Yintoni enokuyilindela xa iVentilator ifunekayo
I-ventilator, eyaziwa ngokuba yimpirator okanye umshini wokuphefumula, iyisisithi seyeza esinika isigulane nge-oxygen xa singakwazi ukuphefumula ngokwabo. I-ventilator igxotha ngobumnene umoya kumaphaphu kwaye ivumela ukuba iphinde iphinde ibuye, njengokuba imiphunga iya kwenza xa ikwazi.
Ngethuba lophina uphando oludinga i-anesthesia jikelele, i-ventilator iyadingeka.
Kukho amaxesha apho i-ventilator iyadingeka emva kokuhlinzwa, njengoko isiguli singenakukwazi ukuphefumula ngokwabo emva kwenkqubo.
Kutheni iVentilator iyadingeka ngexesha lophando
I-anesthesia jikelele isebenza ngokuphazamisa imizimba yomzimba okwesikhashana. Oku kubandakanya izihlunu ezisivumela ukuba siphumeze size siphumelele. Ngaphandle kwendiza, ukuphefumula ngexesha le-anesthesia jikelele lingenakwenzeka. Uninzi lwezigulane zisesipilini ngexesha utyando lwenzeka, ke isilwanyana sinikwe ukuyeka i-anesthesia. Emva kokuba i-anesthesia isale, isigulane sikwazi ukuphefumula sisodwa kwaye sisuswe kwi-ventilator.
Kutheni i-Ventilator ingaba yimfuneko emva kokuPiliswa
I-ventilator iyadingeka xa isiguli singakwazi ukuphefumula kakuhle ngokwaneleyo ukubonelela i-oxygen engqondweni nasemzimbeni.
Ezinye izigulane, ngenxa yokulimala okanye ukugula, azikwazi ukuphefumula ngokufanelekileyo emva kokuba utyando lususwe kwi-ventilator.
Oku kunokwenzeka ngenxa yomsebenzi omphunga wamaphaphu ngaphambi kokuhlinzwa, oko kwenzeka xa izigulane ziwonakalisa emiphakeni yazo ebangelwa zizifo eziPhezulu zokuVimbela i-Pulmonary Disease (COPD) . Izigulane ezibhema nazo zifumana amazinga aphezulu afuna i-ventilator ixesha elide emva kokuhlinzwa.
Oku kwenzeka nangona isigulane sigula kakhulu ukuba singaphefumla.
Oku kwenzeka ngenxa yengozi (njengengozi yemoto esongela ubomi), ukusuleleka okanye enye ingxaki. Isigulane esesiphefumlweni ngaphambi kokuba utyando luya kuhlala luhlala kwindawo yokuqhuma umoya emva kokuhlinzwa kuze kube yilapho zibuyisela ngokwaneleyo ukuphefumula kakuhle.
Olunye uphando ludinga ukuba isigulane sibe kwi-ventilator ngexesha elifutshane emva kokuhlinzwa njengenxalenye yesicwangciso. Ngokomzekelo, izigulane ezinokuvulwa kwentliziyo evulekile zigcinwa ngokuqhubekayo kwiventil de zivuke ngokwaneleyo ukuphakamisa intloko yabo emkhombeni kwaye zilandele imiyalelo elula. Akunikwe isilwanyana sokumisa i-anesthesia, kunoko ivumelekile ukuba igubuke yodwa, kwaye isigulane isuswe kwi-ventilator xa ikulungele ukuphefumula ngokwayo.
Intubation
Ukuze kufakwe kwi-ventilator, isigulane kufuneka sikhululwe . Oku kuthetha ukuthatha i- tube endotracheal ibekwe emlonyeni okanye ekhaleni kwaye ifakwe phantsi kwi-airway. Le bhubhu ine-gasket encinci encinci ehlonyelwe ukuba ibambe ityhubhu kwindawo. I-ventilator iqhotyoshelwe kwi-tube kwaye i-ventilator inikeza "ukuphefumula" kwisigulane.
Ukutshatyalaliswa Ngethuba ngeliVentilator
Ukuba isigulane sisesidlangalaleni emva kokuhlinzwa, amayeza adluliselwa rhoqo ukuze adlulise isigulane.
Oku kwenziwa ngenxa yokuba kunokumotheka kunye nokucaphukisa isigulane ukuba ube ne-tube endotracheal endaweni kwaye uzive ukuba i-ventilator igxotha umoya kumaphaphu. Injongo kukugcina isigulane sithulile kwaye sikhululekile ngaphandle kokubakholisa kakhulu kangangokuthi abakwazi ukuphefumula ngokwabo baze basuswe kwi-ventilator.
Ventilator Weaning
Ukucocwa yigama elisetyenziselwa inkqubo yokususa umntu kwi-ventilator. Uninzi lwezigulane zonyango zisuswe kwi-ventilator ngokukhawuleza kwaye kulula. Basenokubonelelwa ngenani elincinci le-oxygen yangasese ukwenzela ukuba inkqubo ibe lula, kodwa iyakwazi ukuphefumula ngaphandle kobunzima.
Izigulane ezingenako ukususwa kwi-ventilator ngokukhawuleza emva kokuba utyando ludinga ukucocwa, yinkqubo apho izicwangciso zomoya zitshintshile ukuvumela isigulane ukuba sizame ukuphefumula sisodwa, okanye ukuba isentifiketi senze umsebenzi omncinci kwaye isigulane sokwenza okungakumbi. Oku kunokwenziwa iintsuku okanye iiveki, ngokuvumela kancane isigulane ukuba siphucule ukuphefumula.
I-CPAP, okanye uxinzelelo oluqhubekayo lokuhamba ngomoya, luyi-ventilator setting evumela izigulane ukuba zenze umsebenzi wokuphefumla nge-ventilator ekhoyo ukunceda ukuba isiguli singenzi kakuhle. Isilingo se-CPAP, esichazela isigulane sifakwe kwisicwangciso se-CPAP ngexesha elimiselweyo, lingasetyenziselwa ukuchonga ukuba isigulane sinokunyamezela sisuswe kwi-ventilator.
Ezinye izigulane ezisefenini kwithuba elongezelelweyo lwexesha zingabakho kwi-CPAP ngexesha lemini, ziza kuxhaswa inkxaso yomoya ebusuku ukuze ziphumle ngokuzeleyo kwaye ziqhubeke ziphilisa ngaphandle kokuphelelwa ngumsebenzi wokuphefumla.
Ukugqithiswa emva kokuba kwiVentilator
Ukugqithiswa yinkqubo yokuba nethubhu yokugqibela isuswe. Ngethuba le nkqubo, umongikazi ususa umoya kwi-tube ehluthwe kwi-tube kunye nokukhupha iimbophu okanye iteksi ephethe ityhubhu kwindawo. I-tube ithotshulwa ngobumnene emlonyeni womlomo okanye ekhaleni. Ngeli xesha bayakwazi ukuphefumula ngokwabo kwaye i-ventilator ayisakwazi ukubonelela naluphi na uncedo lokuphefumula. Uninzi lwezigulane zinikezwa i-oksijeni ukuncedisa le nkqubo, mhlawumbi ngokusebenzisa i-mask okanye yangasese.
Uninzi lwezigulane zikhwehlela ngethuba le nkqubo, kodwa ayinabuhlungu. Izigulane ezininzi zikhalaza ngesifo somqala emva kokuba zikhungulwe , ngoko i-throat sprays, i-lozenges okanye imithi yokugaya ingasetyenziswa, ukuba isigulane sinokunyamezela kwaye sinokusetyenziswa ngokukhuselekileyo.
Ukunyamezela Ngethuba kwiVentilator
Ukunyamekelwa ngumonde kumntu kwi-ventilator kaninzi kubandakanya ukukhusela intsholongwane kunye nentlungu yesikhumba. Ezi zi gulane zihlala zihlala kwinqanaba lokunyamekela kakhulu (ICU) kwaye zifumana ukubeka iliso rhoqo kunye nokuqwalaselwa.
Itheyipu okanye i-strap isetyenziselwa ukugcina i-tube endotracheal endaweni, oku kutshintshwayo xa ingcolile kwaye ityhubhu ishukunyiswa rhoqo ukusuka kwelinye icala lomlomo kwenye. Ukuhambisa ityhubhu kwenziwa ukwenzela ukukhusela isikhumba kunye nokuphazamiseka kwiphubhu yokuxubha ngokubhekiselele kwiifom zomlomo.
Ukunyamekelwa komlomo kudlalwa rhoqo ukukhusela usulelo. Umlomo uvame ukuba ngumile, ngoko umlomo uhlambulukile kwaye unomanzi ukukhusela amazinyo nokunciphisa naziphi na iibhaktheriya ezinobungozi ezingenza indlela yazo emiphakeni kwaye ibangele i-pneumonia.
Imfihlo yomlomo ilandelwa emlonyeni ukukhusela ukuba ingene emiphakeni kwaye ibangele i- pneumonia . Izicatshulwa emiphakeni zithandwa njengoko isigulane asiyi kukwazi ukukhwehlela ezi zikhungululi ngethuba ngexesha lomoya.
Izigulana ezifuna i-ventilator zihlala zigula okanye zibuthathaka ukuziphindaphinda zona, ukuguquka ngokukhawuleza kuyingxenye yokunyamekela rhoqo.
Ukunyanga okuphefumlelweyo kunikezelwa rhoqo ngonyango lokuphefumula okanye ngabahlengikazi, ukukunceda ukugcina i-airways evulekileyo, izifihla ezincinci ezinokuthi zikho kwaye ziphathe nayiphi na imiphunga yomphunga.
Ixesha elide lokunakekelwa kweVentilator Care
Kwizigulane ezingenako ukucuthwa kwi-ventilator, i-tracheostomy ingafuneka. I-tube endotracheal akufanele ishiywe endaweni engaphezu kweeveki ezimbalwa njengoko ingakugqiba ukutshabalalisa ngokusisigxina kwiintambo zamagama okanye i-windpipe kwaye ingenza i-ventilator isilula kunzima.
Kwizigulane ezilindeleke ukuba zibe kwi-ventilator kwixesha elide, ukuvula okuvuliwe kwenziwa entanyeni kwaye i-ventilator iqhotyoshelwe apho, kunokuba isebenze ngokusebenzisa ityhubhu egcinwe emlonyeni.
Izigulane zivame ukudluliselwa kwiziko elide lokunakekelwa kwexesha elide (LTAC) elinikezela ngononophelo lwentambo. Ezi zixhobo zihlala zikhona iiyunithi apho i-ventilator yokulonda ikhethekileyo, kwaye inkqubo yokunceda isiguli sifumane indlela yokuphefumula ngempumelelo yinxalenye yokunyamekela imihla ngemihla.
> Umthombo:
> Ziziphi iimingcipheko zokuba kwi-ventilator? I-Heart Heart, i-Lung ne-Blood Institute. Kufumaneka ngoSeptemba, 2015. http://www.nhlbi.nih.gov/health/health-topics/topics/vent/risks