Kodi Kuledzera Kungayambike mu ER?

Zamkati

• Kuledzera Kofunikira Kuwerenga
• Kuchita Masewero Amakanema Pakuchipatala

Ululu umaola moyo. Opioids amatha kuthana ndi ululu - ndipo ndiye kuvunda moyo ndi thupi. Kuchiza ululu kumakhalabe kovuta m'dziko lonselo.

Kafukufuku watsopano ku New England Journal of Medicine akuwonetsa za opiod mess m'njira yatsopano, kuwonetsa momwe mankhwala amodzi mu ER angayambitsire chizolowezi cha opioid.

Phunziroli, pafupifupi anthu awiri okha mwa anthu omwe amapatsidwa ma opioid adatha kukhala ogwiritsa ntchito osagwiritsa ntchito mapiritsi opweteka masiku opitilira 180 pachaka. Koma madokotala ena a ER anali olembetsa pafupipafupi. Kwa "otsogola kwambiri" awa ogwiritsa ntchito mosalekeza anali pafupifupi 30% kuposa.

Koma nthawi zambiri anali kuchita bwino potsatira malangizo apano.

Kodi ER Docs Imapereka Ziweto Zambiri?

Phunziro mu New England Journal linali lapadera m'njira zingapo. Adasanthula omwe analibe mankhwala opioid kwa miyezi isanu ndi umodzi mwa omwe adapindula ndi 375,000 Medicare, ambiri aiwo azaka zopitilira makumi asanu ndi limodzi. Okalamba amatenga zambiri zamankhwala, koma ndi gulu lovuta kwambiri akamachiza ululu. Ambiri asokoneza ntchito ya impso, kapena ali ndi matenda oopsa. Kugwiritsa ntchito kupweteka kwakanthawi kochepetsa ma NSAID, monga ibuprofen kapena naproxen, kumabweretsa zoopsa zina. Ndipo anthu ambiri samayankha tylenol. Pamene wina patsogolo panu akumva kuwawa, makamaka wokalamba yemwe sangakhale ndi chithandizo chochuluka, mumatani?

Madokotala a ER amadziwa bwino zomwe mliri wa opioid umachita kwa anthu. Nthaŵi zambiri, ndiwo mzere woyamba wa chithandizo ndipo nthawi zambiri amapereka okhawo kwa opioid osokoneza bongo. Mu kafukufuku wina ku Brigham ndi Women, madokotala a ER adapereka mapiritsi opioid opitilira 30 okha 1.5% ya nthawiyo. Ngati atenga mapiritsi, nthawi zambiri amakhala muyezo wa masiku oyembekezera 3-5.

Izi zikugwirizana ndi chikhalidwe cha mankhwala a ER - kuthetsa vutolo, mkati ndi kunja. Maofesi a ER akuyenera kusamalira zadzidzidzi. Madokotala "okhazikika" amatha kuthana ndi zotsalazo. Ma ER, monga omwe amamwa mankhwala azachipatala, ngati kupumula kuntchito komwe "sanayitanidwe" Kuwongolera nthawi yopuma ndi gawo lalikulu logulitsa pantchito zamankhwala mwadzidzidzi. Madokotala azadzidzidzi sayenera kupereka kutsatira kosatha - nthawi zina amatero.

Ndipo madokotala wamba, odwala kuchipatala amatha kupitiliza mankhwala opioid omwe amaperekedwa mu ER. Maofesi a ER nthawi zambiri amakwatiwa - makamaka ngati pafupifupi theka la nthawi yawo amathera polemba zikalata. Odwala okalamba samawonedwa kuti atha kukhala osokoneza bongo ngati achinyamata. Ndipo ndi nthawi yanji yakufotokozera anthu momwe angatambasulire? Kupereka chithandizo chamankhwala, chomwe sichimalipira? Pamene chithandizo chambiri chakumva kuwawa tsopano chikuyikidwa m'maboma monga chithandizo chazidziwitso, omwe ali ndi nthawi yochita izi mu ER?

Komabe tsopano tikudziwa kuti kuchezera kamodzi ku ER kumatha kubweretsa chizolowezi chamoyo wonse. Kodi ma ER adzakhala ndi nthawi komanso mwayi wolankhula ndi anthu za chithandizo chamankhwala osamwa mankhwala? Kodi angakhale ndi malingaliro, pamene malingaliro a ntchito yawo athana ndi vutoli ndikupitilira?

Izi zimatifikitsa ku vuto lina la "kuwombera kamodzi".

Nkhani Yachilendo ya Xanax

Anthu ambiri aku America amakhala ndi mantha. Pafupifupi awiri mwa atatu mwa iwo amaganiza kuti mantha oyamba akhoza kukhala matenda amtima.

Ambiri amapita ku ER. Ogwira ntchito ku ER, atamasulidwa kuti "ataya" matenda amtima, nthawi zambiri amawapatsa xanax, omwe amatchedwa alprazolam.

Imagwira mwachangu. Vuto lathetsedwa.

Kupatula pafupifupi theka la anthu omwe amapita ku xanax amakhala ndi nthawi yopita ku helluva.

Madokotala azamisala komanso ogona tulo nthawi zambiri sakonda xanax. Nthawi yokha yomwe ndidawona wofufuza wa NIH atadandaula pa siteji pomwe adati xanax sinabweretse vuto lalikulu losokoneza bongo. M'zaka za m'ma 1980, maphunziro ambiri adatulukira akuwonetsa zovuta zambiri zakuchoka ku xanax; Ndinali m'modzi mwa anthu omwe amaphunzira izi.

Kuledzera Kofunikira Kuwerenga

Kuchita Masewero Amakanema Pakuchipatala