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Trauma Thorak

Trauma Thorak. 25 % dari penderita multi trauma ad a komponen trauma thorak 90 % dari penderita trauma thorak dapat diatasi dg tindakan yg sederhana oleh dokter di RS ( atau paramedik dilapangan ) Sehingga hanya 10 % yg memem e rlukan tindakan operasi. Anatomi.

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Trauma Thorak

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  1. Trauma Thorak • 25 %daripenderita multi trauma ada komponentrauma thorak • 90 %daripenderita trauma thorakdapatdiatasi dg tindakanygsederhanaolehdokterdi RS (atauparamedikdilapangan) • Sehinggahanya10 %ygmememerlukantindakanoperasi

  2. Anatomi • A. Dinding dada : tulangiga, ototintercostal, diafragma bag caudal • B. Pleura : parietalis & viseralis -> rongga pleura • C. Paru-paru • D. Mediastinum

  3. Fisiolois Pernafasan Hipoksia & Hiperkapnia HipoxiakadaOksigenygrendah> Dyspnoe Hiperkapniapenimbunankadar CO2 > sianosis • Inspirasi & ekspirasi • Frek normal 12-20 x/’

  4. PenilaianKlinis • 1. JalanNapas (Airway), Sumbatan pd jalannapas • 2. Pernapasan (breathing) • 3. Sirkulasi

  5. Beberapa trauma thorakygmengancamjiwa • Hematothorak • Tension pnemothorak • Tamponadecordis • Fail chest • Sucking chest wound lebar • Rupturtrakeobronkial • Rupturdiafragma • Rupturoesophagus • Ruptur Aorta • Sumbatanjalannapas

  6. Trauma Abdomen • Evaluasidaerahabdomen merupakansalahsatukomponenyg paling kritis • Selama primary survey, pengenalanpenilaiansirkulasi pd penderita pd trauma tumpulmeliputipengenalandinidaritempatperdarahantersembunyi • Gejala & tandaygditimbukankadanglambatsehinggamemerlukantingkatkewaspadaanygtinggiuntukmenetapkandiagnosisnya

  7. Jenis Trauma Abdomen Trauma tumpul Trauma Tajam Luka tusuk: Hati (40%), ususkecil (30%), ususbesar (15%) Luka tembak : ususkecil (50%), ususbesar (40%), hati (30%), strukturvaskuler abdomen (25%) • ResikoRuptur organ • Perdarahansekunder • Peritonitis • Limpa 40-50% • Hepar 35-45% • Reptroperitonium 15%

  8. Gejala & tandapecahnya organ solid • Gejalaperdarahan: anemis, tanda%gejalasyok • Darahpdintraperitoneal akanmegakibatkannyeri pd abdomen ringansampaiberat

  9. Gejala & tandapecahnya organ berongga • Peritonitis timbullambatataucepat

  10. PemeriksaanfisikInspeksi • Bukapakaianuntukmelihatjejas pd badan • Goresan • Robekan • Luka tembus • Benda asingygmenancap • Keluarnyaomentum/ususkecil • Lakukan Log Roll ntukmemeriksabag belakang

  11. Auskultasi • Melaluiteknikiniditentukanapakahadabisingususatautidak • Darah intra peritonumygbebasataukebocoran abdomen dptmenyebabkan ileus, hilangnyabisingusus

  12. Perkusi • Timpani : bilaadanyadilatasilambungakut • Redup : hemoperitonum

  13. Palpasi • Defansmuskuleradalahtandakhasdariiritasiperitoium • Tekananpdpelvisygdapatmengakibatkangerakan abnormal dannyeritekanmenunjukkankecurigaanfraktur pelvis

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