i-cardioversion (buyela esigqi esivamile se-sinus).

Ngakolunye uhlangothi, ungasebenzisi i-defibrillator manual ngaphandle uma ungudokotela: lokhu kungenza isimo sibe sibi nakakhulu.

I-massage yenhliziyo: ukuthi ukwenze nini nokuthi ukwenze kanjani

I-massage yenhliziyo, ngabasebenzi abangewona abezokwelapha, kufanele yenziwe lapho kungabikho umsebenzi kagesi wenhliziyo, lapho usizo lungatholakali futhi kungabikho i-defibrillator ezenzakalelayo / semiautomatic.

I-massage yenhliziyo iqukethe izinyathelo ezilandelayo:

Umhlengi uguqa eceleni kwesifuba, umlenze wakhe usezingeni lehlombe lalowo oshonile.
Ususa, ukuvula noma ukusika uma kunesidingo, izingubo zomuntu ohlukunyeziwe. Ukuqondisa kudinga ukuthintana nesifuba, ukuze uqiniseke ngokuma kwezandla ezifanele.
Beka izandla zakho ngqo phakathi nendawo esifubeni, ngaphezu kwe-sternum, enye phezu kwesinye
Ukuze ugweme ukuphuka izimbambo uma kwenzeka isiguli singase sibe namathambo aphukayo (iminyaka yobudala, i-osteogenesis imperfecta….), intende yezandla kuphela okufanele ithinte isifuba. Ngokucacile, indawo okuxhunywana kuyo kufanele kube ukuvelela kwesundu, okungukuthi ingxenye ephansi yentende eseduze nesihlakala, eqinile futhi iku-eksisi ngelungu. Ukuze kube lula lo othintana naye, kungase kusize ukuhlanganisa iminwe yakho bese uyiphakamisa kancane.
Shifta isisindo sakho phambili, uhlale emadolweni akho, kuze kube yilapho amahlombe akho engaphezulu kwezandla zakho.
Ukugcina izingalo ziqondile, ngaphandle kokugoba izindololwane (bheka isithombe ekuqaleni kwesihloko), umhlengi uyehla enyuka ngokuzimisela, ezulazula okhalweni. I-thrust akufanele ivele ekugobeni izingalo, kodwa kusukela ekuhambeni phambili kwe-torso yonke, okuthinta isifuba somuntu ohlukunyeziwe ngenxa yokuqina kwezingalo: ukugcina izingalo zigobile kuyiphutha.
Ukuze kuphumelele, ukucindezela esifubeni kufanele kubangele ukunyakaza okungaba ngu-5-6 cm ngokucindezela ngakunye. Kubalulekile, ukuze kuphumelele ukusebenza, ukuthi umsindisi akhulule isifuba ngokuphelele ngemva kokucindezelwa ngakunye, egwema ngokuphelele ukuthi intende yezandla isuke esifubeni ibangele umphumela oyingozi wokuphindaphinda.
Izinga elilungile lokucindezelwa kufanele okungenani libe ukucindezelwa okungu-100 ngomzuzu kodwa kungabi ngaphezu kokucindezelwa okungu-120 ngomzuzu, okungukuthi ukuminyaniswa okungu-3 njalo ngemizuzwana emi-2.

Uma kwenzeka ukuntuleka kokuphefumula ngesikhathi esisodwa, ngemva kokucindezelwa kwenhliziyo okungama-30, umqhubi - uma eyedwa - uzomisa ukubhucungwa ukuze anikeze ukuphefumula oku-2 (umlomo uye emlonyeni noma ngemaski noma umlomo), okuzohlala cishe imizuzwana emi-3. ngamunye.

Ekupheleni kwe-insufflation yesibili, qalisa ngokushesha nge-massage yenhliziyo. Isilinganiso sokucindezelwa kwenhliziyo kuya ku-insufflation - esimweni somnakekeli oyedwa - ngakho-ke yi-30: 2. Uma kukhona abanakekeli ababili, ukuphefumula okufakelwayo kungenziwa ngesikhathi esifanayo nokusikhipha inhliziyo.

Ukuphefumula komlomo kuya emlonyeni

Kuzo zonke iziminyaniso ezingama-30 zokubhucungwa kwenhliziyo, ukuminyanisa oku-2 okunokuphefumula okwenziwe kufanele kunikezwe (isilinganiso 30:2).

Ukuphefumula komlomo kuya emlonyeni kuhlanganisa lezi zinyathelo ezilandelayo:

Lalisa olimele endaweni ephansi (isisu sikhuphuke).
Ikhanda likamufi libheke emuva.
Hlola indlela yokuphefumula futhi ukhiphe noma yimiphi imizimba yangaphandle emlonyeni.

Uma AKUSOLWA ukuhlukumezeka, phakamisa umhlathi bese ugobisa ikhanda emuva ukuze uvikele ulimi ekuvimbeni indlela yokuphefumula.

If Umgogodla ukuhlukumezeka kusolwa, musa ukunyakaza kwama-rash, njengoba lokhu kungase kwenze isimo sibe sibi kakhulu.

Vala amakhala esisulu ngesithupha nangomunwe wangaphambili. Isexwayiso: ukukhohlwa ukuvala ikhala kuzokwenza wonke umsebenzi ungasebenzi!

Hofuza ngokujwayelekile bese uvuthela umoya ngomlomo (noma uma lokhu kungenzeki, ngekhala) womuntu ohlukunyeziwe, uhlole ukuthi umbambo luphakanyisiwe yini.

Phinda ngesilinganiso sokuphefumula okungu-15-20 ngomzuzu (ukuphefumula okukodwa njalo ngemizuzwana emi-3 kuya kwemi-4).

Kubalulekile ukuthi ikhanda lihlale li-hyperextended ngesikhathi sokuncibilika, njengoba indawo yomoya engalungile ibeka isisulu engcupheni yokungena komoya esiswini, okungabangela ukuguquguquka kalula. Ukuphinda kuphinde kubangelwe amandla okuvuthela: ukuphephetha kakhulu kuthumela umoya esiswini.

Ukuphefumula komlomo kuya emlonyeni kuhilela ukuphoqelela umoya ohlelweni lokuphefumula lwesisulu ngosizo lwesifihla-buso noma umlomo.

Uma isifihla-buso noma umlomo kungenakwenzeka ukuthi usetshenziswe, iduku likakotini elilula lingasetshenziswa ukuze kuvikelwe umhlengi ekuthinteni ngokuqondile emlonyeni wesisulu, ikakhulukazi uma isisulu sinezilonda ezophayo.

Iziqondiso ezintsha ze-2010 zixwayisa umsindisi wezingozi ze-hyperventilation: ukwanda ngokweqile kwengcindezi ye-intrathoracic, ingozi yokuphefumula komoya esiswini, ukunciphisa ukubuya kwe-venous enhliziyweni; ngenxa yalesi sizathu, i-insufflation akufanele ibe namandla kakhulu, kodwa kufanele ikhiphe inani lomoya elingekho ngaphezu kuka-500-600 cm³ (uhhafu welitha, kusekhondi elilodwa).

Umoya ohogelwe umhlengi ngaphambi kokuwuphephetha kufanele ube “msulwa” ngangokunokwenzeka, okungukuthi kufanele ube nephesenti eliphezulu le-oxygen ngangokunokwenzeka: ngenxa yalesi sizathu, phakathi kokushaya okukodwa nokulandelayo, umhlengi kufanele aphakamise ikhanda lakhe ukuze ahogele umoya. ibanga elanele ukuze angawuholeli umoya okhishwa isisulu, onomoya-mpilo ophansi, noma umoya wakhe siqu (ogcwele isikhutha).

Phinda umjikelezo ongu-30:2 ingqikithi yezikhathi ezingu-5, ubheka ekugcineni izimpawu ze-“MO.TO.RE.” (Ukunyakaza kwanoma yiluphi uhlobo, Ukuphefumula Nokuphefumula), ukuphinda inqubo ngaphandle kokuma, ngaphandle kokukhathala ngokomzimba (kulokhu uma kungenzeka cela ushintsho) noma ngokufika kosizo.

Uma, nokho, izimpawu ze-MO.TO.RE. ukubuya (umhlukunyezwa unyakazisa ingalo, ukhwehlela, unyakazisa amehlo, ukhulume, njll.), kuyadingeka ukuthi ubuyele ephuzwini B: uma ukuphefumula kukhona, isisulu singafakwa ku-PLS (Lateral Safety Position), ngaphandle kwalokho. ukungena komoya kuphela okufanele kwenziwe (10-12 ngomzuzu), kubhekwa izimpawu ze-MO.TO.RE. njalo ngomzuzu kuze kube yilapho ukuphefumula okuvamile kuqalwa kabusha ngokuphelele (okungaba yizenzo eziyi-10-20 ngomzuzu).

Ukuvuselela kufanele kuhlale kuqala ngokucindezelwa, ngaphandle kwesimo sokuhlukumezeka noma uma isisulu siseyingane: kulezi zimo, ama-insufflation angu-5 asetshenziswa, bese ukucindezela-inflation kushintshana ngokujwayelekile.

Lokhu kungenxa yokuthi, esimweni sokuhlukumezeka, kucatshangwa ukuthi awekho umoya-mpilo owanele emaphashini esisulu ukuze kuqinisekiswe ukujikeleza kwegazi okuphumelelayo; ngisho nangokwengeziwe, njengesinyathelo sokuzivikela, uma isisulu siseyingane, qala ngokufaka i-insufflation, ngoba kucatshangwa ukuthi ingane, ejabulela impilo enhle, isesimweni sokuboshwa kwenhliziyo, okungenzeka kakhulu ngenxa yokulimala noma umzimba wangaphandle. esesingene emigudwini yomoya.

Imiswe nini i-CPR

Umhlengi uzomisa i-CPR kuphela uma:

Izimo endaweni ziyashintsha futhi iba engaphephile. Uma kwenzeka ingozi enkulu, umhlengi unomsebenzi wokuzisindisa.
the i-ambulensi ifika nodokotela ibhodi noma imoto yokwelashwa ethunyelwe ngeNombolo Yezimo Eziphuthumayo.
usizo olufanelekayo lufika lusebenza kangcono imishini.
umuntu uphelelwe amandla futhi akasenamandla (nakuba kulokhu sivame ukucela izinguquko, okufanele zenzeke phakathi nokucindezelwa kwe-30, ukuze ungaphazamisi umjikelezo wokunciphisa-inflation).
isihloko siphinde sibe nemisebenzi ebalulekile.

Ngakho-ke, uma kukhona ukuboshwa kwe-cardiopulmonary, ukuvuselela umlomo nomlomo kufanele kusetshenziswe.

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Abatakuli okungebona abezokwelapha (labo abavame ukuba ngama-ambulensi ayi-118) bangathola kuphela ukufa, ngakho-ke bangaqalisi amasu:

uma kwenzeka ubuchopho bubonakala ngaphandle, nciphisa (uma kwenzeka ukuhlukumezeka ngokwesibonelo);
uma kunqunywa ikhanda;
uma kwenzeka ukulimala okungahambisani nhlobo nokuphila;
endabeni yendaba eshisiwe;
endabeni yesihloko esibucayi .

Izichibiyelo ezintsha

Izinguquko zakamuva (njengoba zingabonwa ezincwadini ze-AHA) zihlobene kakhulu noku-oda kunenqubo. Okokuqala, kuye kwaba nokugcizelelwa okukhulayo kokumasajiswa kwenhliziyo kwasekuqaleni, okubhekwa njengokubaluleke kakhulu kunomoya-mpilo wakuqala.

Ngakho-ke ukulandelana kushintshile kusuka ku-ABC (umzila womoya ovulekile, ukuphefumula nokujikeleza) kuya ku-CAB (ukujikeleza, indlela yokuphefumula evulekile nokuphefumula):

qala ngokucindezelwa kwesifuba okungu-30 (okumele kuqale phakathi nemizuzwana eyi-10 yokuqaphela ukuvimba kwenhliziyo);
qhubekela phambili ekuvuleni umzila womoya bese ukhipha umoya.

Lokhu kubambezela kuphela ukungena komoya kokuqala ngamasekhondi angaba ngu-20, okungathinti kabi impumelelo ye-CPR.

Ukwengeza, isigaba se-GAS sisusiwe (ekuhlolweni kwesisulu) ngoba i-agonal gasping ingase ibe khona, ebonwa ngumsindisi kokubili njengokuzwa kokuphefumula esikhumbeni (Sento) futhi ngokuzwakalayo (Ascolto), kodwa okuyinto ayibangeli ukungena komoya okusebenzayo kwamaphaphu ngoba i-spasmodic, ayishoni, futhi imvamisa ephansi kakhulu.

Izinguquko ezincane zithinta imvamisa yokucindezela kwesifuba (kusuka mayelana ne-100 / iminithi okungenani i-100 / min) kanye nokusetshenziswa kwengcindezi ye-cricoid ukuvimbela ukuphefumula kwesisu: ukucindezela kwe-cricoid kufanele kugwenywe njengoba kungasebenzi futhi kungase kubonakale kuyingozi ngokwenza kube ngaphezulu. okunzima ukufaka imishini yokuphefumula ethuthukisiwe njengamashubhu endotracheal njll.

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Indawo yokuphepha yangemuva

Uma ukuphefumula kubuya, kodwa isiguli sisaqulekile futhi akukho ukuhlukumezeka okusolwayo, isiguli kufanele sibekwe endaweni yokuphepha esemaceleni.

Lokhu kuhilela ukugoba idolo elilodwa nokuletha unyawo lomlenze owodwa ngaphansi kwedolo lomlenze ophambene.

Ingalo ebhekene nomlenze ogobile kufanele ishelele phansi kuze kube i-perpendicular to torso. Enye ingalo kufanele ibekwe esifubeni ukuze isandla sibe ohlangothini lwentamo.

Okulandelayo, umhlengi kufanele ame ohlangothini olungenayo ingalo enwetshiwe ngaphandle, abeke ingalo yakhe phakathi kwe-arc eyakhiwe imilenze yesiguli futhi asebenzise enye ingalo ukubamba ikhanda.

Ukusebenzisa amadolo, gingqa isiguli ngobumnene ohlangothini lwengalo yangaphandle, uhambisane nokunyakaza kwekhanda.

Ikhanda libe selinwetshiwe futhi libanjwe kule ndawo ngokubeka isandla sengalo engathinti umhlabathi ngaphansi kwesihlathi.

Inhloso yalesi sikhundla ukugcina indlela yokuphefumula ihlanzekile futhi ukuvimbela ukuqubuka okungazelelwe hlanza ekuvaleni indlela yokuphefumula nokungena emaphashini, ngaleyo ndlela kulimaze ubuqotho bawo.

Esimeni sokuphepha esisemaceleni, noma yikuphi uketshezi oluphumayo luyakhishwa emzimbeni.

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Usizo lokuqala kanye ne-BLS ezinganeni nasezinsaneni

Indlela ye-BLS ezinganeni ezisukela ezinyangeni eziyi-12 kuye kweyisi-8 iyafana naleyo esetshenziswa abantu abadala.

Nokho, kunomehluko, ocabangela amandla aphansi amaphaphu ezingane kanye nezinga lokuphefumula elisheshayo.

Ngaphezu kwalokho, kufanele kukhunjulwe ukuthi ukucindezelwa kufanele kube okujulile kunabantu abadala.

Siqala ngama-insufflation angu-5, ngaphambi kokuqhubekela phambili ku-massage ye-cardiac, enesilinganiso sokucindezela kuya ku-insufflations ye-15: 2. Ngokuya nge-corpulence yengane, ukucindezela kungenziwa ngezitho zombili (kubantu abadala), isitho esisodwa kuphela (ezinganeni), noma ngisho neminwe emibili (inkomba neminwe ephakathi ezingeni lenqubo ye-xiphoid ezinganeni).

Okokugcina, kufanele kukhunjulwe ukuthi njengoba izinga lokushaya kwenhliziyo elivamile ezinganeni liphakeme kunabantu abadala, uma ingane inomsebenzi wokujikeleza kwegazi ngesilinganiso senhliziyo esingaphansi kwe-60 beats / min, isenzo kufanele sithathwe njengoba kwenzeka esimweni sokuboshwa kwenhliziyo.