Njira zotsitsimutsa
Njira yolondola yokha ya kupuma kochita ndi njira ya »pakamwa-kumphuno-pakamwa«. Kuti tigwiritse ntchito njira imeneyi, choyamba mutu wa wodwalayo uyenera kukhazikitsidwa moti chibwano ndi nsagwada ya pansi zvikwezedwe kwambiri (sl. 1, 1. gawo). Tiyenera kuchotsa dothi (matope ndi zina zotero) ndi mano opanga (ma prosthesis) m’kamwa mwa wodwalayo, ndipo tisamale kuti lilime lake lisabwerere kumbuyo ndi kutsekereza njira zopumira.
Timachita kupuma kochitira munthu wovulala motere: timapuma mpweya wabwino momwe tingathere ndipo timauwuzira m’kamwa - m’mphuno mwa wodwalayo (sl. 1, 2. gawo). Kuti tipewe matenda, tingayike kansalu kakang’ono pa pakamwa pa wodwalayo. Mu mpweya umene tikuutulutsa mulipobe mpweya wa okosijeni wokwanira kwa wovulalayo. Pamodzi ndi kuchita kupuma kochitira munthu wovulala, chifuwa cha wodwalayo pafupi ndi mtima chiyenera kukanikizidwa mopepuka ndi kugunda kotsatizana (chenjerani kuti nthiti zisathyoke!), kuti pothamangitsa magazi m’mtima tithandize kayendedwe ka magazi. Tikamasula chifuwa, mtima ungadzazidwenso ndi magazi ndipo motere timakwaniritsa kupuma kochitira munthu wovulala ndi ntchito ya mtima. Izi ziyenera kupitiriza mpaka wodwalayo ayambe kupuma yekha ndi mpaka mtima wake uyambe kugwira ntchito (sl. 1, 3. gawo), kapena mpaka dokotala afike.
CHITHUNZI 1
Poizoni wochokera ku zinthu zosayaka, umachitika chifukwa chotenga mankhwala, bowa ndi zakudya zolakwika kapena mopitirira muyeso zomwe zawonongeka ndi mabakiteriya a gulu la paratyphoid.
Ngati poizoni wotereyu wachitika, choyamba ndi mwamsanga kwambiri muyenera kuchotsa zomwe zili m’mimba ndi m’mitsempha ya wodwalayo. Kuchokera m’mimba yopanda kanthu, madzi angafike m’mitsempha pasanathe 10 min., ndipo zinthu zolimba, kutengera khalidwe ndi kuchuluka kwake, pasanathe 1-6 maola. Ngati wodwalayo ali ndi chidziwitso, muyenera kum’patsa nthawi yomweyo kuti amwe pafupifupi masupuni awiri a malasha a mankhwala (angapezeke m’mafamu, osakanizidwa m’kapu ya madzi a mineral; madzi wamba angagwiritsidwenso ntchito). Pambuyo pake muyenera kuyambitsa wodwalayo kuti asanze (pokanda khoma lapamwamba la pharynx ndi chogwirira cha supuni). Kaya kusanza kwachita bwino kapena ayi, pambuyo pa 3-4 minuti muyenera kachiwiri kupatsa wodwalayo 2 masupuni a malasha a mankhwala ndi madzi. Nthawi zonse muyenera kuitana dokotala, kapena kutumiza wodwalayo kuchipatala.
Poizoni chifukwa cha zinthu zophwanya kapena zodya kwambiri (kaustiki). Poizoni ukhoza kubwera kuchokera ku mitundu iwiri ya zinthu zowawa: ma asidi ndi ma alkali.
Pa kulumwa ndi ma lye (caustic soda, soda, mchere wa lye) mucosa imachotsedwa m’tigawo pa milomo, pa lilime, m’kamwa, m’mmero, m’mimba ndipo malovu otuluka nthawi zambiri amakhala a magazi ndipo akakhudza amakhala oterera. Milomo ndi lilime zimafufuma, kuwawa kumayamba m’mmero, m’mapaipi a chakudya ndi m’mimba, pamakhala kupindika kwa minofu ndi kusanza. Wovulala ndi lye ayenera kupatsidwa madzi a mandimu kapena viniga (1-2 supuni za viniga mu 5 dl. ya madzi) kapena madzi a boric a 3%-ne, kenaka mkaka kapena 1-2 supuni za mafuta odyera a m’nyumba.
Zizindikiro za poizoni wa zidulo m’kamwa: kudyedwa ndi kuyaka pa mucosa (asidi wa sulufure umachititsa mabala akuda, asidi wa mchere oyera, ndipo asidi wa nayitrogeni mabala achikasu). Malovu otuluka amakhala olimba kukhudza ndipo amakhala ndi kukoma kwa asidi.
Wodwalayo ali ndi ululu waukulu m’mimba, kukokana ndipo akusanza. Ayenera kupatsidwa mkaka, mafuta kapena mapuloteni (mazira) zonse zochepetsedwa ndi madzi pang’ono. Pambuyo pake mpatseni 1-2 supuni (za khofi) za magnesium wokazinga wosungunuka mu theka la galasi la madzi kuti amwe pang’onopang’ono. Anthu omwe apezedwa poizoni ndi zinthu zoyambitsa kuwotcha mkati ndikoletsedwa kwambiri kuwakakamiza kusanza.
Chofunika! ngati muli magazi m’chomwe wodwalayo wasanza, n’koletsedwa kupitiriza kumuchititsa kusanza!
Thandizo loyamba pakagwidwa ndi magetsi
Wovulala ayenera kuchotsedwa ku dera la magetsi. Ngati n’kotheka, waya wa magetsi azidulidwe nthawi yomweyo kuchokera mu dera lamagetsi pogwiritsa ntchito switch, kuchotsa fuse, kapena kudula waya. Kudula kumaloledwa kokha ndi chida chotsekedwa bwino, mwachitsanzo chidutswa cha nkhuni zouma, kapena pamapeto pake, nkhwangwa yokhala ndi chogwirira chouma, kapena pliers yokhala ndi chogwirira chotsekedwa.
M’mikhalidwe yapadera muyenera kupanga short circuit. Wopulumutsa mosakayikira ayenera kusamala kutchinjiriza manja ndi miyendo yake ndipo chifukwa chake ayenera kuyima pa bolodi lopanda misomali, pa nsalu zouma kapena pa mpando. Dzanja lake ayenera kuliteteza mwachitsanzo ndi manja a jekete lake, m’nsalu youma, magolovesi a rabara kapena a nayiloni.
Wopulumutsa ayenera kuyika pansi pa wovulalayo chiguduli chosagwira magetsi, mwachitsanzo matabwa ouma kapena zida zamatabwa zopanda mbali zachitsulo, zipewa zouma, mbale za PVC. Zabwino kwambiri n’kuti wovulalayo adumpha yekha ndipo nthawi yomweyo adzimasule ku kukhudzana ndi magetsi, kapena ngati wopulumutsa akweze wovulalayo atadzilekanitsa kale ndi nthaka. Kukhudza wovulalayo kumaloledwa kokha ngati kutchinjiriza kuli kopanda cholakwika. Zala za wovulalayo ziyenera kuchotsedwa payekha komanso mosamala ku malo olumikizana ndipo nthawi yomweyo kukulungidwa ndi nsalu youma kapena nsalu zina.
Ngati waya wa mphamvu utakulungika mozungulira wovulalayo, ndiye kuti waya uyenera kudulidwa ndi manja otetezedwa ndipo mapeto a waya wokhala ndi magetsi akhazikitsidwe kuti asapange ngozi zina.
Kupulumutsa, ndithudi, kuyenera kuyamba nthawi yomweyo komanso mosazengereza, sitiyenera kusiya wovulalayo opanda thandizo. Pambuyo poti magetsi adadulidwa, wovulalayo ayenera kuyikidwa mopingasa, zovala zake zamasulidwe, ndipo gawo lakumtunda la thupi lichotsedwe kwathunthu, ampezere kuwala ndi mpweya wabwino. Mutu wa wovulalayo suyenera kulendewera, koma uyenera kukwezedwa pang’ono ndi kuikidwa chinthu pansi pa mutu (mwachitsanzo, jekete lopindidwa).
Ngati wovulalayo ali pa chikomokere, kuyenera kuyesedwa mosakayikira kumubwezeretsa ku moyo.
M’pamene muyenera kufufuza pakamwa ndi mphuno za wovulalayo kuti muwone ngati zingadutse mpweya. Muyenera kuchotsa malovu, zotsalira za chakudya ndi mano a prosthesis. Ndikoletsedwa kuthira madzi m’kamwa. Ngati wovulalayo sapuma, nthawi yomweyo yambani kupuma kowonjezera. Kubwezeretsa moyo kungathandizidwe ndi kupukuta mapazi, enema, kapena kuthirira mosinthana pachifuwa ndi pamimba ndi madzi ofunda kapena ozizira, koma kupuma kowonjezera sikuyenera kusokonezedwa. Ngati wovulalayo abwerera m’maganizo tiyenera kupitiriza kumusamalira ndipo tisamamusiyire. Muyenera kumupatsa chakumwa chotentha (khofi, tiyi, mowa ndi zina zotero) koma ayenera kukhalabe ali m’kaimidwe ka theka kugona.
Malinga ndi zomwe zachitika, kuvulala kochepa ndi kwanuko kungasiye kwakanthawi osatchulidwa (kenako chithandizo cha dokotala chiyenera kuperekedwa), koma okhawo ovulala omwe akutuluka magazi ayenera kupatsidwa chithandizo cha dokotala nthawi yomweyo.
Mphukira, tchipisi, tinthu ta fumbi. Fumbi, mphukira kapena tizilombo titha kuchotsedwa m’diso pokoka chivundikiro cha pansi ndi kupukuta ndi gauze yoyera kapena chopukutira. Ngati chinthucho chili pansi pa chivundikiro chapamwamba, ndiye kuti muyenera kugwira chivundikiro chapamwamba pakati ndichikoke patsogolo kupita pa chivundikiro chapansi, kuti nsidze zigwire mkati mwa chivundikiro chapamwamba. Ngati mwanjira imeneyi sitingakwanitse kuchotsa chinthu chakunja, musapitirize kuyesa, koma diso lovulala liyenera kumangidwa ndi kufuna chithandizo cha dokotala.
Chinthu chakunja chimene chalowa m’mphuno ya mphuno tiyenera kuyesa kuchichotsa potseka mphuno inayo ndi kuwomba mwamphamvu m’mphuno. Ngati mwanjira imeneyi sitingakwanitse, tiyenera kufunafuna thandizo la dokotala.
Kutulutsa zinthu zakunja zomwe zalowa m’khutu kuyenera kupatsidwa kwa dokotala, chifukwa poyesera kuzichotsa tingavulaze cholumikizira cha khutu. Ngati tizilombo talowa m’khutu, supuni imodzi (ing’ono) ya mafuta, batala wosungunuka kapena madzi iyenera kuthiridwa m’khutu (mu malo ogona) ndipo ikhale 10-15 m mphindi.
Tiyesere kuchotsa thupi lachilendo lomwe lalowa mu trachea mwa kufunsa wovulalayo kuti apume kwambiri ndipo timamumenya pang’onopang’ono kumbuyo pakati pa mapewa. Ngati chinthu chomwe chagwera m’trachea sichili chakuthwa, wovulalayo ayenera kupatsidwa madzi, kenako pakati pa mkate (meča) ndi chakudya cha phala. Ndi koletsedwa m’zochitika zotere kupereka mankhwala oyeretsera. Pakufunika kuyang’aniridwa ndi dokotala.
Tingayesere kuchotsa munga womwe walowa pansi pa msomali pokhapokha ngati gawo lomwe latuluka panja lili lalitali mokwanira kuti tingaligwire ndi pincer kapena thaulo la m’manja. Ngati kuchotsa kwapambana, ndiye kuti bala liyenera kulola kutuluka magazi pang’ono ndipo pambuyo pake lidzozedwe ndi ayodini ndi kuyikidwa bandeji.
Kutumiza wovulalayo
Kutumiza wovulalayo si ntchito yophweka, pa izi pamafunika luso, kusamala ndi mphamvu zathupi zokwanira. Kutumiza molakwika kumawonjezera ululu kwa wovulalayo ndipo kumavuta mkhalidwe wake.
Choyamba muyenera kudziwa ngati wodwalayo ali m’mikhalidwe yoti angatengedwe, ndipo angatengedwe pokhapokha atalandira chithandizo molingana ndi malamulo a thandizo loyamba. Musanatengedwe, magazi ayenera kuchepetsedwa, bala liyikidwe bandeji ndipo miyendo yosweka ikhazikitsidwe kuti isasunthe.
Ngati njira yopita kuchipatala ndi yayitali, wovulalayo, ngati zingatheke, ayenera kupatsidwa tiyi kapena khofi kuti atsitsimuke. Kupatsa mowa (konyaaki ndi zina zotero) kuyenera kupewedwa. Pa kumutengera, wovulalayo ayenera kuyang’aniridwa ndi kuwunikidwa nthawi zonse, ndipo ngati bandeji kapena chomangira choyimitsa chamasuka, chikonzedwe nthawi yomweyo. Ngati kukuchitika kutaya chidziwitso kapena kufooka kwa ntchito ya mtima, njira zoyenera zobwezeretsera moyo ziyenera kugwiritsidwa ntchito.
Njira yotumizira nthawi zonse imadalira mtundu wa kuvulala ndi chiwerengero cha opulumutsa komanso mtundu wa zipangizo zomwe zilipo zotumizira.
Kukweza ndi kugwira wodwala kuyenera kuchitidwa mwaganiziridwa bwino, mwakachetechete ndi mwaukhondo wa maganizo. Kuyenda kulikonse kopsa kopsa kuyenera kupewedwa. Zovala za ovulala zisakhale zokwinya, ndipo tikamukweza, tiyenera kumukweza kuchokera kumbali imene sanavulaleko.
Kutumiza popanda zida zothandizira
Kutengera yekha ndi mthandizi mmodzi. Ngati wovulalayo angathe kuyenda, mthandizi ayenera kumugwira kumbuyo ndipo motero kumuthandiza. Ngati sangathe kuyenda, kapena ali pa chikomokere, ayenera kunyamulidwa motere: mthandizi agwade pafupi naye, akaike dzanja limodzi pansi pa mkhwapa ndi lina amugwire pansi pa bondo, amukweze ndi kumunyamula.
Kutenga ndi anthu awiri opulumutsa. Wovulalayo amene angayende ayenera kuthandizidwa kuchokera mbali ziwiri. Ngati sangathe kuyenda, koma ali ndi chidziwitso, ayenera kumamatira kwa opulumutsa amene amamunyamula. Wovulalayo ali mu chikomokere ayenera kutengedwa motere: wopulumutsa wamphamvu amugwire pansi pa m’khwapa ndipo kudutsa pachifuwa alumikize manja, ndipo winayo adzaima pakati pa miyendo ya wovulalayo ndi kumugwira pansi pa mawondo. Ayenera kumunyamula ndi kumukweza nthawi imodzi.
Kutumiza pogwiritsa ntchito zida zothandizira
Kunyamula pa nosila. Wovulalayo ayenera kuikidwa mosamala pa nosila ali pa kugona. Pa ichi pamafunika anthu awiri, ndipo ngati pali kusweka kwa miyendo yakumunsi, anthu atatu. Opulumutsa ayenera kuyima mbali imodzi ya wovulalayo, kumunyamula nthawi imodzi ndikumuyika pa nosila.
Kukweza, kuyambitsa, kuyimitsa ndi kutsitsa stretcher kuyenera kuchitidwa ndi opulumutsa onse nthawi imodzi, koma sayenera kuyenda nthawi imodzi chifukwa zingapangitse kugwedezeka kwa stretcher. Ngati wodwalayo ayenera kunyamulidwa kwa nthawi yaitali, n’bwino kumangiriza lamba umodzi mbali iliyonse ya stretcher umene opulumutsawo adzayika pa mapewa awo.
Kunyamula wodwalayo ndi zida zapafupi. Ngati tiribe machira pafupi, ndiye tingathe kupanga chida chonyamulira ndi njira yongokhayo. Pakafunika, wovulalayo angayikidwe pa makwerero, pa mapanelo a zitseko omwe achotsedwa, pa tebulo ndipo motero amunyamule. Zimenezi tingachitenso pogwiritsa ntchito bulangete kapena nsalu ya tenti. Machira apafupi angapangidwe ndi matumba awiri a m’lifupi limodzi mwa kuyika matabwa awiri a utali woyenera kudzera m’mphepete mwa pansi. Ngati kulibe machira, wodwala amene ali maso anganyamulidwe pa mpando. Opulumutsa ayenera kuyima mbali ziwiri za wodwalayo, agwire gawo la pansi ndi cholozera cha mpando ndipo motero amunyamule.
Zomwe tikukulimbikitsani kuti zikhale m’bokosi la chithandizo choyamba:
Phukusi la mabandeji, lapakati
zidutswa 2
Pakeji ya mabandeji, yaikulu
zidutswa 2
Bandeji yolumikizira, 10 х 5 m
zidutswa 2
Sterile gauze 1/2 m
zidutswa 2
Wata, 25 g
phukusi 2
Gauze yopapatiza yodulidwa 6 x 6 cm
phukusi 1
Chingwe choletsa kutuluka kwa magazi
phukusi 1
Hanzaplast, 4 cm × 1 m
phukusi 1
Lumo
ma. 1
Chitetezo cha masikelo chopangidwa ndi thumba la nsalu
ma. 1
Ma ampule a ayodini
ma chidutswa 12
Chitsamba cha ammonium
chiwerengero. 3
Buku la kulembamo zolemba (40 masamba)
ma. 1
Buku la thandizo loyamba
ma. 1