syok pada kondisi khusus seperti syok hipovolemik

syok

1. Special Consideration in Shock dr. Aulia Putri Dewita SpJP Departemen Penyakit Jantung dan Pembuluh Darah Fakultas Kedokteran Universitas Sumatera Utara 2022

2. SEMESTER GANJIL TAHUN AJARAN 2024 / 2025 UNJA SEMESTER 6 – PERTEMUAN 3 –

3. Athletes Conditions such as extreme fatigue, dehydration or illness predispose an athlete to shock Shock occurs when cardiovascular system fails to supply enough blood to body’s organ

4. Pregnancy Maternal Shock : something that happens to expectant mothers during pregnancy, labor and delivery or up to six weeks after a child is born due to complications . It can be fatal but highly preventable Hypovolemic shock (hemorrhagic) : Placental abruption, uterine rupture, placenta previa, laceration etc Septic Shock : Post operative endometriosis, gram positive and negative infection including e coli, tools, medical products, surgical equipments Cardiogenic shock : previous cardiac disease, pulmonary embolus Anaphylactic shock : amniotic fluid embolism Neurogenic Shock : uterine inversion

5. PRINSIP PENANGANAN Pastikan jalan napas bebas dan berikan oksigen . Miringkan ibu ke kiri . Hangatkan ibu . Pasang infus intravena (2 jalur bila mungkin ) dengan menggunakan jarum terbesar (no. 16 atau 18 atau ukuran terbesar yang tersedia ). Berikan cairan kristaloid (NaCl 0,9% atau Ringer Laktat ) sebanyak 1 liter dengan cepat (15-20 menit ). Pasang kateter urin ( kateter Folley) untuk memantau jumlah urin yang keluar . L anjutkan pemberian cairan sampai 2 liter dalam 1 jam pertama , atau hingga 3 liter dalam 2-3 jam ( pantau kondisi ibu dan tanda vital). Monitoring a. Central venous pressure (CVP): normal 10 - 12 cm air b Nadi c. Tekanan darah d. Produksi urin e. Tekanan kapilar pam: normal 6 - 18 Torr f. Perbaikan klinik: pucat, sianosis, sesak, keringat dingin, dan kesadaran

6. Medication Hypovolemic ie. Diuretics Cardiogenis ie. B-blockers Distributive (severe drug/contrast allergy)

7. Hypothermia Core body temperature < 35 C Results when body heat loss exceeds body heat production Hypothermia slows all physiologic functions, including cardiovascular and respiratory systems, nerve conduction, mental acuity, neuromuscular reaction time, and metabolic rate. Treatment : Passive rewarming in cases of mild hypothermia (32 C- 35 C)  insulation with heated blanket and warm fluids to drink Active rewarming in cases of moderate to severe hypothermia (< 32 C)  inhalation, IV infusion