Arotaki Tinana Mai i te Upoko ki ngā Waewae mō ngā OSCE me ngā Whakamātau Haumanu

He Aha te Arotaki Tinana Mai i te Upoko ki ngā Waewae, ā, Ahea Ka Mahia ai?

Ko te arotaki tinana mai i te upoko ki ngā waewae te tikanga tonu o te kupu: he aromātai hauora tino oti, tino whai tikanga o ngā pūnaha matua katoa o te tinana, ka timata mai i te upoko, ka ahu tika ana ki ngā waewae. Whakaarohia he whakaahua katoa tēnei o te hauora o tō turoro i tētahi wā motuhake. Ko tēnei whakaahua tuatahi hei pūtake mō koe, kia taea ai e koe te kite tere i ngā whakarereketanga, ahakoa iti, nui rānei, kei roto i tō rātou āhua i muri mai.

He mea nui kia rerekē ai tēnei i te arotaki whāiti. Ahakoa ka tirohia katoatia e te arotaki tinana katoa, ka aro atu te arotaki whāiti ki tētahi raruraru motuhake. Hei tauira, ki te kii te tangata he poto te manawa, ka mahia e koe he arotaki manawa whāiti tonu, kaua e timata ki te tirotiro i tō rātou urupare o ngā karu.

Na, ahea koe ka mahia ai tēnei aromātai matawhānui?

• I te Whakaurunga Mai: Ka tae mai tētahi turoro ki tētahi wāhanga, ki tētahi whare hauora rānei.
• I te Tīmatanga o te Pihinga: Kia whai pūtake mō tō pihinga, ā, kia taea te whakataurite ki ngā kitenga a te nēhi o mua.
• Whai muri i te Panoni Āhua o te Turoro: Ki te panoni ohorere te āhua o tētahi turoro.
• I ngā Whakamātau Hauora Ā-tau: I roto i ngā tari manuhiri, i ngā tari hauora tuatahi rānei.
• I mua, i muri hoki i te Pokanga, i ngā Mahi Nui rānei: Kia mōhio ai ki ngā panoni.

Ma tēnei tikanga tino whakarite, ka tino mārama te ngā mea katoa, ā, ka whai pūtake nui mō tō mahere tiaki nēhi. He wāhanga nui tēnei o ia arotaki nēhi matawhānui.

Me Pēhea te Takataki mō Tō Arotaki

Ka tīmata te arotaki pai i mua i tō pā atu ki te tangata. He mea nui te takataki kia pono ai ngā kitenga, kia pai ai te ngākau o te turoro, kia pai hoki tāu mahi.

Kohikohia Ō Taputapu

Ko te haere anō ki te tiki taputapu kua warewarehia he pōkēhe i te wā, ā, ka puta te ahua o te kore whakarite. I mua i tō kuhunga ki roto i te rūma, kohikohia ō taputapu mahi.

Tō Rārangi Arotaki Tinana Mai i te Upoko ki ngā Waewae:

• Whakarongooro (Stethoscope): Me te diaphragm me te bell.
• Rama Pene (Penlight): mō te tirotiro i ngā karu, te mangai, me te korokoro.
• Rūrahi (Gloves): Kia mau tonu ki ngā tikanga ārai whānui.
• Mātāwaka me te Miro Tuarua: mō te tatau i te manawa o te ngākau, te manawa, me te kaha o te ngongo.
• Pūraka Toto (Sphygmomanometer): Kia mārama kei a koe te rahi tika mō tō turoro.
• Mahana (Thermometer): Hei tirotiro i te pāmahana.
• Pūraka Hāora (Pulse Oximeter): Hei ine i te hāora kei roto i te toto.
• Kaiwhakaheke Arero (Tongue Depressor)
• Kaiwhakamā wāhi (Hand Sanitizer) me te Hopi me te Wai: He mea nui te horoi ringaringa. pūtake
• Tō Roro me Ō Piringa: Ēnei te taputapu nui rawa atu!

Takatakia te Taiao me te Turoro

1. Whakaritea te Muna: Katia te kuwaha ka toia te arai. Kei roto te turoro i tētahi wāhi whakaraerae, ā, ko te whakaute i tōna mana, he mea nui rawa atu.
2. Tirohia te Mārama: Kia mārama kua mārama te rūma kia kore ai koe e ngaro i ngā tohu kitea pērā i te kiri koma, i te pāhuhu.
3. Whakaingoatia Koe me te Whakamārama: Ka timata ki te whakauru mahana. “Kia ora, ko [Tō Ingoa] ahau, ā, ko koe taku nēhi i tēnei rā. Ka mahia e au he arotaki tinana nēhi mai i te upoko ki ngā waewae, he tirotiro noa tēnei kia mārama ai ki tō hauora katoa. Ka uru ki roto ko te tirohanga, te whakarongo, me te pā atu mai i te upoko tae noa ki ngā waewae. He pātai anō tāu i mua i tō tāua tīmatanga?”
4. Whakaūngia te Tuakiri o te Turoro: Kia mau tonu ki te tautuhi i te tuakiri o te turoro mā te whakamahi i ngā tohu tautuhi e rua te iti rawa, pērā i tō rātou ingoa me te rā whānau, ā, kia whakatauritea ki tō rātou poroporo.
5. Hangaia te Hononga: Pātai atu ki a rātou me pēhea tō rātou ngākau. Ko te kōrero iti ka āwhina i te turoro kia pai ake te ngākau, kia rite ki te hoa mahi i roto i tō rātou tiaki.
6. Whakaritea te Ngākau me te Haumaru: Whakaarahia te moenga ki tētahi teitei e pai ana mō koe (kia ora ai tō tuarā!) ā, whakahekea te rārei taha kei te taha e mahi ana koe.

Ngā Tikanga Aromātai Tinana Matua E 4

I roto i te katoa o te arotaki, ka whakamahi koe i ngā tikanga aromātai tinana e 4. He mea nui ki te mārama ki te tikanga o ia mea me te wā e whakamahi ai koe.

1. Tirohanga (Inspection): He mahi noa tēnei o te titiro me te hongi. Ka tīmata mai i te wā e kuhu ana koe ki roto i te rūma. Ka tirohia e koe te tae o te kiri, te pāhuhu, te rite, te pupuhi, me ngā tohu o te mamae.
2. Pāmatanga (Palpation): Te whakamahi i tō ringaringa. Ka whakamahi koe i ngā pito o ō maihao ki te rapu i te āhua, te makuku, me ngā kohinga, ā, ko te tuara o tō ringaringa hei āhua pāmahana. Ka taea te pāmatanga ngāwari (mō te ngāwari) te pāmatanga hōhonu (mō ngā whekau), engari timata tonu ki te ngāwari.
3. Pēhia (Percussion): Ka uru ki te pakipaki i te kiri o te turoro ki ō maihao hei whakaputa oro oro. Ka taea e ngā oro te kii ki a koe mena kei raro te kiko, he kau te kiko, he wai rānei kei roto. He kaha ake tēnei, ā, ka whakamahia i roto i te arotaki puku.
4. Whakarongo (Auscultation): Te whakarongo ki ngā oro o roto o te tinana me tō whakarongooro. Koinei te wā ka arotakihia e koe ngā oro o te ngākau, ngā oro o te mānawa, me ngā oro o te whekau.

Te Arataki Arotaki Tinana Katoa Mai i te Upoko ki ngā Waewae, Taahinga i te Taahinga

Ka pai, kia honoa ngā mea katoa. Koinei te mahi matua. Kia maumahara ki te whakamārama i tō mahi i a koe e haere ana. Ka whakakorea te wehi o te tikanga mō te turoro, ā, ka whai wāhi atu rātou ki tō rātou tiaki.

Wāhanga 1: Te Tirohanga Tuatahi

Ko tēnei tō whakaaro tuatahi, ā, ka whakaritea te tiimatanga o te arotaki katoa.

• ABC me te Mātau: I a koe e ahu atu ana ki te moenga, kia tere te arotaki: Kei te tuwhera tō rātou Ārai Manawa? Kei te pai tō rātou Manawa? Kei te pai tō rātou Rere Toto (tae pai)? Kei te mataara, ka urupare rānei rātou?
• Tirohanga Whānui (Nēhi): He wāhanga nui tēnei o te tukanga arotaki whānui nēhi. Tirohia tō rātou āhua whānui.
  • Taumata o te Mātau: Kei te mataara rātou? E moe ana?
  • Whakaaturanga: Pātai atu ki a rātou ko wai rātou, kei hea rātou, te rā/tau o nāianei, me te take i reira ai rātou. Ka arotakihia tēnei mena kei te Mataara, ka Whakaatu Ake ki te 4 (A&O x4).
  • Ngākau me te Āhua: Kei te marino, kei te pāngia, kei te kōpū rānei tō rātou ngākau?
  • Mā o te Tinana me te Whakaoranga: Kua pai te tiaki, kua pokekore rānei? Ka taea tēnei hei tohu ki tō rātou kaha ki te tiaki i a rātou anō.
  • Tohu o te Mamae: Kei te pāngia rātou e te mamae, kei te uaua te manawa, kei te whakaatu rānei i te pāngia?
• Ngā Tohu Ora me te Mamae:
  • Tīkina te katoa o ngā tohu ora: Mahana, Pūraka Toto, Manawa Ngākau, Manawa, me te Hāora Toto. Kia mārama ki ngā tikanga noa, engari kia whakatauritea ki te pūtake o tō turoro. pūtake
  • Arotakihia te mamae. Ki te kii rātou he mamae, whakamahia te PQRST hei tirotiro atu:
    • Provokes (Tīmata): He aha te pai ake, te kino rānei?
    • Quality (Āhua): Pēhea te ahua (kōiwi, mamae, ngau)?
    • Radiates (Haere): Ka haere ki hea?
    • Severity (Nui): Kei runga i te tauine o te 0-10?
    • Time (Wā): Ahea tīmata ai? Kei te mau tonu, kei te waewae rānei?

Wāhanga 2: Upoko, Karu, Taringa, Ihu, me te Korokoro (HEENT)

Tīmata ai tātou i te mahi a-ringaringa. Ko te arotaki HEENT he tirohanga taipitopito o te upoko me ngā hanganga o te kanohi.

• Upoko/Kanohi:
  • Tirohanga: Tirohia te upoko mō te rahi me te āhua. Tirohia te kanohi mō te rite (pīhono kia ataata, kia kōrere, kia pupuhi ngā paparinga—ka arotakihia hoki te Kiriwa Nati VII). Tirohia te kiri o te upoko mō ngā wharanga, te maroke, me ngā kutu.
  • Pāmatanga: Kia ngāwari te pā atu ki te kura o te upoko mō ngā kohinga, te ngāwari rānei.
• Karu:
  • Tirohanga: Tirohia te kōpū ma (me te mā) me te kōpū kahukahu (me te māwhero me te makuku). Tirohia ngā pakaru, te whero rānei.
  • Arotaki: Koinei te wā ka tae mai te PERRLA: Pupils are Equal, Round, Reactive to Light, and Accommodate.
    1. Whakahekea te mārama. Tirohia kei te rite te rahi o ngā karu.
    2. Whakamahia tō rama pene ki te kiko o tētahi karu, ā, tirohia te karu e whakahaere ana. Hoki atu ki tērā taha.
    3. Tirohia te urupare mā te tono kia titiro rātou ki tētahi mea tawhiti, ā, ki tō maihao e tata ana ki tō ihu. Me whakahaere ngā karu me te whiti atu.
    4. Arotakihia ngā nekehanga o te karu e ono mā te tono kia whai rātou i tō maihao i roto i te tauira “H” me te kore e neke tō rātou upoko. Ka arotakihia te kiriwa nati III, IV, me VI.
• Taringa:
  • Tirohanga: Tirohia te taringa o waho mō te whero, te pakaru, te wōha rānei.
  • Arotaki: Mahia he whakamātau whawhati hei whai whakaaro mō te kaha o tō rātou whakarongo.
• Ihu:
  • Tirohanga: Tirohia te rite me ngā pakaru kitea. Whakamahia tō rama pene ki te tirotiro i te wehe o te ihu, te pakare rānei.
  • Arotaki: Tirohia te ārahi mā te tono kia kati tētahi pongaponga ihu i te wā, ā, kia manawa mā tērā.
• Mangai me te Korokoro:
  • Tirohanga: Whakamātauria ngā ringaringa. Whakamahia tō rama pene ki te tirotiro i ngā ngutu, te kōpū mangai, ngā niho, me ngā waha mō te tae, te makuku, me ngā pakaru. Tirohia te arero me raro o te arero.
  • Arotaki: Pīhono kia kii rātou “ahh” ā, tirohia te puku me te arero ngohengohe kia rite te pikinga (ka arotakihia te kiriwa nati IX me X).

Wāhanga 3: Te Kāhukura

• Tirohanga: Tirohia te rite. Tirohia te mate o te uaua o te kaki (JVD), hei tohu pea mō te nui o te wai. Me kei waenganui te huarahi manawa.
• Pāmatanga:
  • Kia ngāwari te pā atu ki ngā kōpū kōpura i te kaki. Me iti, ngāwari, me te kore mamae.
  • Pāmatia te uaua o te kaki, kotahi anake i te wā. Kaua rawa e pēhia tahi, nā te mea ka taea te aukati i te rere o te toto ki te roro! Kōrero te kaha o te ngongo.
• Arotaki:
  • Tirohia te awhe o te nekehanga mā te tono kia titiro mauī, matau, ake, me raro.
  • Whakamātauhia te kaha o te pakiowhāraki ki te kaha (ka arotakihia te kiriwa nati XI), he wāhanga nui o te arotaki nerve katoa.

Wāhanga 4: Te Uma (Manawa me te Ngākau)

Ko tēnei wāhanga ka honoa te arotaki manawa me te arotaki ngākau.

• Manawa:
  • Tirohanga: Tirohia te uma mō te rite o te piki me te heke. Kōrero te tere, te āhuatanga, me te hōhonutanga o te manawa. Kei te whakamahi rānei i ngā uaua āwhina, hei tohu pea mō te uaua o te manawa?
  • Whakarongo: Ko tēnei te mea nui. Whakarongo ki ngā oro o te pūmua i te taha o mua (anterior) me te tuara (posterior) o te uma. Whakamahia he tauira ritirohanga, e whakataurite ana i ngā oro mai i tētahi taha ki tērā taha. Whakarongo ki te manawa katoa me te whakaputa o ia wāhi. Kōrero ngā oro ohorere (adventitious) pērā i te pakarutanga, te wīwī, te rōnki rānei.
• Ngākau:
  • Whakarongo: Whakarongo ki ngā oro o te ngākau i ngā wāhi matua e rima mā te whakamahi i te “All People Enjoy Time Magazine”:
    • Aortic (2nd wāhi o te rewa, taha matau o te wheua uma)
    • Pulmonic (2nd wāhi o te rewa, taha mauī o te wheua uma)
    • Erb’s Point (3rd wāhi o te rewa, taha mauī o te wheua uma)
    • Tricuspid (4th wāhi o te rewa, taha mauī o te wheua uma)
    • Mitral (5th wāhi o te rewa, te raina waenganui o te taupoki) - Ko tēnei hoki te wāhi o te manawa ngākau āpōkō.
  • Pāmatanga: Rapua te manawa ngākau āpōkō i te wāhi mitral. Ki te kore e rite te āhuatanga o te ngākau, me tatau e koe te manawa ngākau āpōkō mō te 60 hēkona katoa.

Wāhanga 5: Puku (Kāpene me te Urinary)

Ko te arotaki puku he kotahi te ture matua ka panoni te tikanga o ngā taahinga.

• TURE MATUA: Mō te puku, ko te tikanga ko Tirohanga, Whakarongo, Pēhia, ā, ka Pāmatia. Me whakarongo koe i mua i te pā atu, nā te mea ka taea e te pāmatanga te whakaoho i te whekau ka whakaputa oro kāore i reira i mua, ka arahi ki tētahi arotaki tōraro.
• Tirohanga: Tirohia te ahua o te puku (he papatahi, he porotītī, he pupuhi?). Tirohia ngā kōhao, te pāhuhu, me ngā oro kitea.
• Whakarongo: Whakarongo ki ngā oro o te whekau i ngā wāhi e whā (RUQ, LUQ, RLQ, LLQ). Kei te noa, kei te kaha ake, kei te ngoikore rānei?
• Pāmatanga: Whakamahia ngā pito o ō maihao ki te mahi pāmatanga ngāwari i ngā wāhi e whā. Rapua ngā mamae, te pakarutanga, me ngā kohinga kitea. Pīhono ki te turoro mena kei te mamae ratou i mua i tō tīmatanga, ā, waiho taua wāhi mō muri.
• Pīhono: Pīhono mō tō rātou whakahokinga whekau whakamutunga (LBM) me te raru o te mimi, pērā i te mamae me te auau.

Wāhanga 6: Ngā Wāhanga Nui (Musculoskeletal me Peripheral Vascular)

Ahu atu tātou ki ngā ringaringa me ngā waewae. Kia mau tonu ki te whakataurite i tētahi taha ki tērā taha.

• Ngā Wāhanga Nui o Runga me Raro:
  • Tirohanga: Tirohia te kiri mō te tae, te pakaru o te huruhuru, me ngā pāhuhu, te wōha rānei. Tirohia te rite me ngā tohu o te pupuhi (edema).
  • Pāmatanga: Pāmatia te kiri mō te pāmahana me te makuku. Tirohia te edema mā te pēhi i tō koromatua ki runga i te kauae mō etahi hēkona; ki te noho tonu te poki, he “pitting” edema tērā.
  • Arotaki Ngongo: Pāmatia ngā ngongo taha ā-tinana: ngongo radial (ringaringa), ngongo brachial (roto o te kauae), ngā ngongo dorsalis pedis ( runga o te waewae), me ngā ngongo posterior tibial (kei muri o te rekereke). Whakatauhia tō rātou kaha (hei tauira, 2+ te noa).
  • Tirohia te Hokinga Mai o te Tae o te Kāpi: Kia ngāwari te pēhi ki te whao o te ringaringa, waewae rānei kia koma ai, ā, ka tuku. Me hoki mai te tae i roto i te 3 hēkona.
  • Arotaki Whakaara: Pīhono kia kati ngā karu, ā, whakamātauhia tō rātou kaha ki te wehewehe i waenga i te mamae me te mamae ngāwari i runga i ngā ringaringa me ngā waewae.
  • Arotaki Pūkaha:
    • O Runga: Tirohia te kaha o te pupuri o te ringa. Pīhono kia kōpiro rāua i ō maihao e rua.
    • O Raro: Pīhono kia pēhi rātou i ō rātou waewae ki ō ringaringa (plantar flexion) ā, kia kume rātou i ō rātou waewae ki ō ringaringa (dorsiflexion).

Wāhanga 7: Tua (Kāpene me te Kiri)

Ko tēnei te wā pai ki te arotaki i te tuara i a koe e whakarongo ana ki ngā oro o te pūmua o muri.

• Tirohanga: I te wā e noho ana te turoro, e huri ana rānei ki tōna taha, tirohia te kiri i tōna tuara, i te wheua tuarā, me te papa. Kia kaha te aro ki ngā wāhi wheua pērā i te sacrum (coccyx) me ngā rekereke, nā te mea ko ēnei ngā wāhi tino tūponotanga ki ngā mate kiri.
• Arotaki Kiri Whānui: I roto i te katoa o te arotaki, me kōrero koe ki te āhua o te kiri. Tirohia te kōtītara kiri (he inenga nō te wai), mā te ngāwari te pupuri i te kiri i runga i te kāpia, te ringa rānei; me hoki tere mai te āhua.

Te Whakamutunga o te Arotaki: Haumaru me te Tuhinga

Kātahi koe ka mutu! Engari ko ēnei taahinga whakamutunga he mea nui pera i te arotaki anō. Ko tēnei te whakaoti i te pikitia katoa o me pēhea te whakahaere i tētahi arotaki tinana mai i te upoko ki ngā waewae.

• Whakaritea te Haumaru o te Turoro: I mua i tō wehenga atu, kia mārama kua pai te ngākau o te turoro. Whakahekea te moenga ki tōna wāhi iti rawa, maukatihia ngā wīra, araia ngā rārei taha (mehemea e tika ana), ā, kia mārama kua mau te wīra wāea me te teepu i te taha o te moenga. Ko tēnei te karangatia i ētahi wā ko te “4 P’s“: te tirotiro i te Mamae, te Kohinga (Potty), te Tūnga (Position), me ngā Taonga (Possessions).
• Tuhia Ngā Kitenga Katoa: Inaianei, haere tuhia ngā kitenga. Kia maumahara ki te ture koura o te nēhi: “Ki te kore i tuhia, kāore i mahia.” Kia tere, kia tika, kia pūmau hoki. Kōrero ngā mea ka kite koe, ka rongo koe, ka pā atu koe—kaua ko tō whakaaro. Ko ngā tuhinga taipitopito he rekoata ture nui, ā, he raina whakawhitiwhiti mārama mō te rōpū hauora katoa.

Whakamutunga: Mai i te Kaiwhakaako ki te Kaiwhakatere Pono

Ko te arotaki tinana nēhi mai i te upoko ki ngā waewae he kaha tōna. Ko tō whai wāhi ki te whakamahi i ō piringa katoa ki te hanga i tētahi pikitia katoa, me te katoa o te hauora o tō turoro. Akene he roa te rārangi o ngā taahinga i te tīmatanga, engari mā te whakangungu, ka noa noa iho ki a koe—he tikanga mārama, he tikanga tika, ka taea e koe te mahi mā te māia me te tika.

Kia maumahara, ko ia tohunga i tōna wā he kaiwhakaako. Kia mau tonu ki te whakangungu, kia whai tikanga, ā, kaua e mutu te pakirehua. Ma tēnei kaha matua ka taea e koe te kite wawe i ngā raruraru, te mahi tika, ā, te tuku i te kounga teitei o te tiaki mō ō turoro.

Kua rite koe ki te whakamahi? Whakaarohia te hanga o tō ake rārangi arotaki tinana mai i te upoko ki ngā waewae, ā, mahia ngā taahinga me tētahi hoa akomanga, whānau rānei. Ākuanei ka kaha ake te māia o tō māia.