Igumbi labagula kakhulu liyinkonzo yezokwelapha ekhethekile lapho iziguli ezibucayi kakhulu zilaliswa khona esibhedlela kuze kube yilapho imisebenzi yazo ebalulekile ingasasongelwa.

Kuhlukaniswa amayunithi ahlukene egumbi labagula kakhulu:

I-Continuous Monitoring Unit (ICU)

Kuhloswe ngayo ukunakekela iziguli ezisengozini yokwehluleka okudinga ukuqapha ngokucophelela. Kumelwe bakwazi ukubhekana nokwehluleka uma kwenzeka futhi balungiselele isiguli ukudluliselwa kwaso ngokushesha egunjini labagula kakhulu.

Igumbi labagula kakhulu (ICU)

Inikezwe amandla okubhekana nokwehluleka okukodwa isikhathi esilinganiselwe.

Ukuvuselelwa

Ihloselwe ukuphathwa isikhathi eside kweziguli ezinokwehluleka okuningi.

Zonke izinsizakalo azitholakali kuzo zonke izibhedlela: lokhu kuyiqiniso ikakhulukazi ngokuvuselela. Ngakolunye uhlangothi, zonke izibhedlela, zomphakathi noma ezizimele, zinesevisi yokugada eqhubekayo yamahora angu-24.

Igumbi labagula kakhulu ngalinye linomsebenzi walo okhethekile:

• Izifo zenhliziyo;
• I-Nephrological;
• Okokuphefumula;
• I-vascular neurological;
• I-Hematologic;
• Izinsana;
• Izifo zezingane;
• Ukuphathwa kokusha okukhulu;
• Futhi okuningi okuningi

Iziguli zingeniswa ekunakekelweni okujulile lapho umsebenzi owodwa noma eminingi ebalulekile yehluleka ngenxa yalokhu:

• Ukutheleleka okukhulu (ukushaqeka kwe-septic);
• Ukuphelelwa amanzi emzimbeni okukhulu;
• Kusuka kokungezwani komzimba;
• Inkinga yenhliziyo;
• Ubuthi bezidakamizwa;
• Kusuka ku-polytrauma;
• Nge-coma;
• Ukuhluleka kwe-renal acute;
• Ukuhluleka kokuphefumula okunamandla;
• Ukuboshwa kwenhliziyo;
• Ukuhlinzwa okukhulu njengokuhlinzwa kwenhliziyo noma ukugaya ukudla;
• Futhi okuningi okuningi

Egunjini labagula kakhulu, isimo seziguli kanye nokwelashwa okwenziwe kudinga abasebenzi abakhethekile.

Ukukhethekile kwabasebenzi bezokwelapha esizeni kuncike ohlotsheni lomsebenzi:

• Kuyunithi yokuvuselela, ama-resuscitators akhona;
• Egumbini labagula kakhulu ku-cardiology (ICU), izazi zenhliziyo;
• Ophikweni oluqhubekayo lokuqapha, ama-anesthetists;
• Futhi okuningi okuningi

Odokotela bangochwepheshe bokunakekelwa kwe-anesthesia-intensive noma ekunakekelweni okuphezulu futhi basebenza ngokubambisana nabo bonke ochwepheshe besibhedlela: ochwepheshe be-physiotherapist, ochwepheshe be-electroradiology yezokwelapha, umhlengikazi ekunakekelweni okujwayelekile (IDE), ama-ejenti wesevisi yesibhedlela ...

Ukuqhubeka kokuqapha kanye nokunakekelwa kwamahora angu-24 kuqinisekiswa ngosizo lwenani elikhulu lezimo eziphuthumayo kanye nokuba khona unomphela kwethimba lezokwelapha esizeni, ukuphendula ngokushesha kunoma yisiphi isimo esiphuthumayo - ama-IDE amabili eziguli ezinhlanu ekunakekelweni okukhulu, i-IDE eyodwa iziguli ezine e-ICU nase-USC.

Zonke izinsizakalo zokuvuselela abantu zinemishini yokuqinisekisa ukuqapha okuqhubekayo kwemisebenzi eyinhloko yomzimba kanye nesimo seziguli.

Imishini yokuqapha ihlanganisa:

• Ama-Electrocardioscopes;
• Abaqaphi bomfutho wegazi;
• I-colorimetric oximeters - iseli le-infrared elibekwe ku-pulp yomunwe ukukala iphesenti le-oxyhemoglobin egazini;
• Ama-catheters ama-venous Central (VVC).

Futhi ama-constants agadwayo ami kanje:

• Imvamisa yenhliziyo;
• Izinga lokuphefumula;
• Ingcindezi ye-arterial (systolic, diastolic kanye ne-mean): ingaqedwa, sibonga isikhwama esifaka njalo ngezikhathi ezithile, noma ngokuqhubekayo, nge-catheter efakwe emthanjeni we-radial noma wesifazane;
• Ukucindezela kwe-venous ephakathi (PVC);
• Ukugcwala komoya-mpilo;
• Izinga lokushisa: linganqanyulwa - likalwe kusetshenziswa ithemometha - noma liqhubeke lisebenzisa i-probe;
• Futhi abanye ngokwezidingo: ingcindezi ye-intracranial, ukuphuma kwenhliziyo, ukujula kokulala, njll.

Imininingwane yesiguli ngasinye - amagumbi angawodwana - iboniswa ngesikhathi sangempela ekamelweni ngalinye futhi ngokuhambisana esikrinini esisehholo elimaphakathi lenkonzo ukuze abasebenzi bakwazi ukuqapha zonke iziguli ngesikhathi esisodwa. Uma ipharamitha eyodwa ishintsha kungazelelwe, i-alamu ezwakalayo icushwa khona manjalo.

Ukuvuselela indawo yobuchwepheshe obuphezulu lapho kungenzeka khona ukusetha izinhlelo eziningi zokusiza:

• Usizo lokuphefumula: izingilazi zomoya-mpilo, imaskhi ye-oxygen, i-tracheal intubation, i-tracheostomy kanye nezikhathi zokuphefumula zokuphefumula;
• Usizo lwenhliziyo nokuphefumula: izidakamizwa zokubuyisela umfutho ojwayelekile we-arterial, umshini wokusiza ukuphefumula othuthukisa ukutholakala komoyampilo ezithweni, umshini wokusiza wokujikeleza kwegazi ngaphandle kwe-extracorporeal;
• Usizo lwezinso: ukukhishwa kwe-dialysis okuqhubekayo noma okuphakathi;
• Umsoco wokwenziwa: ukudla okunomsoco ngeshubhu esiswini noma umsoco womzali ngokufakwa;
• I-sedation: i-sedation elula - isiguli siyazi - nge-anesthesia jikelele - isiguli sikwi-coma ebangelwa;
• Futhi okuningi okuningi

Okokugcina, ukunakekelwa kwenhlanzeko nokunethezeka, okubizwa ngokuthi ubuhlengikazi, kunikezwa nsuku zonke ngabahlengikazi, abahlengikazi abasizi kanye nama-physiotherapists.

Izinsizakalo zokuvuselela zivulekele imindeni kanye nabathandekayo babo ukuba khona kwabo nokusekelwa kuyingxenye ebalulekile yokululama. Izazi zokusebenza kwengqondo, osonhlalakahle, abaphathi kanye nabamele ezenkolo bayatholakala ukuxhasa iziguli nemindeni yabo.

Inhlolovo eyenziwe nguMnyango Wezocwaningo, Izifundo, Ukuhlola kanye Nezibalo (DREES) ilinganisela inani lemibhede - abantu abadala nezingane, zomphakathi nezizimele - e-France ngo-2018:

• Ngo-5 ekunakekelweni okukhulu;
• Kwaba-5 egunjini labagula kakhulu;
• Ku-8 kuyunithi yokuqapha eqhubekayo.

Ucwaningo olwenziwa ngoNovemba 2020 yi-Société de Pneumologie de Langue Française (SPLF) kanye neNational Professional Council of Pneumology yahlonza zonke izinhlaka zokunakekela zesikhathi eside, izikhungo zabagula kakhulu, izikhungo zokunakekela ukuphefumula kanzima (USIR) kanye nokubhekwa okuqhubekayo kwe-pneumological ( USC) endaweni kazwelonke:

• Ama-USIR, asekelwa iminyango ye-pneumology, atholakala kuphela kuma-CHU: imibhede eyi-104 ezifundeni eziyi-7;
• Ama-USC wamaphaphu asekelwa iminyango ye-pulmonology: imibhede eyi-101, noma imibhede ye-USC engama-81 + imibhede engama-20 ezakhiweni ezihlanganisa i-USIR ne-USC.

Kunzima kakhulu ukubikezela i-prognosis yeziguli ezingeniswe ekunakekelweni okukhulu. Ukuziphendukela kwemvelo - ukuthuthukiswa noma ukuwohloka - kwesimo somtholampilo wesiguli kuzonquma, esimweni ngasinye, amathuba akhe okusinda nokululama okuhle.

Ishicilelwe ngo-Okthoba 2020, ucwaningo lwe-Covid-ICU - ukutheleleka nge-Covid-19 e-Intensive Care Unit, "indawo yabagula kakhulu" - kuhlanganisa abantu abadala abangu-4 baseFrance, eBelgian naseSwitzerland abane-acute breathing distress syndrome exhumene nokutheleleka nge-SARS-CoV-244. Ezinsukwini ezingamashumi ayisishiyagalolunye ngemuva kokungeniswa kwabo ekunakekelweni okukhulu, ukushona kwaba ngu-2%.