Nkokoaa BRUE (Asɛm a Wɔasiesie a Wɔankyerɛkyerɛ Mu Tiawa): Kɔla a Ɛsakra Mpofirim, Ɛyɛ mmerɛw, anaa Ahomegye¶

Sɛ́ wobɛhwɛ akokoaa a onnii afe 1 a ogyae home mpofirim, wadan bruu anaasɛ ne ho yɛ bruu te sɛ ahonhonsɛmdi, wayɛ mmerɛw te sɛ ɔkraman anaasɛ ɔde n’akyi abɔ denneennen, na afei ne ho atɔ no wɔ sikɔne kakraa bi mu no yɛ nsɛm a ɛyɛ hu sen biara a ɔwofo anaa ɔhwɛfo betumi ahu no mu biako. Wɔ mmofra ayaresa a egye ntɛmpɛ mu no, sɛ akokoaa a onnii asram 12 nya mpofirim a ɛtra hɔ nnu simma 1 a ɛfa cyanosis anaa pallor, ɔhome a enni hɔ anaasɛ ɛnkɔ so daa, nsakrae a ɛda adi wɔ ntini mu nne mu, anaasɛ mmuae a ɛsakra a ɛsan kɔ mfiase koraa a ɛnyɛ nea ɛde ba a ɛda adi pefee ho no, nnuruyɛfo bu no sɛ Brief Resolved Unexplained Adeyɛ (BRUE) na ɛyɛ. Sɛ mpo wo ba no hwɛ sɛ n’ani da hɔ ɔha biara mu 100, ne ho yɛ pink, na n’ani agye bere a wobɛfa telefon no a, biribiara a wontumi nkyerɛkyerɛ mu wɔ akokoaa a onnii mfe 1 mu no hwehwɛ sɛ wɔyɛ no aduruyɛ mu nhwehwɛmu ntɛm ara denam wo mpɔtam hɔfo a wobɛfrɛ no so nɔma ahorow a egye ntɛmpɛ (911 wɔ United States ne Canada, 112 wɔ Europa Aman Nkabom no nyinaa mu, 999 wɔ United Kingdom) anaasɛ wɔbɛkɔ mmofra dwumadibea a wɔhwɛ ntɛmpɛ so tẽẽ. Nea ɛte sɛ sikɔne 20 a wɔde gyina hɔ a asiane biara nni ho no betumi ayɛ kɔkɔbɔ sɛnkyerɛnne a edi kan a ɛkyerɛ sɛ obi anya apneic pertussis (ɔfe a ɛyɛ hu), ɔhome mu syncytial virus (RSV), koma a ɛnyɛ den te sɛ Long QT Syndrome, awo mu nipadua mu nneɛma a ɛsakra, anaasɛ laryngospasm, na ɛsɛ sɛ wuhu sɛnea woyɛ adwuma nso mmofra ne nkokoaa CPR ne wɔn a wɔmene wɔn gye akokoaa na wɔma ɛda nsow BRUE efi abofra ketewaa bi hɔ akɔmfosɛm a ɛma ɔhome ne nkokoaa a wɔn home anaasɛ nkokoaa atiridiinini a emu yɛ den ne atiridiinini a ɛma obi ho kyere no.

Yɛ eyi mprempren¶

1. Fa akokoaa no si wɔn nkyɛn petee wɔ baabi a ɛyɛ den na hwɛ mframa kwan ne ɔhome ntɛm ara. Mfa akokoaa a ɔyɛ mmerɛw anaasɛ ontumi nyɛ hwee nkura wo mmati so tẽẽ, efisɛ sɛ wogyina hɔ gyina hɔ a, ɛma mogya fi amemene no mu na ɛma ti a ɛyɛ floppy no hwe ase fi ne hwene mu kɔ ne koko so, na ɛbɔ mframa kwan a ɛyɛ mmerɛw no mu. Fa akokoaa no to wɔn nkyɛn tratraa (gyinabea a nkokoaa no ho tɔ no) wɔ mpa a ɛyɛ den, fam, anaa pon a wɔsesa so sɛnea ɛbɛyɛ a nufusu anaa nsu a ɛsan kɔ mu biara bɛtwe afi anom mmom sen sɛ ɛbɛkɔ ahurututu no mu.
2. Fa hard tactile stimulation gu so simma 5 kosi 10 (nwosow akokoaa no da). Fa ahoɔhare petepete akokoaa no akyi anaa ne nufu dompe (sternum), wɔbɔ wɔn nan a ɛda hɔ kwa no ase anaasɛ wɔbɔ wɔn nan ase, na wɔbɔ mframa a ɛyɛ nwini brɛoo fa wɔn hwene so ma ɛkanyan trigeminal respiratory reflex no. Mmosow akokoaa nkɔ anim ne akyi da mfa nnyane no, efisɛ nusu a wowosow no ma ntini a ɛyɛ mmerɛw a ɛwɔ ti nhwi no mu no yɛ mmerɛw na ɛma amemene mu mogya tu a edi awu.
3. Fi ase yɛ nkokoaa CPR anaasɛ choking rescue ntɛm ara sɛ akokoaa no anhome anaasɛ wannyɛ ho hwee wɔ sikɔne 10 mu a. Fa wo fon to akasam so na frɛ wo mpɔtam hɔ ntɛmpɛ nɔma (911 wɔ United States ne Canada, 112 wɔ European Union nyinaa, 999 wɔ United Kingdom). Sɛ akokoaa no yɛ komm na ontumi nhome bere a wama nsu a ɛyɛ den ama no aduan anaasɛ wabɔ ne ano akyi pɛɛ a, fa nkokoaa akyi akuturuku 5 (a ɛboa anom ne ne koko wɔ wo nsateaa so a ne ti no ba fam sen n’akyi) na fa nsateaa abien pia ne koko 5 **; sɛ akokoaa no ntumi nyɛ hwee a ɔnhome sɛnea ɛsɛ na ɛda adi sɛ biribiara nsiw ne menewa ano a, fi ase Nkokoaa CPR wɔ ne koko a wɔde mia no 30 so kosi mframa a wɔbɔ brɛoo 2 so (anaasɛ 15:2 sɛ ogyefo baanu a wɔatete wɔn wɔ hɔ a), na mia sɛntimita 4 (nsateakwaa 1.5) wɔ koko no mfinimfini kɔ akyiri wɔ nufu no mfinimfini pɛɛ wɔ ahoɔhare a ɛyɛ 100 kosi 120 compressions wɔ simma biara mu.
4. Hwɛ wo dɔn anaa wo telefon dɔn na kyerɛw bere tenten pɔtee ne ayaresabea ho nsɛm anan. Nnuruyɛfo a wɔwɔ dan a wɔhwɛ wɔn a wɔwɔ yare a egye ntɛmpɛ mu no de wɔn ho to nea obi a ɔde n’ani huu akokoaa no hwɛ so de bu akokoaa no sɛ Asiane a Ɛba Fam anaasɛ Asiane Kɛse BRUE. Adwene mu ntoto mu anaa kyerɛw to hɔ: (a) sikani dodow a adeyɛ no dii, (b) anofafa, tɛkrɛma, ne n’anim kɔla pɔtee (blue/purple, ghostly white/grey, anaa hyerɛnn kɔkɔɔ), © sɛ ebia akokoaa no nipadua no yɛɛ floppy koraa (hypotonia) anaasɛ ɛyɛ den na ɛyɛ ahinanan ( .hypertonia), ne (d) nea na akokoaa no reyɛ wɔ simma 5 ansa na adeyɛ no reba no mu (ɔda fam, ɔte kar nkongua so, ɔma aduan, ɔteɛteɛm, anaa osu).
5. Kɔ adwumayɛbea a wɔhwɛ ntɛmpɛ so ntɛm ara sɛ mpo akokoaa no te sɛ nea ɔte ase ɔha biara mu nkyem 100 mprempren a. Mfa akokoaa no nsan nkɔda fie na twɛn anɔpa mmofra oduruyɛfo a wɔbɛkɔ akɔhwɛ no. Wɔ nkokoaa a wonnii asram 12 mu (ne titiriw nkokoaa a wonnii nnafua 60 anaasɛ wɔwoo wɔn ntɛm ansa na wɔadi adapɛn 32) mu no, ahomegye a wɔde gyina hɔ a wɔde sikɔne 30 a wɔasiesie no taa yɛ ɔwɛmfo adeyɛ a edi koma ne ɔhome a ɛto so abien a ɛware, a ɛde nkwa to asiane mu anim nnɔnhwerew bi akyi bere a wɔada kɛse no.
6. Twa baabi a akokoaa no da anaa baabi a wɔma no aduan pɔtee ho mfonini na fa akokoaa no aduan, nnuru, ne wɔn a wɔhwɛ no din bra ayaresabea. Ansa na wobɛkɔ anaasɛ bere a ɔpanyin foforo reyɛ nneɛma no, twa baabi a akokoaa no da no ho mfonini ntɛmntɛm wɔ smartphone so (crib, bassinet, inclined sleeper, car seat, anaa mpanyimfo mpa) na fa aduannuru nkotoku biara a wɔabue, vitamin drops, herbal teething gels, anaa ofie awɔw nnuru bra so nnuruyɛfo a wɔhwɛ ntɛmpɛ so betumi ayɛ nna a ahobammɔ wom ne awuduru ho nhwehwɛmu a edi mũ.

Gyinaesi dua: Nkokoaa kɔla a ɛsakra mpofirim, ɔhome gyae, anaasɛ ne ho yɛ mmerɛw¶

flowchart TD
    A["Akokoaa a onnii asram 12 gyae home mpofirim, dan bruu/ɔyɛ bruu, anaasɛ ɔyɛ mmerɛw/ɔyɛ den"] --> B{"Da flat wɔ nkyɛn + rub sternum / flick soles ma 5 kosi 10 sec. So home san ba?"}
    B -->|"Dabi: Ɔnyɛ hwee na ɔhome sɛnea ɛsɛ"| C["Frɛ 911 / 112 / 999 wɔ akasam so ntɛm ara"]
    C --> D{"So episode no fii ase denam acute choking/gagging wɔ nufusu anaa ade so?"}
    D -->|"Yiw: Mframa kwan no asiw"| E["Yɛ Nkokoaa Akyi Akuturuku 5 + Koko a Wɔbɔ 5; san yɛ bio kosi sɛ mframa kwan no bɛtew anaasɛ sɛ ɛnyɛ nea ɛfata a, fi ase CPR"]
    D -->|"Dabi: Central pause anaasɛ limpness"| F["Fi ase Nkokoaa CPR: 30 koko a wɔde mia (4 cm / 1.5 wɔ bun mu, 100 kosi 120/simma) + 2 a wɔhome brɛoo"]
    B -->|"Yiw: Akokoaa ho tɔ no wɔ sec 60 mu na ɔsan kɔ nea na ɛte kan no mu"| G{"So akokoaa no wɔ sɛnkyerɛnne bi a ɛda adi sɛ ɛyɛ nnam mprempren? (Atiridiinini, ahurututu, ɔfe mpɛn pii, stridor, ɔbrɛ) ."}
    G -->|"Yiw: Ɛnyɛ nea wontumi nkyerɛkyerɛ mu"| H["Ntɛm ara Dwumadibea a Ɛhwɛ Ntɛmntɛm so nhwehwɛmu a wɔyɛ de hwɛ yare a ɛyɛ nnam (Sepsis, RSV, Pertussis, Aspiration, Seizure) ."]
    G -->|"Dabi: Akokoaa hwɛbea te sɛ nea ɔte 100% wɔ mfiase no (Possible BRUE) ."| I{"Hwɛ AAP High-Risk BRUE Criteria (1 biara wɔ hɔ?)"}
    I -->|"Mfeɛ <= nnafua 60 ANAA Ɛnkyɛe < 32 wks (< 45 wks a wɔateɛteɛ) ANAA Bere tenten >= 1 min ANAA Nsɛm a ɛsisi bio ANAA CPR a ɛhia"| J["BRUE A ASIANE KƐSE: Dwumadibea a Ɛho Hia Ntɛmntɛm a wɔde wɔn kɔ hɔ ntɛm ara + Wɔde ayarefo a wɔda ayaresabea + Oximetry a wɔkɔ so yɛ, Pertussis/RSV PCR, ECG a kɔbere 12 wom, Sepsis/Metabolic screen"]
    I -->|"Mfeɛ > nnafua 60 kɔsi 12 mos NE Full-term >= 32 wks NE Adeyɛ a ɛdi kan < 1 min NA CPR biara nhia NE Normal exam"| K["LOW-RISK BRUE: Emergency Department nhwehwɛmu a egye ntɛmpɛ + 1 kosi 4 hr a ɛkɔ so yɛ pulse oximetry, 12-lead ECG, Pertussis test, Safe-Sleep Audit, ne 24-hr 24-hɛ mmofra oduruyɛfo a wɔde di akyi"]

Ayaresa mu gyinapɛn: Dɛn na ɛkyerɛkyerɛ BRUE mu ne nea enti a ɛde sii ALTE ananmu¶

Mfe aduasa ansa na afe 2016 reba no, mmofra nnuruyɛfo de asɛmfua a wɔatwa no tiaa a ɛtrɛw a wɔfrɛ no umbrella ** dii dwuma.ALTE (Apparent Life-Threatening Event)** de kyerɛkyerɛ ehu biara a esii wɔ akokoaa bi mu a ɛmaa ɔhwɛfo bi suroe sɛ akokoaa no rewu. Akyiri yi nhwehwɛmu a wɔyɛe wɔ ayaresabea daa no adi sɛ ɛte saa ALTE na ɛnyɛ pɛpɛɛpɛ wɔ ɔkwan a asiane wom so: ɛde nkokoaa a wɔda so ara yare denneennen wɔ dan a wɔhwɛ wɔn a wɔwɔ yare a egye ntɛmpɛ mu no ne nkokoaa a wɔn ho atɔ wɔn koraa boom, na ɛde ne ho too sɛnea ɔhwɛfo no suro wɔ wɔn tirim so sen nipadua mu agyiraehyɛde ahorow a wɔde wɔn ani bu so. Wɔ afe 2016 mu (na wɔhyɛɛ no ​​den wɔ amanaman ntam mmofra ayaresa akwankyerɛ a edii hɔ bae mu), American Academy of Pediatrics (AAP) kɔhyɛɛ pɛnhyen wɔ bere no mu ALTE na ɔde ** .BRUE (Asɛm a Wɔasiesie a Wɔankyerɛkyerɛ Mu Tiawa)**.

Adum 4 a ɛyɛ ahyɛde a ɛwɔ BRUE diagnosis mu¶

Oduruyɛfo bi bɛkyekyɛ akokoaa bi a ɛba no mu sɛ ** .BRUE** sɛ abofra no nnii asram 12 (afe 1) na adeyɛ no di **adum anan a edidi so yi a wɔde hwehwɛ yare no nyinaa ho dwuma nkutoo a:

1. Tiatiaa (Bere tenten a ennu sikani 60): Adeyɛ a ɛnyɛ ne kwan so no nyinaa dii ennu simma 1 (nokware kɛse BRUE nsɛm a ɛba no di sikɔne 10 kosi 45). Sɛ adeyɛ no dii simma 1 (sikɔne 60) anaa nea ɛboro saa a, ɛboro ahwehwɛde tiawa no so na wɔde wɔn ankasa triage kɔ High-Risk diagnostic pathway no mu.
2. Wɔasiesie (ɔha biara mu nkyem 100 san kɔ mfiase): Edu bere a akokoaa no bedu hɔ akɔyɛ aduruyɛ mu nhwehwɛmu no, na akokoaa no asan aba n’akwahosan tebea a na ɔwɔ mfiase no mu koraa. Ɛsɛ sɛ wɔn koma bɔ, wɔn home a ɛbɔ, oxygen a ɛdɔɔso, ɔhyew, honam ani mogya a wɔde ma, ntini a ɛyɛ den, ne wɔn aniwa a wɔde wɔn ho hyɛ mu no yɛ nea ɛfata koraa. Sɛ akokoaa no kɔ so da, ɔbrɛ, tachypneic (ɔhome ntɛmntɛm), atiridiinini, anaasɛ ne bo fuw a, adeyɛ no ɛnyɛ nea wɔasiesie BRUE, ɛyɛ aduruyɛ mu ntɛmpɛ a ɛyɛ nnam a ɛhwehwɛ sɛ wɔsan nya nkwa ntɛm ara na wɔyɛ adwuma a wɔde wɔn ani asi so.
3. Anyɛ yiye koraa no, botae mu nsakrae pɔtee 4 mu 1 na ɛda adi:
4. Central cyanosis anaa pallor: Bruu, kɔkɔɔ, tuntum tuntum, anaa ahonhonsɛm fitaa/ashen kɔla nsakrae a ɛfa anofafa, tɛkrɛma, anom, anim, anaa mfinimfini dua ho. (Nsa ne anan a ɛyɛ bruu a asiane biara nni ho bere a ɛyɛ nwini, a wonim no sɛ acrocyanosis, anaasɛ bere tiaa bi a ɛyɛ kɔkɔɔ wɔ ano bere a woresu anaasɛ woretwa nsu mu no ɛnyɛ sɛ a BRUE).
5. Ɔhome a enni hɔ, ɛso tew, anaasɛ ɛnkɔ so daa: Ahomegye mu gyinabea ankasa (apnea), shallow gasping, anaasɛ mpofirim a ɛyɛ menewa/aperepere sɛ wobenya mframa. (Akokoaa a wɔawo no foforo home a wɔhome bere ne bere mu a ɛyɛ daa, a akokoaa a wada home ntɛmntɛm mpɛn pii na ogyina simma 5 kosi 10 akyi bere a ɔda so ara yɛ pink koraa no yɛ nipadua mu nimdeɛ a ɛfata na ɛnyɛ a BRUE).
6. Nsakrae a wɔahyɛ no agyirae wɔ ntini ahorow mu (hypotonia anaasɛ hypertonia): Akokoaa no yɛ mmerɛw koraa mpofirim na ɔyɛ Ragdoll-floppy (hypotonia) anaasɛ ɛyɛ den mpofirim a n’akyi yɛ den na n’akyi yɛ kurukuruwa (hypertonia anaasɛ opisthotonos).
7. Altered level of responsiveness: Mpofirim ara akokoaa no nyɛ nea ontumi nyɛ hwee wɔ ne nne ne ne nsa ho, ɔde n’ani a ɛte sɛ ahwehwɛ hwɛ no denneennen, anaasɛ ɔhwere n’adwene.
8. Wɔnnkyerɛkyerɛ mu wɔ abakɔsɛm ne nipadua mu nhwehwɛmu akyi: Sɛ oduruyɛfo a ɔhwɛ ntɛmpɛ so no fa abakɔsɛm a ɛkɔ akyiri na ɔhwehwɛ akokoaa no mu fi ne ti kosi ne nan ase pɛ a, biribiara nni hɔ a ɛda adi pefee sɛ ɛde ba ntɛm ara. Sɛ nhwɛso no, sɛ akokoaa a ne ho yɛ hyew digrii Celsius 39.2 (digrii Fahrenheit 102.6) na ne koko a ɛtwetwe ne ho kɛse no gyae home a, nea wohu no yɛ ahurututu mu yare a efi ɔyare mmoawa mu anaasɛ sepsis, na ɛnyɛ nea wontumi nkyerɛkyerɛ mu BRUE.

Ntotoho pon: BRUE a Asiane Kɛse ne BRUE a Asiane Kɛse ne Wɔn a Wɔnnyɛ BRUE Mimics¶

Ntease a wobɛte ase sɛ ebia wo ba no hwe ase wɔ Low-Risk no mu BRUE anaa Asiane a Ɛkɔ Anim BRUE category no kyerɛ wo nhwehwɛmu ne ayaresabea hwɛ a kuw a wɔhwɛ ntɛmpɛ no bɛyɛ pɛpɛɛpɛ. Sɛ akokoaa bi hwere Asiane a Ɛba Fam gyinapɛn no mu biako mpo a, wɔkyekyɛ mu sɛ Asiane a Ɛkɔ Anim BRUE na ɛyɛ.

Nneɛma a ɛde nkwa to asiane mu a ahintaw a wɔayɛ ho nhwehwɛmu wɔ High-Risk BRUE mu¶

Dɛn nti na nnuruyɛfo a wɔhwɛ ntɛmpɛ so si so dua sɛ wɔbɛma High-Risk akɔ ayaresabea BRUE nkokoaa (te sɛ akokoaa biara a onnii nnafua 60 anaa akokoaa biara a ɔwɔ akɔmfosɛm a ɛto so abien) kɔ ayaresabea bere mpo a akokoaa no reserew na ɔrenom toa wɔ baabi a wɔhwɛ wɔn a wɔwɔ ayaresa a egye ntɛmpɛ mu no? Efisɛ wɔ nkokoaa nkumaa a wɔwɔ autonomic nervous systems a ennyinii mu no, tebea horow ason a ɛde nkwa to asiane mu taa ba a komm, atew ne ho a ɛyɛ ahomegye anaasɛ akisikuru a ɛyɛ wɔn sɛnkyerɛnne a edi kan koraa ansa na sɛnkyerɛnne ahorow a wɔtaa hu te sɛ atiridii anaa ɔfe ada adi da.

1. Laryngospasm ne Ntini mu Chemoreflex ( .LCR) a efi reflux mu¶

Wɔ mmofra a wɔn mfe akɔ anim ne mpanyimfo mu no, sɛ yafunu mu asikre anaa nnompe bi ka ɛnne nhama no a ( .larynx), amemene no mu ntini no kanyan ɔfe a ano yɛ den ma mframa kwan no mu tew. Nanso, wɔ mmofra a wɔawo wɔn foforo ne nkokoaa a wonnii asram 4 kosi 6 mu no, ahurututu mu ntini a ɛwɔ soro no kanyan awotwaa mu nkwagye kwan a ɛyɛ tete de a wɔfrɛ no Laryngeal Chemoreflex (LCR) (wɔayɛ sɛ ɛbɛma awotwaa asiw awotwaa mu nsu a ɔbɛhome wɔ awotwaa mu). Sɛ nufusu a ɛsan ba anaa yafunu mu acid a emu da hɔ ketewaa bi du akokoaa no menewa akyi komm a, ɛnne nhama no kyekyere denneennen wɔ laryngospasm koraa mu, amemene no mfinimfini home gyae, na vagus ntini no ma koma no bɔ brɛoo (bradycardia).

• Nea awofo hu wɔ bere a... LCR spell: Episode no taa si bere a akokoaa no da fam wɔ n’akyi simma 15 kosi 60 wɔ aduan a wɔde ama no akyi (anaasɛ bere a wabɔ no nsu akyi pɛɛ). Akokoaa no yɛ katee mpofirim, ɔde n’akyi bɔ n’ani, obue n’ani kɛse wɔ ehu mu, ɔde nnyigyei biara nni hɔ ka n’ano anaasɛ ɔde ne koko a ɔrepere, ɔdan kɔkɔɔ kɔkɔɔ a ɛhyerɛn na afei ɔyɛ bruu twa anofafa no ho hyia, na awiei koraa no ɔma n’ayɛ a ɛyɛ den tew (inspiratory stridor) wɔ sikɔne 20 kosi 45 akyi bere a ɛnne nhama no gyae no.
• Ntɛm ara a wode wo ho bɛhyɛ mpa ho: Dane akokoaa no kɔ wɔn afã anaasɛ fa no gyina hɔ tẽẽ wɔ digrii 45 so wɔ wo moma so, fa bulb syringe a ɛyɛ mmerɛw twe nufusu a wotumi hu fi hwene mu brɛoo (efisɛ nkokoaa a wonnii asram 4 no hyɛ wɔn hwene mu home), na bɔ mframa a ɛyɛ nwini fa wɔn hwene so. Mfa nsateaa bi nhyɛ menewa no mu da.

2. Apneic pertussis (ɔfe a ɛyɛ hu) ne RSV ahurututu mu yare¶

Awofo hwɛ kwan sɛ akokoaa a ɔwɔ akisikuru (Bordetella pertussis) anaa Ɔhome mu Syncytial Virus (RSV) sɛ wobɛnya ɔfe anaa atiridiinini a ano yɛ den, a ɛyɛ hacking. Wɔ nkokoaa a wonnii asram 3** mu no, saa adwene no betumi adi awu:

• Apnea ansa na ɔfe: Wɔ mmofra a wɔawo wɔn foforo ne nkokoaa nkumaa a wonnii adapɛn 8 a wɔyare no mu bɛyɛ ɔha biara mu nkyem 50 mu RSV anaasɛ akisikuru a efi onua panyin anaa ɔpanyin a ɔwɔ "atiridii a ɛyɛ yaw" a emu nyɛ den hɔ, mfinimfini mframa a ɛba mpofirim (ɔhome a wogyae sikɔne 20 kosi 60 na ɛdan bruu) ne ayaresabea sɛnkyerɛnne a edi kan koraa, ɛba ** nnɔnhwerew 24 kosi 48 ansa na ɔfe, atiridiinini, anaa atiridii biara aba**.
• Absence of the "whoop": Nkokoaa nkumaa nni koko fasu ahoɔden a ɛbɛma wɔayɛ classic inspiratory "whoop" nnyigyei a ɛyɛ whooping cough. Mmom no, wɔde wɔn ano siw mframa kwan mu nsu nketenkete a ɛyɛ nnam so komm, wɔbrɛ, wɔhome kakra, na wonya komayare a emu dɔ. Efisɛ akokoaa a ɔwɔ apneic pertussis ntɛm anaasɛ RSV betumi ayɛ sɛ nea ɛteɛ koraa wɔ akɔmfosɛm a edi kan ntam na afei agyae home daa bere a wɔada denneennen nnɔnhwerew 6 akyi no, dwumadibea ahorow a wɔhwɛ ntɛmpɛ so yɛ nasopharyngeal ** .PCR swabs a wɔde sa Pertussis ne RSV** na wɔma nkokoaa nkumaa kɔ so yɛ wɔn pulse oximetry ne apnea monitors.

3. Koma mu ntini mu yare (Long QT Syndrome, WPW, ne sintɔ ahorow a egyina ductal so) .¶

Asɛm a ɛba mpofirim a akokoaa dan fitaa, fitaa, anaa nsõ te sɛ ahonhonsɛmdi (pallor) na ɛkɔ limp te sɛ ragdoll taa yɛ koma anaa vagal mmom sen ɔhome. Akokoaa biara a wɔhwɛɛ mu sɛ a BRUE (Low-Risk ne High-Risk nyinaa) ɛsɛ sɛ wɔyɛ 12-lead electrocardiogram (ECG):

• Awosu mu Long QT Syndrome (LQTS) ne Brugada Syndrome: Awosu mu ion-channel sintɔ ahorow a ɛwɔ koma no anyinam ahoɔden nhyehyɛe mu no betumi ama polymorphic ventricular tachycardia (torsades de pointes) atu mmirika bere tiaa bi a ɛde ne ho ba awiei. Wɔ sikɔne 20 mmirikatu a ɛma koma no nyɛ den mu no, koma no ahoɔden so tew kodu zero, na ɛma akokoaa no yɛ fitaa na ɔyɛ mmerɛw; sɛ nnyigyei no fi ne ho san kɔ sinus rhythm a ɛfata no so a, akokoaa no sɔre a ne ho yɛ fɛ, kosi sɛ mmirikatu a edi hɔ no bɛma koma no agyae mpofirim (SIDS).
• Wolff-Parkinson-Wɔdefo (WPW) ne Supraventricular Tachycardia ( .SVT): Nkokoaa a wɔwɔ anyinam ahoɔden kwan a ɛka ho wɔ koma no mu no betumi ahuruw mpofirim akodu koma a ɛbɔ 240 kosi 300 simma biara, na ama wɔn honam ani ayɛ fitaa mpofirim, wɔn honam ani ayɛ nsensanee, wɔmma wɔn aduan pa, anaasɛ wɔn ho yɛ wɔn yaw bere tiaa bi.
• Komayare a wɔde wo awo mu a egyina ductal so a ɛba akyiri anaasɛ ALCAPA: Tebea horow te sɛ aorta a ɛyɛ coarctation anaasɛ anomalous left coronary artery a efi ahurututu mu ntini no mu (ALCAPA) betumi ama obi asu mpofirim, ne ho fifiri, ne ho ayɛ kusuu, na ne ho ayɛ mmerɛw bere a ɔrebɔ mmɔden sɛ ɔbɛma aduan no.

4. Nkokoaa a wɔawo wɔn foforo ne nkokoaa a wɔyɛ wɔn ayayade a ɛnyɛ anifere (a Nkokoaa a Wɔyɛ Nkokoaa ka ho) .¶

Nea ɛnte sɛ mmofra a wɔanyinyin a wɔwɔ akisikuru a ɛwosow wɔ ɔkwan a ɛkɔ akyiri so a akyinnye biara nni ho no, nkokoaa a wonnii asram 6 no wɔ myelination a enni mũ wɔ wɔn amemene mu ntini akwan mu. Nea efi mu ba ne sɛ, akisikuru a efi ase wɔ bere anaa amemene no ntini mmeae no taa da adi sɛ autonomic anaasɛ subtle motor phenomena:

• Apneic seizures: Akokoaa no gyae home mpofirim, ɔde n’ani a ɛte sɛ ahwehwɛ hwɛ ɔfã biako, ɔyɛ n’anofafa a ɛyɛ dɛ, ɔde tɛkrɛma, anaa sakre so keka ne nan, na ɔdan bruu a ɛyɛ kusuu sikɔne 30 kosi 60.
• Infantile Spasms (West Syndrome): Efi ase mpɛn pii wɔ asram 3 kosi 8, mpɛn pii no bere a akokoaa no nyane anaasɛ ɔda no pɛɛ no, akokoaa no nya jackknife a ɛbɔ ne kɔn, ne dua, ne ne nsa a ɛtrɛw mu bere tiaa bi, mpofirim simma 1 kosi 2, na ɛtaa ba wɔ akuwakuw mu 5 kosi 15 biara sikani na awofo taa di mfomso sɛ "reflux cramps" anaasɛ ahodwiriw spells. Video a awofo akyere agu hama so ntɛm ne mmofra ntini ho aduruyɛ ho electroencephalogram a egye ntɛmpɛ (EEG) ho hia na wɔasiw nkɔso a ɛsan kɔ akyi daa no ano.

5. Mfomso a wofi awosu mu ba wɔ nipadua mu nneɛma a ɛsakra ne asikre a ɛba fam ho¶

Nneɛma a ɛma nipadua no yɛ adwuma a ɛntaa nsi (te sɛ Medium-Chain Acyl-CoA Dehydrogenase Deficiency [MCADD], fatty acid oxidation sintɔ, urea kyinhyia mu ɔhaw ahorow, ne organic acidemias) mma akokoaa ntumi nsakra srade a wɔde asie no nyɛ glucose bere a odi mmuada wɔ aduan a wɔde ma ntam no. Sɛ akokoaa da kyɛ kakra sen sɛnea ɔtaa yɛ anaasɛ onni aduan pa a, wɔn mogya mu glucose so tew kɛse anaasɛ ammonia a awuduru wom boaboa ano, na ɛma ɔbrɛ mpofirim, ɔyɛ mmerɛw, ɔhome, anaasɛ ɔnyɛ hwee. Sɛ wɔhwɛ mpa ho ntɛmntɛm capillary blood glucose, mogya mu mframa, electrolytes, ne lactate wɔ dwumadibea a wɔhwɛ ntɛmpɛ so a, ɛma wohu nipadua mu nneɛma a ɛsakra no ntɛm ara.

6. Asumansɛm mu mmoawa, meningitis, nsu mu yare, ne nkokoaa botulism¶

Wɔ nkokoaa a wonnii nnafua 60 mu no, ɔyare mmoawa a emu yɛ den (te sɛ nsu mu yare, Kuw B Streptococcus anaa E. coli mmoawa a ɛba ntɛm, anaasɛ meningitis a edi kan) taa de hypothermia (akyi berɛmo mu hyew a ɛba fam sen digrii Celsius 36.0 / digrii Fahrenheit 96.8) anaasɛ apneic a ɛba mpofirim ba a atiridii biara nni mu. Saa ara nso na ntɛm nkokoaa a wɔfrɛ wɔn botulism efi nneɛma a atwa yɛn ho ahyia mu mfutuma a wɔamene mu no ma atiridii ntini a ɛsiane no yɛ mmerɛw, gag reflex a enye, nnompe a ɛboaboa ano, ne ahomegye a esiw kwan mpofirim.

7. Apirakuru a ɛnyɛ akwanhyia (Abusive Head Trauma) ne awuduru a wɔanhyɛ da¶

Ayaresa mu nhwehwɛmu ahorow a wɔasan ahwɛ mu AAP kyerɛ sɛ nkokoaa a wɔde Asiane Kɛse anaasɛ ɛsan ba bio no mu ɔha biara mu nkyem 1 kosi 3 BRUE wɔ abusive head trauma (shaken baby syndrome) a ɛwɔ ase a ɛwɔ occult subdural hematomas a ɛde central brainstem apnea ba, bere mpo a abɔnten so akuru biara nni ti nhwi no so no. Enti nnuruyɛfo yɛ honam ani nhwehwɛmu a wɔde ahwɛyiye yɛ fi wɔn ti kosi wɔn nan ase, hwɛ sɛ anim fontanelle (beae a ɛyɛ mmerɛw) no ayɛ kɛse anaa, wɔhwɛ sɛ ebia anofafa a ɛwɔ soro no mu tetew anaa, na wɔhwɛ sɛ ebia wɔde nnuru a ɛma obi dwo (te sɛ mpanyimfo atiridiinini, diphenhydramine, lidocaine/benzocaine teething gels a wɔde gu nipadua no so a ɛma methemoglobinemia, anaa opioids/cannabis a mmara mma ho kwan).

Safe-sleep ne positional asphyxiation audit akyi BRUE¶

Nkokoaa home a wɔde gyina hɔ kakra ne cyanotic spells pii fi positional obstructive asphyxiation, a ɛba bere a akokoaa ti a emu yɛ duru no dan kɔ n’anim (neck flexion) enti wɔn hwene mia wɔn moma so, na ɛbɔ wɔn mframa a ɛyɛ mmerɛw a ɛte sɛ ntini (trachea) a wɔato mu, anaasɛ bere a mpa so afiri a ɛyɛ mmerɛw yi mframa bɔne a ɛwɔ wɔn hwene mu no. Bere a woretwɛn akwantu a egye ntɛmpɛ anaasɛ bere a woafi ayaresabea asan aba fie akyi pɛɛ no, yɛ Safe-Sleep and Positional Airway Audit a edi mũ yi:

• Audit Car Seats, Strollers, Bouncers, and Infant Swings: Mma akokoaa kwan da sɛ ɔnkɔ so nna kar nkongua so bere a wɔayi afi kar no mu pɛnkoro no, na fa nkongua a ɛkɔ fam a ɛkɔ fam, swing, anaa nursing pillow nni dwuma da sɛ ade a wotaa da. Sɛ wɔkyere kar nkongua bi kɔ ne nnyinaso a ɛyɛ pɛ mu wɔ kar mu a, ɛtra baabi a ahobammɔ wɔ a ɛda fam; sɛ wɔde si dan a wɔtra mu fam a ɛyɛ tratraa so a, nkongua no dan kɔ n’anim, na ɛma abofra a wɔawo no foforo a wada ti hwe ase fi ne hwene mu kɔ ne koko so na esiw mframa kwan no komm (positional asphyxia).
• Audit Baby Slings ne Soft Fabric Wraps: Wɔ nkokoaa a wonnii asram 4 a wɔsoa wɔn wɔ sling anaa wrap mu no, di ** no akyi bere nyinaa .T.I.C.K.S. mmara**: ma nea ɔsoa no Tt**nhwɛ, In view bere nyinaa (mfa ntama nkata akokoaa no anim da), Chwere sɛnea ɛbɛyɛ a wobɛfew akokoaa no ti atifi, ma akokoaa no hwene Kept off their chest (anyɛ yiye koraa no, mpanyimfo nsateaa biako a ɛtrɛw wɔ chin ase), na ma akokoaa no akyi Supported.
• Hyɛ Crib anaa Bassinet no ho akontaabu (ABCs of Safe Sleep): Ɛsɛ sɛ nna bere biara (da bere ne anadwo) yɛ Alone, de si Back (supine), wɔ Crib anaa bassinet mattress a ɛyɛ den na ɛyɛ tratraa a wɔde ntama a wɔahyɛ no den nkutoo akata so. Yi pillows, quilted bumpers, nna kotoku a emu duru, DockATot-style padded loungers, mmoa a wɔde nneɛma ahyɛ mu, ne ntama a ɛho ayɛ hare nyinaa.
• Audit Room Temperature and Overbundling: Ɔhyew a ɛboro so ma akokoaa amemene mu ntini a ɛkanyan no yɛ mmerɛw bere a hypoxia nni no. Ma mpa no nyɛ digrii Celsius 20 ne 22.2 (digrii Fahrenheit 68 ne 72) na anyɛ yiye koraa no, hyɛ akokoaa no atade a ɛyɛ tratraa biako sen sɛnea ɔpanyin bɛhyɛ no yiye (te sɛ kotoku onesie a ɛma ahome wɔ nna kotoku a wɔhyɛ a wɔmfa emu duru mu, a wɔmfa ne ti nkata so).
• Audit Ofie Secondhand Smoke and Vape Aerosol Exposure: Nicotine, sigaret wusiw, anaa vaping aerosols a wɔde di dwuma wɔ ɔhwɛfo ntade so no sɛe nkokoaa amemene mu ntini a ɛyɛ ne ho adwuma chemoreceptors, na ɛsɛe akokoaa tumi a ɔde home na ɔsɔre bere a oxygen so tew no kɛse (auto-resuscitation).

Mpɔtam hɔ ntɛmpɛ nɔma ne adwumakuw no nhyehyɛe ahorow¶

Sɛ wo ba no home gyae a wontumi nkyerɛkyerɛ mu, ne kɔla sesa, anaasɛ ne ho yɛ mmerɛw a, frɛ wo ɔman no ambulance adwumayɛbea a ɛhwɛ ntɛmpɛ so ntɛm ara na ka mfe pɔtee a akokoaa no adi wɔ adapɛn anaa asram mu kyerɛ nea ɔde kɔmaa no no:

• United States ne Canada: Frɛ 911 ntɛm ara na woanya ayaresa a egye ntɛmpɛ (EMS) de kɔ dwumadibea a wɔhwɛ mmofra a egye ntɛmpɛ so. Ayaresabea mu nhwehwɛmu di Amerika Mmofra Ayaresa Sukuu (AAP) ne Canada Mmofra Ayaresa Fekuw (CPS) BRUE ayaresabea adwumayɛ ho akwankyerɛ ahorow. Sɛ wosusu sɛ woanom ofie aduru anaa aduru bi wɔ akwanhyia mu a, frɛ Poison Control nso wɔ 1-800-222-1222 (US) anaa 1-844-764-7669 (Canada).
• United Kingdom: Frɛ 999 ntɛm ara ma ambulance a egye ntɛmpɛ sɛ akokoaa bi gyae home, dan bruu anaa ne ho yɛ bruu, anaasɛ ɔyɛ mmerɛw, na fa akokoaa no kɔ baabi a ɛbɛn no Mmofra Akwanhyia ne Ntɛmntɛm (A&E) dwumadibea. Ayaresa mu nhwehwɛmu di akyi Ɔman Asoɛe a Ɛhwɛ Akwahosan ne Ɔhwɛ a Ɛyɛ Paara So (NICE) ne Royal College of Mmofra ne Mmofra Akwahosan (RCPCH) awo akyi a ɛhwe ase mpofirim a wɔnhwɛ kwan (SUPC) ne BRUE akwankyerɛ ahorow. Sɛ wopɛ nsɛmmisa a ɛdi akyire wɔ bere a wɔayi wo afiri ayaresabea akyi a, frɛ NHS 111.
• European Union: Frɛ 112 wɔ EU aman nyinaa mu na wɔmfa mmofra ambulance nkɔma ntɛm. Ayaresa ho nhyehyɛe ahorow di Europa Resuscitation Council (ERC) mmofra nkwa mmoa mfitiaseɛ akwankyerɛ (a ɛkyerɛ 5 a wɔhome mfitiaseɛ a wɔde gye nkwa ansa na wɔafi aseɛ abɔ wɔn koko mu nhyɛsoɔ wɔ 15:2 ratio ama wɔn a wɔatete wɔn a wɔde mmoa ma) ne ɔman no mu mmofra ayaresa BRUE gyinapɛn ahorow.
• Australia ne New Zealand: Frɛ 000 wɔ Australia anaa 111 wɔ New Zealand na woanya ambulance mmuaeɛ ntɛm ara. Mmofra ayaresa dwumadibea ahorow a wɔhwɛ ntɛmpɛ so di Mmofra Nhwehwɛmu wɔ Dwumadibea a Ɛho Hia Ntɛmntɛm mu Amanaman Ntam Nkitahodi (PREDICT) ne Ahemfie Mmofra Ayaresabea (RCH) Melbourne ayaresabea dwumadie akwankyerɛ ma BRUE.
• India ne Asia-Pacific: Frɛ 112 (India ɔman no ntɛmpɛ nɔma), 995 (Singapore), 119 (Japan ne South Korea), anaa wo mpɔtam hɔ ntɛmpɛ nɔma (hwɛ ne nyinaa nɔma ahorow a egye ntɛmpɛ) na wɔakɔ ayaresabea a ɛto so abiɛsa a ɛwɔ Neonatal anaa Pediatric Intensive Care Unit (NICU/ .PICU).

Nsɛm a wɔtaa bisa¶

Dɛn nti na me ba a wɔawo no foforo no anim danee kɔkɔɔ a ɛyɛ hyew na ogyinae home sikɔne 10 bere a na ɔrebɔ abubuw sɛnea ɛbɛyɛ a ɔbɛfa ne dwensɔtwaa mu no? So ɛno yɛ BRUE?¶

Dabi, sɛ akokoaa a ɔwɔ apɔwmuden bɔ mmɔden sɛ ɔbɛfa nsu anaa mframa (nkɔso tebea a ɛnyɛ hu a wɔfrɛ no nkokoaa dyschezia) a, wɔde wɔn ho to mframa kwan a wɔato mu (Valsalva kwan a wɔfa so yɛ ade), a ɛtaa ma wɔn anim yɛ kɔkɔɔ anaa kɔkɔɔ na ɛma wɔn home gyae bere tiaa bi sikɔne 5 kosi 10 bere a wɔn nan twetwe kɔ soro no. Esiane sɛ nea ɛde ba no yɛ mmɔdenbɔ a ɛda adi sɛ ɛyɛ nipadua mu nhyɛso a ɛfata na akokoaa no mfinimfini ano ne tɛkrɛma nnyɛ bruu anaasɛ fitaa te sɛ ahonhonsɛmdi da nti, Amerika Mmofra Ayaresa Sukuu no yi osu a ɛyɛ kɔkɔɔ a ɛfata ne nsu a ɛyɛ den fi BRUE nkyerɛase no mu pefee.

Me ba no nsa ne ne nan yɛ bruu kakra bere a mibue wɔn ntama a wɔde kyekyere wɔn ho no, ɛwom mpo sɛ ɔrehome sɛnea ɛsɛ de. So ɛsɛ sɛ mefrɛ ambulance?¶

Wɔfrɛ kɔla a ɛyɛ bruu a ɛyɛ nsa, nsateaa, anan, ne nansoaa nkutoo nkutoo wɔ akokoaa a wɔawo no foforo anaa akokoaa kumaa mu no acrocyanosis, na ɛyɛ ntini a ɛnyɛ asiane, a ɛyɛ nea ɛfata wɔ mframa a ɛyɛ nwini ho bere a mogya ntini nketenkete a ɛwɔ akyi no twetwe ma akokoaa no mu yɛ hyew no. Hwɛ akokoaa no mfinimfini ntini mu bere nyinaa: hwɛ anofafa, tɛkrɛma, anom, ne ne koko mfinimfini wɔ hann pa ase. Sɛ tɛkrɛma ne anofafa yɛ hyew na ɛyɛ pink a ɛhyerɛn na akokoaa no home yiye na n’ani da hɔ a, ɛyɛ acrocyanosis a asiane biara nni ho; sɛ anofafa, tɛkrɛma, anaa anim dan bruu, kɔkɔɔ, kusuu, anaa fitaa a ɛyɛ mmerɛw a, ɛyɛ mfinimfini cyanosis na ɛhwehwɛ sɛ wɔfrɛ no ntɛm ara.

So sɛ me ba no nya BRUE a Ɛnyɛ Asiane a, ɛkyerɛ sɛ SIDS (Sudden Infant Death Syndrome) bewu?¶

Mmofra ho nhwehwɛmu akɛse a wɔyɛe wɔ mmeae pii kyerɛ sɛ nkokoaa a wodu gyinapɛn ahorow nyinaa a ɛfa BRUE a Asiane a Ɛba Fam ho (wɔadi boro nnafua 60, wɔwoo wɔn wɔ nyinsɛn adapɛn 32 anaa akyiri yi, adeyɛ tiawa biako a ennu simma 1, CPR a ɛho nhia, ne nipadua mu nhwehwɛmu ne ECG a ɛfata) no wɔ asiane a ɛba fam koraa sɛ wobewu mpofirim akyiri yi a ɛne nkokoaa dodow a wɔde dii dwuma wɔ mfiase no hyia. Da a ahobammɔ wom a wɔde bedi dwuma katee (wɔn nkutoo, wɔ akyi, wɔ mpa a ɛyɛ den a ɛda hɔ kwa mu) da so ara ho hia ma akokoaa biara.

Dɛn nti na oduruyɛfo a ɔhwɛ ayaresabea a wɔhwɛ wɔn a wɔwɔ yare a egye ntɛmpɛ mu no kamfoo kyerɛe sɛ ɛnsɛ sɛ wɔhyɛ sɛ wɔnyɛ mogya mu nhwehwɛmu, wɔn akyi berɛmo mu tap, ne amemene mu nhwehwɛmu mma me ba a ɔwɔ BRUE a asiane a ɛba fam no?¶

Sɛ akokoaa a wadi boro nnafua 60 di Low-Risk BRUE gyinapɛn biako biara ho dwuma katee na ɔyɛ nipadua mu nhwehwɛmu a ɛfata koraa a, nnuruyɛ mu sɔhwɛ ahorow a ɛkɔ akyiri a nkokoaa mpempem pii yɛ no di adanse sɛ mogya a wɔtwe a ɛyɛ hu, akyi berɛmo a wɔtow, koko X-ray, ne amemene mu CT mfonini ahorow no tumi hu sɛ ɛyɛ nea ennu ɔha biara mu nkyem 1 bere a ɛma akokoaa no nya mframa, ɛyaw, . nea efi mu ba a ɛnyɛ nokware, ne nyarewa a wonya fi ayaresabea. Mmom no, AAP akwankyerɛ ahorow a aban mpanyimfo de ma no kamfo kyerɛ sɛ ɛsɛ sɛ wokɔ so hwɛ sɛnea obi koma bɔ no so nnɔnhwerew 1 kosi 4, fa ECG a kɔbere 12 wom a ɛnyɛ nea wɔde hyɛ mu, sɛ wosusuw sɛ wowɔ akisikuru a, fa anom aduru, na wo ne wo mmofra oduruyɛfo di akyi yiye wɔ nnɔnhwerew 24 ntam.

So ɛsɛ sɛ metɔ consumer smart-sock anaasɛ clip-on diaper breathing monitor bere a me ba no anya BRUE awie no?¶

Amerika Mmofra Aduruyɛ Sukuu ne U.S. Aduan ne Nnuru Dwumadibea tu awofo fo sɛ ɛnsɛ sɛ wɔde wɔn ho to adetɔfo smart-socks, mfoninitwa afiri, anaa diaper clips so mfa nsiw SIDS ano anaasɛ wɔnhwɛ akokoaa a wanya BRUE akyi, efisɛ mfiri a wɔde di dwuma no taa hwere hypoxemia bere a ɛkanyan atoro kɔkɔbɔ ahorow no. Sɛ wohu sɛ wo akokoaa no anya BRUE a Asiane Kɛse, ne bere a edi kan koraa, anaasɛ koma/mframa mu yare a ɛhwehwɛ sɛ wɔhwɛ no wɔ fie a, wo duruyɛfo titiriw no bɛkyerɛw koma ne ɔhome ho nhwehwɛmu a ɛyɛ aduruyɛ mu nhwehwɛmu a FDA agye atom aka awofo CPR ntetee a wɔahyɛ da ayɛ ho.

Nsonsonoe bɛn na ɛwɔ BRUE a ɛwɔ abofra a wadi asram 2 mu ne ahomegye a ɛma abofra a wadi asram 14 mu?¶

BRUE ba nkokoaa a wonnii asram 12 so katee na wontumi nkyerɛkyerɛ mu, na ɛtaa ba bere a wɔada, wɔregye wɔn ahome, anaa wɔrema wɔn aduan. Nea ɛne eyi bɔ abira no, akɔmfosɛm a ɛma ɔhome a ɛma obi home no taa ba wɔ mmofra a wɔretu mmirika a wɔadi asram 6 kosi mfe 6 mu bere a biribi a ɛkanyan no pefee akyi pɛɛ: sɛ́ ebia abasamtu mu su (cyanotic blue spell) anaasɛ akuturuku ketewaa bi a ɛba mpofirim anaa ehu (pallid white spell). Wɔn baanu nyinaa hia sɛ wɔyɛ aduruyɛ mu nhwehwɛmu wɔ bere a edi kan a ɛbae no mu, a ECG a wɔde hwehwɛ akɔmfosɛm a ɛyɛ mmerɛw ka ho.

Akwankyerɛ ahorow a ɛfa ho¶

• Nkɔmhyɛ a ɛma ɔhome (blue vs. pale syncope) ne nkokoaa ahomegye a wɔpaw
• Mmofra ne nkokoaa CPR ne wɔn a wɔmene wɔn
• Nkokoaa botulism, ɛwo a wɔannoa a wɔnom, floppy baby syndrome, ne akisikuru
• Nkokoaa a wɔawo wɔn foforo no mu yare, kernicterus, ɔbrɛ, ne nsu a ɛho ntew wɔ mpaboa a ɛyɛ nsu mu no dodow
• Nnɔmba ahorow a egye ntɛmpɛ

Fibea ne aban akwankyerɛ¶

• Amerika Mmofra Ho Adesuabea (AAP, United States): Ayaresabea Adeyɛ Akwankyerɛ: Nsɛm a Wɔasiesie a Wɔankyerɛkyerɛ Mu Tiawa (BRUE) (Kan no na ɛyɛ nsɛm a ɛda adi sɛ ɛde nkwa to asiane mu) ne nkokoaa a asiane a ɛba fam mu nhwehwɛmu (Tieder ne afoforo, Mmofra Ayaresa) ne Adwumakuo a Ɛhwɛ Nkokoaa Owuo Mpofirim So Dae a Dwoodwoo Ho Nkamfo.
• Canada Mmofra Ayaresa Kuw (CPS, Canada): Acute Care Committee Practice Point: Asiane a Ɛba Fam a Wɔasiesie no Tiawa a Wɔasiesie a Wɔankyerɛkyerɛ Mu (BRUE) wɔ Nkokoaa mu.
• Ɔman Asoɛe a Ɛhwɛ Akwahosan ne Ɔhwɛ a Ɛyɛ Paara So (NICE) ne Royal College of Mmofra ne Mmofra Akwahosan (RCPCH, United Kingdom): Akwankyerɛ a Wɔde Yɛ Nhwehwɛmu a Ɛfa Awo Akyi Ahwease a Wɔnhwɛ kwan Mpofirim Ho (SUPC) ne Nsɛm a Ɛda adi sɛ Ɛde Nkwa To asiane mu wɔ Nkokoaabere mu.
• Asoɛe a Ɛhwɛ Nyarewa So na Wosiw Ano (CDC, United States): Ayaresa mu Nneɛma a Ɛfa Pertussis (Whooping Cough) ne RSV Apnea ho wɔ Nkokoaa a wonnii Asram 6 mu.
• Wiase Akwahosan Ahyehyɛde (WHO) ne Amanaman Ntam Nkitahodi Boayikuw a Ɛhwɛ Nnuru a Wɔde Ma Nnipa a Wɔsan Nyan Mu (ILCOR): Mmofra Nkwa Mfitiase Mmoa (PBLS) Nyansahu ho adwene a ɛwɔ hɔ a Ayaresa ho nyansahyɛ ahorow ka ho.