Inggris Snake Bite

download Inggris Snake Bite

of 28

  • date post

    05-Jul-2018
  • Category

    Documents

  • view

    217
  • download

    0

Embed Size (px)

Transcript of Inggris Snake Bite

  • 8/15/2019 Inggris Snake Bite

    1/28

    Morning Report Snake Bite

    ICD X : T.630

    GIZKA YOLANDA PUTRI 1408465718

    SKDI 4

  • 8/15/2019 Inggris Snake Bite

    2/28

    HISTORY TAKING

    Patie t I!e tit"

    1. Name : Mrs. H 2. Age : 42 yo 3. Gender : female 4. Occupation : house ife

    !. "eligion : #slam $. Admitted to the hospital : %& No'em(er 2%1! ). Address : *l. Hangtuah

    +,ung- enayan "aya /e0an(aru

  • 8/15/2019 Inggris Snake Bite

    3/28

    Ai#$a" a ! Ce#%i&a' C( t#(' • /atient tal0 spontaneously. • Assessment: Airway clear

    )#eat*i + • #nspection: (reathing spontaneously- fre uency 2% minute- simetrical

    (oth of chest mo'ement. • /alpation : crepitations 56 • /ercussion : resonant • Auscultation: 'esicular sound 7 76 • Assessment: Breathing clear

    • Action : 2 8 of O2 ith nasal cannula

    PRIMARY SURVEY

  • 8/15/2019 Inggris Snake Bite

    4/28

    Ci#&,'ati( • 9arm e tremity- oedema 5 56 •

    " ; 2 seconds- • Heart rate )2 minutes- regular- feel strong •

  • 8/15/2019 Inggris Snake Bite

    5/28

    Di-a i'it" • G > 1! • #socoric pupil (oth sides • /upil reflects direct and indirect 7 76 • Assessment: mini neurologist e amination as good

    / (-,#e • emperature: 3$-=

    • Action: o'er the patient

  • 8/15/2019 Inggris Snake Bite

    6/28

    SECONDARY SURVEY

    Bitten by a snake on left foot, 30 minutes before admitted to the

    hospital

    CHIEF COMPLAINT

  • 8/15/2019 Inggris Snake Bite

    7/28

    ? 3% minutes (efore admission- patient complaint her left foot as (itten (y a co(ra hen she or0ed on her yard. /atient@s leg as (eing tied up ith ropes a(o'e the sna0e (ites right after the incident. /atient then immediately (rought to the

    hospital.

    RECENT ILLNESS

    HISTORY

    TRAUMA MECHANISM

  • 8/15/2019 Inggris Snake Bite

    8/28

    /atient complaint her foot felt thro(- s ollen-

    eritema and sore on the (itten mar0.

    Nausea 76- 'omiting 76. /atient pu0ed for a(out $ times- mingled ith meal- (lood 56-

    ith amount ? glass- diBBiness 76.

    here@s no (lood fle out from the (itten mar0- dyspnoe 56- loss of conciousness 56-

    ptechiae 56- (lurred 'ision 56

  • 8/15/2019 Inggris Snake Bite

    9/28

    here@s no history of (eing (itten (efore • here@s no illness relati'e to patient@s

    illness

    Pa-t I'' e-- 2i-t(#"

    a i'" I'' e-- 2i-t(#"

    here@s no relati'ity

  • 8/15/2019 Inggris Snake Bite

    10/28

    1. General condition : loo0s ill 2. A areness : composmentis 3. Cital >ign

  • 8/15/2019 Inggris Snake Bite

    11/28

    Head and nec0 : normally hora : normally

    A(domen: normally

    Genitourinarius: normally E tremity: locally state

    Status Generalis :

  • 8/15/2019 Inggris Snake Bite

    12/28

    "egio : orsum pedis sinistra #nspection : hematoma 76- (itten mar0 76- s0in around the (itten mar0 seems in (lac05purple colour. /alpation : tenderness 76- oedema 76- " ;2 seconds and arm e tremity

    Localized state :

  • 8/15/2019 Inggris Snake Bite

    13/28

    >na0e (ite

    Working diagno !

    omplete (lood count

    S"gg! #i$! !%a&ina#ion

  • 8/15/2019 Inggris Snake Bite

    14/28

    C( 'ete '((! &(, t H( : 13-3 8 H : 3!-3 I 9< : 1).=%% H 8

    /8 : 4%2.%%% 8 "< : 4-3= 1% $ 8

    WORKUP

  • 8/15/2019 Inggris Snake Bite

    15/28

    a e ite DIAGNOSIS

  • 8/15/2019 Inggris Snake Bite

    16/28

    #CJ "8 >a(u in,ection 1 'ial in 1%% cc Na 8 A > 1!%% i+

    eftria on in,ection 2 1 gr

    ramadol in,ection 2 3% mg

    TREATMENT

  • 8/15/2019 Inggris Snake Bite

    17/28

    THEORY

    Snak! 'i#!

  • 8/15/2019 Inggris Snake Bite

    18/28

  • 8/15/2019 Inggris Snake Bite

    19/28

  • 8/15/2019 Inggris Snake Bite

    20/28

    1. rangle head- there@s ca'ity (et een eyes and nose

    2. Ha'e 2 caninus

    3. Ha'e o'al pupil 4. here@s t o (ars of sla( (elo its tail

    SNAKE

  • 8/15/2019 Inggris Snake Bite

    21/28

    /oisonous sna0e di'ided (y its to in: #. Neuroto ic: o(ra- ular Kraits L ular

    Karang- ular 9elang##. Hemolitic : "attlesna0e- comperhead. ###. Neuroto ic dan Hemolitic : sea sna0e.

  • 8/15/2019 Inggris Snake Bite

    22/28

    i i

  • 8/15/2019 Inggris Snake Bite

    23/28

    D!gr! !

    V!n!ra i

    (i##!n &ark

    Pain O!d!&a)Eri# !&a

    S* #!&i+ *&,#o&,

    0 0 + +/- < 3 cm/12hour

    0

    I +/- + + 3 12 cm/ 12 hour

    0

    II + + +++ 12 2! cm/ 12 hour

    + , neuroto"ic nausea, di##iness,

    shock III ++ + +++ $ 2! cm/ 12

    hour ++ %hock, ptechi, echimosis

    I& +++ + +++ $ e"tremity ++

    +-a i.+a#ion

  • 8/15/2019 Inggris Snake Bite

    24/28

  • 8/15/2019 Inggris Snake Bite

    25/28

    o holes mar0: oedema- petechiae- (ullae- eritema- echimosis- and tissue necrosis symptomps

    >prayed on the eye → (lindness

    >ign and symptomps of neuroto in : tingling-

    limp- sali'ation- 'omiting- ptosis- a(normalreflects- dyspnoe- respiratory arrest → paraliBed on respiratory muscles.

  • 8/15/2019 Inggris Snake Bite

    26/28

    DIAGNOSE

    • History ta0ing • /hysical e amination • 8a(oratory findings: < - electrolyte

    count- / A/ - fi(rinogen- +reum creatinin

    • Electrocardiography

  • 8/15/2019 Inggris Snake Bite

    27/28

    o slo do n the to in entering (loodstream- to neutraliBed and get rid of the to in and maintaning (lood 'olume. #mmo(iliBation of the affected area Apply cross ise cutlet on the (itten mar0

    ooling the ound soa0 in the cold ater >A 1!%% + supporti'e theraphy6

    TREATMENT

  • 8/15/2019 Inggris Snake Bite

    28/28

    T/ank Yo"