Tampon a Wɔakora So, Stuck Menstrual Cup Suction Release, ne Rectal Ahɔho Nipadua a Ɛho Hia Ntɛmntɛm¶

Sɛ wohu sɛ ɛnyɛ mmerɛw sɛ wobeyi tampon a hama bi ayera, brayɛ kuruwa a wɔatwe no denneennen, kɔndɔm a ahwe ase, anaa ade foforo bi a ɛwɔ akyi berɛmo mu afi hɔ a, ɛkanyan ehu ne aniwu kɛse. Saa aniwu no taa ma nkurɔfo di mfomso a asiane wom wɔ mfiri mu wɔ aguaree mu: wɔtwe wɔn ho denneennen wɔ brayɛ kuruwa a wɔde vacuum ahyɛ mu no dua so (a ɛtwe awotwaa no kɔ fam na ɛma ntini no mu akisikuru kɛse), ofie tweezers, pliers, crochet hooks, anaa kitchen tongs a wɔde hyɛ ɔbea no awotwaa anaa akyi berɛmo mu, anaa aduruyɛ a wɔbɛtwentwɛn so wɔ tampon anaa ade a ɛwɔ akyi berɛmo mu a wɔakora so ho kosi sɛ toxic shock syndrome (TSS) anaasɛ dwensɔtwaa mu a ɛyɛ owuyare bɛba. Wɔ nipadua mu no, vaginal canal no yɛ ntini kotoku a wɔato mu a ɛma anifuraefo ba awiei (7 to 12 cm / 3 to 5 in deep) terminated by the solid cervix, meaning biribiara ntumi "yera wɔ yafunu no mu" da denam vagina, na wobetumi ayi awotwaa mu nneɛma dodow no ara a ɛnyɛ nnam afi hɔ dwoodwoo wɔ fie denam deep squat ne nsateaa abien a ɛho tew so. Nea ɛne eyi bɔ abira koraa no, akyi berɛmo no bue kɔ soro tẽẽ kɔ sigmoid akyi berɛmo a ɛyɛ kurukuruwa no mu na akyi berɛmo mu ntini a ɛwɔ mu ne akyi a tumi wom a ɛkɔ akisikuru a ɛyɛ den te sɛ abotan mu na ɛtwe nneɛma a ɛyɛ torotoro kɔ soro kɔ akyi berɛmo no mu no atwa ho ahyia. Sɛ wobɔ mmɔden sɛ wode nnwinnade bɛkyere ahɔho nipadua a ɛwɔ akyi berɛmo mu wɔ fie, anaasɛ wobɛpia ahwehwɛ toa a tokuru mu a, ɛde asiane ba sɛ wobɛto sigmoid colon no fasu a ɛyɛ tratraa no mu akɔ peritoneal cavity no mu, na ɛde peritonitis a ɛde nkwa to asiane mu aba. Fa wo hwɛ a wo ne no yɛ biako toxic shock syndrome (TSS) frankaa kɔkɔɔ, . sepsis ne septic shock a ɛma mogya tu, na mogya a ɛba yafunu mu, na frɛ wo mpɔtam hɔfo nɔma ahorow a egye ntɛmpɛ (911 wɔ United States ne Canada, 112 wɔ Europa Aman Nkabom no nyinaa mu, 999 wɔ United Kingdom) ntɛm ara sɛ frankaa kɔkɔɔ bi a ɛyɛ tokuru anaa sepsis pue a.

Yɛ eyi mprempren¶

1. MFA dadeɛ tweezers, pliers, tongs, scissors, coat hangers, anaa nsateaa nnadewa a ano yɛ nnam nhyɛ awotwaa anaa akyi berɛmo mu DA. Ofie nnwinnadeɛ twetwe fi ntini a ɛyɛ nsuo mu na ɛtwitwa mu tẽẽ fa akyi awotwaa fornix anaa akyi berɛmo fasuo a ɛyɛ mmerɛw no mu, na ɛma mogya tu kɛseɛ wɔ ntini mu anaasɛ ɛpopae wɔ akyi berɛmo mu. Fa nsateaa a ɛho tew, a wɔahohoro a ɛda hɔ kwa a nnadewa a wɔatwitwa nkutoo di dwuma ma awotwaa mu a ɛnyɛ den, na mmɔ mmɔden da sɛ wode nsa anaa adwinnade beyi ahɔho nipadua a emu dɔ anaa ɛyɛ mmerɛw a ɛwɔ akyi berɛmo mu.
2. Screen ntɛm ara sɛ "Emergency Room Now" Red Flags (Perforation anaa Toxic Shock Syndrome) na frɛ 911 / 112 / 999 anaa kɔ ER sɛ OBIARA wɔ hɔ a:
3. Atiridiinini a ɛkɔ soro mpofirim (\(\ge 38.9 degrees C / 102.0 degrees F\)), honam ani akisikuru kɔkɔɔ a ɛtrɛw "te sɛ owia hyew", ɔfe, atiridiinini a nsu wom, ntini mu yaw kɛse, anaasɛ adwenemhaw bere a ogyina hɔ bere a tampon, kuruwa, anaa nyinsɛn ano aduru wɔ mu (Menstrual Toxic Shock Syndrome [TSS]).
4. Yafunu mu yaw a ano yɛ den, yafunu mu yaw a ɛyɛ den, yafunu a ɛte sɛ kyerɛwpon a ɛyɛ den, mmati ano yaw, mogya a ɛba akyi berɛmo mu kɔkɔɔ a ɛyɛ hyew, anaasɛ ɔtopae wɔ akyi berɛmo anaa ɔbea awotwaa mu ahɔho nipadua akyi (Bowel or Vaginal Vault Perforation / Peritonitis).
5. Ahwehwɛ adeɛ biara, kanea bɔlɔb, ade a ɛyɛ tratraa a wɔde dɔteɛ/porcelain ayɛ, adeɛ a ɛyɛ nnam, anaa batere a ɛretu wɔ akyi berɛmo anaa awotwaa mu (ɛbubuo kɛseɛ ne nnuru a ɛbɛhyew asiane: MPIA, nhyɛ, anaa nhyɛ).
6. Adeɛ a ɛwosow a ɛwɔ mfiri a ɛda so ara tu mmirika wɔ akyi berɛmo anaa akyi berɛmo mu (ɛwosow a ɛkɔ soro tia rectosigmoid junction no ma nhyɛsoɔ necrosis ne perforation ba wɔ nnɔnhwereɛ mu).
7. Sɛ wopɛ sɛ woyi Menstrual Cup a akyea no: Fa wo ho to fam, gyina fam brɛoo, na PINCH kuruwa no FASE (anaasɛ fa wo nsateaa biako kɔ soro wɔ rim no nkyɛn) na ama woabubu vacuum seal no ANSA na woatwe akɔ fam. Ntwe tẽẽ nkɔ fam da wɔ silicone dua a ɛyɛ tratraa no so bere a kuruwa no da so ara yɛ suction-locked wɔ awotwaa no ho. Sɛ wotwe dua no kɔ vacuum seal a enni dɛm so a, ɛyɛ adwuma te sɛ plunger a ɛwɔ wo awotwaa mu.
8. Sɛ wopɛ sɛ wogye Tampon a wɔakora so (hama a ayera) anaa Condom a ahwe ase afi awotwaa no mu: Kae sɛ ɔbea no awotwaa no yɛ kotoku a enwu mu a wɔato mu. Hohoro wo nsa, kɔ fonkoro nan a emu dɔ mu squat (anaasɛ tena tiafi so a wo nan so wɔ nan ase so), fa wo nan ase ntini no gyina brɛoo te sɛ nea wowɔ dwensɔtwaa kankyee (a ɛma awotwaa no ano ne tampon no bɛn baabi a wɔabue no sɛntimita 3 kosi 5), fa nsateaa abien a ɛho tew a wɔde srade ahyɛ mu (index and middle) fa ɔbea awotwaa no akyi fasu no so kɔ akyi fornix a ɛwɔ awotwaa no akyi no, na popa tampon anaa kɔndɔm no fi wo nsateaa abien ntam te sɛ nnuadewa.
9. Wɔ Rectal Foreign Body a ɛntwam mmɔdenbɔ biara wɔ tiafi a edi kan a ɛyɛ brɛoo no so tena ase: GYAE nhyɛso, tra NPO katee (ZERO aduan, ZERO nsu, ZERO laxatives, ZERO enemas), na kɔ tẽẽ kɔ Hospital Emergency Department. Sɛ wofa laxatives anaasɛ tow tap-water enemas wɔ wedged rectal foreign body akyi a, ɛma ɔtopae nsu a ɛwɔ akyi berɛmo no mu a ɛbɔ dwensɔtwaa no fasu.
10. Sɛ kɔndɔm bi hwirew anaa ɛbubuu wɔ awotwaa mu wɔ nnɔnhwereɛ 72 kɔsi 120 a atwam no mu a: Nya Nyinsɛn a Wɔde Siw Ntɛmntɛm ne STI/HIV PEP afotuo nnɛ. Nyinsɛn a wɔnom ntɛm (levonorgestrel wɔ nnɔnhwereɛ 72 mu anaa ulipristal acetate wɔ nnɔnhwereɛ 120 mu, anaa kɔbere/LNG IUD) ne HIV Post-Exposure Prophylaxis (wɔ nnɔnhwerew 72 mu sɛ asiane kɛse a) yɛ bere a ɛho hia bere a wɔayi kɔndɔm a wɔakora so no afi hɔ akyi.

Gyinaesi dua: Vaginal vs. Rectal ahɔho nipadua ne retained menstrual item triage¶

Fa saa ayaresabea nhyehyɛe yi hwɛ sɛ ebia wobetumi de nsateaa a ɛho tew agye ade bi wɔ fie dwoodwoo anaasɛ ɛho hia sɛ wɔhwɛ Ayaresabea a Ɛho Hia Ntɛmntɛm Dwumadibea no ntɛm ara.

flowchart TD
    Start["Adwene a Wɔde Kɔ Brayɛ Mu Ade anaa Ahɔho Nipadua a Ɛwɔ Vagina anaa Rectum mu"] --> RedFlags{"Frɛmfrɛm Kɔkɔɔ BIARA a Ɛwɔ Hɔ Ntɛmntɛm?; - Atiridii >=38.9C (102F), owia hyew a ɛyɛ mmerɛw, adwenemhaw, ɔfe (TSS)?; - yafunu/akyi yafunu mu yaw a emu ye den, yafunu a eye den, anaase mogya a etu mu den?; - adeɛ no yɛ GLASS, nnam, ceramic, battery, anaasɛ ɛda so ara wosow?"}

    RedFlags -->|"YIW ma Frɛko Kɔkɔɔ BIARA"| GoER["AYARESABEA A ƐHYƐ NTAM NTAM (Frɛ 911 / 112 / 999):; 1. MMFA ntwe, ntwitwiw, anaa nhyɛ mu; 2. Tra hɔ katee NPO (Zero aduan, nsu, laxatives, anaa enemas); 3. Sɛ TSS suspected & tampon yɛ mmerɛw sɛ nsateaa, yi brɛoo; 4. Kɔ ER kɔhwehwɛ IV antibiotics / sedated oprehyɛn anaa endoscopic extraction"]

    RedFlags -->|"Frɛmfrɛm Kɔkɔɔ BIARA NNI HƆ"| Location{"Ɛhe na ade a wɔakora so no wɔ?"}

    Location -->|"1. Vagina: Nna Kuruwa anaa Disk a Ɛbata Ho"| CupSteps["SAFE MENSTRUAL CUP SUCTION-RELEASE PROTOCOL:; 1. Gye w’ahome simma 15 (ehu ma pelvic floor ntini mu yɛ den); 2. Hohoro nsa; kɔ deep squat mu wɔ shower a ɛyɛ hyew mu anaasɛ wo nan wɔ stool so; 3. Fa wo ho to fam brɛoo (‘poop push’) na fa kuruwa kɔ fam 3-4 cm; 4. PINCH BASE of cup firmly (anaasɛ fa nsateaa 1 fa soro rim) na woate/te mframa abubu suction; 5. Rock side-to-side wɔ C-fold na twetwe fi adi kɔ so gyina hɔ"]

    Location -->|"2. Vagina: Tampon a Wɔakora so (Ahama a Ayera) anaa Kɔndɔm a Ɛhwe ase"| TamponSteps["NSATEA ABIEN A ƐYƐ AHOHYEHYƐDE A ƐFA VAGINAL SWEEP (Closed Pouch Anatomy):; 1. Fa wo ho to fam kɔ ​​akyiri na gyina fam brɛoo na ama awotwaa no akɔ fam; 2. Fa nsu a egyina lube sra index & mfinimfini nsateaa a ɛho tew; 3. Fa wo nsa fa akyi ɔfasu no so kɔ akyi fornix (awotwaa akyi); 4. Fa tampon/condom kyekyere nsateaa abien ntam na fa wo ho hyɛ mu; 5. Hwɛ ayaresabea wɔ 24h mu sɛ wuntumi nkɔ anaasɛ sɛ nsu fĩ kɔ so a"]

    Location -->|"3. Rectum: Rectal Ahɔho Nipadua Biara a Ɛbata Sphincter Atifi"| RectalSteps["HOSPITAL EMERGENCY DEPARTMENT NKYERƐKYERƐMU:; 1. MFA nnwinnade, nsateaa, enemas, anaa nnuru a wɔde kum akisikuru nhyɛ mu DA; 2. Tra hɔ katee NPO (Zero aduan anaa anonne sɛ ɛba sɛ ɛho hia sɛ wɔde aduru a ɛma obi dwensɔ a); 3. Nantew mu brɛoo & ka kyerɛ triage nurse sɛ 'Rectal foreign body'; 4. ER yɛ yafunu mu X-ray + ɛyaw biara a ɛnyɛ sedated sphincter block yiyi"]

Ɔfa 1: Anatomical Nokware: Nea enti a Vagina yɛ Closed Cul-de-Sac na Rectum yɛ Open Vacuum Tube¶

Sɛ yɛte ɔbea akyi berɛmo no nipadua akwaa pɔtee ne anorectal canal no ase a, eyi ehu a atwa awotwaa mu nneɛma ho ahyia no 90% fi hɔ bere a ɛkyerɛkyerɛ nea enti a nneɛma a ɛwɔ akyi berɛmo mu no hia ayaresabea hwɛ mu no:

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Ɔfã 2: Anamɔn biara: Sɛnea Wobeyi "Stuck" anaa High-Riding Menstrual Cup (Breaking the Vacuum Seal) .¶

Silicone anaa TPE brayɛ kuruwa yɛ adwuma denam negative-pressure suction seal a mframa ntumi nkɔ mu a ɛyɛ wɔ ɔbea no awotwaa no atifi afasu a ɛwɔ awotwaa no ase pɛɛ no so (a ɛnte sɛ ** brayɛ mu diski** a ɛyɛ tratraa, a ɛtra awotwaa dompe no akyi a entumi nnom). Sɛ wokyere brayɛ kuruwa a wɔatwe no ase dua a ɛyɛ tratraa no na wotwe kɔ fam tẽẽ a, nsɔano a mframa ntumi nkɔ mu no yɛ adwuma te sɛ kuruwa a wɔtwe a ɛbata ahwehwɛ ho, na ɛtwe wo awotwaa ne wo awotwaa mu akorae, na ɛma wo ho yɛ wo yaw denneennen, na ɛpow sɛ ɛbɛhinhim.

Di saa ayaresabea nhyehyɛe a ɛwɔ anammɔn 5 yi akyi na yi brayɛ kuruwa a ɛwɔ soro anaasɛ wɔatoto mu denneennen a ɛnyɛ yaw:

1. Anamɔn 1: Gyae Twe na Gye Ahome Simma 15 Sɛ Wo Pelvic Floor no Clenched a:
2. Kuruwa a wɔde hwɛ brayɛ betumi atra mu dwoodwoo akosi ** nnɔnhwerew 12**, enti ɛho nhia sɛ wɔde ahopere bɛpere wo ho wɔ ehu mu. Sɛ w’abam bu bere a woatutu fam simma 5 akyi a, wo hwene fam ntini ahorow no twetwe te sɛ akuturuku, na ɛpia kuruwa no kɔ soro mpo. Gyina hɔ, guare anaa guare a ɛyɛ hyew, na home brɛoo wɔ yafunu mu simma 15.
3. Anamɔn 2: Kɔ Deep Squat mu na Bear Down Rhythmically ("Nantew Kuruwa no Sian"):
4. Mmɔ mmɔden sɛ wubeyi kuruwa a ɛkorɔn bere a wugyina hɔ a wode wo nan biako si so anaasɛ wote hɔ tẽẽ denneennen no. Squat kɔ fam nyinaa wɔ shower mu (anaasɛ tena tiafi so a wo nkotodwe so kɔ soro wɔ aguaree akongua so).
5. Gya ahome na fa wo yafunu ase ne wo hwene fam ntini ahorow no gyina ano (nea wɔde piapia no brɛoo kɔ fam no ara pɛpɛɛpɛ na wɔde yɛ wo dwensɔtwaa anaasɛ wopia akokoaa fi adi). Sɛ wɔsoa awotwaa no mu a, ɛma ɔbea no awotwaa no yɛ tiaa sentimita 3 kosi 5 (nsateakwaa 1.2 kosi 2) na ɛpia kuruwa no ase kɔ fam pɛɛ kɔ ɔbea no awotwaa no ano.
6. Yɛ 3 kosi 5 rhythmic pushes, fa wo nsateaa ano nkutoo kura dua no ano brɛoo sɛnea ɛbɛyɛ a kuruwa no nsan nkɔ soro bere a worehome no (ntwe dua no).
7. Anamɔn 3: Pinch Base no denneennen ANAA Slide Index Finger Baako Kɔ Rim no mu na ama woabubu Suction Seal no:
8. Ɔkwan A (The Two-Finger Base Pinch): Sɛ bearing down ma ribbed bottom bulb a kuruwa no wɔ baabi a wo nsa bɛka a, fa wo clean thumb ne index finger kɔ soro twa stem no ho na pinch the lower body/base of the cup firmly together to dent the silicone wall inward. Wobɛtaa ate pop anaa squelch ketewaa bi nka anaa wobɛte bere a mframa de ahopere twa rim no ho na bubu vacuum no.
9. Ɔkwan B (The Single-Finger Rim Hook for High-Cervix Users): Sɛ wobɔ fam nnyinaso no da so ara ntumi mmu nsɔano a emu yɛ den a atwa awotwaa a ɛsensɛn fam ho ahyia a, fa nsateaa biako a ɛho tew a wɔde kyerɛ ade kɔ soro wɔ kuruwa no nkyɛn nyinaa kosi sɛ wo nsateaa ano bedu atifi rim no ho, afei mia rim no mu kɔ mu kɔ kuruwa no mfinimfini na mframa akɔ mu.
10. Anamɔn 4: Bobɔw Kɔ "C-Shape" a Ɛnyɛ Anifere Mu na Wobɔ No Afã-kɔ-Afã ("The Shimmy"):
11. Fa nnyinaso no a wobɛma ayɛ mmerɛw wɔ wo nsateaa kɛse ne wo nsateaa a wode kyerɛ ade ntam (anaasɛ wode wo mfinimfini nsateaa no bobɔw kakra ma ɛyɛ teateaa C shape), brɛoo wosow kuruwa no afã-kɔ-afã (left-to-right anaasɛ front-to-back) bere a worekyerɛ no kwan akɔ fam na woafi adi wɔ akyi kakra-afei akɔ anim, na woakɔ so agyina hɔ sɛnea ɛbɛyɛ a emu nsɛm no bɛhwie akɔ tiafi anaa nsu a wɔde gu mu no mu.
12. Anamɔn 5: Sɛnea Wobebue Menstrual Disc (Ɛho Nhia sɛ Wonom):
13. Sɛ wode menstrual disc a ɛwɔ rim redi dwuma sen sɛ wode kuruwa a ɛte sɛ dɔn bedi dwuma a, kae sɛ suction seal biara nni hɔ a wobɛbɔ: bɔ fam kɔ akyiri, gyina fam denneennen na ama anim rim no afi wo pubic bone shelf akyi, fa nsateaa biako a wode kyerɛ ade no hyɛ anim rim no ase (anaasɛ ɛboro so), na fa hama kɔ w’anim tẽẽ na fi adi.

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Ɔfa 3: Tampon a Wo werɛ Fi / Wɔakora So, Ahama a Ayera, anaa Kɔndɔm a Ahwease a Wobegye¶

Mmea nsrahwɛ a egye ntɛmpɛ a ɛtaa ba no mu biako ba bere a obi de tampon foforo hyɛ ne bra awiei a onnim sɛ tampon dedaw bi da so ara wɔ mu, anaasɛ bere a tampon hama bi tetew anaasɛ ɛde ne ho hyɛ mu bere a ɔreto nsu anaasɛ ɔrenya nna mu kyɛfa no.

1. Tampon a Wɔakora So a Wɔn werɛ afi Ho Nsɛnkyerɛnne a Wɔayɛ no Tete a Wobehu¶

Sɛ tampon tra awotwaa no mu bɛboro nnɔnhwerew 24 kosi 72+ (ɛtɔ mmere bi a dapɛn biako anaa nea ɛboro saa a onipa no nhu nea enti a ɔwɔ sɛnkyerɛnne ahorow a), ɔbea no awotwaa mu mmoawa a ɛyɛ hyew dɔɔso ntɛmntɛm wɔ rayon/cotton nhama a mogya ayɛ mu ma no mu: - Umistakable Foul, Putrid, anaa "Rotting Meat / Fishy" Vaginal Odor a ɛba mpofirim wɔ nnɔnhwerew 24 kosi 48 mu. - Nsuo a ɛyɛ bruu, pink tuntum, fitaa, anaa purulent (te sɛ akisikuru) a ɛba ɔbea no awotwaa mu. - Akisikuru a ɛyɛ ma anaa nhyɛsoɔ a ɛnyɛ den (mpɛn pii no ɛwɔ ɔhyew a ɛfata koraa na ɛyaw biara nni mu sɛ ɛnyɛ den a, anaasɛ atiridiinini a ano yɛ den mpofirim ne akisikuru ka ho sɛ ɛkɔ so kɔ Toxic Shock Syndrome a).

2. Sɛnea Wobɛfa Nsateaa a Ɛho Tew Begye Tampon anaa Kɔndɔm Dwoodwoo¶

Sɛ wowɔ Toxic Shock Syndrome ho sɛnkyerɛnne biara (atiridii nni hɔ, akisikuru biara nni hɔ, adwenemhaw biara nni hɔ) a, sɔ simma 3 a wɔde gye fie yi hwɛ pɛnkoro ansa na woakɔ ayaresabea a wɔhwɛ wɔn a egye ntɛmpɛ: 1. Fa samina ne nsuo hohoro wo nsa yie na hwɛ sɛ wo nsateaa nnadewa yɛ tiaa na ɛyɛ mmerɛw. Fa srade a wɔde nsu ayɛ (anaasɛ nsuo a ɛyɛ hyew a ɛho tew) a ɛyɛ ayamyeɛ gu wo index ne mfinimfini nsateaa so. 2. Fa no sɛ Deep Frog-Leg Squat: Fa wo ho to fam a wo nkotodwe atrɛw na wo nan ase ayɛ petee wɔ fam, na gyina fam brɛoo te sɛ nea worepia wo dwensɔtwaa bi afi adi. 3. Prapra Akyi Fornix (Awotwaa no Akyi): - Fa wo nsateaa a wode kyerɛ ade ne nea ɛwɔ mfinimfini no hyɛ mu kosi ɔbea no awotwaa no atifi (7 to 10 cm / 3 to 4 inches). - Wobɛte wo cervix (ɛte sɛ hwene ano) dome a ɛyɛ torotoro, ɛyɛ den, kurukuruwa no nka. - Fa wo nsa kɔ kotoku a ɛyɛ kurukuruwa no mu tẽẽ wɔ awotwaa no akyi ne ase kakra (akyi fornix) na popa no brɛoo twa awotwaa no afã horow ho hyia (lateral fornices). Mpɛn pii no, tampon dedaw a wɔahyɛ no den no te sɛ kotoku a ɛyɛ nsu na ɛyɛ den a wɔde asie nkyɛnkyɛn wɔ awotwaa no akyi, bere a kɔndɔm a ɛtwetwe no te sɛ balloon nkaa a ɛyɛ mmerɛw na ɛyɛ hwerɛma. - Pinch tampon anaa condom no wɔ wo index ne middle fingers pads ntam (te sɛ chopsticks) anaa fa wo nsateaa baako hyɛ n’akyi na fa hyɛ mu brɛoo. 4. Never Douche Bere a Woayi Tampon Dedaw Bi Awie: - Sɛ woyi tampon a wɔakora so a ɛyɛ huam no fi hɔ wie a, hua ne nsuo a ɛfiri mu no fi awosu mu fi awosu mu wɔ n’ankasa mu wɔ nnɔnhwereɛ 24 kɔsi 48 ntam berɛ a awotwaa no mu Lactobacillus afifideɛ a ɛwɔ apɔmuden no hohoro asubɔnten no mu. Mfa awotwaa mu nsuo, vinegar hohoro, anaa samina nni awotwaa no mu da, ɛfiri sɛ nsuo a wɔde gu awotwaa mu no hyɛ mmoawa a ɛwɔ soro kɔ soro fa awotwaa no mu kɔ awotwaa no mu (ɛde Pelvic Inflammatory Disease ba) na ɛma acid flora a ɛbɔ ho ban no fi hɔ. - Bere a wobɛkɔ oduruyɛfo anaa ayaresabea: Sɛ wuntumi nte anaasɛ wuntumi nnye tampon no wɔ mmɔdenbɔ brɛoo 2 kosi 3 akyi, sɛ wunnim 100% sɛ ebia asinasin a ɛto so abien da so ara wɔ mu, anaasɛ sɛ nsu fĩ, ɛyaw wɔ akyi berɛmo mu, anaa atiridii kɔ so wɔ nnɔnhwerew 24 akyi wɔ bere a wɔayi afi hɔ akyi a, kɔ ayaresabea a wɔhwɛ wɔn ntɛm anaa mmea ho ɔyaresafo kɔhwehwɛ ntɛm a ɛyaw nnim 30-second speculum a woyi fi hɔ.

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Ɔfã 4: Rectal Foreign Body Emergency (Nea Enti a Ayaresabea a Woyi Fi Mu Gye Wo Nkwa) .¶

Dwumadibea ahorow a wɔhwɛ ntɛmpɛ so wɔ wiase nyinaa sa ayarefo mpempem pii yare afe biara wɔ ahɔho nipadua a ɛwɔ akyi berɛmo mu a wɔakora so (efi mpanyimfo agode a enni nnyinaso a ɛyɛ hyew a ɛdɔɔso, poma a wɔde twitwiw nipadua, ne enema afiri so kosi nkotoku, nsuhina a wɔde tew hua ho, nhabannuru, ne ahwehwɛ nkuku so).

1. Nea Enti a Ɛnsɛ sɛ Wote Aniwu nka Da sɛ Wobɛkɔ ER no mu Ntɛm ara¶

Ade biako pɛ a edi awu sen biara wɔ ahɔho nipadua a egye ntɛmpɛ a ɛba akyi berɛmo mu ne dɔnhwerew 12 kosi 48 a ɛkyɛ wɔ fie a aniwu de ba, a wɔde ka ho ne mmɔden a wɔsɛe no sɛ wɔde nnwinnade betutu ade no afi mu. - Sɛnea Nnuruyɛfo ne Ayarehwɛfo a Wɔhwɛ Nneɛma a Egye Ntɛmpɛ Sa Eyi Ankasa: Wɔ oduruyɛfo a ɔhwɛ ntɛmpɛ dan mu ne ɔyarehwɛfo a ɔhwɛ ayarefo a wɔpaw wɔn fam no, ahɔho nipadua a akɔhyɛ akyi berɛmo mu yɛ nipadua mu adeyɛ a wɔyɛ no daa, a wɔahyɛ da ayɛ, a ɛnyɛ soronko wɔ ayaresabea sɛ wobeyi popcorn ntini bi afi aso mu anaasɛ wɔbɛtew mmati a abubu so. Wɔde aduruyɛ mu kokoam nsɛm ho mmara a emu yɛ den (HIPAA / GDPR / NHS Ahintasɛm) abɔ wo ho ban. - Nea wobɛka wɔ ER Triage Desk: Ɛho nhia sɛ wobɛma ɔkasa tenten wɔ dan a nnipa ahyɛ mu ma a wɔtwɛn mu. Fa krataa bi ma triage nurse no kɛkɛ wɔ wo fon so anaasɛ ka komm sɛ:

"Mewɔ retained rectal foreign body a ɛhwee mu [X] nnɔnhwerew a atwam ni. Wɔde [silicone / plastic / glass / metal] na ɛyɛe, na matra NPO (biribiara nni hɔ a mɛdi anaa mɛnom)."

2. Nea enti a Ayaresabea a Wɔyi Nneɛma Fi Mu no Yɛ Adwuma Bere a Mmɔden a Wɔbɔ wɔ Fie no Di Nkonim¶

Wɔ fie no, wɔato anal sphincter ntini no mu wɔ spasm a ɛyɛ yaw mu (hypertonia) na sigmoid colon a ɛwɔ ade no atifi no yɛ suction lock. Wɔ Dwumadibea a Ɛhwɛ Nneɛma a Egye Ntɛmpɛ So no, nnuruyɛfo wɔ mfaso anan a ɛho hia: 1. Two-View Abdominal and Pelvic X-Rays: Ansa na ɔde ne nsa bɛka akyi berɛmo no, oduruyɛfo no hyɛ sɛ wɔnyɛ X-ray a ɛnyɛ den ntɛmntɛm mfa nhwɛ ade no sorokɔ, sɛnea ɛkɔ, ne ne mudi mu kura (titiriw a ɛkyerɛ sɛ ahwehwɛ no mpaapaee na mframa a ɛnyɛ hwee nni ahurututu no asepneumoperitoneum], a ɛbɛkyerɛ sɛ dwensɔtwaa mu atoto). 2. Intravenous Procedural Sedation + Local Perianal Nerve Block: Ɛdenam IV analgesia/sedation a wɔde ma na wɔde local lidocaine/bupivacaine ma anal sphincter no yɛ mmerɛw so no, anal sphincter ntini a ɛyɛ den no ho dwo koraa a ɛyaw biara nni ho. 3. Breaking the Colonic Vacuum Seal Safely: Te sɛ brayɛ kuruwa a ɛkyekyere no, ade kɛse bi a ɛyɛ torotoro wɔ akyi berɛmo no mu no, wɔde nhyɛso bɔne a ɛwɔ akyi berɛmo no mu a ɛwɔ n’atifi no kura mu. Wɔ ER anaa endoscopy suite mu no, nnuruyɛfo de rɔba a ɛyɛ mmerɛw Foley urinary catheter bi fa brɛoo kɔ soro twa ahɔho ade no nkyɛn, ma balloon a ɛyɛ mmerɛw a ɛwɔ n’atifi no mu, na wɔde mframa fa catheter tube no mu kɔ colon a ɛwɔ ade no atifi no mu, amonom hɔ ara na wobubu vacuum seal no bere a wɔde traction a ɛkɔ fam brɛoo di dwuma de twe ade no fi mu a ɛnyɛ hwee no. 4. Flexible Sigmoidoscopy anaa Operating Room Milking (Without Cutting the Abdomen): Sɛ ade no atu akɔ soro akɔ sigmoid colon no mu a, gastroenterologist anaa colorectal oprehyɛn ho oduruyɛfo de mfoninitwa afiri a ɛyɛ mmerɛw a ɛwɔ afiri titiriw di dwuma, anaasɛ ɔyɛ akyi yafunu mu nsakrae brɛoo (transanal milking) wɔ general anesthesia ase na ama ade no akɔfa akyi berɛmo no mu a enhia sɛ wɔde ma yafunu mu ntwitwiridii wɔ bɛboro 85% kosi 90% mu.

3. Nneɛma Titiriw a Asiane Kɛse Wɔ Rectal Nneɛma a Ɛho Hia Zero Physical Pressure¶

• Ahwehwɛ Nkotoku a Tokuru, Ahwehwɛ a Wɔnom, anaa Kanea Bɔ (Open-End Up anaa Down):
• Sɛ wɔde ahwehwɛ kuruwa anaa toa a ɛyɛ tokuru hyɛɛ mu a ano a abue no hwɛ soro a, akyi berɛmo no mu ntini no su kɔ rim a abue no mu te sɛ ahwehwɛ a wɔde yɛ kuruwa, na sɛ wɔde dade a wɔde hyɛ ahwehwɛ no mu a, ebetumi abubu no wɔ akyi berɛmo no mu. Nnuruyɛfo de awo ho nhama titiriw a wɔde ntama ayɛ, Foley mframa a wɔde hyɛ mu, anaa plaster-wick akwan horow di dwuma wɔ aduru a wɔde kum nipadua no ase de yi ahwehwɛ a enni dɛm.
• Vibrators a Ɛda so ara yɛ adwuma:
• Nantew brɛoo na tena pillow a ɛyɛ mmerɛw a wode wo ho to asen biako so wɔ kwan a ɛkɔ ER no so; nmia wo yafunu ase, efisɛ sɛ womia ano a ɛrebɔ denneennen no so wɔ sacral promontory anaa sigmoid fasu no so a, ɛma mucosal erosion yɛ ntɛmntɛm.

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Mpɔtam hɔ ntɛmpɛ nɔma ne adwumakuw no nhyehyɛe ahorow¶

Sɛ wuhu Toxic Shock Syndrome, dwensɔtwaa mu a wɔatoto (yafunu mu yaw a emu yɛ den, atiridiinini, mogya a ɛretu wo wɔ akyi berɛmo mu, anaasɛ wotɔ piti), anaasɛ ahɔho nipadua a ɛwɔ akyi berɛmo mu a wɔakora so ho sɛnkyerɛnne a, hwehwɛ ayaresabea hwɛ ntɛm ara:

• Amerika:
• Life-Threatening Sepsis / Perforation / Glass Object: Frɛ 911 anaa kɔ tẽẽ kɔ Ayaresabea Emergency Department a ɛbɛn wo (nkɔ nkɔ kɔ retail pharmacy clinic anaa minor urgent care center ma rectal foreign body, efisɛ wonni yafunu X-ray, IV procedural sedation, anaa oprehyɛn backup).
• Tampon / Mfiri a Wɔde Siw Nyinsɛn a Wɔakora So (Atiridii anaa Frɛmfrɛ Kɔkɔɔ biara nni hɔ): Beae biara a Wɔhwɛ Ntɛmntɛm, Awofo a Wɔayɛ Nhyehyɛe (1-800-230-PLAN), OB/GYN adwumayɛbea, anaa Emergency Department betumi ayi tampon anaa kuruwa a wɔakora so wɔ simma 2 mu.
• Canada:
• Emergency Services: Frɛ 911 anaa kɔ Ayaresabea Emergency Department a ɛbɛn wo. Frɛ ɔmantam HealthLine 811 na woanya akwankyerɛ a ɛnyɛ ntɛm wɔ nneɛma a wɔde asie wɔ ɔbea awotwaa mu ne nyinsɛn ano aduru a egye ntɛmpɛ ho.
• Aman Nkabom:
• Emergency Services: Frɛ 999 ma Toxic Shock Syndrome anaa yafunu mu yaw a emu yɛ den/mogya a ɛretu, anaa kɔ Hospital Accident & Emergency (A&E) Department tẽẽ kɔhwehwɛ ahɔhoɔ biara a ɛwɔ akyi berɛmo mu.
• Retained Tampon / Condom + Emergency Contraception: Frɛ NHS 111, kɔ mpɔtam hɔ NHS Sexual Health / Genitourinary Medicine (GUM) Walk-In Clinic, NHS Urgent Treatment Center (UTC), anaa wo GP adwumayɛbea ma woyi speculum da koro no ara na wogye nyinsɛn ano ntɛm a wontua hwee.
• Europa Aman Nkabom:
• Emergency Services: Frɛ 112 anaa kɔ ayaresabea ntɛmpɛ ne oprehyɛn mu apirakuru dwumadibea a ɛbɛn wo.
• Australia ne New Zealand:
• Nneɛma a Ɛho Hia Ntɛmntɛm: Frɛ 000 wɔ Australia anaa 111 wɔ New Zealand, anaa frɛ Healthdirect Australia (1800 022 222) / Healthline NZ (0800 611 116).
• India ne Asia-Pacific:
• Nneɛma a Ɛho Hia: Frɛ 112 wɔ India, 119 wɔ Japan, 995 wɔ Singapore, anaa 999 wɔ Malaysia ne Hong Kong. Kɔ ayaresabea a wɔyɛ adwuma nyinaa a wɔde nnɔnhwerew 24 yɛ oprehyɛn a egye ntɛmpɛ ne awo/mmea ho ka.

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Nsɛm a wɔtaa bisa¶

So tampon, brayɛ kuruwa, anaa kɔndɔm betumi ayera wɔ me nipadua mu na atu kwan akɔ me yafunu anaa me awotwaa mu?¶

Dabi, ɛno yɛ nea entumi nyɛ yiye wɔ nipadua mu. Awotwaa kwan no yɛ ntini a wɔato mu a ɛyɛ anifuraefo a emu dɔ yɛ sɛntimita 7 kosi 12 (nsateakwaa 3 kosi 5) pɛ. Wɔ ɔbea no awotwaa no atifi pɛɛ no, awotwaa a ɛyɛ den a ɛwɔ mfinimfini kwan ketewaa bi (a ne tɛtrɛtɛ yɛ milimita 1 kosi 3) a ɛyɛ ketewaa dodo sɛ tampon, kɔndɔm, anaa brayɛ kuruwa betumi afa mu da no te. Sɛ tampon anaa kɔndɔm te nka sɛ "ayera" a, wɔde si akyi fornix no mu kɛkɛ, kotoku a ɛkɔ mu daa wɔ awotwaa no ano pɛɛ, baabi a wubetumi adu ho denam wo ho a wobɛbɔ mu akɔ akyiri, wobɛsoa fam brɛoo, na wode nsateaa abien a ɛho tew aprapra so.

Dɛn nti na sɛ metwe me brayɛ kuruwa no dua a, ɛyɛ me yaw kɛse na mepow sɛ mɛhinhim?¶

Brayɛ kuruwa tra nea ɛwɔ hɔ denam vacuum suction seal a mframa ntumi nkɔ mu a ɛbɔ wo awotwaa no atifi afasu a atwa wo awotwaa ho ahyia no so. Sɛ wotwe wo ho kɔ fam tẽẽ wɔ ase dua no so a wunni kan bubu saa nsɔano a mframa ntumi nkɔ mu no a, na woretwe kuruwa a wɔtwe nsu no akɔ wo awotwaa ne wo awotwaa mu ntini so tẽẽ. Bere nyinaa fa wo ho to fam kɔ ​​akyiri, fa wo hwene ntini no gyina fam brɛoo na pia kuruwa no kɔ fam sɛntimita 3 kosi 4, na afei pia kuruwa no ase nnyinaso no denneennen wɔ wo nsateaa kɛse ne wo nsateaa a wode kyerɛ ade no ntam (anaasɛ fa wo nsateaa biako kɔ soro na mia soro rim no kɔ mu) na ama mframa akɔ mu na woagyae nea wɔtwe no ansa na woatwe akɔ mu.

Nkyɛ ahe na Toxic Shock Syndrome (TSS) fi tampon a wɔn werɛ afi mu ba, na dɛn ne kɔkɔbɔ nsɛnkyerɛnne no?¶

Nnipa dodow no ara a wogyaw tampon wɔ mu nnafua 1 kosi 3 wɔ akwanhyia mu no nya nsu a ɛyɛ bruu anaa fitaa a ɛnyɛ dɛ koraa a ɛyɛ huam a ɛho tew wɔ nnɔnhwerew 24 kosi 48 mu bere a wɔayi tampon no akyi nkutoo. Nanso, sɛ Staphylococcus aureus anaa Streptococcus pyogenes mmoawa no yɛ exotoxins a, Menstrual Toxic Shock Syndrome (TSS) betumi anya nkɔso ntɛmntɛm. Frɛ 911 / 112 / 999 anaa kɔ Dwumadibea a Ɛhwɛ Ntɛmntɛm so ntɛm ara sɛ obi a ɔde tampon/kuruwa di dwuma mprempren anaa nnansa yi ara no nya atiridiinini kɛse mpofirim (38.9 degrees Celsius / 102 degrees Fahrenheit anaa nea ɛboro saa), ɔfe, atiridiinini a nsu wom, ntini mu yaw kɛse, adwenemhaw anaasɛ ɔtotɔ piti bere a ogyina hɔ, n’ani yɛ kɔkɔɔ, anaasɛ ne ho yɛ kɔkɔɔ a ɛyɛ tratraa a akisikuru a ɛte sɛ owia a ɛhyew.

Dɛn nti na mintumi nnom aduru a wɔde sa akisikuru anaasɛ mentumi mfa enema npia ahɔho nipadua a ɛda me menewam a akɔhyɛ mu wɔ fie?¶

Sɛ ade foforo bi hyɛ akyi berɛmo no atifi anaasɛ sigmoid colon a ɛwɔ fam no mu a, ɛyɛ adwuma te sɛ korɔn a ɛtow dwensɔtwaa no. Sɛ wonom nnuru a ɛkanyan anom anaasɛ wopiapia enema kɔ akyi berɛmo mu wɔ ade a wɔabɔ no akuturuku akyi a, ɛma dwensɔtwaa mu ntini mu yɛ den denneennen na ɛma nsu ne mframa nhyɛso kɛse ba akyi berɛmo a ɛyɛ tratraa no mu, na ebetumi ama akyi berɛmo no fasu atetew (atoto) akɔ wo yafunu mu. Ma wo yafunu mu da mpan koraa (biribiara nni hɔ a wubedi anaa wobɛnom, nnuru a wɔde siw wo yafunu mu, nhyɛ enemas biara) na kɔ Ayaresabea Dwumadibea a Ɛho Hia Ntɛmntɛm no tẽẽ.

So ɛho behia sɛ wɔyɛ me yafunu mu oprehyɛn kɛse na ama wɔayi ahɔho nipadua bi a ɛwɔ me menewam wɔ ayaresabea?¶

Wɔ 85% kosi 90% mu no, ɛho nhia sɛ wɔtwa yafunu mu, sɛ wokɔ Dwumadibea a Ɛhwɛ Ntɛmntɛm so ntɛm ara sen sɛ wode ofie nnwinnade bɛpia ade no akɔ akyiri wɔ fie a. Wɔ ER mu no, nnuruyɛfo yɛ X-ray ntɛmntɛm, wɔma wo nnuru a ɛma wo ho dwo wo ntini mu ne nea ɛma wo ho yɛ wo hyew wɔ mpɔtam hɔ sɛnea ɛbɛyɛ a wo akyi berɛmo no mu ntini no dwo koraa a ɛyaw biara nni mu, wɔde rɔba afiri a ɛyɛ tratraa bi twa ade no ho na ɛde mframa bubu vacuum seal no, na wɔde ade no twetwe brɛoo fa abɔde mu bue no mu.

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Akwankyerɛ ahorow a ɛfa ho¶

• Toxic shock syndrome (TSS): tampon, hwene mu nneɛma a wɔde kyekyere, ne kuru frankaa kɔkɔɔ
• Sepsis ne septic shock a wohu ne ntɛmpɛ ho mmuae
• Dwonku a ɛsiw, akisikuru a wɔabɔ no akuturuku, ne volvulus sɛnkyerɛnne ahorow a egye ntɛmpɛ
• Mogya a ɛba yafunu mu, mogya a ɛfe, ne melena
• Nnɔmba ahorow a egye ntɛmpɛ

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Fibea ne aban akwankyerɛ¶

• World Society of Emergency Surgery (WSES) & American Association for the Surgery of Trauma (AAST): Anorectal Emergency: WSES-AAST Akwankyerɛ a ɛfa Diagnosis, Classification, ne Transanal vs. Surgical Extraction of Retained Rectal Foreign Bodies ho.
• American College of Obstetricians and Gynecologists (ACOG) & Royal College of Obstetricians and Gynecologists (RCOG, UK): Ayaresabea Akwankyerɛ a Ɛfa Ahɔhoɔ a Wɔakora Wɔn Awotwaa Mu, Brayɛ Kuruwa a Wɔyi Fi Hɔ Dwoodwoo, ne Braya mu Toxic Shock Syndrome a Wɔsiw Ano.
• Centers for Disease Control and Prevention (CDC, United States): Toxic Shock Syndrome (Staphylococcal ne Streptococcal) Asɛm no Nkyerɛkyerɛmu, Asiane Nneɛma, ne Ntɛmntɛm Ho Dwumadie ne CDC Ntɛmntɛm Nyinsɛn ne nPEP Akwankyerɛ.
• Ɔman Akwahosan Dwumadibea (NHS, United Kingdom): NHS Ayaresabea Akwankyerɛ: Nea Ɛsɛ sɛ Woyɛ Sɛ Tampon, Braya Kuruwa, anaa Kɔndɔm Kyɛ Ɔbea Awotwaa Mu a.
• American Society of Colon and Rectal Surgeons (ASCRS): Ayaresa mu Dwumadie Nsusuiɛ a ɛfa Rectal Ahɔhoɔ ho dwumadie ne Rectosigmoid Perforation a Wɔsiw ano.