6. how to give resusitation if happened circulation failure?

Answer:

Generally management for circulation is control bleeding by direct pressure or operative

intervention, if bleeding happends.Intravenous fluid therapy with a balanced salt solution should be
initiated. Ringer’s lactate solution is prefarred as the innitial crystallois solution and should be
administered rapidly. Such bolus IV therapy may require the administration of 2-3 liters of solution
to achieve an approprite patien response in the adult patient. All IV solutions should be warmed
either by storage in a warmm environment (37 C to 40 C or 98,9 F to 104 F) or by fluid warming
devices.

Ringer fundin has an isotonic electrolyte compotion resembling human plasma. Its essensial
anions are metabolized in all organs and muscle with minimum oxygen consumtion. Advantages
isotonic and plasma adapted solutions do not affect the electrolyte equilibrium and prevent
intracellular fluid shifts. Recomendded dosage, For adults, the elderly and adolecescents: 500 ml to 3
liters/ 24hr, corresponding to 1 to 6 mmol sodium/kg/24h and 0,03 to 0,17 mmol poyassium/kg/24
h.

Cairan Na+ K+ Cl- Ca++ HCO3 Tekanan

(mEq/L) Osmotik
(mEq/L) (mEq/L) (mEq/L) (mEq/L)
(mOsm/L)
*
Ringer 130 4 190 3 28 273
Laktat
Ringer 130 4 109 3 28# 273
Asetat
NaCl 154 0 0 0 0 308
0,9 %

Good enough for a crystalloid fluid therapy hypovolemic shock. Advantages of crystalloid
fluids among others readily available, inexpensive, easy to use, does not cause allergic reactions and
side effects. Crystalloid fluid overload in the administration can continue with edema throughout the
body so that the use of the excess must be prevented.
An isotonic NaCl solution is recommended for initial treatment of hypovolemic shock with
hiponatremik, hipokhloremia or metabolic alkalosis. RL solution is an isotonic solution that is most
similar to extracellular fluid. RL can be given safely in large quantities to patients with conditions
such as hypovolemia with metabolic acidosis, kombustio and shock syndrome. NaCl 0.45% in 5%
Dextrose solution is used as a temporary fluid to replace fluid loss insensibel.
Ringer acetate has a similar profile with Ringer Lactate. Points of lactate metabolism is
primarily the liver and a small portion of the kidney, while acetate is metabolized in almost all tissues
of the body with muscles as the most important place. Use of Ringer Acetate as fluid resuscitation
should be administered to patients with severe liver function disorders such as cirrhosis of the liver
and lactic acidosis. The presence of lactate in Ringer Lactate solution endanger the patient unwell as
it is converted in the liver to bicarbonate.

Referensi:

American collage of surgeons. Advance trauma life support program for doctors, page 9-13

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