May 12, 2019 2 May 12, 2019 3 General Trauma Assessment 1. Scene size up 2. Initial assessment/ primary survey 3. Rapid trauma survey or focus assessment/ secondary survey
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Scene size up • Universal precaution? • Lihat keadaan sekitar – Prioritas utama: keselamatan penolong lingkungan yang aman untuk bekerja • Initial triage. Berapa jumlah korban? • Mekanisme cedera? • Rapid extrication? • Aktifkan EMS May 12, 2019 5 Alat yang diperlukan • Proteksi penolong • Long back board/scoop stretcher • Cervical collar • OPT, suction • Oksigen
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Cervical collar
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Oropharyngeal tube
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Airway Equipment
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Dressing and Bandages
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Long Back Board
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Scoop stretcher
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Primary survey • Gambaran umum korban • Tentukan respon pasien tingkat kesadaran AVPU • Kaji airway, breathing & circulation lakukan tindakan jika terdapat gangguan – bebaskan airway, stabilkan spine, support pernafasan dan kontrol perdarahan mayor • Tentukan prioritas keputusan transfer ke trauma centre May 12, 2019 13 May 12, 2019 14 Rapid Trauma Survey • Pemeriksaan secara sistematis dari kepala, leher, dada, abdomen, pelvis dan ekstremitas dengan melihat, mendengar, meraba untuk menemukan kasus life threatening
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Secondary survey • SAMPLE (Symptoms, Allergies, Medications, Past medical history, Last oral intake, Events preceding the incident) • Vital sign • Deformities, Contusion, Abrasion, Penetration, Burn, Laceration, Swelling (DCAP-BLS) • Tenderness, Instability, Crepitation (TIC) • Pulse, Movement, Sensation (PMS) • LOC AVPU • Pulse oxymetry •MayIntervensi 12, 2019 lanjut: balut & bidai 16 May 12, 2019 17 Critical Interventions and Transport Decision 1. Initial assessment – Penurunan kesadaran – Respirasi abnormal – Sirkulasi abnormal syok, perdarahan tidak terkontrol 2. Rapid trauma survey – Abnormal chest exam flail chest, etc – Tender/distended abdomen – Pelvic instability – Bilateral femur fractures 3. High risk group
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Transport • Jenis transportasi? • Transfer ke trauma centre berdasar prioritas pasien!