Chipinda chothandizira odwala kwambiri ndi chithandizo chamankhwala chapadera chomwe odwala kwambiri amagonekedwa m'chipatala mpaka ntchito zawo zofunika sizikuwopsezedwanso.

Magawo osiyanasiyana a chipinda chosamalira odwala kwambiri amasiyanitsidwa:

The Continuous Monitoring Unit (ICU)

Cholinga chake ndikusamalira odwala omwe ali pachiwopsezo cha kulephera kofunikira komwe kumafunikira kuyang'aniridwa mwatcheru. Ayenera kukhala okhoza kupirira kulepherako ngati kwachitika ndi kukonzekera wodwalayo kusamutsidwa kwake mofulumira ku chipinda cha odwala mwakayakaya.

Odwala odwala kwambiri (ICU)

Imapatsidwa mphamvu yothana ndi kulephera kumodzi kwa nthawi yochepa.

Kubwezeretsanso

Amapangidwa kuti azisamalira odwala omwe ali ndi zolephera zingapo.

Ntchito zonse sizipezeka m'zipatala zonse: izi ndizochitika makamaka pakutsitsimutsa. Kumbali inayi, zipatala zonse, zaboma kapena zapadera, zimakhala ndi ntchito yowunikira mosalekeza kwa maola 24.

Zipinda zosamalira odwala kwambiri aliyense ali ndi luso lake:

• Matenda a mtima;
• Nephrological;
• Kupuma;
• Mitsempha ya mitsempha;
• Hematologic;
• Neonatal;
• Matenda;
• Kusamalira zilonda zazikulu;
• Ndi zina zambiri

Odwala amaloledwa ku chisamaliro chachikulu ngati ntchito imodzi kapena zingapo zalephera chifukwa cha:

• matenda aakulu (septic shock);
• Kutaya madzi m'thupi kwambiri;
• Kuchokera ku ziwengo;
• Vuto la mtima;
• Kupha mankhwala;
• Kuchokera ku polytrauma;
• Kukomoka;
• pachimake aimpso kulephera;
• pachimake kupuma kulephera;
• Kumangidwa kwa mtima;
• Opaleshoni yaikulu monga opaleshoni ya mtima kapena kugaya chakudya;
• Ndi zina zambiri

M'chipinda cha odwala mwakayakaya, momwe odwalawo alili komanso chithandizo chomwe amalandira chimafunikira anthu apadera.

Kukhazikika kwa ogwira ntchito zachipatala pamalowa kumatengera mtundu wa ntchito:

• Mu chipinda chotsitsimutsa, otsitsimutsa alipo;
• M'chipinda chosamalira odwala kwambiri mu cardiology (ICU), akatswiri amtima;
• Mu gawo loyang'anira mosalekeza, ogonetsa;
• Ndi zina zambiri

Madokotala ndi akadaulo pa chisamaliro chachikulu cha anesthesia kapena chisamaliro chambiri ndipo amagwira ntchito mogwirizana ndi akatswiri onse apachipatalachi: ma physiotherapists, akatswiri azachipatala a electroradiology, nurse in general care (IDE), othandizira azachipatala ...

Kupitiliza kuyang'anira ndi chisamaliro cha maola 24 kumatsimikiziridwa mothandizidwa ndi anthu ambiri ogwira ntchito zachipatala komanso kukhalapo kosatha kwa gulu lachipatala pamalopo, kuti ayankhe mwamsanga pazochitika zilizonse zachangu - ma IDE awiri kwa odwala asanu omwe ali mu chisamaliro chachikulu, IDE imodzi odwala anayi ku ICU ndi USC.

Ntchito zonse zotsitsimutsa zili ndi zida zowonetsetsa kuti ntchito yayikulu ya thupi imayang'aniridwa ndi momwe odwala alili.

Zida zowunikira zikuphatikizapo:

• electrocardioscopes;
• Oyang'anira kuthamanga kwa magazi;
• Colorimetric oximeters - infuraredi cell yoyikidwa mu zamkati za chala kuyeza kuchuluka kwa oxyhemoglobin m'magazi;
• Ma catheter apakati a venous (VVC).

Ndipo zokhazikika zomwe zimawunikidwa ndi izi:

• pafupipafupi mtima;
• Kuthamanga kwa kupuma ;
• Kuthamanga kwa mitsempha (systolic, diastolic ndi mean): ikhoza kutha, chifukwa cha khafu yomwe imatuluka nthawi zonse, kapena mosalekeza, kudzera mu catheter yomwe imayikidwa mu mitsempha ya radial kapena femoral;
• Kuthamanga kwapakati venous (PVC);
• Kuchuluka kwa oxygen;
• Kutentha: kumatha kutha - kuyeza pogwiritsa ntchito thermometer - kapena mosalekeza pogwiritsa ntchito kafukufuku;
• Ndipo ena malinga ndi zosowa: kuthamanga kwa intracranial, kutulutsa mtima, kugona kwakuya, etc.

Deta ya wodwala aliyense - zipinda zapayekha - zikuwonetsedwa mu nthawi yeniyeni mu chipinda chilichonse komanso mofanana pawindo lomwe lili pakatikati pa holo ya utumiki kuti ogwira ntchito athe kuyang'anira odwala onse panthawi imodzi. Ngati chimodzi mwa magawowo chikusintha mwadzidzidzi, alamu yomveka imayambika nthawi yomweyo.

Resuscitation ndi malo opangidwa mwaluso kwambiri momwe mungathere kukhazikitsa njira zambiri zothandizira:

• Thandizo lopuma: magalasi a okosijeni, chigoba cha okosijeni, tracheal intubation, tracheostomy ndi kupuma kwa physiotherapy;
• Thandizo la mtima ndi kupuma: mankhwala obwezeretsanso kuthamanga kwa magazi, makina othandizira kupuma omwe amathandizira kutulutsa mpweya kwa ziwalo, makina othandizira kuzungulira kwa thupi;
• Chithandizo cha aimpso: dialysis yosalekeza kapena yapakatikati;
• Kupanga zakudya: cholowa chakudya ndi chubu m`mimba kapena parenteral zakudya ndi kulowetsedwa;
• Sedation: kuwala kwa sedation - wodwala akudziwa - ndi anesthesia wamba - wodwala ali mu coma yochititsa;
• Ndi zina zambiri

Pomaliza, chisamaliro chaukhondo ndi chitonthozo, chotchedwa unamwino, chimaperekedwa tsiku ndi tsiku ndi anamwino, othandizira anamwino ndi physiotherapists.

Ntchito zotsitsimutsa ndi zotseguka kwa mabanja ndi okondedwa omwe kupezeka kwawo ndi chithandizo ndizofunikira kwambiri pakuchira. Akatswiri a zamaganizo, ogwira ntchito zachitukuko, otsogolera ndi oimira achipembedzo alipo kuti athandize odwala ndi mabanja awo.

Kafukufuku wopangidwa ndi dipatimenti yofufuza, maphunziro, kuyesa ndi kuwerengera (DREES) akuyerekeza kuchuluka kwa mabedi - akulu ndi ana, aboma ndi achinsinsi - ku France mu 2018:

• Pa 5 mu chisamaliro chachikulu;
• Kwa 5 m'chipinda cha odwala kwambiri;
• Pa 8 mu gawo loyang'anira mosalekeza.

Kafukufuku yemwe adachitika mu Novembala 2020 ndi Société de Pneumologie de Langue Française (SPLF) ndi National Professional Council of Pneumology adazindikira malo onse osamalira anthu omwe akhalapo kwanthawi yayitali, zipinda zosamalira odwala kwambiri, zipatala zosamalira odwala kwambiri (USIR) komanso kuyang'anira chifuwa chachikulu ( USC) kudera ladziko:

• Ma USIRs, mothandizidwa ndi dipatimenti ya pneumology, ali mu CHUs okha: mabedi 104 m'madera 7;
• Ma USC a m'mapapo mothandizidwa ndi madipatimenti a pulmonology: mabedi 101, kapena mabedi 81 a USC + mabedi 20 m'magulu ophatikiza USIR ndi USC.

Ndizovuta kwambiri kuneneratu zam'tsogolo za odwala omwe adavomerezedwa ku chisamaliro chachikulu. Chisinthiko - kusintha kapena kuipiraipira - kwa matenda a wodwalayo kudzatsimikizira, pazochitika ndizochitika, mwayi wake wopulumuka ndi kuchira bwino.

Lofalitsidwa mu Okutobala 2020, kafukufuku wa Covid-ICU - matenda a Covid-19 ku Intensive Care Unit, "chipinda chosamalira odwala kwambiri" - adaphatikiza akuluakulu 4 aku France, Belgian ndi Swiss omwe ali ndi matenda opumira kwambiri okhudzana ndi matenda a SARS-CoV-244. Patatha masiku makumi asanu ndi anayi atalandilidwa kuchipatala chachikulu, kufa kunali 2%.