Beranda Artikel Panduan Mudik Sehat, Aman, dan Nyaman, dengan Bekal Pengetahuan Pengelolaan Kedaruratan Kesehatan...

Panduan Mudik Sehat, Aman, dan Nyaman, dengan Bekal Pengetahuan Pengelolaan Kedaruratan Kesehatan Selama di Perjalanan

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Anggota Humas& Publikasi Komunitas Relawan Emergensi Kesehatan Indonesia-KREKI

Tak terasa Ramadhan telah memasuki paruh waktu kedua, dan minggu depan mungkin arus mudik ke kampung halaman akan mulai terlihat eskalasinya.

Berbagai moda transportasi dari tiga matra, darat, laut, dan udara akan mulai dipadati penumpang yang berbondong menuju kota asal atau kampung halamannya.

Kondisi ini tentu perlu diantisipasi dan dipersiapkan dengan baik, termasuk persiapan pribadi dari pelaku perjalanan itu sendiri.

Khusus terkait dengan kesehatan, keselamatan, dan kenyamanan dalam perjalanan, tentulah juga diperhatikan. Mengingat ada karakter perjalanan yang berbeda berdasar moda transportasi yang dipilih dan juga jarak dan waktu tempuh yang dibutuhkan.

Untuk itu perlu dicermati berbagai kondisi yang mungkin terjadi selama perjalanan, khususnya dari aspek kegawatdaruratan. Berdasar karakter dari moda transportasi yang dinaiki kita dapat mempersiapkan diri dan melakukan mitigasi pribadi untuk menilai potensi resiko yang dapat terjadi.

Moda Transportasi Darat

Kereta api, bus, dan mobil pribadi adalah pilihan transportasi mudik yang paling banyak diminati. Tingginya kepadatan di jalan raya dan fasilitas publik seperti di stasiun dan terminal, perlu diprediksi. Kondisi kepadatan dapat berdampak pada peningkatan suhu dan dehidrasi, juga kelelahan fisik yang dapat mempengaruhi konsentrasi pengemudi/operator, juga meningkatkan potensi terjadinya gangguan kesehatan, baik yang bersifat dapatan, maupun memperberat kondisi yang sudah ada.

Untuk itu perlu diperhatikan asupan cairan dan energi dari makanan yang bila menjalankan ibadah puasa dapat diatur sesuai dengan jadwal imsyak dan buka puasa. Jangan lupa untuk merehidrasi diri dengan mengacu kepada rumus rehidrasi sederhana berikut, kebutuhan cairan harian pada orang dewasa normal dengan aktivitas pekerjaan sedang dengan berat badan sekitar 60 Kg adalah 1 liter untuk 10 Kg berat badan yang pertama, lalu 0,5 liter untuk 10 Kg BB yang kedua, dan sisanya 40 x 0,02 = 0,8 L. Total kebutuhan cairan minimum yang perlu di penuhi adalah sekitar  2,3 L yang dapat dibulatkan sampai 2,5 L.

Jangan lupa pada saat syahur mengonsumsi karbohidrat kompleks, protein, dan sedikit lemak serta serat, agar cukup energi tersedia saat melakukan aktivitas perjalanan. Hindari mengonsumsi diuretik alami seperti teh dan kopi yang membuat frekuensi berkemih (buang air kecil) meningkat, secara berlebih. Asupan sewajarnya justru dapat membantu meningkatkan konsentrasi dan memberi efek relaksasi agar dapat mengelola stress yang mungkin terjadi selama durasi perjalanan yang harus dilalui.

Selanjutnya mohon dipersiapkan obat-obat kebutuhan pribadi, terutama bagi para pemudik yang tengah menjalani pengobatan penyakit kronis seperti penderita gangguan metabolik diabetes mellitus, atau penderita gangguan kardiovaskuler seperti hipertensi atau penyakit jantung tertentu.

Selain itu perlu dipersiapkan juga obat-obatan dan berbagai kelengkapan medis yang bersifat P3K, pertolongan pertama pada kecelakaan atau perlengkapan dalam menghadapi kondisi kedaruratan kesehatan yang mungkin terjadi.

Pada moda transportasi darat berbagai resiko seperti kecelakaan lalu lintas ataupun kondisi kedaruratan kesehatan seperti kondisi henti jantung dan nafas dapat saja terjadi. Untuk itu diperlukan bekal pengetahuan, maupun kelengkapan pendukung yang dapat mengurangi resiko fatalitas pada berbagai kondisi tersebut.

Ada baiknya jika kita menggunakan fasilitas transportasi publik, kita terlebih dahulu mencari informasi tentang letak kotak P3K, APAR atau alat pemadam kebakaran, dan jalur evakuasi dalam keadaan darurat. Perlu kita cermati juga ketersediaan fasilitas kesehatan di area pelayanan publik seperti di stasiun dan terminal. Dapat dipetakan pula keberadaan unit AED (automated external defibrilator) yang sudah menjadi obligasi untuk disediakan oleh institusi pelayanan publik.

Ada baiknya memang, jika institusi pelayanan publik secara rutin menyelenggarakan pelatihan penanganan kondisi kedaruratan (khususnya kesehatan) bagi para petugas pelayanan garda depannya.

Untuk itu kita sebagai pengguna jasa layanan transportasi perlu juga mencatat kontak petugas yang bertanggung jawab selama perjalanan, seperti yang telah ditetapkan di PT KAI, dimana nomor telepon seluler kondektur atau customer service selalu ditampilkan di kedua ujung gerbong penumpang. Tujuannya adalah apabila ada hal-hal yang perlu ditangani secara khusus dan cepat, petugas dapat memberikan respon yang adekuat.

Moda Transportasi Laut dan Udara

Pada prinsipnya langkah-langkah yang perlu dilakukan untuk mengantisipasi berbagai kondisi kedaruratan kesehatan di perjalanan, sama dengan di moda transportasi darat. Hanya saja mungkin ada hal yang spesifik di moda laut dan udara. Misal ada resiko tenggelam ataupun mengalami kondisi gangguan kesehatan di ketinggian atau di tengah lautan, yang memerlukan waktu untuk ditangani tenaga medis yang berada di darat.

Sebagai persiapan perlu diantisipasi kemungkinan pengaruh cuaca yang dapat menciptakan terjadinya olakan di perjalanan laut ataupun turbulensi di penerbangan. Jika sensitif terhadap kondisi mabuk laut maupun udara, kita perlu mengatur strategi terkait apa yang kita konsumsi, dan mempersiapkan obat-obatan yang dapat mencegah atau mengurangi rasa tidak nyaman yang dapat terjadi.

Perlu ditekankan sekali lagi, pelajari dan ikuti petunjuk dari awak yang bertugas, terkait mekanisme evakuasi saat terjadi keadaan darurat. Pelajari jalur evakuasi, termasuk letak pintu darurat, pelampung, pemecah kaca, ataupun alat pemadam kebakaran, dan cara penggunaanya, sebagai bekal jika terjadi suatu hal yang tidak diharapkan.

Selanjutnya dapat dipelajari informasi tentang berbagai tata cara pengelolaan kondisi kedaruratan berikut ini,

*Panduan Pertolongan Kedaruratan

 Kesehatan Bagi Penolong Awam*

Henti jantung dan gangguan pernafasan adalah salah satu kondisi kedaruratan yang kerap dijumpai, serta kerap pula berakhir fatal  Untuk itu, informasi ini kita awali dengan pemberian informasi terkait pertolongan pada korban henti jantung dan nafas, untuk selanjutnya diikuti oleh beberapa informasi terkait pertolongan pada beberapa kondisi kedaruratan medis lainnya.

Resusitasi Jantung Paru

RJP atau Cardiopulmonary Resuscitation (CPR) adalah suatu tindakan medis darurat untuk menyelamatkan nyawa seseorang yang mengalami henti jantung atau henti nafas. Berikut adalah tata laksana resusitasi jantung paru secara detail:

Langkah pertama dalam melakukan resusitasi jantung paru adalah evaluasi Kesadaran dan Nafas.

Pastikan kondisi orang yang mengalami hilang kesadaran. Periksa penderita dengan memanggil menggunakan nada cukup keras disertai tepukan pada bahu maupun dada.

Jika tidak terdapat respons pada penderita, periksa nadi karotis, yakni memeriksa nadi pada leher sebelah kanan atau kiri. Cara mudah meraba nadi karotis adalah menggunakan dua jari, awal letakkan pada jakun (jika penderita laki-laki) atau yang setinggi itu jika penderita adalah perempuan, kemudian geser jari ke arah kanan atau kiri hingga sebelum teraba otot sternoclidomastoideus. Raba selama 10 detik dan pastikan apakah terdapat nadi.

Periksa pula apakah korban bernafas atau tidak dengan memperhatikan hembusan nafas dari hidung dan mulut serta melihat gerakan dada dan perut.

Jika tidak terdapat nadi karotis dan henti nafas, maka segera lakukan panggilan telepon ke nomor nasional Public Safety Center di 119, atau

Buka aplikasi HELP-119 dan tekan panic button, lalu ikuti langkah-langkah panduan yang diberikan oleh aplikasi.

Jika aplikasi belum terinstalasi di piranti seluler, dapat diunduh di tautan berikut:

https://play.google.com/store/apps/details?id=com.rpc.kreki119

 Perhatikan apakah disekitar anda terdapat alat automated external defibrillator (AED). Jika tidak terdapat alat tersebut segera lakukan Resusitasi Jantung Paru (RJP).

RJP dimulai dengan tahap awal membuka jalan napas penderita dengan menengadahkan kepala penderita, selanjutnya dilakukan kompresi dada disertai tekanan dengan kekuatan penuh serta berirama di setengah bawah dari tulang dada.

Kompresi dada diberikan dengan syarat dilakukan secara benar, yakni kedalaman tekanan 5 cm, ritme 100 – 120 kali/menit, tanpa interupsi, dan memberikan bantuan pernapasan sebanyak 2 kali setelah melakukan 30 kompresi dada.

(Prakoso, Radityo. Panduan kursus Bantuan Hidup Jantung Dasar. Perhimpunan Dokter Spesialis Kardiovaskular Indonesia. 2021. 7 – 11.)

Penghentian Proses Bakar

Menghentikan proses bakar ini dengan cara menjauhkan / mematikan sumber panas. Untuk luka bakar api dapat dipergunakan air, kain basah, berguling-guling di tanah. Untuk luka bakar listrik dengan cara memutuskan sambungan listrik, jangan menyentuh bagian tubuh korban dan jangan pergunakan cairan apapun untuk menyiram korban.

Pendinginan Luka Bakar

Siram dengan air mengalir selama 20 menit bermanfaat untuk mendinginkan luka, mengurangi nyeri dan mengurangi bengkak. Jangan menggunakan bahan lain seperti kopi, pasta gigi, kecap dll.

Pemberian Obat Anti Nyeri

Bermacam obat yang mudah didapat dan biasa tersedia di rumah seperti paracetamol dan ibuprofen, dapat diberikan kepada korban sesuai dengan dosis yang tertera pada kemasan untuk mengurangi nyeri dan membantu membuat nyaman korban.

Menutup Luka Bakar

Balutan yang bersih dan steril harus dipakai untuk menutup luka agar dapat mencegah terjadinya rasa kedinginan pada korban sebelum atau dalam perjalanan menuju penanganan lebih lanjut dan juga dapat menurunkan resiko infeksi untuk luka bakar kecil pada perawatan di rumah.

Luka bakar merupakan suatu luka yang menyebabkan kerusakan yang tidak hanya melibatkan kerusakan jaringan tubuh seperti kulit, otot atau tulang saja, tetapi kerusakan akibat luka bakar ini begitu rumitnya sehingga dapat menyebabkan kekurangan cairan dll yang akhirnya dapat menyebabkan kerusakan organ-organ tubuh lainnya seperti ginjal, paru-paru bahkan jantung.

(Modul RSUD Mangusada Kabupaten Badung Bali)

Pertolongan Pertama pada Korban Tenggelam

Mencari bantuan terdekat untuk mengeluarkan korban dari air. Hubungi PSC 119, juga buka aplikasi HELP-119.

Mengevaluasi pernafasan dengan memeriksa  dan mendekatkan diri ke hidung dan mulut korban untuk merasakan adanya hembusan nafas serta memperhatikan gerakan dada korban.

Jika korban tidak bernafas segera lakukan RJP sebagaimana yang telah dijelaskan di atas.

Pertolongan Pertama pada Korban Sengatan Listrik

Mematikan sumber arus listrik. Ketika melihat orang lain tersengat listrik, pastikan untuk tidak langsung menyentuhnya.

Jauhkan tubuh korban dari sumber arus listrik dengan cara mendorong tubuh korban dengan benda yang bersifat isolator yang tidak dapat mengalirkan arus listrik.

Segera hubungi PSC 119, juga buka aplikasi HELP-119 dan tekan panic button.

Periksa kondisi  korban. Apakah ada henti nafas dan henti jantung, dan apakah ada luka bakar.

Jika ada henti nafas dan henti jantung lakukan RJP. Jika korban sadar dan bernafas lakukan perawatan pertama pada luka bakar yang terjadi dengan langkah-langkah yang telah dijelaskan di atas.

(Artikel penanganan korban sengatan listrik dari situs Hello Sehat)

Pertolongan Pertama pada Korban Kecelakaan

Tindakan preliminari dan asesmen yang harus dilakukan dalam proses pertolongan pertama pada kecelakaan adalah:

Periksa potensi bahaya di tempat kejadian.

Hubungi PSC 119 atau nuka aplikasi HELP-119 dan tekan panic button. Bantuan kegawatdarutan dapat melakukan evakuasi medis ke fasilitas pelayanan kesehatan terdekat.

Berikan ruang yang Cukup untuk Korban agar dapat bernapas lebih baik.

Lakukan upaya pertolongan sesuai kondisi korban seperti

tidak sadarkan diri, pendarahan, luka bakar, gangguan pada sistem otot rangka seperti terkilir atau fraktur/patah tulang.

Pantau tanda vital seperti denyut nadi, laju pernafasan, dan kesadaran korban sampai bantuan  medis datang untuk mengevaluasi dan mengevakuasi korban.

Metode pertolongan terhadap korban kecelakaan lalu lintas umumnya menggunakan prinsip DRSABC, yaitu kepanjangan dari Danger, Response, Shout, Airway, Breathing,& Circulation.

Penilaian Dini pada Kondisi Korban Kedaruratan

Penilaian yang dilakukan oleh penolong untuk menilai keadaan yang

mengancam jiwa, ada 6 hal yang harus diperhatikan :

1) Kesan Umum, kondisi/gambaran umum dari kecelakaan/musibah yang terjadi

Kasus Trauma atau kasus medis.

2) Memeriksa Respon /Tingkat kesadaran.

Mulailah berbicara dengan korban dengan memperkenalkan diri anda,

nama, institusi, bila penderita pingsan lakukan dengan menepuk-

nepuk tangannya, sambil mengatakan “pak..bapak kenapa?”.

Kemudian nilai respon korban. Untuk memudahkan biasanya

menggunakan singkatan/ASNT :

a). A, Awas (Alert): kesadaran penuh dapat mengenal orang, tempat

dan waktu); tanyakan tentang : nama bapak siapa? Sekarang sedang di mana?, Ini hari apa?

b). S, suara (voice/verbal): korban hanya berespon saat ditanya. Saat

ditanya penolong, korban membuka mata/mengeluarkan

suara.

c). N, Nyeri (Pain): korban hanya membuka mata atau mengeluarkan

suara saat penolong memberikan rangsangan dengan

mencubit;

d). T, tidak respon (Unresponsive): korban tidak bereaksi sama sekali

terhadap rangsangan nyeri pada saat dicubit

3). Pastikan jalan napas terbuka dengan baik

Apabila korban dapat berbicara maka dianggap bahwa nafasnya baik,

tetapi bila penderita tidak dapat berbicara maka nilailah dengan cara:

a). Lihat apakah ada pernapasan?

b). Dengar adakah aliran udara?

c). Rasakan adakah aliran udara keluar dari mulut/hidung? Bila napas

berbunyi (ngorok) dianggap ada gangguan jalan napas.

(Modul Pelatihan Pertolongan Pertama pada Kondisi Kedaruratan untuk Anggota Linmas Malang, Poltekkes Negeri Malang, 2018)

Mobilisasi atau Pemindahan  Korban

Setelah melakukan penilaian keadaan, penilaian dini, dan menghubungi PSC 119 juga menekan panic button di aplikasi HELP-119, selanjutnya penolong/ relawan harus menentukan prioritas pemindahan korban.

Syarat-syarat pemindahan korban:

Penilaian korban sudah dilakukan

Denyut nadi dan pernapasan korban normal

Perdarahan dan patah tulang sudah ditangani

Tidak ada cedera tulang belakang

Rute yang dilalui memungkinkan dan tidak membahayakan penolong dan korban

Terdapat bahaya yang mengancam keselamatan penolong dan korban.

Hindarkan pemindahan korban, bila:

Ketika perjalanan menuju Rumah Sakit atau fasilitas kesehatan dapat memperburuk cedera atau penyakit atau mengakibatkan cedera tambahan

Ketika korban memiliki atau mungkin mengakibatkan kondisi yang mengancam jiwa

Anda tidak yakin dengan jenis dan keparahan cedera atau penyakitnya.

Pertolongan pertama sebaiknya diberikan di tempat korban berada sambil menunggu bantuan datang. Kecuali jika lokasi kejadian tidak memungkinkan korban dibiarkan di tempat tersebut (seperti ada bahaya kebakaran, ledakan, bangunan runtuh, listrik, bahan-bahan berbahaya, dll.), perhatikan hal-hal berikut:

Rencanakan gerakan sebelum mengangkat dan memindahkan korban

Jangan mengangkat dan memindahkan korban jika tidak mampu. Anggap korban mengalami fraktur di bagian leher, stabilkan bagian kepala. Pegang bagian pundak, terus jepit bagian kepala dengan kedua lengan anda untuk menjaga tulang leher dan kepala tetap aman.

Orang yang memegang bagian atas (kepala dan leher) harus mengikuti ke mana pun tubuh digerakkan. Dan, ia harus menjadi leader dalam mengangkat dan memindahkan korban.

Hindari mengangkat dengan otot punggung dan membungkuk (punggung harus tetap lurus). Tetap jaga keseimbangan

Posisikan tubuh Anda dekat dengan tubuh korban saat mengangkat dan memindahkan korban

Pastikan Anda tahu rute tercepat menuju fasilitas kesehatan terdekat

Perhatikan setiap perubahan kondisi korban.

Demikian informasi pengelolaan kondisi kedaruratan medis yang dapat menjadi pemantik bagi proses belajar secara lebih lanjut terkait berbagai pengetahuan yang berguna dalam penanganan kondisi kedaruratan medis yang dapat dilakukan oleh masyarakat awam, wa bil khusus bagi mereka yang sebentar lagi akan memulai perjalanan mudik ke kampung halaman tercinta 

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