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OVERVIEW BLOCK Emergency medicine block will be implemented in semester 7, the fourth year. This block runs for 6 weeks to 5 weeks on and one week for the exams. This block has the burden of six credits. In this block students will learn about the emergency sign, priority sign, the treatment of emergency cases and emergency drugs. Emergency medicine block consists of 5 modules, Traumatology, espiration, !emodynamic, "eurology, and #sychiatry with 5 scenario. Each scenario is gi$en within % week. It is expected that each student is able to understand and master each learning ob&ecti$e. The learning strategies that will be used in this block includes the seven jump tutorial discussion, , clinical skill laboratory, lectures , independent study and plenary. The competency of block taken f om the !e"en a ea of competency #octo by In#one!$an %e#$cal Co&nc$l' %. 'ommunication e fektif (. )asic clinical skills *. +pplication of biomedical sciences in medical practice ,. -anagement of health problems in indi$iduals, families and communities 5. .se of information technology 6. Introspecti$e and life long study 7. The application of ethics, morals and professionalism as well as patient safety.
LE)RNIN* OB+ECTIVE, BLOCK a. *ENER)L -UR-O,E +t the end of this block, students are expected to/ %. +naly0ed of Emergency Sign and mark the Priority Sign. (. +ssessment and management of early (initial assessment) in the case of trauma 1 multiple trauma 1 psychiatric emergencies in the order of priority 2+3)3'4 *. +naly0ed the normal organ function and organ failure caused by trauma 1 multiple trauma ,. Explain and able to life sa$ing procedures and maintain organ function 5. +naly0ed and how to refer patients for definiti$e therapy
6. Explain the legal aspects of trauma and emergency situations b. ,-ECI)L -UR-O,E %. Explain the national policy in handling emergencies and disasters (. +naly0ing of Emergency Sign and mark the Priority Sign in cases of emergencies and traumatology. *. +naly0ing the failure of organ function due to trauma 1 multiple trauma ,. +ssessment and management of early 2initial assessment4 in the case of trauma 1 multiple trauma 1 drowning in the order of priority 2+3)3'4 5. +ble to perform life sa$ing procedures in cases of emergency caused by trauma 6. Explain and understand the use of drugs in treating patients with emergency 7. 'apable of analy0ing and management of $ascular in&uries 5. Initial examination and management of musculoskeletal trauma 6. +ble to explain the symptoms of eye emergencies %7. Explain the legal aspects of trauma and emergency situations a. Explain the informed consent in emergencies b. Explain how make a $isum et repertum %%. Explain the symptoms in the field of pediatric emergency %(. Explain the symptoms of respiratory emergency %*. Explain the mechanisms of airway obstruction in adults %,. .nderstand and master the handling of emergencies in thoracic trauma %5. Explains emergency in maxillofacial trauma %6. Explaining the symptoms of emergency E"T 2Ear "ose Throat4 %7. .nderstand the purpose and indications 8#9 action %5. Explain the results of radiological examination thorax and maxillofacial trauma %6. Explain the mechanisms of airway obstruction in adults and the management of airway obstruction 2respiratory resuscitation4 (7. Explains emergency obstetrics and gynecology (%. .nderstanding the signs and symptoms of shock 2hypoperfusion4 ((. +ble to calculate the fluid in the shock and bleeding (*. Explains emergency abdominal surgery and treatment (,. Explain the cardiac emergency (5. .nderstanding and assessing burns and principles of treatment of burns (6. Explain and capable of handling emergencies on the skin (7. ecogni0e emergencies at the in&ury head and the treatment (5. Explain the radiological examination to help establish the diagnosis of head in&ury (6. Explain a $ariety of emergencies in the field of neurology and handling *7. Explain the mechanism and management of disorders caused by impairment of consciousness intracerebral *%. Explain and perform how to stabili0e the trauma patient transport *(. :escribe the action or emergency patient referral management **. Explains emergency psychiatry and handling *,. Explain the type and management of poisoning
*5. Explain the gastroenterohepatologi emergency *6. Explain the emergency treatment of metabolic and endocrine *7. Explain the emergency treatment of hypertension and renal *5. Explain the forensic toxicology *6. +ble to recogni0e the signs of death ,7. +ble to therapy and techni;ues as well as 'ardiac #ulmonary )rain esuscitation 2 8#94 correctly in adults and children ,%. +ble to perform an endotracheal tube ,(. +ble to take the corpus alienum E"T 2Ear "ose Throat4 ,*. +ble to make <isum Et epertum .. REL)TED ,CIENCE,
1. 'ardiology 2. =ung
4. >urgery. 5. "eurology. 6. Ear "ose Throat 2E"T4. 7. Eye. 8. >kin and ?enital
6. %7. +nesthesia adiology
%%. #sychiatry %(. @orensic /. REL)TION, WIT0 T0E OT0ER BLOCK, In studying this block, there are connection with some of the pre$ious block, ie/ %. )lock 6 2")>>4 (. *. ,. 5. 6. / "eurology, #ediatric, E"T, Eye, >urgery, #sychiatry, >kin and ?enital )lock 6 2 eproducti$e >ystem4 / 9bstetri )lock %7 2cardio$ascular system4 / Interna, @orensic )lock %% 2!ematoimunology4 / Interna, @orensic )lock %( 2 espiratory >ystem4 / Interna, #ediatric )lock %, 2?astroinstestinal >ystem4 / Interna
&e'era (e)ala Jalan Nafas (Airway) Ne#r$l$gi% Sistem Pernafasan isa!ility" Ne#r$geni% Psi%iatri &e'era S)inal
*+*,-*N&. +* /&/N* 0 1,A2+A1343 -/
4#%a 4#%a !a%ar
. -lena y #lenary will be held at 6 weeks.uired to report the results of their study to the group super$isor who has been appointed in writing. discussion of material not co$ered in the tutorial. E. >tudents learn to be independent based on the goals and ob&ecti$es of the scenario blocks. >cenario is that many cases occur in general practice or in hospital. Labo ato y >kill To train or e. T&to $al :iscussion tutorial on Emergency medicine there are 5 scenarios for 5 weeks. =ectures are gi$en will be tailored to each module each week. explanations are considered difficult sub&ects. +ttended by pengampu each course 1 expert. Independent learning is the core of competency3based curriculum. 87 . Each scenario consists of ( meetings. C. #rior to execution skills will be held pre test lab or home work. Each topic in the tutorials will be displayed in the plenary by (3* groups designated. @or students who pretest $alue of less than 77 then it will get the assignment from the '>=. Lect& e :uring this block walk will be done se$eral times face to face with the speakers in the form of lectures.This e$ent was held two sessions or two times with a ( x %77 minutes for each topic skills. B. eporting the results of study done for e$ery module.uip psychomotor theory obtained should be gi$en medical skills training 2skills lab4. >tep 6 independent learning to find answers the learning ob&ecti$es in the scenarios.uali0e studentsB perceptions about the =earning 9b&ecti$e in the scenario. >kills co$ered in this block3 related emergencies cases 2emergency medicine4. >tudents can directly ask the experts about what is doubtful or who do not understand.elf *&$#e# Lea n$n2. but can be de$eloped based on the recommended references or sources 3 sources obtained from the internet. =earning aims to train students to be more skilled in dealing with cases found in general practice. D. #lenary aim to e. The function of college is to structuring the material.LE)RNIN* )CTIVIT1 ). step %35 and step 7. >tudents are re. pro$iding a multidisciplinary $iew of science and integrate knowledge. The presence of skills lab must be %77A.
). >kills =aboratory *. @inal Exam T&to $al! +ssessment tutorial consists of $erbal interactions of students during tutorials. / (7A / (7A / 67A 3$nal E4am )lock final exam held in week 6 at the end of the block. 'omponents of the assessment tutorials also include an assessment of the written report guided independent learning. concentration. argumentation. +ssessed according to its acti$ity 2sharing. Cl$n$cal . while the details are as follows / %. To assess studentsB ability in mastering medical skills will be held the 9b&ecti$e >tructured 'linical Examination 29>'E4. )lock test score of 57A of o$erall $alue. discipline. and psychomotor skills. cogniti$e. Tutorial (.. Terms of exam block is at least 57A college attendance. 87 . domination.%ENT 3R)%EWORK Emergency total $alue of the end blocks %77A. ideas. The number of exam is %57 points with %3day exam. >tudents are re..k$ll! Labo ato y The assessment is conducted e$ery end of the semester by assessing affecti$e.E.uired to follow tutorials %77A. beha$ior 1 manners 1 attitude. between the one and the other does not compensate each other.
'5 (A * -'C +nesthesia .A 6 -'C >urgery 6 '. (A * -'C >urgery 87 .. '. '5 (A * -'C +nesthesia 5 '. '5 (A * -'C >urgery * '.A 6 -'C +nesthesia 7 +ble to explain and 'ogniti$e '*.. ?oal :- =< )) Cty -T: #art of % Explaining the national policy in dealing with 'ogniti$e '*.. '. '5 . '. (A emergencies and disasters * -'C >urgery ( Explains emergency signs and mark the #riority >ign 'ogniti$e in the case of Traumatology +ssessment and management of early 2initial assessment4 in a case of trauma 1 multiple 'ogniti$e trauma 1 drowning in the order of priority 2+)'4 +ble to perform life sa$ing procedures in cases of 'ogniti$e emergency caused by trauma +ble to analy0e the function of organ failure 'ogniti$e due to trauma 1 multiple trauma Explain and understand the use of drugs in treating patients with emergency 'ogniti$e '...BLUE -RINT E%ER*ENC1 %EDICINE "o. '5 .
. '6 '5. '5 '. Explain the informed 'ogniti$e consent in emergency b. '6 '5. '6 '.A 6 6 6 -'C -'C -'C #ediatric =ung +nesthesia %.. '5 9rthopaedic >urgery Eye 6 %7 Initial examination and management of 'ogniti$e musculoskeletal trauma +ble to explain the symptoms of eye 'ogniti$e emergencies Explain the legal aspects of trauma and emergency situations a. '. 'ogniti$e (A of emergency E"T '5 . (A * -'C >urgery %5 %6 %7 Explains emergency in 'ogniti$e '*.A .management in&uries 5 of $ascular '. '5 . (A thorax and maxillofacial trauma * -'C adiology 87 .nderstand the purpose and 'ogniti$e indications 8#9 action '5...nderstand and master the handling of emergencies in 'ogniti$e thoracic trauma (A * -'C (A * -'C '.. '. +ble how to make $isum et repertum Datdaruratan explain his failure symptoms in the 'ogniti$e field of pediatrics Explaining the symptoms 'ogniti$e of respiratory emergency Explain the mechanisms of 'ogniti$e airway obstruction in adults .A . '5 (A * -'C @orensic %% %( %* '5.A * * 6 -'C -'C -'C >urgery E"T +nesthesia %5 Explain the results of radiological examination 'ogniti$e '*. (A maxillofacial trauma Explaining the symptoms '. '6 .
'.%6 Explain the mechanisms of airway obstruction in adults and management of airway 'ogniti$e obstruction 2respiratory resuscitation4 Explains emergency 'ogniti$e obstetrics and gynecology . '6 (A * -'C >urgery * -'C >kin and ?enital (7 (A * -'C "eurosurgical (5 (6 *7 Explain the radiological examination to help 'ogniti$e '*. '5 (A * -'C +nesthesia (7 (% (( (A . '5 '.nderstanding and assessing burns and '5. '5 '. '6 '5. (A establish the diagnosis of head in&ury Explain a $ariety of '5. '5 '5.nderstanding the signs and symptoms of shock 'ogniti$e 2hypoperfusion4 +ble to calculate the fluid 'ogniti$e in the shock and bleeding emergency surgery and 'ogniti$e '.. (A ( ..A (A * 6 6 * * -'C -'C -'C -'C -'C 9bstetrics and ?ynecology +nesthesia +nesthesia >urgery !eart Explains ( * abdominal treatment the cardiac 'ogniti$e '*. '6 '.. 'ogniti$e . emergencies in the field of 'ogniti$e ..A '6 neurology Explain the mechanism and management of disorders '5. '. Explain emergency .A caused by impairment of '6 consciousness intracerebral * -'C adiology 6 -'C "er$e 6 -'C "er$e 87 .A . (5 'ogniti$e (A principles of treatment of '6 burns (6 Explain and capable handling of the skin 'ogniti$e emergergency ecogni0e emergencies at the in&ury in head and the 'ogniti$e treatment '5.
. % +ble to perform an +ttitude endotracheal tube *7 . #sychomotor and +ttitude %67 87 . (A * toxicology '5.Explain and perform and * % how to stabili0e the patient 'ogniti$e transport of trauma :escribe the action or * ( emergency patient referral 'ogniti$e management emergency 'ogniti$e * * Explains psychiatry and handling Explain the type and *. '. (A * treatment of hypertension 'ogniti$e '5 and renal Explain the forensic *5 'ogniti$e '*. '6 '. #sychomotor and . . #sychomotor and +ttitude 'ogniti$e.7 correctly in adults and +ttitude children 'ogniti$e. #sychomotor and . 'ogniti$e management of poisoning *5 Explaining gastroenterohepatologi and 'ogniti$e handling emergency Explain the emergency treatment of metabolic and 'ogniti$e endocrine '5. '5 '5.. *6 +ble to recogni0e the signs 'ogniti$e (A * '6 of death +ble to therapy and the techni.( +ble to take the corpus alienum E"T +ble to make <isum Et epertum +ble to implant #roblem number -'C Note ' -'C -'C -'C 9>'E 9>'E 9>'E 9>'E 9>'E 'ogniti$e.. '5 '..* . '6 '... #sychomotor and +ttitude 'ogniti$e. '5 (A * -'C +nesthesia (A (A (A (A * * * * -'C -'C -'C -'C >urgery #sychiatry Internal -edicine Internal -edicine Internal -edicine Internal -edicine @orensic @orensic '>= +nesthesia '>= +nesthesia '>= E"T '>= @orensic '>= 9bgyn *6 (A * -'C Explain the emergency '.ues of 8#9 'ogniti$e. '5 '.
ideas. looking for a relationship between the problem '5 E synthesis.+ccording to )loomBs taxonomy. comparing the $alues. 87 . breaking the concept into its component parts. diagnosis. implementation. principles. competency to be achie$ed/ • • • • • • '% E only limited know. remember 1 memori0e '( E comprehension. combine the parts into one '6 E e$aluation. E analysis. procedures to sol$e problems '. methods with a standard >9# RE3ERENCE. translations and concludes '* E application. use the concepts.
87 ..:epartment of 9bstetri and ?ynekology #alembang !ospital Teaching. 8akarta/ Gayasan )ina #ustaka 'unningham. ?ynecology. 8akarta /E?' Ob!tet $ an# *$nekolo2$ ' • • • • • • >astrawinata.?ary Het.Edition (%.et.+pleyBs >ystem of 9rthopaedics and @ractures.ni$ersity. (77.!ead In&ury. Edition % )andung / Ellstar 9ffset.npad >arwono #rawirohard&o.alI. 9bstetri Dilliams. 8akarta/E?' +. >ulaiman #rof. (77. %66*. >ulaiman. Iskandar 8apardi. Edition % )andung / Ellstar 9ffset.. -edical @aculty of >riwi&aya . <olume %. 9bstetrics and ?ynecology...(77..& 2e y' • • • • :r. 9bstetrics #hysiology. %65%. Textbook of >urgery Teaching >cience %.8akarta /#ublisher E?'.. >ulaiman. %65%. -edicine faculty of . >upono. 9bstetrics #atology. @. >p)>.npad >astrawinata .-edicine faculty of . 8akarta /E?' >chwart0..%66%.dr.Third Edition. (77. Edition (. . :igest #rinciples of >urgery. Edition 6th. >e$en Edition.(777.al. ?raham +pley.F. >abiston.(776. >astrawinata. 8akarta / E?'.
#rof >idarta Ilyas . Ed .Inte na ' • >udoyo +D.ni$ersity. +dhi :&uanda . . Edition %. (776. Efiaty +rsyad >oepardi.:r.ni$ersity. (77..>. Edition 5th. 8akarta J ?aya )aru. Eye ' • • • • #rof >idarta Ilyas. #rof. )ne!the!$a ' • +nestesiologi.>cience of Eye.FF. et. 8akartaJ E?'.ni$ersity. >cience of Eye. +dams )oies !igler. 87 .(77. >pT!T 2F4 et.(777.. )9EI>. Ear "ose Throat !ead and "eck. Illustrated +tlas of >kin.al. . 8akarta/ -edical @aculty of Indonesia .:r. @irst Edition.ni$ersity. E"T :isease Text )oks. 8akarta. "ana Di&aya. (77*. et al. (77.. Edition (.. %667. +lwi I. Edition 6.>kin :isease. dr.. -edical @aculty of Indonesia . ?eneral 9phthalmology. 8akarta / ENT ' • • #rof. (77(. :r.(77. 8akarta/ )alai -edical @aculty of Indonesia . %66*.>p. 8akarta / E?'.al. Third Edition.+tlas >cience of Eye.. Interna. :aniel ? <aughan. >etiyohadi )..k$n an# *en$tal ' • • #rof. 8akarta/ Didyamedika dr.>iregar. 8akarta/ -edical @aculty of Indonesia .
>nell.. #hysical :iagnosis in 'hildren 87 .#rincipal of "eurology.(77(.:r.ni$ersity • +T=+> adiology. 8akarta / -edical @aculty of Indonesia . :iagnostic of mental disorder.(77(.(775. -ahar -ard&ono.ni$ersity • -y!hc$at yc' • :r. de -a&o -edical @aculty of Indonesia . 'linical "euroanatomy.8akarta J Info -edika 8akarta. ##:?83III.ni$ersity. 8akarta/ -edical @aculty of Indonesia . %665. Edition Fedua.ni$ersity . adiology :iagnostic.Ra#$olo2y ' • >&ahriar asad.(776.'oory >.ni$ersity..@orensic >cience. 8akarta/ -edical @aculty of Indonesia . -atondang dkk.(777. Ne& olo2y' • • • +dam <ictor.(77.nair. 8akarta. 8akarta /E?' -e#$at $c' • • =ecturer of -edical @aculty of Indonesia . #rof. 8akarta /E?' ichard >.#ediatric.:r. 8akarta /E?' #rof.(777. 3o en!$k ' • Textbook of forensik dan medikolegal @F . usdi -aslim. )asic of 'linical "eurology.
T0E 3IR. Initial examination and management of musculoskeletal trauma %7. -$ ma 0&ta& &k6 . . Explaining the national policy in dealing with emergencies and disasters (. +ssessment and management of early 2initial assessment4 in the case of trauma 1 multiple trauma 1 drowning in the order of priority 2+3)3'4 ..OT a.p. *. +naly0e the failure of organ function due to trauma 1 multiple trauma 2. B a. )!7e#$ -&t a6 .p. Initial examination and management of musculoskeletal trauma 2%77 minutes4 87 . E##y %a &#&t . Explain the informed consent in emergencies b. Explain the hemodynamic emergency 6.7 minutes4 c. by # .& 2e y Lect& e 1 by # .Explain the legal aspects of trauma and emergency situations a.6 .p.%ODUL 1 T a&matolo2y C0)-TER I.p. B a. Introduction of emergency block 2(7 minutes4 b.T WEEK LE)RNIN* OB+ECTIVE. 'apable of analy0ing handling and management of $ascular in&ury traumatology 257 minutes4 Lect& e . +naly0ing the failure of organ function due to trauma 1 multiple trauma 5. Explain how to make a $isum et repertum E4pe t lect& e' ). 'apable of analy0ing t auma handling and management of $ascular in&uries 5. 1&5a 0a &n6 . +naly0ed the Emergency Sign and mark the Priority Sign in case of emergencies and Traumatology.7 minutes4 Lect& e ( by # . +ble to perform life sa$ing procedures in cases of emergency caused by the trauma 1multiple trauma 6. >tudents are able to / %. Explain and understand the use of drugs in treating patients with emergency 7. OT 8 # . Explaining the national policy in dealing with emergencies and disasters 2.
3o en!$c Lect& e 1 by # . b. Explain the legal aspects of trauma and emergency situations 2informed consent in emergencies4 257 minutes4 <isum et repertum 257 minutes4 /. )n a. E"$ D$ana6 . % +ble to explain the symptoms of eye emergencies 2%77 minutes4 T&to $al >cenario % . .p. 0elm$ %&chta 6 . )chma# )!!e2af6 .p. b. )ne!the!$a Lect& e 1 by # .. +naly0e the Emergency >ign and mark the #riority >ign in case of emergencies Traumatology. Eye Lect& e 1 by # .k$ll Lab' <isum Et epertum 87 .p.(.p. )n a. )chma# )!!e2af6 . 3 a. 257 minutes4 +ssessment and management of early 2initial assessment4 in the case of trauma 1 multiple trauma 1 drowning in the order of priority 2+3)3'4 257 minutes4 Explain and understand the use of drugs in dealing with emergency patients 2%77 minutes4 Lect& e ( by # .
uake 6. + boy of %6 years was brought to the Emergency . The patient is awake.. 9n physical examination found deformity in the right thigh. . 87 .CEN)RIO 1 E)RT09U)KE VICTI%. looking pale. !e felt pain in right thigh. and the patient can not lift his right leg.7 ichter scale. ight leg look shorter.C0)-TER II.nit immediately after he had remo$ed from the rubble by an earth. $isible bone protruding through the skin which causes the wound in the right thigh %7 cm with a fair amount of bleeding.
). . d. confused4 'hanges in heart rhythmJ fast or $ery slow pulse. feeling faint. :isaster plan and training (. distincti$e and not typical.$2n' • • 'hanges in mental status 2unconscious. ed 'ross4/ trained as a medical first responder #re3hospital emergency ambulance. irregular. police. (. Eme 2ency an# p $o $ty !$2n! >ymptoms and signs in medical emergencies / >ymptoms and signs in medical emergencies is $ery di$erse. Nat$onal pol$cy $n #eal$n2 7$th eme 2enc$e! an# #$!a!te !' >et in integrated emergency response system.uipped with e. ambulance %%5 >upport systems 2fire brigade.ymptom!' • • • • • • • @e$er #ainful "ausea.C0)-TER III. $omiting Excessi$e urination. weak or $ery strong 87 . but without a stretcher e. +bnormal changes of the patientBs $ital signs are lead to medical emergencies. REVIEW RE3ERENCE. was coming to an end >hortness of breath or ha$e difficulty Excessi$e thirst or hunger. >ome things that can be obser$ed suspicion in patients who directs us to a problem medical is/ .3hour emergency unit f. infusion. a strange taste in mouth a. include/ 9rdinary people/ the common people ha$e to master the skills of basic life support Emergency communication system/ %%7 police. %%* fire.uipment and medicine. c. CEN)RIO 1' E)RT09U)KE VICTI%. b. . or not at all :i00iness. drugs4 3 Type of motorcycle is e. there are three types/ 3 )asic types / +ble to perform the procedure +)': 3 #aramedic Type/ +)': K in$asi$e measures 2intubation. lung puncture.
fractures and dislocations of the extremities. head in&ury or cer$ical spine is not weight. including discoloration of the mucous membranes 2pale. head in&ury or facial maksilo3weight. and 87 .uire periodic reassessment 2soft tissue in&uries. excessi$e sweating. red too4 'hanges in skin condition/ temperature. se$ere burns4 #riority Two 2Gellow4/ The patient needs help. maksilo without airway disorders. re. and minor burns4 Third #riority 2?reen4/ #atients degan minor in&uries that do not re.uality of the mucous membrane color 2pale.uire action and transport.uire rapid assessment and medical actions and transport immediately to stay ali$e 2eg. respiratory failure. bluish. chest in&ury without respiratory disorders. red too4 'hanges in blood pressure )ead eyes/ $ery large or $ery small Typical odor of the mouth or nose +bnormal muscle acti$ity such as sei0ures or paralysis ?astrointestinal disorders/ nausea.uiring simple first aid but re.uire immediate stabili0ation. extremely dry. rhythm and . humidity. ma&or fractures without shock.• • • • • • • • • 'hanges in respiratory. #atients may experience an in&ury in a broad range of species 2eg. facial in&uries. $omiting or diarrhea >ign 3 9ther signs that should not exist Think of all patient complaints are true. Ta22$n2 an# 2 o&p$n2 ba!e# t $a2e #riority Lero 2)lack4/ #atient death or fatal in&ury may be ob$ious and not resuscitated @irst #riority 2 ed4/ #atients se$ere in&uries that re. torako3abdominal in&ury. shock or se$ere bleeding. but with a less se$ere in&ury and certainly will not experience life threat in the near future. bluish. If the patient feel bad or uncomfortable it is treated as a medical case T $a2e' Triage is the process of sorting patients by se$erity of specific in&uries or illnesses 2based on the most likely to experience clinical deterioration soon4 to determine the priority of the medical emergency treatment and transportation priorities 2based on a$ailability of the means for action4. abdominal in&uries without shock. and psychological emergency4 #riority @our 2)lue4/ the first group of $ictims with in&uries or critical and potentially fatal penyaki which means do not re.
rotation. pulse. -alpat$on (feel) #resence of tenderness 2tenderness4. In!pect$on (look) The presence of deformity 2deformity4 such as swelling. respiration and body temperature. skin color. -hy!$cal e4am$nat$on of the ca!e: 9btaining a thorough history of the mechanism of in&ury may help identify orthopedic in&uries. In this case the patient suffered an open fracture of the assessment is / ). angulation. related to the patientBs $ital signs including blood pressure. >top cardiac In the e$ent of cardiac arrest.. past medical history. L$fe !a"$n2 p oce#& e! $n ca!e! of eme 2ency Ba!$c l$fe !&ppo t I":I'+TI9"> +.. medications. @urther assessment associated with trauma to the patientBs condition. (. neurological and $ascular status examination in the distal fracture. it will happen immediately stop the circulation.#riority @i$e 2Dhite4/ the first group is definitely dead.uickly lead to brain and $ital organs of 87 . bone fragments 2open fracture4. (. %o"ement (moving) The existence of limited motion in the fracture area. . the in&ury in$ol$es the distal arterial pulsation. >topping the circulation of these will . . >top breathing >top breathing characteri0ed by the absence of chest mo$ement and breathing the air flow from the $ictim 1 patient. @or example. and status consciousness. #alpation of the extremity the fracture. and pre$ious in&ury. In$t$al mana2ement of t a&ma ca!e! ' The initial assessment is done on the case. /. of course. >top breathing is a case that should be taken )asic =ife >upport. shortening. crepitus. capillary refill test.
Examination of the airway. #ro$ide breathing assistance. Ensure $ictim 1 patient is not breathing.URVE1 In the primary sur$ey focused on breathing assistance and help with circulation and defibrillation. nose or mouth to mouth to a stoma 2hole made in the throat4 87 . breath support can dilakukkan through word of mouth. Troubled breathing 2whee0ing4 is an early sign of impending cardiac arrest. (. B <B eath$n2= . If the $ictim 1 patient is not breathing. E . To be able to remember easily the primary sur$ey measures formulated by the alphabet +.&ppo t of b eath 'onsists of two stages/ %. 'ardiac pulmonary resuscitation consists of two stages. which can only be performed by trained medical and paramedical personnel and is a continuation of the primary sur$ey. which can be done by e$eryone >econdary >ur$ey 2>econdary >ur$ey4. listening for breath sounds and feel the breath of the $ictim 1 patient (. E airway 2airway4 breathing 2breathing assistance4 circulation 2circulatory assistance4 defibrilation 2electrical therapy4 ) <)$ 7ay= )$ 7ay +fter completing the basic procedure. followed by action/ %.oxygen deficiency. '. namely ) B C D . )y looking upward mo$ement turunn$a chest. 9pen the airway. and :. namely/ • • >ur$ey of #rimary 2#rimary >ur$ey4. -RI%)R1 . ).
if necessary defibrillation de$ice can gi$e the signal to rescuers to perform defibrillation or continuing help breathing and circulation assistance only. Dhether or not heartbeat $ictim 1 patient can be determined by palpating the carotid artery in the neck area $ictim 1 patient. the type of fracture can be di$ided by/ 87 . Intracardia. called +utomatic External :efibrilation. >.C <C$ c&lat$on= 0elp c$ c&lat$on 'onsists of two stages/ %. #ro$ide help circulation. In the present is already a$ailable tools to :efibrillation 2defibrillator4 which can be used by lay people. (. 2>melt0er >' M )are )?. +scertain whether the heart rate of $ictims 1 patients. If it has been confirmed no heartbeat. This is done if the causes of cardiac arrest (cardiac arrest) is an abnormal heart rhythm called $entricular fibrillation.ues/ D <DE3IBRIL)TION= Defibrilation or in the Indonesian language translated by the term defibrillation is to pro$ide a therapeutic electrical energy. then they could be assisted circulation or the so3called external cardiac compression. trachea. dopamine )nt$?a hythm$a # &2! 9ther / +tropine. where the tool can find $ictims of cardiac arrest defibrillation should be performed or not. (77%4 Type! of f act& e!' To be more systematic. intraosseous @. performed with the following techni. central $eins. calcium oute of administration / #eripheral $eins. dobutamine. D &2! $n pat$ent! 7$th eme 2ency ' Re!&!c$tat$on # &2! <asopressin / +drenaline. Type! of f act& e! an# 7o&n#! 3 act& e! Def$n$t$on' @ractures 2broken bones4 is a breakdown of the continuity of the bone structure and is determined according to the type and extent.
obli. If more than one fracture line. or intraartikuler. or spiral 2spiral 1 twist the stem around the bone4. 87 . ha$e a compression fracture where the bone 2occurs in the spine4 is called compression. if one part broken while the other side of the bend is called greenstick.ue 2angled4. epiphyseal. then called kominutif. Relat$on!h$p bet7een the f act& e )etween the fracture can still relate 2undisplaced4 or far apart 2displaced4.• Locat$on )one fractures can occur in anywhere like on diafisis. W$#e :i$ided into a complete fracture 2complete4 and incomplete 2incomplete4. metaphysical. Conf$2& at$on 8udging from the line frakturnya. • • • • The elat$on!h$p bet7een f act& e 7$th !& o&n#$n2 t$!!&e @ractures can be di$ided into an open fracture 2if there is a relationship between bone and the outside world4 or a closed fracture 2if there is no relationship between the fracture and the outside world4. If the fracture is obtained in con&unction with dislocation of &oints. Example is an incomplete fracture of the crack. it is called a fracture dislocation. @racture with fragments dri$en into the 2often occurs in the skull and facial bones4 is called depression. can be di$ided into trans$erse 2hori0ontal4.
%o"ement (moving) 87 . highly contaminated. angulation. and extensi$e soft tissue damage.. capillary refill test. namely/ * a#e I * a#e II * a#e III / / / clean cuts. . crepitus. skin color. bone fragments 2open fracture4. more extensi$e in&ury without extensi$e soft tissue damage. shortening. -alpat$on (feel) #resence of tenderness 2tenderness4. the in&ury in$ol$es the distal arterial pulsation. #alpation of the extremity the fracture. -hy!$cal E4am$nat$on ' 1. rotation.9pen fractures are di$ided into se$eral grades. neurological and $ascular status examination in the distal fracture. (. In!pect$on (look) The presence of deformity 2deformity4 such as swelling. less than % cm in length.
in areas suspected fracture.rinalysis. )lood type 2especially if the surgery will be performed4. consisting of/ • • • Includes two images are anteroposterior 2+#4 and lateral. (. 'ontains two fractures of the &oints between the proximal and distal parts. namely before and after the action action. Cla!!$f$cat$on of Wo&n#! Dound distinguished by/ 87 . could also be due to the handling of the fracture is called iatrogenic complications. 'ontains two extremity 2especially in children4. in&ury is an in&ury to the tissue that interferes with normal cellular processes. Def$n$t$on of InA& y Dound is a state of loss 1 breakdown of the continuity of the network 2-ans&oer. adiologic examination 2x3rays4. must follow the rules of the role of two.The existence of limited motion in the fracture area. . both the in&ured and those not exposed to in&ury 2to compare with normal4 • #erformed twice. (777/*664. including / • • • • • outine blood.&ppo t' %. the wound can be described by the damage to the kuntinuitas 1 unity of body tissue that is usually accompanied by loss of tissue substance. )lood clotting factors. +rteriography examination performed if suspicion of $ascular damage caused by the fracture. E4am$nat$on . +ccording In ET"+. Compl$cat$on!' The cause of fracture complications in general can be di$ided into two. namely because of the trauma itself. =aboratory examinations. 'reatinine 2muscle trauma may increase the burden of creatinine for renal clearance4.
respiratory. tract elimentarius. 87 . urine b4 The new trauma in&uries/ lacerations. Type of 7o&n# heal$n2 There are three types of wound healing. where the di$ision is characteri0ed by the number of the lost tissue. abscess. potentially infected c4 There is no k ontak the oropharynx. genitourinarius tract.= Ba!e# on the #e2 ee of contam$nat$on a) Clean cuts a4 The cut electi$e b4 >terile. penetrating wounds. b) Clean cuts tercema r a4 b4 c4 d4 c) The cut electi$e #otential infection/ minimal spillage. and genitourinarius elimentarius =onger healing process Contaminated wounds a4 #otential infection/ spillage of elimentarius tract. normal flora 'ontact with the oropharynx. gall bladder. open fractures. old trauma.1= Ba!e# on the ca&!e! a4 b4 c4 d4 e4 f4 Excoriation or abrasion <ulnus scisum or cuts <ulnus laseratum or wound <ulnus punctum or stab wounds <ulnus morsum or animal bites <ulnus combotio or burns (= Ba!e# on the p e!ence 8 ab!ence of t$!!&e lo!! a4 Excoriation b4 >kin a$ulsion c4 >kin loss . espiratorius tract. genito urinary tract. d) Dirty wounds a4 +s a result of the surgery is highly contaminated b4 <isceral perforation.
uired actions can be performed by administering a local anesthetic 54 If you need to do the closure of the wound 2-ans&oer. @ibroblasts 2connecti$e tissue cells4 ha$e a ma&or role in the proliferati$e phase. Tertiary Intention Healing 2Tertiary wound healing4 that is wound was left open for a few days after debridement action.(777/*67 J In ET"+. proliferation and maturation. Inflammation ser$es to control bleeding. the wound edges 2. collagen breakdown and regression of excess wound $ascularity 2-ans&oer. Dounds of this type are usually kept open.4 If the re. pre$ent the in$asion of bacteria.1= (= Primary Intention Healing 2primary wound healing4 that is the healing that occurs immediately after the attempted bertautnya wound edges usually with stitches. *4 ?i$e an antiseptic . 9nce belie$ed to be clean./. @rom one phase to another phase with a continuity that can not be separated. (777/ *65J . This type is characteri0ed by the presence of extensi$e in&ury and loss of tissue in large numbers. (4 emo$e all foreign ob&ects and excision of all dead tissue.&t& $n2 7o&n#! 'lean wounds and are belie$ed not to ha$e an infection and was less than 5 hours may be 87 ./%4.4. (77. 3) Wo&n# 0eal$n2 -ha!e The wound healing process has three phases. (4 #hase #roliferation This stage lasts from day 6 up to * weeks. namely the inflammatory phase. The healing process occurs more complex and longer. *4 #hase of maturation This stage lasts from the day (% and can last for months and ended when the signs of inflammation had disappeared. This wound is the last type of wound healing 2-ans&oer. %4 #hase Inflammation This phase appears soon after in&ury and can continue for 5 days. (777/*67J InET"+.3 7 days4. In this phase there is a wound remodeling is the result of an increase in tissue collagen. Secondary Intention Healing 2>econdary wound healing4 is a wound that does not ha$e a primary healing. . remo$ing debris from the wound tissue and prepare for continued healing process. (77.ome of the !tep! that m&!t be con!$#e e# $n clean$n2 the 7o&n# that $!' %4 Irrigation by as much as possible in order to remo$e dead tissue and foreign bodies.774 .
(777 @emur @ractures.pdate/ 8uly %6. )artholomeus0 =.htm. +$ailable at http/11bedahugm. while the wound is hea$ily contaminated or not demarcated and should be allowed to reco$er per sekundam or per tertiam.pdate/ -arch %5. an infection.net1)edah39rthopedi1@raktur3Terbuka. +tkinson >. #anaro ':+. as fixation and suppression effects that pre$ent the gathering of blood seepage causing hematoma. =ast 87 . in the book/ >afe +naesthesia. type of appointment of in&ury. seek a good en$ironment for wound healing. attitudes of patients and the presence of infection RE3ERENCE. In the book/ !and book of Intensi$e 'are. Remo"al of the !t$tche! >titches remo$ed when the function is no longer needed. (776 9pen fracture. =ast . %666J .cc1NpE*57. %65%J %53(6. >hock. ?eneral principles of fracture care. =ondon/ 'hapman and !all.sewn primer. age.emedicine. Dright 8 E '. Wo&n# clo!& e Dound closure is to stri$e for better en$ironmental conditions in the wound healing process takes place so that optimal. >er$es as a protecti$e dressing to the e$aporation. location. =ast . Con!$#e at$on # e!!$n2 'onsiderations in the closed dressing and bandage the wound is $ery dependent on the assessment of the condition of the wound. >hock. !amblin 8 8. health. +$ailable at http/11www. Time of suture remo$al depends on $arious factors such as.com1orthoped1byname1?eneral3#rinciples3of3@racture3'are.753. +$ailable at/ http/11medisdankomputer.co. *$"$n2 )nt$b$ot$c! ?i$ing antibiotics to the wound clean principle need not be gi$en antibiotics and the wound is contaminated or dirty it needs to be gi$en antibiotics.html.%* )uckley .
In a collection of papers/ Indonesian >ymposium 9n >hock M 'ritical 'are. E?'. %65%J c /%3. %667.pdate/ +ugust *.56 >&amsuhida&at . "ew Gork/ %665. +$ailable at http/11bedahugm. >hock.update/ 8anuary 5. Textbook of >urgery. Introductory book 9rthopaedic >urgery ed. *.klinikindonesia. >tudents are able to / %.. and complications. @racture. @racture healing. re$ised ed. -akassar/ (777. Dim :e 8ong.(. in the book/ @undamental 'ritical >upport. >ociety of 'ritical 'are -edicine. '. Dilson @.ECOND WEEK LE)RNIN* OB+ECTIVE. book %. :ellinger #.net1)edah39rthopedi1@racture. III. (. +ugust *7 3 >eptember %. @armer 8'. Limmerman 8=. The !eart in >hock 2Dith Emphasis on >eptic >hock4.html. (776 -angunsudire&o >.com1bedah1fraktur. %ODULE ( Eme 2ency of Re!p$ at$on C0)-TER I. Indonesia. Explain the symptoms in the field of pediatric emergency Explaining the symptoms of respiratory emergency Explain the mechanisms of airway obstruction in adults 87 . ed. *5(3. Garsif Datampone. =ast update/ 8anuary 7. =ast . pp. pp. Taylor D. =ondon/ %656 as&ad. :iagnosis and -anagement of >hock. (775. %666J %3. 8akarta. +$ailable at http/11www. T0E . Issue %. %%*5366 Thi&s = ?. treatment. (776 @racture.php. In the book/ -anual of 'ritical 'are.
ENT <Ea 6 No!e6 Th oat= Lect& e 1 by # . ENT a.Traumatology maxillofacial 257 minutes4 . .p.. .atya W6 .& 2e y Lect& e / by # . 1&5a 0a &n6 .. 7. )n Emergencies in pediatrics 2%77 minutes4 (. Un#an2 Koma &#$n6 .nderstand and master the handling of emergencies in thoracic trauma Explains emergency in maxillofacial trauma Explaining the symptoms of emergency E"T . -e#$at $c Lect& e 1 by # .p. )ne!the!$a Lect& e .nderstand the ob&ecti$es and actions 'ardiac #ulmonary )rain 2%77 minutes4 esuscitation 2 8#94 /.p.p. Explain the mechanisms of airway obstruction in adults and drowning 2drowning4 257 minutes4 c. 5. 5. Explain the symptoms of respiratory emergency 2%77 minutes4 Lect& e / by # . by # . Den#y %a&lana6 . Emergencies in E"T 2%77 minutes4 87 . Explain the management of airway obstruction 2respiratory resuscitation4 257 minutes4 Lect& e > by # . )n b. 3e #$6 . )n a.p.nderstand the purpose and indications 8#9 action Explain the results of radiological in$estigations thorax and maxillofacial trauma Explain the mechanisms of airway obstruction in adults and the management of airway obstruction 2respiratory resuscitation4 E4pe t lect& e' ). In# a 3a$!al6 . B a.p. 3atah .Emergencies in thoracic trauma 25 7 minutes4 Lect& e > by # . 6. 1&5a 0a &n6 . 6. B a.p. )n ..
>. Ra#$olo2y Lect& e 1 by # .k$ll lab 'ardiac #ulmonary )rain esuscitation 2 8#94 in children and adults 1 Traumatology +d$anced =ife >upport 2+T=>4 87 . Explain the results of radiological examination and maxillofacial trauma of the thorax 2%77 minutes4 T&to $al >cenario ( . Ra# a. Ka yanto6 .p.
CEN)RIO ( 3)CE.uid is brought about him. . 87 . TR)U%) + boy aged 5 years was brought to the Emergency . suffering from facial and &aw in&uries are $ery se$ere. the patient also look crowded. 'onscious patient. 9n physical examination the doctor found the patientBs difficulty answering the .uid battery rupture and the li. !e bounced from the host and his bike hit the pa$ement and the bottle containing the li.nit after an accident.C0)-TER II.uestion being asked by a doctor because of the deformity on the right cheek and out of the mouth and nose bleeding.
>ensory disturbances in the forehead. >econdary asymmetrical facial appearance of the fracture can usually be hidden. 'heck for tenderness. obli. In patients with acute facial trauma. physical examination can be disrupted by the swelling of the face. medications. REVIEW RE3ERENCE. Ostep inO or discontinuity edge orbital bone and bone madibula rhyme.* +cronyms can also be used if the trauma of threatened &iwa. and abrasions of the skin can focus the examiner to indicate parts that ha$e a risk of ner$e in&ury. and lower lip. * ( Examiner carefully assessed for neurological deficits. including facial trigeminal ner$e and facial.ue. ask the same thing as the woman to menenetukan whether there is $iolence on children. In$t$al a!!e!!ment on fac$al t a&ma )!!e!!ment on 3ace T a&ma !istory of trauma to t!e face +mple use of acronyms in the e$aluation of facial trauma patient (allergies. crepitus 2without a strong emphasis for flat bones4. events surrounding the accident) can facilitate a history of trauma with lengkap. * 87 . contusions. with skin abrasions to the soft tissue in&ury !ematoma or bleeding in the wound or the mouth of the hole gidung and as a way out bleeding from the maxillary sinus 1 fracture P!ysical e"amination Examination of systematic head and face can be the starting point and is done in a consistent treatment to pre$ent checks being let loose. =acerations. 'heck as well as the right and the left side and compare. last meal. ask if the trauma is deri$ed from a partner or a person being under threat In children. asymmetry. CEN)RIO (' 3)CE. )!k !pec$f$c B&e!t$on! abo&t t a&ma' -echanism of trauma Dhether the patient had lost consciousness :oes the patient ha$e $ision problems such as double or blurred $ision Is dental patients can normally closed 2normal occlusion4 Dhether the patient can bite without pain :oes the patient possess an area that feels numbness or tingling in the face In women. Deformities of t!e face looks >welling.C0)-TER III. past history.. . cheeks. TR)U%) ).
pupil assessment. (. maxilla are sometimes found floating in the hematoma 2floating maxilla4 * %a4$llofac$al T a&ma an# cla!!$f$cat$on -axillofacial trauma can be classified into two parts. $isual acuity. 5. bone fragments. or foreign body when there is trauma. right. 6. and examination of the con&uncti$a and eyelids. Dhile the definition of hard tissue facial bones of the head is composed of %. 0igomaJ occur separation of the center of the face with cranial bone. the hard tissue facial trauma and facial soft tissue trauma. can also appear gingi$al laceration fracture area. *. /Trauma of the maxillary bone. 7. 0igoma. * !ipestesia the second nostril ( 'heeks bulge disappeared Examination of the oral ca$ity particularly important in patients who mehilangan teeth. or bilateral.'omplete eye examination includes e$aluation of a history of eye disease. / Trauma pyramid os maxillary. nasal. The meaning of facial soft tissue is soft tissue that co$ers the face of hard tissue. . In the oral ca$ity appears occlusion disorders 2malocclusion4 that bulge premolars are not met with the hollow tooth opponent 1 partner. perception of light and red light. -axillofacial trauma to the tissue can include soft tissue and hard tissue. ocular motility. nose. 9cclusion and interkuspasi carefully done because both mandibular and maxillary fractures can result in malocclusion. =e @ort I =e @ort II =e @ort I=I "asal bone )one arch 0igomatikus -andibular bone )one 1 maxillary Eye socket bone Tooth +l$eolar bone / =imited to the al$eolar trauma left. orbitaJ place separations around the bones of the face with a base kranii =e @ort classification used to help diagnose and p treatment / 87 .. =ong3term morbidity in facial fractures are the most associated with ocular and orbital damage. Identification and remo$al of prosthetic oral ca$ity needs to be done.
). ather #urwanto language. 87 . c. =aceration that crosses the line of =anger unfa$orable cosmetic result in poor healing. Excoriation The cut. Ba!e# on the type! of $nA& $e! an# the ca&!e a. )asoeseno. b. wound.3ac$al !oft t$!!&e t a&ma Dound is the anatomical damage. d. discontinuities of a tissue by trauma from the outside arena. +. @acial incision is placed parallel to =angerBs lines 2#edersen ?D. )urn ?unshot wound T a&ma $! a!!oc$ate# 7$th an ae!thet$c &n$t @a$orable or unfa$orable. wound &ab. #ractical textbook oral surgery 2oral surgery4. %657/((64. Trauma to the facial soft tissues can be classified by / 1. 8akarta/ E?'. is associated with =angerBs lines @igure %.
External 'ardiac -assage can be done because most of the heart is located between the breastbone and the backbone so that the pressure from the outside can cause effects on the heart pump which was considered sufficient to regulate the blood circulation at least on the state of clinical death . each time blowing time from %. * b reathing It consists of two stages/ %.Fonsentrasi %63%7A. If there are wounds. hear and feel the breath of breath. and occlusion. middle. espiratory assistance gi$en by ( times. scalp.uite difficult with the trend that %7A of patients had facial trauma and cer$ical spine trauma. a techni. ear. orbit. !ead in&ury (brain injury) may delay the timing of the operation of open reduction internal fi!ation ("#$%) in bone ftraktur face. Treatment of airway disorders is .5 to ( seconds and the $olume of 777 ml 3 %777 ml 2%7 ml 1 kg or until $isible chest patients 1 $ictims gi$en oxygen mengembang. face. Secondary survey neck examination.ue helper hold the ears and nose abo$e the mouth of the patient 1 $ictim while still maintaining the airway remains open. neurological. %a4$llofac$al t a&ma %ana2ement of fac$al t a&ma Primary survey# airway airway disorders result from direct trauma to the larynx. nose. co$ered with moist gau0e while awaiting definiti$e therapy -andibuka bilateral fracture should be stabili0ed so as not to interfere with the airway 87 . mouth to nose. :o no more than %7 seconds (. foreign bodies 2including an aspirated tooth and bone fragments4. mouth to stoma 2a hole made in the throat4. Ensure the patient 1 $ictim is not breathing )y seeing the mo$ement of the chest rise and fall. #ro$ide breathing assistance !elp the breath can be done through word of mouth. or massi$e bleeding from the upper airways.(. mandibular oral ca$ity. "ote the patientBs response c irculation The most important action is to help the circulation of @oreign heart massage.
If there is a septal hematoma or hematoma auricula rice, drainage should be performed and followed by a swathe of press 1 nose tamponade.
dvanced Handling !andling information that is in the first week post3trauma. -andibular fracture/ reduction and fixation of the maxillary arch with a wire or bar produced union and the occlusion is achie$ed within P 5 weeks. eduction and screw fixation with mini plates do not re;uire locking teeth as in the wire and arch bar. @racture of the maxilla/ the reduction of the sulcus approach ginggi$obucalis and infra cilliar palpebra inferiorJ can also be fixed with wire or mini screw plate. ima important orbital fracture repositioning and fixation surgery to restore form and restore the function of orbital motion of the affected eye. "asal fracture repair should not be too long since the trauma, gi$en the nasal bones are flat and often broken3shaped impression, de$iation or crushed. .. Eme 2ency $n tho a4 t a&ma 'ause of/ +irway obstruction, ma&or hemothoraks, cardiac tamponade, pneumothorax persisted. %ana2ement of eme 2ency ' :etermination of in&ury 2penetrating thoracic wall or not4 :etermination of $ital functions 2if necessary resuscitation4 'leanup and closure of wounds )$ 7ay ob!t &ct$on @rom outside the airway/ @oreign @rom within/ The tongue that closes the airway !ow to deal with obstruction/ If the blockage seen taken with a finger or tool to pinch and pull If looks do not blow back or back slaps If the base of the tongue falls backwards doing headt tilt or chin lift.
T a&matolo2y $n the eye! an# t eatment ). B. Def$n$t$on Eye trauma is whether or not intentional acts that cause eye in&ury. The type! of eye t a&ma 1. )CID TR)U%) Traumatic acid is one type of chemical eye trauma and emergencies including the eyes caused by chemical substances are acidic with a p! Q7. >ome acids are often the eye is sulfuric acid, acetic acid, hidroflorida, and hydrochloric acid. #roper management of the trauma chemical is irrigated with sterile isotonic saline and check the p! of the ocular surface by putting the indicator in the fornix of a sheaf of papers. epeat the irrigation if the p! is not located between 7.* to 7.7. 2<aughan, (7774. (. B),E TR)U%) The trauma of alkaline chemicals will gi$e a mild irritation to the eyes when $iewed from the outside. !owe$er, when seen on the inside of the eye, this trauma resulted in an emergency base. )ase will penetrate the cornea, camera oculi anterior, and to the retina ;uickly, so it ended in blindness. +t the base trauma will occur corneal collagen tissue destruction. 'oagulation chemicals are alkaline and cell happening persabunan process, accompanied by dehydration. +ccording to the classification Thoft, basa trauma can be di$ided into / :egree % /'on&uncti$al hyperemia T er&adi accompanied by keratitis pungtata :egree ( /'on&uncti$al hyperemia T er&adi with loss of corneal epithelium ?rade * /9ccuri con&uncti$al hyperemia accompanied by necrosis and loss of corneal epithelium ?rade , / perilimal con&uncti$al necrosis by 57A +ction if there is trauma to ;uickly perform basic irrigation with normal saline as long as possible. Dhen irrigation may be done at least 67 minutes after trauma. #atients were gi$en sikloplegia, antibiotics, E:T+ to bind bases. E:T+ is gi$en after % week of trauma base, necessary to
neutrali0e the collagenase which is formed on the se$enth day. 'omplications that can occur is simblefaron, corneal opacification, edema, and neo$asculari0ation of the cornea, cataracts, accompanied by ptisis eyeball. .. -enet at$n2 t a&ma Is a trauma in which some or all layers of the cornea and sclera ha$e damage. Et$olo2y 9ccurs due to the entry of foreign ob&ects into the bulbus oculi / R R 3 3 3 3 3 3 3 -etal / -agnet, the magnet is not "on3metallic :ecreased $isual acuity =ow intra3ocular pressure Iridocornealis shallow angle >hape and location of the pupil changes "o sightings of the cornea or sclera rupture Tissue prolapse 2off4, such as iris, lens, retina 'on&uncti$al chemosis
%ana2ement Topical antibiotics, eyes closed, and immediately sent to the eye doctor to do surgery. >ystemic antibiotics administered orally or intra$enously, anti3tetanus prophylactic, analgesics, and sedati$es if necessary. should not be gi$en local steroids and splint should not be pressing the eyeball. Expenditures of foreign ob&ects should be done in a hospital with ade;uate facilities. /. Bl&nt t a&ma %. )lunt trauma palpebra + blunt impact could push the eye back to the possibility of damaging the structure on the surface 2eyelids, con&uncti$a, sclera, cornea and lens4 and the structure of the back of the eye 2retina and neural4. )ecause palpebra a protecti$e ball when there is trauma to the eye it will do reefleks close. This will cause the occurrence of hematoma palpebra. !ematoma is due discharge of blood from damaged blood $essels in the trauma (. )lunt trauma to the lens
a. b. c.
=ens dislocation. =ens dislocation occurred in 0onula Linn which breakup will lead to impaired lens position. =ens subluxation. #artly due to rupture so that the lens Linn 0onula mo$e. =uxation +nterior lens. If all the 0onula Linn around the e;uator dropped out due to trauma to the lens into the anterior chamber. =uxation #osterior lens. In blunt trauma is hard on the eyes may occur due to rupture the posterior lens luksasi Linn 0onula around the e;uator of the lens ring so that the lens falls into the glass body and sinking on the plain below the #olus posterior ocular fundus. Traumatic cataract. In the blunt trauma of the anterior subcapsular cataracts will be seen or posterior. 'ontusion cataract lenses pose like a star, and can also be printed in the form of cataract is called a <ossius ring
)lunt trauma to the cornea 'orneal abrasion is a state in which the corneal epithelium regardless of which can be caused by blunt trauma, sharp trauma and chemical trauma and foreign bodies subtarsal. +nd recurrent corneal abrasion can cause extreme pain, which is an emergency corneal abrasion to the eye that can lead to ulceration and edema of the cornea which would disturb the $isual acuity
Trauma fundus oculi )lunt trauma to the eye can lead to abnormalities in the retina, choroid, and optic ner$e. 'hanges that occur may include retinal edema, retinal hemorrhage, retinal detachment, and optic ner$e atrophy. If found patients with blunt trauma and sharp $ision that can not be corrected with the glasses, while the clear eyes of the state media, it can be estimated by abnormalities in the fundus or in the back of the eyeball 29phthalmologist +ssociation of Indonesia, (77(
#ublisher )inarupa script.linical Pathophysiology . p %%753 57. #hiladelphia.77. p 5(*. +pley and >olomon... pp.6*5. =ondon. !arrelson 8-. -usculoskeletal >ystem in >yamsuhida&at .RE3ERENCE. %667. 'arter -+. 8akarta. D) >aunders 'ompany. )utterwordh3!einemann. E?' -edical )ook #ublishers.&ung #andang =amumpatue >tars. %66. E?'. @ractures and :islocation in >abiston 8r :'. >. =ondon. %666.7%.3%(5 87 . %665. %667. in $ntroduction to Trauma Surgery (Ds. pp.?-. p/ %%(. >e$enth Edition. @ifteenth Edition. E?'.%%%6. *e!boo) of Surgery *he +iological +asis of (odern Surgical Practice. %66*. Dilson =-. >&amsuhida&at .oncepts of Disease Processes. p/ *. %665. +natomy and #hysiology of )one and 8oints in #rice >+. )ook II. .*35(5 eksoprod&o. (6th edition. #rinciples of @racture +ge Sistema in (usculos)eletal *rauma. -edical :ictionary. @eagin 8+. )erend -E. the set of -:s examination of Surgery %aculty of (edicine -ecture. @F. p/ . %*65 to %. +rmis. de 8ong D. . @racture and 8oint In&uries in &pley's System of "rthopaedics and %ractures.5*3. issue . as&ad '. 8akarta. =ondon. :orland. p/ %3*(. . *e!tboo) of Surgery.6635%5. 8akarta.
)eing able to calculate the infusion of fluids in shock and bleeding 257 minutes4 87 . .. )ne!the!$a lect& e @ by # .nderstanding the signs and symptoms of shock 2hypoperfusion4 +ble to calculate the fluid in the shock and bleeding Explains emergency abdominal surgery and treatment Explain the cardiac emergency . -$ ma 0&ta& &k6 . 5. B a.p. treatment principles. . 1&5a 0a &n6 . Un#an2 Koma &#$n6 . 5.& 2e y Lect& e > by # . Ob!tet $c! an# *ynecolo2y Lect& e 1 by # . )! $5al T6 . (. Eme 2ency hemo#ynam$c C0)-TER I.p.p.nderstanding the signs and symptoms of shock 2hypoperfusion4 257 minutes4 b. burns.p.nderstanding and assessing burns and principles of treatment of burns Fnow and be able to perform stabili0ation actions with strict monitoring on burns Explain and capable of handling emergencies on the skin E4pe t lect& e' 1. Explains emergency obstetrics and gynecology . Ta&f$B& ahman R6 . T0E T0IRD WEEK LE)RNIN* OB+ECTIVE. Emergency heart 2%77 minutes4 . 6. 7.. %. +a. *. )n a.%ODULE .p. and criteria for inpatient stabili0ation and reference 2%7 7 minutes4 Lect& e @ by # . O* a. aspect of emergency abdominal surgery and treatment 2%77 minutes4 /. 0ea t Lect& e 1 # . B a. Emergency 9bstetrics and ?ynecology 2%77 minutes4 (. .
.yafe$ 0am5ah6 . K K emergency >kin 2%77 minutes4 T&to $al >cenario * . %.p.k$n an# *en$tal Lect& e 1 by # .k$ll lab ETT 2Endo tracheal tube4 87 .>. .
87 . =aboratory results obtained/ proteinuri K*. #atients are aware of pain in the chest and abdomen which caught fire. >lightly hoarse $oice. :uring the +"' obtained blood pressure %571%77 mm!g. 5 months pregnant during the antenatal care 2+"'4 has done regular to a gynecologist. but the patient still feels pain.nit with burns along his chest and abdomen caused by the explosion of a sto$e when she was cooking.. +t the time of the patientBs sudden sei0ure and tension obtained (771%%7 mm!g and a weak but rapid pulse. 9ne day he was taken to the Emergency . 9n examination :88 %67 x per minute .CEN)RIO . The patient complained of breathlessness and coughing. black sputum. .C0)-TER II. + woman of *5 years. his eyebrows on fire. the second leg swelling.TOVE EC-LODE. . )listers were found in the chest and abdomen.
. effecti$e $entilation and support the systemic circulation. 9xygen administration %77A +ims to pro$ide the oxygen re. The main priority is to maintain the airway remains patent. intubation and nasotrakea orotrakea preferred o$er tracheostomy. Intubation can not be done if there has been a burn edema or fluid resuscitation is too much. Intubation Intubation action done before the manifestation of mucosal edema causing obstruction. %ana2ement of a$ 7ay e!&!c$tat$on ' %. *.uirements when there is blocking the airway pathology of oxygen supply. 'ricothyroidotomy +iming with intubation only be considered too aggressi$e and lead to greater morbidity than intubation.C0)-TER III. Endotracheal intubation performed in patients suffering from se$ere burns or suspicion of inhalation in&ury or burns to the upper airway. 1. (. +irway care >uction secretions 2periodic4 Inhalation therapy 87 .' . 'ricothyroidotomy minimi0e dead space. . if compared with intubation. )e careful in gi$ing large doses of oxygen as it can cause oxidati$e stress. REVIEW RE3ERENCE.TOVE EC-LODE. CEN)RIO . 6. it is easier to do bronchoal$eolar rinses and the patient can talk. T eatment of b& n! e!&!c$tat$on a. so it will form free radicals that are $asodilator and modulator of sepsis. 5. #urpose of intubation to maintain airway and the airway pemelliharaan facilities. . In burn patients. tidal $olume increase. The p $nc$ple of t eatment of b& n! an# the$ cla!!$f$cat$on )urn patients should be e$aluated systematically.
uirements of this / The 7ay E"an! %. whereas a dose of children 7. 9n the second day gi$en half the amount of fluid the first day. hours.% to 7. Inhalation therapy generally uses li. 57367A carbohydrates and (53*7A fat. The rest are gi$en in the next %6 hours. N&t $t$onal e!&!c$tat$on In burn patients. m= !alf of the amount of fluid gi$en in the first 5 hours. "utrition pro$ided should contain %73%5A protein. 6. It is expected early nutrition can help pre$ent the occurrence of >I > and -9:>. hours !alf of % K( K* is gi$en in the first 5 hours. hours Extensi$e burns 2A4 x weight 2kg4 to (.gastric can tube 2"?T4.6A base plus bronchodilator when necessary. 5.( mg 1 kg and the 'maintenance' 53(7 mg177 kg e$ery . b. The rest are gi$en in the next %6 hours.+ims to seek a better air atmosphere in the airway lumen and li. then feeding through naso. Ba4te 3o m&la Extensi$e burns 2A4 x weight 2kg4 x .777 cc glucose 5A per (.uefy thick secretions so easily remo$ed. c. hours4.uid sodium chloride 7. If the patient is unconscious. Extensi$e burns 2A4 x weight 2kg4 into m= "a'l per (.75 to 7.( mg 1 kg e$ery . (. 9n the second day gi$en half the amount of fluid the first day. *. the enteral feeding should be done early and the patient does not need to be fasted. T eatment of b& n! ?enerally to relie$e pain from burns used a small dose of morphine intra$enously 2initial adult dose/ 7. )ut there is 87 . There are se$eral ways to calculate the fluid re. Early nutrition can enhance immune function and pre$ent the atrophy of intestinal $illi. m= plasma per hour (. +dditionally bias added substances with specific properties such as atropine sulfate 2lowering the production of secretions4. sodium bicarbonate 2to o$ercome cellular acidosis4 and steroids 2still contro$ersial4 7. 9n the third day be half the amount of fluid the second day. inse bronchoal$eolar ehabilitati$e care for respiration Escharotomy on the wall of the piston which aims to impro$e lung compliance %ana2ement of fl&$# e!&!c$tat$on @luid resuscitation is done by gi$ing replacement fluids. 9n the third day be half the amount of fluid the second day.
some experts conclude that carbon monoxide poisoning is a ma&or cause of inhalation trauma. The incidence of burns increases with age. ben0odia0epines may also be gi$en in addition. TR)U%) %EC0)NI. years. The pre$alence of men and women are e. +ffinity for carbon monoxide binds to hemoglobin (77 times more than the oxygen concentration karboksihemoglobin high enough so that e$en if the concentration of carbon monoxide in the air only 5A. If there is hot steam $apor will cause damage to the distal part of the respiratory tract. Inhalat$on t a&ma Trauma can be defined as the inhalation of acute damage to the respiratory system caused by the inhalation of combustion products or $apor where the patient is in a closed room.also a pro$ision stating methadone 253%7 mg adult dose4 e$ery 5 hours is the treatment of chronic pain is good for all adult burn patients. :irect trauma to the respiratory system the most rare cases. (. Effect of this gas in the tissues causing hypoxia due to carbon monoxide binds to hemoglobin and oxygen and compete with binding to hemoglobin. dry air 2*77 @ or more4 caused damage to the tissue in the upper respiratory tract and laryngs. namely carbon monoxide and smoke inhalation. egion are usually exposed to inhalation trauma is oropharings. Toxicity of carbon monoxide depends on the concentration in the air and how much exposure to carbon monoxide. o To"icity of smoke 87 . In the edema can arise laryngs laryng. Dith the highest incidence is found in o$er 56 years and the lowest incidence below the age group 53%. spasm laryngs. colorless and does not cause irritation resulting from incomplete combustion of carbon. >moke is di$ided into two. tracheobronchial tree or lung parenchyma. Carbon mono"ide 'arbon monoxide gas is a gas that is odorless. Direct trauma Inhalation of hot. and shortness of breath. namely the direct trauma and smoke poisoning. If the patient still feels pain despite the administration of morphine or methadone.% There are two mechanisms of occurrence of inhalation in&ury. >ome literature mentions inhalation trauma was found in *3%5A of patients who present with se$ere burns.ual. namely %/ %.
DI)*NO. (4 Examination Examination re$eals a black3colored sputum. Dhich in minutes will be detected as bronchial edema and peri$asculer. hyaline membrane formation. when the cause of burns due to flames in the room that opens the possibility for the occurrence of inhalation in&ury is reduced. If inhalation trauma se$ere enough. which will lead to the onset of whee0ing due to bronchial obstruction. and the latter no pulmonary edema. +s for some additional symptoms. a hoarse $oice. among others. *4 In$estigations >e$eral in$estigations can be done to establish the diagnosis of inhalation in&ury / a4 'hest x3rays b4 )lood ?as +nalysis 87 . and aldehydes. :iagnosis of inhalation in&ury on the basis that/ %4 +namnesis 9btained from the anamnesis causes burns and whether the patient is stuck in the house that tebakar or not. 9nce established it will be followed by pseudomembranous necroti0ing bronchiolitis. colored laryngs hita 2by examination laryngoskop4 is a significant sign of inhalation trauma. +fter se$eral hours.In addition there are also noxious carbon monoxide gas that is the result of degradation of man3made material. Ekspetorasi black sputum usually occurs at this time. acrolein showed irritation of the respiratory tract of the upper and pulmonary edema. it will cause damage to the al$eoli and the bronchial epithelium which will also spread to the capillary. cough and difficulty breathing. If the patient is stuck in the house then it will increase the likelihood of inhalation trauma. intraal$eolar perdarhan. Dithin a few seconds then it will decrease surfakatan work which will be seen as micro and macro atelectasis. eyebrows and nose hair on fire. +t this time the patient will spend sputum and bronchial mucosa contain. -athophy!$olo2y :irect effects of smoke inhalation on the loss of cilia function and se$ere mucosal edema. the mucosa of trakeobronkial will begin to form membrane peeling and mucopurulent. -eanwhile. fibrin3thrombus formation.I. while the nature of the material produced oxidation of sulfur and nitrogen. 9ne of the aldehyde.
hock Re!pon!e eduction of shock begins with general measures aimed at impro$ing tissue perfusionJ impro$e oxygenation of the bodyJ and maintain body temperature.4 54 64 . Immediately pro$ide first aid in accordance with the principles of resuscitation +)'. namelyJ %4 (4 *4 . -ake sure the $entilation and ade. This action does not depend on the cause of shock. espiration 2) E breathing) should be ensured. -ake sure the airway remains free to make endotracheal intubation. If there is a deep burn on the neck and the body then . if necessary.c4 )ronchoscopy )ronchoscopy is the gold standard examination to confirm the presence of inhalation trauma. +t bronchoscopy examination found / • • • • • )lack !yperemia.uate oxygenation to peripheral regions @luid resuscitation #ulmonary toilet and bronchodilators +nalgosedasi >pecific +ntidotum %ana2ement of !hock <hemo#ynam$c= . +irway 2+ E water way) should be free if necessary with the installation of an endotracheal tube.uickly made incisions to relie$e the neck and body. 87 . bronkorhea #etechial #ink3gray areas of necrosis S Dhite area is flat but sometimes conca$e %)N)*E%ENT Treatment for patients with inhalation trauma. and anaphylactic shock4 should be treated with intra$enous fluids and if necessary the pro$ision of inotropic drugs to maintain cardiac function or $asoconstrictor drugs to cope peripheral $asodilatation. neurogenic shock.. :iagnosis should be established so that it can be a causal treatment. to pro$ide artificial $entilation and administration of oxygen %77A . 'irculatory $olume deficit 2' E circulation) in true hypo$olemic shock or relati$e hypo$olemia 2septic shock.
(. 87 . Tilted3head prop his chin. the contents of the $ein. . either because of bleeding or bleeding that looks in$isible. gi$e oxygen to the pump lid (&mbu bag) or ETT. -onitor pulse. %a$nta$n C$ c&lat$on Immediately attach an intra$enous infusion. such as bleeding from the gastrointestinal tract. placental tissue and the possibility of spending fetal death. signs of pregnancy. rarely longer. skin color. The cause of this disorder is the phase shift occurs 1 o$er the placenta o$erlaps internum cer$ix which causes the release of the placenta. if necessary. Especially in the ampulla of tubal pregnancy. . o$arian pregnancy is rare. if any secretions or $omit. #erform exploitation. Ek!t a&te $ p e2nancy <ectop$c= The cause of this disorder is the o$um transport delays due to mechanical obstruction of the road that passes through the uterine tubes. )leeding is not $isible. 3$n# an# O"e come Ca&!e )leeding is a common cause of shock in trauma patients. (.%a$nta$n Re!p$ at$on %. possible symptoms of peritoneal irritation. blee#$n2 f om 7o&n#!6 or hemateme!$! from gastric ulcer. The diagnosis is confirmed by the presence of amenorrhea *3%7 weeks. ?i$e oxygen 6 liters 1 minute If breathing 1 $entilation is inade. 'lear the airway..uate. *. -lacenta p e"$a #lacenta pre$ia is the implantation of the placenta into the lower uterine segment. and 2'<#4. and possible shock. )bo t$on +bortion is spending the products of conception are age less than (7 weeks of pregnancy. !plen$c $nA& y6 p e2nancy o&t!$#e the &te &!6 pel"$c f act& e!6 and la 2e or multiple f act& e!. such as duodenal ulcers. irregular $aginal bleeding 2not always4. urine production. $aginal bleeding a lot or moderate fe$er 2chills4. /. <isible bleeding. blood pressure. 'an more than one infusion. attach a walker breath (/udel 0 oropharingeal airway). 9n septic abortion. The diagnosis is based on the presence of amenorrhea. Eme 2ency ob!tet $c ).. $aginal bleeding.
9liguria./. accidents 2 traffic accidents4. cyanosis. impaired consciousness4. >trassman operation. is dead or can not li$e. If either one of the following signs or symptoms are found in pregnant women.uipment4 and incarceration 2spasm in the isthmus region of the cer$ix. shock 2weak pulse.77 cc 1 (.ept$c !hock <Bacte $a6 En#oto4$n= The cause of this disorder is the inclusion of gram negati$e bacterial endotoxin 2coli. scarring of the uterus 2the state after cesarean section. and puerperal eclampsia. blue nails4. :ependent on the onset. (. mothers predictably suffered se$ere preeclampsia. enterococcus4. followed by a comma.lostridium welchii) is less common. hours. 87 . We$2ht p eeclamp!$a The term eclampsia comes from the ?reek word for OthunderO. external bleeding $aries4. . #roteinuria. . )lood pressure was %671%%7 mm!g. :iagnosis is made by the placenta is not born spontaneously and was not sure if the placenta is complete.. often caused by an o$erdose of painkillers4.ol&!$o <ab &pt$on= -lacenta #lacental abruption is a normal placenta detaching embedded in the wall of the uterus either partial mauppun complete. eclampsia parturientum. meomenukleasi. are $ery rare. the urine is less than . low blood pressure. cold extremities. >. >ub&ecti$e complaints 2epigastric pain. D. $isual disturbances. bleeding per $agina 2rare and in se$ere cases. more than *g 1 liter. where the latitude is negligible for a drug o$erdose or labor induction of labor pain. The word is used because it seems eclampsia symptoms occur suddenly without any prior signs of another. . headache. pulmonary edema. Reta$ne# placenta <-lacenta Incomplet&!= The cause of this disorder is retained 2born less powerful pain or pathology e. fetopel$ik imbalance. R&pt& e# &te $ The cause of uterine rupture include obstetric measures 2$ersion4. rapid. to weigh fluctuating heart sounds 2almost always exceeds the limits of the norm. The cause is retroplasenta hematoma due to bleeding from the uterus 2changes in blood $essel walls4. di$ided into eclampsia eclampsia gra$idarum. %. cold sweats. @. wedge excision suetu tuba4. increased pressure in the room inter$illus enhanced by hypertension or toxemia. tetanik uterus4. proteus. E. ?ram3positi$e bacterial toxin 2streptococci. pseudomonas. . at the age of (7 weeks or more. aerobakter. The diagnosis is confirmed through the findings of pain 2due to contraction peralinan often exist as a continuous pain. pallor. Eclampsia in women who suffer from sei0ures occur. *. it is generally not there are in se$ere cases4.
-ethyldopa estimated safe for nursing mothers. ?i$ing a thia0ide diuretic should be sad indarkan therefore can cause a decrease in milk production. The hardest complication is maternal and fetal mortality. and platelets less than %77. (. Except for propranolol. found increased le$els of li$er en0ymes with &aundice. sei0ures due to drug anesthesia. 9n examination. or coma due to other causes such as diabetes. -ethyldopa 'lonidine HT3adrenergic agonistI 'alcium channel blockers !ydrala0ine )eta blockers Fnowledge about the pharmacokinetics of anti3!T drugs in breast milk is minimal. bleeding in the retina.777 1 mm. .o"$!$on of the ant$hype ten!$"e effect of b ea!t fee#$n2 Ob!tet $c %ana2ement of -&bl$c 9n my first $isit to ask/ o o o o o o o 9ld hypertensi$e and type of drug used +nd a history of kidney disease or heart 9utcome of last deli$ery @undus examination occuli enal artery auscultation :orsalis pedis artery pulse examination 2coarctatio aorta4 Examination of T: in a sitting position #hysical examination/ 87 . Cont ol of 0ype ten!$on • • • • • b. T eatment of hype ten!$on of p e2nancy a.5. o o o o o c. 'aptopril 'lonidine and le$els in breast milk is minimal. :iagnosis of eclampsia should be distinguished from epilepsy. another beta blocker type found in breast milk with high le$els.
:unn :=. (776. editors.burnsur$i$orsttw. #ollock E. =ockwood '8 and -8 #aidas. )urns.org1burns1grafts.>+.3hour urine creatinine clearance to see Thorax U3ray . 7*35. #reeclampsia and hypertensi$e disorders In Dayne . Issue (. billiar T . eport of the "ational !igh )lood #ressure Education #rogram Dorking ?roup on !igh )lood #ressure in #regnancy. (777/ (77 3(6. editor. !alamka 8.*3. +gusuts (5. :iet ad$ice +hmadsyah I. In/ )runicardi @'. In/ >&amsuhida&at . @etomaternal -edicine +ssociation #9?I th th 87 . !olmes 8!. *7 +ugust (776 . >plit Thickness >kin ?rafting and @ull. 'ohen 'omplications of #regnancy. com . -oenad&at G. h. +-8. (777/ . +ngsar -: et al.. 5th ed. +ndersen :F. :ekker ?+. ((th ed. :ownloaded from/ http/11www. . et al.uency of antenatal antenatal care more often than RE3ERENCE. ?ant "@. (77(/ 57*366. . =uka. !irshon 8-.html. #rasetyono anyway. Issue (. 'uningham @?. (777J %5*/ >% 3 >((.5(.ltrasound examination/ to determine the gestational age / etriksi regular food without salt The fre. 'hurchill =i$ingstone. 'onnecticut/ +ppleton and =ange. >ibai )-. ?uidelines for -anagement of !ypertension In #regnancy In Indonesia. In/ Dilliams 9bstetrics. +-8 9bstet ?ynecol %665J %76/ %*56375. "ew Gork/ -edical )ooks E?'J (775. +lson . edition. #hiladelphia/ Dilliams and Dilkins =ippicott. Ethiology and pathogenesis of #reeclampsia/ 'urrent 'oncept. !ypertensi$e :isorders in #regnancy. -ac :onald #'. In/ >lapper :. :ownloaded from http/11www. de 8ong D. 9bstet ?ynecol. Tala$era @. ) root in&uries. .=aboratory tests at the first antenatal $isit/ o o o o o o o o 'omplete blood and urine examination enal physiology !epatic physiology >erum electrolyte E'? (. editors. >ibai )-. Thermal burns. >chwart0Bs principal surgery. !ypertension in pregnancy. "arad0ay 8@U. !unter 8?. +dler 8. 5 ed. !eimbach :-.>+/ The -c?raw3!ill 'ompaniesJ (777.emedicine health. "ew Gork/ #ublishing 'enter >chool of -edicineJ (77*. Textbook of surgery. In/ 9bstetrics normal and problem pregnancies.
Explain and perform and how to stabili0e the trauma patient transport 25 7 minutes4 b. Ne "e Lect& e 1 by # . %. 6.p.p. ecogni0e emergencies at the in&ury head and penatalaksaannya 2%77 minutes4 lect& e E by # . B a. *.&llyaman6 . . 5. Roe57$ )5ha y6 . . 3OURT0 WEEK LE)RNIN* OB+ECTIVE. B. .% ODUL / Eme 2ency ne& o2en$c C0)-TER I. (.& 2e y lect& e D by # . .p. :escribe the action or the management of emergency patient referrals 257 minutes4 (.. Explain a $ariety of emergencies in the field of neurology and handling 2%77 minutes4 87 . 1&5a 0a &n6 . ecogni0e emergencies at the in&ury head and penatalaksaannya Explain the radiological examination to help establish the diagnosis of head in&ury Explain a $ariety of emergencies in the field of neurology and handling Explain the mechanism and management of disorders caused by impairment of consciousness intracerebral Explain and perform and how to stabili0e the trauma patient transport :escribe the action or emergency patient referral management E4pe t lect& e' 1.
p. Ra#$olo2y Lect& e ( by # . .. . Ra# Explain the radiological examination to help establish the diagnosis of head in&ury 2%77 minutes4 T&to $al >cenario .k$ll lab +ssessment of ?lasgow 'oma >cale 2?'>4 87 .Lect& e ( by # .p. Ka yanto6 . Explain the mechanism and management of disorders caused by impairment of consciousness intracerebral 2%77 minutes4 . Roe57$ )5ha y6 .
C0)-TER II.CEN)RIO / Rac$n2 + young man of %5 years in the conscious state was brought to the emergency unit after a motorcycle accident. . ( 5 x 1 min. 9btained $ital sign obtained T: %57167 mm!g. 87 . the patient experienced a rapid decline in consciousness and response to pain is the lower. right pupil fixed and dilated. confused speech. while the left pupil small and reacti$e. and on physical examination found he matom in the region of the right orbit and right temporal region. esults found history anamnesis loss of consciousness for %7 minutes. pulse 67x 1 min. The patient can not walk alone. +fter *7 minutes.
Way! to !tab$l$5e an# t an!po t t a&ma pat$ent! The focus of treatment of $ictims with head in&uries at area hospitals are pre sa$e li$es and pre$ent disability. long spine board in case of in&ury to the spine and neck in neck in&uries can colar and stabili0ation of simple tools that others can reduce the risk of secondary damage due to an unstable position. In the pre3hospital phase of the emphasis gi$en to maintain the smooth airway.C0)-TER III. -ake sure the patientBs breathing is still there. To a$oid the interference problem handling airway is a priority o$er all other issues. apply first attempt to control bleeding by bandaging press on the in&ured area. patient stabili0ation and transport to the nearest hospital. "ot uncommon in cases of spinal cord in&uries are not properly handling the stabili0ation of secondary in&ury that would cause interference resulting in a more se$ere and reco$ery is not perfect. . $reat!ing (!el%s breat!ing) >econd act of belie$ing that there are no barriers to airway breathing is helpful. If you find any bleeding. In addition aspiration of gastric contents is also a danger that threatens the airway. In addition to checking the existence of a foreign body. Stabili&ation (maintain %osition) 9ften changes in patient position that is not true it will add to the in&ury suffered. Installation of the traumati0ed limb splint. control bleeding and syock. Circulations (control bleeding) Efforts to mempertahnakan cirkulasi that can be done pre hospital is to pre$ent loss of blood in cases of trauma with bleeding.CEN)RIO /' ac$n2 ). airway obstruction may occur because the base of the tongue falling backwards so that it co$ers the flow of air into the lungs.. REVIEW RE3ERENCE. 87 . In patients with impairment of consciousness ha$e a high risk for the occurrence of airway disorders. irway (airway) 9xygenation of brain disorders and other $ital tissues are the fastest killer in the case of trauma.
• • • Simple 1ead $njury Simple diagnosis can be confirmed by head injury There is a history of trauma capitis "ot pass >ymptoms of headache and di00iness ?enerally do not re. $ertigo. 87 . treatment for *35 days for obser$ation of possible complications and gradual mobili0ation. e$en though the neurons were damaged or lost. lost consciousness during re$ersible blockade lasts. therefore.uipment. Therefore. >ymptomatic therapy. EE?. 2. Dhat is important for the occurrence of lesions is the acceleration of the head contusion that instantly cause a shift in the brain and the de$elopment of destructi$e compression forces. <ertigo and $omiting may be due to a concussion in a ma0e or terangsangnya centers in the brain stem.ontusio . and $omiting may appear pale. :ue to blockade it. the brain does not recei$e afferent input and. which is not accompanied by damage to brain tissue. (. 3.uire special treatment. +dditional checks are always made is a photo of the skull. . the memory loss during a limited period before the accident.Trans%ortation (trans%ortation to Hos%ital) Dhere$er possible the patient was brought immediately to the nearest hospital for treatment can be done completely with the proper e. the brain is too strong stretching of the brain stem. 'ommotio cerebri on may also ha$e retrograde amnesia.ommotio cerebri 2apoplexy4 is a stupor that lasted no more than %7 minutes due to head trauma. >trong acceleration also means the head hyperextended. T a&ma cap$t$! an# cla!!$f$cat$on Trauma capitis is a mechanical trauma that directly or indirectly on the head and cause neurological dysfunction. &ust gi$en symptomatic medication and get enough rest.ommotio . .erebri . +mnesia is due to elimination of recorded e$ents in the temporal lobes. &. memory checks.erebri +t contusio cerebri 2brain contusion4 hemorrhage3bleeding within the brain tissue without tearing åanyang in$isible. causing a re$ersible blockade of the tra&ectory of the ascending reticular diffuse. #atients may complain of headache.
anti3 bleeding. Therapy with antiserebral edema. %racture Database . symptomatic. especially in an open depressed fracture. or if there is no more than %7 minutes The patient complained of di00iness. =aceratio =aceratio can be di$ided into direct and indirect. 87 . -aceratio . @racture of the anterior fossa symptoms / • • • >ubkon&ungti$al glasses hematoma without bleeding Epistaxis hinorrhoe The distribution of other head in&uries / %$l# 0ea# InA& y V includes =aseratio and 'ommotio 'erebri o o o o ?'> score of %*3%5 There is no loss of consciousness.Incidence of lesions in the region contusio 4coup4. there is retrograde amnesia and no abnormalities found on neurologic examination. =aceratio while not directly caused by a se$ere deformity due to tissue mechanical strength. and OintermediateO cause symptoms of neurologic deficit that may be a reflex babinsky positi$e and . and treatment of neurotrophic 73%7 days. acute subdural and intercerebral.ranii %ractur be the basis cranii anterior fossa. =aceratio usually associated with a subarachnoid hemorrhage traumatika. 4contrecoup4.-" paralysis. The symptoms depend on the location or where the affected fossa. it nausea.erebri -aceratio cerebri is said if the damage is accompanied by a tear piamater. +s well as $egetati$e centers are in$ol$ed. the patient usually indicates Oorganic brain syndromeO. resulting in $asoparalitis. 5. =ow blood pressure and pulse become slow. $omiting and respiratory problems can arise. In$estigations such as 'T3scan is useful to see the location of the lesion and the possibility of short3term complications. +fter pulleys consciousness returned. :ue to the force de$eloped by the mechanisms that operate in the aforementioned trauma capitis. impaired autoregulation of cerebral blood $essels. fossa posterior fossa and the media. 6. headache There is $omiting. =aceratio directly caused by penetrating head in&ury caused by a penetrating foreign body or fracture fragment. or become rapid and weak.
?'> score of 63%( There are faint more than %7 minutes There are headaches. sei0ures and retrograde amnesia "eurological examination found lelumpuhan ner$es and limbs.= e4am$nat$on The degree of in&ury can be assessed according to the le$el of consciousness through the ?'> system. . the method of E-< 2Eyes. * ( % 87 .%o#e ate hea# $nA& y o o o o o o o o . * ( % 5 .e $o&! 0ea# InA& $e! *la!2o7 Coma . $omiting. &ust in a more se$ere The occurrence of a progressi$e impairment of consciousness The presence of skull fractures and brain tissue apart. The ability of the eyelid 2E4 • • • • (. <erbal. ?'> score Q5 ?e&alnya similar to 'F>.. -o$ement4 %. • • • • • *. * ( % .cale <*C. • • • • • • >pontaneously 9n orders #ain stimuli "ot react 'ommunication capability 2<4 ?ood orientation +nswer chaotic The words do not mean ?roan "o sound -otor skills 2-4 +bility according to the command =ocal reaction +$oidance +bnormal flexion Extension "ot react 6 5 .
b.. Ele$ation of the head b. 87 . k. 9smotic diuresis with mannitol (7A % g 1 kg i$ e. 'T3>can # erhatikan pupil 9$ercome cerebral edema @ix the balance of fluids. be careful of the fracture cer$ical 2neck stabili0ation4 =esion obser$ed in other body parts 'omplete neurologic examination and U fot the head. >edation in the e$ent of se$ere agitation 2mida0olam %3( mg i$4 #. Impro$e cardio$ascular 2shock tackle4 @ix the balance of respiration. h. likuorhoe. 'ases of suspected encephalitis by herpes $irus infection can be administered acyclo$ir %7 mg 1 kg i$ e$ery 5 hours 'ases of meningitis do therapy empirically. . $entilation or good airway E$aluate the le$el of awareness 9bser$e the lesion in the head. %ana2ement of pat$ent! 7$th $mpa$ ment of con!c$o&!ne!! %ana2ement of -at$ent! 7$th #ec ea!e# 8 kah$lan2an a7a ene!! 1. l. f. c. fracture impressions of more than % cm immediately made operati$e >. #rotect patients by ceftriaxon (x% . &.uate oxygenation and $entilation *ene al The apy %. Intubation and hyper$entilation c./. open kranioserebral penetrating in&ury. e. i.$o $ta! p e"ent$on of hea# t a&ma a. the following is the first treatment/ a. whether there are impressions of fracture. neck. /. %ana2ement of t a&ma cap$t$! . signs 3 sign fracture of the cranial base. g. (. !andling emergency decompression of the lesion persisted space (space occupying lesions 1 >9=4 can sa$e patientsB li$es. If there is an increase in I'T.x% g ampicillin i$ and pending culture results +irway protection/ ade. :exametason %7 mg i$ e$ery 6 hours in case of cerebral edema by a tumor or abscess after this therapy I'# monitor should be installed. electrolytes and calories Intra3cranial pressure monitor >ymptomatic treatment or conser$ati$e If there is deterioration of consciousness accompanied by intra3cranial bleeding more than 75 cc. d.
oxygen. while on the mo$e. geographical situation. In addition.uickly achie$e the specified referral hospital. often considered the social. security. there are three things to do / %. There 87 .uabidest. @. should be directly referred to the existing hospital neurosurgical facilities 2pro$incial hospital4. which is accompanied by medical personnel. Therefore. sei0ures. (5 cc a. Thus. look at the situation and conditions in our country. and anxiety.uirements. Dhen it is within easy reach and without aggra$ate the condition of the patient. whene$er possible should any patients with head trauma admitted to hospital with a 'T scan of existing facilities and neurological surgery. (.6A. and cost make it difficult to refer patients. a complete referral letter and &ela s. @. The principle is OTo get 7a definiti$e care in the shortest time B. dia0epam ampoules and $ials khlorproma0ine4. intra$enous fluids or = "a'l 7. and . geographical. so it is necessary to handle for us to determine the best decisions for the patient.. )ut.(. nurses are able to handle a minimum of +)'.uipment and medicine 2among ambubag. E. a$oid the use of naso gastric tube because of the threat of aspiration and reflux >kin/ a$oid pressure sores by tilting right and left e$ery % to ( hours. /. airway obstruction. or both. If the status of the +)' has not stabili0ed. Refe ence to ca!e mana2ement In accordance with the circumstances of each region $ary widely. the use of pneumatic compression stockings. where only in pro$incial hospitals ha$e facilities 2especially outside of 8a$a4.exercises to pre$ent contractures #rophylaxis of deep vein thrombosis 2:<T4/ 5777 iu sc administration e$ery %( hours. and use a mattress that can be de$eloped with wind and heel protector Eyes/ a$oid abrasion of the cornea with the use of lubricants or close your eyes with plaster )owel care/ a$oid constipation with stool softeners 2docusate sodium %77 mg *x%4 and the pro$ision of ranitidine 57 mg i$ e$ery 5 hours to a$oid stress ulcer caused by steroids and intubation )ladder treatments/ indwelling and intermittent catheters cateter urine e$ery 6 hours 8oint mobility/ passi$e 9. . )ut. infusion sets. could be referred to the nearest hospital to get better handling. Dith the risk during transport. >. then the referral system as it is difficult to implement. apnea. there could be a $ariety of circumstances such as shock. If not possible. syringes 5 cc. as well as emergency e. :uring the trip. suction. depending on the selection of transportation facilities. Intra$enous hydration/ using normal saline in patients with cerebral edema or increased I'# "utrition/ do administration $ia enteral nutrition by tube nasoduodenal. it is necessary in the preparation and transport re. the state of +)' patients must remain strictly monitored and super$ised. F. D. Thus. oropharyngeal and nasopharyngeal tube. *. should be referred to the nearest hospital surgical facilities.
Dhere the headache gets worse. 'an anyone watching at home. 87 .uent $omiting. esidence not far from health centers 1 sub3clinics.are se$eral criteria for head in&ury patients are still being treated at home but with close obser$ation. There was no skull fracture. *. an explanation should be gi$en to the family to acti$ely super$ise 2and ask the patient to wake4 e$ery two hours. namely/ %. 9rientation of time and place is still good "o neurological focal symptoms. decreased consciousness. In addition. more fre. . 6. and the paralysis then immediately report to the clinic or medical officer nearest. (.. sei0ures. "o headache or $omiting 3 $omiting. 5.
>cholastic ?roup. part two. (77. 8akarta. :ian akyat. ?a&ah -ada . . (777 87 . 1ead $njuries. 1ead $njuries. -edia +esculapius. 8akarta. . 8akarta.linical 7eurology. second edition.ni$ersity #ress. dian people. (77. 8akarta. ?a&ah -ada . >tructure of "er$e Trauma in >elekta 'apita -edicine Third edition $ol (. )asis of 'linical "eurology. #T :hiana #opular. Telmo -. >cholastic ?roup. +rif et al -ans&oer Editor. %65% >idharta #. -ard&ono -. part two. *th ed. (777 obert =. %65% !asan >&ahrir. -artu0a. 8akarta.orrelative neuroanatomy and %unctional 7eurology. #riguna >idharta. 8akarta. Trauma in the -anual of "eurologic Therapeutics Dith Essentials of :iagnosis. #riguna >idharta.apita Sele)ta 7eurology. "eurology >pecialty "eurology. 8akarta. -ahar -ard&ono. +asis of . (77. (77.ni$ersity #ress. *th ed. second edition. +. %66% !arsono. dian people. "eurology >pecialty "eurology. %66% !arsono.apita Sele)ta 7eurology. litle )rown M 'o. ?a&ah -ada . #T :hiana #opular. +asis of .linical 7eurology.uino. +. litle )rown M 'o. %65% >idharta #. :ian akyat. . %65% !asan >&ahrir. -edia +esculapius. -ard&ono -. :ian akyat.ni$ersity #ress. (77* +lexander 8. Telmo -. +rif et al -ans&oer Editor. )asis of 'linical "eurology. Trauma in the -anual of "eurologic Therapeutics Dith Essentials of :iagnosis. ?a&ah -ada . (77* +lexander 8. >tructure of "er$e Trauma in >elekta 'apita -edicine Third edition $ol (. 8akarta. 8akarta. :ian akyat.RE3ERENCE. (777 obert =. -artu0a. 8akarta. .ni$ersity #ress.orrelative neuroanatomy and %unctional 7eurology. (777 'husid.uino. -ahar -ard&ono. 'husid.
-D6 K*E0 Explain the type and management of poisoning 2%7 7menit4 Lect& e ( by # .p. 5. -!ych$at y Lect& e 1 by # . .ame!t$6 . T0E 3I3T0 WEEK LE)RNIN* OB+ECTIVE.p. )hma# Ta &na6 .p. 6.%ODULE > Eme 2ency -!ych$at y C0)-TER I. )l$ Im on6 . 3o en!$c Lect& e ( by # . Teha Ka o ? K a o6 ..p. *.. %. (. K+ Explains emergency psychiatry and handling 2%77 minutes4 (. Wo o . E"$ D$an a?3$t 6 . 3 Explain the forensic toxicology 2%7 7 minutes4 Lect& e . by # . E"$ D$an a?3$t 6 . 7. -D Explain emergency treatment of hypertension and kidney 2%7 7 minutes4 .p. )l$ Im on6 .p. -D Explain metabolic and endocrine emergency treatment 2%7 7 minutes4 Lect& e / by # .p. Explains emergency psychiatry and handling Explain the type and management of poisoning Explaining gastroenterohepatologi and handling emergency Explain the emergency treatment of metabolic and endocrine Explain the emergency treatment of hypertension and renal Explain the forensic toxicology +ble to recogni0e the signs of death E4pe t lect& e' 1. by # . 3 +ble to recogni0e the signs of death 257 minutes4 87 . -D6 K*E0 Explain gastroenterohepatologi and handling emergencies 2%7 7 minutes4 Lect& e . Inte nal %e#$c$ne Lect& e 1 by # .
k$ll lab Intake of @oreign 9b&ects 2'orpus +lienum4 87 .T&to $al >cenario 5 .
+khir3ultimately3his beha$ior is getting worse and finally he found his room with his mouth foaming . left her boyfriend about a month ago. The family immediately took him to the hospital.UED + (73year3old woman. 87 . and feel there is talk about him. .CEN)RIO > 3EEL -UR. as well as his body was found a bottle of )aygon. !e felt frustrated.C0)-TER II. often locked himself in his room. and something to tease him that he felt his girlfriend decided to use him because there guna.
did not sleep for days.K in a separate syringe +lcoholic delirium. estless noisy conditions >igns and symptoms/ estlessness. Flormetia0ol %3( g per os. -anagement/ • • • b. REVIEW RE3ERENCE.C0)-TER III. 'linical features and diagnosis #sychiatric disorders are often related to/ • • • • • • • #sychotic disorders such as schi0ophrenia and manic. angry.uate staffing for patient safety tie E$aluation and management of • • • 87 . agitation. . particularly those of frontal and temporal lobes of the brain #rotect yourself +lert to the signs of the emergence of $iolence -ake sure there is ade. skip. K K K >inging. Gelling.repeated e$ery ( hours. ItBs hard to communicate. especially when people are paranoid and ha$e hallucinations telling (commanding hallucinations) +lcohol intoxication or other substance Dithdrawal symptoms from alcohol or sedati$e3hypnotic drugs 'atatonic furor :epression agitatif #ersonality disorder is characteri0ed by anger and impulse control disorders 9rganic mental disorders. gi$e chlorproma0ine (77 mg %77 mg I. The $iolence may arise due to psychiatric disorders. pacing. $iolent. aggressi$e.CEN)RIO >' 3eel p& !&e# 1. >kip. plus high3dose multi$itamin +cts of $iolence (violence) 8iolence is a person of physical aggression against others. but can also occur in ordinary people who can not handle the pressure of e$eryday life with a better way. Eme 2ency p!ych$at y a. repeated e$ery ( hours If it is difficult. >peaking chaotic. :isturbing other people. !appy K K K. >uspicious K K K. gi$e haloperidol 5 mg $alium (7 mg I. +ngry.
especially if sleep disturbed. d. . E$aluation and management of • :o not lea$e the patient alone in the room • emo$e ob&ects that could harm Therapy psikofarmaka Trans. focus. >uicide (suicide) >uicide is the death of the intended and carried out by a person against himself. E$aluation of suicide risk Exploration of the possibility of psychosocial inter$entions to reduce the risk of $iolence "eed to be treated to pre$ent $iolence. history of suicide 1 attempted suicide in the family.uantities at once to the patient and the patient should control within a few days. sleep disorders :isturbance of consciousness :ecrease in the clarity of the le$el of awareness on the en$ironment <igilance 'onsists of hyperacti$ity 2associated with withdrawal syndrome4 and hipoakti$itas 2all decreased acti$ity4 'oncentration problems -arked difficulties in maintaining presence. does not ha$e a &ob. 'linical features and diagnosis !igh risk of suicide/ The man. the older the age. The drug of choice is lora0epam *x% mg daily. history of illness 1 chronic pain. 'ontinuous obser$ation Therapy psikofarmaka +ntipsychotic drugs are usually gi$en c. an interruption in se$ere delirium places and people orientation 87 . 8ust finished the operation. iritabel. :o not gi$e the drug in large .uili0er gi$en lightly. :elirium 'linical features and diagnosis • • • • • #rodromal Typically patients complain of fatigue.sually after the binding of ben0odia0epines or antipsychotics gi$en #erform appropriate diagnostic e$aluation. and di$ert attention 9rientation In the mild delirium orientation disruption time. social isolation 1 li$ing alone. for ( weeks. physical examination and psychiatric inter$iew. anxiety. the $ital signs.• • • • )inding of patients only performed by trained staff.
and urinary incontinence. use pisostigmin salicylate %3( mg I< 1 I-. fear is groundless >leep3wake disorders 9ften exhibit agitation at night and trouble sleeping E sundowning "eurological symptoms Include/ dysphasia. rage. incoordination.x%7 mg $alium or %73(7 mg I- 87 . -emory and cogniti$e functions commonly disturbed #erception <isual and auditory hallucinations occurred -ood >ymptoms are often/ anger. asterixis. )e supporti$e and not threatening eassure the patient 9ffer drug Inter$iew guide and psychotherapy • • • E$aluation and management of The main thing is to treat the cause. e. tremor.• • • • • =anguage and cogniti$e =anguage abnormalities occur and incoherence. Dhen the cause anticholinergic toxicity. can be repeated %53*7 minutes if necessary.convulsive therapy) Tricyclic antidepressants %573(77 mg 1 day K . :epression >ymptoms and signs/ • • • • • • • • • • >udden changes in life Early morning insomnia +gitation =oss of appetite and a willingness @eeling $ery desperate >ocial relations rewind >inful delusion "ot able to express thoughts and feelings Treatment/ E'T (electro.
. decontamination is not necessary. hemodialysis 1 peritoneal dialysis. hours #9 1 enteral.ue. .(. or in the gastrointestinal tract after more than . =iberation of the airway Impro$ement of respiratory function Impro$ement of blood circulation system :econtamination :econtamination is a therapeutic inter$ention aimed to reduce exposure to toxins. and pre$ent damage. alkalini0ation of urine. %ana2ement of po$!on$n2 "$ct$m! %. reduce absorption. hours. 87 . urine acidification. Elimination +ction is the action to accelerate the elimination of toxins expenditures are circulating in the blood. and with good techni. +cti$ated charcoal 3 + single dose/ % g 1 kg or *73%77 g of adult and children %53*7 grams <!pec$f$c # &2! an# ant$#ot&m= *. >tabili0ation @orm of cardiopulmonary resuscitation promptly and precisely as follows/ • • • (. +nother act of elimination/ @orced diuresis. except when swallowingW %77 mg 1 kg. • • • • :econtamination of pulmonary :econtamination of the eyes >kin decontamination ?astrointestinal decontamination In general the )aygon intoxication if swallowed dose subtoksik. c. then do/ a. hours first. +ntidotum pro$ision 2if a$ailable4 In most cases of poisoning are $ery few types of toxins antidotumnya drugs and drug preparations that are commercially a$ailable antidotes are $ery few in number. Induction of $omiting ?astric aspiration and kumbah Effecti$e when carried out for (3. b. Dhen still in the ?I tract gi$en repeated doses of acti$ated charcoal *7357 g e$ery .
7. :rug %. >corpion (. *. 7. 6. 8engkol 'assa$a e. . (. 6. 8ellyfish 3 8ellyfish @ood %. (. *.. 'hemicals %. (. >piders . +mphetamines :igoxin Isonia0id 9pioid #aracetamol Darfarin #ropranolol :atura 1 amethyst &manita phaloides 9leander 'yanide -ethanol 1 ethylene glycol eciprocal -ercury +rsenic "a hypochlorite Thallium 9rganophosphate @e "atural toxins +nimal toxins %. b. .. 6.. %. 5. >nake *. Type! of po$!on$n2 a. f. c. d. *. -icrobial toxin/ )otulinum 87 .. (.. 5. 5.
morphine 3W to the >># :igitalis and oxalate 3W towards heart 87 .)ased on where toxins are/ • • In the wild o Toxins in natural gas In households o o o o :etergent :isinfectant Insecticide 'leaner • In agriculture o o o Insecticide !erbicide #esticide • In industrial and laboratory o >trong acid o >trong base In food o '" in cassa$a o )otulinus toxin o #reser$ati$e o +dditi$es In medicine o o !ypnotic >edati$es • • )ased on the organ of the body/ • • • +re hepatotoxic "ephrotoxic )ased on the effects of/ =ocal o o • 'orrosi$e poison !alogen groups >ystemic o o )arbiturates. alcohol.
haloperidol. ecstasy. 6. antihistamines. thallium !ydrogen sulfide. inhibitor cholinesterase/ organophosphates. metoclopramide 87 .. insecticide ataxia. selenium. cocaine. The cl$n$cal #in3point pupils. #henothia0ines. mercaptan No +. anticholinergics/ ben0eksol. acetone 'yanide +rsenic. cerebellar signs Extrapyramidal symptoms -o!!$ble ca&!e! 9pioids. Table 1. 'lonidine. *. 7.o • '9 to the blood !b 'ombination o 'arbolic acid. amphetamines. ben0tropin '"> depressant drugs organophosphate 1 carbamate. carbamat )en0odia0epines (. carbama0epine . 'haracteristic smell of the poison O#o +cetone +lmond ?arlic otten eggs Ca&!e Isopropyl alcohol.+lcohol. anticon$ulsants/ phenytoin. phenothia0ines. decreased :ilated pupils. decreased :ilated tachycardia 'yanosis !ypersali$ation "ystagmus.Tricyclic antidepressants. pupils. causing erosion of the stomach and depression >> >e$eral types of toxins that ha$e the specific odor. 5.
Somatic death 0 systemic death 0 clinical death . phenothia0ines.. *. -eanwhile. >ei0ures Tricyclic antidepressants. 5. calcium antagonists 'ramp. ben0odia0epin takikardi. 6. %7. opioids. theophylline. *. =oss of mo$ement and sensibility 'essation of breathing 'essation of heart beat and blood circulation >ign 3 signs of cellular death %. 2. digoxin.ellular death 0 molecular death >omatic signs of death %. isonia0id =ithium. :ecrease in body temperature 2argor mortis4 )ruised corpse 2li$or mortis4 igid bodies 2rigor mortis4 'hanges in skin 'hanges in eye :ecay and sometimes the process of mummification and adipocere +ccording to the language. anticon$ulsants. !yperthermia )radycardia %%. . tanatologi deri$ed from Thanatos 2death3related4 and logos 2science4. according to the terms. Dhile tanatologi itself is part 87 .5. antihistamines.$2n ? !$2n! of #eath <tanatolo2$= Two stages of death/ %. (. +bdominal diarrhea. tricyclic antidepressants. . 6. halusinasi 'linical simptom may indicate the cause of poisoning /. 'lonidine. antihistamines ) 3 blockers. opiat. ">+I:s. (. tanatologi is the study of death and the changes that occur after death and the factors influencing those changes.Dithdrawal alkohol. organophosphates.
"ear3death 2suspended animation.ta#$&m Death In essence there are two stages of death stages. respiratory system and thus lead to irre$ersible tissue anoxia is complete and thorough. mummifikasi. cell and molecular body. Dith known brain death 2brain stem death4. apparent death4 is the third interruption of life support systems are determined by simple medical de$ices. electric shock and drowning. Dith ad$anced medical e.uipment can still be pro$ed that the three systems are still functioning. decreased body temperature. The death of cellular 1 molecular death is the cessation of acti$ity of the network system. including the brain stem and cerebellum. but the stage of death is also di$ided into fi$e stages as follows/ %. cardio$ascular system. breathing stops. and or biochemical changes. *.. . (.of the forensic medical science that studies about the things that has to do with death and the changes that occur after a person dies and the factors that influence it. pale skin. resulting in the death of an organ or tissue that occur some time after somatic death. + @ sehin a tool can be stopped. the heart and blood circulation stops. . namely the respiratory and cardio$ascular systems are still functioning with the aid of tools. )rain death 2brain stem4 is when the entire contents of the neuronal damage is irre$ersible intracranial. a rigid body 2rigor mortis4. while the other two systems. >omatic death 1 clinical death 1 death is the cessation of the systemic function of the ner$ous system. except the brain stem and cerebellum. muscle relaxation occurs. namely stage somatic death 1 mortality clinical 1 systemic death. ":E is often found in cases of poisoning a sleeping pill. and death of cellular 1 molecular death. 87 . it can be said as a whole person can not otherwise li$e longer. decomposition 2#utrefection 1 decomposition4. 0o7 to Detect %o tal$ty 'hanges may occur early in the time of death or a few minutes later. 5. 'erebral death was damage to both hemispheres of the brain that is irre$ersible. The signs of a bruised corpse 2li$or mortis 1 hipostatis 1 li$iditas post3death4. and corneal light reflex missing eye. for example. thus allowing a more definiti$e diagnosis of death. and adiposera. )ut after some time off after the changes occur is clear.
+. !ariadi. F edokteran . ?itayanti 9f (7%7. . +. .I.ni$ersity of Indonesia.are.. Science %orensic (edicine. "ew Gork/ #ublishing 'enter for -edicine in the @aculty of -edicine. . Emergency (edical .I. (edicine $8 Edition. "ew Gork/ -edia +esculapius. .apita Sele)ta (edicine. "ew Gork/ )inarupa script. 9f (7%7. *e!tboo) of Psychiatry. =ondon/ @aculty of medicine. >: and !. #urwadianto. @aculty of -edicine. (776.RE3ERENCE. Issue *. and )udi >. @aculty of -edicine.nair. *e!tboo) of %orensic (edicine and Science (edi)olegal. 87 .I faculty. 9f (777. =ondon/ >chool of -edicine. 9f %667. "ew Gork/ @F . El$ira.
>p.) Lect& e! N&mbe of 0o& ! ( x 57 B . Emergency >ign4 and mark the priority minutes4 b. Introduction of block emergencies and #olicy national in dealing with emergencies and disasters 257 minutes4 b.c$ence >urgery Info mant dr. >p.) 87 ..U%%)R1 O3 BLOCK )CTIVIT1 I. 257 ( x 57 B >urgery dr. +swedi #utra. The failure organ function due to trauma 1 multiple trauma 257 minutes4 =ecture ( >urgery -anagement of $ascular in&ury 2%7 7 minutes4 =ecture * >urgery Initial inspection and management of musculoskeletal trauma 2%77 ( x 57 B +nesthesia dr. Gu0ar !arun. %o#&le I Top$c! =ecture % >urgery a. >pan +chmad +ssegaf. >p. minutes4 =ecture % +nesthesia a. +ssessment and management of early 2initial assessment4 in the sign in case of emergencies Traumatology. #irma !utauruk.9T ( x 57 B >urgery dr.
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!aryadi. >p.9? ( x 57 B ( x 57 B !eart >urgery dr. . >p. +sri0al T. @atah >atya D.ndang Fomaruddin.urrahman.+n 87 . ad ( x 57 B adiology ( x 57 B 9)?G" dr.T!T dr. >p.) ( x 57 B +nesthesia dr.ndang Fomaruddin. b.+n actions of 8#9 E"T =ecture % Emergency in E"T adiology =ecture % The examination support thorax trauma III and maxillofacial radiologists 9bstetrics and ?ynecology lecture Emergency 9bstetrics ?ynecology 2%77 minutes4 !eart =ecture 'ardiac emergency >urgery =ecture 5 )urns. >p. >p. and criteria for inpatient stabili0ation and referral 2%77 minutes4 >urgery =ecture 6 +spects of emergency abdominal surgery and treatment +nesthesia =ecture 6 a. Gu0ar +aron.2respiratory resuscitation4 257 minutes4 +nesthesia =ecture 5 .) ( x 57 B >urgery dr. >p. >igns and symptoms of shock 2hypoperfusion4 257 minutes4 @luid administration in shock and bleeding 257 minutes4 and dr. . Taufi.nderstand the ob&ecti$es and ( x 57 B E"T ( x 57 B +nesthesia dr. >p. treatment principles. >p. #irma !utauruk.8# dr.
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