CURRICULUM VITAE

N a m a : Prof.Dr.TAMSIL SYAFIUDDIN Sp.P (K)

Alamat : Jln.Karsa No F 1 Kompleks Eks KOWILHAN I
Sei.Agul Medan 20117
Jabatan : Guru Besar Tetap FK- UISU / Luar Biasa FK- USU
Penasehat Perhimpunan Dokter Paru Indonesia Pusat
Ketua Perhimpunan Dokter Paru Indonesia Cabang Sumut
Dewan Pembina Yayasan Asma Indonesia Wilayah Sumut
Ketua Departemen Pulmonologi dan Kedokteran Respirasi FK-UISU
Anggota Dewan Asma Nasional
Anggota Kolegium Perhimpunan Dokter Paru Indonesia Pusat
Anggota Pokja Asma Perhimpunan Dokter Paru Indonesia Pusat
Anggota Pokja PPOK Perhimpunan Dokter Paru Indonesia Pusat
Anggota Tim Akreditasi Pendidikan Spesialis Paru Nasional

Riwayat Pendidikan:
-Dokter Umum, FK-USU Medan,1979
-Dokter Spesialis I Paru, FK-UI Jakarta, 1990
-Dokter Spesialis II Paru, Konsultan Asma/PPOK, 1995

Pendidikan tambahan:
- Pelatihan Kanker Paru, TSUKAGUCHI Hospital, Kobe- Japan 1989
- Pelatihan PPOK, AMAGASAKI Hospital, Kobe- Japan 1990
- Pelatihan Respiratory Physiologi, JAPAN RESPIRATORY PHYSIOLOGIST
CLUB, Kyoto- Japan 1990
- Spirometry Training Course, Department of Respiratory Medicine,
National University Hospital Singapore, Singapore 1997

- Workshop of Bronchoscopy and Autofluorecent Bronchoscopy, RS Persahabatan
Jakarta, Jakarta September 2005

-Training of the new interventional technique of bronchosfiberscopy(Optical Coherence
Tommograhy) , Department of Thoracic Surgery, Tokyo Medical University Hospital,
Tokyo - Japan 2007
- Workshop of the new technique of bronchoscopy, Postgradute Medical Institute,
Singapore General Hospital, Singapore 2008
- Respiratory Masterclass Asthma and COPD, Singapore 2011
- Workshop on Medical Thoracoscopy, The American College of Chest Physicians-The
Indonesian Association of Pulmonologist, RS Persahabatan Jakarta, Jakarta November
1997

- Workshop on Reformation of Higer Education System,HEDS-JICA, Jakarta 1998

- Pulmonary Infections Course, Postgraduate Medical Institute, Singapore General Hospital,
Singapore 2001

- Bronchoscopy &Thoracoscopy Workshop, Postgraduate Medical Institute, Singapore
General Hospital, Singapore 2005
- Workshop on Transbronchial Lung Biopsy and Trasbronchial Needle Aspiration PDPI
Cabang Jakarta, RS Persahabatan Jakarta ,Jakarta 1997
- Workshop on Respiratory Physiology and Its Clinical Application, RS Pusat Angkatan
Darat Gatot Subroto Jakarta, Jakarta Juni 1997
ACUTE RESPIRATORY FAILURE
DIAGNOSTIC
AND
MANAGEMENT
TAMSIL SYAFIUDDIN
DEPARTMENT OF PULMONARY AND RESPIRATORY MEDICINE
FAKULTAS KEDOKTERAN UISU
MEDAN 2013
Initial Assessment
Airway open,no noises
Breathing 12-20 times per minute
Circulation warm, pink, dry, strong
pulses
Disability mental status clear
Vital Signs
Respiratory Assessment
Airway
Open and Clear
Needs Intervention
Breathing
Inspection
Palpation
Percussion
Pulse Oximetry
Auscultation
Circulation & Vital Signs
History
Respiratory failure
Impairment in O
2
uptake
Impairment in CO
2
elimination
Both

Abnormal arterial blood gases
ACUTE RESPIRATORY FAILURE
(SPECTRUM OF CAUSES OF ARTERIAL HYPOXEMIA)
Causes of Respiratory Emergencies
Failure of:
Ventilation : air in/ air out
Diffusion : movement of gases
Perfusion : movement of blood

Compounded by:
Inflammation/mucus production


Hypoxia low oxygen to cells
Causes of hypoxia
Hypoxic hypoxia not enough oxygen
Anemic hypoxia not enough hemoglobin
Stagnant hypoxia not enough perfusion
shock
Histotoxic hypoxia unable to download
Cyanide poisoning
Cyanosis blue discoloration
suggests hypoxia
ACUTE RESPIRATORY FAILURE
ALTITUDE
HYPOVENTILATION
DIFFUSION ABNORMALITTY
RIGHT to LEFT SHUNT
VENTILATION-PERFUSION ABNORMALITY
ALTITUDE
INCREASE IN ALTITUDE
DECREASE IN BAROMETRIC PRESSURE
LOWERRING OF THE PO
2
IN THE INSPIRED AIR
HYPOVENTILATION
(DRUG OVERDOSE AND NEUROMUCULAR WEAKNESS)
ACCUMULATION OF CARBON DIOXIDE
IN THE ALVEOLI
DISPLACING ALVEOLAR OXYGEN
PO
2
AND PCO
2

DIFFUSION ABNORMALITY
PNEUMONIE
PO2 and PCO2
RIGHT TO LEFT SHUNT
ALVEOLUS IS PERFUSED
BUT NOT VENTILATED
(Extreme imbalance V/Q)
PO
2
and PCO
2

CARDIAC and NONCARDIAC
PULMONARY EDEMA
Ventilation-Perfusion Abnormality
( V/Q, 4/5 or 0.8 )
ASTHMA
COPD
EMBOLI
PO
2
and PCO
2

Acute Respiratory Failure

Airway obstruction
COPD
Asthma
Heart failure
Restrictive defects
Pleural effusion
Pneumothorax
Infiltrative diseases
Atelectasis
Obesity
Abdominal distention of all types
Intertitial fibrosis of all types
Acute Respiratory Failure
( continue )
Central nervous system depressions
Drugs
Head injury
Central nervous system infection
Chest wall abnormalities
Congenital and acquired deformities
Trauma (flail chest)
Neuromuscular disease or blockade
DIAGNOSTIC
SUBJECTIVE
OBJECTIVE
ACUTE RESPIRATORY FAILURE
SUBJECTIVE
Dyspnea
Headache
Confusion
Unconsciousness
Restlessness
ACUTE RESPIRATORY FAILURE
Objective
ABGA
( hypoxemia and respiratory acidosis )
Underlying disease
( CX examination )
Tachycardia
Hypotention
BODY CELLS OF HEALTHY
AT REST REQUIRE

250 ml/minute Oxygen
NORMAL CELLULAR AEROBIC RESPIRATION
(OXYGEN CONSUMTION)
Management
Acute respiratory failure
General management
( Improving the P
a
O
2
)
Specific management
( Underlying disease )
24
Management of The Airway
Basic techniques:
1. Head tilt [ respiratory tract in one straight line ].
2. Chin left.
3. Jaw thrust [take tongue with its base & the only technique
done in suspected cervical spine injury patient ].

THANK YOU
Syafiuddin San : You are the Inspiring woman
Imah San : You are the Wind beneath my wings
Arigato gozaimasu
Arigato gozaimasu