Ukugula okuyingozi ezintabeni

Ukugula okubangelwa izintaba kuyisifo esingathinta abagibeli bezintaba, abagibeli bezintaba, abagibeli bezindiza, noma abahambi ezindaweni eziphakeme, ngokuvamile ngaphezu kwamamitha angu-2400.

Ukugula okunamandla ezintabeni kubangelwa ukuncipha komoya nomoya ophansi emazingeni aphezulu.

Ngokushesha lapho ukhuphukela endaweni ephakeme kakhulu, maningi amathuba okuthi uthole ukugula okukhulu ezintabeni.

Indlela engcono yokuvimbela ukugula okuvela phezulu ukukhuphuka kancane kancane. Kungumqondo omuhle ukuchitha izinsuku ezimbalwa ukhuphukela ezinyaweni ezingama-9850 (3000). Ngaphezulu kwaleli phuzu khuphuka kancane ukuze ukuphakama lapho ulele khona kungakhuphuki ngaphezu kwamamitha angama-990 kuya kumamitha ayi-1640 (300m kuya ku-500m) ubusuku ngabunye.

Usengozini enkulu yokugula kakhulu ezintabeni uma:

• Uhlala ezingeni lolwandle noma eliseduze futhi uhambela endaweni ephakeme.
• Wake waba nokugula phambilini.
• Ukhuphuka ngokushesha.
• Awukajwayeli ukuphakama.
• Utshwala noma ezinye izinto ziphazamise ukujwayela.
• Unezinkinga zezokwelapha ezibandakanya inhliziyo, uhlelo lwezinzwa, noma amaphaphu.

Izimpawu zakho nazo zizoya ngejubane lokukhuphuka kwakho nokuthi uzikhandla kangakanani. Izimpawu zisukela ekubeni mnene ziye ekusongeleni impilo. Zingathinta uhlelo lwezinzwa, amaphaphu, imisipha nenhliziyo.

Ezimweni eziningi, izimpawu zimnene. Izimpawu zokugula ezintabeni okuncane kuya kokulingene zingafaka:

• Kunzima ukulala
• Isiyezi noma ikhanda elikhanyayo
• Ukukhathala
• Ubuhlungu bekhanda
• Ukuphelelwa isifiso sokudla
• Isicanucanu noma ukuhlanza
• Ukushaya ngamandla (isilinganiso senhliziyo)
• Ukuphefumula kanzima ngokuzikhandla

Izimpawu ezingavela ngokugula okukhulu kakhulu kwezintaba zifaka:

• Umbala oluhlaza okwesibhakabhaka esikhunjeni (cyanosis)
• Ukuqina kwesifuba noma ukuminyana
• Ukudideka
• Khwehlela
• Akhwehlele igazi
• Ukwehla kokuqonda noma ukuhoxa ekuxhumaneni nomphakathi
• Umbala ompunga noma okhanyayo
• Ukungakwazi ukuhamba kulayini oqondile, noma ukuhamba nhlobo
• Ukuphefumula kancane lapho uphumule

Umhlinzeki wezokunakekelwa kwempilo uzokuhlola bese elalela isifuba sakho nge-stethoscope. Lokhu kungaveza imisindo ebizwa ngama-crackles (rales) ephashini. AmaRales angaba uphawu loketshezi emaphashini.

Ukuhlolwa okungenziwa kufaka phakathi:

• Ukuhlolwa kwegazi
• Ukuskena kwe-Brain CT
• I-x-ray yesifuba
• I-Electrocardiogram (ECG)

Ukuxilongwa kusenesikhathi kubalulekile. Ukugula okunamandla ezintabeni kulula ukuselapha ezigabeni zokuqala.

Ukwelashwa okuyinhloko kwazo zonke izinhlobo zokugula ezintabeni ukwehla (wehlele) endaweni ephansi ngokushesha okukhulu nangokuphepha ngangokunokwenzeka. Akufanele uqhubeke nokukhuphuka uma uba nezimpawu.

Kufanele kunikezwe i-oxygen eyengeziwe, uma ikhona.

Abantu abanezifo ezinzima ezintabeni kungadingeka bangeniswe esibhedlela.

Umuthi obizwa nge-acetazolamide (Diamox) unganikezwa ukukusiza uphefumule kangcono. Kungasiza ukunciphisa izimpawu. Lo muthi ungakwenza uchame kaningi. Qiniseka ukuthi uphuza uketshezi oluningi futhi ugweme utshwala lapho usebenzisa lo muthi. Lo muthi usebenza kahle kakhulu uma uthathwe ngaphambi kokufinyelela endaweni ephakeme kakhulu.

Uma une-fluid emaphashini akho (i-edema ye-pulmonary), ukwelashwa kungafaka:

• Oxygen
• Umuthi womfutho wegazi ophakeme obizwa nge-nifedipine
• I-Beta agonist inhalers ukuvula imigwaqo yomoya
• Umshini wokuphefumula ezimweni ezinzima
• Umuthi wokwengeza ukugeleza kwegazi uye emaphashini abizwa nge-phosphodiesterase inhibitor (njenge-sildenafil)

I-Dexamethasone (i-Decadron) ingasiza ekwehliseni izimpawu zokugula ezintabeni nokuvuvukala kobuchopho (i-cerebral edema).

Amakamelo aphathekayo we-hyperbaric avumela abagibeli ukuba balingise izimo ezindaweni eziphansi ngaphandle kokuhamba ukusuka entabeni. Lawa madivayisi asiza kakhulu uma isimo sezulu esibi noma ezinye izinto zenza ukwehla kwentaba kungenzeki.

Amacala amaningi amnene. Izimpawu zithuthuka ngokushesha lapho ukhuphuka intaba uye endaweni ephansi.

Amacala abucayi angaholela ekufeni ngenxa yezinkinga zamaphaphu (i-pulmonary edema) noma ukuvuvukala kobuchopho (i-cerebral edema).

Ezindaweni ezikude, ukukhishwa ezimeni eziphuthumayo kungenzeka kungenzeki, noma ukwelashwa kungabambezeleka. Lokhu kungaba nomthelela omubi emphumeleni.

Umbono uncike ezingeni lokwehla lapho izimpawu seziqalile. Abanye abantu bathambekele ekuthuthukiseni ukugula okuhlobene nokuphakama futhi kungenzeka bangaphenduli futhi.

Izinkinga zingafaka:

• I-Coma (ukungaphenduli)
• Uketshezi emaphashini (i-edema yamaphaphu)
• Ukuvuvukala kobuchopho (i-cerebral edema), okungaholela ekuqulekeni, ekushintsheni kwengqondo, noma ekulimaleni unomphela kohlelo lwezinzwa
• Ukufa

Shayela umhlinzeki wakho uma ngabe unezimpawu zokugula okunamandla kwezintaba, noma ngabe uzizwe ungcono lapho ubuyela endaweni ephakeme.

Shayela ku-911 noma inombolo yakho ephuthumayo yendawo uma wena noma omunye umgibeli unezinye zalezi zimpawu ezilandelayo:

• Izinga eliguquliwe lokuqapha
• Akhwehlele igazi
• Izinkinga zokuphefumula ezinzima

Ehla ngentaba ngaso leso sikhathi futhi ngokuphepha ngangokunokwenzeka.

Izindlela zokuvimbela ukugula okunamandla ezintabeni zifaka:

• Khuphuka intaba kancane kancane. Ukukhuphuka kancane kancane kuyisici esibaluleke kakhulu ekuvimbeleni ukugula okukhulu ezintabeni.
• Misa usuku olulodwa noma ezimbili zokuphumula kuwo wonke amamitha ayi-600 wokukhuphuka ngaphezulu kwamamitha ayi-8000 (2400 metres).
• Lala endaweni ephakeme lapho kungenzeka.
• Qiniseka ukuthi unekhono lokwehla ngokushesha uma kudingeka.
• Funda ukuthi ungazibona kanjani izimpawu zokuqala zokugula ezintabeni.

Uma uhamba ngaphezu kwamamitha angu-9840 (3000 metres), kufanele uphathe i-oxygen eyanele izinsuku ezimbalwa.

Uma uhlela ukukhuphuka ngokushesha, noma ukukhuphukela endaweni ephakeme kakhulu, cela umhlinzeki wakho ngemithi engasiza.

Uma usengozini yesibalo segazi elibomvu eliphansi (i-anemia), cela umhlinzeki wakho ukuthi uhambo lwakho oluhleliwe luphephile yini. Buza nokuthi ngabe isengezo sensimbi sikulungele yini. I-anemia yehlisa inani le-oxygen egazini lakho. Lokhu kukwenza ube sethubeni lokugula ezintabeni.

Ngenkathi ukhuphuka:

• Ungaphuzi utshwala
• Phuza uketshezi oluningi
• Yidla ukudla okuvamile okunama-carbohydrate amaningi

Kufanele ugweme ukuphakama okuphezulu uma unesifo senhliziyo noma samaphaphu.

Ukuphakama okuphezulu kwe-edema yobuchopho; Ukuphakama kwe-anoxia; Ukugula okuphezulu; Ukugula ezintabeni; Ukuphakama okuphezulu kwe-edema yamaphaphu

• Uhlelo lokuphefumula

UBasnyat B, uPaterson RD. Imithi yokuhamba. Ku: Auerbach PS, Cushing TA, Harris NS, eds. Imithi Yasehlane Lase-Auerbach. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2017: isahluko 79.

UHarris NS. Umuthi ophakeme kakhulu. Ku: Walls RM, Hockberger RS, Gausche-Hill M, ama-eds. Imithi Ephuthumayo yaseRosen: Imiqondo kanye Nokuzijwayeza Komtholampilo. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2018: isahluko 136.

ULuks AM, uHackett PH. Ukuphakama okuphezulu nezimo zezokwelapha esezikhona. Ku: Auerbach PS, Cushing TA, Harris NS, eds. Imithi Yasehlane Lase-Auerbach. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2017: isahluko 3.

Luks AM, Schoene RB, Swenson ER. Ukuphakama okuphezulu. Ku: Broaddus VC, Mason RJ, Ernst JD, et al, abakwa-eds. Incwadi kaMurray neNadel Yemithi Yokuphefumula. Umhlaka 6. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 77.