*Ambulans Gawat Darurat 118 (BT&CLS) TraumaAbdomen

Ambulans Gawat Darurat 118 (BT&CLS)

*Ambulans Gawat Darurat 118 (BT&CLS) TRAUMAATLS A, B, C, D & EDSTC (Definitive Surgery For Trauma Care) Damage Control Surgery (Stop Bleeding Packing & Stop Contamination) Acut Compartment Syndrome ( ACS )

Ambulans Gawat Darurat 118 (BT&CLS)

*Ambulans Gawat Darurat 118 (BT&CLS) DSTC M Mech. Of Injury I Injury Sustained S Symptoms T Therapi

Ambulans Gawat Darurat 118 (BT&CLS)

*Ambulans Gawat Darurat 118 (BT&CLS) TraumaSyok Hemorhagik Sumber Perdarahan;

Toraks Abdomen Pelvis Femur Retroperitoneal

Ambulans Gawat Darurat 118 (BT&CLS)

*Ambulans Gawat Darurat 118 (BT&CLS)Intra danRetro peritoneal :

Ambulans Gawat Darurat 118 (BT&CLS)

*Ambulans Gawat Darurat 118 (BT&CLS)Organ SolidOrgan BeronggaOrganAbdomen Hepar Lien Pankreas Ginjal Lambung rektum Intra / Retroperitoneal

Ambulans Gawat Darurat 118 (BT&CLS)

*Ambulans Gawat Darurat 118 (BT&CLS) Trauma tajam : (Tembus, Tusuk, Tembak High Velocity atau Low Velocity) Trauma tumpul (Benda Keras, Handle Bar Injury)Trauma Abdomen Organ Intraperitoneal - Solid - Berongga

Organ Retroperitoneal - Solid - Berongga

Ambulans Gawat Darurat 118 (BT&CLS)

*Ambulans Gawat Darurat 118 (BT&CLS)Cedera Organ Intra-peritoneal1. Solid (hepar/lien) Perdarahan Intraperitoneal - rangsangan peritoneal (nyeri-nyeri tekan *) - tanda darah intra-perit. - tanda perdarahan (syok-pucat)2. Berongga Sering sulit DD/ !DPL (Diagnostic Peritoneal Lavasage)FAST (Focussed Assessment with Sonography for Trauma)

Ambulans Gawat Darurat 118 (BT&CLS)

*Ambulans Gawat Darurat 118 (BT&CLS)Cedera Organ Intra-peritoneal1. Solid (hepar/lien)2. Berongga (lambung rektum) Peritonitis Umum - nyeri - defans - nyeri tekan - nyeri lepas* - pekak hepar Sering sulit DD/ !Foto Polos abdomenCT Scan / MS CTCURIGA !

Ambulans Gawat Darurat 118 (BT&CLS)

*Ambulans Gawat Darurat 118 (BT&CLS)Cedera Organ Retro-peritoneal( 1. Cedera uretra : ada trias : 1. 2. 3. )Ada perdarahan di OUE (meatal bleeding)

2. Hematom skrotum

3. RT : prostat melayang

Ambulans Gawat Darurat 118 (BT&CLS)

*Ambulans Gawat Darurat 118 (BT&CLS)Cedera Organ Retro-peritoneal( 1. Cedera uretra : ada trias : 1. 2. 3. )

2. Cedera V.Urinaria : Pasang kateter hematuria minimal dan tidak bertambah

3. Cedera Ginjal : Pasang kateter - hematuria, jumlah normal

Catatan : Ruptur buli bila intraperitoneal akan peritonitis

Ambulans Gawat Darurat 118 (BT&CLS)

*Ambulans Gawat Darurat 118 (BT&CLS)Cedera Organ Retro-peritonealDuodenum Pankeas :

Manifestasi lambat : peritonitis

Udara retroperitoneal

Bila langsung menjadi intra-peritoneal langsung peritonitis

Ambulans Gawat Darurat 118 (BT&CLS)

*Ambulans Gawat Darurat 118 (BT&CLS)Cedera Abdomen sering terlambat :Manifestasi sering lambat (perforasi)Ada cedera kepala (kesadaran menurun)Ada cedera spinal (gangguan sensorik)Cedera lain lebih nyeriObat-obatan / alkohol)Cedera retroperitonealBuktikan sejauh mungkin, lalu observasi terus menerus ???

Ambulans Gawat Darurat 118 (BT&CLS)

*Ambulans Gawat Darurat 118 (BT&CLS)Diagnosis dan Pengelolaan Cedera Abdomen (1) :

Anamnesis : mekanisme cedera ( MIST ??? ) Survei primer : A B C D & E Lakukan Pem. Fisik Abdomen : Insp Ausk Palp Perk Syok karena perdarahan intra-peritoneal Perlu. LAPAROTOMI !

Ambulans Gawat Darurat 118 (BT&CLS)

*Ambulans Gawat Darurat 118 (BT&CLS) Survei Sekunder Pem. Fisik Abdomen : Insp Ausk Palp Perk Adjuncts : X-foto DPL FAST CT Scan MS CT DsbJelas cedera intra-abdomen LaparotomiDiagnosis dan Pengelolaan Cedera Abdomen (2) :

Ambulans Gawat Darurat 118 (BT&CLS)

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