Reanimation futhi labagula kakhulu

Fundzisisa therapy (eziphuthumayo) - indlela izifo, okuyisimo esisongela ukuphila. Yokusiza umuntu ukuba aphefumule - inqubo yokutakula ezibalulekile (ukuphila) imisebenzi ilahleka noma ingxenye ivinjiwe ngenxa isifo. Ingabe lezi zindlela enze kube nokwenzeka ukuba ukusungula unomphela zokuqapha kanye yokutakula imisebenzi phakathi ekambisweni esimweni yokuphazamiseka okusheshayo emsebenzini kwezitho neenkambiso. Ngokuvamile, yokusiza umuntu ukuba aphefumule futhi labagula okusebenza ngempumelelo, kanti owokugcina uyoba ngo yezindlela ezitholakalayo okwamanje okuvimbela ukufa e okukhulu (esisongela ukuphila) izifo nezinkinga zempilo yabo, ukulimala.

imiqondo eyisisekelo

ukwelashwa olunzulu - indlela yokwelashwa ubusuku nemini, ezidinga ukusetshenziswa infusions emthanjeni noma izindlela ngokukhishwa kobuthi egazini nge isilawuli njalo izimpawu ezibalulekile. Bathola ngegazi futhi uketshezi lomzimba, avamise okuphindaphindiwe ngokuba okusheshayo-kokulandela ukuwohloka nokwenziwa ngcono imisebenzi ukuphathwa kwabathintwayo isiguli. Indlela yesibili ukulawula - kuba zokuqapha, lapho ukusebenza hardware ngu cardiomonitors sisebenzisa, igesi analyzers, electroencephalograph nezinye izinhlobo imishini.

inqubo yokusiza umuntu ukuba aphefumule ngokuthi izicelo kwezokwelapha kanye namasu hardware umzimba ibuyisela ekuphileni ezimweni eziphuthumayo zenzeka. Uma isiguli usesimweni, okusho usongo ekuphileni, ezivela isifo noma yezinkinga zayo, ngoba njengoba sinjalo yayo yokwelapha olunzulu. Uma isiguli in a state of sebefile, ngeke uphile ngaphandle ukululama okusheshayo imisebenzi elahlekile, inqubo ukubuya futhi isinxephezelo libizwa yokusiza umuntu ukuba aphefumule.

Ukwenza lezi zimpikiswano yokusiza umuntu ukuba aphefumule. Kuyinto Uchwepheshe ewumngcingo, indawo yomsebenzi okuyinto labagula. Ngokuvamile, odokotela kuphela umsebenzi resuscitator alikho, ngoba Uchwepheshe uzothola diploma izinzwa kanye yokusiza umuntu ukuba aphefumule. Emsebenzini, ngokuvumelana ezikhungo ezithintekile, kungathatha izinhlobo ezintathu okuthunyelwe: "izinzwa", kanye ehlukile "yokusiza umuntu ukuba aphefumule" noma "izinzwa".

Doctor egunjini labagula kakhulu iyunithi

Doctor yokwelapha olunzulu - ke obulala izinzwa. Yena uphathelene kokukhetha uhlobo izinzwa iziguli preoperative futhi ukuqapha isimo sabo emva kokuhlinzwa. Uchwepheshe ukusebenza kunoma iyiphi nezikhungo zezokwelapha okuhlukahlukene (ngokuvamile yesifunda noma yesigodi), futhi ukuhlukana libizwa HITD. Kungase kube ezigulini eziye ihlawulelwa umsebenzi, kodwa kuthatha ukulawula izimpawu ezibalulekile. Ngaphezu kwalokho, HITD iziguli ilimele ezisongela ukuphila nezifo, kanye yezinkinga zabo. iziguli postoperative bangezwa efana HITD udokotela obulala izinzwa.

Udokotela yokusiza umuntu ukuba aphefumule

Udokotela yokusiza umuntu ukuba aphefumule kuphela asebenzelana ngayo ukubuyiselwa imisebenzi ebalulekile, futhi ngokuvamile kuba endaweni yomsebenzi kuyinto isiteshi noma substation ambulensi. Ukuba ukufinyelela imishini, esibahlomisela ambulensi Umqeqeshi yokusiza umuntu ukuba aphefumule, angababaza ukumhlenga isiguli endleleni, okuyinto ulusizo kuzo zonke izimo ezihlobene inhlekelele imithi. Ngokuvamile, udokotela-resuscitator engakathenjiswa umshado e yokwelapha olunzulu e HITD kodwa iqinisa ukulawula imisebenzi ebalulekile isiguli e-ambulensi. Lokho ukwenza ukwelashwa nokulawula hardware nemisebenzi nesineke usongo ukufa.

izinzwa

Izinzwa - yisibonelo onguchwepheshe iphrofayela isikhungo sezokwelapha ewumngcingo, isibonelo, ukuya emthola-mpilo umdlavuza noma maphakathi perinatal. Lapha, umsebenzi oyinhloko onguchwepheshe wukuhlela uhlobo izinzwa uma kuhlinzwa iziguli ezifuna isuke ukuhlinzwa. Endabeni perinatal isikhungo izinzwa msebenzi ukukhethwa uhlobo izinzwa iziguli Ukubeletha wenziwa. Kubalulekile ukuthi ukuphathwa olunzulu in nezingane futhi kwenziwe ngaphansi kwalesi sikhungo. Nokho, labagula iziguli kanye nezinsana zabo leyakheke. Ngo HITD izingane (izinsana) kuthiwa neonatologists kanye nabantu abadala akhonzwa obulala izinzwa ukusebenza.

HITD izibhedlela kuhlinzwa

labagula iyunithi esibhedlela, kokuba noma ukuchema kuzo kuhlinzwa, sihlelwe kuncike inani leziguli ezidinga ukuthi kungenelelwe, nokugasela ngamandla ukusebenza. Lapho sokungenelela dispensaries oncological isikhathi isilinganiso ukuhlala isiguli e HITD kunaleyo ukuhlinzwa jikelele. labagula kakhulu lapha ithatha isikhathi eside, njengoba ngokuhamba imisebenzi nakanjani izakhiwo yokwakheka esibalulekile.

Uma sicabangela ezohlinzwa ngenxa yokuthi wayenomdlavuza, iningi eliphelele kwekungenelela ivolumu kakhulu kuhlasimulise nezinkulu izakhiwo resected. Kuthatha isikhathi eside ukutakula ubekezele, njengoba emva kokuhlinzwa namanje ingozi Ukuwohloka impilo, ngisho nokufa kusuka eziningi. Kukhona ebaluleke zokuvimbela kokungenela noma yezinkinga izinzwa, konke ayeziphilisa ngakho ukwesekwa kanye replenishment umthamo wegazi, ingxenye yalo nakanjani elahlekile ngokuhamba ukungenelela. Lezi imisebenzi ukuthi zibaluleke kakhulu ngesikhathi iyiphi nokuvuselelwa post-op.

HITD izibhedlela noma zenhliziyo

Nezenhliziyo nokwelapha izibhedlela zihlukaniswa yokuthi kukhona kokubili iziguli ihlawulelwa ngaphandle ezisongela ukuphila kanye neziguli engazinzile. Kwakudingeka ukuba isungule futhi igcine ukulawula isimo sabo. Endabeni izifo zenhliziyo ukunakwa kakhulu kudinga isilethikusebenza nge yezinkinga yayo ngendlela ukushaqeka cardiogenic noma okungazelelwe ukufa inhliziyo. ukwelashwa Fundzisisa isilethikusebenza kunciphisa ingozi yokufa esikhathini eseduzane, silinganisela okubi uzowubuyisela patency we Umthambo ezihlobene infarct-, kanye ngcono Izibikezelo for isiguli.

Ngokwe-Ministry of Health yezifiso kanye nezincomo ngamazwe, iziguli acute yenhliziyo zidinga ukubekwa i labagula olunzulu ukuze afeze izinyathelo eziphuthumayo. Usizo olunikezwa umsebenzi usizo lokuqala ngaso esigabeni kwezidingo ke ufuna ukubuyisela patency kwemithambo yegazi i-coronary, kuthiwa occluded ngumuntu thrombus. Khona-ke ukwelashwa lesiguli usimamise resuscitator uzihlanganisa: ukwelashwa olunzulu, imithi, hardware kanye nokulawula laboratory isimo.

Ngo HITD zenhliziyo, lapho imisebenzi kuhlinzwa abazenzi emikhunjini noma valve inhliziyo, umsebenzi emnyangweni iyona zakuqala nasezinkingeni ezilandela ngemva kokuhlinzwa ukuvuselelwa kanye isimo yokulandelela. Lezi imisebenzi engqondweni vysokotravmatichnyh ahambisana kwenkathi ende yokutakula futhi lithathelwe. Kukhona njalo awokuthi thrombosis, shunt semithambo noma ami ezifakelwa umphini bokuzenzela noma ezingokwemvelo.

imishini HITD

Reanimation futhi labagula kakhulu - iyona umkhakha kwemithi, okuyinto okuhloswe ngalo ukubhekana ezisongela ukuphila kwesiguli. Lemisebenti kwenziwe iyunithi onguchwepheshe, okuyinto enakho. It kubhekwa yempucuko kakhulu, ngenxa izici nesineke njalo kudingeka hardware laboratory control. Ngaphezu kwalokho, ukwelashwa olunzulu kuhilela ukusungulwa unomphela noma njalo ekuphathweni emthanjeni.

Izimiso ukwelashwa e HITD

Emahhovisi, iziguli akuzona usengozini yokufa kwabantu bengabulawa isifo noma yezinkinga zayo esikhathini esifushane uhlelo ukumnika ukuvuza isetshenziselwa le njongo. Ngo HITD kaningi esikhundleni ukumnika amaphampu. Lokhu imishini evumela ukuba ngokuqhubekayo ukwethula umthamo ethile enohlonze, ngaphandle isidingo lubhoboze umthambo njalo kudinga ukuphatha izidakamizwa. ukumnika futha futhi likuvumela ukungena ukuthaka imithi njalo izinsuku noma ngaphezulu.

izimiso Modern yokwelapha olunzulu esiphuthumayo isifo uthi kakade athuthukile futhi lokhu okulandelayo:

• Umgomo wokuqala ekwelashweni - sinjalo isiguli kanye uzame usesho okuningiliziwe kusebenta kwahulumende;
• ukuzimisela isifo eziyimbangela, okuyinto kuphakamisa nokucekelwa futhi kubonakala ku isimo sempilo, ngokuletha ukufa kungenzeka;
• ekwelapheni eyisisekelo esifweni sinjalo by yokwelapha lingaze;
• nokuqedwa izimo ezisongela ukuphila futhi izimpawu;
• ukuqaliswa laboratory kanye zokuqapha wezinsimbi kwesimiso lesiguli;
• ukuhumusha isiguli egumbini sephrofayela emva kuqiniswa futhi ukuqedwa izici ezisongela ukuphila.

Laboratory nokulawula wezinsimbi

Ukuqapha nesimo sesiguli esekelwe ukuhlolwa imithombo emithathu idatha. Eyokuqala - inhlolovo isiguli, ukusungulwa izikhalazo, ekuboneni Dynamics impilo. Okwesibili - izifundo laboratory kwenziwe ngaphambi ukulaliswa esibhedlela futhi ngesikhatsi ukwelashwa, Ukuqhathanisa imiphumela cwaningo. Umthombo wesithathu - Ulwazi etholakale ngesigaba Luhlolo wezinsimbi. Futhi kulolu hlobo umthombo ulwazi mayelana nesimo sempilo isiguli kanye uhlelo kuhlanganisa ukuqapha ishayela, igazi oxygenation, imvamisa futhi isigqi umsebenzi inhliziyo, umfutho wegazi, umsebenzi ubuchopho.

imishini izinzwa kanye ekhethekile

amagatsha ezinjalo zemithi newusizo njengoba izinzwa kanye labagula atehlukaniseki. Kulabo abasebenza kulezi zindawo, abe idiploma ngamazwi athi "udokotela obulala izinzwa." Lokhu kusho ukuthi kungenzeka nezindaba yokubulala izinzwa, yokusiza umuntu ukuba aphefumule futhi labagula wahlanganyela eyodwa futhi onguchwepheshe efanayo. Ngaphezu kwalokho, lokhu kusho ukuthi ukuhlangabezana nezidingo zezempilo multidisciplinary, kuhlanganisa neminyango inpatient sokuchema kuhlinzwa nokwelapha, HITD eyodwa kuphela. Inama nemishini yokusiza umuntu ukuba aphefumule, ukwelashwa kanye izinzwa ngaphambi kokuhlinzwa.

Yokusiza umuntu ukuba aphefumule futhi labagula kakhulu ezidinga owodwa esigabeni (noma biphasic) ovuselela noma i-cardioverter ovuselela, electrocardiograph, uhlelo of ukupholisa mechanical, dlula cardiopulmonary (uma kudingeka inhlangano kwezempilo ethize), izinzwa analizatorskih izinhlelo ezidingekayo ukuqapha izinkomba of inhliziyo nokusebenza kwengqondo . Kubalulekile futhi ukuba ukumnika amaphampu kwadingeka kwezinhlelo ukuhlela izinhlelo njalo ukumnika ukumnika izidakamizwa.

Isayensi yokubulala izinzwa kudinga imishini ukuphakela izinzwa lapho ephefumula. Lolu hlelo avaliwe noma ephuma kabili evulekile, lapho izinzwa ingxube ukulethwa inikezwe emaphashini. Lokhu kwenza kube nokwenzeka ukusungula endotracheal noma izinzwa endobronchial. Kubalulekile ukuthi izidingo izinzwa edingekayo laryngoscopes futhi endotracheal (noma endobronchial) amashubhu, catheters ngoba kwesinye catheters futhi wokubhoboza ka ngemithambo emaphakathi kanye neuropathy. Imishini esifanayo edingekayo futhi ukulapha olunzulu.

HITD izikhungo perinatal

izikhungo Perinatal - esikhungweni sezempilo lapho ukubeletha zenzeke, okuyinto engase hamba nge ukuxakeka. Lezi kumele sithunyelwe abesifazane abaphethwe kwesisu noma babe zokugula extragenital, engase akwazi ukulimaza abanempilo zabasebenzi. Futhi, kufanele kube khona owesifazane nokukhulelwa pathologies ezidinga ukulethwa ekuseni nokunakekela ezisanda kuzalwa. Fundzisisa yokwelapha nezinsana - ingenye imisebenzi yale izikhungo kanye ukunakekela izinzwa iziguli bazocula ukuhlinzwa.

Ithuluzi yesondlo HITD izikhungo perinatal

Yegatsha Perinatal Intensive Care Centre ifakwe kuye ngenani kuhlelwe iziguli. Lokhu kudinga izinhlelo izinzwa kanye nemishini labagula kakhulu, uhlu letinikwe lapha ngenhla. Ngakho HITD izikhungo perinatal babe futhi izindawo ezingane. Kufanele abe nemishini ekhethekile. Okokuqala, umuntu omdala umuntu afakwe emishinini yokuphefumula nokusakazwa ayifanele osayizi osanda kuzalwa zemizimba okuyizinto omncane.

Namuhla, izindawo ezingane wahlanganyela izinsana ubuhlengikazi enesisindo 500 grams, bazalelwa e-sokukhulelwa amasonto 27 '. Ngaphezu kwalokho, udinga ekhethekile ukunikezwa imithi, ngoba ezizalwa kahle ngaphambi kosuku olunqunyiwe, kudingeka uhlelo lokuqokwa amalungiselelo surfactant. Lokhu izidakamizwa ebizayo, ngaphandle okuyinto akunakwenzeka ubuhlengikazi ngokuthi nosana kuziwa ukuthuthukiswa ukukhanya, kodwa ngaphandle surfactant. wamaphaphu Lokhu kwaziswa kuvimbela alveoli uwela phansi, ekubangelayo inqubo esebenza kahle kwezimila zangaphandle.

Izici lenhlangano umsebenzi HITD

HITD usebenza ubusuku nemini, kanye udokotela owayesebenza izinsuku eziyisikhombisa ngesonto. Lokhu kungenxa ukungakwazi ukuvala imishini uma unesibopho ukondliwa isiguli esithile. Kuye inani leziguli kanye umthwalo egatsheni, kwakheka inani imibhede. ebhentshini elingaphansi ngasinye futhi kufanele ifakwe mpilo kanye nabaqaphi. EBukhoneni ngaphansi kwenani imibhede, inani amadivayisi ukupholisa, Abaqaphi nezinzwa.

UMnyango, okuyinto yakhelwe iziguli 6, ukusebenza 2-3 resuscitator udokotela obulala izinzwa. Badinga ishintshwe ngosuku lwesibili ngemva kwamahora emsebenzini 24. Lokhu kukuvumela ukuba ugcine ithrekhi isiguli ubusuku nemini nangezimpelasonto, lapho ukuqapha iziguli Amahhovisi ejwayelekile udokotela komsebenzi kuphela. Izinzwa kufanele ukuqapha abagulayo abaphila HITD. Futhi, enesibopho iqhaza izingqungquthela ukunakekelwa esisemthethweni, futhi basize iziguli amagatsha ukuphathwa kwabathintwayo kuze esibhedlela HITD.

Siza izinzwa udokotela Nurse nomzanyana esegumbini labagula kakhulu. Ukubala of the number of kubhejwa uqhutshwa kuye inani leziguli. imibhede 6 adinga khona omunye udokotela, abahlengikazi ababili futhi umhlengikazi oyedwa. Le nombolo abasebenzi kumele ube khona emsebenzini ngamunye phakathi nosuku. Abasebenzi ke kuphenduke ngenye ushintsho, futhi, esikhundleni salokho, - eyesithathu.