Tshipese tshidi tshilamakaja ku munu muwule: Tshilamba tshia kuela natshi menu kumpala kua njiwu ya kukosa¶

Tshifulu tshidi tshikuate ku munu udi mujuke kunyima kua disama dia tshianza, dikuma dia nyunyi, ditshibuka, diosha, disama dia difu, biakudia bidi ne sodium wa bungi, anyi disama dia mifuba ki ntshilumbu tshia dilengeja dia mpala to: ntshilumbu tshia lukasa tshia mijilu tshidibu babikila mu lupitadi ne: Ring Tourniquet Syndrome. Bu mudi tshilamba tshia tshiamu katshiyi mua kudiunda, nansha dikola dikese dia tshilamba tshia ku munu ne tshia ku tshiadi didi dipangisha mijilu idi ne bukole bukese idi ipatula mashi mu munu eku mijilu ya tshiamu idi ne bukole bua bungi itungunuka ne kupompa mashi mapiamapia kupitshila ku tshilamba tshia munu too ne ku nsongo ya munu. Mu ma nsa makese, tshintu etshi tshidi tshikebesha dikola dia mashi, dipanga dia mashi mu mijilu, disama dia dikoba, disama dia gangrene, ne dikosa dia munu dia kashidi.

Lekela kukoka, kunyunguluka, anyi kukoka bikole pa tshilamba tshiume tshiuwule diakamue. Dikoka dia bukole misangu ne misangu didi ditapa tshitupa tshia mubidi tshidi pabuipi ne tshiadi (PIP) ne didi dijula ​​tshipupu tshia disama tshidi tshivula misangu ibidi mu minite 10. Pamutu pa nanku, enza mudimu ne tshiamu tshia or tshia tshibambalu tshia malu a mpukapuka tshia mu lupitadi tshia Distal-to-Proximal Compression Wrap (Dental Floss / Elastic String Method) tshisangisha ne dibandisha ne dienza dia glace, anyi ndaku buludiludi ku tshibambalu tshia malu a mpukapuka anyi ku nzubu wa kapia bua kukosa tshilamba kumpala kua lufu lua mijilu ludi kaluyi mua kupingana.

Enza nunku mpindieu¶

1. Tangila bimanyinu bia "Red-Flag" Vascular Ischemia anyi Open Fracture mpindieu. Ndaku buludiludi ku tshibambalu tshia malu a mpukapuka tshia mu lupitadi (anyi ubikile nimero ya malu a mpukapuka ya muaba unudi: 911 mu États-Unis ne mu Canada, 112 mu Union européenne mujima, 999 mu Royaume-Uni; tangila nomba ya tshimpitshimpi) ne kutetshi bua kuela nshinga kumbelu pikala nsongo ya munu mutoke, bule/mukunze (cyanotic), anyi mutoke, umvua mashika a mashika anyi kayi wenza mudimu bimpe, udi wangata sekonde mipite pa 2 bua dikala dia rose dipingane paudi ufina dikasa dia munu (kapilare udi muenze matuku a bungi), anyi pikala munu muikale ne peni mutshibuke mufuba, anyi tshitupa tshia mubidi tshidi tshinyanguke.
2. Lekela kukoka ne ubandishe tshianza tshiebe pa mutu pa mutshima webe munkatshi mua minite 10 anyi 15. Teka tshianza tshiebe pa tshibandilu tshile anyi ukuate tshianza tshiebe tshilulame mu lupepele paudi wela anyi ukuata munu mu mayi mashika (kaayi mashika) anyi mu tshibombi tshia mâyi a mashika tshibuikila mu tshilamba tshitekete munkatshi mua minite 10. Bukole budi bukokela bintu budi bukoka mashi a mu mishipa mu munu eku mashika adi akolesha mishipa ya mashi.
3. Ela mayi a edema kunyima mutangile ku tshianza ne ela munu ne lubricant mukole. Kubanga ku nsongo ya munu ne kuya ku tshianza ne ku tshianza, fina munu bikole ne tshianza tshiebe tshikuabu bua kuela mâyi adi makuate kupitshila ku tshianza mu tshianza. Ela munu mujima ne lukoba ludi muinshi mua tshilamba ne Windex (tshintu tshia kusukula natshi makala tshidi katshiyi ne ammoniaque), nsabanga wa mâyi, vaseline, vaseline wa KY, mafuta a mineral, anyi manteka ne wela tshilamba kumpala ne panyima bitekete bitekete wenza mudimu ne tshienzedi tshia "kunyunguluka" pa mutu ne kuinshi kua tshianza.
4. Bikala dilengeja dia meno kadiyi dikumbane, enza Distal-to-Proximal Dental Floss anyi Ribbon Compression Wrap. Ela nsongo ya tshitupa tshia 90-centimetre (36-inch) tshia waxed flat dental tape/floss, tshilamba tshia soie tshitekete, anyi tshilamba tshia tourniquet tshidi katshiyi ne latex **kuinshi kua tshianza too ne ku tshianza. Kutuadijila pa mutu pa tshiadi tshia munkatshi tshidi tshiuwule (pabuipi ne nsongo ya munu), ela tshilamba tshia ku tshianza tshikole mu mishindu idi kayiyi ne tshitupa kuinshi mutangile ku tshilamba bua kufina tshianza tshidi tshiuwule, pashishe upuekesha mukila ku luseke lua tshianza bua kuendakana ne tshilamba tshia tshianza tshidi katshiyi ne lutatu.
5. Kulekedi tshintu tshia kukanga nabi munu mu minite mipite pa 3 anyi 5 musangu umue to. Tshilamba tshia kuela natshi meno tshidi tshifina mashi bua tshitupa tshîpi; utshibulule diakamue padi tshilamba tshienda tshiya kumpala, anyi utshipatule tshionso tshikala tshilamba katshiyi tshinyunguluka mu minite 3.
6. Bikala tshifulu tshienza ne tungsten carbide, titanium, ceramic, anyi stainless steel ne katshiyi mua kusesuka, ndaku diakamue ku tshibambalu tshia kapia anyi ku nzubu wa malu a njiwu. Biamu bia kale bia kuenza nabi mudimu ne bianza kabiena mua kukosa tungsten carbide anyi titanium to; bipese bia tungsten bidi ne tshia kuikala bipanda bimpe ku diambuluisha dia pinces de vise-grip anyi kutshibula ne tshiamu tshia diamant tshidi tshinyunguluka.

flowchart TD
    A["Tshipese tshilamakaja ku munu muwule"] --> B{"Mutu wa munu mutoke/bule/mutoke, mutoke, mashika, mupuya wa kapila > 2 sec, anyi mufuba mutshibuka/mukosa?"}
    B -->|"Eyowa: Disama dia mashi anyi ditshibuka"| C["KUKENJI ne tshingoma to: Ela tshianza mulu ne uya diakamue ku lupitadi lua ER bua kukosa tshingoma tshia lukasa"]
    B -->|"Tòo: Munu udi ne mpala wa rose, udi ne luya, udi umvua bimpe, kakuena ditshibuka to"| D["Tshitupa 1: Lekela kukoka; bandisha tshianza pa mutu pa mutshima + ela tshintu tshia mashika mu minite 10-15"]
    D --> E["Tshitupa 2: Mabele adi avula too ne ku tshianza + wela mafuta a bungi (sabuni wa kusukula nabi malonga, Windex, vaseline)"]
    E -->|"Tshipese tshitshidi tshilamakaja kunyima kua tshiadi tshia PIP tshidi tshiuwule"| F["Tshitupa 3: Enza dibuikila dia menu dia distal-to-Proximal Waxed Dental Tape (< 3 mins per pass)"]
    F -->|"Tshipese tshitshidi tshilamakaja kunyima kua 2 wrap passes"| G{"Tshifulu tshienza ne tshiamu kayi?"}
    G -->|"Or, Arjan, Platine, tshiamu tshia mitaku, anyi tshiamu tshia mitaku"| H["Enda ku lupitadi lua lukasa, ER, Fire Station, anyi Jeweler bua kupeta tshiamu tshia mitaku tshia tshiamu tshia mitaku"]
    G -->|"Tungsten Carbide, Ceramic, anyi Meteorite"| I["Ingidija Vise-Grip Locking Plier incremental fracture method OR ER diamond rotary cutter"]
    G -->|"Titanium, Cobalt Chrome, anyi Damascus Steel"| J["Enda ku ER anyi ku Fire Department bua kupeta tshiamu tshia diamant tshidi ne mashinyi tshidi ne mayi mashika"]

Bua tshinyi tshilamba tshidi tshilamakaja tshidi tshilua tshilumbu tshia dipanda (Ring Tourniquet Syndrome)¶

Kumvua mushindu udi mubidi wa munu webe kudi kumvuija bua tshinyi kukoka bikole kudi kuenza bua tshilamba tshidi tshilamakaja tshikale tshikole ne bua tshinyi kuindila "too ne malaba mu dinda" kudi mua kukujimijila munu webe:

1. Dibuela dia mu mishipa ne dipatuka dia mu mishipa: Mashi adi abuela mu munu webe kupitshila ku mishipa ibidi mikole idi yenda ku nseke ya munu ne tension wa mashi mukola (pabuipi ne 90 too ne ku 120 mmHg). Mashi adi afuma ku munu webe kupitshila mu mishipa ya pa mutu idi ne bimanu bitekete bidi kunyima kua munu ku bukole bukese menemene (pabuipi ne 10 too ne ku 20 mmHg).
2. The One-Way Check Valve Trap: Padi munu webe uvula bua disama dia tshiadi, dia nyuki, dia dilolo dia mukele, anyi dia kapia, tshiamu tshikole tshidi tshifina kumpala mijilu idi ne bukole bukese, tshipangisha mashi ne mâyi a mu mashi bua kupatuka mu munu. Mu tshikondo atshi, mishipa ya mashi idi ne bukole bua bungi idi itungunuka ne kupompa mashi mapiamapia mu munu panyima pa tshilamba.
3. Dibutuka dia tshiadi: Tshitupa tshia Proximal Interphalangeal (PIP) (tshiamu tshiebe tshia pankatshi) tshidi ne milonda ya synovial idi kayiyi mikole ne milonda idi ipatuka pambelu ne mâyi adibu bakuate. Dîba dionso diudi ukoka tshilamba tshiume, udi ukosa dikoba pa mutu pa tshitupa tshia PIP ne wenza bua histamine ne prostaglandine bipatuke, bikudimuna dikasa dilue tshintu tshikole tshidi ne bule bua tshilamba misangu ibidi.
4. Tshitupa tshia mu tshitupa ne lufu lua mubidi: Padi tshitupa tshia mubidi tshidi tshivula munda mua munu tshibandila pa mutu pa bukole bua dibuela dia mashi mu mishipa (30 mmHg), dienda dia mashi mu mishipa didi ndekelu wa bionso dijika kabidi. Mu mêba 4 too ne ku 6 a disama dia ischémie dijima, mijilu ya ku bianza idi ipeta disama dia kashidi, mijilu idi ifua, ne dikoba didi muinshi mua tshilamba didi dinyanguka too ne ku mufuba. Bua malu makuabu adi akebesha bitupa bia mubidi bidi kabiyi ne tshiadi, bala bulombodi buetu pa tshitupa tshia mubidi tshidi katshiyi ne mashi, dikanga dia mashi, ne tshitupa tshia mubidi tshidi katshiyi ne mashi.

Tablo wa 60-Second Neurovascular Triage¶

Tangila munu webe udi mukuatshike pa tshimfuanyi etshi tshia disungula dia mu lupitadi kunyima kua minite 15 yonso too ne padi tshilamba tshijika:

Mushindu 1: Mushindu wa "Kubandila + Mashika + Kuela mabele + Lubricant"¶

Shi munu obe udi mu Tshitupa tshia 1 (mutoke, wa luya, udi umvua bimpe, kayi ne ditshibuka) ne muwule anu kakese, 60 pa lukama ya bipese bidi bikuate bidi bipatuka ne tshilele etshi tshia diumusha dia munu tshia mu bitupa binayi kakuyi dijinga dia kuela nshinga anyi kutshikosa:

1. Bandisha pa mutu pa mutshima mu minite 10: Ikala panshi ne uteke diboko diebe muulu bua tshianza tshiebe tshikale ne bule bua santimetre 30 (12 inches) kupita mutshima webe. Enza bitekete bitekete, bitekete bitekete "pompa" ne minu yebe (kuyi utshinyisha tshitupa tshidi tshiuwule) bua kuambuluisha mashi a mu mishipa bua kupueka mu diboko diebe dia kumpala.
2. Ela mayi mashika anyi tshibombi tshia mabue a mashika mu minite 10: Ela munu webe mu tshilamba tshia kusukula natshi mâyi mashika a mashika (anyi kuata tshibombi tshia mashika tshibuikila mu tshilamba tshitekete ku munu ne ku tshianza) munkatshi mua minite 10. Kuena ne bua kuela mashika anyi kuela dikoba mu mashika to, ne lekela kuenza mashika diakamue pikala munu mulue mutoke.
3. Wenza "Retrograde Edema Milking": Kumpala kua kuela lubricant, udi mua kuela munu webe munene ne munu wa tshianza tshia balume bikole pa munu udi muwule anu pa mutu pa dikasa dia pankatshi (pankatshi pa dikasa ne tshilamba). Fina bikole munkatshi mua masekonde 10 bua kufina mayi a mubidi wa tshiponji kunyima muinshi mua tshilamba mutangile ku tshianza tshiebe.
4. Ela lubricant wa High-Slip ne wenza mudimu ne "Top-To-Bottom Walk":
5. Ela munu mujima ne ukoke kikoba bua kuela mafuta buludiludi muinshi mua tshilamba tshia ku tshianza. Mafuta mimpe a mu nzubu bilondeshile mushindu udiwu mua kusesuka: mafuta a kuondopa nawu mu mayi (KY Jelly), tshintu tshia kusukula natshi makopo tshia Windex (tshidibu benza natshi mudimu kudi bena mudimu bonso bapiluke bualu bintu bidimu bidi bienza bua dikoba dikale dilengeja bikole kakuyi mafuta), sabuni wa malongo wa mâyi (Dawn/Fairy) **, **petrole, **Jelly, ** mafuta a mabue/mafuta a bana, anyi mafuta a nkunde/mafuta a olive.
6. Kukoki bululame kumpala nansha kakese. Pamutu pa nanku, fina tshitupa tshia ku mutu tshia tshilamba tshikole panshi mu dikoba ditekete dia panyima pa munu webe eku wela tshitupa tshia kuinshi tshia tshilamba kumpala pa mutu pa tshitupa tshia kuinshi tshia dikasa, pashishe tshinyunguluke kuulu too ne kuinshi anu bu muudi wenda ne tshilamba tshikole tshidi tshipatuka ku tshikasa.

Mushindu 2: Tshibambalu tshia malu a tshimpitshimpi "Dental Floss / String Compression Wrap" (Distal-to-Proximal Protocol)¶

Padi dikasa dia munkatshi (PIP) divula dienza tshimanu tshinene tshia tshiamu tshia nshinga kumpala kua tshilamba tshidi lubricant kayi mua kusabuka, baminganga ba lukasa ne baminganga ba bianza batu benza mudimu ne Compression Wrap Technique.

flowchart TD
    A["Longolola 90 cm (36 in) ya tshilamba tshia meno tshia wax, tshilamba tshia soie tshitekete, anyi tshilamba tshia tourniquet tshidi tshikola"] --> B["Tshitupa 1: Pita 15 cm (6 in) ya ndekelu muipi MUINSHI mua tshilamba tshidi tshilamakaja ku tshianza tshiebe anyi ku tshianza tshiebe"]
    B --> C["Tshitupa 2: Ulue ne tshitupa tshile tshidi tshienza mudimu UP kupitshila ku tshitupa tshia pankatshi tshidi tshiuwule (PIP)"]
    C --> D["Tshitupa 3: Ela tshilamba pa mutu pa dikasa ne tshikuate bikole KUINSHI mutangile ku tshilamba (kakuyi mpata pankatshi pa bipese)"]
    D --> E["Tshitupa 4: Ela ndekelu muinshi mua tshibombi tshia ndekelu pabuipi ne tshilamba bua tshiadi tshikale tshitambakane"]
    E --> F["Tshitupa 5: Koka mukila muipi wa ku tshianza mulu ne kumpala mutangile ku nsongo ya munu: bipese bidi biunzuluka bidi bienda ne tshingoma pa mutu pa dikasa"]

Mikenji ya tshitupa ku tshitupa bua tshilamba tshia meno tshia Distal-to-Proximal¶

Ntshinyi tshia kuenza natshi mudimu: - Bimpe kumbelu: Tshilamba tshia meno tshienza ne tshiamu tshia wax (tshialabale ne tshilengeja kupita tshiamu tshia meno tshidi tshinyunguluke bua katshiyi tshikosa dikoba didi diuwule), ⅛-inch (3-millimeter) satin gift ribbon, anyi tshilamba tshitekete tshia elastic tshikosa ku tshilamba tshia luondapu tshidi katshiyi ne latex anyi tshia kuenza natshi manaya. - Kuenza mudimu nansha kakese: Tshilamba tshia kusonga natshi, muonji wa kuloba, anyi tshiamu tshia mitaku, tshidi tshienza mudimu bu tshiamu tshia kukosa natshi fromaje pa dikoba didi dikola.

Dienza (didi diangata minite 2): 1. Ela mukila muinshi mua tshilamba: Kosa tshilamba tshia menu tshia bule bua 90-to-100-centimetre (36-to-40-inch). Ela bu 15 centimètres (6 inches) ya ku muelelu umua muinshi mua tshilamba tshidi tshilamakaja tshileja ku tshianza tshiebe/tshianza tshiebe. - Ufila tshia kuenza pikala tshilamba tshikole bua kuela tshilamba tshia nshinga muinshi muatshi: Kunama nsongo mikosa ya bobby pin, tshiamu tshia kusonga natshi (ku ndekelu kua mêsu), tshiamu tshia kusonga natshi menu tshia plastique, anyi nsongo ya plastike mikole ya tshiamu tshia kuela natshi menu muinshi mua tshilamba bua kukoka tshilamba etshi kuyi ukosa dikoba. 2. Tuadija kujika KU MUTU (Distal to) ku tshianza tshia pankatshi tshidi tshiuwule: - Angata muelelu mule wa tshiamu tshia menu (muelelu wa 75-centimetre ku luseke lua dikasa dia tshilamba) ne uolole too ne ku luseke lua kule lua dikasa diebe dia munkatshi (PIP) (pankatshi pa dikasa diebe dia pankatshi ne dikasa diebe dia munu). - Kuata tshilamba tshikese anyi lomba muntu udi ukuambuluisha bua kukuata tshilamba tshia ntuadijilu anu panyima pa tshianza tshidi tshiuwule bua katshiseki to. 3. Lupepele lukole mu bipese bidi bilenga KUNYIMA ku tshijengu: - Udi mua kuela tshilamba tshia meno bimpe ku munu, wenze mudimu kumbukila ku mutu kua dikasa didi diuwule panshi too ne ku tshilamba tshidi tshilamakaja. - Ikala mushindike ne: tshiamu tshionso tshidi tshilenga tshiamu tshia kumpala ne dikoba dia ZERO didi dipatuka pankatshi pa milongo ya tshiamu tshia nshinga. Paudi wenda unyunguluka pa tshianza tshia munkatshi tshia mafuta mutangile ku tshilamba, neumone tshiamu tshia nshinga tshifina mâyi adi makuate muinshi mua tshilamba mu tshianza tshiebe. - Tungunuka ne kukunguluka too ne padi tshilamba tshifika ku muelelu wa kumpala kua tshilamba, pashishe ukuate ku ndekelu (anyi utshikuate ku tshianza tshiebe). 4. Ela ditontolola dia nsabanga ya kusukula nayi malonga anyi Windex pa tshilamba tshibuikila: - Ela matonsi abidi a nsabanga ya malonga anyi Windex buludiludi pa tshilamba tshia meno tshidi tshibuikila dikasa diebe bua tshiamu tshia mitaku tshienda tshipita pa tshilamba tshia meno kakuyi dikokangana nansha dikese. 6. Umbusha ku mukila wa ku luseke lua tshianza bua kuenda ne tshifulu pa mutu pa tshiadi: - Kuata muelelu muipi wa tshilamba tshiudi muele muinshi mua tshilamba mu tshitupa tshia 1 (mukila wa ku luseke lua tshianza). - Koka mukila au muulu ne kumpala mutangile ku nsongo ya munu webe, umubandishe pamue ne munu eku wenda unyungulula bitekete bitekete tshibombi ku tshibombi tshidi tshinyunguluke munu. - Bu mudi mukila au upita muinshi mua kuinshi kua tshilamba, tshijengu tshionso tshiudi unzulula mu mushindu wa tshiamu mashinyi ne udi utuma tshilamba kumpala pa tshibandilu tshia dental-floss, tshitshikosa anu pa mutu pa tshiadi tshia pankatshi tshidi tshibalakane mu masekonde 10. 7. Bikala dikasa dinene be: Misangu mikuabu, dipasa dimue didi difikisha tshingoma munkatshi mua dikasa dia PIP. Kuata tshilamba pa muaba au, ubulule tshilamba tshia kuela nabi mishiku lukasa bua mashi apita mu sekonde 60, ne upingaje tshilamba tshibidi tshia tusunsa 60 kumpala kua tshilamba bua kumbusha milimetre wa ndekelu.

Mishindu mikuabu ya lupitadi: "Two-Thread Caterpillar Technique" ne Magants Elastiques¶

Shi dikasa diebe dia pankatshi didi ne disama dia nsongo anyi didi ne dikoba dinene didi dienda dibuela kumpala kua tshilamba padibu badiunzulula, teta umue wa ku mishindu ibidi eyi idibu benza nayi mudimu kudi baminganga ba malu a mpukapuka:

1. The Two-Suture / Two-Floss "Caterpillar" Walk: Pamutu pa kuela tshianza tshijima mu nshinga 30, ela bipese bibidi bishilangane bia 30-centimetre (12-inch) bia tshilamba tshia menu tshia wax muinshi mua tshilamba ku nseke mishilangane ya munu (ku luseke lumue/ku luseke lumue kuinshi/ku luseke lua tshianza). Lomba muntu udi ukuambuluisha bua kukoka tshingoma tshia kuulu bikole ku dikasa diebe bua kulengeja tshitupa tshia kuulu tshia dikoba paudi wenda unyungisha muelelu wa kuulu wa tshilamba kumpala 2 milimetre, pashishe ukoke tshingoma tshia kuinshi bikole bua kulengeja tshitupa tshia dikoba tshia ku tshianza paudi wenda unyungulula muelelu wa kuinshi wa tshilamba kumpala. Dishintakaja dia bukole bua kuulu ne kuinshi didi dienda ne tshilamba pa mutu pa dikasa dia osteoarthrite kakuyi dipangisha dienda dia mashi too ne ku mutu kua munu.
2. The Elastic Nitrile Glove Finger-Sleeve Trick: Kosa tshintu tshimue tshia munu tshidi tshikuata non-latex nitrile medical exam glove (kosa tshitupa tshia munu tshikanga bua tshikale tshintu tshidi tshikola). Ku diambuluisha dia tshiamu tshia bobby pin, koka tshitupa tshia kuinshi tshia tshilamba tshia nitrile muinshi mua tshilamba tshidi tshilamakaja, olola tshiamu tshia nitrile bikole pa tshianza tshiebe tshia pankatshi tshidi tshiuwule bua tshiamu tshia elastic tshikuate tshitupa tshia mubidi bimpe, ela pambelu pa tshilamba tshia nitrile ne nsabanga wa mâyi, ne ukose tshilamba tshia nitrile ku dia balume pa mutu pa tshilamba tshidi tshilamakaja.

Mushindu 3: Kukosa anyi kutshibula tshipese (Tshiamu tshia tshiamu ku tshiamu)¶

Shi munu udi uleja disama dia mu tshitupa tshia 2 anyi tshia 3, udi ne ditshibuka anyi ditshibuka, anyi kayi wenza mateta abidi ne tshilamba tshia kukanga natshi, tshiamu tshidi ne bua kukoshibua anyi kutshibula diakamue.

Bilamba bia mabaka bia matuku etu aa ne mpeta ya bilamba kabiena kabidi bienza anu ne or anyi arjan to. Bintu bipite pa 40 pa lukama bia bilamba bia dibaka bia balume bidibu bapana lelu mbienza ne biamu bikole bia mu midimu (tungsten carbide, titanium, cobalt chrome, Damascus steel, anyi zirconium ceramic) bidi bibutula diakamue biamu bia dikosa nabi mikanda bia ku bianza. Umanye tshiamu tshidi ku munu webe kumpala kua kusungula tshiamu tshia mudimu:

Mushindu kayi udi "Vise-Grip Locking Plier Technique" umbusha tshiamu tshia Tungsten Carbide anyi tshia Ceramic mu masekonde 15¶

Bibambalu bia malu a mpukapuka, nzubu ya kapia, ne biamu bia mudimu bia ku nzubu bidi mua kumbusha tshiamu tshikole tshia tungsten carbide anyi ceramic lukasa ne mu bukubi kupita tshiamu tshia or bualu tungsten carbide udi unyanguka bikole padibu bamukuma:

1. Teka bintu bia kukuba nabi mêsu (makalashi a bukubi) kudi mubedi ne kudi musungidi: Padi tshiamu tshia tungsten carbide anyi tshiamu tshia ceramique tshitshibuka, bitupa bikese bia buitshi bidi mua kubuuka pambelu ne lubilu lua bungi. Lamba tshilamba tshitekete anyi tshilamba tshia gaze tshipepele pa pinces dîba dionso diudi utshifina bua kukuata bitupa.
2. Teka mishiku ya bipese bia kukanga nabi (Vise-Grips): Kangula mishiku ya bipese bibidi bia kukanga nabi bua bikale bikumbana bimpe ku diamètre wa pambelu wa tshingoma tshia tungsten ku nseke mishilangane ya munu (**kuteke tshingoma munda mua tshingoma pa dikoba nansha kakese).
3. Kukolesha tshiamu tshia dilongolola natshi ku kakese ku kakese (¼ wa tshikondo tshimue):
4. Longolola tshintu tshidi kuinshi kua tshianza tshia Vise-Grip bua mishiku mikange bimpe ku nseke ya pambelu ya tshilamba ne bukole bukese, pashishe uleke.
5. Kudimuna tshiamu tshia dilongolola natshi mu luseke lua dîba ne tshitupa tshimue tshia binayi, ukanga bikuata too ne padibi bikuma, ne ubikangula.
6. Enza kabidi tshikondo tshia tshitupa tshinayi tshia kukolesha ne kukanga misangu 2 anyi 4. Bu mudi tungsten carbide kayi ne bukole bua kukolesha, tshifulu etshi netshipatule mu tshimpitshimpi "SNAP" ne tshitshibuka bimpe mu bitupa bibidi anyi bisatu kakuyi mishiku idi mua kufina kule menemene munda bua kukuata munu udi muinshi.

Mukenji wa bukubi udi ne mushinga wa bungi padibu bakosa tshiamu tshia mitaku ne tshiamu tshia mudimu tshidi tshinyunguluka (Dikuba dia kapia)¶

Shi tshibambalu tshia kapia anyi muena mudimu wa malu a tshimpitshimpi wenza mudimu ne tshiamu tshia mashinyi tshidi tshinyunguluka (anyi nkata ya diamant ya Dremel) pa tshiamu tshia titanium anyi tshia tshiamu tshia mitaku: 1. Ela tshintu tshia tshiamu tshia mitaku anyi tshingoma tshia manteka tshia tshiamu tshia mitaku / tshintu tshia kukanga natshi ludimi tshibueja mu mayi muinshi mua tshilamba: Kudi ne bua kuikala misangu yonso tshintu tshikole tshia kukuba natshi tshia kapia ne tshia mvita tshibueja pankatshi pa tshilamba tshia munda tshia tshilamba ne dikoba dia mubedi. 2. Lama dilengeja dia mayi mashika ditungunuka: Dikokangana dia tshiamu tshia kukosa natshi bintu tshidi tshinyunguluka tshidi tshienza bua tshiamu tshia titanium anyi tshia or tshifike ku pa mutu pa 80 degrés Celsius (176 degrés Fahrenheit) mu masekonde 5, tshienza bua se: munu ikale ne kapia kakole. Muntu muibidi udi ne tshia kutungunuka ne kuela anyi kuela mayi mashika anyi saline buludiludi pa tshiamu tshidi tshienda tshinyunguluka ne pa tshingoma, ne kuimana kukosa kunyima kua sekonde 3 anyi 5 bua kutangila ni tshiamu tshidi tshishala tshimpe. 3. Kosa mu miaba ibidi (anyi kukangula ne biamu bibidi bia mashi): Bipese bia titanium anyi bia tshiamu tshia mitaku kabiena mua kunzulula ne minu patupu kunyima kua dikosa dimue to; enza dikosa dibidi 180 degrés kumpala kua dikosa dia kumpala bua tshilamba tshikuluke mu bitupa bibidi, anyi wenze mudimu ne biamu bibidi bia kukanga nabi/biamu bia kutangalaja nabi bua kukangula tshitupa atshi kuyi utshikosa ku tshianza tshidi tshiuwule to.

Dilama dia panyima padi tshilamba tshidi tshilamakaja tshipatuka (ne tshilamba tshikosa tshidi mua kulongolodibua anyi?)¶

1. Tangila tshitupa tshia tshijengu bua kumona ni kudi dinyanguka dia dikoba anyi disama: Sukula munu bitekete bitekete ne nsabanga mupepele ne mayi a luya. Shi tshipese tshishiye tshilonda, tshikosa, anyi tshilonda, ela tshitupa tshikese tshia mafuta a petrole anyi mafuta a antibiotique adibu bapanyisha ku tshisalu ne ufuke ne tshilamba tshidi katshiyi tshilamakaja (kuela tshilamba tshia kulamakaja natshi bikole ku tshijengu tshia munu udi wenda ukola to).
2. Tungunuka ne kubandisha muulu munkatshi mua mêba 24 ne kutangila bua kumona ni kudi disama dia nsukadi anyi disama dia mijilu: Ikala ne tshianza tshiebe tshibandisha pa matadi butuku bujima. Tangila munganga diakamue pikala disama dia munu didi ditungunuka munkatshi mua meba mapite pa 2 kunyima kua diumusha dia tshilamba, pikala dikala dikunze dia tshianza (tangila disama dia fasciitis ne dia cellulite bidi bimueneka), anyi wewe kuyi mua kuinama anyi kululamija munu bimpe menemene.
3. Lama bitupa bionso bia mpeta wa or, wa platine, anyi wa arjan: Kuelayi tshilamba tshia dibaka tshikosa to. Muena mudimu wa tshiamu tshia nzembu udi mua kuenza mudimu ne laser anyi kuela tshiamu tshia or, tshia platine anyi tshia arjan tshia sterling bua kutshipingaja pamue ne kutshishintulula bunene bua 0,5 too ne ku 1,5 (anyi kuteka **tshiamu tshia arthrite tshidi tshiunzulula ne tshikanga pa bikono binene) bua katshiyi tshikuata kabidi to.

Nkonko itubu bela misangu ya bungi¶

Mmuaba kayi undi ne bua kuela tshilamba tshia menu bua kumbusha tshilamba tshidi tshilamakaja ku munu udi mujuke?¶

Misangu yonso, ela tshitupa tshipi tshia tshilamba tshia meno tshidibu balengeje ne wax muinshi mua tshilamba tshitangile ku tshianza tshiebe kumpala, pashishe utuadije kuela tshitupa tshile tshikole PA mutu pa tshianza tshia pankatshi tshidi tshiuwule (pabuipi ne mutu wa munu webe) ne tshipuekesha KUINSHI mutangile ku tshilamba. Kujingila kumbukila ku nsongo ya munu panshi too ne ku tshilamba kudi kufina mâyi a edema adi makuate kunyima muinshi mua tshilamba mu tshianza tshiebe ne kuenza bua tshianza tshiebe tshikale tshipepele, kadi kujika kumbukila ku tshilamba pambelu kudi kufikisha ku disama dia munu ne kuenza bua munu ikale mukole.

Mmunyi muudi mua kumbusha tshilamba tshia dibaka tshia tungsten carbide tshidi katshiyi mua kukosa ne tshiamu tshia kupanda natshi tshilamba?¶

Bu mudi tungsten carbide umue wa ku biamu bikole bia pa buloba (bukole bua Mohs 9), biamu bia tshiamu tshia mitaku bidibu benza nabi mudimu mu nzubu ya luondapu ne mu nzubu ya dipanyishila bintu bia mushinga mukole kabiena mua kutshikosa to. Ino, tungsten carbide udi unyanguka bu dikala dia tshiamu tshia mitaku: paudi uvuala makalashi a bukubi, teka mishiku ya Vise-Grip pliers pambelu pa tshilamba, ukoleshe tshiamu tshia ku tshianza tshinene ku tshitupa tshimue tshia binayi ku tshikondo, ne utshikuate misangu ne misangu too ne padi tshiamu tshia tungsten tshinyanguka bimpe mu bitupa bitupa kuyi utshibula munu.

Ndi mua kuya penyi bua kukosa tshilamba tshidi tshilamakaja tshia tshianana pikala tshiamu tshia nshinga katshiyi tshienza mudimu?¶

Shi munu obe udi na dikala dia rose, luya, ne diumvua ne ki mmutshibuke, udi mua kubuela pabuipi ne nzubu yonso wa mudimu wa kapia, nzubu wa luondapu lua lukasa, anyi nzubu wa dipanyishila bintu bia mushinga mukole, bia bungi bia kudibi bidi ne biamu bia kukosa nabi mpeta bia ku bianza anyi bia mashinyi ne nebikose mpeta udi mubuele mu minite mikese. Ino, shi nsongo ya munu obe itoka, ya bule, ya violet, ya mashika, ya mpukapuka, nansha mitapike ku ditshibuka nansha ku mputa, ndaku diakamue ku tshibambalu tshia malu a mpukapuka tshia mu lupitadi.

Bua tshinyi ndi ne bua kumbusha mpeta yanyi yonso diakamue meme mutshibuke ku tshianza, musumibue kudi nyuki anyi muoshe tshianza tshianyi?¶

Disama dionso dia ku tshianza, ku tshianza, ku diboko dia kumpala, anyi mene ku diboko dia kuulu didi dijula ​​mâyi adi asama adi apueka mu minu mu minite 15 anyi 60. Kumbusha bipese bionso mu minite wa kumpala kunyima kua dikuma dia tshianza, diosha, ditshibuka, anyi disuma dia bikunyibua kudi kupangisha tshipese bua kukudimuka tshintu tshia tshiamu tshikole tshidi tshipangisha mashi bua kuenda ne tshidi tshilomba dikosa dia lukasa mu lupitadi.

Miaba mifumina¶

• Société américaine pour la chirurgie de la main (ASSH, États-Unis): Mibelu ya luondapu idi itangila mushindu wa kuondopa disama dia Ring Tourniquet Syndrome, dibuikila dia bintu didi kadiyi dinyangakaja, ne diumusha dia tshiamu tshia mitaku tshia bukole bua bungi.
• Tshikandakanda tshia malu a luondapu lua lukasa ne Bikandakanda bia malu a luondapu lua lukasa: Biomekanike bia difuanyikija dia dikosa dia kule ne dia pabuipi (Caterpillar / Technique wa dikosa dia bukole) ne dikosolola dia pabuipi ne dia kule ne dikosolola dia pinse wa dikanga dia tungsten carbide Rings.
• UK Resuscitation Council ne NHS Emergency Department Clinical Guidelines (United Kingdom): Management of Digital Ischemia and Constriction Band Removal in Hand Trauma.

Malu adi apetangana¶

• Mifuba mityumuke ne disama dia tshiadi tshia kumpala
• Tshitupa tshia mubidi tshidi ne disama dia ischémie, dikanga dia mashi, ne tshitupa tshia mubidi tshidi katshiyi ne mashi
• Dikosa dia mubidi, munu, tshianza, ne dilama dia bitupa bia mubidi
• Diambuluisha dia kumpala ne mashika
• Nomba ya njiwu ya pa buloba bujima