Ngā Tikanga Whakangote mō te Pokanga Kararehe
Pendahuluan
He mea nui te rongoā whakamoe i roto i ngā mahi pokanga katoa, ehara i te mea mō te tangata anake engari mō ngā kararehe hoki. He mea nui ngā tikanga rongoā whakamoe kia pai ai te mahi, kia iti ai te mamae me te ahotea mō te kararehe. Me āta whai te rata kararehe me tā rātou tīma hauora i ēnei tikanga kia pai ai te oranga o te kararehe i te wā e pokanga ana, ā, i muri hoki i te pokanga.
Ngā Wāhanga i roto i te Kawa Whakamamae
Ka taea te wehewehe i ngā tikanga whakamoe kia maha ngā wāhanga: te whakarite i mua i te whakamoe, te whakaū, te tiaki, te aroturuki, me te whakaora i muri i te whakamoe. He whāinga me he tikanga motuhake kei ia wāhanga.
1. Te Whakarite i mua i te Whakamamaetanga
Aromatawai Hauora
I mua i te hoatutanga o te rongoā whakamoe, me whakahaere e te rata kararehe he aromatawai haumanu hōhonu. Kei roto i tēnei ko te whakamātautau tinana, te kohikohi hītori hauora, me ngā whakamātautau taiwhanga pēnei i te whakamātautau toto me te mimi, mēnā e tika ana. Mā ēnei raraunga ka āwhina ki te whakatau i te hauora o te kararehe me ngā āhuatanga mōrearea pea.
Tere
Me nohopuku te nuinga o ngā kararehe i mua i te whakamoenga hei ārai i te mimiti o te pūkahukahu i te wā e pokanga ana. Ko te taunakitanga whānui ko te 8–12 hāora mō te kai mārō me te 2–4 hāora mō te wai, engari ka rerekē pea tēnei i runga i te momo me te āhua hauora o te kararehe.
Te rongoā i mua i te whakamahinga
Ko te rongoā i mua i te whakamahinga ka hoatu hei whakaiti i te manukanuka, hei whakaputa i te whakamarie, me te whakaiti i te horopeta o ngā rongoā whakangote e hiahiatia ana. Ko ētahi o ngā rongoā e whakamahia whānuitia ana ko ngā rongoā whakangote pēnei i te acepromazine, ngā opioid pēnei i te morphine, me ngā rongoā anticholinergic pēnei i te atropine hei whakaiti i te mōrearea o te bradycardia me te nui rawa o te hinu manawa.
2. Te Whakaoho i te Whakamamae
Ko te whakaurunga o te rongoā whakamoe te wāhanga e neke atu ai te kararehe mai i te māramatanga katoa ki te ngaronga o te māramatanga e hiahiatia ana. Ka taea tēnei mā te werohanga ā-uaua, mā te manawa rānei.
Werohanga ā-roto
Ko te tikanga werohanga ā-uaua e whakamahi ana i ngā rongoā pēnei i te propofol, te thiopental, te ketamine rānei, he tere te tīmatanga. Ko ngā painga o tēnei tikanga ko tōna tere o te tukanga me te ngāwari o te ine i te horopeta.
Te manawa
Ka tukuna ngā rongoā whakangote manawa pēnei i te isoflurane, te sevoflurane rānei mā roto i tētahi kopare kanohi, i tētahi rūma whakapūngao rānei. E kiia ana he haumaru ake tēnei tikanga mō ngā kararehe mōrearea nui nā te mea ka taea te whakahaere pai ake i te hohonutanga o te rongoā whakangote.
3. Te Whakaoraora Tiaki
Ko te whāinga o te tiaki he pupuri i te āhua pumau o te rongoā whakamoe mō te kararehe i te wā e pokanga ana. Ko te rongoā whakamoe manawa te tikanga tiaki tino noa nā te mea he ngāwari te whakahaere i te hohonutanga o te rongoā whakamoe. Ka whakamahia he mīhini rongoā whakamoe hei ine i ngā taumata hau e manawahia ana me te hau e manawahia ana, me te whakarite kia tika te hau.
Tērā pea ka hiahiatia ētahi atu rongoā pēnei i ngā rongoā whakamamae mamae (hei tauira, ngā opioid) me ngā rongoā whakangāwari uaua, i runga i te momo pokanga.
4. Aroturuki i te Whakamamae
He mea nui te aroturuki tonu mō te haumaru o te kararehe i te wā e whakamoea ana. Ko ētahi o ngā āhuatanga me aroturuki ko:
Te Auau o te Manawa me te Rīngi: Ka taea e te aroturuki manawa, te ECG rānei te kite i te bradycardia, te tachycardia, te arrhythmia rānei.
Te Pēhanga Toto: Ka mahia ngā inenga pēhanga toto hei whakarite kia tika te rere o te toto. Ko ngā taputapu e whakamahia whānuitia ana ko te Doppler me te oscillometric.
Te Mākū o te Hāora me te CO2: Ka whakamahia te pulse oximetry hei aroturuki i te mākū o te hāora, ko te capnography ia e ine ana i ngā taumata CO2 e manawahia ana.
Te Mahana Tinana: He nui te mōrearea o te mate totoka i te wā e pokanga ana, nō reira he mea nui te aroturuki i te pāmahana, ā, he maha ngā wā ka whakamahia ngā paraikete whakamahana, ngā whakamahana wai rānei.
5. Te Whakaora i Muri i te Whakamamaetanga
Ko te whakaoranga te wā e ara ake ai te kararehe i te rongoā whakamoe. I tēnei wā, ka haere tonu te aroturukitanga kia tino mōhio te kararehe, kia taea ai e ia te pupuri i tōna tūranga tinana.
Te Whakahaere Mamae
He mea tino nui te whakahaere i te mamae i muri i te pokanga. Tērā pea ka hoatu he rongoā mamae pēnei i te opioids, te NSAIDs, te rongoā whakamoe ā-rohe rānei mēnā e tika ana.
Te Tirotiro Tonu
He mea nui te aroturuki i te wā e ora ana. Me whakarite kia noho te kararehe ki tētahi wāhi marino me te aroturuki tata kia kitea ai ngā raruraru pēnei i te matewai nui, te ngoikore o te manawa, te toto rānei i muri i te pokanga.
Ngā Whakaaro Motuhake e pā ana ki ngā Momo
He rerekē ngā hiahia o ia momo kararehe mō te rongoā whakamoe. Anei ētahi whakaaro motuhake mō ia momo kararehe:
Ngā Kurī me ngā Ngeru
Ko ngā kurī me ngā ngeru ngā kararehe e whakamoea ana i roto i ngā whare rongoā kararehe. He rite tonu te whakamahinga o ngā rongoā whakamoe me ngā rongoā mamae ki te whakamahinga i roto i te tangata. Heoi, he rerekētanga anō hoki, pērā i te whakamahinga whānui o te acepromazine i roto i ngā kurī hei rongoā i mua i te rongoā.
Ngā Kararehe Tauhou
Mō ngā kararehe tauhou pērā i te rāpeti, te kiore tītī, te ngārara rānei, me tino tupato nā te mea he rerekē ō rātou āhua tinana me ō rātou āhua tinana. Hei tauira, he nui te mōrearea o ngā rāpeti ki te mimiti i te wai, ā, me whiwhi rongoā motuhake i mua i te whakamahinga. He uaua ake te hoatu i te rongoā whakamoe manawa ki ēnei kararehe i ētahi wā, ā, he maha ngā wā he huarahi kē atu hei whakamahi i ngā tikanga werohanga.
Ngā Kararehe Nui
Me whai tikanga whakamoe motuhake ngā hōiho me ngā kararehe e rite ana ki tō rātou rahi me te pākia o te tinana. He uaua ake te whakaoho me te tiaki, ā, he maha ngā wā ka uru te huinga o ngā rongoā me ngā tikanga.
Ngā raruraru me tā rātou maimoatanga
Pērā i te rongoā whakamoe kararehe, kāore te rongoā whakamoe tangata e ārai i te tūponotanga o ngā raruraru ka puta, tae atu ki:
Te tairongo nui: Te mate pāwera ki ngā rongoā whakangote.
Te Pōuri o te Manawa: He hekenga o te tere o te manawa ka puta mai i te nui rawa o ngā rongoā whakangote.
Te kore wera nui: Tērā pea ka heke te pāmahana o te tinana nā ngā pānga o te rongoā whakamoe.
Ko te whakahaere i ēnei raruraru me whakarite pai mai i te tīma hauora. He mea nui te hoatu i ngā rongoā ārai mate, te whakapūngao ā-ringa, me te aroturuki kaha hei whakatika i ēnei āhuatanga ohorere.
Whakamutunga
He uaua ngā tikanga whakamoe mō te pokanga kararehe, ā, me aro nui ki ia wāhanga, mai i te whakarite i mua i te whakamoe tae noa ki te whakaoranga i muri i te pokanga. Ko te haumaru me te oranga o ngā kararehe te mea nui rawa atu i roto i ngā tikanga whakamoe katoa. Mā te aro tika me ngā tikanga tika, ka taea te whakaiti i te mōrearea o ngā raruraru, ā, ka angitu te pokanga.
