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Luka Bakar

Luka Bakar. Dr. Dewi Haryanti K, SpBP Sub Bagian Bedah Plastik RSUD dr. Moewardi/ FK UNS Ska. Tujuan :. Menjelaskan prosedur penatalaksanaan luka bakar thermis, kimia dan listrik. Overview :. Severity Klasifikasi Luka Bakar Emergency Medical Care Luka Bakar Kimia Luka Bakar Listrik

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Luka Bakar

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  1. Luka Bakar Dr. Dewi Haryanti K, SpBP Sub Bagian Bedah Plastik RSUD dr. Moewardi/ FK UNS Ska

  2. Tujuan: Menjelaskan prosedur penatalaksanaan luka bakar thermis, kimiadanlistrik

  3. Overview: • Severity • Klasifikasi Luka Bakar • Emergency Medical Care • Luka Bakar Kimia • Luka Bakar Listrik • Dressing and Bandaging • Trauma Inhalasi

  4. SeverityLuka Bakar Ditentukan oleh: - derajat kedalaman - luas - critical areas yang terkena - medical condition atau trauma - umur pasien

  5. Derajat Kedalaman (Grade) Luka Bakar:

  6. EPIDERMIS Gr I Gr IIA Gr IIB Gr III DERMIS

  7. Partial ThicknessBurns

  8. Full ThicknessBurns

  9. Luas Luka Bakar • Ditentukan olehpercentage(%) dari body area yang terbakar • Telapak tangan pasien + 1% • ‘rule of nines’ dari Wallace

  10. Rule of nines of Wallace • Membagi tubuh menjadi beberapa bagian • Digunakan untuk mengkalkulasi % permukaan tubuh yang terbakar

  11. Rule of Nines BODY PART ADULT CHILD • Head & Neck 9 18 • Arms 9 (2) 9 (2) • Front & Back 18 (2) 18 (2) • Legs 18 (2) 13.5 (2) • Genitalia 1 1

  12. Rule of Nines (Wallace)

  13. Lokasi Luka Bakar • Meliputicritical areas (wajah, upper airway, hands, genitalia) Pre existing medical conditions • DM • py. Cardiopulmonum, • gangguan psikiatrik, dll

  14. Umur Pasien • < 10 tahun • > 50 tahun

  15. Severity Luka Bakar, dibagi menjadi: • major burns • moderate burns • minor burns

  16. Dewasa * Tanpa resiko ggn fungsi atau kosmetik pada mata, telinga, wajah, tangan, kaki atau perineum

  17. Usia <10 th dan > 50th * Tanpa resiko ggn fungsi atau kosmetik pada mata, telinga, wajah, tangan, kaki atau perineum

  18. Emergency Medical Care • Pasien Dewasa • Stop the burning process &cegah cedera lbh lanjut • Bahan isolator • Monitor airway – beri O2 • Cegah kontaminasi lebih lanjut

  19. Luka Bakar • Indikasi MRS: • semua derajat III • Major Burns dan Moderate Burns • Indikasi poliklinis (rawat jalan): • Minor Burns (kec. Derajat III)

  20. Emergency Medical Care • Selimuti dengan bahan kering & ‘steril’ • No ointments, lotion, or antiseptic • Do not break blisters • Transport ASAP

  21. Emergency Medical Care • Pasien Pediatrik • Greater surface area in relationship to the total body size • Fluid and heat loss >> • Risk of shock, airway and hypothermia ↑ • Consider child abuse

  22. Pasien Pediatrik • Transport - “scoop and run”

  23. Luka Bakar Kimia • Disebabkan karena adanya kontak kulit dengan bahan toksik

  24. Luka Bakar Kimia • Disebabkan oleh alkali, asamdan campuran • Protect yourself from exposure or injury

  25. Luka Bakar KimiaEmergency Care • Stop the burning process • (1) Immediately flush with large amounts of water • (2) Do not contaminate uninjured areas • (3) Continue flushing while enroute to hospital

  26. (4) Cover with dry sterile dressing or clean sheet • (5) Special care of the eyes • Gently /continuously flush • For direct eye injury hold lids open and irrigate the eye

  27. Dry chemicals • Reaction with water can worsen burn • (1) “Brush - then flush” • (2) Remove victims clothing (shoes & socks)

  28. Luka Bakar Listrik • Scene Safety • Do not contact high voltage wires • Consider all wires live • Do not handle down lines • Do not come in contact with patient if the electrical source is live

  29. Emergency Medical Care • May be more serious than it seems • Entry wound is usually a small burn area • Look for an extensive exit wound • Possible tissue damage underneath (current spreads out as it travels through the body)

  30. Emergency Medical Care cont: • Possible Cardiac arrest • Possible Respiratory arrest • Splint possible fractures • Treat wounds with a dry, sterile dressing • Transport

  31. Electrical Burns • Treat any major complications first

  32. Electrical Injuries • Entry wound on head • Exit wound on foot Luka Masuk Luka Keluar

  33. Dressing and Bandaging • Stop bleeding • Protect wound from further damage • Prevent further contamination and infection

  34. Trauma Inhalasi • Chemical fumes • Obvious fumes in the air • Inhaled fumes

  35. Carbon Monoxide (CO) • Deadly poison

  36. Carbon Monoxide • Different than smoke inhalation • Odorless • Tasteless • Not an irritant

  37. Signs and symptoms • a. Dyspnea (difficulty in breathing) • b. Respiratory arrest • c. Cherry red skin

  38. CyanideSigns and Symptoms • Burnt almonds • Dyspnea (difficulty in breathing) • Respiratory arrest

  39. Treatment • a. 100% oxygen through a non-rebreathing mask • b. Be prepared to do basic life support • c. Transport

  40. Pemberian cairan pada Luka Bakar • Formula Baxter • Dewasa 4cc x % luas LB x kg BB =.....cc lar. RL diberikan : ½ bagian pada 8 jam I ½ bagian pada16 jam berikutnya diberikan lar. koloid 500-1000cc pd jam ke 18-24

  41. Pemberian cairan pada Luka Bakar • Formula (modifikasi) Baxter • Anak 2cc x % luas LB x kg BB=...cc lar. RL diberikan: ½ bagian pada 8 jam I ½ bagian pada 16 jam berikutnya larutan koloid 17:3 (sejak jam ke-0) Hari berikutnya diberikan cairan maintenance

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