Kusakanikirana kapena Kutsekemera Kwachinsinsi Kwachidule

Kuchepetsa mavuto pamene zinthu zonse zikulephera

Ngakhale ngakhale chisamaliro chosamalitsa bwino , anthu ena sangathe kupeza mpumulo wokwanira kuvutika kwawo ndipo angafunike zomwe zimadziwika kuti palliative sedation kupeŵa kupweteka ndi kupsinjika.

Musanayambe sedation, gulu la anthu omwe akukuthandizani kapena wokondedwa wanu-omwe amadziwika kuti gulu lothandizira palliative -adzawone njira zambiri zomwe zingathandize kuthetsa mavuto, monga chithandizo chamankhwala choopsa (kugwiritsa ntchito mankhwala onse ndi mankhwala omwe angathandize) ndi kuthandizira maganizo kuti athandizidwe ndi nkhawa.

Cholinga chake ndi kupangitsa munthu wovutika kukhala omasuka. Pamene khamali silikukwanira, palliative sedation ikhoza kusankha.

Uphungu Wopweteka

Nthawi zina zizindikiro zimakhala zovuta kuchiza ndipo zimawoneka kuti sizikugwirizana ndi chithandizo chilichonse. Izi zimachitika nthawi zina mwa anthu omwe ali ndi khansa komanso kumva ululu. Ngakhale kuti mankhwala amamva kupweteka kwambiri , ululu wina sungathe kumasulidwa. Zizindikiro zina zingayambitse mavuto aakulu komanso amatsitsimutsa kwambiri ndi kusanza, kusokonezeka kosasinthasintha kapena kugwidwa, komanso kupuma kwambiri ndi zitsanzo zochepa chabe za zovuta. Pazochitikazi, sedation ingakhale njira yokhayo yopeza chithandizo chokwanira.

Dokotala atagwirizana ndi wodwalayo kapena wogwira ntchitoyo kuti agwiritse ntchito mankhwala osokoneza bongo, amapatsidwa mankhwala osokoneza bongo ndipo amawonjezeka mpaka atayesedwa. Kawirikawiri, anthu omwe akudwala palliative sedation amakhalabe ndi chidziwitso ngakhale atakhala pansi.

Koma ngati inu kapena wokondedwa wanu mudakali ndi zizindikiro zosautsa, kupangitsa kuti munthu asadziwe bwino kungakhale kovomerezeka.

Mankhwala Amankhwala

Mankhwala omwe amagwiritsidwa ntchito pokodza munthu angaphatikizepo mankhwala osokoneza bongo monga Valium (diazepam) ndi phenobarbital, kapena mankhwala opweteka. Kumverera kwa kusungunuka kungakhale kochokera kumtima wokhala ndi nkhawa kuti usamalize kusadziwa.

Kawirikawiri, mankhwala otsika kwambiri omwe amachititsa kuthetsa mavuto akugwiritsidwa ntchito poonetsetsa kuti munthu amene akuchiritsidwayo amakhalabe wodziwa nthawi zonse.

Ngati kutaya chidziwitso ndi njira yokhayo yothetsera mavuto, ingayesedwe ngati yankho laling'ono ndi ogwira ntchito zachipatala omwe amalola kuti ziwalozo zisawonongeke kuti azindikirenso chitsimikizo cha wodwalayo. Zingaganizedwe kuti njira yokhayo yopezera chitonthozo ndiyo kusunga chiwonongeko chathunthu mpaka imfa itapezeka . Ngati njirayi ikutsatiridwa, imfa imachitika sabata imodzi. Kafukufuku wina amasonyeza kuti nthawi yayitali pafupifupi maola 27.

Zotsatira zachipatala

Pali zifukwa zitatu zomwe vuto la wodwala liyenera kukomana asanayambe kugwiritsidwa ntchito poyang'ana:

• Njira zina zothandizira kuthetsa mavuto zakhala zopanda phindu kapena zakhala zopweteka
• Cholinga cha sedation chiyenera kukhala kuchepetsa kuvutika, osati kuthetsa moyo wa wodwala kapena kufulumira imfa
• Wodwalayo ayenera kukhala pafupi ndi imfa kale, kotero kuti sedation sichifupikitsa kwambiri kupulumuka

Palliative sedation sichikuchitidwa popanda wodwalayo kapena chilolezo chake chosankha. Chofunikira ichi ndi chomwe chimatchulidwa ngati chosankha chokhazikika - chomwe chimapangidwa ndi munthu amene akukhudzidwa, kapena kuti munthu wina, malinga ndi mfundo zake, zikhulupiriro zake, ndi zolinga zake.

Chofunika kwa ogwira ntchito zachipatala kuti ateteze chilolezochi chimatsimikizira kuti chisankhocho, ngati chisankhidwa, chikugwirizana ndi zofuna za munthu payekha ndipo popanda mphamvu ya dokotala payekha.

_Zotsatira:

_{Bernard Lo, MD; Gordon Rubenfeld, MD, MSc. "Kugonjetsa Pakati pa Odwala Odwala". JAMA. 2005; 294: 1810-1816.}