anastesi - Indikasi Masuk Icu

8/17/2019 anastesi - Indikasi Masuk Icu

1/22

ICU (INTENSIVE CARE

UNIT)

RAHMI ISLAMIATI

1501211038


2/22

Pendahuuan

Intensive Care Unit (ICU)!

"ua#u $a%&an da'& 'uah "a *an% and&'& (&n"#aa"& d&$a+ah d&'e#u',ea*anan)- den%an "#a. *an% hu"u" dan ,e'en%a,an *an% hu"u" *andu/uan un#u $"e'a"&- ,e'a+a#an- dan #e'a,& ,a"&en ,a"&en *an%ende'a ,en*a- ede'a- a#au ,en*u ,en*u *an% en%anan*a+a a#au ,#en"&a en%ana n*a+a den%an ,'%n"&" du$&a4


3/22

Kemampuan Minimal ICU

Re"u"a"& /an#un% ,a'u Pen%eaan /aan na,a"- #e'a"u &n#u$a"&

#'aea dan ,en%%unaaan en#&a#'

Te'a,& "&%en Pean#auan EK #e'u" ene'u"

Pea"an%an aa# ,au /an#un% daa eadaan%a+a# Pe$e'&an nu#'&"& en#e'a dan ,a'en#e'a Pee'&"aaan a$'a#'&u hu"u" den%an

e,a# dan en*eu'uh Peaa&an ,,a &n.u"e a#au "e,' un#u

#e'a,& "ea'a #'a"&

Kea,uan eauan #ehn& hu"u" "e"ua&den%an eadaan ,a"&en


4/22

Klasifkasi Pelayanan ICU

Pelayanan ICU primerMa,u eauan 'e"u"a"& dan e$e'&anen#&a"& $an#u u'an% da'& 26 /a "e'#a a,ueauan ,ean#auan /an#un%

Pelayanan ICU sekunder

Ma,u e$e'&an en#&a"& 7an#u e$&h aa-eauan $an#uan h&du, a&n #e#a,& #&da #e'au,e"

Pelayanan ICU tersierMa,u ea"anaan "eua a",e,e'a+a#an#e'a,& &n#en"&.


5/22

Ruang lingkup pelayanan ICU

• D&a%n"&" dan ,ena#aa"anaan ",e"&9 ,en*a,en*a au# *an%en%ana n*a+a

• Me$e'& $an#uan dan en%a$& a&h .un%"& a #u$uh "ea&%u"eauan #&ndaan *an% "e%e'a d&,e'uan un#u ean%"un%anh&du,4


6/22

Ruang lingkup pelayanan ICU

Pean#auan .un%"& a #u$uh dan ,ena#aa"anaan #e'hada,,&a"& *an% d&$uan eh ,en*a

Me$e'&an $an#uan ,"&%&" ,ada ,a"&en dan eua'%a *an%eh&du,ann*a "an%a# #e'%an#un% ,ada $a# dan e"&n4


7/22

ICU untuk siapa?

ICU "end&'& d&,e'un#uan $a%& ,a"&en den%an nd&"& ed&" *an%'ee'"&$e dan e&&& ,'",e ,eu&han *an% $a& a'ena "u$e'da*a *an% d&%unaan d& ICU aha4


8/22

,a"&en "a '&" e&,u#&!

Pa"&en ,a"&en *an% #&da "#a$& "ea'a 9"&%&" dan ee'u#ena%a ed&" *an% #e''d&na"& dan $e'ean/u#an- "e'#a ee'u

,e'ha#&an *an% #e& a%a' da,a# d&auan ,en%a+a"an *an% e#a# #e'u" ene'u" "e'#a #e'a,& #'a"&4

Pa"&en ,a"&en *an% daa $aha*a en%aa& de,en"a"& 9"&"eh&n%%a ee'uan ,ean#auan e#a# dan #e'u" ene'u" "ed&auan &n#e'en"& "e%e'a un#u ene%ah #&$un*a ,en*a *e'u%&an4


9/22

INDIKASI MASUK ICU

Mde ,'&'a"

Mde d&a%n"&"

Mde ,a'ae#e' $/e#&.


10/22

Model prioritas

Pasien Prioritas 1

Ke, &n& e'u,aan ,a"&en "a '&" dan #&da "#a$& *an%ee'uan #e'a,& &n#en"&. "e,e'#& duun%an en#&a"&- &n.u" $a#$a#

a"a#&. n#&nu- d4

Cn#h ,a"&en e, &n& an#a'a a&n adaah ,a"&en ,a"a$edah a#au,a"&en "* "e,"&"4


11/22

Model prioritas

Pasien Prioritas

Pa"&en ,ada e, &n& ee'uan ,ea*anan ,ean#auan an%%&hd& ICU a'ena "an%a# $e'&"& un#u en/ad& #&da "#a$& "eh&n%%a

ee'uan #e'a,& &n#en"&. "e%e'a4

n#h /en&" ,a"&en &n& an#a'a a&n e'ea *an% ende'a ,en*a da"a' /an#un%- ,a'u- a#au %&n/a dan eud&an en%aa& ,en*a au# *an%,a'ah4


12/22

Model prioritas

Pasien Prioritas !

Pa"&en ,ada e, &n& adaah ,a"&en *an% eadaann*a "an%a#en%u'an%& eun%&nan e"e$uhan dan an.aa# da'& #e'a,& d& ICU4

Cn#h ,a"&en &n& an#a'a a&n ,a"&en den%an e%ana"an e#a"#a"&"d&"e'#a& ,en*u &n.e"&- pericardial tamponade- "u$a#an /aan na,a"-a#au ,a"&en *an% ende'a ,en*a /an#un% a#au ,a'u #e'&nad&"e'#a& ,&a"& ,en*a au# $e'a#4


13/22

Penge"ualian a#& #a /&a en/ad& and&da# ,endn' '%an

Pa"&en,a"&en *an% ,e#en #e#a,& ena #e'a,& #un/an%anh&du, *an% a%'e"&. dan han*a de& :,e'a+a#an *an% n*aan:"a/a4

Pa"&en daa eadaan e%e#a#&. ,e'anen4

Pa"&en *an% "ea'a 9"&%&" "#a$& a#au "ea'a "#a#&"#& '&"&n*'endah un#u ee'uan #e'a,& ICU4


14/22

Model diagnosis Sistem Kardio#askular

In.a' &a'd au# den%an ,&a"&

S* a'd&%en&

A'&a ,e"

a%a /an#un% au# den%an %a%a na.a" dan a#au ee'uan$an#uan hed&na&

H&,e'#en"& ee'%en"&

Unstable angina d&"e'#a& a'&a- hed&na& *an% #&da "#a$&-

a#au n*e'& dada *an% ,'e"&"#en

Hen#& /an#un%

Ta,nade /an#un% den%an hed&na& *an% #&da "#a$&

D&"e"& aneu'&"a a'#a

7 /an#un% ##a


15/22

Model diagnosis

$#erdosis o%at

Hed&na& *an% #&da "#a$&

De9" en#a den%an %an%%uan /aan na.a"

Ke/an% *an% #&da da,a# #e'a#a"& den%an ,e'a+a#an $&a"a

Pem%eda&an Pa"&en ,"# ,e'a"& *an% ee'uan ,en%a+a"an hed&na& a#au

duun%an en#&a#' a#au ,e'a+a#an &n#en"&. a&nn*a4


16/22

Model parameter o%'ekti(

)anda *ital

Nad& ; 60 a#au < 150 a&en

Teanan da'ah S&"#& ; 80 H% a#au 20 H% d&$a+ah #eanan da'ahn'a ,a"&en

Mean a'#e'&a ,'e""u'e ; =0 H%

Teanan d&a"#& < 120 H%

Re",&'a#'* 'a#e < 35 a&en


17/22


+a%oratorium

Na#'&u "e'u ; 110 E>L a#au < 1?0 E>L

Ka&u "e'u ; 2-0 E>L a#au < ?-0 E>L

Pa@2 ; 50 H%

,H ; ?-1 a#au < ?-? u"a "e'u < 800 %d

Ka"&u "e'u < 15 %d


18/22


Rad&%'a9- US- #%'a9

Ee#'a'd&%'a

Pee'&"aan 9"& a&nn*a(n"e# au#)


19/22

Kriteria keluar ICU

Pasien prioritas 1

Pa"&en ,'&'a" 1 d&eua'an da'& ICU %ila ke%utu&an untuk terapiintensi( tela& tidak ada lagi a#au $&a #e'a,& "ea'a &n#en"&. #eah

gagal a#au tidak %erman(aat "eh&n%%a ,'%n"&" /an%a ,ende /ee4

Cn#h! ,a"&en den%an #&%a a#au e$&h %a%a "&"#& '%an *an% #&da'e",n" #e'hada, ,en%eaan a%'e"&.4


20/22

Kriteria keluar ICU

Pasien prioritas

Pa"&en ,'&'a" 2 d&eua'an $&a eun%&nan un#u endadaee'uan #e'a,& &n#en"&. #eah $e'u'an%4


21/22

Kriteria keluar ICU

Pasien prioritas !

Pa"&en ,'&'a" 3 d&eua'an da'& ICU %ilake%utu&an untuk terapi intensi( tela& tidak adalagi4 Naun- un%&n ,a"&en de&&an d&eua'ane$&h d&n& $&a eun%&nan "e$uh a#au an.aa##e'a,& &n#en"&. n#&nu e&4

Cn#hn*a! ,a"&en den%an ,en*a an/u# *an% #eah#&da $e'e",n #e'hada, #e'a,& ICU un#u ,en*aau#n*a *an% "ea'a "#a#&"#& e,un*a& ,'%n"&"

/an%a ,ende /ee- dan *an% #&da ada #e'a,& *an%

,#en"&a un#u e,e'$a&& ,'%n"&"n*a4


22/22

TERIMAKASIH

anastesi - Indikasi Masuk Icu

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