Ishuri ry'ubuzima n’ubuzima, Helen McArdle Institute of Nursing and Nursing, University of Sunderland, Sunderland, UK
Nicholas Harland, Ishuri ry'ubumenyi bw’ubuzima n’imibereho, Helen McArdle Institute of Nursing and Nursing, University of Sunderland City Campus, Chester Road, Sunderland SR1 3SD, UK.
Ishuri ry'ubuzima n’ubuzima, Helen McArdle Institute of Nursing and Nursing, University of Sunderland, Sunderland, UK
Nicholas Harland, Ishuri ry'ubumenyi bw’ubuzima n’imibereho, Helen McArdle Institute of Nursing and Nursing, University of Sunderland City Campus, Chester Road, Sunderland SR1 3SD, UK.
Koresha umurongo uri munsi kugirango usangire inyandiko yuzuye yiyi ngingo hamwe nabagenzi bawe na bagenzi bawe.Wige byinshi.
COVID-19 Oximetry @ Serivisi yo murugo yatangijwe mugihugu hose.Ibi bituma abarwayi bafite ibyago byinshi bafite ibimenyetso byoroheje bya COVID-19 baguma murugo kandi bakabona impiswi yo gupima ogisijeni (SpO2) inshuro 2 kugeza kuri 3 kumunsi ibyumweru bibiri.Abarwayi bandika ibyo basomye mu ntoki cyangwa kuri elegitoronike kandi bakurikiranwa n'itsinda ry'amavuriro.Icyemezo cyamavuriro cyo gukoresha algorithm gishingiye kubisomwa bya SpO2 murwego ruto, aho impinduka 1-2 zishobora kugira ingaruka kubuvuzi.Muri iki kiganiro, twaganiriye ku bintu byinshi bigira ingaruka ku isomwa rya SpO2, kandi abantu bamwe "basanzwe" bazagira amanota "make asanzwe" kurwego rwubuyobozi bw’amavuriro nta kibazo cyo guhumeka kizwi.Twaganiriye ku buremere bw'iki kibazo dushingiye ku bitabo bijyanye, tunasuzuma uburyo ibyo bizagira ingaruka ku mikoreshereze ya serivisi ya Oximetry @ yo mu rugo, ishobora kwitiranya intego zayo;gabanya ubuvuzi imbonankubone.
Hariho inyungu nyinshi zo gucunga ibibazo bya COVID-19 bidakabije mubaturage, nubwo ibi bigabanya ikoreshwa ryibikoresho byubuvuzi nka termometero, stethoskopi, na oxyde ya pulse mugihe cyo gusuzuma.Ariko, kubera ko gupima impiswi oximetry yumurwayi murugo ari ingirakamaro mukurinda gusura ishami ryihutirwa ridakenewe (Torjesen, 2020) no kumenya hakiri kare hypoxia idafite ibimenyetso, ariko, NHS Ubwongereza irasaba ko igihugu cyose cyakira serivisi ya "Spo2 Measurement @ Home" (NHSE) ,20a) .
Abarwayi boherejwe na Oximetry @ Serivise yo murugo basabwa gukoresha porogaramu cyangwa urupapuro rwanditse kugirango bandike ibyo babonye.Porogaramu itanga ibisubizo byikora / ibyifuzo, cyangwa umuganga akurikirana amakuru.Bibaye ngombwa, umuganga arashobora kuvugana numurwayi, ariko mubisanzwe gusa mumasaha asanzwe yakazi.Abarwayi babwirwa uko basobanura ibisubizo byabo kugirango bashobore gukora bigenga mugihe bikenewe, nko gushaka ubutabazi bwihuse.Bitewe n’ibyago byinshi byo kwandura indwara, abantu barengeje imyaka 65 na / cyangwa bafite ingaruka nyinshi zisobanurwa nk’abatishoboye cyane barimo kwibasirwa nubu buryo (NHSE, 2020a).
Isuzuma ry'abarwayi muri Oximetry @ Serivisi yo murugo ni ukubanza gupima ubwuzure bwa ogisijeni binyuze muri pulse oximeter SpO2, hanyuma ukareba ibindi bimenyetso n'ibimenyetso.Ukoresheje ibipimo bitukura, amber, nicyatsi (RAG), niba SpO2 yumurwayi ari 92% cyangwa munsi yayo, umurwayi ashyirwa mubutuku, kandi niba SpO2 yabo ari 93% cyangwa 94%, bashyirwa mubikorwa nka amber, niba Niba SpO2 yabo ni 95% cyangwa irenga, bashyizwe mubyatsi.Mubisanzwe, abarwayi bicyatsi gusa ni bo bemerewe gukoresha Oximetry @ Urugo (NHSE, 2020b).Ariko, ibintu bitandukanye bitajyanye nindwara birashobora kugira ingaruka kumanota ya SpO2, kandi ibyo bintu ntibishobora kurebwa munzira.Muri iki kiganiro, twaganiriye ku bintu bitandukanye bigira ingaruka kuri SpO2 zishobora kugira ingaruka ku barwayi kugera kuri Oximetry @ Serivisi zo mu rugo.Izi ngingo zishobora kwitiranya igice cyacyo cyo kugabanya umuvuduko wa serivisi zubuvuzi imbonankubone.
Urwego rwemewe rwuzuye rwa ogisijeni yamaraso "rusanzwe" rwapimwe na pulse oximeter (SpO2) ni 95% -99%.Nubgo hariho inyandiko nk’umuryango mpuzamahanga wita ku buzima Pulse Oximetry Training Training (OMS, 2011), aya magambo arahari hose ku buryo ingingo z’ubuvuzi zidakunze kubivuga.Mugihe ushakisha amakuru yubuyobozi kuri SpO2 mubantu badafite ubuvuzi, amakuru make araboneka.Mu bushakashatsi bwakorewe ku bantu 791 bafite imyaka 65 nayirenga (Rodríguez-Molinero et al., 2013), nyuma yo gusuzuma impinduka nka COPD, impuzandengo ya 5% ya SpO2 yari 92%, byerekana igipimo cya 5% Kwuzura kwa ogisijeni mu maraso. ni munsi cyane kurenza ibyo nta bisobanuro bizwi byubuvuzi.Mu bundi bushakashatsi bwakozwe ku bantu 458 bafite imyaka 40-79 (Enright & Sherrill, 1998), urugero rwuzuye rwa ogisijeni mbere y’ikizamini cy’iminota 6 rwagenze ni 92% -98% muri 5%, naho 95%.Ijanisha rya mbere ni 93% -99% kwijana.Ubushakashatsi bwombi ntabwo bwanditse inzira zikoreshwa mugupima SpO2 muburyo burambuye.
Ubushakashatsi bw’abaturage bwakozwe ku bantu 5.152 muri Noruveje (Vold et al., 2015) bwerekanye ko 11,5% by’abantu bafite SpO2 munsi cyangwa bingana na 95% munsi cyangwa munsi y’ibisanzwe.Muri ubu bushakashatsi, abantu bake gusa bafite SpO2 nkeya ni bo bavugaga ko bafite asima (18%) cyangwa COPD (13%), mu gihe abantu benshi bafite imibare ifatika ya BMI barenze 25 (77%) kandi bari binini Bamwe bafite imyaka 70 cyangwa mukuru (46%).Mu Bwongereza, 24.4% by'imanza zapimwe kuri COVID-19 hagati ya Gicurasi na Kanama 2020 zifite imyaka 60 cyangwa irenga, naho 15% zifite imyaka 70 cyangwa irenga [8] (Minisiteri y'Ubuzima n'Imibereho Myiza y'Abaturage, 2020).Nubwo ubushakashatsi bwa Noruveje bwerekana ko 11,5% byabaturage bose bashobora kuba bafite SpO2 nkeya, kandi inyinshi murizo ndwara zidafite uburwayi bw’ubuhumekero, ibitabo byerekana ko hashobora kubaho “miliyoni” za COPD itaramenyekana (Bakerly & Cardwell, 2016) Kandi birashoboka igipimo kinini cyumubyibuho ukabije hypoventilation syndromes (Masa et al., 2019).Umubare munini wibarurishamibare ryamanota "adasanzwe" adasobanutse amanota ya SpO2 aboneka mubushakashatsi bwabaturage ashobora kuba afite indwara zubuhumekero zitamenyekanye.
Usibye gutandukana muri rusange, ibintu byihariye bya protocole ikoreshwa mugupima SpO2 bishobora kugira ingaruka kubisubizo.Hariho itandukaniro rinini cyane hagati yipimwa ryafashwe kuruhuka no gupimwa wicaye (Ceylan et al., 2015).Byongeye kandi, kimwe n'imyaka hamwe n'umubyibuho ukabije, SpO2 irashobora kugabanuka muminota 5-15 yo kuruhuka (Mehta na Parmar, 2017), cyane cyane mugihe cyo gutekereza (Bernardi et al., 2017).Ubushyuhe bwo mu gihimba bujyanye n'ubushyuhe bw’ibidukikije bushobora no kugira ingaruka zikomeye mu mibare (Khan et al., 2015), kimwe no guhangayika, kandi kuba hari impungenge bishobora kugabanya amanota ku ngingo yuzuye (Ardaa et al., 2020).Hanyuma, birazwi neza ko ikosa risanzwe ryo gupima pulse oximeter ari ± 2% ugereranije no gupima gazi yamaraso ya arterial ya SaO2 (American Thoracic Society, 2018), ariko duhereye kumavuriro, duhereye kubikorwa bifatika, kuberako Nta buryo bwo gufata iri tandukaniro, bigomba gupimwa no gukorerwa ku gaciro keza.
Impinduka muri SpO2 mugihe no gupima inshuro nyinshi nikindi kibazo, kandi hari amakuru make cyane kubijyanye nabatari abaganga.Ingano ntoya yicyitegererezo (n = 36) ubushakashatsi bwasuzumye impinduka za SpO2 mugihe cyisaha imwe (16) (Bhogal & Mani, 2017), ariko ntiyigeze itangaza impinduka mugihe cyapimwe inshuro nyinshi, nko muri Oximetry @ Mugihe Murugo.
Mugihe cyiminsi 14 ya Oximetry @ Urugo rwo gukurikirana, SpO2 yapimwe inshuro 3 kumunsi, zishobora kuba kenshi kubarwayi bahangayitse, kandi harashobora gufatwa ibipimo 42.Ndetse ukeka ko protocole imwe yo gupima ikoreshwa muri buri kibazo kandi imiterere yubuvuzi ihagaze neza, hariho impamvu yo kwizera ko hari itandukaniro runaka muribi bipimo.Ubushakashatsi bwabaturage ukoresheje igipimo kimwe cyerekana ko 11,5% byabantu bashobora kuba bafite SpO2 ya 95% cyangwa munsi yayo.Igihe kirenze, igihe, amahirwe yo kubona gusoma gake mugihe cyo gupimwa inshuro nyinshi bibaho mugihe igitekerezo cya COVID -19 gishobora kuba hejuru ya 11.5%.
Algorithm iri inyuma ya Oximetry @ Serivisi yo murugo yerekana ko ibisubizo bibi bifitanye isano n'amanota make ya SpO2 [17] (Shah et al., 2020);abafite SpO2 bagabanuka kugera kuri 93% kugeza kuri 94% bagomba kwisuzumisha imbonankubone kandi bagafatwa nk'abinjira, 92% Kandi hepfo bagomba kwivuza byihutirwa.Hamwe nogushira mubikorwa kwa Oximetry @ Murugo mugihugu hose, gupima SpO2 inshuro nyinshi zafashwe nabarwayi murugo bizaba ikintu cyingenzi mugusobanura imiterere yubuvuzi bwabo.
Ibipimo bya SpO2 bikorwa cyane mugihe gito mugihe oximeter ishyizwe.Umurwayi yicaye nta kiruhuko mu gihe runaka.Kugenda uva aho utegereje kugera kumavuriro bizahagarika ahasigaye.Hamwe nogukora kwa Oximetry @ Serivisi yo murugo, amashusho ya NHS YouTube (2020) yashyizwe ahagaragara.Video irasaba ko abarwayi bafata ibipimo murugo baryama iminota 5, bagashyira oximeter, hanyuma bakabona gusoma neza nyuma yiminota 1 nyuma yo gushyirwa.Ihuza rya videwo ryanyujijwe ku rupapuro rwa interineti rw’ubufatanye rwa NHS rujyanye n’umuntu ushyiraho serivisi ya Oximetry @ Murugo, ariko ntabwo bisa nkaho byerekana ko ibyo bishobora gutanga ibisomwa bike ugereranije nibisomwa byafashwe wicaye.Birakwiye ko tumenya ko indi videwo yo kwigisha ubuzima bwa NHS mu Bwongereza mu kinyamakuru Daily Mail isaba protocole itandukanye rwose, igomba gusoma wicaye (Daily Mail, 2020).
Mubantu batazwi muri rusange, amanota make ya 95%, ndetse no kugabanuka kumanota 1 kubera kwandura COVID-19 bishobora kuvamo Amber, biganisha kubuvuzi butaziguye.Ikidasobanutse neza ni ukumenya niba ingingo imwe yo kugabanuka izatuma ubuvuzi butaziguye bukoreshwa neza mu bantu bafite amanota make mbere y’indwara.
Nubwo algorithm yigihugu ivuga kandi kugabanuka kwa SpO2, kubera ko umubare munini wabantu batanditse amanota yabanjirije indwara ya SpO2, iki kintu ntigishobora gusuzumwa mbere yuko igabanuka ryambere ryatewe na virusi yateje isuzuma rya SpO2.Duhereye ku gufata ibyemezo, ntibisobanutse neza niba urwego rwiza rwuzuye rwuzuye / parufe yumuntu yicaye rugomba gukoreshwa nkibanze mu kwita ku ngingo, cyangwa niba kugabanuka kwuzuye / kugabanura urwego iyo uryamye nyuma yuburuhukiro bigomba gukoreshwa nku shingiro.Ntabwo bigaragara ko hari politiki yemejwe nigihugu kuri iki kibazo.
SpO2% nibintu byingenzi biboneka kumugaragaro kugirango dusuzume COVID-19.NHS Ubwongereza bwaguze oximeter 370.000 kugirango ikoreshwe n’abarwayi benshi kugirango bakwirakwize serivisi.
Ibintu byasobanuwe birashobora gutera impinduka nyinshi zapimwe ingingo imwe ya SpO2, bigatuma abarwayi bareba imbonankubone mubuvuzi bwibanze cyangwa ishami ryihutirwa.Igihe kirenze, abarwayi ibihumbi nibihumbi barashobora gukurikiranwa kuri SpO2, ibyo bikaba bishobora gutuma umubare munini wibisubizo bitari ngombwa imbonankubone.Iyo isesengura ryibintu bigira ingaruka ku isomwa rya SpO2 mu manza za COVID-19 ryasesenguwe kandi rigashyirwa mu rwego rwo gupima amavuriro ashingiye ku mavuriro no mu ngo, ingaruka zishobora kuba zishingiye ku mibare, cyane cyane kuri abo “babuze miliyoni” Ikibazo gikomeye cya SpO2 kirashoboka.Mubyongeyeho, serivisi ya Oximetry @ Murugo birashoboka cyane guhitamo abantu bafite amanota yo guca abantu barengeje imyaka 65 nabafite BMI yo hejuru ifitanye isano nibibazo.Ubushakashatsi bwerekanye ko abaturage "bake basanzwe" bazaba nibura 11.5% byabantu bose, ariko kubera ibipimo byo guhitamo serivisi ya Oximetry @ Murugo, iyi ijanisha risa nkaho riri hejuru cyane.
Kubera ko ibintu byanditse byerekana ingaruka za amanota ya SpO2 biri kukazi, abarwayi bafite amanota make muri rusange, cyane cyane abafite amanota 95%, barashobora kwimuka hagati yicyatsi kibisi na amber inshuro nyinshi.Iki gikorwa gishobora no kubaho hagati yo gupima imyitozo isanzwe yubuvuzi mugihe cyoherejwe kuri Oximetry @ Murugo no gupima bwa mbere mugihe umurwayi akoresheje protocole yiminota 6 aryamye murugo.Niba umurwayi yumva atameze neza, guhangayika mugihe cyo gupimwa birashobora kandi kugabanya abafite amanota yagabanutse munsi ya 95% bagashaka ubuvuzi.Ibi birashobora kuvamo kwitabwaho byinshi bidakenewe imbonankubone, ugashyiraho igitutu cyinyongera kuri serivisi zigeze cyangwa zirenze ubushobozi.
Ndetse no hanze ya Oximetry yashinzwe @ Inzira yo murugo nibikoresho byubuvuzi biha abarwayi oximeter, amakuru yamakuru ku kamaro ka oximeter ya pulse arakwirakwira hose, kandi ntibizwi umubare w’abaturage bashobora kuba bafite okisimeteri ya pulse mu gusubiza icyorezo cya COVID -19, nubwo hari abadandaza benshi batandukanye batanga ibikoresho bihendutse ugereranije na raporo yibikoresho byagurishijwe (CNN, 2020), iyi mibare irashobora kuba byibuze ibihumbi magana.Ibintu byasobanuwe muri iyi ngingo birashobora no kugira ingaruka kuri aba bantu no gushyira ingufu kuri serivisi.
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Igihe cyo kohereza: Nyakanga-15-2021