INSTALLATION AND RELEASING OF RESPIRATORY AIDS

Examiner : dr. Gatot Suharto, Sp.F, MH Kes

Supervisor : dr. Erni H.Situmorang

MEDICOLEGAL ASPECT

INTRODUCTIONLife or Die?

Life Support System Artificial Life

Life promises 0r accident?

Indication? Complication?Medicolegal aspect??

Mechanical ventilatorNegative or positive pressure breathing toolsVentilation and oxygen supplyLong time

Purpose? Life saving Complication

Indication“Spontaneous ventilation in inadequate

patients for life saving”Collapse prophylaxisRespiratory failure or clinical condition that

leads to respiratory failure

Respiratory failure Apnea Shock

Neurological

dysfunction

Heart insufficienc

y

Complication

Weaning ventilationDecreasing ventilation support breathing

spontaneously and can be extubate

airway

GIT

NeuromuscCVS

Lung

Its factorEarly condition which affects patients

Is general patient’s condition in optimal state?

Does patient have respiratory tract problem or being cured?

Does patient breath adequately?

Hospital Intubation Protocol (Operational and Procedural Standard)

1

•Fulfill criteria for starting ventilator support

2

•Preparing Intubation

3

•ventilator setting

4

•Sedation

5

•Nasogastric tube

6

•Muscle relaxant

7

•Confirm the ETT position and connecting to ventilator

8

•Blood Gas Analysis

9

•Continue the medication

10

•Trolley CPR and resuscitation drugs

11

•Thorax X-ray

Extubation criteria according to the Hospital Operational and Procedural standard

1. Neurological

2. Heart

3. Respiration

4.Kidney

5.Temperature

Informed

Consent ?

Agreement that is given by the doctor before examining, curing, or doing any medical procedures

Competention Freedom Giving

Information

Doctor recomendatio

n

Patient understandin

g

Patient’s decision

Patient’s autority

7 element of informed consent (Beaucham and

Childress)

Content

Diagnostic and process

purpose

Alternate

Risk and complication

Prognosis

Cost estimation

Permenkes no 290/Menkes/PER/III/2008 tentang PTM

UU No. 44 Tahun 2009 pasal 32 tentang Rumah Sakit

UU no 36 thn 2009 pasal 56 tentang Kesehatan

LAW FUNDAMENTA

L

CONCLUSIONVentilator : life saving and life threatening

Need informed consent according to the law

Peraturan Menteri Kesehatan nomor 290/MENKES/PER/III/2008,

Undang-Undang nomor 29 tahun 2004 pasal 45, Undang-Undang nomor 36 tahun 2009 pasal 56, 57,

dan 58, Undang-Undang nomor 44 tahun 2009 pasal 32, dan Undang-Undang nomor 23 tahun 1992 pasal 53.