Hoʻoikaika ʻāpana kino

Hana ʻia ka subcutaneous empysema ke komo ka ea i loko o nā mea ma lalo o ka ʻili. Kū pinepine kēia i ka ʻili e uhi ana i ka umauma a i ʻole ka ʻāʻī, akā hiki ke hana ʻia i nā wahi ʻē aʻe o ke kino.

Hiki ke ʻike pinepine ʻia ka subysutanema subcutaneite ma ke ʻano he paheʻe o ka ʻili. Ke manaʻo ka mea mālama olakino (palpates) i ka ʻili, hana ia i kahi ʻano crackling ʻokoʻa (crepitus) ʻoiai ke kuʻi ʻia ke kinoea i loko o kaʻiʻo.

He kūlana laha ʻole kēia. Ke kū ʻia, hiki i nā kumu ke hoʻopili i:

• ʻO ka hāhā naha (pneumothorax), pinepine pinepine ʻia me ka haʻi o ka iwi ʻaoʻao
• Haki iwi alo
• Rupture a haehae paha i ke alaloa
• Wāwahi a haehae paha i ka esophagus a i ʻole ka gastrointestinal tract

Hiki ke hana i kēia ʻano ma muli o:

• Trauma hōʻeha.
• Nā hōʻeha pahū.
• Ka hanu ʻana i ka cocaine.
• ʻO nā mea hoʻowahāwahā a i ʻole nā ​​kuni kemikal o ka esophagus a i ʻole ke ala mokulele.
• Poino luʻu.
• ʻO ka luaʻi ikaika (Boerhaave Syndrome).
• Hoʻopilikia keu, e like me ka pū kī a i ʻole nā ​​ʻeha kuʻi.
• Pertussis (kohā wai).
• ʻO kekahi mau kaʻina hana lapaʻau e hoʻokomo i ka paipu i loko o ke kino. Hoʻopili kēia i ka endoscopy (paipu i loko o ka esophagus a me ka ʻōpū ma o ka waha), kahi laina venous kikowaena (catheter lahilahi i loko o kahi aa kokoke i ka puʻuwai), endotracheal intubation (Tube i loko o ka ʻāʻī a me ka trachea ma o ka waha a ihu), a me ka bronchoscopy (paipu i loko o nā paipu bronchial ma o ka waha).

Hiki ke ʻike ʻia ka ea ma waena o nā ʻili o ka ʻili ma nā lima a me nā wāwae a i ʻole ke kino ma hope o kekahi mau maʻi, e like me ka gas gangrene, a ma hope paha o ka luʻu scuba. (ʻOi aku ka nui o kēia pilikia ma mua o ka Scuba divers me ka hānō ma mua o nā scuba divers.)

ʻO ka hapa nui o nā ʻano kumu e hoʻoulu ai i ka subyshysemis koʻikoʻi ka maʻi, a ke mālama ʻia nei paha ʻoe e kahi mea hāʻawi. I kekahi manawa pono ka noho haukapila. ʻOi aku paha kēia inā pili ka maʻi i kahi maʻi.

Inā ʻoe e ʻike i ke ea subcutaneite e pili ana i kekahi o nā hanana i hōʻike ʻia ma luna, keu hoʻi ma hope o ka ulia pōpilikia, kāhea koke iā 911 a i kāu helu lawelawe kūikawā kūloko.

MAI lawelawe i kekahi wai. MAI neʻe i ke kanaka ke ʻole pono ia e hemo iā lākou mai kahi pōʻino. Palekana i ka ʻāʻī a hoʻi mai ka hōʻeha hou ke hana pēlā.

E ana a mālama ka mea hāʻawi i nā hōʻailona koʻikoʻi o ke kanaka, me:

• Ka māʻona oxygen
• Mahana
• Pulse
• Lāki hanu
• Kaomi koko

E mālama ʻia nā ʻōuli e pono ai. E loaʻa paha i ke kanaka:

• Kākoʻo Airway a me / a hanu paha - me ka oxygen ma o ka lawe ʻana i waho a i ʻole intubation endotracheal (ke kau ʻana o ka pahu hanu ma o ka waha a i ʻole ka ihu i loko o ke alaloa) me ke kau ʻana ma ka ventilator (ka mīkini hanu kākoʻo ola)
• Nā hoʻāʻo koko
• Tube pahu - Tube ma o ka ʻili a me nā mākala ma waena o nā iwi ʻaoʻao i loko o ka pleura (kahi ma waena o ka paia o ka umauma a me ka akemāmā) inā he hāhā o ka hāhā.
• Nānā CAT / CT (tomography axial kamepiula a i ʻole kiʻi kiʻi holomua) o ka umauma a me ka ʻōpū a i ʻole kahi me ka ea subcutaneite
• ECG (electrocardiogram a i ʻole ka huli ʻana o ka naʻau)
• Nā Fluids ma o kahi aa (IV)
• Nā lāʻau lapaʻau e mālama ai i nā ʻōuli
• ʻO nā kukuna X o ka umauma a me kou ʻōpū a me nā ʻāpana kino ʻē aʻe i ʻeha

Pili ka wānana i ke kumu o ka subcutaneous empysema. Inā pili me ka trauma nui, kahi hana a i ʻole ka maʻi, ka paʻakikī o ia mau ʻano e hoʻoholo ai i ka hopena.

ʻO ka subysutanema submysema e pili ana i ka luʻu scuba ka mea pinepine pinepine ʻole.

Crepitus; ʻClepa ʻĀina Lapaʻau; Tysue empysema; ʻO ke kikowaena lapaʻau

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ʻO Cheng G-S, ʻo Varghese TK, ʻo Park DR. ʻO Pneumomediastinum a me mediastinitis. I: Broaddus VC, Mason RJ, Ernst JD, et al, eds. ʻO Murray a me Nadel's Textbook of Respiratory Medicine. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2016: chap 84.

ʻO Kosowsky JM, ʻo Kimberly HH. Maʻi Pleural. 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 67.

Raja AS. Hōʻeha Thoracic. 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 38.