Me pēhea te whakatau i ngā āhuatanga raruraru i roto i te mahi nēhi
Ka taea e ngā āhuatanga ohorere i roto i te mahi nēhi te puta i ngā wā katoa, i ngā horopaki rerekē, mai i ngā rūma ohorere, ngā wāhanga tūroro, ngā pokapū hauora hapori, ngā ratonga tiaki kāinga, tae atu ki ngā hapori i te wā o ngā āhuatanga kino. Ka uru pea ki ngā āhuatanga ohorere te hekenga ohorere o te āhua o ngā tūroro, te pikinga o te maha o ngā tūroro, ngā ngoikore o te pūnaha (pēnei i te motuhanga hiko, te ngoikore rānei o ngā taputapu), ngā pakanga whānau, tae atu ki ngā āhuatanga rerekē pēnei i te pakarutanga o te mate. I roto i ēnei āhuatanga, me noho marino ngā nēhi, me whakaaro tere, me kōrero pai, me whakatau tika i runga i te haumaru o te tūroro. Ka matapakihia e tēnei tuhinga ngā mahi whai hua me ngā mātāpono matua mō te whakatau i ngā āhuatanga ohorere i roto i te mahi nēhi.
Te mārama ki te tikanga o te raruraru me ngā kaupapa matua
Ko te raruraru he āhuatanga e whakatuma ana i te haumaru, te hauora, te pumau rānei o tētahi tangata, o tētahi rōpū rānei, ā, me tere tonu te urupare. I roto i te mahi nēhi, ko ngā kaupapa matua i te wā o te raruraru ko te haumaru o te tūroro, te whakatau i te mate, me te ārai i ngā raruraru. Me wehewehe ngā nēhi i waenga i ngā raruraru tino morearea me ngā mea ka taea te whakaroa. He mea nui ngā mātāpono o te whakarōpūtanga me te aromatawai tere, inā koa he iti ngā rauemi.
Ko tētahi o ngā huarahi matua ki te whakatau i tētahi raruraru ko te whakahaere i tāu ake urupare. Ka taea e te mataku te whakararu i te whakatau kaupapa. Nō reira, me aro tonu ngā nēhi mā te whakamahi i ngā tikanga ngāwari pēnei i te manawa hōhonu, te kōrero pai ki a koe anō, me te whai tonu i tētahi tukanga mahi paerewa kua whakaharatauhia.
Te whakahaere aromatawai tere me te pūnaha
I roto i tētahi āhuatanga ohorere, ka āwhina te aromatawai tere kua whakaritea i ngā nēhi ki te karo i ngā mahi kore e hiahiatia. Ko tētahi huarahi e whakamahia whānuitia ana ko ABCDE:
1. Ara manawa: Kia tuwhera te ara manawa. Tirohia mēnā he aukati, he oro manawa rerekē, he mōrearea rānei o te manawa mimiti.
2. Manawa: Aromatawaihia te tere o te manawa, te hohonutanga, te mākū o te hāora, te whakamahinga o ngā uaua āwhina, me ngā tohu o te mamae.
3. Te Tohanga o te Rere: Tirohia te manawa, te toto totoka, te rere o te toto ki te taha, te toto e kaha ana te toto, me ngā tohu o te ohorere.
4. Hauātanga (tūnga io): Arotakehia te māramatanga (hei tauira, GCS/AVPU), ngā kamo, me ngā tohu o te hypoglycemia, te whiu rānei.
5. Te Whakamārama: Tirohia marietia me te kore e wareware ki te tūmataitinga me te ārai i te hauhautanga.
Me whakauru atu ki tēnei aromatawai he kohikohinga raraunga tere: he hītori poto, he mate pāwera, he rongoā noa, he mate tāpiri, me ngā kaupapa i puta ai te raruraru. Mēnā e pai ana, ka taea e te nēhi te whakamahi i te whakatakotoranga TAUIRA (Ngā Tohu/Ngā Tohu, Ngā Mate Pāwera, Ngā Rongoā, Ngā Hītori o Mua, Te Kai Whakamutunga, Ngā Kaupapa).
Whakaritea ngā wawaotanga e whakaora ana i ngā oranga
I muri i te aromatawai, me mahi tonu te nēhi i te mahi e tino pā ana ki te haumaru o te tūroro. Hei tauira, hoatu te hāora e ai ki te tohu, whakatūria he urunga uaua, whakarite wai whakaora, whakamutua te toto, tīmata rānei i te whakaora manawa (CPR) e ai ki ngā aratohu. I roto i te nuinga o ngā wā, ko ngā wawaotanga nēhi tika me te tere te rerekētanga i waenga i te āhua pumau me te āhua ohorere e kino haere ana.
He mea nui te piri ki ngā tikanga whakahaere paerewa (SOP) me ngā aratohu haumanu kia mau tonu ai te tiaki hauora, kia haumaru ai, kia tika ai hoki. Mēnā ka tūtaki ngā nēhi ki tētahi āhuatanga kei tua atu i te whānuitanga o ō rātou kawenga, me tuku tonu atu e rātou te āhuatanga ki te tākuta, ki te tīma urupare tere rānei, me te whakarato tonu i te tiaki nui.
Te whakawhitiwhiti kōrero whai hua i raro i ngā āhuatanga pēhanga teitei
He maha ngā wā ka whakararuraru ngā raruraru i te whakawhitiwhiti kōrero. Nō reira, me whakamahi ngā nēhi i ngā whakawhitiwhiti kōrero poto, mārama, me te hanganga. Ko tētahi o ngā tikanga rongonui ko te SBAR:
– Āhuatanga: Whakaahuahia te āhua o nāianei (hei tauira, kua poto te manawa o te tūroro, ā, kua heke te mākū o te tinana).
– Papamuri: He kōrero poto mō ngā hītori e pā ana.
– Aromatawai: Aromatawai me te whakamārama i ngā kitenga (hei tauira, te whakapae i te pupuhi pūkahukahu/anaphylaxis).
– Taunakitanga: Me mahi (hei tauira, tono awhina hauora tonu, tono whakarite rongoā, tuku rānei ki te ICU).
Haunga te tīma hauora , me whakahaere hoki te whakawhitiwhiti kōrero ki te whānau me te aroha. Tērā pea ka mataku, ka riri, ka uaua rānei te whakaae ki ngā kōrero a ngā whānau e pāngia ana e te raruraru. Me whakamārama pono ngā nēhi i te āhuatanga, me te whakamahi i te reo e ngāwari ana ki te mārama, me te whakarite kia mōhio te whānau ki ngā mahi e mahia ana. Me pupuri tonu ngā rohe kōrero i runga anō i ngā tikanga matatika me te noho muna o te tūroro.
Te whakahaere tīma me te tohatoha tūranga
Kāore e taea te whakahaere takitahi i tētahi raruraru. Mā te mahi tahi pai ka tere ake te urupare, ka whakaitihia hoki ngā hapa. Mena kei te tūranga wā poto tētahi nēhi hei ārahi i te āhuatanga, me mahi ēnei e whai ake nei:
– Whakatauhia ngā tūranga: ko wai e hoatu ana i te hāora, ko wai e aroturuki ana i ngā tohu ora, ko wai e whakarite ana i ngā rongoā, ko wai e tuhi ana.
– Whakamahia ngā tohutohu poto: he pai ake te whai hua i ngā whakamārama roa.
– Whakawhitiwhiti kōrero ā-porowhita: kia tino whakahokia ngā whakahau, kia whakaūtia hoki (“whakaritea te adrenaline 0,5 mg IM” – “āe, whakaritehia te adrenaline 0,5 mg IM”).
I ngā wā āwhata, i ngā pikinga nui rānei o ngā tūroro, me whakarite hoki e ngā nēhi ngā mea matua, me whai whakaaro ki ngā rauemi e wātea ana, me te mahi tahi me ētahi atu wāhanga.
Te pupuri i te haumaru whaiaro me te aukati i te mate urutā
He mea nui te haumaru o te nēhi ki te haumaru o te tūroro. I roto i tētahi āhuatanga ohorere, ka piki ake te mōrearea o te pānga o te wai tinana, te tutu a te whānau/tūroro, me te ngenge. Me whakamahi tonu ngā nēhi i ngā taputapu tiaki whaiaro e tika ana mō te mōrearea, me mahi i te akuaku ringa, me te whai i ngā tikanga ārai mate.
I ētahi āhuatanga, pērā i te wā e ohooho ana, e pukuriri ana rānei te tūroro, me aro nui ngā nēhi ki te haumaru: kia mau tonu te tawhiti haumaru, kia karanga āwhina, kia whakaitihia hoki te riri. Me mahi noa ngā mahi aukati i runga i ngā ture, ngā tohu, me ngā tuhinga tika.
Te whakatau haumanu me ngā tikanga matatika
He maha ngā raruraru ka puta mai i ngā raruraru: ko wai hei kaupapa matua, āhea me mutu te whakaora, me pēhea rānei te whakaute i te whakatau a te tūroro. Me piri ngā nēhi ki ngā mātāpono matatika o te atawhai, te kore mahi kino, te mana motuhake, me te tika.
Mena ka tukuna he whakahau Kaua e Whakaora (DNR), he tohutohu matatau rānei, me whakarite e te nēhi kia mārama te kaupapa here me ngā tuhinga o te whare hauora. Mena ka whakahē te tīma, me tuku tonu atu ki te kaiwhakahaere hauora me ngā kaiārahi nēhi kia kore ai e hē te whakatau.
He tere, he tika, he whai kiko hoki ngā tuhinga
I roto i tētahi āhuatanga ohorere, ka warewarehia ngā tuhinga. Heoi, he mea nui ngā tuhinga nēhi mō te haere tonu o te tiaki, ngā āhuatanga ture, me te aromatawai kounga. Tuhinga:
– te wā o te aituā me te huringa o ngā āhuatanga,
– ngā tohu ora me ngā kitenga aromatawai,
- ngā wawaotanga i tukuna me te urupare a te tūroro,
– te whakawhitiwhiti kōrero ki ngā tākuta/rōpū me te whānau,
– mahere whai muri.
Whakamahia te reo whaitake, karohia ngā whakapae, ā, tuhia ngā meka.
Te arotake me te whakaoranga i muri i te raruraru
Kia ea te raruraru, me arotake. Mā te whakawhitiwhiti kōrero ka taea e te tīma te matapaki i ngā mea i pai te haere, ngā mea me whakapai ake, me pēhea te ārai i ngā aituā rite. Ka whakaratohia hoki he wāhi mō te tautoko kare ā-roto, nā te mea ka taea e ngā raruraru te whakaoho i te ahotea, te hara, te ngenge hinengaro rānei.
Me mōhio ngā nēhi ki ngā tohu o te ngenge me te ngenge aroha. Ko ngā rautaki whakaora ko te okiokinga tika, te tautoko i ngā hoa mahi, te tuku tohutohu ina hiahiatia, me te whakangungu tonu pēnei i te whakatauira waehere kikorangi, te whakangungu triage, me te whakawhitiwhiti kōrero mō ngā āhuatanga ohorere.
Whakamutunga
Ko te aro atu ki tētahi raruraru i roto i te mahi nēhi me whai i te huinga o ngā pūkenga haumanu, te whakawhitiwhiti kōrero whai hua, te mahi tahi, me te manawanui hinengaro. Ko ngā nēhi e kaha ana ki te mahi aromatawai tere, ki te whakarite i ngā wawaotanga whakaora ora, ki te mahi tahi me tā rātou tīma, ki te pupuri i te haumaru whaiaro, me te tuhi tika i ngā mahi, ka pai ake te rite ki te aro atu ki tētahi āhuatanga ohorere. Mā te whakangungu auau me te ahurea haumaru kaha, kāore e taea te whakahaere noa i ngā raruraru engari ka noho hei wāhi ako hei whakapai ake i te kounga o te tiaki nēhi ā muri ake nei.
