Kua hoahoatia, kua hangaia hoki tēnei tauira i runga i te āhua noa o te tinana o te tangata, mai i tōna āhua whānui ki ōna wāhanga matua katoa. Ko te pakitara o runga o te uma me ngā wheua o te mahunga he mea hanga mā te whakamahi i te kirihou kua whakapakarihia ki te muka karāhe, ko te mata, te ihu, te waha, te arero, te epiglotis, te larynx, te trachea, te bronchi, te esophagus, te pukahukahu, te puku, me te āhua o runga o te uma he mea hanga mā te whakamahi i te kirihou ngohengohe me te rapa. Kua tāutahia he kauae o raro ka taea te neke hei āhei i te waha ki te whakatuwhera me te kati. Mā te nekehanga o ngā hononga o te kaki ka taea e te mahunga te piko whakamuri ki te 80 nekehanga me te whakamua ki te 15 nekehanga. He tohu mārama kei reira e tohu ana i te wāhi whakauru mō te ngongo. Ka taea e te kaiwhakahaere te mahi whakangungu intubation i muri i ngā mahi tuku iho mō te intubation.
Tikanga whakauru ngongo waha:
1. Te whakarite i mua i te pokanga mō te whakaurunga ngongo: A: Tirohia te laryngoscope. Me whakarite kei te hono tika te mata me te kakau o te laryngoscope, ā, kei te kā te rama o mua o te laryngoscope. B: Tirohia te poroporo o te catheter. Whakamahia he ngira hei pupuhi i te poroporo i te pito o mua o te catheter, whakaū kāore he turuturu hau mai i te poroporo, kātahi ka tangohia te hau mai i te poroporo. C: Tōia he kakahu ngohengohe ki roto i te hinu whakahinuhinu ka pania ki te pito o te catheter me te mata o te poroporo. Tōia he paraihe ki roto i te hinu whakahinuhinu ka pania ki te taha o roto o te trachea hei whakahaere i te nekehanga o te catheter.
2. Whakatakotoria te tauira ki te tūnga takoto, me te upoko e anga whakamuri ana, me te kaki e ara ake ana, kia rite te tūnga o te waha, te korokoro me te ara iahiko ki te tuaka kotahi.
3. Ka tū te kaiwhakahaere i te taha o te pane o te tauira, me te pupuri i te laryngoscope ki tōna ringa maui. Me whakatītaha te laryngoscope kua whakamāramahia ki te koki matau ki te korokoro. Me whakauru te mata o te laryngoscope i te tuara o te arero ki te pūtake o te arero, kātahi ka hiki ake ki runga. Ka kitea te taha o te epiglottis. Whakatakotoria te wāhanga o mua o te laryngoscope ki te hononga o te epiglottis me te pūtake o te arero. Kātahi ka hiki ake anō te laryngoscope kia kite i te glottis.
4. I muri i te whakaatu i te glottis, pupurihia te catheter ki tō ringa matau, ka whakarite i te wāhanga o mua o te catheter ki te glottis. Whakauruhia mārire te catheter ki roto i te trachea. Whakauruhia kia 1 cm ki roto i te glottis, kātahi ka huri haere tonu, ka whakaurua anō ki roto i te trachea. Mō ngā pakeke, me 4 cm, ā, mō ngā tamariki, me 2 cm. Ko te roa katoa o te catheter mō ngā pakeke he 22-24 cm (ka taea te whakarerekē i tēnei kia rite ki te āhua o te tūroro).
5. Whakatakotoria he paepae niho ki te taha o te ngongo tracheal, kātahi ka tangohia te laryngoscope.
6. Honoa te taputapu whakaora ki te katitere, ka pēhi i te putea whakaora hei pupuhi i te hau ki roto i te katitere.
7. Ki te whakaurua te catheter ki roto i te trachea, ka pupuhi te catheter kia whānui ngā pukahukahu e rua. Ki te uru pōhēhē te catheter ki te esophagus, ka pupuhi te puku kia whānui, ā, ka puta he tangi haruru hei whakatūpato.
8. Whai muri i te whakaū kua tika te whakaurunga o te catheter ki roto i te trachea, whakapirihia te catheter me te paepae niho ki te rīpene piri roa.
9. Whakamahia he ngira werohanga hei wero i te nui o te hau e tika ana ki roto i te poroporo. Ina pupuhihia te poroporo, ka taea e ia te whakarite kia piri tonu te katitere me te pakitara trachea, ka ārai i te turuturu o te hau mai i te manawa miihini i te wa e tukuna ana te hau ki ngā pukahukahu. Ka taea hoki e ia te ārai i te ruaki me ngā waikura kei hoki ki roto i te trachea.
10. Whakamahia te ngira hei tango i te poroporo me te pupuri i te poroporo.
11. Ki te kore e whakamahia tika te laryngoscope, ā, ka pēhia ngā niho, ka puta he tangi whakaoho.
Wā tuku: Whiringa-ā-rangi 11-2025