Ngaahi Fuka Kulokula Hili hono Fakaʻatā ʻo e Tafá, Tafe Toto ʻi Lotó, mo e Maʻú¶

'Oku kehekehe 'a e ngaahi fika fakavavevave 'i he fonua .. ʻOku fakaʻaongaʻi ʻe he peesi ko ʻení ʻa e 911, ko e fika ia ki he ʻIunaiteti Siteití mo Kānata. ‘Oku ngāue‘aki ‘e he ngaahi fonua lahi kehe ‘a e 112, 999, pe ko ha toe fika kehe. Kumi e fika ki ho fonua ..

Lahi ange 'i he peseti 'e 65 'o e ngaahi founga tafa 'i mamani kotoa 'oku fakahoko he taimi ni 'i ha ambulatory (outpatient) pe vave-faka'ata 'a e makatu'unga, 'Oku 'uhinga ia 'oku laui miliona 'a e kau mahaki 'oku nau mo'ui mei he faka'auha fakalukufua, ngaahi poloka 'o e tu'asino, laparoscopy, vascular 'a e 'alunga, mo e ngaahi tafa 'o e hui pe kete 'i loto 'i honau ngaahi 'api tonu 'o e operaving 'i loto 'i he hours. Lolotonga e lahi taha 'o e mamahi hili 'a e tafa, 'a e 'uto 'oku 'ikai fu'u lahi, mo e ngaahi lavea 'o e kalasi ma'ulalo 'oku fakalelei'i lelei, 'Oku 'ave 'e he 'uluaki 'aho 'e 14 hili 'a e tafa 'a e ngaahi matapa sio'ata 'o e nunu'a ma'olunga ki he fakapulipuli 'a e toto 'i loto, fakalahi 'o e hematomas 'o e halanga 'ea, toloi malignant hyper histhermido kete)**, ngaahi 'anastomotiki 'o e 'uto, 'embolism 'o e ma'ama'a, mo e sepsis hili 'a e tafa.

Ko ho'o ngaahi me'a 'oku fakamu'omu'a vave 'i he taimi 'oku tokanga'i ai ha mahaki tafa na'e toki faka'ata 'oku kovi ange 'i 'api ko hono fakafaikehekehe'i 'o e tafa 'oku 'amanaki ke fakaakeake mei he ngaahi fakatu'utamaki tafa fakatu'utamaki ki he mo'ui, ui 'a e ngaahi ngaue fakafaito'o fakavavevave kimu'a pea toki hoko 'a e 'ohovale 'o 'ikai lava ke fakafoki, tauhi 'a e kete 'o e mahaki urgent return kakato 'a e emp) ‘oku fiema‘u ‘a e loki tafa, malu‘i ‘a e ngaahi tisiū pe ngaahi fokotu‘utu‘u ‘o e halanga ‘eá ‘oku ‘asi maí, pea fakahoko atu ‘a e founga tafa totonu mo e ngaahi tohi faka‘atā ki he kau toketā fakafaito‘ó.

Fai ʻeni he taimí ni .¶

Ta ki he ngaahi sevesi fakafaito'o fakavavevave 'i he taimi pe ko ia ki ha faka'ilonga hili 'a e ngaue 'oku fakatu'utamaki ki he mo'ui: Ta ki ho'o fika fakavavevave fakalotofonua (911 'i he 'Iunaiteti Siteiti mo Kanata, 112 'i he kotoa 'o e 'Iunioni 'Iulope, 999 'i he Pule'anga Fakatahataha, 000 'i 'Aositelelia) pe vakai'i 'emau tohi fakahinohino ki he ngaahi fika fakavavevave kapau ‘oku hoko ‘a e tokotaha mahakí ‘o nounou ‘a e mānavá, mamahi ‘i he fatafatá, ‘ohovale, pōlepole ‘i he‘ene tangutu haké, toto kulokula ngingila ‘oku fakamomoko ‘i he ngaahi teunga, fula vave ‘a e kiá hili ‘a e tafa ‘o e thyroid pe carotid, ngaahi uoua fefeka ‘oku ‘alu hake ‘a e mofí, pe ko ha motu‘a ‘i he keté ‘oku puna ‘o fakaava.
Fakamālohiʻi ʻa e NPO fefeka (ʻikai ha meʻa ʻi he ngutú) ʻi he taimi pē ko iá: ʻOua naʻá ke ʻoange ki he mahakí ha vai, ʻaisi, meʻakai, pe ngaahi faitoʻo fakamamahi ʻi he ngutú ʻi he taimi pē ʻoku mahaloʻi ai ha faingataʻaʻia ʻi he tafa. Kapau kuo pau ke toe fakavavevaveʻi ʻa e mahakí ki he tafa ke taʻofi ʻa e tafe toto ʻi lotó pe fakaleleiʻi ha hū ʻa e ʻutó, ʻoku fakatuʻutāmaki ʻa e maʻu ʻo e vai pe meʻakai ʻi he keté ki he fakaʻamu fakatupu mate lolotonga hono fakahoko fakavavevave ʻo e fakaʻauha fakalūkufua.
Fakatokoto 'a e mahaki ki he mahalo'i 'o e toto 'i loto pe 'ohovale: Kapau 'oku 'uli'uli 'a e mahaki, momoko, clammy, 'oho, pe tachycardic (tu'unga 'o e loto 'o laka hake 'i he 100 'o e ngaahi ta 'i he miniti 'i he malolo), fakatokoto kinautolu 'i honau tu'a pea hiki hake honau va'e 15 ki he 30 senitimita (6 ki he 12 calevomin abs pe) mamahi tafa hui.
Faka'aonga'i 'a e 'omi fakahangatonu fefeka 'i he toto tafa 'i tu'a (tukukehe 'i he paipa 'o e matangi): Kapau 'oku fakamomoko 'a e toto kulokula ngingila 'o fakafou 'i ha teunga tafa 'i ha va'e, fatafata, 'uhiki, pe kete, 'oua na'a ke to'o 'a e la'i gauze 'i lalo; fakatoka ha ngaahi taueli pe gauze kuo fakafonu maʻa mo mātuʻu ʻi ʻolunga pea lomiʻi fefeka hifo ʻaki ho ongo nimá fakatouʻosi.
'Ufi'ufi 'a e ngaahi motu'a 'o e kete kuo popped-open (dehiscence) 'aki ha teunga 'oku 'ikai ke 'i ai ha 'uhinga: Kapau 'oku tukuange 'e he ngaahi tuitui tafa pe ngaahi staples pea 'asi mai 'a e vai lanu pingikī pe ngaahi loop 'o e bowel 'i he lavea, 'oua na'a teitei teke 'a e ngaahi 'okani ki loto. ʻUfiʻufi vetevete ʻa e lavea ʻoku ʻatā ʻaki ha taueli maʻa pe ko ha kofukofu ʻoku ʻikai ke ʻi ai ha meʻa ʻi ai kuo fakamomoko ʻi ha saline ʻoku ʻikai ke ʻi ai ha meʻa ʻi ai pe ko ha vai māfana maʻa mei he paipa, pea kiʻi punouʻi ʻa e tuliki ʻo e mahakí ʻi ha ʻulumotuʻa ke toʻo ʻa e mafasia mei he ʻā ʻo e keté.
Tānaki ʻa e puha tafa mo e lekooti ʻo e faitoʻo fakaʻauhá: ʻOange ki he kau toketā fakafaitoʻó ʻa e fakamatala fakanounou ʻo e tukuange ʻo e falemahakí, fika telefoni fakavavevave ʻa e toketā tafa houa ʻe 24, kaati ʻo e tafa (kapau naʻe ʻai ha hardware pe mesh), mo e ngaahi faitoʻo fakaʻauha toto mo e faitoʻo fakamamahi kotoa pē kuo fakahinohinoʻí.

flowchart TD
    Start["Kovi ange ‘a e Mahaki Hili ‘a e Tafá ‘i ‘Api (Houa ki he ‘Aho ‘e 14 Hili hono Faka‘atā)"] --> Triage{"1. Fakaʻilongaʻi ʻa e Sīpinga Fakavavevave Tefitó ."}
    Triage -->|Shortness of Breath, Chest Pain, or Neck Swelling| AirwayPE["Faingata'a'ia 'i he Hala 'o e 'ea / Vascular: Ta ki he 911/112/999, Nofo hangatonu, Siaki 'a e Hematoma 'o e kia 'oku fakalahi pe Embolism 'o e ma'ama'a"]
    Triage -->|Pale, Sweaty, Dizzy, Heart Rate Over 100, or Expanding Belly/Thigh| Bleed["Toto ʻi Loto pe ʻi Tuʻa: Ta ki he 911/112/999, Tokoto Fakafōlahi, Lomiʻi Maʻu ʻi he Toto ʻi Tuʻa, Tauhi ʻa e NPO"]
    Triage -->|Jaw/Muscle Stiffness, Rapid Fever Over 38.8 C, Dark Urine Within 24 Hours| MH["Mahalo'i Toloi 'a e Hyperthermia Fakatu'utamaki: Ta ki he 911/112/999, To'o 'a e ngaahi kofu, Kapu mo e kili 'o e Fan, Ngaahi puha 'aisi ki he Groin/Neck"]
    Triage -->|Pink Salmon Fluid Gush from Belly Incision or Bowel Visible| Dehisce["Lavea Dehiscence / Evisceration: Ta ki he 911/112/999, 'Ufi'ufi 'aki 'a e Taueli Ma'a Moist Mafana, Piko'i 'a e Tuliki 'i he 'Alumotu'a"]
    Triage -->|Fever, Confusion, Shivering Chills, or Worsening Belly Pain Day 3 to 10| Sepsis["Mahalo'i 'oku 'i ai ha 'Anastomotic Leak pe Sepsis: Ta ki he 911/112/999 pe Toketā Tafa 'i he taimi pe ko ia, 'Oua 'e Tauhi ha Me'a 'i he Ngutu"]
    AirwayPE --> NPO["2. Fakamālohiʻi ʻa e NPO Malohi (ʻIkai ha Vai, Meʻakai, pe Ngaahi Foʻiʻakau Ngutu) ʻi he Keisi ʻo e Toe Fakalele Vave"]
    Bleed --> NPO
    MH --> NPO
    Dehisce --> NPO
    Sepsis --> NPO
    NPO --> Docs["3. Tānaki ʻa e Fakanounou ʻo e Fakaʻatā ʻo e Tafá, Lekooti ʻo e Fakaʻauhá, mo e Ngaahi Hina Faitoʻo Kotoa pē ki he EMS ."]

Laine taimi 'o e ngaahi faingata'a hili 'a e tafa: 'i he taimi 'oku hoko ai ha ngaahi faingata'a pau¶

'Oku muimui 'a e ngaahi faingata'a 'o e tafa 'i he ngaahi taimi fakapaiolosia 'oku lava ke tomu'a tala 'o makatu'unga 'i he hemostasis, metabolism faka'auha, malohi 'o e tensile 'o e lavea, mo e fakafoki 'o e pekitilia. Ko e mahino pe ko e ha e 'aho 'oku 'i ai 'a e mahaki ("Post-Operative Day 0" ko e 'aho ia 'o e tafa) 'oku tokoni ia ki he kau tauhi ke nau 'ilo'i 'a e me'a 'oku 'ikai ke lava 'i loto 'i he sino.

Matapā sioʻata hili ʻa e tafa	Ngaahi Faingataʻaʻiaʻanga Fakatuʻutāmaki Lahi Taha ki he Moʻuí	Ngaahi Faka'ilonga Fakatokanga Kalasi 'i 'Api	Tupunga Fakafisiolosia Fakalukufua
Houa 1 ki he 24 ('Aho 0 ki he 'Aho 1)	1. Palaimeli / Reactive 'a e toto 'i loto 2. Fakalahi 'o e Hematoma 'o e kia 3. Opioid-Fakatupu 'e he loto-mafasia 'o e manava 4. Ko e Hyperthermia Fakatu'utamaki hili 'a e Faka'auha 5. Toxicity Fakalotofonua 'o e Sisitemi Faka'auha (FAKA'OSI)	Ko e 'uto 'i he taimi 'oku tangutu hake ai, kili momoko 'o e 'uli'uli, pulse 'o e fe'auhi 'i he 100 bpm, toto kulokula ngingila 'oku ne fakafonu 'a e ngaahi 'aofi tafa (> 100 mL/houa), fula fufuu 'i he ngutu mo e manava longoa'a, unrousable snoring mo e manava tuai (<8/min), pe mofi fefeka mo e soa.	‘I he normalise ‘a e toto mā‘olungá hili ‘a e ‘osi ‘a e faito‘o faka‘auhá mo e epinephrine, ‘oku kamata ke tafe toto ha ligature tafa ‘oku hē pe ko ha mohenga vascular raw; pe toenga 'o e ngaahi faito'o faka'auha 'oku huhu / opioids 'oku ne ta'ofi 'a e manava pe fakatupu 'a e hypermetabolism 'o e uoua.
Aho 1 ki he 3 (Houa 24 ki he 72)	1. Atelekitasi mo e Niumonia Faka'amu *2. Ko e Fasiitisi Fakaʻauha (Kulupu A Strep* pe Clostridium) 3. Ko e Ta'ofi 'o e Mimi mo e Hematoma Hili 'a e Tu'asino 4. Ko e Fakaʻauha ʻo e Mafú (Puki ʻo e Lotó)**	Mofi takatakai 'i he 38.0 ki he 38.5 tikili Selisiasi (100.4 ki he 101.3 tikili Fahrenheit), manava vave, mamahi lahi 'i he takatakai 'i he motu'a 'oku ongo'i kovi ange 'aupito 'i he lavea 'oku sio, manifinifi "dishwater" 'a e tafe, pe fakafokifā 'a e mamahi 'i he hili 'a e epikdural blocks / legs 'oku 'ikai ke 'i ai ha 'uhinga.	Ko e ngaahi mofi vave hili 'a e op 'i lalo he houa 'e 48 'oku fa'a holo 'a e alveoli 'o e ma'ama'a (atelectasis), tukukehe 'i he taimi 'oku fakahoa ai mo e mamahi lahi 'o e lavea pe blistering, 'a ia 'oku faka'ilonga'i 'a e kakano-kai necrotizing 'a e mahaki kamata 'i loto 'i he houa 'e 24 'o e incision.
Aho 4 ki he 7	1. Leakage Anastomotic (Kete pe Kete) 2. Ko e lavea 'o e Fascial 'oku 'ikai ke 'i ai ha 'uto 3. Ko e Ma'u 'o e Feitu'u Tafa loloto (SSI) 4. Ko e Ngaahi Veini Loto (DVT) mo e Ngaahi Veini Loto (PE)	Ko e tafe fakafokifā ‘a e vai vai lanu pingikī, lanu sāmoní ‘o fakamomoko ‘i ha teunga ‘i he keté hili ‘a e tale pe fakamafasia; mamahi fo‘ou ‘i he keté ‘oku toe kovi ange mo e mamahi ‘i he tumu‘aki umá, hiku, lele vave ‘a e tu‘unga ‘o e lotó, mo e puputu‘u; pe ko ha fo‘i pulu ‘e taha ‘oku fula mo vela ‘o nounou fakafokifā ‘ene mānavá.	Ko e remodeling 'o e collagen mo e tumutumu 'o e ischemia 'o e tisiuu 'i he 'aho 5: kapau 'oku 'ikai lava 'a e ngaahi me'a 'i loto 'o e intestine/sutures, 'oku 'alu 'a e ngaahi me'a 'i he intestine ki he ava 'o e peritoneal; kapau ʻe toho mai ʻa e ngaahi sutu ʻo e fascia ʻo e keté, ʻoku mavaeua ʻa e laveá.
'Aho 7 ki he 14+	1. Toto hono ua (Eschar Sloughing, e.g., Tonsillectomy) 2. Embolism 'o e ma'ama'a (Ma'olunga taha 'o e Fakatu'utamaki 'o e kau mahaki 'i tu'a) 3. Ko e loloto 'o e kete pe Pelvic Abscess *4. Kolositidioiti faingata'a* (C. kehekehe) Kolitis**	Toto kulokula ngingila ‘oku ha‘u mei he ngutú pe ihú ‘i he ‘aho ‘e 7 ki he 10 hili ‘a e tonsillectomy; mamahi fakafokifā ʻi he fatafatá pleuritic mo e ʻikai ke toe ʻi ai; spiking faka'aho "picket-pa" mofi mo e ngaahi sweats 'i he po; pe ko e lahi ‘o e vai ‘oku ‘i ai ‘a e kafo ‘i he hili ‘a e tafa ‘o e ngaahi faito‘o ‘enitipaiōtikí.	Ko e ngaahi fo‘i ‘uhiki‘i manu (eschar) ‘i he kongalotó ‘oku nau kili ‘i he ‘Aho 7 ki he 10 nai, ‘o fakahaa‘i ai ‘a e ngaahi halanga toto ‘i laló; ko e ngaahi fo‘i toto ‘i he ngaahi veini ‘oku fa‘u lolotonga ‘a e ta‘e-ngaue ‘i he tafa ‘oku nau movete pea fononga ki he ngaahi halanga toto ‘o e mafú.

Ko e toto fakapulipuli ‘i loto mo e ‘ohovale hemorrhagic hili ‘a e tafa¶

'Oku kehe mei he toto 'i tu'a mei ha laceration 'o e kili, toto 'i loto hili 'a e tafa 'oku hoko fakalongolongo 'i loto 'i he ngaahi ava 'o e sino 'oku tapuni, 'a e ava 'o e peritoneal (kete), 'a e retroperitoneum ('i mui 'i he ngaahi fatú mo e pelvis), 'a e feitu'u 'o e pleural (fatafata), 'a e pericardium mo e. ‘E lava ke mole ‘a e lita ‘e 1.5 ki he 2.5 (paini ‘e 3 ki he 5) ‘o e totó ‘i ha tokotaha mahaki hili hono to‘o ‘a e fo‘i ‘uto ‘i he laparoscopic, to‘o ‘a e ‘utó, fakalelei‘i ‘a e hernia, pe polypectomy ‘i he colonoscopy, pe ki hono umá hili hono fetongi ‘o e kongalotó, ‘o ‘ikai ha fo‘i mata‘itofe ‘e taha ‘o e toto ‘i he tafa‘aki ki tu‘a ‘o e ‘utó ‘oku ‘asi mai.

Ko e hā ʻoku hoko ai ʻa e pupula ʻo e keté ko ha fakaʻilonga tōmui pea ko e orthostatic vitals ko ha fakaʻilonga vave .¶

'E lava ke fakalahi 'a e ava 'o e peritoneal 'o e kakai lalahi ke pukepuke ha ngaahi lita 'o e toto mo e si'isi'i taha 'oku 'asi 'a e fakalahi 'o e circumference 'o e kongaloto. Tānaki atu ki aí, ko e kau talavou mo‘ui leleí mo e kakai lalahi ta‘umotu‘a lotoloto ‘oku nau fakasi‘isi‘i honau ngaahi halanga toto ‘i he tafa‘akí ke tauhi ‘a e toto mā‘olunga ‘i he‘enau tokoto hifo ke anga-maheni kae ‘oua kuo mole ‘a e peseti ‘e 30 ‘o honau lahi fakakātoa ‘o e totó. Kumi ka ki he ngaahi fuka kulokula totongi huhu'i vave ko 'eni:

Tachycardia malolo ta'efakamaama (Tachycardia 'o e loto 'oku laka hake 'i he 100 ki he 110 'a e ngaahi ta 'i he miniti): Hili hono 'akauni'i 'o e mamahi, ko ha tu'unga 'o e malolo 'o e pulse 'oku kaka hokohoko 'oku fa'a hoko ia ko e fuofua faka'ilonga fakataumu'a 'aupito 'o e toto 'i loto pe ko ha anastomotic leakage.
Orthostatic dizziness or syncope (fainting 'i he tu'u pe tangutu hake): 'Oku ongo'i lelei 'a e mahaki 'i he'ene tokoto 'i he mohenga, ka ko e momeniti pe 'oku nau tangutu ai 'i he tafa'aki 'o e me'alele pe lue ki he falekaukau, 'oku 'uli'uli 'enau sio, 'oku tatangi honau telinga, 'oku nau movete 'i ha efuefu momoko, pea 'oku nau tō.
Fakafekau'aki 'a e diaphragmatic 'o e uma-'o e mamahi (Kehr faka'ilonga): Lolotonga 'oku angamaheni 'a e mamahi 'o e uma 'i he 'uluaki houa 'e 24 hili 'a e tafa laparoscopic mei he toenga 'o e kasa 'o e inflation 'o e kaponi tai'okisaiti ta'efakatu'utamaki, **fo'ou, lahi, pe kovi ange 'a e mamahi 'i he tumu'aki 'o e to'ohema pe to'omata'u pallorani 'o e uma, ** accomp ‘oku fakatahataha‘i ‘a e totó ‘i lalo ‘i he diaphragm pea ‘oku faka‘ita‘i ai ‘a e neave phrenic.
Ngaahi fakatokanga 'o e output 'o e tafa: Kapau na'e fekau'i atu 'a e mahaki ki 'api mo ha tafa 'o e 'uhila 'o e 'uhila 'oku tapuni-suction (hange ko ha 'uhila 'o e Jackson-Pratt pe Blake) pea 'oku fakafokifā 'a e 'uhila 'oku fonu vave 'aki 'a e kulokula ngingila, toto mafana 'o laka hake 'i he **100 mililita 'i he houa (2lli2000). ‘oku tafe toto ‘a e ‘alati pe ipu veini lahi.
Fakahoko 'o e 'uhiki / hematoma 'o e feitu'u 'o e 'uhiki: Hili 'a e 'uhiki 'o e loto, stenting 'o e 'uhiki, pe tafa endovascular 'o fakafou 'i he 'uhiki ('aati 'o e 'uhiki) pe 'a e louhi'i nima ('aati 'o e 'uhiki), ko ha vave 'a e fakalahi, maka-fefeka, throbbing fladdein subskin mo e groin . toto mā‘ulalo (toto ‘i mui ‘i he ‘utó), ko ha fakatu‘utāmaki fakavavevave ia ki he ngaahi halanga totó ‘oku fakatu‘utāmaki ki he mo‘uí.

Tokoni 'uluaki vave ki he tafe toto hili 'a e tafa¶

Tu'u 'o palakū pea hiki hake 'a e va'e: Fakatokoto 'a e mahaki 'o palakū 'i hono tu'a 'i he mohenga pe faliki pea poupou'i honau va'e ki 'olunga 'i he senitimita 'e 15 ki he 30 ('inisi 'e 6 ki he 12) ke fakafoki 'a e toto 'o e ngaahi veini ki he loto. ʻOua naʻá ke teitei lue ha mahaki post-op ʻoku pōlepole ki ha kā; ui ha meʻalele fakahaofi moʻui koeʻuhí ke lava ʻe he kau toketaá ʻo kamata ha ngaahi laine ʻo e ngaahi uoua lalahí ʻi he faliki ʻo e loki mohé.
Fakahangatonu 'a e 'omi 'i he ngaahi feitu'u 'o e puncture 'o e 'uto pe peripheral: Kapau 'oku spurts pe fula 'a e toto kulokula ngingila mei ha feitu'u 'o e catheter 'o e 'uto femoral 'i he 'uto, 'ai 'a e ngaahi to'ukupu, fokotu'u ha takai matolu 'o e gauze pe ko ha tupenu fufulu ma'a fakahangatonu 1 ki he 2 senitimita to58su. skin puncture mark ('a ia 'oku hū mo'oni ai 'a e 'alati ki he 'ā 'o e ipu loloto ange 'i loto), pea lomi'i hangatonu hifo ki he hui 'o e hip mo ho'o mamafa kakato 'o faka'aonga'i 'a e ongo nima 'oku loka'i fakataha kae 'oua kuo to'o 'e he kau toketaa.
'Oua 'aupito na'a ke vete pe to'o ha paipa tafa tukukehe kapau 'e fakahinohino'i 'e he toketā tafa, pea 'oua na'a teitei to'o mai ha tafa.
Tauhi ke mafana 'a e mahaki 'aki 'a e ngaahi palanikete momoko: 'Oku fakapalalisi 'e he hypothermia 'a e ngaahi 'enisaimi 'o e toto (ko e triad fakatupu mate 'o e lavea mo e tafa). ʻUfiʻufi ʻa e mahakí ʻaki ha ngaahi palanikete māfana lolotonga ʻene tatali ki he meʻalele fakahaofimoʻuí.

Fakalahi 'o e hematoma 'o e kia mo e hili 'a e thyroid / carotid 'a e faingata'a'ia 'i he halanga 'ea¶

Ko e ngaahi tafa ʻi he kiá, kau ai ʻa e toʻo ʻo e thyroid, toʻo ʻo e parathyroide, toʻo ʻo e ʻuto, toʻo ʻo e tuʻasino ʻi muʻa ʻo e ʻutó mo e fusion (ACDF), mo e toʻo ʻo e kiá, ʻoku ʻi ai ha fakatuʻutāmaki makehe, hyperacute lolotonga ʻa e ʻuluaki houa ʻe 6 ki he 24 ʻo e sur.

Koe‘uhi ko e ngaahi la‘i fascial loloto ‘o e kiá ‘oku nau fa‘u ha kola fufuu, ‘ikai lava ke fakaloloa ‘o takatakai ‘i he trachea (windpipe), na‘a mo ha ki‘i tānaki‘anga ‘o e mililita ‘e 50 ki he 100 ‘o e totó ‘i loto ‘i he mohenga tafa ‘oku fakalahi vave ai ‘a e mīsini ‘o e loki. Kimu'a pea toki lahi fe'unga 'a e hematoma ke ne holoki 'a e ngaahi mama 'o e cartilage fefeka 'o e trachea fakahangatonu, 'oku poloka 'e he 'omi 'o e venous mo e lymphatic 'a e vai mei he larynx (puha le'o), 'o fakatupu 'a e lahi, vave laryngeal mucosal edema 'oku ne sila'i 'a e halanga 'ea 'oku tapuni 'i loto 'i ha ngaahi miniti.

Ngaahi fuka kulokula ʻo ha hematoma ʻi he kiá ʻoku fakalahi (Ta ki he ngaahi ngāue fakavavevavé ʻi he taimi pē ko iá)¶

Ongo'i 'o e mala'ia 'oku lolotonga hoko mo e ta'efiemalie: 'Oku tangutu fakafokifā 'a e mahaki 'o bolt hangatonu, clutches ki honau kola pe tafa 'o e kia, pea fakaha "'Oku 'ikai ke u lava 'o manava" pe "'Oku ongo'i 'e hoku kia 'oku ou 'ohofi au."
Fula fakalakalaka, fufuu, pe fonu 'i lalo 'i he motu'a 'o e kia: 'Oku 'alu 'a e mu'a pe tafa'aki 'o e kia ki tu'a, ongo'i fefeka pe tense hange ko e 'akau, pea obliterates 'a e ava angamaheni 'i 'olunga 'i he hui 'o e fatafata (suprasternal notch).
Liliu le'o mo e dysphagia: 'Oku hoko 'a e le'o 'o e mahaki 'o 'ikai ke 'i ai ha 'uhinga, 'oku 'ikai ke nau lava 'o folo honau 'uhiki'i manu (drooling).
Inspiratory stridor (ko ha fakaʻilonga tōmui, kimuʻa pea puke): Ko ha leʻo māʻolunga, ngingila, pe ngungu ʻoku fanongoa ʻi he taimi ʻoku mānava ai ʻa e mahakí ʻi. Ko e taimi pē ‘oku hā mai ai ‘a e stridor, ‘oku ‘osi fakasi‘isi‘i ai ‘a e diameter ‘o e halanga ‘eá ‘o laka hake ‘i he peseti ‘e 70 ki he 80, pea ‘e lava ke hoko ‘a e asphyxiation kakato ‘i ha ngaahi miniti si‘i pē.

Tokoni 'uluaki vave ki he fula 'o e kia hili 'a e tafa¶

Tauhi 'a e mahaki 'oku tangutu bolt hangatonu (tu'unga ma'olunga 'o e Fowler): 'Oua 'aupito na'a ke fakatokoto ha mahaki 'oku fula 'a e kia pe stridor 'i honau tu'a; ko e kalāvité mo e engorgement ‘o e ngaahi veini ‘i he supine ‘e tāpuni‘i leva ai ‘a e toenga ‘o e halanga ‘eá. Tuku ke nau tangutu hangatonu ʻo kiʻi punou ki muʻa.
Vevete pe motuhi 'a e ngaahi takai 'o e kia 'i tu'a 'oku fufuu'i 'i he taimi pe ko ia: Kapau 'oku lomi'i fefeka 'e ha takai 'o e gauze circumferential, tepi, pe kola cervical ki he kia 'oku fula, motuhi fakalelei pe peel 'a e tepi constricting nellar 'i tu'a ke fakanonga 'a e 'omi 'i tu'a 'i he hili 'a e collary, tukukehe kapau ko ha spickable 'i tu'a fakaava ʻa e matapā sioʻata ʻo e hū ki he tracheostomy ʻi muʻá kapau ʻe fakahinohinoʻi ʻe he kau fakavavevavé).
Nofo 'i he speakerphone mo e fekau'i fakavavevave mo e toketā tafa: 'I he ngaahi me'a 'oku fu'u lahi 'aupito 'a ia 'oku mole ai ha 'atamai 'o ha mahaki pea liliu lanu pulu mei he faka'auha kakato 'o e halanga 'ea koe'uhi ko ha hematoma hili 'a e thyroidectomy kimu'a pea toki a'u mai 'a e kau toketā, 'e lava ke tataki 'e he pule fakafaito'o fakavavevave ha tokotaha tali kuo ako'i 'o fakafou 'i he polokalama fakavavevave 'o e 'ea 'i he tafa'aki mohenga Di** OP lease re: Faka'ali'ali 'o e kili, Motuhi 'a e sutures, Fakaava 'a e kili, Fakaava 'a e ngaahi uoua, Pack lavea), 'a ia 'oku ne fakanonga 'a e venous congestion fe'unga ke fakafoki 'a e manava. Ki he kau tauhi lay, vave 'a e fekau'i atu 'o e me'alele fakahaofimo'ui mo e ngaahi maama mo e sirens ("fakalahi 'a e hematoma hili 'a e thyroidectomy mo e stridor") fakatokanga ki he kau toketā ke teuteu'i 'a e ngaahi me'angaue tafa fakavavevave 'o e halanga 'ea.

Ko e toto hono ua hili hono to‘o ‘o e tonsillectomy (‘Aho 5 ki he 14)¶

Ko e fānau mo e kakai lalahi ‘oku nau fai ‘a e tonsillectomy ‘oku nau fa‘u ‘a e ngaahi fo‘i ‘uhiki‘i manu hinehina-hina matolu (eschar) ‘i ‘olunga ‘i he ngaahi mohenga tonsillar ‘i loto ‘i he tu‘a ‘o e kongalotó. 'I he vaha'a 'o e Post-Operative 'aho 5 mo e 'aho 10, 'i he tupu 'a e kili mucosal fo'ou 'i lalo, 'oku slough 'a e ngaahi scabs ko 'eni. ‘I he peseti ‘e 2 ki he 5 ‘o e kau mahakí, ‘oku tomu‘a ‘alu atu ai ha fo‘i ‘uhiki‘i manupuna pea fakaava ha va‘a ‘i lalo ‘i he halanga toto ‘i tu‘á.

Na‘a mo ha ki‘i toto kulokula ngingila hili ‘a e tonsillectomy ko ha me‘a fakavavevave ia .

'Oku ui 'e he kau toketā tafa mo e ngaahi fakahinohino fakafaito'o fakavavevave 'i mamani lahi ha ki'i toto 'oku ta'ofi 'e ia 'i he ngutu ko e "toto faka'iloa." Ko ha ki'i tamasi'i pe tokotaha lahi 'oku ne 'anuhi hake ha sepuni ti 'o e toto kulokula ngingila, 'oku 'i ai ha toto fo'ou 'oku ha'u mei he ihu, pe toutou folo (pea kimui ange 'oku ne lua roundcoffeg that brow-" fakalongolongo) ‘oku ‘i ha tu‘unga fakatu‘utāmaki lahi ‘o ha tafe fakafokifā mo lahi ‘a e toto ‘i he kongalotó ‘i he ngaahi houa si‘i ka hoko maí. Ko e toto kotoa pe hili hono tonsillectomy, neongo pe ko e ha hono si'isi'i pe 'oku ngali kuo tu'u, kuo pau ke 'ave vave ia ki ha potungaue fakavavevave 'oku 'i ai 'a e malava ke tafa 'a e telinga, ihu, mo e ngutu (ENT).

Tokoni 'uluaki lolotonga ha toto 'oku lolotonga ngaue 'i he tonsillectomy:
Ta ki hoʻo fika fakavavevave fakalotofonuá ʻi he taimi pē ko iá.
Tauhi e tamasi'i pe tokotaha lahi nofo hangatonu mo punou ki mu'a 'i ha ipu pe sink koe'uhi ke nau lava 'o 'anuhi kotoa 'a e toto mei honau ngutu. Fakalotolahi'i kinautolu ke 'oua na'a nau folo 'a e toto, he 'oku fufū 'e he toto kuo folo 'a e lahi mo'oni 'o e toto 'oku mole pea 'oku ne fakatupu 'a e lua fakamālohi 'oku ne dislodges 'a e ngaahi fo'i 'uto.
Kapau 'oku tokanga kakato 'a e mahaki mo e fengaue'aki, 'oku nau swish malimali mo 'anuhi vai 'aisi-mokomoko pe mimisi 'i ha 'aisi 'o e 'aisi kuo holoki (kapau pe 'oku 'ā pea 'ikai ke choking) lolotonga hono pukepuke ha 'aisi-takai 'i he tupenu ki he tu'a 'i mui mo e tafa'aki 'o e kia tokoni constrict throat vessel paramedics untilve.
Kapau 'e mohe pe 'ohovale 'a e mahaki, fakatakataka'i leva kinautolu ki honau tafa'aki 'i he tu'unga fakaakeake 'o ki'i angle hifo 'a e 'ulu koe'uhi ke tafe 'a e toto mei he kou'ahe ki he faliki kae 'ikai ki he paipa 'o e matangi.

Toloi 'a e hyperthermia kovi mo e kona 'o e sisitemi faka'auha fakalotofonua (FAKA'OSI)¶

Lolotonga e lahi taha ʻo e ngaahi meʻa fakatuʻupakē fekauʻaki mo e fakaʻauhá ʻoku hoko ia ʻi loto ʻi he loki fakaakeake ʻo e falemahakí, ʻoku ʻuhinga ʻa e tukuange vave ʻo e kau mahakí ʻi tuʻá kuo pau ke ʻiloʻi ʻe he kau tauhí ha ongo tali mahuʻinga hili ʻa e fakaʻauhá ʻa ia ʻe lava ke ʻasi ʻi ʻapi lolotonga ʻa e ʻuluaki houa ʻe 12 ki he 24.

1. Fakatoloi 'a e hyperthermia fakatupu maumau hili 'a e faka'auha (MH)¶

Ko e hyperthermia fakatu'utamaki (MH) ko ha mahaki tukufakaholo 'o e ngaahi halanga kalasiume 'o e uoua 'o e hui ('oku fa'a lahi taha 'a e * RYR1 * gene). 'I he taimi 'oku fakahaa'i ai ha taha 'oku faingata'a'ia 'i he MH ki he ** ngaahi faito'o faka'auha fakalukufua 'oku 'ikai ke 'i ai ha 'uhinga ** (** sevoflurane, desflurane, isoflurane **) pe ko e depolarizing 'o e uoua 'o e uoua ** succinylcholine **, 'oku tafe ta'e mapule'i 'a e kalasiume mei he sarcoplasmic 'o e uoua 'o e reticulum. 'Oku loka'i 'a e ngaahi uoua ki he hokohoko atu 'o e fakasi'isi'i, 'o faka'aonga'i 'a e 'osikena, 'o fakatupu 'a e lahi 'o e kaponi tai'okisaiti mo e lactic acid, pea faka'uli 'a e mafana 'o e sino 'o e uho ki 'olunga 'i ha tu'unga 'o e 1 tikili Selisiasi (1.8 tikili Fahrenheit) 'i he miniti 'e 5 kotoa pe.

Neongo 'oku kamata 'a e peseti 'e 90 'o e ngaahi faingata'a'ia 'o e MH lolotonga 'a e tafa pe 'i loto 'i he houa 'e 1 'o e tuku 'o e anesthesia, MH hili 'a e tafa 'e lava ke vela hake 'i ha ngaahi houa hili ha foki 'a e mahaki ki 'api mei he tafa 'i tu'a, pe ko ha mahaki na'e 'i ai ha tali 'oku ma'ama'a, ta'e'iloa 'i he tafa 'e lava ke fakatupulaki 'e he fulminant e **ve.sis.

Ngaahi fuka kulokula 'o e hyperthermia fakatu'utamaki hili 'a e faka'auha:
fefeka 'o e 'uhiki (masseter spasm) ta'efakamaama pe fefeka fakalukufua 'o hange ha maka mo e cramping lahi 'i he fanga ki'i pulu, 'uhiki, kete, mo e tu'a hili 'a e faka'auha fakalukufua.
Vave, loloto 'a e manava (tachypnea) mo e lele 'a e tu'unga 'o e loto 'i he feinga 'a e sino ke puhi'i 'a e kaponi tai'okisaiti lahi ange.
Ko e kili ‘oku hā mottled (patchy kulokula mo e lanu pulu-hina), fulufulua, pea ‘oku ‘asi mai ‘a e vela lahi, ‘oku vave ‘a e hiki hake ‘a e mafana ‘o laka hake ‘i he 38.8 ki he 40.0 tikili Selisiasi (101.8 ki he 104.0 tikili Fahrenheit).
Ko e mimi lanu 'uli'uli, kulokula, pe lanu kola 'oku tupu mei he fakamovetevete 'o e polotini 'o e uoua (myoglobin).
Ngaue vave: Ta ki ho'o fika fakavavevave fakalotofonua 'i he taimi pe ko ia pea fakaha mahino: "Na'e ma'u 'e he mahaki 'a e anesthesia fakalukufua he 'aho ni pea 'oku 'i ai 'a e ngaahi faka'ilonga 'o e hyperthermia kovi, 'Oku mau fie ma'u 'a e fefononga'aki ki ha falemahaki mo e dantrolene 'i he veini." To'o 'a e ngaahi kofu kotoa pe, kohu 'a e kili 'aki 'a e vai momoko, fan igrots, fakafonu 'a e tupenu-papped, w pea 'oua 'aupito na'a ke 'oange 'a e 'asetaminofeni pe 'ipupolofeni. Te ke lava foki ʻo ʻai ke fetuʻutaki ʻa e timi ʻo e falemahakí ki he laine houa ʻe 24 ʻa e Kautaha ʻo e Ngaahi Mahaki Maʻamaʻa ʻo e ʻIunaiteti Siteití (MHAUS) ʻi he 1-800-644-9737 (pe +1-209-417-3722 fakavahaʻapuleʻanga).

2. Fakalotofonua 'o e anesthetic Systemic Toxicity (LAST) mei he ngaahi pamu mamahi 'i 'api pe ngaahi poloka neave .¶

'Oku fa'a faka'ata 'a e kau mahaki 'o e hui mo e kete ki 'api mo e ngaue loloa ** poloka neave peripheral ** (hange ko e liposomal bupivacaine pe ropivacaine) pe ko ha ** elastomeric hokohoko fakalotofonua 'o e mamahi faka'auha 'o e pamu ** (ko ha 'atakai 'o e polo-fotunga 'o e to'oto'o 'i he feitu'u 'o e nervearound manifinifi pe ha catheter). Kapau 'oku hiki 'a e catheter ki ha ipu toto pe infuses fu'u vave, 'oku hiki hake 'a e faito'o faka'auha fakalotofonua ki he ngaahi tu'unga kona 'i he 'uto mo e loto (FAKAMUIMUI):

Ngaahi faka'ilonga fakatokanga vave 'o e neave: Fakafokifā mo'umo'ua mo 'u'ulu 'i he tafa'aki 'o e loungutu mo e 'elelo (perioral paresthesia), ko ha metali 'oku fakaofo 'i he ngutu, ta'anga 'i he telinga (tinnitus), sio 'oku 'ikai ke mahino, lea 'oku 'ikai ke mahino, pe 'oku 'ikai ke mahino 'a e uoua.
Ngaahi faka'ilonga lahi tuai: Fakalukufua seizures, mole 'a e 'atamai, fakatu'utamaki 'a e tuai 'a e tu'unga 'o e loto, pe fakafokifā 'a e tu'u 'a e loto.
Ngaue vave: Vave clamp 'a e paipa 'i he pamu mamahi 'i 'api 'o faka'aonga'i 'a e pelesitiki pinch clamp 'oku fakapipiki ('oua 'aupito na'a to'o 'a e catheter mei he kili tukukehe kapau 'oku fakahinohino'i), ui ho'o fika fakavavevave fakalotofonua, talaange ki he dispatcher "Mahalo'i 'a e fakalotofonua 'o e anesthetic systemic intraven block 'a e mahaki per000. lipid emulsion therapy," pea malu'i 'a e mahaki 'i he tu'unga fakaakeake kapau 'oku kamata ha puke.

Dehiscence lavea 'i he kete ("pa 'a e kete") mo e evisceration¶

'I he vaha'a 'o e 'aho 4 mo e 'aho 10 hili ha tafa 'o e kete (laparotomy, C-vahe, fakalelei'i 'o e hernia, pe resection 'o e kete), 'oku fakafalala kakato 'a e layer 'o e tisiuu fehokotaki 'oku ne pukepuke 'a e puipui 'o e kete ('a e linea alba pe rectus fascia) kimu'a pea toki surllagen Kapau 'oku to'o 'e he sutures 'o fakafou 'i he edematous fascia, 'oku fa'a hoko tonu hili 'a e tale 'a e mahaki, mafu, lua, pe ngaahi mafasia 'i he fale kaukau, 'oku mavahevahe 'a e la'i fascial loloto (dehiscence lavea).

Ko e faka'ilonga fakatokanga kalasi: 'a e "gush vai 'o e salmon-pink".¶

Houa kimu'a pea toki fakaava mo'oni 'a e ngaahi tuitui 'o e kili 'i tu'a pe ngaahi me'a mahu'inga, 'oku meimei ke a'usia 'e he kau mahaki mo e dehiscence loloto 'o e fascial ha fakafokifā, gush lahi 'o e ** manifinifi, lanu pingikī-lanu moli 'a e vai ** ('oku ui fakahisitōlia ** serosanguinous ab "lanu 'o e sāmani" 'o fakafou 'i he'enau vai peritoneal ** fai) kofukofu. 'Oku lipooti foki 'e he kau mahaki tokolahi 'enau ongo'i pe fanongo ki ha "pop" pe tearing sensation makehe 'i loto loloto 'i honau kete 'i he taimi 'oku nau tale ai.

Kapau 'oku toe 'oatu 'e he incision 'o e kili 'i tu'a 'a e hala pea 'uli'uli lanu pingikī, ngingila 'a e ngaahi fo'i 'uto 'o e intestine pe kulokula fatty omentum protrude 'o fakafou 'i he fakaava, kuo fakalakalaka 'a e faingata'a ki he ** .tafa 'o e lavea**.

Tokoni 'uluaki fakasitepu ki he dehiscence mo e evisceration .¶

Ui leva ki he ngaahi sevesi fakafaito'o fakavavevave pea tauhi 'a e mahaki ke NPO fefeka ('ikai ha me'a 'i he ngutu).
Tu'unga 'i he tu'unga 'o e low-Fowler flexed-knee: 'Ai ke tokoto 'a e mahaki 'i hono tu'a 'o ki'i poupou'i hono 'ulu mo hono uma (tikilī 'e 15 ki he 20) pea tuku ha ongo 'ulumotu'a matolu 'i lalo 'i hona tuliki piko. Ko hono punou ‘o e tuí mo e kongalotó ‘okú ne fakanonga ‘a e ngaahi uoua ‘o e rectus abdominis pea ta‘ofi ai ‘a e ngaahi tafa‘aki laveá mei he‘enau toho lahi ange.
'Oua 'aupito na'a ke teke'i 'a e protruding bowel pe tisiuu ki mui 'i loto 'i he kete: Ko hono teke'i 'o e ngaahi 'okani 'oku 'uli'i ki mui 'i loto 'oku ne fakahu hangatonu 'a e fanga ki'i pekitilia 'o e kili ki he ava 'o e peritoneal pea 'e lava ke ne mio'i pe kink 'a e ma'u'anga toto mesenteric 'o e bowel.
Faka'aonga'i ha teunga mafana, moist 'oku 'ikai ke 'i ai ha 'uhinga: Fakamomoko ha teunga 'oku 'ikai ke 'i ai ha 'uhinga 'o e lavea, unfolded 'a e ngaahi pads gauze 'oku 'ikai ke 'i ai ha 'uhinga, pe ko e ma'a taha fo'ou laundered 'a e taueli 'o e ipu pulupulu 'oku ma'u 'i he saline angamaheni 'o e tap (mei ha 'uluaki tokoni tap eyewash 'a e hina kuo wa ** m kuo ma'a mafana ‘o e ‘eá. Fakatoka vetevete ‘a e teunga sū ‘i he lavea ‘oku ‘atā pe ko e ‘uto ‘oku ‘asi, pea ‘ufi‘ufi ‘a e tupenu sū ‘aki ha la‘i takai me‘akai pelesitiki ma‘a pe ko ha taueli mōmoa ma‘a ke pukepuke ‘a e ‘uha mo e vela. (Kapau ‘oku tuku ha teunga mōmoa ‘i he ‘uto ‘oku ‘asi maí, ‘oku mōmoa ‘a e membrane serosal ma‘ama‘á, mate, pea pipiki ki he tupenú).
Splint 'a e kete kapau 'oku tale: Fakahinohino'i 'a e mahaki ke 'oua na'a ne tale pe mafasia; kapau ʻoku ʻikai ke nau lava ʻo taʻofi ha tale, poupouʻi māmālie ha ʻulumotuʻa molū ʻi ʻolunga ʻi he teunga kuo takaí ʻaki ha ongo nima fōlahi.

Anastomotic bowel leakage, ngaahi mahaki 'o e feitu'u tafa, mo e sepsis hili 'a e tafa .¶

Kapau na'e fai ha tafa ki ha mahaki 'o motuhi mo toe fakafehokotaki ha konga 'o e 'uto (anastomosis), hange ko e resection 'o e kolona, bypass 'o e kete, gastrectomy 'o e nima, appendectomy, founga Whipple, pe fakalelei'i 'o e ki'i 'uto, 'oku vaivai taha 'a e hui fo'ou 'oku stapled pe tuitui 'i he vaha'a 'o e **'Aho ** mo e 'Aho 3. Kapau na‘a mo ha hū ‘a e pinhole ‘oku tupulaki (hū ‘anastomotic), ‘oku hū ‘a e ‘ēsiti, bile, pe ko e ‘uhiki‘i manupuna ‘oku fonu ‘i he pekitiliá ki he ava ‘o e keté ‘oku ‘ikai ha me‘a ‘i aí, ‘o fakatupunga ai ‘a e peritonitis kemikale mo e vave ** .mo'utaufu'ua septic.

Founga ke fakafaikehekehe'i 'a e fakamo'ui 'o e incision angamaheni mei he mahaki fakatu'utamaki pe 'i loto 'o e leakage .¶

'Amanaki ki he fakamo'ui angamaheni: Ko e lanu pingikī 'oku si'i hifo 'i he milimita 'e 5 ('inisi 'e 0.2) 'o takatakai 'i he laine 'o e me'a faka'ilonga pe tuitui, ki'i mafana, oozing serous mahino pe kulokula 'ata'ata lolotonga 'a e 'uluaki houa 'e 48, mo e mamahi 'oku fakalelei'i ma'u pe 'i he 'aho takitaha.
Ma'u 'e he Feitu'u Tafa 'i 'olunga (Ui 'a e toketā tafa he 'aho ni): Kulokula (erythema) mafola lahi ange 'i he senitimita 'e 1 ki he 2 mei he motu'a, fula, vela throbbing, mo e matolu, opaque kulokula, lanumata, pe foul-smelling pus 'oku tafe mei he vaha'a 'o e ngaahi tuitui 'o e Dayusu to0). Tā ha laine ʻi he tafaʻaki ki tuʻa ʻo e kulokulá ʻaki ha peni pea hiki ʻa e taimí ke lava ʻe he kau toketaá ʻo sio ki he vave ʻene fakalahí.
Ko e Mahaki ‘o e Tisiu Molumalu ‘oku Necrotizing (Ta ki he 911 / 112 / 999 ‘i he taimi pe ko ia): ‘Oku ‘asi mai ‘i he houa ‘e 24 ki he 72 hili ‘a e tafa. ‘Oku a‘usia ‘e he mahakí ‘a e mamahi loloto fakamamahi mo ta‘etuku mei he ngaahi tu‘unga kotoa pē** ki he anga ‘o e fōtunga ‘o e kilí; ‘e lava ke liliu ‘a e kilí ‘o lanu vāleti-hina fakapo‘uli, fakatupulekina ‘a e ngaahi fo‘i fulufulu‘i‘akau ‘oku fonu ‘i he vaí (bullae), ongo‘i fefeka ‘akau, pe ngingila ‘o hangē ha takai‘anga pupula ‘i he taimi ‘oku ala ai ki aí (subcutaneous crepitus mei he fanga ki‘i pekitilia ‘oku nau fakatupu ‘a e kasá), ‘o ‘alu fakataha mo e mofi lahi, pōlepole, mo e puputu‘u.
Leakage 'o e Anastomotic 'i loto / Peritonitis (Ta ki he 911 / 112 / 999 he taimi pe ko ia): 'Oku fa'a 'asi mai 'a e motu'a 'o e kili 'i tu'a 'oku ma'a mo momoko 'aupito, ka 'i he vaha'a 'o e 'Aho 3 mo e 'Aho 8 'oku tupulaki 'a e mahaki:
Ko e tu'u 'a e loto 'oku malolo 'o laka hake he 100 ki he 110 'a e ta 'i he miniti ('oku fa'a mu'omu'a 'i he mofi 'i he houa 'e 12 ki he 24).
Kovi ange 'a e mamahi 'i he kete 'oku lulululu lahi 'i he taimi 'oku tuki ai 'a e mohenga pe 'i he taimi 'oku nau tale ai (rebound tenderness / le'o).
Hiccups hokohoko, 'uto, 'ikai lava ke paasi 'a e kasa, pe 'uli'uli lanumata/lanumata bilious vomiting.
Fo'ou 'a e puputu'u, mohe, lea 'oku 'ikai ke mahino, tetetete 'a e momoko (rigors), kili 'oku 'ikai ke 'i ai ha 'uto, pe 'ikai ha mimi 'i he houa 'e 12 (ngaahi faka'ilonga 'o e septic shock).

Ko e ngaahi sivi toto hili ‘a e tafa (DVT mo e PE) mo e hematoma ‘i he tu‘asinó .¶

Kuo pau ke fakahoko ha sivi fakaʻosi ʻe ua hili hono tukuange ʻo e mahakí ʻi he ʻaho kotoa pē lolotonga ʻa e ʻuluaki uike ʻe ua ʻi ʻapí:

Ko e Veni Loloto (DVT) mo e Embolism 'o e Ma'ama'a (PE): Ko e tafa 'oku ne fakatupu 'a e hypercoagulability (toto pipiki) lolotonga ia 'oku fakasi'isi'i 'e he fakaakeake 'a e luelue. Fakafehoanaki fakatouʻosi ʻa e ongo foʻi pulu mo e ongo hui ʻi he ʻaho kotoa pē: kapau ʻoku fula, fufuuʻi, māfana, kulokula, pe ngingila ʻa e vaʻe ʻe taha ʻi he foʻi pulu, ʻoua naʻá ke milimili ʻa e vaʻé (ʻe lava ke motuhi ʻe he milimili ʻa e foʻi ʻuhikiʻi pulú). Kapau ‘e fakafokifā pē ‘a e hoko ‘a e mahakí nounou ‘a e mānava ‘i he mālōloó, mamahi māsila ‘i he fatafatá ‘i he taimi ‘oku mānava aí, tale ‘a e totó, lele ‘a e mafú, pe ‘ikai ke toe ‘ilo‘i, telefoni leva ki ho‘o fika fakavavevave fakalotofonuá ki ha mahalo‘i ‘oku ‘i ai ha pulmonary embolism.
Spinal or Epidural Hematoma (Hili e faka'auha 'o e tu'asino, epidural analgesia, pe tafa 'o e tu'asino): Ko e taimi pe 'oku 'osi ai ha poloka 'o e tu'asino pe epidural ('i loto 'i he houa 'e 4 ki he 6), kuo pau ke foki mai 'a e malohi kakato mo e ongo 'i he ongo va'e mo e pule'i angamaheni 'o e bladder pea nofo ma'u pe 'i he tu'unga angamaheni. Kapau 'e ma'u 'e ha mahaki 'i 'api 'a e mamahi lahi, kovi ange 'i he laine lotoloto 'o e tu'a 'o 'alu fakataha mo e fo'ou 'a e 'ikai ke 'i ai ha 'uhinga pe 'oku 'ikai ke 'i ai ha 'uhinga 'i he 'uhiki/'uhiki ("saddle anesthesia"), fakalakalaka 'a e vaivai pe mamafa 'i he va'e, pe 'ikai lava ke mimi / 'ikai lava ke mapule'i, 'oku fakafefeka'i 'e he toto 'a e 'uto 'o e tu'asino (quina e**na). Ta ki he ngaahi ngāue fakavavevavé he taimi pē ko iá; kuo pau ke hoko ‘a e tafa decompression ‘i loto ‘i he houa ‘e 6 ki he 8 ke ta‘ofi ‘a e palalisia tu‘uloá.

Fai ha ako tokoni 'uluaki kuo fakamo'oni'i .

Ko hono tokanga‘i ha taha hili ‘a e tafa ‘oku si‘i ange ‘aupito ‘a e loto-mafasiá ‘i he taimi ‘okú ke ‘ilo‘i ai ‘a e founga ke sivisivi‘i ai ‘a e mānavá, mapule‘i ‘a e tafe toto lahi, mo ‘ilo‘i ‘a e ‘ohovalé. Fakakaukau ke fai ha ako tokoni ʻuluaki mo e CPR ʻi he nima mei he Kolosi Kulokulá, St John Ambulance, pe ko hoʻo kautaha ako fakavavevave fakalotofonuá.

Ngaahi fehu'i 'oku toutou 'eke .¶

Why must you never give water or food to a post-surgical patient who is having a complication?

If a post-operative patient has internal bleeding, a wound that has split open, or a bowel leak, they often require immediate emergency surgery under general anesthesia. When general anesthesia is induced, the muscles that keep stomach contents from flowing up the esophagus relax; if the patient recently drank water or ate food, that fluid can regurgitate into the lungs (pulmonary aspiration), causing fatal chemical pneumonia or suffocation.

What does a sudden gush of pink, salmon-colored watery fluid from an abdominal incision mean?

A sudden gush of thin, pink-orange ("salmon-colored") fluid soaking through an abdominal dressing between 4 and 10 days after surgery is the classic warning sign of deep fascial wound dehiscence, meaning the internal stitches holding the abdominal muscle wall together have parted and peritoneal fluid is escaping. Have the patient lie flat on their back with their knees bent over a pillow, cover the incision with a clean moist towel, and go to the emergency department immediately before loops of intestine push through the opening.

When is a fever after surgery normal, and when is it a medical emergency?

A mild low-grade temperature between 37.5 and 38.2 degrees Celsius (99.5 and 100.8 degrees Fahrenheit) during the first 24 to 48 hours after surgery is commonly caused by normal surgical inflammation or mild lung collapse (atelectasis) and improves with deep breathing exercises. However, a fever above 38.5 degrees Celsius (101.3 degrees Fahrenheit), any fever accompanied by shivering chills, confusion, a racing heart rate over 100 beats per minute, severe wound pain, pus, or a rapidly rising temperature with stiff muscles within 24 hours of anesthesia (malignant hyperthermia) is a medical emergency.

Why is any bleeding from the mouth or nose 7 days after a tonsillectomy dangerous?

Between 5 and 10 days after a tonsillectomy, the white healing scabs in the back of the throat peel off, which can expose an underlying artery. Even a small amount of bright red blood spat from the mouth, dripping from the nose, or swallowed is considered a "herald bleed" that often precedes a massive, life-threatening arterial hemorrhage within hours, so the patient must be evaluated in an emergency department immediately.

What should you do if a patient develops neck swelling or trouble breathing after thyroid or neck surgery?

Rapidly increasing swelling, tightness, a muffled voice, difficulty swallowing, or high-pitched noisy breathing after thyroid, parathyroid, carotid, or cervical spine surgery indicates an expanding neck hematoma that can suffocate the patient by causing rapid airway swelling. Call your local emergency number immediately, keep the patient sitting bolt upright (never lay them flat), and loosen any tight outer bandages around the neck while waiting for paramedics.

Kuo vakaiʻi ʻa e ngaahi maʻuʻanga fakamatalá¶

Kolisi Toketā Tafa ʻAmelika (ACS, ʻAmelika): Ngaahi Maʻuʻanga Tokoni Lelei Taha ki he Tuʻunga Lelei mo e Malu ʻo e Tafá, Ngaahi Fakahinohino ki he Tokangaʻi ʻo e Tafá ʻi ʻApi Hili ʻa e Tafá, mo e Ngaahi Polokalama ki hono Puleʻi ʻo e Tafe ʻa e Totó.
Kautaha Mo'ui 'a Mamani (WHO, Fakavaha'apule'anga): Ngaahi Fakahinohino Fakamamani Lahi ki hono Ta'ofi 'o e Ma'u 'e he Feitu'u Tafa mo e Lisi Malu 'o e Tafa 'a e WHO Ngaahi Tu'unga 'o e Triage hili 'a e tafa.
Kautaha 'o e Hyperthermia Fakatu'utamaki 'o e 'Iunaiteti Siteiti (MHAUS) mo e Kulupu Hyperthermia Fakatu'utamaki 'a 'Iulope (EMHG): 'Ilo'i Fakafaito'o mo e Faito'o Fakavavevave 'o e Hyperthermia Fakatu'utamaki 'o e Acute mo e Toloi hili 'a e tafa.
Sosaieti 'Amelika 'o e Fakafaito'o Fakavahefonua mo e Faito'o Fakamamahi (ASRA, 'Iunaiteti Siteiti): Lisi Sivi ki hono Faito'o 'o e Faka'auha Fakalotofonua 'o e Faka'auha Fakasisitemi (LAST) mo e Ngaahi Fakahinohino ki hono Vakai'i 'o e Spinal/Epidural Hematoma.
Sosaieti 'o e Hala 'Ea Faingata'a (DAS), Kautaha 'a Pilitania 'o e kau Toketā Tafa 'o e Endocrine mo e Thyroid (BAETS), mo e 'Inisititiuti Fakafonua ki he Mo'ui Lelei mo e Tokanga'i Lelei (NICE, Pule'anga Fakatahataha): *Ngaahi Fakahinohino Fakavahefonua ki hono Pule'i 'o e Toto Hili 'a e Tafa Hili 'a e Tafa Thyroid Prognitosis SCOco (NG51).