MEDICOLEGAL ASPECT

INSTALLATION AND RELEASING OF

RESPIRATORY AIDS

Examiner : dr. Gatot Suharto,

Sp.F, MH Kes
Supervisor : dr. Erni H.Situmorang

INTRODUCTION
Life or Die?
Life Support System Artificial Life
Life promises 0r accident?
Indication? Complication?
Medicolegal aspect??

Mechanical ventilator
Negative or positive pressure breathing tools
Ventilation and oxygen supply
Long time

Purpose?

Life saving

Complicatio
n

Indication
Spontaneous ventilation in inadequate

patients for life saving

Collapse prophylaxis
Respiratory failure or clinical condition that
leads to respiratory failure

Respirator
y failure

Apnea

Shock

Neurologic
al
dysfunctio
n

Heart
insufficienc
y

airway

Complication
Lung

GIT

CVS

Neuromus
c

Weaning ventilation
Decreasing ventilation support breathing
spontaneously and can be extubate

Its factor
Early condition which affects
patients
Is general patients condition in
optimal state?
Does patient have respiratory
tract problem or being cured?
Does patient breath adequately?

 Muscle relaxant
Nasogastric tube
Sedation
ventilator setting
Preparing Intubation
Fulfill criteria for starting ventilator
support

6
5
4
3
2
1

Hospital Intubation Protocol

(Operational and Procedural
Standard)

 Thorax X-ray
Trolley CPR and resuscitation drugs
Continue the medication
Blood Gas Analysis
Confirm the ETT position and
connecting to ventilator

11

10
9
8
7

Extubation criteria according

to the Hospital Operational
and Procedural standard
1. Neurological
2. Heart
3. Respiration

4.Kidney
5.Temperature

Agreement that is given by

the doctor before examining,
curing, or doing any medical
procedures

Informe
d
Consent
?

Competentio
n

Freedom

Giving
Information

Patients
decision

Patient
understandin
g

Doctor
recomendati
on

Patients
autority

7 element of
informed consent
(Beaucham and
Childress)

Diagnostic
and
process

Cost
estimation

purpose

Conten
t
Prognosis

Alternate

Risk and
complicati
on

LAW
FUNDAMENTAL

UU no 36 thn 2009 pasal 56 tentang

Kesehatan

CONCLUSION
Ventilator : life saving and life threatening
Need informed consent according to the law
Peraturan Menteri Kesehatan nomor

290/MENKES/PER/III/2008,
Undang-Undang nomor 29 tahun 2004 pasal 45,
Undang-Undang nomor 36 tahun 2009 pasal 56, 57,
dan 58,
Undang-Undang nomor 44 tahun 2009 pasal 32,
dan Undang-Undang nomor 23 tahun 1992 pasal 53.