Kula da tracheostomy a m kula

Kula da haƙuri da tracheostomy aka yi a wani asibiti bayan fassarar ICU haƙuri. Mafi sau da yawa, a tracheostomy aka aza a kan conductive hanyar iska idan ya cancanta samun iska.

Alamomi ga hanya

Yin tracheostomy a cikin mafi m tsit yanayi ya shafi mafi kyau duka selection Hanyar da hankali dissection na trachea homeostasis. Sau da yawa amfani ga tiyata ko endotracheal maganin sa barci topically amfani novocaine bayani.

Da bukatar wani aiki to airway tracheostomy taso:

• a yanayin saukan shafe tsawon inji iska.
• a gaban bulbar cuta.
• ba tare da yiwuwar for free iska permeability na conductive hanyõyi a wata hanya.
• low dace airway bayan gida;

Dabara na tracheostomy

Operation of tracheostomy airway bukatar dama iri scalpels - rauni m yadudduka na fata da kuma tracheal incision. Har ila yau, a lokacin hanya za su shafi: zamiya hooks, baza fata da kuma tsokoki, da shirye-shiryen bidiyo, bakararre swabs kuma Yana shãfe.

A haƙuri aka sanya a cikin supine matsayin da shugaban jefa baya. A fata a kan surface na trachea aka disinfected da barasa, magunguna iri iri, wani bayani da aidin kuma a hankali goge tare da wani bakararre zane.

A lokacin hanya amfani tsaye yanke daga thyroid guringuntsi zuwa babba gefen sternum. Bugu da ari, a kwance shugabanci da aka yanke fascia, sa'an nan ta amfani da aforementioned kit MEDINSTRUMENT auku razdvizheniya tsoka da kuma saki na trachea. Wukar yin aikin tiyata huda trachea aka dissected da kuma kau da karamin m na nama, isa ya saukar da da airway tube.

Free tracheal gefuna a wuraren yanke-kashe kada sutured da fata, wanda na taimaka wa canza tracheostomy shambura. Duk wani wajen rikitarwa dabara da ka yi a tracheotomy, wata hanya ƙwarai yuwuwa ta pre-haƙuri intubation.

A zabi na shambura

Abin dogara, m kula da wani tracheostomy a cikin m kula da ake bukata a zabin da ta dace tube, da zabi na abin da ya dogara da yanayi. A halin yanzu yadu sayi karfe biyu tube tare da wani cuff. Shi ne kuma zai yiwu a yi amfani da roba bututu, da matsa lamba a cikin abin da aka stabilized ta wajen musamman cylinders.

Proper selection na high quality-tube samar da sauki kula da wani tracheostomy a cikin m kula naúrar ba tare da haddasa ba dole ba damuwa ga mãsu haƙuri. A zabin da wani m tube rikitarwa sau da yawa bayyana a matsayin blockage na lumen m bushe gamsai. Saboda haka, ta zabi kamata a bar su su kwararru.

Service tracheotomy shambura

A cikin hali na karfe cannula bukatar hakar na ciki tube akalla sau daya a rana domin tsabtace da kuma antiseptic magani shirye-shirye. Duk da haka, da m rabo na cannula canji ne musamman rare, ba fiye da sau daya a mako.

Cuff cannula for tracheotomy kamata ba kasance a cikin inflated jihar. Lokaci-lokaci cire gare haddi iska da kuma kiyaye barci game da minti 10, sa'an nan ya koma zuwa ga sarari. Kafin nazari a kan yin rigakafi dawo da cuff ya kamata a hankali cire extraneous Skopje abinda ke ciki na oropharynx.

Musamman ostomy kula

Lokaci-lokaci kula da wani tracheostomy aka yi amfani da bakararre gauze da kuma auduga swabs. Zagayenta nama tsabtace Semi-madauwari ƙungiyoyi waje. Bugu da ari nama kiyasta domin rikitarwa da kuma dauke da kwayar cutar raunuka.

Kula da tracheostomy bukatar maye kwa'di a taron na wuce kima danshi ko datti jari tsanani. Gudanar da wani canji hanya ya zama idan akwai wani taimako. Daya mutum yake riƙe da tube a barga matsayi, da kuma mataimakinsa ya maye gurbin tube kambun.

A lokacin farko kwanaki bayan da aiki da shi ne kyawawa don kula da tracheostomy da peristomalnoy yanki a kan jinkiri na 6-8 hours. A daidai wannan lokaci, za ka iya kullum maye gurbin gauze dressings matsayin da bukatar taso. , Tools da kuma shirye-shirye domin kula kamata ko da yaushe ya zama a hannunka.

Kula da tracheostomy: algorithm

Domin da farko lokacin da maye tube samar bayan 'yan kwanaki bayan da aiki. Haka kuma, hanya ya kamata a yi gwani, tun wannan lokacin bai isa ya samar da wata m stoma.

A algorithm na hanya:

• da haƙuri da aka sanya a kan baya da kuma jefa ta kai;
• yi cikakken tsarkakewa daga cikin tracheobronchial ramuka.
• cire phlegm a haƙuri coughs sa artificially.
• An gabatar a cikin tube rami m catheter, sa'an nan cirewa tracheostomy cannula.
• Sauyawa shambura Ya kuranye shugaba.
• Wani sabon bututu yana lazimta kuma gyarawa a barga matsayi.

Haxawa da marasa lafiya da tracheostomy for ventilator

Sau da yawa kula da marasa lafiya da tracheostomy bukatar a dangane da airway ventilator. Da alaka na'urar ta hanyar da cannula baya kafa a gaban karin mahadi.

Domin manufar barga dangane da mãsu haƙuri ga ventilator misali cannula iya maye gurbinsu da wani musamman tsara endotracheal tube ko al'ada zane da wani inflatable cuff. Kai tsaye zuwa ga naúrar kanta ga samun iska tube ne a haɗe zuwa karshen misali hõrarru na'urorin.

zai yiwu rikitarwa

Kula da tracheostomy sau da yawa take kaiwa zuwa magance wasu matsalolin da za su iya bayyana da zaran aiki ne cikakke, da kuma da yawa daga baya, ko da a kwari jihar na haƙuri.

Mafi na kowa wahala ne da ya faru na zub da jini, musamman idan tracheostomy aka yi amfani da samuwa kayan aikin a cikin wani al'amari na gaggawa, a bedside. Kashe wuce kima zub da jini zai iya pulsatile matsawa da jijiya cuff. Duk da haka, don kauce wa wuce kima asarar jini ga mãsu haƙuri ya kamata a ba gaggawa kula gwani.

Sharuddan kula ga tracheostomy bukatar lokaci-lokaci jarrabawa na haƙuri domin gane wani wajen tsanani da rikitarwa kamar subcutaneous emphysema. A sabili da karshen iya zama daidai ba shigarwa na tracheal tube.

Sauran fairly na kowa wahala - airway toshewa iya faruwa spontaneously a kowane lokaci a lokacin haƙuri ta fi. Mafi sau da yawa a cikin hanyar obstructive cututtuka ilimi zama m toshe kwalaba, kafa na lokacin farin ciki gamsai. Idan tracheotomy da aka yi amfani da ciki cannula, matsalar za a iya shafe ta wajen ta tsarkakewa. Rage haƙuri toshewa ma damar aiwatar da injin tsammãni tafarkin.