Organisasi Resusitasi

INTRODUCTION• Resusitasi : upaya sebagai tim untuk selalu

– prepared– trained – organized

• Goals of resuscitation– re-establishing spontaneous respiration &

circulation– maintaining & preserving function of vital

organs

AHA PHASED-RESPONSE APPROACH

Phase I Phase II Phase III Phase IV

Anticipation Arrival of codeteam

Notification offamily

Review

Resuscitationbefore arrival ofcode team

Resuscitation Transfer toappropriatefacility

Maintenance(stabilization)

Documentation

PHASE I - ANTISIPASI

• PERSIAPAN STAF– Bagaimana aktivasi– Dimana peralatan di

tempatkan– Bagaimana memulai

resusitasi– Bagaimana

menggunakan peralatan

PHASE I - ANTICIPATION

• PERSIAPAN PERALATAN– Setting dng mudah

dikenali dan skematis – Label dengan jelas– Display peralatan dan

obat tampak jelas– Pengecekan fungsi

secara harian

N1

-Perawat jaga

-Asistent dalm airway managemen, ventilasi dan suction.

-Rekam medis :kondisi arrest, tanda vital, intervensi kritis, pemberian obat (dosis & rute), monitor tanda vital, kondisi pasien, progres px

D1

-Tim leader

-Memasang cervical colar (trauma), maintain airway, BVM ventilasi.

-Intubasi, memulai ventilasi dan hand over ke N1 saat pasang ventilator mekanik.

-Pasang jalur jugularis ext/CVP jika perlu.

-Komando pada intervensi kritis, pemberian obat, instruksi pemanggilan spesialis lain, /konsultan sesuai kebutuhan

D1

N1

N2

D2

D2

-Prinary & secondary survey.

-Inisiasi CPR bila diperlukan

-Prosedur kritis mis needle thoractomy bila perlu.

- IV set dan cairan dan obat sesuai intruksi D1

-DC shock / Pasang cateter urine dan prosedur lain sesui intruksi D1

-Membantu melepas pakaian px

N2-Membantu melepas pakaian px -Melakukan dan membantu tindakan kritis sesuai perintah pimpinan tim.-Memfasilitasi kebutuhan dan peralatan lain yng diperlukan-Memastikan pemeriksaan penunjang dsb.-Memastikan pemanggilan personal lain yang dibutuhkan : Spesialis konsultant dsb.-Mengumpulkan barang2 px-Menjaga dan mengantar pasien saat transfer, foto, CTscan dsb

POIN PENTING UNTUK DI CATAT

• Before arrival of the code team, one of the nurses will act as leader, designated N1

• Doctor 1, leader of the code team, makes patient management decisions

• Proper documentation of resuscitation is important

• Relatives should be updated periodically

RECEIPT OF STANDBY MESSAGE VIA VHF

HEAL SYSTEM

RECEIPT OF STANDBY CASE

PHASE 2

STANDBY CASE• Prepare equipment• Bring patient to designated area• Dr 1 - manage airway from the head• Dr 2 - iv access• N1 - starts ECG monitoring• N2 -starts CPR• Follow ACLS Algorithms according to

underlying rhythm or ATLS for trauma px

PHASE 3 Notification of family, transfer &

documentation

• Dr 2 - obtain detailed history leading to arrest and update family

• Arrange for transfer to ICU

• Stabilizes patient before transfer

• Inform family of final disposition of patient

PHASE 4 - REVIEW

• Objectives– review of events leading to patient’s

collapse– audit of resuscitation– ventilation and de-stressing opportunity

• Concise, done with skill and sensitivity

• All equipment & consumables to be cleaned, replaced or replenished

ACTION PLAN FOR SPECIALIZED AREAS

• Most specialized areas have their own protocols

• All staff must be thoroughly familiar with their own resuscitation protocols

SUMMARY

• Resuscitation in the general ward can be helped by– prior equipment

preparation– training of all

staff

SUMMARY

• Resuscitation that is organized and efficient maximizes patient’s chance of survival and recovery