03-Airway Dan Breathing
Transcript of 03-Airway Dan Breathing
![Page 1: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/1.jpg)
AGD 1181
Airway dan Breathing
![Page 2: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/2.jpg)
AGD 1182
AIRWAY
Obstruksi : - Total = Akut = Perlahan
- Parsial
![Page 3: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/3.jpg)
AGD 1183 Setiap usaha memperbaiki Airway akan
menggerakkan kepala
Bila trauma : imobilisasi leher• multitrauma• trauma kapitis + penurunan
kesadaran• luka kranial dari klavikula
![Page 4: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/4.jpg)
AGD 1184
AIRWAY : Gejala Obstruksi
1. Sesak ! ! Dapat karena - Airway - Breathing
2. Pernafasan yang berbunyi pernafasan yang tersumbat
![Page 5: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/5.jpg)
AGD 1185
AIRWAY : Gejala obstruksi
1. Sesak• Mengeluh sesak (os sadar)• Takipnea • Retraksi
* suprasternal* infrasternal* antar-iga
![Page 6: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/6.jpg)
AGD 1186
AIRWAY : Gejala obstruksi2. Pernafasan berbunyi :
• Gurgling (bunyi kumur-kumur) Cairan• Snoring (mengorok)
Lidah• Stridor Sumbatan
anatomis
![Page 7: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/7.jpg)
AGD 1187 AIRWAY:
Penanganan obstruksi
Cairan (gurgling) :• Suction• Bila banyak -> miringkan kepala
(trauma : “log roll”)• Bila tidak teratasi : Airway definitif
![Page 8: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/8.jpg)
AGD 1188 AIRWAY:
Penanganan obstruksi
Lidah (snoring) :• Manual : - Head tilt-chin lift
trauma : head tilt (-)- Jaw thrust
• Jalan nafas sementara :- oro/nasofaringeal
![Page 9: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/9.jpg)
AGD 1189
AIRWAY: Penanganan obstruksiSumbatan anatomis (stridor) :
• Trauma : - Edema laring padaluka bakar
- fraktur laring• Non Trauma : - benda asing
- difteri
Biasanya perlu jalan nafas definitif
![Page 10: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/10.jpg)
AGD 11810
Airway definitifAirway definitif : pipa (tube) dalam trakeaIndikasi : 1. Proteksi Airway (“A”) = Ancaman obstruksi = Ancaman aspirasi
2. Perlu ventilasi (“B”)
![Page 11: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/11.jpg)
AGD 11811
Airway definitif
Nasotrakeal
Orotrakeal
Kriko \Trakeostomi
![Page 12: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/12.jpg)
AGD 11812
Airway definitifBlind Naso-tracheal :
- Sambil mendengar pernafasan- Dorong saat inspirasi- Bila suara hilang : masuk esofagus- Hati-hati bila fraktur basis kranii
![Page 13: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/13.jpg)
AGD 11813
BlindNaso-Tracheal
dengarkannafas
![Page 14: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/14.jpg)
AGD 11814
Airway definitif Oro-tracheal : - Dapat tanpa / dengan pelemas otot - Selalu persiapan yang baik = lampu = cuff - Selalu bersiap untuk kriko- tirotomi
![Page 15: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/15.jpg)
AGD 11815
Intubasioro-trakeal
![Page 16: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/16.jpg)
AGD 11816
Intubasi oro-trakeal
Hiper-ekstensi Jangan pada trauma !
![Page 17: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/17.jpg)
AGD 11817
Intubasi oro-trakeal
Sellick
![Page 18: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/18.jpg)
AGD 11818
Airway definitif
Kriko-tirotomi :1. Dengan jarum2. Surgikal oleh dokter
![Page 19: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/19.jpg)
AGD 11819
Kriko-tiroidotomi
Kartilago tiroidMembranaKartilago krikoidTrakea
![Page 20: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/20.jpg)
AGD 11820
Airway definitif
Krikotirotomi - jarum : - Ditusukkan lewat membrana kriko-tiroidea - Sambung dengan oksigen, 1 detik tutup, 4 detik buka - Waktu ekstra 30-45 menit
![Page 21: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/21.jpg)
AGD 11821
Krikotiroidotomi jarum
Paling kecil 14 G
![Page 22: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/22.jpg)
AGD 11822
Kriko-tiroidotomisurgikal
6
![Page 23: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/23.jpg)
AGD 11823
Airway sulit : Penderita tidak sadar& gelisah ataugigi terkatup : ALTERNATIP := Berikan sedativa lalu intubasi lagi = Coba naso-trakeal (kontra indikasi ?)= Oro-trakeal memakai pelemas otot= Kriko-tirotomi dengan jarum sambil menunggu dokter untuk melakukan krikotirotomi surgikal
![Page 24: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/24.jpg)
AGD 11824
Airway sulit :
Darah banyak dalam mulut (sering karena trauma maksilo-fasial) :
- Suction, bila tidak berhasil :- Langsung krikotirotomi
![Page 25: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/25.jpg)
AGD 11825
Breathing
Gejala gangguan breathing :1. Frekuensi pernafasan 2. Dispnea-sianosis3. Pemeriksaan fisik : Look - listen - feel4. Saturasi O2 (bila ada)
![Page 26: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/26.jpg)
AGD 11826
Breathing
Oksigen :
Selalu berikan bila KU kurang baik
![Page 27: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/27.jpg)
AGD 11827
Breathing
Ventilasi tambahan :
- (Mouth to Mouth)- Mouth to mask- Bagging- Ventilator
![Page 28: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/28.jpg)
AGD 11828
BreathingBila Sat O2 < 95 % :-- Airway baik ?-- Ada sebab ? atasi-- (O2 kanul 6 LPM)-- (O2 face mask 10 LPM)-- O2 non-rebreathing mask-- assissted ventilation (sering perlu airway definitif)-- bila ada sebab gangguan breathing : atasi (lihat Thorax.ppt)
![Page 29: 03-Airway Dan Breathing](https://reader036.fdocuments.net/reader036/viewer/2022062818/55cf9453550346f57ba13dad/html5/thumbnails/29.jpg)
AGD 11829
Terima Kasih