Professional Documents
Culture Documents
BURN INJURY
Ruby Riana A
FKUMM
Prcvent the victim frorn nmning which would only fan the flames and
make thern bum faster.
Tbe victim should be insfiucted to lie down on the floor with the
buming side rrypcrmost.
rolld
on the ground
thar drag the victim out of the rmm holding his/her legs.
s/20/20t4
The flarues should be doused with wzter. Smouldering clothing should be removed If
water is not available : Any other non-flammable "cleat" liquid such as mift, camed
drinkcan be used,
The r,ictim should be put on the ground with the buming side uppermost and then
wrapped in a hearv cotton cloth (blankeVnrg/darilcoat or anli other heav_v fabric)
I
e
Don't throVapply
N{ale the victim lie suprne. Watch for the response and assss for AI}C (Aima1,,
Breathing, Circulation) If there is no response and there are no chest moveruents,
cardiopulmonary resuscitation (CPR) should be instituted urgently.
Cooling the bum: The first objective in the burn wound care
is to dissipate the heat. The subcutaneous temperature
continues to rise for a while even after the heat soruce has
been removed. Thereafter, it takes about 3 minutes for the
tissues to return to body temperature
Immediate active cooling of burn wounds with cool tap
water (lavage, soaks, compress or immersion) is effective.
Continuous cooling for the first l0 minutos dissipates heat,
reduces pain, delays onset and minimises the extent of burn
oedema by decreasing the histamine release from the skin
mast cells
s/20/20L4
Pembagian
r Berdasarkan kedalaman
r Berdasarkan luas
r Berdasa*an keparahan
BERDASARKAN KEDALAMAN
sF[@ b
hoi
ti{ddrtEE
Mnd.d ra!
M{*r
BclE FeEl{
Faio m pr gri& iawly pnFdirnl h &dr
dLiut
Tu pqoniord n &pd ot borG: ]{l-fs &F
lfiei.. ielt
s/20/20t4
TIDAK DIHITUNG
DALAM PERHITUNGAN
LUAS LUKA BAKAR
s/20/20L4
BERDASARKAN
BERDASARKAN KEPARAHAN
Parah
critical.
E
E
moderate.
-I]rkat
Riran
!
a
Tlngkat
II 15-300,6
III 5-10%
minor.
Tingkat
Tingkat
Il kuGr 15oA
III kurar 106
s/20120L4
TATA LAKSANA
r
r
r
I
Survai Sekunder
Penreriksaan
Resusitasi cairan
I
r
r
r
fisik
Sjam |
+ 500-1000cc colloid.
Selesai dalam 24 jam sejak kejadian
B
I Replacenent 2 c/k
r DitarrbahKeb
1 Umur sampai I
Di
Surabaya formula
r
r =
{ lTl20Iftisaloid@L)+3/20Koloid an){
dan 16 jmr berikutnya
r dibagi 2 + dalam 8 jam
Moncrief
botolyang sarna
s/20/2014
sl20/20L4
Guidelines
inchil&en.
ons
The addition of colloid-containing fluid following bum
injury,
ially
requirments.
avoid
excessive
a.
10
sl2a/20t4
FASE SUBAKUT
r
r
r Jenis trauma
r
r
r
r
Respintory rnaintenance
lGseimbangan cainn dan elektolit
Nubisi
r
r
r
Management BaKerial
Managementjaringan nekrctik
Skin coverage rnanagernent
11
sl20/20L4
KESEIMBANGAN CAIMN
DAN ELEKTROLIT
rTotal cairan tubuh^,60olo
1. ICF Z|3TBW
2. ECF U3 TBW
- Intravascular
BB
1/q
- intertitial 3la
L2
sl20/20L4
lcseimbangenCairan
I inBrt = oriBlt
I outBJt = scnsiblc + inscnsiblc r,&rb6t
I Evaporative wdter lod in mlJhour : [25 + % of TBS burned]
r al in (>2.59/dL)
I tt4onltor nadl dan hkanan darah
! Monitor el<tjdit dan kseimbangan asarrbasa
r l-lct- 30tO96
r CVPdi pertahankanT- 12 cm H2O
r l.ternpertatnnkanproduk5urin
r Delv6a 0,t1 mutgifti
x TBS in nu
Aa"l< , t-2,,t1r,< /t
d-''
50
13
sl2o/20L4
ELECTROLYTE IMBALANCE
Na 130-145mmo[L
24 mq lkgld
Na defisit
3olo
NacUL
0,9olo
K 3,5
: 513 mmol
cunent Na)
mmol Na
1-2 meq/kg/d
Hypokalemia
7,45o/o Kcl :
.
I meq
r 2040 meq/h diluted in 100-200 NS
r given in 3-4 h, at rab 10 meq/h
Hyperkalemia
r C: glukonas, D40, and insulin
NUTRISI
r
I
r
r
r
r
"Go
Slora/'
Memperkirakan kebutuhan
Memperkirakan kebutuhan
Memperkirakan kebutuhan
Memperkirakan kebutuhan
L4
sl2ol2oL4
KEBUTUHAN IGLORI
Sutherland (1959)
Dewasa
Anak
Curreri (1974)
25 kcal/kgBB + (40 kcal x luas LB)
100
LB0-20o/o
1-1,5
LB 20-404/o 1,5 - 1,8
LB
>,m%
L8
Male:
15
sl20/20L4
CONTOH
TEE
= 1500
= BMRx L,5xL,25
= 2700 kcal
WOUND CARE
r
15
s/20/20L4
SKIN COVERAGE
r Self epitelization
E Skin Grafting, bisa sebelum 4 hari atau setelah
minggu
Kultur kulit
Flap
17
s/20/2014
16#8#2005'
2(#8#
18
s/20l2oL4
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