Umsesane oNxitywe kuMnwe oDumbileyo: Ukunyanzeliswa kweFloss yamazinyo ngaphambi koMngcipheko wokuNxwema¶

Iringi evaleleke kumnwe odumbileyo emva kokulimala kwesandla, ukubetha kwezinambuzane, ukwaphuka, ukutshisa, i-edema yokukhulelwa, i-high-sodium isidlo, okanye i-arthritis flare ayiyongxaki yokuthambisa: yimeko engxamisekileyo yemithambo eyaziwa ngokuba yi-Ring Tourniquet Syndrome*. Ngenxa yokuba intsimbi yentsimbi ayinako ukwanda, ukudumba okuncinci komnwe kunye nokudumba komnwe kukhupha imithambo enoxinzelelo oluphantsi olukhupha igazi emnweni ngelixa imithambo yedijithali enoxinzelelo oluphezulu iqhubeka nokumpompa igazi elitsha ngaphaya kweringi kwincam yomnwe. Kwiiyure nje ezingephi, lo mgibe wemithambo ubangela ukunyuka koxinzelelo lwezicubu, ischemia yemithambo-luvo, isilonda solusu, ukubola, kunye nokunqunyulwa komnwe ngokusisigxina.

Yeka ukunyoshoza, ukujija, okanye ukutsala ngamandla kwiringi eyomileyo edumbileyo ngoko nangoko. Ukuphinda ukutsalwa ngamandla kugruzuka i-proximal interphalangeal (PIP) ye-capsule edibeneyo kwaye ibangele i-reflex inflammatory cascade ephinda kabini ukudumba ngaphakathi kwemizuzu eli-10. Endaweni yoko, sebenzisa i-gold-standard yesebe likaxakeka esibhedlele ** I-Distal-to-Proximal Compression Wrap (I-Dental Floss / I-Elastic String Method) ** idityaniswe nokuphakama kunye ne-icing, okanye uye ngqo kwiSebe eliNgxamisekileyo okanye kwiSikhululo soMlilo ukusika ibhendi ngaphambi kokuba ukufa kwe-nerve engapheliyo kwenzeka.

Yenza oku ngoku¶

1. Khangela i-"Red-Flag" ye-Vascular Ischemia okanye iimpawu ze-Open Fracture ngoku. Yiya ngqo kwiSebe likaNgxamiseko eSibhedlele (okanye utsalele umnxeba kwinombolo yakho yexesha likaxakeka: 911 eUnited States naseKhanada, 112 kulo lonke elase-European Union, 999 eUnited Kingdom; bona amanani kaxakeka) kwaye UNGAZAMI ukusonga umtya ekhaya ukuba incam yomnwe imhlophe, bhlowu/mfusa (cyanotic), okanye inamabala, ivakala ibanda ngumkhenkce okanye ndindisholo ngokupheleleyo, ithatha ngaphezulu kwemizuzwana emi-2 ukuba umbala opinki ubuyele xa ucofa uzipho lweminwe (ukulibazisa ukugcwaliswa kwecapillary), okanye ukuba umnwe uqhawukile, uqhawuke ithambo** livuleke.
2. Yeka ukutsala kwaye uphakamise isandla sakho ngaphezu komgangatho wentliziyo yakho kangangemizuzu eli-10 ukuya kweli-15. Beka ingqiniba yakho kumqamelo omde wemiqamelo okanye ubambe isandla sakho ngqo phezulu emoyeni ngelixa untywilisela okanye usonga umnwe ku-amanzi apholileyo (angabandisi) okanye ipakethe yamanzi omkhenkce ebhijelwe ngetawuli ebhityileyo imizuzu eli-10. Umxhuzulane wakhupha igazi le-venous emnweni ngelixa i-vasoconstricts ebandayo ivula imithambo yegazi.
3. Senga ulwelo lwe-edema ngasemva ukuya entendeni kwaye uqabe umnwe kwisithambisi esishinyeneyo. Ukuqala kwincam yomnwe uye kwiqupha kunye neringi, cudisa umnwe ngokuqinileyo ngesinye isandla sakho ukutyhala ulwelo oluvalelekileyo ludlule umsesane uye entendeni. Gcoba umnwe wonke kunye nolusu olungaphantsi kweringi ngesisa nge-Windex (isicoci seglasi esingena-ammonia), isepha yesitya solwelo, ijeli yepetroleum, ijeli ye-KY, i-oyile yeminerali, okanye ibhotolo* kwaye uslayide iringi ukuya phambili nangasemva ngobunono usebenzisa intshukumo "yokushukuma" ngaphezulu nasezantsi kweqhosha.
4. Ukuba ukuthambisa akuphumeleli, yenza iDistal-to-Proximal Dental Floss okanye iRibbon Compression Wrap. Tshala incam ye-90-centimeter (36-intshi) iqhekeza le** elenziwe ngewax elimcaba lamazinyo eteyiphu/yefloss**, iribhoni yesilika ebhityileyo, okanye i-non-latex ye-tourniquet yebhanti ngasepalini**. Ukuqala ngasentla kweqhina eliphakathi elidumbileyo (kufutshane nencam yomnwe), jija ifloss ngokuqinileyo ngokuchukumisa, iikhoyili ezingenasikhewu ukwehla ukuya kwiringi ukucinezela iqhosha elidumbileyo, emva koko ukhulule umsila kwicala lesundu ukuze uhambe umsesane ngaphandle komgudu phezu kweqhosha elicandiweyo.
5. Ungaze ushiye isigqubuthelo socinezelo emnweni ngaphezu kwemizuzu emi-3 ukuya kwemi-5 ngexesha. Isisongelo sefloss yamazinyo sicinezela okwethutyana ukuhamba kwegazi; yikhulule ngoko nangoko njengoko iringi isiya phambili, okanye uyisuse ngokupheleleyo ukuba iringi ayishukumi kwimizuzu emi-3.
6. Ukuba iringi yenziwe ngetungsten carbide, titanium, ceramic, okanye steel stainless steel kwaye ayisayi kutyibilika, yiya kwiSebe lezoMlilo okanye iGumbi likaNgxamiseko ngoko nangoko. Abasiki bemveli bezacholo bezacholo abanakuyisika itungsten carbide okanye ititanium; amakhonkco e-tungsten kufuneka aqhekezwe ngokucocekileyo kusetyenziswa ukutshixa ipliers ye-vise-grip okanye asikwe nge-diamond rotary saw.

flowchart TD
    A["Umsesane uxinge emnweni odumbileyo"] --> B{"Incam yeminwe imhlophe/ibhlowu/mfusa, indindisholo, ibanda, i-capillary refill> 2 sec, okanye ithambo elaphukileyo/ukusikwa?"}
    B -->|"Ewe: Ischemia eqatha okanye iFracture"| C["MUSA ukusonga ngomtya: Phakamisa isandla kwaye uye kwiSibhedlele ER ngokukhawuleza ukusika iringi likaxakeka"]
    B -->|"Hayi: Umnwe upinki, ushushu, ukuva okuqhelekileyo, akukho kwaphuka"| D["Inyathelo 1: Yeka ukutsala; phakamisa isandla ngaphezu kwentliziyo + sebenzisa ipakethe epholileyo imizuzu eyi-10-15"]
    D --> E["Inyathelo lesi-2: Ukudumba kobisi kwisundu + faka isithambiso esinzima (isepha yesitya, iWindex, ijeli yepetroleum)"]
    E -->|"Umsesane usavaleleke emva kwequpha le-PIP elidumbileyo"| F["Inyathelo lesi-3: Yenza iDistal-to-Proximal Waxed Dental Tape Compression Compression Wrap (< 3 imiz ngokugqitha)"]
    F -->|"Umsesane usabambekile emva kokupasa oku-2 kokusonga"| G{"Yenziwe ngantoni intsimbi iringi?"}
    G -->|"Igolide, iSilivere, iPlatinam, ubhedu, okanye ubhedu"| H["Yiya kuKhathalelo oluKhawulezileyo, i-ER, iSikhululo soMlilo, okanye iJeweler yokusika umsesane oqhelekileyo wentsimbi"]
    G -->|"I-Tungsten Carbide, iCeramic, okanye iMeteorite"| I["Sebenzisa indlela ye-Vise-Grip Locking Plier eyongezelelweyo yokwaphuka OKANYE i-ER idayimane yokusika irotary"]
    G -->|"I-Titanium, iCobalt Chrome, okanye iDamasko Steel"| J["Yiya kwi-ER okanye kwiSebe loMlilo ukuze ufumane i-motorized diamond wheel cutter kunye nedriphu yamanzi abandayo"]

Kutheni umsesane oncamatheleyo ube yimeko kaxakeka yokunqunyulwa amalungu (Ring Tourniquet Syndrome)¶

Ukuqonda i-anatomy yomnwe wakho kuchaza ukuba kutheni ukutsala nzima kwenza umsesane obambekileyo uqine kwaye kutheni ukulinda "de kube ngomso kusasa" kunokubiza umnwe wakho:

1. I-Arterial Inflow vs. Venous Outflow Pressure: Igazi lingena emnweni wakho ngemithambo emibini eyomeleleyo, enezihlunu yedijithali ehamba emacaleni omnwe kuxinzelelo lwegazi oluphezulu (malunga ne-90 ukuya kwi-120 mmHg). Igazi lishiya umnwe wakho kwimithanjana yasemva enqabileyo, ebhityileyo ngasemva komnwe ngoxinzelelo oluphantsi kakhulu (malunga ne-10 ukuya kuma-20 mmHg).
2. I-One-Way Check Valve Trap: Xa umnwe wakho udumbile ngenxa ye-sprain, ukuhlatywa kwenyosi, isidlo sangokuhlwa esinetyuwa, okanye ubushushu, iringi yentsimbi eyomeleleyo icinezela imithambo yomqolo ephantsi koxinzelelo oluphantsi kuqala, ivalele ngokupheleleyo igazi kunye nolwelo lwe-lymphatic ekuphumeni komnwe. Ngeli xesha, imithambo yedijithali enoxinzelelo oluphezulu iqhubeka nokumpompa igazi elitsha lingene ngomnwe udlule umsesane.
3. Iqhuma leKnuckle: I Proximal Interphalangeal (PIP) joint (iqupha lomnwe wakho ophakathi) inamagophe e-synovial joint folds kunye ne-collateral ligaments ethi ibhaluni iphumele ngaphandle ngolwelo oluvalelekileyo. Ngalo lonke ixesha utsala umsesane owomileyo, ukhuhla ulusu phezu kwelungu le-PIP kwaye uqalise ukukhutshwa kwe-histamine kunye ne-prostaglandin, ujike iqhosha libe yibhalbhu yolwelo eqinileyo kabini ubukhulu beringi.
4. Uxinzelelo lweCompartment kunye nokuFa kweTissue: Nje ukuba ukudumba kwezicubu ngaphakathi komnwe kunyuke ngaphezu koxinzelelo lwe-capillary perfusion (30 mmHg), ukuhamba kwegazi kwi-arterial kuyeka nako. Ngaphakathi ** ezi-4 ukuya kwiiyure ze-6 ** ze-ischemia epheleleyo, ii-nerve zedijithali ziba ne-numbness engapheliyo, i-tendon necrose, kunye nolusu olungaphantsi kwendandatho luguguleka ukuya kutsho kwithambo. Ukufumana ezinye izinto ezibangela ukuba amalungu angasebenzi kakuhle, bona isikhokelo sethu i-acute ischemic limb, i-arterial occlusion, kunye ne-pulseless extremity.

Itheyibhile ye-60-yesibini ye-Neurovascular Triage¶

Jonga umnwe wakho uvaleleke kule tshathi yovavanyo lwekliniki rhoqo ngemizuzu eli-15 de umsesane ucime:

Indlela yoku-1: "Ukuphakama + okubandayo + ukuBuyiselwa kwakhona kweMilking + yeLubricant"¶

Ukuba umnwe wakho ukwi-Inqanaba loku-1 (pinki, ukufudumala, ukuva okuqhelekileyo, akukho kwaphuka)* kwaye udumbe ngokuphakathi, i-60 yepesenti yamakhonkco axingileyo aphuma kunye nale ndlela yokuthotywa kwamanyathelo amane ngaphandle kokufuna umtya okanye ukusika:

1. Phakamisa Ngaphezu kweNtliziyo kangangeMizuzu eli-10: Hlala phantsi kwaye uphakamise ingalo yakho ngokuthe nkqo ukuze isandla sakho sibe ngama-30 eesentimitha (ii-intshi ezili-12) ngaphezu kwentliziyo yakho. Yenza "ukumpompa" okucothayo, okuthambileyo ngeminwe yakho (ngaphandle kokuhluza ijoyinti elidumbileyo) ukunceda igazi le-venous ukuba lihle lingene engalweni yakho.
2. Faka isicelo saManzi apholileyo okanye iPakethi yomkhenkce eSongelweyo ngeMizuzu eli-10: Songa umnwe wakho kwilaphu lokuhlamba elifakwe emanzini abandayo omkhenkce (okanye ubambe ipakethe ebandayo ebhijelwe ngetawuli ebhityileyo emnweni nakwiqupha) imizuzu eli-10. Ungaze ufake umkhenkce okrwada owomileyo okanye umkhenkce ulusu ngokuthe ngqo, kwaye uyeke ukupholisa ngoko nangoko ukuba incam yomnwe iyajika.
3. Yenza i-"Retrograde Edema Milking": Phambi kokuba ugalele isithambiso, songela ubhontsi wakho ochaseneyo nomnwe wesalathisi ngokuqinileyo kumnwe odumbileyo kanye ngentla kweqhina eliphakathi (phakathi kwequpha neringi). Cine ngokuqinileyo imizuzwana eyi-10 ukucinezela ulwelo lwethishu esponji ngasemva phantsi kweringi ukuya entendeni yakho.
4. Faka i-Lubricant ye-High-Slip kwaye usebenzise "uHambo oluphezulu ukuya ezantsi":
5. Gcoba umnwe wonke kwaye utsale ulusu umva ukuze uthontsize i-lubricant ngqo ngaphantsi kwebhanti yeringi. Izithambisi zasekhaya ezizezona zilungeleleneyo ukutyibilika kakuhle: isithambisi sotyando esekwe emanzini (KY Jelly), isicoci seglasi sokuqala seWindex (esisetyenziswa phantse ngabo bonke abenzi bezacholo zobuchwephesha kuba ii-surfactants zayo zenza ulusu lutyibilike kakhulu ngaphandle kwegrisi), sepha yesitya solwelo esixutyiweyo (Dawn/Fairy, i-Fairy, i-Fairy, i-Vapetroleum)** ioli / ioli yomntwana **, okanye ** i-coconut / ioli yomnquma **.
6. Ungaze utsalele ngqo uye phambili. Endaweni yoko, cofa umphezulu weringi ngokuqinileyo ujonge ezantsi kwisikhumba esithambileyo esisemva komnwe wakho ngelixa ukekele umzantsi weringi ukuya phambili phezu komphetho ongaphantsi wequpha, uze uwushukumise phezulu ukuya ezantsi njengokuhamba isihlangu esiqinileyo usuka esithendeni.

Indlela yesi-2: iSebe eliNgxamisekileyo "I-Dental Floss / i-String Compression Wrap" (iProtocol ye-Distal-to-Proximal)¶

Xa iqhosha eliphakathi elidumbileyo (PIP) lidala udonga olungqindilili lwerabha phambi kweringi ukuba i-lubricant ingakwazi ukunqumla, oogqirha bexesha likaxakeka kunye noogqirha botyando basebenzisa i-Compression Wrap Technique.

flowchart TD
    A["Lungiselela i-90 cm (36 in) yetheyiphu yamazinyo enewax ethe tyaba, iribhoni yesilika ebhityileyo, okanye i-elastic tourniquet strip"] --> B["Inyathelo 1: Dlula i-15 cm (6 in) kwisiphelo esifutshane PHANTSI kweringi encamathele ngasentendeni/esandleni sakho."]
    B --> C["Inyathelo lesi-2: Zisa isiphelo eside sokusebenza UP udlule iqhina eliphakathi elidumbileyo (PIP)."]
    C --> D["Inyathelo lesi-3: Qinisekisa iluphu ngaphezulu kweqhina kwaye usonge ngokuqinileyo UPHANDO NGAPHANSI ukuya kwiringi (ziro izithuba phakathi kweekhoyili)"]
    D --> E["Inyathelo lesi-4: Cofa isiphelo phantsi kwekhoyili yokugqibela ngasekunene kumsesane ukuze iqhosha libe mcaba ngokupheleleyo."]
    E --> F["Inyathelo lesi-5: Tsala umsila omfutshane wecala lesundu PHEZULU kwaye ngaphambili ukuya kwincam yomnwe: iikhoyili ezikhululayo zihamba ngeringi phezu kwequpha."]

Imiyalelo yenyathelo nenyathelo leDistal-to-Proximal Dental Floss Wrap¶

Yeyiphi imathiriyeli enokusetyenziswa: - Eyona nto ibhetele ekhaya: Iteyiphu yamazinyo eneflethi eyenziwe ngewax (ibanzi kwaye imtyibilizi kunefloss engqukuva ukuze ingasiki kwisikhumba esidumbileyo), i-⅛-intshi (i-3-millimeter) yesatini yeribhoni yesipho, okanye umcu obhityileyo weelastiki osikwe kwiglavu yonyango engeyiyo eyelatex okanye ibhande lokuzilolonga. - Ungaze usebenzise: Umsonto obhityileyo wokuthunga, intambo yokuloba, okanye ucingo lwentsimbi, olusebenza njengesiqhenqi sesonka samasi kwisikhumba esidumbileyo.

Ukuphunyezwa (Kuthatha imizuzu emi-2): 1. Thatha umsila phantsi kweRingi: Sika 90-to-100-centimeter (36-to-40-intshi) ubude betape yamazinyo enewax. Isilayidi malunga ne-15 yeesentimitha (ii-intshi ezi-6)* kwesinye isiphelo ngaphantsi kweringi encamatheleyo ujongise esihlahleni/sentendeni yakho. - Ingcebiso ukuba iringi iqine kakhulu ukutyhala ifloss ethambileyo ngaphantsi: Goba incam egobileyo yephini elibuthuntu bobby pin, inaliti yokuthunga ebuthuntu (i-eye-eye kuqala), iplastic toothpick yeplasitiki, okanye incam yeplastiki eqinileyo ye floss threader phantsi kweringi yokukrazula ulusu ngaphandle kokukrazula ulusu. 2. Qalisa ukuSonga PHEZULU (Distal ukuya) kwiKnuckle eDumbileyo eMphakathini: - Thatha isiphelo eside sefloss yamazinyo (isiphelo seesentimitha ezingama-75 kwicala lequpha leringi) kwaye uyolule uye phezulu kwicala elikude leqhina eliphakathi elidumbileyo (PIP)* (isiqingatha phakathi kwequpha eliphakathi kunye nozipho lomnwe wakho). - Bamba iluphu encinci okanye ube nomncedisi obambe isisongelo sokuqala nje udlula iknuckle edumbileyo ukuze ingatyibiliki. 3. Umoya oqhwethe ngokuchukumisa iiKhoyili ngasemva ngakwiRingi: - Rhoqo ngeflosi yamazinyo ngokucokisekileyo emnweni, usebenze ukusuka ngaphezulu kweqhosha elidumbileyo ujonge kwiringi encamatheleyo. - Qinisekisa ukuba yonke ikhoyili enye ichukumisa ikhoyili yangaphambili nge-ZERO bare skin ephumela ngaphandle phakathi kwemigca yefloss. Njengoko ujija phezu kweqhosha eliphakathi elityebileyo ukuya kwiringi, uya kubukela ifloss icudisa ulwelo olubanjisiweyo ngasemva ngaphantsi kweringi entendeni yesandla sakho. - Qhubeka ujija unyuke de ifloss ibethe kumphetho wangaphambili weringi, emva koko ubambe isiphelo se-taut (okanye uyifake entendeni yesandla sakho). 4. Faka ithontsi lesepha yesitya okanye iWindex phezu kweFloss eSongileyo: - Beka amathontsi ama-2 esepha yesitya elulwelo okanye iWindex ngqo kumaleko agudileyo wefloss yamazinyo evalwe ngewax egqume iqupha lakho ukuze iringi yentsimbi ityibilike phezu kwefloss ngaphandle kokukhuhlana kweqanda. 6. Khululeka kumsila wePalm-Side ukuze uhambe ngeRingi ngaphaya kweKnuckle: - Bamba isiphelo esifutshane sefloss osithulule ngaphantsi kweringi kwiNyathelo 1 (umsila wecala lesundu). - Tsala loo msila phezulu kwaye uye phambili ukuya kwincam yomnwe, uwuphakamise ngokungqamene nomnwe ngelixa ukhulula ngobunono ikhoyili ngekhoyili ejikeleze umnwe. - Kuba laa msila udlula ngaphantsi emazantsi* eringini, sonke isangqa usikhulula ngomatshini iziphako kwaye utyhale iringi phambili kwirempu yefloss ecinezelweyo, uyityibilikise kanye phezu kweqhosha eliphakathi elisicaba ngemizuzwana eyi-10. 7. Ukuba iKnuckle Mkhulu Ngokugqithisileyo: Ngamanye amaxesha, ipasi enye ishenxisa iringi embindini weqhosha le-PIP. Bamba iringi kuloo ndawo, vula ifloss ngokukhawuleza ukuze igazi lijikeleze imizuzwana engama-60, kwaye uphinde uphinde ubophe okwesibini we-60-yesibini ngaphambi kweringi ukucima i-millimeter yokugqibela.

Iindlela ezizezinye zesibhedlele: "Indlela yoBugcisa enemisonto emibini" kunye neegloves ezilula.¶

Ukuba iqupha lakho eliphakathi linesifo samathambo kakhulu okanye linesikhumba esishinyeneyo esihlala sinqwala phambi kweringi ngexesha lokukhulula okuqhelekileyo, zama enye yezi ntlobo zimbini zekliniki zisetyenziswa ngoogqirha bakaxakeka:

1. I-Two-Suture / Two-Floss "Caterpillar" Hamba: Endaweni yokusonga iqupha lonke ngeekhoyili ezingama-30 zomtya, intambo ezimbini ezihlukeneyo eziziisentimitha ezingama-30 (ii-intshi ezili-12) zetape yamazinyo eshinyeneyo ngaphantsi kweringi kumacala achaseneyo omnwe (enye ecaleni komphezulu / kwicala lomzantsi womqolo kunye necala lomzantsi lomqolo). Yiba nomncedisi otsala umtya ongentla uqine kwidolo lakho ukuze ube mcaba umqolo ongaphezulu wesikhumba ngeli lixa ushukumisa isiphelo seringi ukuya phambili ngeemilimitha ezi-2, emva koko tsala umtya ongezantsi ngokuqinileyo ukucaba ukugotywa kwesikhumba sepalmar ngelixa ushukumisa umda ongezantsi weringi ukuya phambili. Ukutshintshana koxinzelelo oluphezulu nolusezantsi luhambisa iringi phezu kweknuckle ye-osteoarthritic ngaphandle kokuyeka ukujikeleza ukuya kwincam yomnwe.
2. I-Elastic Nitrile Glove Glove-Sleeve Trick: Sika ityhubhu yomnwe emxinwa omnye kwi-tight-fit non-latex nitrile iglavu yoviwo lwezonyango (ukusika incam yomnwe evaliweyo ukuze yenze isilinda esoluliweyo). Usebenzisa iphini elibuthuntu le-bobby, tsala umphetho womkhono womnwe we-nitrile ngaphantsi komsesane obambekayo, yolula ityhubhu ye-nitrile ubuyele umva phezu kweqhosha eliphakathi elidumbileyo ukuze irabha e-elastiki icinezele umdibaniso ngokufanayo, gquba umphandle womkhono we-nitrile ngesepha yolwelo, kwaye ujije iringi kanye phezu kwerabha.

Indlela yesi-3: Ukusika okanye ukuqhawula umsesane (i-Metal-by-Metal Triage)¶

Ukuba umnwe ubonisa nayiphi na i-Stage 2 okanye i-Stage 3 ye-vascular compromise, ine-fracture okanye i-laceration, okanye iyasilela iinzame ezimbini ezithambileyo kunye ne-compression wrap, ** i-ring kufuneka inqunyulwe okanye iqhekeke ngokukhawuleza **.

Iibhendi zomtshato zanamhlanje kunye nemisesane yefashoni ayisasenziwa kuphela ngegolide ethambileyo okanye isilivere. Ngaphezulu kweepesenti ze-40 zeebhendi zomtshato zamadoda ezithengiswayo namhlanje zenziwe ngesinyithi se-ultra-hard metal (**tungsten carbide, titanium, cobalt chrome, i-Damasko steel, okanye i-zirconium ceramic **) ezithi ** zitshabalalise ngokukhawuleza izisiki zeringi eziqhelekileyo **. Yazi ukuba yeyiphi intsimbi emnweni wakho ngaphambi kokuba ukhethe isixhobo:

Indlela i "Vise-Grip Locking Plier Technique" iyisusa ngayo iTungsten Carbide okanye iringi yeCeramic kwimizuzwana eyi-15¶

Amasebe angxamisekileyo, izikhululo zomlilo, kunye neebhokisi zezixhobo zasekhaya zinokususa i-ultra-hard ** tungsten carbide ** okanye ** i-ceramic ** iringi ngokukhawuleza kwaye ikhuselekile kuneringi yegolide kuba i-tungsten carbide ** i-brittle kakhulu phantsi koxinzelelo lwamanqaku **:

1. Faka uKhuseleko lwamehlo (Iiglasi zoKhuseleko) kwiSigulana kunye noMhlanguli: Xa itungsten carbide okanye i-ceramic ring fractures, amaqhekeza amancinci abukhali angabhabhela ngaphandle ngesantya esiphezulu. Gcoba ilaphu elibhityileyo okanye i-gauze pad ngokukhululekileyo phezu kweepliers ngexesha lokucinezela ngalinye ukubamba amaqhekeza.
2. Misa imihlathi yeePliyi zokutshixa eziMgangatho (Vise-Grips): Vula imihlathi yeplili yokutshixa ukuze ilingane macala onke kwidayamitha engaphandle yeringi yetungsten kumacala ahlukeneyo omnwe (ungaze ubeke umhlathi ngaphakathi kweringi esikhumbeni).
3. Qinisa isikrufu soLungiso ngokuNgxamisekileyo (¼ Jika ngexesha):
4. Lungisa isikrufu kwisiseko somqheba weVise-Grip ukuze imihlathi ivaleke ngokucokisekileyo ngokuchasene nemiphetho yangaphandle yeringi ngoxinzelelo olukhanyayo, emva koko uyeke.
5. Jika isikrufu sohlengahlengiso ngasekunene nge-ikota enye ukujika, cinezela izibambo zivale de zicofe, kwaye uzivule.
6. Phinda oku ikota-turn qinisa-and-clamp umjikelo 2 ukuya 4 amaxesha. Ngenxa yokuba i-tungsten carbide ine-zero elasticity, iringi iya kuthi ngequbuliso ikhuphe "SNAP" ebukhali kwaye iqhekeke ngokucocekileyo ibe ziziqwenga ezibini okanye ezithathu ngaphandle kwemihlathi ekhe yacudisa ngokwaneleyo ngaphakathi ukucinezela umnwe ngaphantsi.

Umgaqo obalulekileyo wokhuseleko ukuba usika iringi yentsimbi ngesixhobo esijikelezayo (UThintelo lokutshisa iThermal)¶

Ukuba isebe lomlilo okanye igcisa likaxakeka lisebenzisa i-motor rotary cutter (okanye ivili ledayimani le-Dremel) kwi-titanium okanye intsimbi yentsimbi: 1. Slayida isiKhuseli seMetal okanye imela yebhotolo yentsimbi / isicinezeli solwimi esifakwe emanzini phantsi kweRingi: Kufuneka kusoloko kukho ikhaka eliqinileyo lobushushu nencakuba elifakwe phakathi kwebhanti yangaphakathi yeringi kunye nolusu lwesigulana. 2. Gcina unkcenkceshelo lwamanzi abandayo aqhubekayo: Ukukhuhlana okuvela kwivili lokusikwa elijikelezayo kufudumeza i-titanium okanye iringi yegolide ukuya ngaphezu kwama-80 degrees celcius (176 degrees Fahrenheit) kwimizuzwana emi-5, nto leyo ebangela ukutyeba okugcweleyo okujikeleza umtshiso apha emnweni. Umntu wesibini kufuneka aqhubeke enkcunkca okanye athontsize amanzi abandayo okanye i-saline ngokuthe ngqo kwincakuba yokusonta kunye neringi, kwaye anqumame ukusika rhoqo kwimizuzwana emi-3 ukuya kwemi-5 ukuze achukumise-ukukhangela ukuba intsimbi ihlala ipholile. 3. Sika kwiiNdawo ezimbini (okanye uPry Vula ngeeHemostats ezimbini): I-titanium engqindilili okanye iibhanti zentsimbi azinakugotywa zivuleke ngeminwe engenanto emva kokusikwa okunye; mhlawumbi wenze ukusika okwesibini ngama-180 degrees ngokuchasana nokusikwa kokuqala ukuze i-ringtone iwe ibe ziziqingatha ezibini, okanye sebenzisa iziqhoboshi ezibini ezinzima/izisasazo zeringi ukuvula isithuba sivuleke ngaphandle kokujija kwiqhosha elidumbileyo.

I-Aftercare xa umsesane oncamatheleyo uvaliwe (kwaye ingaba iringi esikiweyo ingalungiswa?)¶

1. Hlola iRing Groove ukuze ubone ukonakaliswa kolusu okanye usulelo: Hlamba umnwe ngobunono ngesepha ethambileyo kunye namanzi adikidiki. Ukuba iringi ishiye iblister ekrwada, esikiweyo, okanye enezilonda, sebenzisa umaleko obhityileyo we-petroleum jelly okanye i-ointment ye-antibiotiki engaphezulu kwekhawuntara kwaye ugqume ngebhandeji elixengayo elixengayo (ungaze usonge iteyiphu encamathelayo ngokuqinileyo kwisangqa somnwe obuyayo).
2. ** Qhubeka uPhakamisa kwiiyure ezingama-24 kwaye ujonge ukuDumba okuBuyiselwayo okanye uKwenzakala kweNerve:** Gcina isandla sakho siphakanyiswe kwimiqamelo ngobusuku. Bona ugqirha ngokukhawuleza ukuba i-numbness / tingling kwincam yomnwe iqhubeka ngaphezu kweeyure ze-2 emva kokususwa kwe-ring, ukuba ubomvu buphakamisa isandla (bona i-necrotizing fasciitis kunye ne-cellulitis iiflegi ezibomvu), okanye ukuba awukwazi ukugoba ngokupheleleyo okanye ukuwulungisa umnwe.
3. Gcina Onke amaqhekeza eGolide eSikiweyo, iPlatinam, okanye iRingi yeSilver: Musa ukulahla ibhendi yomtshato esikiweyo. Ibhentshi isacholo inokucoca i-laser-weld okanye i-solder igolide esikiweyo, iplatinam, okanye iringi yesilivere eqaqambileyo ibuyele kunye kwaye iphinde iphinde ibe yi-0.5 ukuya kwi-1.5 ubungakanani obukhulu (okanye ufake i--hinged arthritic shank* evula kwaye ivale ngaphezulu kweknuckles enkulu) ukuze ingaphindi ibanjwe kwakhona.

Imibuzo edla ngokubuzwa¶

Leliphi icala endimele ndilisonge ngalo ifloss yamazinyo ukufumana iringi encamatheleyo kumnwe odumbileyo?¶

Soloko usongela isiphelo esifutshane sefloss yamazinyo ngaphantsi kweringi ukuya entendeni yakho kuqala, emva koko uqalise ukusonga isiphelo eside ngokuqinileyo PHEZU kweqhina eliphakathi elidumbileyo (kufutshane nencam yomnwe wakho) kwaye ujije PHANTSI ukuya kwiringi. Ukusonga ukusuka kwicala lencam yomnwe ukuya kwiringi kucinezela ulwelo lwe-edema oluvalelekileyo ngasemva ngaphantsi kweringi kwisandla sakho kwaye kuyenze ibe mcaba iqupha, ngelixa ukusonga ukusuka kwiringi ukuya ngaphandle kutyhala ukudumba kwincam yomnwe kwaye kwenza umnwe uqine.

Uwususa njani umsesane womtshato we-tungsten carbide ongenakusikwa ngomsiki weringi?¶

Ngenxa yokuba i-tungsten carbide yenye yezona zinyithi ezinzima kakhulu emhlabeni (ubunzima be-Mohs 9), i-standard manual manual cutters ring ring cutters ezisetyenziswa kwiiklinikhi zokunakekelwa ngokukhawuleza kunye neevenkile zobucwebe azikwazi ukunqumla. Nangona kunjalo, i-tungsten carbide i-brittle njengeglasi phantsi koxinzelelo lwamanqaku: ngelixa unxibe iiglasi zokhuseleko, beka imihlathi yokutshixa i-Vise-Grip pliers ngaphesheya komsesane, qinisa i-screw yesithupha ngokujika kwekota enye ngexesha, kwaye ubambe ngokuphindaphindiweyo de umsesane we-tungsten ukrazule ngokucocekileyo ube ziziqwenga ngaphandle kokucofa umnwe.

Ndingaya phi ukuze ndisikwe iringi simahla ukuba iqhinga lomtya alisebenzi?¶

Ukuba umnwe wakho unombala opinki oqhelekileyo, ukufudumala, kunye nokuziva kwaye awuphukanga, ungangena phantse nakwesiphi na isikhululo seSebe soMlilo sendawo, ikliniki yokhathalelo olungxamisekileyo, okanye ivenkile yobucwebe bebhentshi egcwele inkonzo, uninzi lwazo oluphethe ii-ring cutters ze-manual okanye zemoto kwaye ziya kunqumla umsesane oncamatheleyo kwimizuzu embalwa. Nangona kunjalo, ukuba incam yomnwe wakho imhlophe, ibhlowu, imfusa, iyabanda, indindisholo, okanye yonzakele ngenxa yokwaphuka okanye ukutyumzeka kokwenzakala, yiya ngqo kwiSebe likaxakeka yeSibhedlele ngoko nangoko.

Kutheni le nto kufuneka ndikhulule onke amakhonkco am ngoko nangoko ukuba ndikrune isandla sam, ndihlatywe yinyosi, okanye nditshise isandla sam?¶

Nakuphi na ukwenzakala kwisandla, esihlahleni, kwingalo, okanye kwingalo engaphezulu kubangela ulwelo oludumbayo oluhamba lusiya kwiminwe phakathi kwemizuzu eli-15 ukuya kuma-60. Ukususa zonke iindandatho ngaphakathi kwemizuzu yokuqala emva kwempembelelo yesandla, ukutshisa, ukuphuka, okanye i-insect sting inqanda ikhonkco ukuba iguqukele kwi-tourniquet yensimbi eqinile enqumla ukuhamba kwegazi kwaye idinga ukusika ngokukhawuleza esibhedlele.

Imithombo ijongiwe¶

• Umbutho waseMelika woTyando lweSandla (ASSH, eUnited States): *Izikhokelo zeKlinikhi malunga noLawulo lweRing Tourniquet Syndrome, i-Non-Destructive Compression Wrapping, kunye ne-High-Strength Ring Removal *.
• • I-Journal ye-Emergency Medicine * kunye * ne-Annals ye-Emergency Medicine *: * I-Comparative Biomechanics ye-Distal-to-Proximal Winding (I-Caterpillar / i-Elastic Compression Technique) vs. I-Proximal-to-Distal Winding kunye ne-Locking Plier Fragmentation ye-Tungsten Carbide Rings *.
• I-UK Resuscitation Council kunye ne-NHS Emergency Department Guidelines Clinical (eUnited Kingdom): * Ukulawulwa kwe-Digital Ischemia kunye nokususwa kweBand Constriction kwi-Hand Trauma *.

Izikhokelo ezinxulumeneyo¶

• Amathambo aphukileyo kunye ne-sprains uncedo lokuqala
• Ilungu elibukhali le-ischemic, i-arterial occlusion, kunye ne-pulseless extremity
• Ukunqunyulwa kwemilenze okubuhlungu, umnwe, isandla, kunye nokugcinwa kwamalungu
• Utshisa uncedo lokuqala kunye nokupholisa
• Iinombolo zikaxakeka zehlabathi