Nudzodzoe Agbe Si Le To ƒe Tɔdzisasrã Me Kple Dutanu Siwo Le Ŋku alo To Me¶

Nudzodzoe gbagbe si le tsatsam, le ɣli dom, alo le ƒoƒom ɖe tome tẽ, alo bead, bean, fefenu ƒe akpa, magnet, alo button battery si wotu ɖe ɖevi ƒe ŋɔti alo to me yi dzi la bia ŋutilã ƒe wɔwɔme ŋuti sidzedze tututu ale be xɔnametɔ natrɔ mɔxenu bɔbɔe aɖe wòazu amekoko ƒe afɔku o. Elabena ŋutigbalẽ si le tsɛ abe pepa ene si wotsɔ bla ɖe ƒu ŋu tẽ si me ami mele o, eye esi koklozi alo ʋetsuvi ƒe afɔ siwo ŋu lãgbalẽ le la le dzogoe dzi yi megbe ale be ɖeko wòate ŋu azɔ yi ŋgɔ aɖo ta tomeka gbɔ ta la, ne wotsɔ aŋetu alo kotoku ƒo to me la, enaa nudzodzoea ƒoa asi ɖe tympanic la me membrane le vɔvɔ̃ me, alo tsɔa bead goglo aɖe toa bony isthmus gbadzaa la ŋu tẽ to tomeka me. Nusi hiã kpata wue nye be lithium button battery alo pared neodymium magnets si le ŋɔti alo to me la naa elektrikŋusẽ alo nyaƒoɖeamenu ƒe nutrenu aɖe dona le ʋuʋudedi xɔdzo me si fiãa do si nɔa anyi ɖaa to no me ʋuka alo to ƒe ƒu me le aɖabaƒoƒo 60 va ɖo 120 me. Ne wonya alesi woatsɔ mineral alo amititsetse ƒe ami atɔ te nudzodzoe gbagbe dedie, alesi woawɔ "Dada ƒe Agbugbɔgbugbɔ" (Dzila ƒe Nugbugbɔgbugbɔ) si wotu ɖe kpeɖodzi dzi na dutanu siwo le dedie le no me, kple nusiwo mele be woaka tsi ɖeka pɛ hã ŋu gbeɖe o la, eɖea tosese kple mo ƒe wɔwɔmewo ɖa.

Wɔ esia fifia¶

1. Gbã la, de dzesi NUSI le to alo ŋɔti me hafi nàka asi naneke ŋu alo akɔ tsi aɖeke ɖe eme:
2. Button Battery alo Paired Magnets (Nose alo To): Yi Dɔdzikpɔƒe Kpata ƒe Dɔwɔƒe FIFIA. Na ɖevia nanɔ Naneke to Nu me (NPO) hena eɖeɖe kpata, eye MÈGADE tsi, atike, alo tsi aɖeke ŋɔti alo to me o.
3. Nudzodzoe gbagbe le Tome (Nudzodzoe si le ɖiɖim sesĩe, eƒe ʋuʋu, kple vevesese sesẽ): Mègatsɔ aŋe, asibidɛ, alo kotoklobo aƒo to me MELE o. Na amea ƒe dzi nadze eme, kpɔe ɖa be me tome alo tomeka si wonya be woɖe do le wo me o, eye na nudzodzoe la nagaʋuʋu/anyrɔe enumake to tomemi si le xɔme ƒe dzoxɔxɔ alo esi me dzo vie, mineral oil, vidzĩmi, alo amititsetse/amagbemi yɔ to me me (kpɔ Afɔɖeɖe 3).
4. Dry Vegetable Matter (Dried Bean, Pea, Corn Kernel, Seed, or Popcorn) alo Expandable Foam/Water Bead in the Ear: MÈGAKlɔe alo de tsii kple tsi GBEÐE o. Tsi nana bean ƒuƒu, nukuwo, kple hydrogel beads vuvu sesĩe le to ƒe to sesẽ la me, si wɔnɛ be wotsia wo nɔƒe eye wònana wòsẽna nyaƒoɖeamenu ƒe vevesese.
5. Nu Sesẽ si le gbadzaa le Ðevi si wɔa nu aduadu ƒe ŋɔti ÐEKA me (Plastic Bead, Lego Piece, Pea, Foam, alo Tissue Paper, MENYE Batri/Magnet o): Wɔ dodokpɔ fafɛ ɖeka le "Dada ƒe Agbugbɔgbugbɔ" (Dzila ƒe Agbugbɔgbugbɔ) ƒe nyaƒoɖeamenu nyui ƒe ƒoƒo (kpɔ Afɔɖeɖe 4).
6. MÈGADE tsinyegoe, kotoku (Q-tips), bobby pins, alo asibidɛwo ɖe to ƒe mɔ̃ me alo yi ŋɔti me be nàlé nu goglo aɖe GBEÐE o. Ne lãgbalẽgolo gbadza siwo wozãna ɖaa ƒo gogloƒe si le gbadzaa, si me tsi le (abe plastic bead, pearl, BB pellet, alo bean) ene la, aɖuawo ƒua du tsoa anyigba si woƒo la dzi eye wodaa nu la goglo wu, míetsɔnɛ toa ƒua ŋu isthmus of the ear channel against the eardrum, alo no me nu tutu ɖe megbe yi yaƒoƒomɔ̃a me afisi ɖevia ateŋu agbɔ (aspirate)e ɖe woƒe yaƒoƒomɔ̃ me.
7. Alesi woawɔ atɔ te nudzodzoe gbagbe aɖe si le to me enumake:
8. Nɔ anyi alo mlɔ amea dzi eye to si ŋu dɔlélea le la nadze ŋgɔ DZIÐUÐU ɖo ta dzisasrãa gbɔ.
9. Ne tomeka me gblẽ ko (to ƒe do, to ƒe ʋuƒo, alo ʋu si dona le to me ƒe ŋutinya aɖeke mele eŋu o): He gota to blewuu yi dzi kple megbe (le ame tsitsi me) alo ** tẽe yi megbe eye yi anyime vie** (le ɖevi si mexɔ ƒe 3 haɖe o gome) be nàɖɔ to si le abe S ene la ɖo, eye nàkɔ tomemi dzadzɛ , vidzĩ ƒe ami, . alo amititsetse ƒe ami yia tɔdzisasrãa ƒe axadzigli dzi madzudzɔmadzudzɔe vaseɖe esime wòaƒo ƒu ɖe etame, eye nànyrɔ nudzodzoea keŋkeŋ hena aɖabaƒoƒo 5 va ɖo 10 vaseɖe esime eƒe ʋuʋu kple ɣlidodo katã nu tso.
10. (De dzesii: Ne nudzodzoea nye nudzodzoe sue aɖe si dzona abe fotoɖemɔ̃ ene abe nudzodzoe alo ʋetsuvi* ene eye ami aɖeke mele asiwò haɖe o la, tsi xɔa ƒe akaɖiwo katã eye nàklẽ akaɖi si le keklẽm le to ƒe ʋuƒoa godo tututu aɖabaƒoƒo 2 be nàkpɔe ɖa be edo go yi akaɖia gbɔ hã, mègaklẽ akaɖi aɖeke ɖe koklozi alo ʋetsuvi, siwo nye fotophobic, siwo nye fotophobic eye woaɖe do la dzi gbeɖe o goglo wu tso kekeli gbɔ.)*
11. Alesi woawɔ "Dada ƒe Agbugbɔgbugbɔ" (Dzila ƒe Nugbugbɔgbugbɔ) na nusi menye batri o si tsi ŋɔti ÐEKA me:
12. Na dzila si dzi woka ɖo la nagblɔ na ɖevia be yeawɔ "agbugbɔ nukokoe gã aɖe" na wo.
13. Da dzila ƒe nu si le ʋuʋu ɖi la ɖe ɖevia ƒe nu si le ʋuʋu ɖi la dzi keŋkeŋ (wòawɔ nutrenu sesẽ aɖe abe xɔname gbɔgbɔ ene).
14. Zã asibidɛ alo asibidɛ ɖeka nàtsɔ zi ɖevia ƒe ŋɔti si womexe o (si me kɔ) la dzi keŋkeŋ.
15. Na ya kpui ɖeka, ɖaɖɛ, sesẽ ɖe ɖevia ƒe nu me (si anɔ anyi mede sɛkɛnd 1 o, si sɔ gbɔ ko be wòase tsitretsiɖeŋu gɔme esime ɖevia ƒe asikewo le tutum le dzɔdzɔme nu eye ya le zɔzɔm yi dzi le aɖu falɛfalɛa megbe yi ɖe ŋɔti si xe la ƒe megbe), nàtsɔ nua ado goe le ŋɔti si xe la me.
16. Kpɔe ɖa be "Unilateral Foul-Smelling Nasal Discharge" le Toddlers me: Ne ɖevi si le zɔzɔm alo ɖevi sue aɖe xɔ nu ʋeʋĩ, si me ʋuʋudedi le (yellow/green) alo ʋu ƒe amadede si tso ŋɔti ÐEKA KO me ŋkeke alo kwasiɖa geɖe la, tsɔe be no me dutanu si woɣla (abe sponge, paper wad,, alo button kakɛ aɖe ene batri) la dea ŋɔti ma me vaseɖe esime ɖɔkta ƒe no me lãkusi dodokpɔ naɖo kpe edzi be menye nenemae o.

Emergency triage decision tree: To vs. Nose duta ŋutilã & nudzodzoe gbagbe¶

Zã dɔdaƒe ƒe ɖoɖowɔɖi sia nàtsɔ atia mɔnu si tututu woatsɔ aɖee ɖa le dedie eye nàƒo asa na tsidede agble alo dɔwɔnuwo ƒe vodada siwo me afɔku le.

flowchart TD
    Start["Dutanu alo Nudzodzoe Agbe<br/>le Tome alo Ŋku me"] --> SiteCheck{"Ðe Nu la le<br/>TO ME alo NOSTRIL la mea?"}

    SiteCheck -->|"TO ƑE ƲUƲU"| EarType{"Nu Ƒomevi<br/>kae Le Tomemɔa Me?"}

    EarType -->|"LIVE INSECT<br/>(Buzzing, ƒoƒo, vevesese sesẽ)"| InsectCheck{"Ðe Tomemɔ̃wo,<br/>Tomemɔ̃ Siwo Wonya,<br/>alo Ʋu le dodom tso Tɔdzisasrã me Le Dɔnɔa?"}
    InsectCheck -->|"Ẽ (Tomeka / Tubes siwo me do le) ."| InsectER["YI NU KPƆKPƆ KPƆKPƆ ƑE DƆWƆƑE FIFIA:<br/>MÈGAKƆ ami alo tsi ɖe to si me do le me o;<br/>Ðɔkta azã suction/micro-forceps le otoscopy te"]
    InsectCheck -->|"AO (Tomeka si me gblẽ o) ."| OilKill["IMMOBILIZE / DROWN NUdzodzoevi GBÃTƆ:<br/>1. Tilt affected to UP ɖo ta dzisasrã dzi<br/>2. De Mineral Oil, Baby Oil, alo Olive Oil<br/>3. Na wòanɔ tsi me miniti 5 va ɖo 10 vaseɖe esime ʋuʋu katã natɔ<br/>4. Kpɔ ɖɔkta/beléle kpata be nàde tsi alo aɖe nudzodzoe kukuwo ɖa"]

    EarType -->|"BUTTON BATTERY alo SHARP OBJECT<br/>(Glass, Ka, Kotoklobo ƒe Aɖaŋuɖoɖo)"| EarUrgent["KPEKPEÐEŊU ƑE DƆWƆƑE:<br/>1. MÈGADE tsi alo de tsitete ɖe Button Battery<br/>2 dzi GBEÐE o. Batri fiã to ƒe ƒu & mo ƒe lãmeka le < 2 hrs<br/>3. Dzra dɔnɔwo ƒe NPO ɖo be woaɖee ɖa kpata to nusuekpɔmɔ̃ dzi"]

    EarType -->|"Amagbewo / HYDROGEL<br/>(Bean, Pea, Nuku, Bli, Tsi Kuku)"| EarBean["ENT / DƆWƆƑE ƑE ƉEÐE KPƆKPƆ KPƆKPƆ (TSITSI MELE O):<br/>1. MÈGAKlɔe kple tsi GBEÐE o (evuvu bean sesĩe le tɔdzisasrã me)<br/>2. Mègatsɔ aŋetu aƒoe gbeɖe o; atikewɔla zãa kɔsɔkɔsɔ si le dzogoe dzɔdzɔe dzi"]

    EarType -->|"INERT SMOOTH OBJECT<br/>(Plastik-ku, Kpe, Nututunu)"| EarBead["ŊKEKE / ŊKEKE GBESI ME ATIKƆMEDODO:<br/>Mègatsɔ aŋekotoku lée o (etutua ƒu ƒe ƒunukpeƒetetedɔa ŋu);<br/>Atikewɔla tsɔa numimɔ̃, cyanoacrylate-ti,<br/>kɔsɔkɔsɔ si le dzogoe dzɔdzɔe dzi, alo tsi dzodzoe dede tsii la ɖenɛ ɖa"]

    SiteCheck -->|"NOSTRIL (Aɖuɖɔtoe) ."| NoseType{"Nu<br/>ka ƒomevie le ŋɔti me?"}

    NoseType -->|"BUTTON BATTERY alo PAIRED MAGNETS<br/>(alo Black/Ʋu ƒe ƒuƒu + Vevesese)"| NoseBattery["NU KPƆKPƆ KPƆKPƆ KPƆKPƆ KPƆKPƆ KPƆKPƆ KPƆKPƆ KPƆKPƆ KPƆKPƆ KPƆKPƆ KPƆKPƆ KPƆKPƆ KPƆKPƆ KPƆKPƆ Kpata:<br/>1. Septal cartilage perforation dzɔna le gaƒoƒo 1 va ɖo 2 me<br/>2. MÈGAzã dzetsi si wotsɔna ƒua gbe ɖe no me alo tsi si wotsɔna ƒoa tsii GBEÐE o<br/>3. Dzra ɖevi ƒe NPO ɖo hena endoscopic ɖeɖe enumake"]

    NoseType -->|"SAFE INERT AL ORGANIC OBJECT<br/>(Bead, Pea, Lego, Foam, Paper Wad)<br/>le Ðevi si Fa Fafa, Si Le Ŋudzɔ Me"| MothersKiss["WƆ 'DADA ƑE NU KPƆKPƆ' (ALOO BLOW NOSE):<br/>1. Ðevi tsitsi/ame tsitsi: Xlẽ ŋɔti si me kɔ & ƒo ŋɔti sesĩe<br/>2. Ðevi sue: Tre nu ɖe ​​ɖevi ƒe nu dzi, te CLEAR<br/> ŋɔti me do kple asibidɛ, na ya sesẽ kpui 1<br/>3. Ne 2 puffs do kpo nu -> Yi Urgent Care / ER (Mègazã tweezers gbeɖe o)"]

Akpa 1: Nudzodzoe Agbe le Tome¶

Nusita nudzodzoe gbagbe aɖe si le to me hea vevesese kple vɔvɔ̃ sesẽ vɛ¶

Amegbetɔ ƒe gotagome tomemɔ̃ nye mɔ si le abe S ene si ƒe nuwuwu nye ŋkuagbãtɔ si didi abe \(2.5\text{ centimeters}\) (\(1\text{ inch}\)) si xaxa le aŋetu aɖe si woyɔna be bony isthmus si le tomeka ŋgɔ tututu: 1. The Outer Third (Cartilaginous Canal): Wotsɔ ŋutigbalẽ si le ɣie wu, ɖa ƒe ƒuƒoƒo, kple tome lãkusiwo ƒo xlãe. 2. Ememe Eve-Etɔ̃ (Osseous/Bony Canal) kple Tympanic Membrane: Wotsɔ ŋutilã si ƒe titrime nye \(0.2\text{ milimeta}\) ko ƒo xlãe si kpe ɖe taɖuƒu ƒe ƒunukpeƒe ŋu tẽ eye ami si le ŋutigbalẽ te zero, si me Trigeminal Nerve (CN V), Facial Nerve (CN VII), ƒe alɔwo le lãmekawo me Glossopharyngeal Nerve (CN IX), kple Vagus Nerve (CN X, Arnold ƒe lãmeka). 3. Nusita nudzodzoe la mate ŋu agbugbɔ le eɖokui si o: Aƒeme nudzodzoe siwo bɔ siwo ƒua du yia to me le zã me esime amewo mlɔ anyigba, ƒua asaɖa anyi ɖe gota, alo abɔ me, vevietɔ Germany koklozi (Blattella germanica), ʋetsuviwo, tomewu, ** nudzodzoewo**, nyidiwo, kple ʋetsuviwo, ƒe ta le gbadzaa eye... tibial spines siwo fia megbe le woƒe afɔwo dzi. Ne wonya ƒu du yi to ƒe mɔ̃ si le kpuie la me ko la, le ŋutilã me la, womete ŋu trɔna o eye woƒe afɔ siwo le abe lãfu ene la léa tɔdzisasrãa ƒe gliwo ne wodze agbagba be yewoazɔ megbe. Ɣesiaɣi si nudzodzoea dze agbagba be yeayi ŋgɔ la, eƒe asikewo ƒua du toa tympanic membrane si sea nu gɔme nyuie ŋutɔ la dzi tẽ, si wɔnɛ be dziɖegbe aɖe si ɖina sesĩe, si naa tome tsina le dɔnɔa ƒe ta me eye wòhea vevesese kple ʋuʋudedi sesẽ vɛ (to Arnold ƒe vagal reflex dzi).

Se #1 si ku ɖe Nudzodzoewo Ðeɖeɖa ŋu: ƑU / ƑO Nudzodzoea Ɣesiaɣi HAFI ame aɖe nadze agbagba be yeaɖee ɖa¶

Le kɔdzi ƒe dɔwɔƒe siwo kpɔa nudzɔdzɔ kpatawo gbɔ gɔ̃ hã la, dɔdaƒe ŋuti numekukuwo ɖee fia be agbagbadzedze be woatsɔ aŋe ahe nudzodzoe gbagbe si le agbagba dzem ado goe le to me la doa kpo nu alo hea tɔdzisasrã ƒe vuvu, ʋu dona, kple tomeka siwo vuvu vɛ le agbɔsɔsɔ gã aɖe me, elabena nudzodzoea léa eƒe afɔ siwo ŋu lãgbalẽ le la ɖe ƒu ƒe tɔdzisasrãa ƒe gli ŋu eye wòvuvua kakɛkakɛe esime eƒe ŋgɔgbe asikewo vuvua tomeka.

Afɔɖeɖe ɖesiaɖe Aƒeme Immobilization Protocol (Ne Tomeƒu Megblẽ O): 1. Kpɔe ɖa be to me do aɖeke mele amea ŋu o: Bia amea ne to me ʋukawo (tympanostomy grommets), do si wonya le tomeka me, alo ʋu sesẽ/tsi si me kɔ si dona tso to me le nuveviwɔame megbe. (Ne tomeka alo tomeka si me do le le wo si la, MÈGAKƆ tsi aɖeke ɖe to me o; na dɔnɔa ƒe dzi dze eme, lé avɔ dzodzoe si xɔ dzo ɖe to ƒe gota be gbeɖiɖia natsi, eye nàyi dɔwɔƒe si kpɔa nudzɔdzɔ kpatawo gbɔ tẽ.) 2. Ðo dɔnɔa ɖe teƒe si: Na amea namlɔ eƒe axadzi (alo wòanɔ anyi eye wòabɔbɔ ta ɖe axadzi anɔ akɔtaɖonu dzi) eye to si ŋu wògblẽ nu le la nafia asi dziƒoxɔa dzi tẽe YIYI. 3. Tia tsi si le dedie si me ʋeʋẽ lilili le: - Aƒeme tiatia nyuitɔwo: Mineral oil, vidzĩ ƒe ami si me ʋeʋẽ lilili mele o, amititsetse ƒe ami, alo amagbe/canola ami le xɔme ƒe dzoxɔxɔ alo ŋutilã ƒe dzoxɔxɔ si fa miamiamia (mexɔ dzo gbeɖe o.). - Nusitae ami si me wodea amii nyo wu tsi dzro le aƒeme: Nudzodzoewo gbɔa ya to do suesuesue siwo le woƒe ŋutilã ƒe axawo dzi si woyɔna be spiracles, siwo wotsɔ wax fu siwo tsia tsi (tsilénu) siwo nana ʋetsuvi kple koklozi geɖe nɔa agbe le tsi te aɖabaƒoƒo 15 va ɖo 30 esime wole ƒoƒom sesĩe la me. Ami si me wodea amii (mineral oil alo olive oil) tsyɔa spiracles siwo me tsi mele o la dzi enumake eye wòxea wo to capillary action me, ewɔa nudzodzoe la ƒe lãmetutudɔ eye wògbɔa eme le sɛkɛnd 30 va ɖo 120 me esime wònɔa tsia dzi blewuu ɖa le tome. - (Dɔdzikpɔƒe ƒe nyatakaka: Le dɔwɔƒe si kpɔa nudzɔdzɔ kpatawo gbɔ la, atikewɔlawo zãa 2% viscous alo aqueous lidocaine alo mineral oil, si naa to ƒe mɔ̃a tsia to eye wònana koklozi ƒe sodium-mɔwo hã tsia dzodzodzoe kabakaba, togbɔ be mineral oil nana lã ƒomevi aɖewo tsia dzodzodzoe kabakaba wu evɔ meɖua ŋutigbalẽ ƒuƒu o hã.) 4. Dzɔ tomemɔa eye nàde eme vaseɖe eƒe gogloƒe: - Na ame tsitsi alo ɖevi si xɔ wu ƒe 3: Lé gotagome to (pinna) tame blewuu eye nàhee YI dzi kple AMEGBETƆ be nàɖɔ S-curve la ɖo. - Na vidzĩ alo ɖevi si le zɔzɔm si mexɔ ƒe 3 haɖe o: He to si le gota la blewuu TƆTƆE YI MEGBE eye nàɖiɖi vie. - Klɔ amia ɖe tomemɔa ƒe axadzigli dzi blewuu (wòana ya ƒe kuɖɔ siwo xaxa ɖe nudzodzoea megbe nado) vaseɖe esime amia naƒo ƒu ɖe tɔdzisasrãa ƒe mɔnu tututu. 5. Lala miniti 5 va ɖo 10 blibo: Na amea nanɔ anyi kpoo eye to la nadze ŋgɔ dzi vaseɖe esime ʋuʋudedi, ʋuʋudedi, kple ʋuʋu katã nu tso keŋkeŋ hena miniti 5 ya teti. 6. Tsi amia blewuu eye nàdi atikewɔlawo ƒe nudzodzoe kukua ɖeɖe ɖa: Na amea natsɔ ta aɖo afɔkpa dzi eye to si ŋu dɔlélea le la nadze ŋgɔ anyi. Ɣeaɖewoɣi la, ʋetsuvi alo anyidi sue aɖe ƒua du doa goe kple amia. Ne nudzodzoe kukua (alo eƒe akpa aɖe) gakpɔtɔ le to me la, yi atikewɔƒe si wokpɔa dɔnɔwo gbɔ kpata alo dɔwɔƒe si kpɔa nudzɔdzɔ kpatawo gbɔ gbemagbe ke ale be atikewɔla nate ŋu akɔ lã kuku si me gblẽ o la alo akɔe ado goe eye wòalé ŋku ɖe tomeka ŋu, eye wòagblẽ nudzodzoe kukua ƒe akpa aɖewo ɖe to si me dzo le la me hea dɔlékui/fungi sesẽ otitis externa vɛ le ɣeyiɣi 24 va ɖo gaƒoƒo 48 sɔŋ.

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Akpa 2: Dutanu Siwo Megbe Agbe Le Tomemɔa Me¶

Ðevi siwo xɔ tso ƒe ƒe 2 va ɖo ƒe 8 zi geɖe la, wotua dzonu, plastik fefenu ƒe akpa suewo, kpe gbadzɛwo, popcorn ƒe nukuwo, gbe ƒuƒu, crayon ƒe nugbɔ, alo button batriwo ɖe woawo ŋutɔ alo fefewɔla ƒe to me, gake ame tsitsiwo ya gbãa cotton swab (Q-tip) cotton tips, silicone rubber hearing-aid domes, foam zi geɖe tomeka kakɛwo, alo tomeka si me ka mele o silicone ƒe nugbɔwo le tɔdzisasrãa me.

Tome Dutanyanyuiwo ƒe Ƒomedodo 4 Kple Alesi Wòle Be Woawɔ Nu Ðe Wo Ðesiaɖe Ŋu¶

Nusita Wode Se Ðe Tomekaɖiwo (Hopi Tomekaɖiwo) Nu Vevie¶

Mègazã wax "to bosomikaɖi" siwo me do le gbeɖe atsɔ adze agbagba be yeaɖe duta nu, nudzodzoe, alo tomeka ƒe nutrenu aɖe ado goe o. Nu gbagbewo ƒe atikewɔwɔ ŋuti numekuku siwo dzi wokpɔ kple **U.S dzoxɔxɔ ƒe dzobibi sesẽwo kple tosese si me ʋu sina tona ƒe dɔmawɔmawɔ nyuie tegbee.

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Akpa 3: Dutanu siwo le ŋɔti me (No me Do) .¶

Nasal Cavity ƒe Anatomy: Nusitae tutu yi dzi nye vodada #1¶

Ne dzilawo lé ŋku ɖe ɖevi ƒe ŋɔti ŋu tso gota la, ŋɔti ƒe gota tɔdzisasrãa ɖiɖina yia dzi yia ŋkuawo gbɔ, si wɔnɛ be amewo susuna be ŋɔti ƒe mɔa yi yi dzi. - Anatomical Reality: Amegbetɔ ƒe no ƒe do ƒe anyigba (aɖu sesẽ ƒe tame / nu ƒe xɔta) ƒua du dzɔdzɔe yi megbe le tsia dzi (\(90\text{ degrees}\) tsia tre ɖe mo ŋu) yia ŋɔti ƒe megbe (aɖuɖɔtoe). - Dutanu siwo le ŋɔti me ƒe alafa memama 90 kloe nɔa teƒe eve dometɔ ɖeka: le ŋɔti ƒe ŋgɔgbexɔa me tututu le ŋɔti ƒe ʋuƒo si le ete te, alo le titina turbinate ŋgɔ tututu. - Nusitae afɔku le ƒoƒo yi dzi alo aŋetu zazã me: ƒoƒo yi dzi ƒoa ʋuka siwo le bɔbɔe si le ŋgɔgbe no me ʋuka (Kiesselbach ƒe ʋuka / Little ƒe nuto), si wɔnɛ be ʋu si le kpekpem ʋu si dona le ŋɔti me si ɣlaa nusi wotsɔ wɔe la keŋkeŋ. Nusi gavloe wue nye be, ne ètutu bead alo atikutsetse ɖe megbe la, etsɔnɛ toa aɖu ƒe megbekpa dzi yia aɖuɖɔtoe kple yagbɔgbɔ me tẽ, si wɔnɛ be wòdea agbe afɔku me vevie ʋuʋudedi.

Kpata #1 le ŋɔti me: Button Batteries kple Paired Neodymium Magnets¶

1. Button Batteries le Ŋku me (Necrosis le Aɖabaƒoƒo 60 Va ɖo 120 Me) .¶

Ne wotsɔ gaku sue aɖe alo abɔta batri (\(3\text{V}\) lithium alo \(1.5\text{V}\) silver-oxide/alkaline batri si tso tomemɔ̃, fefenu sue aɖe, akɔntabubumɔ̃, alo haƒoƒo ƒe gbedonamegbalẽvi me) de ɖevi ƒe ŋɔti me: - No me ʋuʋudedi si xɔ dzo, si me dze le la ƒoa batri la ƒe nugbɔ nyui (\(+\)) kple nu gbegblẽ (\(-\)) nu ƒu, eye wòwua elektrikŋusẽ ƒe nutome si le gota nu. - Le negative (\(-\)) pole (batri ƒe akpa si le gbadzaa, si le kpuie wu) la, tsi ƒe elektrikŋusẽ ƒe ʋuʋu naa hydroxide ions (\(\text{OH}^-\)), si wɔnɛ be sodium hydroxide (caustic lye si ƒe \(\text{pH}\) nye \(12\text{ va ɖo }13\)) si me wode nu me. - Liquefaction necrosis lɔ̃a lãkusia eye wòɖua nu tẽ to cartilaginous nasal septum me le aɖabaƒoƒo 60 va ɖo 120 me, si gblẽa septal perforation (do si le ŋɔtiwo dome) si nɔa anyi ɖaa, saddle-nose collapse of the bridge of the nose, alo erosion into the orbit or hard palate. - Nuxlɔ̃ame Dzesiwo le No ƒe Abɔta ƒe Batri si Womekpɔ O Ŋu: No me vevesese kpata le akpa ɖeka, dzikudodo, ʋu ƒe amadede dzẽ, yibɔ, alo xɔdzo ƒe ʋuʋudedi/tsi si le dodom tso ŋɔti ɖeka me, mo ƒe vuvu ƒo xlã ŋɔti/ŋku, alo ga ƒe ʋeʋẽ. - Kpekpeɖeŋunana Gbãtɔwo ƒe Sewo: Yi Kɔdzi ƒe Dɔwɔƒe si Kpɔa Nudzɔdzɔ Kpatawo Gbɔ enumake. Mègade dzetsi, ŋɔti me atike, alo tsi ɖe eme gbeɖe o. Na ɖevia Nane Naneke To Nu me (NPO) o.

2. Magnet Siwo Ŋu Ŋusẽ Gã Le Siwo Wotsɔ Wɔ Ðekae Le Nome ƒe Akɔta¶

Ðevi tsitsiwo kple esiwo mexɔ ƒewuiwo haɖe o dea neodymium rare-earth magnet sue eve (alo magnetic "faux nose rings") ɣeaɖewoɣi ŋɔti eveawo me ale be woaƒo ƒu ɖe titina nasal septum dzi. - Magnet-he sẽŋua gbãa ʋuka siwo mebɔbɔ o siwo le lãkusi me (perichondrium) siwo naa nuɖuɖu no me septum cartilage la. - Le gaƒoƒo 2 va ɖo 6 me la, ischemic pressure necrosis gblẽa septal cartilage eye wòdoa do si nɔa anyi ɖaa to septum la me. - Eɖeɖe Kpata: No me magnet eve eve hiã be woaɖe wo ɖa kaba le dɔwɔƒe si kpɔa nudzɔdzɔ kpatawo gbɔ (zi geɖe la, wozãa dɔwɔnu siwo menye magnet o, plastic shims tsɛwo, alo gotagome magnet siwo tsi tre ɖe wo nɔewo ŋu le atike si wua alɔ̃dɔdɔ/ʋukawo ƒe ʋuʋu vɔ megbe).

Afɔɖeɖe ɖesiaɖe ƒe Mɔfiame le "Dada ƒe Agbugbɔgbugbɔ" (Dzila ƒe Agbugbɔgbugbɔ) Mɔnu ŋu¶

Le nu si wonya be ele dedie (abe plastic bead, pea, berry, foam piece, alo Lego stud, menye button battery, magnet, alo sharp glass/pin gbeɖe o) si wotsɔ **ɖevi si le ŋudzɔ, si le ŋudzɔ, si xɔ tso ƒe 1 va ɖo ƒe 8 ƒe ŋɔti me do la, "Dada ƒe Nugbugbɔgbugbɔ" (Dzila ƒe Agbugbɔgbugbɔ) nye vevesesemanɔmee, mɔnu si mewɔa nuvevi ame o si dzi atikewɔwɔ kpata ƒe mɔfiamewo da asi ɖo (Cochrane Systematic Review kple ɖeviwo ƒe dɔwɔƒe gãwo) si ɖea nusi le yaƒoƒo gbãtɔ alo evelia me dzidzedzetɔe le dɔléle siwo wu 60 le alafa me me, si ƒoa asa na gadɔwɔnu dziŋɔwo alo kɔdzi ƒe alɔ̃dɔdɔ:

Afɔɖeɖe 1: Dzra Ðevia Ðo Eye Nàka Ðe Edzi¶

• Na ɖevia nanɔ anyi ɖe tsitrenu (abɔbɔ ɖe ŋgɔ vie) le dzila si dzi nèka ɖo ƒe akɔnu.
• Ðe aɖaŋua me abe fefe alo "akunyawɔwɔ ƒe nugbugbɔ gã" ene ale be ɖevia nagafa avi alo agbɔ ya sesĩe o. (Ne ɖevia tsi eye wòte ŋu wɔ ɖe mɔfiamewo dzi la, bia tso wo si gbã be woatsɔ asibidɛ ɖeka azi ŋɔti si me kɔ si wotu la dzi ko eye woaƒo woƒe ŋɔti sesĩe to ŋɔti si xe la me** eye woatu nu, zi geɖe la, ema ɖeɖe dzaa naa nu la doa goe tẽ.)

Afɔɖeɖe 2: Tre Nua nu eye nàtu ŋɔti si me kɔ la¶

• Dzila la tsɔa woƒe nu si le ʋuʋu ɖi la dana ɖe ɖevia ƒe nu si le ʋuʋu ɖi dzi sesĩe, si wɔnɛ be nutrenu blibo aɖe si me ya megena ɖo o nɔa ɖevia ƒe nuyiwo ŋu (si sɔ kple gbɔgbɔ si woatsɔ axɔ na ame tso nu me yi nu me).
• Dzila la tsɔa asibidɛ gã alo asibidɛ ɖeka mia ɖevia ƒe ŋɔti si womexe o (si le ƒuƒlu) ƒe axadzi keŋkeŋ ɖe ŋɔti la ŋu be wòaxee, eye wògblẽa ŋɔti si xe la ɖi wòʋuna.

Afɔɖeɖe 3: Na Ya Kpuie Si Le Dzodzoe Ðeka¶

• Ne dzila la dze yaƒoƒo gɔme blewu la, ɖevia ƒe dzɔdzɔme nugbɔ ƒe ʋuʋu tua woƒe glottis (gbekawo) be wòakpɔ lãkusia ta, eye wòkplɔa ya si ƒona la yia dzi le aɖu falɛfalɛa megbe yia aɖuɖɔtoe me eye wòtoa ŋɔti ƒe mɔ si xe le megbe la me tẽ.
• Zi alesi dzila la se tsitretsiɖeŋu sue ma le ɖevia ƒe nu me ko la, wotsɔa ya kpui ɖeka, ɖaɖɛ, sesẽ aɖe (si xɔa abe sɛkɛnd 0.5 ene, mègagbɔ ya wògbɔa eme abe gbɔgbɔtsixe si le lãkusi me ene o).
• Ya ƒe nyaƒoɖeamenu nyui la naa bead alo pea la dona tẽ tso ŋɔti si xe la ƒe ŋgɔgbe yi dzila la ƒe ŋgonu alo afɔkpa dzi.

Afɔɖeɖe 4: Nya Ɣekaɣie Wòadzudzɔ ("Atetekpɔ Eve ƒe Seɖoƒe") .¶

• Ne nua medo go o (alo ʋu yi ŋgɔgbekpa dzi tututu afisi wòdze le) le gbɔgbɔ 2 blewu megbe o la, DZUDZƆ enumake eye nàkplɔ ɖevia ayi dɔnɔdzikpɔƒe si kpɔa ɖevia dzi kpata alo dɔwɔƒe si kpɔa nudzɔdzɔ kpatawo gbɔ.
• Nukatae afɔku le Dada ƒe Agbugbɔgbugbɔa me be wòatutu nu la ayi ɖe lãkusi me kloe? Esi ya ƒe nyaƒoɖeamenu nyui la zɔna tso nu me yia dzi yia ŋgɔ doa goe le ŋɔti me ta la, ya ƒe sisi ƒe mɔ̃a ƒoa nu la adzo le yaƒoƒomɔ̃a gbɔ, ke menye ɖe eŋu o.

Alesi woawɔ ade dzesi No alo To ƒe Duta Ŋutilã si "Woŋlɔ Be" Le Ŋkeke aɖewo megbe¶

Ðevi sue siwo xɔ tso ƒe 1 va ɖo ƒe 4 ƒoa nuɖuɖu, ƒumebɔbɔ, tissue paper, crayon, alo bead ɖe woƒe ŋɔti alo to me enuenu evɔ womegblɔnɛ na ame aɖeke o. Kpɔ ŋkuléle ɖe dɔléle ŋuti dzesi siawo siwo tsi megbe ŋu:

Kadodo ƒe nuŋɔŋlɔ si sɔ pɛpɛpɛ na 911 / 112 / 999 kple kɔdzi ƒe vovototodedeameme¶

Zã dɔdamɔnu ŋuti nuŋlɔɖi siawo siwo me kɔ ne èva ɖo dɔwɔƒe si kpɔa nudzɔdzɔ kpatawo gbɔ alo nèle yɔyɔm be woakpe ɖe ye ŋu:

• Na Batri si Wosusu be Button le No alo To me (Nu Kpata):

  *"Emergency triage: nye ɖevi si xɔ ƒe [Age] tsɔ BUTTON BATTERY si wosusu be edze [miame/ɖusime ŋɔti / to ƒe mɔ̃] me abe [Xexlẽdzesi] ene enye [Xexlẽdzesi] aɖabaƒoƒo aɖewoe nye esi va yi [alo ʋu doviviti sesẽ aɖe le eŋu tso ŋɔti ɖeka me eye batri bu le fefenu aɖe me]. Míezã dzetsi alo tsi ƒe dodo aɖeke o eye míetsɔ ɖevia Na naneke to Mouth dzi o (NPO).

• Na Nudzodzoe Agbe si le Tomemɔ me:

  "Nudzodzoe gbagbe aɖe si xaxa ɖe [miame/ɖusime] to ƒe mɔ me goglo si hea vevesese sesẽ vɛ ɖe tomeka ŋu. Esi wònye be [tomeka si me gblẽ o le dɔnɔa ŋu ta la, míetsɔ mineral/amititsetse ƒe ami na nudzodzoea meʋãna o / tomeka si me do le ƒe ŋutinya, míeƒã tsi aɖeke ɖe eme o], eye míehiã totoscopic extraction kple eardrum inspection kaba."

• Na Organic Bean/Seed alo Deep Bead le To alo ŋɔti me:

  "Nye [Ƒe] ƒe vi la ƒe [gbe ƒuƒu / tsi ƒe ku / plastic bead] le [miame/ɖusime to ƒe mɔ̃ / ŋɔti me]. Míetsɔ tweezers ƒoe o eye míede tsi gbea o. Míehiã toscopic/nasal extraction to right-angle hook alo suction catheter zazã me."

Nya siwo wobiaa amewo enuenu¶

Nukatae ne èkɔ mineral oil alo amititsetse ƒe ami ɖe to me la, etɔa te nudzodzoe gbagbe kabakaba wu tsi, eye ɣekaɣie MELE be nàzã ami o?¶

Nudzodzoewo gbɔa ya to ʋuʋudedi suesuesue siwo le woƒe ŋutilã ŋu siwo woyɔna be spiracles siwo me fu siwo me tsi mele o le la me, si wɔnɛ be kokloziwo kple ʋetsuviwo nɔa agbe le tsi te aɖabaƒoƒo geɖe esime wole ƒoƒom ɖe wò to me. Mineral ami si me wodea amii, vidzĩ ƒe ami, alo amititsetse ƒe ami tsyɔa gbɔgbɔtsixe ƒe ʋuʋudedi mawo siwo me tsi mele o la dzi enumake hexea mɔ na wo, eye wògbɔa ya nudzodzoea eye wòzua lãmetututɔ le miniti 1 va ɖo 2 me; ke hã, mele be nàkɔ ami alo tsi aɖeke ɖe to me gbeɖe ne tomeka alo do (do) si wonya le eƒe tomeka me le amea ŋu, alo ne nu si wotsɔ wɔe la menye nudzodzoe o.

Nukatae afɔku le eme nenema gbegbe be woazã aƒeme lãgbalẽgoe alo kotoku atsɔ adze agbagba ahe dzonu alo kpe gbadzɛ aɖe ado goe le ɖevi ƒe to alo ŋɔti me?¶

Amegbetɔ ƒe to ƒe mɔ̃a xaxana zua ƒu ƒe aŋetu (isthmus) le tomeka si le bɔbɔe la ŋgɔ tututu, eye aŋekotoku gbadza siwo wozãna ɖaa mate ŋu aʋuna wòakeke le mɔ gbadza ma me be wòaɖo tome goglo aɖe megbe o. Ne aŋe gbadzɛwo ƒo aŋɔ alo gbe ƒe ŋgɔgbe si le glidzaglidza la, wowɔa nu abe aŋe ene eye wodaa nua to ƒu ƒe aŋetu la ŋu yi tome tẽe yia tomeka me, alo tua no me ku ɖe megbe to aɖu dzi yi ɖevia ƒe yaƒoƒomɔ̃a me.

Nukatae MELE be nàkɔ tsi ɖe to si me gbe ƒuƒu, pea, popcorn-ku, alo tsi-ku le me GBEÐE o?¶

Amagbe ƒuƒuwo (gbewo, peas, bli ƒe nukuwo, nukuwo) kple hydrogel tsiku siwo wowɔ la nye esiwo me tsi le, si fia be woxɔa tsi kabakaba eye wokekena ɖe enu va ɖoa woƒe lolome ƒuƒu ƒe teƒe geɖe. Esi wònye be to ƒe akpa eve le etɔ̃ me ƒe akpa eve le etɔ̃ me le tagbɔƒu sesẽ si mate ŋu akeke o ta la, tsi kɔklɔ ɖe gbe dzi nana wòvuvuna sesĩe ɖe ƒu ƒe gliwo ŋu le aɖabaƒoƒo ʋɛ aɖewo ko me, si wɔnɛ be wòsea veve vevie le nyaƒoɖeamenu me, ŋutigbalẽa vuvu, eye wònana be womate ŋu aɖee ɖa o kloe.

Aleke batri sue aɖe si ƒe abɔta le ɖevi ƒe ŋɔti me ate ŋu atɔ dzo do aɖe to woƒe ŋɔti me le gaƒoƒo 1 pɛ ko me ne edze abe batri la "ku" ene gɔ̃ hã?¶

Batri si "zã" si ƒe abɔta megate ŋu naa ŋusẽ fefenu o gɔ̃ hã gakpɔtɔ léa elektrikŋusẽ si susɔ si sɔ (si wu volt 1.2) be wòatsɔ awɔ elektrikŋusẽ ne ŋɔti me tsi si me dze le xɔdzo ƒo eƒe ga nyui kple vɔ̃ nu ƒu. Elektrikŋusẽ ma ma tsi ƒe molecule siwo le batri la ƒe negative pole la me wozua sodium hydroxide (caustic lye) si me wode nu me, si tsɔa atike ƒoa ŋɔti me ƒunukpeƒewo le miniti 60 va ɖo 120 me; mègatsɔ dze ƒu gbe ɖe ŋɔti me gbeɖe o, eye nàyi xɔ si me wowɔa dɔ kpata le enumake.

Wolé ŋku ɖe dzɔtsoƒewo ŋu¶

• American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS, United States): Dɔwɔƒewo ƒe Nubabla kple Dɔnɔwo ƒe Dedienɔnɔ Ŋuti Mɔfiame le Dutanu siwo le To kple ŋɔti me, Nudzodzoe gbagbewo ƒe ʋuʋu (Mineral Oil / Lidocaine), kple Button Battery / Paired Magnet Emergencies.
• Dukɔa ƒe Fiadu ƒe Aɖi Dɔwɔƒe (United States) kple Europa Habɔbɔ si Kpɔa Ðeviwo ƒe Dɔgboŋutinunya, Aklãŋutinunya Kple Nuɖuɖu Ŋuti Nunya Gbɔ (ESPGHAN): Button Battery Ingestion and Nasal/Otic Impaction Triage and Management Guidelines (si xe mɔ ɖe saline/tsi ƒe gege ɖe no me alo otic button batriwo me kple \(<2\text{ hour}\) endoscopic eɖeɖe enumake nu).
• Cochrane Database of Systematic Reviews and Canadian Medical Association Journal (CMAJ): "Dada ƒe Nugbugbɔgbugbɔ" (Dzila ƒe Agbugbɔgbugbɔ) Mɔnu na No me Dutalãwo le Ðeviwo me: Dɔwɔwɔ nyuie kple Dedienɔnɔ Meta-Kukuɖenuŋu (Cook et al., CMAJ; \(>60\%\) dzidzedzekpɔkpɔ ƒe agbɔsɔsɔ si me nu gbegblẽ sesẽ aɖeke medzɔna le o).
• Dukɔa ƒe Lãmesẽnyawo Gbɔkpɔha (NHS, United Kingdom) kple Fiaɖuƒea ƒe Atikewɔwɔ Kpata ƒe Kɔledzi (RCEM, United Kingdom): Ðeviwo ƒe To kple ŋɔti ƒe Dutaŋutilã ƒe Dɔdamɔnu ƒe Mɔfiamewo (afã ɖeka ƒe ʋuʋudedi si ʋẽna lilili abe aɖuɖɔtoe me duta ŋutilã ɣaɣla ƒe dzesi ene).
• Roberts kple Hedges ƒe Dɔdamɔnu le Atikewɔwɔ Kpata me: To kple ŋɔti me Dutalãwo ɖeɖeɖa ƒe mɔnuwo (Right-Angle Hook, Schuchman Suction, Katz Extractor, Cyanoacrylate, kple Cockroach Immobilization).

Mɔfiame siwo do ƒome kplii¶

• Tokunɔnyenye kpata (to ƒe ƒoƒo) kple tomeka si vuvu si wɔ nuku ŋutɔ ƒe kpekpeɖeŋunana gbãtɔ
• Ðeviwo kple vidzĩwo ƒe CPR kple woƒe ʋuʋu
• Tɔmelã ƒe ƒu si womi, koklozi ƒe ƒu, kple nuɖuɖutome nuɖuɖu impaction
• Nomeʋuʋu (epistaxis) kpekpeɖeŋu gbãtɔ
• Kpekpeɖeŋunana ame tsitsiwo kple ɖeviwo ƒe nutete