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CONFERENCE
FLAIL CHEST
Athaya Febriantyo Purnomo
115070100111014
Pembimbing :
dr. Artono Isharanto, SpB, SpB!"
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IDENTITAS
2
Nama : Tn. Sutrisno
Jenis Kelamin : Pria
Usia: 70 tahun
No Register : 11255330
Alamat: usun !en"eng RT 2#R$ 2 Ke%uh
Kan"ang& Pera'& Jom(ang
Pe'er"aan : S)astaAgama : *slam
+RS : 2, Se%tem(er 2015
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Primary Survey3
Air#ay
Breathing
Cir$u%ation
Disabi%ity
E&posure
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A'Air#ay ()Spine (ontro%*
4
Assessment
Look : tida+ ditemu+an benda asing di a%an na-as
Lise! : terdengar hembusan na-as
Fee" : erasa hembusan na-as a# thrust: tida+ ada sumbatan
(er/i$a%: eas ')*
!esimpu%an:
Air#ay paten
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#
anagement
Pasang $er/i$a% $o%%ar
eassessment
Sumbatan ')*
()spine: eas ')* $ontro%ed.
A'Air#ay ()Spine (ontro%*
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B'Breathing*
$
ASS2SS23
Look :
Pergera+an dada parado+sa%
espiratory ate &6menit, $epat dan dang+a%
eas '* di hemithora+s +anan ra+ea di tengah
2+spansi dada asimetris
Lise! :
Suara na-as 86/ h: )6) 9h: )6) 86/ )6) )6)
86/ )6) )6)
dada +anan redup
Fee" :
!repitasi , nyeri ,
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%
anagement
/enti%ator I(;
B'Breathing*
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('(ir$u%ation*
&
ASS2SS23
9arna +u%it : pu$at
BP: 1506
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'
anagement
I"F> 3S 14 tpm
('(ir$u%ation*
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>'>isabi%ity*
()
Assessment
A"P; : A%ert
?(S: 45@
Pupi% iso+or
( 6
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2'2&posure*
((
Assessment
Lokasi : V app frontotemporal (D)
Ukuran :p: 3 cm
Sifat : Wound
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(2
anagement
en$egah hipotermia denganmemberi+an se%imut pada pasien
a#at %u+a
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SECONDAR* S+R,E*
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(4
Keluhan Utama :
Nyeri dada sebelah kanan
Riwayat Penyakit Sekarang :
Pasien dibawa dalam keadaan sadar mengalami nyeri
dada kanan setelah terjatuh ditabrak motor 1 hari
SMRS. Tidak ingat kejadian (+), muntah (-), sesak (+),
kejang (-)
MOI :
Pasien ditabrak sepeda motor dari arah depan kanan
14
HETERO ANA-NESIS
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(#
!6: an ')*, I$t')*
(6P: S1 S sing%e, murmur ')*,:&6mnt
Abdomen: at, soe
2&tremitas: eas ')*, edema ')*, a+ra%hangat
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($
A%%ergies : disang+a%
-edi$ation : tida+ ada
Past i%%ness : tida+ ada Last mea% : tida+ ada E/ents : !, ditabra+ motor
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(%
Foto hora& AP
=ead ()s$an
;S? FAS6abd
aboratorium :
>, S2, F=, B?A, 6P, ;r6(r
RENCANA PE-ERI.SAANPEN+N/AN0
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HASIL PE-ERI.SAAN LABORATORI+- 2%1'12)(#
Hemao"oi
=emog%obin : 11,@< '1C,4)17,7*
2ritrosit 'B(*: C,@ '4,0)5,5*
eu+osit 9B(: ,04 '4,C)10,C*
=emato+rit : CC,7D '40)47*
rombosit P: 9:15,50D '11,5)14,5*
P>9 :11,<
P" :10,@ '7, E 11,1*
P ( : ,< D '15,0)5,0*
P( :0,10D
6P : 1764<
;r6(r :45,1060,71
Faa% =emostasis 'da%am batasnorma%*
P :10,10 deti+
AP : 4,0 deti+
(&
SE
3atrium : 14C
!a%ium : 4,54
!%orida :111
B0A
p=: 7,5
P(: 7,0 'C5)45*
P: 1@4, '0)100*
Bi$arbonat: 4,
!e%ebihan bassa: 0,C
Saturasi :
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('
HASIL PE-ERI.SAAN RADIOLO0I
Raio"ois :
Fr $ostae I",","I,"II,"III,I
(ontusio pu%monum '>*
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( S$an2)
SA= mengisisisternainterpedun$u%ar,
sisterna ambientdanGuadrigemina%,serta su%$ii regio
-ronta% +anan +iri 2dema $erebri
(! 45@
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2(
;S? FAS =ematothora& de+stra
=idrothora+s de+stra
!ongesti %i/er
ida+ tampa+ $airan
intraabdomen rgan so%id abdomen inta+
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22
=ematothora& de+stra
=idrothora+s de+stra
!ongesti %i/er
ida+ tampa+ $airan
intraabdomen rgan so%id abdomen inta+
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23
=ematothora& de+stra
=idrothora+s de+stra
!ongesti %i/er
ida+ tampa+ $airan
intraabdomen rgan so%id abdomen inta+
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2#
Flail Chest
Multiple Fracture Costae
Hemothoraks Dekstra
Kontusio ulmonum dekstra
CK! "#$
%AH
Cere&ral edema'&s
Multiple open ound at femur
ASSESS-ENT
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2$
/enti%ator I(;
I"F> 3S 14 tpm
S I(;
inda+an (I Shapp p%ate 'interna% H&ation*
edi+amentosa :Ine+si !etoro%a$ C0 mg
Ine+si (iproo&a$in &40mg
Ine+si etronidao% C&5 mg
Ine+si Pira$etam C&C g
Ine+si asam trane&amat C&500 mg
PLANNIN0
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2%
bser/asi Sube+ti- 'nyeri saat bernapas*
bser/asi ?(S, BP, P,
bser/asi tanda)tanda distress na-asbser/asi perbai+an -ra$ture hea%ing
RENCANA -ONITORIN0
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2&
2IA !ASI=