Whakaora hou: tohu, momo, ngā wāhanga, ngā rongoā

E ai ki ngā tatauranga, te tekau o nga hou whakarato tiaki hauora i roto i te ruma tuku, a ka he 1% o whanau katoa i roto i te hiahia o te ki tonu te whānuitanga o CPR. Ko te taumata tiketike o te whakangungu o ngā kaimahi hauora e taea te whakanui ake i te tūponotanga o te ora, me te whakaiti i pōauautanga taea. whakaora rawaka me te wā tika o te hou - te taahiraa tuatahi ki te whakaiti i te maha o ngā matenga, me te whanaketanga mate.

ariā taketake

He aha te mea whakaora fā'ele'i? Tenei raupapa o mehua e hāngai ana ki te whakaora i te tinana o te tamaiti, me te whakahokinga mai o nga mahi ngaro. Kei roto te reira i:

• whakaora manawa;
• tikanga o te whāomo;
• whakamahi o te ventilation aunoa;
• pacemaker me ētahi atu tāutanga.

e kore e kohungahunga wā-Full rapua e mehua whakaora. E whanau ratou kaha, hamama, he pini, me te auau ngakau e noa, te kiri he tae māwhero, urupare pai te tamaiti ki akiaki waho. E whakanohoia tonu ēnei tamariki i runga i puku, me te piringa mahana o te whaea, kope maroke. Respiratory tirotiro hā mucous ki te whakahokia mai ratou patency.

A amo ana i roto i whakaora manawa te whakaaro reira āwhina whawhati tata. Kei te tū te reira i roto i te take o te mutunga o te manawa, me te mahi ngakau. I muri i te wawaotanga taua i roto i te hui o te hua pai, te tono nga taketake o te tiaki kaha. hāngai taua maimoatanga te i whakakore pōauautanga taea tu nga whekau faufaa.

Ki te kore e taea e te manawanui te pupuri takitahi homeostasis, te whakaora o te hou ngā ventilation aunoa (ALV) ranei te whakanoho te pacemaker.

He aha te hiahiatia mō te whakaora i roto i te ruma tuku?

Ki te he iti te hiahia mo te kai o taua ngā, e hiahia ana koe ki te kawe ia ratou i te taha o te tangata kotahi. I roto i te take o te hapūtanga nui me ngā tūmanako o te tonu ngā o CPR i roto i te tuku e rua tohunga.

titau whakaora o te hou i roto i te ruma tuku faaineineraa tupato. I mua i te tukanga o te whanau, tirohia te wātea o tika katoa, ka kia te taputapu i roto i te mahi huru.

1. Me koe ki te hono i te pūtake wera ki te tepu whakaora me taipa i mahana, he pukapuka kope i roto i te puka o te takai.
2. Tirohia mehemea kei te tika tāuta te pūnaha supply hāora. Me waiho te nui rawaka o te hāora ki te whakarite tika i te pēhanga, me te rere auau.
3. He mea tika ki te tirohia i te hihiko o te taputapu e hiahiatia ana e te mo te tangohanga o te tirotiro wahi romahā.
4. A faaineine i taputapu mō te tango o tirotiro pekitīlia i roto i te hui o te wawata (uiuia ai, pūwero, kutikuti, whakatika rauemi), meconium aspirator.
5. Whakapaia ka tirohia i te tapatahi o te putea me te kanohi whakaora me te intubation Kit.

Tautuhi mō intubation ngā o korere endotracheal ki te conductors, me rerekē matatahi laryngoscope me pūhiko e manawapa, kutikuti me karapu.

He aha te mea te angitu o te mehua?

hāngai whakaora fā'ele'i i roto i te ruma tuku kei runga i te mau parau tumu e whai ake mō te angitu:

• wātea o ngā kapa tiaki kaha - i runga i te tini katoa kia whakaora hakari;
• mahi ruruku - kia mahi kapa harmoniously oti ia atu rite tetahi tikanga nui;
• kaimahi whai tohu - kia whai i te taumata tiketike o te matauranga, me ngā pūkenga mahi ia whakaora;
• mahi, tango ki pūkete tauhohenga o te manawanui - kia timata tonu CPR ki te ahua o to ratou hiahia, e kawea atu mehua waho, i runga i te whakautu o te tinana o te manawanui rānei;
• kia riro ei tautururaa me te wātea i tetahi wa taputapu mō te whakaora - ngaue'aki o taputapu.

Ko te take mo te hiahia mo te mahi

Na roto i te āhuatanga etiological o tukino o te ngakau, pūkahukahu, me te tahi atu whekau faufaa o te hou ngā te whanaketanga o te asphyxia, injuries whanau, te whanaketanga o abnormalities congenital, toxemia takenga hopuhopu, me te tahi atu take o te etiology unknown.

Ka taea te tohu whakaora fā'ele'i o ngā tamariki, me te hiahia hoki reira ara i roto i te wā o te whanautanga tamariki. I roto i te take i taua, kia rite te rōpū whakaora, ki te āwhina tonu i tō tamaiti.

Ko te akiaki o taua ngā taea puta i raro i nga tikanga e whai ake nei:

• orua oligohydramnios ranei;
• perenashivanie;
• mate huka whaea;
• takawhita;
• mate hopuhopu;
• pohokore fetal.

Ano, i reira e rave rahi ngā āhuatanga e kua whakatika kua i roto i whanau. I roto i te take o to ratou tupu e taea te tūmanakohia ki hiahia whakaora. ngā taua āhuatanga bradycardia i te tamaiti, he wāhanga whakawhānau, whanau taimi halá, me te tere, previa ranei abruption placental, uterine hypertonus.

asphyxia

Ko te whanaketanga o disorders romahā ki tukanga hypoxia ai te ahua o te tinana i disorders o te pūnaha circulatory, pūkoro tinana me te microcirculation. Next reira ko te mate o nga whatukuhu, ngakau, repe adrenal, roro.

titau Asphyxia wawaotanga tonu i roto i te tikanga ki te whakaiti i te taea o pōauautanga. Take o disorders romahā:

• hypoxia;
• airway takahi (wawata o toto, hūpē, meconium);
• organic whara roro me te mahi CNS;
• malformations;
• iti surfactant.

Me tātaritanga wawaotanga whakaora kawea i roto i muri aromatawai o te tamaiti Apgar.

whakatau tata e	0 ngā	1 wāhi	2 ngā
huru romahā	No	Pathological, pakū noa	Nui tangi, naki
HR	No	Iti iho i te 100 kapakapa ki te meneti	Neke atu i te 100 kapakapa ki te meneti
tae kiri	cyanosis	kiri Pink, waewae kikorangi	māwhero
Tūnga o te reo uaua	No	He paku piko wahi, te āhua o te ngoikore	kaupapa Hohe, oro pai
Ko te tauhohenga ki te āhuatanga ritenga	No	ngonge faaite	pai faaite

Aromatawai o te kāwanatanga ki runga ki te 3 ngā tohu te whanaketanga o asphyxia nui, i te 4 ki te 6 - asphyxia pakeke āhua. Whakaora o te asphyxia hou puta tonu i muri i te aro mātai o tona huru whānui.

Ko te raupapa o aromatawai te mana o

1. whakanohoia ana te tamaiti i raro i te pūtake wera, tona kiri maroke kope mahana. Mai i te kōhao nasal me te mangai ngote te tirotiro. Tū whakaongaonga tūturu.
2. Aromatawai te kupukupu tonu. I roto i te take o te manawataki noa, me te aroaro o nui karanga, puta ki te taahiraa i muri mai. A, no te pakū noa te kupukupu ventilation aunoa ki te hāora mō te 15-20 meneti.
3. He aro mātai o te auau ngakau. Ki te te auau ngakau i runga 100 kapakapa ki te meneti, neke ki te wā i muri mai o te tirohanga. I roto i te take o te auau ngakau i raro 100 ngā patu kawea ventilator. Na ka aromatawai i te whai huatanga o wawao.
   • Pulse i raro 60 - autaki mirimiri ngakau + ventilator.
   • He pini i 60 ki te 100 - ventilator.
   • Pulse i runga 100 - te ventilator roto i te take o te manawa kōhikohiko.
   • I muri i te 30 hēkona, te memeha noa o compressions pouaka ki ventilation, kia kawea therapy tarukino i roto i.
4. Tirotiro i te tae kiri. tae māwhero te tikanga te huru noa o te tamaiti. Ki te hiahia ki te hoatu te hāora, me te mau i te huru o te tamaiti cyanosis akrozianoz ranei.

Me pēhea te ki te kawe i roto i whakaora?

E hiahiatia ana horoia a tukinotia ki te ringa rongoā horoi, kakahu karapu horomata. Kei te whakaritea te whanau o te tamaiti, i muri i te mehua tika - tuhia. whakanohoia whanau hou i raro i te pūtake wera, he kope maroke mahana takaia.

Hei whakahoki i te airway, e taea te tuku iho te upoko mutunga, a whaowhina ana te tamaiti ki runga ki te taha ki maui. Tenei ka mutu te tukanga o te wawata, a ka tango i nga tirotiro o te mangai, me te ihu. Āta hā tirotiro, paitanga ki te aspirator whakataki hohonu.

Ki te kore enei mehua e te āwhina, tonu whakaora hou e tracheal suctioning te whakamahi i te laryngoscope. I muri i te ahua o te manawa, ko te ngaro o tona manawataki, kua whakawhitia te tamaiti ki te ventilator.

Kaha kōwae tiaki tamaiti hou e i muri i whakaora tuatahi mō te āwhina atu, me te tiaki o ngā mahi faufaa.

ventilation

kaupae whakaora fā'ele'i ngā whakahaere ventilation. Tuhinga mō te ventilation pupuri:

• ngaro o te manawa ahua romahā o nekehanga takiri ranei;
• he pini he iti iho i te 100 nga wa i te meneti, ahakoa o te kāwanatanga o manawa;
• cyanosis tamau i roto i te mahi noa o te pūnaha romahā me te Cardiovascular.

kawea ana tēnei huinga o ngā mahi i roto i te whakamahi i te kanohi ranei putea. tono upoko hou paku hoki me ka whiua hoki ki te kanohi mata te. mau ia koutou koromatua, me te maihao. Ko te tahi atu arata'i kauae o te tamaiti.

kia te kanohi i runga i te kauae, ihu me te waha. Kati te reira ki te hau i te pūkahukahu ki te auautanga o te 30 ki te 50 ngā wā mō te 1 meneti. Hā i roto i te putea e taea e meinga te rangi tomo te kōhao pekitīlia. Mai i reira ka taea e te tango koe i te reira te whakamahi i te ngongo puku.

Ki te aroturuki i te whai huatanga o te whakatinanatanga, he mea e tika ana ki te aro ki te ara o te pouaka me te huringa i roto i auau ngakau. tonu te tamaiti kitea tae noa oti tere ora o respiration me auau ngakau.

He aha a pehea ki te intubate?

whakaora fā'ele'i hoki ngā intubation o te pukorokoro, i roto i te take o te kore o te ventilation aunoa mo te 1 meneti. Ko te kōwhiringa tika mō te intubation ngongo - tetahi o nga ngā. Kei te hanga te reira i runga i te taimaha o te tamaiti, me te tau gestational rānei.

Kei te whakahaere ano Intubation i roto i te wā e whai ake nei:

• te hiahia ki te tango meconium hā i te pukorokoro;
• whakahaere ventilation tonu;
• ngä whāwhā whakaora;
• epinephrine;
• tino taimi halá.

I laryngoscopy ngā rama, me te tango i roto i te ringa maui. ringa matau, te pupuri upoko o te tamaiti. Kei te whakaurua e te mata ki te mangai, ka puritia ki te reo turanga. Ara te mata ki te kakau o te laryngoscope, kite whakaora te glottis. whakaurua ngongo Endotracheal te i te taha ki matau i roto i te kōhao-waha, me te te kawea i roto i te aho waiata i te wa o te whakatuwheratanga. Puta ana tēnei i runga i te faaururaa. tū ana te ngongo e tae noa te wāhi kua whakaritea.

nekehia Laryngoscope, ka - te pēne. Tika te takitaki te whakauru ngongo kōpeke te putea manawa. Air tomo nga pūkahukahu, me te ai he haerenga o te pouaka. Next, te hono i te pūnaha hāora supply.

compressions pouaka

Whakaora o te hou i roto i te ruma tuku Kei te raveraa i compressions pouaka, e pupuri ana o nei te whakaaturia i te tere ngakau iti iho i te 80 kapakapa ki te meneti.

E rua ara o compressions pouaka. Mā te whakamahi i te tuatahi, te pēhanga ki runga ki te pouaka i mahi te whakamahi i te taupū me te maihao waenganui o tetahi ringa. I roto i te tahi atu whakatinanatanga, kawea te mirimiri i roto i nga koromatua e rua, me te tahi atu maihao e whai wāhi i roto i te tuara tautoko. Resuscitator neonatolog-whakahaere te pēhi i waenganui i te waenganui, me te tuatoru o raro o te whaturei, proginalas ãpoko ki 1.5 cm whiu auau -. 90 min.

Me tika ki te whai i roto i te tikanga ki te manawa, me te kore e pēhi i runga i te pouaka kawea i roto i te wā kotahi. I roto i te okioki i waenganui i pressings, e kore koe e taea e te tango koutou ringa atu te mata o te whaturei. Pāwhiri i runga i te putea te mahi i muri i nga compressions toru. Hoki nga 2 hēkona he tika ki te pupuri 1 me 3 ventilation te pēhi.

Mahi ka contamination meconium o te wai

Āhuatanga ngā āwhina whakaora fā'ele'i mo poke o te meconium waikahu me te aromātai o Apgar kaute o iti iho i te 6 ngā o te tamaiti.

1. I roto i whakawhanau i muri i te ahua o te matenga o te awa whanau aspirating tonu nga tirotiro o te ihu, me te waha.
2. I muri i te whanautanga o te tamaiti, me te ruma mo te puna o te wera, i te aroaro o te manawa tuatahi, he reira e minaminatia ki te kawe i roto i intubation ngongo nui rahi taea ki te unu i te tirotiro o te pukorokoro me bronchi.
3. Ki te kore koe e taea e tango i te ihirangi, a kua reira he hawhekaihe o meconium, he mea e tika ana ki te reintubirovat tamarii fanau tetahi handset.
4. whakaritea Hā te muri anake kua ihirangi katoa i nekehia atu.

rongoā

hāngai whakaora fā'ele'i o ngā tamariki i runga i te whakahaere i ā wawaotanga pūmārō ranei e kore e anake, engari ano hoki i runga i te whakamahi o te raau taero. I roto i te take o te ventilation aunoa me compressions pouaka, ka kore e whai hua hoki neke atu i te 30 hēkona te mahi, te whakamahi i taero.

whakaora fā'ele'i whai wāhi te whakamahi o te Adrenaline, te tikanga mo te whakaora rōrahi toto, te konutai hydrogencarbonate, naloxone, dopamine.

whakaurua Adrenaline te roto i te ngongo endotracheal ki te pukorokoro, bolus rua ranei. Ko te kukū o te tarukino - 1:10 000 tarukino whakamahia ki te whakapiki ake i te kaha o te ngakau, me te whakaiti i auau ngakau whakaterenga. I muri i whakahaere intratracheal tonu ventilation aunoa, kia e taea te tohaina te tarukino mea whakanoho iho. Ki te tika, faaterehia te kaihoko te 5 meneti i muri mai.

Tātaitanga o te horopeta i runga i te taimaha o te tamaiti rānei:

• 1 kg - 0.1-0.3 ml;
• 2 kg - 0.2-0.6 ml;
• 3 kg - 0.3-0.9 ml;
• 4 kg - 0.4-1.2 ml.

A, no te whakamahia toto mate te hiahia ki te whakaki i te rōrahi o te komuhumuhu albumin toto ranei te, whaiaroaro otinga konutai pūhaumāota otinga o Ringer ranei. E whakahaere Drugs ki te rua o te kōpana uho (10 ml ia 1 kg taimaha tinana) āta runga 10 meneti. Kupu Whakataki vospolniteley BCC taea whakanui i te pēhanga toto, whakaiti acidosis, a ki te haerenga i te auau pini ki te whakapai ake i te kiko pākia.

whakaora fā'ele'i, aru i te ventilation pūkahukahu whai hua, titau te whakataki o te konutai hauwai pākawa waro ki te rua pito ki te whakaiti i tohu o acidosis. E kore e te tarukino kia whakamahia rite te roa rite kore i te tamaiti i whakapumautia pukapuka ventilation tika.

whakamahia dopamine te ki ake i taupū cardiac me filtration glomerular. faarahi te tarukino oko konutai tākihi me faarahi whakawātea mā te whakamahi i whaowhia therapy. Pâmuhia microfluidic i raro i te aroturuki tonu o te pēhanga toto, me te auau ngakau.

Naloxone pâmuhia i te tere o 0.1 ml ia 1 kg taimaha tinana. Founga, whakamahia i roto i te take i reira te tae kiri, me te pini e noa, engari i reira he tohu o te mate pōuri romahā. e kore e taea te whakahaere Naloxone ki te hou ina whakamahia e te whaea taero whakapōauau maimoatanga manawanui ranei te whakamahi i Pë whakapōauau.

A, no te ki te mutu whakaora?

tonu IVL rite te roa rite kore e te tamaiti tangohia ake 6 ngā i runga i te Apgar. kawea ana tēnei aro mātai i roto i nga 5 meneti, me pumau hoki ki runga ki te hawhe haora. Ki te tenei wa i muri i te hou he taupū o iti iho i te 6, ka i whakawhitia e ia ki te ICU o te hōhipera i roto i nei ki te whakahaere whakaora anō, therapy kaha o hou.

Ki te he tino ngaro te whai huatanga o te whakaora, me te reira he asystole me cyanosis, haere tonu te hui tae noa ki te 20 meneti. A, no te kite koe i ara nga tohu iti o miramira, faarahi roanga te wa katoa, tae noa ki he pai nga mehua.

wae whāomo fā'ele'i

I muri i te faaho'iraa mai angitu o te pūkahukahu, me te ngakau o te fanau e whakawhitia ki kaha wae tiaki. He te rata whāinga mahi ki te ārai i pōauautanga taea.

Tamarii fanau i muri i whakaora i roto i te hiahia o te ārai o te takanga o ngawhatanga o te roro ranei atu disorders CNS, mahi fakafoki mai o nga whatukuhu, me te mahi puha o te tinana, māori o te tohanga toto.

kia puta te tamaiti disorders pūkoro tinana i roto i te puka o te acidosis, acidosis lactic, meinga nei e disorders o te microcirculation piringa. I runga i te wahi o te roro kia meinga hukihuki, toto, infarction kaka, edema, te whanaketanga o te pōroa. kia hoki riro koe pōrearea o nga ventricles o te ngakau, kore whakapeka täkihi, atony tōngāmimi, iti hoki adrenal me ētahi atu whēkau endocrine.

Tei runga i te huru o te tamaiti i whakanohoia e i roto i te incubator hāora ranei teneti. tokanga'i tohunga te mahi o okana me ngā pūnaha katoa. Whangaia tukua te tamaiti i muri i anake 12 haora, i roto i te nuinga o te wā - i roto i te ngongo nasogastric.

Hapa i taua whenua kei rāhuitia

Kei te tino riria ana te reira ki te kawe i roto i ngā mahi e kore e i kï haumaru:

• ringihia pēpi wai;
• kōpeke tona uma;
• e patu i runga i nga papa;
• mata tika seti hāora me te rite.

e kore me te whakamahi otinga albumin ki te whakapiki ake i te tuatahi Ph, no te mea e faarahi te reira i te mōrea o te putanga fā'ele'i mate.

e kore e whakaora tikanga e ka whai i te tamaiti i tetahi abnormalities pōauautanga ranei. titau tokomaha ngā mātua faaiteraa pathological i muri ko te hou i roto i te tiaki kaha. Reviews o enei take tohu e whai i te whanaketanga ano rite ō rātou hoa tamariki i roto i te heke mai.