Assalamu’alaikum

Pre Hospital Trauma

Keperawatan Gawat Darurat I

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General Trauma Assessment

1. Scene size up

2. Initial assessment/ primary survey

3. Rapid trauma survey or focus assessment/ secondary survey

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Scene size up

• Universal precaution?

• Lihat keadaan sekitar– Prioritas utama: keselamatan penolong

lingkungan yang aman untuk bekerja

• Initial triage. Berapa jumlah korban?

• Mekanisme cedera?

• Rapid extrication?

• Aktifkan EMS

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Alat yang diperlukan

• Proteksi penolong

• Long back board/scoop stretcher

• Cervical collar

• OPT, suction

• Oksigen

Cervical collar

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Oropharyngeal tube

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Airway Equipment

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Dressing and Bandages

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Long Back Board

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Scoop stretcher

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Primary survey

• Gambaran umum korban• Tentukan respon pasien tingkat

kesadaran AVPU• Kaji airway, breathing & circulation

lakukan tindakan jika terdapat gangguan – bebaskan airway, stabilkan spine, support

pernafasan dan kontrol perdarahan mayor

• Tentukan prioritas keputusan transfer ke trauma centre

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Rapid Trauma Survey

• Pemeriksaan secara sistematis dari kepala, leher, dada, abdomen, pelvis dan ekstremitas dengan melihat, mendengar, meraba untuk menemukan kasus life threatening

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Secondary survey

• SAMPLE (Symptoms, Allergies, Medications, Past medical history, Last oral intake, Events preceding the incident)

• Vital sign• Deformities, Contusion, Abrasion, Penetration, Burn,

Laceration, Swelling (DCAP-BLS)• Tenderness, Instability, Crepitation (TIC)• Pulse, Movement, Sensation (PMS)• LOC AVPU• Pulse oxymetry • Intervensi lanjut: balut & bidai

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Critical Interventions and Transport Decision

1. Initial assessment– Penurunan kesadaran– Respirasi abnormal– Sirkulasi abnormal syok, perdarahan tidak terkontrol

2. Rapid trauma survey– Abnormal chest exam flail chest, etc– Tender/distended abdomen– Pelvic instability– Bilateral femur fractures

3. High risk group

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Transport

• Jenis transportasi?

• Transfer ke trauma centre berdasar prioritas pasien!

Wassalamu’alaikum

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