CHM SC M KH QUN

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Canule Krishaber

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M KH QUN

Th thut trong hi sc cp cu

a ng th t kh qun ra da

Gim khong cht ng dn kh BN th d dng v hu hiu hn

Gip 7/12/12

1.

A Kh th do ng thu b hp:c tnh Kh i lnh tnh hay Lit c m thanh qun P

5.

CH NH M KH QUN
v T
6.

thanh qun
2.

D vt thanh qun Ph n cp thanh qun di So hp thanh kh qun

Nhim trng nng vng c, hng thanh qun;

3.

4.

7.

Chn thng thanh qun; Chn thng li hay xng hm

8.

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CH NH M KH QUN
B Kh th do khng th ho khc m phi:
1. Lit c h hp (st bi lit-poliomyelitis, vim mng no, lit c h hpGuillain Barr) 2.Bnh nhn hn m ko di do chn thng s no, tai bin mch mu no, ng c thuc 3.Gy xng sn, khng ho khc c v au ngc; 4. Vim ph qun nng

C Phu thut vng thanh qun, hng v li

7/12/12 cn gy m qua l m kh qun:

S dung: Khi c ch cho BN rt ng kh qun D dng thay th Dng co BN s dng thi gian ko di t c tn thng nim mc nhy kh qun (BN t khc m) Nhc im: Khng dng c cho BN cn th my Khng dng cho BN c nhu cu iu tr Oxi liu php > 40%

KHAI KH QUN KHNG 7/12/12 BNG

S dng: BN thng kh c hc, thng kh p lc dng BN mt hoc gim phn x nut, ho Nhc im: Tn thng nim mc nhy kh qun do bng qu cng

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KHAI KH QUN C

S dng: Thi gian ngn Nhc im: - Lng ng c th tc do cht dch - Thay mi 5-7 ngy

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KHAI KH QUN NNG

KHAI KH QUN NNG I

S dng: - Thi gian ko di (# 1 thng), lm sch lng nh k hoc i gim nguy c tc nghn Nhc im: 7/12/12 - Gim hiu qu h hp do lng kch ng trong nh

KHAI KH QUN C L THOT

(fenestrated tracheostomy tube)

S dng: BN c d nh rt khai kh qun, gip BN t th qua hu hng Nhc im: Khng dng cho BN cn thng kh p lc dng Khng dng cho BN phn x ho nut gim

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Size

Inner diameter with inner tube (mm) 5 6.4 7.6 8.9

Inner diameter without inner tube (mm) 6.7 8.1 9.1 10.7

Outer diameter (mm) 9.4 8.1 12.2 13.8

4 6 8 10

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CHM SC ng m kh qun
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NH GI BN

H huy p Suy h thp Thay nh huy Tng i p th t ng hc Gim Oxi c (glasgow) ththng kh Kh kh kh th BN thann trong vic loi b tit hoc bng cch ht hoc khac ra am Nhp tim nhanh

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CHM SC ng m kh qun
LM M KHNG KH A VO NG M KH QUN

GI THNG NG TH

Ht m nht nh k mi gi Lm sch lng ng m kh qun long m (ung nhiu nc, thuc

Lm 7/12/12

CHM SC ng m kh qun
CHM SC NG M KH QUN

Thay dy c nh ng nh k Khng sinh d phng Hng dn cch che chn bi khi ra ngoi
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BIN CHNG

Tt canul Tc nghn canul do m c Nhim trng quanh chn ni m kh qun

Nhim trng h hp, xp phi chy

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mu

X TR CC TNH HUNG
Suy gim kh nng trao i kh

Ht mu, m nht, cht nn i Mt kh nng ho Hn ch h hp lng ngc

nh gi tnh trng tc nghn (du hiu kh th, tm ti) Ht m nht thng xuyn 5-10 pht/ln trong 3-4 gi u (cung cp oxy
trc v sau khi ht m. ng ht nh hn hoc bng 2/3 ng knh canule, thi gian mi ln ht khng qu 10-15 giy)

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Lng gi nng oxy trong mu

X TR CC TNH HUNG
Nhim trng phi do l m kh qun ra da

Nguyn nhn: ht m khng m bo v khun, thay bng khng v khun, vim nhim chung quanh chn da di canule do m t.

Theo di DHST, mu sc m, m xung quanh, da di canule m bo v khun khi ht m Ra nng trong mi 4 gi. Dng gc che chn MKQ nn ct trc hay dng gn khng b ta ch

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X TR CC TNH HUNG
Nguy c st canule

Ct dy c gt, cng ca gt va c 2 ngn tay gia da v dy ct.

Trnh gt ct vng ng mch cnh hay gy BN. Quan st da c d ng dy. Trong trng hp b st canule D nn gi ngi n gip ng thi dng km banh rng l m, cho th oxy h tr trc khi c ngi n t li canule mi.

Theo di st h hp BN. 7/12/12

X TR CC TNH HUNG

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