Pleno Sk 4 Emergency

7/17/2019 Pleno Sk 4 Emergency

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“SKENARIO 4”

PLENO TUTORIAL 11 – blok EMERGENCY

Arista !"# a$ria%a 1&1'(11(&1L!o% L )a#a 1&1'(11(*+

Ra%i $,r%a-a sari 1&1'(111&1Gali. $ras!t#o 1&1'(11(+/

0!bora %atas.a 1&1'(11(&M,.a--a ri.o 1&1'(111(2

3a%%a i%sa%i "!# 1&1'(11(//0i !ri% 1&1'(11(*

Sil"i 5,rat,l ai%i 1&1'(1114

6ara7 ob!la 1&1'(111/4Cristo$!r $$ $a%ia%)a%1&1'(11((

K.aris-a Mr 1&1'(11(*1



Tra,-a 8a$itis aala. tra,-a -!ka%ikt!r.aa$ k!$ala baik s!8ara la%)s,%) #a%)-!%#!babka% )a%)),a% 9,%)si %!,rolo)is#ait, )a%)),a% :sik; ko)%iti9; 9,%)si

$sikososial baik t!-$or!r -a,$,% $!r-a%!%<

Klasi:kasi tra,-a ka$itis b!rasarka%=

1.Patologi:

1< Ko-osio s!r!bri

&< Ko%t,sio s!r!bri

< Las!rasio s!r!bri

TRAUMA CAPITIS



2. Lokasi lesi

1< L!si i>,s

&< L!si k!r,saka% "ask,l!r otak

< L!si 9okal

1< Ko%t,sio a% Las!rasi s!r!bri

&< 3!-ato-a I%trakra%ial

1<3!-ato-a Ekstra,ral ?3!-ato-a !$i,ral@

&<3!-ato-a s,b,ral

<3!-ato-a i%tra$ar!%k.i-al

1<3!-ato-a S,barak.%oi&<3!-ato-a I%tras!r!bral

<3!-ato-a I%tras!r!b!llar



3. Derajat kesadaran berdasarkan GCS

Kat!)ori SKG Ga-bara% Kli%ik CT S8a% otak

Mi%i-al 1+ Pi%)sa% ?@; !:sit%!,rolo)i ?@

Nor-al

Ri%)a% 1 – 1+ Pi%)sa% B 1( -!%it;!:sit %!,rolo)ik ?@

Nor-al

S!a%) * – 1& Pi%)sa% 1( -!%it sD/ a- !:sit %!,rolo)ik?F@

Ab%or-al

!rat – ' Pi%)sa% / a-; !:sit%!,rolo)ik ?F@

Ab%or-al

Catatan:

klasifikasi ini untuk pedoman triase di gawat darurat & Jika

abnormalitas CT scan berupa perdarahan intrakranial, penderita

dimasukan klasifikasi trauma kapitis berat.



3!-ato-a!$i,ral

T!rai ia%tara tab,la i%t!r%a – ,ra-at!r3!-ato- -assi9; akibat $!8a.%#a

a<-!%i%)!a -!ia ata, si%,s "!%os,s<

Ta%a ia)%ostik kli%ik=• L,8i i%t!r"al ?F@• K!saara% s!-aki% -!%,r,%• Late .!-i$ar!s! ko%tralat!ral l!si• P,$il a%isokor• abi%sk# ?F@ ko%tralat!ral l!si• Hrakt,r ia!ra. t!-$oral



3!-ato-a !$i,ral i 9ossa$ost!rior

G!ala a% ta%a kli%is=• L,8i i%t!r"al tiak !las

• Hrakt,r kra%ii oksi$ital

• K!.ila%)a% k!saara% 8!$at

• Ga%)),a% s!r!b!ll,-; bata%) otak a% $!r%a9asa%

• P,$il isokor

P!%,%a%) ia)%ostik=

CT S8a% otak= )a-bara% .i$!r!%s ?$!rara.a%@it,la%) t!%)korak a% ,ra; ,-,-%#a ia!ra.t!-$oral; a% ta-$ak biko%"!ks<



3!-ato-a S,b,ral

T!rai ia%tara ,ra-!t!r – arak.%oi; akibatrob!k%#a “bri)i%) "!i%” ?"!%a !-bata%@

1<Ak,t = I%t!r"al l,8i ( – + .ari&<S,bak,t = I%t!r"al l,8i + .ari – bbr$ -i%)),

<Kro%ik = i%t!r"al l,8i b,la%

G!ala a% ta%a kli%is= – Sakit k!$ala – K!saara% -!%,r,% F D

P!%,%a%) ia)%ostik=CT S8a% otak= )a-bara% .i$!r!%s ?$!rara.a%@

ia%tara ,ra-!t!r a% arak%oi; ,-,-%#akar!%a rob!ka% ari bri)i%) "!i%; a% ta-$ak

s!$!rti b,la% sabit



3!-ato- i%tras!r!bral

P!rara.a% $ar!%ki- otak; is!babka%

ol!. $!8a.%#a art!ri i%tras!r!bral-o%o ata, –-,lti$l!

HRAKTUR ASIS KRANII=

1< A%t!rior

G!ala a% ta%a kli%is= k!l,ar%#a 8aira% lik,or -!lal,i.i,%) D r.i%or!a $!rara.a% bilat!ral $!riorbital!88.#-osis D ra8oo% !#! a%os-ia

&< M!ia)!ala a% ta%a kli%is=

k!l,ar%#a 8aira% lik,or -!lal,it!li%)a D otorr.!a Ga%)),a% %< II J III



< Post!rior

G!ala a% ta%a kli%is=

ilat!ral -astoi!88.#-osis D battl!s si)%

P!%,%a%) ia)%ostik= M!-astika% 8aira%s!r!bros$i%al s!8aras!!r.a%a !%)a% t!s .alo

s8a%i%) otak r!sol,siti%))i a% irisa% -- ?+(F@ ?.i). r!sol,tio% a% t.i%s!8tio%@



PER0ARA3ANSUARAK3NOI0

G!ala a% ta%a kli%is= Kak, k,,k

N#!ri k!$ala

isa ia$ati )a%)),a% k!saara%

P!%,%a%) ia)%osis=CT S8a% otak= $!rara.a% ?.i$!r!%s@

ir,a%) s,barak.%oi



PENANGANAN TRAUMA CAPITIS

PRIMARY SUREY = AC0E

SECON0ARY SUREY = -!li$,ti $!-!riksaa% a%ti%aka% la%,ta% s!t!la. ko%isi $asi!% stabil

0ara. = 3b; L!,kosit; .it,%) !%is l!kosit; tro-bosit;,r!,-; k!ati%i%; ),la ara. s!akt,; a%alisis)as ara. a% !l!ktrolit

Uri%! = P!rara.a% ?F@ D ?@

Raiolo)i =

Hoto $olos k!$ala; $osisi AP; lat!ral; ta%)!%sial

CT S8a% otak<

Hoto lai%%#a s!s,ai i%ikasi ?t!r-as,k 9otos!r"ikal@



Ma%a!-!% T!ra$i = Sia$ka% ,%t,k o$!rasi $aa $asi!%#a%) -!-$,%#ai i%ikasi

Sia$ka% ,%t,k -as,k r,a%) raat

P!%a)a%a% l,kal,ka

P!-b!ria% t!ra$i obatobata%s!s,ai k!b,t,.a%

Pleno Sk 4 Emergency

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