Mālama no ka tracheostomy i ka mālama nui mālama

Malama o ka hoʻomanawanui me ka tracheostomy ua hana i loko o ka haukapila ma hope o ka unuhi ana o ICU ahonui. Loa pinepine, he tracheostomy ua kau ma luna o ka lawelawe ala o ka lewa ina kupono hoʻokomo ea.

Nāʻikepili no ke kaʻina hana

Hana tracheostomy i loko o ka loa kupono wahi rula komo ai e pono ai ke koho iaoia a akahele dissection o ka trachea homeostasis. Pinepine hoʻohana 'ia no kaʻoki kino a endotracheal anesthesia topically pili novocaine pāʻoihana.

Ka nele i ka hana i ka airway tracheostomy aicieeaao:

• ma ka hihia o ka hooloihi ae i me mechanical hoʻokomo ea;
• ma ke alo o ka bulbar kāna hana;
• me ka manawa kūpono no ka noa ea permeability o ka lawelawe alanui i loko o kekahi alanui;
• haʻahaʻa ka hoʻokōʻana airway 'Ia;

'Ana i kūpono o ka tracheostomy

Hana o ka tracheostomy airway pono mau ano scalpels - lesion mawaho papa o ka ili a me ka tracheal incision. No hoi i ke kaʻina hana e pili: ka hāʻuleʻana lou, spreaders o ka ili a me nāʻiʻo, pakalōlō, sterile swabs a me wipes.

Ke hoomanawanui Ua waiho ia ma ka supine kulana me ke kiola hoʻi poo. Ka ili ma luna o ka ili o ka trachea ua disinfected me ka waiʻona, antiseptics, he pāʻoihana o ka iodine, a akahele holoi i ka lole sterile.

Iloko o ke kaʻina hana noi vertical oki mai thyroid cartilage a hiki i ke kee na palena o ka sternum. Eia, i ka papamoe kuhikuhi ua kua fascia, a laila, hoʻohana i ka hua kini puʻe wale MEDINSTRUMENT ia lŘlŘ razdvizheniya Muscle a me ka kala ana o ka trachea. Scalpel puncture trachea ua dissected a me ka wehe 'ana o ka uuku huʻa o ka'aʻaʻa, lawa e lawa i ka airway Tube.

Free tracheal kihi a ma wahi oki-aku huʻa sutured i kaʻili, i ka poʻea pau e hoʻololi tracheostomy paipu. I loko nō o ka aho huikauʻano hana oe i hana i ka tracheotomy, he hana nui kōkua ai i nāʻia e mālama '-hoʻomanawanui intubation.

Ke koho ana o ka paipu

Ike loea, manao malama o ka tracheostomy i loko o ka mālama nui malama pono ai i loko o ke koho ana o ka Tube kupono, i ke koho ana i hilinaʻi nui ma luna o ka noho ana. Currently hoʻomano kuai iho la ia mea hiki ke hooheheeia papalua Tube me ka cuff. Ua mea i hiki ke hoʻohana ea paipu, ka puʻe ma i ua stabilized ma ka mea o kūikawā nā paukūʻolokaʻa.

Pono koho o ke kiʻekiʻe-kbps şarkı hoʻolako maʻalahi malama o ka tracheostomy i loko o ka mālama nui mālama pa alima ole ma o na la hoʻokali kūpono 'hana a he leo no ka hoʻomanawanui. Ma ke koho ana o ka uala pono Tube complications pinepine e ala aʻeʻoe me he blockage o ka lumen manoanoa maloo mucus. No laila, e ke haʻalele i kona koho i ka 'Oihana.

Service tracheotomy paipu

Ma ka hihia o ka metala cannula pono ai ka pōʻalo o ka pā Tube ma ka liʻiliʻi koke i ka lā no ka hoʻomaʻemaʻeʻana, a antiseptic lapaʻau hoomakaukau. Naʻe, i ka pā haʻawina o ka cannula loli ka loa pohihihi, i oi aku mamua o hookahi o ka hebedoma.

Cuff cannula no ka tracheotomy e,ʻaʻole noho i loko o ka inflated moku'āina. Kekahi manawa wehe mea loa ea, a mālama e hiamoe ana ma kahi o 10 minuke, alaila, hoi aku la a hiki i ka makahiki. Ma mua ee makou ma preventative ke ola cuff E e akahele wehe extraneous Skopje Contents o ka oropharynx.

Pakahi aku la ia ostomy mālama

Papa'āweʻaweʻa kemika malama o ka tracheostomy ua hana ka hoʻohana sterile gauze a me ka pulupulu swabs. Puni'aʻaʻa ua holoiʻia kalaka nui-hoʻopoepoe neʻe 'ana o waho. E möakäka hou'aʻaʻa auhau no complications a me infectious lesions.

Malama o ka tracheostomy koi hope wili lauoho i loko o ka hanana o excessive ona mau a me ka lepo hoʻomāhuahua nui. E lawe mai i ka hope kaʻina hana e ia ina he mea kekahi kōkua. Kekahi kanaka hoʻopaʻa i ka Tube i loko o ka hale hānai kulana, a me kona mau kānaka kōkua ma replaces Tube nā mea hōʻoia.

I loko o nā lā mua ma hope o ka hana ia mea pono e mālama i tracheostomy a me ka peristomalnoy wahi maʻanuʻu o 6-8 hola. I ka Ia manawa, e hiki mau puku gauze dressings like me ka pono aicieeaao. , Mea Hana a hoʻomākaukau no ka mālamaʻana e mau ia ma ka lima.

Malama o ka tracheostomy: algorithm

No ka mea mua manawa hope şarkı hua mai ma hope o kekahi mau lā ma hope o ka hana. A, i ke kaʻina hana e e hana mākaukau, mai keia manawa mea,ʻaʻole i lawa ke hana i kekahi anuanu stoma.

Ke algorithm o ke kaʻina hana:

• ka hoʻomanawanui ua kau ma luna o kona kua a me Ka Wailele O kona poo;
• hana i ka piha hoomaemae ana o ka tracheobronchial lua;
• e wehe i phlegm i ka hoʻomanawanui coughs kena ae la artificially;
• Ua Ua hoʻolauna i loko o ka şarkı lua'ōlewa catheter, laila extracted tracheostomy cannula;
• Hope paipu i wehe 'ia ke alakaʻi mele;
• A hou paipu ua hoʻopaʻaʻia, a paa i loko o ka hale lioʻoihana;

Ai pili aku nā mea maʻi me ka tracheostomy no ventilator

Pinepine mālama i nā mea maʻi me ka tracheostomy pono i pili i ka airway ventilator. Pili lima kūlana kiʻekiʻe ma ka cannula mua kukuluia ma ke alo o ke kākoʻo i huiʻia.

No ka mea o ka pilina paʻa pilina o ka hoʻomanawanui a hiki i ka ventilator maʻamau cannula i auou caiaiai ia e ka pela papahana endotracheal şarkı aʻike mau manao me ka inflatable cuff. 'Ana a hiki i ka mokuna ia iho no ka hoʻokomo ea şarkı ua pili i ka pau ana o ka hae i kau ia na manao ona.

hiki complications

Malama o ka tracheostomy pinepineʻo e hana me kekahi mau complications i e hou i ka puka ana a me ka hana pono ka pepa, a me ka mea hope, a hiki ma napoo ana o ka hoʻomanawanui.

Ka loa, he pono ole complication o ka hanana o ke kahe ana ke koko, o ka oi aku ina ka tracheostomy ua hana ka hoʻohana 'ana i ka loaʻa hana i loko o ka mea o ka urgency, ma ka moe. Hoʻopau excessive kahe ana ke koko hiki pulsatile mīkini'opihia ma artery cuff. Eia naʻe, e pale excessive kahe o ke koko a hiki i ka hoʻomanawanui e e haawiia pilikia mālama hoʻomalu.

Terms o ka manao no ka tracheostomy noi aku papa'āweʻaweʻa kemika ninaninau o ke ahonui i ka mea e huai ae i kekahiʻano loa complications e like me subcutaneous emphysema. Ke kumu o ka hope i e pololei ole mea hoʻonoho o ka tracheal Tube.

Other 'ano like complication - airway iaʻi ke hana spontaneously i kekahi manawa oiai ka hoʻomanawanui ka hoʻopulapula. Loa pinepine i ke kumu o obstructive symptoms hoʻonaʻauao 'ana i ke anuanu Cork, i hanaʻia o ka manoanoa mucus. Inā tracheotomy Ua hana ka hoʻohana 'ana i ka pahale cannula, ka pilikia hiki ke eliminated ma ka mea o kona hoʻomaʻemaʻe. Alleviate i ka hoʻomanawanui iaʻi kekahi e leie hooko holo wehena mau alahele.