Mosireletsi ea lahliloeng oa NIBP

Fokotsa liphoso tsa NIBP le auscultation ka ho shebella plethysmographic waveform ho pulse oximeter le ho hlokomela khatello ea methapo e bolelang.
"Haeba ho na le sebaka seo u batlang ho ea ho sona, nka u isa teng, kea tseba, ke 'mapa. Haeba ho na le sebaka seo u lokelang ho ea ho sona, ke becha hore nka u isa moo, 'me ke 'mapa. 'Mapa, ke 'mapa, ke' mapa!"- Dora Mofuputsi
Basebeletsi ba bangata ba bongaka ba lilemo tse sekete ba ka bina hammoho ka thabo ha ba ntse ba bala sena, ha batsoali ba bona le basebetsi-'moho le bona ba baholo ba nang le bana ba ntse ba ka sebelisa li-cheese grater leboteng la forebrain ho hlakola mehopolo.
Se khathatsehe, lingaka tsa boomer tsa lesea, nke ke ka qala ho bina pina ea sehlooho ea "Barney" ka mor'a moo, empa ke batla ho bontša lerato le lenyenyane bakeng sa parameter ea bohlokoa e atisang ho hlokomolohuoa, e bolelang khatello ea mali ('mapa). ela hloko haholoanyane palo e nyenyane ka masakaneng a haufi le 'malo oa NIBP, kaha ke e' ngoe ea litekanyo tse ka tšeptjoang tsa perfusion tseo re ka li hlahlobang.
Morao koana ka 2011, ke ile ka ngola sehlooho se reng "Malebela le Maqheka a ho Bala Khatello ea Mali ea EMS." Kholomo ena, hammoho le "Liphoso Tse Hlano Tse Etsang Hore ho Baloa ha Khatello ea Mali ea Hao ho se Nepahetse," e hlaha khafetsa mecheng ea litaba tsa sechaba le li-blog tsa EMS. neng kapa neng ha EMT e ncha e batla thuso ea ho fumana khatello e nepahetseng ea mali ha u ntse u fallela ambulense.
'Me kamehla litabeng tseo tsa maikutlo, basebetsi ba bang ba khale ba bohlale ba thuso ea bongaka bo botle ba bolela hore ho bala ha NIBP ha hoa nepahala le hore u lokela ho "phekola mokuli, eseng mochine". bonyane ba lokela ho fumana khatello ea pele ka letsoho.O nepile, mechini ea NIBP e tsebahala ka hore ha e nepahale.Esita le baetsi ba lisebelisoa ba rialo.Bala bukana ea opereishene ea pelo ea hau 'me u pate boitlamo kae-kae ho eona hore ho bakuli ba rona ba hlokang BP e nepahetseng haholo - bakuli. lipheletsong ka bobeli tsa sekala - 'malo oa NIBP skrineng sa hau e kanna ea se be, eh, khatello ea mali ea' nete.
Haeba ke ne ke e-na le dolara bakeng sa EMT e 'ngoe le e' ngoe eo ka sebete a ileng a phatlalatsa BP e qetellang ka zero (150/90, 120/80, 110/70, nako le nako) kapa BP ea neng a ntša stethoscope tsebeng ea hae 'me a qeaqea a tsilatsila. palo e sa tloaelehang e baloa ka methareng e nang le letšoao le lekanang la hash ... hantle, nka ba le lidolara tse ngata. Mohlomong ha ea lekana ho reka mefuta e 'meli ea feshene eo esale ke e shebile ka nako e telele, empa ho etsahala hangata hoo. Ke bitsa mochine o tsamaisang khatello ea mali ka paramedic polygraph.
Haeba ho ne ho le bonolo ho fokotsa khatello ea mali, re ka be re sa romelle malebela le maqheka mabapi le mokhoa oa ho e etsa selemo le selemo.
Leha ho le joalo, leha cuff ea NIBP e na le tšekamelo ea ho fetelletsa khatello ea mali ea systolic ka ho ts'oha, e fihlella hoo e batlang e le MAP e ts'oanang le tlhahlobo e hlaselang ea methapo.
Phuputsong ea bakuli ba 4,957 ba baholo ba ICU setsing sa tlhokomelo ea thuto e phahameng, ho ile ha fumanoa litekanyetso tse fetang 27,000 tsa khatello ea mali ka nako e le 'ngoe le NIBP le li-catheter-of-arterial sensors. ho feta sehlopheng se nang le khatello ea mali ea arterial systolic ka mefuta e tšoanang (<70 mmHg) .1
Ha ho bapisoa ho ata ha kotsi e mpe ea liphio le lefu la ICU pakeng tsa arterial MAP le MAP e sa hlaseleng, liphapang li ne li le nyane, 'me bangoli ba thuto e etelletseng pele ba fihletse qeto ea hore NIBP e ne e fetelletse khatello ea mali ea systolic maemong a ts'oenyeho, empa eseng ka sekhahla sa khatello ea mali e sa hlaseleng.Likamano tse fumanoeng tsa MAP li ne li le haufi haholo le MAP ea methapo (Lipalo 1 le 2).
Joale ke hobane'ng ha mechine ea NIBP e nepahetse ha e lekanya MAP empa e sa tšepahale ho lekanya khatello ea mali ea systolic?Karabo ke hore seo mochine oa NIBP o se lekanyang ke MAP.Khatello ea bona ea mali e baloang.
Sena ke se fapaneng hantle le kamoo re se etsang ka letsoho;Re etsa hore Korotkoff a tsebe ho tseba khatello ea mali ea systolic le diastolic, ebe ka lipalo re fumana khatello ea mali ho tsoa ho equation e latelang:
Ba bangata ba rona re ithutile palo ena sekolong sa booki ebe re lebala kapele, hobane boholo ba litekanyetso tsa rona tsa kalafo li amana le khatello ea mali ea systolic, le hobane re hloile lipalo. e betere haholo dipalo ho re feta.
Batho ba bangata ba lutseng setulong se ka morao sa ambulense ka nako e fetang metsotso e mehlano ba hlokomela hore nkhono ea bososelang, ea pinki ea boima ba lik'hilograma tse 90 le khatello ea mali ea 84/60 ha a tšoane le monna ea boima ba lik'hilograma tse 250 le mali. khatello ea 90. / 40. Ho nkhono, e ka 'na ea e-ba khatello ea mali ea hae ea letsatsi le letsatsi, litho tsa hae tsa bohlokoa li na le monko o monate.Ho mokhanni oa teraka ea burly, ea letlalo le leputsoa, ​​le mofufutso, ho sa tsotellehe khatello e phahameng ea mali ea systolic, o ne a sa utloahale.
Mehloli e mengata e nka MAP ea 65 mmHg e le moeli o tlaase ka ho fetisisa bakeng sa ho phalla ha litho tsa bohlokoa, tse nang le mefuta e tloaelehileng ea MAP ea 70-110 mmHg. Liphio tsa batho li na le bothata ba hypoperfusion, le hoja lithuto tse ling tsa liphoofolo li bontšitse hore likhoto tse tsoang mali (na u ne u tseba likhoto li na le MAP e tšoanang le ea batho?) li ka mamella MAP ka tlaase ho 50 mmHg ho fihlela metsotso ea 90. Kotsi e matla ea liphio e qala ka hare ho metsotso ea 20 ka MAP e ka tlaase ho 60 mmHg.
Kahoo nakong e tlang ha u ntse u ipotsa hore na mokuli oa hau o tlase empa khatello ea mali ha e mpe hakaalo, shebella plethysmographic waveform ho pulse oximeter ea hau, haeba u lumela hore khatello ea mali ea NIBP lipakeng tsa Indecisive ha e lumellane hantle le tlhahiso ea bongaka ea mokuli, kapa tsebe ea molekane oa hau ea leshano, ela hloko haholo palo eo e nyenyane ka masakaneng haufi le 'malo oa hau oa NIBP.MAP e ke ke ea u lebisa tseleng e fosahetseng.
Ka ho fana ka lintlha tsa hau, u lumella morekisi ea khethiloeng hore a ikopanye le uena 'me lintlha tseo u li rometseng ha li tlas'a kopo ea "Se Rekisetse Boitsebiso ba Ka".Sheba Melaoana ea Ts'ebeletso le Leano la Lekunutu.
Kelly Grayson, NRP, CCP, ke setsebi sa tlhokomelo ea bophelo bo botle Louisiana.Ka lilemo tse fetileng tsa 24, o sebelitse e le setsebi sa tlhokomelo ea bophelo bo botle ba tšimo, mohlokomeli oa tšimo le morupeli.Ke mopresidente oa Louisiana EMS Educators Association le setho sa boto ea 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.
EMS1 e fetola tsela eo sechaba sa EMS se fumanang litaba tse amehang ka eona, se tsebahatsa tlhahisoleseding ea bohlokoa ea koetliso, se buisana le ba bang, 'me se etsa lipatlisiso ka theko ea lihlahisoa le bafani ba thepa.E fetohile sebaka sa marang-rang se pharaletseng le se tšeptjoang bakeng sa litšebeletso tsa bongaka tsa pele ho sepetlele le tsa tšohanyetso.