Virus Corona

TOPNURSE~ Virus Corona atau 2019 Novel Coronavirus adalah virus yang menyerang sistem pernapasan. Penyakit karena infeksi virus ini disebut COVID-19. Virus Corona bisa menyebabkan gangguan pada sistem pernapasan, pneumonia akut, sampai kematian.

Virus 2019 Novel Coronavirus (2019-nCoV) yang lebih dikenal dengan nama virus Corona adalah jenis baru dari coronavirus yang menular ke manusia. Virus ini bisa menyerang siapa saja, baik bayi, anak-anak, orang dewasa, lansia, ibu hamil, maupun ibu menyusui. Infeksi virus ini disebut COVID-19 dan pertama kali ditemukan di kota Wuhan, Cina, pada akhir Desember 2019. Virus ini menular dengan cepat dan telah menyebar ke wilayah lain di Cina dan ke beberapa negara.

Coronavirus adalah kumpulan virus yang bisa menginfeksi sistem pernapasan. Pada banyak kasus, virus ini hanya menyebabkan infeksi pernapasan ringan, seperti flu. Namun, virus ini juga bisa menyebabkan infeksi pernapasan berat, seperti pneumonia, Middle-East Respiratory Syndrome (MERS), dan Severe Acute Respiratory Syndrome (SARS).

Gejala Virus Corona

Infeksi virus Corona atau COVID-19 bisa menyebabkan penderitanya mengalami gejala flu, seperti hidung berair dan meler, sakit kepala, batuk, nyeri tenggorokan, dan demam; atau gejala penyakit infeksi pernapasan berat, seperti demam tinggi, batuk berdahak bahkan berdarah, sesak napas, dan nyeri dada.

Namun, secara umum ada 3 gejala umum yang bisa menandakan seseorang terinfeksi virus Corona, yaitu:

• Demam
• Batuk
• Sesak napas

Menurut penelitian, gejala COVID-19 muncul dalam waktu 2 hari sampai 2 minggu setelah terpapar virus Corona.

Kapan harus ke dokter

Segera ke dokter bila Anda mengalami gejala infeksi virus Corona (COVID-19) seperti yang disebutkan di atas, terutama jika gejala muncul 2 minggu setelah kembali dari Cina atau negara lain yang positif terinfeksi. Orang yang dicurigai terinfeksi virus Corona harus segera dirujuk ke IGD rumah sakit terdekat agar mendapat penanganan yang tepat.

Penyebab Virus Corona

Infeksi virus Corona atau COVID-19 disebabkan oleh coronavirus, yaitu kelompok virus yang menginfeksi sistem pernapasan. Pada sebagian besar kasus, coronavirus hanya menyebabkan infeksi pernapasan ringan sampai sedang, seperti flu. Akan tetapi, virus ini juga bisa menyebabkan infeksi pernapasan berat, seperti MERS, SARS, dan pneumonia.

Ada dugaan bahwa virus Corona awalnya ditularkan dari hewan ke manusia. Namun, kemudian diketahui bahwa virus Corona juga menular dari manusia ke manusia.

Seseorang dapat tertular COVID-19 melalui berbagai cara, yaitu:

• Tidak sengaja menghirup percikan ludah dari bersin atau batuk penderita COVID-19.
• Memegang mulut atau hidung tanpa mencuci tangan terlebih dulu, setelah menyentuh benda yang terkena cipratan air liur penderita COVID-19.
• Kontak jarak dekat dengan penderita COVID-19, misalnya bersentuhan atau berjabat tangan.

Virus Corona dapat menginfeksi siapa saja, tetapi efeknya akan lebih berbahaya atau bahkan fatal bila terjadi pada orang lanjut usia, ibu hamil, orang yang sedang sakit, atau orang yang daya tahan tubuhnya lemah.

Diagnosis Virus Corona

Untuk menentukan apakah pasien terinfeksi virus Corona, dokter akan menanyakan gejala yang dialami pasien. Dokter juga akan bertanya apakah pasien bepergian ke wilayah endemik virus Corona sebelum gejala muncul.

Guna memastikan diagnosis COVID-19, dokter akan melakukan pemeriksaan lanjutan berikut:

• Uji sampel darah
• Tes usap tenggorokan untuk meneliti sampel dahak
• Rontgen dada untuk mendeteksi infiltrat atau cairan di paru-paru

Pengobatan Virus Corona

Infeksi virus Corona atau COVID-19 belum bisa diobati, tetapi ada beberapa langkah yang dapat dilakukan dokter untuk meredakan gejalanya, yaitu:

• Memberikan obat pereda demam dan nyeri. Namun, dokter tidak akan memberikan aspirin kepada penderita COVID-19 yang masih kanak-kanak.
• Menganjurkan penderita COVID-19 untuk mandi air hangat dan menggunakan humidifier(pelembab udara), untuk meredakan batuk dan sakit tenggorokan.
• Menganjurkan penderita COVID-19 untuk istirahat yang cukup dan tidak keluar rumah untuk mencegah penyebaran virus.
• Menganjurkan penderita COVID-19 untuk banyak minum air putih guna menjaga kadar cairan tubuh.

Komplikasi Virus Corona

Pada kasus yang parah, infeksi virus Corona bisa menyebabkan beberapa komplikasi serius berikut ini:

• Pneumonia
• Infeksi sekunder pada organ lain
• Gagal ginjal
• Acute cardiac injury
• Acute respiratory distress syndrome
• Kematian

Pencegahan Virus Corona

Sampai saat ini, belum ada vaksin untuk mencegah infeksi virus Corona atau COVID-19. Oleh sebab itu, cara pencegahan yang terbaik adalah dengan menghindari faktor-faktor yang bisa menyebabkan Anda terinfeksi virus ini, yaitu:

• Hindari bepergian ke Cina atau ke negara lain yang telah ditemukan adanya penularan virus Corona.
• Gunakan masker saat beraktivitas di luar ruangan, terutama di tempat umum atau keramaian.
• Rutin mencuci tangan dengan air dan sabun atau hand sanitizer yang mengandung alkohol setelah beraktivitas di luar ruangan.
• Hindari kontak dengan hewan, terutama hewan liar. Bila terjadi kontak dengan hewan, cuci tangan setelahnya.
• Masak daging sampai benar-benar matang sebelum dikonsumsi.
• Tutup mulut dan hidung dengan tisu saat batuk atau bersin, kemudian buang tisu ke tempat sampah.
• Jangan menyentuh mata, mulut, dan hidung sebelum mencuci tangan.
• Hindari berdekatan dengan seseorang yang sedang sakit.
• Jaga kebersihan benda yang sering disentuh dan kebersihan lingkungan.

Untuk seseorang yang diduga terkena COVID-19, ada beberapa langkah yang bisa dilakukan agar virus Corona tidak menular ke orang lain, yaitu:

• Jangan keluar rumah, kecuali untuk mendapatkan pengobatan.
• Usahakan untuk tinggal terpisah dari orang lain untuk sementara waktu. Bila tidak memungkinkan, gunakan kamar tidur dan kamar mandi yang berbeda dengan yang digunakan orang lain.
• Larang dan cegah orang lain untuk mengunjungi atau menjenguk Anda sampai Anda benar-benar sembuh.
• Sebisa mungkin jangan melakukan pertemuan dengan orang yang sedang sedang sakit.
• Hindari berbagi penggunaan alat makan dan minum, alat mandi, serta perlengkapan tidur dengan orang lain.
• Pakai masker dan sarung tangan bila sedang berada di tempat umum atau sedang bersama orang lain.
• Gunakan tisu untuk menutup mulut dan hidung bila batuk atau bersin, lalu buang tisu ke tempat sampah.

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Acute Respiratory Distress Syndrome

TOPNURSE~ Acute Respiratory Distress Syndrome atau disingkat ARDS adalah kondisi yang muncul ketika cairan mengumpul di alveoli, yaitu kantung udara kecil dan elastis pada paru-paru. Cairan biasanya merembes dari pembuluh darah kecil.

Kumpulan cairan ini dapat membuat paru-paru tidak cukup terisi udara dan pasokan oksigen ke aliran darah menjadi berkurang. Hal tersebut mengakibatkan organ-organ, seperti ginjal dan otak, tidak dapat bekerja normal atau bahkan berhenti berfungsi karena tidak mendapat cukup oksigen.

ARDS biasanya dialami oleh orang yang sudah menderita penyakit kritis atau mengalami cedera cukup parah. Kebanyakan ARDS menyebabkan kematian, meskipun ada pula penderita yang dapat sembuh total. Besarnya risiko kematian bergantung dari usia penderita dan tingkat keparahan ARDS.

Gejala Acute Respiratory Distress Syndrome

Gejala yang dialami penderita ARDS dapat berbeda-beda, tergantung dari penyebab dan tingkat keparahannya. Beberapa gejala yang mungkin dirasakan oleh penderita ARDS adalah:

• Napas menjadi sangat pendek.
• Sesak napas dan frekuensi napas menjadi cepat.
• Tekanan darah turun.
• Penurunan kesadaran dan merasa sangat lelah.
• Banyak berkeringat.
• Pusing.
• Bibir atau kuku berwarna kebiruan.
• Batuk kering.
• Demam.
• Denyut nadi cepat.

Penyebab Acute Respiratory Distress Syndrome

Penyebab ARDS adalah merembesnya cairan dari pembuluh darah kapiler (pembuluh darah terkecil) dalam paru-paru ke dalam alveoli, tempat di mana seharusnya darah dipasok dengan oksigen. Pada kondisi normal, membran pembuluh darah akan menjaga cairan tetap di dalam. Adanya cedera atau penyakit yang berat dapat menyebabkan kebocoran cairan dari dinding pembuluh darah. Cedera dan penyakit tersebut di antaranya adalah:

• Sepsis.
• Menghirup zat berbahaya, seperti asap pekat atau uap kimia.
• Pankreatitis.
• Tersedak muntahan atau kondisi nyaris tenggelam.
• Pneumonia berat.
• Cedera di kepala, dada, atau bagian tubuh lainnya.
• Luka bakar.
• Overdosis obat tidur atau antidepresan.
• Menerima transfusi darah dengan volume darah yang banyak.

Beberapa faktor yang meningkatkan risiko seseorang terkena ARDS adalah:

• Ketergantungan alkohol.
• Berusia di atas 65 tahun.
• Perokok.
• Menderita penyakit paru-paru kronis.

Diagnosis Acute Respiratory Distress Syndrome

Tidak ada metode pemeriksaan spesifik untuk mendeteksi ARDS. Diagnosis yang dilakukan terhadap pasien yang dicurigai ARDS didasarkan pada pemeriksaan fisik, foto Rontgen dada, serta pemeriksaan analisis gas darah dari pembuluh arteri untuk melihat kadar oksigen dalam darah. Pemeriksaan darah juga dapat dilakukan untuk melihat adanya anemia atau infeksi. Selain foto Rontgen, dokter dapat melakukan CT scan untuk mendiagnosis ARDS.

Pemeriksaan jantung juga mungkin akan disarankan bagi penderita ARDS, sebab gangguan jantung dan ARDS memiliki gejala yang sama. Beberapa pemeriksaan jantung yang dapat dilakukan adalah:

• Elektrokardiogram (EKG), untuk melihat aktivitas listrik dalam jantung.
• Ekokardiografi, untuk mendeteksi gangguan pada struktur dan fungsi jantung penderita.

Pengobatan Acute Respiratory Distress Syndrome

Beberapa langkah yang dapat dilakukan dokter untuk mengatasi ARDS adalah:

• Pemberian oksigen. Dokter akan meningkatkan kadar oksigen dalam aliran darah penderita dengan memberikan oksigen tambahan melalui selang hidung ataupun masker.
• Alat bantu napas atau ventilator. Ventilator membantu memberikan tekanan udara tambahan ke paru-paru penderita.
• Mengatur asupan cairan. Dokter akan mengatur jumlah cairan infus dan nutrisi yang masuk ke tubuh penderita, sesuai hasil uji klinis dan keadaan umum pasien.
• Pemberian obat-obatan. Dokter akan memberikan obat untuk mencegah dan mengatasi infeksi, meredakan nyeri dan ketidaknyamanan, mencegah penggumpalan darah pada kaki dan paru, dan meminimalisasi refluks asam dan isi lambung. Bila diperlukan diberikan obat tidur, terutama untuk pasien yang menggunakan alat bantu napas.
• Rehabilitasi paru. Tindakan ini diperlukan untuk memperkuat sistem pernapasan dan meningkatkan kapasitas paru-paru saat pemulihan dari ARDS.

Komplikasi Acute Respiratory Distress Syndrome

Pasien ARDS berisiko menderita komplikasi saat menjalani pengobatan. Beberapa komplikasi tersebut di antaranya adalah:

• Penggumpalan darah. Berbaring terus-menerus dapat meningkatkan risiko terjadinya penggumpalan darah, terutama pada pembuluh darah vena dalam di tungkai (deep vein thrombosis).
• Kolaps paru-paru (pneumothorax). Penggunaan ventilator berfungsi memberikan tekanan udara tambahan untuk meningkatkan aliran oksigen dalam darah. Ventilator juga membantu membersihkan cairan dalam alveoli. Namun penggunaan ventilator berisiko membuat robekan kecil pada kantung udara paru-paru, sehingga membuat udara dalam paru-paru keluar melalui lubang kecil tersebut dan menyebabkan paru-paru kempis.
• Infeksi. Untuk menyambungkan paru-paru dengan mesin (ventilator), dimasukkan pipa atau selang ke dalam tenggorokan sampai melewati pita suara. Selang ini merupakan benda asing bagi tubuh yang berisiko melukai dan mengiritasi saluran pernapasan, serta menjadi tempat pertumbuhan bakteri.
• Fibrosis paru. Fibrosis paru mengakibatkan paru-paru menjadi tidak elastis dan sulit mengalirkan oksigen.

Beberapa gangguan kesehatan juga berisiko diderita oleh pasien ARDS yang berhasil disembuhkan, seperti:

• Gangguan pernapasan (biasanya napas menjadi pendek), sampai membutuhkan oksigen tambahan saat pulang ke rumah.
• Depresi.
• Gangguan daya pikir dan daya ingat akibat otak sempat kekurangan pasokan oksigen.
• Melemahnya otot akibat terlalu lama berbaring dan tidak digunakan.
• Merasa lemas dan lelah.

Pencegahan Acute Respiratory Distress Syndrome

Ada beberapa hal yang dapat dilakukan seseorang untuk menurunkan risiko menderita ARDS, yaitu:

• Menghentikan kebiasaan merokok dan menghindari asap rokok.
• Berhenti mengonsumsi minuman beralkohol.
• Rutin mendapatkan vaksin flu setiap tahun dan vaksin pneumonia setiap lima tahun untuk mengurangi risiko infeksi paru-paru.

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Ketahui Perbedaan COVID-19 dengan SARS dan MERS

TOPNURSE~ Meski disebabkan oleh kelompok virus yang sama, yaitu coronavirus, ada perbedaan di antara COVID-19, SARS, dan MERS. Tidak hanya masa inkubasi penyakitnya, perbedaan ketiga penyakit ini juga ada pada kecepatan penularan serta pengobatannya.

COVID-19, SARS, dan MERS merupakan penyakit infeksi virus pada saluran pernapasan yang bisa berakibat fatal. SARS (severe acute respiratory syndrome) pertama kali mewabah di China pada tahun 2002, sementara MERS (Middle-East respiratory syndrome) pertama kali muncul di Timur Tengah pada tahun 2012.

Pada akhir tahun 2019, muncul penyakit baru di China yang dinamakan COVID-19 (Coronavirus Disease 2019). Penyakit ini telah menyebabkan banyak kematian di berbagai negara.

Perbedaan COVID-19 dengan SARS dan MERS Berdasarkan Masa Inkubasi

Masa inkubasi adalah waktu yang diperlukan oleh kuman untuk berkembang biak di dalam tubuh seseorang hingga menimbulkan keluhan. Dengan kata lain, masa inkubasi adalah rentang waktu antara terjadinya infeksi dan munculnya gejala.

Meskipun virus penyebab COVID-19, SARS, dan MERS berasal dari keluarga virus yang sama, yaitu coronavirus, ketiga penyakit ini memiliki masa inkubasi yang berbeda. Masa inkubasi penyakit MERS adalah 2–14 hari (rata-rata 5 hari), dan masa inkubasi penyakit SARS adalah 1–14 hari (rata-rata 4-5 hari). Sementara masa inkubasi COVID-19 adalah 1–14 hari, dengan rata-rata 5 hari.

Perbedaan COVID-19 dengan SARS dan MERS Berdasarkan Gejala dan Penyebaran

Pada derajat ringan, ketiga penyakit ini dapat menyebabkan demam, batuk, nyeri tenggorokan, hidung tersumbat, lemas, sakit kepala, dan nyeri otot. Jika semakin berat, gejala ketiganya dapat menyerupai pneumonia, yaitu demam, batuk parah, kesulitan bernapas dan napas cepat. Perbedaan besar di antara ketiga penyakit ini adalah COVID-19 jarang disertai keluhan pilek dan keluhan pencernaan, seperti buang air besar cair (menceret), mual, dan muntah.

Penyebaran coronavirus dari hewan ke manusia sebenarnya sangat jarang, tapi hal inilah yang terjadi pada COVID-19, SARS, dan MERS. Manusia dapat tertular coronavirus lewat kontak langsung dengan hewan yang terjangkit virus ini. Cara penyebaran ini disebut transmisi zoonosis.

SARS diketahui ditularkan dari luwak ke manusia, sedangkan MERS ditularkan dari unta berpunuk. Sementara pada COVID-19, ada dugaan bahwa hewan yang pertama kali menularkan penyakit ini ke manusia adalah kelelawar.

Seseorang dapat terjangkit virus Corona jika ia menghirup percikan air liur yang dikeluarkan oleh penderita COVID-19 saat bersin atau batuk. Tidak hanya itu, penularan juga dapat terjadi jika seseorang memegang benda yang telah terkontaminasi percikan air liur penderita COVID-19 lalu memegang hidung atau mulut tanpa mencuci tangan terlebih dahulu.

SARS dan COVID-19 diketahui lebih mudah menyebar dari manusia ke manusia daripada MERS. Dan jika dibandingkan dengan SARS, penularan COVID-19 dari manusia ke manusia lebih mudah terjadi dan lebih cepat.

Sejauh ini, angka kematian akibat COVID-19 tidak lebih tinggi dibandingkan SARS dan MERS. Angka kematian SARS mencapai 10%, sedangkan MERS mencapai 37%. Namun, penularan COVID-19 yang lebih cepat dibandingkan SARS dan MERS membuat jumlah penderita penyakit ini meningkat tajam dalam waktu singkat.

Perbedaan COVID-19 dengan SARS dan MERS Berdasarkan Pengobatan

Sejauh ini, belum ada obat yang terbukti efektif dalam mengatasi COVID-19. Beberapa obat antivirus, seperti oseltamivir, lopinavir, dan ritonavir, sudah dicoba untuk diberikan kepada pasien COVID-19 sambil terus diteliti.

Sedangkan pada SARS dan MERS, pemberian lopinavir, ritonavir, serta obat antivirus spektrum luas terbaru bernama remdesivir sudah terbukti efektif sebagai pengobatan.

Pada penderita infeksi virus Corona dengan gejala yang berat, di samping obat antivirus, mereka juga perlu mendapatkan terapi cairan (infus), oksigen, antibiotik, serta obat-obatan lainnya sesuai gejala yang muncul. Penderita COVID-19 juga perlu dirawat di rumah sakit agar kondisinya dapat dipantau dan tidak menularkan infeksi ke orang lain.

Upaya pencegahan terhadap ketiga penyakit ini dapat dilakukan dengan rutin mencuci tangan, menutup mulut dan hidung ketika batuk dan bersin, serta memasak daging dan telur hingga matang sebelum dimakan. Selain itu, sebisa mungkin hindari kontak dengan orang yang sedang batuk dan demam.

Segera periksakan diri Anda ke dokter di fasilitas kesehatan terdekat, seperti klinik, Puskesmas, atau rumah sakit, apabila Anda mengalami gejala infeksi pernapasan, seperti demam, batuk, bersin, pilek, atau nyeri tenggorokan, apalagi jika Anda sampai mengalami sesak napas.

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Middle East Respiratory Syndrome Coronavirus (MERS CoV)

TOPNURSE~ Penyakit Middle East Respiratory Syndrome Coronavirus (MERS CoV) adalah penyakit saluran pernapasan yang disebabkan oleh coronavirus. Penyakit ini menular dari unta ke manusia, serta dari manusia ke manusia.

MERS CoV diduga awalnya berasal dari unta yang hidup di negara-negara Timur Tengah, seperti Arab Saudi, Yordania, dan Yaman. Meski MERS CoV juga terjadi di beberapa negara di Eropa dan Amerika, namun penderitanya diketahui terserang penyakit ini setelah bepergian ke negara Timur Tengah. Oleh sebab itu, penyakit ini sering disebut juga sindrom pernapasan Timur Tengah.

Meski MERS CoV menular, tetapi penularannya tidak semudah flu biasa. MERS CoV lebih rentan menular melalui kontak langsung, misalnya pada orang yang merawat penderita MERS tanpa menerapkan prosedur perlindungan diri terhadap virus dengan baik.

Gejala Middle East Respiratory Syndrome Coronavirus (MERS CoV)

Gejala MERS CoV umumnya muncul 1-2 minggu setelah penderita terinfeksi virus. Beberapa gejala yang timbul adalah:

• Batuk
• Pilek
• Sakit tenggorokan
• Demam
• Menggigil
• Nyeri otot
• Sesak napas

Pada kasus yang jarang terjadi, MERS CoV juga dapat menimbulkan gejala batuk berdarah, mual dan muntah, serta diare.

Kapan harus ke dokter

Kebanyakan kasus MERS CoV terjadi di wilayah Arab Saudi dan negara-negara Timur Tengah. Periksakan ke dokter bila Anda baru kembali dari negara-negara tersebut dan mengalami gejala gangguan pernapasan.

Beberapa penderita MERS CoV hanya mengalami gejala ringan seperti gejala flu. Meski demikian, pemeriksaan ke dokter tetap perlu dilakukan bila gejala tersebut muncul setelah Anda kembali dari negara yang memiliki kasus infeksi MERS CoV.

Penyebab Middle East Respiratory Syndrome Coronavirus (MERS CoV)

MERS CoV disebabkan oleh coronavirus, yaitu kelompok virus yang menyebabkan batuk pilek dan infeksi saluran pernapasan akut (ISPA). Selain menginfeksi manusia, MERS CoV juga dapat menginfeksi hewan, khususnya unta. Beberapa faktor yang dapat meningkatkan risiko seseorang tertular MERS CoV adalah:

• Berada di dekat penderita MERS CoV, terutama bagi lansia, orang dengan sistem kekebalan tubuh yang lemah, dan petugas medis yang merawat penderita MERS CoV.
• Baru pulang dari Arab Saudi atau negara sekitarnya, dan mengalami gejala gangguan pernapasan.
• Kontak dengan unta yang terinfeksi virus ini, termasuk meminum susunya dan memakan dagingnya yang tidak dimasak dengan benar-benar matang.

Diagnosis Middle East Respiratory Syndrome Coronavirus (MERS CoV)

Dokter akan bertanya tentang gejala yang dialami pasien dan kemungkinan pasien kontak dengan penderita MERS CoV. Dokter juga akan menanyakan apakah pasien baru saja bepergian ke Arab Saudi atau negara sekitarnya.

Untuk memastikan apakah di dalam tubuh pasien terdapat virus penyebab MERS CoV, dokter akan melakukan pemeriksaan penunjang, seperti:

• Tes usap tenggorokan
• Tes darah
• Pemeriksaan sampel tinja
• Uji sampel dahak
• Rontgen dada

Pengobatan dan Pencegahan Middle East Respiratory Syndrome Coronavirus (MERS CoV)

Sampai saat ini, belum ada metode maupun vaksin untuk mengobati dan mencegah MERS CoV. Bagi pasien dengan gejala ringan, dokter akan meresepkan obat untuk meredakan demam dan nyeri. Dokter juga akan menyarankan pasien beristirahat di rumah dan sebisa mungkin menghindari kontak dengan orang lain untuk mencegah penyebaran virus.

Bagi pasien yang mengalami gejala berat, diperlukan penanganan intensif di rumah sakit. Pasien akan diberikan oksigen, antibiotik, dan infus. Bila perlu, dokter akan memonitor fungsi organ tubuh secara intensif dan memasangkan alat bantu napas.

Meski belum ada vaksin untuk mencegah MERS CoV, risiko tertular virus ini dapat dikurangi dengan melakukan beberapa langkah berikut:

• Rutin mencuci tangan dengan air dan sabun, terutama sebelum makan atau sebelum menyentuh wajah. Bila tidak ada sabun, gunakan hand sanitizer.
• Menutup hidung dan mulut dengan tisu ketika bersin atau batuk, lalu buang tisu tadi ke tempat sampah.
• Membersihkan dan mensterilkan benda yang sering disentuh banyak orang, seperti pegangan pintu.
• Hindari kontak dengan seseorang yang sedang sakit, termasuk berbagi pakai alat makan.
• Jangan melakukan kontak dengan unta yang sedang sakit, dan jangan pula memakan daging serta meminum susunya.

Komplikasi Middle East Respiratory Syndrome Coronavirus (MERS CoV)

MERS CoV yang tergolong parah sangat berbahaya, bahkan dapat menyebabkan kematian. Diketahui bahwa 30-40% penderita MERS CoV meninggal dunia, terutama penderita yang juga memiliki gangguan sistem imun, seperti penderita diabetes atau kanker.

Komplikasi yang dapat terjadi pada penderita MERS CoV adalah:

• Pneumonia
• Gagal ginjal
• Gagal napas
• Syok sepsis

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How to Get Rid of Old Scars ?

Top 10 Remedies :

Overview

TOPNURSE~While some people consider their scars to be marks of pride, many people just want them to go away. Since they can affect your appearance, they can make you feel self-conscious.

If you want to get rid of an old scar, you need to understand what a scar is and what type you’re trying to get rid of.

A scar forms as part of the natural healing process following an injury. When the dermis — the second layer of skin — is damaged, your body forms collagen fibers to repair the damage, and that results in a scar.

• In most cases, the faster a wound heals, the less collagen will be deposited and the less noticeable the scar will be.
• Typically, the severity of the scar is based on the severity of the injury or damage.
• Scars form differently on different parts of the body.
• Scars form differently based on the age of the injured person.
• There are different types of scars.

Different types of scars

There are different types of scars, each with defining characteristics.

Atrophic scars

Atrophic scars are characterized by the loss of tissue. They appear depressed, serrated, or flat against the upper layer of the skin. Often atrophic scars have darker skin pigmentation than other area of your skin. Examples of atrophic scars include acne scars and chickenpox scars.

Hypertrophic scars

Hypertrophic scars are characterized by excess tissue that forms over the skin as it heals. Unlike a keloid scar, it does not grow outside the injured area. Hypertrophic scars are commonly darker than other skin in the area.

Keloid Scars

Keloid scars are the result of aggressive healing and an overproduction of tissue. They are characterized by a raised, thick, puffy appearance. They are typically darker than the surrounding skin. Unlike a hypertrophic scar, keloid scars can grow beyond the injured area.

Contracture scars

Contracture scars result from large areas of skin being lost or damaged, typically from burns. They are characterized by tight, shiny skin that can restrict movement.

The top 10 remedies for getting rid of scars

There’s no known way to make scars totally disappear, but many will become lighter over time on their own.

That being said, advocates of natural healing believe that there are remedies that can speed up the lightening process and make a scar less noticeable. Here are some of the remedies that have been effective for some people.

Aloe vera

1. Remove the dark green “skin” from the flatter side of an aloe vera leaf.
2. Scoop out the almost clear light green gel.
3. Apply the gel directly to your scar using circular motions.
4. After half an hour, wash the gel off with fresh, cool water.
5. Repeat twice each day.

Vitamin E

1. Cut open a vitamin E capsule over the scar and squeeze the oil onto the scar (you might need more than just one capsule to get enough liquid for full coverage).
2. For about 10 minutes, massage the oil on and around the scar.
3. After about 20 minutes wash off the oil with warm water.
4. Repeat this process a minimum of 3 times per day.

Honey

1. Before going to bed, cover your scar with a layer of honey.
2. Wrap the honey-covered scar with a bandage.
3. Leave it on for one full night.
4. In the morning, remove the bandage and wash off the honey with warm water.
5. Make this part of your routine every night.

Coconut oil

1. Heat a few tablespoons of coconut oil, just enough to liquefy it.
2. Massage the oil into the scar for about 10 minutes.
3. Let the skin absorb the oil for a minimum of one hour.
4. Repeat two to four times every day.

Apple cider vinegar

1. Combine 4 tablespoons of distilled water with 2 tablespoons of apple cider vinegar.
2. Dip a cotton ball into the water-cider mixture and generously dab your scar.
3. Let it dry.
4. Do this every night before you go to bed, washing the area in the morning.

Lavender and olive oil

1. Mix three drops of lavender essential oil into three tablespoons of extra-virgin olive oil.
2. Massage the mixture into the scarred area for about 5 minutes.
3. Leave the oil in place for about 30 minutes.
4. Rinse the area with warm water.
5. Repeat this process a minimum of three times a day.

Lemon

1. Cut a wedge from a fresh lemon.
2. Gently rub the juicy side of the lemon on the scar while you squeeze the juice onto the scar.
3. Relax for about 10 minutes before rinsing off the area with cool water.
4. Do this every day at approximately the same time.

Potato

1. Slice a potato into medium thick rounds.
2. Using a circular motion, rub the potato slice on your scar.
3. Once the potato slice starts to dry out, discard it and continue rubbing with another slice.
4. Continue rubbing and replacing for about 20 minutes and then let the scar air-dry for about 10 minutes.
5. Rinse the area with cool water.
6. Repeat this process at least one time each day

Rosehip and frankincense

1. Slice a potato into medium thick rounds.
2. Using a circular motion, rub the potato slice on your scar.
3. Once the potato slice starts to dry out, discard it and continue rubbing with another slice.
4. Continue rubbing and replacing for about 20 minutes and then let the scar air-dry for about 10 minutes.
5. Rinse the area with cool water.
6. Repeat this process at least one time each day

Baking soda

1. Mix distilled water — a little at time — into two tablespoons of baking soda until it forms a paste.
2. Wet your scar with distilled water and then apply the paste to the wet scar.
3. Hold the paste in place with a warm compress for 15 minutes.
4. Rinse the area and repeat daily.

Before trying any of the remedies above, thoroughly wash and dry the scar and the area around it. Also, only use these remedies on scars — not open wounds. Should any of these remedies cause any irritation, stop use immediately.

The takeaway

If you want to make a scar look less noticeable, you may want to try a natural remedy. There are many people who believe that natural remedies can get the job done.

As with any home remedy, have a conversation with your doctor before starting. Your doctor can offer insights and recommendations about which remedies you should or should not try.

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Postoperative Care: Definition and Education

Postoperative Care

TOPNURSE~Postoperative care is the care you receive after a surgical procedure. The type of postoperative care you need depends on the type of surgery you have, as well as your health history. It often includes pain management and wound care.

Postoperative care begins immediately after surgery. It lasts for the duration of your hospital stay and may continue after you’ve been discharged. As part of your postoperative care, your healthcare provider should teach you about the potential side effects and complications of your procedure.

Before you have surgery, ask your doctor what the postoperative care will involve. This will give you time to prepare beforehand. Your doctor may revise some of their instructions after your surgery, based on how your surgery went and how well you’re recovering.

Prepare ahead of time

Ask as many questions as possible before your surgery, and ask for updated instructions before you’re discharged from the hospital. Many hospitals provide written discharge instructions.

Ask your doctor questions such as:

• How long will I be expected to remain in the hospital?
• Will I need any special supplies or medications when I go home?
• Will I need a caregiver or physical therapist when I go home?
• What side effects can I expect?
• What complications should I watch out for?
• What things should I do or avoid to support my recovery?
• When can I resume normal activity?

The answers to these questions can help you prepare ahead of time. If you expect to need help from a caregiver, arrange for it before your surgery. It’s also important to learn how to prevent, recognize, and respond to possible complications.

Depending on the type of surgery you have, there are many potential complications that can arise. For example, many surgeries put patients at risk of infection, bleeding at the surgical site, and blood clots caused by inactivity. Prolonged inactivity can also cause you to lose some of your muscle strength and develop respiratory complications. Ask your doctor for more information about the potential complications of your specific procedure.

Postoperative care in the hospital

After your surgery is complete, you will be moved to a recovery room. You’ll probably stay there for a couple of hours while you wake up from anesthesia. You’ll feel groggy when you wake up. Some people also feel nauseated.

While you’re in the recovery room, staff will monitor your blood pressure, breathing, temperature, and pulse. They may ask you to take deep breaths to assess your lung function. They may check your surgical site for signs of bleeding or infection. They will also watch for signs of an allergic reaction. For many types of surgery, you will be placed under general anesthesia. Anesthesia can cause an allergic reaction in some people.

Once you’re stable, you’ll be moved to a hospital room if you’re staying overnight, or you’ll be moved elsewhere to begin your discharge process.

Outpatient surgery

Outpatient surgery is also known as same-day surgery. Unless you show signs of postoperative problems, you’ll be discharged on the same day as your procedure. You won’t need to stay overnight.

Before you’re discharged, you must demonstrate that you’re able to breathe normally, drink, and urinate. You won’t be allowed to drive immediately following a surgery with anesthesia. Make sure you arrange transportation home, preferably ahead of time. You may feel groggy into the following day.

Inpatient surgery

If you have inpatient surgery, you’ll need to stay in the hospital overnight to continue receiving postoperative care. You may need to stay for several days or longer. In some cases, patients who were originally scheduled for outpatient surgery show signs of complications and need to be admitted for ongoing care.

Your postoperative care will continue after you’ve been transferred out of the initial recovery room. You will probably still have an intravenous (IV) catheter in your arm, a finger device that measures oxygen levels in your blood, and a dressing on your surgical site. Depending on the type of surgery you had, you may also have a breathing apparatus, a heartbeat monitor, and a tube in your mouth, nose, or bladder.

The hospital staff will continue to monitor your vital signs. They may also give you pain relievers or other medications through your IV, by injection, or orally. Depending on your condition, they may ask you to get up and walk around. You may need assistance to do this. Moving will help decrease your chances of developing blood clots. It can also help you maintain your muscle strength. You may be asked to do deep breathing exercises or forced coughing to prevent respiratory complications.

Your doctor will decide when you’re ready to be discharged. Remember to ask for discharge instructions before you leave. If you know that you’ll need ongoing care at home, make preparations ahead of time.

Postoperative care at home

It’s very important that you follow your doctor’s instructions after you leave the hospital. Take medications as prescribed, watch out for potential complications, and keep your follow-up appointments.

Don’t overdo things if you’ve been instructed to rest. On the other hand, don’t neglect physical activity if you’ve been given the go ahead to move around. Start to resume normal activities as soon as you safely can. Most of the time, it’s best to gradually return to your normal routine.

In some cases, you may not be able to care for yourself for a while after your surgery. You may need a caregiver to help tend your wounds, prepare food, keep you clean, and support you while you move around. If you don’t have a family member or friend who can help, ask your doctor to recommend a professional caregiving service.

Contact your doctor if you develop a fever, increased pain, or bleeding at the surgical site. Don’t hesitate to contact your doctor if you have questions or aren’t recovering as well as expected.

The takeaway

Appropriate follow-up care can help reduce your risk of complications after surgery and support your recovery process. Ask your doctor for instructions before you have your surgery and check for updates before you leave the hospital. Contact your doctor if you suspect you’re experiencing complications or your recovery isn’t going well. With a little planning and proactive care, you can help make your recovery as smooth as possible.

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DEFINITION OF ELDERLY CARE

ELDERLY CARE

DEFINITION OF ELDERLY CARE

Elderly care is the fulfillment of the special needs and requirements that are unique to senior citizens. This broad term encompasses such services as assisted living, adult day care, long term care, nursing homes, hospice care, and home care. Elderly care emphasizes the social and personal requirements of senior citizens who need some assistance with daily activities and health care, but who desire to age with dignity.

RESOURCES

• Utah Division of Aging and Adult Services, The Utah Division of Aging and Adult Services (DAAS) provides senior services and adult protective services. DAAS was created as Utah’s State Unit on Aging by Utah statute (62A-3-104) giving the Division the legal authority to establish and monitor programs that serve the needs of Utah’s seniors. The Division is the sole state agency, as defined by the Older Americans Act of 1965 as amended to:
• (1) serve as an effective and visible advocate for the aging and adult population of Utah
• (2) develop and administer a state plan under the policy direction of the Board
• (3) take primary responsibility for state activities relating to the Older Americans Act.
• The Division also administers the Adult Protective Services program to investigate cases of abuse, neglect, and exploitation of vulnerable adults. Trained staff in a statewide system of offices, work with local law enforcement and community partners to educate and assist victims to access appropriate resources within the community.

The AARP Caregiving Resource Center offers expert advice and resources for your senior care needs.  This site will help answer all of your questions and includes:

• Caregiving Tools
• Connect with an Expert
• Find Support
• Find a Provider
• Care for the Caregiver
• Locating Resources
• Caregiving News.

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Newborn Care From All Body

~Face

It's disconcerting to see a newborn with a red, blotchy face, but baby acne is a common and harmless condition.

Care tip: Wash your baby's face daily with a mild baby soap.

~Eyes

Some babies have a yellowish discharge or crusting in the eye or on the lid, which is usually caused by a blocked tear duct. This condition can last several months.

Care tip: Wipe the area using a cotton ball moistened with warm water.

~Scalp

Many newborns develop a scaly scalp condition called cradle cap. It typically disappears in the first few months.

Care tip: Wash your baby's hair with a gentle baby shampoo no more than three times a week and gently brush out the scales daily using a baby hairbrush or soft toothbrush.

~Nose

Babies' narrow nasal passages tend to fill with mucus.

Care tip: Gently unclog nostrils with an infant-sized nasal bulb syringe or try the trauma-minimizing Nosefrida (nosefrida.com). To loosen mucus, insert saline solution with an eyedropper before suctioning.

~Nails

A newborn's nails usually are soft, but they can scratch his sensitive skin.

Care tip: Use baby nail clippers or blunt-nosed scissors. Clip after his bath when nails are soft, or when he's asleep and his fingers are relaxed.

~Skin

Some babies develop red, itchy patches called eczema or atopic dermatitis—an inheritable skin condition.

Care tip: Limit baths to 10 minutes, and use a mild, fragrance-free soap and lukewarm water; liberally apply hypoallergenic skin cream immediately afterward. Stick to cotton clothing.

~Bottom

Too much moisture plus sensitive skin can equal diaper rash for many babies.

Care tip: Change diapers frequently. Rinse your baby's bottom with water during each change and blot dry. Avoid using wipes; they may irritate skin. Barrier creams, such as petroleum jelly or white zinc oxide, may help.

~Umbilical cord

Keep the umbilical cord stump clean and dry; it will shrivel and fall off within a few weeks.

Care tip: Avoid covering the cord area with a diaper and stick to sponge baths until the stump detaches.

~Circumcision

The tip of the penis will be swollen, and a yellow scab will appear.

Care tip: Gently clean the genital area with warm water daily. Use petroleum jelly to protect the site and prevent the penis from sticking to a diaper.

~Legs

Newborns' legs are bowed out and the feet are turned in, which is no surprise, given their previous cramped living quarters.

Care tip: Don't worry about it—your baby's legs and feet will straighten in anywhere from six to 18 months.

~Feet

Newborns' toes frequently overlap and the nails look ingrown (but aren't).

Care tip: Don't sweat it—this appearance is perfectly normal.

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First Aid for Broken Bones and Fractures

What is a broken bone?

TOPNURSE~A broken bone happens when one of your bones becomes cracked or broken into multiple pieces. It’s also known as a fracture. It can result from a sports injury, accident, or violent trauma.

Broken bones usually aren’t life threatening, but they do require immediate medical care. Learn how to recognize the symptoms of a broken bone, provide first-aid treatment, and get professional help.

What are the symptoms of a broken bone?

A broken bone can cause one or more of the following signs and symptoms:

• intense pain in the injured area that gets worse when you move it
• numbness in the injured area
• bluish color, swelling, or visible deformity in the injured area
• bone protruding through the skin
• heavy bleeding at the injury site

How can you provide first-aid care for a broken bone?

If you suspect that someone has a broken bone, provide first-aid treatment and help them get professional care:

• Stop any bleeding: If they’re bleeding, elevate and apply pressure to the wound using a sterile bandage, a clean cloth, or a clean piece of clothing.
• Immobilize the injured area: If you suspect they’ve broken a bone in their neck or back, help them stay as still as possible. If you suspect they’ve broken a bone in one of their limbs, immobilize the area using a splint or sling.
• Apply cold to the area: Wrap an ice pack or bag of ice cubes in a piece of cloth and apply it to the injured area for up to 10 minutes at a time.
• Treat them for shock: Help them get into a comfortable position, encourage them to rest, and reassure them. Cover them with a blanket or clothing to keep them warm.
• Get professional help: Call 911 or help them get to the emergency department for professional care.

If the person doesn’t appear to be breathing, is unconscious, or both, call 911 for medical help and begin CPR. You should also call 911 if:

• you suspect they’ve broken a bone in their head, neck, or back
• the fractured bone has pushed through their skin
• they’re bleeding heavily

Otherwise, help them get to the emergency department by car or other means so a doctor can diagnose their condition and recommend appropriate treatment.

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Surgical Wound

What is a surgical wound?

A surgical wound is a cut or incision in the skin that is usually made by a scalpel during surgery. A surgical wound can also be the result of a drain placed during surgery. Surgical wounds vary greatly in size. They are usually closed with sutures, but are sometimes left open to heal.

What are the types of surgical wounds?

Surgical wounds can be classified into one of four categories. These categories depend on how contaminated or clean the wound is, the risk of infection, and where the wound is located on the body.

Class I: These are considered clean wounds. They show no signs of infection or inflammation. They often involve the eye, skin, or vascular system.

Class II: These wounds are considered clean-contaminated. Although the wound may not show signs of infection, it is at an increased risk of becoming infected because of its location. For example, surgical wounds in the gastrointestinal tract may be at a high risk of becoming infected.

Class III: A surgical wound in which an outside object has come into contact with the skin has a high risk of infection and is considered a contaminated wound. For example, a gunshot wound may contaminate the skin around where the surgical repair occurs.

Class IV: This class of wound is considered dirty-contaminated. These include wounds that have been exposed to fecal material.

What causes surgical wounds?

Surgical wounds are created when a surgeon makes an incision or cut with a surgical instrument called a scalpel. A wide variety of medical circumstances require surgery. The size of a wound depends on the type of procedure and location on the body.

What are the risk factors for surgical wound infections?

Any surgical procedure will create a surgical wound. The likelihood of a wound infection after surgery is between 1 and 3 percent.

Risk factors for developing a surgical wound infection include having other medical issues, such as diabetes or a weakened immune system. Smokers, older adults, and people who are overweight also have an increased risk of infection. Emergency surgeries, abdominal surgeries, and surgeries that last longer than two hours bring a higher risk of infection, too.

What are the symptoms of surgical wound infections?

Surgical wounds are frequently monitored to make sure they are healing properly. Infections may affect only the skin, tissue under the skin, or implants, according to the Centers for Disease Control and Prevention. Signs of a surgical wound infection include:

• increased pain and redness around the wound
• delayed healing
• the presence of pus
• a foul smell, or drainage from the wound

In some cases, an infected surgical wound can appear dried out or deeper. Fever may also be a common symptom.

How are surgical wound infections diagnosed?

A physician can diagnose a surgical wound infection by examining the wound, assessing symptoms, or taking a culture of fluid drained from the wound.

How is a surgical wound treated?

Treatment for a surgical wound sometimes depends on where it’s located on the body. Surgical dressings are normally placed over the wound and may need to be changed regularly. The skin around the surgical wound will likely need to be cleaned, often with salt water and soap. The wound may also need to be irrigated with salt water. This involves filling a syringe with salt water and spraying the skin around the wound.

Home care

Home care for a surgical wound may involve some of the same procedures, including frequent dressing changes and cleaning. Over-the-counter pain medication can also reduce discomfort. Often, patients are discharged from the hospital before a surgical wound has completely healed. It is essential that patients follow all at-home care instructions. Following directions properly will promote healing and decrease chances of an infection.

What are some complications of surgical wounds?

When surgical wounds cause infection, it typically occurs within 30 days of surgery. Infections may be red, painful, hot to the touch, or drain pus. To treat infections, your physician may prescribe an antibiotic, or they may have to open the wound to clean it.

What is recovery like for surgical wounds?

Recovery varies and can last for weeks to months. Your surgeon should be able to give you specific information on when you can go back to work, exercise again, and return to your daily routine.

What is the outlook for surgical wounds?

The outlook for a surgical wound that is properly healing is good. Following infection control recommendations can increase the chances that the wound heals well.

Source 

https://www.healthline.com

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