Obuvune bw’emmundu ezifuuwa empewo enyigirizibwa: Okuyingira kw’empewo, okuyingira mu lususu, n’okulumwa empewo¶

Layini z’empewo enyigirizibwa mu maduuka mu galagi z’emmotoka, amaduuka g’embaawo, amaduuka g’ebyuma, n’amakolero zitera okukola ku bbaala 6.2 ku 8.6 (pawundi 90 ku 125 buli square inch, oba psi), nga layini za loole ennene n’empewo ez’amakolero zituuka ku bbaala 10.3 ku 12 (150 ku 175 psi). Olw’okuba empewo enyigirizibwa telabika, tewunya, era ewulikika nga nnyogovu era nga terina bulabe bwonna ng’oli wala, abakozi batera okukozesa emmundu eziggule ezifuuwa empewo enyigirizibwa okufuuwa enfuufu mu nfuufu, ebyuma ebizigo, oba okusiimuula engoye zaabwe ez’emirimu, emikono n’enviiri. Omuze ogwo nsobi eyinza okutta omuntu. Entuuyo y’empewo enyigirizibwa etafugibwa bw’ekwatibwa mu sentimita emu ku 2 (yinsi 0.4 ku 0.8) okuva ku mubiri, oba singa omukozi akozesa engalo ensajja okuziyiza ensonga y’entuuyo, ekiwujjo ky’empewo waggulu wa 2 bar (30 psi) kyangu okukuba okuyita mu ngoye n’olususu olutaliiko kamogo, oba okuyingira mu bitundu ebitonotono ebirabika obulungi, emisumaali, amaaso, amatu, oba omubiri orifices, okufuuwa ebitundu ebiri wansi w’olususu nga bbaatule n’okukaka ebiwujjo by’empewo butereevu mu misuwa n’emisuwa egyakutuse.

Empewo enyigirizibwa bw’emala okuyingira mu musaayi, ekola vascular gas embolism etambula mu sikonda ntono okutuuka ku ludda olwa ddyo olw’omutima, gy’ekuba n’efuuka ekifuba ekinyigirizibwa ekiziyiza omusaayi okutambula mu mawuggwe (right ventricular air lock), oba okusala mu ntambula y’emisuwa okuziyiza emisuwa mu bwongo n’omutima, nga ekoppa okusannyalala okw’amaanyi oba omutima okuyimirira. Eky’effujjo ekisingawo kwe kuzannya embalaasi mu mpewo enyigirizibwa: okusonga hoosi y’empewo y’omu dduuka ku bisambi oba mu kisambi kya mukozi munno okuva ku **sentimita 10 okutuuka ku 15 (yinsi 4 ku 6) okuva ku sentimita 10 okutuuka ku 15 (yinsi 4 ku 6) okuva weewala, ne bw’oyita mu jjiini enzito ey’omulimu ya denim, okukuba empagi ya ggaasi ow’amaanyi butereevu okuyita mu nnywanto y’omumwa gwa nnabaana, n’ofuuwa n’okutulisa ekyenda ekinene mu bbanga eritakka wansi wa kitundu kya sikonda. Okumanya engeri y'okuteeka omuntu alina obulwadde bw'okusannyalala kw'empewo mu mbeera ya left-lateral decubitus (Durant) position, okugaba oxygen akulukuta waggulu ebitundu 100 ku 100, okutegeera subcutaneous emphysema ("Rice Krispies" crackling wansi w'olususu), n'okuddukanya okukutuka kw'ekyenda ky'omukka kitaasa obulamu. Laba ennamba z’amangu, . okukuba empiso ya pressure washer n’obuvune bw’okukuba ebyuma ebikuba amasannyalaze, . obuvune mu maaso, era okukankana.

Kino kikole kati¶

1. Ggala oba ggyako empewo enyigirizibwa amangu ddala era otambuze omuntu ayisiddwa ku kifo ekipapajjo okuva ku byuma ebikola. Tosimbira ekkuuli kubwatuka kw’empewo enyigirizibwa ku lususu olw’okuba tewali musaayi gwa bweru; ggaasi wa puleesa ennene ayingira ng’ayita mu kinnya kya ppini ekitono ennyo ekisiba emabega waakyo ate empewo n’esalasala okuyita mu nnyonyi z’ebinywa n’eyingira mu misuwa.
2. Singa omuntu afuna obuzibu mu kifuba, okulumwa mu kifuba, okuziyira, okutabulwa, okwogera obubi, okusannyalala, oba okugwa oluvannyuma lw’okubwatuka kw’empewo enyigirizibwa, biteeke amangu ddala ku ludda lwabwe olwa KKONO ng’omutwe n’ekifuba bipapajjo oba nga biwanise katono wansi (Durant / left-lateral Trendelenburg position). Lying on the left side traps buoyant air ebiwujjo mu ntikko y’omusuwa ogwa ddyo n’omusuwa ogwa ddyo okuva ku nkola y’okufuluma kw’emisuwa gy’amawuggwe omutima ne gusobola okugenda mu maaso n’okupampagira omusaayi mu mawuggwe; laba okusannyalala (stroke). era okulwala omutima.
3. Kuba ennamba yo ey'amangu mu kitundu kyo (911 mu Amerika ne Canada, 112 okwetoloola omukago gwa Bulaaya, 999 mu Bungereza) era otegeeze bulungi nti: "Okuteeberezebwa okuzimba empewo y'emisuwa okuva mu mpiso y'empewo enyigirizibwa eya puleesa enkulu." Tegeeza abasindika abantu nti omulwadde ayinza okwetaaga okukyusibwa mu bwangu mu ddwaaliro eririmu Hyperbaric Oxygen Therapy (HBOT) recompression ekisenge; kebera ennamba z’amangu.
4. Muwa oxygen atambula nnyo ebitundu 100 ku 100 ng’oyita mu masiki etali ya kussa ku liita 15 buli ddakiika amangu ddala ng’ekitongole kya oxygen ekisookerwako ku mulimu oba omusawo atuuse. Okussa oxygen ebitundu 100 ku 100 kinaaza nayitrojeni okuva mu musaayi, ne kivaamu okusaasaana okuwanvu okukendeeza ku biwujjo by’empewo ebinyigirizibwa ebirimu nayitrojeni ebikwatiddwa munda mu musaayi gw’obwongo n’omutima ebibya.
5. Singa empewo enyigirizibwa yafulumizibwa okumpi n’enkwaso, ekisambi, oba olubuto (okuzannya embalaasi oba okugwa mu butanwa ku nnyindo) ate ng’oyo alumizibwa mu lubuto mu ngeri ey’amangu oba olubuto olukaluba, oluzimba, zikuume nga zigalamidde, TEWALI kuwa KYONNA mu kamwa, era weetegekere okukubwa amangu. Omukka gwa puleesa ogw’amaanyi gukutula ekibumba ekinene ekya sigmoid ne kiwaliriza empewo okuyingira mu lubuto ekituli (tension pneumoperitoneum), okunyigiriza omusuwa oguyitibwa vena cava ne diaphragm.
6. Ggyawo empeta zonna, essaawa, n’emikono eminywevu ku mukono oba omukono ogufuyiddwa empewo mu bwangu, era otambule ekitundu ku ddaala ly’omutima. Tosiigako tight elastic compression wrap oba ice pack ku kitundu ekizimba n’empewo eri wansi w’olususu, kubanga okufuuwa kw’ebitundu bya puleesa enkulu kuleeta mangu limb-threatening compartment syndrome; laba okunyiga obuvune n’obulwadde bw’ekisenge.

Omuti gw’okusalawo: obuvune bw’emmundu efuuwa empewo enyigirizibwa n’okusunsula embolism¶

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Fizikisi y’okulumwa kw’empewo enyigirizibwa n’etteeka ly’obukuumi erya OSHA 2-bar (30-psi).¶

Lwaki empewo enyigirizibwa eyingira mu lususu lw’omuntu n’ebitundu by’omubiri¶

Abakozi bangi balowooza nti olw’okuba empewo enyigirizibwa ggaasi okusinga ekyuma ekigumu oba omugga gw’amazzi aga puleesa eya waggulu nga pressure washer oba hydraulic hose, emala kubuuka ku lususu. Mu butuufu, olususu lw’omuntu n’olususu oluli wansi w’olususu biwa obuziyiza obutono mu ngeri eyeewuunyisa eri omukka omungi ogw’omukka ogunyigirizibwa:

• 0.2 okutuuka ku 0.35 bar (3 ku 5 psi): Puleesa emala munda mu kamwa, ennyindo oba enseke okukutula omusuwa gw’omuntu, olubuto oba ekyenda ekinene.
• 0.35 ku 1.0 bar (5 ku 15 psi): Puleesa emala okukutula ekikuta ky’amatu g’omuntu (tympanic membrane) oba okugoba ekikuta ky’amaaso (globe luxation) n’okukaka empewo emabega w’enkulungo y’amaaso.
• 0.8 to 2.0 bar (12 to 30 psi): Esobola okuvuga obucaafu, ekyuma ekiwujjo, n’empewo okuyita mu kasumaali akatono, akasala empapula, oba okunyiga ku ngalo, n’esalasala okuyita mu bikuta by’emisuwa egy’okunyiga okuva ku nsonga y’engalo okutuukira ddala mu mukono ogw’omu maaso ne bbugwe w’ekifuba mu sikonda emu.
• Esukkulumye ku 2.0 bar (30 psi) n’okutuuka ku 8.6 bar (125 psi): Puleesa y’empewo y’omu dduuka etali ya mutindo. Nga ekwatiddwa butereevu ku lususu obwereere oba olugoye olugonvu, entuuyo y’empewo eya bbaala 6 ku 8 (90 ku 120-psi) ekubwa butereevu mu lususu olutaliiko kamogo, n’efuuwa ekitundu ky’omubiri n’ebikumi n’ebikumi bya mililita z’empewo enyigirizibwa, n’ekutula emisuwa egy’okunsi wansi w’olususu, era n’ekuba ggaasi butereevu mu ntambula y’emisuwa.

Etteeka lya OSHA 29 CFR 1910.242(b) n’etteeka ly’ensi yonna erya 2-bar (30-psi) eritali ddene¶

Okuziyiza empewo etta n’okuyingira mu lususu, ekitongole kya United States Occupational Safety and Health Administration (OSHA Standard 29 CFR 1910.242(b)), UK Health and Safety Executive (HSE), n’enkola z’obukuumi ez’ensi yonna ezenkanankana nazo zilagira nnyo nti empewo enyigirizibwa ekozesebwa mu kuyonja erina okukendeezebwa okutuuka ku kipimo ekitakka wansi wa bbaala 2 (30 psi). pressure, era awo wokka nga balina chip guarding ennungi n’ebikozesebwa mu kwekuuma.

Ekikulu, ekkomo lino erya 2-bar (30-psi) likwata ku dead-end static pressure, ekitegeeza puleesa epimiddwa ku nsonga y’emmundu efuuwa nga entuuyo enywezeddwa ku kintu ekigumu (nga engalo y’omukozi oba engoye):

1. Lwaki emmundu efuuwa eya mutindo etali mu mateeka emenya mateeka okuyonja: Singa layini y’empewo y’omu dduuka ekola ku bbaala 7 (100 psi) era ng’ekozesa entuuyo y’emmundu ey’ekikomo eya payipu enzigule eya bulijjo nga temuli kitereeza puleesa oba ebituli ebiwummuza ku mabbali, okunyiga entuuyo eyo ku lususu kituusa puleesa ya layini enzijuvu 7 bar (100 psi) mu tissue.
2. Engeri emmundu efuuwa obukuumi etuukana n’enkola ya OSHA gy’ekola: Entuuyo y’obukuumi egoberera amateeka erina ebituli ebisala ebisimiddwa mu radial relief oba Venturi tip ku mabbali g’ekitereeza puleesa mu layini ekiteekeddwa wansi wa 2 bar (30 psi). Singa ensonga y’entuuyo y’obukuumi enyigirizibwa mu butanwa mu ngeri efudde ku lususu lw’omukozi, omukutu omukulu guzibikira, era empewo efuluma ebbali okuva mu miryango egy’obuyambi egy’omu bbanga (radial relief ports) kale puleesa y’olususu efudde tesobola kusukka bbaala 2 (30 psi).

Vascular air embolism: empewo y’amaduuka bw’eyingira mu musaayi¶

Engeri empewo enyigirizibwa gy’etambula okuva ku kiwundu ky’engalo oba mu bulago okutuuka ku mutima n’obwongo¶

Emmundu efuuwa empewo enyigirizibwa bw’ewaliriza ggaasi okuyita mu lususu lw’omukono, mu maaso, ensingo oba ekisenge ky’ekifuba, ensawo ya ggaasi egaziwa ekola puleesa y’ebitundu esinga nnyo puleesa y’omusaayi eya bulijjo ey’emisuwa (eba ya bbaala 0.005 ku 0.015 zokka, oba mmHg 4 ku 12). Gaasi asika butereevu mu misuwa egy’omu lususu egyasaliddwa era atambula ng’ayita mu makubo abiri ag’enjawulo:

1. Venous Air Embolism (Right-Heart Air Lock): Ebiwujjo bya ggaasi bikulukuta waggulu mu misuwa gy’omukono oba ensingo ne biyingira mu misuwa egy’okungulu ne biyingira mu right atrium ne right ventricle y’omutima. Olw’okuba empewo enyigirizibwa so ng’ate omusaayi ogw’amazzi tegunyigirizibwa, ekisenge kya ddyo bwe kinyigirizibwa okwetooloola ensawo ennene ey’empewo (mu ngeri entuufu mililita 50 ku 100, nga hoosi y’edduuka ey’ebbaala 7 gy’etuusa mu katundu ka sikonda), ekinywa ky’omutima kimala kunyigiriza ne kigaziya ekiwujjo ky’ekifuba okusinga okusindika omusaayi mu maaso mu musuwa gw’amawuggwe. Omutima ogufuluma gukendeera okutuuka ku ziro, ekivaako obulwadde bwa cyanosis obw’amangu (olususu olwa bbululu), puleesa okugwa, n’okusiba kw’amasannyalaze agatali ga ‘pulseless electrical activity’ (PEA).
2. Arterial / Cerebral Air Embolism (Paradoxical Embolism): Nga Abantu abakulu abalamu ebitundu 25 ku 30 ku buli 100 balina akatundu akatono akalinga aka flap wakati w’emisuwa egya ddyo ne kkono egy’omutima egiyitibwa patent foramen ovale (PFO) nga mu budde obutuufu esigala nga nzigale. Ebiwujjo by’empewo eby’emisuwa bwe biziba emisuwa gy’amawuggwe ne bireetera puleesa ku ludda olwa ddyo olw’omutima okulinnya, ekifuba ekyo kigguka, ne kikyusa ebiwujjo by’empewo enyigirizibwa butereevu mu ludda olwa kkono olw’omutima, mu musuwa gw’omusuwa, emisuwa gy’omutima (ekireeta okuzimba amangu emisuwa gy’omutima), ne emisuwa gy’obwongo (ekireeta okusannyalala amangu, okukonziba, okuziba amaaso, oba okukoma). Empewo era esobola okuyingira butereevu mu misuwa gy’amawuggwe singa emmundu efuuwa mu kamwa esukkiridde okufuuwa n’ekutula emisuwa gy’amawuggwe (pulmonary barotrauma).

Okutegeera obulwadde bw’empewo obuyitibwa vascular air embolism ku mwaliiro gw’edduuka¶

Teebereza obulwadde bw’empewo obuyinza okutta omuntu singa omukozi eyaakakozesa emmundu efuuwa empewo enyigirizibwa oba eyafuna obuvune mu hoosi y’empewo afuna obubonero bwonna ku buno wammanga mu sikonda okutuuka ku ddakiika 30:

• Okussa obubi mu bwangu (dyspnea), okusesema, oba okuwulira ng'oziyira
• Obulumi obw’amaanyi mu kifuba wansi w’omugongo nga buwerekerwako puleesa okukka amangu, olususu olumyufu oba olwa bbululu, n’okuzirika ennyo
• Acute neurological deficits mimicking a stroke: Okutabulwa okw’amangu, obutasobola kwogera (aphasia), okugwa mu maaso, okunafuwa oba okusannyalala ku ludda olumu olw’omubiri (hemiparesis), okubulwa okulaba okw’amangu, oba generalized tonic-clonic seizures; laba okusannyalala (stroke). era okukonziba
• Okugwa mu bwangu n'okubulwa amagezi

Okulabirira okw’amangu mu mitendera ku mutendera ku biteeberezebwa okuba n’obulwadde bw’okuzimba empewo enyigirizibwa¶

1. Teeka omuntu ayisiddwa mu Durant maneuver (Left-Lateral Decubitus, Head Flat oba Slightly Down):
2. Yiringisiza omugenzi ku oludda lwabwe olwa kkono amangu ddala.
3. Olw’okuba ekitundu ekifuluma mu kisenge kya ddyo (omusuwa gw’amawuggwe) kituula ku kitundu eky’omu maaso ekya kkono eky’ekisenge ky’omutima ogwa ddyo, okuyiringisiza omulwadde ku ludda lwe olwa kkono kireetera ekiwujjo ky’empewo ekibuuka okulengejja waggulu mu ntikko y’omusuwa ogwa ddyo ne bbugwe ow’ebbali ow’omusuwa ogwa ddyo, ne kigogola ekkubo omusaayi ogw’amazzi okukulukuta wansi w’ekibumba okuyingira mu mawuggwe.
4. Kuuma omutwe n’omubiri nga bipapajjo (supine/left-lateral), oba okulengejja ebigere katono waggulu (10 ku 15 degrees Trendelenburg) mu bufunze bwokka singa venous right-heart air lock eteeberezebwa era nga tewali buvune ku mutwe; singa okuzimba emisuwa gy’obwongo kwaleeta dda obubonero bwa stroke, abasawo bangi aba hyperbaric basinga kwagala flat left-lateral or flat supine positioning kale puleesa y’emisuwa gy’obwongo teyongera kuzimba bwongo. Okusinga byonna, totuuza mulwadde nga yeegolodde.
5. Tuusa oxygen ebitundu 100 ku 100 mu bwangu:
6. Empewo y’amaduuka enyigirizibwa erimu nayitrojeni ebitundu 78 ku 100 ate okisigyeni ebitundu 21 ku 100. Omukozi bw’assa omukka gwa oxygen ogw’obujjanjabi ebitundu 100 ku 100 ng’ayita mu masiki enywevu etali ya kuddamu kussa ku liita 15 buli ddakiika, nayitrojeni aggyibwa mu musaayi gwe ogw’emisuwa.
7. Nayitrojeni akwatiddwa munda mu biwujjo by’empewo ebiri mu misuwa asaasaana mangu mu musaayi ogwetooloddewo ogutaliimu nayitrojeni era n’afulumizibwa amawuggwe, n’akendeeza ku bungi bw’ebiwujjo ebitundu 50 ku buli 100 oba okusingawo ate ng’etuusa omukka omulungi ennyo mu bitundu by’obwongo ebiyitibwa ischemic brain tissue.
8. Kola CPR ey'omutindo ogwa waggulu singa oyo ayisiddwa obubi aba taddamu era nga tassa bulungi:
9. Singa omulwadde agwa mu kusiba omutima okuva mu kkufulu y’empewo ey’omu lubuto olwa ddyo, biyiringisize nga bipapajjo ku mugongo gwabwe ku kifo ekikalu era otandike okunyigiriza okw’amaanyi ekifuba ku kunyigirizibwa 100 ku 120 buli ddakiika, sentimita 5 ku 6 (yinsi 2 ku 2.4) mu buziba amangu ddala; laba CPR ne AED.
10. Okunyigirizibwa okw’amaanyi okw’ebweru mu kifuba mu mubiri kumenya ensawo ennene ey’okusiba empewo ey’omu lubuto olwa ddyo mu microbubbles entonotono ne ziziwaliriza okugenda mu maaso okuyita mu kitanda ky’emisuwa gy’amawuggwe olwo okutambula kw’omusaayi ne kusobola okuddamu.
11. Okukwasaganya entambula ey'amangu okutuuka mu kifo kya Hyperbaric Oxygen Therapy (HBOT):
12. Obujjanjabi obukakafu obw’okuzimba emisuwa oba emisuwa egy’amaanyi ye hyperbaric recompression therapy (typically at 2.8 atmospheres absolute), mu mubiri emenya ebiwujjo bya ggaasi okutuuka wansi wa kimu kya kusatu eky’obunene bwabyo okusinziira ku tteeka lya Boyle n’okuzzaawo okutambula kw’omusaayi mu bwongo n’omutima.

Emphysema wansi w’olususu n’okukuba empiso y’olususu ku puleesa ey’amaanyi ku mukono n’omukono¶

Lwaki obuvune bw'engalo z'empewo enyigirizibwa "obutaliimu musaayi" mbeera ya mangu ey'okulongoosa¶

Makanika oba omukugu mu byuma bw’akuba emmundu efuuwa bbaala 7 (100-psi) mu butanwa ku finger pad, engalo, engalo oba omukono ogw’omu maaso, naddala singa wabaawo enjatika entonotono eya giriisi, ekiwundu ekikutuse, oba omusumaali ogw’okuwanirira, empewo y’omukka efumita olususu n’efuuwa ekifo ekisumuluddwa wansi w’olususu n’ennyonyi enzito ez’omu maaso.

Mu sikonda 2 ku 5, omukozi afuna:

• Okuzimba okulinga bbaatule okw’amangu okudduka okuva ku ngalo okutuuka ku mukono, omukono ogw’omu maaso, omukono ogwa waggulu, ekibegabega, ensingo, n’okutuuka n’okubuna ffeesi ne bbugwe w’ekifuba.
• Tactile crepitus ("Rice Krispies" crackling under the skin): Bw'okwata mpola ku mukono oba ensingo ezimba, owulira n'owulira okunyiga, okubuuka, oba okuwuuma okw'enjawulo ng'enkumi n'enkumi z'obuwundo bw'empewo obutonotono obusibiddwa bukyuka wansi w'engalo zo (subcutaneous emphysema).
• Obulumi obw’amaanyi obwa puleesa, okuwunya, n’okuziyira: Singa empewo ya puleesa eya waggulu emala efuyirwa mu bitundu by’omukono oba eby’omu maaso ebinywevu, ebitali binywevu, puleesa y’ebitundu erinnya okusinga puleesa y’okufuyira emisuwa, n’esalako omusaayi okugenda mu binywa n’obusimu (pneumatic compartment syndrome). Ekirala, empewo enyigirizibwa mu maduuka terimu buwuka; kifuuse kicaafu nnyo olw’enfuufu y’amafuta ga compressor crankcase oil mist, amazzi amakyafu aga condensation, rust scale okuva mu steel receiver tanks, n’enfuufu y’amaduuka, ekivaako cellulitis ey’amaanyi ey’eddagala n’obulwadde obutta mu bwengula obuziba; laba okukuba empiso ya pressure washer n’obuvune bw’okukuba ebyuma ebikuba amasannyalaze.

Obuyambi obusookerwako ku mpiso y’empewo enyigirizibwa wansi w’olususu¶

1. Yambula empeta zonna, essaawa, obukomo, n’ebikondo by’essaati ebinywezeddwa mu sikonda 60 ezisooka: Okuzimba kw’empewo wansi w’olususu kugenda mu maaso mangu nnyo okusinga okuzimba okwa bulijjo okunyiga; empeta ya zaabu oba ey’ekyuma ejja ku tourniquet engalo mu ddakiika bbiri.
2. Kebera ensingo n'omukutu gw'empewo singa empewo ebadde erondooledde waggulu ng'eyise ku kibegabega: Empewo enyigiriziddwa efuyiddwa mu ngalo oba mu mukono bw'omu maaso bw'esalasala okuyita mu kitundu ky'omukono (brachial fascia) mu mediastinum (wakati w'ekifuba) n'ensingo (pneumomediastinum), ensingo y'oyo akubwa eyinza okuzimba mu ngeri erabika era eddoboozi lyabwe liyinza okutwala eddoboozi ery'amaanyi, ery'ennyindo, "Donald." Duck" oba hoarse quality ("hamman's crunch" eyinza okuwulirwa ku mutima). Londoola nnyo engeri gye bassa era bakuume nga bakkakkamu.
3. Bikka akatundu akatono akayingira ne gaasi enkalu etaliimu buwuka era okwate omukono nga teguliimu ku ddaala ly’omutima: Tositula mukono waggulu waggulu w’omutwe (ekikendeeza puleesa y’emisuwa n’okukubiriza empewo okuyingira mu misuwa) era togireka kuwanirira wansi.
4. Nnywerera ku kwekenneenya eddwaaliro ery’amangu n’okukuba X-ray: Ne bwe kiba nti omuntu ayisiddwa obulungi awulira bulungi mu nkola, omuntu yenna alina obulwadde bwa crepitus wansi w’olususu okuva mu hoosi y’empewo y’omu dduuka yeetaaga ebifaananyi eby’amangu (okulaga maapu ya ggaasi mu bitundu by’omubiri n’ekifuba), okuziyiza tetanus, eddagala eritta obuwuka eriweebwa mu misuwa egy’amaanyi (against waterborne and oil-borne bacteria), n’okulondoola compartment syndrome oba obutwa bwa langi/amafuta.

Okuzannya embalaasi mu mpewo enyigirizibwa n’okukutuka kw’olubuto olutulika¶

Lwaki okusonga hoosi y’empewo ku bisambi bya mukozi munno kitta¶

Mu byafaayo by'obukuumi bw'amakolero, ekimu ku bikangabwa ebisinga okuddirira era eby'akatyabaga ku maduuka ye "compressed air horseplay": omukozi mu ngeri ey'okusaaga akuba oba okufulumya emmundu efuuwa empewo enyigirizibwa okumpi n'amatabo oba ekisambi kya mukozi munne nga bwe bafukamira ku ntebe y'okukoleramu, oba akozesa entuuyo y'empewo okufuuwa enfuufu ku ntebe y'empale ye.

Abakozi balowooza mu ngeri ey’ekikangabwa nti jjiini oba ebibikka ebizito ebya denim biziyiza empewo, oba nti entuuyo y’empewo erina okuteekebwa mu mubiri mu nseke okusobola okuleeta obulabe. Ebiteberezebwa byombi bya bulimba:

1. Ekikolwa ky’empewo: Ekiwujjo ky’empewo enyigirizibwa ekifuluma mu ntuuyo ku 5 ku 9 bar (70 ku 130 psi) kikola empagi ya ggaasi ekwatagana, esukkulumye ku maloboozi. Ne bwe kiba nga kiri ku sentimita 5 okutuuka ku 20 (yinsi 2 ku 8), empagi eyo ey’empewo eyita awatali kufuba mu biwuzi ebilukibwa eby’empale y’omulimu, n’eyita wakati w’ebikuta by’omugongo, era n’ewaliriza ekitundu ky’omu lubuto okugguka mu milisekondi.
2. Okubwatuka kw’olubuto mu kaseera katono: Ekyenda ekinene ky’omuntu kirina puleesa y’okubutuka mu mubiri eya 0.16 ku 0.27 bar yokka (2.3 ku 4.0 psi, oba 120 ku 200 mmHg). Layini y’empewo y’omu dduuka etuusa emirundi 25 ku 40 ku puleesa y’okubutuka kw’ekyenda ky’omuntu, n’ekuba liita 20 ku 40 ez’empewo buli sikonda mu nseke. Mu sikonda ezitakka wansi wa 0.5, ekiyungo kya rectosigmoid oba cecum kibwatuka ng’ensawo y’empapula efuukuuse ennyo.
3. Tension pneumoperitoneum: Empewo y’omu dduuka eya puleesa ennene eyiwa okuyita mu bbugwe w’ekyenda eyakutuse mu kisenge ky’olubuto ekissiddwa. Olubuto lw’oyo attiddwa lugenda ebweru okukaluba ng’engooma mu sikonda ntono. Puleesa eno ey’omukka oguyitiridde mu lubuto (tension pneumoperitoneum) esika nnyo ekisenge ky’omubiri (diaphragm) waggulu mu kifuba, n’emenya amawuggwe omuntu alemeddwa okussa, era n’egwa omusuwa ogwa wansi (inferior vena cava) kale nga tewali musaayi guyinza kudda mu mutima, ate mu kiseera kye kimu n’ewaliriza obuwuka bw’omusulo okuyingira mu lubuto n’emisuwa.

Okuddamu okw’amangu olw’okukutuka kw’ekyenda eky’empewo n’okusika omuguwa kw’ekifuba¶

1. Kuba 911 / 112 / 999 mu bwangu era oloope "Obuvune bw'empewo enyigirizibwa mu puleesa ey'amaanyi mu nseke/olubuto nga buteeberezebwa okuba nga bufunye ebituli mu kyenda n'okusika omuguwa mu nnyindo." Buli ddakiika ebalwa; okufa kusukka ebitundu 40 ku buli 100 awatali kukendeeza mangu ku puleesa n’okulongoosebwa okuddaabiriza.
2. Teeka omuntu akubwa mu mbeera ya kkono-lateral oba supine position ng’amaviivi gafukamidde katono: Tomukaka kugalamira singa olubuto olugaziye lumulemesa okussa, era tomutuuzangako bolt upright. Okuziwagira ku oludda lwa kkono kiyamba okukendeeza ku bulabe bw’okuzimba empewo mu misuwa mu kiseera kye kimu ng’abajjanjabi abasookerwako baddamu.
3. TOwanga KYONNA mu kamwa (towa mazzi, ddagala eriweweeza ku bulumi, oba eddagala eriweweeza ku asidi): Omulwadde yeetaaga okulongoosebwa mu bwangu mu ngeri ey’okunoonyereza n’okuddaabiriza ekyenda ng’akozesa eddagala eribudamya.
4. Wagira empewo n’okwetegekera okukendeeza ku kunyigirizibwa kw’empiso y’abasawo abasookerwako: Singa olubuto lufuumuulwa nnyo n’empewo enyigirizibwa nga n’omuntu abadde afuuse bbululu (cyanotic) era nga tasobola kutambuza bbugwe w’ekifuba kye okussa, abasawo ab’omulembe abayamba obulamu oba abasawo abafuna obuvune basobola okukola okukendeeza empiso mu bwangu mu kisenge ky’olubuto ku mabbali g’entambula ey’amangu; laba okukankana.

Amaaso, amatu, n’omumwa barotrauma okuva mu mpewo enyigirizibwa¶

Okukuba empiso y’empewo mu maaso n’enkulungo (Orbital Emphysema) .¶

Entuuyo y’empewo enyigirizibwa bw’efuluma okumpi ne ffeesi, oba ebikuta by’enku ebitambuzibwa emmundu ekika kya 7-bar (100-psi) bwe bikuba eriiso, omugga gw’empewo gusobola okukutula conjunctiva (oluwuzi olugonvu olubikka enjeru y’eriiso) enzirugavu nga tefufumita kitundu kya liiso kyennyini, ne kifuuwa ebikowe by’amaaso n’ekisenge ky’amagumba emabega w’eriiso n’empewo ey’amaanyi (orbital emphysema): okuzimba omubiri (emphysema) **:

• Obulabe bw’obulwadde bw’obusimu bw’amaaso obunyigirizibwa: Empewo ekwatiddwa emabega w’ekikuta ky’amaaso munda mu kisenge ky’amaaso ekikaluba eky’amagumba esika ekikuta ky’amaaso mu maaso (proptosis) n’enyigiriza obusimu bw’amaaso n’omusuwa gw’amaaso ogw’omu makkati, ekiyinza okuvaako okuziba amaaso okw’olubeerera mu ddakiika 60 ku 90.
• Okulabirira amangu:
• Gamba oyo ayisiddwa obubi TOFUUKA nnyindo oba okusesema ng’akamwa kaggaddwa (ekiwaliriza empewo ya sinus ennyingi okuyingira mu nkulungo).
• Tonyiga TO kunyigiriza ku bikoola by’amaaso ebizimba; tape engabo enkalu ey’obukuumi oba ekikopo ky’empapula dome ku bbali w’amagumba g’ekisenge ky’amaaso; laba obuvune mu maaso.
• Okutambuza amangu ddala mu kitongole ky’abalwadde ab’amangu okukendeeza ku buzito bw’amaaso.

Okubwatuka kw’omukutu gw’amatu n’okukutuka kw’olususu lw’amatu¶

Okukozesa hoosi y’empewo okufuuwa enfuufu okuva mu nviiri oba enkokola okumpi n’okutu kikuba tympanic membrane (eardrum) n’okukubwa amaloboozi (okusukka 120 ku 135 decibels) ne pneumatic overpressure:

• Obubonero: Obulumi bw’amatu obw’amaanyi, okukuba okw’amaanyi (tinnitus), okubulwa okuwulira okuzibye, okuvaamu omusaayi oba amazzi amayonjo agakulukuta okuva mu mulyango gw’amatu, n’okuziyira okuwuuta (barotrauma vertigo) singa amagumba g’amatu aga wakati gasindikibwa mu ddirisa ery’omu matu erya oval.
• Okulabirira amangu: Kuuma okutu nga nkalu. Toteekako matondo g’oku matu, amazzi, oba ppamba munda mu mulyango gw’amatu. Teeka gaasi etaliimu buwuka enzirugavu ku kutu okw’ebweru era oyambe oyo alina ekiziyiro okugalamira obulungi.

Ennamba z’embeera ez’amangu mu bitundu n’ebiragiro by’ebitongole¶

Bw’oba ​​oyita empeereza ey’amangu olw’empiso y’empewo enyigirizibwa, embolism, oba obuvune bw’okubwatuka mu lubuto, tegeeza mu bulambulukufu omusindika puleesa ya layini mu psi oba bar era saba Advanced Life Support (ALS) paramedics nga balina oxygen ekulukuta ennyo n’okukwatagana ne Hyperbaric Oxygen Therapy (HBOT) oba Level 1 Trauma Center. Laba ennamba z’amangu ku nnamba z’okuyingira mu nsi yonna.

Ebibuuzo ebitera okubuuzibwa¶

Lwaki OSHA ekoma ku mmundu ezifuuwa empewo enyigirizibwa okutuuka ku 30 psi (2 bar) nga zikozesebwa mu kuyonja, era 30 psi zikyayinza okukulumya?¶

OSHA Standard 29 CFR 1910.242(b) ekwata empewo enyigirizibwa ekozesebwa okuyonja ku puleesa esinga obunene ey’okutambula (maximum dead-end static pressure) eya 2 bar (30 psi) kubanga okugezesebwa kulaga nti empewo y’amaduuka etafugibwa waggulu wa 2 bar (30 psi) ekwatibwa okumpi n’omubiri esobola okukuba butereevu okuyita mu lususu lw’omuntu n’ewaliriza ebiwujjo bya ggaasi ebitta okuyingira mu misuwa n’emisuwa. Naye, bbaala 2 (30 psi) kkomo nnyo erikwata ku kwoza ekitundu ky’ekyuma, so si layisinsi ya kufuuwa mpewo ku mubiri gwo: ne ku bbaala 0.35 ku 1 (5 ku 15 psi), omugga gw’empewo enyigirizibwa guyinza okukutula endongo y’amatu, okufuuwa ebikuta by’ebyuma mu maaso, oba okukutula ekyenda ekinene singa kiba kiragirwa okumpi n’emikutu gy’omubiri. Empewo enyigirizibwa ku puleesa yonna tesaana kukozesebwa kuggya nfuufu ku ngoye, olususu oba enviiri.

Empewo enyigirizibwa eyinza etya okuyingira mu musaayi singa tewabaawo musaayi gulabika ku lususu?¶

Entuuyo y’empewo enyigirizibwa ku bbaala 6 ku 8 (90 ku 120 psi) bw’esika omukono, engalo oba ensingo, omugga gwa ggaasi ogusukkulumye ku maloboozi guyinza okuyingira nga guyita mu kumenya okutono mu lususu, gamba ng’akasumaali akatono, enjatika y’olususu enkalu, oba okukunya kw’ekyuma ekiyitibwa burr scratch, oba okukuba ekituli ekituufu okuyita mu lususu olutaliiko kamogo. Olw’okuba empewo ya puleesa enkulu efuuwa mangu ebitundu ebiri wansi w’olususu n’enyigiriza ekituli ekitono ekiyingira okuva munda, kumpi tewali musaayi gufuluma bweru. Mu kiseera kino, ensawo ya ggaasi eya puleesa ey’amaanyi munda mu kitundu ky’omubiri egaziwa eggulawo emisuwa egy’omu lususu egy’ebisenge ebigonvu era n’ewaliriza ebiwujjo by’empewo okuyingira butereevu mu ntambula y’emisuwa ng’eyolekera omutima.

Lwaki omuntu ateeberezebwa okuba n’obulwadde bwa compressed-air embolism yandibadde ateekebwa ku ludda lwe olwa kkono (Durant position) okusinga okutuula waggulu?¶

Ebiwujjo by’empewo bwe biyingira mu musuwa okuva mu buvune bw’omukono oba mu bulago, bitambula okutuuka mu kisenge kya ddyo n’omusuwa ogwa ddyo ogw’omutima, gye bisobola okukola ekiwujjo ky’ekifuumuuka ekinyigirizibwa ekiziyiza omusaayi okuyingira mu musuwa gw’amawuggwe okutuuka mu mawuggwe (ekizibiti ky’empewo eky’omu kisenge ekya ddyo). Olw’okuba ekkubo erifuluma mu misuwa gy’amawuggwe lituula ku nsonda eya waggulu ku kkono ey’omu maaso ey’omusuwa gwa ddyo, okuyiringisiza omuntu ayisiddwa ku ludda lwabwe olwa kkono ng’omubiri gwe gufuukuuse kireetera ensawo y’empewo ewunyiriza okulengejja waggulu okutuuka ku bbugwe wa ddyo n’entikko y’ekisenge ky’omutima, okuva ku vvaalu y’okufuluma, ne kisobozesa omusaayi ogw’amazzi okukulukuta wansi w’ekibumba okuyingira mu mawuggwe. Okutuuza omulwadde nga yeegolodde kisobozesa ebiwujjo by’empewo okulengejja waggulu mu misuwa gy’obwongo oba okuzibikira ddala omukutu gw’amawuggwe ogufuluma.

Kiki ekivaako "Rice Krispies" okuwulira ng'ewunya wansi w'olususu oluvannyuma lw'akabenje k'empewo enyigirizibwa, era kya bulabe?¶

Okuwulira okunyiga, okubuuka oba okuwuuma okuwulira wansi w’olususu ng’okwatiddwako kiyitibwa subcutaneous crepitus (oba subcutaneous emphysema), ekiva ku nkumi n’enkumi z’ensawo z’empewo enyigirizibwa eziwalirizibwa okuyingira mu layers z’amasavu ne fascial wansi w’olususu. Wadde ng’empewo entono wansi w’olususu esobola okukkakkana ng’eyingiziddwa omubiri, obulwadde bwa emphysema obuva wansi w’olususu okuva mu hoosi y’empewo ey’omu dduuka mbeera ya mangu mu by’obujjanjabi olw’ensonga ssatu: ekisooka, bukakasa nti omukka gwa puleesa eya waggulu yamenya ekiziyiza ky’olususu era nga gutwala akabi k’okuzimba empewo y’emisuwa; ekyokubiri, empewo ekwatiddwa mu bifo ebinywevu mu ngalo oba mu mikono gy’omu maaso esobola okusalako entambula y’omusaayi n’ereeta obulwadde bwa compartment syndrome; n’ekyokusatu, empewo y’amaduuka efuyira enfuufu y’amafuta ga kompyuta, obusagwa, ne bakitiriya mu buziba mu bikuta by’emisuwa, nga kyetaagisa okwekenneenya amangu eddwaaliro n’okukozesa eddagala eritta obuwuka.

Okusonga hoosi y’empewo enyigirizibwa ku mpale y’omuntu kiyinza kitya okuvaako ekyenda ekinene okukutuka nga tekikutte ku lususu lwe?¶

Layini y’empewo y’amaduuka eya bulijjo ku bbaala 6 ku 8.6 (90 ku 125 psi) efulumya empagi ya ggaasi ey’amaanyi agayita butereevu mu kuluka kwa jjiini za denim oba coveralls. Singa entuuyo etunuulirwa mu bisambi oba mu kitundu ky’omubiri ekiyitibwa perineum okuva ne ku sentimita 10 ku 15 (yinsi 4 ku 6) okuva wano, empagi y’empewo eyingizibwa mu mwala gw’omumwa gwa nnabaana, n’ewangula omusuwa gw’omumwa gwa nnabaana amangu ago, era n’efuuwa ekyenda ekinene ne puleesa yaayo ey’okubutuka emirundi 25 ku 40 eya bbaala 0.2 (3 ku 4 psi), n’ebwatuka ekisenge ky’ekyenda mu bbanga eritakka wansi wa kitundu kya sikonda era okujjuza ekituli ky’olubuto empewo ya puleesa eya waggulu ne bakitiriya.

Ekitabo kino kiwa ebiragiro by’obujjanjabi obusookerwako mu kifo we bakolera n’okusunsula mu bwangu ku buvune obuva ku mpewo n’empewo enyigirizibwa era tekidda mu kifo ky’obujjanjabi obw’ekikugu. Lowooza ku ky’okukola omusomo ogukakasibwa ogw’obujjanjabi obusookerwako, CPR, n’okugaba omukka gwa oxygen ng’oyita mu Red Cross, St John Ambulance, oba omuwa obukuumi ku mulimu mu ggwanga lyo.

Ebiragiro ebikwatagana nabyo¶

• Empiso ya pressure washer n’obuvune mu kickback y’ekintu ky’amasannyalaze
• Ekibya kya puleesa, ttanka ya compressor y’empewo okukutuka, n’okubwatuka kw’omupiira ogwawuddwamu
• Emmundu y’emisumaali n’ekiziyiza empewo okuyingira n’obuvune mu ricochet
• Obuvune mu maaso
• Obuvune mu kunyiga n’obulwadde bw’ekisenge

Ensonda n’obulagirizi obutongole¶

• Ekitongole ekivunaanyizibwa ku byokwerinda n’ebyobulamu ku mirimu (OSHA, Amerika): 29 CFR 1910.242(b) Empewo Enyigirizibwa Ekozesebwa Okwoza
• Ekitongole ky’ebyobulamu n’obukuumi (HSE, Bungereza): Obukuumi bw’empewo enyigirizibwa (PUWER Guidance)
• Ekitongole kya Canada ekikola ku bulamu n’obukuumi ku mirimu (CCOHS, Canada): Empewo enyigirizibwa ey’okuyonja n’Empapula z’obukuumi bw’ebikozesebwa mu mpewo
• Undersea and Hyperbaric Medical Society (UHMS, International) & Divers Alert Network (DAN): Engeri y’okuddukanya obulwadde bw’okuzimba emisuwa n’emisuwa
• Ekibiina ky’Amerika ekikola ku kulongoosa omukono (ASSH, Amerika): Obuvune bw’empiso ya puleesa ey’amaanyi mu bitundu eby’okungulu