Amasu Okuphatha Imithi Emisipheni
Ukunikezwa kwemithi ngaphakathi kwemisipha kungenye yezinqubo zezokwelapha ezenziwa njalo ezindaweni zokunakekelwa kwempilo, kokubili ezibhedlela, ezikhungweni zezempilo zomphakathi, kanye nasezikhungweni ezizimele. Le ndlela ihilela ukufaka imithi ngqo ezicutshini zemisipha, okuvumela ukumuncwa okusheshayo kunokunikezwa ngaphansi kwesikhumba, kodwa ngokuvamile kuhamba kancane kunokunikezwa ngemithambo yegazi. Ngenxa yokuthi le nqubo iyahlasela futhi ingaba nezinkinga, abasebenzi bezempilo kudingeka baqonde izimiso, ukukhethwa kwezindawo zokujova, imishini efanele, indlela yokwelapha engasebenzisi amagciwane, kanye nokuxhumana okuhle kokwelapha.
Incazelo kanye nenhloso yokujova nge-intramuscular
Umjovo we-intramuscular uwukunikeza umuthi ngokufaka inalithi emisipheni ngokujula okuthile. Umgomo uwukufeza ukumuncwa kwemithi okusheshayo nokuzinzile, ikakhulukazi emithini engakwazi ukunikezwa ngomlomo (isb., ngenxa yokuhlanza, ukumuncwa okuphazamisekile, noma isidingo sokuqala ngokushesha kwesenzo). Ngaphezu kwalokho, indlela ye-IM ivame ukusetshenziselwa imijovo, ama-antibiotic athile, ama-analgesics, ama-antiemetics, amavithamini, kanye nemithi ye-depot (ekhishwa kancane) eyenzelwe ukuhlala esicutshini semisipha isikhathi eside.
Izinkomba kanye nokuphikisana
Izinkomba ezijwayelekile zomjovo we-IM zifaka: isidingo somphumela osheshayo, umthamo omncane wemithi, umuthi ofanele izicubu zemisipha, kanye nezimo zeziguli ezivimbela ukunikezwa ngomlomo. Kodwa-ke, kuneziphazamiso okufanele zicatshangelwe, njengezinkinga zokujiya kwegazi (i-hemophilia, i-thrombocytopenia enzima, noma ukusetshenziswa kwama-anticoagulants), ukutheleleka noma ukuvuvukala endaweni yomjovo, ukushaqeka okukhulu/ukuncipha komswakama okunganciphisa ukumuncwa, kanye nokungezwani komzimba nezingxenye zemithi.
Ezigulini ezinemisipha emincane kakhulu (isib., abantu asebekhulile abancane kakhulu, abangondlekile kahle, noma izimo ezithile zemisipha), kufanele kuqashelwe kakhulu ekukhetheni indawo kanye nosayizi wenaliti. Ezinsaneni nasezinganeni, indawo kanye nomthamo wemithi kufanele kulungiswe ngokuya ngeminyaka kanye nokukhula kwemisipha.
Ukulungiselela ngaphambi kwesenzo
Impumelelo yomjovo we-intramuscular ayinqunywa nje kuphela ngobuchwepheshe obuqondile kodwa nangokulungiselela okuhlelekile. Isinyathelo sokuqala ukuqinisekisa ukunemba kokunikezwa kwemithi: isiguli esifanele, umuthi ofanele, umthamo ofanele, isikhathi esifanele, umzila ofanele, kanye nemibhalo efanele. Uma kutholakala, sebenzisa izihlonzi ezimbili (isib. igama nosuku lokuzalwa) ukuqinisekisa ukuthi isiguli esifanele sinikezwa.
Okulandelayo, yenza ukuhlolwa okufushane: umlando wokungezwani komzimba, isimo sesikhumba endaweni yokujova, isimo sokujiya (uma kufanele), kanye nezinga lokukhathazeka noma ubuhlungu. Chaza inqubo kafushane nangokucacile, kufaka phakathi noma yimiphi imizwa engaba khona, bese uthola imvume yesiguli. Ukuxhumana okuhle kunganciphisa ukucindezeleka kwemisipha, kwenze umjovo ube mnandi futhi kunciphise ingozi yobuhlungu.
Amathuluzi nezinto ezidingekayo
Imishini evame ukusetshenziswa ihlanganisa isirinji, inaliti enobukhulu obufanele (ubude negeyiji), ama-alcohol swab noma ama-antiseptic, amagilavu ahlanzekile, amabhandeji uma kudingeka, kanye nesitsha sokucija (ibhokisi lokuphepha/isitsha sokucija) sokulahla inaliti. Ukukhethwa kwenaliti kuthonywa ubudala, usayizi womzimba, indawo yokucija, kanye nokuqina komuthi. Imithi ejiyile ngokuvamile idinga inaliti enobubanzi obukhulu ukuze ijojwe kahle.
Isimiso esibalulekile ukugcina inqubo yokungasebenzi kahle kwegciwane: geza izandla zakho ngokwezindinganiso, gqoka amagilavu, uhlanze isikhumba nge-antiseptic, futhi ugweme ukuthinta ingxenye yenaliti engenamagciwane.
Ukukhethwa kwendawo yokujova nge-intramuscular
Ukukhetha indawo yokujova kubalulekile ekuvimbeleni ukulimala kwemithambo yegazi kanye nemithambo yegazi kanye nokuqinisekisa ukuthi umuthi ungena emisipheni.
1. I-Ventrogluteal (gluteus medius/minimus)
Ngokuvamile inconywa njengendawo ephephile ngoba ikude ne-sciatic nerve kanye nemithambo yegazi emikhulu, futhi inesendlalelo samafutha angaphansi kwesikhumba esincane kakhulu kunesifunda se-dorsogluteal. Ifanele abantu abadala nezingane ezindala, futhi ingaphatha amavolumu amakhulu.
2. I-Vastus lateralis (ithanga eliseceleni)
Lena indawo ekhethwa kakhulu yizinsana nezingane ezincane ngoba imisipha yazo ikhule kakhulu futhi ingozi yokulimala kwemizwa iphansi. Kwabantu abadala, le ndawo ingasetshenziswa futhi, ikakhulukazi uma indawo ye-gluteal ingafaneleki. Indawo evamile iyingxenye yesithathu ephakathi yethanga langaphandle.
3. I-Deltoid (ingalo engenhla)
Ngokuvamile isetshenziselwa imijovo noma imijovo emincane. Inzuzo ukuthi kulula ukuyifinyelela, kodwa ingozi yokushaya izakhiwo ezizungeze ihlombe iphakeme uma indawo yomjovo ingakabekwa kahle. Ngenxa yokuthi imisipha ye-deltoid incane, umthamo womjovo uvame ukulinganiselwa.
4. I-Dorsogluteal (gluteus maximus)
Le ndawo ibilokhu isetshenziswa ngokwesiko, kodwa iziqondiso eziningi zanamuhla zisebenzisa ukuqapha okukhulu ngenxa yengozi yokulimala kwemizwa ye-sciatic kanye nokushintshashintsha kokwakheka kwemithambo yegazi. Uma isetshenziswa, ukunqunywa okunembile kwe-quadrant yangaphandle engaphezulu kubalulekile.
Izinyathelo zokwenza umjovo we-intramuscular
Ngokuvamile, inqubo yokujova nge-IM ilandela lolu chungechunge:
1. Geza izandla zakho bese ulungisa umuthi
Zijwayeze ukuhlanzeka kwezandla. Lungisa imithi ngokwesilinganiso, hlola usuku lokuphelelwa yisikhathi kanye nokucaca/ubuqotho bomuthi. Uma umuthi usebhodleleni/e-ampule, sebenzisa indlela efanele ukunciphisa ukungcola nokuvimbela ukulimala.
2. Beka isiguli endaweni yaso
Indawo okufanele ivumele imisipha ukuthi iphumule. Kumsipha we-ventrogluteal, isiguli singalala ngohlangothi lwaso amadolo egobile kancane. Kumsipha we-vastus lateralis, isiguli singalala silele. Kumsipha we-deltoid, isiguli singahlala izingalo zikhululekile.
3. Khomba indawo okujovwe kuyo
Thola indawo yomjovo ngokwesimo somzimba. Qinisekisa ukuthi indawo ayinamanxeba, imihuzuko, ukubomvu, noma izimpawu zokutheleleka.
4. Isibulali-magciwane sesikhumba
Hlanza isikhumba nge-alcohol/antiseptic swab ngendlela ejikelezayo kusukela maphakathi kuya emngceleni. Vumela ukuthi kome ukuze uthole umphumela omuhle kakhulu we-antiseptic nokunciphisa ukuhlaba.
5. Faka inaliti nge-engeli engama-degree angu-90.
Bamba i-syringe njengokuphatha ipensela noma i-dart, bese ufaka inaliti ngokushesha nangokuqinile nge-engeli engama-degree angu-90 ebusweni besikhumba ukuze ufinyelele izicubu zemisipha.
6. Ukuzinza kanye nokufakwa kancane komuthi
Uma inaliti isifakiwe, qinisa isirinji ukuze ingashukumi. Jova umuthi kancane kancane ukuze unciphise ubuhlungu futhi usize ukusabalalisa umuthi kuyo yonke imisipha.
7. Khipha inaliti bese ucindezela
Khipha inaliti nge-engeli efanayo nokufakwa. Cindezela indawo yokujova nge-gauze ehlanzekile noma uboya bekotini. Gwema ukubhucungwa ngamandla, ikakhulukazi ngemithi ethile (njengeminye imijovo noma imithi ecasulayo), njengoba lokhu kungandisa ubuhlungu noma kubangele ukuthi imithi isakazeke ezicutshini ezingaphansi kwesikhumba.
8. Lahla izinaliti ngokuphephile futhi zibhalwe phansi
Ungaphindi ufake inaliti ngaphandle kokuthi kulandelwe iziqondiso zokuphepha ezithile. Yilahle ngokushesha ebhokisini lokuphepha. Bhala phansi uhlobo lomuthi, umthamo, indlela, indawo, isikhathi sokusetshenziswa, kanye nempendulo yesiguli.
Indlela ye-Z-track kanye nokuvimbela ukuvuza kwezidakamizwa
Ngemithi ecasulayo noma ebeka engcupheni yokushintsha umbala wesikhumba, inqubo ye-Z-track ingacatshangelwa. Lo mgomo uhilela ukuhambisa isikhumba kanye nezicubu ezingaphansi kwesikhumba eceleni ngaphambi kokufaka inaliti. Ngemva kokuba umuthi ujovwe futhi inaliti ikhishwe, isikhumba siyakhululwa ukuze kudalwe indlela yokujova enobume buka-Z. Le ndlela isiza ukuvimbela ukuvuza kwemithi ezicutshini ezingaphansi kwesikhumba futhi inciphise ukucasuka.
Izinkinga ezingaba khona
Ezinye izinkinga zomjovo we-IM zifaka phakathi ubuhlungu bendawo nokuvuvukala, i-hematoma, ithumba elibangelwa ukutheleleka, ukusabela kokungezwani komzimba, ukulimala kwemizwa, kanye nokufakwa ngengozi emthanjeni wegazi (noma ngabe indlela ye-IM iqondiswe emisipheni). Ukuvimbela okungcono ukukhetha indawo efanele, i-asepsis eqinile, inaliti enobukhulu obufanele, kanye nendlela efanele yomjovo. Ukuqashelwa kwesiguli ngemva kokuphathwa nakho kubalulekile, ikakhulukazi emithini engaba nokusabela kokungezwani komzimba.
I-Penutup
Ukunikezwa kwemithi esicutshini kuyikhono eliyisisekelo kodwa elibalulekile ekusebenzeni kwezokwelapha. Ukuhlonza isiguli kanye nemithi ngendlela efanele, ukukhetha indawo ephephile yomjovo, ukusetshenziswa kwemishini efanele, kanye nokunamathela ezimisweni ze-aseptic kuyisisekelo esibalulekile sokunciphisa izinkinga nokuthuthukisa induduzo yesiguli. Ngokuqeqeshwa okuhlelekile kanye nokunamathela ezinqubweni zokusebenza ezijwayelekile, imijovo ye-intramuscular ingenziwa ngokuphepha, ngempumelelo, nangobungcweti, ngesikhathi esifanayo isekela ikhwalithi ethuthukisiwe yezinsizakalo zezempilo.
