dr.yus,spb trauma thoraks
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Oleh
SMF Bedah RSUD dr.H.Abdul Moeloek
Propinsi Lampung.
PPGD/RSUD AM2009.
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Trauma Thorax
25 % multi-trauma
25 % kematian traumaPerlu operasi : hanya 10 %Sisanya cukup tindakan
sederhana
PPGD/RSUD AM2009.
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Anatomi
Tekanan -!
PPGD/RSUD AM2009.
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Anatomi
"ila ca#um
pleura tekananmen$adi positi :
kolaps
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Trauma thorax :
&an'sun' men'ancam nya(a
temukan pada primary sur#ey )!
Potensial men'ancam nya(a
temukan pada secondary sur#ey!
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Trauma thorax yan'
men'ancam nya(a*Primary Sur#ey
1+ ,struksi air(ay
2+ ,pen pneumotoraks.+ Tension pneumotoraks
/+ lail hest kontusio paru
5+ 3asi hematotoraks
4+ Tamponade $antun'
Trauma thorax yan'
men'ancam nya(a*Primary Sur#ey
1+ ,struksi air(ay
2+ ,pen pneumotoraks.+ Tension pneumotoraks
/+ lail hest kontusio paru
5+ 3asi hematotoraks
4+ Tamponade $antun'
A
"
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1+ ,struksi Air(ay :
3aniestasi :
'an''uan air(ay
sesak
stridor
serak
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1+ ,struksi Air(ay 6 Tindakan :
7alan naas deiniti intuasi!
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2+ ,pen Pneumo-thorax
8dara pilih masukli(at luan'tahanan leih kecil!
9an''uan#entilasi
Suckin' chest
(ound
3aniestasi : "reathin' )
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2+ ,pen Pneumo-thorax : Tindakan
Tutup ) Pipa toraks S;
Tutup rapatatau :
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.+ Tension Pneumo-thorax
Pneumothorax Tension =PPGD/RSUD AM2009.
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Pneumothora !ension Pn.
Insp. : Ekspansi # simetris
Ausk. : Bs. a!as satu sisi
Perk. : "ipersnr satu sisi
$rakea ter%rn&
'ena (e)er %istensi
S*k
3aniestasi : "reathin' )
PPGD/RSUD AM2009.
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.+ Tension Pneumo-thorax
Tindakan :
1+ ;ekompresi 2+ Pipa Toraks
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/+ lail hest nspirasi ?kspirasi
3aniestasi : "reathin' )
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/+ lail hest
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5+ 3assi#e Cematothorax
"ila D 1500 cc
initial!
"ila D 200 cc*$am
3aniestasi : - "reathin'- irculation
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5+ 3assi#e Cematothorax
Tindakan :
hest Tue"ila massi#e : torakotomi
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4+ Tamponade 7antun'
1+;istensi ena
&eher
2+"unyi 7antun'
7auh
.+Eadi kecil-cepat
3aniestasi : irculation syok )!
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4+ Tamponade 7antun' : Tindakan
Percardiocentesis
pasan' ?
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Potensial men'ancam nya(a
temukan pada secondary sur#ey!
Serin' :+raktur >'a
+Pneumothorax 6 simple+Cemothorax ukan masi!+
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raktur >'araktur >'a::+Satu / ,e,erapa i&a- ,iasan*a
ti%ak ,er,a)a*a+Ber,a)a*a ,i(a :
Pa%a ran& usia (anut
pneumnia1
Bi(a %isertai kntusi paru+$i%ak memer(ukan tin%akan
seperti p(ester %((1+Bi(a san&at n*eri intersta(
,(k
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Pneumothorax sederhana
$ertutup
$rauma / nn traumaBi(a trauma serin& a%a
!raktur I&a
$er,uka
$rauma taam / tumpu(
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Pneumothorax sederhana
mun&kin sesak /
ti%ak sesakter%eteksi pa%a
pem.!isik %an 3+traksti%ak semua per(u
pemasan&an 45SD6
F
F
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Cemothorax ukan masi!
Terdeteksi pada pem+isik * F-toraksTidak semua perlu pipa toraks
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entilasi tamahan :
Ter'antun' keadaan-"reathin'-
-p,2
-p,2
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!erima
"asihPPGD/RSUDAM2009