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  • Skoring Dalam Trauma: Suryadi Soedarmo

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    tepat rshs
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    Skoring dalam Trauma document discusses various trauma scoring systems used to evaluate trauma patients, including: 1. Physiological scoring systems like GCS, RTS, APACHE which evaluate parameters that can change over time. 2. Anatomical scoring systems like AIS and ICD which evaluate specific body regions and typically do not change unless further diagnostics are performed. 3. Injury Severity Score (ISS) and Trauma and Injury Severity Score (TRISS) which combine anatomical and physiological scores to provide an overall assessment of injury severity and predicted patient outcomes.

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    Definitive Surgical Trauma Course

    Original Title

    10. Trauma Skoring

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    Skoring dalam Trauma document discusses various trauma scoring systems used to evaluate trauma patients, including: 1. Physiological scoring systems like GCS, RTS, APACHE which evaluate parameters that can change over time. 2. Anatomical scoring systems like AIS and ICD which evaluate specific body regions and typically do not change unless further diagnostics are performed. 3. Injury Severity Score (ISS) and Trauma and Injury Severity Score (TRISS) which combine anatomical and physiological scores to provide an overall assessment of injury severity and predicted patient outcomes.

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    32 views23 pages

    Skoring Dalam Trauma: Suryadi Soedarmo

    Uploaded by

    tepat rshs
    Skoring dalam Trauma document discusses various trauma scoring systems used to evaluate trauma patients, including: 1. Physiological scoring systems like GCS, RTS, APACHE which evaluate parameters that can change over time. 2. Anatomical scoring systems like AIS and ICD which evaluate specific body regions and typically do not change unless further diagnostics are performed. 3. Injury Severity Score (ISS) and Trauma and Injury Severity Score (TRISS) which combine anatomical and physiological scores to provide an overall assessment of injury severity and predicted patient outcomes.

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    of 23

    Skoring dalam Trauma

    Suryadi Soedarmo
    Kegunaan Skoring

    Berapa skor ?

    Akan hidup ?

    Minimal Th/ ?
    Fisiologis

    -GCS
    -RTS
    -CRAMS
    Skoring -APACHE

    Anatomis

    - AIS
    - ICD
    Skoring fisiologis :
    - parameter fisiologis
    - berubah-ubah
    - konvensi : admittance

    Skoring anatomis :
    - Umumnya tidak berubah
    - Berubah bila cara diagnostik
    lebih lanjut
    AIS : Abbreviated Injury Scale
    -85

    1. Kepala
    2. Leher
    3. Toraks
    6. Spine
    4. Abdomen
    7. Eksternal
    5. Ekstr.
    (kulit)
    7 Regio
    AIS : Abbreviated Injury Scale

    -7 Regio
    -Tiap regio : 0. No injury
    1. Minimal
    2. Moderate
    3. Serious
    Lihat 4. Severe
    Tabel
    5. Critical
    (6. Maximal injury)
    AIS : Abbreviated
    Injury Scale
    Eksternal : 2

    Kepala :
    (Edema Serebri –3)
    Intraserebral H. -5
    Injury Severity Score
    AIS(1)^2 + AIS(2)^2 + AIS(3)^2

    Hanya 3 regio

    Maximal : 5^2 + 5^2 + 5^2


    atau : AIS=6
     =75
    Luka Wajah >5 cm -2
    Epidural hematoma >100 cc -5
    Kontusio Paru -3
    Fraktur Femur -3

    ISS = 5^2 + 3^2 + 3^2


    = 25 + 9 + 9 = 43
    Revised Trauma Score

    1. GCS
    2. SBP
    3. RR
    Revised Trauma Score : recoding
     
    GCS SBP RR

    3 0 0
    0
    4-5 0-49 >0-5
    1
    6-8 50-75 6-9
    2
    9-12 76-89 >29
    3
    12 >89 10-29
    4
    (Calculated) Revised Trauma Score

    RTS=(GCS*0.9368)+(SBP*0.7326)+(RR*0.2908)

    Recoding
    PRE : Preliminary Outcome
    Based Evaluation

    RTS
    0

    Ps50 Isobar

    8 ISS
    0 75
    Metodologi TRISS

    -Trauma and Injury Severity Score


    -Memakai = Anatomis – AIS
    = Fisiologis - RTS
    TRISS :

    1. ISS
    2. RTS
    3. Umur : < 55 ( =0 )
    55> ( =1 )
    4. Tumpul atau tajam
    TRISS : (yang menghafal ini gila)

    Trauma Tajam :
    b=1.1430*RTS-0.1516*ISS-2.6676*Umur-0.6029
    Trauma Tumpul :
    b=0.9544*RTS-0.0768*ISS-1.9052*Umur-1.2470

    1
    Ps = -----------------
    1+exp(-b)
    Trauma.exe
    TRISS :
    Probability of Survival
    Ps : 0.00…. Sampai 0.99….

    Ps < 0.5 : dihitung akan †


    Ps > 0.5 : dihitung akan hidup
    Kesudahan
    TRISS :
    Mati Hidup

    Expected Unexpected
    <0.5 Death Survivor
    Ps

    Unexpected Expected
    >0.5 Death Survivor
    Kriteria
    Temp
    APACHE II
    MAP
    Nadi Skor MR
    RR
    0-4 <4%
    paO2
    pH arterial 5-9
    Serum HCO3 10-14
    Serum Na 15-19
    Serum K 20-24
    Creatinine 25-29
    Hematokrit
    30-34
    Lekosit
    GCS >34 >85%

    4-3-2-1-0 -1-2-3-4
    Keterbatasan

    • There is no single scoring system that can


    provide a perfect description. Care must be
    taken when interpreting the results of
    injury severity scoring to recognize that
    there will always be aspects of the patient's
    condition that were not captured.
    • E.g. The EMS system
    ?
    Terima Kasih

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