Tracheal intubation: pamene nthawi ifika lachiwiri ...

zinthu Emergency thupi pamene CPR ayenera kumwedwa posachedwapa, amafuna kuchita bwino ogwira ntchito kuchipatala. Njira kuwatsitsimula osankhidwa makamaka pa malo malingana limatchula za kugonjetsedwa, ndi kukula kwa alili ndi mwayi kukhwimitsa zofunikira mosataya nthawi.

Njira amenewa ndi akayakaya intubation. Zikuonetsa kuti tracheal intubation:

U ndikosatheka m'mapapo mpweya mu njira zina; kukana ya ziwalo zina ndi zimakhala (mwachitsanzo, n'zovuta ventilate mapapo za amayi apakati ndi toxemia, anthu akunenepa mu sternum a);

U pamaso pa zotupa angapo m'mbali;

U kulowa trachea ndi bronchi vomitus, pamaso pa ntchofu viscous lalikulu zedi, mwazi kudzazidwa pakamwa;

U kulephera kwa kuwatsitsimula mtima mkati kukomoka (mphindi zisanu);

U kufunika lotseguka kutikita mtima;

U zina mayendedwe a wodwalayo kuchipatala kuwatsitsimula.

Komanso kuwatsitsimula lili angapo contraindications pamene tracheal intubation sangathe ntchito chifukwa anaopseza kuti moyo ndi thanzi la wodwalayo. Osati intubated anavulala msana m'dera khomo lachiberekero, pamaso pa mabala akuya khosi, zotupa, kutupa, zochepa sayenda temporomandibular olowa.

Tracheal intubation, ndondomeko njira ayenera kutsata mosamalitsa ndi kokha kuchitidwa ndi ogwira ntchito kuchipatala chifukwa unsembe pachithunzichi wa endotracheal chubu kungachititse.

Zida chifukwa intubation ndi chubu, limene lakonzedwa kupereka mpweya wabwino ndi kubwezeretsa airway patency. chubu Zimenezi zimathandizanso kuti amasule wa airway ntchofu, vomitus. Agwiritsidwa endotracheal chubu ndi opaleshoni - izo wopereka mpweya ochititsa dzanzi.

Madokotala kuchititsa intubation motere: wovulalayo zaperekedwa kwa atagona malo, mutu wake chopendekekera mmbuyo ngati kuli kotheka. Kawirikawiri, mapewa amaika pilo, ngati si - pindani zovala mu mawonekedwe a wodzigudubuza kuti pang'ono kuchotsa sternum. Pofuna kuchepetsa oyamba a endotracheal chubu ntchito laryngoscope. Kawirikawiri oyamba a endotracheal chubu umachitika premedication - kugwiritsira mankhwala kupereka sabweretsa chisoni intubation ndi minofu anasiya, amene masulani minofu kwa malowedwe a chubu mu trachea a. Ngati wodwalayo ali mu mkhalidwe matenthedwe kapena boma la kukomoka, ndi tracheal intubation imagwiridwa popanda kutsatira zinthu zimenezi. Nthawi zambiri tracheal intubation akhunyu ndi kuchita - mu nkhani iyi, pakamwa zambiri zachiwawa ndi azichita zinthu zofunika.

tsamba Laryngoscope ndi unkagunda epiglottis, potero kumasula mwayi kwa kupita patsogolo. muzu wa lilime akankhidwira ndi khomo m'phuno kusonyeza anaikapo chubu endotracheal. Kutalika kwa chubu zimasiyanasiyana, iwo amasankhidwa pasadakhale malinga ndi zaka za wodwalayo.

Ngati ndondomeko zichitike molondola, ndiye mpweya Nkhuntho mu chubu amamva phokoso mu mapapo, zooneka kayendedwe ka chifuwa, mpweya akubwerera. Ayeretsedwe airway woonda chubu mwa nkhani endotracheal chubu kuchotsedwa.

Tracheal intubation - ndi udindo kwambiri kuwatsitsimula. Ngati nthawi si intubate wodwala, vuto lake chatsika ndi mphindi iliyonse m'kupita. Pa nthawi yomweyo pamene intubation Sikuti kuti ndifulumire - ndondomeko si chifukwa airway choipa chifukwa mwachangu mayikidwe a chubu. Pofunafuna intubate iyenera kugwiritsidwa ntchito kwa salinso kuposa mphindi zitatu - mwinamwake ayesetse mpweya yokumba.