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    This document provides information on three emergency department cases. The first case involves a 67-year-old man presenting with shortness of breath and cough. Key findings include pneumonia and sepsis. The second case involves a 59-year-old woman with chest pain. Key findings include acute heart failure and ST elevation myocardial infarction (STEMI). The third case involves a 25-year-old woman with difficulty breathing. Key findings include acute severe asthma and community-acquired pneumonia. For each case, the document provides relevant diagnostic information and recommended treatment approaches.

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    k as Us Internship

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    This document provides information on three emergency department cases. The first case involves a 67-year-old man presenting with shortness of breath and cough. Key findings include pneumonia and sepsis. The second case involves a 59-year-old woman with chest pain. Key findings include acute heart failure and ST elevation myocardial infarction (STEMI). The third case involves a 25-year-old woman with difficulty breathing. Key findings include acute severe asthma and community-acquired pneumonia. For each case, the document provides relevant diagnostic information and recommended treatment approaches.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    33 views19 pages

    K As Us Internship

    Uploaded by

    yunii
    This document provides information on three emergency department cases. The first case involves a 67-year-old man presenting with shortness of breath and cough. Key findings include pneumonia and sepsis. The second case involves a 59-year-old woman with chest pain. Key findings include acute heart failure and ST elevation myocardial infarction (STEMI). The third case involves a 25-year-old woman with difficulty breathing. Key findings include acute severe asthma and community-acquired pneumonia. For each case, the document provides relevant diagnostic information and recommended treatment approaches.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pptx, pdf, or txt
    of 19

    KASUS

    ABCDEFASTHUG

    A Airway
    B Breathing
    C Circulation
    D Disability / Consciousness
    E Exposure / Electrolytes
    F Feedings
    A Analgesia
    S Sedation
    T Thromboembolic prophylaxis
    H Head of Bed Elevated
    U Ulcer prophylaxis
    G Glucose control

    Kasus 1
    Pria 67 tahun datang ke IGD dengan
    keluhan sesak memberat sejak 2 jam
    SMRS
    Batuk dahak 3 hari warna kuning,
    demam ada
    Hipertensi (-), DM (-), obat2an (-)
    PF: delirium, TD 100/70, nadi 110,
    suhu 39, napas 28, VAS 0, saturasi
    perifer: 94%
    Paru: ronki basah kasar kanan,
    jantung: BJ I,II reguler, lain2 normal

    Lab:
    DPL: 13/40/11000/105000 MCV/MCH:
    88/28
    Hitung jenis: 0/0/5/80/35/5 GDS: 135
    Ureum/kreatinin: 60/2.6
    SGOT/SGPT: 18/20
    PT: 16/12, APTT: 51/30, fibrinogen 89,
    Ddimer 1000
    AGD: 7,32/28/92/18/95,3 Na/K/Cl:
    135/3,5/99

    Masalah terkini?
    1. Pneumonia komunitas
    2. Sepsis berat
    3. Acute confusional state
    4. Acute Kidney Injury
    5. Disseminated Intravascular
    Coagulation
    6. Asidosis metabolik bercampur
    alkalosis
    respiratorik

    Tatalaksana?
    Diagnostik: laktat darah, kultur sputum dan darah,
    prokalsitonin
    Terapi:
    1. Oksigen nasal kanula 3-4 liter per menit
    2. Loading cairan NS 30 ml/kgBB
    3. Pasang kateter Foley
    4. Ceftriaxone 1x2 gram IV
    5. Levofloxacin 1x750 mg IV
    6. Inhalasi ventolin:bisolvon 1:1 tiap 20 menit
    7. Parasetamol 3x1 gram IV
    8. Omeprazol 1x40 mg IV
    9. Transfusi cryoprecipitate
    10. Transfusi FFP

    Kasus 2
    Wanita 59 tahun datang ke IGD
    dengan keluhan nyeri dada kiri sejak
    3 jam SMRS
    PF: GCS15, TD 140/90 nadi: 100,
    suhu 36,5, napas 28, saturasi perifer
    93%, JVP 5+0cm H20, paru ronki
    basah halus bilateral basal
    Sebagai dokter jaga IGD, langkah
    pertama?

    Lab
    DPL: 11/33/11500/342000 MCV/MCH:
    85/29
    Hitung jenis: 0/1/2/67/25/3
    Ureum/kreatinin: 34/1,2 GDS: 132
    SGOT/SGPT: 15/23
    AGD: 7,48/30/81/22/94
    Na/K/Cl: 130/4/101

    EKG

    Rontgen Toraks PA

    Masalah?
    1. Acute Heart Failure
    2. STEMI

    Tiba-tiba pasien tak sadarkan diri.


    Monitor EKG menunjukkan gambar ini

    Tatalaksana sesuai gambaran


    Monitor
    Defibrilasi 200 Joule

    Kasus 3
    Wanita 25 tahun dibawa ke IGD dengan sesak napas
    sejak 1 jam lalu. Napas berbunyi ngikngik. Menurut
    ibunya, sejak 2 hari lalu, pasien batuk pilek demam.
    Batuk berdahak kuning
    PF: compos mentis, TD 110/70 nadi:120, suhu 38,
    napas 40, VAS tak bisa dinilai (pasien sulit bicara
    karena sesak)
    Saturasi perifer: 90%
    PAru: ronki basah kasar bilateral, mengi bilateral
    Lain-lain normal
    Sebagai dr jaga IGD, langkah apa yang harus
    segera dilakukan?

    DPL: 13,5/41/13500/455000
    MCV/MCH: 82/29
    Hitung jenis: 0/0/5/82/30/4 GDS 101
    Ureum/kreatinin: 30/1 SGOT/SGPT:
    20/22
    AGD: 7,49/25/85/23/95 Na/K/Cl:
    144/3,5/110

    Masalah
    1. Asma akut berat
    2. CAP

    Tatalaksana
    1. Oksigen nasal kanul 4 LPM
    2. Infus RL 500 ml/8 jam
    3. Inhalasi salbutamol 2,5 mg +
    ipratropium
    0,5 mg tiap 15-30 menit
    4. Injeksi metilprednisolon 1x62,5 mg
    IV
    5. Injeksi ceftriaxone 1x2 gram IV
    6. Levo 1x700 mg IV

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