He maha ngā wā ka whakamahia te whakaurunga ngongo ihu mō ngā tūroro e uaua ana ki te whakatuwhera i te waha, e kore rānei e taea te whakauru i te laryngoscope, ā, mō ngā tūroro e pokangahia ana te waha, nō reira he maha ngā wā ka whakamahia te whakaurunga ngongo matapo. Me pupuri te whakaurunga ngongo matapo i te manawa noa o te tūroro, me whakamahi i te rere o te manawa hei whakarongo ki te tangi o te catheter, me te neke i te mahunga o te tūroro hei whakatika i te ahunga o te catheter kia taea ai te whakauru ki roto i te trachea. I muri i te whakamoe, ka maturuturuhia te otinga 1%****** mai i te pongaponga hei whakaoho i te whakahekenga o ngā oko toto mucosal. Nā te mea kei te taha maui te papa piko o te ngongo tracheal, he māmā ake te uru atu ki te glottis mā te whakaurunga ngongo ki te pongaponga maui. I roto i te mahi haumanu, ka whakamahia te pongaponga matau anake ina whakararuraru te whakaurunga ngongo pongaponga maui i te mahi. I te wā o te whakaurunga ngongo, i tuatahitia te whakangungu whakaora manawa-pūkahukahu o te hurihanga ihu tangata, kātahi ka whakauruhia te catheter hinu ki roto i te pongaponga, poutū ki te rārangi roa o te ihu, ā, i waho o te pongaponga mā roto i te mīti ihu noa i te papa o te ihu. I rangona he tangi manawa nui mai i te waha o te catheter. I te nuinga o te wā, i whakamahia te ringa maui hei whakatika i te tūnga o te upoko, i whakamahia te ringa matau hei whakatō i te ngongo, kātahi ka nekehia te tūnga o te upoko. I angitu te whakaurunga i te nuinga o te wā i te wā i tino kitea ai te haruru o te rere o te catheter i roto i te tauira whakatō ngongo hiko tracheal. Mena ka āraia te ahunga whakamua o te catheter, ā, ka haukotia te tangi o te manawa, tera pea kua paheke te catheter ki roto i te piriform fossa i te taha kotahi. Mena ka puta ngā tohu o te asphyxia i te wā kotahi, tera pea ka tino hoki whakamuri te upoko, ka whakaurua ki roto i te hononga o te epiglottis me te turanga arero, ka hua ake he pēhanga o te glottis epiglottis, pērā i te ngaro o te ātete, me te haukoti o te tangi o te manawa, ko te nuinga nā te piko nui o te upoko, ka puta te catheter ki roto i te esophagus. Mena ka puta ngā āhuatanga o runga ake nei, me tango te catheter mō tētahi wā poto, ā, me whakatika te tūnga o te upoko i muri i te putanga mai o ngā oro manawa. Mena he uaua te whakatō ngongo matapo, ka taea te whakaatu i te glottis mā te waha me te laryngoscope. I nekehia te catheter ki mua me te whakauru ki roto i te trachea i raro i te tirohanga mārama. Heoi anō, ka taea te whakamāu i te pito o te catheter ki te forceps hei tuku i te catheter ki roto i te glottis, kātahi ka taea te neke ake i te catheter ki te 3 ki te 5cm. Ko ngā painga o te whakaurunga ngongo nasotracheal koia ēnei: (1) Kaua te ngongo nasotracheal e rahi rawa, nā te mea ki te rahi rawa, he nui te tūponotanga o te kino ki te larynx me te rohe subglottic, nō reira he onge te whakamahi i te diameter nui rawa o te ngongo; ② Ka taea te kite i te tauhohenga o te mucosa ihu ki te whakaurunga ngongo, mēnā he whakaohooho; ③ I pai ake te uka o te ihu, ā, he iti ake te paheke i kitea i te wā e whāngai ana me te manawa horihori; ④ He nui te piko o te cannula ihu (kāore he koki koi), ka taea te whakaiti i te pēhanga ki te taha o muri o te larynx me te anga hanganga; ⑤ I pai ngā tūroro e ara ana ki te whakaurunga ngongo ihu, he pai te mahi horomi, ā, kāore e taea e ngā tūroro te ngau i te whakaurunga ngongo; ⑥ Mō te hunga he uaua ki te whakatuwhera i te waha, ka taea te whakamahi i te whakaurunga ngongo ihu. Ko ngā ngoikoretanga e whai ake nei: (1) Ka taea te whakauru i te mate ki roto i te ara manawa o raro mā te whakaurunga ngongo ihu; ② He roa te pūwero o te whakaurunga ngongo ihu, ā, he iti te whānui o roto, nō reira he nui te wāhi mate, ā, he ngāwari te aukati i te pūwero e ngā waikura, ka whakanui ake i te ātete o te ara manawa; ③ He roa te wā e pau ana ki te mahi i roto i te āhuatanga ohorere, ā, ehara i te mea ngāwari ki te angitu; ④ He uaua ki te whakaurunga ngongo mā roto i te kōhao ihu ina he whaiti te trachea.
Wā tuku: Hanuere-04-2025