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  • Terapi Cairan Dan Obat Emergensi

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    The document discusses fluid therapy and emergency medications. It notes that fluid therapy is used to treat acute hypovolemia and shock by starting fluids but should be stopped once hypervolemia occurs. It mentions there is no clear dosing guideline as patient risk factors vary. Crystalloids are preferred over colloids. Monitoring is needed for fluid therapy side effects like electrolyte imbalances and hypervolemia. Vasopressors like norepinephrine should be considered if the patient does not respond to fluid resuscitation. The document also reviews the uses of amiodarone for arrhythmias.

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    The document discusses fluid therapy and emergency medications. It notes that fluid therapy is used to treat acute hypovolemia and shock by starting fluids but should be stopped once hypervolemia occurs. It mentions there is no clear dosing guideline as patient risk factors vary. Crystalloids are preferred over colloids. Monitoring is needed for fluid therapy side effects like electrolyte imbalances and hypervolemia. Vasopressors like norepinephrine should be considered if the patient does not respond to fluid resuscitation. The document also reviews the uses of amiodarone for arrhythmias.

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    3 views22 pages

    Terapi Cairan Dan Obat Emergensi

    Uploaded by

    Bagus Maro
    The document discusses fluid therapy and emergency medications. It notes that fluid therapy is used to treat acute hypovolemia and shock by starting fluids but should be stopped once hypervolemia occurs. It mentions there is no clear dosing guideline as patient risk factors vary. Crystalloids are preferred over colloids. Monitoring is needed for fluid therapy side effects like electrolyte imbalances and hypervolemia. Vasopressors like norepinephrine should be considered if the patient does not respond to fluid resuscitation. The document also reviews the uses of amiodarone for arrhythmias.

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    of 22

    Terapi Cairan dan

    Obat Emergensi

    TOMMY KRISTANTO
    EMERGENCY MEDICINE
    Terapi Cairan
    • Kondisi Akut  Resusitasi
    • Start  hypovolemia/shock
    • Stop  hypervolemia

    Seccombe, A., & Sapey, E. (2018). What is the evidence base for fluid resuscitation in
    acute medicine?. Clinical Medicine, 18(3), 225.
    Syok  butuh TERAPI CAIRAN

    Jalil, B. A., & Cavallazzi, R. (2018). Predicting fluid responsiveness: a review of literature and a guide for the clinician. The American journal of emergency medicine, 36(11), 2093-2102.
    Seccombe, A., & Sapey, E. (2018). What is the evidence base for fluid resuscitation in acute medicine?. Clinical Medicine, 18(3), 225.
    Seccombe, A., & Sapey, E. (2018). What is the
    evidence base for fluid resuscitation in acute
    medicine?. Clinical Medicine, 18(3), 225.
    Padhi, S.,(2013). Intravenous fluid
    therapy for adults in hospital:
    summary of NICE guidance
    Padhi, S.,(2013). Intravenous fluid
    therapy for adults in hospital:
    summary of NICE guidance
    Padhi, S.,(2013). Intravenous fluid
    therapy for adults in hospital:
    summary of NICE guidance
    Padhi, S.,(2013). Intravenous fluid
    therapy for adults in hospital:
    summary of NICE guidance
    Padhi, S.,(2013). Intravenous fluid
    therapy for adults in hospital:
    summary of NICE guidance
    Padhi, S.,(2013). Intravenous fluid
    therapy for adults in hospital:
    summary of NICE guidance
    Boer, C., Bossers, S. M., & Koning, N. J. (2018). Choice of fluid type: physiological concepts and
    perioperative indications. British journal of anaesthesia, 120(2), 384-396.
    EFEK SAMPING
    • HYPERVOLEMIA
    • ELECTROLYTE IMBALANCE
    (hyponatraemia, hyperchloraemia,
    hyperkalemia, hypocalcaemia)

    Boer, C., Bossers, S. M., & Koning, N. J. (2018). Choice of fluid type: physiological concepts and
    perioperative indications. British journal of anaesthesia, 120(2), 384-396.
    TAKE HOME MESSAGES

    TERAPI CAIRAN 
    HIPOVOLEMIA/SHOCK

    BELUM ADA DOSIS YANG


    TEPAT  FAKTOR RESIKO
    DARI PASIEN BERBEDA-
    BEDA

    KRISTALOID >> KOLOID

    MONITORING EFEK
    SAMPING TERAPI CAIRAN
    Wieruszewski, P. M., & Khanna, A. K. (2022). Vasopressor choice and timing in vasodilatory
    shock. Critical Care, 26(1), 1-8.
    Obat Emergensi (BHL)
    Russell, J. A. (2019). Vasopressor therapy in critically ill patients with
    shock. Intensive care medicine, 45(11), 1503-1517.

    VASOPRESSOR  BILA TIDAK RESPON TERAPI CAIRAN


    NOREPINEPHRIN  1ST CHOICE
    Russell, J. A. (2019). Vasopressor therapy in critically ill patients with
    shock. Intensive care medicine, 45(11), 1503-1517.
    Russell, J. A. (2019). Vasopressor therapy in critically ill patients with
    shock. Intensive care medicine, 45(11), 1503-1517.
    APA YANG • SHOCK TERKONTROL
    • MAP > 65 mmHg DITAMBAH
    INGIN • Urine output > 0.5 ml/kg/jam ATAU
    PENURUNAN 10% KADAR LAKTAT
    DICAPAI?? DARI NILAI SEBELUMNYA
    • Anti aritmia  atrium/ ventrikel aritmia
    • Memblok kanal kalium
    • Dosis :
    • Unstable : 150-300 mg IV
    • Stable:
    • Loading 150-300 mg IV pada Ventrikular Aritmia
    • Dilanjut 1 mg/jam selama 6 jam dan 0,5 mg/jam untuk 18
    jam

    Hamilton, D., Nandkeolyar, S., Lan, H., Desai, P., Evans, J., Hauschild, C., ... & Hilliard, A. (2020). Amiodarone: a comprehensive guide for
    clinicians. American Journal of Cardiovascular Drugs, 20(6), 549-558.
    Hamilton, D., Nandkeolyar, S., Lan, H., Desai, P., Evans, J., Hauschild, C., ... & Hilliard, A. (2020). Amiodarone: a comprehensive guide for
    clinicians. American Journal of Cardiovascular Drugs, 20(6), 549-558.

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