Okokuqala, iziguli ezigula kakhulu yindlela yokunakekelwa okuyisisekelo
⒈ ukwamukela iziguli ngemfudumalo, isiguli esifakwe egumbini lezimo eziphuthumayo noma egunjini labagula kakhulu, Impahla Yokunakekela Isiguli ukuze kugcinwe umoya osendlini uhlanzekile, ufudumele futhi unomswakama ufanelekile;isiguli esihle kanye namalungu omndeni we-mission yesibhedlela (Isigaba).
⒉ ukuhlolwa okufika ngesikhathi:
Kubandakanya isimo esiyisisekelo, izimpawu eziyinhloko, izimo zesikhumba, ukuhlolwa okusizayo okuhle, izinhlobonhlobo zamapayipi, ukwelashwa kwezidakamizwa nokunye.
⒊ izinyathelo zokunakekelwa kwezimo eziphuthumayo: ukusungulwa okusheshayo kokufinyelela kwe-venous (kuye ngokuthi isimo kanye nezakhiwo zezidakamizwa ukulungisa izinga lokudonsa), umoya-mpilo (kuye ngokuthi isimo sokulungisa ukugeleza komoya-mpilo), ukuqapha kwe-ECG, i-catheterization yokuhlala, ukushisa, ukwenza okuhlukahlukene. yokuqoqwa kwesampula, Izinsiza Zokunakekela Isiguli ukusiza isheke elihambisanayo, uma kunesidingo, ukulungiselela okusebenzayo kwangaphambi kokuhlinzwa
⒋ uhlezi phezulu futhi uphephile
⑴ ngokwesifo ukuthatha isikhundla esifanele.
⑵ ukuze ulondoloze umoya womoya patency, iziguli ikhoma kufanele okufika ngesikhathi ukuncela ikhala kanye nekhala kanye endotracheal secretions, ukuze umoya-mpilo.
Amazinyo ⑶ avaliwe, ukudlikizela kwesiguli kungasetshenziswa amaphedi wamazinyo, izimbobo, ukuvimbela ukulunywa ngolimi, isijobelelo solimi.
⑷ umkhuhlane ophezulu, i-coma, i-delirium, ukucasuka, ababuthakathaka kanye nezinsana kanye nezingane ezincane kufanele zengezwe ucingo, uma kunesidingo, ukunikeza ibhande, ukuvimbela umbhede, ukuqinisekisa ukuphepha kwesiguli.
⑸ lungisa zonke izinsiza zokuhlenga, izidakamizwa nezinto zokusebenza, ukuhlenga kwangaphakathi misa isimo esilindile.
⒌ ukubhekisisa lesi simo: ukunakekelwa komuntu siqu,Impahla Yokunakekela Isiguli izimpawu ezibalulekile zesiguli, ukwazi, umfundi, ukopha, i-SpO2, i-CVP, ukujikeleza kwegazi nomchamo nezinye izimo zokubhekwa okunamandla;nodokotela ngenkuthalo ukutakula, wenze amarekhodi ubuhlengikazi.
⒍ imithi enqunyiwe, ukusetshenziswa kweseluleko sikadokotela ngomlomo, okumele kuphindwe ngaphandle kwemvume yokuyisebenzisa.
⒎ gcina izinhlobonhlobo zamapayipi zibushelelezi, zimile kahle, indawo ephephile ukuze uvimbele ukucisha, ukusonteka, ukuvinjwa;ubuchwepheshe obuqinile obuyinyumba ukuvimbela ukutheleleka kabusha.
⒏ ukugcina indlu yangasese ibushelelezi: ukugcinwa komchamo ukuze uthathe izindlela zokusiza ukuchama;uma kunesidingo, i-catheterization;ukuqunjelwa njengesimo se-enema.
⒐ kuye ngesimo okufanele ukunakekelwa ngaso ekudleni: ukugcina amanzi, ibhalansi ye-electrolyte kanye nokuhlangabezana nezidingo eziyisisekelo zokudla komzimba;Iziguli ezizila ukudla zingase zibe umsoco we-venous we-peripheral.
Ukunakekelwa okuyisisekelo
9, izinwele, amehlo, umzimba, umlomo, ikhala, isandla, unyawo, i-perineum, ididi, isikhumba sihlanzekile;ezinhlanu embhedeni: ezintathu zokuqala, Umuthi, ubuhlengikazi, irayisi, umuthi, amanzi embhedeni wesiguli).
⑵ ekuseni, ukunakekelwa kwakusihlwa izikhathi ezi-2 ngosuku;ukunakekelwa komlomo we-urethral izikhathi ezi-2 ngosuku;ukunakekelwa kwe-tracheotomy izikhathi ezi-2 ngosuku;qaphela ukuvikelwa kwamehlo.
⑶ ukugcina ukusebenza kwezitho, ukuqinisa imisebenzi yokwenziwa komzimba noma ukusiza imisebenzi esebenzayo.
⑷ ukuqeqeshwa okuhle kokukhwehlela, njalo ngamahora angu-2 ukusiza iziguli ziphenduke, zibuyisele emuva, ziqondise ukuze ziphefumule kakhulu, ukusiza ukukhipha uketshezi.
⑸ qinisa ukunakekelwa kwesikhumba, ukuvimbela izilonda zokucindezela.
⒒ ukunakekelwa kwengqondo: ukugada okufika ngesikhathi, ukunakekelwa kweziguli,Izinsiza Zokunakekela Iziguli ngokwesimo ukuze zixhumane nemindeni yazo, ukusungulwa kobudlelwane obuhle bamanesi nesiguli, ukuze bathole ukwethenjwa kwesiguli, ukubambisana komndeni kanye nokuqonda.
Okwesibili, isimiso sokunakekela iziguli ze-coma
(I) Qaphela amaphuzu
⒈ ukuqaphelisisa izimpawu ezibalulekile (T, P, R, BP), usayizi womfundi, impendulo yokukhanya.
⒉ ukuhlola ukuphazamiseka kwe-GLS kwenkomba yokuqaphela kanye nezinga lokuphendula ukuze uqonde izinga lokukoma, kutholwe izinguquko ezibikwe ngokushesha kudokotela.
⒊ ukubhekwa kweziguli ngamanzi, ibhalansi ye-electrolyte, ukurekhoda inani lamahora angu-24, ukunikeza isiqondiso ngesisekelo sokubuyiselwa kwamanzi emanzini.
⒋ qaphela ukuhlola indle yesiguli, bheka ukuthi impendulo engaba khona yini.
(2) amaphuzu wobuhlengikazi
⒈ shayela isiguli: ukuhlinzwa, owokuqala ukubiza igama laso, chaza inhloso yokuhlinzwa kanye nezindlela zokuphepha.
⒉ ukusungula nokugcina indlela yokuphefumula ebushelelezi: thatha uhlangothi lwekhanda ohlangothini, nganoma yisiphi isikhathi ukusula uketshezi lwe-tracheal, ukulungele ukumunca izinto, nganoma yisiphi isikhathi ukumunca.
⒊ ukugcina ukujova ngomthambo: irekhodi eliqinile lenani lezidakamizwa ezisetshenzisiwe.
⒋ ukugcina isitho somzimba sisebenza kahle, ukuvivinya umzimba okujwayelekile kanye nokubhucungwa ukuze kuhlinzekwe ngokomzimba, ukuvimbela isandla, unyawo nokufinyela, ukuwohloka kanye nokukhubazeka kwemizwa.
⒌ ukugqugquzela ukululama kokusebenza kobuchopho: phakamisa umbhede ngamadigri angama-30 kuye kwangama-45 noma unikeze isimo sokuma kwe-recumbent, ukwelashwa okunqunyiwe kanye nokuhogela umoya-mpilo.
⒍ ukuze kugcinwe ukusebenza okujwayelekile kokukhipha isisu: ukuhlolwa okuvamile kweziguli ezinomchamo wesinye, ngesikhathi sokunikeza indlu yangasese yombhede, ukusiza ukubhucunga isisu esingaphansi ukuze kuthuthukiswe ukuchama, ukufakwa kwe-catheterization noma ukushintshwa kwezikhwama zomchamo kufanele kunake ubuchwepheshe be-aseptic.
⒎ ukuze uhlale uhlanzekile futhi unethezekile: susa amazinyo okufakelwa, iphini lezinwele, ukuthena umunwe (uzwane) A;ukunakekelwa komlomo kwansuku zonke kabili, gcina umlomo uhlanzekile futhi unomswakama, ungapendwa ngamafutha kapharafini (lipstick) ukuvimbela udebe oluqhekekile;okugeza isihlabathi njalo futhi perineal ukuwasha, Faka esikhundleni izingubo ezihlanzekile.
⒏ qaphela ukuphepha: ukuyaluza kufanele kube umbhede owengeziwe, uma kunesimo esibi kakhulu, esifanele ukunikeza izithiyo;ukwazi ngokudlidliza umkhuhlane omkhulu, ukucasuka kwe-meningeal,Impahla Yokunakekela Isiguli kufanele inikezwe ukupholisa okuphumelelayo futhi ibeke iphedi lezinyo, ukuvimbela isihlathi esiluma;Zonke izinhlobo zamapayipi, ukugwema ukushelela.
⒐ ukuvimbela izifo zamaphaphu: buyela emuva ukuyodubula, ukugqugquzela ukukhwehlela kwesiguli, ukumunca ngesikhathi;gcina ukufudumala, ukugwema amakhaza, ukusetshenziswa kwamanzi ashisayo lapho izinga lokushisa kwamanzi lingelula ngaphezu kwama-degrees angu-50, alikwazi ukuxhumana ngokuqondile nesikhumba ukuvimbela ukushisa.
⒑ Ukuvimbela izilonda zokucindezela: ukusetshenziswa kombhede womoya, ingxenye yesipontshi ephumela ngaphandle, gcina iyunithi yombhede ihlanzekile futhi ibushelelezi.Njalo ngo-1 ~ 2h sukuma kanye.
⒒ ukunakekelwa kwamehlo: susa amalensi ukuze ukhokhele ukugada.Iziguli azikwazi ukuvala ijwabu leso, ukusetshenziswa okujwayelekile kwama-saline bristles ukugeza iso, ngamafutha eso noma intambo kawoyela kaVaseline ukuvikela i-cornea,Izisetshenziswa Zokunakekelwa Kwesiguli ukuvikela ukomisa kwe-cornea nokuvuvukala.
(Iii) Imfundo yezempilo
⒈ thola umndeni ngesiqondiso samalungu omndeni ukuthi wenze ukuqwashisa okuhambisanayo kweziguli ukuthi ziqale kabusha ukuqeqeshwa ukuze zisize iziguli ezinokunyakazisa umzimba kancane kanye nokumasaja.
⒉ ukunakekelwa kwengqondo: ukunakekela ukukhuthaza iziguli,Impahla Yokunakekela Isiguli ukuze iziguli zibone izimiso zazo emndenini nasemphakathini ukuze kwandiswe ukuzethemba kokunqoba lesi sifo.