Dabaylaha naxdinta leh ee la geliyey ee Defibrillator (ICD) iyo cillad-samaynta wadnaha¶

Malaayiin dad ah oo adduunka oo dhan ah ayaa ku nool ** Qalab Elektroonig ah oo La-Maraaci karo Wadnaha (CIED)** oo ku hoos jira maqaarka xabadka sare (ama caloosha/dhinaca bidix): midkoodna Pacemaker joogto ah (PPM) kaas oo ka ilaaliya wadnuhu inuu si tartiib ah u garaaco (** bradycardia**), (** tachycardia ventricular ama fibrillation ventricular *), ama ** Daaweynta Dib-u-habaynta Wadnaha (CRT-P ama CRT-D) Qalabka laba-geesoodka ah ee wadne-gabka. Marka ICD ay keento koronto koronto oo degdeg ah oo gudaha ah (taas oo bukaannadu ku sifeeyaan sida "dareen sida in faras laabta loogu laado"), ama marka qalabka garaaca wadnaha uu ku guuldareysto inuu qabto muruqa wadnaha miyir beelid), ama marka maqaarka ku dul yaal jeebka qalabka uu noqdo ** guduudan, barara, ama lumay , ogaanshaha saxda ah "1-Shock vs. 2-ama-More- Shocks (Duufaanta Korontada)" qaanuunka kala soocida, iyadoo la og yahay in ** taabashada bukaanka inta lagu jiro shoogga ICD ay 100 boqolkiiba badbaado u tahay meelaha agjoogayaasha, iyo ogaanshaha suufka agagaarka aaladda lagu rakibay waxay badbaadisaa nolosha.

Hadda samee tan¶

1. Qofku si degdeg ah ha u fadhiisto ama u jiifsado si siman si aanay u dhicin oo aanay madaxa garaacin haddii garaaca wadnaha uu keeno shoog kale ama madow gaaban.
2. ** Codso "1-Shock vs. Multiple- Shocks" Xeerka Kala soocida (Ururka Laxanka Wadnaha & Tilmaamaha AHA):**
   • Wac 911/112/999 isla markiiba HADDII:** Qofku helo 2 ama ka badan shoog ICD 24 saac gudahood; AMA la helay 1 shoog oo leh calaamad kasta oo socota (xabad xanuun, neefta oo kugu yaraata, madax-furnaan, garaaca wadnaha, wareer, ama lallabbo); AMA Qofka ** miyir beelay (miyir beelay)** kahor ama inta lagu jiro shoogga. Wac 911 gudaha Maraykanka iyo Kanada, 112 guud ahaan Midowga Yurub, 999 gudaha Boqortooyada Ingiriiska, ama arag dhammaan nambarada degdega ah.
   • ** HADDII QOFKU UU HELO 1 NAXDIN KALIYA oo uu dareemo 100% caadi ah, feejigan, iyo calaamado la'aan 60 ilbiriqsi gudahood:** Ka dhig inay been u jiifaan ama si deggan u fadhiyaan guriga, ha kiciyaan gudbinta fogaanta gacanta ee ** kormeeraha guriga ee sariirta** (ama talefanka gacanta), oo ** wac Wadnahooda / Qalabkooda degdegga ah ee isla maalinta. (Haddii ay bilaabaan inay dareemaan xanuun ama shoog labaad goor kasta, wac 911/112/999 isla markiiba.)
3. Haddii uu qofku kufo oo uu jawaabi waayo oo uusan si caadi ah u neefsaneyn, ku bilow gacmahaaga CPR isla markiiba oo ku lifaaq AED: Waligaa ha ka labalabayn cabsida aad ka qabto in aad ka naxdo ICD-kooda gudaha.
4. ** Xaqiiqda Badbaadada Goob Joogaha:** ICD-gu wuxuu bixiyaa qiyaastii \(30\qoraalka{to }40\text{ Joules}\) gudaha muruqa wadnaha. Haddii aad samaynayso cadaadin laabta ama aad ku hayso bukaan hal milli-ilbiriqsi oo sax ah dabkooda gudaha ee ICD, ma dhaawacmi kartid, ugu badnaan, waxaad dareemi doontaa dhib la'aan, hindhiso khafiif ah maqaarka xabadka (haddii aad xidhato galoofyada caafimaadka nitrile, waxba ma dareemi doontid haba yaraatee).
5. ** Xeerka Meelaynta AED suufka ee qalabka wadnaha qaada/ICD:** U fiirso oo dareeme leydi adag oo birta ah ee maqaarka hoosteeda ka hooseysa lafta bidix ama midig. Dhig suufka dhegdhegeysan ee AED ugu yaraan \(2.5\text{ sentimitir}\) (\(1\text{inji}\)) meel ka fog aaladda la tallaalay (ama isticmaal ** meeleynta hore iyo gadaal [ hore iyo gadaalba] meelaynta suufka**), una ogolow AED inay si caadi ah u baarto oo u naxdo.
6. Haddii ICD-du ay si isdaba-joog ah u ridayso inta uu bukaanku yahay WIDE TOOS, deji, oo si caadi ah u hadlaya ("Aan ku habboonayn ICD Shocks" oo ka yimid silig jaban ama fibrillation degdeg ah):
7. Bukaanku si buuxda ha u jiifsado oo is deji (oohin, argagax, iyo dhaqaaqa waxay kordhiyaan garaaca wadnaha ee "aagga naxdinta leh" ee ICD, taasoo keenaysa shoog dheeraad ah).
8. Isla markiiba wac 911/112/999 oo u sheeg diraha: "Bukaanku aad buu u soo jeedaa oo si isdaba joog ah uga naxay ICD-da la geliyey, waxaan u baahanahay kalkaaliye caafimaad oo horumarsan oo leh ECG 12-lead ah iyo qalab caafimaad."
9. ** Ka dhaqaaji taleefan kasta, smartwatch, charger wireless magnetic (MagSafe), sigaarka elektaroonigga ah/vape, ama xargaha daweynta magnetka ugu yaraan \(15\text{ sentimeter}\) (\(6\text{inji}\)) ka fog laabta.**
10. ** Haddii bukaanku leeyahay qalab-qaade (ama ICD) oo uu yeesho dawakhaad daran, suuxdin u dhow, daal daran, ama garaaca curcurka oo gaabis ka hooseeya \(40\text{}}50\text{ garaaca daqiiqaddii}\)
11. Tuhmanaha ** Qalab Sameeyaha Ku Guuldarraysta Qabashada, Hoggaanka Kala-baxa, ama baabi'inta baytariga**. U jiifso bukaanka lugaha oo xoogaa kor u kacaya, wac 911/112/999, oo soo saar ** Wallet Pacemaker/ICD Identification Card** (kaaso taxaya soo saaraha: Medtronic, Abbott/St. Jude, Boston Scientific, Biotronik, ama MicroPort, nambarka modelka, iyo goobaha la qorsheeyay).
12. Ka eeg maqaarka korkiisa jeebka qalabka ee laabta: Haddii maqaarka ka sarreeya qalabka wadnaha garaaca ama ICD uu muujiyo ** casaan, barar, diirimaad, jilicsanaan, dareere/malax dareere ah, finan guduudan, ama cidhifka birta ah ee qalinka ah ee maqaar khafiif ah (nabaad guur)**, u tag Waaxda Gurmadka degdega ah isla maalintaas. **Weligaa ha tuujin, hamudin, hana saarin irbad jeebka garaaca wadnaha oo barara ***, waligaa ha iska indha tirin qandhada heerka hoose ee qalabka wadnaha garaaca/ICD (CIED endocarditis infective).

Geedka go'aanka kala soocida degdega ah: shooga ICD, garaaca wadnaha garaaca, iyo caabuqa jeebka¶

Adeegso jaantuska socodka bukaan-socodka 60-ka ilbiriqsi ee ugu horreeya si aad u maamusho xaalad kasta oo degdeg ah oo qalab wadnaha ah oo la geliyo.

flowchart TD
    Start["Xaalad degdeg ah oo ku jirta Bukaanka la tallaalay<br/>Pacemaker (PPM), Defibrillator (ICD), ama Qalabka CRT"] --> EventType{"Waa maxay Dhibaatada Aasaasiga ah ee <br/> Qalabka?"}

    EventType -->|"BUKAANKA JAWAAB ILAALI AH<br/>& Caadi ahaan Uma Neefsado"| Arrest["Xariga Wadnaha (ICD way ku guuldareysatay inay beddesho laxanka):<br/>1. Wac 911 / 112 / 999 & Bilow cadaadiska laabta hadda<br/> Ku dheji AED: Meesha suufka>= 2.5 cm (1 inch) oo ka fog<br/> aaladaha bararsan (ama isticmaal meelaynta suufka hore-iyo-Back AP) <br/>3. Raac tilmaamaha AED daahid la'aan"]

    EventType -->|"NAXDINKA AY ICD KEENAY<br/>(Bukaan Miyir ah)"| ShockCount{"Imisa naxdin ayaa dhacay<br/>& Sidee buu Bukaanku Dareemaa?"}

    ShockCount -->|"2 AMA KA BADAN shoog 24 saacadood gudahood <br/>(>= 3 Shocks = ' Duufaan koronto ICD')"| StormER["DEG DEG 911 / 112 / 999 DEGDEG:<br/>1. Dhig bukaan jiif oo si buuxda u deggan (hoos u dhiga adrenaline) <br/>2. Tuhunka VT/VF Duufaanta Korontada AMA Shoox aan habboonayn <br/> (oo ka yimid rasaasta jabtay / kormeerka AFIB / T-mowjadaha) <br/>3. EMS/ER waxay dhigtaa 12-lead ECG; Haddii shoog aan habboonayn oo ku saabsan<br/> kormeeraha, takhaatiirta cajalado Ring Magnet korka ICD si ay u joojiyaan <br/> shooga iyadoo ilaalinaysa qalabka wadnaha garaaca."]

    ShockCount -->|"1 NAXDIN KELIYA<br/>+ Bukaanku Waxa Uu Dareemaa 100% Caadi & Calaamadaha-free<br/>1 daqiiqo gudahood"| SingleShock["XIDHIIDHKA QALABKA WADNIGA DEGDEGGA AH:<br/>1. Ku naso fadhiga/jiif; Ha wadin<br/>2. U dir buug-gacmeedka Fogfog-guri gudbinta HADDA<br/>3. Wac Clinic Aaladda lambarka-wacitaanka si aad u hesho tilmaamo<br/>4. Haddii shoog 2aad ama calaamad kasta ay dhacdo -> Wac 911"]

    EventType -->|"Dawakhsanaan, Suuxdin, AMA garaaca <40-50 BPM<br/>"| PacerFail["KHILAAFKA XUMAADKA PACEMAKERKA:<br/>(Ku guuldareysiga Qabashada, Hogaaminta Waxyeelaynta Hogaaminta, ama Kormeerka) <br/>1. Wac 911/112/999 Isla markiiba; jiifa bukaan<br/>2. Ka saar wixii taleefoon ah/magneetooyin ah oo u jira 15 cm xabadka<br/>3. Keen Kaadhka Aqoonsiga Qalabka Wallet ee su'aalaha ER"]

    EventType -->|"qeylo dhaan la maqleyn karo AMA FIIRO GAAR AH<br/>Xabka Guddaha"| BeepAlert["QALABKA GUDAHA EE OGEYSIINTA QALABKA:<br/>Waxay tuseysaa Battery ERI, Beddelka Waxyeelada rasaasta, ama Qaabka Mag.<br/>Hadduu bukaanku ladnaado -> Wac Rugta Qalliinka maanta.<br/>Haddii dawakhsan tahay, neeftu ku qabato, ama naxdo -> U tag ER hadda."]

    EventType -->|"guduudan, bararay, shuban, AMA maqaar daaray<br/>Gacanka Qalabka (ama Qandho aan la Sharacin)"| PocketInf["CIED jeebka / ENDOCARDITIS:<br/>1. Qiimaynta Waaxda Degdegga ah ee isla-maalin ah<br/>2. Waligaa ha tuujin ama hakumudin jeebka<br/>3. Wuxuu u baahan yahay dhaqamada dhiiga, antibiyootiga faleebbaha, iyo wadarta soo saarista"]

Qaybta 1: Qaladaadka Wadnaha-Defibrillator (ICD) La qabadsiin karo iyo "Duufaanta Korontada"¶

Sida ICD u daweyso arrhythmias ka hor iyo inta lagu jiro shoogga¶

Cardioverter-Defibrillators Casriga ah (ICDs), oo ay ku jiraan ** ICD-yada transvenous ** (oo leh fiilooyinka xididdada wadnaha laga galo) iyo ** ICD-yada subcutaneous (S-ICDs)** (la geliyo maqaarka hoostiisa dhinaca feeraha bidix), dhab ahaantii waxay leeyihiin ** laba heer oo daweyn ah ** marka ay ogaadaan khatarta degdegga ah ee rthm 1. Tier 1: Anti-Tachycardia Pacing (ATP, Painless): Marka ICD ay ogaato laxanka ventricular ee joogtada ah (** monomorphic ventricular tachycardia [VT]), waxay marka hore isku daydaa inay jebiso wareegga si xanuun la'aan ah iyadoo gaarsiinaysa xawaare degdeg ah oo ah 8 ilaa 10 garaaca garaaca garaaca wadnaha oo ka dhaqso badan. Bukaanku haba yaraatee ma dareemaan ATP (ama waxay dareemayaan kaliya 2-ilbiriqsi). 2. Tier 2: High-Voltage Defibrillation Shock (\(30\text{ to }41\text{ Joules}\)): Haddii ATP aan xanuun lahayn ay ku guul dareysato inay joojiso laxanka, ama haddii laxanku uu ku soo dadajiyo ** Fibrillation Ventricular (VF)* ama VT gudaha ah ($> 20pm) ilaa ** 5 ilaa 10 ilbiriqsi** wuxuuna si toos ah u gaarsiiyaa shoog koronto ah oo ku dhaca muruqa wadnaha. - Sababtoo ah bukaanku inta badan weli wuu miyir qabaa inta lagu jiro VT (ama dib u soo noqda 2 ilbiriqsi ka dib shoogga), waxay la kulmaan indho-la'aan degdeg ah, indho la'aan aragtidooda (fosphenes), qallafsanaan xoog leh oo laabta iyo garabka muruqa, iyo dareenka dharbaaxo culus oo ku dhacay lafta naaska.

Run "Haboon" Duufaanta Korantada vs. "Aan Habboonayn" Shook ICD¶

Marka bukaanku helo shoog badan oo isku xigta (** ICD Electrical Storm**, oo si adag loogu qeexay \(\ge 3\text{dhacdooyinka shoogga VT/VF ama ICD ee joogtada ah 24-saac gudahood}\)), dhakhaatiirta caafimaadka iyo dhakhaatiirta degdegga ah waxay adeegsadaan kormeeraha ECG ee 12-hoggaanka ah si ay isla markiiba u kala saaraan laba sababood oo kala duwan:

Sida Magnets-ka Giraaniga Kilinigu ugu Shaqeeyaan Qalab-sameeyayaasha iyo ICD-yada (Xeerka Caafimaad ee Muhiimka ah)¶

Bukaanno badan iyo xitaa qaar ka mid ah shaqaalaha daryeelka caafimaadka ayaa ku jahawareersan waxa dhacaya marka ** xoog leh ** magnet giraanta kiliinikada *** (ama magnet neodymium ee macaamiisha ah ee talefoonka/vape) uu taabto laabta qalabka wadnaha lagu rakibay. Magnet-ku wuxuu u sameeyaa shay ka soo horjeeda qalabka wadnaha wadnaha iyo ICD:

1. ** Saamaynta Magnet-ka ee Defibrillator La-Darsi Karo (ICD):**
2. In si toos ah magnetka kor loogu qaado ICD ** waxay joojisaa / damisaa DHAMMAAN BAAHINTA TACHYARRHYTHMIA IYO shoogga Voltage SARE** (sidaa darteed ICD ma garaaci doonto **** wadnaha inta magnet lagu hayo laabta), ** iyadoo laga tagayo ICD-ga tartiib-tartiib-heereedka kaydinta garaaca wadnaha shaqada 100%.
3. Isla marka aad magnetka ka qaaddo laabta, ICD isla markiiba waxay dib ugu celisaa difaaceeda naxdinta leh.
4. Waa maxay sababta Macaamiisha Magnets (MagSafe iPhones, Smartwatches, Magnetic Vape Pens, CPAP Magnetic Clips) ay khatar ugu yihiin Jeebka Shaarka sentimitir}$ (\(6\text{inji}\)) ee ICD-gooda, ama ay seexdaan iyagoo taleefoonkoodu laabta saaran yahay, **magnet-ku wuxuu si aamusnaan ah u curyaamiyaa shoogga defibrillator-ka naf-badbaadinta inta uu ku nasanayo. ICD (\(30\text{cm}\) [\(12\text{inji}\)] qalab awood sare leh).
5. ** Saamaynta Magnet-ku ku leeyahay Qalab-sameeyaha Joogtada ah (PPM):**
6. Ku dhejinta magnetka qalabka garaaca wadnaha ee caadiga ah ** kama damiso qalabeeyaha garaaca wadnaha *, taa beddelkeeda, waxay u beddeshaa garaaca wadnaha "Asynchronous Pacing Mode" (DOO ama VOO mode), halkaasoo garaaca garaaca wadnaha ee bukaanka iska indhatiro garaaca wadnaha ee bukaanka oo uu ku shido heer go'an (sida caadiga ah $85\text{10}1pm). * (Kaliya dhakhaatiirta degdega ah ee loo tababaray kormeeraha ECG ee tooska ah waa inay waligood magnet bukaan marsadaan qalabka wadnaha garaaca ama ICD.)

Qeybta 2: Sameynta CPR iyo Isticmaalka AED ee Bukaanka leh qalab sameeye ama ICD¶

Haddii qofka qalabka wadnaha ku shaqeeya ama ICD uu ku dhaco, uu jawaabi waayo, oo aanu si caadi ah u neefsanin (ama uu neefsanayo), ** qalabkii lagu rakibay ayaa ku guuldareystay inuu badbaadiyo** (ama sababtoo ah laxanku waa PEA/asystole aan naxdin lahayn, muruqa wadnuhu waa ischemic si uu uga jawaabo, ama batteriga / rasaasta ayaa guuldareystay). ** Daaweyn degdeg ah CPR iyo Automated External Defibrillator (AED) waa fursadda kaliya ee ay ku badbaadaan.**

Raac kuwan 3 Xeerarka Dib-u-soo-nooleynta AHA/ERC ee Rasmiga ah ee bukaanada leh aaladaha la rakibay:

1. Weligaa dib ha u dhigin cadaadiska laabta: Gacmahaaga dhig meesha saxda ah ee saxda ah, xarunta laabta laabta qeybta hoose ee lafta naaska (sternum), oo si adag oo degdeg ah u riix (\(100\qoraalka{la }120\qoraalka{ cadaadis daqiiqaddii}\), \(5\qoraalka{ ilaa }6\)qoraal{cm}$ [$2}text{2}. Sababtoo ah qalabka wadnaha garaaca iyo ICD waxay ku rakiban yihiin hoosta lafta bidix ama midig (lafaha) (ama kilkilaha bidix ee ICD hoostiisa), gacmahaaga bartamaha lafta naaska meelna uma dhowa sanduuqa birta ah.
2. ** Kawaran Haddi Gudaha ICD-gu Naxdo Inta Gacmahaydu Ay Ku Sugan Yihiin Laabta?**
3. ** Sii wad inaad sameyso CPR: *** Xataa haddii ICD-ga gudaha uu ku dhufto \(35 \ qoraal {-Joule}\) shoog halka gacmahaaga qaawan ay ku cadaadinayaan laabta, korontadu waxay ku sii jirtaa gudaha daloolka laabta inta u dhaxaysa gariiradda wadnaha gudaha iyo titanium-ka. In ka yar 1 volt ayaa gaarta maqaarka oogada. Waxba laguma yeeli doono.
4. • (Fiiro gaar ah: Haddii aad aragto laabta bukaanka oo si lama filaan ah uga dillaacay shoogga gudaha ICD inta lagu jiro CPR, si fudud u ogolow 1 ilaa 2 sekan in shoogga uu dhammeeyo oo sii wad qiimeynta CPR/AED.)*
5. ** Halkee lagu dhejiyaa Pads-ka AED ee Dibadda:**
6. Markaad laabta qaawdo, raadi \(3\text{ to } }5\text{cm}\) nabar qaliinka ah iyo barar leydi ah oo adag maqaarka hoostiisa oo ka hooseeya lafta midig ama bidix (ama dhinaca feeraha hoose ee bidix ee S-ICD).
7. ** Waligaa si toos ah ha ugu dhejin suufka AED dusha sare ee wadne-sameeyaha/ICD bararka:** Daabka birta ee maqaarka hoostiisa waxay xannibaysaa shoogga AED ee dibadda inay gaarto wadnaha waxayna burburisaa wareegga aaladda.
8. ** Dhig suufka AED ugu yaraan \(2.5\text{ sentimitir}\) (\(1\text{inji}\)) dhinaca ama ka hooseeya qalabka la rakibay ee bararsan** (ama suufka dhig ** hore- danbe [ hore iyo-Back] booska **: hal suuf oo ku yaala dhanka hore ee-bidix, iyo laabta inta u dhaxaysa qalabka kale).

Qaybta 3: Aqoonsiga Qalabaynta Qalab Sameeyaha iyo Dhibaatooyinka Maqabashada Kadib¶

5-ta Calaamadood ee Degdegga ah ee Qalab Sameeyaha ama rasaasta¶

Haddii qof qaba qalabka wadnaha garaaca ama ICD uu yeesho mid ka mid ah calaamadahan soo socda, isla markiiba u gee waaxda xaaladaha degdegga ah:

1. ** Calaamadaha Calaamadaha Bradycardia ("Ku guuldareysiga Qabashada" ama "Ku guuldareysiga Soo saarista"):**
2. Qofku waxa uu dareemaa dawakhaad, madax fudayd, daciifnimo, neefsasho gaaban, jahawareer, ama daal (** syncope**), iyo hubinta garaaca wadnaha ee curcurka ama luqunta waxay muujinaysaa garaaca wadnaha ** si weyn uga gaabiya heerka heerka hoose ee garaaca wadnaha**
3. ** Digniinta Pulse Pulse Oximeter/Smartwatch Digniinta Gudaha "Ku guul dareysiga Qabashada", garaaca garaaca wadnaha ayaa wali soo dira xabo koronto oo yar-yar oo laga yaabo in kormeeraha wadnuhu uu ku tiriyo \(70 qoraal bpm}\), laakin muruqa wadnuhu dhab ahaantii ma tuujinayo, marka garaaca wadnaha dhabta ah ee curcurka ama garaaca garaaca wadnaha waa \(30 kaliya qoraal{bpm}\). Had iyo jeer ku dareemo farahaaga dhabta ah radial ama garaaca carotid.
4. ** Hiigsi joogta ah ama garaaca laabta/Muruqa Caloosha (Lead-ka-baxa ama Daloolinta):**
5. Haddii bukaanku uu si lama filaan ah u bilaabo inuu yeesho si joogto ah, metronome-xikmad joogto ah (\(60\qoraalka{ ilaa }80\qoraal{wadnaha daqiiqad}\), oo u dhiganta garaaca wadnaha saxda ah) ama garaaca laxanka muruqa xuubka laabta oo garaac kasta, qalab sameeye/ICD ayaa mid ka mid ah ** ayaa ka baxay meel ka saraysa kaas oo maamula diaphragm) ama ** dalooliyay gidaarka khafiifka ah ee halbowlaha midig**, khatar gelinaya pericarditis ama tamponade wadnaha.
6. ** Barar kedis ah, Midab-doorsoon, ama Xididdada Hal Gacan (Xiddiga Subclavian Thrombosis):**
7. Sababtoo ah garaaca wadnaha iyo ICD waxay sii maraan subclavian iyo xididada axillary ** hoosta lafaha koodhka, xinjirowga dhiigga ( xididdada xididdada qotodheer ee sare-xaraf*) ayaa ka samaysan kara agagaarka fiilooyinka, taasoo keenaysa ** gacanta bidix ama midig, gacanta, iyo dhinaca luqunta inay bararaan, xanuunaan, oo noqdaan casaan-guduud.
8. ** Xakamaynta wadnaha wadnaha & Twiddler Syndrome:**
9. Haddii bukaanku si miyir la'aan ah u rogo, u wareego, ama ku ciyaaro sanduuqa garaaca wadnaha ee maqaarka (Twiddler's Syndrome), fiilooyinku waxay dabeyaan sida gariiradda kalluumeysiga oo isla markiiba ka soo baxaan darbiga wadnaha. Weligaa ha maroojin hana ku riixin sanduuqa qalabka ee maqaarka hoostiisa.
10. ** Been la maqli karo, Gariir, ama Digniino Gariir oo ka imanaya Laabta Gudihiisa:**
11. ICD-yada casriga ah iyo aaladaha CRT (Medtronic, Boston Scientific, Abbott, Biotronik) waxay leeyihiin af-hayeen ku dhex dhisan ama matoor gariir oo soo saaraysa ** dhawaaq dhawaaq sare leh (sida saacada alaarmiga ama seeriga ambalaansada) ama gariir xoog leh** waqtiyo go'an maalin kasta marka qalabku ogaado digniinta muhiimka ah: Battery gaadhey, Beddelka Siligga (silig jabay), ama ** wadno-xannuun heer-sare ah oo daba-dheeraaday**.
12. Haddii bukaanku maqlo dhawaaqa laabta ama uu dareemo gariir: Haddii ay si buuxda u roon yihiin, wac Rugta Qalabkooda isla maalintaas; Haddii ay qabaan dawakhaad, neefta oo kugu yaraata, ama shoog, isla markiiba u tag Waaxda Gurmadka.

Qeybta 4: Caabuqa Jeebka Qalabka, Nabaad guurka Maqaarka, iyo CIED Endocarditis¶

Waa maxay sababta finan yar, qolof, ama silig ka dul muuqda qalabka wadnaha qaada waa xaalad degdeg ah oo qalliin¶

Si ka duwan caabuqa maqaarka ee cududda ama lugaha oo lagu daweyn karo dhalo 7-maalmood ah oo kiniinka antibiyootiga afka laga qaato, ** caabuq kasta oo bakteeriya ah oo taabta qalab-sameeyaha ama jeebka ICD ama fiilooyinka waa xaalad degdeg ah oo nafta halis gelisa. - Bakteeriyada (gaar ahaan Staphylococcus aureus iyo Staphylococcus epidermidis) waxay sameeyaan gaashaan difaac caato ah (biofilm) oo ku yaal dahaarka caagagga iyo birta ee qalabka wadnaha qaada taasoo keenta in antibiyootiga aysan gudaha u gelin karin. - Sababtoo ah hogaamiyeyaashaasi waxay si toos ah hoos ugu sii maraan xididada waxayna ku xiraan gudaha atrium midig, valve tricuspid, iyo ventricle midig, ** caabuq jeebka yar ee u muuqda ayaa si toos ah hoos ugu dhigaya fiilooyinka galka wadnaha iyo dhiiga *, taasoo keenta ** CIED Infective Endocarditis iyo Sepsis (taas oo qaadaysa 20 ilaa 30 boqolkiiba heerka dhimashada haddii soo saarista aaladda dib loo dhigo).

Liiska hubinta calanka cas ee caabuqa jeebka aaladda & nabaad guurka (Tag ER / Wadnaha Maanta)¶

Ku baadh maqaarka xabadka dushiisa qalabka wadnaha garaaca ama ICD oo iftiin dhalaalaya leh: - [ ] ** Casaan (erythema), diirimaad, barar, ama damqasho cusub oo garaac ah ** korka jeebka aaladda (ha ahaato 2 toddobaad qalliinka ka dib ama 5 sano ka dib). - [ ] ** Dheecaan ururin (isbedbedel), malax, qolof huruud ah, ama dheecaan cad/dhiig leh** oo ka soo daadanaya nabarrada qaliinka. - [ ] ** Nabaad guurka ka hor ama Frank Maqaarka:** Maqaarka ka sarreeya gees ka mid ah qalabka birta ah ama siligga wuxuu noqdaa ** warqad-dhuuban, dhalaalaysa, taut, iyo casaan-guduud ah (ku dheggan birta hoose), ama ** gabal bir ah oo bir ah ama dahaadh cad/siil cad ah ayaa si muuqata uga soo baxaysa dalool yar oo maqaarka ah. *(XEERKA XANUUNKA AH: Xataa haddii uu jiro malax eber ah iyo xanuun eber ah,haddii qayb ka mid ah qalabka birta ah ama siliga ay hawada dibadda uga soo baxdo maqaarka, dhammaan aaladda iyo dhammaan fiilooyinka wadnuhu waxay 100% wasakhaysan yihiin bakteeriyada, waana in qalliin lagu sameeyaa cisbitaal khaas ah. Si dabacsan ugu dabool faashad qallalan oo nadiif ah oo nadiif ah maqaarka hoostiisa, birtana ha isku dayin inaad maanta dib u riixdo. - [ ] Xummad aan la sharraxin, qarqaryo, ama dhididka habeenkii ee Bukaan kasta oo leh qalab-qaade ama ICD: Xitaa haddii maqaarka jeebka laabta uu u ekaado boqolkiiba 100 caadi ah, qandho kasta oo aan la sharraxin ($> 38 ^\circ\text dhirta ku taal wadnaha ayaa hogaaminaya.

Qoraalka isgaarsiinta saxda ah ee 911/112/999 iyo kala soocida isbitaalka¶

Had iyo jeer qaado ** kaadhkaaga aqoonsiga jeebka wadnaha ee ICD** (ama ku kaydi sawir cad oo hore iyo danbe ee kaadhka shaashadda aqoonsiga caafimaadka ee casriga ah). Isticmaal qoraalladan saxda ah inta lagu jiro xaalad degdeg ah:

• ** Shoogga ICD ee Badan ("Duufaanta Korontada") ama 1 Shock leh Calaamadaha:**

  " Waxaan u baahanahay gurmad degdeg ah oo Ambalaasta Taageerada Nolosha Sare ee [Cinwaanka Saxda ah]. Bukaanku waa [da'] jir la rakibay [Sare: Medtronic / Boston Scientific / Abbott / Biotronik] Defibrillator (ICD) kaas oo helay [Lambarka] shoog hore [daqiiqado/saacadaha xanuunka laabta] iyo dawakhaad ayaanu qabnaa. fidsan oo gebi ahaanba weli taagan, una baahan 12-lead ECG la socodka iyo u qaadida cusbitaal leh awood su'aalo weydiinta qalabka wadnaha."

• ** Loogu Shakisan yahay Guul-darrida Wadnaha garaaca wadnaha ( garaaca wadnaha oo tartiib tartiib ah, miyir beelid, ama garaacid diaphragm):**

  " Kala soocida degdega ah: Bukaan-socodkani waxa uu leeyahay qalab sameeye [Sare] ah oo la rakibay oo waxa uu la kulma dawakhaad ba'an/ suuxdin ba'an 12-lead ECG, raajo laabta, iyo su'aalaha qalabka stat."

• Infakshanka Jeebka ama Nabaad guurka Maqaarka:

  • "Bukaanku waxa uu leeyahay qalabka wadnaha lagu tallaalay ee laabta [bidix/midig] wuxuuna soo saaray [guduudasho ba'an iyo barar / dheecaan dheecaan ah / bir qaawan ama siligga oo sii xumaanaya maqaarka / qandho aan la garanayn.

Su'aalaha soo noqnoqda¶

Koronto ma la iga qaadi doonaa haddii aan hayo xubin qoyskayga ah ama aan ku sameeyo CPR marka ay ICD-ga gudaha ahi ay argagaxaan?¶

Maya, laguma dhaawacmi karo ama koronto laguma qabsan karo haddii aad qof taabanayso marka uu gudaha gudaha ku shido Cardioverter-Defibrillator (ICD) Sababtoo ah shoogga waxaa la geeyaa gudaha laabta inta u dhaxaysa siliga wadnaha iyo daboolka qalabka (qiyaastii 30 ilaa 40 Joules gudaha, toban jeer ka yar shoogga cusbitaalka dibadda ah), ku dhawaad ​​dhammaan tamarta korantada waxay ku sii jirtaa gudaha jirkooda; ugu badnaan, goobjooge taabto maqaar qaawan ayaa dareemi doona gariir muruq khafiif ah oo aan dhib lahayn, iyo xidhashada galoofyada caafimaadka ayaa xannibaya xitaa dareenkaas gebi ahaanba.

Maxaan ugu baahanahay inaan u tago qolka xaaladaha degdega ah 2 shoog ICD 24 saacadood gudahood, marka 1 shoog mararka qaarkood kaliya u baahan yahay wac dhakhtarkayga wadnaha?¶

Haddii ICD-gaagu uu keeno 1 shoog oo aad isla markiiba dareento boqolkiiba 100 ganaax leh eber xanuun laabta ah, dawakhaad, ama neefta oo gaaban, waxay la macno tahay ICD waxay si guul leh u joojisay hal xabbo oo wadne xanuun wadnahaaguna wuxuu ku soo noqday xamaasad deggan (waxay u baahan tahay wicitaan degdeg ah oo taleefoon ah iyo gelinta fog ee rugta wadnahaaga). Si kastaba ha noqotee, helitaanka 2 ama in ka badan shoog 24 saacadood gudahood (ama 3+ shoog, oo loo yaqaan "Duufaan koronto") macnaheedu waa ama garaaca wadnaha dilaaga ah ayaa si toos ah u soo laabanaya sababtoo ah wadna qabad cusub, potassium hooseeya, ama wadnaha oo shaqeyn waayay, ama silig jabay ayaa kugu naxay si aan habboonayn, labaduba waa xaalado degdeg ah oo nafta halis gelinaya oo u baahan ambalaas degdeg ah.

IPhone (MagSafe), dabaylaha smartwatch, ama qalinka birlabeedka magnetic ma dami karaa runtii defibrillator la geliyey (ICD)?¶

Haa, Cardioverter-Defibrillator kasta oo la-Muuqan karo waxa ku jira birlab birlab ah ama beddelka Hoolka-saamaynta loogu talagalay si takhaatiirta cisbitaalka ay u dhigaan magnet giraan xoog leh laabta si ay si ku-meel-gaar ah u joojiyaan shoogga. Taleefannada casriga ah ee casriga ah ee leh giraanta dallacaadda magnetka ee wireless-ka ah (sida Apple MagSafe), xajiyeyaasha smartwatch magnetic, e-sigaarka/vapes leh koofiyadaha magnetic, iyo cajaladaha maaskaro ee CPAP magnetic waxay ka kooban yihiin magnets neodymium awood leh oo dhaqaajin kara haddii la dhigo 15 sentimitir (6 inji) xabadkaaga (sida jeebka naaska), si aamusnaan ah ayaa CD-ga u joojinaya awoodda magnetkaaga. ka guuray.

Muxuu dhakhtarku kaliya u qori karin kiniinka antibiyootiga afka ah ama uu u qori karo jeebka garaaca wadnaha ee bararsan, sida bararka maqaarka caadiga ah?¶

Marka bakteeriyadu ay gasho jeebka agagaarka qalabka wadnaha garaaca ama ICD, ama haddii maqaarku soo baxo xitaa millimitirka qalabka birta ah uu ka muujiyo maqaarka, bakteeriyadu waxay samaysaa fiilooyinka caaga ah ee caatada ah ee aan la baabi'in taasoo si toos ah hoos ugu sii marta xididdada gudaha wadnahaaga. Waligaa haku dhufan jeebka garaaca wadnaha, weligaa ha isku hallayn kaniiniyada afka oo keliya: daawaynta caabuqa aaladda la xaqiijiyay waxay u baahan tahay antibiyootiga xididada ee isbitaalka iyo ka saarista qalliin dhamaystiran ee koronto-dhaliye iyo fiilooyinka si aanu caabuqu u keenin dilaaga wadnaha-valve endocarditis.

Ilaha la hubiyay¶

• ** Bulshada Laxanka Wadnaha (HRS, United States), Ururka laxanka Wadnaha ee Yurub (EHRA), iyo Asia Pacific Rhythm Society (APHRS):** (CIED) Maaraynta iyo Ka-soo-saarka rasaasta* (Infekshanka jeebka iyo nabaad guurka).
• ** American Heart Association (AHA, United States):** * Maareynta Kiliinikada ee Bukaannada leh Cardioverter-Defibrillators (1-Shock vs. Multiple-Shock Patient Plan), * AHA Qaangaarka Aasaasiga ah iyo Tilmaamaha Taageerada Nolosha Sare ( Meelaynta AED Pad ee Bukaan-socodka Wadnaha / ICDs) ee Maraykanka (JAHA) Magnets Macaamiisha (MagSafe / Sigaarka Elektrooniga ah) iyo Faragelinta CIED.
• Bulshada Yurub ee Wadnaha (ESC) iyo Golaha Dib u soo noolaynta Yurub (ERC): * Tilmaamaha ESC ee Wadnaha Wadnaha iyo Daawaynta Dib-u-habaynta Wadnaha* iyo Maaraynta Endocarditis Infekshanka.
• ** Adeegga Caafimaadka Qaranka (NHS, United Kingdom) iyo Aasaaska Wadnaha ee Ingiriiska (BHF, Boqortooyada Ingiriiska):**

Tilmaamaha la xidhiidha¶

• Dadka waaweyn iyo carruurta CPR iyo AED hagaha
• Wadnaha orodka degdega ah (SVT), maneuver Valsalva oo la beddelay, iyo calamada cas ee arrhythmia
• Aqoonsiga wadna xanuunka iyo gargaarka degdega ah
• Suuxdin ( syncope) gargaarka degdegga ah iyo calamada cas ee wadnaha
• Sepsis iyo aqoonsiga naxdinta septic