PENGANTARPENGANTAR

INTRO TO ANESTHESIA INTRO TO ANESTHESIA

ANESTESIOLOGI & REANIMASIANESTESIOLOGI & REANIMASIRSUD JAYAPURARSUD JAYAPURA

PAPUAPAPUA

ANESTHESIAANESTHESIA

ANESTHESIAANESTHESIA - Partial or complete - Partial or complete loss of sensation with or with out loss loss of sensation with or with out loss of consciousness as result of disease, of consciousness as result of disease, injury, or administration of an injury, or administration of an anesthetic agent, usually by injection anesthetic agent, usually by injection or inhalation.or inhalation.

HISTORY OF ANESTHESIAHISTORY OF ANESTHESIAPRIMITIVE TECHNIQUESPRIMITIVE TECHNIQUES

ClubClub StrangulationStrangulation AlcoholAlcohol MesmerismMesmerism PlantsPlants

HISTORY OF ANESTHESIAHISTORY OF ANESTHESIAINHALATION AGENTSINHALATION AGENTS

Nitrous OxideNitrous Oxide1799 Davy1799 Davy1824 Hickman1824 Hickman1844 Wells1844 Wells

Ether Ether 1842 Long1842 Long1847 Snow1847 Snow

HISTORY OF ANESTHESIAHISTORY OF ANESTHESIAINHALATION AGENTSINHALATION AGENTS

• Modern AgentsModern Agents• Halothane 1956Halothane 1956• Enflurane 1972Enflurane 1972• Isoflurane 1981Isoflurane 1981• Sevoflurane and DesfluraneSevoflurane and Desflurane

HISTORY OF ANESTHESIAHISTORY OF ANESTHESIALOCAL/REGIONALLOCAL/REGIONAL

1836 needle trochar1836 needle trochar 1844 hollow needle1844 hollow needle 1851 syringe1851 syringe 1884 Koller opthalmic anesthesia1884 Koller opthalmic anesthesia 1885 Hallstead/Hall local/regional 1885 Hallstead/Hall local/regional

blocksblocks 1898 Bier spinal1898 Bier spinal

CARA PEMBERIAN ANESTESI :CARA PEMBERIAN ANESTESI :

ANESTESI

UMUM

REGIONAL : - LOKAL (INFILTRASI)- BLOCK SARAF- PERIDURAL- SPINAL (SAB)

(Sub Arachnoid Block)- DLL

INHALASI

UMUM

MASKER

INTUBASIORAL

NASAL

ANESTESIOLOGI & ANESTESIOLOGI & REANIMASIREANIMASI

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PhysiologiFarmakologi

PatologiPengembangan SDM seutuhnya,teknis-professional, manajerial,

komunikasi - interpersonalTeam building multi disiplin/profesi/sektor

System developmentSPGDT/B/P

Transportasi-komunikasi (Ramed)Iman & taqwa

Etika : Saya senantiasa mengutamakan kesehatan penderita

Ekonomi & Bisnis

Pengelo

laan life

support

di pra RS, IR

D,OK,RR/ROI,ICU Pengelolaan nyeri & stress

2. Mengurangi penderitaan1. Mempertahankan hidup

Dalam KONAS di Yogyakarta 1998Sudah diterima nama menjadi Anestesiologi & Reanimasi

Landasan ekonomi

Landasan spiritual

Landasan organisasi &manajerial

Landasan ilmu dasar

Wilayah penerapan

Hakekat anestesiologi &reanimasi

IPTEK

IMTAQ

EKBIS

VISI PERAN ANESTESIOLOGI & REANIMASIIlmu Kedokteran

KPPIA IDSAI/Jogja,16-17 Des’05/Koes

VISI PERAN ANESTESIOLOGI & REANIMASIIlmu Kedokteran

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Pengelolaan life su

pport

di pra RS, IRD,OK,RR/ROI,IC

U Pengelolaan nyeri & stress

2. Mengurangi penderitaan1. Mempertahankan hidup

Wilayah penerapan

Hakekat anestesiologi &reanimasi

KPPIA IDSAI/Jogja,16-17 Des’05/Koes

BLSALS

PLS

ACLS

Advance General EmergencyLife Support (A. GELS) forAnesthesiologist

High riskHigh frequencyHigh successProcedure

- Primary prevention- Secondary prevention

Local specific- Malaria- DHF- GEBLS : Basic life support (A, B, C, BRAIN)

ALS : Advance life supportATLS : Advance trauma life support (Trauma oriented L.S)ACLS : Advance cardiac life support (Cardiac oriented L.S.)NLS : Neonatal life supportPLS : Pediatric life supportOLS : Obstetric life support

ATLS

PTC

Pathophysiology& pharmacology

PTC : Primary trauma careA : AirwayB : BreathingC : Circulation

OLS

Advance General Emergency Life Support (AGELS)

NLS

LANDASAN IDEAL UNTUK TEAM BUILDING

Saya senantiasa mengutamakan kesehatan(keselamatan) penderita

WHAT IS THE BEST FOR MY PATIENTNOT

WHAT IS THE BEST FOR ME( Do it my way)

Apa peran Dokter ?Apa peran Dokter ?

1.1. To protect and save life To protect and save life 2.2. To alleviate suffering To alleviate suffering

Tujuan UmumTujuan Umum

Better patient care Better patient care Through better team work Through better team work Based on better knowledge Based on better knowledge

and better understanding and better understanding

Sharing common knowledge

Better understanding

Mutual respect and mutual need satisfaction

Better teamwork

Better patient care

BEDAHANESTESIOLOGI

&REANIMASI

STRATEGI DASAR PENANGGULANGANPASIEN GAWAT DARURAT DI IRD

1.Tahap Life Support (Resusitasi – Stabilisasi)Leading sector : Anesthesiologi – ReanimasiSupporting sector : Bedah

2. Tahap Definitif Diagnosis – Definitif TreatmentLeading sector : BedahSupporting sector : Anesthesiology – Reanimasi

(Konsep diatas dikenal dengan nama Shifting Leadership)

Hak – hak pasienHak – hak pasien

1.1. The right to be respected The right to be respected 2.2. The right for safety The right for safety 3.3. The right for information The right for information 4.4. The right to choose The right to choose 5.5. The right to be heard The right to be heard

Landasan Etik DasarLandasan Etik Dasar

Saya senantiasa mengutamakan Saya senantiasa mengutamakan kesehatan ( keselamatan ) kesehatan ( keselamatan ) penderita.penderita.

Be FRIENDLIER Be SAFER Be FASTER

In a Team of PROFESSIONALISM

07.00 datang pasien laki – laki 58 07.00 datang pasien laki – laki 58 tahun / tahun / 65 Kg, turun dari mobil, 65 Kg, turun dari mobil, didorong diatas kursi roda menuju ke didorong diatas kursi roda menuju ke triage. triage.

Bagaimana sikap anda...... Bagaimana sikap anda......

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