PENGKAJIAN BTLS

Overview
Langkah pengkajian BTLS
• BTLS Primary Survey
• BTLS Secondary Survey
• BTLS Ongoing Exam

Pengkajian awal dihubungkan dengan

Rapid Trauma Survey or Focused Exam
• Initial Assessment interruptions

Critical conditions and critical interventions

 Pengkajian BTLS
BTLS Primary Survey B T

•Scene Size-up
L S

P R I

•Initial Assessment
M A
R Y

•Rapid Trauma Survey or

S U
R V
E Y

Focused Exam

BTLS Secondary Survey

BTLS Ongoing Exam
Secondary On-Going
Survey Exam

-2
 Scene Size Up
Standard precaution

Scene safety

Initial triage (jumlah korban)

Butuh pertolongan dan alat

Mekanisme injuri
Initial Assessment
B
T
L
S

P
R I
M
A
R
Y

S
U
R
V
E
Y

Secondary On-Going
Survey Exam
 BTLS PRIMARY SURVEY
Keadaan umum korban:
1. usia, jenis kelamin
2. Tampilan umum korban
3. Posisi tubu dan lingkungan korban
4. Aktvitas korban
5. major injuries or bleeding
Noted: triage pasien secara cepat sangat
diperlukan
 BTLS Primary Survey
Kurang dari 2 menit
•Initial Assessment and Rapid Trauma Survey
Apakah perlu intervensi yg di delegasikan
???
Survey akan dihentikan bila:
1.Lingkungan membayakan
2.Adanya sumbatan jalan napas
3.Henti jantung
 Assess Mental Status
• Take C-Spine control
• A – Alert and immediately responsive
• V – Responsive to verbal stimuli
• P – Responsive to painful stimuli
• U – Unresponsive
 Assess Airway
• Open if necessary using jaw-thrust maneuver
• Consider oro- or naso-pharyngeal airway
• Note unusual sounds and correct cause
– Snoring – oro-/naso-pharyngeal airway
– Gurgling – suction
– Stridor – consider intubation
– Silence
 Correcting silence
• Attempt ventilation
• Reposition
• Heimlich
• Visualize and remove
• Intubate
 Assess Breathing

• Look, Listen, Feel

• Rate, Rhythm, Depth (tidal volume)
• Use of accessory muscles/retractions
• Treat
– Absent – ventilate x2, check pulse
– < 12/min – assist ventilation
– Decreased tidal volume – assist ventilation
– Labored – oxygen 10 liters NRB
– Normal or rapid – consider oxygen
 Assess Circulation -
Pulses

• Compare radial • Rhythm

and corotid – Regular
• Rate – Irregular
– Normal • Quality
– Fast – Weak
– Slow – Thready
– Bounding
 Assess Circulation -
Skin
• Color
• Temperature
• Moisture
Assess Circulation -
Bleeding
• Direct pressure
• Pressure dressing
Determine priority
Load and Go Situation ?

– Poor general impression

– Mental status changes
– Difficulty breathing
– Shock
– Chest pain
– Severe bleeding
– Severe pain
 Rapid Trauma Survey
• Head to toe
• Rapid sweep to identify major injuries
which could prove life threatening
• DCAP-BTLS
 Rapid Trauma Survey
Inspect and Palpate for
DCAP-BTLS
D = Deformities B = Burns
C = Contusions T = Tenderness
A = Abrasions L = Lacerations
P = Punctures/ S = Swelling
Penetrations
Deformities Contusions

Abrasions Punctures/Penetrations
Burns Tenderness

Lacerations Swelling
Rapid Trauma Survey
Head
Neck
Chest
Abdomen
Pelvis
Extremities
Posterior
 Head: DCAP-BTLS + Crepitation

Neck: DCAP-BTLS + Jugular Vein Distention and

Crepitation

Chest: DCAP-BTLS + Crepitation and

Breath Sounds (Presence and Equality)
 Listen to both sides of the chest. Is air entry present?
Absent? Equal on both sides? Compare left side to right
side.

Mid-clavicular Mid-axillary
 Abdomen: DCAP-BTLS + Firmness and Distention

Pelvis: DCAP-BTLS (Compress gently)

 Extremities: DCAP-BTLS + Distal Pulse,
Sensation, Motor Function

Posterior: DCAP-BTLS
TERIMAKASIH