Iha naha a haki paha

ʻO ka iwi ā naha, he haki (haʻi) i ka iwi ā. ʻO ka iwi āpau i hoʻoneʻe ʻia, ʻo ia ka ʻaoʻao haʻahaʻa o ka iwi ā i neʻe aku mai kona kūlana maʻamau i hoʻokahi a i ʻole nā ​​ami ʻelua kahi e hoʻopili ai ka iwi ā i ka iwi poʻo (temporomandibular ami).

Hoʻola maikaʻi kahi iwi ā naha a dislocated paha ma hope o ka mālama ʻana. Akā e lilo i ka iwi ā i ka wā e hiki mai ana.

Komo pū nā pilikia:

• Paʻa Airway
• Kahena
• Ka hanu ʻana i ke koko a i ʻole ka meaʻai i loko o nā akemāmā
• ʻO ka ʻai paʻakikī ʻana (ka manawa pōkole)
• Ke kamaʻilio paʻakikī ʻana (wā pōkole)
• ʻO ka maʻi o ka iwi ā a i ʻole ke alo
• ʻEha ʻo Jaw joint (TMJ) a me nā pilikia ʻē aʻe
• Numbness o kahi ʻāpana a i ʻole ke alo
  
• Nā pilikia kaulike i nā niho
• ʻŌhū

ʻO ke kumu maʻamau o ka uha a haki paha ka ʻeha o ka maka. Pili paha kēia i:

• Limanui
• Ulia ʻenehana
• ʻAhaʻa kaʻa kaʻa
• ʻO ka hōʻeha leʻaleʻa a haʻuki paha
• Nā huakaʻi a hāʻule
• Ma hope o ke kaʻina hana niho a lāʻau lapaʻau paha

ʻO nā ʻōuli o ka iwi ā naha:

• ʻEha ma ka maka a i ʻole ka iwi ā, ma ke alo o ka pepeiao a i ʻole ka ʻaoʻao i hoʻopili ʻia, ʻoi aku ka maikaʻi o ka neʻe ʻana
• ʻO ka palapū a me ka pehu ʻana o ka maka, ke kahe ʻana o ka waha mai ka waha
• ʻO ka nau ʻana i ka paʻakikī
  
• ʻOʻoleʻa ʻo Jaw, he paʻakikī e wehe ākea ka waha, a i ʻole he pilikia e pani ana i ka waha
• Ke neʻe nei ʻo Jaw i kekahi ʻaoʻao i ka wā e wehe ana
• Ka palu a ʻeha paha o ka Jaw, ʻoi aku ka maikaʻi me ka nahu ʻana a me ka nau ʻana
• Loose a ʻeha paha nā niho
• Lū a i ʻole ʻano helehelena o ka papalina a i ʻole ka iwi ā
• Numbness o ka helehelena (ʻo ia hoʻi ka lehelehe lalo)
• ʻEha pepeiao

ʻO nā ʻōuli o ka auwae dislocated pū kekahi:

• ʻEha ma ka maka a i ʻole ka iwi ā, ma ke alo o ka pepeiao a i ʻole ka ʻaoʻao i hoʻopili ʻia, ʻoi aku ka maikaʻi o ka neʻe ʻana
• Nahu i manaʻo "off" a kekee paha
• Nā pilikia e kamaʻilio ana
• Hiki ʻole ke pani i ka waha
• Drooling no ka hiki ʻole ke pani i ka waha
• Ile laka a i ʻole ʻāʻī e hele i waho i mua
• ʻO nā niho i kū ʻole i ka laina kūpono

ʻO ke kanaka me ka iwi ā naha a dislocated paha e pono ai i ka lāʻau lapaʻau koke. ʻO kēia no ka mea he pilikia hanu paha kā lākou a he kahe paha. Kāhea i kāu helu pilikia kūloko (e like me 911) a i ʻole kahi haukapila kūloko no ka ʻōlelo aʻoaʻo hou aʻe.

E hoʻopaʻa mālie i ka iwi ā me kou mau lima ma ke ala e hele ai i ka lumi pilikia. Hiki iā ʻoe ke wahī i kahi kaula ma lalo o ka iwi ā ma luna o ke poʻo o ke poʻo. E maʻalahi ke hoʻoneʻe i ka bandage inā pono ʻoe e luaʻi.

I ka haukapila, inā loaʻa iā ʻoe nā pilikia hanu, hiki i ke kahe nui, a i ʻole ka pehu nui ʻana o kou alo, e hoʻokau ʻia kahi paipu i kāu mau alaloa e kōkua i ka hanu ʻana.

KANAWAI HOPE

ʻO ka mālama ʻana i ka iwi ā haʻi e pili ana i ka haki o ka iwi. Inā loaʻa iā ʻoe kahi haki liʻiliʻi, hiki iā ia ke hoʻōla iā ia iho. Pono paha ʻoe i nā lāʻau ʻeha. E ʻai paha ʻoe i nā meaʻai palupalu a noho i kahi papa wai no kekahi manawa.

Pono pono ke ʻoki kino no ka haʻihaʻi o nā haʻi. Hiki ke kaulaʻi ʻia ka iwi ā i nā niho o ka ʻaoʻao ʻē aʻe e kūpaʻa ka ʻāʻī ʻoiai ke hoʻōla. Waiho maʻamau nā kaula ʻo Jaw i kahi no 6 a 8 mau pule. Hoʻohana ʻia nā pā liʻiliʻi (elastics) e hoʻopaʻa pū i nā niho. Ma hope o kekahi mau pule, wehe ʻia kekahi o nā elastics e ʻae i ka neʻe a hoʻoliʻiliʻi i ka paʻa paʻa.

Inā pili ka iwi ā, hiki iā ʻoe ke inu wai wale a ʻai paha i nā meaʻai palupalu. E loaʻa koke nā ʻokiʻoki kūpala e ʻoki i nā elastics i ka hanana o ka luaʻi a i ʻole choking. Inā pono e ʻokiʻoki i nā kaula, e kāhea koke aku i kāu kauka mālama ola i hiki ai ke hoʻololi i nā kaula.

LUNAKI KANAWAI

Inā hemo kou iwi ā, hiki i ke kauka ke hoʻihoʻi iā ia i kahi kūpono i ka hoʻohana ʻana i nā manamana nui. Pono paha nā lāʻau numbing (anesthetics) a me nā mea hoʻomaha musele e hoʻomaha ai nā mākala.

Ma hope, pono e hoʻokūpaʻa i kou ā. Pili kēia i ka hoʻopaʻa ʻana i ka iwi ā i ka waha e wehe ākea ai ka waha. I kekahi mau hihia, pono ke ʻoki e hana i kēia, ke ʻike ʻia inā hana hou nā dislocations o ka iwi ā.

Ma hope o ka hemo ʻana o kou iwi ā, ʻaʻole pono ʻoe e hāmama ākea i kou waha no 6 mau pule. Kākoʻo i kou ālima me hoʻokahi a i ʻole ʻelua mau lima ke kaniʻuʻu a me ka ʻū.

Mai hoʻāʻo e hoʻoponopono i ke kūlana o ka iwi ā. Pono ke kauka i kēia.

Pono ka iwi ā naha a dislocated paha e nānā koke i ka lāʻau. ʻO nā hōʻailona kūpilikiʻi me ka paʻakikī o ka hanu ʻana a i ʻole ke kahe nui.

I ka wā o ka hana, nā haʻuki, a me nā hana leʻaleʻa, ka hoʻohana ʻana i nā pono palekana, e like me ka mahiole i ka pāʻani ʻana i ka pōpeku, a i ʻole ka hoʻohana ʻana i nā kiaʻi waha hiki ke pale a hōʻemi paha i kekahi mau ʻeha i ka maka a i ʻole ka iwi ā.

Iwi auwae; Iwi ā iwi; Fractured mandible; Paha iwi; Hōʻoki ʻo TMJ; Hoʻoneʻe Mandibular

• Haki haʻi mandibular

ʻO Kellman RM. Hōʻeha Maxillofacial. I: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Ke poʻo poʻo a me ka ʻāʻī. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2015: chap 23.

ʻO Mayersak RJ. Trauma helehelena. I: Nā paia RM, Hockberger RS, Gausche-Hill M, nā ʻaoʻao. ʻO Rosen's Emergency Medicine: Nā Manaʻo Manaʻo a me ka hana lapaʻau. 9th ed. Piladelapia, PA: Elsevier; 2018: chap 35.