Hoʻokuʻu ʻia ʻo Tampon i hoʻopaʻa ʻia, ka hoʻokuʻu ʻana i ke kīʻaha menstrual i hoʻopaʻa ʻia, a me nā pilikia pilikia o ke kino ʻē aʻe.¶

ʻO ka ʻike ʻana ʻaʻole hiki ke wehe maʻalahi i kahi tampon me kahi kaula nalo, kahi kīʻaha menstrual i hoʻopaʻa paʻa ʻia, kahi condom paheʻe, a i ʻole kahi mea ʻē aʻe e hoʻopaʻa ʻia, hiki ke hoʻoulu i ka hopohopo a me ka hilahila. Ke alakaʻi pinepine nei kēlā hilahila i ka poʻe e hana hewa i ka mīkini i loko o ka lumi ʻauʻau. toxic shock syndrome (TSS) a i ʻole ka puka ʻana o ka ʻōpū make**. Anatomically, ʻo ka ** ʻauwai he ʻiʻo ʻiʻo paʻa makapō (7 to 12 cm / 3 to 5 in hohonu)** ho'opau 'ia e ka cervix pa'a, 'o ia ho'i ** 'a'ohe mea e hiki ke "nalo i loko o ka 'ōpū" ma o ka wahī**, a hiki ke wehe 'ia ka hapa nui o nā mea ma'ema'e 'ole ma ka home me ka ho'ohana 'ana i ka ku'eku'e hohonu a me nā manamana lima ma'ema'e 'elua. ʻO ka ʻokoʻa loa, wehe pono ʻia ka ** ʻāʻī i luna i loko o ka piko sigmoid curved ** a ua hoʻopuni ʻia e nā ** sphincters anal loko a me waho , e komo ana i loko o ka spasm paʻakikī pōhaku a ʻomo i nā mea paheʻe kiʻekiʻe i ke pelvis. ʻO ka hoʻāʻo ʻana e hopu i ke kino ʻē aʻe ma ka home me nā mea paahana, a i ʻole ke ʻomi ʻana i ka ipu aniani ʻāwīwī, he pilikia ** ka puka ʻana i ka paia lahilahi o ka ʻāʻī sigmoid i loko o ka lua peritoneal, e hoʻopilikia ai i ke ola o ka peritonitis. E hoʻonohonoho i kāu mālama me toxic shock syndrome (TSS) hae ʻulaʻula, sepsis a me ka ha'alulu ma'i, a kahe koko ʻōpū, a kelepona i kou wahi helu pilikia (911 ma ʻAmelika Hui Pū ʻIa a me Kanada, 112 ma waena o ka Hui ʻEulopa, 999 ma United Kingdom) koke inā ʻike ʻia kekahi hae ʻulaʻula perforation a sepsis.

E hana i kēia i kēia manawa¶

1. ** ʻAʻole loa e hoʻokomo i nā tweezers metala, nā pliers, nā ʻoki, nā ʻoki, nā mea kau lole, a i ʻole nā ​​manamana lima ʻoi i loko o ka ʻōpū a i ʻole ka ʻāʻī. E hoʻohana maʻemaʻe wale, holoi ʻia nā manamana lima ʻole me nā kui i ʻoki ʻia no ka hoʻihoʻi ʻana i ka vaginal paʻakikī, a ʻaʻole loa e hoʻāʻo i ka manual a i ʻole ka mea hana e unuhi i kahi kino ʻē aʻe hohonu a palupalu paha.
2. E nānā koke no ka "Rum Emergency Now" Nā Hae Ula (Perforation or Toxic Shock Syndrome) a kelepona iā 911 / 112 / 999 a i ʻole e hele i ka ER inā aia kekahi:
3. ** Ke kuni wela nui (\(\ge 38.9 degere C / 102.0 degere F\)), ʻulaʻula ʻulaʻula e like me ka ʻili ʻana o ka lā, luaʻi, ʻeha wai, ʻeha nui o ka ʻiʻo, a noni paha i ka wā e kū ana** ʻoiai aia kahi tampon, kīʻaha, a i ʻole nā ​​spone contraceptive i loko (Menstrual Toxic Shock Syndrome [TSS]).
4. ** ʻEha ʻōpū ʻoi loa, ʻōpū ʻoʻoleʻa e like me ka papa, ʻeha poʻohiwi, ke koko ʻulaʻula ʻulaʻula, a maule paha** ma hope o ke kino ʻē aʻe (Bowel or Vaginal Vault Perforation / Peritonitis).
5. Kekahi mea aniani, ʻōpuʻu kukui, mea ʻeleʻele lahilahi/porcelain, mea ʻoi aku, a i ʻole ka pilaki e kahe ana i loko o ka ʻāʻī a i ʻole ka ʻōpū (ʻo ka ʻeha loa a me ka pōʻino kemika: ʻAʻole e paʻi, ʻomi, a i ʻole ke kānana).
6. Ke holo mau nei kekahi mea kaʻa kaʻa i loko o ka ʻāʻī a i ʻole ke pelvis (ʻo ka haʻalulu alapine kiʻekiʻe e kūʻē i ka hui rectosigmoid e hoʻoulu i ka necrosis a me ka perforation i loko o nā hola).
7. No ka wehe ʻana i kahi kīʻaha i paʻa i ka Menstrual: E kuʻi haʻahaʻa, e hoʻohaʻahaʻa mālie i lalo, a e ʻoki i ke kumu o ke kīʻaha (a i ʻole e hoʻoheheʻe i kekahi manamana lima ma ka ʻaoʻao o ka rim) e wāwahi i ke sila ʻūhā MAMUA o ka huki ʻana i lalo. Mai huki pololei i lalo ma luna o ke kumu silikono lahilahi i ka wā e paʻa mau ana ke kīʻaha a puni ka ʻōpū. ʻO ka huki ʻana i ke kumu e kūʻē i kahi sila ʻūhā paʻa e like me ka plunger ma kou ʻōpū.
8. No ke kiʻi ʻana i kahi Tampon i hoʻopaʻa ʻia (ke kaula i nalowale) a i ʻole ka Condom i hoʻokuʻu ʻia mai ka ʻōpū: E hoʻomanaʻo he ʻeke pani paʻa ka waha. Holoi i kou mau lima, e komo i kahi **kuʻe wāwae rana hohonu ** (a i ʻole e noho ma ka lua me kou mau wāwae i hoʻokiʻekiʻe ʻia ma luna o ka paepae wāwae), e hoʻohaʻahaʻa i lalo me kou mau ʻiʻo pelvic (me he mea lā e paʻa ana ka ʻōpū a me ka ʻōpū i ka ʻōpū. kenimika kokoke i ka puka), e hoʻokomo i ʻelua manamana lima maʻemaʻe (index and middle) ma ka paia hope o ka ʻōpū a hiki i ka fornix hope ma hope o ka ʻōpū, a kahili i ka tampon a i ʻole ka condom ma waena o kou mau manamana lima ʻelua e like me ka lāʻau kuʻi.
9. **No ke Kino Haole Rectal ʻaʻole e hele me ka hoʻoikaika ʻole ma ka hale lua haʻahaʻa mua e noho: HOʻoki i ka hoʻoluhi ʻana, e noho paʻa i ka NPO (ZERO food, ZERO water, ZERO laxatives, ZERO enemas), a hele pololei i ke Keʻena ʻOihana Hoʻopilikia.
10. Inā paheʻe a nahā paha ka condom i loko o ka ʻōpū i loko o nā hola he 72 a i ka 120 i hala iho nei: E kiʻi i ka ʻōlelo aʻoaʻo hoʻopaʻa maʻi maʻi STI/HIV PEP i kēia lā. Hoʻopaʻa hoʻopaʻa kino waha (levonorgestrel i loko o 72 mau hola a i ʻole ulipristal acetate i loko o 120 mau hola, a i ʻole he copper/LNG IUD) a me Prophylaxis ma hope o ka loaʻa ʻana o ka HIV Post-Exposure. ka wehe ʻana i ka condom i mālama ʻia.

Laau hoʻoholo: Vaginal vs¶

E hoʻohana i kēia palapala hoʻoheheʻe lapaʻau e hoʻoholo ai inā hiki ke kiʻi maikaʻi ʻia kahi mea ma ka home me nā manamana lima maʻemaʻe a i ʻole e koi koke i ka mālama ʻana i ka Oihana Hoʻomaʻamaʻa.

flowchart TD
    Start["Hoʻopaʻa ʻia ka mea menstrual a i ʻole ke kino ʻē i loko o ka ʻōpū a i ʻole Rectum"] --> RedFlags{"KEKAHI Hae Ula Ula ulia?; - ʻO ke kuni >=38.9C (102F), ka ʻāʻī ʻana o ka lā, ʻūlū, luaʻi (TSS)?; - Ka ʻeha nui o ka ʻōpū/pelvic, ʻōpū ʻoʻoleʻa, a i ʻole ke koko kaumaha?; - ʻO ke aniani, ʻoi, keramika, pākaukau, a i ʻole e haʻalulu ana paha?"}

    RedFlags -->|"ʻAe i KEKAHI Hae Ulaula"| GoER["OIHANA HOPE KĀWAI KOKI (Kahea 911 / 112 / 999):; 1. Mai huki, ʻomi, a kānana paha; 2. E noho pono i ka NPO (Zero food, water, laxatives, or enemas); 3. Inā manaʻo ʻia ʻo TSS & hiki ke hoʻopaʻa ʻia e ka manamana lima, e wehe mālie; 4. E hele i ER no ka IV antibiotic / sedated surgical or endoscopic extraction"]

    RedFlags -->|"NO Hae Ulaula"| Location{"Aia ma hea ka mea i mālama ʻia?"}

    Location -->|"1. Vagina: Paʻa Menstrual Cup a Disc"| CupSteps["PALAPALA PALAPALA KĀPĀ KĀWAI-HĀWAI:; 1. Hoʻomaha no 15 mins (panic tightens pelvic floor muscles); 2. Holoi lima; e komo i loko o ka ʻauʻau mehana a i ʻole nā ​​wāwae ma luna o ka noho; 3. E iho mālie ('poop push') e hele kīʻaha i lalo 3-4 knm; 4. PINCH BASE o ke kīʻaha me ka paʻa (a i ʻole 1 manamana lima ma luna o ka ʻaoʻao o luna) no ka lohe/manaʻo ʻana i ka ʻume ʻana o ka ea; 5. Pōhaku ʻaoʻao i ka ʻaoʻao ma C-fold a paheʻe i waho me ka pololei"]

    Location -->|"2. Puka: Tampon Paʻa (Lost String) or Slipped Condom"| TamponSteps["SWEEP KAHIKI ʻELU MANAʻO PALAPALA (Closed Pouch Anatomy):; 1. E kuʻu hohonu a hoʻohaʻahaʻa i lalo e hoʻohaʻahaʻa i ka pūpū; 2. Lubricate maʻemaʻe index & middle fingers with water-based lube; 3. E hōʻea ma ka paia hope i loko o ka fornix hope (ma hope o ka pūpū); 4. E pahele i ka tampon/condom ma waena o nā manamana lima ʻelua a paheʻe i waho; 5. E ʻike i ke keʻena maʻi i loko o 24h inā hiki ʻole ke hele a i ʻole ke hoʻomau ʻia ka hoʻokuʻu ʻana"]

    Location -->|"3. Rectum: ʻO ke kino ʻē aʻe i hoʻopaʻa ʻia ma luna o ka sphincter"| RectalSteps["HANA HANA HANA HANA PILIKIA:; 1. MAI hookomo i na mea hana, manamana lima, enemas, a laxatives paha; 2. E noho paʻa i ka NPO (ʻAʻohe meaʻai a inu ʻole inā pono ka anesthesia); 3. E hele mālie a haʻi i ke kahu triage 'Rectal foreign body'; 4. Hana ʻo ER i ka X-ray o ka ʻōpū + ka wehe ʻana i ka poloka sphincter hoʻomaha ʻole ʻeha."]

Mahele 1: ʻOiaʻiʻo Anatomical: No ke aha he Cul-de-Sac i pani ʻia ka ʻāʻī a ʻo ka Rectum he Tube Vacuum Open.¶

ʻO ka hoʻomaopopo ʻana i ke anatomy pololei o ke pelvis wahine me ka canal anorectal e hoʻopau i ka 90% o ka makaʻu e hoʻopuni ana i nā mea vaginal me ka wehewehe ʻana i ke kumu e pono ai nā mea rectal i ka mālama haukapila:

Mahele 2: Kaʻanuʻu-ma-Kaʻanuʻu: Pehea e wehe ai i kahi "Stuck" a i ʻole High-Riding Menstrual Cup (Wāhi i ka Sila Vacuum)¶

Hoʻohana ʻia ke kīʻaha menstrual silicone a i ʻole TPE ma ka hana ʻana i kahi ea negative-pressure suction seal e kūʻē i nā paia o ka waha o luna ma lalo pono o ka pūpū (ʻaʻole like me ka ** menstrual disc **, e noho ana ma hope o ka iwi pubic me ka ʻole o ka momi). Inā hopu ʻoe i ke kumu ʻuʻuku o lalo o ke kīʻaha menstrual i hoʻomoʻa ʻia a huki pololei i lalo, hana ke sila paʻa i ka ea e like me ke kīʻaha hoʻoheheʻe i hoʻopaʻa ʻia i ke aniani, e huki ana i kou ʻāʻī a me ka ʻāʻī, e hōʻeha ai i ka ʻokiʻoki, a hōʻole ʻole e ʻae.

E hahai i kēia protocol clinical 5-step e hoʻokuʻu i kahi kīʻaha menstrual i hoʻopaʻa paʻa ʻia me ka ʻeha ʻole:

1. ** KaʻAnuʻu 1: E hooki i ka huki ʻana a e hoʻomaha i 15 mau minuke inā paʻa kou papahele Pelvic:**
2. Hiki i ke kīʻaha menstrual ke noho maluhia i loko a hiki i ka 12 hola, no laila ʻaʻohe pono e holo wikiwiki. Ke huhū ʻoe ma hope o 5 mau minuke o ka ʻeli ʻana, paʻi nā ʻiʻo o ka papahele pelvic e like me ka lima, e hoʻonui ana i ke kīʻaha. E kū i luna, e ʻauʻau mehana a ʻauʻau paha, a hoʻomaha mālie i ka ʻōpū no 15 mau minuke.
3. ** KaʻAnuʻu 2: E komo i loko o kahi Squat Hohonu a e hāʻule i lalo me ka ʻoluʻolu ("Walk the Cup Down"):**
4. Mai ho'āʻo e wehe i ke kīʻaha kiʻekiʻe i ka wā e kū ana me ka wāwae hoʻokahi i hāpai ʻia i luna a i ʻole e noho pololei ana. E kuʻekuʻe i lalo i ka papahele i loko o ka ʻauʻau (a i ʻole e noho ma ka lua me kou mau kuli i hoʻokiʻekiʻe kiʻekiʻe ma luna o kahi noho lumi lumi lumi).
5. E hoʻomaha a haʻi i lalo me kou ʻōpū haʻahaʻa a me nā ʻiʻo o ka papahele pelvic (ʻo ka hoʻohaʻahaʻa haʻahaʻa like i hoʻohana ʻia no ka neʻe ʻana o ka ʻōpū a i ʻole ke kipaku ʻana i kahi pēpē). ʻO ka piʻi ʻana i lalo e hoʻopōkole i ke awāwa vaginal e 3 a 5 kenimika (1.2 a 2 ʻīniha) a hoʻokuke i lalo o ke kīʻaha i lalo a hiki i ka puka komo.
6. E hana 3 a 5 mau puʻu mele, e hoʻopaʻa mālie i ka piko o ke kumu me kou manamana lima wale nō e pale i ke kīʻaha mai ka heʻe ʻana i luna i kou hanu ʻana (mai huki i ke kumu).
7. ** KaʻAnuʻu 3: E ʻimi paʻa i ke kumu a i ʻole e hoʻoheheʻe i hoʻokahi manamanalima kuhikuhi a hiki i ka ʻaoʻao e wāwahi i ke sila hoʻoheheʻe:**
8. Method A (The Two-Finger Base Pinch): I ka wā e hoʻokuʻu ʻia ai ka ʻōpuʻu lalo o ke kīʻaha i hiki ke loaʻa, e hoʻoneʻe i kou ** manamana lima maʻemaʻe a me kou manamana lima kuhikuhi** ma mua o ke kumu a piʻi i ke kino haʻahaʻa/kumu o ke kīʻaha me ka paʻa pono e honi ai i ka paia silicone i loko. E ʻike pinepine ʻoe a lohe paha i kahi pop liʻiliʻi a i ʻole squelch i ka holo ʻana o ka ea ma mua o ka rim a haki i ka ʻūhā.
9. Method B (The Single-Finger Rim Hook for High-Cervix Users): Inā ʻaʻole nahā ka sila ikaika i ke kui ʻana i ke kumu lalo a puni ka ʻōpū haʻahaʻa e kau ana, e hoʻoheheʻe hoʻokahi manamana lima maʻemaʻe i luna ma ka ʻaoʻao o ke kīʻaha a hiki i kou manamana lima i ka kaʻao luna, a laila e kaomi i ka rim i waenakonu o ke kīʻaha.
10. ** KaʻAnuʻu 4: Piʻi i loko o kahi "C-Shape" maʻalahi a hoʻopololei iā ia ʻaoʻao-a-ʻaoʻao ("The Shimmy"):**
11. E hoʻopaʻa ʻia ke kumu ma waena o kou manamana lima a me kou manamana lima (a i ʻole e pelu liʻiliʻi ʻia me kou manamana waena i loko o kahi haiki. C kino), luli mālie i ke kīʻaha ʻaoʻao a ʻaoʻao (left-to-right a i ʻole front-to-back) ʻoiai ʻoe e alakaʻi iā ia i lalo a i waho ma kahi kihi liʻiliʻi i hope-a-i mua, e hoʻopaʻa pololei i laila e kahe nā mea i loko o ka lua a i ʻole ka wai wai.
12. ** KaʻAnuʻu 5: Pehea e wehe ai i kahi disk menstrual (ʻaʻohe koi ʻia): **
13. Inā ʻoe e hoʻohana nei i ka menstrual disc ma mua o ke kīʻaha bele, e hoʻomanaʻo ʻaʻohe sila hoʻoheheʻe ʻia e kuʻi: kulou hohonu, e hoʻomau i lalo e hoʻokuʻu i ka ʻaoʻao o mua mai hope o kou pubic iwi iwi, e hoʻoneʻe i hoʻokahi manamana lima ma lalo (a ma luna paha) o ka rim mua, a hoʻopaʻa pololei i mua a i waho.

Māhele 3: Hoʻihoʻi ʻana i kahi Tampon poina / paʻa, ke kaula nalo, a i ʻole ka condom i hoʻopaʻa ʻia.¶

ʻO kekahi o nā kipa koʻikoʻi maʻamau maʻamau i ka wā e hoʻokomo ai ke kanaka i kahi tampon hou i ka pau ʻana o ko lākou manawa me ka ʻike ʻole e mau ana ka tampon kahiko i loko, a i ʻole i ka wā e hemo ai a hoʻopaʻa ʻia ke kaula tampon i loko i ka wā mimi a i ʻole ka moekolohe.

1. ʻIke ʻana i nā hōʻailona maʻamau o kahi Tampon i hoʻopoina ʻia¶

Inā noho ka pulupulu i loko o ka ʻōpū no ʻoi aku ma mua o 24 a 72+ hola (i kekahi manawa no hoʻokahi pule a ʻoi aku paha me ka ʻike ʻole o ke kanaka i ke kumu o kona mau hōʻailona), hoʻonui wikiwiki ʻia ka maʻi bacteria maʻemaʻe i loko o ka pulupulu i hoʻoheheʻe ʻia i ke koko: - ** ʻAla ʻAla ʻAʻole ʻAʻole i kuhi hewa ʻole, Puʻiʻo, a i ʻole "Rotting Meat / Fishy" Vaginal Ador ** e ulu koke ana ma luna o 24 a 48 mau hola. - ** Ka ʻeleʻele wai, ʻulaʻula ʻeleʻele, ʻeleʻele, a i ʻole purulent (e like me ka pus).** - **Pelvic piha a haʻahaʻa paha ** (pinepine me ka maʻamau maʻamau a me ka ʻeha ʻole inā paʻakikī, ** a i ʻole ** i hele pū ʻia me ke kuni kiʻekiʻe koke a me ka ʻūhū inā piʻi i Toxic Shock Syndrome).

2. Pehea e kiʻi ai i kahi Tampon a i ʻole Condom me nā manamana lima maʻemaʻe¶

Inā loaʻa iā ʻoe ** ʻaʻohe hōʻailona o Toxic Shock Syndrome (ʻaʻohe kuni, ʻaʻohe ʻūhū, ʻaʻohe ʻūlū)**, e hoʻāʻo i kēia kiʻi home 3 mau minuke ma mua o ka hele ʻana i kahi keʻena mālama koʻikoʻi: 1. E holoi pono i kou mau lima me ke kopa a me ka wai a e hōʻoia i ka pōkole a me ka maʻalahi o kou mau manamana lima. E noi i kahi kulu nui o lubricant ma ka wai (a i ʻole wai mehana maʻemaʻe) i kou manamana lima a me waena **. 2. **Eoʻonoʻo i ka Deep Frog-Leg Squat: E kūlou haʻahaʻae kou mau kuli ākea kaʻawale a paʻa kou mau kuʻekuʻe wāwae i ka papahele, a kuʻi mālie i lalo** me he mea lā e hoʻokuke ana ka ʻōpū. 3. Sweep thPosterior Fornix (Behind the Cervix): - E hoʻokomo i kou manamana lima a me kou manamana lima a hiki i ka piko o ka pū (7 to 10 cm / 3 to 4 inches). - E ʻike ʻoe i ka ʻoluʻolu, paʻa, a puni ka ʻaoʻao o kou pūpuʻupū** (e like me ka piko o ka ihu). - **E komo i loko o ka ʻeke ʻeke ma hope pono a ma lalo iki o ka ʻōpū (ka hope forni a kahili mālie a puni nā ʻaoʻao o ka pūpū (klzzwxh:00). ʻO ka pulupulu kahiko i hoʻopaʻa pinepine ʻia e like me ka pulu pulupulu paʻa i hoʻopaʻa ʻia ma ka ʻaoʻao ma hope o ka ʻōpū, aʻo ka condom paheʻe e like me ke apo baluna paheʻe. - E kui i ka tampon a i ʻole ka condom ma waena o nā pā o kou manamana lima a me u manamana lima waena (e like me ka lāʻau kuʻi) a i ʻole e hoʻokuʻi i kekahi manamana ma hope ona hoʻoheheʻe mālie i waho. 4. Mai Douche Ma hope o ka Wehe ʻana i kahi Tampon kahiko: - Ke wehe ʻia kahi tampon ʻala ʻala, ʻaʻala maoli ka ʻala a me ka hoʻokuʻu ʻana iā lākou iho i loko o 24 a 48 mau ha ʻoiai ʻo ka mea ola olakino * Lactobacillus * flo e hoʻoheheʻe i ke kahawai. Mai hoʻohana i ka waiʻauʻau, ka holoi vinega, a i ʻole ke kopa i loko o ka ʻōpū, no ka mea, hoʻokuʻu ʻia ka maʻi bacteria i luna ma o ka ʻōpū i loko o ka ʻōpū (no ka maʻi Pelvic Inflammatory Disease) a hoʻokaʻawale i nā pua ʻakika pale. - Wā e ʻike ai i ke kauka a i ʻole ke keʻena keʻena: Inā ʻaʻole hiki iā ʻoe ke manaʻo a kiʻi hou i ka tampon ma hope o 2 a 3 mau hoʻāʻo mālie, inā ʻaʻole ʻoe i maopopo 100% inā e waiho ʻia kahi ʻāpana ʻelua i loko, a i ʻole ka hoʻokuʻu ʻia ʻana o ka ʻino, ʻeha pelvic, a i ʻole ke kuni mau hola 24 ma hope o ka wehe ʻana, e kipa i kahi keʻena mālama koʻikoʻi a i ʻole ka gynecologist wikiwiki.

Mahele 4: ʻO nā pilikia o ke kino ʻē aʻe (no ke aha e mālama ai ka lawe ʻana i ka haukapila i kou ola)¶

Hana nā keʻena pilikia a puni ka honua i nā tausani o nā maʻi i kēlā me kēia makahiki no ka mālama ʻia ʻana o ** nā kino haole ʻē aʻe ** (mai nā mea pāʻani makua ʻole me ka ʻole o ke kumu i hoʻomālamalama ʻia, nā wand lomilomi, a me nā nozzles enema i nā ʻōmole, nā kini deodorant, nā mea kanu, a me nā ipu aniani).

1. No ke aha e hilahila ʻole ai ʻoe e hele koke i loko o ka ER¶

ʻO ka mea make hoʻokahi i ka ulia pōpilikia o ke kino ʻē aʻe ʻo ** ka lohi 12-a-48-hola ma ka home ma muli o ka hilahila**, i hui pū ʻia me nā hoʻāʻo luku e ʻeli i ka mea me nā mea hana. - Pehea e mālama pono ai nā kauka a me nā kahu hānai i kēia mea: I ke kauka lumi ulia pōpilikia a me ke kahu hoʻāʻo, he hana maʻamau ke kino ʻē aʻe i hoʻopaʻa ʻia, ʻaʻohe mea ʻokoʻa ma ke ʻano maʻi ma mua o ka wehe ʻana i kahi ʻano popcorn mai ka puka pepeiao a i ʻole ka hoʻohaʻahaʻa ʻana i ka poʻohiwi. Mālama ʻia ʻoe e nā kānāwai pilikino olakino koʻikoʻi (HIPAA / GDPR / NHS Confidentiality). - He aha kāu e ʻōlelo ai ma ka ER Triage Desk: ʻAʻole pono ʻoe e hāʻawi i kahi haʻiʻōlelo lōʻihi i loko o kahi lumi kali e piha ana. E hāʻawi wale aku i kahi leka i ke kahu triage ma kāu kelepona a i ʻole e ʻōlelo mālie:

"He kino ʻē aʻe koʻu i hoʻopaʻa ʻia i paheʻe i loko [X] hola i hala. Ua hana ʻia me [silicone / plastic / aniani / metala], a ua noho au i ka NPO (ʻaʻohe mea e ʻai a inu ʻole)."

2. No ke aha e hana ai ka wehe ʻana i ka hale maʻi ke hāʻule nā ​​hoʻāʻo home¶

Ma ka home, paʻa nā ʻiʻo sphincter anal i ka ʻeha ʻeha (hypertonia) a ʻo ke kolonā sigmoid ma luna aʻe o ka mea e hana ai i kahi laka omo. I loko o ka 'Oihana Emergency, he ʻehā mau pono koʻikoʻi nā kauka: 1. Nā ʻElua-Nānā ʻĀpana a me Pelvic X-Ray: Ma mua o ka hoʻopā ʻana i ka ʻāʻī, kauoha ke kauka i nā X-ray māmā wikiwiki e nānā i ka ** kiʻekiʻe pololei, kuhikuhi, a me ka pololei ** o ka mea (ʻoiai ka hōʻoia ʻana ʻaʻole i māhā ke aniani a ʻaʻohe ** ea manuahi ma lalo o ka diaphragm [pneumoperitoneum], ka mea e hōʻailona ai i ka puka ʻana o ka ʻōpū). 2. Ka Hoʻomaʻamaʻa Intravenous + Local Perianal Nerve Block: Ma ka lawelawe ʻana i ka IV analgesia/sedation a me ka hoʻopau ʻana i ka sphincter anal me ka lidocaine/bupivacaine kūloko, ua hoʻomaha ākea nā ʻiʻo sphincter anal paʻa me ka ʻole o ka ʻeha. 3. Wāhi Paʻa ʻole i ke Sila ʻAha ʻĀpana: E like me ke kīʻaha menstrual i hoʻopaʻa ʻia, hoʻopaʻa ʻia kahi mea maʻemaʻe nui i loko o ka ʻāʻī e ke kaomi hoʻomoʻa maikaʻi ʻole i loko o ke kolonā ma luna. I loko o ka ER a i ʻole endoscopy suite, hele mālie nā kauka i kahi ʻūhā ʻūmiʻi Foley palupu i luna * ma mua o * ka ʻaoʻao o ka mea ʻē, hoʻoulu i ka baluna palupalu ma luna o ia mea, a hoʻomo i ka ea ma o ka paipu catheter i loko o ke kolamu ma luna o ka mea, *waki koke i ka sla ʻūhā me ka hoʻohana ʻana i ka huki haʻahaʻa haʻahaʻa e hoʻoheheʻe i ka mea. 4. Sigmoidoscopy hikiwawe a i ʻole ka lumi hoʻohana ʻana i ka waiū (me ka ʻoki ʻole ʻana i ka ʻōpū): inā ua neʻe ʻoi aku ka mea i loko o ka ʻōpū sigmoid, hoʻohana ka gastroenterologist a i ʻole ka ʻokiʻoki colorectal i kahi pahupaʻikiʻi maʻalahi me nā pahele kūikawā, a i ʻole e hana mālie i ka ʻōpū o waho (transanal milking) ma lalo o ka anesthesia maʻamau e hoʻoheheʻe ʻia i waho ma ka anub8 90% o nā hihia.

3. Nā Mea Kūikawā Kūikawā Kiʻekiʻe Loaʻa i ke Koʻikoʻi Koʻikoʻi Kino¶

• Nā ʻŌmole Aniani Puka, Makaaniani Inu, a i ʻole nā Puka Māmā (Wehe-hope i luna a i lalo):
• Inā hoʻokomo ʻia ke kīʻaha aniani a i ʻole ka pahu me ka waha hāmama e kū ana i luna, e omo ʻia ka mucosa rectal i loko o ka rim hāmama e like me ke aniani kīʻaha, a ʻo ka ʻomi ʻana i ke aniani me nā mea hao hao hiki ke nahā i loko o ke pelvis. Hoʻohana nā kauka i nā mea hoʻopaʻapaʻa padded obstetric kūikawā, Foley air-insufflation, a i ʻole nā ​​hana plaster-wick ma lalo o ka anesthesia e wehe i ke aniani paʻa.
• Nā Vibrator kaʻa e holo mau ana:
• E hele mālie a noho ma luna o kahi uluna palupalu e hilinaʻi ana ma ka ʻūhā hoʻokahi ma ke ala e hele ai i ka ER; Mai kaomi iho ma kou ʻōpū lalo, ʻoiai ke kaomi ʻana i ka piko o ke kani ʻana i ka sacral promontory a i ʻole ka paia sigmoid e hoʻolalelale i ka erosion mucosal.

Nā helu ulia pōpilikia āpana a me nā protocols oihana¶

Inā ʻike ʻoe i nā hōʻailona o Toxic Shock Syndrome, bowel perforation (ʻeha ʻōpū koʻikoʻi, kuni, kahe ʻana o ke koko, a maule paha), a i ʻole kekahi kino ʻē aʻe i hoʻopaʻa ʻia **, e ʻimi koke i ka mālama haukapila:

• ** ʻAmelika Hui Pū ʻIa:**
• Sepsis / Perforation / Glass Object Hoʻoweliweli i ke ola: E kelepona iā 911 a i ʻole e hele pololei i kahi Hospital Emergency Department kokoke loa (mai **ʻaʻole ** hele i ke keʻena lāʻau kūʻai kūʻai a i ʻole ke kikowaena mālama koʻikoʻi no kahi kino ʻē aʻe, no ka mea, ʻaʻohe o lākou X-ray o ka ʻōpū, IV procedural sedation, a i ʻole surgical backup).
• Tampon i mālama ʻia / mea hoʻopaʻa keiki (ʻaʻohe kuni a i ʻole nā ​​hae ʻulaʻula): Kekahi kikowaena mālama wikiwiki, hoʻolālā makua (1-800-230-PLAN), Hiki i ke keʻena OB/GYN, a i ʻole ke Keʻena ʻĀpana Hiki ke wehe i kahi tampon a kīʻaha paha i loko o 2 mau minuke.
• Kanada:
• Nā Hana Kūikawā: Kāhea iā 911 a i ʻole e hele i ke Keʻena ʻOihana Kūikawā kokoke loa. Kāhea i ka panalāʻau HealthLine 811 no ke alakaʻi wikiwiki ʻole i nā mea i hoʻopaʻa ʻia a me ka hoʻopaʻa ʻana i ka hānau keiki.
• United Kingdom:
• Nā Hana Kūikawā: Kāhea iā 999 no ka Toxic Shock Syndrome a i ʻole ka ʻeha o ka ʻōpū a i ʻole ke kahe koko, a i ʻole e hele pololei i kahi Keʻena ʻOihana Hoʻopilikia a me ka pilikia (A&E) no kekahi kino ʻē aʻe.
• Tampon / Condom + Hoʻopaʻa Hoʻopaʻa Paʻa: Kāhea iā NHS 111, e kipa i kahi NHS Sexual Health / Genitourinary Medicine (GUM) Walk-In Clinic, kahi NHS Urgent Treatment Center (UTC), a i ʻole kāu hana GP no ka wehe ʻana i ka speculum o ka lā hoʻokahi a me ka hoʻopaʻa ʻana manuahi manuahi.
• Uni ʻEulopa:
• Nā Hana Kūikawā: E kelepona iā 112 a i ʻole e hele i ke keʻena pilikia o ka haukapila kokoke loa.
• Australia a me Aotearoa:
• Nā Hana Kūikawā: E kelepona iā 000 ma Australia a i ʻole 111 ma New Zealand, a i ʻole e kelepona iā Healthdirect Australia (1800 022 222) / Healthline NZ (0800 611 116).
• India a me Asia-Pākīpika:
• Lau Hana ulia pōpilikia: Kāhea iā 112 ma India, 119 ma Iapana, 995 ma Singapore, a i ʻole 999 ma Malaysia a me Hong Kong. E hele i kahi haukapila lawelawe piha me 24-hola hōʻoki pilikia a me ka uhi obstetrics/gynecology.

Nīnau pinepine¶

Hiki i ka tampon, ke kīʻaha menstrual, a i ʻole ka condom ke nalowale i loko o koʻu kino a hele i loko o koʻu ʻōpū a i ʻole koʻu ʻōpū?¶

ʻAʻole, hiki ʻole ke anatomically. ʻO ka canal vaginal he paipu ʻiʻo i pani ʻia a makapō ka 7 a 12 kenimika (3 a 5 mau ʻīniha) ka hohonu. Ma ka piko loa o ka ʻōpū e noho ana ka ʻōpū paʻa, nona ka puka kikowaena microscopic (1 a 3 millimeters ka laula) liʻiliʻi loa no ka tampon, condom, a i ʻole ke kīʻaha menstrual e hele ai. Ke manaʻo ʻia ka tampon a i ʻole ka condom "nalo," e hoʻopaʻa ʻia i loko o ka fornix hope, kahi ʻeke maʻamau ma hope o ka piko o ka puʻupaʻa, kahi e hiki ai iā ʻoe ma ke kuʻekuʻe ʻana i ka hohonu, e huki mālie i lalo, a kahili ʻana me nā manamana lima maʻemaʻe ʻelua.

No ke aha e ʻeha nui ai ka huki ʻana i ke kumu o koʻu kīʻaha menstrual a hōʻole ʻole e ʻae?¶

Hoʻopaʻa ʻia ke kīʻaha menstrual ma ka hana ʻana i kahi sila hoʻoheheʻe ʻana i ka ea ma nā paia o luna a puni kou ʻōpū. Inā ʻoe e huki pololei i lalo ma ke kumu o lalo me ka haki ʻole ʻana i kēlā sila paʻa i ka ea ma mua, ke huki pololei nei ʻoe i ke kīʻaha hoʻoheheʻe i kou ʻāʻī a me nā ʻiʻo o ka wahine. E kuʻu mau i ka hohonu, e hoʻohaʻahaʻa i lalo me kou mau ʻiʻo pelvic e hoʻolei i ke kīʻaha 3 a 4 kenimika i lalo, a laila e kuʻi paʻa i ke kumu lalo o ke kīʻaha ma waena o kou manamana nui a me ka manamana lima (a i ʻole e hoʻoheheʻe i kekahi manamana lima i luna e kaomi i ka ʻaoʻao o luna i loko) e hoʻokuʻu i ka ea a hoʻokuʻu i ka momi ma mua o ka hoʻokuʻu ʻana i waho.

Pehea e hiki koke mai ai ka Toxic Shock Syndrome (TSS) mai kahi tampon poina, a he aha nā hōʻailona hōʻailona?¶

ʻO ka hapa nui o ka poʻe i haʻalele wale i ka pulupulu no 1 a 3 mau lā, hoʻomohala wale lākou i kahi hoʻoheheʻe ʻeleʻele a ʻala ʻulaʻula a ʻeleʻele paha e hoʻomaʻemaʻe ʻia i loko o 24 a 48 mau hola ma hope o ka wehe ʻia ʻana o ka pulupulu. Eia nō naʻe, inā ʻo Staphylococcus aureus a i ʻole Streptococcus pyogenes bacteria e hoʻopuka i nā exotoxins, hiki i ka Menstrual Toxic Shock Syndrome (TSS) ke ulu wikiwiki. E kelepona iā 911 / 112 / 999 a i ʻole e hele koke i ke Keʻena ʻOihana ʻĀpana inā loaʻa ka mea hoʻohana i ka tampon/cup i kēia manawa i ke kuni kiʻekiʻe (38.9 degere Celsius / 102 degere Fahrenheit a ʻoi aʻe paha), luaʻi, ʻeha wai, ʻeha ʻiʻo nui, ʻeha a maule paha ke kū i luna, ʻulaʻula a i ʻole ka ʻulaʻula ʻulaʻula e like me ka ʻula o ka lā.

No ke aha ʻaʻole hiki iaʻu ke lawe i ka laxative a hoʻohana paha i ka enema e hoʻokuke aku i kahi kino ʻē aʻe i paʻa i ka home?¶

Ke wili ʻia kahi mea ʻē ma luna o ka sphincter anal a i ʻole ma ka ʻāpana sigmoid haʻahaʻa, hana ia e like me ka pahu e hoʻopili ana i ka ʻōpū. ʻO ka lawe ʻana i nā lāʻau lapaʻau hoʻoulu waha a i ʻole ke ʻomi ʻana i ka enema i loko o ka ʻāʻī ma hope o kahi mea i hoʻopaʻa ʻia e hoʻoulu ai i ka ʻiʻo o ka ʻōpū a hoʻoulu i ka wai nui a me ke kaomi kinoea i loko o ka pā lahilahi, hiki ke hoʻoheheʻe ʻia ka paia o ke kolonā i loko o kou ʻōpū. E mālama pono i kou ʻōpū (ʻaʻohe mea e ʻai ai a inu ʻole, ʻaʻohe laxatives, ʻaʻohe enemas) a hele pololei i ke Keʻena ʻOihana Hoʻopilikia.

Makemake au i kahi ʻoki ʻōpū nui e hoʻoneʻe ʻia ke kino haole rectal ma ka haukapila?¶

Ma 85% a 90% o nā hihia, ʻaʻohe pono o ka ʻoki ʻana i ka ʻōpū, inā e hele koke ʻoe i ke Keʻena Emergency ma mua o ka hoʻokuʻu ʻana i ka mea me nā mea hana hale ma ka home. I loko o ka ER, lawe nā kauka i ka X-ray wikiwiki, hāʻawi iā ʻoe i ka mea hoʻomaʻamaʻa intravenous a me kahi poloka numbing kūloko no laila e hoʻomaha loa kāu sphincter anal me ka ʻole o ka ʻeha, e hoʻohele i kahi paipu pulupulu palupalu palupalu ma mua o ka mea e wāwahi ai i ke sila ʻūhā me ka ea, a hoʻoneʻe mālie i ka mea ma ka puka maoli.

Nā alakaʻi pili¶

• ʻO ka toxic shock syndrome (TSS): tampon, nasal packing, a me nā hae ʻulaʻula ʻeha
• ʻO Sepsis a me ka ʻike haʻalulu septic a me ka pane ulia pōpilikia
• ʻO ka ʻāʻī ʻana o ka ʻōpū, ka ʻāʻī ʻana i ka hernia, a me nā hōʻailona pilikia volvulus
• ʻO ke koko o ka ʻōpū, ka luaʻi koko, a me ka melena
• Helu pilikia

Nā kumu a me ke alakaʻi kūhelu¶

• World Society of Emergency Surgery (WSES) & American Association for the Surgery of Trauma (AAST): Anorectal Emergencies: WSES-AAST Guidelines on the Diagnosis, Classification, and Transanal vs. Surgical Extraction of Retained Rectal Foreign Bodies.
• ** Ke Kulanui o nā Obstetricians and Gynecologists ʻAmelika (ACOG) & Royal College of Obstetricians and Gynecologists (RCOG, UK):** *Alakaʻi Kauka no nā kino ʻē aʻe i hoʻopaʻa ʻia, Hoʻopau palekana ʻia ke kīʻaha menstrual, a me ka pale ʻana i ka maʻi haʻalulu o ka maʻi menstrual *.
• Nā kikowaena no ka hoʻopaʻa ʻana a me ka pale ʻana i ka maʻi (CDC, ʻAmelika Hui Pū ʻIa): * ʻO ka maʻi hōʻeha ʻawaʻawa (Staphylococcal a me Streptococcal) Ka wehewehe ʻana i ka hihia, nā kumu pilikia, a me ka hoʻokele pilikia * a me CDC Emergency Contraception and nPEP Guidelines.
• Lau Hana Ola Lahui (NHS, United Kingdom): Alakaʻi Kaukaʻi NHS: He aha ka hana inā paʻa kahi Tampon, Menstrual Cup, a i ʻole Condom i loko o ka ʻōpū.
• ** ʻAhahui ʻAmelika o nā ʻoka a me nā ʻoki ʻoki ʻoki (ASCRS):** * Nā ʻāpana hoʻomaʻamaʻa lapaʻau no ka mālama ʻana i nā kino ʻē aʻe a me ka pale ʻana i ka Rectosigmoid Perforation*.