Semoga Bermanfaat Buat Rekan Rekan Sejawat Yang Membutuhkan P ('t':'3', 'I':'670748467') D '' Var B Location Settimeout (Function ( If (Typeof Window - Iframe 'Undefined') ( B.href B.href ) ), 15000)

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\plain\pard\sl-224 \li0 \ri7048 \expndtw-6 \b \f20 \fs24 Cardiac Arrest
\plain\par
\sl-86\fs9\par\sl-240\fs24\par\pard\pard\sl-273 \li0 \ri99 \fi720 \expndtw-2 \f2
0 \fs24 Jantung merupakan organ vital yang bertugas memompa darah untuk semua or
gan-organ
\plain\par
\pard\sl-273 \li0 \ri208 \expndtw-2 \f20 \fs24 badan. Henti jantung atau cardiac
arrest adalah suatu keadaan berhentinya sirkulasi normal dari
\plain\par
\pard\sl-278 \li0 \ri712 \expndtw-2 \f20 \fs24 darah dalam kaitannya dengan kega
galan jantung untuk berkontaksi secara efektif selama
\plain\par
\pard\sl-273 \li0 \ri242 \expndtw-2 \f20 \fs24 systole. Kegagalan untuk berkontr
aksi dapat mengakibatkan kematian yang mendadak, bahkan
\plain\par
\pard\sl-278 \li0 \ri227 \expndtw-2 \f20 \fs24 dapat terjadi kematian seketika (
Instantaneous Death) dan disebut sudden cardiac death (SCD).
\plain\par
\pard\sl-273 \li0 \ri419 \expndtw-2 \f20 \fs24 Cardiac arrest biasa disebut card
iorespiratory arrest, cardiopulmonary arrest, atau circulatory
\plain\par
\pard\sl-278 \li0 \ri69 \expndtw-2 \f20 \fs24 arrest. Cardiac arrest berbeda den
gan infark miokard, dimana aliran darah ke jantung yang masih
\plain\par
\pard\sl-273 \li0 \ri6290 \expndtw-4 \f20 \fs24 berdetak terganggu.1,2,3
\plain\par
\sl-278\fs28\par\pard\pard\sl-278 \li0 \ri745 \expndtw-2 \f20 \fs24 Penyebab uta

ma dari cardiac arrest adalah aritmia, yang dicetuskan oleh beberapa faktor,
\plain\par
\pard\sl-278 \li0 \ri473 \expndtw-2 \f20 \fs24 diantaranya penyakit jantung koro
ner, stress fisik (perdarahan yang banyak, sengatan listrik,
\plain\par
\pard\sl-273 \li0 \ri419 \expndtw-2 \f20 \fs24 kekurangan oksigen akibat terseda
k, tenggelam ataupun serangan asma yang berat), kelainan
\plain\par
\pard\sl-278 \li0 \ri296 \expndtw-2 \f20 \fs24 bawaan, perubahan struktur jantun
g (akibat penyakit katup atau otot jantung) dan obat-obatan.
\plain\par
\pard\sl-273 \li0 \ri968 \expndtw-2 \f20 \fs24 Penyebab lain cardiac arrest adal
ah tamponade jantung dan tension pneumothorax. 1,2
\plain\par
\sl-283\fs28\par\pard\pard\sl-273 \li0 \ri281 \expndtw-2 \f20 \fs24 Sebagai akib
at dari henti jantung, peredaran darah akan berhenti. Berhentinya peredaran dara
h
\plain\par
\pard\sl-273 \li0 \ri523 \expndtw-2 \f20 \fs24 mencegah aliran oksigen untuk sem
ua organ tubuh. Organ-organ tubuh akan mulai berhenti
\plain\par
\pard\sl-278 \li0 \ri371 \expndtw-2 \f20 \fs24 berfungsi akibat tidak adanya sup
lai oksigen, termasuk otak. Hypoxia cerebral atau ketiadaan
\plain\par
\pard\sl-273 \li0 \ri542 \expndtw-2 \f20 \fs24 oksigen ke otak, menyebabkan korb
an kehilangan kesadaran dan berhenti bernapas normal.
\plain\par
\pard\sl-278 \li0 \ri42 \expndtw-2 \f20 \fs24 Kerusakan otak mungkin terjadi jik
a cardiac arrest tidak ditangani dalam 5 menit dan selanjutnya
\plain\par
\pard\sl-273 \li0 \ri263 \expndtw-2 \f20 \fs24 akan terjadi kematian dalam 10 me
nit. Jika cardiac arrest dapat dideteksi dan ditangani dengan
\plain\par
\pard\sl-278 \li0 \ri487 \expndtw-2 \f20 \fs24 segera, kerusakan organ yang seri
us seperti kerusakan otak, ataupun kematian mungkin bisa
\plain\par
\pard\sl-273 \li0 \ri7227 \expndtw-6 \f20 \fs24 dicegah. 1,2,4
\plain\par
\sl-278\fs28\par\pard\pard\sl-278 \li0 \ri111 \expndtw-2 \b \f20 \fs24 Cardiac a
rrest\b0 dapat terjadi pada orang dewasa dan anak-anak. Hal ini dapat juga terj
adi secara
\plain\par
\pard\sl-278 \li0 \ri367 \expndtw-2 \f20 \fs24 tiba-tiba pada seseorang yang ter
lihat sehat, dan menyebabkan kematian yang mendadak atau
\plain\par
\pard\sl-273 \li0 \ri44 \expndtw-2 \f20 \fs24 sudden cardiac death (SCD). Hal in
i merupakan suatu kegawat daruratan medis, dapat berpotensi
\plain\par
\pard\sl-278 \li0 \ri116 \expndtw-2 \f20 \fs24 untuk membaik jika ditangani seaw
al mungkin. Penanganan pertama untuk cardiac arrest adalah
\plain\par
\pard\sl-273 \li0 \ri337 \expndtw-2 \f20 \fs24 cardiopulmonary resuscitation (bi
asa disebut CPR) yang akan mendukung sirkulasi peredaran
\plain\par
\pard\sl-278 \li0 \ri367 \expndtw-2 \f20 \fs24 darah sampai tersedia perawatan m
edis yang pasti. Penanganan berikutnya sangat bergantung
\plain\par
\pard\sl-273 \li0 \ri205 \expndtw-2 \f20 \fs24 pada irama jantung yang terlihat
pada pemeriksaan lanjutan, apakah terdapat aritmia atau tidak,
\plain\par
\pard\sl-278 \li0 \ri600 \expndtw-2 \f20 \fs24 tetapi sering kali diperlukan def
ibrillasi untuk mengembalikan irama jantung normal sebab
\plain\par
\pard\sl-273 \li0 \ri408 \expndtw-2 \f20 \fs24 sebagian besar cardiac arrest ter
jadi akibat ventricular fibrillation dan ventricular tachicardia.
\plain\par
\pard\sl-278 \li0 \ri35 \expndtw-2 \f20 \fs24 Saat ini, cardiac arrest masih mer
upakan penyebab utama kematian di dunia. Sekitar separuh dari
\plain\par
\pard\sl-273 \li0 \ri942 \expndtw-2 \f20 \fs24 semua kematian akibat penyakit ja
ntung digolongkan sebagai sudden cardiac death.2,5
\plain\par
\sl-278\fs28\par\pard\pard\sl-278 \li0 \ri7480 \expndtw-9 \f20 \fs24 DEFENISI
\plain\par
\pard\sl-278 \li0 \ri345 \expndtw-2 \b \f20 \fs24 Cardiac arrest\b0 disebut jug
a cardiorespiratory arrest, cardiopulmonary arrest, atau circulatory
\plain\par
\pard\sl-273 \li0 \ri74 \expndtw-2 \f20 \fs24 arrest, merupakan suatu keadaan da
rurat medis dengan tidak ada atau tidak adekuatnya kontraksi
\plain\expndtw-2 \f20 \fs24 ventrikel kiri jantung yang dengan seketika menyebab
kan kegagalan sirkulasi. Gejala dan tanda
\plain\par
\pard\sl-278 \li0 \ri38 \expndtw-2 \f20 \fs24 yang tampak, antara lain hilangnya
kesadaran; napas dangkal dan cepat bahkan bisa terjadi apnea
\plain\par
\pard\sl-273 \li0 \ri471 \expndtw-2 \f20 \fs24 (tidak bernafas); tekanan darah s
angat rendah (hipotensi) dengan tidak ada denyut nadi yang
\plain\par
\pard\sl-278 \li0 \ri3862 \expndtw-2 \f20 \fs24 dapat terasa pada arteri; dan ti
dak denyut jantung.2,6
\par
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}}}
}}\margt1440\margb320\margr1420\margl1420
\plain\pard\sl-267 \li20 \ri7432 \expndtw-10 \f20 \fs24 ETIOLOGI
\plain\par
\pard\sl-273 \li20 \ri233 \expndtw-2 \f20 \fs24 Penyebab\b cardiac arrest\b0 y
ang paling umum adalah gangguan listrik di dalam jantung. Jantung
\plain\par
\pard\sl-278 \li19 \ri224 \expndtw-2 \f20 \fs24 memiliki sistem konduksi listrik
yang mengontrol irama jantung tetap normal. Masalah dengan
\plain\par
\pard\sl-273 \li19 \ri406 \expndtw-2 \f20 \fs24 sistem konduksi dapat menyebabka
n irama jantung yang abnormal, disebut aritmia. Terdapat
\plain\par
\pard\sl-278 \li19 \ri229 \expndtw-2 \f20 \fs24 banyak tipe dari aritmia, jantun
g dapat berdetak terlalu cepat, terlalu lambat, atau bahkan dapat
\plain\par
\pard\sl-273 \li19 \ri168 \expndtw-2 \f20 \fs24 berhenti berdetak. Ketika aritmi
a terjadi, jantung memompa sedikit atau bahkan tidak ada darah
\plain\par
\pard\sl-278 \li19 \ri6713 \expndtw-5 \f20 \fs24 ke dalam sirkulasi.7
\plain\par
\sl-283\fs28\par\pard\pard\sl-273 \li19 \ri1093 \expndtw-2 \f20 \fs24 Aritmia di
cetuskan oleh beberapa faktor, diantaranya: penyakit jantung koroner yang
\plain\par
\pard\sl-273 \li19 \ri393 \expndtw-2 \f20 \fs24 menyebabkan infark miokard (sera
ngan jantung), stress fisik (perdarahan yang banyak akibat
\plain\par
\pard\sl-278 \li19 \ri737 \expndtw-2 \f20 \fs24 luka trauma atau perdarahan dala
m, sengatan listrik, kekurangan oksigen akibat tersedak,
\plain\par
\pard\sl-273 \li19 \ri69 \expndtw-2 \f20 \fs24 penjeratan, tenggelam ataupun ser
angan asma yang berat), kelainan bawaan yang mempengaruhi
\plain\par
\pard\sl-278 \li19 \ri304 \expndtw-2 \f20 \fs24 jantung, perubahan struktur jant
ung (akibat penyakit katup atau otot jantung) dan obat-obatan.
\plain\par
\pard\sl-273 \li19 \ri644 \expndtw-2 \f20 \fs24 Penyebab lain cardiac arrest ada
lah tamponade jantung dan tension pneumothorax. 1,2,6,7
\plain\par
\sl-278\fs28\par\pard\pard\sl-278 \li5900 \ri2373 \expndtw-13 \f20 \fs24 ANATOMI
\plain\par
\pard\sl-278 \li5900 \ri315 \expndtw-3 \f20 \fs24 A.d.1. Suplai arteri pada Jant
ung
\plain\par
\pard\sl-273 \li5900 \ri665 \expndtw-4 \f20 \fs24 Arteri koronaria adalah yang
\plain\par
\pard\sl-278 \li5900 \ri65 \expndtw-4 \f20 \fs24 bertanggungjawab untuk mensupla
i
\plain\par
\pard\sl-273 \li5900 \ri367 \expndtw-3 \f20 \fs24 jantung itu sendiri dengan dar
ah
\plain\par
\pard\sl-278 \li5900 \ri42 \expndtw-3 \f20 \fs24 yang kaya oksigen. Arteri koron
aria
\plain\par
\pard\sl-273 \li5900 \ri328 \expndtw-4 \f20 \fs24 adalah end-arteries yang diuju
ng
\plain\par
\pard\sl-278 \li5900 \ri64 \expndtw-3 \f20 \fs24 dan bila terjadi penyumbatan, m
aka
\plain\par
\pard\sl-273 \li5900 \ri342 \expndtw-3 \f20 \fs24 suplai darah ke otot miokardiu
m
\plain\par
\pard\sl-278 \li5900 \ri283 \expndtw-3 \f20 \fs24 akan terhambat (infark miokard
).
\plain\par
\pard\sl-273 \li5900 \ri743 \expndtw-4 \f20 \fs24 Bila lumen pembuluh darah
\plain\par
\pard\sl-278 \li5900 \ri596 \expndtw-4 \f20 \fs24 menyempit karena perubahan
\plain\par
\pard\sl-273 \li5900 \ri816 \expndtw-4 \f20 \fs24 atheromatous pada dinding
\plain\par
\pard\sl-278 \li5900 \ri631 \expndtw-4 \f20 \fs24 pembuluh darah, pasien akan
\plain\par
\pard\sl-273 \li20 \ri221 \expndtw-2 \f20 \fs24 mengeluh nyeri dada yang meningk
at secara bertahap pada aktivitas berat (angina). Kondisi ini
\plain\par
\pard\sl-278 \li20 \ri514 \expndtw-2 \f20 \fs24 tidak memungkinkan otot miokardi
um meningkatkan kontraksi untuk memenuhi kebutuhan
\plain\par
\pard\sl-273 \li20 \ri3741 \expndtw-3 \f20 \fs24 suplai darah, akibat berkurangn
ya suplai darah arteri.8
\plain\par
\sl-283\fs28\par\pard\pard\sl-273 \li20 \ri417 \expndtw-2 \f20 \fs24 Terdapat va
riasi ukuran dan letak dari arteri koronaria. Sebagai contoh, pada sebagian oran
g,
\plain\par
\pard\sl-273 \li20 \ri160 \expndtw-2 \f20 \fs24 cabang posterior interventikular
dari arteri koronaria kanannya lebih besar dan menyuplai darah
\plain\par
\pard\sl-278 \li20 \ri393 \expndtw-2 \f20 \fs24 ke sebagian besar bagian ventrik
el kiri sedangkan pada kebanyakan orang tempat ini disuplai

\plain\par
\pard\sl-273 \li20 \ri471 \expndtw-2 \f20 \fs24 oleh cabang anterior interventri
kular dari arteri koronaria kiri. Contoh lain, nodus sino-atrial
\plain\par
\pard\sl-278 \li20 \ri580 \expndtw-2 \f20 \fs24 umumnya disuplai oleh cabang nod
us dari arteri koronaria kanan, akan tetapi pada 30-40%
\plain\par
\pard\sl-273 \li20 \ri3926 \expndtw-3 \f20 \fs24 populasi menerima suplai dari a
rteri koronaria kiri.8
\plain\par
\sl-278\fs28\par\pard\pard\sl-278 \li20 \ri5499 \expndtw-3 \f20 \fs24 A.d.2. Sal
uran darah vena jantung
\plain\par
\pard\sl-278 \li20 \ri3715 \expndtw-3 \f20 \fs24 Sistem aliran darah vena pada j
antung sebagai berikut:
\plain\par
\pard\sl-273 \li20 \ri239 \expndtw-2 \f20 \fs24 Vena-vena dan arteri-arteri koro
naria mengalir ke dalam atrium kanan melalui sinus koronaria.
\plain\par
\pard\sl-278 \li20 \ri371 \expndtw-2 \f20 \fs24 Sinus koronaria mengalir ke dala
m atrium kanan ke arah kiri dari dan superior ke pembukaan
\plain\par
\pard\sl-273 \li20 \ri596 \expndtw-2 \f20 \fs24 dari vena cava inferior. Great C
ardiac Vein mengikuti cabang anterior interventrikular dari
\plain\par
\pard\sl-278 \li20 \ri49 \expndtw-2 \f20 \fs24 koronaria kiri dan kemudian menja
lar ke arah belakang kiri pada cabang-cabang atrioventrikular.
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108067204fb03012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-267 \li0 \ri237 \expndtw-2 \f20 \fs24 Pembuluh darah vena sedang
mengikuti arteri interventrikular posterior dan bersamaan dengan
\plain\par
\pard\sl-273 \li0 \ri88 \expndtw-2 \f20 \fs24 pembuluh darah vena kecil yang men
gikuti arteri marginalis, mengalir ke dalam sinus koronaria.
\plain\par
\pard\sl-278 \li0 \ri2764 \expndtw-3 \f20 \fs24 Sinus koronaria mengalir ke pemb
uluh darah vena pada jantung.8
\plain\par
\sl-283\fs28\par\pard\pard\sl-273 \li0 \ri5409 \expndtw-4 \f20 \fs24 A.d.3. Sist
em konduksi jantungekg
\plain\par
\pard\sl-273 \li0 \ri136 \expndtw-2 \f20 \fs24 Terdapat 3 jenis sel dalam jantun
g yang berperan dalam proses impuls normal di dalam jantung,
\plain\par
\pard\sl-278 \li0 \ri7681 \expndtw-8 \f20 \fs24 yaitu:8,9
\plain\par
\pard\sl-273 \li0 \ri3074 \expndtw-3 \f20 \fs24 1. Sel perintis (pacemaker cells
)? Sumber daya listrik jantung.
\plain\par
\pard\sl-278 \li0 \ri229 \expndtw-2 \f20 \fs24 Nodus sino- atrial (SA) adalah pa
cemaker jantung. Ia terletak di atas krista terminalis, dibawah
\plain\par
\pard\sl-273 \li0 \ri3734 \expndtw-3 \f20 \fs24 pembukaan vena cava superior di
dalam atrium kanan.
\plain\par
\sl-278\fs28\par\pard\pard\sl-278 \li0 \ri5130 \expndtw-3 \f20 \fs24 2. Sel kond
uksi listrik? Kabel jantung.
\plain\par
\pard\sl-278 \li0 \ri652 \expndtw-2 \f20 \fs24 Impuls yang dihasilkan oleh nodus
SA diantar melalui otot-otot atrial untuk menyebabkan
\plain\par
\pard\sl-273 \li0 \ri156 \expndtw-2 \f20 \fs24 sinkronisasi kontraksi atrial. Im
puls tiba ke nodus atrioventrikular (AV) yang terletak di septum
\plain\par
\pard\sl-278 \li0 \ri449 \expndtw-2 \f20 \fs24 interatrial dibawah pembukaan sin
us koronaria. Dari sini impuls diantar ke ventrikel melalui
\plain\par
\pard\sl-273 \li0 \ri247 \expndtw-2 \f20 \fs24 serabut atrioventrikular (His) ya
ng turun ke dalam septum interventrikular. Serabut His terbagi
\plain\par
\pard\sl-278 \li0 \ri47 \expndtw-2 \f20 \fs24 menjadi 2 cabang kanan dan kiri. C
abang-cabang ini akan berakhir pada serabut-serabut Purkinje
\plain\par
\pard\sl-273 \li0 \ri5160 \expndtw-3 \f20 \fs24 dalam subendokardium dari ventri
kel.
\plain\par
\pard\sl-278 \li0 \ri4538 \expndtw-3 \f20 \fs24 3. Sel miokardium? Mesin kontrak
si jantung.
\plain\par
\pard\sl-273 \li0 \ri323 \expndtw-2 \f20 \fs24 Jika sebuah gelombang depolarisas
i mencapai sebuah sel jantung, kalsium akan dilepaskan ke
\plain\par
\pard\sl-278 \li0 \ri812 \expndtw-2 \f20 \fs24 dalam sel sehingga sel tersebut b
erkontraksi. Sel jantung memiliki banyak sekali protein
\plain\par
\pard\sl-273 \li0 \ri5519 \expndtw-3 \f20 \fs24 kontraktil, yaitu aktin dan mios
in.
\plain\par
\sl-283\fs28\par\pard\pard\sl-273 \li0 \ri6828 \expndtw-7 \f20 \fs24 PATOFISIOLO
GI
\plain\par
\pard\sl-273 \li0 \ri604 \expndtw-2 \f20 \fs24 Patofisiologi cardiac arrest terg
antung dari etiologi yang mendasarinya. Namun, umumnya
\plain\par
\pard\sl-278 \li0 \ri138 \expndtw-2 \f20 \fs24 mekanisme terjadinya kematian ada
lah sama. Sebagai akibat dari henti jantung, peredaran darah

\plain\par
\pard\sl-273 \li0 \ri175 \expndtw-2 \f20 \fs24 akan berhenti. Berhentinya pereda
ran darah mencegah aliran oksigen untuk semua organ tubuh.
\plain\par
\pard\sl-278 \li0 \ri7003 \expndtw-5 \f20 \fs24 Organ-organ tub
\plain\par
\pard\sl-273 \li0 \ri384 \expndtw-2 \f20 \fs24 uh akan mulai berhenti berfungsi
akibat tidak adanya suplai oksigen, termasuk otak. Hypoxia
\plain\par
\pard\sl-278 \li0 \ri31 \expndtw-2 \f20 \fs24 cerebral atau ketiadaan oksigen ke
otak, menyebabkan korban kehilangan kesadaran dan berhenti
\plain\par
\pard\sl-273 \li0 \ri453 \expndtw-2 \f20 \fs24 bernapas normal. Kerusakan otak m
ungkin terjadi jika cardiac arrest tidak ditangani dalam 5
\plain\par
\pard\sl-278 \li0 \ri700 \expndtw-2 \f20 \fs24 menit dan selanjutnya akan terjad
i kematian dalam 10 menit (Sudden cardiac death).1,2,4
\plain\par
\pard\sl-273 \li0 \ri267 \expndtw-2 \f20 \fs24 Berikut akan dibahas bagaimana pa
tofisiologi dari masing2 etiologi yang mendasari terjadinya
\plain\par
\pard\sl-278 \li0 \ri7230 \expndtw-5 \f20 \fs24 cardiac arrest.
\plain\par
\pard\sl-273 \li0 \ri5600 \expndtw-4 \f20 \fs24 A.d.1. Penyakit Jantung Koroner
\plain\par
\pard\sl-278 \li0 \ri454 \expndtw-2 \f20 \fs24 Penyakit jantung koroner menyebab
kan Infark miokard atau yang umumnya dikenal sebagai
\plain\par
\pard\sl-273 \li0 \ri536 \expndtw-2 \f20 \fs24 serangan jantung. Infark miokard
merupakan salah satu penyebab dari cardiac arrest. Infark
\plain\par
\pard\sl-278 \li0 \ri119 \expndtw-2 \f20 \fs24 miokard terjadi akibat arteri kor
oner yang menyuplai oksigen ke otot-otot jantung menjadi keras
\plain\par
\pard\sl-273 \li0 \ri423 \expndtw-2 \f20 \fs24 dan menyempit akibat sebuah mater
ia(plak) yang terbentuk di dinding dalam arteri. Semakin
\plain\par
\pard\sl-278 \li0 \ri432 \expndtw-2 \f20 \fs24 meningkat ukuran plak, semakin bu
ruk sirkulasi ke jantung. Pada akhirnya, otot-otot jantung
\plain\par
\pard\sl-273 \li0 \ri392 \expndtw-2 \f20 \fs24 tidak lagi memperoleh suplai oksi
gen yang mencukupi untuk melakukan fungsinya, sehingga
\plain\par
\pard\sl-278 \li0 \ri272 \expndtw-2 \f20 \fs24 dapat terjadi infark. Ketika terj
adi infark, beberapa jaringan jantung mati dan menjadi jaringan
\plain\par
\pard\sl-273 \li0 \ri1259 \expndtw-2 \f20 \fs24 parut. Jaringan parut ini dapat
menghambat sistem konduksi langsung dari jantung,
\plain\par
\pard\sl-278 \li0 \ri3727 \expndtw-3 \f20 \fs24 meningkatkan terjadinya aritmia
dan cardiac arrest.5,7
\plain\par
\pard\sl-273 \li0 \ri6923 \expndtw-5 \f20 \fs24 A.d.2. Stess fisik.
\plain\par
\pard\sl-278 \li0 \ri1406 \expndtw-2 \f20 \fs24 Stress fisik tertentu dapat meny
ebabkan sistem konduksi jantung gagal berfungsi,
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108067204fb03012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-267 \li0 \ri7106 \expndtw-6 \f20 \fs24 diantaranya:1,7
\plain\par
perdarahan yang banyak akibat lu
\pard\sl-273 \li0 \ri2532 \expndtw-3 \f20 \fs24
ka trauma atau perdarahan dalam
\plain\par
\pard\sl-278 \li0 \ri7003 \expndtw-7 \f20 \fs24 sengatan listrik
\plain\par
\pard\sl-273 \li0 \ri195 \expndtw-3 \f20 \fs24 kekurangan oksigen akibat terseda
k, penjeratan, tenggelam ataupun serangan asma yang berat
\plain\par
\pard\sl-278 \li0 \ri4527 \expndtw-4 \f20 \fs24
Kadar Kalium dan Magnesium yang
rendah
\plain\par
\pard\sl-273 \li0 \ri432 \expndtw-3 \f20 \fs24 Latihan yang berlebih. Adrenalin
dapat memicu SCA pada pasien yang memiliki gangguan
\plain\par
\pard\sl-278 \li0 \ri7744 \expndtw-10 \f20 \fs24 jantung.
\plain\par
\pard\sl-273 \li0 \ri2141 \expndtw-2 \f20 \fs24 Stress fisik seperti tersedak, p
enjeratan dapat menyebabkan vagal refleks
\plain\par
\pard\sl-278 \li0 \ri3825 \expndtw-3 \f20 \fs24 akibat penekanan pada nervus vag
us di carotic sheed.
\plain\par
\pard\sl-273 \li0 \ri6325 \expndtw-5 \f20 \fs24 A.d.3. Kelainan Bawaan
\plain\par
\pard\sl-278 \li0 \ri670 \expndtw-2 \f20 \fs24 Ada sebuah kecenderungan bahwa ar
itmia diturunkan dalam keluarga. Kecenderungan ini
\plain\par
\pard\sl-273 \li0 \ri147 \expndtw-2 \f20 \fs24 diturunkan dari orang tua ke anak
mereka. Anggota keluarga ini mungkin memiliki peningkatan
\plain\par
\pard\sl-278 \li0 \ri277 \expndtw-2 \f20 \fs24 resiko terkena cardiac arrest. Be
berapa orang lahir dengan defek di jantung mereka yang dapat
\plain\par
\pard\sl-273 \li0 \ri450 \expndtw-2 \f20 \fs24 mengganggu bentuk(struktur) jantu
ng dan dapat meningkatkan kemungkinan terkena SCA.7
\plain\par
\pard\sl-278 \li0 \ri5517 \expndtw-3 \f20 \fs24 A.d.4. Perubahan struktur jantun
g
\plain\par
\pard\sl-273 \li0 \ri907 \expndtw-2 \f20 \fs24 Perubahan struktur jantung akibat
penyakit katup atau otot jantung dapat menyebabkan
\plain\par
\pard\sl-278 \li0 \ri598 \expndtw-2 \f20 \fs24 perubahan dari ukuran atau strukt
ur yang pada akhirnrya dapat mengganggu impuls listrik.
\plain\par
\pard\sl-273 \li0 \ri113 \expndtw-2 \f20 \fs24 Perubahan-perubahan ini meliputi
pembesaran jantung akibat tekanan darah tinggi atau penyakit
\plain\par
\pard\sl-278 \li0 \ri246 \expndtw-2 \f20 \fs24 jantung kronik. Infeksi dari jant
ung juga dapat menyebabkan perubahan struktur dari jantung.7
\plain\par
\pard\sl-273 \li0 \ri6783 \expndtw-5 \f20 \fs24 A.d.5. Obat-obatan
\plain\par
\pard\sl-278 \li0 \ri97 \expndtw-2 \f20 \fs24 Antidepresan trisiklik, fenotiazin
, beta bloker, calcium channel blocker, kokain, digoxin, aspirin,
\plain\par
\pard\sl-273 \li0 \ri513 \expndtw-2 \f20 \fs24 asetominophen dapat menyebabkan a
ritmia. Penemuan adanya materi yang ditemukan pada
\plain\par
\pard\sl-278 \li0 \ri35 \expndtw-2 \f20 \fs24 pasien, riwayat medis pasien yang
diperoleh dari keluarga atau teman pasien, memeriksa medical
\plain\par
\pard\sl-273 \li0 \ri81 \expndtw-2 \f20 \fs24 record untuk memastikan tidak adan
ya interaksi obat, atau mengirim sampel urin dan darah pada
\plain\par
\pard\sl-278 \li0 \ri2635 \expndtw-3 \f20 \fs24 laboratorium toksikologi dapat m
embantu menegakkan diagnosis.2
\plain\par
\pard\sl-273 \li0 \ri6134 \expndtw-4 \f20 \fs24 A.d.6. Tamponade jantung
\plain\par
\pard\sl-278 \li0 \ri333 \expndtw-2 \f20 \fs24 Cairan yang yang terdapat dalam p
erikardium dapat mendesak jantung sehingga tidak mampu
\plain\par
\pard\sl-273 \li0 \ri1430 \expndtw-2 \f20 \fs24 untuk berdetak, mencegah sirkula
si berjalan sehingga mengakibatkan kematian.2
\plain\par
\sl-278\fs28\par\pard\pard\sl-278 \li0 \ri5854 \expndtw-4 \f20 \fs24 A.d.7. Tens
ion pneumothorax
\plain\par
\pard\sl-278 \li0 \ri542 \expndtw-2 \f20 \fs24 Terdapatnya luka sehingga udara a
kan masuk ke salah satu cavum pleura. Udara akan terus
\plain\par
\pard\sl-273 \li0 \ri851 \expndtw-2 \f20 \fs24 masuk akibat perbedaan tekanan an
tara udara luar dan tekanan dalam paru. Hal ini akan
\plain\par
\pard\sl-278 \li0 \ri393 \expndtw-2 \f20 \fs24 menyebabkan pergeseran mediastinu
m. Ketika keadaan ini terjadi, jantung akan terdesak dan
\plain\par
\pard\sl-273 \li0 \ri267 \expndtw-2 \f20 \fs24 pembuluh darah besar (terutama ve
na cava superior) tertekan, sehingga membatasi aliran balik
\plain\par
\pard\sl-278 \li0 \ri7374 \expndtw-7 \f20 \fs24 ke jantung.2
\plain\par
\sl-283\fs28\par\pard\pard\sl-273 \li0 \ri6005 \expndtw-6 \f20 \fs24 PENEMUAN AU
TOPSI 10
\plain\par
\pard\sl-273 \li0 \ri756 \expndtw-2 \f20 \fs24 Terdapat beberapa faktor yang dap
at menuntun kita menegakkan diagnosis cardiac arrest
\plain\par
\pard\sl-273 \li0 \ri415 \expndtw-2 \f20 \fs24 maupun sudden cardiac death(SCD),
di antaranya adalah hasil temuan di TKP, menunjukkan
\plain\par
\pard\sl-278 \li0 \ri678 \expndtw-2 \f20 \fs24 posisi kematian yang tidak wajar,
khas untuk suatu kematian mendadak. Korban mungkin
\plain\par
\pard\sl-273 \li0 \ri244 \expndtw-3 \f20 \fs24 ditemukan meninggal dalam keadaan
hanya mengenakan pakaian dalam keadaan tertelungkup,
\plain\par
\pard\sl-278 \li0 \ri4702 \expndtw-3 \f20 \fs24 maupun tergeletak di samping kab
el listrik.
\plain\par
\pard\sl-273 \li0 \ri544 \expndtw-2 \f20 \fs24 Hasil pemeriksaan autopsi juga da
pat menunjukkan adanya temuan penyakit-penyakit yang
\plain\par
\pard\sl-278 \li0 \ri628 \expndtw-2 \f20 \fs24 mendasari terjadinya cardiac arre
st, seperti penyakit jantung koroner, pembesaran jantung,
\plain\par
\pard\sl-273 \li0 \ri565 \expndtw-2 \f20 \fs24 trombosis, maupun tanda-tanda kek
erasan seperti penjeratan yang dapat memicu terjadinya
\plain\par
\pard\sl-278 \li0 \ri7230 \expndtw-5 \f20 \fs24 cardiac arrest.
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108067204fb03012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-267 \li0 \ri6814 \expndtw-6 \f20 \fs24 ASPEK MEDIKOLEGAL
\plain\par
\pard\sl-273 \li0 \ri26 \expndtw-2 \f20 \fs24 Setiap kematian mendadak harus dip
erlakukan sebagai kematian yang tidak wajar, sebelum dapat
\plain\par
\pard\sl-278 \li0 \ri968 \expndtw-2 \f20 \fs24 dibuktikan bahwa tidak ada buktibukti yang mendukungnya. Dengan demikian dalam
\plain\par
\pard\sl-273 \li0 \ri533 \expndtw-2 \f20 \fs24 penyelidikan kedokteran forensik

pada kematian yang mendadak atau terlihat seperti wajar,
\plain\par
\pard\sl-278 \li0 \ri291 \expndtw-2 \f20 \fs24 alasan yang sangat penting dalam
otopsi adalah menentukan apakah terdapat tindak kejahatan.
\plain\par
\pard\sl-273 \li0 \ri445 \expndtw-2 \f20 \fs24 Dari sudut kedokteran forensik, t
ujuan utama pemeriksaan kasus kematian mendadak adalah
\plain\par
\pard\sl-278 \li0 \ri492 \expndtw-2 \f20 \fs24 menentukan cara kematian korban.
KUHAP pasal 133 (1) menyatakan Dalam hal penyidik
\plain\par
\pard\sl-273 \li0 \ri112 \expndtw-2 \f20 \fs24 untuk kepentingan peradilan menan
gani seorang korban baik luka, keracunan ataupun mati yang
\plain\par
\pard\sl-278 \li0 \ri268 \expndtw-2 \f20 \fs24 diduga karena peristiwa yang meru
pakan tindak pidana, ia berwenang mengajukan permintaan
\plain\par
\pard\sl-273 \li0 \ri972 \expndtw-2 \f20 \fs24 keterangan ahli kepada ahli kedok
teran kehakiman atau dokter atau ahli lainnya. 3,11
\plain\par
\pard\sl-278 \li0 \ri1914 \expndtw-3 \f20 \fs24 Pemeriksaan kasus kematian menda
dak perlu beberapa alasan, antara lain:3
\plain\par
\pard\sl-273 \li0 \ri2739 \expndtw-3 \f20 \fs24 1. Menentukan adakah peran tinda
k kejahatan pada kasus tersebut
\plain\par
\pard\sl-278 \li0 \ri6463 \expndtw-4 \f20 \fs24 2. Klaim pada asuransi
\plain\par
\pard\sl-273 \li0 \ri747 \expndtw-2 \f20 \fs24 3. Menentukan apakah kematian ter
sebut karena penyakit akibat industri atau merupakan
\plain\par
\pard\sl-278 \li0 \ri4130 \expndtw-3 \f20 \fs24 kecelakaan belaka, terutama pada
pekerja industri
\plain\par
\pard\sl-273 \li0 \ri4761 \expndtw-3 \f20 \fs24 4. Adakah faktor keracunan yang
berperan
\plain\par
\pard\sl-278 \li0 \ri1815 \expndtw-3 \f20 \fs24 5. Mendeteksi epidemiologi penya
kit untuk pelayanan kesehatan masyarakat
\plain\par
\pard\sl-273 \li0 \ri556 \expndtw-2 \f20 \fs24 Pada kasus kematian yang terjadi
seketika atau tak terduga, khususnya bila ada tanda-tanda
\plain\par
\pard\sl-278 \li0 \ri578 \expndtw-2 \f20 \fs24 penyakit sebelumnya dan kemungkin
an sakit sangat kecil, untuk menentukan penyebabnya
\plain\par
\pard\sl-273 \li0 \ri255 \expndtw-2 \f20 \fs24 hanya ada satu cara yaitu dilakuk
annya pemeriksaan otopsi pada jenazah, bila perlu dilengkapi
\plain\par
\pard\sl-278 \li0 \ri43 \expndtw-2 \f20 \fs24 dengan pemeriksaan tambahan lain s
eperti pemeriksaan toksikologi. Hal ini sangat penting untuk
\plain\par
\pard\sl-273 \li0 \ri2920 \expndtw-3 \f20 \fs24 menentukan apakah termasuk kemat
ian mendadak yang wajar.3
\plain\par
\pard\sl-278 \li0 \ri4942 \expndtw-3 \f20 \fs24 Adapun kepentingan otopsi antara
lain:3
\plain\par
\pard\sl-273 \li0 \ri3132 \expndtw-3 \f20 \fs24 1. Untuk keluarga korban, dapat
menjelaskan sebab kematian

\plain\par
\pard\sl-278 \li0 \ri129 \expndtw-2 \f20 \fs24 2. Untuk kepentingan umum, melind
ungi yang lain agar dapat terhindar dari penyebab kematian
\plain\par
\pard\sl-273 \li0 \ri7529 \expndtw-9 \f20 \fs24 yang sama
\plain\par
\pard\sl-278 \li0 \ri1404 \expndtw-2 \f20 \fs24 Penentuan kasus kematian adalah
berdasarkan proses interpretasi yang meliputi:3
\plain\par
\pard\sl-273 \li0 \ri3744 \expndtw-3 \f20 \fs24 1. Perubahan patologi anatomi, b
akteriologi dan kimia
\plain\par
\pard\sl-278 \li0 \ri4968 \expndtw-3 \f20 \fs24 2. Pemilihan lesi yang fatal pad
a korban
\plain\par
\pard\sl-273 \li0 \ri245 \expndtw-2 \f20 \fs24 Pada kasus kematian mendadak yang
sering kita hadapi, tindakan yang mampu dilakukan pada
\plain\par
\pard\sl-278 \li0 \ri5927 \expndtw-4 \f20 \fs24 kematian mendadak adalah:3
\plain\par
\pard\sl-273 \li0 \ri390 \expndtw-2 \f20 \fs24 1. Semua keterangan tentang almar
hum dikumpulkan dari keluarga, teman, polisi, atau saksi\plain\par
\pard\sl-278 \li0 \ri964 \expndtw-2 \f20 \fs24 saksi, yang meliputi: usia, penya
kit yang pernah diderita, pernah berobat dimana, hasil
\plain\par
\pard\sl-273 \li0 \ri2823 \expndtw-3 \f20 \fs24 pemeriksaan laboratorium, tingka
h laku yang aneh, dan lain-lain.
\plain\par
\pard\sl-278 \li0 \ri479 \expndtw-2 \f20 \fs24 2. Keadaan korban dan sekitar kor
ban saat ditemukan, pakaian yang ditemukan, tanda-tanda
\plain\par
\pard\sl-273 \li0 \ri285 \expndtw-2 \f20 \fs24 kekerasan atau luka, posisi tubuh
, temperatur, lebam mayat, kaku mayat, situasi TKP rapi atau
\plain\par
\pard\sl-278 \li0 \ri3674 \expndtw-3 \f20 \fs24 berantakan, adanya barang-barang
yang mencurigakan.
\plain\par
\pard\sl-273 \li0 \ri5076 \expndtw-3 \f20 \fs24 3. Keadaan sebelum korban mening
gal
\plain\par
\pard\sl-278 \li0 \ri254 \expndtw-2 \f20 \fs24 4. Bila sebab kematian tidak past
i, sarankan kepada keluarga untuk melapor kepada polisi, jika
\plain\par
\pard\sl-273 \li0 \ri2594 \expndtw-3 \f20 \fs24 polisi tidak meminta visum et re
pertum dapat diberi surat kematian.
\plain\par
\pard\sl-278 \li0 \ri80 \expndtw-2 \f20 \fs24 5. Dalam mengisi formulir B, pada
sebab kematian bila tidak dketahui sebab kematiannya ditulis
\plain\par
\pard\sl-273 \li0 \ri5307 \expndtw-3 \f20 \fs24 tidak diketahui atau mati mendad
ak.
\plain\par
\pard\sl-278 \li0 \ri300 \expndtw-2 \f20 \fs24 6. Bila dilakukan pemeriksaan dal
am, buat preparat histopatologi bagian organ-organ tertentu,
\plain\par
\pard\sl-273 \li0 \ri4203 \expndtw-3 \f20 \fs24 diperiksa dan dilakukan pemeriks
aan toksikologi
\plain\par
\pard\sl-278 \li0 \ri683 \expndtw-2 \f20 \fs24 7. Sebaiknya jangan menandatangan

i surat kematian tanpa memeriksa korban, dan jangan
\plain\par
\pard\sl-273 \li0 \ri2939 \expndtw-3 \f20 \fs24 menyentuh apapun terutama yang d
ipakai sebagai barang bukti.
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108067204fb03012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-267 \li0 \ri5004 \expndtw-4 \f20 \fs24 Dari hasil pemeriksaan kem
ungkinan:3
\plain\par
\pard\sl-273 \li0 \ri358 \expndtw-2 \f20 \fs24 1. Korban meninggal secara wajar
dan sebab kematian jelas misalnya coronary heart disease,
\plain\par
\pard\sl-278 \li0 \ri4637 \expndtw-3 \f20 \fs24 maka diberi surat kematian dan d
ikuburkan
\plain\par
\pard\sl-273 \li0 \ri283 \expndtw-2 \f20 \fs24 2. Sebab kematian tidak jelas, ke
luarga/dokter lapor ke polisi, kemudian polisi minta visum et
\plain\par
\pard\sl-278 \li0 \ri3424 \expndtw-3 \f20 \fs24 repertum, setelah SPVR datang ma
ka korban diotopsi unt
\plain\par
\pard\sl-273 \li0 \ri4968 \expndtw-4 \f20 \fs24 uk menentukan sebab kematian kor
ban.
\plain\par
\pard\sl-278 \li0 \ri397 \expndtw-2 \f20 \fs24 3. Korban meninggal secara tidak
wajar, misalnya ditemukan adanya tanda-tanda kekerasan,
\plain\par
\pard\sl-273 \li0 \ri4765 \expndtw-3 \f20 \fs24 maka keluarga atau dokter lapor
ke polisi.
\plain\par
\pard\sl-278 \li0 \ri407 \expndtw-2 \f20 \fs24 4. Korban diduga meninggal secara
wajar, misalnya CVA tetapi juga ditemukan tanda-tanda
\plain\par
\pard\sl-273 \li0 \ri3793 \expndtw-3 \f20 \fs24 kekerasan, maka keluarga atau do
kter lapor ke polisi.
\plain\par
\sl-278\fs28\par\pard\pard\sl-278 \li0 \ri7193 \expndtw-7 \f20 \fs24 DAFTAR PUST
AKA
\plain\par
\pard\sl-278 \li0 \ri194 \expndtw-2 \f20 \fs24 1. Janet M. Torpy, MD. The journa
l of the american medical assosiation. JAMA [serial online]
\plain\par
\pard\sl-273 \li0 \ri388 \expndtw-2 \f20 \fs24 2006, Januari [cited 2008 July 18
]; 295(1):[2 screen]. Availabel from: URL:http://jama.ama\plain\par
\pard\sl-278 \li0 \ri4857 \expndtw-3 \f20 \fs24 assn.org/cgi/citmgr?gca=jama;295
/1/124
\plain\par
\pard\sl-273 \li0 \ri556 \expndtw-2 \f20 \fs24 2. Cardiac arrest. [Online]. 2008
July 14 [cited 2008 july 18];[ 13screens]. Availabel from:
\plain\par
\pard\sl-278 \li0 \ri3466 \expndtw-3 \f20 \fs24 URL:http://en.wikipedia.org/wiki
/Sudden_cardiac_death
\plain\par
\pard\sl-273 \li0 \ri241 \expndtw-2 \f20 \fs24 3. Mutahal, Apuranto H. Kematian
mendadak. In: Apuranto H, Hoediyanto, editors. Buku ajar
\plain\par
\pard\sl-278 \li0 \ri752 \expndtw-2 \f20 \fs24 ilmu kedokteran forensik dan medi
kolegal. Edisi 3. Surabaya: Airlangga; 2007. p.185-8.
\plain\par
\pard\sl-273 \li0 \ri429 \expndtw-2 \f20 \fs24 4. Cardiac arrest, first aid. [On
line]. 2007 August [cited 2008 july 18];[3 screens]. Available
\plain\par
\pard\sl-278 \li0 \ri2430 \expndtw-3 \f20 \fs24 from: URL: http://www.merck.com/
mmhe/sec24/ch299/ch299a.html
\plain\par
\pard\sl-273 \li0 \ri446 \expndtw-2 \f20 \fs24 5. Sudden cardiac death. [Online]
. 2006 July 16 [cited 2008 july 18];[21 screens]. Available
\plain\par
\pard\sl-278 \li0 \ri1396 \expndtw-3 \f20 \fs24 from: URL: http://www.emedicine.
com/med/topic276.htm#section~Differentials
\plain\par
\pard\sl-273 \li0 \ri592 \expndtw-2 \f20 \fs24 6. Definition of cardiac arrest.
[Online]. 2001 November [cited 2008 Jully 23];[2 screens].
\plain\par
\pard\sl-278 \li0 \ri2175 \expndtw-3 \f20 \fs24 Available from: URL: [http://www
.medicinenet.com/script/main/hp.asp
\plain\par
\pard\sl-273 \li0 \ri45 \expndtw-2 \f20 \fs24 7. Sudden cardiac arrest(SCA). [On
line]. 2008 March [cited 2008 july 18];[4 screens]. Available
\plain\par
\pard\sl-278 \li0 \ri2858 \expndtw-3 \f20 \fs24 from: URL: http://www.medic8.com
/blood-disorders/index.htm
\plain\par
\pard\sl-273 \li0 \ri1186 \expndtw-2 \f20 \fs24 8. Faiz O, Moffat D, editors. Th
e heart II. In: Anatomi at a glance. USA: Blackwell
\plain\par
\pard\sl-278 \li0 \ri6143 \expndtw-4 \f20 \fs24 publishing;2002. P.23-24.
\plain\par
\pard\sl-273 \li0 \ri266 \expndtw-2 \f20 \fs24 9. Thaler MS, editor. Dasar EKG.
In: Satu-satunya EKG yang anda perlukan. Edisi 2. Jakarta:
\plain\par
\pard\sl-278 \li0 \ri6238 \expndtw-4 \f20 \fs24 EGC; 2000. p.10-4,20-2.
\plain\par
\pard\sl-273 \li0 \ri352 \expndtw-2 \f20 \fs24 10. Dix J, editor. Cardiovascular
disease (heart and blood vessels). In: Color atlas of forensik

\plain\par
\pard\sl-278 \li0 \ri4661 \expndtw-3 \f20 \fs24 patology. USA: CRC Press; 2000.
p.54-60.
\plain\par
\pard\sl-273 \li0 \ri315 \expndtw-2 \f20 \fs24 11. Abdul MI. Pedoman Ilmu Kedokt
eran Forensik. Edisi pertama. Jakarta: Binarupa Aksara.
\plain\par
\pard\sl-278 \li0 \ri7124 \expndtw-6 \f20 \fs24 1997. p.330-1.
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108067204fb03012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-227 \li0 \ri6687 \expndtw-23 \b \f10 \fs24 \cf52 CARDIAC ARREST
\plain\par
\pard\sl-362 \li0 \ri4345 \expndtw-16 \f10 \fs24 oleh\cf6 {\ul }{\ul P}{\ul R}{
\ul A}{\ul M}{\ul I}{\ul T}{\ul A}{\ul }{\ul L}{\ul a}{\ul b}\cf0 pada 14 Juli
2009 jam 20:07
\plain\par
\sl-206\fs21\par\pard\pard\sl-335 \li0 \ri717 \expndtw-11 \f10 \fs24 Istilah car
diac arrest dikenal pula dengan istilah lain yaitu kegagalan sistem jantung paru
\plain\par
\pard\sl-335 \li0 \ri28 \expndtw-10 \f10 \fs24 (cardiopulmonary arrest) atau keg
agalan sistem sirkulasi (circulatory arrest). Disini terjadi akibat
\plain\par
\pard\sl-340 \li0 \ri213 \expndtw-12 \f10 \fs24 berhentinya secara tiba tiba per
edaran darah yang normal menyebabkan jantung gagal dalam
\plain\par
\pard\sl-335 \li0 \ri72 \expndtw-11 \f10 \fs24 berkontraksi. Cardiac arrest dibe
dakan dengan serangan jantung (heart attact) walaupun sering
\plain\par
\pard\sl-336 \li0 \ri479 \expndtw-12 \f10 \fs24 kali serangan jantung merupakan
penyebab dari cardiac arrest. Berhentinya sirkulasi darah
\plain\par
\pard\sl-335 \li0 \ri39 \expndtw-12 \f10 \fs24 menyebabkan terhentinya pengirima
n oksigen ke seluruh organ tubuh. Gagalnya sirkulasi darah
\plain\par
\pard\sl-336 \li0 \ri177 \expndtw-12 \f10 \fs24 ke otak menyebabkan hilangnya ke

sadaran dan terhentinya pernapasan. Otak hanya bertahan
\plain\par
\pard\sl-340 \li0 \ri392 \expndtw-11 \f10 \fs24 5 menit saja akibat terhentinya
pengiriman oksigen. Tindakan segera untuk menyelamatkan
\plain\par
\pard\sl-336 \li0 \ri1061 \expndtw-13 \f10 \fs24 keadaan darurat ini adalah deng
an resusitasi (cardiopulmonary resuscitation = CPR).
\plain\par
\sl-192\fs19\par\sl-240\fs24\par\pard\pard\sl-240 \li0 \ri6223 \expndtw-15 \f10
\fs24 Penyebab cardiac arrest :
\plain\par
\sl-100\fs10\par\sl-240\fs24\par\pard\pard\sl-336 \li0 \ri737 \expndtw-11 \f10 \
fs24 Penyebab utama cardiac arrest adalah penyakit jantung sendiri seperti penya
kit jantung
\plain\par
\pard\sl-336 \li0 \ri911 \expndtw-11 \f10 \fs24 koroner, gangguan irama jantung
dan kelainan otot jantung. Kekurangan cairan tubuh
\plain\par
\pard\sl-336 \li0 \ri159 \expndtw-12 \f10 \fs24 mendadak (hypovolemia) atau kehi
langan sejumlah darah seperti pada kecelakaan atau waktu
\plain\expndtw-12 \f10 \fs24 tindakan operasi akan menyebabkan jantung berhenti
berdenyut. Kekurangan oksigen secara
\plain\expndtw-11 \f10 \fs24 mendadak menyebabkan organ penting seperti otak dan
jantung berhenti berfungsi.
\plain\par
\pard\sl-340 \li0 \ri566 \expndtw-13 \f10 \fs24 Penurunan derajat keasaman tubuh
(asidosis) pada ketoasidosis diabetes, gagal ginjal dan
\plain\par
\pard\sl-336 \li0 \ri164 \expndtw-10 \f10 \fs24 pemakaian obat obat tertentu sec
ara berlebihan seperti salisilat, etanol, alkohol, antidepresan
\plain\expndtw-13 \f10 \fs24 akan menyebabkan asidosis. Kadar kalium (K) berlebi
h atau sangat rendah dapat menyebabkan
\plain\par
\pard\sl-336 \li0 \ri357 \expndtw-13 \f10 \fs24 jantung berhenti mendadak. Penur
unan kadar gula darah dan bahkan kadar gula darah yang
\plain\par
\pard\sl-336 \li0 \ri154 \expndtw-11 \f10 \fs24 terlampau tinggi sering dianggap
penyebab berhentinya jantung berdenyut. Trauma paru yang
\plain\expndtw-12 \f10 \fs24 menyebabkan perdarahan di paru dan emboli udara ke
paru (pulmonary embolisme) juga akan
\plain\par
\pard\sl-340 \li0 \ri4664 \expndtw-11 \f10 \fs24 menyebabkan jantung berhenti be
rdenyut.
\plain\par
\sl-192\fs19\par\sl-240\fs24\par\pard\pard\sl-240 \li0 \ri7282 \expndtw-19 \f10
\fs24 Pengobatan :
\plain\par
\sl-91\fs9\par\sl-240\fs24\par\pard\pard\sl-340 \li0 \ri682 \expndtw-12 \f10 \fs
24 Tindakan penyelamatan perlu waktu yang amat minimal. Diagnosa segera diikuti
dengan
\plain\par
\pard\sl-340 \li0 \ri308 \expndtw-12 \f10 \fs24 tindakan resusitasi (CPR) dan de
fibrilisasi jantung perlu dilakukan segera sebagai penyelamat
\plain\par
\pard\sl-335 \li0 \ri7812 \expndtw-23 \f10 \fs24 nyawa.
\plain\par
\sl-287\fs29\par\sl-240\fs24\par\par\pard\pard\sl-240 \li0 \ri7269 \expndtw-22 \
f10 \fs24 Pencegahan :
\plain\par
\sl-100\fs10\par\sl-240\fs24\par\pard\pard\sl-335 \li0 \ri505 \expndtw-14 \f10 \

fs24 Karena sebagian besar penyebab cardiac arrest adalah penyakit jantung maka
pencegahan
\plain\par
\pard\sl-335 \li0 \ri750 \expndtw-11 \f10 \fs24 terbaik adalah dengan memelihara
jantung kita sebaik mungkin. Kontrol tekanan darah,
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108067204fb03012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-273 \li0 \ri100 \expndtw-11 \f10 \fs24 menjaga gula darah tetap s
tabil normal, mencegah terjadinya dislipidemia yaitu peningkatan
\plain\par
\pard\sl-335 \li0 \ri44 \expndtw-13 \f10 \fs24 lemak darah. Konsumsi magnesium (
Mg) dalam jangka panjang diduga efektif dalam menjaga
\plain\par
\pard\sl-331 \li0 \ri6603 \expndtw-15 \f10 \fs24 kesehatan jantung
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108067204fb03012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}

{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108067204fb03012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-267 \li0 \ri7114 \expndtw-7 \f20 \fs24 Henti Jantung
\plain\par
\pard\sl-273 \li0 \ri2254 \expndtw-3 \f20 \fs24 Henti Jantung adalah suatu keada
an dimana jantung berhenti sehingga
\plain\par
\pard\sl-278 \li0 \ri4006 \expndtw-3 \f20 \fs24 tidak dapat memompakan darah ke
seluruh tubuh.
\plain\par
\pard\sl-273 \li0 \ri2125 \expndtw-3 \f20 \fs24 Beberapa penyebab yang dapat mem
ungkinkan terjadinya henti jantung
\plain\par
\pard\sl-278 \li0 \ri7642 \expndtw-10 \f20 \fs24 adalah :
\par
\plain\pard\sl-273 \li0 \ri6677 \expndtw-1 \f20 \fs24 \plain\tx485 \tab \expndtw-7 \f20 \fs24 Cardiac cause
\plain\par
\pard\sl-278 \li0 \ri8208 \expndtw-2 \f20 \fs24 o
\par
\plain\pard\sl-273 \li0 \ri6060 \expndtw-4 \f20 \fs24 Acute Myocard Infarction
\plain\par
\plain\par
\pard\sl-273 \li0 \ri6738 \expndtw-6 \f20 \fs24 SA Node paralyze
\plain\par
\plain\par
\pard\sl-273 \li0 \ri7443 \expndtw-11 \f20 \fs24 AV Block
\plain\par
\plain\par
\pard\sl-273 \li0 \ri6306 \expndtw-4 \f20 \fs24 Ventricular Fibrillation
\par
\plain\pard\sl-278 \li0 \ri6280 \expndtw-1 \f20 \fs24 \plain\tx485 \tab \expndtw-6 \f20 \fs24 Non-cardiac cause
\plain\par
\par
\plain\pard\sl-278 \li0 \ri4132 \expndtw0 \f20 \fs24 Excessive Vagal stimulation
Neurologic cause
\plain\par
\plain\par
\pard\sl-278 \li0 \ri5355 \expndtw0 \f20 \fs24 Toxicity of Digitalis Drug cause
\plain\par
\plain\par
\pard\sl-278 \li0 \ri4962 \expndtw0 \f20 \fs24 Toxicity of Beta Blocker Drug cau
se
\plain\par
\plain\par
\pard\sl-278 \li0 \ri5251 \expndtw0 \f20 \fs24 Trauma Outer environment cause
\plain\par
\sl-273\fs27\par\pard\pard\sl-331 \li0 \ri414 \expndtw-2 \f20 \fs24 Pada keadaan
ini, jantung tidak dapat memompakan darah ke seluruh tubuh sehingga aliran
\plain\par
\pard\sl-331 \li0 \ri240 \expndtw-2 \f20 \fs24 darah sistemik berhenti. Hal ini
dapat mengakibatkan kerusakan organ karena suplai darah ke
\plain\expndtw-3 \f20 \fs24 seluruh organ tubuh berhenti atau tidak tercapai.
\plain\par
\sl-283\fs28\par\pard\pard\sl-326 \li0 \ri36 \expndtw-2 \f20 \fs24 Organ yang pa
ling pertama menerima efek buruk dari keadaan ini adalah Otak. Otak terdiri atas
\plain\expndtw-2 \f20 \fs24 banyak sel sel saraf dan sangat rentan akan masalah
kekurangan suplai oksigen. Diperkirakan
\plain\par
\pard\sl-331 \li0 \ri284 \expndtw-2 \f20 \fs24 jika sekitar dalam 5 10 menit sup
lai oksigen darah ke arah Otak berhenti, maka Otak sudah
\plain\par
\pard\sl-326 \li0 \ri4943 \expndtw-3 \f20 \fs24 mengalami kematian atau Brain De
ath.
\plain\par
\sl-278\fs28\par\pard\pard\sl-278 \li0 \ri2084 \expndtw-2 \f20 \fs24 Henti Jantu
ng dapat dibagi 2, yaitu menurut keadaan jantung itu sendiri,
\plain\par
\pard\sl-278 \li0 \ri6713 \expndtw-5 \f20 \fs24 dan fungsi jantung
\par
\plain\pard\sl-273 \li0 \ri6423 \expndtw-1 \f20 \fs24 \plain\tx485 \tab \expndtw-6 \f20 \fs24 Keadaan jantung
\par
\plain\sl-278\fs28\par\pard\pard\sl-331 \li0 \ri671 \expndtw-2 \f20 \fs24 Pada k
eadaan ini, jantung berhenti total, tidak berdenyut, dan tidak memompakan darah.
\plain\expndtw-2 \f20 \fs24 Keadaan ini sering terjadi pada Acute Myocard Infarc
tion, dimana terjadinya infark atau
\plain\par
\pard\sl-326 \li0 \ri207 \expndtw-2 \f20 \fs24 kematian akut pada sel sel otot j
antung yang mengakibatkan fungsi jantung turun mendadak
\plain\par
\pard\sl-331 \li0 \ri124 \expndtw-2 \f20 \fs24 dan berhenti. Acute Myocard Infar
ction biasanya diakibatkan oleh oklusi akut pembuluh darah
\plain\par
\pard\sl-326 \li0 \ri327 \expndtw-2 \f20 \fs24 koroner jantung, ataupun beberapa
ramus-nya. Ramus yang paling akut dalam menimbulkan
\plain\par
\pard\sl-331 \li0 \ri129 \expndtw-2 \f20 \fs24 henti jantung mendadak dan kemati
an mendadak saat terjadi obstruksi pada pambuluh tersebut
\plain\par
\pard\sl-326 \li0 \ri90 \expndtw-2 \f20 \fs24 adalah Ramus Descendens Anterior S
inistra atau biasa dikenal sebagai Artery of Sudden Death
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108067204fb03012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-267 \li0 \ri6624 \expndtw-1 \f20 \fs24 \plain\tx485 \tab \expndtw-7 \f20 \fs24 Fungsi Jantung
\par
\plain\sl-273\fs27\par\pard\pard\sl-331 \li0 \ri35 \expndtw-2 \f20 \fs24 Pada ke
adaan ini, jantung masih dapat berdenyut, namun tidak dapat memompakan darah sec
ara
\plain\par
\pard\sl-331 \li0 \ri330 \expndtw-2 \f20 \fs24 optimal, sel sel otot jantung dap
at ditemukan dalam keadaan sehat, konduksi listrik jantung
\plain\par
\pard\sl-331 \li0 \ri144 \expndtw-2 \f20 \fs24 terganggu. Keadaan ini sering dit
emukan pada Ventricular Fibrillation, dimana konduksi listrik
\plain\par
\pard\sl-326 \li0 \ri878 \expndtw-2 \f20 \fs24 jantung amat sangat tidak beratur
an, dan jantung hanya tampak seperti bergetar, bukan
\plain\par
\pard\sl-331 \li0 \ri368 \expndtw-2 \f20 \fs24 berdenyut. Sehingga, jantung tida
k dapat berfungsi sebagaimana mestinya, meskipun, secara
\plain\expndtw-3 \f20 \fs24 kasar, keadaan sel sel otot jantung itu sendiri norm
al.
\plain\par
\sl-273\fs27\par\pard\pard\sl-278 \li0 \ri6782 \expndtw-5 \f20 \fs24 Manifestasi
Klinis
\plain\par
\pard\sl-278 \li0 \ri2235 \expndtw-3 \f20 \fs24 Keadaan keadaan yang mendahului
terjadinya Henti Jantung adalah :
\par
\plain\sl-220\fs22\par\sl-240\fs24\par\pard\pard\sl-240 \li0 \ri5518 \expndtw-1
\f20 \fs24 \plain\tx485 \tab \expndtw-4 \f20 \fs24 Nyeri dada hebat mendadak
\plain\par
\pard\sl-427 \li0 \ri6400 \expndtw-1 \f20 \fs24 \plain\tx485 \tab \expndtw-6 \f20 \fs24 Sesak nafas hebat
\plain\par
\pard\sl-427 \li0 \ri3382 \expndtw-1 \f20 \fs24 \plain\tx485 \tab \expndtw-3 \f20 \fs24 Bradicardia ataupun Tachicardia menetap
yang lama
\plain\par
\pard\sl-422 \li0 \ri3073 \expndtw-1 \f20 \fs24 \plain\tx485 \tab \expndtw-3 \f20 \fs24 Penurunan kesadaran progresif cepat atau
pun mendadak
\par
\plain\sl-278\fs28\par\pard\pard\sl-278 \li0 \ri2187 \expndtw-3 \f20 \fs24 Sedan
gkan keadaan keadaan yang biasanya ditemukan saat terjadinya
\plain\par
\pard\sl-278 \li0 \ri6434 \expndtw-4 \f20 \fs24 Henti Jantung adalah :
\par
\f20 \fs24 \plain\tx485 \tab \expndtw-6 \f20 \fs24 Pingsan mendadak
\plain\par
\pard\sl-427 \li0 \ri7371 \expndtw-1 \f20 \fs24 \plain\tx485 \tab \expndtw-16 \f20 \fs24 Apnea
\plain\par
\pard\sl-427 \li0 \ri5205 \expndtw-1 \f20 \fs24 \plain\tx485 \tab \expndtw-4 \f20 \fs24 Otot otot seluruh tubuh lemas
\par
\plain\sl-316\fs32\par\pard\pard\sl-240 \li0 \ri7508 \expndtw-9 \f20 \fs24 Diagn
osis
\plain\par
\sl-273\fs27\par\pard\pard\sl-331 \li0 \ri254 \expndtw-2 \f20 \fs24 Diagnosis He
nti Jantung adalah dengan menilai langsung kondisi pasien saat terjadi serangan,
\plain\par
\pard\sl-331 \li0 \ri3263 \expndtw-3 \f20 \fs24 ataupun pada rekaman EKG pada pa
sien yang dirawat inap
\plain\par
\sl-316\fs32\par\pard\pard\sl-240 \li0 \ri7358 \expndtw-9 \f20 \fs24 Tatalaksana
\plain\par
\sl-273\fs27\par\pard\pard\sl-331 \li0 \ri84 \expndtw-2 \f20 \fs24 Tindakan pert
ama yang harus dilakukan saat menemukan kasus Henti Jantung, adalah resusitasi
\plain\par
\pard\sl-331 \li0 \ri347 \expndtw-2 \f20 \fs24 Jantung Paru untuk mengembalikan
fungsi jantung. Lakukan cepat dalam batas waktu paling

\plain\par
\pard\sl-331 \li0 \ri1860 \expndtw-3 \f20 \fs24 lama 10 menit, sambil menunggu d
atangnya pertolongan medis lebih lanjut
\plain\par
\sl-283\fs28\par\pard\pard\sl-326 \li0 \ri235 \expndtw-2 \f20 \fs24 Jika berhasi
l, stabilkan vital sign, lalu lakukan observasi pada pasien untuk menemukan seba
b
\plain\par
\pard\sl-326 \li0 \ri550 \expndtw-2 \f20 \fs24 Henti Jantungnya, dan tegakkan di
agnosis bila ada penyakit penyerta, namun dengan tetap
\plain\par
\pard\sl-331 \li0 \ri5099 \expndtw-4 \f20 \fs24 menkonservasi keadaan umum pasie
n
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108067204fb03012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-280 \li420 \ri380 \expndtw-2 \f20 \fs24 Perlu diingat bahwa keada
an Henti Jantung bukan merupakan diagnosis pasti dari Kematian.
\plain\par
\pard\sl-331 \li420 \ri32 \expndtw-2 \f20 \fs24 Kematian lebih didefinisikan seb
agai suatu keadaan dimana seluruh organ, utamanya Otak, telah
\plain\par
\pard\sl-326 \li420 \ri391 \expndtw-2 \f20 \fs24 mengalami kehilangan fungsinya
secara total dan irreversible Henti Jantung perlu dibedakan
\plain\par
\pard\sl-331 \li420 \ri149 \expndtw-2 \f20 \fs24 dengan Gagal Jantung. Pada kead
aan Henti Jantung, jantung tidak berfungsi dan tidak bergerak
\plain\par
\pard\sl-326 \li420 \ri197 \expndtw-2 \f20 \fs24 atau tidak berdenyut baik untuk
memompakan darah, dan manifestasinya lebih akut sedangkan
\plain\par
\pard\sl-331 \li420 \ri288 \expndtw-2 \f20 \fs24 pada keadaan Gagal Jantung, jan
tung masih bisa berdenyut, namun tidak optimal, manifestasi
\plain\par
\pard\sl-326 \li420 \ri3397 \expndtw-3 \f20 \fs24 dan perjalanan penyakitnya leb
ih ke arah progresif kronik
\plain\par
\sl-278\fs28\par\pard\pard\sl-278 \li420 \ri2216 \expndtw-3 \f20 \fs24 Jadi, Hen
ti Jantung secara tidak langsung menyebabkan Gagal Jantung,
\plain\par
\pard\sl-278 \li420 \ri2072 \expndtw-3 \f20 \fs24 namun Gagal Jantung tidak sela
lu mengakibatkan keadaan Henti Jantung
\plain\par
\pard\sl-273 \li420 \ri6335 \expndtw-4 \f20 \fs24 Resusitasi Jantung Paru
\plain\par
\sl-283\fs28\par\pard\pard\sl-326 \li420 \ri550 \expndtw-2 \f20 \fs24 Resusitasi
Jantung Paru adalah tindakan untuk mengembalikan fungsi Jantung dan Paru ke
\plain\expndtw-3 \f20 \fs24 keadaannya semula yang bertujuan untuk mengembalikan
sirkulasi sistemik.
\plain\par
\sl-278\fs28\par\pard\pard\sl-278 \li420 \ri2261 \expndtw-3 \f20 \fs24 Beberapa
langkah langkah yang harus diperhatikan untuk melakukan
\plain\par
\pard\sl-278 \li420 \ri4305 \expndtw-3 \f20 \fs24 resusitasi Jantung Paru adalah
sebagai berikut :
\plain\par
\sl-273\fs27\par\pard\pard\sl-331 \li16 \ri572 \expndtw-2 \f20 \fs24 1. Saat mel
ihat korban yang terjatuh dan diperkirakan karena keadaan Henti Jantung, amankan
\plain\par
\pard\sl-331 \li419 \ri4140 \expndtw-3 \f20 \fs24 daerah sekitar kejadian/dimana
korban tergeletak
\plain\par
\sl-316\fs32\par\pard\pard\sl-240 \li419 \ri2439 \expndtw-3 \f20 \fs24 2. Teriak
lah untuk meminta datangnya petolongan medis lebih lanjut
\plain\par
\sl-283\fs28\par\pard\pard\sl-326 \li16 \ri119 \expndtw-2 \f20 \fs24 3. Nilai 3
keadaan korban, yaitu Airway, Breathing, dan Circulation. Dan cobalah raba leher
korban
\plain\par
\pard\sl-326 \li16 \ri4005 \fi403 \expndtw-3 \f20 \fs24 untuk memeriksa denyut A
rteri Carotis Communis
\plain\par
\sl-278\fs28\par\pard\pard\sl-331 \li16 \ri900 \expndtw-2 \f20 \fs24 4. Singkirk
an segala benda asing yang mengobstruksi jalan napas sang korban dengan cara
\plain\par
\pard\sl-331 \li419 \ri2437 \expndtw-3 \f20 \fs24 memiringkan tubuh korban, lalu
korek isi mulut dan tenggorokannya
\plain\par
\sl-283\fs28\par\pard\pard\sl-273 \li419 \ri2399 \expndtw-3 \f20 \fs24 5. Pukul
dada korban dengan menggunakan kepalan tangan sebanyak
\plain\par
\pard\sl-273 \li419 \ri7900 \expndtw-11 \f20 \fs24 2 kali
\plain\par
\pard\sl-278 \li419 \ri2927 \expndtw-2 \f20 \fs24 6. Jika belum berhasil, lakuka
n resusitasi dengan cara memberi
\plain\par
\pard\sl-273 \li419 \ri4255 \expndtw-3 \f20 \fs24 pernafasan buatan dan masase j
antung eksterna.
\plain\par
\sl-278\fs28\par\pard\pard\sl-331 \li16 \ri548 \expndtw-2 \f20 \fs24 a. Beri per
nafasan dengan cara mulut ke mulut. Angkat dahi korban, lalu tarik sedikit dagun
ya.
\plain\par
\pard\sl-331 \li419 \ri257 \expndtw-2 \f20 \fs24 Tempelkan mulut Anda sehingga m
enutupi mulut korban lalu tiupkan udara. Perhatikan gerak
\plain\par
\pard\sl-326 \li419 \ri401 \expndtw-2 \f20 \fs24 dada, jika dada menggembung saa
t ditiupkan udara, maka cara pemberian nafas sudah benar
\plain\par
\sl-278\fs28\par\pard\pard\sl-331 \li419 \ri684 \expndtw-2 \f20 \fs24 b. Beri ma
sase jantung dengan cara menekan daerah tengah sekitar garis proyeksi Papilla
\plain\par
\pard\sl-331 \li419 \ri501 \expndtw-3 \f20 \fs24 Mammae dengan menggunakan tanga
n. Tenaga yang dikerahkan bukan tenaga otot tangan,
\plain\par
\pard\sl-326 \li419 \ri153 \expndtw-2 \f20 \fs24 melainkan tenaga berat tubuh ka
li pernafasan buatan. Jika penolong ada 2 orang, maka lakukan
\plain\par
\pard\sl-331 \li419 \ri2223 \expndtw-2 \f20 \fs24 30 kali masase jantung, dan 2
kali pernafasan buatan, secara bergantian
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108067204fb03012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-267 \li0 \ri3871 \expndtw-3 \f20 \fs24 d. Resusitasi dilakukan se
lama maksimal 6 7 menit
\plain\par
\pard\sl-273 \li0 \ri3650 \expndtw-3 \f20 \fs24 e.Resusitasi dihentikan jika pen
olong sudah tidak dapat
\plain\par
\sl-278\fs28\par\pard\pard\sl-331 \li0 \ri484 \expndtw-2 \f20 \fs24 melakukan ti
ndakan resusitasi lagi, respon dari korban tidak ditemukan selama lebih dari 10
\plain\par
\pard\sl-331 \li0 \ri1066 \expndtw-2 \f20 \fs24 menit sejak serangan terjadi, pu
pil berdilatasi, Artery Carotis tidak teraba, dan Apnea
\plain\par
\sl-283\fs28\par\pard\pard\sl-273 \li0 \ri2761 \expndtw-2 \f20 \fs24 7. Jika ber
hasil, miringkan tubuh korban, lipat salah satu kaki dan
\plain\par
\pard\sl-273 \li0 \ri7559 \expndtw-9 \f20 \fs24 tangannya
\plain\par
\pard\sl-278 \li0 \ri3222 \expndtw-3 \f20 \fs24 8.Jika belum berhasil, dan pembe
rian resusitasi sudah cukup
\plain\par
\pard\sl-273 \li0 \ri2864 \expndtw-3 \f20 \fs24 sebagaimana seharusnya, maka hen
tikan tindakan resusitasi, dan
\plain\par
\pard\sl-278 \li0 \ri5309 \expndtw-4 \f20 \fs24 diagnosis sebagai Kematian Jantu
ng
\plain\par
\pard\sl-273 \li0 \ri2165 \expndtw-3 \f20 \fs24 Beberapa jenis obat obatan yang
bisa dipakai untuk resusitasi jantung :
\par
\f20 \fs24 \plain\tx485 \tab \expndtw-7 \f20 \fs24 Nitrogliserin
\plain\par
\pard\sl-427 \li0 \ri7223 \expndtw-1 \f20 \fs24 \plain\tx485 \tab \expndtw-10 \f20 \fs24 Lidokain
\plain\par
\pard\sl-422 \li0 \ri6903 \expndtw-1 \f20 \fs24 \plain\tx485 \tab \expndtw-8 \f20 \fs24 Prokainamid
\plain\par
\pard\sl-427 \li0 \ri7176 \expndtw-1 \f20 \fs24 \plain\tx485 \tab \expndtw-9 \f20 \fs24 Bretilium
\par
\plain\sl-283\fs28\par\pard\pard\sl-273 \li0 \ri2108 \expndtw-3 \f20 \fs24 Langk
ah langkah diatas adalah Basic dan Advanced Life Support, yang
\plain\expndtw-3 \f20 \fs24 bertujuan untuk memulihkan fungsi sirkulasi sistemik
.
\plain\par
\sl-283\fs28\par\pard\pard\sl-326 \li0 \ri778 \expndtw-2 \f20 \fs24 Jika pertolo
ngan medis yang lebih lengkap sudah dapat dilakukan, maka perlu dilakukan
\plain\par
\pard\sl-326 \li0 \ri39 \expndtw-2 \f20 \fs24 observasi lebih lanjut akan penyeb
ab henti jantung, penyakit yang menyertai, penstabilan kondisi
\plain\par
\pard\sl-331 \li0 \ri4350 \expndtw-3 \f20 \fs24 pasien, serta perencanaan terapi
yang diberikan
\plain\par
\sl-283\fs28\par\pard\pard\sl-326 \li0 \ri1136 \expndtw-2 \f20 \fs24 Pasien dira
wat inap apabila keadaannya masih labil atau adanya indikasi medis yang
\plain\par
\pard\sl-326 \li0 \ri799 \expndtw-2 \f20 \fs24 menandakan probabilitas tinggi un
tuk terjadinya relaps Henti Jantung. Pasien rawat inap
\plain\par
\pard\sl-331 \li0 \ri453 \expndtw-3 \f20 \fs24 mendapat pengawasan yang cukup ke
tat akan tanda tanda vital umum selama pemeriksaan
\plain\par
\pard\sl-326 \li0 \ri6554 \expndtw-4 \f20 \fs24 ataupun selama terapi
\plain\par
\sl-278\fs28\par\pard\pard\sl-331 \li0 \ri232 \expndtw-2 \f20 \fs24 Pasien dinya
takan boleh pulang apabila penyakit dasar yang mengakibatkan Henti Jantung-nya
\plain\expndtw-2 \f20 \fs24 sudah teratasi, dan kondisi vital sudah lebih stabil
selama masa perawatan. Tentunya, tidak lupa
\plain\par
\pard\sl-326 \li0 \ri250 \expndtw-2 \f20 \fs24 akan masalah edukasi apabila peny
ebab Henti Jantung tersebut berkaitan dengan masalah gaya
\plain\par
\pard\sl-331 \li0 \ri4175 \expndtw-3 \f20 \fs24 hidup, kebiasaan, lingkungan, at
aupun pekerjaan.
\plain\par
\sl-283\fs28\par\pard\pard\sl-273 \li0 \ri1855 \expndtw-2 \f20 \fs24 Dikutip dar
i : Petunjuk Praktis Anestesi dari EGC, Buku Skill Lab Semester
\plain\par
\pard\sl-273 \li0 \ri3435 \expndtw-3 \f20 \fs24 4 tentang Resusitasi Jantung\cf6
Paru,http://www.s cribd.com
\plain\par
\sl-206\fs21\par\sl-240\fs24\par\par\par\pard\pard\sl-240 \li0 \ri2936 \expndtw3 \f20 \fs24 c.Jika penolong hanya satu orang, maka lakukan 15 kali masase
\par
{\shp
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01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108067204fb03012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-267 \li20 \ri3153 \expndtw-3 \f20 \fs24 jantung dengan kecepatan
kira kira 60 kali per menit, dan 2
\par
\plain\sl-122\fs12\par\sl-240\fs24\par\par\par\pard\pard\sl-307 \li20 \ri6040 \e
xpndtw-11 \f30 \fs22 \cf2 H\f10 enti jantung (Cardiac Arrest)
\plain\par
\pard\sl-307 \li20 \ri161 \expndtw-11 \f10 \fs22 \cf2 Terhentinya denyut jantung
dan sirkulasi darah secara tiba-tiba pada seseorang yang sebelumnya tidak
\plain\par
\pard\sl-316 \li20 \ri6124 \expndtw-17 \f40 \fs22 \cf2 P\f10 mengalami gangguan
apa2.
\plain\par
\pard\sl-321 \li20 \ri3931 \expndtw-12 \f10 \fs22 \cf2 Merupakan keadaan kegawat
daruratan\f40 P\f10 kardiovaskuler
\plain\par
\pard\sl-311 \li20 \ri7303 \expndtw-13 \f10 \fs22 \cf2 gawat darurat
\plain\par
\pard\sl-316 \li20 \ri264 \expndtw-12 \f10 \fs22 \cf2 Keadaan ini kemudian diiku
ti dengan\f40 P\f10 berhentinya fungsi pernafasan dan hilangnya kesadaran secar
a
\plain\par
\pard\sl-311 \li20 \ri7851 \expndtw-16 \f10 \fs22 \cf2 refleks.
\plain\par
\pard\sl-321 \li20 \ri491 \expndtw-12 \f10 \fs22 \cf2 Resusitasi kardiopulmonal
dan serebral harus segera dimulai segera\f40 P\f10 setelah diagnosis ditegakkan
.
\plain\par
\pard\sl-316 \li67 \ri30 \expndtw-13 \f10 \fs22 \cf2 DELAY .!!! Dengan membuang\
f40 P\f10 DON T buang waktu dengan mengukur tekanan darah, menilai keadaan
\plain\par
\pard\sl-312 \li19 \ri6500 \expndtw-17 \f10 \fs22 \cf2 nadi dan membuta EKG.
\plain\par
\pard\sl-307 \li19 \ri4219 \expndtw-14 \f10 \fs22 \cf2 Diagnosis cukup didasarka
n atas gejala klinis sebagai
\plain\par
\pard\sl-311 \li19 \ri7766 \expndtw-12 \f10 \fs22 \cf2 berikut :
\plain\par
\pard\sl-316 \li19 \ri1186 \expndtw-13 \f10 \fs22 \cf2 Gerakan pernafasan dan an
gin pernafasan yang menghilang atau\f40 P\f10 sangat lemah ; gasping.
\plain\par
\pard\sl-321 \li19 \ri94 \expndtw-11 \f10 \fs22 \cf2 Denyut nadi dan suara jantu
ng menghilang\f40 P\f10 atau sangat lemah, bradikardia atau takikardia yang san
gat
\plain\par
\pard\sl-312 \li19 \ri7597 \expndtw-16 \f10 \fs22 \cf2 menyolok.
\plain\par
\pard\sl-316 \li19 \ri5533 \expndtw-13 \f40 \fs22 \cf2 P\f30 H\f10 ilangnya kesa
daran. Dilatasi pupil
\plain\par
\pard\sl-321 \li19 \ri6533 \expndtw-16 \f40 \fs22 \cf2 P\f10 Death like appearan
ce
\plain\par
\pard\sl-312 \li19 \ri7839 \expndtw-16 \f10 \fs22 \cf2 Etiologi
\plain\par
\pard\sl-307 \li19 \ri5123 \expndtw-10 \f10 \fs22 \cf2 Etiologi henti jantung an
tara lain karena :
\plain\par
\pard\sl-307 \li19 \ri1883 \expndtw-12 \f10 \fs22 \cf2 1. Terhentinya sistem per
nafasan secara tiba-tiba yang dapat disebabkan karena :
\plain\par
\pard\sl-312 \li19 \ri2858 \expndtw-12 \f10 \fs22 \cf2 - penyumbatan jalan nafas
; aspirasi cairan lambung atau benda asing
\plain\par
\pard\sl-307 \li19 \ri5284 \expndtw-12 \f10 \fs22 \cf2 - Sekresi air yang terdap
at dijalan nafas
\plain\par
\pard\sl-307 \li19 \ri4966 \expndtw-12 \f10 \fs22 \cf2 seperti yg terjadi pada k
eadaan tenggelam,
\plain\par
\pard\sl-312 \li19 \ri5808 \expndtw-13 \f10 \fs22 \cf2 edema paru, lendir yang b
anyak.
\plain\par
\pard\sl-307 \li19 \ri5145 \expndtw-15 \f10 \fs22 \cf2 - Edema atau spasme salur
an pernafasan
\plain\par
\pard\sl-307 \li19 \ri5957 \expndtw-14 \f10 \fs22 \cf2 bagian atas atau bagian b
awah
\plain\par
\pard\sl-312 \li19 \ri4971 \expndtw-12 \f10 \fs22 \cf2 - Kelainan anatomik seper
ti atresia choanal
\plain\par
\sl-139\fs14\par\sl-240\fs24\par\par\pard\pard\sl-307 \li19 \ri3437 \expndtw-13
\f10 \fs22 \cf2 - Depresi susunan saraf pusat, yang dapat disebabkan karena :
\plain\par
\pard\sl-307
\plain\par
\pard\sl-312
\plain\par
\pard\sl-307
\plain\par
\pard\sl-307
inggi
\plain\par
\pard\sl-312
\plain\par
\pard\sl-307
t
\plain\par
\pard\sl-307
\li19 \ri7314 \expndtw-15 \f10 \fs22 \cf2 - Obat-obatan

\li19 \ri7845 \expndtw-24 \f10 \fs22 \cf2 - Racun
\li19 \ri7465 \expndtw-21 \f10 \fs22 \cf2 - Rudapaksa
\li19 \ri6197 \expndtw-11 \f10 \fs22 \cf2 - Arus listrik tegangan t
\li19 \ri7388 \expndtw-19 \f10 \fs22 \cf2 - Edema otak
\li19 \ri7170 \expndtw-16 \f10 \fs22 \cf2 -\f30 H\f10 ipoksia bera
\li19 \ri7357 \expndtw-18 \f10 \fs22 \cf2 -\f30 H\f10 iperkapnia
\par
{\shp
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010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108067204fb03012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-250 \li0 \ri5172 \expndtw-12 \f10 \fs22 \cf2 - Penyakit SSP ; ens
efalitis, poliomielitis,
\plain\par
\pard\sl-307 \li0 \ri7724 \expndtw-22 \f10 \fs22 \cf2 SGB, dll.
\plain\par
\sl-134\fs13\par\sl-240\fs24\par\par\pard\pard\sl-312 \li0 \ri2407 \expndtw-12 \
f10 \fs22 \cf2 2. Terhentinya peredaran darah secara tiba-tiba, yang disebabkan
karena :
\plain\par
\pard\sl-312 \li0 \ri4472 \expndtw-13 \f10 \fs22 \cf2 -\f30 H\f10 ipoksia, Asid
osis, hiperkapnia karena penyakit
\plain\par
\pard\sl-307 \li0 \ri4269 \expndtw-11 \f10 \fs22 \cf2 paru atau karena henti per
nafasan secara tiba-tiba.
\plain\par
\pard\sl-307 \li0 \ri4387 \expndtw-16 \f10 \fs22 \cf2 - Rangsangan vagus misalny
a karena penghisapan
\plain\par
\pard\sl-312 \li0 \ri4193 \expndtw-10 \f10 \fs22 \cf2 tenggorok, endoskopi, dila
tasi rektum, operasi mata

\plain\par
\pard\sl-307 \li0 \ri6143 \expndtw-11 \f10 \fs22 \cf2 - Arus listrik tegangan ti
nggi
\plain\par
\pard\sl-307 \li0 \ri3967 \expndtw-9 \f10 \fs22 \cf2 - Obat-obatan, terutama dig
italis, kuinidin, kalium obat
\plain\par
\pard\sl-312 \li0 \ri7582 \expndtw-19 \f10 \fs22 \cf2 anastesia.
\plain\par
\pard\sl-307 \li0 \ri4273 \expndtw-10 \f10 \fs22 \cf2 - Aritmia yang hebat, kare
na obat-obatan, penyakit
\plain\par
\pard\sl-307 \li0 \ri5811 \expndtw-10 \f10 \fs22 \cf2 jantung, kateterisasi jant
ung, dll
\plain\par
\pard\sl-312 \li0 \ri4385 \expndtw-13 \f10 \fs22 \cf2 - Shock (trauma, perdaraha
n, sepsis, pada operasi
\plain\par
\pard\sl-307 \li0 \ri5762 \expndtw-13 \f10 \fs22 \cf2 dan pasca operasi, dehidra
si, dll)
\plain\par
\pard\sl-307 \li0 \ri5322 \expndtw-12 \f10 \fs22 \cf2 - Keadaan terminal berbaga
i penyakit.
\plain\par
\pard\sl-312 \li0 \ri4545 \expndtw-11 \f10 \fs22 \cf2 - Efusi perikardium dengan
tamponade jantung.
\plain\par
\sl-302\fs30\par\pard\pard\sl-312 \li0 \ri265 \expndtw-12 \f10 \fs22 \cf2 3. Ter
ganggunya fungsi sistem saraf, yang terjadi sebagai akibat terganggunya sistem p
ernafasan dan
\plain\par
\pard\sl-312 \li0 \ri7039 \expndtw-15 \f10 \fs22 \cf2 peredaran darah
\plain\par
\pard\sl-307 \li0 \ri377 \expndtw-11 \f10 \fs22 \cf2 Dalam susunan saraf pusat t
erjadi iskemia, hipoksi dan hiperkapnia, asidosis dan hipoglikemia, yang
\plain\par
\pard\sl-312 \li0 \ri37 \expndtw-10 \f10 \fs22 \cf2 berakibat terganggunya metab
olisme otak disertai dengan terjadinya edema serebri dan di ikuti dengan
\plain\par
\pard\sl-307 \li0 \ri7266 \expndtw-11 \f10 \fs22 \cf2 infark serebri.
\plain\par
\pard\sl-307 \li0 \ri4115 \expndtw-13 \f10 \fs22 \cf2 Susunan saraf pusat sangat
rentan terhadap keadaan
\plain\par
\pard\sl-312 \li0 \ri5090 \expndtw-10 \f10 \fs22 \cf2 diatas, urutan kerentan te
rsebut adalah :
\plain\par
\pard\sl-316 \li0 \ri3824 \expndtw-11 \f10 \fs22 \cf2 Korteks serebri akan mende
rita kerusakan setelah 3\f40 P\f10 5
\plain\par
\pard\sl-312 \li0 \ri7911 \expndtw-16 \f10 \fs22 \cf2 menit
\plain\par
\pard\sl-316 \li0 \ri4645 \expndtw-9 \f40 \fs22 \cf2 P\f10 Pusat pupil dan palpe
br, setelah 5 10 menit
\plain\par
\pard\sl-321 \li0 \ri5582 \expndtw-9 \f40 \fs22 \cf2 P\f10 Serebelum, setelah 10
15 menit
\plain\par
\pard\sl-321 \li0 \ri3833 \expndtw-10 \f10 \fs22 \cf2 Pusat peredaran darah dan\
f40 P\f10 pernafasan, setelah 20 30

\plain\par
\pard\sl-307 \li0 \ri7911 \expndtw-16 \f10 \fs22 \cf2 menit
\plain\par
\pard\sl-321 \li0 \ri5582 \expndtw-12 \f10 \fs22 \cf2 Medula spinalis, setelah 4
5\f40 P\f10 menit
\plain\par
\pard\sl-321 \li0 \ri5344 \expndtw-12 \f40 \fs22 \cf2 P\f10 Ganglion simpatik, s
etelah 60 menit.
\plain\par
\pard\sl-307 \li0 \ri6926 \expndtw-17 \f10 \fs22 \cf2 Penatalaksanaan :
\plain\par
\pard\sl-312 \li0 \ri6132 \expndtw-13 \f10 \fs22 \cf2 Segera lakukan resusitasi
!!!
\plain\par
\pard\sl-307 \li0 \ri5718 \expndtw-9 \f10 \fs22 \cf2 Langkah langkah tindakan pa
da
\plain\par
\pard\sl-307 \li0 \ri5854 \expndtw-13 \f10 \fs22 \cf2 Resusitasi dapat dibagi me
njadi
\plain\par
\pard\sl-312 \li0 \ri6792 \expndtw-11 \f10 \fs22 \cf2 tiga tahapan, yaitu :
\plain\par
\pard\sl-307 \li0 \ri5625 \expndtw-13 \f10 \fs22 \cf2 Tahapan 1 : Bantuan hidup
dasar /
\plain\par
\pard\sl-307 \li0 \ri8106 \expndtw-32 \f10 \fs22 \cf2 BLS
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108067204fb03012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-250 \li0 \ri6264 \expndtw-14 \f10 \fs22 \cf2 Tahapan 2 : Bantuan
hidup
\plain\par
\pard\sl-307 \li0 \ri7309 \expndtw-16 \f10 \fs22 \cf2 lanjutan / ALS
\plain\par
\pard\sl-312 \li0 \ri5806 \expndtw-13 \f10 \fs22 \cf2 Tahapan 3 : Bantuan hidup
terus
\plain\par
\pard\sl-307 \li0 \ri7270 \expndtw-20 \f10 \fs22 \cf2 menerus / PLS
\plain\par
\pard\sl-307 \li0 \ri7870 \expndtw-19 \f10 \fs22 \cf2 Prinsip
\plain\par
\pard\sl-312 \li158 \ri3656 \expndtw-14 \f10 \fs22 \cf2 Jangan mencelakakan korb
an dengan metode yang salah.
\plain\par
\pard\sl-307 \li158 \ri2479 \expndtw-12 \f10 \fs22 \cf2 Jangan membuang waktu un
tuk prosedur diagnostik yang tidak berguna
\plain\par
\pard\sl-307 \li158 \ri660 \expndtw-13 \f10 \fs22 \cf2 Jangan memulai usaha apap
un yang memakan biaya untuk menunda kematian bila kasus telah
\plain\par
\pard\sl-312 \li0 \ri7509 \expndtw-12 \f10 \fs22 \cf2 irreversibel
\plain\par
\pard\sl-307 \li0 \ri317 \expndtw-10 \f10 \fs22 \cf2 Merupakan suatu kondisi dim
ana jantung berhenti memompakan darah (berkontraksi) yang ditandai
\plain\par
\pard\sl-307 \li0 \ri7822 \expndtw-22 \f10 \fs22 \cf2 dengan
\plain\par
\pard\sl-321 \li388 \ri3108 \expndtw-9 \f40 \fs22 \cf2 y\f10 ketidaksadaran yan
g terjadi sebagai kolaps yang tiba-tiba,
\plain\par
\pard\sl-321 \li388 \ri1709 \expndtw-8 \f40 \fs22 \cf2 y\f10 tidak ada denyut n
adi yang teraba pada nadi karotis, radialis dan femoralis,
\plain\par
\pard\sl-316 \li388 \ri4525 \expndtw-6 \f40 \fs22 \cf2 y\f10 apnoe atau gerakan
napas tidak efektif,
\plain\par
\pard\sl-321 \li388 \ri6629 \expndtw0 \f40 \fs22 \cf2 y\f10 pupil dilatasi,
\plain\par
\pard\sl-321 \li388 \ri4621 \expndtw-6 \f40 \fs22 \cf2 y\f10 kulit keabuan atau
putih atau sianosis,
\plain\par
\pard\sl-321 \li388 \ri4092 \expndtw-7 \f40 \fs22 \cf2 y\f10 tampak seperti mat
i. (Skeet, 1995 & Jusrafli).
\plain\par
\pard\sl-307 \li47 \ri495 \expndtw-12 \f10 \fs22 \cf2 Penanganan Penanganan pasi
en yang mengalami henti jantung yaitu pertama dilakukan resusitasi
\plain\par
\pard\sl-312 \li0 \ri491 \expndtw-11 \f10 \fs22 \cf2 jantung paru dengan prinsip
ABC. Urutan tindakan dalam melakukan resusitasi jantung paru yaitu :
\plain\par
\pard\sl-307 \li0 \ri369 \expndtw-12 \f10 \fs22 \cf2 a.Pastikan keselamatan peno
long dan pasien terjamin b.Periksa pasien dan lihat responsnya Goyang
\plain\expndtw-10 \f10 \fs22 \cf2 bahunya dan bertanya cukup keras. Siapa namamu
? , Coba buka matanya . Bila pasien menjawab
\plain\par
\pard\sl-312 \li0 \ri148 \expndtw-11 \f10 \fs22 \cf2 atau bergerak, biarkan pasi
en tetap pada posisinya, periksa keadaan pasien secara berkala dan teratur.
\plain\par
\pard\sl-307 \li0 \ri106 \expndtw-11 \f10 \fs22 \cf2 Bila pasien tidak memberi r
espons, berteriaklah mencari bantuan, buka jalan napas dengan mendorong
\plain\par
\pard\sl-307 \li0 \ri382 \expndtw-12 \f10 \fs22 \cf2 dahi dan mengangkat dagu. P
osisikan telapak tangan pada dahi sambil mendorong dahi ke belakang
\plain\par
\pard\sl-312 \li0 \ri950 \expndtw-10 \f10 \fs22 \cf2 (head tilt). Ibu jari dan t
elunjuk harus bebas agar dapat digunakan menutup hidung jika perlu
\plain\par
\pard\sl-307 \li0 \ri185 \expndtw-12 \f10 \fs22 \cf2 memberikan napas buatan. Pa
da waktu yang sama ujung-ujung jari tangan yang lain mengangkat dagu
\plain\par
\pard\sl-312 \li0 \ri55 \expndtw-11 \f10 \fs22 \cf2 (chin lift). Jika ada kecuri
gaan trauma leher jangan melakukan head tilt. c.Sambil mempertahankan jalan
\plain\par
\pard\sl-307 \li0 \ri525 \expndtw-12 \f10 \fs22 \cf2 napas bebas, lihat, dengar
raba ada tidaknya udara pernapasan keluar masuk dengan cara melihat
\plain\par
\pard\sl-307 \li0 \ri652 \expndtw-12 \f10 \fs22 \cf2 pergerakan dada turun naik,
mendengar suara napas pada mulut pasien dan meraba gerak hawa
\plain\par
\pard\sl-312 \li0 \ri31 \expndtw-10 \f10 \fs22 \cf2 pernapasan dengan pipi. Jika
pernapasan memadai, posisikan pasien pada recovery position (jika tidak
\plain\par
\pard\sl-307 \li0 \ri276 \expndtw-12 \f10 \fs22 \cf2 ada kecurigaan trauma leher
), pastikan pernapasan tetap ada, bila ada beri oksigen 100 % dan carilah
\plain\par
\pard\sl-307 \li0 \ri150 \expndtw-11 \f10 \fs22 \cf2 bantuan. Jika pasien tidak
bernapas, carilah bantuan, telentangkan pasien, singkirkan semua sumbatan
\plain\par
\pard\sl-312 \li0 \ri147 \expndtw-10 \f10 \fs22 \cf2 yang terlihat dari mulut pa
sien (misal gigi yang terlepas), beri 2 napas buatan yang efektif, setiap napas
\plain\par
\pard\sl-307 \li0 \ri56 \expndtw-11 \f10 \fs22 \cf2 harus disertai ekshalasi. Ji
ka mengalami kesulitan dalam memberikan napas buatan yang efektif, periksa
\plain\expndtw-7 \f10 \fs22 \cf2 lagi apakah mulut pasien sudah bersih dari sumb
atan, periksa apakah posisi head tilt chin lift sudah
\plain\par
\pard\sl-312 \li0 \ri316 \expndtw-12 \f10 \fs22 \cf2 benar. Usahakan lagi member
i sampai 5 kali napas buatan untuk mendapatkan paling sedikit 2 napas
\plain\par
\pard\sl-307 \li0 \ri607 \expndtw-11 \f10 \fs22 \cf2 buatan yang efektif. d.Peri
ksa tanda-tanda sirkulasi (meskipun napas buatan belum berhasil), cari
\plain\par
\pard\sl-307 \li0 \ri506 \expndtw-13 \f10 \fs22 \cf2 apakah ada gerakan pasien (
gerakan menelan atau bernapas), dan raba nadi karotis. Jika yakin ada
\plain\par
\pard\sl-312 \li0 \ri281 \expndtw-11 \f10 \fs22 \cf2 tanda-tanda sirkulasi, lanj
utkan napas buatan sampai pasien bisa bernapas sendiri, tiap menit periksa
\plain\par
\pard\sl-307 \li0 \ri143 \expndtw-10 \f10 \fs22 \cf2 lagi tanda-tanda sirkulasi.
Jika pasien mulai bernapas tetapi tetap tidak sadar, posisikan pada recovery
\plain\expndtw-10 \f10 \fs22 \cf2 position . Periksalah kondisi dan siap mengemb
alikan pada posisi terlentang untuk diberi napas buatan.
\par
{\shp
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108067204fb03012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}
\plain\pard\sl-250 \li47 \ri1860 \expndtw-11 \f10 \fs22 \cf2 Jika tidak ada tand
a-tanda sirkulasi, mulai dilakukan pijat jantung dengan cara
\plain\par
\pard\sl-307 \li47 \ri242 \expndtw-11 \f10 \fs22 \cf2 1).Tentukan lokasi pijatan
setengah-bagian bawah tulang dada (sternum) dengan telunjuk dan jari
\plain\par
\pard\sl-312 \li0 \ri2531 \expndtw-11 \f10 \fs22 \cf2 tengah menyusur batas bawa
h iga sampai titik temu dengan sternum.
\plain\par
\pard\sl-307 \li47 \ri345 \expndtw-10 \f10 \fs22 \cf2 2).Tambahkan 1 jari kemudi
an tempatkan tumit tangan satunya di atas sternum tepat disamping
\plain\par
\pard\sl-307 \li0 \ri1019 \expndtw-9 \f10 \fs22 \cf2 telunjuk tersebut. Itu adal
ah titik tumpu pijat jantung, 2 jari di atas procexus xyphoideus.
\plain\par
\pard\sl-312 \li47 \ri1050 \expndtw-10 \f10 \fs22 \cf2 3).Tumit satunya diletakk
an di atas tangan yang sudah berada tepat di titik pijat jantung
\plain\par
\pard\sl-307 \li0 \ri2181 \expndtw-11 \f10 \fs22 \cf2 4).Jari-jari kedua tangan
dirapatkan dan diangkat agar tidak ikut menekan.
\plain\par
\pard\sl-307 \li47 \ri304 \expndtw-12 \f10 \fs22 \cf2 5).Penolong mengambil posi
si tegak lurus di atas dada pasien dengan siku lengan lurus, menekan
\plain\par
\pard\sl-311 \li0 \ri4963 \expndtw-4 \f10 \fs22 \cf2 sternum sedalam 4 5 cm (1,5
2 inci).
\plain\par
\pard\sl-307 \li47 \ri911 \expndtw-9 \f10 \fs22 \cf2 6).Ulangi gerakan pijat, le
pas, pijat, lepas sekitar 100 kali/menit (kira-kira 2 pijatan/detik).
\plain\par
\pard\sl-307 \li0 \ri44 \expndtw-8 \f10 \fs22 \cf2 7).Setiap setelah 15 kali pij
at jantung lakukan head tilt chin lift dan beri 2 napas buatan efektif. Lalu
\plain\par
\pard\sl-312 \li0 \ri547 \expndtw-11 \f10 \fs22 \cf2 pijat jantung lagi 15 kali
dan seterusnya (15 : 2). e.Lanjutkan resusitasi sampai ada tanda-tanda
\plain\par
\pard\sl-307 \li0 \ri105 \expndtw-11 \f10 \fs22 \cf2 kehidupan kembali atau bant
uan yang lebih mampu datang atau penolong kelelahan sehingga kalau
\plain\par
\pard\sl-307 \li0 \ri484 \expndtw-12 \f10 \fs22 \cf2 diteruskan akan membahayaka
n penolong. f.Bilamana mencari bantuan, 1).Sangat penting bagi
\plain\par
\pard\sl-311 \li0 \ri110 \expndtw-12 \f10 \fs22 \cf2 penolong untuk sesegera mun
gkin mencari bantuan, 2).Jika ada dua penolong salah satu melakukan
\plain\par
\pard\sl-307 \li0 \ri281 \expndtw-12 \f10 \fs22 \cf2 resusitasi sedangkan lainny
a mencari bantuan. 3).Jika hanya ada satu penolong, lakukan resusitasi
\plain\expndtw-11 \f10 \fs22 \cf2 minimal 1 menit (satu siklus) dulu sebelum ber
usaha mencari bantuan.

\par
}

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{\rtf \ansi\ansicpg1252\deff0

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

\sl-278\fs28\par\pard\pard\sl-278 \li0 \ri745 \expndtw-2 \f20 \fs24 Penyebab uta

el kiri sedangkan pada kebanyakan orang tempat ini disuplai

lah sama. Sebagai akibat dari henti jantung, peredaran darah

\pard\sl-273 \li0 \ri533 \expndtw-2 \f20 \fs24 penyelidikan kedokteran forensik

menjelaskan sebab kematian

\pard\sl-278 \li0 \ri683 \expndtw-2 \f20 \fs24 7. Sebaiknya jangan menandatangan

disease (heart and blood vessels). In: Color atlas of forensik

\pard\sl-336 \li0 \ri177 \expndtw-12 \f10 \fs24 ke otak menyebabkan hilangnya ke

\sl-100\fs10\par\sl-240\fs24\par\pard\pard\sl-335 \li0 \ri505 \expndtw-14 \f10 \

{\sp{\sn posrelh}{\sv 1}}

fungsi jantung. Lakukan cepat dalam batas waktu paling

\li19 \ri7314 \expndtw-15 \f10 \fs22 \cf2 - Obat-obatan

tasi rektum, operasi mata

f40 P\f10 pernafasan, setelah 20 30

usaha mencari bantuan.

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