Mishonga Inodhaka Nemishonga Yepfungwa Muzvipatara
Mishonga inodhaka nemishonga yepfungwa imhando dzakakosha dzemishonga muhutano hwemazuva ano, kunyanya muzvipatara. Yose ine mabhenefiti akakosha mukurapa, anosanganisira kurapa marwadzo akakomba, pfari, matambudziko ekuzvidya mwoyo, uye kunyange kupa mushonga wekurwadziwa panguva yekuvhiyiwa. Zvisinei, nekuda kwekugona kwayo kuvimba nemishonga, kushungurudzwa, uye migumisiro yakakomba, kushandiswa kwayo, kuchengetwa, uye kurekodhwa muzvipatara kunofanirwa kutariswa zvakanyanya uye zvichienderana nemitemo inoshanda.
Kunzwisisana kwakazara uye kusiyana
Kazhinji, mishonga inodhaka mishonga inoshanda zvakanyanya patsinga dzemuviri, zvichikonzera kudzikira kwekuziva, kuderedza marwadzo, uye mukana wekuvimba nezvinodhaka. Muchipatara, mishonga inodhaka inowanzo shandiswa semishonga inonyaradza marwadzo kana sechikamu cheanesthesia. Panguva imwecheteyo, mishonga inodhaka yepfungwa mishonga inokanganisawo tsinga dzemuviri, asi inonyanya kusanganiswa nekuchinja kwemaitiro epfungwa nemaitiro, akadai sekunyaradza, kudzivirira kuzvidya mwoyo, kurwisa psychotic, kana mhedzisiro inosimudzira pfungwa. Mishonga inodhaka yepfungwa inewo njodzi yekushungurudzwa uye inogona kutungamira mukuvimba nezvinodhaka, kunyangwe mhedzisiro yayo yakasiyana neyemishonga inodhaka.
Musiyano mukuru pakati pezviviri izvi unoonekwa muzviratidzo zvavo zvikuru zvekurapa: zvinodhaka zvinowanzo shandiswa pakurwadziwa, nepo zvinodhaka zvepfungwa zvichiwanzo shandiswa pazvirwere zvepfungwa, matambudziko ekurara, kunyaradza, kana mamwe mamiriro etsinga. Zvisinei, muzvipatara, mapoka maviri aya emishonga anowanzo shandiswawo pakurapa chirwere chekurwadziwa, kutarisirwa kwakanyanya, uye pakurapa zvirwere zvakakomba.
Mabasa ekurapa muzvipatara
Pachipatara, mishonga inodhaka nemishonga yepfungwa inoita basa rakakura. Semuenzaniso, muvarwere vanovhiyiwa mushure mekuvhiyiwa, kurwadziwa kuri pakati nepakati kusvika kwakanyanya kunowanzoda mishonga inodhaka inonyaradza marwadzo kuti ivabatsire kufema zviri nani, kufamba nekukurumidza, uye kuderedza kushushikana kwemuviri. Muvarwere vanokuvara, kurwadziwa kwakanyanya kunokonzerwa nekukuvara kunogona kukanganisa kugadzikana kweropa, zvichiita kuti kupa mishonga zvinobudirira kuve chikamu chakakosha chekutarisira kunoponesa hupenyu.
Mukurapa kweanesthesia, mishonga yemishonga inodhaka neyepfungwa inowanzo shandiswa sechikamu chemaitiro eanesthesia, kunyaradza, kana kunyaradza varwere vanoda kufefetera kwemuchina muchikamu chevarwere vanorwara zvakanyanya (ICU). Uyezve, muchikamu chekukurumidzira, mimwe mishonga inoshandiswa kurapa kusagadzikana kwakanyanya, kuvhiringidzika kwepfungwa, kana kuvhunduka kunotyisidzira kuchengetedzeka kwevarwere nevashandi.
Zvisinei, mabhenefiti aya akakosha anofanira kugara achiongororwa nokungwarira. Chipimo, nzira yekushandiswa kwemushonga, nguva yekurapwa, uye kunyange zvimwe zvirwere zvinosangana nemurwere (semuenzaniso, matambudziko ekufema, matambudziko echiropa, kana nhoroondo yekushandisa zvinodhaka zvisina kunaka) zvinhu zvakakosha pakusarudza mushonga wekiriniki.
Mienzaniso yekushandiswa uye zviratidzo
Mimwe mishonga inowanzoshandiswa muzvipatara (zvichienderana nemitemo yemushonga uye mitemo yemuno) inosanganisira morphine, fentanyl, pethidine, uye oxycodone. Zviratidzo zvikuru zvemishonga iyi kurwadziwa kwakanyanya, kenza, kurwadziwa mushure mekuvhiyiwa, uye semushonga unobatsira pakurwadziwa.
Panguva imwecheteyo, mishonga yepfungwa inowanikwa kakawanda muzvipatara inosanganisira benzodiazepines (semuenzaniso, diazepam kana midazolam) yekuderedza kushushikana, kuzvidya mwoyo, uye kurwisa pfari; pamwe nemimwe mishonga inogona kushandiswa pazvirwere zvepfungwa, kusagadzikana, kana mamiriro chaiwo sezvinodiwa nekiriniki. Semuenzaniso, kune varwere vane pfari kwenguva refu, benzodiazepines inogona kuva mushonga wekutanga wakakosha.
Mukushandiswa kwese uku, nheyo huru ndedzekuratidza kwakarurama, murwere akakodzera, mushonga wakarurama, dose rakakodzera, uye kutarisa kwakarurama. Zvikanganiso mune chero ipi zvayo yenzvimbo idzi zvinogona kukonzera kuora mwoyo kwekufema, kusaziva zvakanaka, matambudziko emwoyo, uye kunyange rufu—kunyanya kana mushonga wacho ukatorwa pasina kutarisa kwakakodzera.
Njodzi nemigumisiro yekufungidzira
Mishonga inodhaka inogona kukonzera migumisiro yakaipa yakadai sekuda kurutsa, kuvimbiwa, kuvaviwa, kuchengetwa kweweti, uye, zvakanyanya kuipa, kuora mwoyo kwekufema. Njodzi inowedzera muvarwere vakwegura, avo vane chirwere chemapapu chisingaperi, matambudziko ekurara akadai sesleep apnea, kana kana mishonga inodhaka ikasanganiswa nemimwe mishonga inonyaradza.
Mishonga yepfungwa, kunyanya mishonga inonyaradza uye inonyaradza uropi, inogona kukonzera hope dzakanyanya, kushaya simba rekushanda zvakanaka, kuvhiringidzika mupfungwa (kunyanya kune vakwegura), kutsamira pamishonga, uye njodzi yekudonha. Kushandiswa kwemishonga iyi kuvarwere vane chiropa chisina kushanda zvakanaka kana kuti itsvo kunoda kungwarira zvakanyanya sezvo kunogona kuwedzera nguva yekushanda kwemushonga uyu.
Kunze kwemigumisiro yekurapa, imwe njodzi yakakura zvakafanana ndeyekudzoreredza mishonga (kudzoreredza mishonga kuti isashandiswe zvisina kunaka), izvo zvinogona kuitika munzvimbo dzehutano uko masisitimu ekuchengetedza asina kusimba. Nokudaro, zvipatara zvinowanzoita matanho akaomarara emishonga iyi.
Kutarisira nzvimbo dzemishonga muzvipatara
Kutarisira mishonga inodhaka nemishonga inodhaka muzvipatara kunowanzova basa reChipatara cheMishonga (IFRS), pamwe chete nezvikamu zvebasa (ER, wadhi, unit yevanorwara zvakanyanya, wadhi, nezvimwewo). Kutarisira kunosanganisira kuronga zvinodiwa, kutenga, kugamuchira, kuchengeta, kugovera, kushandisa, uye kuparadzwa kwemishonga yapera kana yakakuvara.
1. Kuronga nekutenga
Zvipatara zvinoronga zvinodiwa zvichienderana nemaitiro ezvirwere, huwandu hwevarwere, mashandisirwo azvo, uye kuwanikwa kwemamwe marapirwo. Kutenga kunoitwa nenzira dzepamutemo kuti zvive nechokwadi chekuti mhando uye zviri pamutemo.
2. Kuchengetera
Mishonga inodhaka nezvinhu zvinokanganisa pfungwa zvinofanirwa kuchengetwa munzvimbo dzakakiyiwa dzine mukana wakaganhurirwa, kazhinji uchishandisa makabati akakosha kana makamuri ekuchengetera zvinhu ane ma control ane ma double-locked controls. Mune zvimwe zvipatara, mamwe makamuri anoshandisa "ma controlled drug cabinet" kana mamwe masisitimu ekuchengetedza.
3. Kugovera
Kuendesa mushonga kubva kupharmacy kuenda kuchipatara kunoitwa zvichienderana nemaitiro akanyorwa, kazhinji pamwe chete negwaro rekukumbira uye humbowo hwekuti wasvika. Izvi zvinoita kuti huwandu hwemushonga hwakanyorwa uye hutevedzerwe.
4. Kurekodha uye kushuma
Chimwe chezvinhu zvinonyanya kukosha pakugadzirisa mishonga iyi ndechekuchengetedza zvinyorwa zvakasimba: huwandu hwemishonga yakagamuchirwa uye yakapihwa, huwandu hwese hwemushonga, kuzivikanwa kwemurwere, chiremba anorayira mishonga, uye vashandi vakapa mishonga uye vakagamuchira. Ongororo dzemukati dzinoitwa nguva nenguva kuti vaone kusawirirana kwemushonga.
5. Kuparadzwa
Mishonga yakakuvara kana kuti yapera haigone kuraswa zvisina hanya. Maitiro ekuparadzwa anowanzoda mushumo, zvapupu, uye kutevedzera mitemo yepamutemo.
Maitiro ekunyora mishonga yakachengeteka uye kuburitsa mishonga
Kuti zvive nechokwadi chekuti mishonga inodhaka nemishonga inorwisa pfungwa yakachengeteka, kunyora mishonga inodhaka nemishonga inorwisa pfungwa muzvipatara kunofanirwa kutevedzera nhungamiro dzekurapa uye mwero wekutarisira. Vanachiremba vanonyora mishonga zvichibva pane zviratidzo, vanofunga nezvezvisingabvumirwi, kupindirana kwemishonga, uye vanogadza zvinangwa zvekurapa (semuenzaniso, chiyero chekurwadziwa kwemishonga). Varapi vemishonga vanoongorora mishonga kuti vave nechokwadi chekuti mushonga wacho wakakodzera, fomu remushonga, nzira yekupa mishonga, uye kupindirana kunogona kuitika.
Vanamukoti, sevatariri vekupa mishonga, vanoita basa rakakosha pakuona kuti "murwere akakodzera, mushonga wakakodzera, dose rakakodzera, nguva yakakodzera, nzira chaiyo, uye magwaro akakodzera." Kutarisirwa kwemurwere mushure mekupiwa mushonga kwakakosha, kunyanya kune varwere vane njodzi huru kana kuti vane migumisiro yakaipa yakadai sekudzikira kwekufema kana kudzikira kwekuziva, chiito nekukurumidza uye nzira inoshanda yekutumira varwere kuchipatara zvakakosha.
Kudzivirira kushungurudzwa uye tsika dzekuchengetedza
Kudzivirira kushandiswa zvisina kunaka hakusi kungovhara kabhineti chete, asiwo tsika yekuchengetedzeka kwevarwere uye kuvimbika kwehurongwa. Zvipatara zvinofanirwa kuita kudzidziswa kwevashandi vehutano nguva dzose, kuongororwa kwezviwanikwa nekushandiswa, tsika yekushuma zviitiko pasina mhosva, uye masisitimu anoderedza mikana yekushandiswa kwedata. Kushandisa zvinyorwa zvekurapa zvemagetsi uye masisitimu emishonga akabatanidzwa kunobatsirawo kutevedzera mashandisirwo emishonga nemazvo.
Kune murwere, dzidzo inokoshawo. Varwere nemhuri dzavo vanofanira kunzwisisa kuti mushonga uyu unoshandiswa pakurapa pasi pemitemo yakaoma, haufanirwe kugoverwa, uye vanofanira kuzivisa nyanzvi dzehutano nezve allergies, matambudziko ekufema, kana kushandiswa kwemimwe mishonga inogona kukanganisa hutano.
Penutup
Mishonga inodhaka uye inorapa pfungwa zvinhu zvakakosha pakuchengetwa kwechipatara—kubatsira varwere kubata marwadzo akakomba, pfari, uye kuzvidya mwoyo kwakanyanya, pamwe nekutsigira anesthesia nekurapwa kwakanyanya. Pasinei nemabhenefiti ayo, kune njodzi huru dzemigumisiro yakakomba uye mukana wekushungurudzwa, saka manejimendi ayo anofanira kutevedzera misimboti yekudzivirira, mitemo, uye mitemo yakasimba yebasa. Nekuronga kwakakodzera, kuchengetwa kwakachengeteka, kuchengetwa kwezvinyorwa kwakarurama, uye kushanda pamwe chete pakati pevanachiremba, varapi vemishonga, uye vanamukoti, zvipatara zvinogona kuona kushandiswa kwakakodzera, kwakachengeteka, uye kune mutoro kwemishonga iyi kuchengetedza varwere nenharaunda.
