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All Journal Indonesian Journal of Anesthesiology and Reanimation (IJAR) Jurnal Komplikasi Anestesi
Nur, Rifdhani Fakhrudin
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Medicine & Pharmacology

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Manajemen Akhir Hayat pada Pasien Kritis dI ICU Nur, Rifdhani Fakhrudin; Suryono, Bambang; Sarosa, Pandit
Jurnal Komplikasi Anestesi Vol 2 No 2 (2015): Volume 2 Number 2 (2015)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v2i2.7209

Abstract

Telah dilakukan manajemen akhir hayat pada pada seorang perempuan usia 63 tahun, dengan diagnosis ROSC pascahenti jantung, edema serebri difus, asidosis metabolik, anemia, dan hipoalbumin yang dirawat di ICU. Keadaan akhir hayat ditunjukkan dengan adanya tanda-tanda kematian batang otak dan kegagalan fungsional berupa kegagalan usaha nafas yang menetap pada pasien yang dapat menyebabkan kematian pada hari ke-3 perawatan. Dokter menjelaskan tentang kondisi akhir hayat pasien berupa tanda-tanda kematian batang otak, prognosis dan kemungkinan yang akan terjadi dan keputusan yang harus diambilkeluarga mengenai keadaan akhir hayat pada pasien. Keluarga memutuskan menerima kondisi pasien, meminta untuk meneruskan bantuan yang sekarang diberikan namun tidak melakukan pertolongan lanjut jika kondisi memburuk. Rohaniwan melakukan pendampingan berupa bimbingan rohani, konselingspiritual akhir hayat, bimbingan ibadah dan doa untuk pasien. Belum ada komunikasi yang intensif antara tim medis tentang kondisi akhir hayat pada pasien. Pendampingan dilakukan sampai saat kematian dengan mengundang keluarga, tidak melakukan resusitasi jantung paru sesuai permintaan keluarga dan menyatakan kematian pasien di hadapan keluarga.
Perbandingan Efikasi Analgesi antara Penambahan Klonidin Konsentrasi Akhir 1,875 mcg/ml dengan Penambahan Fentanil Konsentrasi Akhir 1,25 mcg/ml pada Bupivakain 0,125% Isobarik untuk Analgesi Epidural Infus Kontinu Pascaoperasi Laparotomi Ginekologi Onkol Nur, Rifdhani Fakhrudin; Artika, I Gusti Ngurah Rai; Sudadi
Jurnal Komplikasi Anestesi Vol 3 No 2 (2016): Volume 3 Number 2 (2016)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v3i2.7236

Abstract

Latar belakang : Belum pernah dilakukan penelitian tentang perbandingan efi kasi analgesi penambahan klonidin dibandingkan fentanil pada obat anestesi lokal untuk analgesi epidural infus kontinu pada pasien pascaoperasi laparotomi ginekologi onkologi.Tujuan : Penelitian ini bertujuan membandingkan efi kasi analgesi antara penambahan klonidin dengan fentanil pada bupivakain 0,125% isobarik untuk analgesi epidural infus kontinu pascaoperasi laparotomi ginekologi onkologiMetode : Penelitian single blind randomized controlled trial ini melibatkan 60 pasien yang menjalani operasi laparotomi ginekologi onkologi dengan anestesi epidural dan analgesi epidural infus kontinu. Sampel dibagi melalui randomisasi menjadi 2 kelompok BF dan BK, masing-masing 30 pasien. Injeksi analgesi epidural pada kelompok BF adalah injeksi bolus 10 ml bupivakain 0,125%+fentanil 50 mcg dilanjutkan infus epidural kontinu bupivakain 0,125%+fentanil 1,25 mcg/ml. Kelompok BK mendapatkan injeksi bolus 10 ml bupivakain 0,125%+klonidin 75 mcg, dilanjutkan infus epidural kontinu bupivakain 0,125%+klonidin1 mcg/ml.Hasil : Nilai VAS saat istirahat dan saat gerakan ringan lebih rendah secara bermakna pada kelompok BK dibandingkan kelompok BF pada menit ke-15, jam ke-6 dan jam ke-12 pascaoperasi dengan nilai p<0,05. Perbedaan nilai VAS saat istirahat dan saat gerakan ringan antara dua kelompok kurang dari 0,9 cm pada semua periode penilaian. Frekuensi tambahan fentanil sebagai rescue analgetik lebih banyak secara bermakna pada kelompok BF (26,7%) daripada kelompok BK (3,3%). Kejadian hipotensi, bradikardi mual muntah dan pruritus tidak berbeda diantara dua kelompok.Kesimpulan : Penambahan klonidin menghasilkan efikasi analgesi lebih baik secara statistik namun tidak menghasilkan efikasi analgesi lebih baik secara klinis daripada penambahan fentanil pada bupivakain 0,125% isobarik untuk analgesi epidural infus kontinu pascaoperasi laparotomi ginekologi onkologi.
Basic Life Support Training: The Effectiveness and Retention of The Distance-Learning Method Nur, Rifdhani Fakhrudin; Prasamya, Erlangga; Ikhwandi, Arief; Utomo, Prattama Santoso; Sudadi
Indonesian Journal of Anesthesiology and Reanimation Vol. 5 No. 1 (2023): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V5I12023.18-26

Abstract

Introduction: Basic Life Support (BLS) training during the COVID-19 pandemic needed to be effective as well as prevent disease transmission between trainers and participants. The distance-learning method is one of the recommended modified training methods. However, there is still limited research that evaluates the effectiveness of the distance-learning method for BLS training for laypersons during the COVID-19 pandemic. Objective: To evaluate the effectiveness and retention of the distance-learning method for BLS training in improving the participant's knowledge and skills. Methods: This is a non-randomized quasi-experimental study (one group pre-test and post-test design). A total of 64 TAGANA (Taruna Siaga Bencana/disaster volunteer) members of Sleman Regency who had undergone the distance learning method for BLS training were the participants of this study. A knowledge questionnaire and observation checklist were prepared and tested for context validity by an expert group. Data on the participant's knowledge were collected before and after the training session, and data on the participant's skills were recorded after the training session. After the training, a social media group was created to provide a periodical refresher of the BLS materials and facilitate discussions between the speakers and the study's samples. Data on knowledge retention and skills were recorded six months post-training. Results: The distance-learning method for BLS training effectively increased the participants' knowledge of BLS, indicated by a significantly higher final knowledge score than before the training (Z=-6.904, p <0.001). The method also provided sufficient BLS skills, indicated by most of the samples (93.7%) passing the skill observation test even though no participant had attended a similar training before. Moreover, the participant's knowledge and skills scores were significantly lower six months after the training session than immediately after training (Z=-5.157, p <0.001; Z=-4.219, p <0.001). Conclusion: The distance-learning method for BLS training effectively increased the participant's BLS knowledge and skills. However, their knowledge and skills decreased at six months post-training. Overall, the distance-learning method has been proven as a promising alternative to BLS training during and after the COVID-19 pandemic.
Developing an Effective Team-Based Emergency Training Program for Medical Students Hartono, Pinter; Adiyanto, Bowo; Nur, Rifdhani Fakhrudin; Ancilla, Cornelia; Rahma, Aulia Zuhria
Indonesian Journal of Anesthesiology and Reanimation Vol. 6 No. 1 (2024): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V6I12024.1-13

Abstract

Introduction: Team-based patient management in critical care demands a knowledgeable, skillful, and responsive doctor who collaborates well on teams. Medical education is responsible for producing competent graduates who meet the above requirements. However, the current medical curriculum in Indonesia tends to focus only on individual knowledge and appraisal. There was no standardized university-based group emergency training and examination with comprehensive emergency topics beyond cardiac and trauma cases. Objective: This study aimed to develop and evaluate a team-based emergency training program that enhances medical students' preparedness and teamwork skills in dealing with future emergencies in the workplace. Methods: We developed Acute Life Threatening Events Management (ALTEM), a three-day emergency training program consisting of pre-test, lectures, guided skill practice, group (case-based) simulation exam, and post-test. Group simulation occurred in a virtual hospital with high-fidelity mannequins, actual medical equipment (i.e., beds, monitors, drugs, tools, pads), two-way mirror rooms, and simulated patient family to resemble real hospital situations. The program was then evaluated by a modified Kirkpatrick evaluation model, which measures individual perception, satisfaction, understanding, and performance related to the program. Results: A total of 114 participants were involved in this study. Most subjects (>80%) had a good experience with the program. ALTEM training program significantly increased communication and teamwork (p <0.001) and decision-making towards critical patients (p <0.001) in the univariate analysis. Communication and teamwork remained related considerably in the multivariate analysis (aOR 7.866; p = 0.005). Conclusion: The ALTEM simulation program obtained a good response from the subjects and was a prospective program to improve medical students' competence and teamwork skills in emergencies.
Co-Authors Ancilla, Cornelia Artika, I Gusti Ngurah Rai Bambang Suryono, Bambang Bowo Adiyanto Hartono, Pinter Ikhwandi, Arief Prasamya, Erlangga Rahma, Aulia Zuhria Sarosa, Pandit Sudadi Utomo, Prattama Santoso