Ke kahe nei ka mīkini anesthesia?Pehea e nānā ai i ka ʻōnaehana hanu

Pono e nānā mau i ka hana o kēlā me kēia mīkini anesthesia holoholona.Eia ka pehea e loiloi ai i kāu ʻōnaehana hanu mīkini, pono e hoʻāʻo ʻia ma mua o kēlā me kēia hoʻohana.
Pono e ho'āʻo i kāu mīkini anesthesia no nā leaks e hōʻoia i ka hana pono o ka mīkini ke hoʻohana ʻia.Kūkākūkā kēia ʻatikala pehea e nānā ai i ka ʻōnaehana hanu o kahi mīkini anesthesia holoholona.He ʻatikala ʻokoʻa e wehewehe i ka nānā ʻana i ka ʻōnaehana kaomi a me ka ʻōnaehana scavenging.
Aia i loko o ka ʻōnaehana hanu nā ʻāpana āpau e pono ai no ka hāʻawi ʻana i ka hui ʻana o ke kinoea anesthetic i ka mea maʻi.Ma mua o kēlā me kēia hoʻohana ʻana, e nānā pono i nā ʻāpana o ka ʻōnaehana hanu e hōʻoia ʻaʻole lākou e pōʻino.No ka mea, ʻo ia ke kumu maʻamau o nā leaks mai nā mīkini anesthesia (e ʻike i ka ʻaoʻao ʻaoʻao), pono loa e hana i kahi hoʻāʻo leak ma ka ʻōnaehana hanu ma mua o kēlā me kēia hoʻohana.
Hoʻopili ʻia ke kaapuni rebreathing me ka inhalation a me ka exhalation check valve (check valve), pop-up valve (adjustable pressure limiting valve), reservoir bag, pressure gauge, intake valve (ʻaʻole i loaʻa ma nā mīkini a pau) a me CO2 Absorbent tank.ʻO ke ʻano maʻamau o ke kaapuni rebreathing i hoʻohana ʻia i ka poʻe veterinarians ʻo ia ka ʻōnaehana circulatory, i hoʻolālā ʻia e kahe ke kinoea i hoʻokahi ʻaoʻao.ʻO ka hoʻonohonoho hose hanu hiki ke lilo i mau paipu i hoʻopili ʻia me kahi ʻāpana ʻano Y (ʻano ʻāpana Y), a i ʻole kahi hoʻolālā coaxial me ka hose inhalation i loko o ka hose exhalation (general F).
E hoʻokuʻi i hoʻokahi paipu hanu i ka pahu hoʻopaʻa inhalation, e hoʻopili i kekahi i ka pahu hoʻoheheʻe, a laila hoʻohui i ka ʻeke hoʻopaʻa i ka nui o ka mea maʻi i ka waha o ka ʻeke.ʻO kahi ʻē aʻe, hiki ke hoʻāʻo ʻia kēlā me kēia ʻāpana o ke kaapuni rebreathing me ka hoʻohana ʻana i kēia mau ʻanuʻu:
Helu 1A.E hoʻāʻo i nā ʻāpana o ka ʻōnaehana hanu me ka hoʻohana ʻole ʻana i nā paipu a i ʻole nā ​​ʻeke waihona.(Puke ho'āʻo Vetamac) (Na Michelle McConnell, LVT, VTS [Anaesthesia and Analgesia])
Helu 1B.E ho'āʻo i ka paipu hanu me kahi plug ma ke awa o ka ʻeke waihona.(Puke ho'āʻo Vetamac) (Na Michelle McConnell, LVT, VTS [Anaesthesia and Analgesia])
Helu 1C.E hoʻāʻo i ka ʻeke waihona me nā pahu ma ka inhalation a me ka exhalation check valve.(Puke ho'āʻo Vetamac) (Na Michelle McConnell, LVT, VTS [Anaesthesia and Analgesia])
E pani i ka pahu pop-up a pani i ka hope o ka ma'i o ke kaapuni me kou manamana nui a lima paha.Mai hoʻohana i nā kiwi paʻa pop-up no ka nānā ʻana i ke kaomi.Hoʻolālā ʻia kēia mau pahu e kahe ma hope o ka loaʻa ʻana o kekahi kaomi, no laila hiki iā lākou ke keʻakeʻa i ka loiloi maoli o nā ʻōnaehana hanu leak-free.
E hoʻopiha i ka ʻōnaehana me ka oxygen ma o ka wehe ʻana i ka mika kahe a i ʻole ke kaomi ʻana i ka valve hoʻomaʻemaʻe oxygen a hiki i ka piʻi ʻana o 30 cm H2O ma ke ana kaomi.A hiki i kēia kaomi, hoʻopau i ka mīkini kahe.Inā ʻoe e hoʻohana i ka paipu hoʻopau i ʻōlelo ʻia ma ke ʻano hana ʻē aʻe o ka ʻanuʻu 1, mai hoʻohana i ka valve flush oxygen.Hiki ke hoʻopōʻino ke kaomi kiʻekiʻe hikiwawe i nā ʻāpana palupalu o loko o ka mīkini anesthesia.
Inā ʻaʻohe leaks i loko o ka ʻōnaehana hanu, pono e noho mau ke kaomi no ka liʻiliʻi he 15 kekona (Figure 2).
Kiʻi 2. Nānā kaomi o ka ʻōnaehana rebreathing (Wye dual hose configuration), mālama ʻia ke ana kaomi ma 30 cm H2O.(Na Darci Palmer, BS, LVT, VTS [Anaesthesia and Analgesia])
E wehe mālie i ka pahu pop-up a nānā i ka hoʻokuʻu ʻana o ke kaomi o ka ʻeke waihona.Mālama kēia i ka hana pono o ka ʻōnaehana scavenging a me ka pop-up valve.Mai wehe wale i kou lima mai ke awa mai.Hiki i ka hāʻule koke ʻana o ke kaomi ke hōʻino i kekahi mau ʻāpana o ka mīkini anesthesia.Hiki ke hoʻokomo i ka lepo i komo i loko o ka paipu hanu a pili i ke ala ea o ka mea maʻi.
Hoʻohana pū ka inhalation a me ka exhalation check valve e hōʻoia i ka neʻe ʻana o ke kinoea i hoʻokahi ʻaoʻao i loko o ka ʻōnaehana hanu.Hana ʻia lākou me nā mea ʻeleʻele a māmā, i kapa ʻia ʻo discs, waiho ʻia i loko o kahi dome alohilohi i ʻike ʻoe iā lākou e neʻe ana.Hoʻokomo ʻia ka valve ala hoʻokahi ma luna o ka mīkini anesthesia ma kahi kūlana a i ʻole ke kū.ʻO ka hiki ʻole o kēia mau kiwi ke hoʻoulu i ka hanu hou ʻana o CO2, he mea pōʻino i ka mea maʻi i ka hoʻohana ʻana i ka mīkini anesthesia.No laila, ma mua o kēlā me kēia hoʻohana ʻana i ka mīkini anesthesia, pono e loiloi ʻia ka hiki o ka valve ala hoʻokahi.
Nui nā ala e hoʻāʻo ai i ka valve check, akā ʻo ka mea aʻu i kamaʻāina loa ai, ʻo ia ke ʻano hoʻohaʻahaʻa kaomi, e like me ka mea i wehewehe ʻia ma lalo nei.
ʻO ka pahu hoʻoheheʻe piha piha e pale i ka hoʻihoʻi ʻana o ke kinoea i ka mīkini.Inā ʻaʻohe leakage, e hoʻomau ʻia ka ʻeke (Figure 3).
Kiʻi 3. Ka loiloi ʻana i ka pono o ka pahu hoʻoheheʻe suction.Inā ʻaʻohe leakage, e hoʻomau ʻia ka ʻeke waihona.(Na Darci Palmer, BS, LVT, VTS [Anaesthesia and Analgesia])
Pono e ho'opa'a 'ia ka pahu piha exhalation i ka kahe 'ana o ka ea ma waho o ka mīkini.Inā ʻaʻohe leakage, pono e hoʻonui ʻia ka ʻeke (Figure 4).
Kiʻi 4. ʻO ka loiloi ʻana i ka pono o ka exhalation check valve.Inā ʻaʻohe leakage, e hoʻomau ʻia ka ʻeke waihona.(Na Darci Palmer, BS, LVT, VTS [Anaesthesia and Analgesia])
Pehea e ʻike ai i ka leak.I ka hana ʻana i ke kaomi ʻana i ka mīkini anesthesia, hiki i ka wai kopa ke kōkua i ka hoʻoholo ʻana i ke kumu o ka leak.E hahai i ka holo ʻana o ke kinoea ma o ka mīkini anesthesia a pipi i ka wai kopa ma nā wahi a pau e lilo ai i kumu o ka leaks.Inā he leak, e hoʻomaka ana ka wai kopa mai ka mīkini mai (Kiʻi 5).
Hiki ke hoʻohana ʻia kahi mea ʻike leak refrigerant (kūʻai ʻia mai Amazon ma lalo o $30) no ka ʻike ʻana i nā mahu hydrocarbon halogenated.ʻAʻole ʻike ka mea hana i ka ʻike a i ʻole nā ​​ʻāpana o ka miliona o ka inhalant, akā ʻoi aku ka maʻalahi ma mua o ka hoʻāʻo "sniff" maʻamau i ka wā e pili ana i ka ʻike ʻana i nā leaks e noho ana ma lalo o ka evaporator.
Kiʻi 5. ʻO ka wai kopa i kāpīpī ʻia ma ka pahu hoʻoheheʻe CO2 e hoʻopuka i nā ʻōhū, e hōʻike ana e kahe ana ka sila kopa o ka pahu.(Na Darci Palmer, BS, LVT, VTS [Anaesthesia and Analgesia])
Nā ʻanuʻu e hana i ka nānā ʻana i ke kaomi ma ke kaapuni hanu hou (ka hoʻonohonoho hose F maʻamau).Loaʻa i ka Universal F kahi hose inhalation (coaxial configuration) i loko o ka hose exhalation, no laila hoʻokahi wale nō hose i hoʻopili ʻia i ka mea maʻi, akā ma ka hopena o ka mīkini, ua hoʻokaʻawale ʻia nā paipu, no laila ua hoʻopili ʻia kēlā me kēia paipu i kona ʻāpana pili.I ka valve.E hahai i ke kaʻina hana like i hōʻike ʻia ma luna e nānā i ke kaomi o ka hoʻonohonoho hose lua Wye.Eia kekahi, pono e like ke kaʻina hoʻāʻo o loko me ka kaapuni coaxial Bain (e ʻike i lalo).
Hoʻohana pinepine ʻia nā kaapuni hanu ʻole no nā poʻe maʻi liʻiliʻi e kōkua i ka hōʻemi ʻana i ke kū ʻana o ka hanu i ka wā o ka hoʻoulu ʻana.ʻAʻole hoʻohana kēia mau kaapuni i nā mea hoʻoheheʻe kemika no ka wehe ʻana i ka CO2, akā e hilinaʻi i nā kiʻekiʻe kiʻekiʻe o ka holo ʻana o ke kinoea hou e hoʻolei i ka CO2 i hoʻokuʻu ʻia i loko o ka ʻōnaehana.No laila, ʻaʻole paʻakikī loa nā ʻāpana o ke kaapuni hanu hou ʻole.ʻO nā kaapuni hanu ʻole ʻelua i hoʻohana mau ʻia i ka lāʻau lapaʻau holoholona ʻo ia ka Bain coaxial circuit a me ka Jackson Rees circuit.
ʻO ka nānā ʻana i ke kaomi o ke kaapuni hanu hou ʻole (Bain coaxial me ka hoʻohana ʻana iā Bain block).Hoʻohana pinepine ʻia ka Bain coaxial circuit me kahi poloka Bain i hiki ke hoʻokomo ʻia ma kahi mīkini anesthesia.ʻAe kēia i ke kaapuni e hoʻohana i ke awa hoʻopaʻa wai, ke ana kaomi, a me ka pahu pop-up.
E hahai i nā ʻanuʻu 2 a 5 i hōʻike ʻia ma luna nei e nānā i ke kaapuni hanu hou.E ʻoluʻolu e hoʻomaopopo ʻoiai inā mau ke kaomi, ʻaʻohe mea hōʻoiaʻiʻo ʻaʻole e kahe ka paipu i loko o ke kaapuni coaxial.ʻElua mau ala no ka loiloi ʻana i nā paipu i loko: ka hoʻāʻo pale a me ka hoʻāʻo ʻana i ka oxygen flushing.
E hoʻohana i ka penikala a i ʻole ka syringe plunger e pani i ka paipu i loko ma ka hopena o ka mea maʻi no ka 2 a i ka 5 kekona.
Ma muli o ke anawaena o ka paipu i loko, ʻaʻole hiki ke ālai ʻia nā ʻano kaapuni coaxial a pau.Pono e nānā pono ʻia ka paipu i loko ma mua o kēlā me kēia hoʻohana ʻana i mea e pili pono ai i ka mea maʻi a me nā ʻaoʻao ʻelua o ka mīkini.Inā loaʻa kahi pilikia me ka pono o ka paipu i loko, pono e hoʻolei ʻia ke kaapuni.ʻO ka hemahema o ka paipu i loko e hoʻonui nui i ka wahi make mechanical, hiki ke alakaʻi i ka nui o ka hanu hou ʻana o CO2.
E ho'ā i ka pahu hoʻoheheʻe oxygen a nānā i ka ʻeke waihona.Inā paʻa ka paipu o loko, pono e hoʻoheheʻe iki ʻia ka ʻeke waihona (Venturi effect).
Inā hoʻokaʻawale ka paipu i loko mai ka hopena mīkini o ke kaapuni, hiki ke hoʻonui ʻia ka ʻeke waihona ma mua o ka hoʻoheheʻe ʻana i kēia hoʻāʻo.
ʻO ka nānā ʻana i ke kaomi ʻana o ke kaapuni hanu hou ʻole (Jackson Rees).Hiki ke hoʻohana ʻia ke kaʻina hana like i hōʻike ʻia ma luna no ka pōʻaiapuni (Wye dual hose configuration) rebreathing circuit no ka hana ʻana i nā hoʻopaʻa kaomi ma ke kaapuni ʻole rebreathing Jackson Rees.ʻO ka pahu pop-up he pihi i kaomi ʻia ma ka ʻeke waihona wai a i ʻole he valve e neʻe ana ma waena o nā kūlana hāmama a pani ʻia.ʻAʻole hoʻohana ke kaapuni ʻo Jackson Rees maʻamau i kahi ana kaomi.No laila, no ka hana ʻana i ke kaomi ʻana i ke kaapuni, pono e hoʻopiha piha ʻia ka ʻeke waihona no ka liʻiliʻi loa he 15 a 30 kekona e ʻike ai inā loaʻa kekahi mau leaks.Pono e wehe ʻia ka valve pop-up e hoʻomaha i ke kaomi i ke kaapuni, ma mua o ka wehe ʻana i ka lima mai ke awa maʻi.E ho'āʻo kēia i ka hana maʻamau o ka valve pop-up.Hiki ke kūʻai ʻia a hoʻohana ʻia ma ke kaapuni ʻo Jackson Rees (Figure 6).Hiki ke hoʻohana ʻia ke ana kaomi no ka nānā ʻana i ke kaomi o ke kaapuni ʻo Jackson Rees ma ke ʻano like me nā kaapuni hanu ʻē aʻe.​​​
Kiʻi 6. ʻO ke ana hoʻopaʻapaʻa hoʻokuʻu ʻia ma ke kaapuni ʻo Jackson Rees non-rebreathing.(SafeSigh Pressure Gauge-Vetamac) (Na Michelle McConnell, LVT, VTS [Anaesthesia and Analgesia])
Allen M, Smith L. Ka nānā ʻana a me ka mālama ʻana i nā lako.I loko o Cooley KG, Johnson RA, Eds: Hoʻolālā Veterinary a me nā lako nānā.Hoboken, New Jersey: John Wiley & Sons;2018: 365-375.
Ua lilo ʻo Darci Palmer i mea anesthesia a me analgesic veterinary technologist i ka makahiki 2006. Ua lawelawe ʻo ia ma ke ʻano he kākau ʻōlelo hoʻokō o ka Veterinary Technical College of Anesthesia and Analgesia.He kumu aʻo ʻo Darci no ka Veterinary Support Personnel Network (VSPN) a he luna hoʻomalu o ka hui Facebook Veterinary Anesthesia Nerds.


Ka manawa hoʻouna: Nov-15-2021