Kwihlabathi loomatshini bokuthomalalisa iintlungu, kukho into ethobekileyo kodwa ebaluleke kakhulu eyaziwa ngokuba yi-APL (Adjustable Pressure Limiting) valve.Esi sixhobo singazicingeliyo, esisoloko sisetyenziswa ngabathomalalisi ngexesha leenkqubo zonyango, sidlala indima ebaluleke kakhulu ekuqinisekiseni ukhuseleko nokusebenza kokungena komoya kwesigulana.
UmGaqo wokuSebenza weValve ye-APL
Ivalve ye-APL isebenza kumgaqo olula kodwa obalulekileyo.Iquka i-disk elayishiwe entwasahlobo, kwaye umsebenzi wayo uquka ukulungelelanisa uxinzelelo ngaphakathi kwesiphaluka sokuphefumla.Ngokuguqula i-knob, ukunyanzeliswa kwentwasahlobo kwaye ngaloo ndlela uxinzelelo olufakwe kwidiski lunokuguqulwa.I-valve ihlala ivaliwe kuze kube yilapho ingcinezelo kwisiphaluka sokuphefumula, emele utolo oluluhlaza, idlula amandla asetyenziswe ngumthombo, obonakaliswe lutolo olupinki.Kulapho kuphela apho ivalve ivula khona, ivumela igesi egqithisileyo okanye uxinzelelo ukuba lubaleke.Igesi ekhutshwe yi-valve ye-APL ngokuqhelekileyo iqondiswe kwinkqubo yokucoca, iqinisekisa ukukhutshwa okukhuselekileyo kweegesi ezingaphezulu ukusuka kwigumbi lokusebenza.
Ukusetyenziswa kweValve ye-APL
Ukujonga Ukunyaniseka koMatshini we-Anesthesia
Olunye usetyenziso olubalulekileyo lwevalvu ye-APL kukuqinisekisa ukuthembeka komatshini wokuthomalalisa iintlungu.Iindlela ezahlukeneyo, kuxhomekeke kwizikhokelo zomenzi, zingasetyenziswa.Ngokomzekelo, emva kokudibanisa umatshini we-anesthesia kwisiphaluka sokuphefumla, umntu unokuvala i-valve ye-APL, avale i-Y-connector yesiphaluka sokuphefumula, kwaye ulungelelanise ukuhamba kwe-oksijini kunye ne-valve yokugungxula ngokukhawuleza ukufezekisa ukufundwa koxinzelelo lwe-airway ye-30 cmH2O.Ukuba isalathisi sihlala sizinzile ubuncinane imizuzwana ye-10, ibonisa ukunyaniseka komatshini okulungileyo.Ngokufanayo, umntu unokuvavanya umatshini ngokubeka i-valve ye-APL kwi-70 cmH2O, ukuvala ukuhamba kwe-oksijeni, kunye nokubandakanya ukukhawuleza ngokukhawuleza.Ukuba uxinzelelo luhlala kwi-70 cmH2O, lubonisa inkqubo evalwe kakuhle.
Isigulana-ngokuzenzekelayo ukuphefumla State
Ngexesha lokuphefumla komguli, ivalve ye-APL kufuneka ihlengahlengiswe ibe ngu-“0” okanye “Spont.”Ezi zicwangciso zivula ngokupheleleyo i-valve ye-APL, iqinisekisa ukuba uxinzelelo ngaphakathi kwesekethe yokuphefumula luhlala lusondele kwi-zero.Olu lungelelwaniso lunciphisa izigulane ezixhathisayo ezongezelelweyo ezinokudibana nazo ngexesha lokuphefumla okuzenzekelayo.
Ukungeniswa kokuPhumeza komoya oLawulwayo
Ukungena komoya ngesandla, i-valve ye-APL ilungelelaniswe kwindawo efanelekileyo, ngokuqhelekileyo phakathi kwe-20-30 cmH2O.Oku kubalulekile njengoko uxinzelelo oluphezulu lomoya kufuneka lugcinwe ngokubanzi ngaphantsi kwe-35 cmH₂O.Xa unikezela umoya ococekileyo womoya ngokucinezela isikhwama sokuphefumla, ukuba uxinzelelo ngexesha lokuphefumlelwa ludlula ixabiso le-valve ye-APL, i-valve ye-APL iyavula, ivumela igesi engaphezulu ukuba ibaleke.Oku kuqinisekisa ukuba uxinzelelo luyalawulwa, lukhusela umonakalo kwisigulane.
Ukugcinwa kweMishini yokuPhumelela komoya ngexesha loTyando
Ngexesha lokungenisa umoya ngoomatshini, i-valve ye-APL idlula ngokuyimfuneko, kwaye ukusetwa kwayo kunempembelelo encinci.Nangona kunjalo, njengesithintelo, kulisiko ukunyenyisa ivalve ye-APL ibe ngu-“0” ngexesha lolawulo lomoya lomatshini.Oku kuququzelela ukutshintshela kulawulo lwezandla ekupheleni kotyando kwaye kuvumela ukujonga ukuphefumla okuzenzekelayo.
Ukwandiswa kwemiphunga phantsi kwe-Anesthesia
Ukuba ukunyuka kwamaxabiso emiphunga kuyimfuneko ngexesha lotyando, i-valve ye-APL imiselwe kwixabiso elithile, ngokuqhelekileyo phakathi kwe-20-30 cmH₂O, kuxhomekeke kwingcinezelo efunekayo yokuphefumula.Eli xabiso liqinisekisa ukunyuka kwamaxabiso okulawulwayo kwaye ligwema uxinzelelo olugqithisileyo kwimiphunga yesigulane.
Ukuqukumbela, ngelixa i-valve ye-APL isenokubonakala ingabonakali kwihlabathi loomatshini bokuthomalalisa iintlungu, indima yayo ibalulekile ngokungathandabuzekiyo.Ifaka isandla ekukhuselekeni kwesigulane, umoya osebenzayo, kunye nempumelelo epheleleyo yeenkqubo zonyango.Ukuqonda i-nuances ye-valve ye-APL kunye nezicelo zayo ezahlukeneyo kubalulekile kwii-anesthetists kunye nabaqeqeshi bezempilo ukuze baqinisekise impilo-ntle yezigulane ekunyamekeleni kwabo.
