Ihahamuka Ryagabanijwe Imfashanyo Yambere, Amarushanwa, hamwe no Kubungabunga Igice Cyinshi¶

A ** ihahamuka ** (gucamo burundu cyangwa igice cyurutoki, igikumwe, ikiganza, ukuboko, urutoki, ikirenge, cyangwa ukuguru ukoresheje amashanyarazi, imashini yinganda, umurimyi w’imirima, ibyatsi, impanuka yimodoka, cyangwa guturika) bitera ibintu bibiri byihutirwa, bikomeye: ni **. Kuva abantu bambere batera amaguru nintoki mu myaka ya za 1960, microsurgurgie yubaka ya kijyambere yatumye bishoboka kudoda imiyoboro yamaraso itarenza milimetero 1 (santimetero 0,04) ya diametre no kugarura imikorere idasanzwe kurutoki rwaciwe, intoki, amaboko, amaboko, igihanga, ugutwi, nizuru.

Nubwo, urutoki cyangwa ikiganza cyaciwe bishobora kugarurwa neza mubyumba byo gukoreramo biterwa ahanini nuburyo abarebera hamwe nababitabye bwa mbere bakemura ikibazo cyamaraso ndetse nigice cyaciwe muminota 15 yambere aho byabereye. Amakosa abiri ateye ubwoba asenya burundu igice cyumubiri cyaciwe mbere yuko agera mubitaro ni ** gushyira igice cyaciwe ku buryo butaziguye ku rubura cyangwa mu mazi ya barafu ** (gikonjesha kandi kigaturika imiyoboro y'amaraso ya microscopique, bigatuma ** iatrogène frostbite necrosis **) na ** igashiramo igice cyaciwe mu kibindi cy'amazi, saline, cyangwa antiseptic ** (ikaba yuzuye amazi). Kumenya igihe washyira mubikorwa byubucuruzi bwumuyaga wubucuruzi hamwe nigitutu cyambaye igitutu, uburyo bwo gutandukanya ** igice ("hafi") cyo gutemwa ** utagoretse ikiraro cyuruhu gisigaye, nuburyo bwo guteranya ** Imifuka ibiri yimifuka-Ubukonje bukonje ** ikiza ubuzima ningingo.

Kora ubu¶

1. ** Hamagara nimero yawe yihutirwa hanyuma usabe inkeragutabara zitezimbere (ALS). ** Hamagara 911 muri Amerika na Kanada, 112 hirya no hino mubumwe bw’ibihugu by’Uburayi, 999 mu Bwongereza, 000 muri Ositaraliya, cyangwa urebe ububiko bwa nimero yihutirwa. Vuga neza ko ufite ** ihahamuka ** kugirango EMS ishobore kuyobora umurwayi mukigo cy’ihungabana gifite ubushobozi bwo kongera mikorobe.
2. ** Kuvura umurwayi MBERE yo guhiga igice cyaciwe: banza ugenzure kuva amaraso kumutwe. **
3. ** Ku rutoki, igikumwe, cyangwa ikiganza cy'intoki: ** Uzamure ikiganza hejuru y'urwego rw'umutima hanyuma ukande uruzitiro rwinshi rwa gazi sterile gahoro gahoro uhanganye n'amaraso ava muminota 5 kugeza 10. .
4. ** Kubiganza, Ukuboko, Ikibero, cyangwa Amaguru yo Hasi (cyangwa gutembera kwa arterial spurting): ** Ako kanya shyira ikirahuri cyumuyaga wubucuruzi ** tourniquet ** (nka CAT cyangwa SOFTT-W) ** santimetero 5 kugeza kuri 7 (santimetero 2 kugeza kuri 3) hejuru yigitereko cyoguhagarika kugeza igihe wandike umuyonga kugeza igihe uhagaritse umuyaga wose, wandike igihe cyose uhagaritse kumuyaga.
5. ** Niba urutoki cyangwa ingingo byaciwe BISANZWE (biracyafatanwa numurongo wuruhu, imitsi, cyangwa imitsi), NTUKIGERE uca cyangwa ngo ubikuremo.
6. ** Zigama igice cyumubiri cyaciwe burundu ukoresheje "Uburyo bubiri bwimifuka-Ubukonje bukonje" (ubushyuhe bwa dogere selisiyusi 4 / dogere 39 Fahrenheit): **
7. ** Intambwe A.
8. ** Intambwe B.
9. ** Intambwe C (Woga hanze)
10. ** NTUKIGERE ushyira urutoki cyangwa igihimba cyaciwe ku rubura, NTUKIGERE ubipakira mu rubura rwumye, kandi ntuzigere ubishira mu mazi cyangwa muri saline.
11. ** Komeza umurwayi aryamye (cyangwa yicaye hamwe n'ukuboko gukomeretse hejuru), NPO rwose (ntakintu nakimwe kumunwa), hanyuma ugapfunyika mubitambaro bishyushye.

Icyemezo cyihutirwa cyibiti byo gucibwa byuzuye kandi igice¶

flowchart TD
    Start["Complete or Partial Traumatic Amputation<br/>(Finger, Thumb, Hand, Arm, Toe, Foot, Leg, Ear, Nose, or Scalp)"]
    CallEMS["Call Emergency Medical Services (ALS Paramedics) Immediately<br/>Priority 1: Treat the Patient and Control Stump Hemorrhage First"]
    PartialCheck{"Is the Body Part COMPLETELY Detached<br/>or PARTIALLY Attached by a Skin/Tissue Bridge?"}
    PartialCare["PARTIAL ('NEAR') AMPUTATION PROTOCOL<br/>1. NEVER cut or sever the remaining skin/tendon bridge<br/>2. Control bleeding with firm direct pressure (or proximal tourniquet if arterial)<br/>3. Gently untwist/align part into natural anatomical position<br/>4. Cover wound with sterile saline-moistened gauze + bulky pad<br/>5. Splint limb securely; if part is completely cold/white, place cool pack<br/>   OUTSIDE a thick dry towel barrier distal to wound without freezing"]
    StumpLevel{"COMPLETE AMPUTATION: What Level of the Limb is Severed?"}
    MajorStump["MAJOR LIMB AMPUTATION (Hand, Wrist, Forearm, Upper Arm, Foot, Leg, Thigh)<br/>1. Apply Commercial Windlass Tourniquet 5-7 cm (2-3 in) ABOVE stump<br/>   (Even if arterial spasm temporarily hides spurting)<br/>2. Tighten until all bleeding stops and record exact time<br/>3. Cover raw stump end with sterile saline-moistened gauze + dry bulky dressing"]
    DigitStump["DIGIT OR FACIAL AMPUTATION (Finger, Thumb, Toe, Ear, Nose)<br/>1. Elevate hand/foot above heart level<br/>2. Apply firm direct pressure to stump with thick sterile gauze for 5-10 min<br/>3. Wrap snug pressure bandage around hand/stump<br/>4. NEVER put a rubber band or string tourniquet around the base of a finger"]
    PartCare["TWO-BAG MOIST-COLD PRESERVATION OF SEVERED PART<br/>1. Gently rinse off gross dirt with sterile saline (DO NOT scrub or use soap)<br/>2. Wrap part in sterile gauze lightly dampened with sterile normal saline<br/>3. Seal wrapped part inside a dry, watertight plastic bag (Bag 1)<br/>4. Place Bag 1 into a mixture of Crushed Ice + Water (4 deg C / 39 deg F) (Bag 2)<br/>5. NEVER touch part directly to ice; NEVER use dry ice; NEVER soak in liquid"]
    Transport["Keep Patient Warm, Calm, and Strictly NPO (Nothing by Mouth)<br/>Send labeled cooled part in the SAME ambulance with the patient"]

    Start --> CallEMS
    CallEMS --> PartialCheck
    PartialCheck -->|Partially Attached| PartialCare
    PartialCheck -->|Completely Detached| StumpLevel
    StumpLevel -->|Major Limb / Uncontrolled Arterial| MajorStump
    StumpLevel -->|Finger, Thumb, Toe, Ear, Nose| DigitStump
    MajorStump --> PartCare
    DigitStump --> PartCare
    PartialCare --> Transport
    PartCare --> Transport

Ubushyuhe na Cold Ischemia Igihe Windows: Kuki gukonjesha urutoki n'ukuboko bihindura isaha¶

Igihe kingana iki igice cyumubiri cyacitse gishobora kubaho nta maraso atemba mbere yuko ingirangingo zacyo zipfa burundu (** ischemic necrosis **)? Igisubizo gishingiye kubintu byingenzi biologiya: ** niba igice cyumubiri cyaciwe kirimo imitsi ya skeletale. **

• ** Imitsi ya skeletale ** (yuzuza ukuboko, ukuboko hejuru, ikibero, ukuguru kwakaguru, nikiganza cyikiganza) ifite ogisijeni ikenewe cyane. Ku bushyuhe bwicyumba (** ischemia ishyushye **), imitsi ya skeletale yaciwe itangira gupfa ingirabuzimafatizo idasubirwaho no kurekura potasiyumu yubumara na myoglobine nyuma yamasaha ** 4 kugeza 6.
• ** Intoki n'ibikumwe (imibare) **, bitandukanye, ** irimo imitsi ya ZERO skeletal . Imitsi yimura intoki zawe rwose yicara mukuboko kwawe no mumikindo, ikurura intoki zawe ukoresheje imigozi miremire yera ( imitsi **). Kuberako urutoki rugizwe gusa namagufa, imitsi, imitsi, imiyoboro yamaraso, ibinure, nuruhu (ibyo byose bikenera cyane ogisijeni ya metabolike ikenera cyane), urutoki cyangwa igikumwe gikonje neza birashobora guhindurwa neza ** kugeza kumasaha 12 nyuma ya ischemia ishyushye, cyangwa amasaha 24 (kandi mugihe cyanditse amasaha 30+) iyo bibitswe kuri dogere selisiyusi (39 dogere 39 Fahrenheit) **.

Uburyo bwo gucibwa: Impamvu Gukata Guillotine byoroshye guhinduranya kuruta Avulsion cyangwa Crush¶

Microsurgeons isuzuma uburyo igice cyaciwe kubera ko uburyo bugena santimetero zingahe z'imitsi yangiritse igomba gutemwa cyangwa gusimbuzwa imitsi:

1. ** Ikarishye ("Guillotine") Igabanywa: ** Byatewe nicyuma cya chef, icyuma cyamabati, impapuro za guillotine, ikirahure, cyangwa umuhoro. Uruhu, amagufwa, imitsi, imitsi, hamwe nimiyoboro y'amaraso bikataguwe neza mu ndege imwe ifunganye hamwe no gukomeretsa gake ku mpande zombi. ** Itwara igipimo kinini cyo gutsinda (85% kugeza 92%). **
2. ** Amashanyarazi yaho yaho: ** Biterwa nigiti kiremereye cyicyuma, gutandukanya ibiti, umuryango wimodoka, cyangwa imashini ya hydraulic ita urutoki cyangwa ikiganza. Imiyoboro y'amaraso yajanjaguwe hejuru ya santimetero 1 kugeza kuri 3 (0,5 kugeza kuri 1,2-santimetero), bisaba ko habaho kubaga imitsi yo kubaga no kugabanya amagufwa cyangwa imitsi y'imitsi.
3. ** Avulsion (Pull-Off) cyangwa "Impeta Avulsion" Amputation: ** Byatewe mugihe urugingo rufashwe muri auger, umugozi, uruzitiro rwa PTO, cyangwa mugihe impeta yubukwe bwa ** ifashe kurwego, uruzitiro, cyangwa uburiri bwikamyo mugihe umuntu asimbutse , akuramo uruhu, imitsi, hamwe nurupapuro rurerure rwuzuye urutoki. Nubwo igufwa rishobora kuba ridakomeye imbere muri avulion yimpeta "yangiritse", umurongo wa microscopique imbere ( tunica intima ) yimitsi irambuye kandi ushwanyagurika santimetero nyinshi mukiganza ( "Ikimenyetso gitukura" ** kuruhande rwubwato), bisaba koherezwa mumitsi itoroshye.

Intambwe ku yindi tekinike: Kwita ku Murwayi na Stump¶

Intambwe ya 1: Igenzura kuva amaraso kuri Stump (Umuvuduko utaziguye na Windlass Tourniquet)¶

1. ** Kubitunga urutoki, igikumwe, cyangwa amano: **
2. Saba umurwayi kwicara cyangwa kuryama hanyuma ** uzamure ikiganza cyangwa ikirenge cyakomeretse hejuru y'umutima **.
3. Shira igicucu cyinshi cya sterile gauze yamashanyarazi hejuru yigitereko kiva amaraso hanyuma ** kanda cyane hamwe nintoki zawe zuzuye muminota 5 kugeza 10 utabanje kureba **.
4. Iyo ibikorwa byihuta bimaze kugabanuka, funga igituba (kitagabanya) igitambaro cya sterile hejuru yigitereko nintoki.
5. ** Impamvu utagomba na rimwe guhambira umugozi wa reberi, umugozi, kogosha umusatsi, cyangwa gufatisha imbaraga ku rutoki ruva amaraso: ** Buri muyoboro wa digitale ukoresha impande zose hamwe na ** nervice ya ** ya digitale mu gipande gito cya neurovasculaire kitarenze milimetero 2 z'ubugari. Gufata hemostat buhumyi mukiganza cyurutoki cyangwa guhambira umugozi wa reberi uzengurutse urutoki rwajanjaguye imitsi ya digitale hamwe nigice cyiza cyimitsi mikorobe ikenera kudoda urutoki inyuma, kandi bishobora gutera gangrene yibitoki bisigaye. Umuvuduko utaziguye no kuzamuka bizagenzura 99 ku ijana byogucibwa.
6. ** Kubice Bikuru Bikuru (Ukuboko, Ukuboko, Ukuboko, Ukuboko, Ikirenge, Ukuguru, Ikibero): **
7. Ako kanya koresha ** ubucuruzi bwumuyaga wubucuruzi ** (CAT, SOFTT-W, cyangwa SAM XT) ** santimetero 5 kugeza kuri 7 (santimetero 2 kugeza kuri 3) hafi (hejuru) igikomere cyo gutemwa ** ku ruhu rwambaye ubusa niba bishoboka.
8. ** Ntuzigere ushyira irushanwa hejuru yinkokora cyangwa ivi ** (aho amagufwa abiri yimbere cyangwa amaguru yo hepfo yo hepfo arinda imitsi ihuza imitsi); niba gucibwa biri munsi yivi cyangwa inkokora, shyira tourniquet iburyo ** hejuru ** ikivi cyangwa inkokora kumatako imwe cyangwa igufwa ryo hejuru.
9. Kenyera ikirahuri kugeza igihe amaraso atukura yose atukura ahagaritse burundu, shyira inkoni muri clip, hanyuma ** andika igihe nyacyo cyo gusaba ** kuri label ya tourniquet no kumutwe wumurwayi.
10. Gupfukirana impera mbisi yikigiti hamwe na ** sterile gauze padi yatose hamwe na saline isanzwe ya sterile **, hejuru hanyuma wambaye ihahamuka ryumye wambaye hanyuma ugapfunyika neza kugirango urinde amagufwa nu mitsi bigaragara.

Intambwe ya 2: Gucunga igice ("Hafi" cyangwa kituzuye) Amputation¶

Iyo ibiti, ibyatsi, cyangwa impanuka bisize urutoki, ikiganza, cyangwa ikirenge ** kimanikwa nikiraro cyuruhu, imitsi, cyangwa imitsi **: 1. ** Ntuzigere wuzuza gucibwa: ** Ndetse na santimetero 1 (0.4-santimetero) y'uruhu rudafite uruhu rwinyuma rwurutoki akenshi rurimo imitsi ya ** dorsal hamwe nimiyoboro ya lymphatique ** ikenera kuvoma amaraso kurutoki nyuma yo kubaga asana imiyoboro yimikindo. Gukata kiriya kiraro cyuruhu byangiza imiyoboro yimitsi kandi birashobora kurimbura urutoki. 2. ** Witonze udahuzagurika kandi uhuze: ** Niba ikiganza, ikirenge, cyangwa urutoki rwaciwe igice cyahinduwe kuri dogere 90 cyangwa 180 cyangwa bikiziritse inyuma, uzamure witonze kandi ubishyigikire muburyo bwa ** busanzwe bwa anatomique ** bityo imiyoboro yamaraso iri imbere yikiraro cyuruhu idacometse. 3. ** Kwambara no gucamo ibice: ** Gupfundikisha lacerasi yuguruye hamwe namagufa yerekanwe hamwe na ** sterile saline-yuzuye ya gauze **, padi utitangiriye itama uzengurutse imibare cyangwa ingingo hamwe nimyenda yumye ya sterile, hanyuma ** ugabanye ikiganza cyose / ukuboko cyangwa ikirenge / akaguru ** kurubaho rwa padi cyangwa kuguruka kugirango bidashobora guhindagurika cyangwa kugoreka mugihe cyo gutwara. 4. ** Nigute ushobora gukonjesha igice cyaciwemo igice kitagira amaraso? ** Niba ikiganza cyangwa urutoki bifatanye igice kirenze gukata byera rwose, bikonje, kandi bidafite imbaraga (bivuze ko arteri yaciwe kandi uruhu / tendon yonyine igumaho), uzingire igice cyacitsemo ibice ** byumye byumye byambaye ubusa hamwe nigitambaro cya mbere **, hanyuma ushireho igikonjo gikonje ** igice cyumubyimba utuje neza kuruhande ikiraro.

Intambwe ku yindi tekinike: "Uburyo-Imifuka ibiri-Ubushuhe bukonje" kubice bikabije¶

Umuntu wese uri aho hantu agomba kumenya gupakira urutoki rwaciwe burundu, igikumwe, ikiganza, ugutwi, izuru, umutwe, cyangwa amenyo / amagufwa bityo akagera mubitaro mumiterere yibinyabuzima:

Intambwe ya 1: Shakisha kandi witonze witonze igice cyaciwe¶

• Shinga abarebera hamwe gushakisha aho ibice byose byaciwe (niba intoki nyinshi zaciwe n’isuka, reba imbere mu ntoki z'akazi, ku meza yabonetse, cyangwa mu mwenda w’imyenda: ndetse urutoki ruvunitse cyane rudashobora guhindurwa ubwacyo rufite agaciro gakomeye kuri microsurgeon nka ** "banki y’ibice" kugira ngo isarure imitsi ihuye, imitsi, imitsi, uruhu, cyangwa amagufwa.
• Tora igice ukoresheje uturindantoki two kwa muganga. Ntuzigere ucumita cyangwa gukurura imiyoboro y'amaraso yoroheje cyangwa imigozi y'imitsi ikurikira uhereye kumutwe.

Intambwe ya 2: Koza witonze GUSA niba wanduye cyane (Never Scrub)¶

• Niba igice gifite isuku, ntukarabe.
• Niba itwikiriwe n'umwanda, ibyatsi, cyangwa ibiti, fata witonze hanyuma usukemo umugezi woroshye wa ** sterile 0.9% umunyu usanzwe ** (cyangwa amazi yo mu icupa asukuye niba saline itaboneka) hejuru yayo kugirango ireremba imyanda irekuye.
• ** Ntuzigere usiba, koza, cyangwa ngo uhanagure hejuru yaciwe **, na ** ntuzigere ukora ku gice cyaciwe ukoresheje isabune, guswera inzoga, hydrogen peroxide, povidone-iyode (Betadine), chlorhexidine, cyangwa kwiyuhagira amazi **. Antiseptics chimique cauterize kandi yica selile nziza ya endoteliyale iri mumitsi ya microscopique.

Intambwe ya 3: Wizingire mu gishanga (Ntigitonyanga) Sterile Gauze Layeri¶

• Fata ipasi ya sterile cyangwa isukuye idafite lint idafite isuku hanyuma uyisukure hamwe na ** sterile isanzwe yumunyu ** (cyangwa amazi meza yo kunywa), hanyuma ** ukureho amazi arenze urugero ** bityo gauze ni ** itose byoroheje, NTIBIKORESHEJWE **.
• Uzenguruke gauze yuzuye hafi y'urutoki cyangwa ingingo zaciwe. Iki gicucu kijimye kirinda guhumeka ikirere mugihe gikora nk'igitereko gikingira imbere mu gikapu.

Intambwe ya 4: Funga imbere mu gikapu cyamazi # 1 (Inzitizi Yimbere Yumye)¶

• Shira igice cyumubiri uzengurutswe na gaze imbere mumifuka isukuye, yuzuye amazi ** zip-hejuru ya plastike ** (cyangwa igikombe cya sterile ntangarugero igikombe / igikono cyintoki, ugutwi, cyangwa izuru; cyangwa igikapu gisukuye cyane cyimyanda ya plastike kumaboko cyangwa ikirenge).
• Kanda witonze umwuka urenze kandi ** funga igikapu cyuzuye amazi ** kugirango ntamazi ushonga uturutse hanze ntashobora kwinjira no gushiramo tissue.

Intambwe ya 5: Shira igikapu # 1 mumufuka # 2 Irimo 50/50 Urubura-Amazi Yogosha¶

• Fata igikapu cya kabiri kinini cya pulasitike, indobo, cyangwa gukonjesha hanyuma wuzuze ** hafi yingingo zingana zingana zisanzwe zijanjaguwe / zifite urubura N'amazi akonje akonje ** (ubwogero bwa ** ice-water slush **).
• Shira ikidodo ** Umufuka # 1 ** imbere ** Umufuka # 2 ** kugirango ureremba muruvange rwamazi.

Intambwe ya 6: Ikirango hamwe na Transport hamwe¶

• Andika izina ryuzuye ryumurwayi **, igice cyumubiri **, nigihe ** cyigihe cyo gutemwa ** kurupapuro rwa kaseti hanze yumufuka # 2.
• Komeza umurwayi ** ashyushye ** (apfunyitse mubiringiti kugirango wirinde hypothermia na vasospasm), ** rwose NPO (ntakintu kumunwa) ** kugirango anesthesia yihutirwa irashobora guhita itangira, kandi ** ohereza igice cyaciwe gikonje muri ambulance imwe hamwe numurwayi **.

Ibihe bidasanzwe byo gucibwa: Umutwe, ugutwi, izuru, urutoki rw'abana, n'impamvu Nikotine / Cafeine igomba kwirindwa¶

1. Kuvunika umutwe, Amatwi akomeye, Amazuru, niminwa¶

Iyo umusatsi muremure ufashwe mumashini yinganda cyangwa imbwa kuruma cyangwa kugwa bikurura ugutwi, izuru, cyangwa iminwa: * ** Kuvunika umutwe: ** Umutwe ufite imwe mu miyoboro ikungahaye cyane mu mitsi kandi ikava amaraso menshi. Igenzura kuva kumutwe wumutwe hamwe numuvuduko utaziguye hamwe no gupfunyika umutwe, kandi ** uzigame igihanga cyose cyavunitse (harimo umusatsi) ukoresheje uburyo bumwe bumwe bwimifuka ibiri-Imifuka-Ubukonje **. Microsurgeons irashobora guhuza imiyoboro imwe yigihe gito yimitsi hamwe nimiyoboro kugirango igarure igihanga cyose cyogosha umusatsi. * ** Amatwi, Amazuru, niminwa: ** Bika buri gice gitandukanijwe na karitsiye hamwe nuruhu ukoresheje Uburyo bubiri-Imifuka-Ubukonje. Nubwo anastomose ya microcasculaire yomato ntoya yamatwi idashoboka, kubaga plastique bakoresha uburyo bwa karitsiye yabitswe kugirango biyubaka.

2. Amputations z'abana bato (Urugi rw'imodoka na Hinges)¶

Abana bato bakunze gucibwa urutoki iyo umuryango uremereye urutoki: * ** Abana bafite ubushobozi budasanzwe bwo gukiza no gukiza mikorobe.

3. Kubuzwa burundu kunywa itabi, Nikotine, Vaping, na Cafeine¶

Mugihe kibanziriza ibitaro no mubyumweru nyuma yo kubagwa inshuro, umurwayi agomba gutegekwa byimazeyo: ** itabi rya zeru, vapi ya nikotine zero cyangwa pouches, na cafeyine zero **: * ** Nikotine ** ni imwe mu mbaraga zikomeye za arterial vasoconstrictors izwi. Gufata n'akantu kamwe k'itabi cyangwa vape bikurura spasime ikaze yimitsi ya santimetero 0.8 yasanwe, kugabanya umuvuduko wamaraso kurutoki rwatewe hejuru ya 80% kandi bigatera trombose nurupfu rwigice cyongeye kugaruka. * Kubwimpamvu nyayo, ** komeza umubiri wumurwayi ushyushye hamwe nibiringiti ** muri ambulance; guhinda umushyitsi no gukonja bikurura vasoconstriction yimpuhwe mumaboko namaguru.

Gutuza, uburyo bwo kuvura amaraso muburyo bukwiye hamwe no kubika imifuka ibiri ikonje bikonje biha microsurgeon amahirwe meza ashoboka yo kugarura umuntu cyangwa ikiganza. Tekereza gufata ubufasha bwambere bwemewe kandi uhagarike amasomo ya Bleed binyuze muri Croix-Rouge y'igihugu cyangwa umuryango utukura wa Crescent, Ishuri Rikuru ry’Abanyamerika, cyangwa St John Ambulance.

Ibibazo bikunze kubazwa¶

Inkomoko yagenzuwe¶

• ** Sosiyete y'Abanyamerika ishinzwe kubaga ikiganza (ASSH, Amerika): ** * Amabwiriza y’ubuvuzi yerekeranye no kwita ku byihutirwa ku mibare yaciwe, amaboko, n’ibihimba (Protokole yo kubika imifuka ibiri no kwerekana ibimenyetso) *.
• ** Sosiyete y'Abongereza ishinzwe kubaga ikiganza (BSSH) & Ishyirahamwe ry’Abongereza ry’Abaganga ba Plastike, Reconstructive and Aesthetic Surge (BAPRAS, Ubwongereza): ** * Ibipimo ngenderwaho byo gucunga ihungabana rikomeye ryo hejuru no guhindurwa kwa Amputation *.
• ** Ishuri rikuru ry’abaganga bo muri Amerika (ACS, Amerika): ** * Hagarika Inkunga Yubuzima Bwiza & Advanced Trauma Ubuzima (ATLS): Kugenzura Amaraso akabije, Amarushanwa ya Windlass, hamwe no guhahamuka kwa Amputation *.
• ** Komite ishinzwe ubuvuzi bwa Tactical Combat Casualty (CoTCCC / Sisitemu ihuriweho n’ihungabana, Amerika): ** * Amabwiriza ya TCCC: Gusaba Tourniquet yo gusaba ihahamuka *.
• ** Ihuriro mpuzamahanga ry’umuryango utabara imbabare Croix-Rouge hamwe n’imiryango itukura (IFRC, International): ** * Imfashanyo ya mbere mpuzamahanga, gutabara, n’amabwiriza y’uburezi: Amacakubiri n’amaraso akomeye *.

Kuyobora¶

• Kugenzura amaraso bikabije hamwe na tourneque
• Fungura (compound) kuvunika no gutandukana
• Kumenagura ibikomere no kumenyekanisha syndrome
• Kumenyekanisha no gutabara byihutirwa
• Ibihe byihutirwa by amenyo hamwe n amenyo yakuweho
• Imibare yihutirwa no kohereza mpuzamahanga