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DOA

E.EE Primary survey

.

A B C D E < lomenit

Airway and C- spine control

Membebaskanjalannafas Hambatanjalannafas :
⑤
Cara : Triple airway manner Gurgling → cairan ( suction) Mayo
Head tilt snoring pangkallidah ( Gudel / OPA)
}kI
→
.fr Cervical
chin lift Stridor → corpus alienumlektraksi )
.

( jejasdidavicuia
Taw trust keatas ) → collar neck
lansnoskop → Magill
Forceps

Breathing & ventilation 16-24×11

.

Menilaipernafasan Pernafasanspontan :
Takipneu
Cara : Look : gerakan dada / perut ( Oksigenasi )
Listen : stetoskopltelingakedada Bradipneu
Feel : rasakanhembvsanudarakepipi ( ventilator)
① Spartan : lntubasi → Ventilator
 Circulation and Bleeding control
ftp.HR.CRT/L2detiK
" " " "
Stabilkantlemodinamik Hentikanperdarahan
Normal Holliday Segar 1245am
: Nonfarmakologi : Bebattekanluka
Presyok :TDt HRT Akraldingin
, ,
Klein Arteri / Vena
Cairankristaloid 10-20 cc /KGBB /jam Debridement Iuka
Syok : TD-oterukur.Nadi-oteraba.ATraiding in Farmakologi :

Cairankristaloid 20C /KGBB / 15 merit lnj.tranexamat-vi.tk

Cairankoloid 10-20 cc 1kg881 15 Merit

.io#oieoa.?r:yyJJMenilait-ungsineuro/
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ogispasien
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Gcs :
Eye (4) Verbal 157 Motorik (6)
5 D N 1
GCS Max : 15
Spartan Diperintah Nyeri Unresponse
min :3

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• Recognition (Anamnesis PD Head ,
to

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,
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 Bedah Saraf (Neurosurgery)
EFF Trauma Kapit is
.
E
DX :
: ceaerakepaia
• sakitkepala
• +1- Penurunankesadaran
• Gangguanmemori
• Defisitneurologi -11-

• Muntahproyektil -11 - TT -11K

Ring an Sed ang Berat

Tx * Resusitasi ABCDE → clear
( GCS 13-15 ) ( GCS 9-12 ) ( GCS < 9)
:

* Farmakologisimptomatik
Head CT scan
* Rujuk →

① Retain an otak : Comusiocerebri

( Gegarotak ) It Kesadaran 210 menit

④ Retain an otak : Contusiocerebri

( Memoir otakltrtkesadaran > 10 merit
"
"
salt & Pepper app
 EE .
Perdarahan Intracranial

# ( | \ \
"
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p

EDH SDH SAH ICH IVH sekunder

( Epidural Hemorrhage ) ( subdural Hemorrhage ) ( subarachnoid Hemorrhage )( Intracerebral Hemorrhage ) ( lntraventrikel Hemorrhage )

Kontras
t late
"
week onset

Rllptur Rllptur
E. Meningensmedia
A. E E Raptor
E
""" " r
E Perluasandari
. :
Bridging vein :
A. vertebra basilan's :
A. cerebri :
DX
-

:• Lusid interval -5 -

DX : • Akut →
" -3hm
ICH / SAH
Hiperdens
• Tandaherniasi DX : Rangsangmeningens ④ DX : Rangsangmeningens Terseringdi v. lateralis
-

• subakut -314 -21hr ) -

a. Pupil anisokor lsodens kadukvduk ,

Kernig ,
Penunjang :(Tscannoncontras Kronik -71721hr hlpodens) Penunjang Bndtinski -10
Penunjang Penunjang
-

• > : : :

• Hiperdens Biconvex Penunjang : Ctscannoncontras Ctscannoncontras Ctscannoncontras

( comb "n9 )
llentikuler)
Ctscannoncontras • Hiperdenssela sela -
• Hiperdenshemisfer • Hiperdenspdventrikel
hemisfercerebri
gyrus cerebri sistem
gekynkaf.Hiperdensq.com.af
( Cekung ) / ④ STELATA SHAPE /
Bintang
✓
Bulan Sabit /
Tx Resusitasi ABCD E- → clear
Semilunar / : *

* Farmakologisimptomatik
Crescent
* Rujuk → Manitolloperatif 20%015-1941×980
E.EE Fraktur Basis Cranium piamater

Foramen
Magna

ANTERIOR MEDIA POSTERIOR

•
Epistaksis ,
rinorea • Otorea ,
hematoma • It kesadaran ( Komal
• Hematoma perioiblta • Hematoma retroauricula
Battle sign
"
"
"
Racoon Eyes "

Tx : * Resusitasi ABCD E- → clear

* Farmakologisimptomatik
* Rujuk → Manitolloperatif
Penunjang :

⑥ Foto submentoverteks
Garis Fraktur pada basis cranium
C
C D
"
⑥ Annalisa cairan CSF
"
:
Lab : • Halo sign CD

• B- 2 transfer in ,
glukosa
⑨ GOLD STANDARD : CT SCAN
 lurid interval

Raptor A. men ingens media

DX : EDH
Hiperdens
biconvex/
Cembung / lenticular

✗
✗ lucid EDH
✗
✗

Hipekdens
Biconvex EDH

✗ FDH

✗ SAH
✗ ICH
 Bedah Toraks Kardiak Vaskular
Naaman's
EEEHematothoraxp.CC
E : Trauma thorax
EEE Pneumothorax
.
•

E
EIB Fail Chest
.

Trauma thorax
.

RuptutrA.thoraa.ca/intercostalis E Trauma thorax :

:

DX • Closed Pneumothorax ltertutup ) Fraktur segmental min -319A berturut

:@ Sesaknafasdipengaruhiposisi
• Nyeridada
• Open Pneumothorax lterbllka) DX :@ Nyeridadaberat
• Tension / Venti Pneumothorax
pp : • Pernafasanasimetrisijejas -10 DX
• Nyeridadasaatbernapas
Fremitustt Redup
:@ sesaknafas-odipengaruhiposi.si
pp : • Pernafasanasimetrisijejas -01
• .

• vesikulermenurun • Nyeridada
• Paradoksal Krepitasi
,

Nasif : 71500C atau PD : • Pernafasanasiimetrisijejas -10 • vesikulermenurun

200C /jam • Fremitus II. Hipersonor
• Vesikulermenurun
Hematopnellmojensionpnemothorax :

thorax
X-Ray X-Ray
Thorax TDtt.TV#iRR > 30×1
( air fluid
.
-

Thorax
Sliaranafasmenghilang
level )

sudutcos.to/--renicustumpul ,
Hiperlusen ,
corakanltvaskular ,

Opasitashomogeninferiorpanl Pleural linen trachea deviasi

,

Meniscus signal Trachea kebag sehat

,
Tx ;AzcpE
-

deviasikebag.se hat Farmakologisimptomatlk

Tx : ABCDE
Posisisemifowler 45° opoid Analgetiklnterkostal
Farmakologisimptomatik Rujuk -7 ORIF
Rujuk -7bUSD / chest tube KSIMAL
 Pneumothorax

TRAUMA-11K NON TRAUMA-11K

SPONTAN

TDI
TUTT , sesak

Tertutllp Terbllk Tension / Suara nafas

primer Sikander Menon " ""'

closed Openea Ventil
I 1 1
I 1
Trauma Trauma Massive
① Riw -
Penyakit ④ Riuipenyakit
Para para
TUMPUL Tajam
I
1 One way
Sucking chest valve
a>% Wound
1
✓

⇐→
1
Needle decompression /

Plaster3sisithorakosintesisigqATLS@diothDewasailcsV.M-11L

Anak : ICS -1.11111 MCL

SD
 DX :
tomatothorax
ICS I MAL

✗
✗
Awal : Needle decompress
✗ Ics I MAL
✗

→
Tempo nad,DX
: Tension Pneumothorax
janning

DX Tension
: Pneumothorax
Hiperlusen
 Bedah Pediatric
Atresia ESOF""

Atresia oilier
' ' ' '
HSP
} NON BIKER

Atresia
' - . . . .
- . - .

}
Duodenum Tejenum
Hirsch prong
,

Disease
lntususepsi / -
BILLER
lnvaginasi
Volvulus

Atresia Ani
 ECF Atresia Eso pagus
.
01150 hidroamnim
( AFI < 5)
Agenesis -

Renal

E : Retain an Kong en ital lpolihidroamnion )

AFI 725
DX : • Muntah -0 hijau ( non biker) 5-25

• Drooling saliva , anaktampak Kelapa ran

• Batak → Fistula eso tracheal

• Pemeriksaan → NGT / 06T ma SUK < 10cm

" "
coiled NGT
Penunjang : Foto Thorax Abdomen
-

"
The glasses abdomen / NO Gasses in abdomen
"

Tx : Resusitasi c- AB
Nutrisi Parenteral
Ruiuk →
operatip HSP

EEE Hip entropic

.
stenosis Pyloric
6

E : Retain an kongenital

DX Muntah -0 hiiau ( muntah postprandial proyektil)

-

: •

terabasepertibuahzaitun1olivesignP@nunjangi.signT
PD :
Palpa si
-
Oto 8h10 :
single bubble caterpillar
,

Barium Swallow :
umbrella sign Mushroom
,

meal
string sing
Tx

Resusitasic-ABNutrisParenteraLRujuk-7OperatifE@3.A
:

tresia Duodenum dan Jejenum

E : Retain an kongenital
DX : • Muntahhijaulbilierl
• Distensi abdomen → Darn contour , Darmsteifung ,

aus : Metonic sound

Penunjang : Foto 8h10
Double bubble sign → Atresia Duodenum
Triple bubble sign → Atresia Jejenum

Tx : Resusitasi c- AB
Nutrisi Parenteral
Rujuk →
operatip
 EFA Hirschsprung
.
Disease Dan Atresia Ani

/E
t
: Kelainankongenital
do % Rectosigmoid
DX : • Muntahhijau ( oilier)
Darn contour , Darmsteifung
aganglionik • Distensi abdomen → .

& Metonic sound

p Meissner
luenyempwtlctaktingsi
.

• Makoni "m > 245am BAB ①

p Aurbach
.

PD : RT :
Anus + >
Hirschsprung
kolostomi

Ñ÷÷:
Anus -
> A. Ani BAB
✗enyemprot →
letakrendah Letaktingai : > 1,5cm

Penunjang : Atresia Ani → lnvertogram

Letakrendah :< 1,5cm } jarakrektum kulit
-

diata.FM Levatorani
1,5cm
Hirschsprung disease I
.

↳ A. Aniletak tinggi
ditarik
" "

Awal : BNO : Megacolon

Barium enema
Him dibawahmtevatorani
:

"
llsusseperticorong "
↳ A- Aniletakrendah
Sawtooth appearance NIDAR
Gold Std :
Biopsi PA
Tx :

Nucterlpuasa)
lnfus Krista bid
" Dekompresi lambing
Antibiotikprofilaksis
"
Rujuk

EEE olvu / us tepelintir

E : Diet gang -0 padawaktunya ,
manuver abdomen

DX : • Muntahhijaulbilierl

• Distensi abdomen → Darn contour , Darmsteifung .

Metonic sound
• Nyeriakutlberatltiba ?
Penllnjang :
Midgut volvulus D. 1,1 ,
C. Pwx

Barium enema : Cork -

screw app

sigmoid
Foto BNO :
coffee Bean app

Nucterlpuasa)
TX : NIDAR lnfus Krista bid
Dekompresi lambing
Antibiotikprofilaksis
Rujuk
 Dancing sign -01
EFE lntususepsi
.
/ Invaginas i
E : Diet gang -0 tepat man uver abdomen
,

DX : • Nyeri abdomen kolikdan berat

• BAB
seperti jelly berdarah Red current jelly stool
" "

PD paipasi → Banana sign sausage sign

:
, .

RT Pseudo portico sign

:

Penunjang : USE Doughnut sign / target sign

:
.

Pseudo kidney sign / sandwich sign

Barium enema coiled Spring appearance
:

(Tx
.

: Reduksi manual → pemberian Barium enema

v Tika gagal →
operatif →g=
Diagnostic -

NIDAR
Terapeutik
Nucter lpuasa)
In f- us Krista bid
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Dekompresi lambing Nama -

nama
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EFF Atresia Oilier
.

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E : Idiopatik ,
Munch Pada Usia 2- 5mg

3 Kasih Ku Pucat Dx : 1. Taundis

2.
Hepatosplenomagali
3. BAB dem pul

Penunjang :

Lab : • Hiperbilirubinemia
Bilirubin total b- -12mg 1dL
Bilirubin direct 2- 7mg 1dL
•☒ 560T , SGPT IT

1156 : Tidakditemukan vesica felea

Gold Std :
laparotomi kolangiografi atau
Sisa ductus biliarisekstrahepatik
Tx Rujuk Operas i Kasai £26111an
" "
: → yang Fibrotik → Triangular cord sign
 Keluar usus dari dinding umbilical
( Anomali pada dividing abdomen )

EEE Omfalokel
t.EE?6astroschisisUsusterbungkusselaput Hsus -

terbungkusselaput

Tx : Lapisiselaput TX : Tutu pi Uscis dengan

Nacho ,g%
dengankasadibasah , silo bag / urinbagster.it
I 1
RUJUK RUJUK
single bubble , caterpilar

DX HSP
:

HSP

DX
Hirschsprung disease
:
 Bedah P lastik (P lastic Surgery)
EFF Luka Bakar / Combutio / Burn Injury

E •
• Sinarmatahari 61 ••o Listrik
III
:
6.
• Api • Bahanbakarkimia
• llappanaslairpanas ( Asam Basakuat )
-

Buk
Bula -0 epidermis
-0^+02
•

Grade -1 •
kemerahaninyeri
✗
1- 3 papilaris
Bulabelumpecahltegang )

kemerahan.sangatnyen.ly
Ita
•

• Dermis
Grade it Retikularis
1-16 • Bulapeiahlkendur
-
• Pucat ,
nyeri

Grade in • ⑦ Bula Hipodermis

-
• tulitpucatlhitam ,
-0 Nyeri

PD :
Rule of g g

g •9 g g
"
l 1% 19 Tdksimetris :
g g

g g Palmar 11%1
 EE:(abiognatopalatoschisis
Formula →
• Luaslukabakargrade 2710%
Bibir Gusi Palatum celah
Baxter Grade 3 berapapunolonya
• 4ccxKg88x%TBSA max50% Laoiolbibir)

1/2 Total :8jamI Lokasi Gnatolgusil

1/2 Total :16jamI palatolpalatum )

Labi€aÉ Sisi
Unilateral ldextra / sinistral

PAYF.si , Bilateral

Komplit mencapai foramen incision

Keparahan
lnkomplithanyadipalatum mole
/
mencapaipalatumdvrum

TX Farmakologi
: o•Luas 71% •• Debridement Rule Often :

Booklets < 1% Analgetik Luka grade 72

Analgetik AB Sistemik Was ✗ 4,5% • Hsia 210min94
AB Topikallsilversulfadiatine) TT / ATS • BB 710 pound 15kg )
TT / ATS
• Lemos'it<10.000
listrik ARHMIA
Komplikasi : /
• 1-167, logrldl
• Edema larynx → Trauma inhalasi •• Ventrikelfibrilasi
* Buluwajahgosong * lukamasukdanlukakehtar → lukalistrik
Tx : Riljuk → Operatif
Dahaklkotoranhidunghitam * Palpitasi HR > 100×11
'

* :

cjelaga )
TX :
Defibrilasi / Dc shock
* Suaraserak

Tx :
Pemasangan ETT / nvasif
( Tracheostomy / Cricotiroidektomi )
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9%
4×50×18
*
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3600
cc|z

lnvañf Trauma inhalagi

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