|GUOI BENH 1. DAL CUONG V6 rung li phuong phap didu tri nhim giai phéng dom dich ra khéi phdi nha chu d6ng tac dung mdt lye co hoc qua thanh ngyc truyén vao phdi, lam cdc cuc dém i dong dinh vao phé quan nhé bj bong ra rdi dém dugc dan hu vao phé quan Ién va ho téng ra ngoai hoac duge hut bang sonde hat dom I. CHi DINH Ngudi bénh dat Sng n6 khid quan, Mé khi quan, Cae bénh vé ph : Vim phé quan, viém phi xe phdi, hen phé quan... nghén man tinh (COPD), ap Ngudi bénh nam lau ngay it ct dgng: Nguoi bénh hén mé, liét, guilan bare... CHONG CHi DINH NGUOI BE! tim mach, Ngudi bénh sau mé din luu ndi so, ting dp luc ndi so, xudt huyét no nhing ngay dau. 1 dang trong tinh trang ning: suy hé hdp c4p, pha phdi cdp, séc, tray Bénh tim mach : Nhdi mau co tim cdp, suy tim nang.. - Chan thuong phéi, xuat huyét phdi, - Nguoi bénh gay xwong sun chura cé dinh. = Ngudi bénh cé dn uu mang phéi (chéng chi dinh tuong déi). IV.CHUAN BI 1. Ngudi thye hign 02 Didu dudng hodc 01 diéu dudng va 01 ky thuat vién.duge dao tao chuyén Khoa héi site cp ctru. 2. Dung cu 2.1 VGt tu tiéu hao - Ging sach: 01 di. ~ Khan béng to: 01 edi ~ Dung dich sat khudn tay nhanh - Xa phong diét khudn - Mat 02 cdi. ~ Khau trang: 02 cdi 2.2. Dung cu cép citu: - Béng, Mask.81 3.Ngwoi bénh - Thong bio ,giai thich cho Ngudi bénh (néu tinh ) hode ngudsi nha Igi ich cua viée v6 rung Idng ngue, dong vién ho cling hop tac. - D§t ngudi bénh 6 tu thé thich hgp tay theo vj tri tén thuong & phéi: nim ngiza thing, nim nghiéng phai hodc nghiéng trai. Dau cao hode chan cao, hoc cho Ngudi bénh ngéi... 4. Hd so bénh an: Phiéu chim séc ( bang theo doi). vV.CAC BUOC TIEN HANH: 1. Didu duéng di mi, rita tay bang dung dich savondoux, deo khau trang. 2. Thong bio, gidi thich, déng vién Ngudi bénh cing hop tic 3. Dat Ngudi bénh & tu thé thich hop, tién hanh v6 truéc, rung sau. 3.1. Kj thuat vé: Diéu dudng ding hai ban tay chum cdc ngén tay, khum long ban tay v6 déu Ién thinh ngue hod ving lung, sao cho thanh ngye hoe ving Img ( ic canh ciia ban tay tigp xtc véi st dung lyc cua ban tay, hoat d6ng khép cé tay. V6 nhe nhang déu din dich chuyén trén long nguc hoac ving lung. Vigc vé rung tao rap Ie duong tic dung |én thanh ngye va vio phéi 1am cho dom dai va mi long ra va dén tir cdc nhénh voi phé quan nhé vé nhanh phé quan Ién hon, V6 lign tue 10_15 phiit /1 bén rdi chuyén sang rung, Luu_y: Khi v6 rung chi tap trung vé 1én bé mat khung suén, tranh vé lén edt séng, xuong ttc, da day va phan duéi khung suén vi cé thé gay chan thuong cho lich, gan, than va cdc tang 6 thap. 3.2. Kj thugt rung: - Diéu duéng dudi ban tay dt ban tay lén thinh ngyc, ving lung (néu rung & lung) tuong img véi phan thuy phéi cin din lu, sir dung lye rung ciia co canh tay va vai tae dng toi ban tay truyén Iye rung [én thinh ngye va cdc phan thuy phdi tuong img. Chit ys: d6ng tac rung dugc thyc hién trong thoi ky thé ra, yu cdu Ngudi bénh thé ra tir tir dé dé thuc hién néu cé thé. Khuyén khich Nguéi bénh ho téng dm ra ngoai, tién hanh hit dm ngay sau 46. 4, Sau khi thy hign song ky thuat git Ngudi bénh tre vé tu thé thoai mai. 5. Didu duéng thu don dung cy. thao gang (néu di gang), rita tay bing dung dich savondoux dudi voi nude. 6. Ghi phiéu cham séc.82 VI. THEO DOI - Theo dai sat mach, spo2, nhip thé cla Ngudi bénh trude, trong va sau khi tién hanh v6 rung. VII. TAI BIEN VA XU TRI 1. Suy hé hap: spo2 tut, © mat tim t4i,thé nhanh hoge chm...» Ngimg v6 rung, cho Ngudi bénh vé tu thé thich hgp, tang oxy va hut dom (néu can). 2. Chan thuong ldng ngye do ky thuat thé bao. Khi vé phai dim bao ding ky thuat. * Mot sé chai ¥ khi v6, rung - Téng thdi gian vd va rung khéng qué 30- 40 phat - Khitién hanh phai luén theo dai sat mach, nhip thé, SPO2, sie mat Nguoi bénh. Khi v6 ,rung nhac Ngudi bénh nhin ho (Néu Nguoi bénh tinh) dén khi budn ho nhiéu thi ging site ho khac cho dom, mu téng ra duge nhiéu. V6 rung xong nén hit dm ngay bén vita vé rung rdi méi sang bén kia. TAI TIEU THAM KHAO . A Reference Manual for Nurses and Healthcare Managers in Ethiopia; Addis Ababa, Ethiopia; Dec-2011 Lippincott's nursing procedures; (2009); Respiratory Care; Fifth Edition; Lippincott Williams & Wilkins; pp 550-585 . Ruth F. Craven; Constance J. Hirnle; (2007); Respiratory Function; y Fundamentals of Nursing, Fifth Edition; Lippincott Williams & Wilkins; pp 833-875,