He aha te Tracheostomy? Te Whāinga, te Hātepe & te Oranga

Ko te tracheostomy he hātepe pokanga e hanga ana i tētahi āputa iti i mua o tō kaki hei āwhina i a koe ki te hā. E hono tika ana tēnei āputa ki tō trachea (pūkahukahu), ka karo i tō waha me tō ihu. Ahakoa te ahua nui i te tuatahi, ka taea e tēnei hātepe te whakaora i te ora, ā, he wā poto noa iho, e hoatu ana ki tō tinana te tautoko hā e hiahiatia ana i te wā o te oranga.

He aha te tracheostomy?

Ka hangaia e te tracheostomy tētahi ara tika mō te hau kia tae ki ō pūkahukahu mā tētahi rua iti i tō kaki. I te wā o te hātepe, ka hangaia e tētahi tākuta pokanga tētahi tapahi i te trachea, ā, ka whakaurua tētahi ngongo motuhake e kiia ana ko te ngongo tracheostomy, te "ngongo trach" rānei.

Ko tēnei ngongo te mahi hei ara hā hou e karo katoa ana i tō ara rererangi o runga. Whakaarohia he hanga i tētahi tomokanga kē ki tō pūnaha hā i te wā e kore e pai te ara noa mā tō ihu me tō waha.

Ko te āputa tonu e kiia ana ko te stoma, ā, he rite tonu te rahi ki te dime. He maha ngā tāngata e noho pai ana me te tracheostomy, ā, i te nuinga o ngā wā, ka taea te whakahoki i te wā e pai ake ana te āhua o te tūāhua.

He aha te take i mahia ai te tracheostomy?

Ka tūtohu ngā tākuta i te tracheostomy i te wā e hiahia ana koe ki te tautoko hā mō te wā roa, i te wā rānei e aukatia ana, e pakaru ana rānei tō ara rererangi o runga. Ka taea te whakamahere i tēnei hātepe i mua i te wā, i te wā rānei e mahia ana i ngā tūāhua ohorere i te wā e hiahiatia ana te āwhina hā tonu.

Ko ngā take tino noa ko te hau mīhini roa, ngā wharanga nui ki te korokoro, ki te kaki rānei, me ētahi āhua rongoā e pā ana ki te hā. Me titiro tātou ki ngā tūāhua motuhake e tika ana tēnei hātepe.

Koinei ngā tūāhua rongoā matua e hiahia ana ki te tracheostomy:

• Te hauora roa e tautokona ana e te mīhini (i muri i te 7-10 rā i runga i te mīhini manawa)
• Te pupuhi nui o te korokoro, o te reo rānei i te mate, i te whara rānei
• Ngā mate pukupuku o te upoko, o te kaki rānei e aukati ana i te ara rererangi
• Te whara nui o te kanohi, o te kaki ranei i ngā aituā
• Ngā āhuatanga neurological e pā ana ki ngā uaua manawa
• Ngā āhuatanga rerekē o te ara rererangi i ngā pēpi
• Te moe moe nui e kore e aro ki ētahi atu rongoā
• Te pararutiki o te aho reo e pā ana ki ngā taha e rua
• Ngā pānga nui i te taha o te kanohi me te kaki

Ka āta arotakehia ia āhuatanga e tō rōpū hauora hei whakatau mēnā ko te tracheostomy te kōwhiringa pai mō ō hiahia motuhake. Ko te whāinga tonu kia mōhio ka taea e koe te manawa marie, me te haumaru.

He aha te tikanga mō te tracheostomy?

Ka taea te mahi tracheostomy i roto i te rūma whakahaere, i tō taha moenga rānei i te wāhanga tiaki nui. Ko te tikanga e 20-45 meneti te roa, i runga i tō āhuatanga motuhake, me mēnā he mea whakamahere, he mea mahi rānei i te ohorere.

Ka whakamahi tō tākuta i te rongoā whānui (mēnā kāore anō koe i runga i te hauora) i te rongoā ā-rohe rānei me te whakamaungia. Ka whakawhirinaki te kōwhiringa ki tō āhuatanga o nāianei me te tūnga manawa.

Anei ngā mea e pā ana i te wā o te tikanga:

1. Ka horoia tō wāhi kaki, ka hipokina ki ngā uhi pure
2. Ka hanga e te tākuta he tapahi whakapae iti i te wāhi o raro o tō kaki
3. Ka wehea ngā uaua me ngā kiko kia tae ki te trachea
4. Ka hangaia he wāhi iti i roto i te trachea, i waenga i te 2nd me te 4th porowhita tracheal
5. Ka whakaurua te ngongo tracheostomy mā tēnei wāhi
6. Ka mau te ngongo ki te wāhi me ngā tuitui me ngā here huri noa i tō kaki
7. Ka katia te tapahi huri noa i te ngongo ki ngā tuitui

Whai muri i te tikanga, ka tino mātakitakihia koe kia mōhio kei te pai te mahi a te ngongo me te pai o tō manawa. Ko te nuinga o te tangata ka urutau ki te manawa mā te ngongo tracheostomy i roto i ngā hāora ruarua.

Me pēhea te whakarite mō tō tracheostomy?

Mēnā kua whakamaherehia tō tracheostomy, kaua i te mahi ohorere, ka whakamārama tō rōpū hauora i ngā mahi whakarite motuhake. Mā te whakarite e āwhina te tikanga kia tino haumaru, me te pai o ngā hua whakaora.

Ka arotake tō tākuta i tō hītori hauora, ngā rongoā o nāianei, me te mahi i ngā whakamātautau e tika ana i mua i te tikanga. Ka hiahiatia ngā whakamātautau toto me ngā rangahau whakaahua hei whakamahere i te wāhi tika o tō tracheostomy.

Koinei te mea ka taea e koe te tūmanako i te wāhanga whakarite:

• Ngā whakamātautau toto hei tirotiro i tō mahi whakaheke toto me te hauora whānui
• X-ray pouaka, CT scan rānei hei arotake i tō ara rererangi me te anatomy o te kaki
• Te kōrero mō te whakamutu i ētahi rongoā pēnei i ngā whakaheke toto
• Te tukanga whakaae i te wā e whakamāramahia ana ngā tūponotanga me ngā painga katoa
• Tūnga NPO (kore he mea i te waha) mō ngā hāora maha i mua i te tikanga
• Te whakanoho i te rārangi IV mō ngā rongoā me ngā wai
• Te whakatakoto me te whakarite i ngā taputapu mātakitaki

Mēnā kei runga kē koe i te tūāpapa hau, he maha o ēnei whakaritenga kua oti kē pea. Ka whakarite tō rōpū hauora kia tū tōia koe i te mea ka taea i mua i te haere tonu ki te pokanga.

Me pēhea te pānui i tō manaaki tracheostomy?

Ko te māramatanga ki tō manaaki tracheostomy ko te ako mō ngā wāhanga rerekē o tō ngongo me te mōhio ki ngā tohu kei te pai te mahi o ngā mea katoa. He maha ngā wāhanga o tō ngongo tracheostomy e mahi ngātahi ana kia tuwhera me te haumaru tō ara rererangi.

Ka noho te ngongo o waho ki te wāhi, ka whakarato i te ara rererangi matua, i te mea ka taea te tango i te ngongo o roto mō te horoi. He maha ngā ngongo he pōro (e kiia ana he cuff) ka taea te pupuhi hei hiri i te ara rererangi i te wā e hiahiatia ana.

Anei ngā mea nui hei aroturuki me te mārama:

• Te tūnga o te ngongo - me noho ki waenganui, kia mau hoki ki te stoma
• Ngā oro manawa - me mārama, me ngāwari te haere mā te ngongo
• Te tae me te nui o te wai - he mea noa te wai mārama ki te wai mā
• Te kiri huri noa i te stoma - me mawhero, me te rongoā me te kore whero nui
• Ngā here ngongo, te kaipupuri rānei - me piri engari kaua e rawa piri
• Te pēhanga o te cuff (mehemea e tika ana) - ka mau tonu i ngā taumata haumaru e tō rōpū tiaki

Ka whakaako tō rōpū hauora i a koe, i ō whānau rānei, me pēhea te whakarato i te tiaki tracheostomy taketake, tae atu ki ngā tikanga horoi me te ngote. He mea nui tēnei mātauranga mō te pupuri i tō hauora me te ārai i ngā raruraru.

Me pēhea te whakahaere i tō tiaki tracheostomy?

Ko te whakahaere i tō tracheostomy e hāngai ana ki ngā tikanga horoi ia rā, te aroturuki mō ngā raruraru, me te mōhio ki te wā hei rapu awhina. Mā te tiaki tracheostomy pai e ārai ngā mate me te pupuri i tō manawa kia pai, kia whai hua.

Ko ngā āhuatanga nui o te tiaki ko te pupuri i te wāhi kia mā, te whakahaere i ngā wai, me te whakarite kia tika te tūnga o te ngongo. Ka whakarato tō rōpū hauora i ngā tohutohu taipitopito i hangaia mō tō momo ngongo tracheostomy.

Anei ngā mahi tiaki ia rā:

• Te horoi huri noa i te stoma ki te wai pure, ki te wai tote rānei
• Te huri i te kākahu tracheostomy kia maroke ai te wāhi
• Te ngote i ngā wai ina hiahiatia kia mārama ai te ara rererangi
• Te horoi, te huri rānei i te ngongo o roto i te aronga
• Te tirotiro kei te mau ngā here ngongo, ngā kaipupuri rānei, engari kaua e rawa piri
• Te aroturuki mō ngā tohu o te mate, o ngā raruraru rānei
• Te whakamākū i te hau e hāpai ana koe kia kore ai e maroke

He maha ngā tāngata e whakahaere ana i tā rātou tiaki tracheostomy i te kāinga me te whakangungu tika me te tautoko. Ka whakarite tō rōpū hauora kia pai koe ki ngā āhuatanga katoa o te tiaki i mua i te tukunga.

He aha te momo ngongo tracheostomy pai rawa atu?

Ko te ngongo tracheostomy pai rawa atu e whakawhirinaki ana ki o hiahia rongoa motuhake, te hanganga tinana, me nga whainga mo te wa roa. He maha nga momo ngongo e wātea ana, he mea hanga ia momo mo nga ahuatanga rereke me nga hiahia o te manawanui.

Ma to taakuta e whiriwhiri te ngongo e tika ana i runga i nga mea penei i te hiahia ki te hauora miihini, to kaha ki te korero, me te roa e hiahia ana koe ki te tracheostomy. Ka taea te huri i te ngongo i muri mai mena ka huri o hiahia.

Ko nga momo ngongo tracheostomy noa ko:

• Ngongo cuffed - he poihau inflatable hei hiri i te ara rererangi mo te hauora
• Ngongo uncuffed - ka taea e te hau te rere i te taha o te ngongo me te ara rererangi o runga
• Ngongo fenestrated - he rua e tuku ana i te rere o te hau ma o reo mo te korero
• Ngā tūwāhi kōrero - he taapiri motuhake hei awhina i a koe ki te korero i a koe e manawa ana ma te ngongo
• Ngongo o roto ka taea te whakamahi - ka ngawari ake te horoi me te whakaiti i te mate
• Ngongo flange ka taea te whakatika - ka taea te whakarite mo nga hanganga tinana kaki rereke

Ka mahi tahi to roopu rongoa me koe ki te kimi i te momo ngongo e pai ana ki a koe te haumaru, te whakamarie, me te kounga o te oranga. Ka taea te huri i nga ngongo i te wa e pai ake ana to ahuatanga, e huri ana ranei o hiahia.

He aha nga mea morearea mo nga raruraru tracheostomy?

Ko etahi mea ka nui ake to tupono ki nga raruraru me te tracheostomy, ahakoa te nuinga o nga tangata e pai ana ki te tiaki tika. Ko te mohio ki enei mea morearea ka awhina i to roopu rongoa ki te tango i etahi atu whakatupatotanga me te aro turuki i a koe.

Ko te tau, te ahua o te hauora, me te take i mahia ai to tracheostomy he mea nui ki te whakatau i to taumata morearea. Ko te nuinga o nga raruraru ka taea te aukati me te tiaki pai me te mohio wawe ki nga raru.

Ko nga mea ka nui ake to morearea ko:

• Te pakeke (nui ake i te 65 tau)
• Te mate huka, ētahi atu āhuatanga rānei e pā ana ki te whakaora patunga
• Te whakaiti i te pūnaha ārai mate mai i ngā rongoā, i te mate rānei
• Te kai rawakore, te iti rānei o te pūmua
• Te hītori pōkaipaipa, te whakamahi tonu rānei i te tupeka
• Te momomo e pā ana ki te hanganga o te kaki
• Te pokanga kaki o mua, te rongoā iraruke rānei
• Ngā mate toto, te whakamahi rānei i ngā rongoā whakaheke toto
• Te mate pūkahukahu mau tonu, ngā mate manawa rānei e pā ana ki te manawa

Kāore te whai i ngā āhuatanga tūpono e kī ana ka whai raruraru koe, engari e kī ana ka nui ake te aro o tō rōpū tiaki ki te ārai i ngā raruraru. He maha ngā āhuatanga tūpono ka taea te whakahaere, te whakapai ake rānei mā te tiaki hauora tika.

He pai ake te whai i te tracheostomy rangitahi, i te tracheostomy tūturu rānei?

Ko te nuinga o ngā tracheostomies he mea kia rangitahi, me te whāinga kia tangohia te ngongo ina pai ake tō āhuatanga. Heoi anō, e whai hua ana ētahi tāngata mai i te tracheostomy tūturu i runga i ō rātou āhuatanga hauora motuhake.

Ko te whakatau mō te rangitahi, te tūturu rānei e whakawhirinaki ana ki ngā āhuatanga pēnei i tō āhuatanga, te kaha ki te ora, me ngā whāinga hauora whānui. Ka kōrero tō rōpū hauora i ēnei kōwhiringa ki a koe me tō whānau.

He pai ake ngā tracheostomies rangitahi ina:

• Kei te ora koe i te mate, i te whara rānei
• Kei te hiahia koe i te tautoko manawa mō te wā poto
• E tika ana kia ngaro te pūhi, te aukati rānei i tō ara rererangi o runga
• Kei te ora koe i te pokanga nui
• Ka pai ake pea tō āhuatanga neurological i te wā

He mea tika pea ngā tracheostomies tūturu ina:

• He āhuatanga neurological haere tonu tō
• Kāore e taea te hanga anō i te ara rererangi o runga
• He mate pūkahukahu mau tonu tō
• Kua pā tonu te rongoā mate pukupuku ki tō ara rererangi
• E pai ana koe ki te tracheostomy wā roa atu i ētahi atu kōwhiringa

Ahakoa he "pūmau" te tracheostomy, ka taea te arotake anō i tō āhuatanga i roto i te wā, ā, ka taea te tango i te wā e huri ana tō hauora.

He aha ngā raruraru ka puta mai i te tracheostomy?

Ahakoa he tikanga haumaru te tracheostomy, pērā i ngā pokanga katoa, ka raru pea. Ko te nuinga o ngā raruraru he mea onge, ā, ka taea te ārai, te rongoā pai rānei i te wā e puta ana.

Ka puta ngā raruraru i te wā o te tikanga, i te wā tonu o te whakaora, ka tipu rānei i te wā roa e whakamahia ana. Ka tino mātakitaki tō rōpū hauora mō ngā tohu o ngā raruraru.

Ngā raruraru tōmua (i roto i ngā rā tuatahi) pea:

• Te toto mai i te wāhi pokanga
• Te mate i te taha o te stoma
• Te nekehanga o te ngongo, te tango rānei i tētahi
• Pneumothorax (pūkahukahu kua hinga)
• Te kino ki ngā hanganga tata pērā i ngā oko toto
• Te uaua ki te whakatakoto i te ngongo

Ngā raruraru i muri mai (wiki ki ngā marama i muri mai) pea:

• Tracheal stenosis (te whāiti o te ara rererangi)
• Te hanganga o te kiko granulation i te taha o te stoma
• Te aukati i te ngongo mai i ngā huna
• Te pakaru o te kiri i te taha o te stoma
• Te uaua ki te horomia
• Ngā huringa o te reo
• Tracheoesophageal fistula (te hononga onge i waenga i te ara rererangi me te esophagus)

Ka taea te ārai i te nuinga o ngā raruraru mā te manaaki tika me te aroturuki i ngā wā katoa. Ka whakaako tō rōpū hauora i a koe me pēhea te mōhio ki ngā tohu whakatūpato me te wā ki te rapu āwhina tonu.

Āhea au e kite ai i te tākuta mō ngā āwangawanga tracheostomy?

Me whakapā atu koe ki tō kaiwhakarato hauora i te wā tonu ki te kite koe i ngā tohu o ngā raruraru, ki te uaua rānei koe ki te hā mai i tō tracheostomy. Mā te mahi tere ka ārai i ngā raruraru iti kia kore e nui.

Ko ētahi āhuatanga e hiahia ana ki te tiaki ohorere tonu, i te wā e tatari ana ētahi atu mō tētahi whakaritenga auau, he kōrero waea rānei. He mea nui te ako ki te mōhio ki te rerekētanga mō tō haumaru.

Rapua he manaakitanga ohorere tonu mēnā ka pā ki a koe:

• Te uaua ki te manawa, te poto rānei o te manawa
• Te nekehanga o te ngongo, te aukati rānei
• Te nui o te toto mai i te stoma
• Te mamae o te uma, ngā tohu rānei o te pneumothorax
• Te pupuhi nui huri noa i te kaki
• Ngā tohu o te mate kino pēnei i te kirika me te wiri
• Te kore e taea te kōrero, te horo rānei ohorere

Whakapā atu ki tō tākuta i roto i ngā hāora 24 mō:

• Te piki ake, te huri rānei o te tae o ngā wai
• Te toto iti kāore e mutu i te pēhanga
• Te whero, te pupuhi rānei huri noa i te stoma
• He ngongo e tū ana te wātea, kāore rānei i te tū tika
• Te mare tonu, ngā huringa rānei i tō reo
• Te riri o te kiri, te pakaru rānei huri noa i te ngongo

Ko te whai i te whanaungatanga pai ki tō rōpū hauora me te māramatanga ki te wā ki te rapu awhina ka nui ake te haumaru me te whakamarie o te noho ki te tracheostomy.

Ngā pātai e pātai pinepine ana mō te tracheostomy

Q.1 He pai ake te tracheostomy i te intubation roa?

Āe, he pai ake te tracheostomy i te intubation roa mō te hunga e hiahia ana ki te tautoko manawa mo te wā roa. I muri i te 7-10 rā i runga i te tūāwhiorangi mā te ngongo i tō waha, ka noho haumaru ake, ka whakamarie ake te tracheostomy.

Ka whakaiti te tracheostomy i te tūponotanga o te whara o te aho reo, ka māmā ake te tiaki waha, ka pai ake te whakamarie o te tūroru. Ka whakaiti hoki i te hiahia mō te rongoā whakawai nui, ka māmā ake te wehe atu i te tūāwhiorangi ina rite koe.

Q.2 Ka taea e koe te kai noa me te tracheostomy?

He maha ngā tāngata ka taea te kai noa me te tracheostomy, engari kei runga i tō āhuatanga motuhake me te momo ngongo. Mēnā he ngongo cuffed tō, kua pupuhi, tērā pea me whakaiti koe i te wā kai kia taea ai te horo noa.

Ka arotakehia e tō tākuta reo me te rōpū hauora tō mahi horomia, ā, ka tūtohu pea i ētahi tikanga motuhake, i ngā whakarerekētanga kai rānei. Ko ētahi tāngata e hiahia ana ki ngā ngongo whāngai mō te wā poto i te wā e ako ana ki te horomia marie anō.

Q.3 Ka taea e au te kōrero me te tracheostomy?

Ka taea te kōrero me te tracheostomy, ahakoa me ētahi whakarerekētanga, taputapu motuhake rānei. Mēnā he ngongo kāore he pūwāhi, ka taea rānei e koe te whakaiti i te pūwāhi, ka rere te hau mā ō aho reo, ka taea te kōrero.

Ka taea e ngā tūwāhi kōrero me ngā ngongo fenestrated te āwhina ki te whakahoki mai i tō reo. Ka mahi tō tākuta reo ki a koe ki te kimi i te tikanga pai mō tō āhuatanga. He maha ngā tāngata ka whakahoki mai i ngā pūkenga kōrero pai mā te whakangungu tika me ngā taputapu.

Q.4 Kia pēhea te roa o te whakaora mai i te pokanga tracheostomy?

Ko te whakaora tuatahi mai i te pokanga tracheostomy te tikanga 1-2 wiki, ahakoa ka ora te katoa i runga i ō rātou ake tere. Ko te wāhi stoma te tikanga ka ora i roto i te 5-7 rā, ā, ka taea e koe te tīmata ki te ako i ngā tikanga tiaki i roto i ngā rā tuatahi.

Ko te urutau katoa ki te noho me te tracheostomy ka roa pea te maha o ngā wiki ki ngā marama, i runga i tō hauora whānui me te take mō te tikanga. Ka whakarato tō rōpū hauora i te tautoko tonu i te wā o tō whakaora.

Q.5 Ka taea te tango i te tracheostomy?

He maha ngā tracheostomies ka taea te tango i te wā kua whakatauhia te take i raro i te tikanga. Ko te tukanga e kiia ana ko te decannulation, ā, kei roto i te whakaiti haere i tō whakawhirinaki ki te ngongo.

Ka arotakehia e tō rōpū hauora tō manawa, tō horomia, me tō āhua whānui i mua i te ngana ki te tango. Ko te stoma te tikanga ka kati noa i roto i ngā rā ki ngā wiki i muri i te tangohanga o te ngongo, ahakoa ka hiahia ētahi tāngata ki tētahi pokanga iti hei kati katoa.