Thuso ya potlako ya kalafi ya go tlhomamisa selo sa kwa ntle le go tsenngwa¶

Kgobalo ya go kokotelwa mo koteng e diragala fa selo se se lelefaditsweng se se gagametseng (se se jaaka legare la thipa, thobane ya tshipi, terata ya logong, kala ya setlhare, karolo ya galase, šafote ya motsu, kgotsa selo se se bofelelang sethunya sa dinala sa mowa) se tlhaba mmele mme se nna se tsentswe mo tseleng ya ntho. Le fa go bona selo se se tlhagelelang ka leitlho go tsosa keletso e e nonofileng ya tlholego mo motswasetlhabelong le mo bathong ba ba lebileng go se ntsha ka bonako, go ntsha selo se se bapotsweng mo tshimong ke nngwe ya ditsela tse di bonako tsa go baka go dutla madi a a bolayang ka bonako.

Mo teng ga mmele, šafote ya selo se se tsenngwang e dira jaaka polaka e e tlhomameng ya motšhini (internal tamponade), e gatelela dintlha tse di kgaotsweng tsa ditshika tse di nang le kgatelelo e e kwa godimo, ditshika tse dikgolo, kgotsa diphaposi tsa pelo kgatlhanong le dithishu tse di di dikologileng. Ka nako e e tshwanang, milimitara nngwe le nngwe ya go tshikhinyega ga kafa thoko kgotsa ya go dikologa e e dirisiwang mo setshwarong se se tlhagelelang kwa ntle ga mmele e gola go nna areke e e bulegileng e e kgaoganyang kwa ntlheng e e kwa teng mo teng ga sehuba, mpa, molala kgotsa legata. Go itse melao e e gagametseng ya kalafi ya gore selo se se kokotetsweng ga se a tshwanela go amiwa leng, dipharologano tse pedi tse di sa tlwaelegang tsa tsela ya mowa e e bolokang botshelo le CPR, le gore go ka agiwa jang bolster e e gagametseng ya dikarolo tse dintsi kgotsa seaparo sa lesale se se lotlelang selo se se sa tshikinyegeng gotlhelele ka nako ya sepalangwa go ka kaya pharologano fa gare ga go falola le go tswa ka bonako.

Dira se jaanong¶

1. Tlogela selo se se kokotetsweng se le mo lefelong la sone sentle mme o bolelele motswasetlhabelo gore a se ka a se tshwara kgotsa a se goga. E ka tswa e le thipa ya boapeelo mo sehubeng, karolo ya galase mo molaleng, karolo ya rebar e e tsenang mo seropeng, kgotsa lenala la go foreima mo lengoleng, O SE KE wa e goga mme o se ka wa letla molwetse go tswa.
2. Leletsa nomoro ya gago ya tshoganyetso ya selegae ka bonako mme o kope bobedi bathusi ba kalafi ba Tshegetso ya Botshelo e e Gatetseng Pele (ALS) le Phalotso ya Setegeniki e e Bokete fa motho a tshwaragane le sebopego se se tlhomameng. Letsa 911 kwa United States le Canada, 112 go ralala Kopano ya Yuropa, 999 kwa United Kingdom, kgotsa dinomoro tsa tshoganyetso. Bolelela moromedi fa go tlhokega di-haeteroliki tse di segang kgotsa dishaga tsa go namola molelo go golola motswasetlhabelo mo terateng, mo keriting ya di-rebar, kgotsa mo metšhineng.
3. Tshwara selo se se tlhagelelang sentle ka seatla se le sengwe fa o ntse o sega diaparo go dikologa ntho ya go tsena. Le ka motlha o se ke wa goga hempe kgotsa marokgo mo godimo ga selo se se kokotetsweng, ka gonne letsela le tshwara šafote le go tlhotlheletsa ntlha ya ka fa teng mo ditshikaneng tsa madi. Dirisa dikere tsa trauma kgotsa sekere go sega diaparo gotlhelele go tswa mo motheong wa selo.
4. Laola go dutla madi kwa ntle ka go gatelela thata ka gauze e e senang megare mo letlalong GO DIKOLOGA motheo wa selo, o se ke wa kgarameletsa kwa tlase mo selong ka bosone. Baya menwana e e nang le ditlelafo le dipedi tsa gauze tse di menaganeng mo matlhakoreng oobedi a ntho ya go tsena mme o dirise kgatelelo e e tlhomameng ya go ya kwa tlase mo letlalong le le dikologileng kwa teng.
5. Aga setsidifatsi se seleele, se se gagametseng se segolo (sethibela-ring sa donut, dirolo tsa gauze tse pedi, kgotsa kopi e e sireletsang e e theipitsweng) go fitlha go bonnye halofo ya bogodimo jwa selo se se tlhagelelang. Kgobokanya dithapo tse di biditsweng, dithapo tse di menaganeng tsa go utlwa botlhoko, kgotsa dithaole tse di phepa mo matlhakoreng otlhe a gaze-rap, paterone go dikologa padding go lotlela selo kgatlhanong le go thekesela gope go go tswang kwa letlhakoreng le lengwe.
6. Boloka motswasetlhabelo a sa tshikhinyega gotlhelele, a thutafetse, le NPO (a se sepe ka molomo) fa o ntse o lebile go dutla madi mo teng le go tshoga. O se ka wa mo naya metsi, dijo, kgotsa melemo ya molomo. Boloka letsogo le le gobetseng kgotsa mmele o sa tshikinyege fa o tsamaya mo godimo ga sepalangwa sa ambulense, mme o tlhole go itaya ga pelo go go kgakala, mmala wa letlalo, le go hema metsotso mengwe le mengwe e le 5.

Setlhare sa tshwetso sa tshoganyetso sa go bapolwa le dilo tse di tsenngwang¶

flowchart TD
    Start["Victim with Impaled or Embedded Foreign Object"]
    StopPull["CRITICAL RULE: DO NOT PULL OUT THE OBJECT<br/>Manually steady object and call EMS + Fire Technical Rescue"]
    ExceptionCheck{"Does the Object Meet One of the Two Rare Removal Exceptions?<br/>1. Piercing the cheek with catastrophic airway bleeding<br/>2. Directly blocking chest compressions during Cardiac Arrest"}
    ExceptionCare["RARE CLINICAL EXCEPTION PROTOCOL<br/>- Cheek perforation blocking airway: carefully extract ONLY if needed to suction/pack oral bleeding and secure airway<br/>- Blocking CPR in confirmed cardiac arrest: remove or cut flush ONLY if required to perform life-saving chest compressions"]
    PinnedCheck{"Is the Victim Impaled onto a Fixed Immovable Structure?<br/>(Rebar in concrete, iron picket fence, tree trunk, machinery)"}
    TechRescue["PINNED CASUALTY / TECHNICAL EXTRICATION<br/>1. Manually support victim's full body weight so gravity cannot tear wound<br/>2. Wait for Fire Rescue to cut the structure AWAY from the body<br/>3. Cool metal with water and shield victim if saws/torches are used<br/>4. Leave a 10 to 15 cm (4 to 6 in) stub attached to transport into OR"]
    LocationCheck{"Identify Anatomical Region of Free-Standing Impaled Object"}
    EyeGlobe["Eye / Orbit Impalement<br/>1. Zero pressure on eyeball<br/>2. Build tall gauze collar + tape paper cup over object<br/>3. Cover BOTH eyes to stop conjugate eye movement"]
    ChestNeckAbd["Neck, Chest, Abdomen, Pelvis, or Skull<br/>1. Press gauze AROUND base (never on skull fragments)<br/>2. Seal sucking chest wound around shaft with vented dressing<br/>3. Build twin-roll or doughnut stabilizer and monitor for shock"]
    Extremity["Limb / Extremity Impalement<br/>1. Press gauze around base to control bleeding<br/>2. Apply bulky bolster + splint entire limb joint-to-joint<br/>3. Check distal pulse, capillary refill, and nerve function"]

    Start --> StopPull
    StopPull --> ExceptionCheck
    ExceptionCheck -->|Yes: Airway Blocked or CPR Impossible| ExceptionCare
    ExceptionCheck -->|No: All Other Cases (99.9%)| PinnedCheck
    PinnedCheck -->|Yes: Pinned to Fence / Rebar / Post| TechRescue
    PinnedCheck -->|No: Object Mobile with Patient| LocationCheck
    LocationCheck -->|Eye or Orbit| EyeGlobe
    LocationCheck -->|Head, Neck, Chest, or Abdomen| ChestNeckAbd
    LocationCheck -->|Arm, Hand, Leg, or Foot| Extremity

Go bapisa dikgaolo tsa mmele le dikotsi tse di rileng tsa go tlhomama¶

Dibopeho tsa ka hare tse tshoseditsweng ke ntho e kentsweng le tsela e tobileng eo o sebedisang kgatello ya ho tsitsisa e itshetlehile ka ho phethahetseng ka sebaka sa mmele se phuntsweng.

Bomekheniki jwa ditshedi jwa go tsenelela mo teng ga mmele le kotsi ya letsogo la lever¶

Go tlhaloganya lebaka la go bo dingaka tse di arang batho ba ba utlwileng botlhoko di gatelela gore selo sengwe le sengwe se se tsenngwang se tlhomamisege ka kelotlhoko pele ga se isiwa kwa bookelong, akanya ka maatla a mabedi a metšhini a a dirang kwa ntlheng ya sebetsa kgotsa thobane e e mo teng ga mmele wa molwetse:

1. Tamponade ya ka fa gare le go boela morago ga sejana¶

Fa selennere e e gagametseng (e e jaaka thobane ya tshipi ya dimilimitara di le 12 / 0.5-inch kgotsa legare la thipa la bophara jwa disentimetara di le 3) e tsenya tshika e kgolo ya madi kgotsa serwe se se tiileng sa methapo (jaaka sebete, sebete, kgotsa diphilo), dilo di le tharo di diragala ka nako e le nngwe go fokotsa go elela ga madi: * Go thibela ka metšhini: Tshipi e e tiileng kgotsa logong e tsaya bokoa jo bo tlhomameng jwa karolo ya sefapano mo leboteng la sejana. * Go tlhotlhorega ga mesifa e e borethe ya methapo: Mabota a ditshika a a segilweng kgotsa a a otlollotsweng a na le ditlhale tsa mesifa e e borethe e e sediko tse di ngotlang ka tsela e e bontshang go dikologa šafote ya kwa ntle. * Kgatelelo ya hematoma ya mo methapong: Madi a kwa tshimologong a dutlelang mo sebakeng se se gagametseng sa fascial se se dikologileng methapo a a tlhotlhorega mme a gatelela morago kgatlhanong le lebota la mothapo.

Fa selo seo se ka gogwa kgotsa sa tshikinyega, dikgoreletsi tsotlhe tse tharo tse di sireletsang di a palelwa ka ponyo ya leitlho: polaka ya motšhini e a nyelela, sejana se se gagogileng se a bulega, mme legogo le le sireletsang la thishu e e boleta le a gagoga.

2. Phelelo ya Fulcrum le Letsogo la Lever¶

Selo se se kokotetsweng se dira jaaka lever ya maemo a ntlha e fulcrum ya yone (ntlha ya pivot) e nnang mo nthong e e tsenang mo letlalong: * A re re kota ya logong kgotsa motsu o tswa disentimetara di le 20 (disentimetara di le 8) kwa ntle ga sehuba kgotsa mpa mme o tsenelela disentimetara di le 10 (disentimetara di le 4) mo teng ga mmele. * Fa ntlha e e kwa ntle e e tlhagelelang e thulana ka nako ya fa go rwalwa ka sepalangwa kgotsa e reketla ka disentimetara di le 4 fela (disentimetara di le 1,5) mo ambulenseng, ntlha e e bogale e e ka fa teng e akgega go kgabaganya areke ya disentimetara di le 2 (disentimetara di le 0,8) mo teng ga pelo, mafatlha, kgotsa sebete**, e dira jaaka win ka ditshika le ditshika tse disha tse di sa gobelang. * Ka jalo, go tlhomamisa selo se se kokotetsweng go tlhoka go lotlela šafote bonnye go ya kwa godimo ga boleele jwa yone jo bo tlhagelelang gore fulcrum e se ka ya kgona go dikologa mo godimo ga letlalo.

Diphapogo tse pedi fela tsa kalafi tse mo go tsone selo se se bapotsweng se ka tlosiwang¶

Go ralala dikaelo tsa Komiti ya Boditšhabatšhaba ya Puisano ya go Tsosolosa (ILCOR), Kholetšhe ya Dingaka tsa Amerika ya Tshegetso ya Botshelo ya Dikgobalo Tse di Kwa Godimo (ATLS), le Tshegetso ya Botshelo ya Dikgobalo tsa Pele ga Bookelo (PHTLS), go na le maemo a mabedi fela a a sa tlwaelegang a a tshosetsang botshelo a mo go one motho yo o tsibogang pele ga go ya kwa bookelong a letleletsweng go tlosa

Mokgwa o o sa tlwaelegang 1: Go kokotelwa ga marama a a phunyegileng go go bakang go thibana ga tsela ya mowa mo go maswe¶

Fa selo se phunya lebota le le bonolo le le nang le nama la lerama (buccal cavity) go tsena mo molomong, se baka go dutla madi ka bonako mo tshikeng ka tlhamalalo mo morago ga mometso o o ka se kgoneng go laolwa kgotsa go gogwa go dikologa selo, mme se thibela ka tlhamalalo mopholosi go boloka tsela ya mowa e bulegile theno doan pharynx, motheo wa legata, kgotsa lerapo la mokwatla wa popelo): * Ngaka e e katisitsweng kgotsa mopholosi a ka nna a ntsha selo ka kelotlhoko mo lerameng fela fa go tlhokega go phutha ka fa teng le ka fa ntle ga lebota la lerama ka gauze le go phepafatsa tsela ya mowa gore molwetse a se ka a hupelwa ke madi. * Go farologana le seo, fa go kokotelwa ga marama go sa tlale ka matlhagatlhaga mo tseleng ya mowa mme molwetse a kgona go hema le go kgwa mathe kgotsa go gogwa ka pabalesego, kgotsa fa selo seo se tsenelela kwa teng mo magaleng a a thata, mo molaleng, kgotsa mo motheong wa legata, se tlogele sentle mme o se tlhomamise kwa ntle.

Pharologano 2: Selo se se thibelang ka tlhamalalo go gatelelwa ga sehuba ga CPR go go bolokang botshelo kgotsa go bewa ga tsela ya mowa mo go emeng ga Pelo go go netefaditsweng¶

• Go kokotelwa ga sehuba kwa pele fa pelo e eme: Fa motho yo o gobetseng a se na go itaya ga pelo mme a sa heme (go ema ga pelo go go netefaditsweng)** mme selo se se kokotetsweng ka tlhamalalo mo gare ga lerapo la sehuba (sternum) se dira gore go se ka ga kgonega mo mmeleng go baya diatla mo sehubeng go dira go tsosolosa pelo le makgwafo ka go sa dirise CPR1. dintsho. Baphalotsi ba tshwanetse go sega selo seo se lekana le lebota la sehuba ka bonako kgotsa, fa didirisiwa tsa go sega di seyo, ba se tlose gore go gatelela sehuba ga boleng jo bo kwa godimo go simolole ka bonako.
• Go kokotelwa mo mokwatleng kgotsa mo setlhopheng se se thibelang go tsena mo tseleng ya mowa fa go hema/pelo e eme: Fa motswasetlhabelo yo o idibetseng, yo o tlhokang go hema, yo o sa thunyeng pelo a tlhomilwe ka sefatlhego kwa tlase kgotsa a na le selo se seleele se se tlhagelelang mo mokwatleng wa gagwe se se mo thibelang go mo pitikololela mo mokwatleng wa gagwe go bula tsela ya mowa le go dira CPR, bafalotsi ba tshwanetse go tlhoma mattress a mabedi ka fa gare ga tsone mo seteretšheng ka jalo selo se lepelela fa fatshe fa gare ga dipedi fa molwetse a robetse ka tlhogo; fa seo se sa kgonege mme molwetse a swa ka ntlha ya go thibana ga tsela ya mowa kgotsa go ema ga pelo, go khutshwafatsa kgotsa go tlosa kgoreletso eo go dira tiro ya go tsosolosa ke selo se se tlang pele.

Mokgwa wa kgato ka kgato: go aga seaparo se segolo sa go tlhomamisa¶

Le ka motlha o se leke go tlhomamisa selo se se kokotetsweng ka go baya fela methalo e e sephaphathi ya theipi e e kgomarelang go kgabaganya bogodimo jwa setshwaro jaaka tante; theipi e otlolla mme e letla šafote ho pendulum morao le morao ka ho otla ha pelo e nngwe le e nngwe le thupa ya tsela. Go na le moo, dirisa nngwe ya mekgwa e meraro ya go tlhomamisa popego go ikaegile ka popego ya selo.

Mokgwa 1: Twin-Roll Bolster (E siametse dithipa tse di sephaphathi, dikarolwana tsa galase, le dišafote tse ditelele)¶

1. Abela Molekane 1 go tshwara selo se sa tshikinyege: Molekane 1 o tshwara selo se se tlhagelelang ka bonolo ka menwana e e nang le ditlelafo go thibela go sekama gope fa Molekane 2 a baakanyetsa go apara.
2. Tshasa diphete tsa motheo tsa gauze e e kgaoganeng go dikologa ntho ya go tsena ga letlalo: Tsaya dithibela tse pedi tse dikima tse di senang megare tsa kgobalo kgotsa ditlhopha tsa diphete tsa gauze tsa disentimetara di le 10-ka-10 (4-ka-4-inch). Relela mokgobo o le mongwe o o sephaphathi mo letlalong kgatlhanong le letlhakore la molema la legare/šafote mme mokgobo wa bobedi o sephaphathi kgatlhanong le letlhakore la moja gore di sandwich lebadi la go tsena ka thata le go laola go dutla madi.
3. Beya dirolo tse pedi tse di thata tse di bokete go bapa le šafote: Tsaya dirolo tse pedi tse dikgolo tse di sa bulwang tsa cling gauze, dithapo tse pedi tsa crepe tse di phuthilweng, diboloko tse pedi tsa foam splint, kgotsa dithaole tse pedi tsa diatla tse di phuthilweng thata. Beha rolo e le nngwe e bapileng kgahlano le lehlakoreng le leng le le leng la ntho e hlahang (e phomotse hodima dipedi tsa motheo).
4. Aga bogodimo go fitlha go bonnye diperesente di le 50 go ya go 75 tsa boleele jo bo tlhagelelang: Fa setshwaro se tswela kwa ntle ka disentimetara di le 12 (disentimetara di le 5), kgobokanya llaga ya bobedi ya dithapo tse di biditsweng ka enkele ya didikirii di le 90 (setaele sa "log cabin") go fitlhelela go tlatsa go fitlha kwa bonnyeng disentimetara di le 6 go ya go disentimetara di le 9 go ya kwa godimo.
5. Lotlela bolster mo lefelong la yone ka gauze ya rolara ya setshwantsho sa borobedi le theipi: Phuthela gauze e e bulegileng ya rolara kgotsa bandage ya elastic ka thata go dikologa letsogo kgotsa mmele, o fete go dikologa le fa gare ga dirolo tse dikgolo ntle le go gatelela kwa tlase mo godimo ga selo se se kokotetsweng. Fetsa ka go tlhomamisa di-roll mo letlalong ka methalo e e bulegileng ya theipi ya kalafi ya letsela kgotsa theipi ya duct. Ke fela fa bolster e tiile jaaka letlapa fa Molekane 1 a gololang seatla sa bone ka iketlo.

Mokgwa wa 2: The Donut Ring Pad (E siametse ditlhogo tse dikhutshwane, manala, mitlwa, le dilo tsa legata/matlho)¶

Fa selo se se tsenngwang se tlhagelela fela ka disentimetara di le 2 go ya go di le 6 (disentimetara di le 1 go ya go di le 2.5) kwa godimo ga letlalo, kgotsa fa o tshwanetse go tila go gatelela gaufi le legata le le thubegileng kgotsa bolo ya leitlho, aga Doughnut Ring Pad: 1. Tsaya setlhako se se tshesane sa khutlotharo se se menaganeng go nna cravat, boleele jwa gauze ya rolara, kgotsa taulo e e phepa ya dijana. 2. Phuthela ntlha e nngwe ya setlhako makgetlo a le mabedi kgotsa a le mararo go dikologa menwana e e anameng ya seatla sa gago go dira loop e e fa gare e phatla ya yone e e kafa teng e leng bophara go sekae go feta selo se se kokotetsweng. 3. Fetisa mogatla o o setseng wa setlhako kgapetsakgapetsa mo lehuting le le fa gare le go dikologa rim, o goga phuthelo nngwe le nngwe sentle go fitlha o bopa torus ya letsela e e kitlaneng, e e tiileng** e e bokima jwa disentimetara di le 4 go ya go di le 6 (1.5 go ya go di le 2.5 inches). 4. Ka bonolo theola lesoba le bohareng la lesale la donut hodima ntho e hlahisitsweng e le hore rim e padded e phomole letlalong le phetseng hantle le potapotileng leqeba ntle le ho ama ntho ka boyona, ebe o tlatsa sekgeo sefe kapa sefe pakeng tsa lesale le ka hare le shaft ka gauze e bonolo e fluffed mme o theipe donut fatshe ka polokeho.

Mokgwa wa 3: Thebe ya Tshireletso ya Kopi / Khounu (E siametse dipensele, megala, kgotsa dinalete mo leitlhong kgotsa mo manonyeletsong)¶

1. Dikaganyetsa motheo wa selo ka lesale la donut la gauze le le bonolo le le ikhutsitseng mo moleng wa marapo.
2. Tsaya kopi ya go nwa ya pampiri e e gagametseng, kopi ya foam, kgotsa kopi ya melemo ya polasetiki e e boleele jo bo lekaneng gore botlase jwa yone bo tla phepafatsa ntlha e e kwa godimo ya selo se se kokotetsweng ka bonnye disentimetara di le 2 (0.8 inches).
3. Fa selo se le seleele thata go ka tsewa mo koping e le nngwe, sega phatla e nnye mo tlase ga kopi, relela kopi ka iketlo mo godimo ga šafote, paka gauze e e borethe e e sa gagamalang fa gare ga kopi le šafote go emisa thoromo, mme o bofelele rim e e bulegileng ya kopi ka thata mo letlalong le le di dikologileng kgotsa mo modikologong wa marapo.

Go laola motswasetlhabelo yo o kgomareditsweng mo sebopegong se se tlhomameng (Rebar, Magora, Ditlhare)¶

Dingwe tsa ditiragalo tsa tshoganyetso tse di raraaneng thata tsa pele ga bookelo di diragala fa modiri wa kago a wela mo bareng e e nonotshang ya konkoreite (rebar) e e emeng, ngwana kgotsa motsamaya ka dinao a wela mo terateng ya tshipi e e betlilweng e e nang le dintlha, kgotsa mokgweetsi a kokotelwa ka terata ya logong e e phunyang ka seporo sa koloi kgotsa setlhare

Goreng maatlakgogedi e le mmaba yo o gaufi¶

Fa motho a kokotelwa mo koteng e e tlhomameng ya terata kgotsa mo thobaneng e e emeng ya rebar, kgogedi e gogela bokete jwa mmele wa gagwe kwa tlase ka bonako go bapa le šafote, e gagola ntho e e ka fa teng ka bophara motsotswana mongwe le mongwe fa a lepeletse kgotsa a wela fa fatshe.

1. Tshegetsa bokete jotlhe jwa mmele wa motswasetlhabelo ka bonako: Dira gore batho ba le babedi kgotsa ba le bararo ba ba lebileng kgotsa bafalotsi ba tsene ka bonako mme ba tshware mmele wa motho, dinoka, le maoto go ya kwa godimo ka bogodimo jo bo tlhomameng le angle ya go bapolwa gore bokete jwa mmele jwa lefela bo lepelele mo thobane e e bapotsweng. Relela diboloko tsa logong tsa go tlhoma bana, setulo se se tiileng, lere, kgotsa diboto tse di kgobokantsweng kafa tlase ga motswasetlhabelo go tlosa kgatelelo mo matsogong a bafalotsi fa ba ntse ba emetse go namolwa ka molelo.
2. O se ka wa tsholetsa motswasetlhabelo GODIMO le KWA TSWA ga terata kgotsa rebar: Le fa thobane ya rebar e le borethe kgotsa tlhogo ya terata e lebega e le khutshwane, go tsholetsa motswasetlhabelo mo tlhogong mo tshimong go tshwana ka tiro le go goga thipa go tswa mo mmeleng mme go tla tsosa go dutla madi go go sa laolegeng mo teng.
3. Sega sebopego KGALE le motswasetlhabelo, o tlogele setlhogo sa disentimetara di le 10 go ya go di le 15 (disentimetara di le 4 go ya go di le 6): Ditlhopha tsa phalotso tsa molelo le tsa setegeniki di tla sega tlhomeso ya terata, kala ya setlhare, kgotsa thobane ya rebar ka phepafalo go tswa mo sebopegong sa motsadi gore molwetse a kgone go tsholediwa mo letlhakoreng la bone la impwi

Melawana e e botlhokwa fa go sega dithapo tsa tshipi kgotsa dintlhana tsa terata ya tshipi gaufi le motswasetlhabelo¶

Fa baphalotsi ba molelo kgotsa batsibogi ba madirelo ba tshwanetse go sega thobane ya tshipi kgotsa tlhomeso ya logong e e gokeletsweng mo mothong yo o gobetseng, dikotsi di le nne tsa mmele di tshwanetse go laolwa:

Dilo tse di kgethegileng tse di tsenngwang mo makgetlong a a kwa godimo: Dihuku tsa Ditlhapi, Ditlhobolo tsa Dinala, le Dithapo tsa Taser¶

Ga se selo sengwe le sengwe se se tsenngwang e leng thobane e kgolo ya rebar; dingaka tsa maemo a tshoganyetso le batho ba ba tsibogelang kwa nageng gantsi ba kopana le dihuku tsa ditlhapi tse di tlhabang, dinala tsa go dira diforeime tsa mowa le ditlhotlhomiso tsa sebetsa sa motlakase se se tlhabang se se tsamaisang motlakase (Taser).

1. Dihuku tsa Tlhapi tse di Tlhabang¶

Fishhook e na le shank e e kobegileng e e felelang ka ntlha e e bogale le barb e e supang kwa morago e e diretsweng go tshwara mo nameng fa e gogelwa kwa morago.

• Fa o sa tshwanela go tlosa fishhook mo tshimong:
• Sehuku se tsentswe mo kgotsa gaufi le bolo ya leitlho, letlhokwa la leitlho, kgotsa modikologo wa marapo (thebe ka kopi ya pampiri mme o ye ka bonako kwa ngakeng ya matlho).
• Sehuku se tsentswe mo godimo ga tshika e kgolo kgotsa mothapo (molala, letsogo la radial/ulnar, letheka, antecubital fossa), mo teng ga capsule ya lelokololo la monwana kgotsa sheath ya tendon ya flexor, kgotsa ka fa tlase ga lenala la monwana.
• Ke treble hook e e nang le dintlha tse dintsi e e nang le ntlha e e fetang e le nngwe e e fitlhilweng kgotsa e e akgegang gaufi le letlalo ka tsela e e kotsi fa e dirisiwa ka tsela e e sa siamang.
• Kafa dingaka di tlosang sekgomaretsi sa letlalo se se sa raraanang se se nang le tlhaba e le nngwe ka gone:
• Mokgwa wa Advance-and-Cut (o o babalesegileng go gaisa mo dihuku tse di tseneletseng kgotsa tse dikima): Morago ga go tlhotlhora letlalo le go phepafatsa ka sebolaya-ditwatsi, ntlha le tlhaba ya sekgomaretsi di kgoromelediwa kwa pele go tsamaelana le sebopego sa tlholego sa sekgomaretsi go fitlhela ntlha e e tlhabang e ntsha ka boalogodimo jwa letlalo; di-wire cutters di bo di kgaola ntlha e e tlhabang, mme shank e e borethe e e senang tlhaba e tshegediwa kwantle ga maiteko ape go tswa mo lehuting la go tsena.
• Mokgwa wa String-Yank (wa dihuku tse di seng boteng mo letlalong le le nang le nama): Loop ya thapo e e nonofileng ya go tshwara ditlhapi kgotsa theipi ya mokhubu e phuthelwa go dikologa ntlha e e fa gare ya go koba ga huku fa mopholosi a tobetsa leitlho/shank ya yank e e sephaphathi fa fatshe kgatlhanong le letlalo (e e ntshang brirmilong the bar aseke ya shank.

2. Dikgobalo tsa Ditlhobolo tsa Dinala tsa Mowa¶

Di-nailers tsa segompieno tse di dirisang mowa le tse di senang thapo di thuntsha dinala tsa disentimetara di le 5 go ya go di le 9 (disentimetara di le 2 go ya go di le 3,5) ka lobelo lwa dimitara di le 400 ka motsotswana (maoto a le 1 300 ka motsotswana). Se se botlhokwa ke gore, dinala tsa kago gantsi di ring-shank (di na le tlhale ya annularly) kgotsa di na le dithapo tsa polasetiki/thapo ya go kopanya (manala a a kopantsweng) mme di apesitswe ka dikgomaretsi tsa resin tse di nyerologang fa di thulana le go kgomaretsa lenala mo lerapong.

• Prothokholo ya thuso ya potlako ya dikgobalo tsa tlhobolo ya dinala:
• O se ke wa ntsha setshwariso sa sethunya sa manala ka di-pliers kapa hamore ya lenala sebakeng sa mosebetsi: Go goga lenala le le nang le thapo e e tlhabang kgotsa le le nang le ring-shank kwa ntle go ya kwa morago go gagola ditshika, ditshika, le ditshika tsa madi mme go tlogela dithapo tse di leswe le dikarolwana tsa marapo tse di apesitsweng ka kopore kgotsa sebaka sa lerapo se se kwa teng.
• Tshwara kgobalo nngwe le nngwe ya tlhobolo ya dinala mo sehubeng, mo tlhogong, mo molaleng, kgotsa mo mpeng jaaka kgobalo e e tshosetsang botshelo e e lekanang le go thuntshiwa ka tlhobolo: Diperesente di feta 25 tsa dikgobalo tsa tlhobolo ya dinala tsa pelo kwa tshimologong di tsamaya kgotsa di bua pele ga di nna le cardiac tamponade e e bolayang ka tshoganyetso. Leletsa 911/112/999 ka bonako.
• Go phunya lenala la seatla, monwana, lengole, kgotsa leoto: Tlogela lenala le sa amiwa, aga donut e nnye ya gauze kgotsa bolster ya mafatlha go dikologa tlhogo ya lenala e e tlhagelelang, kgaoganya letsogo kgotsa lengole mo boemong jo bo bonweng, mme o ye kwa lephateng la tshoganyetso go dira **go tlhatlhobiwa ka lerapo, go tlhatlhobiwa ka lerapo, ditlhabo tsa terata tse di fitlhegileng), go ntsha ka karo, go nonotsha tetanus, le go akaretsa dibolayamegare.

3. Dipatlisiso tse di Tlhabang tsa Sebetsa sa Motlakase se se Tsamaisiwang (CEW / Taser)¶

Dipatlisiso tsa Taser tsa tiragatso ya molao di na le silintara ya dart ya tshipi e e nang le ntlha ya barb e e tlhamaletseng ya dimilimitara di le 9 go ya go di le 12 (disentimetara di le 0.35 go ya go di le 0.47). Diporobe tse di tsenngwang mo leitlhong, sefatlhegong, molala, mometso, letsweleng la mosadi, mo sehubeng/dirweng tsa tlhakanelodikobo, kgotsa ka tlhamalalo mo diphuthelwaneng tsa marapo kgotsa tsa methapo di tshwanetse go tlhomama mo lefelong la tsone mme di tlosiwe kwa bookelong.

Go tlhomama ga thuso ya ntlha go thibela gore go bapolwa go se ka ga bolaya pele ga bathusi ba kalafi ba goroga, mme go ikatisa ka diatla go dira gore bokgoni jono bo itirele fela fa go le mo kgatelelong. Akanyetsa go wetsa thuso ya potlako e e netefaditsweng, Stop the Bleed, kgotsa khoso ya go utlwa botlhoko mo nageng ka mokgatlho wa gago wa bosetšhaba wa Sefapaano se Sehibidu kgotsa Red Crescent, Kholetšhe ya Dingaka tsa Amerika, kgotsa Ambulense ya St John.

Dipotso tse di bodiwang kgapetsakgapetsa¶

Metswedi e tlhotlhomisitswe¶

• Kholetšhe ya Dingaka tsa Amerika (ACS, United States): Buka ya Khoso ya Baithuti ya Tshegetso ya Botshelo ya Dikgobalo Tse di Tsweletseng (ATLS): Kgobalo e e Tsenelelang, Dikgobalo tsa go Kopolwa, le Taolo ya go Tshola Madi.
• Mokgatlho wa Bosetšhaba wa Botegeniki jwa Kalafi ya Maemo a Tshoganyetso (NAEMT, United States): Tshegetso ya Botshelo ya Pele ga Kgobalo ya Bookelo (PHTLS): Taolo ya Dilo tse di Bapotsweng le go Ntsha ka Setegeniki.
• Komiti ya Puisano ya Boditšhabatšhaba ya go Tsosolosa (ILCOR, Boditšhabatšhaba) & Sefapaano se Sehibidu sa Amerika: Dikaelo tsa Thuso ya Ntlha le go Tsosolosa: Go Dula Madi thata le Dilo Tse di Sele tse di Kopotsweng.
• Tirelo ya Bosetšhaba ya Boitekanelo (NHS, United Kingdom) & Ambulense ya St John (United Kingdom): Buka ya Thuso ya Ntlha: Dilo tse di Tsenngwang, Go Kgaolwa ga Ditokololo, le go Dula Madi a a Masisi kwa Ntle.
• Disenthara tsa Taolo le Thibelo ya Malwetse (CDC / NIOSH, United States): Pabalesego ya Ditlhobolo tsa Dinala le Taolo ya Kalafi ya Dikgobalo tsa Dibofelelo tsa Mowa tsa Lebelo le le Kwa Godimo.
• Legoro la Tlhokomelo ya Pele ga Bookelo, Kholetšhe ya Segosi ya Dingaka tsa go Ara ya Edinburgh (United Kingdom): Kaelo ya Tumelano ka ga Taolo ya Pele ga Bookelo ya go Kgoma ga Sehuba le mo Mpeng.

Dikaedi tse di tsamaelanang¶

• Go laola go dutla madi thata le di- tourniquet
• Go anya ntho ya sehuba le thuso ya potlako ya mafatlha a a phutlhameng
• Go ntsha mala mo mpeng le go tlhokomela ntho e e bulegileng mo mpeng
• Selo se sele mo leitlhong le mo tshireletsong ya kgolokwe e e bulegileng
• Temogo ya tshoganyetso le tlhokomelo ya tshoganyetso
• Dinomoro tsa tshoganyetso le thomelo ya boditšhabatšhaba