Tizilombo Tizilombo M'makutu ndi Zinthu Zakunja Kumphuno kapena Khutu¶

Tizilombo tamoyo tikukwawa, kulira, kapena kukanda molunjika ku khutu, kapena mkanda, nyemba, chidole, maginito, kapena batani la batri likakankhira mmwamba mphuno kapena ngalande ya khutu la mwana, zimafunikira chidziwitso chenichenicho kuti wopulumutsa asasinthe chotchinga chosavuta kukhala tsoka la opaleshoni. Chifukwa theka lamkati la ngalande ya khutu la munthu limakutidwa ndi khungu lopyapyala lomwe limamangiriridwa ku fupa lokhala ndi mafuta a zero, komanso chifukwa miyendo ya mphemvu kapena kakumbuyo imakhota cham'mbuyo kotero imatha kuyenda kutsogolo kupita ku eardrum, kulowa m'khutu ndi zingwe kapena swab ya thonje imapangitsa kuti tizilombo toyambitsa matenda tidutse chiwombankhanga. yopapatiza bony isthmus molunjika kudutsa m'makutu. Chofunikira kwambiri, ** batani la lithiamu ** kapena ** maginito a neodymium ** mkati mwa mphuno kapena khutu limapanga magetsi amagetsi kapena kupanikizika mumatope omwe amawotcha dzenje losatha kupyolera mu septum yamphuno kapena fupa la khutu mkati mwa **60 mpaka 120 mphindi . Kudziwa momwe mungachepetsere tizilombo tamoyo motetezeka ndi mchere kapena mafuta a azitona, momwe mungapangire umboni wozikidwa ** "Kupsompsona kwa Amayi" (Kupsompsona kwa Makolo) kwa zinthu zakunja zotetezeka za m'mphuno, ndi zinthu zomwe siziyenera kukhudza ngakhale dontho limodzi la madzi limapulumutsa kumva ndi mawonekedwe a nkhope.

Chitani izi tsopano¶

1. Choyamba, dziwani zomwe zili mkati mwa khutu kapena mphuno musanakhudze chilichonse kapena kuthira madzi aliwonse:
2. Batani Labata Kapena Maginito Ophatikizana (Mphuno Kapena Khutu): Pitani molunjika ku **Dipatimenti Yangozi Zachipatala TSOPANO **. Sungani mwanayo Nothing by Mouth (NPO) kuti achotsedwe mwadzidzidzi, ndipo MUSATIKE madontho, zopopera, kapena madzi m'mphuno kapena m'khutu.
3. Tizilombo Tizilombo M'makutu (Kulira mokweza, kukanda, ndi kuwawa koopsa): OSATI** kubaya zingwe, zala, kapena thonje m'khutu. Chepetsani munthuyo, onetsetsani kuti ** alibe** thumba la khutu lodziwika bwino lobowoka kapena machubu a m'khutu, ndi kulepheretsani / kumiza tizilombo nthawi yomweyo podzaza ngalande ya khutu ndi kutentha kwa chipinda kapena mafuta ofunda pang'ono, mafuta a ana, kapena azitona/masamba amafuta (onani Gawo 3).
4. Dry Vegetable Matter (Nnyemba Zouma, Nandolo, Njere, Njere, kapena Popcorn) kapena Foam/Mkanda Wamadzi Wowonjezera Mkhutu: MUSAMATSUZERE kapena kuthirira ndi madzi. Madzi amapangitsa nyemba zouma, njere, ndi mikanda ya hydrogel kutupa mwamphamvu mkati mwa fupa lolimba lomwe limatseketsa khutu ndi kuwawa kwambiri.
5. Chinthu Chokhazikika Pamphuno Imodzi ya Mwana Wogwirizana (Pulasitiki Bead, Lego Piece, Pea, Foam, kapena Tissue Paper, OSATI Battery/Magineti): Yesani kuyeserera kamodzi kofatsa kwa *"Kupsompsona kwa Amayi" (Kupsompsona kwa Makolo) nkhonya yamphamvu 4 (onani)
6. OSATI KUKUSA zitsulo, nsonga za thonje (Q-tips), ma bobby pin, kapena zala ku ngalande ya khutu kapena mmwamba pamphuno kuti ugwire chinthu chozungulira. Pamene zopindika zathyathyathya zitsina chinthu chosalala, chonyowa (monga mkanda wapulasitiki, ngale, BB pellet, kapena nyemba), nsagwada zimatsika kuchoka pa chinthucho, chopindika ndikuwombera chinthu chopindika. Kukankhira chinthu cha m'mphuno cham'mphuno cham'mphepete mwa ngalande ya m'makutu, kapena kukankhira chinthu cha m'mphuno cham'mbuyo mumsewu wa mpweya, kumene mwanayo akhoza ku kukokera m'mphuno*.
7. Momwe mungaletsere tizilombo tamoyo m'ngalande ya khutu nthawi yomweyo:
8. Khalani kapena mugoneni munthuyo pansi ndi **khutu lomwe lakhudzidwalo moyang'ana Mmwamba molunjika padenga **.
9. Pokhapo ngati thumba la m'khutu liri bwino (palibe mbiri ya bowo la eardrum, machubu a khutu, kapena kutuluka magazi kuchokera m'khutu): Kokani khutu lakunja pang'onopang'ono ** mmwamba ndi kumbuyo ** (mwa munthu wamkulu) kapena ** molunjika kumbuyo ndi pansi pang'ono ** (mwa mwana wosapitirira zaka 3) kuwongola ngalande ya khutu yooneka ngati S, mafuta a maolivi m'mbali mwake, ndi kutsanulira mafuta a mwana* khoma la ngalandeyo mpaka itayimba pamwamba, ndikumiza tizilombo kwathunthu kwa 5 mpaka mphindi 10 mpaka kusuntha konse ndikuyima.
10. (Zindikirani: Ngati kachiromboka ndi kachirombo kakang'ono kamene kamauluka ngati njenjete kapena udzudzu* ndipo mulibe mafuta, zimitsani magetsi onse akuchipinda ndikuunikira tochi yowala kunja kwa khutu lotseguka kwa mphindi ziwiri kuti muwone ngati atuluka poyang'ana kuwala, osawunikiranso pa mphemvu kapena kambuku komwe kuli kutali ndi kambuku* kuwala.)*
11. Mmene mungapangire "Kupsompsona kwa Amayi" (Kupsompsona kwa Makolo) pa chinthu chomwe sichikhala ndi batri chomwe chili mumphuno IMODZI:
12. Uzani kholo lodalirika kuwuza mwanayo kuti amupatsa "kupsompsona kwakukulu."
13. Ikani kholo lotsegula pakamwa paokha pakamwa lotseguka la mwanayo (kupanga chisindikizo cholimba ngati kupuma kopulumutsa).
14. Gwiritsani ntchito chala chimodzi kapena chala chachikulu ** kukanikiza mphuno YOSABIDWA (yoyera) ya mwanayo kutseka kotheratu**.
15. Perekani** mpweya umodzi waufupi, wakuthwa, wokhazikika** m'kamwa mwa mwanayo (wosakwana 1 sekondi imodzi, wokwanira kuti amve kukana pamene mphuno ya mwanayo imatseka mwachibadwa ndipo mpweya umayenda kuseri kwa mkamwa wofewa kupita kuseri kwa mphuno yotsekedwa), ndikutulutsa chinthucho kuchokera m'mphuno yotsekedwa.
16. Fufuzani za "Unilateral Unilateral Fool-Smelling Nasal Discharge" mwa Ana: Ngati mwana wamng'ono kapena wamng'ono ayamba kununkhiza, purulent (yellow/green) kapena mamina otuluka magazi akutuluka m'mphuno IMODZI YOKHA** kwa masiku kapena milungu ingapo, tengani thupi lachilendo lobisika la m'mphuno (monga, siponji kapena batire la pepala) mphuno mpaka atatsimikiziridwa mosiyana ndi mayeso a mphuno ya mphuno ya dokotala.

Mtengo wosankha zadzidzidzi: Khutu vs. Mphuno yachilendo & tizilombo tamoyo¶

Gwiritsani ntchito tchati chachipatalachi kuti musankhe njira yeniyeni yochotsera chitetezo ndikupewa zolakwika zakuthirira kapena zida zowopsa.

flowchart TD
    Start["Zinthu Zakunja Kapena Tizilombo Zamoyo<br/>mu Ear Canal kapena Nostril"] --> SiteCheck{"Kodi Chinthu Chili mu<br/>EAR CANAL kapena M'NOSTRIL?"}

    SiteCheck -->|"NGANJA YA MATU"| EarType{"Ndi mtundu wanji wa chinthu<br/>chili mu ngalande ya Khutu?"}

    EarType -->|"TIZINYAMATA ZA MOYO<br/>(Kuba, kukanda, kupweteka kwambiri)"| InsectCheck{"Kodi Wodwala Ali ndi Machubu A Makutu,<br/>Odziwika Otchedwa Perforated Eardrum,<br/>kapena Akutuluka Magazi Kuchokera Ku Canal?"}
    InsectCheck -->|"INDE (M'makutu Wong'ambika / Machubu)"| InsectER["PITANI KU DIPARTMENT YA ZADZIDZIDZIKO TSOPANO:<br/>OSATITSA mafuta kapena madzi m’bwalo la khutu lobowoka;<br/>Sing’anga adzagwiritsa ntchito kuyamwa/kukanika kwapang’onopang’ono pansi pa otoscopy"]
    InsectCheck -->|"NO (Intact Eardrum)"| OilKill["TIZIGWIRITSA NTCHITO / KUMWA TIZIZINTHU POYAMBA:<br/>1. Yendekerani khutu MNYU molunjika kudenga<br/>2. Dzazani ngalande yamakutu ndi Mafuta a Mineral, Mafuta a Ana, kapena Mafuta a Azitona<br/>3. Khalani omira kwa mphindi 5 mpaka 10 mpaka kusuntha konse kuyimitsidwa<br/>4. Onani dokotala/chisamaliro chachangu kuti kuthirira kapena kuchotsa kachilombo kakufa"]

    EarType -->|"BATTON BATTERY kapena Sharp OBJECT<br/>(Galasi, Waya, Tip Swab ya Thonje)"| EarUrgent["NTCHITO YONSE ZOCHITIKA ZONSE:<br/>1. MUSAMATSIRIRE kapena kuyika madontho pa Battery Yabatani<br/>2. Battery imawotcha fupa la ngalande ya khutu & minyewa yakumaso mu <2 hrs<br/>3. Sungani ma NPO oleza mtima kuti achotsedwe mwachangu"]

    EarType -->|"ZIMENE ZABWENZI / HYDROGEL<br/>(Nyemba, Nandolo, Njere, Chimanga, Mkanda Wamadzi)"| EarBean["KUCHOKERA KWA ENT / CLINIC KUCHOTSA (PALIBE MADZI):<br/>1. OSATI MTIMA ndi madzi (amafufuma nyemba zolimba mu ngalande)<br/>2. Osagwedeza ndi tweezers; dokotala amagwiritsa ntchito mbedza yolunjika"]

    EarType -->|"INERT SMOOTH OBJECT<br/>(Mkanda Wapulasitiki, Mwala, Chofufutira)"| EarBead["MAYESERO A MANKHWALA A TSIKU LIMOMWENO/TSIKU LOTSATWA:<br/>OSATI KUGWIRITSA NTCHITO (kukankhira fupa la m’mimba);<br/>Dokotala amachotsa ndi catheter, ndodo ya cyanoacrylate,<br/>mbeza ya kumanja, kapena kuthirira madzi ofunda"]

    SiteCheck -->|"NOSTRIL (Nasal Cavity)"| NoseType{"Ndi Mtundu Wanji Wachinthu<br/>chili mu Mphuno?"}

    NoseType -->|"BATTON BATTERY kapena MAGNETS OWIRITSIDWA<br/>(kapena Zingwe Zakuda/Zamagazi + Ululu)"| NoseBattery["MFUMU YA 60-MNG'ONO YOTHANDIZA DZIKO LATSOPANO:<br/>1. Septal cartilage perforation imachitika pakadutsa maola 1 mpaka 2 <br/>2. MUSAMAgwiritse ntchito utsi wa saline wa m'mphuno kapena madontho amadzi<br/>3. Sungani mwana NPO kuti atulutse mwachangu endoscopic"]

    NoseType -->|"ZOCHITIKA ZOSANGALALA KAPENA ZOCHITIKA ZONSE <br/>(Mkanda, Nandolo, Lego, Foam, Wad Wamapepala)<br/>mu Mwana Wodekha, Wachidziwitso"| MothersKiss["ONANI 'KUpsyopsyona KWAMAYI' (OR PWANI mphuno):<br/>1. Mwana wamkulu/wamkulu: Tsekani mphuno yowoneka bwino & kuwombera mphuno mwamphamvu<br/>2. Mwana wamng'ono: Tsekani pakamwa pa mwana, dinani CLEAR<br/> Tsekani mphuno ndi chala, perekani mpweya umodzi wokhazikika <br/>3. Ngati 2 kukoka kulephera -> Pitani ku Urgent Care / ER (Osagwiritsa ntchito ma tweezers)"]

Gawo 1: Tizilombo Zamoyo mu Ngalande Yamakutu¶

Chifukwa chiyani tizilombo tamoyo m'khutu timayambitsa ululu woopsa komanso mantha¶

Ngalande yomveka yakunja ya munthu ndi ngalande yakhungu yooneka ngati S pafupifupi \(2.5\mawu{centimeters}\) (\(1\text{inchi}\)) yaitali yomwe imapendekera pabotolo lotchedwa bony isthmus kutsogolo kwa khutu la khutu: 1. Yakunja Yachitatu (Ngalande Ya Cartilaginous): Yokhala ndi khungu lokhuthala, zipolopolo za tsitsi, ndi zotupa za m'makutu. 2. Zam'kati-Ziwiri Zazitatu (Osseous/Bony Canal) ndi Tympanic Membrane: Zokhala ndi khungu lokha \(0.2\text{millimeters}\) wandiweyani wolumikizidwa molunjika ku periosteum ya fupa la chigaza lokhala ndi ziro subcutaneous fat, losatetezedwa ndi nthambi za **Trigeminal Nervecial Nerve (Cervecial Nerve), GNry Vngeal (CNryV) Mitsempha (CN IX), ndi Vagus Nerve (CN X, mitsempha ya Arnold) . 3. Chifukwa chiyani tizilombo sitingathe kubwereranso patokha: Tizilombo tating'onoting'ono ta m'nyumba timene timakwawira m'makutu usiku anthu akamagona pansi, kumisasa panja, kapena m'munda, makamaka Mphepete zaku Germany (Blattella germanica), kambuku, ng'ombe, moth, ** nyerere, ndi nsonga zam'mbuyo pamiyendo yawo. Akangokwawira m'ngalande ya khutu, sangathe kutembenuka ndipo miyendo yawo yamsana imagwira pamakoma a ngalandeyo ngati ayesa kubwerera chakumbuyo. Nthawi zonse tizilombo timayesa kupita patsogolo, zikhadabo zake zimawombera molunjika ku ultra-sensitive **tympanic membrane **, kutulutsa phokoso la bingu, logontha mkati mwa mutu wa wodwalayo ndikuyambitsa kupweteka kwakukulu ndi nseru (kudzera mu Arnold's vagal reflex).

Lamulo #1 la Kuchotsa Tizilombo: IPHA / SONKHANI NYEZI NTHAWI ZONSE PAMENE wina wayesera kuchotsa.¶

Ngakhale m'madipatimenti odzidzimutsa kuchipatala, kafukufuku wachipatala amasonyeza kuti kuyesa kukoka ** tizilombo tovutitsa ** kuchokera ku ngalande ya khutu ndi forceps kumalephera kapena kumayambitsa ** kuphulika kwa ngalande, kutuluka magazi, ndi kuphulika kwa makutu ** pamtengo wapamwamba, chifukwa tizilombo timagwirizanitsa miyendo yake yotchinga pakhoma la ngalande ndi kung'amba kutsogolo kwake.

Pang'onopang'ono Kukhazikitsa Kunyumba Kwapakhomo (Pamene Eardrum Imakhala Yolimba): 1. Onetsetsani kuti palibe kuboola m'khutu: Funsani ngati munthuyo ali ndi machubu a m'khutu (tympanostomy grommets), bowo lomwe limadziwika m'khosi, kapena kutuluka magazi kwambiri/madzi otuluka m'khutu atavulala. (Ngati ali ndi mphira wa m’khutu wobowola kapena machubu a m’khutu, OSAtsanulira madzi aliwonse m’khutu; khazikani mtima pansi wodwalayo, gwirani nsalu yonyezimira kunja kwa khutu kuti musamveke, ndipo pitani kuchipatala mwamsanga.) 2. Imikani wodwala: Muuzeni munthuyo kuti agone chammbali (kapena akhale atapendeketsa mutu wake chammbali atatsamira pa pilo) ndi khutu lomwe lakhudzidwalo loloza Mmwamba padenga. 3. Sankhani madzi otetezeka a viscous akumizidwa: - **Zisankho zabwino kwambiri zapakhomo: ** Mafuta amchere, mafuta amwana osanunkhira, mafuta a azitona, kapena mafuta amasamba/canola pa kutentha kapena kutentha kwa thupi (sikutentha.). - Chifukwa chiyani mafuta a viscous ndi apamwamba kuposa madzi opanda pakhomo: Tizilombo timapuma timabowo ting'onoting'ono m'mbali mwa matupi awo otchedwa spiracles, omwe ali ndi tsitsi la sera lopanda madzi (hydrophobic) lomwe limalola kafadala ndi mphemvu zambiri kukhala ndi moyo pansi pa madzi kwa mphindi 15 mpaka 30 pamene zikuphwanya mwamphamvu. Mafuta a viscous (mafuta amchere kapena mafuta a azitona) nthawi yomweyo amavala ndikumatula ma hydrophobic spiracles ndi capillary action, kupuwala ndi kuyimitsa tizilombo mkati mwa masekondi 30 mpaka 120 kwinaku akuyandama pang'onopang'ono kutali ndi khutu la khutu. - (Chidziwitso ku chipatala: M’dipatimenti yoona za ngozi, madokotala amagwiritsa ntchito 2% viscous kapena aqueous lidocaine kapena mineral oil, amene onse amatsekereza ngalande ya khutu ndi kuimitsa njira za sodium ya mphemvu mofulumira, ngakhale kuti mafuta amchere amapuwala zamoyo zina mofulumira popanda kuluma khungu laiwisi.) 4. Wongolani ngalande ya khutu ndikudzaza mpaka mkamwa: - Kwa wamkulu kapena mwana wazaka zapakati pa 3: Gwirani pang'onopang'ono pamwamba pa khutu lakunja (pinna) ndikulikoka KUMWAMBA NDI CHAMmbuyo kuti muwongole mapindikira a S. - Kwa khanda kapena wamng'ono wosakwanitsa zaka 3: Kokani khutu lakunja pang'onopang'ono KUWONONGA CHAMmbuyo ndi kumusi pang'ono. - Pang'onopang'ono kuthira kapena kuponyera mafuta m'mbali mwa khoma la ngalande ya khutu (kulola kuti mpweya wotsekeka kumbuyo kwa tizilombo uthawe) mpaka mafuta atayika pakhomo la ngalandeyo. 5. Dikirani mphindi 5 mpaka 10 zathunthu: Musungeni munthuyo ali chigonere khutu layang'ana m'mwamba mpaka kukanda, kulira, ndi kuyenda zitalekeratu kwa mphindi zosachepera zisanu. 6. Chotsani mafutawo pang'onopang'ono ndipo pemphani kuti muchotse tizilombo takufa: Muuzeni munthuyo kuti apendeketse mutu wake pa chopukutira khutu lomwe lakhudzidwalo liyang'ane pansi. Nthawi zina udzudzu kapena nyerere zimayandama ndi mafutawo. ** Ngati tizilombo takufa (kapena mbali yake) tikhalabe mkati mwa ngalande ya khutu, pitani kuchipatala mwamsanga kapena dipatimenti yodzidzimutsa tsiku lomwelo ** kotero kuti dokotala akhoza kutulutsa mtembo wakufayo ndikuyang'ana khutu la khutu, kusiya tizilombo takufa mkati mwa ngalande ya khutu yotentha imayambitsa bakiteriya / mafangasi aakulu ** otitis kunja kwa maola 48 24.

Gawo 2: Zinthu Zosakhala Zamoyo Zakunja mu Ngalande Yamakutu¶

Ana azaka 2 mpaka 8 nthawi zambiri amakankha mikanda, tizigawo ting'onoting'ono ta pulasitiki, timiyala, maso a popcorn, nyemba zouma, nsonga za khrayoni, kapena mabatani m'makutu mwawo kapena m'makutu a mnzawo, pamene akuluakulu nthawi zambiri amathyola nsonga za thonje (Q-nsonga), mapulagi a mphira, mapulagi osamva,zingwe zolumikizira nsonga za silicone ya earbud ** mkati mwa ngalande.

Magulu 4 a Matupi Akunja a Khutu ndi Momwe Aliyense Ayenera Kusamalidwa¶

Chifukwa chiyani Kukhetsa M'makutu (makandulo a Hopi Ear) Ndikoletsedwa Kwambiri¶

Osagwiritsa ntchito makandulo a makutu a sera opanda pake poyesa kuyamwa chinthu chachilendo, tizilombo, kapena pulagi yamakutu. Maphunziro oyendetsedwa ndi biomedical ndi US Food and Drug Administration (FDA) ndi AAO-HNS amatsimikizira kuti makandulo am'makutu amatulutsa zero vacuum suction mkati mwa ngalande ya khutu (ufa wa waxy mkati mwa kandulo woyaka umachokera kwathunthu ku sera ya kandulo) ndipo nthawi zambiri amadontha ** sera yamadzimadzi yowira molunjika pa khutu lakumva komanso kuyaka kwambiri.

Gawo 3: Zinthu Zakunja Pamphuno (Nasal Cavity)¶

Anatomy of the Nasal Cavity: Chifukwa chiyani kukankhira mmwamba ndiye cholakwika # 1¶

Makolo akamayang'ana mphuno ya mwana kuchokera kunja, mlatho wakunja wa mphuno umatsetsereka m'mwamba kumayang'ana maso, zomwe zimatsogolera anthu kuganiza kuti njira yamphuno ikupita ** mmwamba . - Zowona Zachilengedwe: Pansi pa mphuno ya munthu (pamwamba pa kamwa yolimba / denga la pakamwa) pamathamangira yowongoka cham'mbuyo mopingasa (\(90\text{ degrees}\) perpendicular to face) chakumbuyo kwa mmero (nasopharynx). - Pafupifupi 90 peresenti ya matupi akunja amphuno amakhala m'malo amodzi mwa madontho awiri: mkati mwa chipinda cha kutsogolo kwa mphuno pansi pa turbinate yotsika **, kapena kutsogolo kwa ** turbinate yapakati **. Chifukwa chiyani kutukula m'mwamba kena kugwiritsa ntchito zingwe ndizowopsa: Kukweza m'mwamba kumakwapula ukonde wapamphuno wakutsogolo kwa m'mphuno (Kiesselbach's plexus / Little's area), kupangitsa kuti thupi likhale lolemera. kutuluka magazi m'mphuno zomwe zimabisa chinthu kwathunthu. Choipa kwambiri, kukankhira mkanda kapena chiponde kumbuyo kumagwetsera kumbuyo kwa m'kamwa molunjika ku ** kholingo ndi trachea **, zomwe zimayika moyo pachiswe. kutsamwitsa.

Zadzidzidzi #1 Mphuno: Mabatire Abatani ndi Maginito Ophatikizidwa a Neodymium¶

1. Mabatire a Batani mu Nostril (Necrosis mu 60 mpaka 120 Mphindi)¶

Pamene batire yaing'ono kapena mabatani (\(3\text{V}\) lithiamu kapena \(1.5\text{V}\) silver-oxide/alkaline batire kuchokera ku chothandizira kumva, chidole chaching'ono, chowerengera, kapena khadi lolonjera nyimbo) ikankhidwira m'mphuno mwa mwana: - Nthenda ya m'mphuno yonyowa, yamchere imalumikiza malo abwino (\(+\)) ndi opanda (\(-\)) a batri, ndikumaliza **chigawo chakunja cha electrolytic **. - Pamtengo wa negative (\(-\)) (mbali yopyapyala, yocheperako ya batire), electrolysis yamadzi imapanga hydroxide ions (\(\text{OH}^-\)), kupanga concentrated sodium hydroxide (caustic lye with a \(\text{pH}\) of \(12\text{ to }13\)). - Liquefaction necrosis imasungunula mucosal lining and amadya molunjika ku cartilaginous nasal septum mkati 60 mpaka 120 minutes, kusiya kuphulika kwanthawi zonse septal perforation (dzenje loyimba mluzu pakati pa mphuno), kugwa kwa chishalo-mphuno ya mlatho wa mphuno, kapena kukokoloka kolimba kwa mphuno. - Zizindikiro Zochenjeza Za Batani La M'mphuno Mosadziwa: Kupweteka kwadzidzidzi kumbali imodzi yamphuno, kupsa mtima, kuda, bulauni, zakuda, kapena dzimbiri zotulutsa magazi kuchokera m'mphuno imodzi, kutupa kumaso kuzungulira mphuno/diso, kapena fungo lachitsulo. - Malamulo Othandizira Oyamba: Pitani ku Dipatimenti Yowopsa Yachipatala mwachangu. Musamathire madzi a saline, opoperapo m'mphuno, kapena madzi. Musalole Mwana Kuti Asakhale Pakamwa pakamwa (NPO).

2. Maginito Ophatikizana Kwambiri Kudutsa Septum ya M'mphuno¶

Ana okulirapo ndi achichepere nthawi zina amayika maginito ang'onoang'ono ang'onoang'ono a neodymium (kapena maginito "mphete zapamphuno") mkati mwa mphuno zonse ziwiri kotero kuti amalumikizana pakati pamphuno septum. - Kukopa kwamphamvu kwa maginito kumaphwanya mitsempha yamagazi ya mucosal (perichondrium) yomwe imadyetsa chiwombankhanga champhuno. - Mkati mwa **2 mpaka maola 6 **, ischemic pressure necrosis imawononga septal cartilage ndikuboola dzenje losatha kudzera mu septum. - Kuchotsa Mwachangu: Maginito a m'mphuno ophatikizidwa amafunikira kuchotsedwa mwachangu kwa dipatimenti yadzidzidzi (nthawi zambiri pogwiritsa ntchito zida zopanda maginito, mashimu apulasitiki opyapyala, kapena maginito otsutsa akunja pambuyo pa anesthesia / vasoconstriction).

Upangiri wapapang'onopang'ono ku "Kupsompsona kwa Amayi" (Kupsompsona kwa Makolo) Njira¶

Kwa chinthu chodziŵika bwino (monga mkanda wa pulasitiki, nandolo, mabulosi, thovu, kapena Lego stud, yopanda batani lokhala ndi batani, maginito, kapena galasi/pini yakuthwa) yoyikidwa mu mphuno IMODZI ya mwana wanzeru, wazaka zapakati 1 ndi 8, klzzwxh:0080 ndikumva kuwa" njira yovomerezedwa ndi malangizo azachipatala (Cochrane Systematic Review ndi madipatimenti akuluakulu azadzidzi za ana) omwe amachotsa bwino chinthucho pamfuti yoyamba kapena yachiwiri mu **kupitilira 60 peresenti ya milandu **, kupewa zida zachitsulo zowopsa kapena kukomoka kwachipatala:

Gawo 1: Konzekerani ndi Kutsimikizira Mwanayo¶

• Mwanayo akhale mowongoka (atatsamira patsogolo pang’ono) pa chifuwa cha kholo lodalirika.
• Fotokozani njirayo ngati masewera kapena "kupsompsona kwamatsenga kwakukulu" kuti mwanayo asalire kapena kupuma kwambiri. (Ngati mwanayo wakula ndipo amatha kutsata malangizo, choyamba afunseni kuti angolemba ** kukanikiza mphuno yomveka bwino ndi chala chimodzi ndikupumula mphuno yake mwamphamvu kudzera mumphuno yotsekeka ** atatseka pakamwa, ndipo nthawi zambiri chinthucho chimatuluka.)

Khwerero 2: Tsekani Pakamwa ndikutseka Mphuno Yoyera¶

• Kholo limatsegula pakamwa pake mwamphamvu pakamwa lotseguka la mwanayo, n’kupanga chidindo chotchinga mpweya chonse pamilomo ya mwanayo (chofanana ndi kupereka mpweya wopulumutsa pakamwa ndi pakamwa).
• Ndi chala chachikulu kapena chala chamlozera, kholo likukanikizira m’mbali mwa mphuno ya mwanayo YOSABIDWA (yopanda kanthu) mosabisa m’mphuno kuti atseke, mphuno yotsekekayo ikatseguke.

Khwerero 3: Perekani Mpweya Waufupi, Wakuthwa Kwambiri¶

• Kholo likamayamba kuwomba pang’onopang’ono, mphuno yachibadwa ya mwanayo imatseka glottis (zingwe za mawu) kuteteza mapapo, kutulutsa mpweya wotuluka kuseri kwa mkamwa wofewa kulowa m’mphuno ndi kulunjika kutsogolo kudzera munjira yotsekeka ya m’mphuno kumbuyo kwa chinthucho.
• Pamene kholo likumva kukana pang'ono m'kamwa mwa mwanayo, limatulutsa mpweya umodzi waufupi, wakuthwa, wolimba wokhazikika (wokhala pafupifupi masekondi 0.5, osaumira ngati mpweya wakuya wa m'mapapo).
• Kuthamanga kwa mpweya wabwino kumatulutsa mkanda kapena nandolo molunjika kutsogolo kwa mphuno yotsekedwa pa tsaya la kholo kapena thaulo.

Gawo 4: Dziwani Nthawi Yoyimitsa ("Two-Try Limit")¶

• Ngati chinthucho sichikutuluka (kapena kusunthira kutsogolo kwenikweni komwe chikugwera) pambuyo **pakukweza pang'onopang'ono ** 2, Imani nthawi yomweyo ndipo mutengere mwanayo kuchipatala kapena dipatimenti yachangu.
• N'chifukwa chiyani Kupsopsona kwa Amayi kumakhala ndi chiopsezo choyandikira zero chokankhira chinthucho m'mapapo? Chifukwa chakuti mpweya wabwino umayenda kuchokera mkamwa **mmwamba ndi kutsogolo kuchokera kumphuno , vector ya mpweya imakankhira chinthucho ** kutali ndi njira ya mpweya, osati kulowera komweko.

Momwe mungadziwire "Kuyiwalika" Mphuno kapena Khutu Lachilendo la Thupi Masiku Pambuyo pake¶

Ana aang'ono azaka zapakati pa 1 mpaka 4 nthawi zambiri amakankhira chidutswa cha chakudya, siponji, pepala, khrayoni, kapena mkanda m'mphuno kapena m'khutu popanda kuuza aliyense. Onani masiginecha awa akuchedwa:

Zolemba zenizeni za 911/112/999 ndi kuyeserera kuchipatala¶

Gwiritsani ntchito zolemba zomveka bwino izi mukafika ku dipatimenti yazadzidzi kapena kuyimba thandizo:

• Pa Battery Yokayikiridwa ya Batani Mphuno kapena Khutu (Mwadzidzi Wamsanga):

  "Kuyesa mwadzidzidzi: mwana wanga [Wazaka] wazaka zakubadwa adayika BATTON BATTERY yomwe amaganiziridwa kuti [m'mphuno yakumanzere / kumanja / ngalande ya khutu] pafupifupi [Nambala] mphindi zapitazo [kapena ali ndi mphuno yakuda yamagazi kuchokera kumphuno imodzi ndi batire yosowa pachidole]. kuphulika kwa septal kapena khutu la mafupa a m'makutu mkati mwa mphindi 60 mpaka 120, timafunikira kuyang'ana mwamsanga kwa dokotala ndikuchotsa pakali pano."

• Kwa Kachilombo Kamoyo Kungalande Ya Khutu:

  *"Wodwalayo ali ndi tizilombo tamoyo tomwe timatsekeredwa mkati mwa ngalande ya khutu [kumanzere / kumanja] kumayambitsa ululu wopweteka kwambiri pa khutu.

• Kwa Nyemba/Mbewu kapena Mkanda Wakuya Mkhutu kapena Mphuno:

  *"Wazaka wanga [Wazaka] ali ndi [nyemba zouma / mkanda wamadzi / pulasitiki] m'ngalande ya khutu / mphuno ya kumanzere/kumanja]. SITIDZACHITA ndi zomangira ndipo SINAkuthiririra nyembayo ndi madzi. Timafunika kuchotsa mphuno ya otoscopic/mphuno pogwiritsa ntchito mbedza yolowera kumanja kapena catheter yoyamwa."

Mafunso omwe amafunsidwa pafupipafupi¶

Chifukwa chiyani kuthira mafuta amchere kapena mafuta a azitona m'khutu kumayimitsa tizilombo tamoyo mwachangu kuposa madzi, ndipo ndi liti pamene simuyenera kugwiritsa ntchito mafuta?¶

Tizilombo toyambitsa matenda timapuma timabowo tating'ono m'mphepete mwa matupi awo otchedwa spiracles omwe ali ndi tsitsi lopanda madzi, zomwe zimalola mphemvu ndi kafadala kukhala ndi moyo pansi pamadzi kwa mphindi zambiri pamene zikumenyana ndi eardrum. Mafuta a viscous mineral, mafuta a ana, kapena mafuta a azitona nthawi yomweyo amavala ndikutchinga ma pores omwe amapumira a hydrophobic, kufooketsa ndi kupumitsa tizilombo mkati mwa mphindi imodzi mpaka 2; komabe, musathire mafuta kapena madzi aliwonse m'khutu ngati munthuyo ali ndi machubu a khutu kapena bowo lodziwika (bowolo) m'makutu awo, kapena ngati chinthucho sichiri tizilombo.

N'chifukwa chiyani kuli koopsa kugwiritsa ntchito zomangira zapakhomo kapena thonje kuyesa kuchotsa mkanda kapena mwala kukhutu kapena mphuno mwa mwana?¶

Ngalande ya khutu la munthu imasefukira n’kukhala fupa la m’mbali mwa fupa la m’makutuwo, ndipo zitsulo zokhala ndi thabwa zathyathyathya sizingatseguke kwambiri mkati mwa ngalandeyo n’kufika kuseri kwa mkanda wozungulira. Nsalu zafulati zikatsina mkanda woterera wa mkanda kapena nyemba, zimakhala ngati mphero ndikuombera chinthucho molowera m'khosi la fupa la m'khutu, kapena kukankhira mkanda wa m'mphuno cham'kamwa m'kamwa mwa mwanayo.

Chifukwa chiyani simuyenera kuthira madzi m'khutu lomwe lili ndi nyemba zouma, nsawawa, chimanga, kapena mkanda wamadzi?¶

Zamasamba zouma (nyemba, nandolo, maso a chimanga, njere) ndi mikanda yamadzi yopangira hydrogel ndi hygroscopic, kutanthauza kuti imamwa madzi mwachangu ndikukulitsa kangapo kukula kwake kowuma. Chifukwa chakuti magawo awiri mwa magawo atatu a ngalande ya khutu ali ndi fupa lolimba la chigaza lomwe silingathe kutambasula, kuthira madzi panyemba kumapangitsa kuti lifufumire mwamphamvu ku makoma a mafupa mkati mwa mphindi zochepa, zomwe zimayambitsa kupweteka kwakukulu, kupweteka kwapakhungu, ndi kuchititsa kuti kuchotsa osachita opaleshoni kukhala kosatheka.

Kodi batire laling'ono la batani m'mphuno mwa mwana lingawotche bwanji bowo pamphuno mwa ola limodzi lokha ngakhale batire ikuwoneka ngati "yakufa"?¶

Ngakhale batire ya "batani" yomwe singathenso mphamvu ya chidole imakhalabe ndi mphamvu yotsalira yotsalira (kupitirira 1.2 volts) kuyendetsa magetsi pamene ntchofu yamchere yam'mphuno yonyowa imagwirizanitsa zitsulo zake zabwino ndi zoipa. Mphamvu yamagetsi imeneyo imagawaniza mamolekyu amadzi pamtengo woipa wa batri kukhala sodium hydroxide (caustic lye), yomwe imasungunula chichereŵechereŵe champhuno mkati mwa mphindi 60 mpaka 120; osapopera saline m'mphuno, ndipo pitani kuchipatala mwamsanga.

Magwero afufuzidwa¶

• American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS, United States): Clinical Consensus and Patient Safety Guidance on Foreign Bodies in the Ear and Nose, Live Insect Immobilization (Mineral Oil / Lidocaine), ndi Button Battery / Paired Magnet Emergency.
• National Capital Poison Center (United States) ndi European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN): Button Battery Ingestion and Nasal/Otic Impaction Triage and Management Guidelines (kuletsa madontho a saline/madzi mu mabatire a m'mphuno kapena otic ndi kuchotsa mwamsanga $<2\text{ola)
• Cochrane Database of Systematic Reviews and Canadian Medical Association Journal (CMAJ): Njira ya "Kupsompsona kwa Amayi" (Kupsompsona kwa Makolo) kwa Matupi Achilendo Amphuno mwa Ana: Kuchita Bwino ndi Chitetezo cha Meta-Analysis (Cook et al., CMAJ; \(>60\%\) zopambana zopambana).
• National Health Service (NHS, United Kingdom) ndi Royal College of Emergency Medicine (RCEM, United Kingdom): Pediatric Ear and Nasal Foreign Body Clinical Guidelines (chipembere chonunkha chimodzi chokha monga chizindikiro cha thupi lachilendo la m'mphuno).
• Njira Zachipatala za Roberts ndi Hedges mu Mankhwala Odzidzimutsa: Njira Zochotsa Thupi la Otic ndi Mphuno Zachilendo (Right-Angle Hook, Schuchman Suction, Katz Extractor, Cyanoacrylate, ndi Cockroach Immobilization).

Maupangiri ogwirizana¶

• Kugontha kwadzidzidzi (sitiroko yamakutu) ndi kuvulala kowopsa kwapang'onopang'ono thandizo loyamba
• CPR ya ana ndi makanda ndikutsamwitsidwa
• Kumeza fupa la nsomba, fupa la nkhuku, ndi kugunda kwa chakudya cham'mero
• Nosebleeds (epistaxis) thandizo loyamba
• Kutsamwitsa thandizo loyamba kwa akulu ndi ana