Reanimation uye yevanorwara zvikuru

Intensive (chimbichimbi) kurapa - nzira kurapa zvirwere, upenyu pangozi. Nokumutswa - kupora kwacho inokosha (upenyu) mabasa vakarasika kana zvishoma akarwiswa somugumisiro chirwere. dzokurapa idzi kuti tikwanise kumisa zvachose zvichiongororwa uye kupora mashandiro kupindira kwacho panyaya kutsanya kuvhiringidzika basa nadzo uye hurongwa. Kazhinji, nokumutswa uye yevanorwara zvikuru zviri zvikuru, uye wokupedzisira aripo nzira yokudzivisa rufu kwazvo (chinouraya) zvirwere vavo matambudziko, makuvaro.

zvinhu pfungwa

Ndichibvunza kurapa - nzira yokurapa kumativi wachi, yaida kushandisa intravenous infusions kana detoxification nzira nguva dzose kudzora zviratidzo zvinokosha. Vakawana akabuda kuburikidza neropa uye muviri zvinwiwa, anowanzoshandurwa kudzokororwa kutsanya-Tracking kuti kuderera uye uvandudze pakati somatic mashandiro zvomurwere. Nzira yechipiri kudzora - ndiwo zvichiongororwa, riri rakatangwa muna Hardware kubudikidza utilizing cardiomonitors, gasi analyzers, electroencephalograph uye dzimwe mhando michina.

Nokumutswa muinonzi somushonga mafomu uye Hardware mitoo muviri anodzokera kuupenyu zvashata mamiriro kuitika. Kana murwere ari mamiriro, zvinoreva upenyu, kunobva chirwere kana zvayo matambudziko, nokuti ayo Kudzikamiswa ndichibvunza kurapa. Kana murwere ari ezvinhu kurapwa rufu uye haangazvidembi kurarama pasina kukurumidza kuzoita akarasika mashandiro, muitiro yokudzoka uye muripo inonzi nokumutswa.

Yaita nyaya idzi nokumutswa. It rakamanikana nyanzvi, nzvimbo basa unova yevanenge. Kakawanda, vanachiremba chete basa resuscitator hakuwaniki, nokuti nyanzvi achagamuchira chitupa pamusoro anesthesiology uye nokumutswa. Kumabasa, maererano akakodzera masangano, unogona kutora mhando nhatu namagwatidziro: "nemukoti anokotsirisa", uyewo vakaparadzana "nokumutswa" kana "anesthesiologist".

Chiremba mune yevanenge

Chiremba ndichibvunza kurapa - nayo anesthesiologist. Ari hanya kusarudza mhando yokutindivadza varwere preoperative uye kuongorora kwavo ezvinhu pashure kuvhiyiwa. A Mazvikokota kushanda chero hwakasiyana-siyana dzokurapa nzvimbo (kazhinji romunharaunda kana dunhu), uye kuparadzana anonzi HITD. Pangava varwere ndanyarara hangu basa, asi zvinoda kudzorwa zviratidzo zvinokosha. Uyewo, HITD muri varwere akuvara zvinouraya uye zvirwere, uyewo avo matambudziko. Varwere Postoperative vanogona akafanana HITD chiremba nemukoti anokotsirisa.

Chiremba nokumutswa

Chiremba nokumutswa chete nayo kudzorerwa anokosha, uye kazhinji nzvimbo basa iri yemapurisa kana substation amburenzi. Vaibvumirwa kupinda midziyo, chinoshongedzera ari murairidzi nokumutswa amburenzi, anogona resuscitate murwere mumugwagwa, iyo inobatsira mumamiriro ose ezvinhu chokuita nenjodzi mushonga. Kakawanda, chiremba-resuscitator haina kuita basa ndichibvunza kurapa muna HITD asi anovamba kudzora anokosha murwere ari amburenzi. Izvozvo mumabasa kurapwa uye Hardware kudzora mashandiro anoita murwere atarisana norufu.

Anesthesiologist

Nemukoti anokotsirisa - muenzaniso nyanzvi mune rakamanikana Profile zvipatara Somuenzaniso, mune imwe kenza kiriniki kana mune perinatal pakati. Pano, huru basa chiremba ndiko kuronga mhando yokutindivadza pavarwere vanoda richabva kuvhiyiwa. Kana perinatal centre nemukoti anokotsirisa basa iri pakusarudza norudzi yokutindivadza kune varwere caesarean chikamu rinoitwa. Zvakakosha kuti vanyatsodzidziswa kunorapwa vana iri kuitwa pakati ichi. Zvisinei, mashoko yevanenge varwere uye vachangoberekwa vari muronga. In HITD vana (vacheche) vari kushanda neonatologists uye vakuru kushumirwa anesthesiologist.

HITD zvomusejari zvipatara

Yevanenge vari muchipatara, une kuvhiya kutsvetera, zvinonzi vakaronga zvichienderana neuwandu varwere zvinoda kupindira, uye kukuvadza hwokushanda. Kana kupindira mune oncological dispensaries avhareji nguva mutsigiro murwere muna HITD kupfuura ari mukuru kuvhiyiwa. Yevanorwara zvikuru pano anotora refu, sezvo iri nzira remapazi kunotozongoita zvaparadzwa zvinokosha anatomical hurongwa.

Kana tikafunga kenza kuvhiyiwa, Mhedziso vazhinji kupindira dzine zvinorwadza uye guru Vhoriyamu resected zvivako. Zvinotora nguva yakareba murefu kupora, sezvo pashure pokuvhiyiwa ichiri pangozi Kuipa utano, uye kunyange rufu kubva zvinoverengeka. Pane zvinokosha Kudzivirira kupindira kana yokutindivadza matambudziko, nechouviri rutsigiro uye replenishment bhuku ropa, chikamu iyo kunotozongoita akarasika ari weboka kupindira. mabasa ava kukosha panguva chero post-kushanda vapore.

HITD emwoyo zvipatara

Cardiology uye dzokurapwa zvipatara zviri kusiyaniswa kuti pane varwere vose ndanyarara hangu pasina kutyisidzirwa kuti upenyu uye varwere kugadzikana. Vaifanira kuumba uye kuramba kudzora avo ezvinhu. Kana emwoyo zvirwere kuteerera zvinoda myocardial infarction pamwe nemamwe matambudziko ayo ari muchimiro cardiogenic kuvhunduka kana kungoerekana cardiac rufu. Ndichibvunza kurapa pane myocardial infarction kunoderedza ngozi rufu muna anofungidzirwa rokuti, kushomeka uwandu zvinokuvadza kudzorera patency iri infarct-chokuita tsinga, uyewo vanatsiridze fungidziro kuti murwere.

Maererano Bazi Health protocols uye vanorumbidza dzakawanda, mune varwere coronary chakasimba zvinoda placement muimba yevanenge kuita chimbichimbi matanho. Assistance inopiwa mushandi rwekutanga pa padariro pakukurukura, ipapo iwe uchida adzorere patency ari coronary arteries, ayo occluded pedyo thrombus. Zvadaro kurapwa murwere kudzikamisa vavimbisana resuscitator: ndichibvunza kurapa, mishonga, Hardware uye rabhoritari kudzora mamiriro.

In HITD emwoyo, apo zvomusejari akavhiyiwa yaitwa pamidziyo kana mwoyo mavharuvhu, basa racho dhipatimendi ndiyo yokutanga postoperative vapore uye chinzvimbo Tracking. akavhiyiwa aya vysokotravmatichnyh pfungwa dziri pamwe yakareba kupora uye kwadzakabva. Pane nguva dzose refu ndingangokuvara thrombosis, vascular shunt kana anomira akasima chakagadzirwa kana dzinongozviitikira vharafu.

HITD midziyo

Reanimation uye ndichibvunza care - ndiye indasitiri muitiro mushonga, izvo nechinangwa kugadzirisa kutyisidzira kuti murwere upenyu. Nyaya idzi kuitwa nyanzvi Unit, iro tsime akashongedzerwa. It anonzi zvikuru yemazuva ano akura, nekuti zviri murwere nguva dzose vanoda Hardware uye mumarabhoritari kuzvidzora. Uyezve, ndichibvunza kurapa kunosanganisira pokugadzwa zvechigarire kana kakawanda intravenous yaitonga.

Principles kurapwa muna HITD

In chinyakare mahofisi, varwere vasiri norufu kubva chirwere kana ayo zvakaoma kunzwisisa zviri pfupi aizomupa donhwe gadziriro rinoshandiswa kuti chinangwa ichi. In HITD kazhinji nayo kuchatsiviwa aizomupa pombi. midziyo iyi inobvumira kungoramba yokusuma mumwe dose yamarudzi, pasina chikonzero kuponjesa imwe tsinga nguva dzose zvinoda vachiita zvinodhaka. aizomupa pombi inokupai panopindwa medicaments akaramba mazuva kana kupfuura.

Modern Misimboti ndichibvunza kurapa uye nokukurumidza chirwere inoti kare dzakabudirira uye vari zvinotevera:

• Vavariro yokutanga kurapwa - Kudzikamiswa murwere uye kuedza uwane chirwere kutsvaka;
• Kutsunga runotikurudzira chirwere, izvo chinokurwadzai kudzikisirana uye zvinoratidzwa pamusoro mamiriro utano, paakauyisa fungidzira rufu;
• mabatiro chaicho chirwere wehurumende Kudzikamiswa kubudikidza symptomatic kurapa;
• kubviswa ezvinhu zvinouraya uye zviratidzo;
• Implementation pakati kwomurabhoritari uye richishanda richiona kuti murwere ezvinhu;
• kushandura murwere ari Profile mupanda pashure Kudzikamiswa uye kubviswa zvinoita zvinouraya.

Laboratory uye richishanda masimba

Monitoring ezvinhu zvomurwere kwakavakirwa ane tinyatsonzwisisa wevatatu date zvinyorwa. Chokutanga - murwere kuongorora, pakatangwa zvichemo, achizivisa utano simba. Chechipiri - rabhoritari zvidzidzo anoitwa asati kubvuma uye panguva kurapwa, kuenzanisa migumisiro Analyses. The bhuku wechitatu - ruzivo vakawana kuburikidza paku bvunzo. Uyewo hworudzi urwu mashoko pamusoro utano mamiriro murwere uye hurongwa chinosanganisira richiona nezvezvabuda kupomba, ropa oxygenation, kakawanda uye mutinhimira kubva cardiac basa, BP, pfungwa basa.

Rufimbi uye chinokosha midziyo

matavi akadaro anobatsira mushonga sezvo anesthesiology uye yevanorwara zvikuru zvakabatana chaizvo. Nyanzvi vanoshanda muzvinhu izvi, vane dhipuroma nemashoko "chiremba anesthesiologist." Izvi zvinoreva kuti nyaya anesthesiology, nokumutswa uye yevanorwara zvikuru anogona riitwe mumwe chete nyanzvi. Uyezve, iyi zvinoreva kuti zvinodiwa multidisciplinary zvoutano zvivako, kusanganisira inpatient madhipatimendi ose zvomusejari uye dzokurapwa kutsvetera, chete chete HITD. Zvinonzi akashongedzerwa pamwe nemidziyo nokumutswa, kurapwa uye yokutindivadza pamberi kuvhiya.

Nokumutswa uye yevanorwara zvikuru dzinoda kuroorwa-danho (kana biphasic) defibrillator kana cardioverter defibrillator, electrocardiograph, kwegadziriro zvokuimba kufefetedza, Moyo yokunzvenga (kana waiti munhu chaizvo utano sangano), sensors uye analizatorskih hurongwa vaifanira kuongorora zviratidzo kwomwoyo uye pfungwa basa . Zvinokoshawo kuti aizomupa pombi zvinodiwa kuchinja kubva mugadziriro kugara aizomupa aizomupa zvinodhaka.

Anesthesiology Zvinoda midziyo kupa inhalation yokutindivadza. Izvi up kana Semi-rakavhurika hurongwa, panopinda rufimbi musanganiswa pakukurukura inopiwa mumapapu. Izvi zvinoita kuti pave endotracheal kana endobronchial yokutindivadza. Zvakakosha kuti zvinodiwa yokutindivadza zvaida laryngoscopes uye endotracheal (kana endobronchial) sepombi, catheters kuti dundira catheters uye ponji pamusoro nechepakati uye peripheral mutsinga. Chete midziyo runodiwa uye kunyatsodzidza kurapa.

HITD perinatal nzvimbo

Perinatal nzvimbo - a utano Zvivako apo kuzvarwa kutora nzvimbo, iyo Tingangonyanya kuenda matambudziko. Izvi zvinofanira akatuma vakadzi vanotambura pamuviri kana vane extragenital zvokurwara, vanokwanisa kukwanisa kukuvadza mu basa utano. Uyewo, panofanira kuva mukadzi pamuviri pathologies yaida mangwanani pakukurukura uye achangoberekwa hanya. Intensive neonatal kurapa - mumwe mabasa nzvimbo idzi pamwe kupa yokutindivadza kutarisira varwere ndiani kuvhiya.

Danho Nokuraramisa HITD perinatal nzvimbo

Branch Perinatal Intensive Care Centre iri vakagadzirira zvichienderana vakaronga nhamba wevarwere. Izvi zvinoda yokutindivadza gadziriro uye yevanorwara zvikuru midziyo, mazita yakapiwa pamusoro. Saka HITD perinatal nzvimbo vane uye chiremba zvivako. Vanofanira kuva rinokosha michina. Chekutanga, mukuru chakagadzirwa afemeruke uye kufamba kweropa hazvisi akakodzera vachangoberekwa hukuru zviri izvo zvishoma.

Nhasi, chiremba zvivako mubasa roukoti vacheche achirema 500 magiramu, vakaberekwa panguva vhiki 27 'gestation. Uyezve, iwe unofanira chaiyo Urongwa mishonga, nekuti vana vakaberekwa zvakanaka yakakodzera isati musi, paida kugadzwa kuva surfactant gadziriro. Izvi mishonga dzinodhura, pasina iro hazvibviri ukoti sezvo rusvava anouya kukura chiedza, asi pasina surfactant. Izvi zvinhu kunodzivisa zvemapapu Formação de anowira pasi, iyo irimo muitiro vakarongeka kwokunze afemeruke.

Zvakakurukurwa sangano basa HITD

HITD anoshanda kunhivi wachi, uye chiremba pabasa mazuva manomwe pavhiki. Izvi imhaka nekusagona kudzima midziyo kana zviri kukonzera zvokudya imwe murwere. Zvichienderana uwandu varwere uye mutoro Bazi, nhamba pamibhedha aumbwa. Mumwe berth anofanirawo nepokuongorora ventilator uye monitors. MuHupo isingasviki nhamba mibhedha, uwandu kufefetedza mano, monitors uye sensors.

The Dhipatimendi iri rakagadzirirwa 6 varwere, kushanda 2-3 resuscitator chiremba anesthesiologist. Vanofanira kushandurwa pazuva rechipiri pashure maawa 24 of basa. Izvi zvinobvumira kuti arambe murwere kumativi wachi uye pakupera kwevhiki, kana richiona wevarwere mwero mahofisi ndiyo chete nachiremba basa. Nemukoti anokotsirisa vanofanira kuongorora varwere vari HITD. Uyewo, anosungwa kuita zvinenge kutarisirwa Misangano, uye kubatsira varwere matavi somatic kusvikira muchipatara HITD.

Batsira chiremba Nurse nemukoti anokotsirisa uye yevanorwara zvikuru mukoti. The kukarukureta mukuwanda vachibhejera zvinhu zviri kuitwa zvichienderana neuwandu varwere. 6 Mibhedha zvinoda kuvapo imwe chiremba, vanamukoti vaviri uye mumwe mukoti. nhamba iyi vashandi vanofanira kuva pane mumwe basa masikati. Staff ipapo ne mumwe chinja, uye, uyewo, - wechitatu.