Nā ʻenehana lawelawe lāʻau lapaʻau intramuscular
ʻO ka lawelawe ʻana i nā lāʻau lapaʻau intramuscular (IM) kekahi o nā kaʻina hana lapaʻau i hana pinepine ʻia ma nā wahi mālama ola, ma nā haukapila, nā kikowaena olakino kaiāulu, a me nā hana pilikino. Pili kēia ala i ka hoʻokomo pololei ʻana i nā lāʻau lapaʻau i loko o nā ʻiʻo, e ʻae ana i ka omo wikiwiki ʻana ma mua o ka lawelawe ʻana ma lalo o ke kino, akā lohi ma mua o ka lawelawe ʻana ma ke kino. No ka mea he invasive kēia kaʻina hana a he hiki ke loaʻa nā pilikia, pono nā limahana mālama ola e hoʻomaopopo i nā loina, ke koho ʻana i nā wahi injection, nā lako kūpono, ke ʻano aseptic, a me ke kamaʻilio therapeutic maikaʻi.
Ka wehewehena a me ke kumu o ka inikini intramuscular
ʻO ka inikini intramuscular ka lawelawe ʻana i ka lāʻau lapaʻau ma ke komo ʻana i kahi nila i loko o ka nui o nā ʻiʻo ma kahi hohonu kikoʻī. ʻO ka pahuhopu ka hoʻokō ʻana i ka omo ʻana o ka lāʻau lapaʻau wikiwiki a paʻa, ʻoi aku hoʻi no nā lāʻau lapaʻau i hiki ʻole ke lawelawe waha ʻia (e.g., ma muli o ka luaʻi ʻana, ka hemahema o ka omo ʻana, a i ʻole ka pono no ka hoʻomaka wikiwiki ʻana o ka hana). Eia kekahi, hoʻohana pinepine ʻia ke ala IM no nā lāʻau pale, kekahi mau antibiotics, analgesics, antiemetics, vitamins, a me nā lāʻau depot (hoʻokuʻu lohi) i hana ʻia e noho lōʻihi i loko o nā ʻiʻo.
Nā hōʻailona a me nā contraindications
ʻO nā hōʻailona maʻamau no ka inikini IM e komo pū ana me: ka pono no ka hopena wikiwiki, kahi liʻiliʻi o ka lāʻau lapaʻau, kahi lāʻau lapaʻau kūpono no nā ʻiʻo, a me nā kūlana o ka mea maʻi e pale ai i ka lawelawe waha. Eia nō naʻe, aia kekahi mau contraindications e noʻonoʻo ai, e like me nā maʻi clotting koko (hemophilia, thrombocytopenia koʻikoʻi, a i ʻole ka hoʻohana ʻana i nā anticoagulants), ka maʻi a i ʻole ka mumū ma kahi i inikini ʻia, ka haʻalulu koʻikoʻi/hypoperfusion hiki ke hōʻemi i ka omo ʻana, a me nā maʻi allergies i nā ʻāpana lāʻau.
I nā poʻe maʻi me ka liʻiliʻi o ka nui o nā ʻiʻo (e.g., nā poʻe ʻelemakule wiwi loa, ka nele i ka meaʻai, a i ʻole kekahi mau maʻi neuromuscular), pono e akahele nui i ke koho ʻana i kahi a me ka nui o ka nila. No nā pēpē a me nā keiki, pono e hoʻoponopono ʻia kahi a me ka nui o ka lāʻau lapaʻau e like me ka makahiki a me ka ulu ʻana o nā ʻiʻo.
Hoʻomākaukau ma mua o ka hana
Keberhasilan injeksi intramuskular tidak hanya ditentukan oleh ketepatan teknik, tetapi juga oleh persiapan yang sistematis. Langkah awal adalah melakukan verifikasi “benar” dalam pemberian obat: benar pasien, benar obat, benar dosis, benar waktu, benar rute, dan benar dokumentasi. Jika tersedia, gunakan identifikasi dua penanda (misalnya nama dan tanggal lahir) untuk memastikan pasien yang tepat.
ʻO ka mea aʻe, e hana i kahi loiloi pōkole: ka mōʻaukala o nā maʻi allergies, ke ʻano o ka ʻili ma kahi i hoʻokomo ʻia ai ke koko, ke kūlana coagulation (inā pili), a me ke kiʻekiʻe o ka hopohopo a i ʻole ka ʻeha. E wehewehe pōkole a maopopo i ke kaʻina hana, me nā manaʻo hiki ke loaʻa, a loaʻa ka ʻae o ka mea maʻi. Hiki i ke kamaʻilio maikaʻi ke hōʻemi i ka ʻeha o nā ʻiʻo, e ʻoluʻolu ai ka hoʻokomo ʻana a me ka hōʻemi ʻana i ka pilikia o ka ʻeha.
Nā mea hana a me nā mea e pono ai
ʻO nā lako hana i hoʻohana pinepine ʻia e komo pū me kahi syringe, kahi nila o ka nui kūpono (ka lōʻihi a me ke ana), nā ʻūpā waiʻona a i ʻole nā mea pale maʻi, nā mīkina lima maʻemaʻe, nā kāʻei inā pono, a me kahi pahu ʻoi (pahu palekana/pahu ʻoi) no ka hoʻolei ʻana i ka nila. Hoʻopili ʻia ke koho ʻana o ka nila e ka makahiki, ka nui o ke kino, kahi i hoʻokomo ʻia ai, a me ka mānoanoa o ka lāʻau. ʻO nā lāʻau lapaʻau mānoanoa maʻamau e pono ai kahi nila nui aʻe no ka hoʻokomo ʻana i ka laumania.
ʻO ke kumumanaʻo koʻikoʻi ka mālama ʻana i ke ʻano aseptic: holoi i kou mau lima e like me nā kūlana, e komo i nā mīkina lima, e hoʻomaʻemaʻe i ka ʻili me ka antiseptic, a pale i ka hoʻopā ʻana i ka ʻāpana sterile o ke nila.
Ke koho ʻana i kahi e hana ai i ka inikini intramuscular
Pemilihan lokasi suntik adalah kunci untuk mencegah cedera saraf dan pembuluh darah serta memastikan obat masuk ke otot.
1. Ventrogluteal (gluteus medius/minimus)
Hoʻomaopopo pinepine ʻia ʻo ia he wahi palekana no ka mea mamao loa ia mai ke aʻalolo sciatic a me nā kīʻaha koko nui, a he lahilahi iki ka papa momona subcutaneous ma mua o ka ʻāpana dorsogluteal. He kūpono ia no nā pākeke a me nā keiki makua, a hiki ke lawelawe i nā nui nui.
2. Vastus lateralis (paha bagian lateral)
ʻO kēia kahi i makemake nui ʻia no nā pēpē a me nā kamaliʻi ʻōpio no ka mea ua ulu nui ko lākou mau ʻiʻo a ua emi ka pilikia o ka hōʻeha ʻana o ke aʻalolo. I nā pākeke, hiki ke hoʻohana ʻia kēia wahi, ʻoiai inā ʻaʻole kūpono ka ʻāpana gluteal. ʻO ka wahi maʻamau ka hapakolu waena o ka ʻūhā waho.
3. Deltoid (lengan atas)
Hoʻohana nui ʻia ia no nā lāʻau pale a i ʻole nā inikini liʻiliʻi. ʻO ka pōmaikaʻi, maʻalahi ke komo ʻana, akā ʻoi aku ka kiʻekiʻe o ka pilikia o ka pā ʻana i nā ʻano a puni ka poʻohiwi inā ʻaʻole i hoʻonoho pono ʻia kahi i inikini ʻia. No ka mea, ʻoi aku ka liʻiliʻi o ka ʻiʻo deltoid, ua kaupalena pinepine ʻia ka nui o ka inikini.
4. Dorsogluteal (gluteus maximus)
Ua hoʻohana maʻamau ʻia kēia wahi, akā nui nā alakaʻi hou e akahele nui aku ma muli o ka pilikia o ka hōʻeha ʻana o ke aʻalolo sciatic a me nā ʻano anatomical i loko o nā kīʻaha koko. Inā hoʻohana ʻia, he mea nui ka hoʻoholo pololei ʻana i ka quadrant waho o luna.
Nā ʻanuʻu o ke ʻano hana injection intramuscular
Ma keʻano laulā, ua hahai ke kaʻina hana hoʻokomo IM i kēia kaʻina hana:
1. Cuci tangan dan persiapan obat
E hoʻomaʻemaʻe i ka lima. E hoʻomākaukau i ka lāʻau lapaʻau e like me ka nui o ka lāʻau, e nānā i ka lā palena pau a me ka maopopo/kūpono o ka hoʻomākaukau ʻana. Inā aia ka lāʻau lapaʻau i loko o kahi vial/ampule, e hoʻohana i ke ʻano kūpono e hōʻemi i ka haumia a pale i ka hōʻeha.
2. Posisikan pasien
Pono ke kūlana e ʻae i nā ʻiʻo e hoʻomaha. No ka ʻiʻo ventrogluteal, hiki i ka mea maʻi ke moe ma ko lākou ʻaoʻao me nā kuli e kulou iki ʻia. No ka ʻiʻo vastus lateralis, hiki i ka mea maʻi ke moe moe. No ka ʻiʻo deltoid, hiki i ka mea maʻi ke noho me nā lima e hoʻomaha ana.
3. Identifikasi lokasi suntik
E hoʻoholo i kahi i inikini ʻia e like me ke ʻano o ke kino. E hōʻoia i ka ʻole o nā ʻeha, nā palapū, nā ʻulaʻula, a i ʻole nā hōʻailona o ka maʻi.
4. Antisepsis kulit
E hoʻomaʻemaʻe i ka ʻili me kahi ʻūpā waiʻona/antiseptic ma kahi neʻe pōʻai mai ke kikowaena a i ka ʻaoʻao. E hoʻomaloʻo no ka hopena antiseptic kūpono a e hōʻemi i ke ʻala.
5. Masukkan jarum dengan sudut 90 derajat
E paʻa i ka syringe e like me ka paʻa ʻana i ka penikala a i ʻole ka dart, a laila e hoʻokomo koke i ka nila a paʻa i kahi kihi 90-degere i ka ʻili e hiki ai i nā ʻiʻo.
6. Stabilisasi dan injeksi obat perlahan
Ke hoʻokomo ʻia ka nila, e hoʻopaʻa i ka syringe i ʻole e neʻe. E hoʻokomo mālie i ka lāʻau lapaʻau a me ke kūpaʻa e hōʻemi i ka ʻeha a kōkua i ka hoʻolaha ʻana i ka lāʻau lapaʻau ma loko o nā ʻiʻo.
7. Tarik jarum dan lakukan penekanan
E huki i ke kui ma ke kihi like me ke komo ʻana. E kaomi i kahi i hoʻokomo ʻia me ka gauze maʻemaʻe a i ʻole ka pulupulu. E pale i ka lomilomi ikaika, ʻoiai me kekahi mau lāʻau lapaʻau (e like me kekahi mau lāʻau pale a i ʻole nā lāʻau hoʻonāukiuki), no ka mea hiki i kēia ke hoʻonui i ka ʻeha a i ʻole ke kumu o ka laha ʻana o ka lāʻau lapaʻau i loko o ka ʻiʻo subcutaneous.
8. Buang jarum dengan aman dan dokumentasi
Mai pani hou i ka nila ke ʻole e hahai ʻia nā alakaʻi palekana kikoʻī. E hoʻolei koke iā ia i loko o kahi pahu palekana. E palapala i ke ʻano o ka lāʻau lapaʻau, ka nui o ka lāʻau, ke ala, ka wahi, ka manawa o ka lawelawe ʻana, a me ka pane a ka mea maʻi.
ʻO ke ʻano hana Z-track a me ka pale ʻana i ka leakage lāʻau
Pada obat yang bersifat iritatif atau berisiko menimbulkan perubahan warna kulit, teknik Z-track dapat dipertimbangkan. Intinya adalah menggeser kulit dan jaringan subkutan ke samping sebelum jarum masuk, kemudian setelah obat disuntikkan dan jarum ditarik, kulit dilepas sehingga jalur suntikan “tertutup” seperti huruf Z. Teknik ini membantu mencegah kebocoran obat ke jaringan subkutan dan mengurangi iritasi.
Nā pilikia hiki ke loaʻa
ʻO kekahi mau pilikia o nā inikini IM e komo pū ana me ka ʻeha kūloko a me ka pehu ʻana, ka hematoma, ka abscess ma muli o ka maʻi, nā hopena aleri, ka ʻeha o ke aʻalolo, a me ka inikini ulia pōpilikia i loko o kahi kīʻaha koko (ʻoiai inā ua kuhikuhi ʻia ke ala IM i loko o kahi ʻiʻo). ʻO ka pale maikaʻi loa, ʻo ia ke koho kūpono ʻana i kahi, ka asepsis paʻa, kahi nila kūpono, a me ke ʻano inikini kūpono. He mea koʻikoʻi nō hoʻi ka nānā ʻana i ka mea maʻi ma hope o ka lawelawe ʻana, ʻoiai no nā lāʻau lapaʻau me ka hiki ke loaʻa nā hopena aleri.
Pani
ʻO ka lawelawe ʻana i ka lāʻau lapaʻau intramuscular he mākaukau kumu akā koʻikoʻi i ka hana lapaʻau. ʻO ka ʻike pololei ʻana i ka mea maʻi a me ka lāʻau lapaʻau, ke koho palekana ʻana i kahi injection, ka hoʻohana ʻana i nā lako kūpono, a me ka mālama ʻana i nā loina aseptic nā kumu nui no ka hōʻemi ʻana i nā pilikia a me ka hoʻomaikaʻi ʻana i ka ʻoluʻolu o ka mea maʻi. Me ke aʻo ʻana i hoʻonohonoho ʻia a me ka mālama ʻana i nā kaʻina hana maʻamau, hiki ke hana ʻia nā inikini intramuscular me ka palekana, ka maikaʻi, a me ke ʻano loea, me ke kākoʻo pū ʻana i ka maikaʻi o nā lawelawe mālama ola.
