Scribd Logo
Upload

Welcome to Scribd!

  • 16 views

    (Initial Assesment) : Penilaian Awal Dan Resusitasi Penderita Trauma

    Uploaded by

    upik
    This document discusses the principles and procedures for initial assessment and resuscitation of trauma patients. It covers the primary survey which evaluates the patient's airway, breathing, circulation, disability, and exposure. The airway section details techniques for opening and maintaining the airway, including manual maneuvers, adjuncts, endotracheal intubation, and surgical airway if needed. The breathing section evaluates respiration rate, effort, and oxygenation. Assisted ventilation may be needed and oxygen should always be administered. Conditions threatening breathing like tension pneumothorax must be recognized during the primary survey.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd

    (Initial Assesment) : Penilaian Awal Dan Resusitasi Penderita Trauma

    Uploaded by

    upik
    16 views42 pages
    This document discusses the principles and procedures for initial assessment and resuscitation of trauma patients. It covers the primary survey which evaluates the patient's airway, breathing, circulation, disability, and exposure. The airway section details techniques for opening and maintaining the airway, including manual maneuvers, adjuncts, endotracheal intubation, and surgical airway if needed. The breathing section evaluates respiration rate, effort, and oxygenation. Assisted ventilation may be needed and oxygen should always be administered. Conditions threatening breathing like tension pneumothorax must be recognized during the primary survey.

    Original Description:

    initia; assesment

    Original Title

    04 Initial Assesment

    Copyright

    © © All Rights Reserved

    Available Formats

    PPT, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document discusses the principles and procedures for initial assessment and resuscitation of trauma patients. It covers the primary survey which evaluates the patient's airway, breathing, circulation, disability, and exposure. The airway section details techniques for opening and maintaining the airway, including manual maneuvers, adjuncts, endotracheal intubation, and surgical airway if needed. The breathing section evaluates respiration rate, effort, and oxygenation. Assisted ventilation may be needed and oxygen should always be administered. Conditions threatening breathing like tension pneumothorax must be recognized during the primary survey.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    16 views42 pages

    (Initial Assesment) : Penilaian Awal Dan Resusitasi Penderita Trauma

    Uploaded by

    upik
    This document discusses the principles and procedures for initial assessment and resuscitation of trauma patients. It covers the primary survey which evaluates the patient's airway, breathing, circulation, disability, and exposure. The airway section details techniques for opening and maintaining the airway, including manual maneuvers, adjuncts, endotracheal intubation, and surgical airway if needed. The breathing section evaluates respiration rate, effort, and oxygenation. Assisted ventilation may be needed and oxygen should always be administered. Conditions threatening breathing like tension pneumothorax must be recognized during the primary survey.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    You are on page 1of 42

    NURSING CONSULTANT AND TRAINING CENTRE

    PENILAIAN AWAL
    DAN RESUSITASI PENDERITA TRAUMA

    (Initial Assesment)

    BTCLS / IRNI / LKKI 2008


    NURSING CONSULTANT AND TRAINING CENTRE
    PRINSIP

    Kenali terlebih
    dahulu keadaan
    yang mengancam
    nyawa

    BTCLS / IRNI / LKKI 2008


    NURSING CONSULTANT AND TRAINING CENTRE

    Prinsip Penanggulangan
    Penderita Trauma

    Survai Primer
    Survai Sekunder
    Terapi Definitif

    BTCLS / IRNI / LKKI 2008


    NURSING CONSULTANT AND TRAINING CENTRE
    SURVAY PRIMER

    Dalam Pikiran Sekuensial


    Dalam tindakan Simultan

    Dilakukan sampai Penderita


    Dalam keadaan Stabil

    BTCLS / IRNI / LKKI 2008


    SURVAY PRIMER
    NURSING CONSULTANT AND TRAINING CENTRE

    A. Airway (+C Spine Control )


    B. Breathing (+Ventilation )
    C. Circulation (+ Kontrol Perdarahan)
    D. Disability ( GCS,Tanda Lateralisasi )
    E. Exposure

    BTCLS / IRNI / LKKI 2008


    NURSING CONSULTANT AND TRAINING CENTRE
    HATI HATI AIDS

    Selalu pakai alat Proteksi


    Sarung tangan
    Kaca mata
    Dll

    BTCLS / IRNI / LKKI 2008


    NURSING CONSULTANT AND TRAINING CENTRE
    AIRWAY

    1. Hanya 6 8 Menit bila Obstruksi


    total
    2. Selalu Pikirkan C Spine Control

    BTCLS / IRNI / LKKI 2008


    NURSING CONSULTANT AND TRAINING CENTRE
    AIRWAY
    Curiga fractur servikal bila :
    Setiap trauma kapitis
    Setiap multi Trauma
    Setiap ada luka (tumpul) diatas
    klavikula
    Prio mekanik trauma mendukung

    BTCLS / IRNI / LKKI 2008


    NURSING CONSULTANT AND TRAINING CENTRE
    AIRWAY

    Bila curiga fraktur servikal

    Fiksasi kepala secara manual


    Pasang Cervical Collar
    Bila perlu diikat pengaman

    BTCLS / IRNI / LKKI 2008


    NURSING CONSULTANT AND TRAINING CENTRE
    AIRWAY
    Okstruksi Parsial
    Cairan (gurgling) Suction
    Lidah jatuh kebelakang : Snoring

    Cara manual
    TINDAKAN
    PERAWAT
    Airway Sementara

    BTCLS / IRNI / LKKI 2008


    AIRWAY
    NURSING CONSULTANT AND TRAINING CENTRE

    Head Tilt
    Perasat Manual : Chin Lift
    Jaw Thrust

    Oropharyngeal Airway Tidak sadar


    Airway Sementara :
    Nasopharygeal Airway Sadar

    BTCLS / IRNI / LKKI 2008


    AIRWAY
    NURSING CONSULTANT AND TRAINING CENTRE

    Teknik Manual : Jaw Thrust


    Chin Lift
    Airway Sementara :
    - Oro pharyngeal Tidak sadar
    - Naso Pharyngeal Sadar

    BTCLS / IRNI / LKKI 2008


    AIRWAY
    NURSING CONSULTANT AND TRAINING CENTRE

    Intubasi Endoktraeheal :

    (Blind ) Naso - tracheal


    Oro Tracheal

    Selalu coba Naso Tracheal dulu !

    BTCLS / IRNI / LKKI 2008


    NURSING CONSULTANT AND TRAINING CENTRE
    AIRWAY

    Bila tidak dapat intubasi

    Kriko - Tiroidotomi

    BTCLS / IRNI / LKKI 2008


    NURSING CONSULTANT AND TRAINING CENTRE
    HATI HATI !!

    Setiap penderita
    dalam koma
    sewaktu waktu
    dapat
    mengalami
    Apnea

    BTCLS / IRNI / LKKI 2008


    BREATHING
    NURSING CONSULTANT AND TRAINING CENTRE

    Pernapasan yang baik


    Frekwensi dewasa : 20
    Anak : 30
    Bayi : 40
    2. Tidak ada gejala Dispnea dll
    3. Pemeriksaan fisik baik

    BTCLS / IRNI / LKKI 2008


    BREATHING
    NURSING CONSULTANT AND TRAINING CENTRE

    Pemeriksaan Fisik
    Inspeksi : Peranjakan Simetris
    Anskultasi : Bising nafas Vesikular
    Kiri-kanan
    Perkusi : Sonor kiri-kanan

    BTCLS / IRNI / LKKI 2008


    NURSING CONSULTANT AND TRAINING CENTRE
    PULSE OXYMETRY

    Breathing ( untuk Sementara ) baik


    Bila Saturasi 02 > 95 %

    BTCLS / IRNI / LKKI 2008


    Bila Breathing Tidak
    NURSING CONSULTANT AND TRAINING CENTRE

    Adekuat
    Bantu pernafasan / Assisted
    Ventilation :
    Mounth to mouth/mask
    Bagging (Ambu bag )
    Respirator

    BTCLS / IRNI / LKKI 2008


    Selalu Berikan Oxygen
    NURSING CONSULTANT AND TRAINING CENTRE

    - Udara Bebas mengandung o2. : 21 %


    - Nasal Kanul 2 L/ mnt : 24 %
    - Nasal Kanul 6 L/ mnt : 44 %
    - Face Mask : 90 %

    BTCLS / IRNI / LKKI 2008


    NURSING CONSULTANT AND TRAINING CENTRE

    BREATHING
    Keadaan yang harus di kenali pada
    survay Primer :
    Tension Preumothorax
    Massive Hematothorax
    Tamponade Jantung
    Open Preumothoray
    Flaill Chest + Kontusio Paru

    BTCLS / IRNI / LKKI 2008


    BREATHING
    NURSING CONSULTANT AND TRAINING CENTRE

    Tension Pneumothorax ditandai :


    Vena jugolaris ,
    Sesak nafas,
    Trachea terdorong,
    Bunyi Nafas (wheezing) ??

    Jarum besar di ICS 2


    Mid Klavikular WSD
    BTCLS / IRNI / LKKI 2008
    BREATHING
    NURSING CONSULTANT AND TRAINING CENTRE

    Open Pneumothorax Kasa 3 Sisi


    Closed Pneumothorax WSD

    BTCLS / IRNI / LKKI 2008


    BREATHING
    NURSING CONSULTANT AND TRAINING CENTRE

    Flail Chest ( + Kontusio Paru )

    ICU ( Kemungkinan Respirator )

    BTCLS / IRNI / LKKI 2008


    NURSING CONSULTANT AND TRAINING CENTRE

    BREATHING
    Massive hematothorax
    WSD > 1500 cc
    > 200 cc/Jam
    Torakotomi cito

    BTCLS / IRNI / LKKI 2008


    BREATHING
    NURSING CONSULTANT AND TRAINING CENTRE

    Tamponade Jantung ditandai :


    Sesak ,Syok, JVP Nadi lemah, BJ lemah

    Perikardio Sintesis Kemungkinan Torakotomi

    BTCLS / IRNI / LKKI 2008


    CIRCULATION
    NURSING CONSULTANT AND TRAINING CENTRE

    SYOK DIKENALI DARI :


    - Nadi lemah dan cepat
    - Akral Dingin
    - Kesadaran mulai menurun
    - Bila tensi turun, Syok berat

    BTCLS / IRNI / LKKI 2008


    CIRCULATION
    NURSING CONSULTANT AND TRAINING CENTRE

    Bila penderita dingin dan


    Tachycardia

    SYOK !!
    BTCLS / IRNI / LKKI 2008
    NURSING CONSULTANT AND TRAINING CENTRE
    CIRCULATION

    Umumnya Syok hemoragik


    (Syok lain mungkin)
    Bila Jantung berhenti
    umumnya sudah terlambat

    BTCLS / IRNI / LKKI 2008


    CIRCULATION
    NURSING CONSULTANT AND TRAINING CENTRE

    Perdarahan :
    Perdarahan Eksternal
    Perdarahan Internal
    - Toraks
    - Abdominal
    - Pelvis
    - Tulang Panjang
    BTCLS / IRNI / LKKI 2008
    Perdarahan Eksternal
    NURSING CONSULTANT AND TRAINING CENTRE

    Umumnya direct Pressure


    (Perban tekan) akan berhasil

    Jangan jahit
    dulu !!

    BTCLS / IRNI / LKKI 2008


    CIRCULATION
    NURSING CONSULTANT AND TRAINING CENTRE

    Mengurangi Perdarahan Internal


    - Pelvis : PASG
    Gurita
    - Tulang Panjang : traction,
    Splint
    - Toraks/Abdoman ??

    BTCLS / IRNI / LKKI 2008


    CIRCULATION
    NURSING CONSULTANT AND TRAINING CENTRE

    Kontrol Perdarahan

    Perbaikan Volume

    BTCLS / IRNI / LKKI 2008


    NURSING CONSULTANT AND TRAINING CENTRE CIRCULATION
    .
    Akses Vena
    Dewasa Anak
    V.Perifer Vena Perifer
    Vena Sentral Intraosicus
    Vena Seksi Vena Seksi

    BTCLS / IRNI / LKKI 2008


    NURSING CONSULTANT AND TRAINING CENTRE

    CIRCULATION
    Infus :
    - Dua Jalur
    - IV Catheter kaliber besar
    - RL 1-2 liter looding
    - Cairan di hangatkan

    BTCLS / IRNI / LKKI 2008


    CIRCULATION
    NURSING CONSULTANT AND TRAINING CENTRE

    Ada Respon : looding di pelankan

    Baik Diagnose/ terapi

    Sementara Looding lagi

    Beri Darah
    Kamar Operasi

    Tidak ada Respon : Kamar Operasi

    BTCLS / IRNI / LKKI 2008


    DISABILITY
    NURSING CONSULTANT AND TRAINING CENTRE

    GCS Hati hati bila GCS turun 2


    atau lebih.
    Tanda lateralisasi
    - Pupil ( isokor )
    - Tanda lateralisasi lainnya
    Epidural hematom bisa mati cepat

    BTCLS / IRNI / LKKI 2008


    NURSING CONSULTANT AND TRAINING CENTRE

    EXPOSURE
    Buka : Buka semua pakaian
    Tutup : Takut hipotermia

    ( Pra RS : Tunggu dulu )

    BTCLS / IRNI / LKKI 2008


    NURSING CONSULTANT AND TRAINING CENTRE

    Foley Cath & NGT


    Foley Cath jangan dipasang bila :
    - Ada darah di OUE
    - Hematom di Scrotum
    - RT: Prostat Hight riding
    NGT jangan dipasang bila :
    - Fraktur basis kranii anterior

    BTCLS / IRNI / LKKI 2008


    NURSING CONSULTANT AND TRAINING CENTRE

    SURVAI SEKUNDER
    Pemeriksaan teliti dari kepala sampai
    kaki
    Kepala leher toraks abdomen
    pelvis ekstermitas - log roll

    Finger in every orifice

    BTCLS / IRNI / LKKI 2008


    X RAY ( FOTO RUTIN )
    NURSING CONSULTANT AND TRAINING CENTRE

    1. Servikal ( lateral )
    2. Toraks (AP)
    3. Pelvis (AP)

    Hanya bila stabil

    BTCLS / IRNI / LKKI 2008


    NURSING CONSULTANT AND TRAINING CENTRE

    TERIMA KASIH

    BTCLS / IRNI / LKKI 2008

    You might also like

    pFad - Phonifier reborn

    Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

    Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


    Alternative Proxies:

    Alternative Proxy

    pFad Proxy

    pFad v3 Proxy

    pFad v4 Proxy