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Perawatan Anak Dengan

Covid-19:
Teori dan Praktik di Fasilitas Kesehatan

Ns. Defi Efendi, Sp.Kep.An


*Dept. Kep. Anak FIKUI defiefendi@ui.ac.id
*NICU RSUI
*Pengurus Pusat IPANI
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Apa yang akan kita disukiskan ?

o COVID-19: Apakah berbeda pada anak?


o Penapisan pasien
o Penggunaan APD yang Emosional VS Rasional
o Perawatan anak dengan COVID-19
o Post Hospital Management: Sebuah tren yang akan kita hadapi

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Keluarga Besar Corona Virus

Sumber: Adnan, M., Khan, S., Kazmi, A., Bashir, N., & Siddique, R. (2020).
COVID-19 infection : Origin , transmission , and characteristics of
human coronaviruses. Journal of Advanced Research, 24, 91–98.
https://doi.org/10.1016/j.jare.2020.03.005
Keluarga Besar Corona Virus

Sumber: Adnan, M., Khan, S., Kazmi, A., Bashir, N., & Siddique, R. (2020).
COVID-19 infection : Origin , transmission , and characteristics of
human coronaviruses. Journal of Advanced Research, 24, 91–98.
https://doi.org/10.1016/j.jare.2020.03.005
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Courtesy: Muhamad Adam (2020)
1 COVID-19
Apakah berbeda pada anak?
Apa yang bisa kita pelajari?
• Banyak anak yang tidak memiliki
gejala demam
• Tingkat keparahan anak dengan
Covid-19 pada usia 10-19 serupa
dengan lansia>70th

Sumber: Bi, Q., Wu, Y., Mei, S., Ye, C., Zou, X., Zhang, Z., Liu, X., Wei, L., Truelove, S. A., Zhang, T., & Gao, W. (2020). Epidemiology and transmission of COVID-19 in 391
cases and 1286 of their close contacts in Shenzhen , China : A retrospective cohort study. Lancet Infect Dis, 3099(20), 1–9. https://doi.org/10.1016/S1473-3099(20)30287-5
COVID‐19 epidemic:
Diseases characteristics in children
(She, J., Liu, L., & Liu, W (2020))

Transmission Chain. The Lancet, 19–21. https://doi.org/10.1101/2020.03.03.20028423


Sumber: Lewnard, J. A., & Lo, N. C. (2020). COVID-19 in Children: The Link in the
Peneluran terbanyak: Keluarga

Penularan di fasilitas Kesehatan

Gejala ringan: Potensi besar menularkan (Lewnard, J. A., & Lo,


N. C. (2020))

Transmisi melalui droplet, aerosol, dan conjunctiva

*Mungkin* dapat ditularkan melalui sal. Pencernaan

Belum terdapat bukti yang memadai transimisi dari ibu ke bayi


Tingkat keparahan berdasar usia:
Belajar dari China

Dong, Y., Mo, X., Hu, Y., Qi, X., Jiang, F., & Jiang, Z. (2020)
Penapisan Pasien Anak

2 COVID-19
Pada kasus anak,
sentra pelayanan
melakukan upgrade
kriteria:

▪ OTG → ODP
▪ ODP → PDP
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Penggunaan Emosional
VS
APD Rasional
APD - Emosional
APD
Level 1
Sumber: Gugus Tugas Percepatan Penanganan Covid-19.
(2020). Rekomendasi APD Berdasarkan Tingkat
Perlindungan (pp. 1–25). www.covid19.go.id
APD
Level 2
Sumber: Gugus Tugas Percepatan Penanganan Covid-19.
(2020). Rekomendasi APD Berdasarkan Tingkat
Perlindungan (pp. 1–25). www.covid19.go.id
APD
Level 3
Sumber: Gugus Tugas Percepatan Penanganan Covid-19.
(2020). Rekomendasi APD Berdasarkan Tingkat
Perlindungan (pp. 1–25). www.covid19.go.id
APD Rasional

Unduh panduan lengkap WHO berbahasa Indonesia:


https://www.who.int/docs/default-source/searo/indonesia/covid19/who-2019-penggunaan-rasional-alat-perlindungan-diri-
untuk-covid-19-dan-pertimbangan.pdf?sfvrsn=7eb7ebc7_2
Perawatan Anak dengan

4 COVID-19
Triage Flow for Countries with
No or Limited Community Transmission
Sumber:Center for disease Control & prevention. (2020). Standard Operating Procedure
(SOP) for Triage of Suspected COVID-19 Patients in non-US Healthcare Settings: Early
Identification and Prevention of Transmission during Triage. U.S. Department of Health &
Human Services. https://www.cdc.gov/coronavirus/2019-ncov/hcp/non-us-settings/sop-triage-
prevent-transmission.html
Triage Flow for Countries with
Widespread Community Transmission
Sumber:Center for disease Control & prevention. (2020). Standard Operating Procedure
(SOP) for Triage of Suspected COVID-19 Patients in non-US Healthcare Settings: Early
Identification and Prevention of Transmission during Triage. U.S. Department of Health &
Human Services. https://www.cdc.gov/coronavirus/2019-ncov/hcp/non-us-settings/sop-triage-
prevent-transmission.html
Airway
Management
Fokus Keperawatan
Airway Management

Sumber: Adnan, M., Khan, S., Kazmi, A., Bashir, N., & Siddique, R. (2020).
COVID-19 infection : Origin , transmission , and characteristics of
human coronaviruses. Journal of Advanced Research, 24, 91–98.
https://doi.org/10.1016/j.jare.2020.03.005
Fokus Keperawatan Pada
Tatalaksana Jalan Napas

Sumber: Adnan, M., Khan, S., Kazmi, A., Bashir, N., & Siddique, R. (2020).
COVID-19 infection : Origin , transmission , and characteristics of
human coronaviruses. Journal of Advanced Research, 24, 91–98.
→ Tekanan Negatif → Kenali AGP →Tidak bergantian

Ners
Lingkungan

Tindakan
→ Dekontaminasi →Persiapan / → Batasi jumlah
minimal 2 kali/hari Ceklist perawat (1 orang +
→ Ruangan →Penggunan Anastesi/GP)

https://doi.org/10.1016/j.jare.2020.03.005
individu HME/Viral filter → Kaji “Komorbid”
→ Muscle relaxant Ners
→ Gunakan Box → APD Level III
Intub/Plastik → Persiapkan
skeneraio sulit
Ceklist Persiapan Airway Management

Sumber : Cook et. Al (2020) Consensus guidelines for managing


the airway in children with COVID-19; Highlighting
differences in practice from adult guidelines
Kenali
AGP
Sumber: Matava et al (2020). Pediatric Airway Management in Coronavirus
Disease 2019 Patients: Consensus Guidelines From the Society for
Pediatric Anesthesia’s Pediatric Difficult Intubation Collaborative and
the Canadian Pediatric Anesthesia Society
Resusitasi
Sumber: Matava et al (2020). Pediatric Airway Management in Coronavirus
Disease 2019 Patients: Consensus Guidelines From the Society for
Pediatric Anesthesia’s Pediatric Difficult Intubation Collaborative and
the Canadian Pediatric Anesthesia Society
Courtesy: Saptadi (2020)
Kesalahan Rangkaian Viral Filter
Step Up:
Pediatric Respiratory Support
Monitoring Tanda Perburukan

Sumber: Akre, A. M., Finkelstein, M., Erickson, M.,


Liu, M., Vanderbilt, L., & Billman, G. (2010).
Sensitivity of the Pediatric Early Warning Score
to Identify Patient Deterioration. Pediatrics,
125(4). https://doi.org/10.1542/peds.2009-0338
Pilihan yang
sulit ditengah
wabah….
Terkadang, karena suatu
kondisi, anak dengan
swab positif harus
dipulangkan dari faskes.

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Perawatan di Rumah
Monitor Kebersihan
gejala Anak tangan

Hiegiene Jaga
diri Penyebaran

Kebersihan Monitor
lingkungan Gejala Diri
Thanks!
Any questions?
You can find me at:
defiefendi@ui.ac.id

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