Morning Report

29 september 2017
R/Male/ 15 y.o
CHIEF COMPLAINTS: lacerated wound on left knee

it has been suferred since 2 hours. Initially patient

was riding a motorcycle, then patient crash with a
motorcycle and it made laceratif wound on left knee.
History of lost of consciousness (-), Pain (+),
bleeding (+), nausea and vomit (-)
History of previous illnes : not found
History of drug use: not found
 PRIMARY SURVEY

A: Clear
B: Spontan, RR 20 x/menit
C: Acral warm, HR 84 x/menit, BP 120/70mmHg
D: GCS 15, Pupil isokor
E: Secondary survey
 SECONDARY SURVEY

Head & Neck : Abnormality not found

Chest : Abnormality not found
Abdomen : Abnormality not found
Extremities : Localizes status
 Status Lokalisata

Localized state :
Knee :

Lacerated wound on the knee size 5 x 5 cm, irregular

edge, tendon based, minimal contamination, active
bleeding (-)
Clinical Photo
Working diagnose:
vulnus laceratum o/t region patella sinistra
Treatment :
- Antibiotic injection
- Analgesic injection
- ATS injection
- Wound toilet
- Primary suture
- Foto genu AP/L
post OP