Bai 13
HUT THONG OLfONG HO HAP
M yc TI^U
1. Trinh bay dtfqc muc dich hut thdng dieting hd hdp.
2. Neu dtfqc chi dinh hut thdng dtfdng hd hdp.
3. Trinh bdy dtfqc quy trinh hut thdng dudng hd hdp.
1. MUC DICH CUA HUT THONG DlTONG HO HAP
Hut thong dtfdng ho hap cho ngtfdi benh la ky thuat dung mot ong thong
noi vdi mot may hut, dtfa vao mui mieng, hong hoac dtfa qua ong noi khi quan,
canyl md khi quan nhim muc dich hut dich, ddm dai bi tic nghen trong dtfdng
ho hap cua ngtfdi benh ra ngoai. Hay noi cach khac hut thong dtfdng ho hap la
nhim muc dich khai thong dtfdng ho hap cho ngtfdi benh.
2. CAC TRUONG HOP HUT THONG DLTdNG HO HAP
•
- Ngtfdi benh co nhieu ddm rai khong khac ra dtfdc.
- Ngtfdi benh hon me tang tiet ddm rai.
- Ngtfdi benh hit phai chat non.
- Tre ngay sau de.
- Ngtfdi benh md khi quan, dat noi khi quan, thd may.
3. NGUYEN TAC CHUNG
- Phai dam bao ky thu&t vo trung trong khi hut thong dtfdng ho hap de
tranh gay boi nhilm cho ngtfdi benh.
- Phai thtfdng xuyen hut dcJm rai cho ngtfdi benh de dtfdng ho hap luon
dtfdc thong thoat, khong bi tic nghen nhtfng khong dtfdc hut qua 3 - 5
lin/ddt, moi ldn hut khdng qua 10 - 15 giay vi hut nhieu lan hen tuc va
hut lau g&y thieu oxy, loan nhip tim.
- Khdng dtfOc hut qua sau vk phai dam bao ap ltfc hut:
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+ Ngtfdi ldn hut vdi ap ltfc ttf 100 - 120 mmHg.
+ Tre em hut vdi ap ltfc ttf 50 - 75 mmHg. Vdi tre em neu hut vdi ap ltfc
manh se lam ton thtfdng niem mac dudng ho hap.
- Neu khong co may hut thi co the dung bdm tiem 50 - 100 ml va ong sonde
de hut.
4. QUY TRiNH HUT THONG DUONG HO HAP
4.1. Chuan bi ngtfdi benh: ngtfdi benh nim ngtia, dau thap (ke goi dtfdi vai).
4.2. Chuan bi ngtfdi dieu dtfdng
- Dieu dtfdng co dti ao, mu, khau trang.
- Rtia tay thtfdng quy.
4.3. Chuan bi dung cu, phtfdng tien
- May hut, hop vo khuan dtfng: gac, ong hut (cd to nho tuy theo ngtfdi benh).
. Kim Kocher, coc, gang tay.
Dung dich Natriclorua 0,9%
- Chau dtfng dung dich sat khuan de ngam ong thong, tui dtfng do ban.
4. 4. Ky thuat tien hanh.
• Hut thong diidng ho hdp tren.
- Dat ngtfdi benh d ttf the thuan ldi
- Cim dien vao may, md may de kiem tra va dieu chinh ap ltfc
- Xe tui dtfng ong thong, dieu dtfdng mang g&ng, lip ong thong vao diu
day may hut va hut 1 it ntfdc vao ong
- Dtfa ong thong vao cac vi tri (khoang mieng, hau, lo mui sau, dtfdi ltfdi).
- Bat cong tac cho may hut.
- Moi lan hut khong qua 15 giay, khong hut qua 5 lan/ 1 ddt.
- Hut xdng tit may, thao ong thong cho vao dung dich sat khuan.
- Giup ngtfdi benh nim lai ttf the thoai mai.
• Hut dich khi quan (qua dng ndi khi quan hoac canuyn khi quan)
- Xe tui dtfng ong thong, dieu dtfdng mang gang, lip ong thong vio may hut.
- Dtfa ong thong vao ong noi khi quan ho&c canuyl khi quan (dtfa den khi
ngtfdi benh c6 phan xa ho thi dtfng lai).
- Md may hut, keo ttf ttf ong thong ra, vtfa keo vtfa xoay irag thdng han che
day di, day lai.
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- Hut dich theo 3 tu the (dau ngtia thing, dku nghieng phai, dau nghieng trai).
- Moi ddt hut khong qua 2 phut, moi lan hut khong qua 30 giay.
- Hut xong cho ngUdi benh thd oxy 100% trong 2 phut.
4.5. Thu don dung cu - ghi phieu theo doi
- Thu don dung cu gon gang, thao gang.
- Ghi ho sd:
+ Thdi gian lam thu thuat.
+ Tinh trang ngtfdi benh trtfdc, trong va sau khi hut.
+ Dieu dtfdng ky ten.
Bang 13. Bang kiem ky thuat hut thong dudng ho h ip
TT Noi dung Cd khdng
* Chuan bj ngudi benh
1Giai thich cho ngudi benh hoac ngudi nha yen tam.
* Chuan bj ngudi Dieu dudng
2Di6u dudng co du mu, ao, khau trang, rCra tay thudng quy.
* Chuan bj dung cu
3M6t khay chu nhat, tru cam kim Kocher, cdc nude chin, gang tay.
4tfng hut, hop bong gac.
5May hut, chau dung dung djch khif khuan, tui dung do ban.
* Ky thuat tien hanh
6Dat ngudi benh d tuthe thuan ldi.
7C lm may hut, kiem tra va dieu chinh ap luc.
8OiSu dudng mang gang. Noi ong hut vdi h£ thdng may hilt va hut mdt it
nude vao ong.
9Dua dlu dng thong vao hut d cac vj tri mieng, hau hong, mui.
10 M5i lan hut khdng qua 15 giay, m5i ddt hut khdng qua hai phut, sau
m6i lln hut phai hut nude de ong duoc thdng.
11 Thao dng thdng bo vao dung djch khCf khuln trudc khi co rOfa.
* Thu dpn dung c^i
12 Thu don dung cu, thao gang, ghi phi§'u cham sdc.
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*
CAU HOI LLTpNG GIA
Hoan thien cac cau sau bang cach chon tti, cum tti thich hdp dien vao cho
trong.
1. Hai ky thuat hut thong dtidng ho hap la: hut thong diidng ho h&'p
...A ... va ...B.
2. Khi hut thong dUdng ho hap phai thiic hien tot khau
.....
A
...........
3. Khi hut thong dtfdng ho hap khong hut lien tu c
.....
A
.........
lin
4. Thdi gian cho moi lan hut dtfdc quy dinh
.....
A
........
Chon y dung nhat de tra ldi cho cac cau hoi sau.
5. Ap ltfc hut thong dtfdng hd hap quy dinh khi hut dich chc ngtfdi ldn 1&:
A: 80 - 90 mmHg.
B: 90 - 100 mmHg.
C: 100 - 120 mmHg.
D: 120 - 140 mmHg.
6. Ap ltfc hut thcng dtfdng ho hap quy dinh khi hut dich cho tre em 1&:
A: 40 - 50 mmHg.
B: 50 - 60 mmHg.
C: 50 - 75 mmHg.
D: 60 - 80 mmHg.
Phan biet dung, sai cac cau sau bang cach dien dau (V) vho cot A cho cau
dung, cot B cho cau sai.
TT Npi dung A B
7Hut thdng doting ho htfp ap dung cho tre ngay sau de.
8Tu thtf cCia ngudi benh khi hut thdng dudng htf htfp Id nSrn ngtia gtfi
cao d£u.
9Ky thuSt hilt thong dudng ho help: bat ctfng tac cho mdy hoat dtfng, dua
tfng hut v&o, hut djch tU ngoai vao trong.
10 Sau khi hut thtfng dudng htf hap dudi cho ngudi btfnh thd oxy 100%
trong 2 phut.
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