rjpo dr sofyan
TRANSCRIPT
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Resusitasi jantung paru
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Tujuan pembelajaran
• Mampu menjelaskan tentangpengertian resusitasi jantung paru
• Mampu menjelaskan tentang tahap-tahap resusitasi jantung paru
• Mampu menjelaskan tentang tujuanresusitasi jantung paru
• Mampu menjelaskan tentang indikasidilakukan resusitasi jantung paru
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Pendahuluan
• Resusitasi jantung paru adalah suatuusaha untuk mengembalikan fungsipernapasan dan fungsi sirkulasi yang
terganggu akibat suatu kegawatanuntuk mencegah kematian.
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PENDERITA GAWAT
DARURAT
PENDERITA GAWAT
DARURAT
HIPOKSEMIAHIPERKARBIA
HIPOKSEMIAHIPERKARBIA
HENTI JANTUNGHENTI NAFAS
SINDROM MBO
SINDROM MBO
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INITIAL ASSESSMENT /MANAGEMENT
INITIAL ASSESSMENT /MANAGEMENT
Injury
Primary sur!y an" a"jun#$s
R!sus#i$a$i%n
R!!a&ua$i%n
S!#%n"ary sur!y an" a"jun#$s
R!!a&ua$i%n
O'$imi(! 'a$i!n$ s$a$us
Trans)!r
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BILA TERJADI HENTI NAFAS DAN HENTI JANTUNG
BILA TERJADI HENTI NAFAS DAN HENTI
JANTUNG
K!$!r&am*a$an
+ m!ni$
, m!ni$
+- m!ni$
K!mun.inan *!r0asi&
12 / +--
3- / +--
+ / +--
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4P4R / RJPO 5P!$!rSa)ar6
4P4R / RJPO 5P!$!rSa)ar6
L S Em!r.!n#y O8y.!na$i%nA 9 Air:ayB 9 Br!a$0!4 9 4ir#u&a$!
L S R!s$%ra$i%n %) S'%n$an!%us 4ir#u&a$i%nD 9 Dru.s an" F&ui"sE 9 EKGF 9 Fi*ri&&a$i%ns $r!a$m!n$
L S P%s$ R!sus#i$a$i%n Brain Ori!n$!" T0!ra'yG 9 Gau.in.H 9 Human m!n$a$i%n
I 9 In$!nsi! #ar!
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'0R6'7
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Air:ay
head tilt
neck lift
Don’t do Be careful
neck lift
chin lift
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J'6 TR#*T dianjurkan
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Or$-pharyngeal
tube
Perhatikan ukuran
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1 2
3 4
OROFARINGEALTUBE
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8as$-pharyngeal tube
Tidak merangsang muntah#kuran u) dewasa 9 mm atau
jari kelingking kanan
8as$pharyngealtube
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NASOFARINGEAL
TUBE
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Mallampathi klasi:kasi
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BR2'T084
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GANGGUAN =ENTILASI(penderita masih
bernafas)
GANGGUAN =ENTILASI(penderita masih
bernafas)% / Li0a$
Sian%sis Ta0i'n!a S$a$us m!n$a&Dis$!nsi !na &!0!r
Asim!$ri "a"aPara&isis %$%$ na)as
$!n / "!n.ar K!&u0an9 >Ta *isa na)as?@ S$ri"%r :0!!(! ↓ a$au 0i&an. suara n
& / ra*aHa:a !s'irasi Ems!ma su*u$an
Kr!'i$asi / $!n"!rn!ss / ny!ri D!iasi $ra0!a
jun#$sPu&s! %8im!$!r 4O; "!$!#$%r Gas "ara0 Cray "a"a
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BEBERAPA ISTILAHBEBERAPA ISTILAH
• =!n$i&a$i%nA&iran 5%&um!6 u"ara !&uar masu 'aru
• Ti"a& %&um!
=%&um! u"ara yan. "i0isa' / "i!&uaran 'a"asa$u a&i na)as *iasa 2 m& / . ** -.9 ,-- 33 m&
•=a 5 T=Ds 6 Fr! 5 3-- +3- 6 +- <3--•Minu$! %&um!
Ti"a& %&um! 8 )r!7 3 & / m!ni$
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• Hi'%!n$i&a$i%nMinu$! %&um! *!ruran.
• Hi'!r!n$i&a$i%n
Minu$! %&um! m!nin.a$
• Param!$!r !n$i&asiPa4O; N <3 ,3 mmH.
Hi'%!n$i&asi Pa4O; Hi'!r!n$i&asi Pa4O; ↓
………….beberapaistilah
………….beberapaistilah
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4ARA PEMBERIAN=ENTILASI
4ARA PEMBERIAN=ENTILASITan'a A&a$
M%u$0 $% m%u$0M%u$0 $% n%s!M%u$0 $% m%u$0 an" n%s!
D!n.an A&a$Sa)ar air:ayEs%'0a.!a& %*$ura$%r air:ayFa#! mas / '%#!$ mas Laryn.!a& mas Ba.a&!mas Ba.a&!$u*!=!n$i&a$%r
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8afasberhenti
8afas ada
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(0R(#'T0O8
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4IR4ULATION4IR4ULATION
Ass!ssm!n$ %) Or.an P!r)usi%n
L!!& O) 4%n#i%ussn!s
Sin #%&%r an" $!m'!ra$ur!
Pu&s! ra$! an" #0ara#$!r
Urinary %u$'u$
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GANGGUANSIRKULASIGANGGUANSIRKULASI
• Sy%
• Disri$mia / Arry$0mia
• H!n$i jan$un.
• "&&
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akukan !(*Bila Perlu s)d % kali
B*28T0 J'8T#84
PR2(OR!0' T#MB
P'*'84 MO80TOR 234 ) !2/0BR0'TOR
T28T#3'8 '!' T0!'387' 'R0TM0'
R'B' !287#T '. 3'ROT0* ; ) -
+/)+T B#3'8 +/)+T*elama RJPPeriksa P$sisi , perlekatan 2lektr$dePastikan Jalan nafas bebas 0+ line
Pasien +/)+T yg refrakt$r thd !(*2pinephrin <mg)%-=> atau+as$pressin ?@ iu ) <5 saja
Pasien bukan +/)+T2pinephrin <mg)%-=> 0+
Pertimbangkan & 8aBic'ntiarritmiaPacu Jantung
RJP < menit RJP sampai % A
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P$tensial Penyebab enti Jantung
• ip$1$lemia
• ip$ksia
• idr$gen 0$n 'sid$sis C
• iper)hip$kalemia)Metab$lik
• ip$termi
• T ablet T$ksiskObat C
• T amp$nade
• T ensi$n Pneum$t$rak
• T r$mb$sis ($r$ner
• T r$mb$sis Pulm$ner
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3OMPR2*0
• Bila < Pen$l$ng & – <= 3. dada luar ; D kali + dalam <= detik – < menit " ? daur 3 + Minimal " E@ 3 ; F C
• Bila D Pen$l$ng & – E 3$m. !ada uar ; < +ent dalam = menit – < menit minimal <D daur 3$m-+en pd D
pen$l$ng
• 21aluasi & –
*etelah ? !aur 3+ e1aluasi
< Pen$l$ng – *etelah <D !aur 3+ e1aluasi D Pen$l$ng – *imultan Resp , denyut nadi = menit – Bila ada pantau pernafasan dan nadi dgn ketat
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.
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'ssess Rhythm'ssess Rhythm
• !e:brillate up t$ % times
• 2pinephrine G se1eral d$se$pti$ns
• 'ntiarrhythmic agents
– id$caine – Bretylium
– Magnesium
–
Pr$cainamide
=!n$ri#u&ar Fi*ri&&a$i%n
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Tachycardia with *eri$us
*igns)*ympt$ms
• 0mmediate cardi$1ersi$n
• Premedicate when p$ssible
•
*ynchr$niHed setting
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Tachycardia with$ut *eri$us
0nstability
• 8arr$w-c$mple5
– 'den$sine
– +erapamil
– !iltiaHem
– β-bl$ckers
– !ig$5in• *ynchr$niHed
cardi$1ersi$n
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Pulseless 2lectrical
'cti1ity
Pulseless 2lectrical
'cti1ity • S!ar#0 )%r r!!rsi*&! #aus!s an"
$r!a$
• E'in!'0rin!
• A$r%'in! )%r a*s%&u$! %r r!&a$i!
*ra"y#ar"ia
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'syst$le
• *earch f$r re1ersible causesand treat if p$ssible
• ($nsider transcutane$uspacing
• 2pinephrine
•'tr$pine
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Bradycardia GPatient 8$t in 'rrest
• 'tr$pine
• !$pamine• 2pinephrine
• Transcutane$us
pacing• Trans1en$us pacing
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!e:brilasi•
#ntuk mengakiri disrithmia +T ) +/• Penyebab primer /ibrilasi +entrikel
– 0nsu:siensi 3$r$naria.
– Reaksi Obat
– Tenggelam.
• Medikament$sa kadang
– merubah /+ jadi 'sist$le
–
0ntracable terhadap RJP• (ara yg diterima efektf untuk +/I !( sy$k
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Paddle P$siti$ns G !e:brillati$n $r(ardi$1ersi$n
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!e:brilasi
• Memperkecil tahanan dinding dada
• Membuat $ptimum p$la gel$mbang sy$klistrik
• Tegangan yang diberikan pada & – 'B " watt detik
– '* " j$ule
• '* lebih 2fektif dapat dipr$gram dgncepat disinkr$nasi dgn gel T bila adak$ntraksi.
• Tidak ter antun aliran listrik. P$rtable.
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Tehnik !e:brilat$r
• enti Jantung yang !isaksikan – Berikan !(* <-D menit sejak +/ terjadi.
• enti Jantung yang Tidak !isaksikan – akukan RJP dulu kira kira D menit
– Baru diikuti ) dilakukan !(*
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08!03'*0 B!
<. 28T0 8'/'*• Penanganan !ini enti 8afas )
*umbatan Jalan 8afas dapat
menghindari JD. 28T0 J'8T#84
– enti Jantung Primer I penyampaian @D
ke jaringan akan berhenti @D ygtertinggal akan habis dalam beberapadetik.
– enti Jantung dapat disertai +/+T
'sist$l
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3'P'8
• B! dilakukan
<. Tidak ada resp$n
D. Tidak ada nadi
%. Tidak ada 8afas
• B! tidak dilakukan
<. *td Terminal penyakit yg tidak dapatdisembuhkan
D. 3ematian n$rmal pd peny. 'kut)kr$nik%. !ipastikan /gs Otak tidak akan pulih
?. Bila - < jam tidak ada 8adi 8$rm$termitanpa RJP
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3'P'8 B! !028T03'8
<. B0' B! T2' B2R'*0
D. B0' T0!'3 B2R'*0 &
SETELAH 30 MNT TANPA TANDA
KEBERHASILAN : MIDRIASIS, REFLEKS
CAHAYA NEGATIF, TIDAK BERNAPAS
SPONTAN, TIDAK SADAR
%. *2('R' /0*03 P28OO84 T0!'3M'MP#.
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32M#84308'8 P'*3' B!
<. 3ORB'8 M28J'!0 *'!'R
D. 3ORB'8 !087'T'3'8 M'T0<. 3$rban tetap tidak sadar
D. Tidak Timbul +entilasi *p$ntan
%. Pupl !ilatasi?. Tidak ada nadi
%. 3ORB'8 BM !'P'T !087'T'3'8 M'T0 !'8B2#M T0MB# !287#T 8'!0 *PO8T'8
?. !287#T 8'!0 *PO8T'8 T2T'P0 B2#M P#0
32*'!'R'887' +28T0'*0 *PO8T'8 B0*' '!') T0!'3
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TERIMA KASIH