Okokuqala, izigulane ezigula kakhulu yinkqubo yokhathalelo olusisiseko
⒈ ulwamkelo olufudumeleyo lwezigulane, isigulana esibekwe kwigumbi likaxakeka okanye kwigumbi labagula kakhulu, iZixhobo zokuNakekela izigulana ukugcina umoya wangaphakathi ucocekile, ushushu kwaye ufanelekile;isigulana esilungileyo kunye namalungu osapho esibhedlele (iCandelo) lobuthunywa.
⒉ uvavanyo olungexesha:
Kubandakanya imeko esisiseko, iimpawu eziphambili, iimeko zesikhumba, uviwo oluncedisayo olufanelekileyo, iindidi zemibhobho, unyango lweziyobisi njalo njalo.
⒊ amanyathelo ononophelo olungxamisekileyo: ukusekwa ngokukhawuleza kokufikelela kwi-venous (kuxhomekeke kwimeko kunye neempawu zeziyobisi ukulungelelanisa izinga lokudonsa), i-oksijeni (kuxhomekeke kwimeko yokulungelelanisa ukuhamba kwe-oksijeni), ukubeka iliso kwe-ECG, i-catheterization yokuhlala, ukufudumala, ukwenza iindidi ezahlukeneyo. ingqokelela yomfanekiso,Izixhobo zokuKhathalela isiGulane ukuncedisana neTshekhi ehambelanayo, ukuba kuyimfuneko, ulungiselelo olusebenzayo lwaphambi kotyando.
⒋ umqolo kwaye ukhuselekile
⑴ ngokwesifo ukuthatha indawo efanelekileyo.
⑵ Ukugcina i-patency yomoya, izigulane ze-coma kufuneka zibe yimpumlo yokufunxa kwangexesha kunye neempumlo kunye ne-endotracheal secretions, kwi-oxygen inhalation.
⑶ amazinyo avalwe, ukuxhuzula komguli kunokusetyenziswa iipads zamazinyo, ukuvuleka, ukuthintela ukulunywa ngolwimi, isimamva solwimi.
⑷ umkhuhlane ophezulu, i-coma, i-delirium, ukucaphuka, ubuthathaka kunye neentsana kunye nabantwana abancinci kufuneka bongezwe ucingo, ukuba kuyimfuneko, ukunika ibhendi, ukukhusela ibhedi, ukuqinisekisa ukhuseleko lwesigulane.
⑸ lungisa zonke izixhobo zokuhlangula, amachiza kunye nezixhobo, uhlangulo lwangaphakathi lusete imeko yokulinda.
⒌ ukujonga imeko ngokusondeleyo: ukhathalelo lomntu, Izixhobo zokukhathalelwa kwesigulana iimpawu ezibalulekileyo zesigulana, ukuqonda, umfundi, ukopha, i-SpO2, i-CVP, ukujikeleza kwe-peripheral kunye nomchamo kunye nezinye iimeko zokuqwalaselwa okuguquguqukayo;kunye nogqirha ukuhlangula ngenkuthalo, yenza iirekhodi zobunesi.
⒍ amayeza amiselweyo amiselweyo, ukuphunyezwa kwengcebiso kagqirha ngomlomo, ukuba iphindwe ngaphandle kwemvume yokusebenzisa.
⒎ gcina iindidi zemibhobho imtyibilizi, imiswe ngokufanelekileyo, indawo ekhuselekileyo yokuthintela ukuvaleka, ukujija, ukuvaleka;itekhnoloji engqongqo eyinyumba yokuthintela usulelo lokubuyela umva.
⒏ ukugcina indlu yangasese igudile: ukugcinwa komchamo ukuthatha iindlela zokunceda ukuchama;ukuba kukho imfuneko ye-catheterization;ukuqhina njengemeko ye-enema.
⒐ kuxhomekeke kwimeko yokunyamekela ukutya: ukugcina amanzi, ibhalansi ye-electrolyte kunye nokuhlangabezana neemfuno ezisisiseko zesondlo somzimba;Izigulana ezizila ukutya zinokuba yi-peripheral venous nutrition.
Ukhathalelo olusisiseko
I-9, iinwele, amehlo, umzimba, umlomo, impumlo, isandla, unyawo, i-perineum, i-anus, isikhumba sicocekile;ezintlanu ukuya ebhedini: ezintathu zokuqala, Medicine, nursing, irayisi, amayeza, amanzi ebhedini isigulane).
⑵ kusasa, ukhathalelo lwangokuhlwa amaxesha ama-2 ngemini;ukunakekelwa komlomo we-urethral amaxesha ama-2 ngosuku;ukhathalelo lwe-tracheotomy amaxesha ama-2 ngosuku;nikela ingqalelo ekukhuseleni amehlo.
⑶ ukugcina ukusebenza kwelungu, ukomeleza imisebenzi yokwenziwa komzimba okanye ukunceda imisebenzi esebenzayo.
⑷ ukuqeqeshwa kokukhwehlela okuphefumla kakuhle, yonke i-2h yokunceda izigulane zijike, zidubule emva, isikhokelo sokuphefumula okunzulu, ukunceda ukukhupha iimfihlo.
⑸ ukomeleza ukhathalelo lwesikhumba, ukuthintela izilonda zoxinzelelo.
⒒ ukhathalelo ngokwasengqondweni: ukujikeleza ngexesha, ukhathalelo lwezigulana,Izixhobo Zokukhathalelwa Kwezigulana ngokwemeko yokunxibelelana neentsapho zabo, ukusekwa kobudlelwane obuhle bomongikazi nesigulane, ukuze bafumane intembeko yesigulana, intsebenziswano yosapho kunye nokuqondana.
Okwesibini, izigulane ze-coma zikhathalela isiqhelo
(I) Qwalasela iingongoma
⒈ ukujonga ngokusondeleyo iimpawu ezibalulekileyo (T, P, R, BP), ubukhulu bomfundi, impendulo yokukhanya.
⒉ Vavanya ukuphazamiseka kwe-GLS kwisalathiso sokuqonda kunye nenqanaba lokuphendula ukuqonda iqondo le-coma, lufumene utshintsho oluxelwe ngokukhawuleza kugqirha.
⒊ ukuqwalaselwa kwezigulane ngamanzi, ibhalansi ye-electrolyte, ukurekhoda isixa seeyure ezingama-24, ukunika isikhokelo kwisiseko sokubuyisela kwakhona emanzini.
⒋ nikela ingqalelo ekujongeni ilindle lesigulana, jonga ukuba ngaba impendulo enokubakho.
(2) iindawo zokonga
⒈ fowunela isigulana: utyando, owokuqala ukubiza igama laso, achaze injongo yotyando kunye nezilumkiso.
⒉ ukuseka nokugcina i-airway egudileyo: thatha icala lentloko yecala ukuya kwicala, nangaliphi na ixesha ukucima i-secretions ye-tracheal, ukulungele ukumunca izinto, nangaliphi na ixesha ukufunxa.
⒊ ukugcina ukufakwa kwi-intravenous: irekhodi engqongqo yesixa samachiza asetyenzisiweyo.
⒋ ukugcina isuntswana elisebenzayo lelungu, umthambo rhoqo kunye nokuphulula ukubonelela ngokwasemzimbeni, uthintelo lwesandla, unyawo kunye nokuqhawuka, ukonakala kunye nemithambo-luvo.
⒌ ukukhuthaza ukubuyiswa komsebenzi wobuchopho: phakamisa ibhedi kwi-30 ukuya kwi-45 degrees okanye ukunika i-semi-recumbent posture, unyango olumiselweyo kunye ne-oxygen inhalation.
⒍ ukugcina umsebenzi oqhelekileyo wokukhupha: ukuhlolwa rhoqo kwezigulane ezinokugcinwa komchamo wesinyi, ngexesha lokunika indlu yangasese yokulala, ukunceda ukuphulula amazantsi esisu ukukhuthaza ukuchama, ukufakwa kwe-catheterization okanye ukutshintshwa kweengxowa zomchamo kufuneka kuhlawule ingqalelo kwi-teknoloji ye-aseptic.
⒎ ukugcina ucocekile kwaye ukhululekile: susa i-denture, i-hairpin, ukuthena umnwe (uzwane) A;ukhathalelo lomlomo lwemihla ngemihla kabini, gcina umlomo ucocekile kwaye ufumile, unokupeyintwa ioyile yeparafini (lipstick) ukuthintela ukucandeka komlomo;ukuhlanjwa kwesanti rhoqo kunye nokuhlanjwa kwe-perineal, Buyisela impahla ecocekileyo.
⒏ nikela ingqalelo kukhuseleko: ukuxhwaleka kufuneka kube yibhedi eyongezelelweyo, ukuba kukho imeko embi kakhulu, efanele ukunika imiqobo;ukwazi ngokuxhuzula ngumkhuhlane ophezulu, ukucaphuka kwe-meningeal, Izixhobo zoNyango lweSigulane kufuneka zinikwe ukupholisa okusebenzayo kunye nokubeka iphedi lezinyo, ukuthintela isidlele esilumayo;Zonke iintlobo zemibhobho, ukunqanda ukutyibilika.
⒐ ukuthintela ukusuleleka kwemiphunga: ukujika rhoqo ukubuyisela ukudubula, ukuvuselela ukukhwehlela kwesigulane, ukufunxa ngexesha elifanelekileyo;gcina ukufudumala, ukuphepha ukubanda, ukusetyenziswa kwamanzi ashushu xa ubushushu bamanzi bungekho lula kwii-degrees ezingaphezu kwama-50, awukwazi ukudibanisa ngokuthe ngqo ulusu ukuthintela ukutshisa.
⒑ Ukuthintela izilonda zoxinzelelo: ukusetyenziswa kwebhedi yomoya, ithambo eliphuma kwindawo yesipontshi, gcina iyunithi yebhedi icocekile kwaye igudile.Rhoqo nge-1 ~ 2h yima kanye.
⒒ ukhathalelo lwamehlo: susa iilensi zokudibanisa ukuhlawula ilungelo lokugcina.Izigulana azikwazi ukuvala ijwabu leso, ukusetyenziswa rhoqo kwe-saline bristles ukuhlamba iliso, nge-oil yamehlo okanye i-oyile ye-Vaseline ukukhusela i-cornea, iSixhobo sokuKhathalela isigulana ukuthintela ukomisa kwe-corneal kunye nokudumba.
(Iii) Imfundo yezempilo
⒈ fumana usapho ngesikhokelo samalungu osapho ukuba luqhube ulwazi oluhambelanayo lwezigulana ukuba ziphinde ziqale uqeqesho ukunceda izigulana ngokwenza umthambo kunye nokuphulula umzimba.
⒉ ukhathalelo ngokwasengqondweni: ukhathalelo lokukhuthaza izigulana,Izixhobo zokhathalelo lwezigulane ukuze izigulana ziqonde iinqobo zazo kusapho noluntu ukonyusa ukuzithemba ukoyisa isifo.