Nā kūlana no ka nānā ʻana i nā anesthetic maʻamau

Kōmike Kumu: Nā Kūlana Kūlana Aʻo a me nā Pono (ʻĀpono ʻia e ka ASA House of Delegates ma ʻOkakopa 21, 1986, i hoʻoponopono hope ʻia ma ʻOkakopa 20, 2010, a ua hōʻoia hope ʻia ma ʻOkakopa 28, 2015)

Pili kēia mau kūlana i ka mālama anesthesia āpau, ʻoiai, i nā hanana pilikia, lawe mua ʻia nā hana kākoʻo ola kūpono. Hiki ke hoʻonui ʻia kēia mau kūlana i kēlā me kēia manawa e pili ana i ka hoʻoholo o ka anesthesiologist kuleana. Hoʻolālā ʻia lākou e paipai i ka mālama hoʻomanawanui ʻana i ka maikaʻi, akā ʻo ka nānā ʻana iā lākou ʻaʻole hiki ke hōʻoia i kekahi hopena hopena maʻi. Kuhi ʻia lākou i kēlā me kēia manawa, e like me ka mea i hōʻoia ʻia e ka ulu ʻana o ka ʻenehana a me ka hana. Pili lākou i nā anesthetics āpau āpau, nā anesthetics āpana a me ka mālama ʻana i ka anesthesia nānā. ʻO kēia pae o nā kūlana maʻamau wale nō i ka pilikia o ka nānā anesthetic maʻamau, kahi mea nui o ka mālama anesthesia. I kekahi ʻano maʻamau a ʻano ʻē paha, 1) kekahi o kēia mau ʻano o ka nānā ʻana he kūpono ʻole paha i ke olakino, a me 2) hoʻohana kūpono ʻole o nā ʻano nānā i wehewehe ʻia e ʻike ʻole i nā hanana olakino maikaʻi ʻole. Hiki ʻole ke hōʻoki pōkole i ka nānā mau †. ʻAʻole kuhi ʻia kēia mau maʻamau no ka noi ʻana i ka mālama o ka mea hoʻomanawanui i ka hana a i ʻole i ka hana o ka mālama ʻeha.

1. KULA I
E noho ana nā limahana anesthesia kūpono i loko o ka lumi ma loko o ke ʻano o nā anesthetics āpau, nā anesthetics āpana a me ka mālama ʻana i nā anesthesia.
1.1 Pahuhopu -
Ma muli o nā loli wikiwiki i ke kūlana hoʻomanawanui i ka wā anesthesia, e noho mau nā limahana anesthesia kūpono e kiaʻi i ka mea maʻi a hāʻawi i ka mālama anesthesia. I ka hanana aia kahi weliweli ʻike pololei, e laʻa, radiation, i ka anesthesia
nā limahana e koi ana i ka nānā mamao ʻana o ka mea maʻi, pono e hana i kekahi mea no ka nānā ʻana i ka mea maʻi. Inā loaʻa kahi pilikia i kahi manawa pōkole o ke kanaka ke kuleana nui no ka anesthetic, ka
E hoʻohana ʻia ka hoʻokolokolo maikaʻi loa o ka anesthesiologist i ka hoʻohālikelike ʻana i ka pilikia me ke kūlana hoʻomanawanui anesthetized a me ke koho ʻana o ka mea i waiho ʻia ke kuleana no ka anesthetic i ka wā noho manawa ʻole.

2.KAHI II
Ma nā anesthetics āpau, e loiloi mau ʻia ka oxygenation o ka mea hoʻomanawanui.
2.1 oxygenation -
2.1.1 Pahuhopu -
E hōʻoia i ka lawa pono o ka oxygen i loko o ka gas i hoʻoulu ʻia a me ke koko i nā anesthetics āpau.
2.2 Nā Papahana -
2.2.1 Ke kinoea i hoʻoulu ʻia: I loko o kēlā me kēia lawelawe ʻana o ka anesthesia ākea e hoʻohana ana i ka mīkini anesthesia, e ana ʻia ka lehulehu o ka oxygen i loko o ka ʻōnaehana hanu hoʻomanawanui e kahi mea hoʻokolohua oxygen me kahi alarm alarm limit palena haʻahaʻa e hoʻohana ana.
2.2.2 Ka oxygenation koko: Ma nā anesthetics āpau, e hoʻohana ʻia kahi hana helu o ka helu oxygenation e like me ka pulse oximetry. nā limahana kime mālama anesthesia.

3.VENTILATION
3.1 Pahuhopu - E hōʻoia i ka ea kūpono o ka mea maʻi ma nā anesthetics āpau.
3.2 Nā Papahana -
3.2.1 E loaʻa i kēlā me kēia mea maʻi ka loaʻa anesthesia laulā i ka pono o ka ea e loiloi mau ʻia. ʻO nā hōʻailona hōʻailona kūpono e like me ka huakaʻi o ka umauma, ka nānā ʻana i ka ʻeke hanu reservoir a me ka auscultation of breath kani e pono. E mālama mau ʻia ka nānā ʻana i ke alo o ke kalapona kalapona make ke hoʻokō ʻia ke ʻole e hōʻoia ʻia e ke ʻano o ka mea maʻi, ka hana a me nā pono hana.
Paipai nui ʻia ka mālama ʻana i ka nui o nā kinoea make.
3.2.2 Ke hoʻokomo ʻia kahi Tube endotracheal a i ʻole mask mask laryngeal, pono e hōʻoia ʻia kona kūlana kūpono e ka loiloi lapaʻau a me ka ʻike ʻana i ka carbon dioxide i loko o ke kinoea pau. Ke hoʻomau nei ka loiloi kalapona kalapona hopena, i ka hoʻohana ʻia mai ka manawa o ka endotracheal tube / laryngeal mask hoʻonoho, a hiki i ka extubation / hoʻohemo a hoʻomaka ʻana paha i ka hoʻoili i kahi mālama mālama postoperative, e hana ʻia me ka hoʻohana ʻana i kahi metekualite e like me capnography, capnometry a i ʻole spectroscopy lehulehu. *
Ke hoʻohana ʻia ka capnography a i ʻole ka capnometry, e lohe ʻia ka hopena o ka hopena CO2 e ka mea anesthesiologist a i ʻole nā ​​limahana o ka hui anesthesia. *
3.2.3 Ke kaohi ʻia ka ea e kahi ʻenekini mīkini, ma laila e hoʻohana mau i kahi hāmeʻa hiki ke ʻike i ka hemo ʻana o nā mea o ka ʻōnaehana hanu. Pono e hāʻawi ka hāmeʻa i kahi hōʻailona lohe i ka wā i ʻoi aku ai kāna paepae alarm.
3.2.4 I ka wā anesthesia āpana (me ka ʻole sedation) a i ʻole anesthesia kūloko (me ka ʻole sedation), e loiloi ʻia ka lawa ʻana o ka ea ma o ka hoʻomau mau ʻana i nā hōʻailona hoʻokolohua qualitative. I ka wā o ka sedation hohonu a hohonu paha, e loiloi ʻia ka lawa pono o ka ea ma o ka hoʻomau mau ʻana o nā hōʻailona hōʻailona qualitative a me ka nānā ʻana no ke kū ʻana o carbon dioxide i hoʻopiʻi ʻia a ke ʻole i kāpae ʻia a hoʻopau ʻole ʻia paha e ke ʻano o ka mea maʻi, ka hana, a me nā pono hana.

4.CIRCULATION
4.1 Pahuhopu - E hōʻoia i ka lawa o ka hana o ka mea hoʻomanawanui i ka wā o nā anesthetics āpau.
4.2 Nā Papahana -
4.2.1 E loaʻa mau i nā mea hoʻomanawanui ka anesthesia i ka electrocardiogram e hōʻike mau ʻia mai ka hoʻomaka ʻana o ka anesthesia a hiki i ka hoʻomākaukau ʻana e haʻalele i ka wahi anesthetizing.
4.2.2 E loaʻa i kēlā me kēia mea maʻi ka loaʻa anesthesia i ke kahe o ke koko arterial a me ka helu o ka puʻuwai e hoʻoholo a loiloi ʻia ma ka liʻiliʻi i kēlā me kēia ʻelima mau minuke.
4.2.3 E loaʻa i kēlā me kēia mea maʻi ka anesthesia laulā, me ka mea aʻe i luna, a loiloi mau ʻia ka hana kahe e ka liʻiliʻi o kekahi o kēia mau mea: pulse monitoring, or pulse
plethysmography a i ʻole oximetry.

5. KA HOOMANAO KINO
5.1 Pahuhopu - E kōkua i ka mālama ʻana i ka mahana o ke kino kūpono i nā anesthetics āpau.
5.2 Nā Hana Hana - E nānā ʻia ka mahana i kēlā me kēia mea maʻi e loaʻa ana i ka anesthesia ke manaʻo ʻia nā hoʻololi nui i ka mahana o ke kino.
† E hoʻomaopopo he "mau" ka wehewehe ʻana ma ke ʻano he "hoʻomau pinepine a pinepine i ka kūliʻi wikiwiki" akā ʻo ka "hoʻomau" ʻo ia hoʻi "hoʻolōʻihi ʻia me ka ʻole o ka mea keakea i kēlā me kēia manawa."
* Ma lalo o nā kūlana extenuating, hiki i ka anesthesiologist kuleana ke kāpae i nā koi i kaha ʻia me kahi asterisk (*); paipai ʻia ke hana ʻia kēia, pono e ʻōlelo ʻia pēlā (me nā kumu) i kahi memo i ka moʻolelo olakino o ka mea maʻi.

 


Manawa Post: 27-07-21