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Keperawatan UNEJ
HISTORY
ANGKA KEMATIAN TINGGI
ORGAN PENTING UNTUK OKSIGENISASI TUBUH
Trimodal Death Distribution
Introduction
Penetrating injuries
E.g. stab wounds etc.
Primarily peripheral lung
Haemothorax
Pneumothorax
Cardiac, great vessel or oesophageal injury
Blunt injuries
Either:
direct blow (e.g. rib fracture)
deceleration injury
compression injury
Rib fracture is the most common sign of blunt
thoracic trauma
Fracture of scapula, sternum, or first rib
suggests massive force of injury
Chest wall injuries
Rib fractures
Flail chest
Open pneumothorax
Rib fractures
Pulmonary contusion
Pneumothorax
Haemothorax
Parenchymal injury
Trachea and bronchial injuries
Pneumomediastinum
Pneumothorax
By bleeding presence:
- stopped (Reviloi – Gregoire test negative)
- continues (Reviloi – Gregoire test positive)
By clots presence:
- clotted
- unclotted
By infection complication presence:
- non-infected
- infected
Indication for urgent
thoracotomy
In pneumothorax:
Absence of active air catchment during more than
2 days (presence of pneumothoraz on CXR)
In hemothorax:
Evacuation of > 1000ml blood simultaneously or
bleeding continues during 4 hours with blood
loss > 200 ml per hour
Cardiac Tamponade
KEMATIAN CEPAT
OTAK
PEMBULUH DARAH BESAR
JANTUNG
TERANCAM KEMATIAN
A
B
C
D
JAW THRUST
CERVICAL COLLAR
LIHAT
Pupil ?
Test nafas !
Darah di mulut ?
Penekanan trakhea ?
Bersihkan
Intubasi
Crycothyroidotomi
Reposisi sternum
OKSIGEN 10 L / MENIT
NON REBREATHING MASK
MONITOR OXYMETRI / SAT OKSIGEN
GANGGUAN
PENGEMBANGAN PARU ??
LIHAT
RABA
KETOK
DENGAR
TRAUMA DADA ?
SESAK / FREKWENSI NAFAS CEPAT
CARI
JEJAS
LUKA TEMBUS
BENTUK DINDING DADA TAK SIMETRIS
KREPITASI
PERKUSI HIPERSONOR ATAU REDUP
SUARA NAFAS HILANG /JAUH
BUNYI JANTUNG HILANG
TUMPUL
DADA SIMETRIS. VENA LEHER LEBAR
TRAKHEA TIDAK DITENGAH
TENSION
PNEUMOTORAK
PNEUMOTORAK
NEEDLE
TORAKOSENTESIS
WSD SELA IGA 2
SELA IGA 5
SUARA NAFAS REDUP HEMOTORAK
HILANG WSD
( TORAKOTOMI )
DADA TAK SIMETRIS
(FLAIL CHEST )
PNEUMO / WSD
HEMOTORAK
???
OXYGEN
KONTUSIO PARU
BAGGING
OR VENTILATOR
EDEMA
LUKA TEMBUS
SUCKING WOUND
TEST CAIRAN PNEUMOTORAK
WSD &
TUTUP LUKA
HEMATO ?
DARURAT
Jahit tiga sisii
LUKA TEMBUS DADA KIRI
SUARA JANTUNG HILANG
LIHAT !!!
VENA LEHER LEBAR
TAMPONADE JANTUNG
PERICARDIOSENTESIS
EMFISEMA SUBCUTAN
TRAUMATIK ASPIKSIA
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