04 Initial Assesment
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7/23/2019 04 Initial Assesment
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
(Initial Assesment)
PENILAIAN AWAL
DAN RESUSITASI PENDERITA TRAUMA
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7/23/2019 04 Initial Assesment
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
Kenali terlebihKenali terlebih
dahulu keadaandahulu keadaan
an! men!an"aman! men!an"am
na#ana#a
$RINSI$$RINSI$
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
Survai Primer
Survai Sekunder
Terapi Definitif
PrinsipPrinsipPenanggulanganPenanggulangan
Penderita TraumaPenderita Trauma
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
Dalam Pikiran Sekuensial
Dalam tindakan Simultan
Dilakukan sampai Penderita
Dalam keadaan Stabil
SURVAY PRIMERSURVAY PRIMER
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
A. Airway (+C Spine Control )
B. Breathing (+entilation )
C. Cir!ulation (+ "ontrol Perdarahan)
D. Di#a$ility ( %CS&Tanda 'aterali#a#i )
. po#ure
SURVAYSURVAY
PRIMERPRIMER
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
Selalu pakai alat Protek#i
* Sarung tangan
* "a!a mata
* Dll
%ATI %ATI & AIDS%ATI %ATI & AIDS
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
. ,anya - / 0enit $ila 1$#truk#itotal
2. Selalu Pikirkan C Spine Control
AIR'AAIR'A
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7/23/2019 04 Initial Assesment
8/42BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
Curiga fra!tur #ervikal $ila 3* Setiap trauma kapiti#
* Setiap multi Trauma* Setiap ada luka (tumpul) diata#
klavikula
* Prio mekanik trauma mendukung
AIRWAYAIRWAY
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7/23/2019 04 Initial Assesment
9/42BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
Bila !uriga fraktur #ervikal
* 4ik#a#i kepala #e!ara manual
* Pa#ang Cervi!al Collar
* Bila perlu diikat pengaman
AIR'AAIR'A
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7/23/2019 04 Initial Assesment
10/42BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
1k#truk#i Par#ial* Cairan (gurgling) Su!tion
* 'idah 5atuh ke$elakang 3 Snoring
AIRWAYAIRWAY
Cara manualCara manual
AirwayAirway
SementaraSementara
TINDAKANPERAWAT
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7/23/2019 04 Initial Assesment
11/42BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
Head TiltHead Tilt
Jaw ThrustJaw Thrust
Chin LiftChin Lift
AIRWAYAIRWAY
Perasat ManualPerasat Manual
::
AirwaAirwa
SementaraSementara::
Oropharyngeal Airway Tidaksadar
asopharygeal Airway Sadar
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7/23/2019 04 Initial Assesment
12/42BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
Teknik 0anual 3 6aw Thru#t
Chin 'ift
* Airway Sementara 3
7 Oro pharyngeal Tidak sadar
7 Naso Pharyngeal Sadar
AIR'AAIR'A
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7/23/2019 04 Initial Assesment
13/42BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
Intubasi Endoktraeheal :
(Blind ) Naso - tracheal
Oro Tracheal
Selalu coba Naso Tracheal dulu !
AIRWAYAIRWAY
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7/23/2019 04 Initial Assesment
14/42BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
Bila tidak dapat intu$a#i
"riko 7 Tiroidotomi
AIR'AAIR'A
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7/23/2019 04 Initial Assesment
15/42BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
Setiap penderitadalam koma
#ewaktu waktudapat mengalami
Apnea
!ATI " !ATI ##!ATI " !ATI ##
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7/23/2019 04 Initial Assesment
16/42BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
Pernapa#an yang $aik
* 4rekwen#i dewa#a 3 28
Anak 3 98 Bayi 3 :8
2. Tidak ada ge5ala Di#pnea dll
9. Pemerik#aan fi#ik $aik
$REAT!IN%$REAT!IN%
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17/42BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
Pe"eriksaan #isikPe"eriksaan #isik
;n#pek#i 3 Peran5akan Simetri#
An#kulta#i 3 Bi#ing nafa# e#ikular "iri7kanan
Perku#i 3 Sonor kiri7kanan
$REAT!IN%$REAT!IN%
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7/23/2019 04 Initial Assesment
18/42BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
Breathing ( untuk Sementara ) $aik
Bila Satura#i 82 < => ?
PULSE &'YMETRYPULSE &'YMETRY
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7/23/2019 04 Initial Assesment
19/42BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
Bantu pernafa#an @ A##i#ted
entilation 3
* 0ounth to mouth@ma#k
* Bagging (Am$u $ag )
* e#pirator
$ila $reat(ing$ila $reat(ing
Tida) Ade)uatTida) Ade)uat
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20/42BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
7 dara Be$a# mengandung o2. 3 2 ?
7 a#al "anul 2 '@ mnt 3 2: ?7 a#al "anul - '@ mnt 3 :: ?
7 4a!e 0a#k 3 =8 ?
Selalu $eri)anSelalu $eri)an
&*gen&*gen
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21/42BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
"eadaan yang haru# di kenali pada#urvay Primer 3
* Ten#ion Preumothora
* 0a##ive ,ematothora
* Tamponade 6antung
* 1pen Preumothoray
* 4laill Che#t + "ontu#io Paru
$REAT!IN%$REAT!IN%
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7/23/2019 04 Initial Assesment
22/42BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
Tension Pneumothorax ditandai : Vena jugolaris , Sesak nafas, Trachea terdorong, Buni !afas "#hee$ing% &&
$REAT!IN%$REAT!IN%
Jarum !esar di "CS #Jarum !esar di "CS #
Mid $ %la&ikularMid $ %la&ikular
'S('S(
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7/23/2019 04 Initial Assesment
23/42BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
1pen Pneumothora "a#a 9 Si#i
Clo#ed Pneumothora ESD
$REAT!IN%$REAT!IN%
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7/23/2019 04 Initial Assesment
24/42BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
4lail Che#t ( + "ontu#io Paru )
;C ( "emungkinan e#pirator )
$REAT!IN%$REAT!IN%
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7/23/2019 04 Initial Assesment
25/42BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
'assi(e hematothorax
)SD * +-- cc
* .-- cc/0am
Torakotomi cito
$REAT!IN%$REAT!IN%
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7/23/2019 04 Initial Assesment
26/42BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
Tamponade 6antung ditandai 3
Se#ak &Syok& 6P adi lemah& B6 lemah
$REAT!IN%$REAT!IN%
Perikardio $Perikardio $SintesisSintesis
%emungkinan%emungkinanTorakotomiTorakotomi
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
SOK DIKENALI DARI SOK DIKENALI DARI
1 !adi lemah dan cepat1 2kral Dingin
1 3esadaran mulai menurun
1 Bila tensi turun, Sok berat
+IR+ULATI&N+IR+ULATI&N
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
Bila penderita dingin dan
Tachcardia
+IR+ULATI&N+IR+ULATI&N
S)O% **
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
* mumnya Syok hemoragik
(Syok lain mungkin)* Bila 6antung $erhenti
umumnya #udah terlam$at
+IR+ULATI&N+IR+ULATI&N
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
Perdarahan 3
* Perdarahan k#ternal
* Perdarahan ;nternal
7 Torak#
7 A$dominal7 Pelvi#
7 Tulang Pan5ang
+IR+ULATI&N+IR+ULATI&N
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
mumnya dire!t Pre##ure
(Per$an tekan) akan $erha#il
Perdara(anPerdara(an
E)sternalE)sternal
Jangan +ahitdulu **
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
0engurangi Perdarahan ;nternal
7 Pelvi# 3 PAS%
%urita
7 Tulang Pan5ang 3 tra!tion&
Splint 7 Torak#@A$doman FF
+IR+ULATI&N+IR+ULATI&N
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
3ontrol Perdarahan
Perbaikan Volume
+IR+ULATI&N+IR+ULATI&N
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE +IR+ULATI&N+IR+ULATI&N
Akses ,enaAkses ,ena-
De#asa AnakV4Perifer
Vena Sentral
Vena Seksi
Vena Perifer5ntraosicus
Vena Seksi
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
In$us :
7 Dua 6alur 7 ; Catheter kali$er $e#ar
7 ' 72 liter looding
7 Cairan di hangatkan
+IR+ULATI&N+IR+ULATI&N
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
2da 6espon :
+IR+ULATI&N+IR+ULATI&N
Baik Diagnose/ terapi
Sementara Looding lagi
$eri Dara($eri Dara(
Kamar &perasiKamar &perasi
looding dilooding di
pelankanpelankan
Tidak ada .espon : %amar
Operasi
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
DISA*ILITDISA*ILIT
* %CS ,ati hati $ila %CS turun 2atau le$ih.
* Tanda laterali#a#i 7 Pupil ( i#okor )
7 Tanda laterali#a#i lainnya
* pidural hematom $i#a mati !epat
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
E+$OSUREE+$OSURE* Buka 3 Buka #emua pakaian
* Tutup 3 Takut hipotermia
( Pra %S : Tunggu dulu )
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
,-le Cath . NGT,-le Cath . NGT* 4oley Cath 5angan dipa#ang $ila 3
7 Ada darah di 1
7 ,ematom di S!rotum
7 T3 Pro#tat ,ight ridingG
* %T 5angan dipa#ang $ila 3
7 4raktur $a#i# kranii anterior
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
SUR/AI SEKUNDERSUR/AI SEKUNDER
*Pemerik#aan teliti dari kepala #ampaikaki
"epala leher torak# a$domen pelvi# ek#termita# 7 log roll
* 4inger in every orifi!e
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BTCLS / IRNI / LKKI 2008BTCLS / IRNI / LKKI 2008
NURSING CONSULTANT AND TRAINING CENTRE
+ & RA ( ,OTO RUTIN )+ & RA ( ,OTO RUTIN )
. Servikal ( lateral )
2. Torak# (AP)9. Pelvi# (AP)
/Hanya !ila sta!il /
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NURSING CONSULTANT AND TRAINING CENTRE
TERI0A KASI%