MANAGEMENT OF AIRWAY, BREATHING & CIRCULATION

Dr Nurullah Hidajah N

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SISTEM PERNAFASAN Airway (jalan nafas) Paru-paru Paru Rongga dada

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UPPER AIRWAY Nose and mouth Pharynx Oropharynx Nasopharynx Trachea Larynx

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LOWER AIRWAY

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LOWER AIRWAY Trachea Bronchus Bronchioles Alveolus Lungs : Visceral pleura (surface of lungs) Parietal pleura (internal chest wall) Interpleural space (potential space)5

Disruption of AirwayAcut

TotalInsidous

ObstructionPartial

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OBSTRUCTION AIRWAYDefinisi : Kegagalan sistem pernafasan dalam memenuhi kebutuhan metabolik tubuh akibat sumbatan jalan nafas (airway) Penyebabnya : sekret/ cairan, benda asing, edema pharynx dan larynx, gigi terlepas, lidah jatuh ke belakang.7

OBSTRUCTION AIRWAY

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Gejala Obstruksi Airway1. Sesak Mengeluh sesak (korban sadar) Takipnea Retraksi suprasternal infrasternal intercostal9

2. Pernafasan berbunyi : Gurgling (bunyi kumur-kumur) kumurCairan

Snoring (mengorok)Lidah

Stridor

Sumbatan anatomis

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TUJUAN AIRWAY MANAGEMENT

Membebaskan jalan nafas untuk menjamin pertukaran udara secara normal

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Airway ManagementCairan (gurgling) : Suction Bila banyak -> miringkan kepala( trauma : log roll )

Bila tidak teratasi : Airway definitif

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Airway Management Lidah ( snoring ) :Manual : - Head tilt-chin lift tilttrauma : head tilt (-)- Jaw

thrust

Jalan nafas sementara :- Oro

/ nasofaringeal tube

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Head Tilt Chin Lift

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Jaw Thrust

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Airway ManagementSumbatan anatomis (stridor) : Trauma : Edema laring pada luka bakar, Fraktur laring Non Trauma : Benda asing, difteri Diperlukan jalan nafas definitif16

Airway definitif Airway definitif : pipa (tube) dalam trakea Indikasi : 1. Proteksi Airway (A) = Ancaman obstruksi = Ancaman aspirasi 2. Perlu ventilasi (B)

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BREATHING After establishing an airway , your next step should to be assess breathing. Look : Breathing pattern regular or irregular Adequate expansion, retractions Listen : Shortness of breath when speaking Unresponsive place ear next to patients mouth Is there any movement of air ?

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BREATHING Feel Check the volume of breathing by placing your ear and cheek next to the patients mouth

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Adequate Breathing Rate Adult 12 20/min Child 15 30/min Infant 25 50/min

Rhythm Regular Irregular20

Adequate Breathing Quality Breath sounds present and equal Chest expansion adequate and equal

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Tujuan Breathing Management Memperbaiki fungsi ventilasi dengan cara memberikan nafas buatan untuk menjamin kebutuhan oksigen dan pengeluaran karbondioksida

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BREATHING MANAGEMENT TANPA ALAT mouth to mouth mouth to nose DENGAN ALAT ENG mask pipa oksigen BVM ventilator

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CIRCULATIONSistem Kardiovaskuler: Pump : Jantung Fluid : Darah Pipes : Pembuluh darah arteri arteriola anastomosis vena venula plexus venosus kapiler24

Perfusi akan mengalami gangguan apabila ada kegagalan dari ketiga faktor diatas.

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SISTEM KARDIOVASKULERParu -paru (pertukaran O2 &CO2) vena pulmonalis Jantung arteri seluruh tubuh (pertukaran kembali O2 &CO2) vena ParuParuparu

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GANGGUAN SIRKULASI Henti Jantung Syok

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TUJUAN MANAGEMENT CIRCULATION Mengembalikan fungsi sirkulasi darah

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TERIMAKASIH

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