Endotracheal tube (ityhubhu endotracheal): iintlobo, zobukhulu, iinjongo. Cwangcisa i ekumfakeni

Ngelishwa, abafezekanga. Ezahlukahlukeneyo ukulimala kunye nezigulo Kwiimeko kakhulu, kufuneka ngoko nangoko ukunceda umntu ekubandezelweni. Ingakumbi ukuba yonakele, ezisongela ubomi. Ezi ziquka iimeko ezingxamisekileyo ezifana ezifana ngokuma isithintelo, zokuma, ukothuka, ukufa isiqaqa. Unyango ezi ezimbi kufuneka kwenziwe kwicandelo labagula kakhulu. Noko ke, amanyathelo ngoko nangoko kufuneka kuthathwe ngoko nangoko emva kovavanyo yomguli, oko kukuthi kwinqanaba le kaxakeka. Xa imoto, "-ambulensi" umiselwe tracheal ekumfakeni, a defibrillator, Ambu bag. Ezi izixhobo zonyango kufuneka kuphela kwiimeko kakhulu, xa umntu akanako ukuphefumla ngokuzimeleyo.

Yintoni na tube endotracheal?

Ngokuqhelekileyo, le ekumfakeni tracheal ibhekisela iinkqubo ezingemnandi. Kodwa ke, nangona ngenkxamleko, kuyimfuneko ngenxa yezizathu zempilo na. Ukuze kwandise yomoya ukuqinisekisa ufikelelo ioksijini emiphungeni, ityhubhu endotracheal ifakiwe. Kufuneka akwazi intubate ugqirha naziphi na izifundo ezikhethiweyo. Ingakumbi eli khono kudingeka kunye resuscitators anaesthesiologists, oogqirha ambulensi. Ngenxa yokuqaliswa umoya endotracheal ityhubhu lung uba eqhelekileyo kwakhona, nangona umonakalo yomoya. Ukongezelela, ngokusebenzisa le ndlela enokwenziwa unikezelo yokwenziwa ioksijini. Kukho iintlobo ezininzi kweetyhubhu endotracheal (20). Ziyashiyana ngobukhulu phambi yindlela eyongezelelweyo (ikhola). Zonke izixhobo ekumfakeni ziye zohlulwa ngokwendidi 2: tube onkcenkceshelwayo kunye nasotracheal. Ahluke ngeendlela ukulalana isixokelelwano sokuphefumla. Kwimeko yokuqala, ityhubhu endotracheal lifakwa ngomlomo, elinesibini - ngokusebenzisa iivesi ngeempumlo. Kuzo zombini embodiments, iingxaki nazo ngenxa yomonakalo omzimba. Ngoko ke, ngaphambi kokukhetha indlela wolawulo lwe ityhubhu, kufuneka ukuvavanya imingcipheko. Noko ke, ekumfakeni kufuneka wenziwe xa oko kuyimfuneko ukuze imisebenzi ebalulekileyo zomzimba.

Ubungqina obubonakalayo buxela ukuba zolawulo ithumbu endotracheal

Xa lithi kakhulu ekunikeni ngokuma kunokwenzeka kuphela ngokuthi unike ityhubhu tracheal emlonyeni okanye nakumarhanana. Kwiimeko ezininzi, isigulana akuthethi zintlungu ngexesha le nkqubo. Ekubeni abantu abafuna bazamile, kaninzi zingqondweni. Kukho Yayibubungqina zilandelayo tracheal ekumfakeni:

1. Imfuneko umoya ngomatshini. yomatshini lwenziwa kuphela kwinqanaba uncedo olungxamisekileyo, kodwa ICU. Ukwenza le nkqubo akunakwenzeka ngaphandle tracheal ekumfakeni.
2. Imfuneko Ukubulawa jikelele. Kule imeko, kufuneka ukuqaliswa tube ukuyilandela. Ngapha koko, ngexesha zomzimba jikelele buyasikhulula zonke izihlunu, kuquka izihlunu zemiphunga.
3. Ukuphunyezwa tracheal kunye lavage inyumoniya. Le nkqubo kubonisiwe iziguli yencindi, imixholo isisu esiya ngokuma.
4. Ukuphuculwa exchange gas phakathi imiphunga kunye nokusingqongileyo.

Kukholelwa ukuba ityhubhu endotracheal yaziswa ngomlomo (orotracheal) iboniswe phantsi kweemeko ezinzima kakhulu. Phakathi kwabo - stop zokuphefumla umsebenzi intliziyo (ukufa lwezonyango) , kunye coma na imvelaphi. intshayelelo Nasotracheal iye iingxaki ezimbalwa kwaye igqalwa nokomzimba ngakumbi. Kunjalo, kuba nokuthintela ukusilela ezihlasela zosulele ngokuphefumla, ngokufuthi oogqirha angenise ityhubhu ngomlomo.

Izixhobo ze-tracheal ekumfakeni

Xa specialist labagula kakhulu kufuneka kusoloko kukho iseti enye tracheal ekumfakeni. Igcinwe kwibhokisi ezizodwa izixhobo eziyilelwe umoya miphungeni. Misela ukuba ekumfakeni baphume labagula kakhulu xa kuyimfuneko. Oku kusebenza kwiimeko apho isigulane ngokukhawuleza kubonisiwe umoya ngomatshini. izixhobo zonyango ziyafumaneka kwi isethi:

1. Laryngoscope. Esi sixhobo imelwe macandelo ezimbini eziphambili - ibe likhaba kunye nomqheba. Isebenza ngenxa ibhetri okanye iibhetri. Bona lifakwa isiphatho laryngoscope. Yabe angene ezahlukahlukeneyo (egosogoso kunye ngqo). Le nxalenye lifakwa kwisisu ngomlomo. Ekupheleni nencakuba has ukukhanya esikhanyisela yomoya. ubukhulu laryngoscope Selection kuxhomekeke kubudala yesigulane, imeko kwisisu ngomlomo.
2. iintlobo ezahlukeneyo kweetyhubhu endotracheal. Ikhithi iquka izixhobo ekumfakeni zombini abadala kunye nabantwana. Ahluke ngobukhulu, phambi okanye kungekho cuff, ubukhulu ephandle, ubude kunye nenani lumens. Ngezi ngemibhobho ingaqhuba iye phandle bobabini ekumfakeni onkcenkceshelwayo kunye nasotracheal. Amaninzi abafazi sebenzisa ubukhulu bile 7-8, amadoda - 8-10. Ngenjongo ekumfakeni lezigulane abadala zifuna endotracheal ityhubhu nge cuff. Ukuqinisekisa patency ye yomoya abantwana - ngaphandle kwayo.
3. Umqhubi endotracheal tube ukuba adlulisele i begoba oyifunayo.
4. forceps egobile.
5. amachiza డొమైన్ idomeyini ye zomzimba.

Nangona yokuba practice ayithethi usebenzise zonke ngothotho lwezixhobo, ubukho babo kuyimfuneko ngokupheleleyo.

Kwezinye iimeko, ukuqaliswa ityhubhu endotracheal akwamkelekanga?

Nangona ekumfakeni libhekisela iinkqubo eziyimfuneko, oko lineqela Izimo. Ezi ziquka: ukwenzakala entanyeni, nangezilonda kwi nemingxuma zomlomo kunye ngeempumlo, iindumbisa yomoya. Kule meko, ityhubhu intshayelelo anganawo inzuzo kodwa negalelo kuphela kuphuhliso iingxaki kakhulu (isithuba izihlunu, spinal intambo kukwenzakala). Ngoko ke, ngaphambi kokuqhubeka ekumfakeni, kuyimfuneko ukuhlola umlomo kunye nempumlo, sinikele ingqalelo imeko yomqolo eliphezulu.

Ukongeza, ukuqaliswa ityhubhu endotracheal kusenokuba nzima phantsi kweemeko ezithile, non Izimo. Phakathi kwabo: ulwimi enkulu, intamo emfutshane, okanye umhlathi, ukutyeba, phuhlu kakhulu amazinyo ngaphambili, umlomo emxinwa kunye okungahambi noqhoqhoqho. Phambi iimpawu ezinjalo umguli, ekumfakeni kufuneka kwenziwa ngononophelo. Kule meko, kukhethwa kusungulo tube nasotracheal. Kufuneka ube 1-2 ubukhulu ezincinane.

Su ekumfakeni

ekumfakeni Orotracheal lwenziwa ngolu hlobo lulandelayo:

1. Nomonde ibekwe kwindawo eqinileyo, olahla umva intloko yakhe kancinane kwaye tyhala umhlathi asezantsi phambili. Ngenxa yoko, siphume ephezulu kukho ngokuma-moya enye. Ukuba kunokwenzeka, ibekwe phantsi kuluhlu entanyeni.
2. Ukuba kuyimfuneko, lingadlulanga ngomlomo vomitus, ukwakheka ubumdaka.
3. Ngenisa blade laryngoscope (ekunene). Kubalulekile ukuba angamchukumisi na isifo yomlomo namazinyo.
4. Emva koko, ityhubhu endotracheal ifakiwe. Igqitha emlonyeni nasemqaleni. Kwinqanaba imisipha, ityhubhu kufuneka sibhalwe ngenyameko phakathi kwabo em- uqhoqhoqho.
5. Laryngoscope isusiwe.
6. Emali a cuff ngenxa ukulungisa ithumbu endotracheal.

ekumfakeni Nasotracheal lwenziwa kwi kakhulu efanayo. Umahluko ukusonjululwa ityhubhu kunye nokuqaliswa kwayo kuloo ndawo ibinomthwebeba ngeempumlo. Kulo mzekelo, i laryngoscope ayisetyenziselwanga.

Indlela yokwenza lo yokuphefumla emiphungeni abantwana?

Kukho iimeko apho tracheal ekumfakeni kuyimfuneko ukwenza abantwana. Amaninzi, kuyimfuneko ukuba umbungu nzulu ikuphwe kakubi na. Kwakhona ekumfakeni kusenokuba yimfuneko kwixesha lweentsana xa uzingela iziphene kwenkqubo bokuphefumla sentliziyo. Kuzo zombini ezi meko, lo efunekayo umoya ngomatshini. Ubungqina obubonakalayo buxela ukuba ekumfakeni kule minyaka junior and aphezulu nobuntwana ngokufanayo abadala. Phakathi kwazo kukho: ukusilela ezihlasela zosulele ngokuphefumla, angabikho zingqondweni, eqhuba Ukubulawa jikelele.

Yintoni na ke isikali ubunzulu ekumfakeni?

Ubunzulu apho kufuneka ufake ityhubhu endotracheal, ixhomekeke ubukhulu kunye nobunzima baso umntwana. Ukuze wenze oku, sebenzisa isikali okhethekileyo. Uya kusebenza iintsana ngaphambi kwexesha kuzalwa. Ezinobunzima-1 kg umntwana ukuba kusetyenziswe ubungakanani 2.5 endotracheal ityhubhu. Ukujula kwawo ilinganiswa ukusuka kulawulo komlomo kwaye 6-7 cm. ubunzima Body kg 2 kusetyenziswa ubungakanani tube ilingana 3. Ubunzulu ngenaliti kufuneka abe ngaphezulu kwe-8 cm. Ukuba umntwana ubunzima phakathi kwe-2 no-4 kg lisetyenziswa ubungakanani yobisi № 3 5. Ubunzulu kule meko ukusuka cm 9 ukuya kwi-10. Kuba ezisanda kuzalwa kunye nabantwana, ogama ubunzima ngaphezulu kwe-4 kg, usebenzisa ubukhulu tube 4. Ubunzulu of intshayelelo - 11 cm.

Yintoni kuba ezinobuzaza emva tracheal ekumfakeni?

Kufuneka kukhunjulwe ukuba ukusungulwa kwalo endotracheal ityhubhu ingxaki eziyingozi ezifana umonakalo inwebu kwiinwebu izibilini. Ngoko ke, lo ukuxhaphaza kufuneka ziqhutywe yi liyincutshe onamava. Icandelo labagula kakhulu, ngaphambi kokuqalisa ekumfakeni, zomzimba olwenziweyo. Iingxaki ziqhelekileyo zibandakanya: umonakalo amazinyo, ukuba isifo se pharynx, emphinjeni ngokungenisa ithumbu. Ukuze uphephe oku, kufuneka ukuba esweni ngenyameko imeko yesigulane.

Ukufakelwa i ityhubhu endotracheal: izimvo zeengcali

Technique of ekumfakeni umntu wonke ugqirha. Kunjalo, kungcono ukwenza oku ukuphululwa intensivists kunye Iintlungu. Ngokutsho kwabo, ngaphandle uqeqesho olulodwa, kwaye kungekho iimeko ludlolo, akunakwenzeka ukuba tracheal ekumfakeni. Ngapha koko, iingxaki kule nkqubo inokuba vuhlayiseki. Noko ke, ukuba ukunika uncedo lokuqala ngenxa yezizathu zempilo linyanzelekile ugqirha naliphi elithile.