tatalaksana luka bakar- ankes 2012.pptx

7/17/2019 tatalaksana luka bakar- ankes 2012.pptx

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Dr. Widi Yuli Harianto

Tata laksanaLuka Bakar


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Menjelaskan prosedur penatalaksanaanluka bakar thermis, kimia dan listrik

Tujuan:


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Severity Klasifkasi Luka Bakar Emergency Medical Care Luka Bakar Kimia

Luka Bakar Listrik Dressing and Bandaging Trauma Inhalasi

Overview:


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Ditentukan oleh:

- derajat kedalaman

- luas

- critical areas yang terkena

- medical condition atau trauma

- umur pasien

SeverityLuka Bakar


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Derajat Kedalaman (Grade)Luka Bakar:

Derajat kedalaman(Grade)

Struktur yg terkena Gejala dan Keluhan

rade I!"uperf#ial Burns$

Han%a men&enailapisan atas kulit

!epidermis$

-Hiperemi-'%eri (-

Bullae )

rade II!*artial Thi#knessBurns$

Men&enai epidermisdan seba&ian dermis

-)lembab, mottled,kulit merah + memutih-) '%eri ((-)Bullae (

rade III

!ull Thi#kness Burns$

Men&enai seluruh

lapisan kulit

))) kerin&

))) putih-#oklattua-hitam)))#harred))) tdk n%eri


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DERMIS

EPIDERMIS

Gr I

Gr IIA

Gr IIB

Gr III


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Partial Thikness Burns


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!ull Thikness Burns


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Ditentukan olehpercentage!$ dari body area%an& terbakar

Telapak tan&an pasien ( / 0rule o1 nines2 dari Walla#e

Luas Luka Bakar


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Memba&i tubuh menjadi beberapa ba&ian Di&unakan untuk men&kalkulasi

permukaan tubuh %an& terbakar

"ule o# nines o# $allae


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B3DY *45T 4D6LT 7HILD Head 8 'e#k 9 /: 4rms 9 !;$ 9 !;$ ront 8 Ba#k /: !;$ /: !;$

Le&s /: !;$ /


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Rule of Nines(Wallace)


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Meliputi critical areas !>ajah, upper airway, hands, &enitalia$

*re e?istin& medi#al #onditions

Lokasi Luka Bakar

DM

py. Cardiopulmonum

!an!!uan psikia"rik dll


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@ /A tahun =A tahun

#mur $asien


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major burns moderate burns

minor burns

SeverityLuka Bakar& di'agi

menjadi:


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Deasaajor Burns oderate

BurnsinorBurns

LB &r II;= LB &r II /=);= LB &r II @/=

LB &r III/A LB &r III ;)/A!C$

LB &r III @;

LB men&enai mata, telin&a,

>ajah, tan&an, kaki atauperineum %an& men&akibatkan&an&&uan kosmetik atau 1un&si

Electrical burns

LB disertai trauma inhalasi

LB disertai 0underlying diseases2

Chemical burns

LB disertai trauma pen%erta lain% &anpa resiko !!n fun!si a"au kosme"ik pada ma"a "elin!a 'aa "an!an kaki a"au perine


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*sia +, th dan . /th

ajor Burns oderate Burns inor Burns

LB &r II ;A LB &r II /A);A LB &r II @ /A

LB &r III /A LB &r III ;)/A !C$ LB &r III @ ;

Lainn%a de>asa

% &anpa resiko !!n fun!si a"au kosme"ik pada ma"a "elin!a 'aa "an!an kaki a"auperineum


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*asien De>asa

Stop the burning process0 egah edera l'h lanjut

Bahan isolator onitor airway1 'eri 23 4egah kontaminasi le'ih

lanjut

Emergency Medical Care


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Indikasi M5"E semua derajat III

Major Burns dan Moderate Burns

Indikasi poliklinis !ra>at jalan$E Minor Burns !ke#. Derajat III$

Luka Bakar


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Selimuti dengan 'ahankering 0 5steril6

No ointments lotion orantiseptic

!o not brea" blisters Transport 7S7P

8mergeny edial 4are


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*asien *ediatrik Greater surface area in relationship to the total

body size

luid and heat loss

5isk o1 sho#k, air>a% and h%pothermia F

Consider child abuse

8mergeny edial 4are


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Transport ) Gscoop and run

Pasien Pediatrik


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Disebabkan karena adan%a kontak kulitden&an bahan toksik

Luka Bakar Kimia


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Disebabkan oleh alkali, asam dan#ampuran

*rote#t %oursel1 1rom e?posure or injur%

Luka Bakar Kimia


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"top the burnin& pro#ess

(,) 9mmediately ush ith

large amounts o# ater (3) Do not ontaminateuninjured areas

(;) 4ontinue ushinghile enroute to hospital

Luka Bakar Kimia Emergency

Care


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!$ 7oJer >ith dr% sterile dressin& or#lean sheet

!=$ "pe#ial #are o1 the e%es

Gently


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5ea#tion >ith >ater #an >orsen burn

(,) =Brush - then ush> (3) "emo?e ?itims

lothing (shoes 0 soks)

Dry hemials


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"#ene "a1et% Do not ontat high ?oltageires

4onsider all ires li?e Do not handle don lines Do not ome in ontat ith

patient i# the eletrial soureis li?e

Luka Bakar Listrik


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Ma% be more serious than it seems ntr% >ound is usuall% a small burn area Look 1or an e?tensiJe e?it >ound *ossible tissue dama&e underneath !#urrent

spreads out as it traJels throu&h the bod%$

8mergeny edial 4are


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*ossible 7ardia# arrest *ossible 5espirator% arrest

"plint possible 1ra#turesTreat >ounds >ith a dr%, sterile dressin&Transport

8mergeny edial 4are

ont:


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Treat an% major #ompli#ations frst

8letrial Burns


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ntr% >ound on head ?it >ound on 1oot

8letrial 9njuries

Luka Masuk Luka *eluar


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"top bleedin& *rote#t >ound 1rom 1urther dama&e *reJent 1urther #ontamination and in1e#tion

Dressing and Bandaging


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7hemi#al 1umes

2'?ious #umes in the air 9nhaled #umes

Trauma 9nhalasi


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Deadl% poison

4ar'on ono@ide (42)


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Dierent than smoke inhalation

2dorless

Tasteless %ot an irritant

4ar'on ono@ide


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a. D%spnea !di#ult% in breathin&$ b. 5espirator% arrest #. 7herr% red skin

Signs and symptoms


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Burnt almonds D%spnea !di#ult% in breathin&$ 5espirator% arrest

4yanide

Signs and Symptoms


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a. /AA o?%&en throu&h a non)rebreathin&mask

b. Be prepared to do basi# li1e support #. Transport

Treatment


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ormula Ba?ter De>asa

## ? luas LB ? k& BB N.....## lar. 5L

diberikan E O ba&ian pada : jam I

O ba&ian pada/P jam berikutn%adiberikan lar. koloid =AA)/AAA## pd jam ke /:);

Pem'erian airan pada LukaBakar

Pem'erian airan pada Luka


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ormula !modifkasi$ Ba?ter 4nak

;## ? luas LB ? k& BBN...## lar. 5L

diberikanE O ba&ian pada : jam I

O ba&ian pada /P jam berikutn%a larutan koloid /QE< !sejak jam ke)A$

Hari berikutn%a diberikan #airan maintenan#e

Pem'erian airan pada LukaBakar

tatalaksana luka bakar- ankes 2012.pptx

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