Kegawat Daruratan Muskulo Skeletal

8/16/2019 Kegawat Daruratan Muskulo Skeletal

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PENDAHULUAN

• Mmrlu!an "inda!an s#ra

• $isa mn#an%am &i'a

•

K%a%a"an prmann• Kadaan umum pndri"a di

pri(ri"as!an

•

AIR WA)• $REATHING

• *IR*ULATION



RAKTUR TER$UKA

• Trdapa" 7u-un#an an"ara "ulan# dan dunialuar s-a#ai a!i-a" r(-!n0a &arin#an 0an#mnu"upi "ulan#.

•Sur#i%al Emr#n%0 !arna -iasan0adisr"ai mul"ipl in&ur0 dan s5r s7(%!.

• Di TKP lu!a 7arus di"u"up d#n !ain 0an#-rsi7 dan s"ril sampai pasin "i-a di

ruma7 sa!i".

• Di ruma7 sa!i" dila!u!an #nralassssmn" dan li= "7ra"nin# %(ndi"i(ns.



RAKTUR TER$UKA

• Smua =ra!"ur "r-u!a 7arusdian##ap s-a#ai lu!a 0an#"r!(n"aminasi > %(n"amina"d

'(und ? mn%#a7 "r&adin0ain=!si.

• Pnan#anan @

+. Immdia" '(und %(5r.

. An"i-i("i% Pr(p70lais.

/. Earl0 '(und d-ridmn".

1. S"a-iliBa"i(n (= "7 =ra%"ur.



D I S L O K A S I

• Prmu!aan sndi s%ara !(mpli"-r#sr, "ida! ada la#i !(n"a!dian"ara !dua u&un# "ulan#.

• SU$LUKSASI @ prmu!aan sndis%ara in!(mpli" -r#sr, masi7 ada!(n"a! dian"ara !dua u&un# "ulan#.



D I S L O K A S I

• GAM$ARAN KLINIK

+. $n"u! sndi a-n(rmal dan -(n0 landmar!-r#sr.

. Gra!an sndi "r7am-a" dan n0ri./. T0pi%al d=(rmi"is @

C S7(uldr a-du%"i(n d=(rmi"0.

C El-(' i(n d=(rmi"0.

C Hip, an"ri(r i(n, a-du%"i(n dan

"rnal r("a"i(nd=(rmi"0.



D I S L O K A S I

C Hip, p(s"ri(r li(n,addu%"i(n dan

in"rnal r("a"i(nd=(rmi"0.

C Kn i(n d=(rmi"0.

C An!l 5arus d=(rmi"0.



D I S L O K A S I

• TREATMENT

+. *l(sd rdu%"i(n s#ra dalam#nral ans"7si .

. Imm(-ilisasi un"u! / min##u.

/. isi("7rap0 ROM %r%is.



D I S L O K A S I

• KOMPLIKASI

+. Nur( 5as%ular in&ur0

. M0(si"is OssiF%ans/. A5as%ular N%r(sis

1. S"inss (= "7 &(in"s

4. Unrdu%d disl(%a"i(ns6. R%urrn" disl(%a"i(n

8. Os"(ar"7ri"is.



*OMPARTMENT S)NDROME

• Sala7 sa"u !(mpli!asi =ra!"ur.

• $ldin#, (dm inamasi "!ananin"ra!(mpar"mn aliran dara7 mus%l

is%7amia

nr5 mus%l n%r(sis didalam!(mpar"mn.

• Nr5 masi7 dapa" r#nrasi ""api ("(" "ida!r%(5r0.

•

O"("

di#an"i inlas"i% F-r(us "issu

9(l!manns Is%7ami% *(n"ra%"ur.

• $isa &u#a dis-a-!an pmasan#an #ip 0# !"a".



ADULT RESPIRATOR) DISTRESSS)NDROME

• AT EM$OLI

C a" Gl(-uls +< m =a" m-(li paru.

C Tr&adi pada d'asa 0# mn#alami "ulan#

pan&an# 2 "ru"ama mul"ipl %l(sd 3 C Han0a sdi!i" mn#alami =a" m-(lism

s0ndr(m.

C Sum-r =a" m-(li -(n marr('.

C $isa !arna lu!a -a!ar, rnal in=ar%"i(n %ardi(

pulm(nar0 (pra"i(ns.



ADULT RESPIRATOR) DISSTRESS)NDROME

• TREATMENT

+. Rin#an m(ni"(rin# analisa #as dara7

uid -alan%.

. H0p(ia (!si#n./. S5r rspira"(r0 diss"rs @

C I*U

C 9n"ila"(r C S'anQGanB %a"7"riBa"i(n 2 m(ni"(rin#

%ardia% =un%"i(n 3



ADULT RESPIRATOR) DISSTRESS)NDROME

1. Sup(r"i= @

C Hparin %#a7"7r(m-(m-(li

C S"r(id rdu%d pulm(nar0(dm



NEURO9AS*ULAR INJUR)

• K(mpli!asi =ra!"ur

• ra!"ur s!i"ar Kn J(in", l-(' &(in", 7umrus dan =mur.

• Pu"us, r(-!, !(mprsi a"au !(n"usi.

• Karna "rauma a"au =ra#mn =ra!"ur




• GEJALA KLINIK

C Pars"7sia a"au Num-nss

C U&un# &ari din#in dan pu%a"

C *0an(sis

C Pulsasi mnurun sampai "d!"ra-a

→ Angiogram EMG ( Elektro Myo Graf )

NCV ( Nerve Conduction Test )




• TREATMENT

C Lpas splin" a"au spal!

C Qra0 didu#a ada pn!anan pada

nur(5as!ulr rp(sisi

C Assssmn" sir!ulasi slama /< mni"

C $ila "ida! ada pr-ai!an pl(r

C ra!"ur

diF!sasi 2 ORI 3



*RUSH S)NDROME

• Han%urn0a ("("Q("("

• Karna "rauma a"au "(urniu" 0an#"rlalu lama dipasan# 2 C 6 &am 3

• A%id M0(7ama"in 2 *0"(%7r(m * 3 lpasdari ("(" sir!ulasi #in&al -l(!"u-ulus #in&al A. Rnalis spasm An(i%Sl Tu-ulus N!r(sis sl "u-ulus.

• Prdara7an s7(%! s!rsi rnalis ,l(' (u"pu" urmia a%id(sis



*RUSH S)NDROME

• $ila s!rsi rnal !m-ali dlm +min##u pasin slama".

• K-an0a!an pasn Rnal Dial0sisa"au mnin##al dalam +1 7ari.

THERAPI

C Ampu"asi ss#ra mun#!in.



DEEP 9ENOUS THROM$OSIS2D9T3

• K(mpli!asi dari "rauma dan sur#r0.

• Srin# "r&adi pada 5na "un#!ai-a'a7, &aran# pada =mur dan pl5is.

• T7r(m-us sir!ulasi paru pulm(nar0 m-(lism =a"al

• Pn0-a- 70pr%(a#ula-ili"0 dara7

dis-a-!an a!"i=asi =a!"(r (l7"7r(m-(plas"in 0# !luar dari &arin#an0# rusa!




• S%(ndar0 a%"(r @

C S"asis !arna "(urniu" a"au "i#7" -anda#

C T!anan pada m&a (prasi

C Imm(-ilisasi lama C Krusa!an nd("l pm-ulu7 dara7

• a!"(r Rsi!( @

C (ran# "ua

C Pasn d#n pan0a!i" Kardi(5as!ulr C Pasn d#n "ira7 -arin# lama s"la7 "rauma

C S"la7 Hip Ar"7r(plas"0.




• GEJALA KLINIK @

C N0ri

C $n#!a! C Tmpra"ur !uli" sdi!i"mnin#!a"

C D(rsi l!si (("

Pain 2H(mans Si#n3

C Pulm(nar0 Em-(lism *7s"pain,




• Dia#n(sis @

C 9n(#rap70

C USG

C D(pplr

• Pn%#a7an @

C El5asi !a!i C S"(!in#

C Er%is




• TREATMENT

C L(!al D9T @

S"(!in# Elas"is

L(' d(s 7parin 4<<< uni" /s7ari

C Pulm(nar0 Em-(lism @

*ardi(rspira"(r0 Rsus%i"a"i(n 9as(prss(r

Lar# d(s 7parin +4.<<< uni"



GAS GANGRENE

• Pn0-a- @ *l(s"ridial Wl%7ii, (r#anism 0#dapa" 7idup -rmul"ipli!asi pada &arin#an 0#l(' (i#n 2 anar(-i% (r#anism 3

• T(in 0# di7asil!an (r#anism ini mn0ran#dindin# sl "issu n%r(sis mn0-ar.

• Gam-aran Klini! dlm 1 &am @

C Pain

C S'llin# C Dis%7ar# !%(!la"an -r-au !7as 2#as

=(rma"i(n3



GAS GANGRENE

• Pn%#a7an lu!a &an#an di&a7i"!"a" s"la7 d-ridman '(und"(il" 7%"in#

• THERAPI

C Li5 sa5in# "ra"mn"

C An"i-i("i!a

C H0pr-ari% Oi#n



TETANUS

• Pn0-a- @ *l(s"ridium T"ani

• E("(in aliran dara7 l0mp7a"i! *n"ralNr5 S0s"m 2 an"ri(r 7(rn 3

• G&ala Klini! T(nus *l(nus pada ("(" 'a&a7 danra7an# 2 "rismus, risus sard(ni%us 3, -ila mn#nai("(" diap7ra#ma dan in"r%(s"a mnin##al

• THERAPI @

C D-ridmn

C An"i-i("i!

C Human An"i"(in 2 T"anus Immun(#l(-in 3

C In"u-asi K(n"r(l Rspirasi

Kegawat Daruratan Muskulo Skeletal

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