Airway Problem:
Chocking = Heimlick manuever
Gurgling = Suction
Stretor/Stridor/Wheezing = Nilai Jackson Criteria
Jackson Criteria for Airway obstruction:
I = Dispnue, Stridor inspirasi ringan, retraksi suprasternal
II = + retraksi supra dan infraklavikula, sianosis ringan, dan pasien tampak mulai gelisah.
III = + retraksi interkostal, epigastrium, dan sianosis lebih jelas.
IV = + wajah yang tampak tegang, dan terkadang gagal napas
Tatalaksana:
I = Intubasi
II-III = Trakeostomi
IV = Needle Cricotiroidotomi dilanjutkan dengan Surgical Cricotiroidotomi
Breathing Problem → Titrasi oksigen
Rhonki = Bronkodilator + NaCl 3%
Wheezing = Bronkodilator + Kortikosteroid
Rales basal = Diuretik
Rales basal = Diuretik
Gagal napas = Intubasi
Rontgen thorax:
Efusi = Thoracocentesis
Efusi = Thoracocentesis
Pneumothorax = Needle dan tube thoracotomy
Tumor Paru = Bronkodilator
Paru kesan normal = Cek lab lengkap, EKG, CT
Circulation Problem
Cardiac Arrest (Adult / Pediatric)
ROSC
Bradiaritmia (Adult, Pediatric, Neonatus)
Takiaritmia (Adult, Pediatric)
ROSC
Bradiaritmia (Adult, Pediatric, Neonatus)
Takiaritmia (Adult, Pediatric)
Tamponade = Pericardiocentesis
Anafilaksis Berat
A: Oedem laring
Nebule Epinefrin 5 mg (murni) setiap 20 menit (max 3x)
Intubasi / Cricotiroidectomi
B: Wheezing
Nebul Salbutamol + Steroid
C: Hipotensi
Loading NS 20 cc/kgBB
IM Epinefrin 0.01 mg/kgBB (max 0.3 mg/dosis)
Syok? Drip Vasopressor
Adjuvan:
IV Difenhidramin 25-50 mg
IV Metilprednisolon 1-2 mg/kgBB (max dose 125 mg)
Rawat inap untuk monitoring reaksi bifasik dalam 72 jam
Disability
Penurunan kesadaran: GCS-PCS
Ada Rh, Wh, Rales = Asidosis respiratorik
Hipotensi, Aritmia, CAD = Shock
DL, GDS, Na-K, Ur/Cr, SGOT/SGPT = Sesuai temuan
Syncope = Cough, Ortostatik, Micturition (miksi)
CT Scan Brain = Sesuai temuan