View
287
Download
9
Category
Preview:
Citation preview
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
1/38
LUKA BAKARLUKA BAKAR
( COMBUSTIO )( COMBUSTIO )Dr. Syahrifl Syahar,Sp B.Dr. Syahrifl Syahar,Sp B.
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
2/38
PENDAHULUANPENDAHULUAN
Lua !aar a"#a M$r!i%i&a' %a"Lua !aar a"#a M$r!i%i&a' %a"M$r&ali&a' &i"##i M$r&ali&a' &i"##i
RSUPN CM (**+) -,-+RSUPN CM (**+) -,-+
RSU Dr.S$/&$0$ (1222) 13,4RSU Dr.S$/&$0$ (1222) 13,4
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
3/38
5ASE LUKA BAKAR5ASE LUKA BAKAR
1.FASE AKUT/FASE SYOK/FASE AWAL1.FASE AKUT/FASE SYOK/FASE AWAL
- Kejadian/IRD- Kejadian/IRD
- Problem Pernaa!an- Problem Pernaa!an
- L"#a- L"#a
$.FASE SU%AKUT$.FASE SU%AKUT
-Dalam &era'a(an-Dalam &era'a(an
-Problem l"#a)ine#!i)!e&!i!-Problem l"#a)ine#!i)!e&!i!
*.FASE LA+,UT*.FASE LA+,UT
-Se(ela beroba( jalan-Se(ela beroba( jalan -Problem &ar"() #on(ra#("r-Problem &ar"() #on(ra#("r
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
4/38
PEN6EBAB LUKA BAKARPEN6EBAB LUKA BAKAR
.. ApiApi
1.1. Air pa"a'Air pa"a'
.. Baha" i0iaBaha" i0ia4.4. Li'&ri,p/&ir,ra%ia'iLi'&ri,p/&ir,ra%ia'i
7.7. S/"#a&a" 'i"ar 0a&ahariS/"#a&a" 'i"ar 0a&ahari
3.3. L/%aa" &u"#u pa"a'L/%aa" &u"#u pa"a'-.-. L/%aa" B$0L/%aa" B$0
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
5/38
DERA8AT KEDALAMAN LUKADERA8AT KEDALAMAN LUKABAKARBAKAR
.. LUKA BAKAR DERA8AT ILUKA BAKAR DERA8AT I
9 Epi%/r0i'9 Epi%/r0i'
1.1. LUKA BAKAR DERA8AT IILUKA BAKAR DERA8AT II9 D/ra:a& IIA 'up/rf'ial 9 D/ra:a& IIA 'up/rf'ial
Sup/rf'ial %/r0i'Sup/rf'ial %/r0i'
Or#a" $r#a" uli& 0a'ih !aiOr#a" $r#a" uli& 0a'ih !aiP/"y/0!uha" Sp$"&a" 294 hariP/"y/0!uha" Sp$"&a" 294 hari
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
6/38
9 DERA8AT IIB (%//p)9 DERA8AT IIB (%//p) Ha0pir '/luruh !a#ia" %/r0i'Ha0pir '/luruh !a#ia" %/r0i'
Or#a" $r#a" uli& '/!a#ia" !/'arOr#a" $r#a" uli& '/!a#ia" !/'ar0a'ih u&uh0a'ih u&uh
P/"y/0!uha" l/!ih %ari !ula"P/"y/0!uha" l/!ih %ari !ula"
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
7/38
. LUKA BAKAR DERA8AT III. LUKA BAKAR DERA8AT III
Sa0pai $&$&;&ula"#Sa0pai $&$&;&ula"# Ti%a "y/ri %a" hila"# '/"'a'iTi%a "y/ri %a" hila"# '/"'a'i
T/r:a%i $a#ula'i pr$&/i" ESKART/r:a%i $a#ula'i pr$&/i" ESKAR
P/"y/0!uha" l/!ih la0aP/"y/0!uha" l/!ih la0a
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
8/38
LUAS LUKA BAKARLUAS LUKA BAKAR
A.
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
9/38
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
10/38
KRITERIA BERAT RIN=ANN6AKRITERIA BERAT RIN=ANN6A(AMERICAN BURN ASSOCIATION)(AMERICAN BURN ASSOCIATION)
. Lua !aar ri"#a". Lua !aar ri"#a"
9 LB %/ra:a& II > 79 LB %/ra:a& II > 7
9 LB %/ra:a& II > 2 pa%a a"a a"a9 LB %/ra:a& II > 2 pa%a a"a a"a
9 LB %/ra:a& III > 9 LB %/ra:a& III >
1. Lua !aar '/%a"#1. Lua !aar '/%a"#
9 LB %/ra:a& II 7917 ( D/?a'a)9 LB %/ra:a& II 7917 ( D/?a'a) 9 LB %/ra:a& II 2912 ( A"a a"a )9 LB %/ra:a& II 2912 ( A"a a"a )
9 LB %/ra:a& III > 29 LB %/ra:a& III > 2
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
11/38
. Lua !aar !/ra&. Lua !aar !/ra&
9 LB %/ra:a& II @ 17 ( D/?a'a ) LB9 LB %/ra:a& II @ 17 ( D/?a'a ) LB
9 D/ra:a& II @ 12 ( A"a a"a )9 D/ra:a& II @ 12 ( A"a a"a )
9 LB %/ra:a& III @ 29 LB %/ra:a& III @ 29 LB 0/"#/"ai9 LB 0/"#/"ai
&a"#a",?a:ah,&/li"#a,0a&a&a"#a",?a:ah,&/li"#a,0a&a
, ai %a" #/"i&alia;p/ri"/u0., ai %a" #/"i&alia;p/ri"/u0.
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
12/38
PENATALAKSANAANPENATALAKSANAANPENDERITA LUKA BAKARPENDERITA LUKA BAKAR
5ASE AKUT5ASE AKUT
I. PRIMAR6 SURE6I. PRIMAR6 SURE6
A. Air?ay %a" /rial 'pi"/ pr$&/'iA. Air?ay %a" /rial 'pi"/ pr$&/'i B. Br/a&hi"# %a" /"&ila'iB. Br/a&hi"# %a" /"&ila'i
C. Cirula'i %a" $"&r$l p/r%araha"C. Cirula'i %a" $"&r$l p/r%araha"
D. Di'a!ili&y p/0/ri'aa"D. Di'a!ili&y p/0/ri'aa""/ur$l$#i'."/ur$l$#i'.
E. Ep$'ur/E. Ep$'ur/
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
13/38
II. SECONDAR6 SURE6II. SECONDAR6 SURE6
a. A"a0"/'aa. A"a0"/'a
B. P/0/ri'aa" f'i ( /pala9 ai )B. P/0/ri'aa" f'i ( /pala9 ai )
C. Pri"'ip p/"a"#a"a"C. Pri"'ip p/"a"#a"a"
. H/"&ia" p/"y/!a! LB. H/"&ia" p/"y/!a! LB
1. U"i/r'al pr/au&i$",HI,h/pa&i&i'.1. U"i/r'al pr/au&i$",HI,h/pa&i&i'.
. R/'u'i&a'i aira". R/'u'i&a'i aira"
194 RL BB Lua' LB194 RL BB Lua' LB
4. i&al 'i#"4. i&al 'i#"
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
14/38
7. P/0a'a"#a" N=T7. P/0a'a"#a" N=T
3. P/0a'a"#a" uri"/ a&/&/r3. P/0a'a"#a" uri"/ a&/&/r
-. A''/''0/"& p/rFu'i /'&r/0i&a'-. A''/''0/"& p/rFu'i /'&r/0i&a'+. C$"&i"u/% /"&ila&$ry a''/''0/"&+. C$"&i"u/% /"&ila&$ry a''/''0/"&
*. Pai"& 0a"a#/0/"&*. Pai"& 0a"a#/0/"&
2. P'y$'$ial a''/''0/"&2. P'y$'$ial a''/''0/"&. P/0!/ria" T/&a"u' T$$i%. P/0!/ria" T/&a"u' T$$i%
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
15/38
1. Ti0!a"# !/ra& !a%a"1. Ti0!a"# !/ra& !a%a". PENCUCIAN LUKA DI KAMAR. PENCUCIAN LUKA DI KAMAR
OPERASI ( Biu' T$&al ) OPERASI ( Biu' T$&al )
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
16/38
PERA
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
17/38
PEMERIKSAAN LABORATORIUMPEMERIKSAAN LABORATORIUM
.H&,HB.H&,HB1.Al!u0i"1.Al!u0i"
.R5T,L5T.R5T,L5T
4.El/&r$li&,Na,K,CL,HCO4.El/&r$li&,Na,K,CL,HCO7.BUN,Uri"ali'a,AB=7.BUN,Uri"ali'a,AB=
3.5$&$ &h$ra3.5$&$ &h$ra-.Car!$y h/0$#l$!i"-.Car!$y h/0$#l$!i"+.EC= ( Trau0a li'&ri )+.EC= ( Trau0a li'&ri )
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
18/38
RESUSITASI CAIRANRESUSITASI CAIRAN
5$r0ula Ea"'5$r0ula Ea"'
5$r0ula Br$$/5$r0ula Br$$/
5$r0ula Parla"%5$r0ula Parla"%M$%ifa'i Br$$/M$%ifa'i Br$$/
5$r0ula M$"aF$5$r0ula M$"aF$
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
19/38
5ORMULA BATER5ORMULA BATER
ari Per(ama ari Per(ama
De'a!a RL 0 2 %% 2 3 l"a! L%/$0 jamDe'a!a RL 0 2 %% 2 3 l"a! L%/$0 jam
Ana# RL De2(ran 4 15 *Ana# RL De2(ran 4 15 *
$ 2 %% 2 3 l"a! L% 6$ 2 %% 2 3 l"a! L% 6
Keb"("an Faali Keb"("an Faali
7 1 (a"n %% 2 188 7 1 (a"n %% 2 188
1 9 * (a"n %% 2 5: 1 9 * (a"n %% 2 5:
* - : (a"n %% 2 :8 * - : (a"n %% 2 :8
; ,"mla airan diberi#an dalam < jam &er(ama; ,"mla airan diberi#an dalam < jam &er(ama; Diberi#an 1= jam beri#"(n>a; Diberi#an 1= jam beri#"(n>a
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
20/38
MONITORIN= RESUSITASIMONITORIN= RESUSITASICAIRANCAIRAN
. Pr$%u'i uri"/;:a0.. Pr$%u'i uri"/;:a0. D/?a'a 2,7 ;#!!;:a0(2972 ;:a0)D/?a'a 2,7 ;#!!;:a0(2972 ;:a0)1. Oli#uria1. Oli#uria
. Ha/0$hr$0$#/"uria(R/% pi#0/"&/%9. Ha/0$hr$0$#/"uria(R/% pi#0/"&/%9 Uri"/)Uri"/)4. Bl$$% pr/''ur/.4. Bl$$% pr/''ur/.
7. H/ar& Ra&/.7. H/ar& Ra&/.3. H& %a" H!.3. H& %a" H!.
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
21/38
TRAUMA INHALASITRAUMA INHALASI
P/"y/!a! P/"y/!a!
9 Trau0a pa"a' la"#'u"#9 Trau0a pa"a' la"#'u"#
9 K/rau"a" A'ap;#a' &$i9 K/rau"a" A'ap;#a' &$i
9 Car!$" 0$"$i%a9 Car!$" 0$"$i%a
Kli"i' Kli"i'
9 P/"uru"a" K/'a%ara"9 P/"uru"a" K/'a%ara"
9 Di'&r/' "aFa'9 Di'&r/' "aFa'
9 Tahip"/u9 Tahip"/u
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
22/38
PERNA5ASANPERNA5ASAN
U%ara pa"a'9999iri&a'i999/%/0a999U%ara pa"a'9999iri&a'i999/%/0a999$!'&ru'i$!'&ru'i
9999#a#al "aFa'.9999#a#al "aFa'.
EF/ &$i %ariEF/ &$i %aria'ap(H","$1,hl,!/"'i",a'ap(H","$1,hl,!/"'i",
999 iri&a'i 999 !r$"h$$"&ri'i 999 #a#al 999 iri&a'i 999 !r$"h$$"&ri'i 999 #a#al NaFa'.NaFa'.
CCO 9999 hip$'iaO 9999 hip$'ia
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
23/38
TIPE TRAUMA INHALASITIPE TRAUMA INHALASI
K/rau"a" COK/rau"a" CO
Trau0a i"hala'i %ia&a' #l$&i'Trau0a i"hala'i %ia&a' #l$&i'
Trau0a i"hala'i %i!a?ah #l$&i'Trau0a i"hala'i %i!a?ah #l$&i'=AMBAR.=AMBAR.
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
24/38
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
25/38
PENATALAKSANAANPENATALAKSANAAN
TANPA DISTRES PERNA5ASANTANPA DISTRES PERNA5ASAN
. I"&u!a'i. I"&u!a'i
1. O'i#/" 194 li&/r;0/"i&1. O'i#/" 194 li&/r;0/"i&. P/"#hi'apa" '/r/&. P/"#hi'apa" '/r/&
4. Hu0i%ifa'i %/"#a" N/!uliG/r;34. Hu0i%ifa'i %/"#a" N/!uliG/r;3
:a0:a07. Br$"h$%ila&$r.7. Br$"h$%ila&$r.
3. P/0a"&aua" %i'&r/' p/r"aFa'a".3. P/0a"&aua" %i'&r/' p/r"aFa'a".
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
26/38
=E8ALA;TANDA=E8ALA;TANDADISTRES PERNA5ASANDISTRES PERNA5ASAN
=/:ala 'u!:/&iF #/li'ah,'/'a "aFa'=/:ala 'u!:/&iF #/li'ah,'/'a "aFa'=/:ala $!:/&iF =/:ala $!:/&iF
9 RR 0/"i"#a& ( @ 2 ;0/"i& )9 RR 0/"i"#a& ( @ 2 ;0/"i& )
9 Sia"$&i9 Sia"$&i9 A&if&a' $&$& p/r"aFa'a" 0/"i"#a&A&if&a' $&$& p/r"aFa'a" 0/"i"#a&9
A"ali'a #a' %arahA"ali'a #a' %arah
-.Th$ra 5$&$.-.Th$ra 5$&$.
+. B/% $!'/ra'i %u%u; %u%u.+. B/% $!'/ra'i %u%u; %u%u.
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
27/38
DEN=AN DISTRESDEN=AN DISTRESPERNA5ASANPERNA5ASAN
.. Trah/$'&$0iTrah/$'&$0i
1.1. O'i#/" 19 4 li&/r ; 0/"i&O'i#/" 19 4 li&/r ; 0/"i&
.. Br$"hial ?a'hi"#.Br$"hial ?a'hi"#.4.4. Hu0i%ifa'i %/"#a" "/!uliG/rHu0i%ifa'i %/"#a" "/!uliG/r
7.7. Br$"h$%ila&$rBr$"h$%ila&$r
3.3. P/0a"&aua" %i'&r/' p/r"aFa'a"P/0a"&aua" %i'&r/' p/r"aFa'a"-.-. 5$&$ &$ra5$&$ &$ra
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
28/38
LUKA BAKAR LISTRIKLUKA BAKAR LISTRIK
K/ru'aa" :ari"#a" %i'/!a!a" K/ru'aa" :ari"#a" %i'/!a!a"
.. Aru' !$la !ali.Aru' !$la !ali.
9 K/ru'aa" l$al ; 'i'&/0i9 K/ru'aa" l$al ; 'i'&/0i1.1. L$"a&a" /"/r#i.L$"a&a" /"/r#i.
.. Tr$0!$'i'.Tr$0!$'i'.
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
29/38
PENAN=ANAN LUKA BAKARPENAN=ANAN LUKA BAKARLISTRIKLISTRIK
A.A. Pri0ary Sur/y.Pri0ary Sur/y.
B.B. S/$"%ary Sur/y S/$"%ary Sur/y
. P/0/ri'aa" 5i'i ( /pala9 ai ). P/0/ri'aa" 5i'i ( /pala9 ai )
1. Paaia" %a" p/rhia'a" %i!ua 1. Paaia" %a" p/rhia'a" %i!ua a. P/ri'a &i&i $"&aa. P/ri'a &i&i $"&a
!. E'&i0a'i lua' LB;D/ra:a& LB!. E'&i0a'i lua' LB;D/ra:a& LB
. S&a&u' N/ur$l$#i'. S&a&u' N/ur$l$#i' %. Trau0a lai", Fra&ur; %i'l$a'i%. Trau0a lai", Fra&ur; %i'l$a'i
/. ET/. ET
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
30/38
C. RESUSITASIC. RESUSITASI
.. Bila LB, RL 1 4 ;#!!; lua' LBBila LB, RL 1 4 ;#!!; lua' LB
1.1. Ha/0$hr$#/" ( 0y$#l$!i" ), uri"/Ha/0$hr$#/" ( 0y$#l$!i" ), uri"/
$u& pu& %ip/r&aha"a" -7 22 ;:a0,$u& pu& %ip/r&aha"a" -7 22 ;:a0,
'a0pai uri"/ :/r"ih.'a0pai uri"/ :/r"ih.
.. Bi.Na&. %i&a0!aha" %i%ala0 RLBi.Na&. %i&a0!aha" %i%ala0 RL'a0pai'a0pai
pH @ 3.2pH @ 3.2
4. Ma"i&$l :ara"#4. Ma"i&$l :ara"#
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
31/38
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
32/38
PATO=ENESIS LUKA BAKARPATO=ENESIS LUKA BAKAR
Pa%a lua !aar AR5 %apa& %i/#ahPa%a lua !aar AR5 %apa& %i/#ahara ara
. R/'u'i&a'i aira".. R/'u'i&a'i aira".
1. M/"/#ah i"F/'i.1. M/"/#ah i"F/'i.
. Hi"%ari $!a& $!a& N/Fr$&$'i.. Hi"%ari $!a& $!a& N/Fr$&$'i.
4. K$r/'i /l/&r$li& %a" /'/i0!a"#a"4. K$r/'i /l/&r$li& %a" /'/i0!a"#a"a'a0 %a" !a'aa'a0 %a" !a'a
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
33/38
INDIKASI DIALISAINDIKASI DIALISA
9 Ur/u0 @ 22 72 0#;%l9 Ur/u0 @ 22 72 0#;%l
9 Cr/a&i"i"/ @ + 2 0#;%l9 Cr/a&i"i"/ @ + 2 0#;%l
MODALITAS DIALISA MODALITAS DIALISA . H/0$%ialy'a.. H/0$%ialy'a.
1. K$"&i"yu1. K$"&i"yu
H/0$%ialy'a;H/0$fl&ra'i.H/0$%ialy'a;H/0$fl&ra'i.. P/ri&$"/al %ialy'a.. P/ri&$"/al %ialy'a.
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
34/38
S6STEMIC IN5LAMATOR6S6STEMIC IN5LAMATOR6RESPONSE S6NDROME ( SIRS )RESPONSE S6NDROME ( SIRS )
%a" MULTI9 'y'&/0 Or#a"%a" MULTI9 'y'&/0 Or#a"Dy'Fu"&i$" Sy"%r$0/Dy'Fu"&i$" Sy"%r$0/
SIRS SIRS
M/rupaa" r/'p$" li"i' !/r'iFa& 'i'&/0iM/rupaa" r/'p$" li"i' !/r'iFa& 'i'&/0i%a" /'a#/ra&iF &/rha%ap !/r!a#ai STIMULUS%a" /'a#/ra&iF &/rha%ap !/r!a#ai STIMULUSKLINIS !/ra& KLINIS !/ra&
JJ . I"F/'i . I"F/'i
9 "i%u' i"F/'i9 "i%u' i"F/'i 9 E"%$&$'i"9 E"%$&$'i" 9 E'$&$'i"9 E'$&$'i"
9 A"&i#/" iru'; :a0ur9 A"&i#/" iru'; :a0ur 1. N$" i"F/'i1. N$" i"F/'i
9 Trau0a9 Trau0a
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
35/38
5a&$r pr/%i'p$'i'i Ti0!ul"ya5a&$r pr/%i'p$'i'i Ti0!ul"yaSIRSSIRS
.. 5a&$r i"&/r"al.5a&$r i"&/r"al.KU p/"%/ri&a, $"%i'i pr/0$r!i%. KU p/"%/ri&a, $"%i'i pr/0$r!i%.
1.1. 5a&$r /'&/r"al.(8/"i' &rau0a %a"5a&$r /'&/r"al.(8/"i' &rau0a %a"p/"a&ala'a"aa""ya), 0/"/"&ua"p/"a&ala'a"aa""ya), 0/"/"&ua"P/r:ala"a" p/"yai& %a" Pr$#"$'aP/r:ala"a" p/"yai& %a" Pr$#"$'a
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
36/38
PERA
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
37/38
1. Si" #raF&i"#.1. Si" #raF&i"#.
I00/%ia&/ ( '/#/ra )I00/%ia&/ ( '/#/ra )
D/lay/% P/"u"%aa" ),'a0pai %/"#a"D/lay/% P/"u"%aa" ),'a0pai %/"#a"4 hari pa'a %/!ri%/0/"&.4 hari pa'a %/!ri%/0/"&.
8/10/2019 LUKA BAKAR(COMBUSTIO).ppt
38/38
P/ra?a&a" LB D/ra:a& II %ala0P/ra?a&a" LB D/ra:a& II %ala0%a" D/ra:a& III .%a" D/ra:a& III .
P/"yuli& "/r$'i' :ari"#a".P/"yuli& "/r$'i' :ari"#a".
.P/"uia" lua..P/"uia" lua.
1.N/r$&$0i %a" %/!ri%/0/"& .1.N/r$&$0i %a" %/!ri%/0/"& .E'ar/&$0i ( E'i'i &a"#/"'ial )E'ar/&$0i ( E'i'i &a"#/"'ial )'/%i"i 0u"#i" u"&u 0/"/#ah'/%i"i 0u"#i" u"&u 0/"/#ahSIRS %a" MODS, 94 hari pa'aSIRS %a" MODS, 94 hari pa'a
/%/ra a&au > 0i"##u./%/ra a&au > 0i"##u. Pr$'/%ur i"i %ilaua" 0a'i0al lua'Pr$'/%ur i"i %ilaua" 0a'i0al lua'
LB 7.LB 7.
Recommended