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All Journal Journal Kiara Nursing and Midwifery
Saharuddin
Universitas Graha Edukasi; STIKes Pasapua
Health Professions Public Health Social Sciences

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Application of the SAHAR Model in Emergency Nursing Management of Pulmonary Edema: A Case Report Saharuddin; Sirojudin
Journal Kiara : Nursing and Midwifery Vol. 3 No. 1 (2026): Edisi March - August 2026
Publisher : Kiara Group

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Abstract

Background: Structured clinical decision-making is essential in the emergency management of cardiogenic pulmonary edema, yet practical application of frameworks like the SAHAR model remains unreported. Objective: This case study describes the application of the SAHAR model in emergency nursing care for an elderly patient with cardiogenic pulmonary edema. Methods: A qualitative case study was conducted at an emergency department in Indonesia. Data were collected through patient assessment, nursing intervention, and outcome evaluation. The nursing process was analyzed using the six SAHAR themes. Results: The patient presented with chest pain, severe dyspnea, hypertension, tachypnea, hypoxemia, bilateral crackles, jugular vein distention, and peripheral edema. The SAHAR model guided the nurse to prioritize airway, breathing, and circulation; implement semi-Fowler positioning, oxygen therapy, furosemide, ISDN, and fluid monitoring; and achieve clinical improvement within the evaluation period. Discussion: The structured decision-making process enabled rapid recognition of cardiogenic pulmonary edema, appropriate prioritization of life-threatening conditions, and timely evidence-based interventions aligned with pathophysiology. The SAHAR model provides a practical framework for emergency nursing in cardiogenic pulmonary edema. Further multicenter studies are warranted
SAHAR Model-Based Nursing Care for Peritonitis and Acute Kidney Injury: A Critical Care Case Study Muh Salman Al Farisi; Saharuddin
Journal Kiara : Nursing and Midwifery Vol. 3 No. 1 (2026): Edisi March - August 2026
Publisher : Kiara Group

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Background: Structured clinical decision-making is critical in peritonitis with acute kidney injury (AKI), yet application of the SAHAR model in intensive care remains unreported. Objective: To describe the application of the SAHAR model in nursing care for a patient with peritonitis and AKI Methods: A qualitative case study was conducted in an Indonesian hospital. Data were collected through nursing assessment, monitoring, record review, and outcome evaluation, then analyzed using the six SAHAR themes. Results: The SAHAR model guided cue recognition (hypoxemia, hyperkalemia, hemodynamic instability) and prioritization of three nursing diagnoses: impaired gas exchange, risk of shock, and acute pain. Interventions included oxygen therapy, strict fluid balance monitoring, fentanyl analgesia, and electrolyte correction. After 3×24 hours, the patient showed partial clinical improvement, with stable hemodynamics, reduced respiratory rate, and a decreased pain score. Discussion: The SAHAR model's structured approach enabled systematic clinical judgment and timely prioritization of life-threatening conditions. These findings align with previous research on decision-making frameworks in emergency and critical care nursing, demonstrating the model's potential to enhance patient safety and care quality in complex cases such as peritonitis with AKI
Co-Authors Muh Salman Al Farisi Sirojudin