penanganan cedera thorax

8/18/2019 Penanganan Cedera Thorax

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LIZA KHAIRUNNISA

04124705098Penanganan Cedera Thorax

A A!r"a# $ %a&an Na'a( )• L!ha* ada (+,-a*an a*a+ *!da.• %a" *hr+(* a*a+ /h!n &!'* da a* d!g+na.an

%a" *hr+(* ,endorong rahang d!&a.+.an dengan /ara,e,egang (+d+* rahang -a"ah $ang+&+( ,and!-+&ae) dan,endorong rahang -a"ah .e de anCh!n &!'* d!&a.+.an dengan /ara ar! e,ar! (a&ah (a*+ *angan

d!&e*a..an d!-a"ah rahang .e,+d!an (e/ara ha*!3ha*! d!ang.a*.ea*a( arah de an I-+ ar! *angan #ang (a,a dengan r!ngan,ene.an -!-!r -a"ah +n*+. ,e,-+.a ,+&+* I-+ ar! +gada a* d!&e*a..an d! -e&a.ang g!g! (er! -a"ah dan (e/ara-er(a,aan ,engang.a* dag+ dengan ha*!3ha*!

an+ er /h!n &!'* *!da. -o&eh ,en#e-a-.an h! ere.(*en(!&eher *er+*a,a ada ender!*a *ra+,a dengan .e,+ng.!nan,enga&a,! a*ah *+&ang &eher #ang d!*anda! dengan 6

Adan#a e a( a*a+ er&+.aan d!a*a( .&a !.+&aAdan#a *ra+,a .e a&a d!(er*a! en+r+nan .e(adaran

+&*! &e *ra+,a!o,e.an!. ,end+.+ng

• Pe,a(angan C3( !ne .on*ro& !.a .e,+ng.!nan adan#a /edera&eher a a* +&a dengan ,engg+na.an .ed+a *angan a*a+ aha

eno&ong $ !.a eno&ong &e-!h dar! 1 orang)• Pada .or-an #ang ,a(!h da a* -er-!/ara d!angga a!r"a# *!da.

ada (+,-a*an• Pada .or-an #ang *!da. ,enge&+ar.an (+ara a*a+ *!da. (adar 6

Loo. ,e&!ha* &ang(+ng .e rongga ,+&+* ada a*a+ *!da.n#a(+,-a*an ada a&an na'a(L!(*en ,endengar.an (+ara na'a( ada *!da.n#a (nor!ng a*a+

g+rg&!ngee& ,era(a.an dengan ! ! a*a+ +ngg+ng *angan adan#a

he,-+(an na'a( dar! .or-an• %!.a ada (+,-a*an 6

:+rg&!ng .arena /a!ran $darah (e/re* a( !ra(! &a,-+ng)(+/*!on a*a+ .a(aSnor!ng .arena &!dah *er a*+h .e -e&a.ang g+ede& a!r"a#a*a+ oro'ar!ngea& a!r"a#S*r!dor .arena en#e, !*an d! &ar!ng a*a+ *ra.ea er-a!.ana!r"a# d!(*a& *ra.eo(*o,#

• %!.a ,a(!h -e&+, -erha(!& d!&a.+.an


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Kr!/o*!ro!do*o,# ,e,-+a* a&+r en*!&a(! -ar+ d! daerah*enggoro.an d!an*ara *+&ang .r!.o!d dan *!ro!d engan

,engg+na.an ar+, a&!ng -e(ar #ang ada d! ,!d&!ne a*a( o(.r!/o!dKa&o d! -edah a!r"a# de;n!*! e , -er! B2

Se*e&ah d!-er! B2 ,a(!h ngoro. e,a(angan


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• !&a.+.an need&e de/o, re(! > need&e *hora/o(!n*e(!(

,eng+-ah *en(!on ,en ad! (!, &e ne+,o*horaxDChe(* *+-e -+*+h "a.*+D

ICS 2 &!nea ,!d/&a !/+&a ,engh!ndar! ar*er! !n*er/o(*a&!(Pr!n(! need&e de/o, re(! (+dah a,an ad! ,en+ngg+

ere(*+ +an .e&+arga *!da. ,a(a&ah• < a&+a(! &ag! /e. RR dan P *!da. ada ,a(a&ah• Per(!a an /he(* *+-e

• In'or,ed /on/en* /he(* *+-eERen/anan#a (a#a a.an ,e,a(ang (e&ang d! dada agar +dara.e&+ar $!nd!.a(! *en(!on dan he,o ne+,o*horax)FD.e,+ng.!nan *erda a* .o, &!.a(! -!(a *er.ana e,-+&+hdarah !.a *er ad! ,a.an a.an d!&a.+.an &!ga(!D

• Per(!a an• A&a* 6

3 L!do/a!n 53= a, +& a(e *!/ an*!(e *!/3 oe. (*er!& hand(/oon ,e(h /&a, (e&ang>*hora/a&

*+-e>N:T $de"a(a 283@2 ana.3ana. 24 -a#! 20)(+/*!on -enang

3 o*o& GS d!!(! a!r 503100 // 1 (e&ang ,en+ + ar+ ,a(+. .e a!r agar +dara #ang.e&+ar *!da. ,a(+. &ag! .e ar+

1 (e&ang *ergan*+ng *!da. (a, a! ,a(+. .e a!r(e-aga! en*!&a(! d!h+-+ng.an dengan (+/*!on+dara *erh!(a ro-e.an ,en+*+ (end!r! !.a gaga&d!&a.+.an *hora/o(*o,#

• B era*or• Pa(!en $ o(!(! (e*engah d+d+.)

• Pe,a(angan /he(* *+-e• A(e *!/ an*!(e *!/• oe. (*er!&• Ane*e(!a $ ICS 5 a*a+ = .e .!r! .anan a*a( #ang en*!ng

.+&!*n#a)• In(!(! d! ICS 5 a*a+ = &!nea ,!dax!&ar!( an*er!or .!ra ? .!ra 53=

/,DICS 5 *er&e*a. (e*!ngg! !ga = $an*er!or) !ga 9 $&a*era&) !ga 12$ o(*er!or)D

• a(+..an *hora/a& *+-e>N:T *er-e(ar3 Ada &+-ang3&+-angn#a (e.!*ar 4 ar! -!a(an#a no =

• %ah!* 63 %ah!* ,a*ra( hor! on*a& (e&ang *!da. -o&eh *er ah!* *!da.

-o&eh (!, +& ,a*!3 S!, +& 1x &!&!*.an 132x (!, +& *a&! (e a*+ (+ a#a

,+dah d!-+.a


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3 T+*+ dengan (o'ra*+& dan .a(a• Sa,-+ng.an (e&ang .e GS• L!ha* +&ang RR PR dan P

• Pen!&a!an• arah !n!(!a& Pne+,o*horax $3)

arah *er&!ha* d! ron*gen !.a (+dah ,en/a a! @00 //nor,a&n#a /a!ran &e+ra *!da. *er&!ha*

• Und+&a(! Tanda !n(! ra(! $a!r *+r+n) dan e.( !ra(! $a!r na!.)Und+&a(! ,en+n +..an o(!(! -a!. + +ng (e&ang ada d! /a +,

&e+raD/a +, &e+ra *er-ag! !(/era& $,en#era /a!ran &e+ra) dan

ar!e*a&!( $,e, rod+.(! /a!ran &e+ra 1 L>har!)• A!r -+-&e d!&!ha* (aa* !n( !ra(! (a, a! (aa* ar+

,enge,-ang !.a *er+(3*er+(an d!(e-+* /on*!n+o+( a*a+re( !ra*or# -+-&eA!r -+-&e ,enanda.an adan#a +dara d! /a +, &e+ranor,a&n#a ada (e-en*ar (aa* ar+ ,enge,-ang .e,+d!anh!&ang

• /on*!n+o+( -+-&e ,enanda.an adan#a ro-e.anar!e*a& !(/era& $ aren.!, ar+)

%!.a ro-e.an .e/!& -!a(an#a ,en+*+ (end!r! !.a *er ad!/on*!n+o+( -+-&e ,a.a (+/*!on d!(a,-+ng.an dengan (e&ang#ang ,enggan*+ng dan har+( .eda

• Prod+.(! ,enen*+.an !nd!.a(! *hora/o*o,#In!(!a& -&ood J 500 // a*a+ 200//> a, (e&a,a 4 a, er*a,a$he,o*horax ,a((! e)

erda(ar.an 150//> a, (e&a,a @ a,• 23@ har! -e&+, ,engh!&ang

• Ga&a+ +n (+dah d!-er! ane(*e(! dada a.an *e*a (a.!* (aa* ar+-er.e,-ang ,a(+..an -o&+( I

• !a(an#a .on(+& rad!o&og! +n*+. ,e&!ha* &e*a. (e&ang$.e an angan a*a+ .e ende.an) dan enge,-angan ar+

3 Thora/a& *+-e arahn#a .e a*a( .a&o .e -a"ah d!(e-+*.!ng.!ng a*a+ *er&! a*

DKo, &!.a(! d! -a"ah .+&!* e,;(e,a -aha#a -!&a ,en#e-a-.anene.anan -+&&a ne/.D

C C!r/+&a*!on• L!ha* PR dan P• AP $2S @ )>@• arah =37


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• Ca!ran 16@ /a!ran .r!(*a&o!d /e a* .e&+ar o&+,e!n*ra a(/+&ar (anga* d!-+*+h.an RL 1>@ #ang han#a -er*ahan

Ke&a( I Ke&a( II Ke&a( III Ke&a( IKeh!&angandarah $,L)

Sa, a! 750 75031500 150032000 J2000

Keh!&angandarah $

o&+,edarah)

Sa, a! 15 153@0 @0340 J40

en#+* nad! M100 J100 J120 J140

Te.anandarah Nor,a& Nor,a& en+r+n en+r+n

Te.anan nad! Nor,a& a*a+na!.

en+r+n en+r+n en+r+n

re.+en(!na'a(

14320 203@0 @0340 J@5

Prod+.(! +r!n$,L> a,)

J@0 203@0 5315 T!da. -erar*!

CNS>S*a*+(,en*a&

Sed!.!*/e,a(

Aga. &e,a( Ce,a(-!ng+ng

!ng+ng&e(+$&e*harg!/)

Penggan*!an/a!ran$H+.+, @61)

Kr!(*a&o!d Kr!(*a&o!d Kr!(*a&o!ddan darah

Kr!(*a&o!ddan darah

• S#o. dera a* I ,a.an dan ,!n+, -!a(a• S#o. dera a* II .o/or RL 2L (e.a&! -!(a d!+&ang $&!a* .&!n!()

o er&oad de/o, en(a(! a*a+ -!(a +ga 1500 RL dan 500.o&o!d $ h! er*on!. /a!ran !n*er(*!*!a& d!*ar!. &a,a dan!n*ra a(a(! de'e. d!*+*+ ar*!.e&>.o&o!d)

• S#o. dera a* III gan*! darah• Pada a(!en /edera a-do,en (+rg!/a& re(+(!*a(!

S#o. ,on!*or dengan +r!ne o+* +* 0 531 //>.g > a,Pe,er!.(aan a&!ng /e a* a.ra& ,en ad! d!ng!n

!(a-!&!*#N!&a! :CS

<


6/9

Cedera Thorax L!'e Threa*en!ng1 Ten(!on Pne+,o*horax

Ten(!on ne+,o*horax -er.e,-ang .e*!.a *er ad! one "a#a& e$'eno,ena en*!&) .e-o/oran +dara #ang -era(a& dar! ar+3ar+ a*a+ dar! &+ar ,e&a&+! d!nd!ng dada ,a(+. .e da&a, rongga&e+ra dan *!da. da a* .e&+ar &ag! $one "a# a& e) A.!-a* +dara

#ang ,a(+. .e da&a, rongga &e+ra #ang *!da. da a* .e&+ar &ag!,a.a *e.anan d! !n*ra &e+ra& a.an (e,a.!n ,en!ngg! ar+3 ar+,en ad! .o&a ( ,ed!a(*!n+, *erdorong .e (!(! -er&a"anan dan,engha,-a* enge,-a&!an darah ena .e an*+ng $ eno+( re*+rn)(er*a a.an ,ene.an ar+ .on*ra&a*era&

Pen#e-a-• Ko, &!.a(! engg+naan en*!&a(! ,e.an!. $ en*!&a*or) dengan

en*!&a(! *e.anan o(!*!' ada ender!*a #ang ada .er+(a.anada &e+ra !(/era&

• Ko, &!.a(! dar! ne+,o*horax (ederhana a.!-a* /edera *horax*e,-+( a*a+ *a a, dengan er&+.aan aren.!, ar+ #ang *!da.,en+*+ a*a+ (e*e&ah (a&ah arah ada e,a(angan .a*e*er(+-.&a !a (a*a+ ena +g+&ar!( !n*erna

• e'e. a*a+ er&+.aan ada d!nd!ng dada !.a (a&ah /ara,en+*+ de'e. a*a+ &+.a *er(e-+* dengan e,-a&+* .eda+dara $o//&+(! e dre((!ng() ,e.an!(,e .a*+ $ a a& e)

• ra.*+r *+&ang -e&a.ang *horax #ang ,enga&a,! erge(eran$d!( &a/ed *hora/!/ ( !ne 'ra/*+re)

!agno(!(• !*ega..an (e/ara .&!n!( *!da. -o&eh *er&a,-a* .arena

,en+ngg+ .on;r,a(! rad!o&og!(• N#er! dada (e(a. #ang -era* d!(*re(( erna'a(an *a.!.ard!

h! o*en(! de !a(! *ra.ea h!&angn#a (+ara na'a( ada (a*+ (!(!dan d!(*en(! ena &eher

• an!'e(*a(! &an +* (!ano(!(

2 He,o*horax ,a((! e Ter.+, +&n#a +dara dan /a!ran d! (a&ah (a*+ he,!*horax da a*,en#e-a-.an gangg+an +(aha -erna'a( a.!-a* ene.anan ar+3


7/9

ar+ dan ,engha,-a* en*!&a(! #ang ade.+a* Perdarahan #ang-an#a. dan /e a* a.an ,e, er/e a* *!,-+&n#a (#o.

He,o*horax ,a((! e #a!*+ *er.+, +&n#a darah dengan /e a* &e-!hdar! 1500// d! da&a, rongga &e+ra dan a*a+ 200//> a, (e&a,a 234

a, $ -!a(an#a @ a,) a*a+ @35//>.g > a, %!.a 1 a, er*a,a rod+.(! 500// ,a.a &ang(+ng d!&a.+.an*hora/o*o,#

Pen#e-a-• L+.a *e,-+( #ang ,er+(a. e,-+&+h darah (!(*e,!. a*a+

e,-+&+h darah ada h!&+( ar+• Cedera *+, +&

He,o*horax ,a((! e .eh!&angan darah h! o o&e,!a -era*ena &eher da a* .o&a ( $ a*) *e*a ! .adang d!*e,+.an d!(*en(! ena

&eher !.a d!(er*a! *en(!on

!agno(!(• !*ega..an dengan adan#a (#o. #ang d!(er*a! dengan (+ara

na'a( ,engh!&ang dan er.+(! e.a. ada (!(! dada #ang

,enga&a,! *ra+,a

Tera ! a"a&• Penggan*!an o&+,e darah #ang d!&a.+.an -er(a,aan dengan

e,a(angan /he(* *+-e no @8 ren/h &a&+ de.o, re(! rongga&e+ra (e/e a*n#a

• !,+&a! dengan !n'+(e /a!ran .r!(*a&o!d dan .e,+d!an e,-er!andarah dengan go&ongan ( e(!;. (e/e a*n#a

• Ke*!.a .!*a ,en/+r!ga! he,o*horax ,a((! e er*!,-ang.an +n*+.,e&a.+.an a+*o*ran('+(! $ darah rongga &e+ra da a*

d!.+, +&.an da&a, ena, +ngan #ang /o/o. +n*+.a+*o*ran('+(!)

Ke +*+(an *ora.o*o,# -!&a d!da a*.an .eh!&angan darah *er+(,ener+( (e-an#a. 200//> a, da&a, "a.*+ 234 a, *e*a ! (*a*+(;(!o&og! ender!*a *e*a d!+*a,a.an Tran('+(e darah (anga*d! er&+.an (e&a,a ada !nd!.a(! +n*+. *hora/o*o,#

L+.a *e,-+( *horax d! daerah an*er!or ,ed!a& dar! gar!( +**!ng (+(+a*a+ &+.a d! o(*er!or ,ed!a& dar! (/a +&a har+( d! er*!,-ang.an

.e,+ng.!nan d! er&+.ann#a *hora/o*o,# o&eh .arena .e,+ng.!nan


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,e&+.a! e,-+&+h darah -e(ar (*r+.*+r h!&+( a*a+ an*+ng #ango*en(!a& ,en ad! *a, onade an*+ng

@ Ta, onade an*+ngSer!ng d!(e-a-.an o&eh &+.a *e,-+( "a&a+ +n de,!.!an /edera*+, +& +ga da a* ,en#e-a-.an er!/ard!+, *er!(! darah -a!. dar!

an*+ng e,-+&+h darah -e(ar ,a + +n dar! e,-+&+h daraher!/ard!+,

!agno(!(!agno(!( .&a(!. ada&ah adan#a *r!a( -e/.

1 Pen!ng.a*an *e.anan ena2 Pen+r+nan *e.anan ar*er!@ S+ara an*+ng ,en a+h

• Pen!&a!an (+ara an*+ng ,en a+h (+&!* d!*e,+.an -!&a I: -er!(!.• !(*en(! ena &eher *!da. d!*e,+.an .arena h! o o&e,!a• H! o*en(! (er!ng d!(e-a-.an .arena h! o o&e,!a• P+&(+( aradox+( ada&ah .eadaan ;(!o&og!( d!,ana *er ad!

en+r+nan dar! *e.anan darah (!(*o&!. (e&a,a !n( !ra(! ( on*an!&a en+r+nan *er(e-+* J 10 ,,Hg ,a.a !n! ,er+ a.an *anda

&a!n *er ad!n#a *a, onade an*+ng %!.a *erda a* *en(!on ada (!(! .!r! ,a.a a.an (a,a dengan

*a, onade an*+ng• Tanda K+((,a+& $ en!ng.a*an *e.anan ena ada (aa* !n( !ra(!

-!a(a) ada&ah .e&a!nan arado.(a& #ang (e(+ngg+hn#a dan,en+n +..an adan#a *a, onade an*+ng

• P


9/9

• Pe,-er!an /a!ran !n'+(e a"a& .arena a.an da a* ,en!ng.a*.an*e.anan ena dan CB +n*+. (e,en*ara

• Per!/ard!o(!n*e(!( ,e&a&+! (+-(!'o!d Pada *!nda.an !n!engg+naan &a(*!/3(hea*ed need&e a*a+ !n(er(! dengan *e.n!.

Se&d!nger ,er+ a.an /ara a&!ng -a!. *e*a ! da&a, .eadaan#ang &e-!h ga"a* r!or!*a( ada&ah a( !ra(! darah dar! .an*+ng

er!.ard• on!*or!ng

penanganan cedera thorax

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