SESAK NAPAS

Kasus 1 Laki-laki usia 25 tahun dibawa ke puskesmas dengan keluhan sesak napas. Penderita terlihat pucat dan kebiruan. Nadi teraba cepat dan lemah.

Informasi Penting - Laki-laki 25 tahun - Sesak napas - Pucat - Kebiruan - Nadi cepat - Nadi lemah

Pertanyaan 1. Bagaimana patomekanisme terjadinya sesak napas dan hal apa saja yang bisa menyebabkan sesak napas? 2. Bagaimana penanganan awal untuk penderita dengan keluhan sesak napas? 3. Mengapa pasien pucat? 4. Mengapa pasien kebiruan? 5. Mengapa nadi pasien lemah? 6. Mengapa nadi pasien cepat? 7. Bagaimana penanganan selanjutnya pada pasien ini?

MENILAI TINGKAT KESADARAN

A V P U

The patient is alert and awake The patient responds to verbal stimulation

The patient responds to painful stimulation

The patient is completely unresponsive

Approach safely

Check response
Shout for help

Open airway
Check breathing Call 997 30 chest compressions 2 rescue breaths

AHA Guideline 2

APPROACH SAFELY!
Approach safely
Check response Shout for help
Victim

Scene
Rescuer

Open airway
Bystanders

Check breathing

Call 112
30 chest compressions 2 rescue breaths

CHECK RESPONSE
Approach safely
Check response Shout for help Open airway Check breathing

Call 977
30 chest compressions 2 rescue breaths

AHA Guideline 2

CHECK RESPONSE

Shake shoulders gently Ask Are you all right? If he responds

Leave as you find him. Find out what is wrong.

Reassess regularly.

AHA Guideline 2

SHOUT FOR HELP

Approach safely
Check response Shout for help Open airway Check breathing

Call 977
30 chest compressions 2 rescue breaths

AHA Guideline 2

OPEN AIRWAY
Approach safely
Check response Shout for help Open airway Check breathing

Call 977
30 chest compressions 2 rescue breaths

AHA Guideline 2

AIRWAY OPENING BY NECK EXTENSION

Campbell

OPEN AIRWAY

Head tilt and chin lift - lay rescuers - non-healthcare rescuers

No need for finger sweep unless solid material can be seen in the airway

AHA Guideline 2

OPEN AIRWAY

Head tilt, chin lift + jaw thrust - healthcare professionals

AHA Guideline 2

CHECK BREATHING

Approach safely
Check response Shout for help Open airway Check breathing

Call 977
30 chest compressions 2 rescue breaths

AHA Guideline 2

CHECK BREATHING

Look, listen and feel for NORMAL breathing Do not confuse agonal breathing with NORMAL breathing

AHA Guideline 2

AGONAL BREATHING
Occurs shortly after the heart stops in up to 40% of cardiac arrests Described as barely, heavy, noisy or gasping breathing

Recognise as a sign of cardiac arrest

Erroneous information can result in withholding CPR from cardiac arrest victim

AHA Guideline 2

POTENTIALLY REVERSIBLE CAUSES

(5 Hs & 5 Ts):
Hypoxia Hypovolemia Hypothermia Hyper/hypoK+and metabolic disorders H+ ions (acidosis)

Tension pneumothorax Tamponade Toxic/therap. disturbances Thrombosis coronary Thrombosis pulmonary

AHA Guideline 2

Approach safely
Check response Shout for help Open airway Check breathing

Call 977
30 chest compressions 2 rescue breaths

AHA Guideline 2

FOREIGN-BODY AIRWAY OBSTRUCTION (FBAO)

Approximately 16 000 adults and children receive treatment for FBAO in the UK yearly

SIGNS Are you choking?

Other signs

MILD obstruction YES

Can speak, cough, breathe

SEVERE obstruction Unable to speak, may nod

Can not breathe/wheezy breathing/silent attempts to cough/ unconsciousness

AHA Guideline 2

ADULT FBAO TREATMENT

AHA Guideline 2

BACK BLOWS

AHA Guideline 2

ABDOMINAL THRUSTS

AHA Guideline 2

30 CHEST COMPRESSIONS

Approach safely
Check response Shout for help Open airway Check breathing

Call 977
30 chest compressions 2 rescue breaths

AHA Guideline 2

CHEST COMPRESSIONS
Place the heel of one hand in the centre of the chest Place other hand on top Interlock fingers

Compress the chest

Rate 100 min-1 Depth 4-5 cm Equal compression : relaxation

When possible change CPR operator every 2 min

AHA Guideline 2

RESCUE BREATHS

Approach safely
Check response Shout for help Open airway Check breathing

Call 977
30 chest compressions 2 rescue breaths

AHA Guideline 2

RESCUE BREATHS

Pinch the nose Take a normal breath Place lips over mouth Blow until the chest rises Take about 1 second Allow chest to fall Repeat

AHA Guideline 2

Breathing: Mouth To Nose (when to use)

Cant open mouth

Cant make a good seal

Severely injured mouth

Stomach distension
Mouth to stoma (tracheotomy)

AHA Guideline 2

RESCUE BREATHS
RECOMMENDATIONS: - Tidal volume 500 600 ml - Respiratory rate give each breaths over about 1s with enough volume to make the victims chest rise

- Chest-compression-only continuously at a rate of 100 min

AHA Guideline 2

CONTINUE CPR

30

AHA Guideline 2

Approach safely

Check response
Shout for help

Open airway
Check breathing Call 977 30 chest compressions 2 rescue breaths

AHA Guideline 2

AHA Guideline 2

AHA Guideline 2

Approach safely Check response Shout for help Open airway Check breathing Call Emergency System

Approach safely Check response Shout for help Open airway Check breathing Call Emergency System

30 chest compressions
2 rescue breaths

Attach AED
Follow voice prompts

DEFINITIVE CARE

RUJUKAN DAN TRANSPORTASI

TERIMA KASIH

Pertanyaan : Muthmainna klp 12 : dari algoritma penanganan pasien, apakah tidak berbahaya pada pasien sesak napas cardiac arrest kita beri kompresi ? Tenri allo : bukankah indikasi resusitasi jantung paru saat nadi tidak Teraba ?