Assalamu

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AssalamualaikumPre 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

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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

• Initial assessment
• Penurunan kesadaran
• Respirasi abnormal
• Sirkulasi abnormal ? syok, perdarahan tidak
  terkontrol
• Rapid trauma survey
• Abnormal chest exam ? flail chest, etc
• Tender/distended abdomen
• Pelvic instability
• Bilateral femur fractures
• High risk group

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Transport

• Jenis transportasi?
• Transfer ke trauma centre berdasar prioritas
  pasien!

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Wassalamualaikum