Kosukola mpota ya ntolo mpe lisalisi ya liboso ya mimpululu oyo ekweaki¶

Kopema ya bato na ndenge ya momeseno etalelaka vide oyo ekɔtaka na mopɛpɛ te, oyo ezali na pression négative na kati ya cavité thoracique. Kati na likolo ya libanda ya mimpululu (pleure viscérale) mpe efelo ya kati ya mokuwa ya mokɔngɔ (pleure pariétale) ezali na esika ya pleural microscopique, oyo ebatelami na pression négative sub-atmosphérique ya pene na -4 kino -8 centimètres ya mayi. Ntango masasi, mbeli, eteni ya shrapnel, mokuwa ya mokɔngɔ oyo ebukani, to libumu ya mimpululu oyo euti na mbalakaka epasuki na kati ya vide oyo ekangami, mopɛpɛ ekɔtaka mbangumbangu na esika ya pleural mpe elongolaka mimpululu oyo ezali na élastique mosika na efelo ya ntolo, mpe esalaka ete poumon ekwea (pneumothorax).

Ntango libulu ya libanda oyo ezali koleka na efelo ya ntolo ezali monene mpenza (pene na ndambo mibale likoló na misato ya diamɛtrɛ ya nzela ya mopɛpɛ to koleka), mopɛpɛ ezwaka nzela oyo ezali na résistance moke mpe emɛlaka mbala moko na efelo ya ntolo na esika ya kokita na trachée, mpe yango esalaka ete mpota ya ntolo oyo ezali komɛla (pneumothorax oyo efungwami). Likambo ya mabe koleka, soki mopɛpɛ ekɔti na kati ya ntolo na mpema mokomoko to ekangami na nse ya bandage oyo ekangami mobimba mpe ezali na nzela ya kokima te, mpasi oyo ezali na kati ya ntolo ekómaka likoló ya nivo ya mopɛpɛ, enyataka mpenza mimpululu mpe ebɛtaka misisa minene oyo ezongisaka makila na motema. Urgence oyo ya koboma, oyo babengaka pneumothorax ya tension, esalaka arrêt obstructif cardiaque fatal na kati ya ba minutes longola se soki eyebani mpe e décompression.

Sala boye sikoyo¶

1. Benga mbala moko nimero ya urgence ya esika ofandi mpe senga ba paramédicaux ya Advanced Life Support (ALS). Benga 911 na Etats-Unis mpe Canada, 112 na Union européenne mobimba, 999 na Royaume-Uni, 000 na Australie, to tala répertoire ya banimero ya mbalakaka. Lakisa polele mpota ya ntolo oyo ekɔti na kati to oyo bakanisaka ete mimpululu ekwei mpo ete basali ya lisalisi ya liboso bámema ba joints ya ntolo, ba kits ya décompression ya aiguilles, mpe oxygène.
2. Bóbimisa ntolo mobimba PE tala na malembe mokɔngɔ mpe mabolongo soki ezali na mpota ya kobima. Kata to tombolá chemise mobimba tii na nkingo. Ntango nyonso oyo omoni mpota na ntolo na liboso, mbala moko rouler to yoka na nse ya mapeka, mabolongo (axillae), mpe mokɔngɔ mpo na libulu ya mibale, mpe kangá liboso libulu ya monene to oyo ezali kobulungana mingi.
3. Zipa mbala moko mpota ya ntolo oyo ezali komela oyo ezali polele na lobɔkɔ oyo ezali na gant ntango ozali kobimisa mpema, na nsima pakola eloko oyo batɛkaka na ntolo oyo ezali na mopɛpɛ to Pécheur occlusif à trois côtés. Kopangusa makila mpe motoki na loposo mpo ete adhésif ekangama, sɛngá mobɛli apema (kobimisa mpema), mpe kosembola eloko oyo batɛkaka na ntolo oyo ezali na mopɛpɛ likoló ya libulu. Soki ozali na sceau ya ventilateur ya mombongo te, ruban carré ya enveloppe ya plastique hermétique, papier papier, to enveloppe ya pad ya défibrillateur na kaka na ngambo MISATO, kotika coin ya se sans enveloppe lokola valve ya flutter.
4. Kozinga ata moke te bandage élastique ya makasi nzela mobimba zingazinga ya ntolo mpe kotika ata moke te eloko oyo ezali na mopɛpɛ te oyo ezali na ngámbo minei oyo ekangamaka na mopɛpɛ te. Kokanga mpota ya ntolo oyo efungwami oyo ezali na mopɛpɛ te na ngámbo nyonso minei kozanga ete ezali na valve ya kokɔtisa mopɛpɛ ekangaka mopɛpɛ oyo ezali kobima na mimpululu oyo ezoki na kati ya ntolo, mpe nokinoki ekómisaka mpota ya polele oyo ekoki kobika na ** pneumothorax ya tension** oyo ebomaka.
5. Fanda mobɛli oyo azali na makanisi, oyo azali kopema semba to na mwa kokita (to kobalusama mwa moke na ngámbo oyo azoki) mpo na kotika ete mimpululu ya malamu epanzana. Kotindika ata moke te mobɛli oyo azali na makanisi mpe azali kobunda mpo na kopema na kozoka na ntolo alala patatalu na mokɔngɔ na ye longola kaka soki immobilisation ya mokuwa ya mokɔngɔ esɛngi yango.
6. Kolandela kopema nsima ya segɔnde 60 mpe "BURP" mbala moko eloko oyo ekangami na ntolo soki mobɛli akómi na mpema mokuse, cyanotique, to abungisaki pulse radiale na ye. Soki kopema ya mobɛli ebebi na mbalakaka nsima ya kotya eloko oyo ekangami na ntolo, longola nsima coin moko ya pansement na boumeli ya segɔnde 3 to 5 na ntango ya kopema mpo mopɛpɛ oyo ekangami na pression na ntolo, pakola makila nyonso oyo ekangami na valve, mpe zongisá eloko oyo ekangami na mopɛpɛ.

Nzete ya mokano ya mbalakaka mpo na bampota ya ntolo oyo efungwami mpe mimpululu oyo ekweaki¶

flowchart TD
    Start["Penetrating Chest Trauma, Blunt Rib Impact, or Sudden Sharp Pleuritic Chest Pain"]
    CallEMS["Call Emergency Medical Services (ALS Paramedics) Immediately<br/>Expose entire anterior chest, armpits, and posterior back"]
    ImpaleCheck{"Is a Knife, Rod, or Shard Still Impaled in the Chest?"}
    ImpaleChest["IMPALED CHEST OBJECT PROTOCOL<br/>1. DO NOT pull out the impaled object<br/>2. Seal sucking gap around base of blade with petroleum gauze/plastic<br/>3. Leave one corner unsealed to vent air<br/>4. Stabilize blade with twin bulky gauze rolls"]
    OpenCheck{"Is There an Open Wound in the Chest Wall?<br/>(Hissing/sucking sound, frothy pink blood bubbles, chest wall defect)"}
    ClosedPneumo["CLOSED PNEUMOTHORAX / HEMOTHORAX / FLAIL CHEST<br/>1. Do NOT apply chest seal if skin is intact<br/>2. Sit patient upright or semi-reclined (Fowler's position)<br/>3. Calm patient to slow rapid breathing<br/>4. Watch continuously for Tension Pneumothorax signs"]
    SealChoice{"Do You Have a Commercial Vented Chest Seal?<br/>(HyFin Vent, SAM Chest Seal, Asherman, Russell, Halo Vent)"}
    CommercialSeal["Apply Commercial Vented Chest Seal<br/>1. Wipe blood and sweat dry around wound<br/>2. Center one-way valve/channels directly over hole at end-exhalation<br/>3. Seal second hole on back if exit wound exists"]
    ThreeSided["Build Improvised Three-Sided Flutter-Valve Dressing<br/>1. Cut airtight plastic square 5 cm (2 in) wider than wound<br/>2. Tape TOP, LEFT, and RIGHT edges airtight to dry skin<br/>3. Leave BOTTOM corner completely UNTAPED to drain blood & vent air"]
    MonitorTension{"Monitor Every 60 Seconds: Worsening Dyspnea, Agitation,<br/>Absent Breath Sounds, Hypotension, or Neck Vein Distension?"}
    BurpSeal["TENSION PNEUMOTHORAX DEVELOPING: BURP THE SEAL NOW<br/>1. Peel back one side of chest seal for 3 to 5 seconds<br/>2. Listen/feel for rush of trapped air and blood escaping<br/>3. Wipe clotted blood off wound and re-apply vented seal<br/>4. ALS Paramedic performs Needle Decompression / Finger Thoracostomy"]
    StableTransport["Continue Monitoring & Reassuring Patient<br/>Position upright or tilted toward injured side until ALS arrival"]

    Start --> CallEMS
    CallEMS --> ImpaleCheck
    ImpaleCheck -->|Yes: Object Impaled| ImpaleChest
    ImpaleCheck -->|No: No Object Present| OpenCheck
    OpenCheck -->|No: Closed Skin| ClosedPneumo
    OpenCheck -->|Yes: Open Chest Wound| SealChoice
    SealChoice -->|Yes| CommercialSeal
    SealChoice -->|No| ThreeSided
    ImpaleChest --> MonitorTension
    CommercialSeal --> MonitorTension
    ThreeSided --> MonitorTension
    ClosedPneumo --> MonitorTension
    MonitorTension -->|Yes: Tension Signs Present| BurpSeal
    MonitorTension -->|No: Breathing Stable| StableTransport
    BurpSeal --> MonitorTension

Kokokanisa makambo ya mbalakaka ya ntolo oyo ekoki koboma moto¶

Traumatisme thoracique mpe ba fuites spontanées ya mopepe ya pleural ebimisaka ba syndromes cliniques mitano ekeseni. Kokesenisa mimpululu ya pɛtɛɛ oyo ekwei na mpota ya ntolo oyo ezali komɛla polele, pneumothorax ya tension, hémothorax monene, to ntolo oyo elɛmbi nde emonisaka ezala esika oyo esengeli mbala moko mpe kolongolama oyo ekobikisa bomoi.

Pathophysiology of a sucking chest wound (Open Pneumothorax)¶

Under normal physiological conditions, when your diaphragm contracts downward and your intercostal muscles pull your ribcage outward, intra-thoracic pressure drops slightly below outside atmospheric pressure (from -4 down to -8 \(\text{cmH}_2\text{O}\)). Because the chest wall is completely sealed, the only pathway for air to enter the chest is down the mouth, trachea, and bronchi, inflating both lungs effortlessly.

The "Two-Thirds Tracheal Diameter" threshold¶

An adult human trachea has an internal diameter of roughly 18 to 24 millimeters (0.7 to 0.95 inches). If a knife blade, high-velocity rifle round, shotgun blast, or impaled fence spike creates an open hole through the chest wall whose cross-sectional diameter is two-thirds the diameter of the trachea (roughly 12 to 15 millimeters / 0.5 to 0.6 inches) or larger, the laws of fluid dynamics dictate that air follows the path of least resistance:

1. Because the short hole through the ribcage offers far less airway resistance than the long, branching bronchial tree, every time the victim tries to inhale, outside room air rushes directly through the hole in the chest wall into the pleural space rather than coming down the windpipe into the lungs.
2. As room air fills the pleural space on the injured side, the lung on that side collapses completely and cannot exchange oxygen.
3. Even worse, as the victim inhales and exhales, stale carbon-dioxide-rich air sloshes back and forth uselessly between the collapsed lung and the healthy lung (Pendelluft or "pendulum air"), while the mediastinum (containing the heart and vena cava) wobbles side to side (mediastinal flutter), rapidly exhausting the patient and causing severe hypoxia and hypercapnia.

Classic signs of an open sucking chest wound¶

• Audible sucking, hissing, or slurping sound coming from the chest or back wound each time the casualty gasps for air.
• Frothy, bright pink or red blood bubbling or sputtering out of the wound during exhalation or coughing (unlike dark red venous oozing or bright red arterial spurting from an arm wound, frothy bubbles prove air from the respiratory tract or pleural space is mixing with blood).
• Subcutaneous emphysema: Air forced under the skin of the chest wall and neck creates a strange, crackling "Bubble Wrap" or "Rice Krispies" sensation (crepitus) when you press your fingers lightly on the skin around the collarbone or ribs.

Step-by-step technique: Applying a Vented Chest Seal or Three-Sided Dressing¶

The immediate goal of first aid for an open chest wound is to convert an open pneumothorax into a simple vented pneumothorax: blocking outside air from sucking in during inhalation while allowing trapped internal air and blood to escape during exhalation.

Method A: Commercial Vented Chest Seal (Gold Standard: CoTCCC & First Aid Guidelines)¶

Modern trauma kits carry purpose-built Vented Chest Seals (such as the HyFin Vent, SAM Chest Seal, Russell Chest Seal, Halo Vent, or Bolin/Asherman seal). These feature an aggressive medical hydrogel adhesive pad equipped with either a raised one-way dome valve or multiple laminar-flow vent channels that let air and blood escape outward while sealing flat against the skin when the patient inhales.

1. Expose the wound and check the back: Cut the shirt away completely. Always check the back and armpits for an exit wound; if there are two holes (an entry and an exit), apply a vented chest seal to the primary sucking hole and a second seal (vented if available) to the exit hole.
2. Wipe the skin around the wound completely dry: This is the step most rescuers forget under stress. Even the best hydrogel adhesive will slide right off skin coated in wet blood, sweat, mud, or rainwater. Use a dry gauze pad inside the chest seal package to briskly wipe a 10-centimeter (4-inch) circle of skin around the hole as dry as possible.
3. Peel the backing and apply at the end of exhalation: If the patient is conscious, ask them to breathe out (exhale) and pause for one second (exhaling pushes extra air out of the pleural space before you seal it). Center the one-way valve or laminar vent channels directly over the hole and press the adhesive firmly from the center outward to eliminate wrinkles.

Méthode B: Kosila improvisé na ngambo misato occlusif Flutter-Valve Dressing¶

Soki ozali na sceau ya ntolo oyo ezali na ventilation commerciale te na kati ya trousse na yo ya secours ya liboso, esengeli otonga Tree-Sided Occlusive Dressing:

1. Luka eteni ya matériel flexible oyo ekɔtaka na mopepe mobimba, oyo ezali na ba pores te: Ba gaze ya pamba esalaka te yango moko mpo mopepe elekaka kaka na coton tissé. Salelá moko ya biloko oyo elandi oyo mopɛpɛ ekɔtaka te:
2. Papier ya kati ya peto to enveloppe ya plastique ya pansement ya gaze stérile to pad ya défibrillateur AED.
3. Carré oyo bakati na saki ya plastique ya congélateur ya makasi, emballage ya gants ya nitrile, to enveloppe ya plastique ya peto oyo ekangami.
4. **Gaze stérile pétrolatum (Vaseline) ezipami na couche ya papier ya papier to ya plastique.
5. Na 10 secondes ya liboso yambo biloko ezala prêt: Beta maboko na yo ya gant mbala moko likolo ya libulu ya kosukola na tango ya kobimisa pema, tombola mua moke litindi ya loboko na yo tango mobeli azali kobimisa mopepe mpo mopepe ebima, pe kokanga yango plat tango azali kopema.
6. Kata carré ya plastique ata 5 centimètres (2 pouces) ya largeur koleka mpota na ngambo nionso: Soki plastique ezali moke mingi, aspiration ya inhalation ekobenda eteni mobimba ya plastique na libulu ya mpota.
7. Kopangusa loposo ya zinga zinga ekauka mpe kotia plastique likolo ya mpota tango mobeli azali kobimisa mpema.
8. Tape ba côtés MISATO entièrement hermétique, tika coin ya SE to côté ya minei entièrement UNTAPED:
9. Pakola ruban médicale ya large to ruban conduite oyo ezipaka mobimba bord ya likolo, bord ya gauche, mpe bord ya droite ya carré ya plastique mpo mopepe moko te ekota na se ya ba bords misato wana.
10. Tika bord ya se (to coin ya se oyo etali gravité) ezanga ruban mobimba.
11. Ndenge soupape ya flutter esalaka: Tango mobeli apema, pression négative na kati ya ntolo ebendaka feuille ya plastique oyo ekangami te mpe ekoma na mayi na loposo, ekangami na libulu na mopepe makasi mpo mopepe ya libanda ekota te. Ntango mobɛli abimi mpe kosukosu, pression positive na kati ya ntolo epusaka mopepe mpe makila oyo ekangami libanda uta na nse ya nsɔngɛ ya nse oyo ekangami te na kasɛti lokola valve ya flapper ya nzela moko.

Koyeba mpe kosalisa Pneumothorax ya Tension ("Kopanzana na Sceau") .¶

Pneumothorax ya tension ezali catastrophe mécanique oyo ebomaka mbala moko oyo ekoki kobima soit na fracture ya mokuwa ya mokɔngɔ oyo ekangami / laceration ya poumons to tango pandage ya mpota ya ntolo oyo efungwami ekomi kokangama to ekangami na ngambo nyonso minei.

Ndenge nini pneumothorax ya tension ebomaka (Choc Obstructif) .¶

Na mpema nyonso, mililitre 50 kino 100 ya mopɛpɛ ebimaka na mimpululu oyo epasuka mpe ekɔtaka na esika ya pleural oyo ekangami mpe ekoki kokima te kozonga na kati ya ba bronches to kobima na efelo ya ntolo: 1. Pression na kati ya côté ya ntolo oyo ezoki emati de négatif (-5 \(\text{cmH}_2\text{O}\)) à positif makasi (+15 à +30 \(\text{cmH}_2\text{O}\)). 2. Banyataka mimpululu oyo ezoki na nse mpe ekómaka mwa boule moko oyo ezangi mopɛpɛ na hilum, nzokande diaphragme oyo ezali na ngámbo wana epusami na nse na libumu. 3. Poche oyo ezali kopanzana ya mopepe ya pression makasi ezali kotindika médiastinum mobimba (motema, aorta, vena cava supérieure, vena cava inférieure, mpe trachée) na ngambo na ngambo ya ntolo oyo ezoki te, kofina poumon ya malamu oyo etikali. 4. Etape ya koboma: Lokola vena cava supérieure mpe inférieure ya mur mince ezongisaka makila désoxygénée na côté droit ya motema na ba pressions veineuses ya nse mingi (kaka 2 à 8 mmHg), déplacement médiastinal e kinks ba veine minene nionso mibale lokola tuyau ya jardin oyo egumbami. Makila ekoki lisusu kokota na motema te (précharge ekiti na zéro), sortie cardiaque ekiti makasi, mpe mobeli azali ko souffrir arrêt cardiaque sans pulsée activité électrique (PEA) na pure mécanique choc obstructif.

Ba 7 drapeaux rouges cliniques ya Tension Pneumothorax¶

Tala mobeli nyonso ya traumatisme ya ntolo lokola faucon mpo na bilembo oyo elandi ya komata ya pression intrathoracique:

Etape na etape: Ndenge ya "BURP" Seal ya Ntolo mbala moko¶

Soki moto oyo azwi likama oyo alati eloko oyo batɛkaka na ntolo to elamba ya plastiki oyo ezali na ngámbo misato amonisi n’o moko ya bilembo ya likebisi oyo ezali awa na likoló (kobeba nzala ya mopɛpɛ, kobulungana, mbɛbu ya langi ya bule, to kolɛmba ya pulse):

1. Simba coin moko ya sceau ya ntolo to pansement ya plastique na misapi ya gants mpe longola yango lisusu na loposo mpo na kobimisa libulu ya mpota mobimba.
2. Fina na malembe na loposo pembeni ya mpota to zela tango mobɛli azali kobimisa mpema na boumeli ya 3 to 5 secondes: Tango pneumothorax ya tension ya solo ezali, okoyoka mbala moko to okoyoka kopumbwa makasi to hiss ya mopepe oyo ekangami mpe makila ya mousse oyo ezali kobima na mpota, elandi na kati ya ba secondes na mobeli kopema mozindo mpe langi mpe pulse na bango ekobonga.
3. Kopangusa bouchon ya makila oyo ekangami: Salelá gaze stérile mpo na kopangusa biloko nyonso ya minene oyo ezali lokola gelée oyo ezalaki kokanga nzela ya mpota to valve ya nzela moko ya sceau ya ntolo.
4. Kozongela lisse ya sceau ya ntolo oyo ezali na mopepe (to kopakola oyo ya sika ya peto) na suka ya kobimisa mpema: Soki valve ya sceau ya ntolo ekangami na makila na elikya te mpe ozali na sceau ya ventilation ya rechange te, tika coin sans bande to tika mpota ezipami kaka na gaze stérile oyo ekangami te, oyo ekɔtaka na mopepe ntango ozali kolandela makila oyo ezali kobima.

Ndenge nini ba Paramédicaux mpe minganga ya ALS basalisaka Pneumothorax ya Tension Fermée¶

Soki mobɛli azwi pneumothorax ya tension oyo ezali na libulu ya libanda te na efelo ya ntolo (ndakisa, nsima ya kobɛta volan na ndenge ya pɛtɛɛ, kokwea ya motuka, to kobukana ya bleb na mbalakaka), ezali na eloko moko te oyo ekangami na ntolo mpo na kopumbwa. Ba paramédicaux ya soutien de vie avancé (ALS) na ba cliniciens ya traumatisme basalaka mbala moko Décompression ya Thoracostomie à aiguilles: * Kokotisa cathéter ya molai, ya monene (10-to-14-cauge, 8,25-centimètre / 3,25-inch) likolo ya aiguilles mbala moko likolo ya bord ya likolo ya mokuwa ya nse (mpo na koboya artérie intercostale, veine, mpe nerf oyo ezali kotambola na rainure na nzela ya na nse bord ya mokuwa moko na moko) soit na 5e espace intercostal na ligne antérieure/mid-axillaire (site préféré ya ATLS 10e Edition moderne na ba grands) to espace intercostal 2ème na ligne milieu claviculaire, mbala moko ko ventiler mopepe pressurisé na hiss audible tiii tango bakotia tube ya ntolo (thoracostomie tube) ya définitif.

Positionnement optimal ya malade na gestion ya Flail Chest¶

Ndenge ya ko positionner malade oyo azali na blessure ya ntolo¶

• Koyeba mpe kopema: Tika mobeli afanda semba to semi-recliné na angle ya 45 à 60 degrés (position ya Fowler), to kogumbama mwa liboso na mabolongo na ye (position ya tripode). Kofanda semba esalela gravité mpo na kobenda binama ya libumu na nse longwa na diaphragme mpe ekobaka kosangisa makila ya pleural (hémothorax) na nse ya cavité ya ntolo mpo ete ba lobes ya likolo ya mimpululu ekoka naino kopema.
• Kobalusa epai ya ngambo oyo ezoki (ntango olingi): Soki mobɛli azali na mpota ya ntolo oyo ekangami to mikuwa ya mokɔngɔ oyo ebukani na ngámbo moko mpe alingi kogumbama, kobalusa yango mwa moke na ngámbo oyo ezoki ekangisaka mikuwa ya mokɔngɔ oyo ezali kosala mpasi na etanda to na oreiller mpe epesaka nzela na poumon ya likoló oyo ezoki te bonsomi mobimba epanzana mobimba kozanga makila to biloko oyo ebimi na ngambo mosusu carina na kati ya mimpululu ya malamu.
• Kozanga koyeba mpe kopema (kozanga kozoka na mokuwa ya mokɔngɔ): Tia mobɛli na position ya récupération latérale na côté YOKA NA SE (poumon ya santé likolo). Kotiya ngámbo oyo ezoki na mabele esalaka ete makila oyo ebimaka na kati ya mimpululu oyo ebebi esopana te na kati ya bronche ya lititi monene mpe ezindisa mimpululu oyo ezali malamu, nzokande kotika mimpululu ya likoló oyo ezali malamu epanzana na bonsomi nyonso.

Lisalisi ya liboso mpo na Flail Chest (Multiple Broken Ribs na Mouvement Paradoxal)¶

Ntango impact ya énergie makasi ebukaka mikuwa mibale to koleka ya mikuwa oyo ezali pembenipembeni na bisika mibale to koleka, eteni wana ya rectangle ya mokuwa ya mokɔngɔ ebungisaka boyokani na yango ya mikuwa na eteni mosusu ya efelo ya ntolo. * Ndenge emonanaka (Paradoxical Breathing): Tango mutu azali kopema IN, pression négative na kati ya ntolo ezo sukola segment ya côte flottant oyo ebukani NA KATI pendant que ntolo oyo etikali ezo tambola libanda; tango ba pema OUT, segment oyo ebukani ezo souffler LIBANDA. * Mpo na nini tozali LISUSU te na ruban ya mikuwa ya mokɔngɔ to kotya basaki ya zelo ya kilo na ntolo ya flail: Eleki bambula mingi, babikisi bazingaki makasi bandage élastique zingazinga ya mokuwa mobimba ya mokɔngɔ to batyaki saki ya zelo ya kilo na eteni moko ya flail. Baekzamɛ ya minganga emonisaki ete kokanga efelo ya ntolo to kotya kilo na yango na basaki ya zelo epekisaka mimpululu oyo ezali malamu te, ebebisaka atelectase (kokwea ya alvéolaire), mpe esalaka nokinoki ete moto apema malamu te. * Soin ya mikolo oyo oyo esalemi na ba preuves pona Flail Chest: 1. Kozinga ata moke te ruban circonférence to bandages élastiques na ntolo. 2. Salelá "Self-Splinting" ya malembe na oreiller doux: Fandisa mobeli oyo azali na conscience semi-semba mpe pesa bango oreiller ya mbeto ya doux, couverture pliée, to veste ya peluche mpo na kosimba na malembe na mikuwa ya mokɔngɔ oyo ezoki na lobɔkɔ na bango moko, mingimingi ntango ozali kosukosu to komata likoló ya ba boule. 3. Bomibongisa mpo na kosunga kopema: Lokola likama ya solo ya bomoi na ntolo ya flail ezali contusion pulmonaire ya mozindo (tissus pulmonaires oyo ezongisi, oyo etondi na mai) mbala moko na nse ya mikuwa ya mokɔngɔ oyo ebukani, mbala mingi bato ya maladi balɛmbaka mpe basɛngaka ventilation ya sac-valve-mask (BVM) na pression positive mpe intubation na lopitalo.

Intervention ya secours ya liboso mpo na mpota ya ntolo oyo ezali komela ezali moko ya bandakisa ya polele esika oyo action simple na miniti mibale ya liboso epekisaka directement arrêt cardiaque. Tala kozwa cours ya secours ya liboso oyo endimi, Stop the Bleed, to tactique ya soins ya urgence ya ba victimes na nzela ya société nationale na yo ya Croix-Rouge to Croissant-Rouge, Collège américain ya ba chirurgiens, to St John Ambulance mpo na kosala pratique ya application ya sceau ya ntolo elongo na molakisi.

Mituna oyo batunaka mingi¶

Ba sources e vérifié¶

• Comité ya soins ya ba victimes ya combat tactique (CoTCCC / Système ya ba traumatismes conjoints, Etats-Unis): Mabongisi ya TCCC mpo na basali ya monganga: Bokambami ya Pneumothorax Ouvert (Scelles ya ntolo oyo ezali na ventilation), Burping, mpe Décompression ya Pneumothorax na Tension.
• Collège américain ya ba chirurgiens (ACS, Etats-Unis): Manuel ya cours ya ba élèves ya soutien de vie ya traumatisme avancé (ATLS) (10e édition): Traumatisme thoracique, Pneumothorax ouvert, ntolo ya flail, na hémothorax massif.
• Comité internationale de liaison sur la réanimation (ILCOR, International) & Association américaine du cœur / Croix-Rouge américaine: Boyokani na oyo etali science na ba recommandations ya traitement (CoSTR) pona gestion ya ba soins ya liboso ya ba blessures ya ntolo ya polele.
• Institut National ya Excellence ya Santé mpe ya Soins (NICE) & NHS (Royaume-Uni): Traumatisme ya minene: Evaluation mpe gestion ya liboso ya traumatisme ya ntolo na ba environnements avant lopitalo mpe lopitalo (NG39).
• Société thoracique britannique (BTS, Royaume-Uni): Bokambami ya bokono ya pleural: Bokambami ya Pneumothorax spontané mpe traumatique.
• Conseil européen ya réanimation (ERC, Europe): Mabongisi ya secours ya liboso mpe Arrêt cardiaque traumatique (Ba causes réversibles: Pneumothorax ya tension).

Ba guides oyo etali yango¶

• Impalement mpe stabilisation ya objet étranger intégré
• Contrôle ya hémorragie makasi na ba tourniquets
• Evisceration ya libumu mpe soin ya ba blessures ya libumu ya polele
• CPR mpe réanimation ya arrêt cardiaque
• Reconnaissance ya choc na soins ya urgence
• Ba numéros ya urgence na dispatch international