Management of Airway, Breathing Circulation

MANAGEMENT OF
AIRWAY, BREATHING
CIRCULATION
Ns. Mohammad Ali Hamid, S. Kep., M.

Kes.
PROGRAM STUDI S1 KEPERAWATAN
FAKULTAS ILMU KESEHATAN
UNIVERSITAS MUHAMMADIYAH JEMBER
Kansas Airway Supplement
1
2015
ANATOMY OF AIRWAY
Cavum Nasi
Cavum Oris
Lidah
Larynx
Pharynx
Kansas BEMS EMS Educator Task Force
UPPER AIRWAY
Nose and mouth
( warms, moistens and

filters air )
Pharynx
Oropharynx
Nasopharynx
Epiglotis
Trachea
Cricoid cartilage
Larynx ( voice box )

Lower Airway

LOWER AIRWAY
Filtration
Transmission of air
Trachea
Mainsteam bronchi
Bronchioles
Terminal bronchioles
Lungs :
Visceral pleura (surface of lungs)
Parietal pleura (internal chest wall)
Interpleural space (potential space)
Disruption of Airway
Acut
Total
Insidous
Obstruction
Partial

OBSTRUCTION
The size of obstruction affects the
available air exchange

Penyebabnya kemungkinan :
sekret, benda asing, darah, edema

pharynx dan larynx, gigi, lidah
jatuh ke belakang.

OBSTRUCTION

AIRWAY : Gejala
Obstruksi
1. Sesak
Mengeluh sesak (os sadar)
Takipnea
Retraksi
suprasternal
infrasternal
antar-iga

AIRWAY : Gejala
Obstruksi
2. Pernafasan berbunyi :
Gurgling (bunyi kumur-kumur)
Cairan
Snoring (mengorok)
Stridor
Lidah
Sumbatan anatomis
10
Penanganan Obstruksi
Cairan (gurgling) :
Suction
Bila banyak -> miringkan kepala
( trauma : log roll )
Bila tidak teratasi :
Airway definitif

11
Lidah ( snoring ) :
Manual : - Head tilt-chin lift
trauma : head tilt (-)
- Jaw
thrust
Jalan nafas
sementara :
- Oro
/ nasofaringeal
12
Head Tilt Chin Lift

13
Jaw Thrust

14
Sumbatan anatomis (stridor) :
Trauma : Edema laring pada luka

bakar, Fraktur laring
Non Trauma : Benda asing, difteri

Diperlukan jalan nafas definitif

15
Airway definitif
Airway definitif : pipa (tube) dalam
trakea
Indikasi : 1. Proteksi Airway (A)
= Ancaman obstruksi
= Ancaman aspirasi
2. Perlu ventilasi

16
(B)
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 ?
17
BREATHING
Feel
Check the volume of breathing by

placing your ear and cheek next to the
patients mouth
Auscultate
Stethoscope
Mid clavicular about the second
intercostal space and the fourth or
fifth anterior midaxillary line or next
to sternum
18
BREATHING
Check both sides
Present and equal bilaterally
Diminished or absent

19
Adequate Breathing
Normal rate
Adult 12 20/min
Child15 30/min
Infant 25 50/min
Rhythm
Regular
Irregular

20
Adequate Breathing
Quality
Breath sounds present and equal
Chest expansion adequate and equal
Effort of breathing : use of accessory
muscle predominately in infants and
children
Depth
Adequate chest rise and fall
Full breath sounds heard
21
Inadequate Breathing
Rate
Outside the normal limits

Tachypnea ( rapid breathing )
> 20
Badypnea ( slow breathing ) <
12
Rhythm
Irregular breathing pattern
22
Inadequate Breathing
Quality
Breath sounds diminished, noisy or absent

Excessive use of accessory muscle, retractions
Reduce air flow at nose / mouth
Inadequate chest expansion
Depth
Shallow ( impaired depth ) breathing

Agonal respirations occasional gasping respirations
Skin Color
Retractions
Seesaw breathing ( abdominal dan chest move in
opposite directions )
23
BREATHING
Respiratory
effort?
Retractions?
Rate and rate
trends
Air movement
(look, listen, feel;
stethoscope later)

24
VENTILASI
TANPA ALAT
mouth to mouth
mouth to nose
DGN ALAT
mouth to mask
pipa oksigen
BVM
ventilator
25
VENTILASI
Mouth-to-mouth Ventilation
Air we breath contains 21 % Oxygen
5% used by the body
16% is exhaled
Danger of infectious disease

26
VENTILASI
Mouth-to-Mask
Eliminates direct contact with patient
One-way valve system
Can provide adequate or greater
volume than BVM

27
VENTILASI
BVM
Consist of self-inflating bag, one way
valve, face mask, intake / oxygen
reservoir valve and oxygen reservoir
By adding oxygen and a reservoir close
to 100% oxygen can be delivered to the
patient
Volume of approximately 1.600 ml
Provides less volume than mouth-tomask
Available in infant,child and adult sizes
28
CIRCULATION
The cardiorespiratory system also
includes the lungs

The cardiovascular system is
tightly integrated with the renal
system,respiratory system,
muscular system and nervous
system

29
CARDIOVASCULAR ANATOMY

30
Cardiovascular Anatomy

31

32

33
CARDIOVASCULAR SYSTEM
Transports oxygen, fuel to cells
Cells get energy needed to stay
alive by reacting oxygen with fuel

(usually glucose)
Removes carbon dioxide, waste
products for elimination from body
Cardiovascular system makes up :
the heart, the blood and the blood
vessels
( veins, arteries, arterioles,
venules,capillaries
)Task Force
Kansas BEMS EMS Educator
34
SISTEM KONDUKSI KELISTRIKAN

JANTUNG
SA node
AV node
Bundle of his
Bundle branches
Purkinje network

35
Cardiovascular System
Transport oxygen fuel to cells
Removes carbondioxide waste
products for elimination from body

36
Untuk mempertahankan perfusi
diperlukan :
Pump : Heart
Pipes : Blood Vessels
Fluid : Blood
Perfusi akan mengalami gangguan
apabila ada kegagalan dari ketiga

faktor diatas.

37
sakalangkong

38

Management of Airway, Breathing Circulation

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MANAGEMENT OF

Ns. Mohammad Ali Hamid, S. Kep., M.

( warms, moistens and

Kansas Airway Supplement

Kansas Airway Supplement

Kansas Airway Supplement

available air exchange

sekret, benda asing, darah, edema

Kansas Airway Supplement

Kansas Airway Supplement

Kansas Airway Supplement

Bila tidak teratasi :

Kansas Airway Supplement

Head Tilt Chin Lift

Kansas Airway Supplement

Kansas Airway Supplement

Trauma : Edema laring pada luka

Non Trauma : Benda asing, difteri

Kansas Airway Supplement

Kansas Airway Supplement

After establishing an airway your next step

should to be assess breathing.

Check the volume of breathing by

Kansas Airway Supplement

Kansas Airway Supplement

Outside the normal limits

Breath sounds diminished, noisy or absent

Shallow ( impaired depth ) breathing

Kansas Airway Supplement

Kansas Airway Supplement

Kansas Airway Supplement

includes the lungs

Kansas Airway Supplement

Kansas Airway Supplement

Kansas Airway Supplement

Kansas Airway Supplement

Kansas Airway Supplement

alive by reacting oxygen with fuel

SISTEM KONDUKSI KELISTRIKAN

Kansas Airway Supplement

products for elimination from body

Kansas Airway Supplement

Untuk mempertahankan perfusi

Perfusi akan mengalami gangguan

apabila ada kegagalan dari ketiga

Kansas Airway Supplement

Kansas Airway Supplement

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