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http://id.scribd.com/doc/82669939/Klasifikasi-Derajat-Keparahan-Gigitan- lar

Klasifikasi!Derajat!Keparahan!Gigitan! lar "eferensi!#: http://www.ispub.com/journal/the_internet_journal_of_emergency_medicine/volume_5_ number_1_42/article_printable/snake_bite_envenomation_a_comprehensive_evaluation_ of_severity_treatment_and_outcome_in_a_tertiary_care_south_indian_hospital.html "eferensi!2: ihat!di!halaman!web:!"hlm.!4# http://www.facs.org/trauma/publications/snakebite.pdf "eferensi!3: http://www.wheelessonline.com/ortho/snake_bite_wounds $everity!scoring:  grade!%:!no!envenomation.!!fang!marks!and!minimal!pain.  grade ! &: ! minimal ! envenomation. ! fang ! marks' ! pain' ! 1 ! to ! 5 ! inches ! of ! edema ! and! erythema!in!1st!5!hours(!no!systemic!symptoms  grade!&&:!moderate!envenomation.!fang!marks'!pain'!)*12!inches!of!edema!in!first!12! hours(systemic!symptoms!may!be!present!along!with!rapid!progression!of!signs!from! grade!&'!may!have!bleeding!from!bite!site(  grade!&&&:!severe!envenomation.!fang!marks'!pain'!edema!greater!than!12!inches!in! first!12!hours'!systemic!symptoms'!including!coagulation!defects(!signs!of!grade!&!and! &&!envenomation!appear!in!rapid!progression(  grade!&+:!very!severe!envenomation.! !local!reaction!develops!rapidly( !edema!may! involve ! ipsilateral ! trunk. ! ecchymoses' ! necroses' ! and ! blebs ! develop( ! potential ! for! compartment!syndrome

ote!that! no ! grading ! system ! is ! perfect ! and ! with ! time' ! clinical ! manifestations ! change ! re/uiring! grading!changes.!-his!classification!divides!the!systemic!manifestations!into!4!grades. G"%D& ! ': ! 0inimal ! 1nvenomation."eferensi!$: http://www.!1dema! and!erythema!)!to!12!inches!is!present!during!first!12!hours. ! .rescuediver. G"%D&!''':!$evere!1nvenomation.!$ystemic!involvement!possible!with!s/s3!of!severe! local!pain'!nausea'!vomiting'!giddiness'!low*grade!fever'!palpable!lymph!nodes.!.!grading!system!for!the!severity!of!pit!viper!bites!has!been!established!for!the!purpose!of! treatment. ! 0oderate ! to ! severe ! pain ! is ! present.org/med/snake%1. ! 1dema ! and! erythema!from!1!to!5!inches!in!diameter!is!present!during!the!initial!12!hours.!1dema!and!erythema!is!612!inches.!5apid!onset!of!shock.o ! general ! symptoms ! or ! systemic ! involvement.!0ultiple!bites!are!fre/uently! present. .htm . !$ystemic !involvement !is !fre/uently!present!with! s/s3!severe!pain'!tachycardia'!thready!pulse'!hypothermia'!ecchymosis!and!generali4ed! petechia.! 2ang ! or ! tooth ! marks ! are ! apparent. ! 1dema ! is ! widespread ! and ! may ! include ! the ! trunk ! ipsilateral ! to ! the ! involved! e3tremity. G"%D&!'':!0oderate!1nvenomation. G"%D& ! '(: ! 13tremely ! $evere ! 1nvenomation. ! $ystemic ! involvement ! apparent ! with! blood!tinged!secretions'!renal!shutdown'!coma!and!death.

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