2.resusitation (airway, breathing, & circulation).ppt
TRANSCRIPT
7/23/2019 2.RESUSITATION (Airway, Breathing, & Circulation).ppt
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RESUSITASIRESUSITASIPERBAIKAN AIRWAYPERBAIKAN AIRWAY,, BREATHINGBREATHING,,
DANDAN
SIRKULASISIRKULASI
Dr. Gatot Waluyo Sp.B (K)BADr. Gatot Waluyo Sp.B (K)BA
7/23/2019 2.RESUSITATION (Airway, Breathing, & Circulation).ppt
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Airway (A) + Breathing (B)Airway (A) + Breathing (B) AnatomisAnatomis
Ventilasi (RR)Ventilasi (RR) FisiologisFisiologis
MenurunMenurun ApneaApnea
Ventilasi (RR)Ventilasi (RR)
MeningkatMeningkatHiperventilasiHiperventilasi
7/23/2019 2.RESUSITATION (Airway, Breathing, & Circulation).ppt
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asi (RR) Menurun A
Syaraf
entral(me!ulla o"longata)
#erifer($n%inter&ostales
V% ervi&alis)
Airway(tersum"at total)
AssesmentSentral : Trauma kepala
Kesadaran
Saraf perifer : pasien tdk sadar
trauma supra clav
multiple trauma
sadar – nyeri lokal
Airway : suara nafas – hilang
tambahan
Ed!a "
prdara#a$
%ra&tur
'.T#oraal*
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!akan Saraf sentral ksigenasi sel (mikrosirkula
Sungkup
#er"aikan airway#er"aikan "reathing#er"aikan sirkulasi
E+alua*
Nad
A&ral
K*adara$
RR
T"Ur$
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'in!akan 'in!akan saraf perifersaraf perifer
Fiksasi / immobilisasi
V.cervicalisE+alua*
'in!akan gangguan Airway
Perbaikan Airway E+alua*
7/23/2019 2.RESUSITATION (Airway, Breathing, & Circulation).ppt
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#osisi Sni*ng position
Menghilang "struksi
CAIR PADAT (chocking)
Suction(sedot) Dewasa Anak
sadar Tidak sadar Back blow+Chest trust
Heilichanou!er
(berdiri)
Heilich"anou!er
(tidur)
PERBAIKAN AIRWAY (A)
7/23/2019 2.RESUSITATION (Airway, Breathing, & Circulation).ppt
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"struksi pangkal li!ah
Menarik man!i"ulae atas
Menggan,al pangkalli!ah
hin lift -aw trust$asopharingeal
tu"eropharingeal
tu"e
'in!akan airway !e.nitif
$on/surgi&al Surgi&al
I$tua*-ry#ot#yrodoto! Tra#o*to!
7/23/2019 2.RESUSITATION (Airway, Breathing, & Circulation).ppt
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RR Meningkat hyperventilation
Rt#!
Pr$aa*a$ da$/&al
Airway (A) Breathing (B)
#er"aikan
Airway
#er"aikan
Breathing
PosisiSuction
Oro/Nasopharyngeal tubeIntubasiCrychothyroidotomiTracheostomi
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Perbaikan Breathing (B)
BR0A'H1$2
#aru paru
3in!ing 'hora4
3iaphragma 5 tot #ernafasan
Assesment
Look
(inspeksi)
Listen
(Auscultasi)
Feel
(PalpasiPerkusi)
7/23/2019 2.RESUSITATION (Airway, Breathing, & Circulation).ppt
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elainan Paru paru
engembang penuh
engembang tidak penuh
Tidak mengembangAsses!ent
6 7 'ra&hea !eviasi V%,ugularis menon,ol me!iastinum ter!es tension pneumothora4 #ergerakan !in!ing !a!a tertinggal paru paru mengem" atau ti!ak men
LISTEN : Vesikular paru paru mengembang penuh
Suara paru paru menurun mengembang tidak penuh
Suara paru paru hilang tidak mengembang
F006 (perkusi) 7 Hipersonor u!ara Re!up &airan 5 !arah
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#neumothora4 'ertutup
'er"uka
TINDAKAN0
#neumothora4 tertutup
'ension
Simple
Ndl t#orao$t**
1
P!a*a$/a$ t#ora2 tu WSD
La$/*u$/ t#ora2 tu WSD
Flui!othora4 5 Hematothora4
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Pneumothorax terbuka
'utup luka
#lester pa!a8 sisi
Bahan steril9 ke!ap u!ara
Bentuk segiempat
: sisi "e"as
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DINDING DADA
Fraktur ostae
nyeri
Flail &hest RR meningkat
Single Multiple
3 fraktur p!'iap segmen 'iap segmen ; 3 fraktur
Fiksasi &ostae yang fraktur hilang
2erakan para!o4al saat "ernafas
Flail &hest
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ASSESMENT
: FRA'<R 7
F006 '0A$ S'0R$<M $=0R1#H' 'HRA>
;: FRA'<R 76 7 S0SA
20RAA$ #ARA3>A6#H' 'HRA> 7 M<6'1#60 FRA'<R S'A0 M<6'1#60 FRA'<R 3A6AM : S'A0
"IN#AKAN
: fraktur 7 nyeri analgetik
;: Fraktur 7 .ksasi !aerah yang ti!ak ter.ksir
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'' #0R$AFASA$
3iaphragma"ergerak Ventilasi (+)
'erganggu karenaVolume
A"!omen
$yeri a"!omen
Udara / gas
Cairan / darah
Organ abdomen
Vesi&a urinaria
<terus (hamil)ASSESMENT RR
PARU PARU NORMAL
DINDING THORAX NORMAL
U!AAN AA SESUATU " A#OMEN
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TINDAKAN
Decompresi
<!ara 5 gas
airan 5 !arah
rgan a"!omen
Pasang NGT (disedot aktif
Pasang pipa rectal
surgical
Pada !esica urinaria
Pasang kateter decompresi
"amil ##
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S"R$U%AS" (C)
Fungsi Mengangkut 4ygen ke sel (mikrosirkulasi)
&antung'embuluh darah
arah
po!pa
ppa
*
'olu! dara# $tra+a*&ular
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-A$'<$2
'RA<MA ar!ia& 'ampona!e
$$/'RA<MA #enyakit ,antung
ASSESMENT
AR31A 'AM#$A30
$$/'RA<MA
SESAK NAPAS
T4N54LAN 'ENA 5UGULARIS
RIWAYAT PENYAKIT 5ANTUNG
EKG
EKG
PH4T4 TH4RA6
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ar!ia& 'ampona!e
$on/'rauma
Pericardiocentesis (surgical resusitation)
Obatobatan (cardiologi)
Tindakan
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#0MB<6<H 3ARAH
Besar
0n!/arteriole
ruptur
61RS 5 S1RS
perdarahan
edema
'1$3AA$
'embuluh darah besar
0n!/arteriole
Mengikat 5 menyam"ung pem (surgi&al resusitati
Resusitasi &airan
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3ARAH Isi
Volume intravaskular
Assesment
'ekanan !arah <rine
'1$3AA$ 7 R0S<S1'AS1 A1RA$
ulse #ressure
(##)
Mean Arterial #ressure
(MA#) ?arna -umlah
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TERIMATERIMA
KASIHKASIH