Tracheostomy

ʻO kahi tracheostomy kahi hana ʻoki e hana i kahi wehe ma o ka ʻāʻī i loko o ka trachea (windpipe). Hoʻokomo pinepine ʻia kahi paipu ma o kēia wehe e hāʻawi i ke ala ākea a lawe i nā huna mai nā akemāmā. Kapa ʻia kēia paipu he paipu tracheostomy a i ʻole trach Tube.

Hoʻohana ʻia ka anesthesia laulaha, ke ʻole koʻikoʻi ke kūlana. Inā kū kēlā, waiho ʻia kahi lāʻau numbing i kahi e kōkua ai iā ʻoe e hōʻemi i ka ʻeha i ke kaʻina hana. Hāʻawi ʻia nā lāʻau ʻē aʻe e hoʻomaha a hoʻomaha ʻoe (inā he manawa).

Hoʻomaʻemaʻe ʻia ka ʻāʻī a kāwele ʻia. Hana ʻia nā ʻokiʻoki e hōʻike i nā apo cartilage paʻakikī e hana i ka paia o waho o ka trachea. Hoʻokumu ka mea lapaʻau i kahi wehe i loko o ka trachea a hoʻokomo i kahi pahu tracheostomy.

Hana ʻia kahi tracheostomy inā loaʻa iā ʻoe:

• ʻO kahi mea nui e ālai ana i ke alaloa
• He hiki ʻole ke hanu iā ʻoe iho
• ʻO kahi abnormalities hoʻoilina o ka larynx a i ʻole trachea
• Hanu ʻia i nā mea hoʻopilikia e like me ka uahi, ka mahu, a i ʻole nā ​​kino ʻino ʻē aʻe i pehu a ālai i ke alaloa
• Ka maʻi ʻaʻai o ka ʻāʻī, hiki ke hoʻopili i ka hanu ʻana ma ke kaomi ʻana i ke ala ākea
• Pālolo o nā mākia e hoʻopili i ka ale ʻana
• Nā hōʻeha ʻeha a waha paha
• ʻO ke kaha a puni ka pahu leo ​​(larynx) e pale ai i ka hanu maʻamau a me ka ale ʻana

ʻO nā pilikia no kekahi anesthesia:

• Pilikia i ka hanu ʻana
• Nā hopena i nā lāʻau, e like me ka puʻuwai puʻuwai a me ka hahau ʻana, a i ʻole ka hopena maʻi (pākī, pehu, paʻakikī hanu)

ʻO nā pilikia no kekahi ʻoki kino:

• Kahena
• Maʻi kīnā
• ʻEha ʻeha, me ka maʻi lōlō
• Scarring

ʻO nā pilikia ʻē aʻe e:

• Ka pilina maʻamau ma waena o ka trachea a me nā moku koko nui
• Ka poino i ke kelepaʻi thyroid
• Ka hopena o ka trachea (laha ʻole)
• Holo ka pune o ka hū a me ka māmā
• ʻO nāʻiʻo scar i ka trachea e hōʻeha ai i ka hanu a pilikia paha i ka hanu ʻana

Hiki paha i kahi kanaka ke makaʻu a manaʻo hiki ʻole ke hanu a ʻōlelo i ka wā e ala mua ana ma hope o ka tracheostomy a me ka hoʻokau ʻana i ka pahu tracheostomy. E emi ana kēia manaʻo i ka hala ʻana o ka manawa. Hāʻawi ʻia nā lāʻau e kōkua ai i ka hōʻemi ʻana i ke koʻikoʻi o ka mea maʻi.

Inā lōʻihi ka tracheostomy, e hoʻoneʻe ʻia ka paipu. E hiki wawe ka hoʻōla, e waiho ana i kahi ʻili liʻiliʻi. I kekahi manawa, pono ʻia kahi kaʻina hana e hoʻopau i ka pūnaewele (stoma).

I kekahi manawa hiki ke ulu i ke koʻikoʻi, a i ʻole ke ʻūiki ʻana o ka trachea, i hiki ke hoʻopili i ka hanu ʻana.

Inā kū mau ka paipu tracheostomy, hāmama ka lua.

Pono ka hapa nui o ka poʻe i 1 i 3 mau lā e hoʻopili i ka hanu ʻana ma o ka pahu tracheostomy. Lōʻihi iki kahi manawa e aʻo ai pehea e kamaʻilio ai me nā poʻe ʻē aʻe. I ka mua, he mea hiki ʻole paha i ke kanaka ke kamaʻilio a hana kani paha.

Ma hope o ka hoʻomaʻamaʻa ʻana a me ka hoʻomaʻamaʻa ʻana, hiki i ka hapanui o ka poʻe ke aʻo e kamaʻilio me kahi pahu tracheostomy. E aʻo ka poʻe a ʻohana paha i ka mālama ʻana o ka tracheostomy i ka wā o ka haukapila e noho ai. E loaʻa paha ka lawelawe mālama home.

Hiki iā ʻoe ke hoʻi i kou nohona maʻamau. Ke kū ʻoe ma waho, hiki iā ʻoe ke komo i kahi uhi leʻaleʻa (kahi scarf a i ʻole pale ʻē aʻe) ma luna o ka tracheostomy stoma (hole). E hoʻohana i nā hana palekana ke hōʻike ʻia ʻoe i ka wai, aerosol, pauka, a i ʻole nā ​​mea ʻai.

• Tracheostomy - moʻo

Greenwood JC, Winters ME. Mālama Tracheostomy. I: Roberts JR, Custalow CB, Thomsen TW, eds. ʻO Roberts a me Hedges 'Nā Kauka Lapaʻau i ka Medicine Emergency a me ka Care Acute. ʻEpekema 7 Piladelapia, PA: Elsevier; 2019: chap 7.

Kelly A-M. Nā pilikia kūpikipiki. I: Cameron P, Jelinek G, Kelly A-M, Brown A, Little M, eds. Puka o ka Medicine Emergency Emergency. ʻEhā ed. Piladelapia, PA: Elsevier Churchill Livingstone; 2015: chap 6.