Uruyoya n'umwana CPR no kunyiganyiga: ubuyobozi bwo gusubiza ubuzima mu buzima bw'abana¶

Iyo uruyoya ruri munsi y’umwaka umwe canke umwana ahagaritse guhema canke aniha ivyo arya, igiceri canke agakinisho gatoyi, isegonda yose irahambaye. Udakunze abantu bakuze, umutima wabo uhagarara bukwi na bukwi akenshi uterwa n’uguhagarara kw’umutsi w’umutima canke uguhungabana kw’umuyagankuba w’umutima, uguhagarara kw’umutima kw’abana hafi kwama gutangura nk’indwara y’inyenyeri y’uguhema** (nk’uguhagarara kw’umubiri w’amahanga, kurohama, guhagarara cane, guhagarara cane, guhagarara cane nk’aho) imitsi y’umutima y’umwuka w’ikirere gushika umutima uhagaritse gutera.

Kubera ko abana bari mu ndwara y’umutima bamaze gutakaza umwuka w’umwuka (oxygène) uri mu maraso yabo imbere y’uko umutima wabo uhagarara, CPR y’abana isaba gufatanya igifu no guhumekera mu gukiza (bitandukanye n’ugukora CPR y’amaboko gusa ku bantu bakuze). Iyi nkuru ikurikira amabwirizwa ariho ubu ya Komite Mpuzamakungu y’Ivy’Ugusubiza Umutima (ILCOR), Ishirahamwe ry’Umutima ryo muri Amerika (AHA), Inama y’Ubwongereza y’Ugusubiza Ubuzima, n’Umusaraba Mutukura kugira ngo bigufashe gukuraho inzira y’impwemu yazibiye no gusubiza ubuzima uruyoya canke umwana.

Ivyo ubikore ubu: uruyoya runyiganyiga (rutarashika umwaka umwe)¶

Iyo uruyoya ruri maso ariko rutunguranye rudashobora kurira, rudashobora gukorora, rudashobora guhema, ruhinduka ubururu hirya no hino y’iminwa, canke rugakora gusa inyigisho z’akanwa zicereje canke rugatera ijwi rirenga:

1. Wemeze ko umwana afise ubuzibuzi bukomeye bw’inzira y’impwemu. Iyo umwana ariko ararira cane canke akorora cane, ntumukubite umugongo, kuko igikomere gikomeye ari co gisukura neza inzira y’impwemu; gumana na bo kandi urabe neza. Uce ukora ubwo nyene iyo gusa igikomere gicereje, guhema bihagaze canke badashobora gutanga ijwi.
2. Shira umwana w’uruhinja amaso hasi ku kuboko kwawe. Icara canke upfukame uruhutse ukuboko kwawe ku itako ryawe kugira ngo uhagarare neza. Fata umwana amaso hasi ukurikije ukuboko kwawe kw’imbere umutwe wiwe uri mu mfuruka iri hasi y’igikiriza, ushigikire urwaya rwiwe rw’amagufa n’amatama hagati y’urukumu rwawe n’intoke zawe utafyonda ku muhogo woroshe uri munsi y’ikibuno.
3. Utere ibipfunsi 5 bikomeye mu mugongo. Ukoresheje igitsintsiri c’ukuboko kwawe kw’ubuntu, utere ibipfunsi 5 vyihuta kandi bikomeye mu mugongo bihuye neza hagati y’ibitugu vy’uruyoya.
4. Sandwich maze uhindure uruyoya rube hejuru. Shira ukuboko kwawe kw’ubuntu n’ukuboko kwawe kw’imbere ku mugongo w’umwana, ushire inyuma y’umutwe wiwe mu kiganza cawe, hanyuma uhindukize umwana ata nkomanzi amaso hejuru ku itako ryawe rihanganye, umutwe wiwe ugume uri hasi y’umubiri wiwe.
5. **Ushire intoke 2 (canke ibikumu 2) hagati y’igufa ry’ibere, munsi gato y’umurongo w’ivyiyumviro uri hagati y’amabere. Kanda ugororotse hasi 4 centimeters (1.5 inches), nk’ica gatatu c’uburebure bw’igikiriza, incuro 5 zitandukanye ku rugero rw’ugutera 1 ku segonda.
6. Subiramwo ibipfunsi 5 mu mugongo n’ibipfunsi 5 mu gikiriza udasiba. Guma uhinduranya ibipfunsi 5 mu mugongo n’ibipfunsi 5 mu gikiriza gushika ico kintu kivuye hanze umwana akarira, canke gushika umwana acitse intege kandi ntaco yishuye (aho nyene uhita utangura Unconscious Infant CPR aha hepfo).

Ivyo ubikore ubu: CPR y’uruyoya canke y’umwana ataco yishuye¶

Iyo uruyoya (ruri munsi y’umwaka umwe) canke umwana (ufise imyaka 1 gushika mu myaka y’ubuyabaga) adashobora kwishura, akaremba, kandi adahema neza (canke akaruhuka rimwe na rimwe gusa):

1. Semerera usaba imfashanyo maze uhamagare inomero y’ivyihutirwa yo mu karere kawe ku nkuru y’ijwi. Nusabe uwugukurikira ahamagare 911 muri Leta Zunze Ubumwe za Amerika na Canada, 112 mu bihugu vyose vy’Ubumwe bw’Uburaya, 999 mu Bwongereza, canke 000 muri Ostraliya (raba vyose inomero z'ivyihutirwa) maze bazane igikoresho co hanze gikora (AED). Niba ufise telefone ngendanwa kuri wewe, uce uyihamagara ubwo nyene uyishire kuri speakerphone kugira ngo utangure CPR ata delay. (Nimba uri wenyene rwose ata telefone iri hafi kandi n’ugusenyuka ntikwabaye bukwi na bukwi/wabonye, banza ukore iminota 2 / 5 cycles ya CPR imbere yo gutwara umwana canke kwirukira kuri telefone).
2. Urambike uruyoya canke umwana ku mugongo ku kintu gikomeye kandi gikomeye. Koresha hasi, hasi canke imeza ikomeye; ntukigere ukora CPR ku matela canke ku sofa yoroshe aho umubiri wose utera hasi iyo umuntu asunitse.
3. Uhe amafyigo 30 akomeye kandi yihuta (100 gushika kuri 120 ku munota).
   • Ku mwana w’uruyoya (ari munsi y’umwaka umwe): Koresha ubuhinga bwo gukikuza ibiganza vy’ibikumu bibiri (zingira ibiganza vyose ku rubavu rw’umwana maze ukande igice co hasi c’igufa ry’ibere n’ibikumu vyose bibiri iruhande n’uruhande) canke **ubuhinga bw’ibiganza bibiri hasi cent the two just the umurongo w’ibere). Sunika hasi sentimetero 4 (1,5 inches), canke kimwe ca gatatu c’uburebure bw’imbere gushika inyuma bw’igikiriza.
   • Ku mwana (imyaka 1 gushika mu myaka y’ubuyabaga): Shira igitsintsiri c’ukuboko kumwe (canke ibiganza 2 bifatanye nimba umwana ari munini canke ibiganza vyawe birushe) ku gice co hasi c’igufa ry’ibere. Sunika ugororotse hasi sentimetero 5 (2 inches), canke kimwe ca gatatu c’uburebure bw’igikiriza.
   • Reka igifu gisubire inyuma (gisubire hejuru) bimwe bishitse inyuma y’ugusunika kwose.
4. Fungurira inzira y’impwemu usuzume akanwa nimba bariko baranyiganyiga. Nimba ugufatwa kwatanguye mu kunyiganyiga, fungura akanwa cane urabe imbere; iyo ubonye neza ikintu kidakomeye, ugikuremwo buhoro buhoro n’urutoke rwawe rw’agahama. Hanyuma ufungure inzira y'impwemu ukoresheje uburyo bwo "guhobera" butagira aho bugarukira ku mwana w'uruyoya (ntuce uhengamira umutwe w'uruyoya kure cane inyuma) canke uguhengamira umutwe, guterura ikibuno ku mwana.
5. Tanga impwemu 2 zo gukiza (isegonda 1 kuri buri).
   • Ku mwana w'uruhinja: Fuka akanwa n'izuru ry'umwana neza n'akanwa kawe hanyuma ufuhe umuyaga w'ubugwaneza uva ku matama yawe mu segonda 1 gusa gushika ubonye igifu c'umwana kiduga bigaragara. Reka igifu kigwe, hanyuma ushire umuyaga wa kabiri w’isegonda 1.
   • Ku mwana: Upfuke amazuru y’umwana ayoroshe upfutse n’urukumu rwawe n’urukumu rw’ikigereranyo, ufunge iminwa yawe hejuru y’akanwa k’umwana, hanyuma uhe impwemu 2 z’ubugwaneza z’isegonda 1 gushika gusa igifu kiduze.
6. Bandanya ukora inzinguzingu z’ugufatanya 30 n’uguhema 2 utahagaze. Bandanya ugenda ku rugero rwa 30:2 gushika uruyoya canke umwana atanguye guhema no kwinyiganza, AED ishitse kandi yiteguriye gusuzuma, canke abaganga bafata ikibanza cawe.

Ubuvuzi bw'abana n'ingingo ya CPR¶

flowchart TD
    Start["Uruyoya (<umwaka umwe) canke Umwana (umwaka umwe gushika mu myaka y'ubuyabaga) ari mu bibazo"] --> ConsciousCheck{"None uruyoya canke umwana yoba azi kandi akavyifatamwo neza?"}

    ConsciousCheck -->|Yes, Conscious Choking| SoundCheck{"Boba bashobora gukorora ku nguvu, kurira canke kuvuga?"}
    SoundCheck -->|Yes, strong cough| Encourage["NTUKIBAZE Inyuma canke ngo Uvyivangamwo<br/>Guma hafi kandi uremeshe gukorora<br/>Hamagara abarungika ivyihutirwa iyo inzitizi igumaho"]
    SoundCheck -->|No, silent/unable to breathe| AgeChoke{"Uwo mwana afise imyaka ingahe?"}

    AgeChoke -->|Infant Under 1 Year| InfantChoke["Guhinduranya 5 Gukubita Umugongo n’Igukubita 5 mu Gikiriza<br/>Gushigikira urwaya; gumana umutwe uri hasi y’igikiriza<br/>NTUKIGEZE utera uruyoya mu nda"]
    AgeChoke -->|Child Age 1 to Puberty| ChildChoke["Tanga Inkomezi zo mu Nda (Heimlich) canke<br/>Inkomezi 5 zo Gutera Mu Mugongo + Inkomezi 5 zo Gutera Mu Nda<br/>Subiramwo gushika ikintu kivuyeho canke umwana akagenda acumbagira"]

    InfantChoke --> GoesLimp{"Mbega baracitse abacumbagira/batagira ico bakora?"}
    ChildChoke --> GoesLimp
    GoesLimp -->|Yes| StartCPR

    ConsciousCheck -->|No, Unresponsive| BreathCheck{"Guhema neza? (Irengagize guhema rimwe na rimwe)"}
    BreathCheck -->|Yes, breathing normally| RecoveryPos["Shira mu kibanza co gukira ku ruhande<br/>Hamagara 911 / 112 / 999 maze ukurikirane guhema"]
    BreathCheck -->|No, not breathing or only gasping| StartCPR["Hamagara 911/112/999 kuri Telefone y’Ijwi<br/>Utange Impemu 30 : Impwemu 2 zo Gukiza<br/>Igitigiri: 100 gushika kuri 120/min; reba mu kanwa imbere yo guhema iyo upfutse<br/>Fata AED n'ibikoresho vy'abana vuba bibonetse"]

Kugereranya amategeko yo kuzura uruyoya, abana n'abakuze¶

Ubutandukane bw’imibiri hagati y’uruyoya, umwana ariko arakura be n’umuntu akuze busaba ko umuntu ahindura cane ukuntu amaboko ashirwa, uburebure bw’ugufatanya be n’ingene inzira y’impwemu igenda.

Ubutandukane bukomeye bw'umubiri mu nzira z'impwemu z'uruyoya n'urw'abana¶

Gutahura igituma umubiri w’uruyoya n’uw’umwana utandukanye n’uw’umuntu mukuru birabuza amakosa abiri asanzwe akorwa n’abarokozi, atuma umuntu adashobora guhema canke agakomeretsa ingingo zo mu mubiri:

1. Kubera iki UTAGOMBA KWIGEZE ukora ibikorwa vyo gutera inda (Heimlich) ku mwana w’uruyoya atarashika ku mwaka 1¶

Mu mwana w’uruyoya atarashika ku mezi 12, umwobo wo mu nda ni muto, imitsi y’uruhome rw’inda iratotahaye, kandi igitigu n’umutsi w’umubiri ni binini cane bihuye, bikaba bishika kure cane munsi y’agace k’uburinzi k’imbavu zo hasi. Gutera inda hejuru ku mwana atarashika ku mwaka umwe kenshi bica bica igitigu canke umutsi w’umwana, bigatuma asohoka amaraso imbere mu mubiri yica. Ni co gituma abana bato bari munsi y’umwaka umwe baterwa ibipfunsi 5 mu mugongo n’ibipfunsi 5 mu gikiriza ku igufa ry’ibere rikomeye, ntibakubitwa mu nda.

2. Kubera iki gukura cane izosi ry’uruyoya bituma umutsi w’umuyaga wiwe ufunga¶

Uruyoya rufise umugongo munini cane w’igihanga (occiput) ugereranije n’umubiri wabo, izosi rigufi, ururimi runini rungana, n’umuyoboro w’umuyaga (trachea) ukozwe mu bizingiti vy’imitsi yoroshe kandi bishobora guhinduka bisa n’umukenke wo kunywa ushobora guhinduka aho kuba umuyoboro ukomeye.

• Iyo uruyoya ruryamye hasi rupfutse umugongo, igihanga caco kinini co mu mugongo kiratera ikibuno caco imbere mu gikiriza.
• Ariko rero, iyo uhengamye umutwe w’uruyoya gushika inyuma nk’umuntu akuze, impeta z’imitsi yoroshe y’umuhogo w’uruyoya zirafunga zigafunga, zigahagarika rwose impwemu zawe zo gukiza kwinjira mu mahaha, zigatuma umwuka winjira mu nda y’uruyoya aho kwinjira.
• Igihe cose ushire umutwe w'uruyoya mu kibanza co "guhobera" kitagira aho kigarukira (uravye hejuru ugororotse mu gisenge nk'aho woba uriko urahobera ishurwe, umuyoboro w'ugutwi ukaba uringaniye n'imbere y'urutugu). Gushiramwo igitambaro co mu minwe gipfutse munsi y’ibitugu vy’umwana birafasha gufata iyo nzira nyayo y’ukutagira aho ibogamiye mu buryo busanzwe.

3. Kubera iki ubuhinga bwo gukikuza ibiganza n’ibikumu 2 ari bwo bwiza kuruta ubundi bwo gufasha abana bato¶

Amabwirizwa y’ubu y’ugusubiza ubuzima mu mubiri ava muri AHA, ILCOR, n’Inama y’Ubwongereza y’Ugusubiza Ubuzima mu Buzima agaragaza ubuhinga bwo gukikuza ibiganza bukoresheje urukumu 2 kuruta uburyo bwa kera bwo gusubiza ubuzima mu buryo bw’urukumu 2 igihe cose bishoboka:

• Zingira intoke zawe ku mpande n’inyuma y’urubavu rw’uruyoya kugira ngo rufashe umugongo wabo mu gihe ushira ibikumu vyawe vyose bibiri iruhande n’uruhande hagati y’igufa ry’ibere munsi gato y’umurongo w’ibere.
• Gukanda n’ibikumu vyose bibiri bituma umutima ugira umuvuduko munini w’amaraso, ugashika ku burebure buhoraho bw’amasentimetero 4 (1,5 inches), kandi bikabuza intoke zawe gufata canke gusenyuka ku gifu c’umutima gitoya mu kiringo c’iminota 2 c’ugutera umutima.

Ugunyiganyiga kw'umwana (imyaka 1 gushika mu myaka y'ubuyabaga)¶

Iyo umwana mutoyi canke w’ishure aniha kandi adashobora kuvuga, gukorora cane canke guhema:

1. Baza "Uriko uranyiganyiga?" kandi usuzume ikimenyetso c’ugunyiganyiga kw’isi yose (amaboko afashe ku muhogo, amajambo y’ubwoba, ugukorora gucereje, canke uguhumeka kw’ijwi rirenga).
2. Gutanga ibipfunsi vyo mu mugongo n’ibipfunsi vyo mu nda:
   • Protocole mpuzamakungu / Red Cross / UK / EU / ANZCOR: Umwana wishingikirize imbere mu rukenyerero, ushire mu gikiriza ciwe n’ukuboko kumwe, hanyuma ushire 5 sharp back blows hagati y’ibitugu n’igitsintsiri c’ikindi kiganza cawe. Nimba ico kintu kitasohotse, uce ukurikira ubwo nyene ukoresheje ibipfunsi 5 vyo mu nda.
   • Uko wokora ibikorwa vyo gutera umwana mu nda (Heimlich maneuver): Fukama canke uhagarare inyuma y’umwana ataco uhinduye kugira ngo umubiri wawe ube ku burebure bwabo. Zingira amaboko yawe munsi y’amaboko yabo mu rukenyerero rwabo. Kora igipfunsi n’ukuboko kumwe maze ushire uruhande rw’igikumwe c’igipfunsi cawe ruringaniye n’umurongo wo hagati w’inda, hejuru gato y’inda (intanga) kandi munsi cane y’isonga ry’ibere ry’agahomerabunwa (xiphoid process). Fata igipfunsi cawe n’ikindi kiganza cawe maze ukwegere imbere no hejuru ukoresheje ugusunika kwihuta kandi gutandukanye gushika ico kintu kivuye hanze.

Amabateri y'ubuto yamizwe n'amasumasi akomeye cane¶

Si ikintu cose umuntu amize kizibira umuyoboro w’umuyaga; ibiceri n’utubateri dutoduto akenshi bica biguma hagati mu umuhogo (umuyoboro w’ibifungurwa) mu gihe umwana agishobora guhema no kuvuga. Ibintu bibiri vyo mu rugo bigereranya ivyihutirwa vy’imbere mu nzu iyo bimizwe:

Igiceri ca litiyumu / ubuto bwo gufata bateri (Itegeko ry'amasaha 2 ryo guturira imiti)¶

Iyo umwana amize (canke asunikiye mu zuru canke mu gutwi) ibateri y’ibiceri vy’ibara ry’agahama (nk’ibateri y’imilimetero 20 CR2032 iboneka mu bifunguruzo vy’imodoka, mu bikoresho vyo gukoresha kure, mu minzane y’ubuhinga bwa none, mu matara y’icayi atagira urubeya, no mu makarita y’indamukanyo y’umuziki), ni ikintu gisanzwe gihumeka vyihutirwa n’ibimenyetso vya zero**.

Iyo bateri y’ubuto yinjiye mu muhogo utose, amacandwe araheza umurongo w’umuyagankuba uri hagati y’ibice vyiza n’ibibi vy’iyo bateri. Ivyo bituma haba umuyagankuba wo hanze ugabanya ama molecule y’amazi biciye mu guhindura amazi kugira ngo haboneke sodium hydroxide (lye) itera umuriro ifatanye n’uruhome rw’umuhogo. Mu masaha 2 gusa, iyo bateri irashobora guturira umwobo ugororotse uciye mu nzira y’umuyaga ukaja mu nzira y’umuyaga (tracheoesophageal fistula) canke mu aorta, bigatuma umuntu ava amaraso yo mu mutima yica imisi canke mbere amayinga menshi inyuma y’aho iyo bateri ikuweho.

Itegeko ry'ubuto bwa bateri (AHA / Ubumara bwo kugenzura / amabwirizwa ya NASPGHAN):

1. Uce ugenda ubwo nyene uja mu cumba c’ubuvuzi bw’abana kugira ngo bakoreshe X-ray vyihutirwa n’ugukuraho endoscope. Ntutegereze ko ibimenyetso vy’ingwara bigaragara.
2. Umuhe UBUKI bwa pasteurized mu nzira GUSA iyo umwana afise amezi 12 (umwaka 1) canke arenga kandi bateri yari yamizwe mu masaha 12 aheze:
   • Uhe mililitiro 10 (ibiyiko 2 vy’icayi) vy’ubuki bwo mu nzu butagira agasembwa mu kanwa buri minota 10 (gushika ku bipimo 6) mu gihe uriko uratwara imodoka uja mu bitaro, canke mililitiro 10 z’umuti witwa sucralfate suspension nimba uhari. Ubuki bufise uburemere burengeye ubw’umubiri burapfuka uruhande rw’ibati y’ubuto imbere mu nzira y’umuhogo, bugatuma habaho inzitizi y’umubiri igabanya ivyimburwa vy’amazi vyitwa alkaline hydroxide kandi bikagabanya uburebure bw’uguturika kw’imitsi imbere y’uko umuganga abaga iyo bateri.
   • NTUKIGEZE uha ubuki uruyoya ruri munsi y’amezi 12 (umwaka 1) kubera ingorane zo kurwara botulisme y’uruyoya.
   • NTUKIGEZE ucerezwa gutwara imodoka uja ku bitaro kugira ngo ugende kugura ubuki, kandi ntumuhe ubuki iyo umwana adashobora kumira, ariko aranyiganyiga, canke iyo haciye amasaha arenga 12 kuva abunywa (igihe umuhogo ushobora kuba waramaze gutoboka).
3. NTUTUME umuntu atera umuruho kandi ntumuhe ibindi vyo kurya canke ivyo kunywa.

Amasumasi akomeye cane yitwa neodymium¶

Iyo umwana amize utugingo ngengabuzima tubiri canke turenga dutoduto tw’ubutaka budasanzwe (canke utugingo ngengabuzima tumwe n’ikintu c’icuma), utwo tugingo ngengabuzima turakwegerana cane mu nzira zitandukanye z’amara mato n’amanini, tugaca dufatanya uruhome rw’amara hagati yavyo maze tugatuma umuntu agira ischemic necrosis, amara atoboka, n’indwara y’amara yica. Rondera ubwo nyene imirasire y’izuba mu gisata c’ivyihutirwa ku bijanye n’ivyo wikeka ko umuntu yanywa umuyagankuba.

Ibibazo bikunda kubazwa¶

Amasoko yasuzumwe¶

• Ishirahamwe ry’umutima ryo muri Amerika (AHA): 2020 na 2024 Amabwirizwa y’ugusubiza ubuzima mu mutima n’amahaha no kwitwararika vyihutirwa umutima n’imitsi: Igice ca 4: Ubufasha bw’ubuzima bw’abana bw’ishimikiro n’ubuteyimbere.
• Komite mpuzamakungu y’ubucuti ku bijanye no gusubiza ubuzima mu buzima (ILCOR): Uguhurizako ku vyerekeye ubuhinga n’impanuro z’ubuvuzi (CoSTR) ku bijanye n’ugufasha abana mu buzima.
• Resuscitation Council UK: 2021 Amabwirizwa y'Ishingiro ry'Ubuzima bw'Abana n'Imirongo y'Imibiri y'Inyamahanga y'Abana.
• Umusaraba Mutukura w’Amerika n’Ishirahamwe Mpuzamakungu ry’Umusaraba Mutukura n’Ishirahamwe ry’Ukwezi Gutukura (IFRC): Imirongo ngenderwako mpuzamakungu y’ubutabazi bwa mbere, CPR, na AED.
• Ikigo c’igihugu kijejwe ubumara (Leta Zunze Ubumwe za Amerika) n’ishirahamwe ry’abana ryo muri Amerika y’Uburaruko ryitaho ivy’ubuvuzi bw’ibihaha, ivy’amaraso n’ivy’imirire (NASPGHAN): Itegeko ry’igihugu ry’ugutoranya no kuvura ubuki n’ugufata amabateri y’ubuto.

Inyobora zifitaniye isano¶

• CPR y'abantu bakuze n'abakiri bato n'amaboko gusa
• Gutabara abantu bakuze banyiganyiga (ubuhinga bwa Heimlich)
• Gukiza abarohamye no kubasubiza ubuzima
• Ivyiyumviro bikomeye vy'umubiri n'imiti y'abana
• Ububiko bw'inomero z'ivyihutirwa