Kaitiaki NIBP tuku

Whakaitihia nga hapa o te NIBP me te auscultation ma te maataki i te ngaru plethysmographic i runga i te oximeter pulse me te tohu i te pehanga toto toharite.
"Mehemea he waahi e hiahia ana koe ki te haere, ka taea e au te kawe i a koe ki reira, e mohio ana ahau, ko au te mapi. Mena he waahi e hiahia ana koe ki te haere, ko taku whakaaro ka taea e au te kawe i a koe ki reira, ko au te mapi. Ko ahau te mapi, ko ahau te mapi, ko ahau te mapi!"- Dora te Explorer
He maha nga kaimahi hauora mano tau kei te harikoa ki te waiata i a ratou e panui ana i tenei, ko o ratau maatua me o raatau hoa pakeke me nga tamariki kei te whakamahi tonu i nga kaitapa tiihi ki te roro o mua hei whakakore i nga maharatanga.
Kaua e manukanuka, peepi boomer medics, e kore ahau e timata ki te waiata i te waiata kaupapa "Barney" a muri ake nei, engari e hiahia ana ahau ki te whakaatu i te aroha iti mo te tawhā tohu nui e warewarehia ana, mean arterial pressure (mapi). kia nui ake te aro ki te iti o nga reu i te taha o te panui NIBP, na te mea ko tetahi o nga inenga pono o te hinu ka taea e tatou te aromatawai.
I te tau 2011, i tuhia e au he pou e kiia nei ko "Tips and Tricks for EMS Blood Pressure Readings". i nga wa katoa ka rapu awhina tetahi EMT hou me pehea e tika ai te pehanga toto i te wa e neke ana ki te waka tūroro.
A, i nga wa katoa i roto i aua miro korero, ka tohu etahi o nga kaitohutohu tawhito mohio ko nga korero a te NIBP he tino kore i te tika, me "kia atawhai koe i te manawanui, kaua ko te aroturuki". me whiwhi ratou i te pehanga tuatahi ma te ringa.He tika ia, he kino rawa nga miihini NIBP.Ahakoa nga kaihanga taputapu e kii ana.Pnuihia te pukapuka a te kaiwhakahaere o to ngakau aroturuki me te huna i te whakakao ki tetahi waahi kei roto i o maatau turoro e hiahia ana ki te BP tika te nuinga - nga turoro i nga pito e rua o te tauine - ko te panui NIBP i runga i to mata kaore pea, he toto toto tika.
Mena he taara taku mo ia EMT nana i kii maia he BP ka mutu ki te kore (150/90, 120/80, 110/70, ia wa) he BP ranei nana i kumea te stethoscope mai i tona taringa me te omaoma. He tau kerekere ka panuitia ki te mita me te tohu hautei rite... kaati, he maha aku taara.Kare pea e ranea ki te hoko i te whaanui huatau kua roa e titirohia ana e au, engari he maha nga wa ka pera. Ka karangahia e ahau he aroturuki toto toto a-ringa he polygraph paramedic.
Mena he ngawari ki te tarai i te pehanga toto, kaore matou e tuku tohutohu me nga mahi tinihanga mo te mahi i ia tau, i ia tau.
Heoi, ahakoa ko te NIBP cuff te kaha ki te whakanui i te pehanga toto systolic i roto i te ohorere, ka tutuki tata ki te MAP rite ki te aro turuki totika.
I roto i te rangahau mo nga turoro ICU pakeke 4,957 i roto i te whare tiaki tuatoru, neke atu i te 27,000 nga uara tahanga toto i whiwhi i te wa kotahi me te NIBP me te catheter-of-arterial sensors. He nui ake te whara o te whatukuhu me te mate i roto i te roopu inehia e te NIBP systolic. atu i te roopu me te pehanga toto systolic arterial i te awhe rite (< 70 mmHg).1
I te whakataurite i te wharanga o te whatukuhu whakapeka me te mate o te ICU i waenga i te MAP arterial me te MAP noninvasive, he iti noa nga rereketanga, a ka whakatauhia e nga kaituhi ako matua ko te NIBP i nui ake te pehanga toto systolic i roto i te ahua ohorere, engari ehara i te mea kaore i te whakaheke toto.Ko nga hononga MAP i whiwhi i tino tata ki te MAP arterial (Whakaahua 1 me te 2).
Na te aha i tino tika ai nga miihini NIBP ki te ine i te MAP engari he kore pono ki te ine i te pehanga toto systolic?
He rereke tenei o te mahi a-ringa;ka whakamaaramatia e matou a Korotkoff ki te whakatau i te pehanga toto systolic me te diastolic, katahi ka puta ma te pangarau te pehanga toto totika mai i te wharite e whai ake nei:
He maha o tatou i ako i tenei tatauranga i roto i te kura nēhi, katahi ka wareware wawe, na te mea ko te nuinga o a tatou tawhā maimoatanga e pa ana ki te pehanga toto systolic, a, na te mea e kino ana tatou ki te pangarau. Te ahua nei ko nga miihini NIBP e ahu mai ana i te pehanga toto mai i te MAP me te tere o te pupuhi ehara i te mea he pai ake te mahi pangarau i a tatou.
Ko te nuinga o nga tangata kua neke atu i te rima meneti te noho ki muri o te waka tūroro, ka mohio ko te kuia mawhero e ataata ana, e 90 pauna te taumaha me te 84/60 te pehanga toto, kaore he rite ki te tangata e 250 pauna te taumaha, he toto tona. Te pēhanga 90./40. Mo te kuia, koinei pea te toto o ia ra, he pai te para o ona whekau.
Ko te nuinga o nga puna korero ko te MAP o te 65 mmHg te paepae iti rawa mo te urunga okana tino nui, me te awhe MAP noa o 70-110 mmHg. Ko nga whatukuhu o te tangata he kaha ake te aro ki te hypoperfusion, ahakoa kua whakaatuhia e etahi rangahau kararehe he kiore toto (i mohio koe He rite tonu te MAP o te kiore ki te tangata?) Ka taea e te MAP te iti ki te 50 mmHg mo nga meneti 90. Ka timata te whara o te whatukuhu i roto i nga meneti 20 me te MAP i raro i te 60 mmHg.
Na, i te wa e whai ake nei ka whakaaro koe mena he iti te hau o to manawanui engari kaore i te kino te pehanga toto, tirohia te ngaru plethysmographic i runga i to oximeter pulse, mena kei te whakapono koe karekau te pehanga toto NIBP i waenga Indecisive e tino rite ki te Ko te whakaaturanga haumanu a te manawanui, te taringa teka ranei o to hoa, kia aro nui ki taua nama iti kei roto i nga reu i te taha o to panui NIBP.Kare koe e arai i te MAP ki te huarahi he.
Ma te tuku i o korero, ka whakaae koe ki te kaihoko kua tohua ki te whakapiri atu ki a koe me nga raraunga ka tukuna e koe kaore i raro i te tono "Kaua e Hokona Aku Korero Whaiaro".
Ko Kelly Grayson, NRP, CCP, he paramedic tiaki tino nui i Louisiana.Mo nga tau 24 kua pahure ake nei, kua mahi ia hei paramedic mara, he paramedic mo te kawe waka, he kaitirotiro mara me te kaiwhakaako.Ko ia te perehitini o te Louisiana EMS Educators Association me he mema poari o te Los Angeles National Registered EMT Association.
He holds an associate degree in general studies from Nunez Community College, Louisiana State University Eunice.Kelly was recognized as the 2016 Louisiana Paramedic of the Year, the 2002 Louisiana EMS Instructor of the Year, and the 2002 Louisiana AHA District Teacher of the Year, and was the recipient of the 2012 Best Regular Featured Web Column/Industry Maggie Award and 2014 Best Online Column at the Annual Folio Eddie Awards.He is a frequent speaker at EMS conferences, has contributed to various EMS training materials, and is the author of the popular blog A Day In a Day In a Ambulance Driver, "En Route: A Paramedic's Stories of Life, Death and Everything Inbetween" and "Live: More Stories About Life, Death, and What's In Between".You can follow him on Twitter (@AmboDriver), Facebook, LinkedIn, or email kelly@ambulancedriverfiles.com.Kelly is a member of the EMS1 Editorial Advisory Board.
Ko te EMS1 kei te whakarereke i te huarahi e kitea ai e te hapori EMS nga korero e tika ana, te tautuhi i nga korero whakangungu nui, te whakawhitiwhiti korero ki a raatau ano, me te rangahau i nga hoko hua me nga kaiwhakarato.