I-Endotracheal Intubation

-Delile

• Kungani kwenziwa i-endotracheal intubation?
• Ziyini izingozi ze-endotracheal intubation?
• Izingozi ze-Anesthesia
• Izingozi zokungena ngaphakathi
• Ngikulungiselela kanjani ukungena kwe-endotracheal?
• Kwenziwa kanjani ukufakwa kwe-endotracheal intubation?
• Yini ongayilindela ngemuva kwe-endotracheal intubation

Kuyini i-endotracheal intubation?

I-Endotracheal intubation (EI) imvamisa inqubo ephuthumayo eyenziwa kubantu abangazi lutho noma abangakwazi ukuziphefumulela bodwa. I-EI igcina umoya ovulekile futhi isiza ukuvimbela ukuminyana.

Ku-EI ejwayelekile, unikezwa i-anesthesia. Ngemuva kwalokho, kufakwa ithubhu lepulasitiki eliguquguqukayo emlonyeni wakho ukuze likusize uphefumule.

I-trachea, eyaziwa nangokuthi i-windpipe, iyishubhu elihambisa umoya-mpilo emaphashini akho. Usayizi wepayipi lokuphefumula ulingana nobudala bakho nobukhulu bomphimbo. Ishubhu ligcinwa liboshwe ngesigaxa somoya esincane esihlohla ishubhu ngemuva kokufakwa kwalo.

I-trachea yakho iqala ngaphansi nje komphimbo wakho, noma ibhokisi lezwi, futhi yehlela ezansi ngemuva kwesifuba sesifuba, noma i-sternum. I-trachea yakho bese iyahlukana bese iba amashubhu amabili amancane: i-bronchi enkulu engakwesokudla nangakwesobunxele. Ishubhu ngalinye lixhuma kwelinye lamaphaphu akho. I-bronchi bese iyaqhubeka ihlukaniswa ibe yimigwaqo emincane nencane yomoya ngaphakathi kwamaphaphu.

I-trachea yakho yakhiwa uqwanga olunzima, imisipha nezicubu ezixhuma. Ulwelwesi lwayo lunezicubu ezibushelelezi. Njalo lapho uphefumula, i-windpipe yakho iba yinde kancane futhi ibe banzi. Ibuyela kusayizi wayo okhululekile njengoba uphefumulela ngaphandle.

Ungaba nobunzima bokuphefumula noma ungahle ungaphefumuli nhlobo uma kukhona indlela esendleleni yomoya ivinjiwe noma yonakele. Yilapho i-EI ingadingeka.

Kungani kwenziwa i-endotracheal intubation?

Ungadinga le nqubo nganoma yisiphi sezizathu ezilandelayo:

• ukuvula izindlela zakho zomoya ukuze ukwazi ukuthola i-anesthesia, imithi, noma i-oxygen
• ukuvikela amaphaphu akho
• umise ukuphefumula noma unenkinga yokuphefumula
• udinga umshini ozokusiza uphefumule
• ulimele ekhanda futhi awukwazi ukuphefumula wedwa
• udinga ukuthanjiswa umzimba isikhathi esithile ukuze ululame ekulimaleni kanzima noma ekuguleni

I-EI igcina indlela yakho yomoya ivulekile. Lokhu kuvumela umoya-mpilo ukuthi udlule ngokukhululeka uye nasemaphashini akho njengoba uphefumula.

Ziyini izingozi ze-endotracheal intubation?

Izingozi ze-Anesthesia

Ngokuvamile, uzoba ngaphansi kwe-anesthesia ejwayelekile phakathi nenqubo. Lokhu kusho ukuthi ngeke uzwe lutho njengoba kufakwa ishubhu. Abantu abaphilile ngokuvamile abanazo izinkinga nge-anesthesia ejwayelekile, kepha kunengozi encane yezinkinga zesikhathi eside. Lezi zingozi zixhomeke kakhulu empilweni yakho ejwayelekile nohlobo lwenqubo oyenzayo.

Izici ezingakhuphula ubungozi bakho bezinkinga nge-anesthesia zifaka:

• izinkinga ezingapheli ngamaphaphu akho, izinso, noma inhliziyo
• isifo sikashukela
• umlando wokuquleka
• umlando womndeni wokusabela okungahambi kahle ku-anesthesia
• ukulala ubuthongo
• ukukhuluphala ngokweqile
• ukungezwani komzimba nokudla noma imithi
• ukusetshenziswa kotshwala
• ukubhema
• ubudala

Izinkinga ezinkulu zingavela kubantu abadala asebekhulile abanezinkinga ezinkulu zezokwelapha. Lezi zinkinga azivamile kepha zingafaka:

• isifo senhliziyo
• ukutheleleka kwamaphaphu
• unhlangothi
• ukudideka kwesikhashana kwengqondo
• ukufa

Cishe umuntu oyedwa noma ababili kuyo yonke i-1,000 bangavuka kancane ngenkathi bengaphansi kwe-anesthesia ejwayelekile. Uma lokhu kwenzeka, abantu bavame ukuqaphela indawo ebazungezile kodwa ngeke babuzwe ubuhlungu. Ezimweni ezingavamile, bangabuzwa ubuhlungu obukhulu. Lokhu kungaholela ezinkingeni ezingokwengqondo zesikhathi eside, ezinjenge-post-traumatic stress disorder (PTSD). Izici ezithile zingenza lesi simo sibe lula kakhulu:

• ukuhlinzwa okuphuthumayo
• izinkinga zenhliziyo noma zamaphaphu
• ukusetshenziswa kwesikhathi eside kwama-opiate, ama-tranquilizers, noma i-cocaine
• ukusetshenziswa kotshwala nsuku zonke

Izingozi zokungena ngaphakathi

Kukhona ezinye izingozi ezihlobene ne-intubation, njenge:

• ukulinyazwa kwamazinyo noma umsebenzi wamazinyo
• ukulimala emphinjeni noma kuqhoqhoqho
• uketshezi oluningi kakhulu ezithweni noma kwizicubu
• ukopha
• izinkinga zamaphaphu noma ukulimala
• ukufisa (okuqukethwe esiswini kanye nama-asidi agcina emaphashini)

Udokotela obulala izinzwa noma i-ambulensi EMT uzokuhlola ngaphambi kwenqubo yokusiza ukwehlisa ubungozi balezi zinkinga ukuthi zivele. Uzobhekwa futhi ngokucophelela kuyo yonke inqubo.

Ngikulungiselela kanjani ukungena kwe-endotracheal?

Intubation inqubo ehlaselayo futhi ingadala ukungakhululeki okukhulu. Kodwa-ke, ngokujwayelekile uzonikezwa i-anesthesia ejwayelekile kanye nemithi yokuphumula yemisipha ukuze ungezwa buhlungu. Ngezimo ezithile zezokwelapha, inqubo ingadinga ukwenziwa ngenkathi umuntu esavukile. I-anesthetic yendawo isetshenziselwa ukundiza indlela yomoya ukuze kunciphise ukungakhululeki. Udokotela wakho wokubulala izinzwa uzokwazisa ngaphambi kwe-intubation uma lesi simo sisebenza kuwe.

Kwenziwa kanjani ukufakwa kwe-endotracheal intubation?

I-EI ivame ukwenziwa esibhedlela, lapho uzonikezwa i-anesthesia. Ezimweni eziphuthumayo, abosizo lokuqala endaweni yesimo esiphuthumayo bangenza i-EI.

Enqubweni ejwayelekile ye-EI, uzoqala uthole i-anesthetic. Uma usuthanjisiwe, i-anesthesiologist yakho izokuvula umlomo bese ifaka insimbi encane enelambu elibizwa ngokuthi i-laryngoscope.Le nsimbi isetshenziselwa ukubona ingaphakathi lomphimbo wakho, noma ibhokisi lezwi. Lapho nje imisipha yakho yezwi isitholakele, ithubhu epulasitiki eguquguqukayo izofakwa emlonyeni wakho bese idluliselwa ngaphesheya kwezintambo zakho zezwi engxenyeni engezansi yetrachea yakho. Ezimweni ezinzima, i-laryngoscope yekhamera yevidiyo ingasetshenziswa ukunikeza umbono oningiliziwe wendiza yomoya.

Udokotela wakho wokubulala izinzwa uzobe elalela ukuphefumula kwakho nge-stethoscope ukuze aqiniseke ukuthi ishubhu lisendaweni efanele. Uma ungasadingi usizo lokuphefumula, ishubhu liyasuswa. Ngesikhathi sezinqubo zokuhlinzwa nasesigunjini sabagula kakhulu, ishubhu lixhunywa kumshini wokuphefumula, noma umshini wokuphefumula, uma usendaweni efanele. Kwezinye izimo, ithubhu lingadinga ukuthi linamathiselwe isikhwama isikhashana. Udokotela wakho wokubulala izinzwa uzosebenzisa isikhwama ukupompa umoya-mpilo emaphashini akho.

Yini ongayilindela ngemuva kwe-endotracheal intubation

Ungaba nomphimbo obuhlungu omncane noma ubunzima bokugwinya ngemuva kwenqubo, kepha lokhu kufanele kuphele ngokushesha.

Kukhona nobungozi obuncane bokuthi uzohlangabezana nezinkinga kusuka kwinqubo. Qiniseka ukuthi ushayela udokotela wakho ngokushesha uma ukhombisa noma yiziphi kulezi zimpawu ezilandelayo:

• ukuvuvukala kobuso bakho
• umphimbo obuhlungu obukhulu
• ubuhlungu besifuba
• ubunzima bokugwinya
• kunzima ukukhuluma
• ubuhlungu bentamo
• ukuphelelwa umoya

Lezi zimpawu zingaba yisibonakaliso sezinye izinkinga nge-airway yakho.