Ini Merupakan Makalah Tentang Sudden Cardiac Death, Dimana Data Ini Saya Buat Dalam Tugas Di Bagian Penyakit Dalam

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\plain\pard\sl-295 \li2871 \ri3364 \fi816 \expndtw-12 \f20 \fs24 BAB II

\plain\par
\pard\sl-417 \li2871 \ri2914 \expndtw-6 \f20 \fs24 TINJAUAN PUSTAKA
\par
\plain\sl-283\fs28\par\sl-240\fs24\par\par\par\pard\pard\sl-240 \li5 \ri5610 \ex
pndtw-2 \b \f20 \fs24 A. Cardiac Arrest
\plain\par
\pard\sl-417 \li5 \ri5991 \expndtw-2 \b \f20 \fs24 1. Pengertian.
\plain\par
\pard\sl-407 \li5 \ri45 \fi720 \expndtw2 \i \f20 \fs24 Cardiac arrest\i0 adalah
hilangnya fungsi jantung secara tiba-tiba dan
\plain\par
\pard\sl-412 \li5 \ri45 \expndtw0 \f20 \fs24 mendadak, bisa terjadi pada seseora
ng yang memang didiagnosa dengan penyakit
\plain\expndtw0 \f20 \fs24 jantung ataupun tidak. Waktu kejadiannya tidak bisa d
iperkirakan, terjadi dengan
\plain\par
\pard\sl-417 \li5 \ri45 \expndtw0 \f20 \fs24 sangat cepat begitu gejala dan tand
a tampak (American Heart Association,2010).
\plain\par
\pard\sl-412 \li5 \ri45 \expndtw1 \f20 \fs24 Jameson, dkk (2005), menyatakan bah
wa\i cardiac arrest\i0 adalah penghentian
\plain\par
\pard\sl-412 \li5 \ri236 \expndtw-2 \f20 \fs24 sirkulasi normal darah akibat keg
agalan jantung untuk berkontraksi secara efektif.
\plain\par
\pard\sl-412 \li5 \ri47 \fi720 \expndtw-2 \f20 \fs24 Berdasarkan pengertian di a
tas maka dapat diambil suatu kesimpulan bahwa
\plain\par
\pard\sl-417 \li5 \ri46 \expndtw-1 \f20 \fs24 henti jantung atau\i cardiac arre
st\i0 adalah hilangnya fungsi jantung secara mendadak
\plain\par
\pard\sl-412 \li5 \ri41 \expndtw0 \f20 \fs24 untuk mempertahankan sirkulasi norm
al darah untuk memberi kebutuhan oksigen
\plain\expndtw-1 \f20 \fs24 ke otak dan organ vital lainnya akibat kegagalan jan
tung untuk berkontraksi secara
\plain\expndtw-10 \f20 \fs24 efektif.
\plain\par
\sl-115\fs11\par\sl-240\fs24\par\par\pard\pard\sl-240 \li5 \ri5324 \expndtw-4 \b
\f20 \fs24 2. Faktor predisposisi
\plain\par
\pard\sl-408 \li5 \ri50 \fi720 \expndtw0 \f20 \fs24 Iskandar (2008), mengatakan
bahwa faktor risiko\i cardiac arrest\i0 adalah:
\plain\par
\pard\sl-412 \li5 \ri49 \expndtw0 \f20 \fs24 Laki-laki usia 40 tahun atau lebih,
memiliki kemungkinan untuk terkena\i cardiac
\plain\par
\pard\sl-417 \li5 \ri43 \expndtw2 \i \f20 \fs24 arrest\i0 satu berbanding delap
an orang, sedangkan pada wanita adalah satu
\plain\par
\pard\sl-412 \li5 \ri49 \expndtw0 \f20 \fs24 berbanding 24 orang. Semakin tua se
seorang, semakin rendah risiko henti jantung
\plain\expndtw0 \f20 \fs24 mendadak. Orang dengan faktor risiko untuk penyakit j
antung, seperti hipertensi,
\plain\expndtw0 \f20 \fs24 hiperkholesterolemia dan merokok memiliki peningkatan
risiko terjadinya cardiac
\plain\par
\pard\sl-417 \li5 \ri5356 \expndtw-4 \f20 \fs24 arrest (Iskandar,2008).
\plain\par
\pard\sl-412 \li5 \ri44 \fi710 \expndtw3 \f20 \fs24 Menurut American Heart Assoc
iation (2010), seseorang dikatakan
\plain\expndtw-1 \f20 \fs24 mempunyai risiko tinggi untuk terkena\i cardiac arr
est\i0 dengan kondisi: a) Ada jejas
\plain\expndtw1 \f20 \fs24 di jantung akibat dari serangan jantung terdahulu. b)
Penebalan otot jantung
\plain\par
\pard\sl-417 \li5 \ri45 \expndtw0 \f20 \fs24 (Cardiomyopathy). c) Seseorang yang
sedang menggunakan obat-obatan untuk
\par
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\plain\pard\sl-295 \li5 \ri50 \expndtw0 \f20 \fs24 jantung. d) Kelistrikan jantu
ng yang tidak normal. e) Pembuluh darah yang tidak
\plain\par
\pard\sl-417 \li5 \ri4504 \expndtw-3 \f20 \fs24 normal. f) Penyalahgunaan obat.
\plain\par
\pard\sl-412 \li5 \ri40 \fi360 \expndtw0 \f20 \fs24 a) Adanya jejas di jantung k
arena serangan jantung terdahulu atau oleh sebab
\plain\par
\pard\sl-412 \li725 \ri41 \expndtw2 \f20 \fs24 lain; jantung yang terjejas atau
mengalami pembesaran karena sebab
\plain\expndtw0 \f20 \fs24 tertentu cenderung untuk mengalami aritmia ventrikel
yang mengancam
\plain\par
\pard\sl-417 \li725 \ri45 \expndtw0 \f20 \fs24 jiwa. Enam bulan pertama setelah
seseorang mengalami serangan jantung
\plain\par
\pard\sl-412 \li725 \ri41 \expndtw1 \f20 \fs24 adalah periode risiko tinggi untu
k terjadinya cardiac arrest pada pasien
\plain\expndtw-3 \f20 \fs24 dengan penyakit jantung\i atherosclerotic.
\plain\par
\pard\sl-412 \li5 \ri47 \fi360 \expndtw0 \f20 \fs24 b) Penebalan otot jantung (\
i cardiomyopathy)\i0 karena berbagai sebab (umumnya
\plain\par
\pard\sl-417 \li725 \ri46 \expndtw0 \f20 \fs24 karena tekanan darah tinggi, kela
inan katub jantung) membuat seseorang
\plain\par
\pard\sl-412 \li725 \ri3206 \expndtw-3 \f20 \fs24 cenderung untuk terkena\i car
diac arrest\i0 .
\plain\par
\pard\sl-412 \li5 \ri47 \fi360 \expndtw3 \f20 \fs24 c) Seseorang sedang mengguna
kan obat-obatan untuk jantung; karena
\plain\par
\pard\sl-412 \li725 \ri49 \expndtw-2 \f20 \fs24 beberapa kondisi tertentu, beber
apa obat-obatan untuk jantung (anti aritmia)
\plain\par
\pard\sl-417 \li725 \ri48 \expndtw-1 \f20 \fs24 justru merangsang timbulnya arit
mia ventrikel dan berakibat\i cardiac arrest\i0 .
\plain\par
\pard\sl-412 \li725 \ri49 \expndtw-2 \f20 \fs24 Kondisi seperti ini disebut\i p
roarrythmic effect\i0 . Pemakaian obat-obatan yang
\plain\expndtw-1 \f20 \fs24 bisa mempengaruhi perubahan kadar potasium dan magne
sium dalam darah
\plain\expndtw1 \f20 \fs24 (misalnya penggunaan diuretik) juga dapat menyebabkan
aritmia yang
\plain\par
\pard\sl-417 \li725 \ri3504 \expndtw-4 \f20 \fs24 mengancam jiwa dan\i cardiac
arrest\i0 .
\plain\par
\pard\sl-412 \li5 \ri45 \fi360 \expndtw1 \f20 \fs24 d) Kelistrikan yang tidak no
rmal; beberapa kelistrikan jantung yang tidak
\plain\par
\pard\sl-412 \li725 \ri49 \expndtw0 \f20 \fs24 normal seperti\i Wolff-Parkinson
-White-Syndrome\i0 dan sindroma gelombang
\plain\expndtw1 \f20 \fs24 QT yang memanjang bisa menyebabkan\i cardiac arrest\
i0 pada anak dan
\plain\par
\pard\sl-417 \li725 \ri5451 \expndtw-7 \f20 \fs24 dewasa muda.
\plain\par
\pard\sl-412 \li5 \ri41 \fi360 \expndtw1 \f20 \fs24 e) Pembuluh darah yang tidak
normal, jarang dijumpai (khususnya di arteri

\plain\par
\pard\sl-412 \li725 \ri45 \expndtw0 \f20 \fs24 koronari dan aorta) sering menyeb
abkan kematian mendadak pada dewasa
\plain\expndtw-2 \f20 \fs24 muda. Pelepasan adrenalin ketika berolah raga atau m
elakukan aktifitas fisik
\plain\par
\pard\sl-417 \li725 \ri41 \expndtw0 \f20 \fs24 yang berat, bisa menjadi pemicu t
erjadinya\i cardiac arrest\i0 apabila dijumpai
\plain\par
\pard\sl-412 \li725 \ri5512 \expndtw-6 \f20 \fs24 kelainan tadi.
\plain\par
\pard\sl-412 \li5 \ri46 \fi360 \expndtw0 \f20 \fs24 f) Penyalahgunaan obat; peny
alahgunaan obat adalah faktor utama terjadinya
\plain\par
\pard\sl-412 \li725 \ri42 \expndtw0 \i \f20 \fs24 cardiac arrest\i0 pada pender
ita yang sebenarnya tidak mempunyai kelainan
\plain\par
\pard\sl-417 \li725 \ri4967 \expndtw-5 \f20 \fs24 pada organ jantung.
\par
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\plain\pard\sl-300 \li5 \ri4561 \expndtw-4 \b \f20 \fs24 3.Tanda-tanda cardiac a
rrest.
\plain\par
\pard\sl-412 \li5 \ri43 \fi720 \expndtw0 \f20 \fs24 Tanda- tanda cardiac arrest
menurut Diklat Ambulans Gawat Darurat 118
\plain\par
\pard\sl-412 \li5 \ri6202 \expndtw-6 \f20 \fs24 (2010) yaitu:
\plain\par
\pard\sl-412 \li5 \ri43 \fi1080 \expndtw0 \f20 \fs24 a. Ketiadaan respon; pasien
tidak berespon terhadap rangsangan suara,
\plain\par
\pard\sl-412 \li1085 \ri2949 \fi360 \expndtw-3 \f20 \fs24 tepukan di pundak atau
pun cubitan.
\plain\par
\pard\sl-417 \li5 \ri40 \fi1080 \expndtw1 \f20 \fs24 b. Ketiadaan pernafasan nor
mal; tidak terdapat pernafasan normal
\plain\par
\pard\sl-412 \li1085 \ri3341 \fi360 \expndtw-4 \f20 \fs24 ketika jalan pernafasa
n dibuka.
\plain\par
\pard\sl-412 \li5 \ri120 \fi1080 \expndtw0 \f20 \fs24 c. Tidak teraba denyut nad
i di arteri besar (karotis, femoralis, radialis).
\plain\par
\f20 \fs24 4.Proses terjadinya\i cardiac arrest
\plain\par
\pard\sl-408 \li5 \ri49 \fi830 \expndtw1 \f20 \fs24 Kebanyakan korban henti jant
ung diakibatkan oleh timbulnya aritmia:
\plain\par
\pard\sl-412 \li5 \ri48 \expndtw-1 \f20 \fs24 fibrilasi ventrikel (VF), takhikar
di ventrikel (VT), aktifitas listrik tanpa nadi (PEA),
\plain\expndtw-3 \f20 \fs24 dan asistol (Diklat Ambulans Gawat Darurat 118, 2010
).
\plain\par
\pard\sl-417 \li5 \ri5129 \fi360 \expndtw0 \f20 \fs24 a) Fibrilasi ventrikel
\plain\par
\pard\sl-412 \li716 \ri43 \expndtw-1 \f20 \fs24 Merupakan kasus terbanyak yang s
ering menimbulkan kematian mendadak,
\plain\expndtw1 \f20 \fs24 pada keadaan ini jantung tidak dapat melakukan fungsi
kontraksinya,
\plain\expndtw0 \f20 \fs24 jantung hanya mampu bergetar saja. Pada kasus ini tin
dakan yang harus
\plain\par
\pard\sl-417 \li716 \ri1475 \expndtw-3 \f20 \fs24 segera dilakukan adalah CPR da
n DC shock atau defibrilasi.
\plain\par
\pard\sl-412 \li5 \ri4901 \fi360 \expndtw0 \f20 \fs24 b) Takhikardi ventrikel
\plain\par
\pard\sl-412 \li716 \ri49 \expndtw1 \f20 \fs24 Mekanisme penyebab terjadinyan ta
khikardi ventrikel biasanya karena

\plain\expndtw-2 \f20 \fs24 adanya gangguan otomatisasi (pembentukan impuls) ata
upaun akibat adanya
\plain\par
\pard\sl-417 \li716 \ri45 \expndtw1 \f20 \fs24 gangguan konduksi. Frekuensi nadi
yang cepat akan menyebabkan fase
\plain\par
\pard\sl-412 \li716 \ri49 \expndtw1 \f20 \fs24 pengisian ventrikel kiri akan mem
endek, akibatnya pengisian darah ke
\plain\expndtw-1 \f20 \fs24 ventrikel juga berkurang sehingga curah jantung akan
menurun. VT dengan
\plain\expndtw-2 \f20 \fs24 keadaan hemodinamik stabil, pemilihan terapi dengan
medika mentosa lebih
\plain\par
\pard\sl-417 \li716 \ri38 \expndtw0 \f20 \fs24 diutamakan. Pada kasus VTdengan g
angguan hemodinamik sampai terjadi
\plain\par
\pard\sl-412 \li716 \ri44 \expndtw3 \f20 \fs24 henti jantung (VT tanpa nadi), pe
mberian terapi defibrilasi dengan
\plain\expndtw-3 \f20 \fs24 menggunakan DC shock dan CPR adalah pilihan utama.
\plain\par
\pard\sl-412 \li5 \ri3645 \fi360 \expndtw0 \f20 \fs24 c)\i Pulseless Electrical
Activity\i0 (PEA)
\plain\par
\pard\sl-417 \li716 \ri41 \expndtw1 \f20 \fs24 Merupakan keadaan dimana aktifita
s listrik jantung tidak menghasilkan
\plain\par
\pard\sl-412 \li716 \ri49 \expndtw-1 \f20 \fs24 kontraktilitas atau menghasilkan
kontraktilitas tetapi tidak adekuat sehingga
\par
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\plain\pard\sl-295 \li356 \ri47 \expndtw0 \f20 \fs24 tekanan darah tidak dapat d
iukur dan nadi tidak teraba. Pada kasus ini CPR
\plain\par
\pard\sl-417 \li356 \ri2761 \expndtw-3 \f20 \fs24 adalah tindakan yang harus seg
era dilakukan.
\plain\par
\pard\sl-412 \li5 \ri5967 \expndtw0 \f20 \fs24 d) Asistole
\plain\par
\pard\sl-412 \li356 \ri45 \expndtw-1 \f20 \fs24 Keadaan ini ditandai dengan tida
k terdapatnya aktifitas listrik pada jantung,
\plain\expndtw1 \f20 \fs24 dan pada monitor irama yang terbentuk adalah seperti
garis lurus. Pada
\plain\par
\pard\sl-417 \li356 \ri1516 \expndtw-3 \f20 \fs24 kondisi ini tindakan yang haru
s segera diambil adalah CPR.
\par
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}}}
\cols2\colno1\colw5244\colsr26\colno2\colw2928
\plain\pard\sl-351 \li2650 \ri600 \expndtw-17 \b \f10 \fs18 Henti Jantung Tanpa
Nadi
\plain\par
\pard\sl-254 \li2650 \ri108 \fi359 \expndtw-5 \f10 \fs18 a) BLS algoritma: memin
ta
\plain\par
\pard\sl-254 \li3010 \ri211 \fi360 \expndtw-15 \f10 \fs18 bantuan, lakukan CPR.
\plain\par
\pard\sl-249 \li3010 \ri0 \expndtw-5 \f10 \fs18 b) Beri oksigen bila tersedia.
\plain\par
\pard\sl-254 \li3010 \ri72 \expndtw-4 \f10 \fs18 c) Pasang monitor jantung.
\par
\column
\plain\pard\sl-289 \li0 \ri2535 \expndtw-13 \f10 \fs22 1
\par
\sect\sectd\sbknone\cols6\colno1\colw112\colsr329\colno2\colw111\colsr228\colno3
\colw544\colsr1466\colno4\colw1977\colsr1833\colno5\colw874\colsr325\colno6\colw
394
\plain\sl-124\fs12\par\sl-240\fs24\par\par\par\par\par\pard\pard\sl-220 \li0 \ri
0 \expndtw-13 \f10 \fs22 4
\par
\column
\plain\sl-278\fs28\par\sl-240\fs24\par\pard\pard\sl-220 \li0 \ri0 \expndtw-13 \f
10 \fs22 3
\par
\column
\plain\sl-230\fs23\par\sl-240\fs24\par\par\pard\pard\sl-220 \li0 \ri0 \expndtw-2
6 \f10 \fs22 VF/VT
\par
\column
\plain\sl-283\fs28\par\sl-240\fs24\par\pard\pard\sl-355 \li0 \ri0 \expndtw-9 \f1
0 \fs22 2\b \dn8 \fs18 Periksa\dn0 irama jantung,
\plain\par
\pard\sl-254 \li0 \ri376 \fi297 \expndtw-15 \b \f10 \fs18 perlu defibrilasi?
\par
\column
9 \b \f10 \fs18 Asistol/PEA
\par
\column
\plain\sl-144\fs14\par\sl-240\fs24\par\par\pard\pard\sl-220 \li0 \ri254 \expndtw
-13 \f10 \fs22 9
\par
\sect\sectd\sbknone\cols3\colno1\colw2971\colsr1881\colno2\colw2917\colsr173\col
no3\colw255
\plain\pard\sl-268 \li135 \ri1463 \expndtw-18 \b \f10 \fs18 Beri 1 kali shock
\plain\par
\pard\sl-254 \li135 \ri0 \fi359 \expndtw-5 \f10 \fs18 a) Manual biphasic: dng uk
uran
\plain\par
\pard\sl-254 \li495 \ri680 \fi360 \expndtw-15 \f10 \fs18 khusus (120-200 J)
\plain\par
\pard\sl-249 \li495 \ri235 \expndtw-7 \f10 \fs18 b) AED : dng ukuran khusus.
\plain\par
\pard\sl-254 \li495 \ri673 \expndtw-4 \f10 \fs18 c) Monophasic: 360 J
\plain\par
\pard\sl-259 \li135 \ri1213 \expndtw-20 \b \f10 \fs18 Lakukan CPR segera
\par
\column
\plain\pard\sl-336 \li0 \ri146 \expndtw-16 \f10 \fs18 Lakukan CPR segera sebanya
k 5 siklus
\plain\par
\pard\sl-249 \li0 \ri558 \expndtw-9 \f10 \fs18 Ketika telah tersedia IV/IO, beri
\plain\par
\pard\sl-254
IO,
\plain\par
\pard\sl-254
1 dosis
\plain\par
\pard\sl-249
\plain\par
\pard\sl-254
\plain\par
\pard\sl-254
V/IO
\plain\par
\pard\sl-249
ensi
\li0 \ri238 \expndtw-11 \f10 \fs18 vasopresor. Epinephrine 1 mg IV/

\li0 \ri0 \expndtw-10 \f10 \fs18 ulangi setiap 3-5 menit atau beri
\li0 \ri615 \expndtw-10 \f10 \fs18 vasopresin 40 unit IV/IO untuk
\li0 \ri479 \expndtw-11 \f10 \fs18 menggantikan epinephrine dosis
\li0 \ri20 \expndtw-10 \f10 \fs18 pertama dan kedua. Atropin 1 mg I
\li0 \ri229 \expndtw-11 \f10 \fs18 untuk asistol atau PEA dng freku
\par
\column
\par
\sect\sectd\sbknone\cols4\colno1\colw112\colsr51\colno2\colw111\colsr243\colno3\
colw1679\colsr2654\colno4\colw3346
3 \f10 \fs22 6
\par
\column
\par
\column
\plain\pard\sl-187 \li0 \ri0 \expndtw-16 \b \f10 \fs18 Periksa irama jantung,
\plain\par
\pard\sl-249 \li0 \ri376 \expndtw-15 \b \f10 \fs18 perlu defibrilasi?
\par
\column
\plain\pard\sl-254 \li0 \ri392 \expndtw-9 \f10 \fs18 lambat, ulangi tiap 3-5 men
it ( sampai 3
\plain\par
\pard\sl-254 \li0 \ri2625 \expndtw-18 \f10 \fs18 dosis)
\par
\sect\sectd\sbknone\cols4\colno1\colw3474\colsr1955\colno2\colw222\colsr89\colno
3\colw1679\colsr110\colno4\colw667
\plain\pard\sl-225 \li135 \ri563 \expndtw-13 \f10 \fs18 Lanjutkan pemberian CPR
sementara
\plain\par
\pard\sl-254 \li135 \ri0 \expndtw-8 \f10 \fs18 defibrilator di-\i charge\i0 kem
udian berikan 1 kali
\plain\par
\pard\sl-249 \li135 \ri2587 \expndtw-19 \f10 \fs18 shock.
\plain\par
\pard\sl-254 \li135 \ri251 \expndtw-17 \b \f10 \fs18 Segera mulai lagi CPR Setel
ah pemberian
\plain\expndtw-10 \b \f10 \fs18 defibrilasi.\b0 Ketika IV/IO tersedia, berikan
\plain\par
\pard\sl-249 \li135 \ri1045 \expndtw-14 \f10 \fs18 vasopresor dan lanjutkan CPR
\plain\par
\pard\sl-254 \li135 \ri1059 \expndtw-10 \f10 \fs18 (sebelum/sesudah defibrilasi)
\plain\par
\pard\sl-254
O
\plain\par
\pard\sl-249
.
\plain\par
\pard\sl-254
n 1 dosis
\plain\par
\pard\sl-254
\li135 \ri814 \fi359 \expndtw-4 \f10 \fs18 a) Epinephrine 1 mg IV/I

\li495 \ri786 \fi360 \expndtw-10 \f10 \fs18 Ulangi setiap 3-5 menit
\li135 \ri328 \fi359 \expndtw-5 \f10 \fs18 b) Mungkin bisa diberika
\li855 \ri347 \expndtw-10 \f10 \fs18 vasopresin 40 unit IV/IO untuk
\plain\par
\pard\sl-249 \li855 \ri163 \expndtw-11 \f10 \fs18 menggantikan dosis pertama dan
\plain\par
\pard\sl-254 \li855 \ri782 \expndtw-10 \f10 \fs18 kedua dari epinephrine.
\plain\par
\sl-316\fs32\par\sl-240\fs24\par\pard\pard\sl-355 \li135 \ri784 \fi499 \expndtw10 \f10 \fs22 7\b \dn8 \fs18 Periksa\dn0 irama jantung,
\par
\column
\plain\sl-235\fs23\par\sl-240\fs24\par\par\par\par\par\par\par\par\par\par\par\p
ar\par\par\par\pard\pard\sl-220 \li0 \ri0 \expndtw-30 \f10 \fs22 12
\par
\column
\plain\sl-239\fs24\par\sl-240\fs24\par\par\par\par\par\par\pard\pard\sl-249 \li0
\ri0 \expndtw-16 \b \f10 \fs18 Periksa irama jantung,
\plain\par
\pard\sl-249 \li0 \ri376 \expndtw-15 \b \f10 \fs18 perlu defibrilasi?
\par
\column
\plain\sl-206\fs21\par\sl-240\fs24\par\par\par\par\par\pard\pard\sl-220 \li0 \ri
400 \expndtw-30 \f10 \fs22 11
\par
\sect\sectd\sbknone\cols4\colno1\colw112\colsr809\colno2\colw1261\colsr2233\coln
o3\colw2285\colsr757\colno4\colw740
\plain\sl-249\fs25\par\sl-240\fs24\par\pard\pard\sl-220 \li0 \ri0 \expndtw-13 \f
10 \fs22 8
\par
\column
\plain\pard\sl-249 \li0 \ri0 \expndtw-15 \b \f10 \fs18 perlu defibrilasi?
\par
\column
\plain\pard\sl-187 \li0 \ri0 \expndtw-12 \f10 \fs18 a).Jika asistol kembali ke b
ox10
\plain\par
\pard\sl-254 \li0 \ri46 \expndtw-9 \f10 \fs18 b).Jika ada aktifitas kelistrikan,
\plain\par
\pard\sl-249 \li0 \ri311 \expndtw-10 \f10 \fs18 periksa nadi, jika tidak ada
\par
\column
\plain\sl-144\fs14\par\pard\pard\sl-254 \li0 \ri131 \expndtw-17 \f10 \fs18 Kemba
li
\plain\expndtw-17 \f10 \fs18 ke box 4
\par
\sect\sectd\sbknone\cols3\colno1\colw3856\colsr171\colno2\colw3691\colsr191\coln
o3\colw288
\plain\pard\sl-249 \li58 \ri41 \expndtw-12 \f10 \fs18 Lanjutkan CPR , lakukan de
fibrilasi 1X. Segera mulai
\plain\par
\pard\sl-254 \li58 \ri364 \expndtw-11 \f10 \fs18 lagi CPR setelah pamberian defi
brilasi. Berikan
\plain\par
\pard\sl-254 \li58 \ri124 \expndtw-12 \f10 \fs18 bersamaan dng CPR (sebelum/sesu
dah defibrilasi)
\plain\par
\pard\sl-249 \li58 \ri558 \expndtw-11 \f10 \fs18 amiodrone 300mg IV/IO, kemudian
siapkan
\plain\par
\pard\sl-254 \li58 \ri0 \expndtw-10 \f10 \fs18 kemungkinan tambahan 150 mg, atau
lidocain 1-1,5
\plain\expndtw-11 \f10 \fs18 mg/kg BB dosis pertama, kemudian 0,5-0,75 mg/kg
\plain\par
\pard\sl-249 \li58 \ri2923 \expndtw-17 \f10 \fs18 (max 3)
\par
\column
\plain\pard\sl-235 \li388 \ri1376 \expndtw-11 \f10 \fs18 nadi, kembali ke box 10
.
\plain\par
\pard\sl-254 \li388 \ri1050 \expndtw-10 \f10 \fs18 c). Jika nadi teraba, lanjutk
an
\plain\par
\pard\sl-249 \li388 \ri1047 \expndtw-10 \f10 \fs18 ke perawatan post resusitasi.
\plain\par
\sl-270\fs27\par\pard\pard\sl-278 \li0 \ri0 \expndtw-3 \f20 \fs24 (Diklat Ambula
ns Gawat Darurat 118,
\plain\par
\pard\sl-278 \li0 \ri2655 \fi120 \expndtw-11 \f20 \fs24 2010).
\par
\column
\par
\sect\sectd\sbknone\plain\sl-208\fs21\par\pard\pard\sl-278 \li2559 \ri1752 \expn
dtw-3 \f20 \fs24 Skema 2.1 Algoritma penatalaksanaan
\plain\par
\pard\sl-278 \li2559 \ri2206 \fi561 \expndtw-4 \f20 \fs24 henti jantung pada ari
thmia
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
00110806da04d803012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-300 \li5 \ri6208 \expndtw-7 \b \f20 \fs24 5. Prognosis
\par
\plain\pard\sl-412 \li5 \ri47 \fi720 \expndtw0 \f20 \fs24 Kematian otak dan kema
tian permanen dapat terjadi hanya dalam jangka
\plain\expndtw0 \f20 \fs24 waktu 8 sampai 10 menit dari seseorang tersebut menga
lami henti jantung (Diklat
\par
\plain\pard\sl-412 \li5 \ri43 \expndtw0 \f20 \fs24 Ambulans Gawat Darurat 118,20
10).
\plain\tx4058 \tab \expndtw1 \f20 \fs24 Kondisi tersebut dapat dicegah dengan
\par
\plain\pard\sl-412 \li5 \ri44 \expndtw0 \f20 \fs24 pemberian resusitasi jantung
paru dan defibrilasi segera (sebelum melebihi batas
\plain\par
\pard\sl-417 \li5 \ri46 \expndtw2 \f20 \fs24 maksimal waktu untuk terjadinya ker
usakan otak), untuk secepat mungkin
\plain\par
\pard\sl-412 \li5 \ri49 \expndtw-2 \f20 \fs24 mengembalikan fungsi jantung norma
l. Resusitasi jantung paru dan defibrilasi yang
\plain\expndtw1 \f20 \fs24 diberikan antara 5 sampai 7 menit dari korban mengala
mi henti jantung, akan
\plain\expndtw0 \f20 \fs24 memberikan kesempatan korban untuk hidup rata-rata se
besar 30% sampai 45 %.
\plain\par
\pard\sl-417 \li5 \ri45 \expndtw1 \f20 \fs24 Sebuah penelitian menunjukkan bahwa
dengan penyediaan defibrillator yang
\plain\par
\pard\sl-412 \li5 \ri39 \expndtw2 \f20 \fs24 mudah\i diakses\i0 di tempat-temp
at umum seperti pelabuhan udara, dalam arti
\plain\expndtw2 \f20 \fs24 meningkatkan kemampuan untuk bisa memberikan pertolon
gan (defibrilasi)
\plain\expndtw0 \f20 \fs24 sesegera mungkin, akan meningkatkan kesempatan hidup
rata-rata bagi korban
\plain\par
\pard\sl-417 \li5 \ri1728 \expndtw-3 \i \f20 \fs24 cardiac arrest\i0 sebesar 64
% (American Heart Assosiacion.2010).
\plain\par
\f20 \fs24 6. Resusitasi Jantung Paru /\i Cardio Pulmonary Resusitation
\plain\par
\pard\sl-412 \li5 \ri5666 \fi422 \expndtw-2 \b \f20 \fs24 a. Pengertian
\plain\par
\pard\sl-412 \li456 \ri45 \fi446 \expndtw1 \f20 \fs24 Menurut Wong, yang dikutip
dalam (Krisanty.dkk, 2009), Resusitasi
\plain\expndtw0 \f20 \fs24 Jantung-Paru (RJP) adalah suatu cara untuk memfungsik
an kembali jantung
\plain\expndtw-9 \f20 \fs24 dan paru.
\plain\par
\pard\sl-412 \li456 \ri49 \fi446 \expndtw-1 \i \f20 \fs24 Cardio Pulmonary Resus
itation\i0 (CPR) adalah suatu teknik bantuan hidup
\plain\par
\pard\sl-417 \li5 \ri37 \fi451 \expndtw0 \f20 \fs24 dasar yang bertujuan untuk m
emberikan oksigen ke otak dan jantung sampai
\par
\plain\pard\sl-412 \li456 \ri41 \expndtw1 \f20 \fs24 ke kondisi layak, dan
\plain\tx2962 \tab \expndtw1 \f20 \fs24 mengembalikan fungsi jantung dan pernafa
san ke
\par
\plain\pard\sl-412 \li456 \ri4238 \expndtw-3 \f20 \fs24 kondisi normal(Nettina,
2006).
\plain\par
\sl-115\fs11\par\sl-240\fs24\par\par\pard\pard\sl-240 \li456 \ri2957 \expndtw-3
\b \f20 \fs24 b. Prosedur\i Cardio Pulmonary Resusitation
\plain\par
\pard\sl-408 \li456 \ri43 \fi441 \expndtw2 \f20 \fs24 Pada penanganan korban\i
cardiac arrest\i0 dikenal istilah rantai untuk
\plain\par
\pard\sl-412 \li456 \ri44 \expndtw1 \f20 \fs24 bertahan hidup (\i chin of surviv
al\i0 ); cara untuk menggambarkan penanganan
\plain\expndtw0 \f20 \fs24 ideal yang harus diberikan ketika ada kejadian\i car
diac arrest\i0 . Jika salah satu
\plain\par
\pard\sl-417 \li456 \ri45 \expndtw0 \f20 \fs24 dari rangkaian ini terputus, maka
kesempatan korban untuk bertahan hidup
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
00110806da04d803012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-295 \li36 \ri42 \expndtw3 \f20 \fs24 menjadi berkurang, sebalikny
a jika rangkaian ini kuat maka korban
\plain\par
\pard\sl-417 \li36 \ri1966 \expndtw-3 \f20 \fs24 mempunyai kesempatan besar untu
k bisa bertahan hidup.
\plain\par
\pard\sl-412 \li36 \ri41 \fi446 \expndtw-2 \f20 \fs24 Menurut (Thygerson,2006),
dia berpendapat bahwa\i chin of survival\i0 terdiri
\plain\expndtw-1 \f20 \fs24 dari 4 rangkaian:\i early acces, early CPR, early d
efibrillator,\i0 dan\i early advance
\plain\expndtw-15 \i \f20 \fs24 care.
\plain\par
\pard\sl-417 \li36 \ri46 \fi859 \expndtw0 \f20 \fs24 a.\i Early acces\i0 : kema
mpuan untuk mengenali/mengidentifikasi gejala
\plain\par
\pard\sl-412 \li1256 \ri46 \expndtw2 \f20 \fs24 dan tanda awal serta segera mema
nggil pertolongan untuk
\plain\expndtw-5 \f20 \fs24 mengaktifasi EMS.
\plain\par
\pard\sl-412 \li36 \ri48 \fi859 \expndtw2 \f20 \fs24 b.\i Early CPR\i0 : CPR ak
an mensuplai sejumlah minimal darah ke
\plain\par
\pard\sl-417 \li1256 \ri42 \expndtw0 \f20 \fs24 jantung dan otak, sampai defibri
lator dan petugas yang terlatih
\plain\par
\pard\sl-412 \li1256 \ri4457 \expndtw-5 \f20 \fs24 tersedia/datang.
\plain\par
\pard\sl-412 \li36 \ri39 \fi859 \expndtw0 \f20 \fs24 c.\i Early defibrillator\i
0 : pada beberapa korban, pemberian defibrilasi
\plain\par
\pard\sl-412 \li896 \ri423 \fi360 \expndtw-3 \f20 \fs24 segera ke jantung korban
bisa mengembalikan denyut jantung.

\plain\par
\pard\sl-417 \li36 \ri45 \fi859 \expndtw2 \f20 \fs24 d.\i Early advance care\i0
: pemberian terapi IV, obat-obatan, dan
\plain\par
\pard\sl-412 \li627 \ri2113 \fi628 \expndtw-3 \f20 \fs24 ketersediaan peralatan
bantuan pernafasan.
\plain\par
\pard\sl-412 \li36 \ri41 \fi590 \expndtw1 \f20 \fs24 Ketika jantung seseorang be
rhenti berdenyut, maka dia memerlukan
\plain\expndtw0 \f20 \fs24 tindakan CPR segera. CPR adalah suatu tindakan untuk
memberikan oksigen
\par
\plain\pard\sl-417 \li36 \ri46 \expndtw0 \f20 \fs24 ke paru-paru
\plain\tx1621 \tab \expndtw2 \f20 \fs24 dan mengalirkan darah ke jantung dan ota
k dengan cara
\par
\plain\pard\sl-412 \li36 \ri46 \expndtw-2 \f20 \fs24 kompresi dada. Pemberian CP
R hampir sama antara bayi (0-1 tahun), anak(1-8
\par
\plain\pard\sl-412 \li36 \ri40 \expndtw-11 \f20 \fs24 tahun),
\plain\tx954 \tab \expndtw-23 \f20 \fs24 dan
\plain\tx1540 \tab \expndtw-12 \f20 \fs24 dewasa
\plain\tx2491 \tab \expndtw1 \f20 \fs24 (8 tahun/lebih),
\plain\tx4395 \tab \expndtw-14 \f20 \fs24 hanya
\plain\tx5211 \tab \expndtw-12 \f20 \fs24 dengan
\plain\tx6143 \tab \expndtw-11 \f20 \fs24 sedikit
\plain\tx7012 \tab \expndtw-10 \f20 \fs24 variasi
\par
\plain\pard\sl-412 \li12 \ri5309 \fi24 \expndtw-5 \f20 \fs24 (Thygerson,2006).
\plain\par
\pard\sl-417 \li36 \ri42 \fi532 \expndtw-1 \f20 \fs24 Sebelum pelaksanaan prosed
ur, nilai kondisi pasien secara berturut-turut:
\plain\par
\pard\sl-412 \li36 \ri40 \expndtw2 \f20 \fs24 pastikan pasien tidak sadar, pasti
kan tidak bernafas, pastikan nadi tidak
\plain\par
\pard\sl-412 \li36 \ri437 \expndtw-2 \f20 \fs24 berdenyut, dan interaksi yang ko
nstan dengan pasien (Krisanty. dkk,2009).
\plain\par
\pard\sl-412 \li12 \ri41 \fi528 \expndtw0 \f20 \fs24 Prosedur CPR menurut (Netti
na,2006;Thygerson,2006), adalah terdiri
\plain\par
\pard\sl-417 \li12 \ri3519 \expndtw-2 \f20 \fs24 dari\i airway, breathing\i0 d
an\i circulation\i0 :
\par
\plain\pard\sl-417 \li718 \ri176 \expndtw1 \b\i \f20 \fs24 a)\i0 Menentukan
\plain\tx2696 \tab \expndtw-9 \b \f20 \fs24 ketiadaan
\plain\tx3949 \tab \expndtw-6 \b \f20 \fs24 respon/Kebersihan
\plain\tx6134 \tab \expndtw-15 \b \f20 \fs24 Jalan
\plain\tx6912 \tab \expndtw-13 \b \f20 \fs24 Nafas
\plain\par
\pard\sl-412 \li718 \ri5101 \fi427 \expndtw-8 \b\i \f20 \fs24 (airway):
\par
\plain\pard\sl-407 \li1025 \ri42 \expndtw1 \f20 \fs24 (1). Yakinkan lingkungan t

elah aman, periksa ketiadaan respon
\plain\par
\pard\sl-417 \li1476 \ri49 \expndtw0 \f20 \fs24 dengan menepuk atau menggoyangka
n pasien sambil bersuara
\plain\par
\pard\sl-412 \li1476 \ri2433 \expndtw-8 \f20 \fs24 keras "Apakah anda baik-baik
saja?"
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
00110806da04d803012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-295 \li456 \ri49 \expndtw1 \f20 \fs24 Rasionalisasi: hal ini akan
mencegah timbulnya\i injury\i0 pada
\plain\par
\pard\sl-417 \li456 \ri1038 \expndtw-3 \f20 \fs24 korban yang sebenarnya masih d
alam keadaan sadar.
\plain\par
\pard\sl-412 \li5 \ri44 \expndtw0 \f20 \fs24 (2). Apabila pasien tidak berespon,
minta seseorang yang saat itu
\plain\par
\pard\sl-412 \li456 \ri48 \expndtw2 \f20 \fs24 bersama kita untuk minta tolong (
telp:118). Apabila kita
\plain\expndtw-1 \f20 \fs24 sendirian, korbannya dewasa dan di tempat itu tersed
ia telepon,
\plain\par
\pard\sl-417 \li456 \ri47 \expndtw1 \f20 \fs24 panggil 118. Apabila kita sendiri
, dan korbannya bayi/anak\plain\par
\pard\sl-412 \li456 \ri41 \expndtw0 \f20 \fs24 anak, lakukan CPR untuk 5 siklus
(2 menit), kemudian panggil
\plain\expndtw-17 \f20 \fs24 118.
\plain\par
\pard\sl-412 \li5 \ri40 \fi57 \expndtw0 \f20 \fs24 (3). Posisikan pasien\i supi
ne\i0 pada alas yang datar dan keras, ambil
\plain\par
\pard\sl-417 \li456 \ri46 \expndtw1 \f20 \fs24 posisi sejajar dengan bahu pasien
. Jika pasien mempunyai
\plain\par
\pard\sl-412 \li456 \ri47 \expndtw0 \f20 \fs24 trauma leher dan kepala, jangan g
erakkan pasien, kecuali bila
\plain\expndtw-5 \f20 \fs24 sangat perlu saja.
\plain\par
\pard\sl-412 \li456 \ri69 \expndtw-1 \f20 \fs24 Rasionalisasi: posisi ini memung
kinkan pemberi bantuan dapat
\plain\par
\pard\sl-417 \li456 \ri67 \expndtw0 \f20 \fs24 memberikan bantuan nafas dan komp
resi dada tanpa berubah
\plain\par
\pard\sl-412 \li456 \ri5067 \expndtw-11 \f20 \fs24 posisi.
\plain\par
\pard\sl-412 \li5 \ri4172 \fi62 \expndtw-5 \f20 \fs24 (4). Buka jalan nafas
\plain\par
\pard\sl-412 \li5 \ri40 \fi624 \expndtw-2 \f20 \fs24 (a).\i Head-tilt/chin-lift
maneuver:\i0 letakkan salah satu tangan di
\plain\par
\pard\sl-417 \li1085 \ri43 \expndtw1 \f20 \fs24 kening pasien, tekan kening ke a
rah belakang dengan
\plain\par
\pard\sl-412 \li1085 \ri43 \expndtw2 \f20 \fs24 menggunakan telapak tangan untuk
mendongakkan
\plain\expndtw0 \f20 \fs24 kepala pasien. Kemudian letakkan jari-jari dari tanga
n
\plain\expndtw-1 \f20 \fs24 yang lainnya di dagu korban pada bagian yang bertula
ng,
\plain\par
\pard\sl-417 \li1085 \ri625 \expndtw-3 \f20 \fs24 dan angkat rahang ke depan sam
pai gigi mengatub.
\plain\par
\pard\sl-412 \li1085 \ri65 \expndtw1 \f20 \fs24 Rasionalisasi: tindakan ini akan
membebaskan jalan
\plain\expndtw-4 \f20 \fs24 nafas dari sumbatan oleh lidah.
\plain\par
\pard\sl-412 \li5 \ri44 \fi624 \expndtw0 \f20 \fs24 (b).\i Jaw-thrust maneuver\
i0 : pegang sudut dari rahang bawah
\plain\par
\pard\sl-417 \li1085 \ri49 \expndtw-2 \f20 \fs24 pasien pada masing-masing sisin
ya dengan kedua tangan,
\plain\par
\pard\sl-412 \li1085 \ri310 \expndtw-3 \f20 \fs24 angkat mandibula ke atas sehin
gga kepala mendongak.
\plain\par
\pard\sl-412 \li1085 \ri43 \expndtw-2 \f20 \fs24 Rasionalisasi: teknik ini adala
h metode yang paling aman
\plain\expndtw0 \f20 \fs24 untuk membuka jalan nafas pada korban yang dicurigai
\plain\par
\pard\sl-417 \li1085 \ri2902 \expndtw-4 \f20 \fs24 mengalami trauma leher.
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
00110806da04d803012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-300 \li68 \ri3814 \expndtw-2 \b\i \f20 \fs24 b).\i0 Pernafasan (
\i Breathing)
\plain\par
\pard\sl-412 \li68 \ri41 \fi350 \expndtw2 \f20 \fs24 (1). Dekatkan telinga ke mu
lut dan hidung pasien, sementara
\plain\par
\pard\sl-412 \li994 \ri42 \expndtw0 \f20 \fs24 pandangan kita arahkan ke dada pa
sien, perhatikan apakah
\plain\expndtw1 \f20 \fs24 ada pergerakan naik turun dada dan rasakan adanya uda
ra
\plain\expndtw0 \f20 \fs24 yang berhembus selama\i expirasi.\i0 (Lakukan 5-10
detik). Jika
\plain\par
\pard\sl-417 \li994 \ri46 \expndtw0 \f20 \fs24 pasien bernafas, posisikan korban
ke posisi\i recovery\i0 (posisi
\plain\par
\pard\sl-412 \li994 \ri1955 \expndtw-3 \f20 \fs24 tengkurap, kepala menoleh ke s
amping).
\par
\plain\pard\sl-412
\plain\tx2602 \tab
\plain\tx3432 \tab
\plain\tx4864 \tab
\plain\tx5474 \tab
\plain\tx6137 \tab
\li994 \ri69 \expndtw-6 \f20 \fs24 Rasionalisasi:

\expndtw-13 \f20 \fs24 untuk
\expndtw-8 \f20 \fs24 memastikan
\expndtw-23 \f20 \fs24 ada
\expndtw-16 \f20 \fs24 atau
\expndtw-9 \f20 \fs24 tidaknya
\par
\plain\pard\sl-412 \li456 \ri3744 \fi537 \expndtw-5 \f20 \fs24 pernafasan sponta
n.
\plain\par
\pard\sl-417 \li456 \ri67 \expndtw-16 \f20 \fs24 (2).
\plain\tx1047 \tab \expndtw0 \f20 \fs24 Jika ternyata tidak ada, berikan bantuan
\fs22 pernafasan\i \fs24 mouth to
\par
\plain\pard\sl-412
\plain\tx1863 \tab
\plain\tx2535 \tab
\plain\tx3491 \tab
\plain\tx5104 \tab
\plain\tx6261 \tab
\li994 \ri69 \expndtw-14 \i \f20 \fs24 mouth

\expndtw-13 \f20 \fs24 dengan
\expndtw-7 \f20 \fs24 menggunakan
\expndtw-9 \f20 \fs24 amfubag.
\expndtw-13 \f20 \fs24 Selama
\par
\plain\pard\sl-412 \li994 \ri62 \expndtw0 \f20 \fs24 memberikan bantuan pernafas
an pastikan jalan nafas pasien
\plain\expndtw0 \f20 \fs24 terbuka dan tidak ada udara yang terbuang keluar. Ber
ikan
\plain\par
\pard\sl-417 \li994 \ri70 \expndtw-2 \f20 \fs24 bantuan pernafasan sebanyak dua
kali (masing-masing selama
\plain\par
\pard\sl-412 \li994 \ri4562 \expndtw-7 \f20 \fs24 2-4 detik).
\plain\par
\pard\sl-412 \li994 \ri47 \expndtw0 \f20 \fs24 Rasionalisasi: pemberian bantuan
pernafasan yang adekuat
\par
\plain\pard\sl-412
\plain\tx2536 \tab
\plain\tx3477 \tab
\plain\tx4183 \tab
\plain\tx5124 \tab
\plain\tx6636 \tab
\li994 \ri43 \expndtw-6 \f20 \fs24 diindikasikan

\expndtw-16 \f20 \fs24 dada
\expndtw-9 \f20 \fs24 terlihat
\expndtw-9 \f20 \fs24 mengembang
\expndtw-19 \f20 \fs24 dan
\par
\plain\pard\sl-417 \li994 \ri44 \expndtw0 \f20 \fs24 mengempis, terasa adanya ud
ara yang keluar dari jalan nafas
\plain\par
\pard\sl-412 \li994 \ri816 \expndtw-3 \f20 \fs24 dan terdengar adanya udara yang
keluar saat\i expirasi.
\par
\plain\pard\sl-417 \li10 \ri4996 \expndtw-2 \b\i \f20 \fs24 c). Circulation
\plain\par
\pard\sl-407 \li456 \ri41 \expndtw4 \f20 \fs24 Pastikan ada atau tidaknya denyut
nadi, sementara tetap
\plain\par
\pard\sl-417 \li456 \ri41 \expndtw0 \f20 \fs24 mempertahankan terbukanya jalan n
afas dengan\i head tilt-chin lift
\plain\par
\pard\sl-412 \li456 \ri42 \expndtw-1 \f20 \fs24 yaitu satu tangan pada dahi pasi
en, tangan yang lain meraba denyut
\plain\expndtw0 \f20 \fs24 nadi pada arteri carotis dan femoral selama 5 sampai
10 detik. Jika
\plain\expndtw-3 \f20 \fs24 denyut nadi tidak teraba, mulai dengan kompresi dada
.
\plain\par
\pard\sl-417 \li456 \ri42 \expndtw-2 \f20 \fs24 (1). Berlutut sedekat mungkin de
ngan dada pasien. Letakkan bagian
\plain\par
\pard\sl-412 \li908 \ri37 \expndtw0 \f20 \fs24 pangkal dari salah satu tangan pa
da daerah tengah bawah dari
\plain\expndtw-1 \f20 \fs24 sternum (2 jari ke arah cranial dari\i procecus xyp
hoideus\i0 ). Jari\plain\expndtw-3 \f20 \fs24 jari bisa saling menjalin atau dikeataskan menjauhi
dada.
\plain\par
\pard\sl-417 \li908 \ri40 \expndtw2 \f20 \fs24 Rasionalisasi: tumpuan tangan pen
olong harus berada di
\plain\par
\pard\sl-412 \li908 \ri34 \expndtw1 \f20 \fs24 sternum, sehingga tekanan yang di
berikan akan terpusat di
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
00110806da04d803012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-295 \li468 \ri46 \expndtw1 \f20 \fs24 sternum, yang mana akan men
gurangi resiko patah tulang
\plain\par
\pard\sl-417 \li468 \ri5003 \expndtw-12 \f20 \fs24 rusuk.
\plain\par
\pard\sl-412 \li16 \ri41 \expndtw2 \f20 \fs24 (2). Jaga kedua lengan lurus denga
n siku dan terkunci, posisi
\plain\par
\pard\sl-412 \li468 \ri47 \expndtw-1 \f20 \fs24 pundak berada tegak lurus dengan
kedua tangan, dengan cepat
\plain\expndtw0 \f20 \fs24 dan bertenaga tekan bagian tengah bawah dari sternum
pasien
\plain\par
\pard\sl-417 \li468 \ri2552 \expndtw-3 \f20 \fs24 ke bawah, 1 - 1,5 inch (3,8 5 cm)
\plain\par
\pard\sl-412 \li16 \ri39 \expndtw0 \f20 \fs24 (3). Lepaskan tekanan ke dada dan
biarkan dada kembali ke posisi
\plain\par
\pard\sl-412 \li468 \ri40 \expndtw2 \f20 \fs24 normal. Lamanya pelepasan tekanan
harus sama dengan
\plain\expndtw-2 \f20 \fs24 lamanya pemberian tekanan. Tangan jangan diangkat da
ri dada
\plain\par
\pard\sl-417 \li468 \ri3212 \expndtw-4 \f20 \fs24 pasien atau berubah posisi.
\plain\par
\pard\sl-412 \li468 \ri43 \expndtw0 \f20 \fs24 Rasionalisasi: pelepasan tekanan
ke dada akan memberikan
\plain\expndtw-3 \f20 \fs24 kesempatan darah mengalir ke jantung.
\plain\par
\pard\sl-412 \li16 \ri41 \expndtw2 \f20 \fs24 (4). Lakukan CPR dengan dua kali n
afas buatan dan 30 kali
\plain\par
\pard\sl-417 \li468 \ri48 \expndtw1 \f20 \fs24 kompresi dada. Ulangi siklus ini
sebanyak 5 kali(2 menit).
\plain\par
\pard\sl-412 \li468 \ri45 \expndtw1 \f20 \fs24 Kemudian periksa nadi dan pernafa
san pasien. Pemberian
\plain\expndtw4 \f20 \fs24 kompresi dada dihentikan jika: a).telah tersedia AED
\plain\expndtw0 \f20 \fs24 (Automated External Defibrillator). b). korban menunj
ukkan
\plain\par
\pard\sl-417 \li468 \ri39 \expndtw-1 \f20 \fs24 tanda kehidupan. c). tugas diamb
il alih oleh tenaga terlatih. d).
\plain\par
\pard\sl-412 \li468 \ri113 \expndtw-3 \f20 \fs24 penolong terlalu lelah untuk me
lanjutkan pemberian kompresi.
\plain\expndtw2 \f20 \fs24 Rasionalisasi: bantuan nafas harus dikombinasi dengan
\plain\expndtw-1 \f20 \fs24 kompresi dada. Periksa nadi di arteri carotis, jika
belum teraba
\plain\par
\pard\sl-417 \li468 \ri779 \expndtw-3 \f20 \fs24 lanjutkan pemberian bantuan naf
as dan kompresi dada.
\plain\par
\pard\sl-412 \li16 \ri45 \expndtw1 \f20 \fs24 (5). Sementara melakukan resusitas
i, secara simultan kita juga
\plain\par
\pard\sl-412 \li468 \ri39 \expndtw-2 \f20 \fs24 menyiapkan perlengkapan khusus r
esusitasi untuk memberikan
\plain\expndtw-4 \f20 \fs24 perawatan\i definitive.
\plain\par
\pard\sl-417 \li468 \ri46 \expndtw-2 \f20 \fs24 Rasionalisasi; perawatan definit
ive yaitu termasuk di dalamnya
\plain\par
\pard\sl-412 \li468 \ri44 \expndtw3 \f20 \fs24 pemberian defibrilasi, terapi oba
t-obatan, cairan untuk
\plain\expndtw1 \f20 \fs24 mengembalikan keseimbangan asam-basa, monitoring dan
\plain\expndtw-3 \f20 \fs24 perawatan oleh tenaga terlatih di ICU.
\par
\plain\pard\sl-417 \li16 \ri41 \expndtw-16 \f20 \fs24 (6).
\plain\tx602 \tab \expndtw0 \f20 \fs24 Siapkan defibrillator
\plain\tx2990 \tab \expndtw3 \f20 \fs24 atau AED (Automated External
\plain\par
\pard\sl-412 \li16 \ri3724 \fi451 \expndtw-4 \f20 \fs24 Defibrillator) segera.
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
00110806da04d803012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-295 \li432 \ri50 \fi590 \expndtw2 \f20 \fs24 CPR yang diberikan p
ada anak hanya menggunakan satu tangan,
\plain\par
\pard\sl-417 \li432 \ri38 \expndtw0 \f20 \fs24 sedangkan untuk bayi hanya menggu
nakan jari telunjuk dan tengah. Ventrikel
\plain\par
\pard\sl-412 \li432 \ri43 \expndtw1 \f20 \fs24 bayi dan anak terletak lebih ting
gi dalam rongga dada, jadi tekanan harus
\plain\expndtw-3 \f20 \fs24 dilakukan di bagian tengah tulang dada.
\plain\par

\f20 \fs24 B. Konsep Kesiapan
\plain\par
\pard\sl-412 \li5 \ri6047 \expndtw-2 \b \f20 \fs24 1. Pengertian
\plain\par
\pard\sl-408 \li5 \ri45 \fi657 \expndtw1 \f20 \fs24 Kesiapan adalah keseluruhan
kondisi seseorang yang membuatnya siap
\plain\par
\pard\sl-412 \li5 \ri46 \expndtw0 \f20 \fs24 untuk memberi respon atau jawaban d
engan cara tertentu terhadap suatu situasi.
\plain\par
\pard\sl-417 \li5 \ri41 \expndtw0 \f20 \fs24 Penyesuaian kondisi pada suatu saat
akan berpengaruh atau kecenderungan untuk
\plain\par
\pard\sl-412 \li5 \ri4528 \expndtw-4 \f20 \fs24 memberi respon(Slameto,2003).
\plain\par
\pard\sl-412 \li5 \ri44 \fi657 \expndtw0 \f20 \fs24 Menurut Soemanto (1998), ada
orang yang mengartikan kesiapan sebagai
\plain\expndtw0 \f20 \fs24 suatu kesediaan seseorang untuk berbuat sesuatu. Seor
ang ahli bernama Cronbach
\plain\par
\pard\sl-417 \li5 \ri44 \expndtw-1 \f20 \fs24 memberikan pengertian tentang kesi
apan sebagai segenap sifat atau kekuatan yang
\plain\par
\pard\sl-412 \li5 \ri2454 \expndtw-3 \f20 \fs24 membuat seseorang dapat bereaksi
dengan cara tertentu.
\plain\par
\pard\sl-412 \li5 \ri44 \fi657 \expndtw1 \f20 \fs24 Wolff, dkk (2010), dalam Int
ernational Journal of Nursing menyatakan
\plain\expndtw-2 \f20 \fs24 bahwa penggunaan kata kesiapan\i (readiness)\i0 da
lam literature keperawatan tidaklah
\plain\par
\pard\sl-417 \li5 \ri46 \expndtw1 \f20 \fs24 didefinisikan dengan pasti dan dike
mbangkan sebagai suatu konsep. Terdapat
\plain\par
\pard\sl-412 \li5 \ri42 \expndtw0 \f20 \fs24 beberapa perspektif yang berbeda, t
ergantung dari sisi mana mereka memaknai
\plain\expndtw0 \f20 \fs24 kesiapan\i (readiness)\i0 tersebut. Selanjutnya mer
eka (Wolff.dkk,2010) mengartikan
\plain\expndtw0 \f20 \fs24 kesiapan menjadi empat tema pokok yaitu: mempunyai ke
mampuan dasar umum
\plain\par
\pard\sl-417 \li5 \ri45 \expndtw1 \f20 \fs24 dan kemampuan untuk menangani hal-h
al yang bersifat khusus, memberikan
\plain\par
\pard\sl-412 \li5 \ri43 \expndtw1 \f20 \fs24 perawatan yang aman kepada klien, m
ampu menghadapi atau bertahan dengan
\plain\expndtw0 \f20 \fs24 kenyataan sekarang dan kemungkinan-kemungkinan kedepa
n, serta mempunyai
\plain\expndtw-3 \f20 \fs24 keseimbangan antara pelaksanaan, pengetahuan dan ber
pikir.
\plain\par
\pard\sl-417 \li5 \ri45 \fi720 \expndtw-1 \f20 \fs24 a. Mempunyai kemampuan dasa
r umum dan kemampuan untuk menangani
\plain\par
\pard\sl-412 \li1085 \ri44 \expndtw0 \f20 \fs24 hal-hal yang bersifat khusus. Pe
rawat dituntut tidak hanya siap dalam
\plain\expndtw0 \f20 \fs24 kondisi stabil dan sesuatu yang sudah biasa saja, tet
api juga dalam hal\plain\expndtw0 \f20 \fs24 hal bersifat khusus yang memerlukan konsentrasi tingg
i dan keadaan
\plain\par
\pard\sl-417 \li1085 \ri3670 \expndtw-4 \f20 \fs24 yang sedang berubah dan baru.
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
00110806da04d803012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-295 \li5 \ri45 \fi720 \expndtw0 \f20 \fs24 b. Memberikan perawata
n yang aman kepada klien. Pemberian perawatan
\plain\par
\pard\sl-417 \li1085 \ri40 \expndtw0 \f20 \fs24 yang aman kepada klien merupakan
suatu komponen yang penting dari

\plain\par
\pard\sl-412 \li1085 \ri41 \expndtw-1 \f20 \fs24 praktek keperawatan. Seorang pe
rawat yang dikatakan siap mempunyai
\plain\expndtw0 \f20 \fs24 alasan yang menyakinkan kenapa dia memutuskan untuk m
elakukan
\plain\expndtw-1 \f20 \fs24 suatu tindakan keperawatan dan mendemonstrasikan kem
ampuan untuk
\plain\par
\pard\sl-417 \li1085 \ri51 \expndtw0 \f20 \fs24 melaksanakan praktek keperawatan
sesuai dengan etika, penuh kehati\plain\par
\pard\sl-412 \li1085 \ri4829 \expndtw-5 \f20 \fs24 hatian, dan aman.
\plain\par
\pard\sl-412 \li5 \ri41 \fi720 \expndtw2 \f20 \fs24 c. Mampu menghadapi atau ber
tahan dengan kenyataan sekarang dan
\plain\par
\pard\sl-412 \li1085 \ri44 \expndtw0 \f20 \fs24 kemungkinan-kemungkinan kedepan.
Perawat harus bisa menunjukkan
\plain\par
\pard\sl-417 \li1085 \ri49 \expndtw1 \f20 \fs24 bahwa mereka mampu bekerja (berf
ungsi) dengan realitas yang ada
\plain\par
\pard\sl-412 \li1085 \ri45 \expndtw0 \f20 \fs24 sekarang, dengan segala keterbat
asannya, dan mereka juga harus bisa
\plain\expndtw0 \f20 \fs24 beradaptasi terhadap suatu yang baru dan perubahan-pe
rubahan yang
\plain\expndtw0 \f20 \fs24 terjadi dalam dunia kesehatan. Perawat mempunyai dasa
r pengetahuan
\plain\par
\pard\sl-417 \li1085 \ri47 \expndtw1 \f20 \fs24 yang baik untuk mengenali situas
i yang sedang terjadi dan mampu
\plain\par
\pard\sl-412 \li1085 \ri657 \expndtw-3 \f20 \fs24 memutuskan kapan mereka memerl
ukan bantuan jika dibutuhkan.
\plain\par
\pard\sl-412 \li5 \ri44 \fi720 \expndtw2 \f20 \fs24 d. Mempunyai keseimbangan an
tara pelaksanaan, pengetahuan dan
\plain\par
\pard\sl-412 \li1085 \ri44 \expndtw-1 \f20 \fs24 berpikir.\i Critical Thinking\
i0 yaitu kemampuan untuk membuat keputusan
\plain\par
\pard\sl-417 \li1085 \ri41 \expndtw0 \f20 \fs24 yang pasti dan hati-hati tentang
kondisi klien, adalah komponen kunci
\plain\par
\pard\sl-412 \li1085 \ri40 \expndtw-1 \f20 \fs24 dari kesiapan. Pelaksanaan tind
akan keperawatan harus didasari dengan
\plain\expndtw0 \f20 \fs24 kemampuan untuk berpikir kritis berdasarkan pengetahu
an yang cukup
\plain\expndtw-6 \f20 \fs24 dari perawat.
\plain\par
\sl-254\fs25\par\sl-240\fs24\par\pard\pard\sl-240 \li5 \ri45 \fi600 \expndtw0 \f
20 \fs24 Kesimpulan yang bisa diambil berdasarkan berbagai pendapat di atas adal
ah
\plain\par
\pard\sl-412 \li5 \ri42 \expndtw1 \f20 \fs24 bahwa kesiapan perawat adalah kemam
puan perawat untuk bisa berfikir kritis
\plain\expndtw0 \f20 \fs24 berdasarkan ilmu yang dimilikinya, bisa beradaptasi d
engan kondisi sekarang dan
\plain\expndtw0 \f20 \fs24 perkembangan dunia kesehatan, mampu memberikan asuhan
keperawatan yang
\plain\par
\pard\sl-417 \li5 \ri44 \expndtw-2 \f20 \fs24 aman bagi klien, dan siap menghada
pi kondisi pasien baik yang stabil maupun yang
\plain\par
\pard\sl-412 \li5 \ri4677 \expndtw-4 \f20 \fs24 memerlukan perhatian khusus.
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
00110806da04d803012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-300 \li5 \ri2902 \expndtw-2 \b \f20 \fs24 2. Faktor-faktor yang m
empengaruhi kesiapan.
\plain\par
\pard\sl-412 \li5 \ri63 \fi417 \expndtw0 \f20 \fs24 Kolaborasi yang efektif dan
kreatif dari sektor pendidikan, praktik klinik dan
\plain\expndtw0 \f20 \fs24 pembuat kebijakan sangat diperlukan untuk membentuk p
erawat yang siap, sesuai
\plain\expndtw0 \f20 \fs24 dengan standar kompetensi dan penampilan kerja yang d
iharapkan (Wolff dkk,
\par
\plain\pard\sl-412 \li5 \ri69 \expndtw-11 \f20 \fs24 2010).
\plain\tx920 \tab \expndtw1 \f20 \fs24 Faktor-faktor yang mempengaruhi kesiapan
terdiri dari pengetahuan,
\par
\plain\pard\sl-417 \li5 \ri54 \expndtw0 \f20 \fs24 pengalaman, peraturan/protoko
l yang jelas, sarana dan suplai yang cukup, serta
\plain\par
\pard\sl-412 \li5 \ri4181 \expndtw-3 \f20 \fs24 pelatihan/training (Wolff.dkk,20
10).
\plain\par
\pard\sl-412 \li5 \ri5588 \fi360 \expndtw0 \f20 \fs24 a) Pengetahuan
\plain\par
\pard\sl-412 \li725 \ri63 \expndtw-2 \f20 \fs24 Sektor pendidikan bertanggung ja
wab menyiapkan perawat yang siap secara
\plain\par
\pard\sl-417 \li725 \ri62 \expndtw1 \f20 \fs24 teori dan akademi. Membekali pera
wat dengan ilmu-ilmu keperawatan
\plain\par
\pard\sl-412 \li725 \ri110 \expndtw-2 \f20 \fs24 yang memadai dan menjadikannya
siap untuk terjun ke dunia praktik klinik.
\plain\par
\pard\sl-412 \li5 \ri5636 \fi360 \expndtw0 \f20 \fs24 b) Pengalaman
\plain\par
\pard\sl-412 \li725 \ri58 \expndtw0 \f20 \fs24 Sektor klinik berperan dalam memb
eri kesempatan atau tugas kepada staff
\plain\par
\pard\sl-417 \li725 \ri65 \expndtw0 \f20 \fs24 perawat dengan hal-hal baru dan p
enanganan situasi yang bersifat khusus
\plain\par
\pard\sl-412 \li725 \ri2436 \expndtw-3 \f20 \fs24 guna memperoleh pengalaman-pen
galaman baru.
\plain\par
\pard\sl-412 \li5 \ri3551 \fi360 \expndtw0 \f20 \fs24 c) Peraturan/protokol yang
jelas (SOP)
\plain\par
\pard\sl-412 \li725 \ri62 \expndtw1 \f20 \fs24 Pembuat kebijakan (Rumah Sakit),
mempunyai tanggung jawab untuk
\plain\par
\pard\sl-417 \li725 \ri59 \expndtw-2 \f20 \fs24 membuat kebijakan, peraturan dan
protokol yang jelas untuk dijalankan oleh
\plain\par
\pard\sl-412 \li725 \ri2402 \expndtw-3 \f20 \fs24 setiap staff perawat dalam men
jalankan tugasnya.
\plain\par
\pard\sl-412 \li5 \ri4114 \fi360 \expndtw0 \f20 \fs24 d) Sarana dan suplai yang
cukup
\plain\par
\pard\sl-412 \li725 \ri58 \expndtw0 \f20 \fs24 Pembuat kebijakan bertanggung jaw
ab terhadap ketersediaan sarana dan
\plain\par
\pard\sl-417 \li725 \ri5067 \expndtw-5 \f20 \fs24 suplai yang cukup.

\plain\par
\pard\sl-412 \li5 \ri5160 \fi360 \expndtw0 \f20 \fs24 e) Pelatihan/training
\plain\par
\pard\sl-412 \li725 \ri60 \expndtw2 \f20 \fs24 Pembuat kebijakan (Rumah sakit) m
empunyai tanggung jawab untuk
\plain\expndtw1 \f20 \fs24 pengembangan staff dengan pelatihan dan training untu
k meningkatkan
\plain\par
\pard\sl-417 \li725 \ri958 \expndtw-2 \f20 \fs24 respon staff perawat terhadap b
erbagai situasi (kegawatan pasien).
\plain\par
\f20 \fs24 C. Pengetahuan
\plain\par
\plain\par
\pard\sl-412 \li5 \ri44 \fi720 \expndtw0 \f20 \fs24 Pengetahuan adalah hasil "ta
hu" dan ini terjadi setelah orang melakukan
\plain\expndtw0 \f20 \fs24 penginderaan terhadap suatu objek tertentu, sedangkan
penginderaan ini terjadi
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
00110806da04d803012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-295 \li5 \ri46 \expndtw0 \f20 \fs24 melalui panca indera manusia
yakni indera penglihatan, pendengaran, penciuman,
\plain\par
\pard\sl-417 \li5 \ri45 \expndtw-2 \f20 \fs24 rasa dan raba yang sebagian besar
pengetahuan manusia diperoleh melalui mata dan
\plain\par
\pard\sl-412 \li5 \ri4868 \expndtw-4 \f20 \fs24 telinga(Notoatmodjo, 1993).
\plain\par
\pard\sl-412 \li5 \ri46 \fi720 \expndtw0 \f20 \fs24 Pengetahuan diperoleh dari s
ekumpulan informasi yang saling terhubung
\plain\expndtw0 \f20 \fs24 secara sistematik sehingga memiliki makna. Informasi
diperoleh dari data yang
\par
\plain\pard\sl-417 \li5 \ri46 \expndtw1 \f20 \fs24 sudah diolah, sehingga mempun
yai arti.
\plain\tx4492 \tab \expndtw1 \f20 \fs24 Selanjutnya data ini akan dimiliki
\par
\plain\pard\sl-412 \li5 \ri41 \expndtw-2 \f20 \fs24 seseorang seseorang dan akan
tersimpan dalam neuron-neuron (menjadi memori) di
\par
\plain\pard\sl-412 \li5 \ri45 \expndtw-10 \f20 \fs24 otaknya.
\plain\tx1146 \tab \expndtw2 \f20 \fs24 Kemudian ketika manusia dihadapkan pada
suatu masalah, maka
\par
\plain\pard\sl-412
\plain\tx1176 \tab
\plain\tx1892 \tab
\plain\tx3093 \tab
\plain\tx3938 \tab
\plain\tx5948 \tab
\plain\tx6548 \tab
\plain\tx7398 \tab
\li5 \ri45 \expndtw-8 \f20 \fs24 informasi

\expndtw-19 \f20 \fs24 yang
\expndtw-8 \f20 \fs24 tersimpan
\expndtw-13 \f20 \fs24 dalam
\expndtw-6 \f20 \fs24 neuron-neuronnya
\expndtw-21 \f20 \fs24 dan
\expndtw-10 \f20 \fs24 terkait
\par
\plain\pard\sl-417 \li5 \ri47 \expndtw1 \f20 \fs24 permasalahan tersebut, akan s
aling terhubung dan tersusun secara sistematik
\plain\par
\pard\sl-412 \li5 \ri47 \expndtw-2 \f20 \fs24 sehingga memiliki model untuk mema
hami atau memiliki pengetahuan yang terkait
\plain\expndtw0 \f20 \fs24 dengan permasalahan yang dihadapinya. Kemampuan memil
iki pengetahuan atas
\plain\expndtw1 \f20 \fs24 objek masalah yang dihadapi sangat ditentukan oleh pe
ngalaman, latihan atau
\plain\par
\pard\sl-417 \li5 \ri3237 \expndtw-3 \f20 \fs24 proses belajar(Tjakraatmadja dan
Lantu, 2006).
\plain\par
\f20 \fs24 2. Tingkat Pengetahuan
\plain\par
\pard\sl-407 \li5 \ri56 \fi720 \expndtw1 \f20 \fs24 Notoatmodjo (1993), membagi
tingkat pengetahuan yang dicapai dalam
\plain\par
\pard\sl-417 \li5 \ri3641 \expndtw-3 \f20 \fs24 domain kognitif menjadi 6 tingka
tan yaitu:
\plain\par
\pard\sl-412 \li5 \ri5935 \expndtw0 \f20 \fs24 a. Tahu\i (know)
\plain\par
\pard\sl-412 \li5 \ri40 \fi720 \expndtw2 \f20 \fs24 Tahu diartikan sebagai mengi
ngat suatu materi yang telah dipelajari
\plain\expndtw1 \f20 \fs24 sebelumnya. Pengetahuan tingkat ini adalah mengingat
kembali terhadap suatu
\plain\par
\pard\sl-417 \li5 \ri42 \expndtw2 \f20 \fs24 yang spesifik dari seluruh bahan ya
ng dipelajari atau rangsangan yang telah
\plain\par
\pard\sl-412 \li5 \ri52 \expndtw0 \f20 \fs24 diterima. Oleh sebab itu, ini merup
akan tingkat pengetahuan yang paling rendah.
\plain\expndtw1 \f20 \fs24 Untuk mengukur bahwa seseorang tahu tentang apa yang
dipelajari antara lain
\plain\par
\pard\sl-412 \li5 \ri933 \expndtw-3 \f20 \fs24 menyebutkan, menguraikan, mendefe
nisikan, menyatakan dan sebagainya
\plain\par
\pard\sl-417 \li5 \ri4492 \expndtw0 \f20 \fs24 b. Memahami\i (Comprehention)
\plain\par
\pard\sl-412 \li5 \ri45 \fi720 \expndtw0 \f20 \fs24 Memahami diartikan sebagai s
uatu kemampuan untuk menjelaskan secara
\plain\expndtw0 \f20 \fs24 benar tentang objek yang diketahui dan dapat menginte
rpretasikan materi tersebut
\plain\expndtw1 \f20 \fs24 secara benar, orang yang telah paham terhadap objek a
tau materi harus dapat
\plain\par
\pard\sl-417 \li5 \ri45 \expndtw0 \f20 \fs24 menjelaskan, menyebutkan contoh, me
nyimpulkan, meramalkan dan sebagainya
\plain\par
\pard\sl-412 \li5 \ri4670 \expndtw-4 \f20 \fs24 terhadap objek yang dipelajari.
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
00110806da04d803012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-295 \li5 \ri5089 \expndtw0 \f20 \fs24 c. Aplikasi\i (Application
)
\plain\par
\pard\sl-417 \li5 \ri47 \fi720 \expndtw0 \f20 \fs24 Aplikasi diartikan sebagai k
emampuan untuk menggunakan materi yang
\plain\par
\pard\sl-412 \li5 \ri49 \expndtw1 \f20 \fs24 telah dipelajari pada situasi atau
kondisi sebenarya, aplikasi ini diartikan dapat
\plain\expndtw2 \f20 \fs24 menggunakan hukum-hukum, rumus, metode, prinsip dan s
ebagainya dalam
\plain\expndtw-4 \f20 \fs24 konteks atau situasi yang lain.
\plain\par
\pard\sl-417 \li5 \ri5383 \expndtw0 \f20 \fs24 d. Analisis\i (Analysis)
\par
\plain\pard\sl-412
\plain\tx1662 \tab
\plain\tx2416 \tab
\plain\tx3827 \tab
\plain\tx4624 \tab
\plain\tx6104 \tab
\plain\tx7588 \tab
\par
\li725 \ri38 \expndtw-12 \f20 \fs24 Adalah

\expndtw-13 \f20 \fs24 suatu
\expndtw-9 \f20 \fs24 kemampuan
\expndtw-14 \f20 \fs24 untuk
\expndtw-8 \f20 \fs24 menjabarkan
\expndtw2 \f20 \fs24 materi atau
\expndtw-13 \f20 \fs24 suatu
\plain\pard\sl-412 \li5 \ri45 \expndtw-15 \f20 \fs24 objek

\plain\tx932 \tab \expndtw-10 \f20 \fs24 kedalam
\plain\tx2142 \tab \expndtw-5 \f20 \fs24 komponen-komponen,
\plain\tx4709 \tab \expndtw-10 \f20 \fs24 tetapi
\plain\tx5646 \tab \expndtw-15 \f20 \fs24 masih
\plain\tx6611 \tab \expndtw-12 \f20 \fs24 dalam
\plain\tx7580 \tab \expndtw-13 \f20 \fs24 suatu
\par
\plain\pard\sl-412 \li5 \ri41 \expndtw0 \f20 \fs24 struktur organisasi tersebut
dan masih ada kaitannya satu sama lain. Kemampuan
\plain\par
\pard\sl-417 \li5 \ri48 \expndtw2 \f20 \fs24 analisa ini dapat dilihat dari peng
gunaan kata kerja dapat menggambarkan,
\plain\par
\pard\sl-412 \li5 \ri42 \expndtw0 \f20 \fs24 membedakan, mengelompokkan dan seba
gainya. Analisis merupakan kemampuan
\plain\expndtw-3 \f20 \fs24 untuk mengidentifikasi, memisahkan dan sebagainya.
\plain\par
\pard\sl-412 \li5 \ri5489 \expndtw0 \f20 \fs24 e. Sintesa (Syntesis)
\plain\par
\pard\sl-417 \li5 \ri52 \fi720 \expndtw0 \f20 \fs24 Adalah suatu kemampuan untuk
meletakkan atau menggabungkan bagian\plain\par
\pard\sl-412 \li5 \ri41 \expndtw-1 \f20 \fs24 bagian dalam suatu bentuk keseluru
han yang baru. Dengan kata lain sintesis adalah
\plain\expndtw-2 \f20 \fs24 suatu kemampuan untuk menyusun formasi baru dari inf
ormasi-informasi yang ada,
\plain\expndtw0 \f20 \fs24 misalnya dapat menyusun, menggunakan, meringkas, dan
menyesuaikan terhadap
\plain\par
\pard\sl-417 \li5 \ri3869 \expndtw-3 \f20 \fs24 suatu teori atau rumusan yang te
lah ada.
\plain\par
\pard\sl-412 \li5 \ri5162 \expndtw0 \f20 \fs24 f. Evaluasi\i (Evaluation)
\plain\par
\pard\sl-412 \li5 \ri42 \fi720 \expndtw-1 \f20 \fs24 Evaluasi ini berkaitan deng
an kemampuan untuk melakukan justifikasi atau
\plain\expndtw0 \f20 \fs24 penilaian terhadap suatu materi atau objek. Penilaian
itu berdasarkan suatu kriteria
\plain\par
\pard\sl-417 \li5 \ri1602 \expndtw-3 \f20 \fs24 yang ditentukan sendiri atau men
ggunakan kriteria yang telah ada.
\plain\par
\f20 \fs24 D. Pengalaman
\plain\par
\pard\sl-412 \li5 \ri4815 \expndtw0 \b \f20 \fs24 1. Pengertian Pengalaman
\par
\plain\pard\sl-412
\plain\tx2156 \tab
\plain\tx2896 \tab
\plain\tx3784 \tab
\plain\tx4658 \tab
\plain\tx6209 \tab
\plain\tx7665 \tab
\li725 \ri63 \expndtw-8 \f20 \fs24 Pengalaman

\expndtw-13 \f20 \fs24 kerja
\expndtw-11 \f20 \fs24 adalah
\expndtw-11 \f20 \fs24 proses
\expndtw-7 \f20 \fs24 pembentukan
\expndtw-7 \f20 \fs24 pengetahuan
\par
\plain\pard\sl-412 \li5 \ri71 \expndtw-1 \f20 \fs24 ketrampilan tentang metode s
uatu pekerjaan karena keterlibatan karyawan tersebut

\plain\expndtw2 \f20 \fs24 dalam pelaksanaan tugas pekerjaan (Manulang,1984). Se
dangkan Knoers &
\plain\expndtw0 \f20 \fs24 Hadinoto (1999), mengartikan pengalaman sebagai suatu
proses pembelajaran dan
\plain\par
\pard\sl-417 \li5 \ri60 \expndtw0 \f20 \fs24 pertambahan perkembangan potensi be
rtingkah laku baik dari pendidikan formal
\plain\par
\pard\sl-412 \li5 \ri66 \expndtw1 \f20 \fs24 maupun non formal atau bisa diartik
an sebagai suatu proses yang membawa
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
00110806da04d803012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}

\plain\pard\sl-295 \li5 \ri60 \expndtw0 \f20 \fs24 seseorang kepada suatu pola t
ingkah laku yang lebih tinggi. Suatu pembelajaran
\plain\par
\pard\sl-417 \li5 \ri59 \expndtw1 \f20 \fs24 juga mencakup perubahaan yang relat
if tepat dari perilaku yang diakibatkan
\plain\par
\pard\sl-412 \li5 \ri1632 \expndtw-3 \f20 \fs24 pengalaman, pemahaman dan prakte
k(Knoers & Haditono, 1999).
\plain\par
\pard\sl-412 \li5 \ri65 \fi720 \expndtw0 \f20 \fs24 Dari uraian tersebut dapat d
isimpulkan, bahwa pengalaman adalah tingkat
\plain\expndtw0 \f20 \fs24 penguasaan pengetahuan serta ketrampilan seseorang da
lam pekerjaannya yang
\plain\par
\pard\sl-417 \li5 \ri64 \expndtw2 \f20 \fs24 didapatkan dari pendidikan formal m
aupun nonformal, sebagai proses yang
\plain\par
\pard\sl-412 \li5 \ri1764 \expndtw-3 \f20 \fs24 membawa seseorang kepada pola ti
ngkah laku yang lebih tinggi.
\plain\par
\f20 \fs24 2. Indikator dari Pengalaman
\plain\par
\pard\sl-412 \li5 \ri1316 \fi720 \expndtw-3 \f20 \fs24 Ada beberapa indikator pe
ngalaman kerja(Foster, 2001) yaitu:
\plain\expndtw-4 \f20 \fs24 a. Lama waktu/ masa kerja.
\plain\par
\pard\sl-412 \li288 \ri67 \expndtw1 \f20 \fs24 Ukuran tentang lama waktu atau ma
sa kerja yang telah ditempuh seseorang
\plain\expndtw0 \f20 \fs24 dapat memahami tugas - tugas suatu pekerjaan dan tela
h melaksanakan dengan
\plain\par
\pard\sl-417 \li288 \ri6662 \expndtw-15 \f20 \fs24 baik.
\plain\par
\pard\sl-412 \li5 \ri2494 \expndtw-3 \f20 \fs24 b. Tingkat pengetahuan dan keter
ampilan yang dimiliki.
\plain\par
\pard\sl-412 \li288 \ri63 \expndtw0 \f20 \fs24 Pengetahuan merujuk pada konsep,
prinsip, prosedur, kebijakan atau informasi
\plain\expndtw0 \f20 \fs24 lain yang dibutuhkan oleh karyawan. Pengetahuan juga
mencakup kemampuan
\plain\par
\pard\sl-417 \li288 \ri67 \expndtw0 \f20 \fs24 untuk memahami dan menerapkan inf
ormasi pada tanggung jawab pekerjaan.
\plain\par
\pard\sl-412 \li288 \ri64 \expndtw-1 \f20 \fs24 Sedangkan keterampilan merujuk p
ada kemampuan fisik yangdibutuhkan untuk
\plain\expndtw-3 \f20 \fs24 mencapai atau menjalankan suatu tugas atau pekerjaan
.
\plain\par
\pard\sl-412 \li5 \ri3159 \expndtw-3 \f20 \fs24 c. Penguasaan terhadap pekerjaan
dan peralatan.
\plain\par
\pard\sl-417 \li288 \ri63 \expndtw0 \f20 \fs24 Tingkat penguasaan seseorang dala
m pelaksanaan aspek-aspek tehnik peralatan
\plain\par
\pard\sl-412 \li288 \ri5235 \expndtw-5 \f20 \fs24 dan tehnik pekerjaan.
\plain\par
\f20 \fs24 E. Pelatihan (\i training\i0 )
\plain\par
\plain\par
\pard\sl-408 \li5 \ri46 \fi720 \expndtw1 \f20 \fs24 Sikula dalam Sumantri (2000)
, mengartikan pelatihan sebagai: "proses
\plain\par
\pard\sl-412 \li5 \ri47 \expndtw0 \f20 \fs24 pendidikan jangka pendek yang mengg
unakan cara dan prosedur yang sistematis
\plain\expndtw2 \f20 \fs24 dan terorganisir. Para peserta pelatihan akan mempela
jari pengetahuan dan
\plain\par
\pard\sl-417 \li5 \ri48 \expndtw2 \f20 \fs24 keterampilan yang sifatnya praktis
untuk tujuan tertentu". Nawawi (1997),
\plain\par
\pard\sl-412 \li5 \ri41 \expndtw0 \f20 \fs24 menyatakan bahwa pelatihan pada das
arnya adalah proses memberikan bantuan
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
00110806da04d803012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-295 \li5 \ri41 \expndtw1 \f20 \fs24 bagi para pekerja untuk mengu
asai keterampilan khusus atau membantu untuk
\plain\par
\pard\sl-417 \li5 \ri45 \expndtw0 \f20 \fs24 memperbaiki kekurangannya dalam mel
aksanakan pekerjaan. Fokus kegiatannya
\plain\par
\pard\sl-412 \li5 \ri44 \expndtw-2 \f20 \fs24 adalah untuk meningkatkan kemampua
n kerja dalam memenuhi kebutuhan tuntutan
\plain\expndtw-3 \f20 \fs24 cara bekerja yang paling efektif pada masa sekarang.
\plain\par
\pard\sl-412 \li5 \ri63 \fi748 \expndtw0 \f20 \fs24 Ivancevich (2008), mendefini
sikan pelatihan\i (training\i0 ) sebagai "sebuah
\plain\par
\pard\sl-417 \li5 \ri54 \expndtw1 \f20 \fs24 proses sistematis untuk mengubah pe
rilaku kerja seorang/sekelompok pegawai
\plain\par
\pard\sl-412 \li5 \ri60 \expndtw3 \f20 \fs24 dalam usaha meningkatkan kinerja or
ganisasi". Pelatihan terkait dengan
\plain\expndtw1 \f20 \fs24 keterampilan dan kemampuan yang diperlukan untuk peke
rjaan yang sekarang
\plain\expndtw0 \f20 \fs24 dilakukan. Pelatihan berorientasi ke masa sekarang da
n membantu pegawai untuk
\plain\par
\pard\sl-417 \li5 \ri58 \expndtw-2 \f20 \fs24 menguasai keterampilan dan kemampu
an (kompetensi) yang spesifik untuk berhasil
\plain\par
\pard\sl-412 \li5 \ri5555 \expndtw-5 \f20 \fs24 dalam pekerjaannya.
\plain\par
\f20 \fs24 2. Tujuan Pelatihan
\plain\par
\pard\sl-412 \li5 \ri505 \fi782 \expndtw-2 \f20 \fs24 Moekijat (1993), menjelask
an tujuan umum pelatihan sebagai berikut :
\par
\plain\pard\sl-412
\plain\tx2280 \tab
\plain\tx4163 \tab
\plain\tx5285 \tab
\plain\tx6390 \tab
\plain\tx7547 \tab
\li1123 \ri67 \expndtw1 \f20 \fs24 a. untuk

\expndtw-7 \f20 \fs24 mengembangkan
\expndtw-8 \f20 \fs24 keahlian,
\expndtw-10 \f20 \fs24 sehingga
\expndtw-9 \f20 \fs24 pekerjaan
\expndtw-14 \f20 \fs24 dapat
\par
\sect\sectd\sbknone\cols2\colno1\colw1299\colsr184\colno2\colw6676
\plain\sl-105\fs11\par\sl-240\fs24\par\par\pard\pard\sl-240 \li1123 \ri0 \expndt
w-28 \f20 \fs24 b.
\plain\par
\sl-110\fs11\par\sl-240\fs24\par\par\pard\pard\sl-240 \li1123 \ri8 \expndtw-27 \
f20 \fs24 c.
\par
\column
\plain\pard\sl-412 \li0 \ri1764 \expndtw-3 \f20 \fs24 diselesaikan dengan lebih
cepat dan lebih efektif.
\plain\par
\pard\sl-412 \li57 \ri68 \expndtw1 \f20 \fs24 untuk mengembangkan pengetahuan\i
,\i0 sehingga pekerjaan dapat
\plain\par
\pard\sl-417 \li0 \ri3574 \expndtw-4 \f20 \fs24 diselesaikan secara rasional.
\plain\par
\pard\sl-412 \li57 \ri62 \expndtw1 \f20 \fs24 untuk mengembangkan sikap\i ,\i0
sehingga menimbulkan kemauan
\plain\par
\pard\sl-412 \li0 \ri541 \expndtw-3 \f20 \fs24 kerjasama dengan teman-teman pega
wai dan dengan pimpinan.
\par
\sect\sectd\sbknone\plain\sl-115\fs11\par\sl-240\fs24\par\par\pard\pard\sl-240 \
li5 \ri5399 \expndtw-5 \b \f20 \fs24 3. Manfaat Pelatihan
\plain\par
\pard\sl-408 \li5 \ri67 \fi720 \expndtw1 \f20 \fs24 Robinson dalam Marzuki (1992
), mengemukakan pendapatnya tentang
\plain\par
\pard\sl-412 \li5 \ri4466 \expndtw-3 \f20 \fs24 manfat pelatihan sebagai berikut
:
\par
\plain\pard\sl-412 \li725 \ri67 \expndtw-27 \f20 \fs24 a.
\plain\tx1131 \tab \expndtw0 \f20 \fs24 Pelatihan sebagai alat untuk memperbaiki
kemampuan individu atau
\plain\par
\pard\sl-417 \li725 \ri1025 \fi412 \expndtw-3 \f20 \fs24 kelompok dengan harapan
memperbaiki performa organisasi.
\par
\plain\pard\sl-412 \li725 \ri59 \expndtw1 \f20 \fs24 b. Keterampilan tertentu di
ajarkan agar karyawan dapat melaksanakan
\plain\par
\pard\sl-412 \li725 \ri1893 \fi412 \expndtw-3 \f20 \fs24 tugas-tugas sesuai deng
an standar yang diinginkan.
\par
\plain\pard\sl-412 \li725 \ri68 \expndtw-27 \f20 \fs24 c.
\plain\tx1131 \tab \expndtw1 \f20 \fs24 Pelatihan juga dapat memperbaiki sikap-s
ikap terhadap pekerjaan,
\plain\par
\pard\sl-417 \li725 \ri3349 \fi412 \expndtw-4 \f20 \fs24 terhadap pimpinan atau
karyawan.
\par
\plain\pard\sl-412 \li725 \ri325 \expndtw0 \f20 \fs24 d. Manfaat lain dari pelat
ihan adalah memperbaiki standar keselamatan.
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
00110806da04d803012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-300 \li5 \ri49 \expndtw0 \b \f20 \fs24 F. Hubungan Antara Faktorfaktor yang Mempengaruhi Kesiapan Perawat
\plain\par
\pard\sl-417 \li5 \ri4230 \expndtw-4 \b \f20 \fs24 dalam Menangani\i Cardiac Ar
rest\i0 .
\plain\par
\sl-201\fs20\par\sl-240\fs24\par\pard\pard\sl-240 \li5 \ri38 \fi720 \expndtw0 \f
20 \fs24 Wolff, dkk.(2010), menyatakan ada beberapa faktor yang mempengaruhi
\plain\par
\pard\sl-417 \li5 \ri42 \expndtw-2 \f20 \fs24 kesiapan perawat, antara lain: pen
getahuan, pengalaman, dan training. Ketiga faktor
\plain\par
\pard\sl-412 \li5 \ri48 \expndtw0 \f20 \fs24 tersebut akan saling menguatkan unt
uk membentuk suatu kesiapan. Sebagaimana
\plain\expndtw0 \f20 \fs24 yang dikatakan oleh Tjakraatmadja & Lantu (2006), bah
wa kemampuan memiliki
\plain\expndtw-1 \f20 \fs24 pengetahuan atas objek masalah yang dihadapi sangat
ditentukan oleh pengalaman
\plain\par
\pard\sl-417 \li5 \ri4654 \expndtw-3 \f20 \fs24 dan latihan atau proses belajar.
\plain\par
\pard\sl-412 \li5 \ri45 \fi720 \expndtw1 \f20 \fs24 Pengetahuan sangat berhubung
an erat dengan kesiapan. Sebagai contoh
\plain\expndtw-2 \f20 \fs24 dalam kondisi seseorang menghadapi pasien\i cardiac
arrest\i0 , agar seseorang tersebut
\plain\expndtw0 \f20 \fs24 mampu mengambil keputusan terhadap apa yang akan dila
kukan, maka dia harus
\plain\par
\pard\sl-417 \li5 \ri48 \expndtw0 \f20 \fs24 mempunyai pengetahuan tentang\i ca
rdiac arrest,\i0 yaitu pada tingkat evaluasi yang
\plain\par
\pard\sl-412 \li5 \ri43 \expndtw-1 \f20 \fs24 merupakan tingkatan tertinggi dari
pengetahuan. Sebagaimana yang dikatakan oleh
\par
\plain\pard\sl-412
\plain\tx2310 \tab
\plain\tx3371 \tab
\plain\tx4116 \tab
\plain\tx5456 \tab
\plain\tx6628 \tab
\plain\tx7694 \tab
\li5 \ri38 \expndtw-5 \f20 \fs24 Notoadmodjo(1993);

\expndtw-9 \f20 \fs24 evaluasi
\expndtw-9 \f20 \fs24 merupakan
\expndtw-8 \f20 \fs24 tingkatan
\expndtw-8 \f20 \fs24 tertinggi
\expndtw-14 \f20 \fs24 dari
\par
\plain\pard\sl-412 \li5 \ri43 \expndtw1 \f20 \fs24 pengetahuan, adalah kemampuan
untuk melakukan justifikasi atau penilaian
\plain\par
\pard\sl-417 \li5 \ri44 \expndtw1 \f20 \fs24 terhadap suatu meteri atau objek, p
enilaian itu berdasarkan suatu kriteria yang
\plain\par
\pard\sl-412 \li5 \ri45 \expndtw0 \f20 \fs24 ditentukan sendiri atau menggunakan
kriteria yang telah ada. Kemampuan untuk
\plain\expndtw1 \f20 \fs24 menilai, kemampuan untuk berfikir kritis dan mengambi
l keputusan terhadap
\par
\plain\pard\sl-412
\plain\tx1110 \tab
\plain\tx1974 \tab
\plain\tx2949 \tab
\plain\tx3938 \tab
\plain\tx4702 \tab
\plain\tx5528 \tab
\plain\tx6272 \tab
\plain\tx7232 \tab
\li5 \ri42 \expndtw-9 \f20 \fs24 tindakan

\expndtw-11 \f20 \fs24 sesuai
\expndtw-10 \f20 \fs24 kondisi
\expndtw-14 \f20 \fs24 klien
\expndtw-11 \f20 \fs24 itulah
\expndtw-10 \f20 \fs24 disebut
\expndtw-9 \f20 \fs24 kesiapan
\par
\plain\pard\sl-417 \li5 \ri5741 \expndtw-5 \f20 \fs24 (Wolff.dkk,2010).
\plain\par
\pard\sl-412 \li5 \ri42 \fi720 \expndtw2 \f20 \fs24 Pengalaman merupakan faktor
penting yang mempengaruhi kesiapan
\plain\expndtw1 \f20 \fs24 seseorang, dalam arti akan lebih meningkatkan kemampu
an seseorang dalam
\plain\expndtw2 \f20 \fs24 menangani sesuatu. Pengalaman kerja dapat memperdalam

dan memperluas
\plain\par
\pard\sl-417 \li5 \ri47 \expndtw1 \f20 \fs24 kemampuan kerja. Semakin sering ses
eorang melakukan pekerjaan yang sama,
\plain\par
\pard\sl-412 \li5 \ri43 \expndtw2 \f20 \fs24 semakin terampil dan semakin cepat
dia menyelesaikan pekerjaan tersebut.
\plain\expndtw-2 \f20 \fs24 Semakin banyak macam pekerjaan yang dilakukan seseor
ang, pengalaman kerjanya
\plain\expndtw1 \f20 \fs24 semakin kaya dan luas, dan memungkinkan peningkatan k
inerja(Simanjutak,
\plain\par
\pard\sl-417 \li5 \ri5776 \expndtw-5 \f20 \fs24 Payama J. ,2005).
\plain\par
\pard\sl-412 \li5 \ri48 \fi777 \expndtw0 \f20 \fs24 Pendapat ahli yang lain meng
atakan bahwa pengalaman kerja seseorang
\plain\expndtw3 \f20 \fs24 menunjukkan jenis-jenis pekerjaan yang pernah dilakuk
an seseorang dan
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
00110806da04d803012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-295 \li5 \ri48 \expndtw0 \f20 \fs24 memberikan peluang yang besar
bagi seseorang untuk melakukan pekerjaan yang
\plain\par
\pard\sl-417 \li5 \ri45 \expndtw-2 \f20 \fs24 lebih baik. Semakin luas pengalama
n kerja seseorang, semakin terampil melakukan
\plain\par
\pard\sl-412 \li5 \ri47 \expndtw0 \f20 \fs24 pekerjaan dan semakin sempurna pola
berpikir dan sikap dalam bertindak untuk
\plain\expndtw0 \f20 \fs24 mencapai tujuan yang telah ditetapkan (Puspaningsih,A
. 2004). Dengan kata lain
\plain\expndtw0 \f20 \fs24 bahwa seorang yang berpengalaman akan lebih siap bila
dihadapkan pada suatu
\plain\par
\pard\sl-417 \li5 \ri5022 \expndtw-5 \f20 \fs24 beban masalah yang sama.
\plain\par
\pard\sl-412 \li5 \ri49 \fi720 \expndtw0 \f20 \fs24 Faktor lain yang mempengaruh
i kesiapan adalah training. Training yang
\plain\expndtw0 \f20 \fs24 mempunyai pengertian proses pendidikan jangka pendek
yang menggunakan cara
\plain\expndtw0 \f20 \fs24 dan prosedur yang sistematis dan terorganisir, menuru
t Sikula dalam ( Sumantri,
\plain\par
\pard\sl-417 \li5 \ri45 \expndtw-1 \f20 \fs24 2000), bertujuan untuk mengubah pe
rilaku kerja sekelompok pegawai dalam usaha
\plain\par
\pard\sl-412 \li5 \ri42 \expndtw2 \f20 \fs24 meningkatkan kinerja organisasi (Iv
ancevich,2008). Pelatihan yang efektif
\plain\expndtw0 \f20 \fs24 merupakan pelatihan yang berorientasi proses, dimana
organisasi tersebut dapat
\plain\expndtw0 \f20 \fs24 melaksanakan program-program yang sistematis untuk me
ncapai tujuan dan hasil
\plain\par
\pard\sl-417 \li5 \ri5620 \expndtw-5 \f20 \fs24 yang dicita-citakan.
\plain\par
\pard\sl-412 \li5 \ri48 \fi720 \expndtw-2 \f20 \fs24 Pelatihan efektif apabila p
elatihan tersebut dapat menghasilkan sumber daya
\plain\expndtw0 \f20 \fs24 manusia yang meningkat kemampuannya, keterampilan dan
perubahan sikap yang
\plain\expndtw0 \f20 \fs24 lebih mandiri.Keefektifan pelatihan akan mempengaruhi
kualitas kinerja sumber
\plain\par
\pard\sl-417 \li5 \ri44 \expndtw2 \f20 \fs24 daya manusia yang dihasilkannya. Si
mamora (1987), mengukur keefektifan
\plain\par
\pard\sl-412 \li5 \ri49 \expndtw0 \f20 \fs24 pendidikan dan pelatihan: 1)bagaima
na reaksi-reaksi/perasaan partisipan terhadap
\plain\expndtw0 \f20 \fs24 program; 2) peningkatan pengetahuan, keahlian, dan si
kap-sikap yang diperoleh
\plain\expndtw0 \f20 \fs24 sebagai hasil dari pelatihan; 3) perilaku perubahan-p
erubahan yang terjadi pada

\plain\par
\pard\sl-417 \li5 \ri47 \expndtw0 \f20 \fs24 pekerjaan sebagai akibat dari pelat
ihan; dan 4) hasil-hasil dampak pelatihan pada
\par
\plain\pard\sl-412 \li5 \ri45 \expndtw0 \f20 \fs24 keseluruhan yaitu
\plain\tx2105 \tab \expndtw1 \f20 \fs24 efektivitas organisasi atau pencapaian p
ada tujuan-tujuan
\par
\plain\pard\sl-412 \li5 \ri49 \expndtw0 \f20 \fs24 organisasional. Perawat yang
telah mendapatkan pelatihan penanganan\i cardiac
\plain\expndtw0 \i \f20 \fs24 arrest\i0 diharapkan mendapatkan peningkatan peng
etahuan, mempunyai keahlian
\plain\par
\pard\sl-417 \li5 \ri41 \expndtw0 \f20 \fs24 yang lebih meningkat seperti yang d
iajarkan dalam pelatihan, dan menunjukkan
\plain\par
\pard\sl-412 \li5 \ri49 \expndtw0 \f20 \fs24 adanya perubahan sikap yang lebih s
iap bila sewaktu-waktu ada kejadian\i cardiac
\plain\expndtw-4 \i \f20 \fs24 arrest\i0 di tempat kerjanya.
\par
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}}}
\plain\pard\sl-300 \li5 \ri4992 \expndtw-2 \b \f20 \fs24 G. Kerangka Teori
\par
\sect\sectd\sbknone\cols2\colno1\colw3554\colsr1477\colno2\colw2528
\plain\sl-297\fs30\par\sl-240\fs24\par\par\par\pard\pard\sl-240 \li5 \ri0 \fi182
\expndtw-4 \f20 \fs24 Faktor-faktor yang mempengaruhi:
\plain\par
\sl-283\fs28\par\pard\pard\sl-240 \li5 \ri95 \fi542 \expndtw0 \f20 \fs24 1.\b P
engetahuan\b0 penanganan
\plain\par
\pard\sl-412 \li548 \ri1099 \fi360 \expndtw-6 \i \f20 \fs24 cardiac arrest.
\plain\par
\pard\sl-412 \li5 \ri239 \fi542 \expndtw0 \f20 \fs24 2.\b Pengalaman\b0 menang
ani
\plain\par
\plain\par
\pard\sl-412 \li5 \ri237 \fi542 \expndtw0 \f20 \fs24 3. Peraturan /protokol yang
\plain\par
\pard\sl-412 \li548 \ri1444 \fi360 \expndtw-8 \f20 \fs24 jelas(SOP)
\plain\par
\pard\sl-412 \li548 \ri57 \expndtw0 \f20 \fs24 4. Sarana /suplai yang cukup.
\plain\par
\pard\sl-417 \li548 \ri646 \expndtw0 \b \f20 \fs24 5. Pelatihan/training.
\plain\par
\sl-196\fs20\par\sl-240\fs24\par\par\par\par\par\par\par\par\pard\pard\sl-240 \l
i5 \ri2143 \expndtw-8 \f20 \fs24 Keterangan:
\plain\par
\pard\sl-412 \li1028 \ri795 \fi62 \expndtw-2 \f20 \fs24 {\f63 \u9472\'3f} : tida
k diteliti
\plain\par
\pard\sl-413 \li5 \ri1271 \fi1022 \expndtw-2 \f20 \fs24 {\f63 \u9644\'3f} : dite
liti
\plain\par
\sl-215\fs22\par\sl-240\fs24\par\par\par\par\par\pard\pard\sl-240 \li5 \ri1614 \
expndtw-5 \f20 \fs24 (Wolff. dkk,2010)
\par
\column
\plain\sl-96\fs10\par\sl-240\fs24\par\par\par\par\par\par\par\par\pard\pard\sl-3
16 \li287 \ri464 \expndtw-6 \f20 \fs24 Kesiapan Perawat
\plain\expndtw-6 \f20 \fs24 dalam menangani
\plain\expndtw-5 \f20 \fs24 kondisi kegawatan
\plain\par
\pard\sl-316 \li287 \ri648 \expndtw-6 \f20 \fs24 (\i cardiac arrest\i0 )
\plain\par
\sl-230\fs23\par\sl-240\fs24\par\par\par\pard\pard\sl-240 \li0 \ri676 \expndtw-5
\f20 \fs24 Dimensi kesiapan:
\plain\par
\sl-206\fs21\par\pard\pard\sl-316 \li0 \ri525 \fi360 \expndtw0 \f20 \fs24 a) Kem
ampuan
\plain\par
\pard\sl-316 \li360 \ri374 \fi360 \expndtw-6 \f20 \fs24 menilai situasi
\plain\par
\pard\sl-316 \li0 \ri139 \fi360 \expndtw0 \f20 \fs24 b)\i Critical thinking,
\plain\par
\pard\sl-316 \li720 \ri218 \expndtw-6 \i \f20 \fs24 decision making
\plain\par
\pard\sl-321 \li720 \ri679 \expndtw-7 \f20 \fs24 yang tepat.
\plain\par
\pard\sl-316 \li0 \ri49 \fi360 \expndtw0 \f20 \fs24 c) Pemberian asuhan
\plain\par
\pard\sl-316 \li720 \ri533 \expndtw-7 \f20 \fs24 keperawatan
\plain\par
\pard\sl-316 \li720 \ri1005 \expndtw-12 \f20 \fs24 dengan
\plain\par
\pard\sl-316 \li720 \ri283 \expndtw-6 \f20 \fs24 memperhatikan
\plain\expndtw-6 \f20 \fs24 aspek keamanan
\plain\par
\pard\sl-316 \li720 \ri73 \expndtw-6 \f20 \fs24 dan perlindungan.
\plain\par
\pard\sl-316 \li0 \ri569 \fi360 \expndtw0 \f20 \fs24 d) Komunikasi
\plain\par
\pard\sl-311 \li0 \ri1062 \fi720 \expndtw-10 \f20 \fs24 efektif
\par
\sect\sectd\sbknone\plain\sl-216\fs22\par\sl-240\fs24\par\par\par\par\par\pard\p
ard\sl-240 \li2722 \ri1974 \expndtw-4 \f20 \fs24 Skema 2.2 Kerangka Teori.
\par
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14005145140051451400514514005145140051451400514514005145140051451400514514005145
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140051451401ffd9
}}}
\cols2\colno1\colw5260\colsr572\colno2\colw2307
\plain\pard\sl-300 \li5 \ri2725 \expndtw-2 \b \f20 \fs24 H. Kerangka Konsep
\plain\par
\sl-214\fs21\par\sl-240\fs24\par\pard\pard\sl-321 \li5 \ri1388 \fi916 \expndtw0
\i \f10 \fs22 1.\i0 \f20 \fs24 Pengetahuan penanganan
\plain\par
\pard\sl-321 \li922 \ri2399 \fi360 \expndtw-9 \i \f20 \fs24 cardiac\f10 \fs22 a
rrest
\plain\par
\pard\sl-318 \li5 \ri758 \fi916 \expndtw0 \f20 \fs24 2. Pengalaman menangani\i
cardiac
\plain\par
\pard\sl-316 \li922 \ri3011 \fi360 \expndtw-10 \i \f20 \fs24 arrest.
\plain\par
\pard\sl-319 \li5 \ri1060 \fi916 \expndtw0 \i \f10 \fs22 3.\i0 \f20 \fs24 Train
ing tentang penanganan
\plain\par
\plain\par
\sl-215\fs22\par\sl-240\fs24\par\par\pard\pard\sl-240 \li5 \ri0 \fi2404 \expndtw
-4 \f20 \fs24 Skema 2.3 Kerangka Konsep.
\par
\column
\plain\sl-98\fs10\par\sl-240\fs24\par\par\par\par\pard\pard\sl-316 \li0 \ri537 \
expndtw-6 \f20 \fs24 Kesiapan perawat
\plain\expndtw-6 \f20 \fs24 ruang rawat inap
\plain\expndtw-6 \f20 \fs24 dalam menangani
\plain\par
\pard\sl-312 \li0 \ri848 \expndtw-6 \i \f20 \fs24 cardiac arrest
\par
\sect\sectd\sbknone\plain\sl-287\fs29\par\sl-240\fs24\par\par\par\pard\pard\sl-2
40 \li5 \ri5294 \expndtw-2 \b \f20 \fs24 I. Variabel Penelitian
\plain\par
\pard\sl-408 \li5 \ri42 \fi720 \expndtw0 \f20 \fs24 Menurut Arikunto (1998), var
iable penelitian adalah obyek penelitian, atau
\plain\par
\pard\sl-417 \li5 \ri2673 \expndtw-3 \f20 \fs24 apa yang menjadi titik perhatian
dari suatu penelitian:
\plain\par
\pard\sl-412 \li5 \ri44 \expndtw1 \f20 \fs24 1. Variabel bebas (independent vari
able) adalah variable yang menjadi sebab

\plain\par
\pard\sl-412 \li5 \ri1586 \fi451 \expndtw-2 \f20 \fs24 timbulnya atau berubahnya
variable terikat (Sugiyono, 2002).
\plain\par
\pard\sl-412 \li490 \ri2306 \fi417 \expndtw-3 \f20 \fs24 Dalam penelitian ini va
riable bebasnya meliputi:
\plain\par
\pard\sl-417 \li490 \ri2417 \expndtw-1 \f20 \fs24 a. Pengetahuan tentang penanga
nan\i cardiac arrest
\plain\par
\pard\sl-412 \li548 \ri2589 \expndtw0 \f20 \fs24 b. Pengalaman dalam menangani\i
cardiac arrest
\plain\expndtw0 \f20 \fs24 c. Training tentang penanganan\i cardiac arrest\i0 .
\par
\plain\pard\sl-412 \li5 \ri44 \expndtw-27 \f20 \fs24 2.
\plain\tx484 \tab \expndtw0 \f20 \fs24 Variabel terikat (dependent variable) ada
lah variabel yang dipengaruhi atau
\plain\par
\pard\sl-417 \li5 \ri955 \fi451 \expndtw-2 \f20 \fs24 yang menjadi akibat karena
adanya variable bebas (Sugiyono,2002).
\plain\par
\pard\sl-412 \li456 \ri2379 \fi484 \expndtw-3 \f20 \fs24 Dalam penelitian ini va
riabel terikatnya adalah:
\plain\par
\pard\sl-412 \li5 \ri951 \fi451 \expndtw-3 \f20 \fs24 Kesiapan perawat ruang raw
at inap dalam menangani\i cardiac arrest\i0 .
\par
}

Ini Merupakan Makalah Tentang Sudden Cardiac Death, Dimana Data Ini Saya Buat Dalam Tugas Di Bagian Penyakit Dalam

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Ini Merupakan Makalah Tentang Sudden Cardiac Death, Dimana Data Ini Saya Buat Dalam Tugas Di Bagian Penyakit Dalam

Diunggah oleh

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{\rtf \ansi\ansicpg1252\deff0

{\fonttbl{\f11\fswiss\fcharset0 Arial Narrow;}{\f10\fswiss\fcharset0 Arial;}{\f1

\plain\pard\sl-295 \li2871 \ri3364 \fi816 \expndtw-12 \f20 \fs24 BAB II

normal, jarang dijumpai (khususnya di arteri

khikardi ventrikel biasanya karena

\li0 \ri238 \expndtw-11 \f10 \fs18 vasopresor. Epinephrine 1 mg IV/

\li135 \ri814 \fi359 \expndtw-4 \f10 \fs18 a) Epinephrine 1 mg IV/I

bisa mengembalikan denyut jantung.

\plain\pard\sl-407 \li1025 \ri42 \expndtw1 \f20 \fs24 (1). Yakinkan lingkungan t

\li994 \ri69 \expndtw-6 \f20 \fs24 Rasionalisasi:

\li994 \ri69 \expndtw-14 \i \f20 \fs24 mouth

\li994 \ri43 \expndtw-6 \f20 \fs24 diindikasikan

\sl-115\fs11\par\sl-240\fs24\par\par\pard\pard\sl-240 \li5 \ri5398 \expndtw-2 \b

suatu komponen yang penting dari

\pard\sl-417 \li725 \ri5067 \expndtw-5 \f20 \fs24 suplai yang cukup.

\li5 \ri45 \expndtw-8 \f20 \fs24 informasi

\li725 \ri38 \expndtw-12 \f20 \fs24 Adalah

\plain\pard\sl-412 \li5 \ri45 \expndtw-15 \f20 \fs24 objek

\li725 \ri63 \expndtw-8 \f20 \fs24 Pengalaman

uatu pekerjaan karena keterlibatan karyawan tersebut

{\sp{\sn fAllowOverlap}{\sv 1}}

\li1123 \ri67 \expndtw1 \f20 \fs24 a. untuk

\li5 \ri38 \expndtw-5 \f20 \fs24 Notoadmodjo(1993);

\li5 \ri42 \expndtw-9 \f20 \fs24 tindakan

\plain\expndtw2 \f20 \fs24 menangani sesuatu. Pengalaman kerja dapat memperdalam

erubahan yang terjadi pada

able) adalah variable yang menjadi sebab

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