of 51 /51
Resusitasi jantung paru

Rjpo Dr Sofyan

Embed Size (px)

Citation preview

Page 1: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 1/51

Resusitasi jantung paru

Page 2: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 2/51

 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

Page 3: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 3/51

Pendahuluan

• Resusitasi jantung paru adalah suatuusaha untuk mengembalikan fungsipernapasan dan fungsi sirkulasi yang

terganggu akibat suatu kegawatanuntuk mencegah kematian.

Page 4: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 4/51

PENDERITA GAWAT

DARURAT

PENDERITA GAWAT

DARURAT

HIPOKSEMIAHIPERKARBIA

HIPOKSEMIAHIPERKARBIA

HENTI JANTUNGHENTI NAFAS

SINDROM MBO

SINDROM MBO

Page 5: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 5/51

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

Page 6: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 6/51

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- / +--

+ / +--

Page 7: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 7/51

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!

Page 8: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 8/51

Page 9: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 9/51

'0R6'7

Page 10: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 10/51

Air:ay

head tilt

neck lift

Don’t do Be careful

neck lift

chin lift

Page 11: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 11/51

 J'6 TR#*T dianjurkan

Page 12: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 12/51

Or$-pharyngeal

tube

Perhatikan ukuran

Page 13: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 13/51

1 2

3 4

OROFARINGEALTUBE

Page 14: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 14/51

8as$-pharyngeal tube

   Tidak merangsang muntah#kuran u) dewasa 9 mm atau

 jari kelingking kanan

8as$pharyngealtube

Page 15: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 15/51

NASOFARINGEAL

TUBE

Page 16: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 16/51

Page 17: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 17/51

Page 18: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 18/51

Mallampathi klasi:kasi

Page 19: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 19/51

Page 20: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 20/51

BR2'T084

Page 21: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 21/51

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

Page 22: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 22/51

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$

Page 23: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 23/51

• 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

Page 24: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 24/51

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

Page 25: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 25/51

8afasberhenti

8afas ada

Page 26: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 26/51

(0R(#'T0O8

Page 27: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 27/51

Page 28: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 28/51

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$'u$

Page 29: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 29/51

GANGGUANSIRKULASIGANGGUANSIRKULASI

• Sy% 

• Disri$mia / Arry$0mia

• H!n$i jan$un.

• "&&

Page 30: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 30/51

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

Page 31: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 31/51

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

Page 32: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 32/51

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

Page 33: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 33/51

.

Page 34: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 34/51

Page 35: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 35/51

Page 36: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 36/51

'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

Page 37: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 37/51

 Tachycardia with *eri$us

*igns)*ympt$ms

• 0mmediate cardi$1ersi$n

• Premedicate when p$ssible

*ynchr$niHed setting

Page 38: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 38/51

 Tachycardia with$ut *eri$us

0nstability

• 8arr$w-c$mple5

 – 'den$sine

 – +erapamil

 – !iltiaHem

 – β-bl$ckers

 – !ig$5in• *ynchr$niHed

cardi$1ersi$n

Page 39: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 39/51

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

Page 40: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 40/51

'syst$le

• *earch f$r re1ersible causesand treat if p$ssible

• ($nsider transcutane$uspacing

• 2pinephrine

•'tr$pine

Page 41: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 41/51

Bradycardia GPatient 8$t in 'rrest

• 'tr$pine

• !$pamine• 2pinephrine

•  Transcutane$us

pacing•  Trans1en$us pacing

Page 42: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 42/51

!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

Page 43: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 43/51

Paddle P$siti$ns G !e:brillati$n $r(ardi$1ersi$n

Page 44: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 44/51

!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.

Page 45: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 45/51

 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 !(*

Page 46: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 46/51

Page 47: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 47/51

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

Page 48: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 48/51

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

Page 49: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 49/51

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#.

Page 50: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 50/51

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 

Page 51: Rjpo Dr Sofyan

7/26/2019 Rjpo Dr Sofyan

http://slidepdf.com/reader/full/rjpo-dr-sofyan 51/51

TERIMA KASIH