Anesthetic apparatus: mhando, maitiro. Mazuva ano mishonga yemakirini

Dzimwe nguva munhu anotarisana nezvinetso zvakakomba nehutano hwake, kana nzira yakanakisisa yekurapa inopindira kupindira. Hazvibviri kuita chirwere kune chero nhengo pasina anesthesia, zvisinei kuti murwere achaona kurwadziwa kunorwadza, uko pakuguma kunogona kumuuraya. Kune marudzi akawanda eesesthesia, asi yakadzika uye yakareba zvikuru inopiwa nerubatsiro rwezvinhu zvakakosha. Chigadzirwa cheanesthesia, iyo ndiyo inoshandiswa kunyanya muimba yekushandisa, inobvumira murwere kuti aite nokukurumidza anesthesia, panguva iyo chero kupindira kunoitwa. Asi chii icho chigadzirwa?

Anesthetic apparatus: rudzi rwechigadzirwa chii?

Anesthesia mishonga inyanzvi yezvokurapa iyo inotarisirwa kugovera anesthesia yakawanda. Izvi zvinogona kuinzi anesthetic maintenance system. Kana zviri munguva dzakapfuura, kushanda kwezvigadziri izvi kwakaderedzwa kuva chokwadi chekupa inhalation anesthetics uye magasi ekusimbiswa kwehupenyu mudunhu revarwere, saka mishonga yemakemikari yemazuva ano inopa mikana yakawanda. Haisi chete inogona kupa oxygen uye inhalation anesthetics mumhando yegesi kana mvura, asiwo kuita sarudzo yakazara yezviratidzo zvinokosha:

• Kushingaira mumhepo;
• Kuyerera uye kuongororwa kwe okisijeni;
• Kushandura mafungiro emapapu emurwere.

Mukuona kwekuti zviitiko zvekuita basa rakaoma zvikuru nekushandiswa kweaneshehesia rinowanzoonekwa sechinhu chakakosha, uyezve, zvakakosha kuita mhepo inoputika yemapapu. Panguva yekushanda, zvigadzirwa zvemazuva ano zveimwe nguva zvinotsiva mabasa emapfupa ekufema emuviri wemunhu, oxygenation uye ventilation zvinopiwa. Kupa anesthesia, endotracheal tube kana mashizha anesthetic inoshandiswa.

Pamusoro pezvo, chigadzirwa ichi chinokubvumira kudzora ivhu nekumanikidzwa, asi nzira dzinogona kuve dzakasiyana, somuenzaniso, inogona kunge inobatsira kana inodzora ventilation, inodzvinyirirwa kana inotsigirwa, uye mamwe mabasa akawanda.

Ndeipi iyo inonzi anesthesia yakashandiswa?

Anesthetic and breathing apparatus haishandisirwi chete kupindira kwekuvhiya, asiwo panguva yekurapa kwezvirwere zvakasiyana-siyana zvinokonzerwa nemabasa ekukosha emumuviri:

• Yakanyanya mwoyo kusakundikana;
• Kugumburwa mubasa rekufuridzirwa kwemuviri: pneumonia, asthma, kuzvikudza kwemapapu;
• Shock;
• Coma;
• Kushungurudza mamiriro ezvinhu etiology yakasiyana;
• Kukuvara kukuru uye kupisa;

• Zvirwere zvinotapukira, kunyanya botulism, tetanus nevamwe;
• Mhando dzakanaka dzehupfu.

Modular anesthesia system ine maitiro akawanda ekushanda:

• Inopa kukonzera kwakanaka, iyo inodyidzwa nguva dzose;
• Zvakanaka kumanikidzwa, asi kunodyidzwa muzvikamu zviviri;
• Kusanganiswa kwezvinhu zviviri zvinorondedzerwa pamusoro apa.

Mhando yezviridzwa zveaneshesia

Parizvino, nhamba yakawanda yezvigadzirwa zvakaonekwa kuti havasi rubatsiro rwechiremba chete, apo mukuru anesthesia (anesthesia) inodiwa , asiwo kune vanachiremba vanofanira kurapa varwere vane hutano hwakaoma.

Kuti tibatsire vanachiremba mukurapa, vataki vanopa mhando dzemhando dzezviridzwa:

• Floor;
• Wall;
• Portable.

Pasi yemhando yakagadzirirwa nekuvhara maitiro uye rutsigiro rwakaita sevhiri, izvo zvakaita kuti zvive nyore kuita kuti zvive nyore sezvinobvira pasi pemirairo.

Mhando dzakasiyana-siyana dzinowanzoshandiswa pakudzidzisa helicopter nekuchenesa, ambulensi kana ambulensi yemhando yemazuva ano.

Zvigadziriswa kana zvigadziriswa zvakasikwa kuti zvigadzirire vashandi vekukurumidzira uye vanunura nemichina yakakosha uye isingakundiki iyo inobatsira munzvimbo ipi zvayo kubatsira murwere nehupi hwehutano hwechirwere ichi.

Mukuwedzera, zvigadziridzo zvinowedzera zvakagadzirirwa ne mabhatiriyo anobatsira chigadziro mune chero mamiriro ezvinhu kuti ashande kwemaawa akawanda pasina kupera. Uyewo, zviyero zvose zvinogona kusiyana zvichienderana nerudzi rupi rwevarwere. Semuenzaniso, kune vana, zviyero zvakadaro zvinonzi neonatal uye vane mamwe mabasa akawanda.

Nheyo yeanesthesia mafura

Anesthesia inoshanda pamutemo wejojo. Vanobatsira kupinza mumapapu emurwere mubhuku reanesthetics muchimiro chemhepo inosanganiswa neokisijeni, kana kuti imwe chete yeoksijeni. Zvose zvinoenderana nemamiriro acho ezvinhu: zvakakosha kuita chirwere kana kudzorerazve, zvinokosha kufunga nezvezera remurwere, uremu hwake, uyewo zvirwere zvevarindi.

Mhepo inoputika inoitwa nemhepo yakasimba pamagumo emhepo inoputika 5-10-15 cm yemvura chikamu, asi kuverenga kunofungidzirwa. Zvinokwanisika kuita mhepo inoputika yemapapu kwemaawa akawanda, uye dzimwe nguva mazuva kana makore. Iko kunewo zvakakwirira-purogiramu zvigadzirwa. Vanouya nenzira dzakasiyana-siyana: volumetric, jet uye oscillatory.

Iyo jet device inowanzoshandiswa, uye inopa huwandu hwemapfupa ekufema mukati ma100-300 paminiti. Nokudaro, zvinokwanisika kuderedza mutoro uri pamwoyo, kuvandudza kuteura ropa uye kupisa kwegesi mumapapu. Kushandiswa kwemavhenekeri kunogona kuenzaniswa nemagetsi anowanikwa.

Unyanzvi hwehutano hweanesthesia zvigadzirwa

Hapana humwe huri nani huri nani, mune sciences dzakawanda (kuvhiyiwa, anesthesiology nekudzokazve) zvakabatanidzwa pamwe chete kune anesthesia machine. Zvigadzirwa zvakadaro zvakashandiswa kwenguva yakareba, asi zvigadzirwa zvemazuva ano zvakasiyana nemabasa akasiyana siyana uye kubatsira kunyange mumatambudziko akaoma. Zvivako zvemazuva ano zvine maitiro akadaro:

• High pressure;
• Dosimeter;
• The evaporator of anesthetics mumvura;
• Inovakwa-in muvhenekeri, iyo ine maitiro akawanda ekushanda;
• Kufuridzirwa kwedunhu nekunyura;
• Chiratidziro chekuongorora nzira;
• Aspirator;
• Humidifier yemubatanidzwa wekupemha.

Iyo dosimeter uye evaporator inodiwa kuitira kuti kunyatsogadzirisa muyero wezvinodhaka. Muzviitiko zvakawanda, rudzi rwemhepo inoshandiswa iyo inoshandiswa pakuderera kwemugadziro kushandiswa kushanduka. Evaporator - unyanzvi hunokosha, huri mairi hunochinjwa kuva chigadziriswe chemajini mumhepo.

Iko rinoputika rinoshandiswa nenzira imwechete yekutora ventilation uye sechitoro chemishonga inodhaka.

Zviratidzo zveaneshesia zvigadzirwa

Nhasi, anesthesiology nekusimudzirwa kwaenda mberi. Zvose zvinokonzerwa nekuti imichina yemazuva ano inobvumira munguva pfupi kubatsira varwere vane hutachiona hwakaoma. Kazhinji kazhinji, masangano ekurapa anoshandisa zvinobudirira uye mari yeanesthesia. Vane sarudzo dzakasarudzwa, izvo zvinoita kuti zvikwanise kutora modules kubva kune izvo kana zvimwe zvido zvemumwe nyanzvi uye zvakananga zvekushanda.

Mukuwedzera, rimwe nerimwe rinenge riripo anesthesia rine zvaro zvakasiyana:

• Rudzi rwe anesthetic fan. Uye kune maviri acho: pneumatic uye magetsi, uye mune dzimwe mhando hakuna fan kunze zvachose.
• Rotameter: mechanical kana electronic.
• Kushandiswa kwakasiyana-siyana kwegasi: mhepo, oksijeni, nitrous oxide, xenon nevamwe.
• Kugona kana kusakwanisa kushandisa pasi kuderera anesthesia.
• Nguva yakawanda iyo inobvumira kuti chigadzirwa chiitirwe zvakakwana.
• Kuyera.
• Kusiyanisa zvichienderana nezera remurwere.

Imwe misiyano yakakosha iri muhutano hwekudzivirirwa kwemajini. Vagadziri vanogadzira mienzaniso inoda kusachena kwekufema dunhu rekusuruvara, uye kune iyo iyo matambudziko akadaro haafaniri kudiwa.

Asi kuti unzwisise zvakajeka maitiro eesesthesia makemikari, unofanirwa kutarisa huwandu hwemadzinza anozivikanwa zvikuru.

Chigadzirwa cheanesthesia "Polinarkon"

Ichi chigadzirwa chinobva kumudzimai wekuumba, inonzi inonyanya kufanirwa. Kusvika iye zvino, vanachiremba vakawanda vakapa mhinduro dzakanaka dzechigadzirwa ichi, nokuti inobatsira kupa kufema kune murwere pane rimwe remakwikwi mana. Vanonyatsopindirana nemapurisa anopa mhepo yakasvibirira, asi inonyanya kuenzaniswa nemidziyo yakadai: PO-5 kana 6, PHASE-5, iyo inozoguma inoita kuti zvikwanise kugadzirisa zvakanaka uye nguva dzose kuongorora huwandu hwemapapu. Mienzaniso yakafanana inowanika pamutengo.

Ancillary machine Fabius Plus

Ichi chigadzirwa chinobva kuGerman chigadzirwa "Dreger" chinonyanya kufarirwa. Avo vakanga vatozviedza mumabasa avo vakagutsikana. Ichi chigadzirwa chakagadzirirwa neE-vent fan, iyo inopa maitiro emhepo ekuzorora:

• Bhuku / zvinyorwa;
• Kudzora ivhu;
• Nenguva dzose kushandiswa kuzvidzora;
• Nesimba rinotsigirwa;
• Inononganiswa zvimwe zvekuvhenekera.

Chimwe chinhu chinonzi anesthetic chinonzi "Draeger Fabius" inogadzirisa motokari yemagetsi ine piston uye inofambisa magetsi. Muchirongwa pane bhatiri, uye inoshanda zvakasununguka kwemaminitsi 45. Iyi faira ine yakanyatsonaka uye inonzwisisika.

Unyanzvi hwehutano hwe "Fabius"

Kuti uchinzwisise zvakanakira zvii zvechigadziri ichi, zviri nani kuti tsanangurire pakarepo mabasa ayo:

• Kuenderera mberi kuongororwa kwe O2 kutarisa panguva yekufemerwa;
• Nguva dzose kuongororwa kwekufema kwepamusoro uye maminitsi emuviri;
• Kuongorora pasina kukanganiswa kwepamusoro pekumanikidzwa mumugwagwa wekupema;
• Kushingaira mupata.

Kuti utaure kuti chiyi ichi chinopesana nezvimwe zvizhinji, unoda kuziva zvaro zvakasiyana:

• Iyo yakagadziridzwa nemuvara kuratidza, uko magetsi uye zviratidzo zvinoratidza zviratidzo zvinoratidzwa;
• Ane nzira yakasimba uye yakachengeteka ye mechanical rotors;
• Pane mukana wekugadzirisa panguva imwechete evaporator ye inhalation anesthetics;
• Anofamba, saka zviri nyore kuti chiremba agadzirise nzvimbo yakakwana yekushanda;
• Chinhu chakakosha chetrolley, iyo inogonawo kugadzirisa imwe rudzi rwezvigadzirwa.

Asi hazvina mhosva kuti iyo yakagadzirwa sei anesthesia, murwere wese anofanira kuziva kuti inogona kukuvadza muviri.

General anesthesia: migumisiro yemuviri

Pasinei nekuti anesthesia yakaiswa nenzira yakarurama uye nyanzvi yeanesesthesiologist, inofanira kuyeukwa kuti kuiswa kwayo kunosanganisira zvimwe zvinogona kuitika, pakati payo:

• Hypotension;
• Gag reflex;
• Arrhythmia;
• Edema weuropi;
• Asphyxia;
• Matambudziko mu pulmonary system;
• Zvinopisa simba;
• Kuora kweiyo;
• Zvisina kukodzera muhutachiona hunopa huropi.

Ivo pachavo, varwere vakanga vakwevedzwa neaneshesia vakawanda , migumisiro yemuviri inotsanangura: kuparadzirwa kwemashoko, kukanganiswa kwepfungwa zvishoma, zvinetso zvekutaura. Vamwe varwere vane kugadzikana, kunyangadza, kutya, kusuruvara.

Kunyanya anesthesia inonyanya kubata vana, vakadzi vanotakura vana, uye vakwegura.

Kuongorora kwechiremba

Anesthetic apparatus mumutambo wayo inoshandiswa navanachiremba, vanaesthesiologists uye resuscitators. Maererano nemhinduro dzavo, zviyero zvakange zvakagadzirirwa zvirongwa zvekushanda munguva dzakakura dzeSoviet zvakanga zvisina kubudirira uye zvinobatsira. Asi panguva ino, apo zvigadzirwa zvisingagadziri, zvose zvakashanduka zvakajeka, zvigadzirwa zvemazuva ano zvine zvakawanda zvakakosha, kuitira kuti vanachiremba vanogona kubatsira kunyange vanhu vanorwara zvakakomba. Nekubatsira kwavo, zvaikwanisika kuderedza kufa kwevarwere vanorwara zvakanyanya.

Mhedziso

Kupfupisa, munhu anogona kutaura zvakasimba kuti mazuva ano mashandisirwo emhando ipi zvayo inyanzvi dzinobatsira dzisingabatsiri kukurumidza kupa aneshesia kune munhu, asiwo kutsigira basa rinokosha rezvimwe nhengo. Mukuwedzera, nerubatsiro rwavo, anesthesiologist inogona kusarudza mukana wakakwana kune mumwe murwere. Anesthesia mafurai emhando ipi zvayo inogona kushandiswa chete nevanyanzvi vane ruzivo, muchipatara kana mumapoka ekununura mafambiro mumugwagwa.