Kutarisira tracheostomy mu yevanorwara zvikuru

Care murwere ane tracheostomy rinoitwa muchipatara pashure shanduro ICU murwere. Kakawanda, munhu tracheostomy rinorambidzwa pamusoro conductive nzira dzedenga kana zvakakodzera kufefetedza.

Zvairatidza kuti nzira

Achiita tracheostomy rinonyanya yakakodzera mira ezvinhu kunosanganisira Zvakanyanya Kunaka Panguva Yepamuviri kusarudzwa nzira uye nokungwarira kwetsinga yacho trachea homeostasis. Inowanzoshandiswa kunorapwa kana endotracheal yokutindivadza topically kuiswa novocaine mhinduro.

Kudiwa kuvhiyiwa kuti kufema tracheostomy unomuka:

• kune kwenguva refu zvokuimba kufefetedza;
• pamberi bulbar zvirwere;
• pasina mukana pachena mhepo permeability pamusoro conductive nzira mune imwe nzira;
• yakaderera kunyatsoshanda yemweya chimbuzi;

Chidobi kuti tracheostomy

Nokushanda tracheostomy yemweya kunoda wandei mhando scalpels - lesion dzokunze akaturikidzana ganda uye tracheal incision. Uyewo panguva nzira anofanira kushandisa: zvishoma nezvishoma mumatope zvikorekedzo, spreaders ganda uye tsandanyama, clip, chena swabs ndokupisika.

Murwere anoiswa mukati supine nzvimbo ine musoro chakakandwa musana. The ganda pamusoro pemvura trachea iri disinfected pamwe doro, antiseptics, mhinduro ine ayodhini uye nokungwarira akapusika ane chena jira.

Panguva nzira akashandisa wehunyambiri chekawo kubva thyroid shwashwa kusvika rokumusoro kumucheto sternum. Uyezve, chinjikira mirayiridzo unotemwa fascia, uye ipapo kushandisa chambotaurwa nezvacho Kit MEDINSTRUMENT kunoitika razdvizheniya tsandanyama uye kusunungurwa trachea. Scalpel ponji trachea iri dissected uye kubviswa duku kurova-rova pamusoro rinenge rwakakwana anobvumawo yemweya chubhu.

Free tracheal micheto munzvimbo akacheka-kure kurova-rova sutured kuti ganda, izvo zvinoita kuti kuchinja tracheostomy sepombi. Pasinei munhu asi yakaoma nzira iwe kuita tracheotomy, imwe nzira akwanise zvikuru pre-murefu intubation.

The kusarudza sepombi

Yakavimbika, ngwarira kuchengeta tracheostomy iri yevanorwara zvikuru hunodiwa kusarudzwa yakakodzera chubhu, kusarudza iyo inoenderana nemamiriro ezvinhu. Pari nevakawanda yakatengwa simbi kaviri chubhu ine cuff. Zvinogonekawo kuti kushandisa zvikwepa mapurasitiki, kumanikidzwa umo iri kudzikamiswa pachishandiswa anokosha sepombi.

Kwakakodzera pakusarudza yepamusoro chubhu kunopa nyore kuchengeta tracheostomy iri yevanenge pasina kukonzera kufanira kuzvuzvungudza kumurwere. In kusarudzwa ane kukodzera chubhu yematambudziko kazhinji simuka somunhu blockage pamusoro lumen makobvu madzihwa akaomeswa. Naizvozvo, masarudziro inofanira kusiiwa nyanzvi.

Service tracheotomy sepombi

Kana simbi cannula kunoda dzokubudisa womukati chubhu kanenge kamwe chete pazuva kuti kuchenesa uye akambozvishandisa kuuraya utachiona kurapwa gadziriro. Zvisinei, zvikamu nechokunze cannula kuchinja kushoma chaizvo, kwete kupfuura kamwe pavhiki.

Cuff cannula nokuti tracheotomy haafaniri kugara muimba inflated mamiriro. Nguva nenguva kubviswa kwazviri zvakawandisa mhepo uye akaramba akarara anenge 10 maminitsi, ipapo vakadzokera pazvakaringana. Vasati vatanga preventative kupora cuff inofanira kunyatsoongorora kubvisa extraneous kuSkopje zviri oropharynx.

Zvikurukuru ostomy kutarisirwa

Periodic kuchengeta tracheostomy rinoitwa kushandisa chena gauze uye donje swabs. Yakapoteredza zvinyama vakachenesa Semi-tenderera masangano outwards. Uyezve zvinyama kuongororwa kuti matambudziko uye zvirwere maronda.

Care of tracheostomy kunoda yokutsiva kiyi iri chiitiko wokunzwa unyoro kana tsvina kuwanda chakakomba. Kuita yokutsiva nzira inofanira kuva kana paine rubatsiro. Mumwe munhu ane chubhu mudanga chinzvimbo, uye mubatsiri wake unotsiva chubhu yokuisira.

Mumazuva okutanga avhiyiwa zviri zvinodiwa kutarisira tracheostomy uye peristomalnoy nharaunda pane zvikamu maawa 6-8. Panguva iyoyowo, unogona kugara kutsiva gauze dressings sezvo kudikanwa. , Tools uye gadziriro nokutarisirwa inofanira kugara pedyo.

Care of tracheostomy: algorithm

Kokutanga yokutsiva chubhu yakabereka pashure pemazuva mashoma avhiyiwa. Uyezve, nzira inofanira kuitwa unyanzvi, sezvo nguva ino haisi kukwana kuumba batana stoma.

The algorithm of nzira:

• murwere anoiswa pamusoro musana wake uye kupotsera musoro wake;
• akaita yokunatsa yakazara tracheobronchial makomba;
• kubvisa phlegm murwere kukosora kunokonzerwa artificially;
• Zvinonzi akasuma kupinda chubhu mhango kusanduka anobudisa mushonga zvishoma nezvishoma, ipapo abudisa tracheostomy cannula;
• Replacement sepombi akaita akabvisa kondakita;
• A nyere itsva vakasungira uye wakaiswa mudanga rezvipfuwo panzvimbo;

Unobva varwere vane tracheostomy nokuda ventilator

Kazhinji kutarisira varwere vane tracheostomy kunoda kubatana kuti kufema ventilator. Zvakabatana mudziyo kuburikidza cannula kare akasimbisa pamberi webetsero yeimwe.

Nechinangwa mudanga kubatana murwere kuti ventilator mureza cannula inogona chikatsiviwa yakarongerwa endotracheal chubhu kana kwakajairika akaitwa ane Inflatable cuff. Zvakananga chikwata chokubaira kufefetedza chubhu wanamatira kuguma mureza akateya pasi mano.

zvinogoneka yematambudziko

Care of tracheostomy kazhinji kunotungamirira kukurira zvimwe zvirwere kuti vaonekwe paakangoridza oparesheni zvakakwana, uye pave paya, kunyange panguva rakadzikama mamiriro murwere.

The inonyanya kuomesa ndiyo panowanikwa ropa, kunyanya kana ari tracheostomy rinoitwa vachishandisa anowanika zvishandiso panyaya yokukurumidzira, panguva parutivi pomubhedha. Kubvisa ropa rakawanda anokwanisa pulsatile compression kubudikidza tsinga cuff. Zvisinei, kuti tisanyanyozvidya nokurasikirwa neropa murwere anofanira kupiwa zvashata kutarisirwa nyanzvi.

Terms of hanya tracheostomy zvinoda nguva nenguva kuzviongorora murwere kuti kubata nani kwazvo nemamwe matambudziko akadai subcutaneous emphysema. Mhaka yokupedzisira angava sizvo kugadzwa tracheal chubhu.

Other zvakajairika kuomesa - yemweya mhingaidzo anogona zvaitika chero panguva murwere vapore. Most kazhinji chikonzero obstructive zviratidzo dzidzo kunova gobvu koko, kuumbwa guru madzihwa. Kana tracheotomy Kwaiitirwa kushandisa cannula yomukati, dambudziko anogona kubviswa pachishandiswa yokuzvinatsa kwayo. Kuderedza murwere mhingaidzo inokupai kuurayiwa Vacuum chido anotenderera.