COVID-19 Yana Bayyana Darajar Bidiyo Laryngoscopy

A cikin sassan gaggawa da rukunin kulawa mai zurfi a duk faɗin ƙasar COVID-19 ya canza yadda asibitoci ke aiki. Tare da karuwar buƙata don tallafawa marasa lafiya a cikin wahalar numfashi, ana sanya sabon mai da hankali kan laryngoscopy na bidiyo (VL) don shigar da marasa lafiya da aka sanya a cikin injin iska.

VL ya sami karɓuwa mai girma saboda ingantaccen gani yana sa mafi kusantar intubation zai yi nasara a ƙoƙarin farko, yana sa tsarin ya zama mafi aminci ga likitoci da marasa lafiya idan aka kwatanta da laryngoscopy kai tsaye (DL). Bugu da ƙari, VL yana rage haɗarin yada ƙwayar cuta mai saurin yaduwa.

"Kasancewar laryngoscope na bidiyo a kowane intubation yana rage kurakurai da matsalolin da ba a zata ba, yana haɓaka amsawa, koyo da koyarwa," in ji Marco Zaccagnini, Magungunan Magungunan Numfashi/Rijista Mai Kula da Anesthesia Clinical. "Yana raba intubation tare da ƙungiyar likitocin kuma yana ba da yanayin tsaro ga masu aiki da marasa lafiya."

Intubation na al'ada

Intubracheal intubation ya haɗa da shigar da bututun endotracheal na filastik ta bakin ko hanci, ta maƙogwaron (wanda ya haɗa da muryoyin murya), kuma a ƙarshe a cikin maƙogwaro (iska mai iska). Ana jagorantar bututun zuwa wurin tare da na'urar da aka sani da laryngoscope, kafin a haɗe ta da injin hura iska.

A cikin intubation na DL na al'ada, likita na iya ganin ƙarshen laryngoscope yayin da yake shiga bakin, amma dole ne ya dogara da "ji" da gogewa don tabbatar da cewa ya guji ƙoshin ƙoshin kuma an sanya shi daidai. Kai tsaye laryngoscopy na iya zama da wahala tare da wasu marasa lafiya. Samun ra'ayi na maƙogwaron maɓalli ne ga wannan dabarar kuma ana iya yin tasiri akan abubuwa kamar tsari da motsi na wuyansa da muƙamuƙi, da kuma yanayin jikin babban iska.

Yin intubation hanya ce ta yau da kullun, har ma fiye da haka yayin bala'in COVID-19, amma ba shi da haɗari. Lokaci -lokaci, ana iya lalacewa ga hakora, bakin ko trachea, kuma ana iya shigar da laryngoscope ba zato ba tsammani a cikin esophagus. Wani lokaci ƙoƙarin laryngoscopy na farko bai yi nasara ba, yana buƙatar ƙoƙarin na gaba. Haɗarin haɗarin ga mai haƙuri yana ƙaruwa tare da yawan ƙoƙarin. A cikin shari'o'in COVID-19, masu ba da lafiya waɗanda ke yin laryngoscopy na iya zama cikin haɗarin kamuwa da cutar.

DL yana da ƙalubale don ƙwarewa, amma tare da ƙwarewa, likitocin anesthesiologists da masu ilimin numfashi sun ƙware da wannan dabarar kuma galibi suna samun nasara akan ƙoƙarin wucewar farko. Nazarin ya nuna[i], duk da haka, cewa ɗaliban likitanci da mazaunan maganin cutar sankara suna da ƙarancin ƙimar nasarar farko fiye da gogaggun masu ilimin likitanci.

Sababbin shaidu

Laryngoscopy na bidiyo, a gefe guda, yana da sauƙin koya saboda yana ba da tabbaci na gani na ci gaba da bututun numfashi zuwa cikin huhu. Wannan yana inganta yuwuwar cewa intubation zai yi nasara a ƙoƙarin farko ko da mai ba da lafiya ba shi da ƙwarewa, ko kuma idan yanayin mai haƙuri ya sa hanya ta yi wahala. Tare da VL, kyamara a ƙarshen laryngoscope yana ba da ingantacciyar hangen nesa na saman iska, gami da muryoyin murya, nuna hotunan bidiyo a cikin ainihin lokaci akan allon da aka makala a hannun laryngoscope.

An tabbatar da mafi girman nasarar nasara ga VL a cikin binciken 2019 wanda Dr. Ruediger Noppens ya jagoranta, farfesa na farfesa kan ilmin likitanci a Jami'ar Yammacin Turai a London, Ontario. Wannan fitina ta ƙasa da ƙasa ta ƙunshi marasa lafiya sama da 2,000 kuma idan aka kwatanta nasarar nasara ta farko ta intubations ta amfani da madaidaicin laryngoscope da laryngoscope na bidiyo na McGrath MAC, wanda Medtronic ya yi.

Binciken ya gano cewa VL yana da nasarar nasarar wucewa na farko na kashi 94 cikin ɗari, idan aka kwatanta da kashi 82 na DL, kuma yana haifar da raunin haƙuri. A cewar Dakta Noppens, wannan binciken shine ainihin shaidar farko don tallafawa amfani da VL don intubations na yau da kullun. Masu binciken sun kammala cewa kawai fa'idar DL ita ce tsada, kodayake mafi girman kuɗin farko na na'urar bidiyo na iya wuce ta tanadi a cikin lokaci da matsalolin likita.

Wannan labari ne mai kyau ga gaggawa da likitocin ICU, waɗanda galibi ke yin ƙarancin intubations na yau da kullun fiye da masu ilimin likitanci. VL kuma yana da aminci ga likitocin da ke hulɗa da COVID-19 saboda ba lallai ne su kusanci fuskar mara lafiya kamar yadda suke yi da DL ba. Yana da aminci ga marasa lafiya ma, saboda yana haifar da raunin rauni.

Yayin da asibitoci ke ta faman jinyar marasa lafiya masu tsananin kamuwa da cutar COVID-19, ƙungiyoyin ƙwararru[ii] a ƙasashe da yawa sun fara ba da shawarar yin amfani da VL don taimakawa rage yaduwar cutar. Waɗannan shawarwarin sun samo asali daga shaidar ingantacciyar nasarar intubation ta farko da haɓaka tazara tsakanin mai badawa da mai haƙuri yayin aikin.

Kodayake fa'idodin VL suna ƙara fitowa fili, DL ya kasance matsayin kulawa a Kanada, yayin da aka keɓe VL don wahalar intubations. Makomar VL a halin yanzu shine batun muhawara a tsakanin alummomin cutar, tare da mutane da yawa suna gaskata ainihin tambayar ba ko zata maye gurbin DL a matsayin ma'aunin kulawa ba, amma yaushe.


Lokacin aikawa: 25-07-21