Ukufundisa ngezonyango, i-Endotracheal intubation, i-Esal intubation, ngaba uyifundile?

Ukufakwa kwempumlo kudla ngokusetyenziswa kwizigulana ezinobunzima bokuvula umlomo okanye i-laryngoscope ayinakufakwa, nakwizigulana ezenza utyando lomlomo, ngoko ke kusetyenziswa ukufakelwa kwempumlo ngokungaboniyo. Ukufakwa kwempumlo ngokungaboniyo kufuneka kugcine isigulana siphefumla ngokuzenzekelayo, kusetyenziswe ukuhamba komoya ukumamela isandi se-catheter, kwaye kushukunyiswe intloko yesigulana ukuze kulungiswe indlela i-catheter ebekwe ngayo ukuze ifakwe kwi-trachea. Emva kwe-anesthesia, isisombululo se-1%****** sakhutshwa empumlweni ukuze kubangele ukuxinana kwemithambo yegazi ye-mucosal. Ngenxa yokuba umphezulu othe tyaba we-tracheal tube wawungasekhohlo, kwakulula ukufikelela kwi-glottis ngokufaka i-intubation empumlweni yasekhohlo. Kwimisebenzi yeklinikhi, i-nostril yasekunene isetyenziswa kuphela xa ukufakwa kwempumlo yasekhohlo kuphazamisana notyando. Ngexesha lokufakwa kwetyhubhu, ukulinganisa uqeqesho lokuvuselela i-cardiopulmonary pulmonary lwe-human nasal alar eversion kwenziwa kuqala, emva koko i-lubricant catheter yafakwa empumlweni, ijonge ngqo kumgca we-nasal longitudinal, kwaye iphume empumlweni nge-common nasal meatus kumgangatho wempumlo. Isandi esikhulu sokuphefumla sasivakala sivela emlonyeni we-catheter. Ngokubanzi, isandla sasekhohlo sasisetyenziselwa ukulungisa indawo yentloko, isandla sasekunene sasisetyenziselwa ukufakwa kwetyhubhu, kwaye emva koko isikhundla sentloko sashukunyiswa. Ukufakwa kwaba yimpumelelo kakhulu xa ingxolo yokuhamba komoya we-catheter yayiyeyona icacileyo kwimodeli ye-electronic tracheal intubation. Ukuba inkqubela phambili ye-catheter ivaliwe kwaye isandi sokuphefumla siphazamisekile, kusenokwenzeka ukuba i-catheter ityibilike kwi-piriform fossa kwelinye icala. Ukuba iimpawu ze-asphyxia zenzeka ngaxeshanye, intloko inokuba ibuyele umva kakhulu, ifakwe kwi-epiglottis kunye ne-tongue base junction, nto leyo ebangela ukuba i-epiglottis pressure glottis, efana nokuxhathisa kuphele, kwaye ukuphazamiseka kwesandi sokuphefumla, ikakhulu ngenxa yokujika kwentloko kakhulu, i-catheter ingene kwi-esophagus okubangelwe yiyo. Ukuba ezi meko zingasentla zenzeka, i-catheter kufuneka irhoxiswe kancinci, kwaye indawo yentloko kufuneka ilungiswe emva kokuba kuvele izandi zokuphefumla. Ukuba ukufakelwa okuphindaphindiweyo okungaboniyo kwakunzima, ii-glottis zinokuvezwa ngomlomo nge-laryngoscope. I-catheter iphuculwe ngesandla sasekunene yaze yafakwa kwi-trachea phantsi kombono ocacileyo. Okanye, incam ye-catheter inokubotshwa nge-forceps ukuthumela i-catheter kwi-glottis, kwaye emva koko i-catheter inokunyuswa nge-3 ukuya kwi-5cm. Iingenelo zokufakelwa kwe-nasotracheal zezi zilandelayo: (1) Ityhubhu ye-nasotracheal akufuneki ibe nkulu kakhulu, kuba ukuba inkulu kakhulu, amathuba okonakala kwi-larynx nakwindawo engaphantsi kwe-glottic aphezulu, ngoko ke ukusetyenziswa kobubanzi obukhulu kakhulu betyhubhu kunqabile; ② Impendulo ye-nasal mucosa kwi-intubation inokubonwa, nokuba kukho ukuvuselela; ③ I-nasal cannula ilungisiwe ngcono, kwaye ukutyibilika okuncinci kwafunyanwa ngexesha lokuncancisa kunye nokuphefumla okwenziweyo; ④ Ukugoba kwe-nasal cannula kukhulu (akukho Angle ibukhali), okunokunciphisa uxinzelelo kwinxalenye engasemva ye-larynx kunye ne-cartilage yolwakhiwo; ⑤ izigulana ezivukileyo zaziziva zikhululekile ngokufaka i-nasal intubation, isenzo sokuginya sasilungile, kwaye izigulana azikwazanga ukuluma i-intubation; ⑥ kwabo banengxaki yokuvula umlomo, kungasetyenziswa i-nasal intubation. Iingxaki zezi zilandelayo: (1) Usulelo lunokungeniswa kwindlela yokuphefumla esezantsi ngokufaka i-nasal intubation; ② I-lumen ye-nasal intubation inde kwaye ububanzi bangaphakathi buncinci, ngoko ke indawo efileyo inkulu, kwaye i-lumen kulula ukuyivala yi-secretions, eyonyusa ukumelana kwendlela yokuphefumla; ③ Utyando kwimeko engxamisekileyo luthatha ixesha kwaye akulula ukuphumelela; ④ Kunzima ukuyifaka kwi-nasal cavity xa i-trachea incinci.