Ubwa mbere, abarwayi barembye cyane gahunda yibanze yo kwita
Kwakira neza abarwayi, umurwayi ashyirwa mu cyumba cyihutirwa cyangwa ishami ryita ku barwayi, ibikoresho byo kwita ku barwayi kugira ngo umwuka wo mu nzu ube mwiza, ubushyuhe n'ubushuhe bukwiye;umurwayi mwiza hamwe nabagize umuryango wibitaro (Igice).
Assessuation gusuzuma ku gihe:
Harimo ibintu byibanze, ibimenyetso nyamukuru, imiterere yuruhu, isuzuma ryiza ryabafasha, imiyoboro itandukanye, kuvura ibiyobyabwenge nibindi.
Measures ingamba zita kubyihutirwa: ishyirwaho ryihuse ryinjira mumitsi (ukurikije imiterere n'imiti kugirango uhindure igipimo cyigitonyanga), ogisijeni (ukurikije uko ibintu bimeze kugirango uhindure umwuka wa ogisijeni), gukurikirana ECG, catheterisiyasi, gushyuha, gukora ibintu bitandukanye cyo gukusanya icyitegererezo, Ibikoresho byo kwita ku barwayi kugirango bifashe Kugenzura bihuye, nibiba ngombwa, gutegura neza gutangira
Supine kandi ufite umutekano
Ukurikije indwara kugirango ifate umwanya ukwiye.
⑵ kugirango ugumane umwuka uhumeka, abarwayi ba koma bagomba guhumeka neza izuru nizuru hamwe na endotracheal, kugirango bahumeke umwuka wa ogisijeni.
⑶ amenyo afunze, guhungabana k'umurwayi birashobora gukoreshwa amenyo, gufungura, kugirango urinde ururimi, ururimi.
Fever umuriro mwinshi, koma, delirium, kurakara, intege nke nimpinja nabana bato bagomba kongerwamo uruzitiro, nibiba ngombwa, guha itsinda, gukumira uburiri, kurinda umutekano wabarwayi.
Gutegura ibikoresho byose byo gutabara, ibiyobyabwenge nibikoresho, gutabara mu nzu gushiraho leta ihagaze.
Gukurikiranira hafi uko ibintu bimeze: kwita ku muntu ku giti cye, Ibikoresho byo kwita ku barwayi ibimenyetso byingenzi by’umurwayi, ubwenge, umunyeshuri, kuva amaraso, SpO2, CVP, kuzenguruka kwa peripheri hamwe ninkari hamwe nubundi buryo bwo kwitegereza imbaraga;hamwe na muganga gutabara cyane, kora inyandiko zubuforomo.
Imiti yagenwe, gushyira mu bikorwa inama za muganga zo mu kanwa, gusubiramo nta ruhushya rwo gukoresha.
Komeza imiyoboro itandukanye neza, ikosowe neza, ahantu hizewe kugirango wirinde, ihindagurika, ihagaritswe;tekinoroji itajenjetse kugirango wirinde kwandura retrograde.
⒏ kugirango ubwiherero bugende neza: kugumana inkari gufata uburyo bwo gufasha inkari;nibiba ngombwa catheterisation;kuribwa mu nda nkibisabwa kugirango umuntu atere.
Bitewe nuburyo bwo kwita ku mirire: kubungabunga amazi, kuringaniza electrolyte no guhaza ibikenerwa byibanze byimirire yumubiri;abarwayi biyiriza ubusa barashobora kuba imirire yimitsi.
Ubuvuzi bwibanze
9, umusatsi, amaso, umubiri, umunwa, izuru, ikiganza, ikirenge, perineum, anus, uruhu rusukuye;bitanu kugeza ku buriri: bitatu bya mbere, Ubuvuzi, ubuforomo, umuceri, imiti, amazi ku buriri bw'abarwayi).
⑵ mugitondo, nimugoroba kwita inshuro 2 kumunsi;kwita ku kanwa ka urethral inshuro 2 kumunsi;kwita kuri tracheotomy inshuro 2 kumunsi;witondere kurinda amaso.
Maintain kubungabunga imikorere yingingo, gushimangira ibikorwa byumubiri byumubiri cyangwa gufasha ibikorwa bifatika.
Training imyitozo yo guhumeka neza, buri 2h kugirango ifashe abarwayi guhindukira, kurasa inyuma, kuyobora guhumeka neza, kugirango bafashe gusohora.
⑸ gushimangira kwita ku ruhu, kwirinda ibisebe.
Care Kwita ku mitekerereze: irondo ku gihe, kwita ku barwayi, ibikoresho byo kwita ku barwayi ukurikije uko ibintu bimeze kugira ngo bavugane n'imiryango yabo, hashyizweho umubano mwiza w'abaforomo n'abarwayi, kugira ngo bagirire ikizere abarwayi, ubufatanye mu muryango no kumvikana.
Icya kabiri, abarwayi ba koma bita kuri gahunda
(I) Itegereze ingingo
Gukurikiranira hafi ibimenyetso byingenzi (T, P, R, BP), ingano yabanyeshuri, igisubizo cyumucyo.
⒉ gusuzuma ihungabana rya GLS ryerekana igipimo cyurwego rwo gusubiza kugirango wumve urugero rwa koma, wasanze impinduka zahise zimenyeshwa muganga.
⒊ kwitegereza abarwayi bafite amazi, kuringaniza electrolyte, andika amasaha 24, kugirango batange ubuyobozi bushingiye kumazi.
Witondere kugenzura intebe yumurwayi, urebe niba igisubizo gishobora kuba.
(2) ingingo zabaforomo
Hamagara umurwayi: imikorere, uwambere guhamagara izina ryayo, sobanura intego yibikorwa no kwirinda.
Gushiraho no kubungabunga inzira nziza: fata uruhande rwumutwe kuruhande, igihe icyo aricyo cyose kugirango usibe ururenda rwa tracheal, witeguye kunyunyuza ibintu, igihe icyo aricyo cyose.
Gukomeza kwinjiza imitsi: kwandika neza umubare wibiyobyabwenge byakoreshejwe.
Kubungabunga ingingo zikora, gukora imyitozo ngororamubiri isanzwe hamwe na massage kugirango utange umubiri, gukumira amaboko, ibirenge n'amasezerano, guhindura no guhagarika umutima.
⒌ guteza imbere imikorere yubwonko: kuzamura uburiri kuri dogere 30 kugeza 45 cyangwa gutanga igihagararo cya kabiri, kwivuza byateganijwe no guhumeka umwuka wa ogisijeni.
Gukomeza imikorere isanzwe yo gusohora: gusuzuma buri gihe abarwayi bafite inkari zifata inkari, mugihe cyo gutanga umusarani wigitanda, kugirango bafashe gukanda inda yo hepfo kugirango bateze inkari, catheterisation cyangwa gusimbuza imifuka yinkari bigomba kwitondera tekinoroji ya aseptic.
Kubungabunga isuku kandi neza: kura amenyo, umusatsi, gutema urutoki (amano) A;buri munsi kwita kumunwa kabiri, komeza umunwa kandi usukure, birashobora gusiga irangi amavuta ya paraffine (lipstick) kugirango wirinde iminwa;kwiyuhagira umucanga bisanzwe no gukaraba perineal, Simbuza imyenda isukuye.
Witondere umutekano: guhagarika umutima bigomba kuba uburiri bwinyongera, niba hari uburemere bukabije, bukwiye gutanga inzitizi;ubwenge hamwe no guhinda umuriro mwinshi, kurakara kwa meningeal, Ibikoresho byita ku barwayi bigomba guhabwa ubukonje bwiza no gushyira amenyo, kugirango wirinde umusaya;Ubwoko bwose bwo kuvoma, kugirango wirinde kunyerera.
Kurinda kwandura ibihaha: guhora usubira kurasa, kubyutsa inkorora yumurwayi, guswera mugihe;komeza ushyushye, kugirango wirinde ubukonje, gukoresha amazi ashyushye mugihe ubushyuhe bwamazi butoroshye kurenza dogere 50, ntibishobora guhura nuruhu kugirango wirinde gutwikwa.
⒑ kwirinda ibisebe byumuvuduko: gukoresha uburiri bwumwuka, amagufwa asohoka igice cya sponge, komeza igice cyigitanda kandi gisukure.Buri 1 ~ 2h uhagarare rimwe.
Care kwita kumaso: kura lensike yo guhuza kugirango wishyure.Abarwayi ntibashobora gufunga ijisho, gukoresha buri gihe imitsi ya saline yoza ijisho, hamwe n'amavuta yo kwisiga cyangwa amavuta ya Vaseline kugirango barinde cornea, Ibikoresho byita ku barwayi birinda gukama no gutwika.
(Iii) Inyigisho zubuzima
⒈ shaka umuryango uyobowe nabagize umuryango gukora ubukangurambaga bujyanye n’abarwayi gukomeza imyitozo yo gufasha abarwayi bafite imyitozo ngororamubiri na massage.
Care Kwita ku mitekerereze: kwita ku gushishikariza abarwayi, ibikoresho byo kwita ku barwayi kugira ngo abarwayi bamenye indangagaciro zabo mu muryango no muri sosiyete kugira ngo bongere icyizere cyo gutsinda indwara.