Triase dan Pananganan Gawat

Darurat
Hendro Wartatmo
PMPK FKUGM

Triase (Triage)tosort
Doingthegreatestgoodforthegreatestnumberofpeople
using the available resources
usingtheavailableresources
Chaoticsituation asystemthatissimpleandclearis
mostlikelytosucceed
Triageshouldbeatoolbywhichaseeminglyunmanageable,
overwhelmingsituationcanbeorganized.
Triageshouldbeadynamicprocesscarriedoutatseveral
h ld b d
d
l
levelsthroughoutthesystem.
One of the goals of triage should be to diagnose critical
Oneofthegoalsoftriageshouldbetodiagnosecritical
injuriesrequiringlifesavingtreatmentintheshortestpossible
time.

 To
Tothisendpatientsarecategorizedintogroupstodetermine
this end patients are categorized into groups to determine
theirpriorityfortreatmentandtransporttodefinitivecare
facilities.
"priorityone,""emergency,"orthecolorredindicatesthe
needforimmediatecare;
"prioritytwo,""urgent,"orthecoloryellowindicatesthatcare
"priority two " "urgent " or the color yellow indicates that care
maybedelayedforalimitedperiodoftimewithoutsignificant
mortality;
"prioritythree,""nonurgent,"orthecolorgreenindicatesthat
caremaybedelayeduntilthepatientsintheothercategories
have been dealt with
havebeendealtwith.
Afourthgroup,describedwiththeterm"expectant"orthe
colorblack,hasbeenadvocatedbysometodenotepatients
whoaredeadorexpectedtodie.

Trunkeysscurve
Trunkey
curve
Trauma deaths

IImmediate
di t
deaths

hours

Early deaths

Late deaths

weeks

Single Triage ( SIT )

SingleTriage(SIT)
Untuk pasien yangdatang
yang datang satu persatu
Sesuai situasi diUGDseharihari

*Triage:TechniquesandApplicationsinDecisionMaking.
Katharyn Kennedy,MDRichardVAghababian,MDLucilleGans,MDCPhuli
Lewis,MD
AnnalsofEmergencyMedicine.August1996Volume28Number2

20

50

Luka
Lecet

15 CKR

KORBAN

Tdk ada
Tindakan
segera
Paliatif

Triage
Officer

10

-# femur
tertutup
- # terbuka
-Ruptur
hepar
-Tension
Pnthorax
-Multiple
trauma dg
syok

Mening
-gal

Tindakan
Life saving

Km
Mayat

50
KORBAN
Triage
Officer

20

Luka
Lecet

15

CKR

10

-Multiple
t
trauma
dg
d
syok
-# femur
tertutup
- # terbuka
-Ruptur
hepar
-Tension
Pnthorax

Mening
-gal

Tdk ada
Tindakan
segera
Paliatif
Tindakan
Intensif
Tindakan
Life saving

Km
Mayat

KORBAN

Luka
Lecet

Rawat
Jalan

CKR

Obser
Ob
vasi

Triage
Officer

1000 0rang !!

-# femur
tertutup
- # terbuka
-Ruptur
hepar
-Tension
Pnthorax

Ti d k
Tindakan

- CKB
GCS = 3

R.Khusus

Mening
-gal

Km
Mayat

Operasi
Operasi
Operasi

Luka
Lecet
CKR

KORBAN
Triage
Officer

1000 0rang

CHAOS !!

Tertunda

Penampungan
P
seadanya

-# femur
tertutup
- # terbuka
-Ruptur
hepar
-Tension
Pnthorax

A ti
Antri

- Multiple
M lti l
trauma dg
syok

Terlantar

Mening
-gal

Antri
Antri
Antri

Penuh,Iden
tifikasi ?

KORBAN

Luka
Lecet

Dipulangkan
/ Pindahkan

CKR

Ruang rwtt
R
Yang layak

Triage
Officer

1000 0rang

-# femur
tertutup
- # terbuka
-Ruptur
hepar
-Tension
Pnthorax

Ti d k
Tindakan

- CKB
GCS = 3

Ruang
khusus

Mening
-gal

Km
Mayat

Operasi-2
Operasi-3
Operasi-1

SingleTriage:

Untukpasientunggal
Kategoripasien
Immediate
(AMI,Perdarahandalam)

Urgent
U
t
(Stroke,Apendisitis)

NonUrgent
(Luka,Dislokasi,Fraktur)
(
,
,
)

SimpleTriase AndRapidTransport
( START )
(START)
Proposesfivecategories.
Usingacolorcodedsystem,itincludesabluecategoryfor
patients who are unlikely to survive or whose survival would
patientswhoareunlikelytosurviveorwhosesurvivalwould
dependonreceivingextensiveorcomplicatedtreatment
rapidly.Patientsinthiscategorywouldreceivetreatmentafter
priorityonebutbeforeprioritytwocases,providedtheir
numberswerenotsolargeastodetractfromthetreatment
oftheurgentpatients.
g
p

Re Triage !!
ReTriage!!

SecondaryAssessement
Secondary
Assessement forVictimsEndpoint
for Victims Endpoint
(SAVE)

Dilakukan bila jumlah korban luar biasa dan jauh melampaui

kapasitas penolong.
Kategori korban :
Yangakan selamat apapun tindakan yangdilakukan
Yangakan tidak selamat apapun tindakan yangdilakukan
Yangtidak
Yang tidak termasuk kedua golongan diatas ,keselamatannya
keselamatannya sangat
tergantung intervensi yg dilakukan tim penolong

Medical Emergency Response

MedicalEmergencyResponse

Hospitalisation
area

Transportation
Transfer

Damage
area

RedCross
Public
HealthPost
Hospital

Damaged
Area

Puskesmas
FieldHospital

RegionalResponse
Regional
Response
ofHealthSector

Terima Kasih