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"Describes all aspects of the management of cardiopulmonary arrest in adults and children. The management of life-threatening cardiac emergencies, including myocardial infarction and various arrhythmias is also described in detail"

"Salah satu  kompetensi prosedur yang harus dicapai mahasiswa profesi pada mata kuliah praktik klinik gawat darurat adalah melakukan tindakan resusitasi jantung paru. Efikasi diri menjadi salah satu faktor yang mempengaruhi tingkat keberhasilan tindakan resusitasi jantung paru. Tujuan dari penelitian ini adalah untuk mengetahui sumber-sumber yang berhubungan dengan tingak efikasi diri dalam melakukan resusitasi jantung paru menggunakan metode survei analitik pendekatan cross sectional. Penelitian ini melibatkan 84 mahasiswa profesi ners Fakultas Ilmu Keperawatan Universitas Indonesia yang merupakan lulusan sarjana reguler. Pengumpulan data dilakukan dengan menyebarkan kuesioner online kemudian data dianalisis menggunakan SPSS 24. Berdasarkan hasil analisis data menunjukan terdapat hubungan yang signifikan antara verbal persussion (p = 0,047) dan physiological and affective state (p = 0,003) dengan tingkat efikasi diri dalam melakukan resusitasi jantung paru. Fasilitator diharapkan untuk selalu memberikan feedback positif terhadap pencapaian mahasiswa meskipun belum maksimal dan menyampaikan komentar dan kritik yang positif sehingga memotivasi mahasiswa untuk terus meningkatkan kemampuannya. Selain itu, mahasiswa diharapkan untuk selalu berpikir positif guna mengurangi tingkat kecemasan, stres, mauun depresi dan meningkatkan physiological and affective state.

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One of the competency procedures that must be achieved by internship nursing students in clinical emergency practice courses is to perform cardiac pulmonary resuscitation. Self-efficacy is one of the factors that influences the success rate of cardiopulmonary resuscitation. The research aimed to identify the sources that related to the level of self-efficacy in performing cardiopulmonary resuscitation used analitic cross sectional design study. The research involved 84 internship nursing students of Faculty of Nursing Universitas Indonesia who came from regular undergraduate program. The research shown a significant association between verbal persussion with cardiopulmonary self-efficacy rate (p = 0,047) and physiological and affective state with cardiopulmonary self-efficacy rate  (p = 0,003). Facilitators are expected to always provide positive feedback on student achievement even though it has not been maximized and deliver positive comments and criticisms so it can motivates students to continue improve their abilities. In addition, students are expected to always think positively in order to reduce levels of anxiety, stress, depression, and improve their physiological and affective state."

"ABSTRAKHenti jantung sering terjadi di instalasi gawat darurat dan Return of spontaneus circulation ROSC masih rendah. ROSC dipengaruhi oleh kualitas kompresi RJP yang dilakukan perawat. Penelitian ini bertujuan mengidentifikasi faktor yang berhubungan dengan kualitas kompresi RJP. Penelitian ini menggunakan metode Crossectional yang melibatkan 72 responden dengan teknik Stratified Sampling di ruang IGD, Kamar Bedah, ICU, HCU, HCU paru, dan CVCU. Variabel independen usia, jenis kelamin, indeks massa tubuh, kelelahan, frekuensi pelatihan, pengetahuan, dan kesadaran diri dianalisis hubungannya variabel dependent variabel dependent kualitas kompresi pada RJP. Hasil analisis uji chi-square dan uji regresi logistik menunjukkan hubungan yang signifikan antara usia, jenis kelamin, indeks massa tubuh, kelelahan, frekuensi pelatihan, pengetahuan, kesadaran diri dengan kualitas kompresi pada resusitasi jantung paru p

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ABSTRACTCardiac arrest often occurs in emergency unit and Return of spontaneus circulation ROSC is still low. ROSC is influenced by the quality of CPR compression performed by nurses. This study aimed to identify factors related to CPR compression quality. This research used crossectional method involving 72 respondents with Stratified Sampling technique in Emergency Unit, Surgical Unit, Intensive Care Unit, High Care Unit, and Cardio Vasculare Care Unit. Independent variables including age, sex, body mass index, fatigue, training frequencies, knowledge, and self awareness are analyzed the dependent variable of CPR compression quality. The result of chi square test and logistic regression test show the significant correlation between age, sex, body mass index BMI , fatigue, training frequencies, knowledge, self awareness with CPR compression quality p "

"Henti jantung merupakan situasi darurat tertinggi yang membutuhkan resusitasi jantung paru segera. Jika dilakukan dengan benar, peluang hidup tanpa kecacatan neurologis pasien pasca henti jantung meningkat sebesar tiga kali lipat. Peran perawat vital dalam keberhasilan RJP karena umumnya menjadi responden pertama yang mengidentifikasi henti jantung dan mengaktifkan rantai keberlangsungan hidup di Rumah Sakit sebelum bantuan lanjutan datang. RJP berkualitas yang diberikan bergantung pada aspek kognitif, afektif dan psikomotorik perawat. Tujuan penelitian ini adalah mengetahui hubungan antara pengetahuan, sikap dan kesadaran diri perawat dengan kualitas RJP dewasa di Rumah Sakit. Desain penelitian ini adalah cross sectional dengan consecutive sampling pada 89 responden. Pengumpulan data menggunakan kuesioner Knowledge Questions on Adult Basic Life Support (BLS), Attitude Questions Related to Cardiopulmonary Resuscitation CPR awareness in clinical practice dan lembar observasi Report Card CPR Quality Analysis American Heart Association , Hasil penelitian ini mendapatkan mayoritas responden berusia £ 35 tahun (84,27%), berjenis kelamin pria (51,7%), pengalaman kerja < 10 tahun (29,2%), status kepegawaian PNS (88,8%), bekerja di unit perawatan dewasa (61,8%), mengikuti pelatihan BHD £ 2 tahun (58,4 %) serta melakukan RJP ke pasien dalam waktu £ 6 bulan terakhir (59,6%). Mayoritas responden memiliki pengetahuan rendah (58,6%), sikap baik terhadap RJP (52,8%) dan kesadaran diri tinggi terhadap RJP(50,6%). Tidak ditemukan hubungan signifikan antara pengetahuan RJP, sikap terhadap RJP dan kesadaran diri perawat dengan kualitas RJP dewasa. Namun ditemukan bahwa pelatihan RJP berhubungan dengan kualitas RJP dewasa. Simpulan dari penelitian ini adalah pelatihan BHD merupakan variabel yang berkontribusi sebesar 71,1% terhadap kualitas RJP dewasa. Rekomendasi penelitian ini adalah perawat perlu melakukan pelatihan RJP yang diperbaharui setiap 2 tahun sekali sesuai dengan rekomendasi AHA.

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Cardiac arrest is the highest level of emergency condition that requires immediate cardiopulmonary resuscitation (CPR). Proper resuscitation increases the chance of survival without neurological damage by three times. Role of nurses is pivotal in CPR as they are commonly the first responders to identify cardiac arrest and activate the chain of survival before the advanced team arrives. A proper quality of CPR is affected by nurse's cognitive, affective, and psychomotor aspect. Objective: to identify the association between nurse's knowledge, attitude, and self-awareness and quality of adult CPR at hospital. Method: The study was cross-sectional with consecutive sampling which involved 89 participants. The study involved Knowledge Questions on Adult Basic Life Support (BLS), Attitude Questions Related to Cardiopulmonary Resuscitation, CPR Awareness in clinical practice and observation sheet of Report Card CPR Quality Analysis American Heart Association to collect data. Result: Majority of participants were younger than 35 years old (84,27%), males (51,7%), with working experience less than 10 years (29,2%), civil servants (88,8%), working in adult care unit (61,8%), attended Basic Life Support training within last 2 years (58,4 %), had performed CPR within last 6 months 6 (59,6%), had low level of knowledge (58,6%), proper CPR attitude (52,8%) and high level of self awareness (50,6%). There was no significant correlation between knowledge on CPR, attitude toward CPR, nurse's self awareness of CPR and quality of adult CPR. However, there was significant association between CPR training and quality of adult CPR (P=0,048). Conclusion: CPR training was the most significant variable affecting quality of adult CPR by 71.1%.Recommendation: nurses are required to attend an updated CPR training biannually as recommended by AHA."

"The textbook will describe the relationship between human cardiopulmonary system and exercise in a format that is related to the mode of exercise, health status and aging. It will include data regarding exercise training principles and the adaptations of the cardiopulmonary following, anaerobic, resistance and aerobic training. A more in-depth presentation of the cardiopulmonary system adaptations in pressing environments such as: warm, cold and altitude. Therefore, students will experience a depth and extent of content balanced with unique and effective learning features: It will help students find the way by both the text and subject matter. Knowing cardiopulmonary exercise function in health and disease will allow understand new research and findings relevant to cardiovascular status as assessed by cardiopulmonary exercise indices. It will bring together investigational exercise physiologists, cardiologists and scientists who share a wealth of experience needed to judge the cardiovascular status and function, and the impairments of patients with a variety of cardiac dysfunction. This book will provide a comprehensive, updated presentation of the information of the cardiovascular system as a whole, and its individual components."

"Henti jantung masih merupakan penyebab kematian utama di dunia. Walau telah ada kemajuan dalam hal tatalaksana kegawatdaruratan kardiovaskular, angka ketahanan hidup mereka dengan henti jantung di luar rumah sakit tetap rendah. Pedoman resusitasi jantung paru dan kegawatdaruratan kardiovaskular meski telah diperbaharui namun pendekatan terhadap keadaan henti jantung di luar rumah sakit masih jauh dari optimal. Hal ini memberi peluang bagi resusitasi kardioserebral untuk menjadi alternatif resusitasi pada keadaan henti jantung di luar rumah sakit. Resusitasi kardioserebral layak menggantikan resusitasi jantung paru pada keadaan henti jantung di luar rumah sakit karena telah terbukti memperbaiki ketahanan hidup dan fungsi serebral pada pasien dengan henti jantung.

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AbstractCardiac arrest remains a leading cause of death in the world. Although advances in emergency cardiac care has been achieved, the survival rate of those with out-of-hospital cardiac arrest remains low. Guidelines for CPR and emergency cardiovascular care though have been updated, their approach to out-of-hospital cardiac arrest is far from optimal. This provides an opportunity to advocate cardiocerebral resuscitation as an alternative to traditional cardiopulmonary resuscitation for out-of-hospital cardiac arrest. Because cardiocerebral resuscitation results in improved survival and cerebral function in patients with witnessed cardiac arrest and a shockable rhythm whom have greatest chance of survival, it should replace CPR especially for out-of-hospital cardiac arrest."

"Latar belakang: Penurunan curah jantung merupakan masalah yang penting dalam penatalaksanaan pasca-bedah jantung terbuka karena penurunan curah jantung ini meningkatkan morbiditas dan mortalitas pasien. Modalitas untuk pemantauan curah jantung bergeser dari invasif ke non-invasif. Alat ultrasonic cardiac output monitor (USCOM) dan ekokardiografi menjadi alat baru yang non-invasif. Bila dibandingkan dengan alat ekokardiografi yang membutuhkan keahlian khusus, alat USCOM dapat dijadikan alat pengukuran indeks curah jantung alternatif secara intermiten oleh tenaga medis terlatih.Tujuan: Untuk mengetahui kesesuaian hasil pengukuran indeks curah jantung dengan alat USCOM dibandingkan ekokardiografi pada anak pasca-bedah jantung terbuka dengan pintasan jantung paru.Metode: Studi potong lintang (cross sectional) pada anak pasca-bedah jantung terbuka dengan PJP dengan metode pengukuran simultan indeks curah jantung dengan alat USCOM dan ekokardiografi di Rumah Sakit Cipto Mangunkusumo, Jakarta, dari bulan Juni-Juli 2014.Hasil: Tiga belas pasien yang menjalani bedah jantung terbuka berhasil diukur dengan alat USCOM dan ekokardiografi secara simultan. Subyek terdiri atas 8 laki-laki dan 5 perempuan dengan median usia 3 tahun (1-12 tahun). Median berat badan, tinggi badan, dan luas permukaan tubuh berturut-turut 11 kg (5,5-29 kg), 82 cm (63-133 cm), dan 0,53 m2 (0,32- 0,98 m2). Diagnosis terbanyak berturut-turut adalah tetralogi Fallot (5 subyek), defek septum ventrikel (3 subyek), dan DORV (2 subyek). Pada analisis Bland-Altman indeks curah jantung yang diukur dengan alat USCOM dibandingkan ekokardiografi didapatkan perbedaan rerata sebesar 0,115 L/menit/m2 (IK95% -0,536 hingga 0,766) dan batas kesesuaian -3,616 hingga 3,846 L/menit/m2. Hasil tambahan penelitian ini berupa perbedaan rerata indeks isi sekuncup 0,03 mL/m2 (IK95% -5,002 hingga 5,065) dan batas kesesuaian -28,822 hingga 28,885 mL/m2. Perbedaan rerata diameter LVOT -0,017 cm (IK95% -0,098 hingga 0,064) dan batas kesesuaian -0,285 hingga 0,251 cm. Perbedaan rerata nilai VTI didapatkan sebesar -2,991 cm (IK95% -4,670 hingga -1,311) dan batas kesesuaian -12,616 hingga 6,635 cm.Kesimpulan: Pengukuran indeks curah jantung dengan alat USCOM dibandingkan ekokardiografi pada anak pasca-bedah jantung terbuka dengan PJP didapatkan perbedaan rerata kedua pengukuran kecil dan batas kesesuaian 95% yang lebar. Pada pengukuran indeks curah jantung yang makin rendah, perbedaan atau selisih rerata semakin kecil dan memiliki kesesuaiannya lebih baik.

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Background: Low cardiac output is important problem in post-open heart surgery management because this condition increase morbidity and mortality. Modality of cardiac output monitoring shifted from invasive to non-invasive. Ultrasonic cardiac output monitor (USCOM) and echocardiography are new non-invasive tools. Echocardiography needs special skill, but USCOM can used by trained user because of fast learning curve of skill.Objectives: To determine the agreement of cardiac index measurement by USCOM and echocardiography in children after open heart surgery with cardiopulmonary bypass.Methods: Cross sectional study using simultaneous measurement of cardiac index by USCOM and echocardiography on post-open heart surgery patient in Cipto Mangunkusumo Hospital Jakarta, from Juni-Juli 2014.Results: Thirteen post-open heart surgery of pediatric patient were enrolled (8 male and 5 female, median of age 3 years old (1-12 years old). Median of body weight, height, and body surface area respectively were 11 kg (5,5-29 kg), 82 cm (63-133 cm), dan 0,53 m2 (0,32-0,98 m2). Diagnosis of patient were tetralogi Fallot (5 subject), ventricular septal defect (3 subject), dan double outlet right ventricle (2 subject). This study using Bland-Altman analysis of cardiac index measurement by USCOM and echocardiography. Mean bias was 0,115 L/minute/m2 (95%CI -0,536 to 0,766) and limit of agreement was -3,616 to 3,846 L/minute/m2. Secondary outcome of this study was mean bias of stroke volume index 0,03 mL/m2 (95%CI -5,002 to 5,065) and limit of agreement was -28,822 to 28,885 mL/m2. Mean bias of LVOT diameter was -0,017 cm (95%CI -0,098 to 0,064) and limit of agreement was -0,285 to 0,251 cm. Mean bias of VTI was -2,991 cm (95%CI -4,670 to -1,311) and limit of agreement -12,616 to 6,635 cm.Conclusion: Cardiac index measurement by USCOM and echocardiography in children after open heart surgery has narrow mean bias and wide limit of agreement. Mean bias was narrower and good agreement in patient with low cardiac index."

"Latar Belakang: Pasien anak dengan penyakit jantung bawaan sianotik memiliki risiko perdarah pasca-operasi cardiopulmonary bypass (CPB) yang tinggi .Pada CPB, heparin digunakan sebagai antioagulan, dikembalikan dengan protamine sulfat dan diukur menggunakan activated clotting time (ACT). Heparin dapat menginduksi perdarahan dan protamine sulfat berlebih dapat berperan sebagai antikoagulan. Penelitian mengenai hubungan antara dosis awal heparin dan nilai ACT pasca pemberian protamine terhadap perdarahan pasca-operasi belum diteliti pada pasien anak dengan penyakit jantung bawaan sianotik di CMGH. Tujuan: Untuk menilai korelasi antara dosis awal heparin dan nilai ACT pasca pemberian protamine terhadap perdarahan pasca-operasi pada pasien anak dengan penyakit jantung bawaan sianotik di CMGH. Metode: Penelitian ini merupakan penelitian descriptive-analytical, dengan metode cross-sectional. Pasien berusia 0 hingga 17 tahun, memiliki penyakit jantung bawaan sianotik, dan menjalani operasi jantung terbuka elektif disertakan dalam penelitian ini. Sebanyak 100 rekam medis dari Januari 2016 hingga Maret 2018 di CMGH digunakan dalam penelitian ini. Analisis dilakukan dengan mencari korelasi antara dosis awal heparin dan nilai ACT pasca-pemberian protamine terhadap perdarahan pasca-operasi. Hasil: Terdapat korelasi positif antara dosis awal heparin dengan perdarahan pasca-operasi (p=0,011). Korelasi antara ACT pasca pemberian protamine dengan perdarahan pasca-operasi adalah p=0,257. Perdarahan pasca-operasi yang dialami pasien adalah 15,3 mL/kgBB (3,0 – 105,6 mL/kgBB). Konklusi: Penelitian ini menunjukkan bahwa ada korelasi positif antara dosis awal heparin dan perdarahan pasca-operasi; dosis tinggi menghasilkan perdarahan yang lebih banyak pada pasien anak yang sianotik di CMGH. Selanjutnya, tidak ditemukan adanya korelasi antara nilai ACT pasca-protamine dan perdarahan pasca-operasi.

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. Background: Pediatric cyanotic CHD patients have an increased risk of post-operative bleeding following cardiopulmonary bypass (CPB). In CPB, heparin is used as an anticoagulant, reversed by protamine sulphate and measured using activated clotting time (ACT). Heparin can induce bleeding and excess protamine sulphate can act as an anticoagulant. No studies of the same kind has been done to assess the relationship between the initial heparin dose and post-protamine ACT value to post-operative bleeding in pediatric cyanotic congenital heart disease cases in CMGH.

Aim: To assess the correlation between initial heparin dose and post-protamine ACT value to post-operative bleeding in pediatric cyanotic congenital heart disease patients in CMGH

Method: This is a descriptive-analytical study, utilizing cross-sectional method. Patients aged 0 to 17 years old with cyanotic congenital heart disease, undergoing elective open heart surgery were included. A total of 100 medical records from January 2016 to March 2018 in CMGH were used. The correlation between initial heparin dose and post-protamine ACT value to post-operative bleeding was analyzed.

Result: Initial heparin dose and post-operative bleeding showed a positive correlation (p=0.011). The correlation between post-protamine ACT value and post-operative bleeding is p=0.257. Post-operative bleeding experienced by the patients is 15.3 mL/kgBW (3.0 – 105.6 mL/kgBW)."