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Intubation ndiko kuiswa kwechubhu yepurasitiki mutrachea kuti ivhure nzira yemhepo. The trachea inhengo inotarisira kufamba kwemhepo kuenda kumapapu. Tube intubation inonzi endotracheal intubation. Iyo endotracheal tube inoiswa mutrachea nekuipinza kuburikidza nemuromo wemuromo. Mumamiriro ezvinhu akasiyana, kana pasina imwe nzira yekuwana, tracheal tube inoiswa mu trachea kuburikidza nemhino. Intubation inzira inoitwa kwete chete panguva yekuvhiyiwa kwakasarudzika, asiwo kana paine emergency.

Intubation - chii ichocho?

Tracheal intubation inosanganisira kuisa pombi yepurasitiki mu trachea - chinangwa chemaitiro ndechekuzarura nzira yemhepo. Chubhu yakanyatsoiswa inodzivirira murwere kubva pakuda nechikafu. Chigadzirwa chacho chakagadzirirwa kuti chive nechokwadi chekufema kwemapapu kwakakodzera nekushandiswa kwemhepo yekufemerera kana bhegi rinozviputira. Intubation inoitwa neanesthesiologist kana paramedic.

Tracheal intubation inzira yakaoma. Haikwanise kuitwa nguva dzose mupre-hospital setting. Kusiyana nemaitiro epiglotting, maitiro acho anotora nguva yakareba uye ane njodzi. Nzira yacho inofanira kugara ichiitwa nemunhu ane ruzivo ane ruzivo rwakakura mu intubating varwere.

Murwere intubation - zviratidzo

Zviratidzo zve endotracheal intubation yemurwere ndezvi:

  1. Kudzivirirwa kwekufema - iyi nzira inoitwa kana paine kutadza kufema kwakanyanya. Murwere anofanira kuiswa intubated kudzivirira aspiration yeropa kana mudumbu zviri mukati. Tracheal intubation inoitwawo kana oxygenation isingagoneki nechiso chemeso.
  2. Kuitisa resuscitation - kugadzirisa tracheal chubhu inodzorera kupomba kwakakodzera kwemhepo kumapapu. Tracheal intubation inofanira kuitwa apo murwere anenge asingazivi kana kuti asingafemi. Iyi nzira inoshandiswa muzviitiko zvinopisa upenyu.
  3. Kutungamirirwa kweanesthetic - iyo nzira inoitwawo kana zvichidikanwa kushandisa musuru inozorodza. Chiratidzo chemuitiro wacho kubatanidzwa kwemurwere mukushanda pasi peanesthesia, iyo inoda mechanical ventilation.

Oral uye mhino intubation

Kune nzira mbiri dzeintubation - kuburikidza nemuromo kana nemhino. Chinodiwa midziyo ndeye endotracheal chubhu uye laryngoscope. Dzimwe nguva, anesthetist anogona kushandisa gwara, oropharyngeal chubhu, uye yakakosha kubata. Oral intubation ndiyo yakajairika nzira yekusarudza muzviitiko zvakawanda. Saizi yetracheal chubhu inofanirwa kugara ichienderana nezera, bonde uye kuvaka kwemurwere.

Oral intubation ndiko kuiswa kwechubhu mupombi pakati pezwi. Kuguma kwechubhu kunoiswa pamusoro pebifurcation yetrachea uye iyi inogara iri nzvimbo yakanyatsotsanangurwa. Intubation kuburikidza nemhino inosanganisira kuisa chubhu mu nasopharynx - apo kuguma kwechubhu kunoonekwa muhuro, chiremba anoshandisa laryngoscope.

Nzira mbiri idzi hadzichinjike. Oral intubation inonyanya kushandiswa pakurapa vanhu vakuru. Zvakare, nasal intubation inoshandiswa kurapa vacheche uye vanhu mushure mekuvhiyiwa oropharyngeal. Aya matekiniki anosiyanawo mumhando yezvishandiso zvinoshandiswa - nasal intubation inoshandisa machubhu akareba uye akatetepa, akakombama kupfuura ayo emuromo intubation.

Intubation - dzimwe nzira

Rapid intubation inowanzoshandiswa apo kuiswa kwe endotracheal tube kunogona kubvumira zviri mukati megastric kupinda mukati mekufema. Vanhu vakafuta, vakadzi vane pamuviri, vanhu vane gastrointestinal kuvharwa, uye vanhu vane dumbu rakazara vari pangozi. Inoshandiswawo apo murwere anofanira kuvhiyiwa kamwe kamwe.

Retrograde intubation inzira inosanganisira kubaya ganda, subcutaneous tishu uye cricothyroid ligament. Nekuda kweizvozvo, kuvhurika kunogadzirwa kuburikidza iyo gwara rinogona kuiswa mularynx. Chigadzirwa chacho chinotungamirirwa kumuromo wemuromo uye inoisa endotracheal tube pairi. Kusiyana nemuromo intubation, haidi kushandiswa kwelaryngoscope. Kana murwere ari intubated, chiremba anobvisa gwara.

Intubation - nhanho nhanho

Musoro wemurwere unofanirwa kutenderedzwa kumashure panguva yekuvhiyiwa kubatsira murapi kutungamira chubhu. Iyo endotracheal tube inoiswa uchishandisa laryngoscope - iyo laryngoscope inoshandiswa kuvhenekera muromo wemuromo uye kuchengetedza rurimi munzvimbo yakagadzikana. Panguva yekushanda, chiremba anoisa chubhu neruoko rumwe, achishandisa laryngoscope yakagadzirirwa pa 45-degree angle. Izvi zvinoita kuti chubhu ipinde mutrachea. Pane imwe nguva, chiremba anobvisa laryngoscope uye anonamatira ventilator kana manual resuscitator kune tube.

Intubation - matambudziko

Intubation, senge chero nzira yekurapa, inotakura njodzi yematambudziko. Zvinetso zvinowanzoitika ndezvi:

  1. huro inorwadza,
  2. kukosora,
  3. kuridza mhere,
  4. kunetsa kumedza mate
  5. kukuvara kwemazino,
  6. kuderera kwekuchinja mu larynx,
  7. adhesions,
  8. mikukutu.

Kuti udzivise matambudziko ehutano, chiremba anotarisa nzvimbo yechubhu mushure mekuita. Mukuwedzera kune njodzi dzataurwa pamusoro apa, zvakakosha kutaura kuti kunewo njodzi yekuputika uye kukuvadzwa kwezwi rezwi - zvisinei, izvi hazviwanzoitiki zviitiko, zvinokonzerwa nemamiriro ezvinhu asina kunaka eanatomical. Mucosal kubuda ropa kunogona kuitika panguva yemhino intubation

Exstubation - chii ichocho?

Ichi chiito chekubvisa tracheal tube kubva mutrachea. Zvisinei, izvi zvisati zvaitika, murwere anofanira kufema akazvimirira, kupindura mirairo uye ane chikosoro reflex. Isati yabviswa chubhu kubva mutrachea, murwere anogamuchira oksijeni. Chiremba anotarisawo kuzara kweokisijeni muropa. Extubation inotakurawo imwe njodzi yematambudziko.

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