Ngandlela-thile "ukufa kwezemvelo" kuyona ndlela ikhethekileyo kubo bonke abantu.
Ngaba unqwenela ukuhlaziywa xa intliziyo yakho iyeka okanye uyeka ukuphefumla? Lo ngumbuzo oqhelekileyo wokugula okungapheliyo kunye nabadala kwiindawo zokunakekelwa kwempilo. Ngokuqhelekileyo kuboniswe ngexesha lokungeniswa esibhedlele, kwisiko lonesiza, kwiprogram yempilo okanye i- hospice . Xa ndivuma izigulane kwiprogram ye- hospice endiyisebenzelayo, ndihlala ndiqinisekisa ukuba isigulane kunye nabathandekayo babo baye bathetha ngokumalunga nalo kwaye sele batyikitye ifom ye-Do Not Resuscitate (DNR).
Ngamanye amaxesha, nangona kunjalo, ndiphendulwa ngokukhwankqiswa kwaye "ngokukhawuleza"!
Ithelevishini yenze umsebenzi ogqwesileyo wokuphambukisa amayeza enyani, kuquka ukuvuselelwa kwezigulane ezifa. Imiboniso yezokwelapha ingabonisa indoda enokubanjwa kwintliziyo yokufumana i-CPR kunye nokuvuka phakathi kwesifuba . Uninzi lwezigulane eziboniswe kwi-TV kwisebe eliphuthumayo livuselelwe kwaye libuyele kwiindawo zabo zangaphambili ngelo xesha. Ngaba kunjalo ngokwenene, kodwa?
Kutheni ungazange Uvuselele Umyalelo onokuthi ube nguNyulo olufanelekileyo
Kungekudala, ndathetha nomguli wam malunga nokuba ungathanda ukutyikitya iDNR. Impendulo yakhe yokuqala kukuba wayefuna ukusayina enye. Wayengafuni ukuhlaziywa, kuba akafuni ukuhlala naluphi na uhlobo lwesifo sengqondo okanye intliziyo. Intombi yakhe yaza yamelana nayo kwaye yamqinisekisa ukuba abantu bahlaselwa yintliziyo ngexesha lonke, kwaye bahamba kakuhle - akukho mpilo okanye intliziyo.
Kwakwanele ukutshintsha ingqondo yakhe.
Wayegqibile imigaqo ngaphambili eyathi isifiso sakhe singagcinwa siphila ngenkxaso yokuphila. Ndamkhumbuza oku, kwaye yena kunye nentombi yakhe baphendula ukuba abagadi be-paramedics kufuneka bamphefumule kwakhona esibhedlele, kwaye ngoko oogqirha banokugqiba isigqibo sokuba benze ntoni.
Le ndoda yayinomdlavuza wamaphaphu owaye wasasazeka kwingqondo yakhe.
Ndandithiyile ukuba ndibe ngumbali weendaba ezimbi, kodwa ndimele ndimxelele oko wayejongene nayo. Ukuhlaziywa akuyona into ecocekileyo kwaye iyinyameko njengoko ichaza kumabonwakude. Isifuba kufuneka sinyanzeliswe nzima kwaye sinzulu ngokwaneleyo ukupompa igazi entliziyweni. Oku kunokukhokelela kwizimbambo eziphukileyo , iimiphunga eziphefumlelweyo kunye nentliziyo eyingozi. Iiparamedics zihamba ngaphaya komoya omnene ngomlomo kunye nokufaka iphepheni yokuphefumula emqaleni wengqondo. Ukutshatyalaliswa kombane kufuneka kuhanjiswe ukuzama ukuphazamisa intliziyo kwakhona kwisigqi esivamile . Umgca we-intravenous (IV) wawuza kuqalwa, ngoko imishanguzo enamandla inokuhanjiswa kuyo. Isigulana sithunyelwa kwisibhedlele, kwaye ukuba ayengabonakali esele saphelile, banokuthi baxakeke ngokukhawuleza kumashishini oxhasayo, ngaphandle kokubonisana nentsapho.
Ziziphi amathuba ukuba konke oku kusebenza? Iimanani, ngelixa zingenakulungeleka ngokuchanekileyo ngenxa yokungafani kwiindlela zokunika ingxelo, bonisa ukuba ukusinda emva kokuhlaziya ku-6 ukuya ku-15% kwizigulane esele sezibhedlele, 1 ukuya kwi-2% kwizigulana kumakhaya asebekhulile kunye phakathi kwe-4 ukuya kuma-38% kwizigulane zivuselele kwiindawo zokunakekelwa kwezempilo.
Ezi zibalo zizona zibi kakhulu kwizigulane ezinokugula okungapheliyo, umhlaza okanye ukugula komqondo. Ekubeni uninzi lwabantu abakhathalelekileyo okanye ukunakekelwa kwezibhedlele banomnye okanye ngaphezulu kweemeko, ukusinda kwabo kuya kufana nokufana nabahlali basekhaya abahlengikazi-1 ukuya ku-2%. Kubalulekile ukuba uqaphele ukuba i-1 ukuya kwi-2% yezigulane zihlala ziba nomonakalo othile kwingqondo okanye entliziyweni.
Umbuzo ngoku uya kuba, "Ngaba kukufanelekile ukuba ndibeke okanye ndibe ngumntu wamthandayo ngenkqubo yokuhlaziya i-1 ukuya kwi-2% ithuba lokusinda?" Kwezinye izigulane, impendulo nguyebo. Abanye ke baya kubona ukuba nangona ukuphinda baphumelele, babeya kuba nesifo esifanayo okanye imeko abaye bayenza ngoku, njengesigulane ndidibana naye etshilo intombi yakhe, "Ndiza kuba nomhlaza.
Nangona bebendiphefumle, kuya kuphinda kwenzeke kwakhona ngenye indlela. "
Ukufakela ukungavuki, akukho Mgaqo, okanye INYE IMyalelo
Esibhedlele, umyalelo wokuba ugweme ukuhlaziya ngokuqhelekileyo ubizwa ngokuba "akukho khowudi." Ugqirha kuphela ongabhala umyalelo wesigulane ukuba "akukho khowudi." Ukuba wena okanye othandekayo wakho usezibhedlele kwaye awuzange ucelwe ukuba ukhethe ukuphinda uvuselele, qiniseka ukuba uya kuzisa lo ugqirha. Ukuba unqwenela ukuba ungagcini, xelela ugqirha kunye nabahlengikazi malunga nale nto. Iphondo ngalinye linemigaqo yalo yokumisela akukho myalelo wekhowudi, kwaye kukho iifom ofuna ukuba usayine.
Ukuba wena okanye othandekayo wakho kwikhaya lokunonyamekela , uzakufuna ukutyikitya ifom ye-DNR ukuze uvumele abasebenzi basekhaya labahlengikazi bazi ukuba awufuni ukuhlaziywa. Abasebenzi basekhaya labahlengikazi banamalungelo okusemthethweni ukuba baphinde bavuselele izigulane zabo ngaphandle kokuba babe ne-DNR esayinwe. Uninzi lwamakhaya olunamakhaya lunamafomu ngaphezu kwee-DNR, ngamanye amaxesha zibizwa ngokuba yi "Intenance Preference of Care" (i-PIC). Ezi fom zikuvumela ukuba wenze izigqibo malunga nokuba ungasibhedlele okanye ungayifumani i-antibiotics, ii-IV kunye nesondlo sokufakelwa .
Ngaphandle kweziko lempilo, ama-paramedics, xa bebizelwa kwimeko yesigulane esingaphenduliyo, kufuneka ukuba umthetho uzame ukuvuselela nokuthutha isiguli esibhedlele, ngaphandle kokuba kuboniswe ifomu efanelekileyo ye-DNR. I-hospice kunye nee-arhente zempilo zasekhaya, kunye namaziko oogqirha, zinezi fom zifumaneke kwizigulane zabo.
Vumela iMiyalelo yokuLawulwa kweNdalo (AND AND) iphakanyisiwe njengenye indlela eya kwiNkundla yeNkundla yeNkundla yokuPhumela iMveli (Do not Resuscitate). Ngelixa i-DNR ibeka nje ukuba akukho mvavanyo ekufuneka yenziwe ukuqalisa ukuphefumula okanye ukuqala kwakhona intliziyo xa iyeka, i-Allow Allowing Death (AND AND) iya kuqinisekisa ukuba kuthathwa amanyathelo enduduzo kuphela. Oku kubandakanya ukugodla okanye ukuyeka ukuhlaziywa, ukuxhaswa kwamanzi, ukusetyenziswa kwamanzi, kunye nezinye iindlela eza kunokubangela ukufa kwendalo. Vumela imiyalelo yokufa kweNdalo yenzelwe iigulane ezigulayo kuphela.
Ukuba ngaba unqwenela ngokwenene okanye umnqweno wakho othandekayo ukuba angaphinde ahlaziywe, thabatha amanyathelo afanelekileyo ukuqinisekisa ukuba izifiso zakho ziyahlonishwa. Xoxa nodokotela wakho okanye umboneleli wezempilo malunga ne "Musa ukuvuselela" umyalelo namhlanje.
Imithombo:
UFilipu J Podrid, MD; Morton F Arnsdorf, MD; MACC; kunye noJie Cheng, MD, PhD, FACC. Isiphumo sokubanjwa ngokukhawuleza kwenhliziyo ku-Uptodate.com.
Cantor, MD, kunye al. I-Do-Not-Resuscitate Orders kunye noLondolozo lwezeMpilo zoLondolozo lweMpilo lwangaphakathi 2003; 163: 2689-2694