Maitiro Ekutanga Anesthetic Monitoring

Komiti Yekutanga: Maitiro uye Maparamendi Ekudzidzira (Yakagamuchirwa neASA House yeVamiriri muna Gumiguru 21, 1986, yekupedzisira yakagadziriswa muna Gumiguru 20, 2010, uye yekupedzisira yakasimbiswa musi waGumiguru 28, 2015)

Aya matanho anoshanda kune ese anesthesia kutarisirwa kunyangwe, mumamiriro ekukurumidzira, matanho akakodzera ehupenyu anotsigira. Aya matanho anogona kupfuurwa chero nguva zvichibva pakutongwa kweanotarisira chiremba anoona nezvebasa. Izvo zvakagadzirirwa kukurudzira hutano hwakanaka hwevarwere, asi kuzvichengeta hakugone kuvimbisa chero mhedzisiro yemurwere. Ivo vari pasi pekudzokororwa nguva nenguva, sekuvimbiswa nekushanduka kwetekinoroji uye maitiro. Ivo vanoshanda kune vese general anesthetics, enharaunda anesthetics uye kuongororwa kweanesthesia kuchengetwa. Iyi seti yematanho inongotaura chete nyaya yeiyo yekutanga anesthetic yekutarisa, inova chimwe chinhu cheanesthesia kuchengetedza. Mune mamwe mamiriro asingawanzoitika kana asina kujairika, 1) dzimwe dzenzira dzekutarisa dzinogona kunge dzisingashande kuchipatara, uye 2) kushandiswa kwakakodzera kwenzira dzakarondedzerwa dzekutarisa dzinogona kutadza kuona zvinoitika pakiriniki. Kukanganiswa kushoma kwekuenderera-kutarisisa kunogona kunge kusingadzivike. Aya madanho haana kuitirwa kunyorera kutarisiro kwemurwere anovharira pabasa kana mukuitisa kwekurwadziwa kwekutambudzika.

1. STANDARD I
Anokwanisa anesthesia vashandi vachave varimo mukamuri mukati mekutungamira kweese general anesthetics, enharaunda anesthetics uye kuongororwa kweanesthesia kuchengetwa.
1.1 Chinangwa -
Nekuda kwekukurumidza kuchinjika kwehutano hwevarwere panguva yeanesthesia, vashandi vanokwanisa anesthesia vacharamba varipo kuti vaongorore murwere uye vape kurapwa kweanesthesia. Muchiitiko apa pane yakanangana nenjodzi inozivikanwa, semuenzaniso, radiation, kune iyo anesthesia
vashandi vangangoda kutariswa kure kwemurwere, imwe nzira yekutarisa murwere inofanirwa kuitwa. Muchiitiko chekuti dambudziko rinoda kusavapo kwenguva pfupi kwemunhu anonyanya kukonzera kutindivadza, iyo
kutonga kwakanakisa kweanesthesiologist kuchashandiswa mukuenzanisa emergency pamwe nemamiriro emurwere asingatendeseki uye mukusarudzwa kwemunhu akasiyiwa ane chekuita neanesthetic panguva yekushaikwa kwechinguva.

2. STANDARD II
Munguva yese yeanesthetics, oxygenation yemurwere, kufefetedza mweya, kutenderera uye tembiricha zvinoramba zvichiongororwa.
2.1 Oxygenation -
2.1.1 Chinangwa -
Kuchengetedza kukwana kwakaringana kweokisijeni mune yakafemerwa gasi uye neropa panguva yese yeanesthetics.
2.2 Maitiro -
2.2.1 Gasi rakafemerwa: Panguva yega yega yekutonga kweanesthesia muchina, iko kukosheswa kwemhepo mumhepo yekufema murwere kunoyerwa neyekuongorora okisijeni ine alarm yekumisikidza yakadzika iri kushandiswa. *
2.2.2 Ropa oxygenation: Munguva yese yeanesthetics, nzira yekuyera yekuongorora oxygenation senge pulse oximetry ichashandiswa. * Kana oximeter yekupomba yashandiswa, iyo inowirirana pombi yekupururudza toni uye yakadzika chikumbaridzo alarm inonzwika kune anesthesiologist kana iyo anesthesia care timu yevashandi. * Kujekesa kwakakwana uye kuratidzwa kwemurwere kunokosha kuti uongorore ruvara. *

3.VHIDHENDA
3.1 Chinangwa - Kuona kufefetera kwakaringana kwemurwere panguva dzese dzeanesthetics.
3.2 Nzira -
3.2.1 Murwere wese anowana anesthesia yakajairika anowana kukwana kwemhepo yekufema inoramba ichiongororwa. Unyanzvi hwekiriniki zviratidzo senge chipfuva kushanya, kucherechedzwa kwedziva rekufema bhegi uye kusimudzira mweya wekufema kunobatsira. Kuenderera mberi uchiongorora kuvapo kweakapera kabhoni dhayokisaidhi ichaitwa kunze kwekunge isina kusimbiswa nemhando yemurwere, maitiro kana michina.
Kuongororwa kwehuwandu hwehoriyamu yegasi rapera kunokurudzirwa zvakanyanya. *
3.2.2 Kana pakaiswa endotracheal tube kana laryngeal mask, kumira kwayo kwakakodzera kunofanirwa kusimbiswa nekiriniki yekuongorora uye nekuzivikanwa kwekabhoni dhayokisaidhi mune mweya wapera. Kuenderera mberi kwekupedzisira-tidal kabhoni dioksidi ongororo, ichishandiswa kubva panguva yekupedzisira endotracheal chubhu / laryngeal masiki kuiswa, kusvikira kubviswa / kubviswa kana kutanga kuendesa kunzvimbo yekuchengetedza mushure mekuvhiya, ichaitwa uchishandisa nzira yakawandisa senge capnography, capnometry kana mass spectroscopy. *
Kana capnography kana capnometry ikashandiswa, yekupedzisira tidal CO2 alarm inonzwika kune anesthesiologist kana anesthesia care timu yevashandi. *
3.2.3 Kana kufefetedza kwemhepo kuchidzorwa nemuchina wekufema, pachave nekuenderera mberi kwekushandisa chishandiso chinokwanisa kuona kubviswa kwezvikamu zvefemhu system. Chigadzirwa chinofanira kupa chiratidzo chinonzwika kana alarm yacho yapfuura.
3.2.4 Munguva yedunhu anesthesia (isina kunyaradza) kana yeinesthesia yemuno (isina kunyaradza), kukwana kwemhepo yekufema kunozotariswa nekuenderera mberi kwekutarisa kweakakodzera makiriniki zviratidzo. Munguva yepakati kana yakadzika sedation kukwana kwemweya wekufema kunozotariswa nekuenderera mberi kwekutarisa kweakakodzera makiriniki zviratidzo uye kuongorora kwekuti kune mweya mweya carbon kunze kwekudzivirirwa kana kusadzikiswa nehunhu hwemurwere, maitiro, kana michina.

4. KUTenderera
4.1 Chinangwa - Kuona kukwana kweropa rekutenderera kweropa panguva yese yeanesthetics.
4.2 Nzira -
4.2.1 Murwere wese anowana anesthesia anofanirwa kuve neiyo electrocardiogram inoramba ichiratidzwa kubva pakutanga kweanesthesia kudzamara agadzirira kubva panzvimbo inovhenekesa. *
4.2.2 Murwere wese anowana kutindivadza anove neropa rekumanikidza uye kurova kwemoyo kwakatemwa nekuongororwa kanenge maminetsi mashanu. *
4.2.3 Murwere wese anogamuchira anesthesia anowanzove, kuwedzera pane zvataurwa pamusoro apa, basa rekutenderera rinoramba richiongororwa nechimwe chete chezvinotevera: kurova kwekupomba, kusimudzira kurira kwemoyo, kuongorora kwekutsvaga kwemukati mekumanikidza, ultrasound peripheral kupomba kwekutarisa, kana kupomba
plethysmography kana oximetry.

5. KUPENYA KWEMuviri
5.1 Chinangwa - Kubatsira mukuchengetedza tembiricha yemuviri yakakodzera panguva yese yeanesthetics.
5.2 Maitiro - Murwere wese anowana anesthesia anozotariswa netembiricha kana kiriniki inoshanduka mukushisa kwemuviri kunoitirwa, kutarisirwa kana kufungidzirwa.
Cherekedza kuti "kuenderera mberi" kunotsanangurwa se "kudzokororwa nguva zhinji uye kazhinji mukuteedzana nekukasira" asi "kuenderera" kunoreva "kureba pasina kukanganiswa chero nguva."
* Pasi pemamiriro ezvinhu anowedzera, anesthesiologist ane mutoro anogona kuregedza zvinodiwa zvakatemwa neasterisk (*); zvinokurudzirwa kuti kana izvi zvaitwa, zvinofanirwa kutaurwa (kusanganisira zvikonzero) mutsamba mune rekodhi rekurapa kwemurwere.

 


Post nguva: 27-07-21