Q＆A
Mubvunzo: Ndinofanira kuvhura gomba rakawanda-rinoshanda pane mask kuti ndikurudzire kudzingwa kwe CO2?
A: Kuvhura maburi akawandisa pamasikisi kuti akurudzire kudzingwa kwe CO2 hakukurudzire CO2 kudzingwa kwevarwere.Nekudaro, kana murwere aine yakanyanya CO2 chengetedzo, iyo inoramba yakakwira mushure mekugadziriswa kwakamisikidzwa kweasina-invasive ventilator modhi, paramita, uye masiki kusarudzwa, uye mask inopindirana zvakasimba kumeso kwemurwere nekuderera kwemhepo, gomba diki rinogona kuvhurwa wedzera huwandu hwekusaziva kwemhepo kuvuza.Ichi chikamu chekubuda kwemhepo chinogona kuderedza nzvimbo yakafa mumasiki, kuderedza kudzokorora kufema kwekabhoni dioxide uye kukurudzira kubuda kwekabhoni dioxide, asi kuchenjerera kunofanira kutorwa kutarisa vhoriyamu yekubuda kwemhepo kuti risave yakakura, zvikasadaro zvichaita. kutungamirira kune yakanyanyisa kubhadharwa kwemhepo, kuwedzera kusagadzikana kwevarwere, ventilator baseline drift, zvichiita kuti kuderera kwemhepo yemhepo, kuvhiringidza nemhepo yemhepo basal air flow, nguva yakareba yekuenzanisa, kukonzera kunonoka kana asynchronous trigger, kana kunyange kukanganisa kusina kukodzera, kunyanya kune The pressure trigger ine. iyo yakanyanya kukanganisa, uye zvakare inoderedza kufefetera zvakanaka kana kutoita kuti isashande.
Mubvunzo: Panguva yekushandiswa kweVCV modhi, pane kudonha panguva imwe chete mukumanikidza kana kuyerera kunokwira, asi waveform inodzokera kune yakajairwa mushure mekuchinja kumapapu akafananidzwa.
A: Kune varwere vanorwara zvakanyanya vanogamuchira mechanical ventilation, airbag leakage inowanzova nengozi.Kana iyo airbag inodonha ikaonekwa munguva, kurapwa nekukurumidza hakuzokonzeri mhedzisiro yakakomba.Kana iyo inodonha ikasaonekwa nenguva kana kuwanda kwekubuda kwemhepo kwakakura, zvinogona kukonzera kusakwana kwemhepo muvarwere vanorwara zvakanyanya, zvichikonzera kuchengetwa kwekabhoni dioxide uye hypoxemia, izvo zvinogona kutungamirira kumigumisiro yakakomba uye inogona kutyisa hupenyu mukurwara kwakanyanya. varwere.
Q: Murwere akanyatsogadziriswa uye ma parameter akaiswa zvine musoro, nei mhepo yekumanikidza yakakwira alarm alarm?
A: Kana iwe uchigona kusabvisa man-muchina kutarisana, uye parameter matambudziko.Zvadaro nyaya huru dzinoda kureva zvinotevera.
1. Ventilator circuit kana airway zvinokonzera
Dunhu remhepo rinoputika rinowanzovharwa nedunhu rakatsemuka;dunhu rakavharwa nemvura mumhepo yekufema.Nzira yemhepo yakavharwa ne secretions;nzvimbo yetracheal tube inoshandurwa uye kuvhura kuri pedyo nemadziro emadziro;kukosora, etc.
Kurapa kupikisa.
(1) Tarisa kuti usabvisa mhepo yemhepo kubva pakumanikidzwa, kukanganiswa, uye kuunganidzwa kwemvura muchubhu, chengetedza nzvimbo yechubhu yakasungwa zvishoma zvishoma pane chinzvimbo chetracheal tube interface kudzivirira condensate reflux, uye dump condensate munguva yakakodzera. maitiro.
(2) Kubuda pachena kwekufema.Varwere vanoita kurapwa kwemhepo kuburikidza nemhepo yekugadzira vanorasikirwa nebasa ravo nekuda kwe epiglottis, kuvharidzirwa kwemucosal cilia chiitiko, kushaya simba kwechikosoro reflex, kunyanya kuoma kubudisa sputum, kunonoka kuvharidzirwa kwemhepo yemhepo, zvichingodaro, zvichiita kuti mhepo irege kupera kana kuwedzera kwehutachiona.Kana huturu hwemurwere hwakanamira, isa 5 ~ 10ml yemadonhwe esaline panzira yemhepo kuti uwedzere kubuda.Kuti udzivise kuunganidzwa kwemukati memhepo, ita mechanical kufema kwekanguva mushure mesaline madonhwe, kuitira kuti mvura yakasvibiswa inogona kupinda mumhepo diki yekudzikisa sputum uye kumutsa basa reciliary uye wozoita kusveta.Tarisa kushanda kwehumidifier, chengetedza humidification tembiricha 32～36 ℃, humidity 100%, uye kazhinji mhinduro yekunyorovesa haifanirwe kunge iri pasi pe250ml kwe24h kudzivirira secretion kubva pakuoma.
(3) Maererano nehurefu hwechikamu chakafumurwa chetracheal tube, gadzirisa nzvimbo yetracheal tube uye gadzirisa tracheal tube kana tracheotomy cannula.Kana tracheal chubhu iri mutete, ipa vhoriyamu yemvura yakafanira, dzikisa mwero wekufemerwa uye kurebesa nguva yekufemerwa kuchengetedza mhepo yemhepo iri pasi pe30cmH2O, uye tsiva chubhu yakakora kana zvichidikanwa zvichienderana nemamiriro chaiwo.
(4) Pakubatsira murwere kutendeuka, munhu anofanira kuvhiya vaviri vaviri.Munhu mumwe chete anofanira kubvisa chubhu yakarukwa kubva pachibatiso chekufemesa, bata chubhu yakarukwa neruoko rumwe chete obata bendekete remurwere nerumwe ruoko, uye zvinyoro nyoro achidhonza matako emurwere akananga kudivi remukoti.Mumwe wacho anobata musana nemagaro emurwere kuti abatsire nechisimba uye kupeta murwere nemapiro akapfava.Rongedzazve chubhu mushure mekutendeuka uye chengetedza kune mubati.Dzivirirai chubhu yekufema kubva pakudhonza trachea uye kushatirisa chikosoro chemurwere.
2. Ventilator zvinokonzeresa
Kunyanya iyo yekufemerera inspiratory valve kana expiratory valve malfunction, uye sensor yekumanikidza yakakuvadzwa.
Nguva yekutumira: Sep-13-2022