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  • ABDOMINAL TRAUMA Fk-Usu

    Diunggah oleh

    Ratika Ayu Piliang
    77 tayangan23 halaman
    This document discusses the initial management of abdominal trauma. It covers the anatomy of the abdomen, mechanisms of injury, primary survey and resuscitation, physical examination, diagnostic tests including blood tests, imaging, and diagnostic peritoneal lavage. It indicates when laparotomy or surgery is needed, such as for shock, abdominal rigidity, free air or fluid in the abdomen. The goal is to quickly identify and treat life-threatening injuries while determining if further invasive procedures are required.

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    ABDOMINAL TRAUMA fk-usu.ppt

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    This document discusses the initial management of abdominal trauma. It covers the anatomy of the abdomen, mechanisms of injury, primary survey and resuscitation, physical examination, diagnostic tests including blood tests, imaging, and diagnostic peritoneal lavage. It indicates when laparotomy or surgery is needed, such as for shock, abdominal rigidity, free air or fluid in the abdomen. The goal is to quickly identify and treat life-threatening injuries while determining if further invasive procedures are required.

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    © All Rights Reserved
    Unduh sebagai PPT, PDF, TXT atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    77 tayangan23 halaman

    ABDOMINAL TRAUMA Fk-Usu

    Diunggah oleh

    Ratika Ayu Piliang
    This document discusses the initial management of abdominal trauma. It covers the anatomy of the abdomen, mechanisms of injury, primary survey and resuscitation, physical examination, diagnostic tests including blood tests, imaging, and diagnostic peritoneal lavage. It indicates when laparotomy or surgery is needed, such as for shock, abdominal rigidity, free air or fluid in the abdomen. The goal is to quickly identify and treat life-threatening injuries while determining if further invasive procedures are required.

    Hak Cipta:

    © All Rights Reserved
    Unduh sebagai PPT, PDF, TXT atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    dari 23

    ABDOMINAL

    TRAUMA
    INTRODUCTION INITIAL
    MANAGEMENT
    Dr A S R U L

    DEPARTMENT OF SURGERY

    Anatomy
    Externa

    Abdomen Anterior
    Flank
    Back

    Anatomy
    Interna

    Cavum Peritoneal
    Rongga Retroperitoneal space
    Pelvis

    Anamnese
    Tembus
    Tumpul
    Weapon

    Kecepatan
    Jarak

    Point of impact

    Intrusion

    Safety devices

    Position

    Ejection

    Mekanisme Trauma
    Tumpul

    Spleen, liver, and hollow


    viscus
    Kompressi
    Crushing
    Deselerasi (fixed organs)

    Penetrative objects

    should not be
    removed except where
    definitive treatment can be
    provided.

    stab wound
    small intestine clearly
    protrudes

    Before the patient


    arrives

    Primary Survey and


    Resuscitation
    Airway and Cervical Spine Control
    Breathing
    Circulation and Haemorrhage Control
    Dysfunction of Central Nervous

    System
    Exposure and Environtmental Control
    Secondary Survey
    Definitive Care

    Trauma team in action

    The Glasgow coma scale.


    Parameter

    Response

    Score

    Eye opening

    Nil

    To pain

    To speech

    Spontaneously

    Nil

    Extensor

    Flexor

    Withdrawal

    Localising

    Obeys
    command

    Nil

    Groans

    Words

    Confused

    Orientated

    Motor response

    Verbal response

    Pemeriksaan Fisik
    Diagnostik
    Inspeksi
    Auskultasi
    Perkusi
    Palpasi

    Pemeriksaan fisik disekitar abdomen


    yg teliti :
    Pemeriksaan Anal dan Rektum
    Pemeriksaan Vagina
    Pemeriksaan Meatus Urethra

    Pemeriksaan Khusus :

    Baseline Blood Tests


    NGT
    Kateter
    Rontgent Thoraks dan Abdomen
    Imejing Tambahan
    USG
    CT Scan

    Trauma Abdomen

    Indikasi Laparotomi

    Shock yg tak bisa dijelaskan


    Abdomen tegang dan bising usus menghilang
    Eviserasi
    Udara bebas intraperitoneal
    Ruptur diafragma
    Positif Lavase Peritoneal
    Semua Luka Tembak / tusuk yang menembus
    peritoneum

    Radiologi
    Rutin

    Blunt : Thorak AP, pelvis


    Penetrating : Thorak AP, abdomen
    dengan marker (Jika hemodinamik
    normal)

    Kontras

    Urethrogram
    Cystogram

    Diagnostic Peritoneal
    Lavage

    Indikasi
    Pemeriksaan Abdomen meragukan
    Sulit memeriksa os.

    alkohol, obat, trauma capitis

    Hipotensi yg menetap meskipun resustiasi


    cairan cukup
    Trauma multipel

    tu. Thoraks, pelvik atau spinal

    Luka tusuk, peritoneum robek

    Diagnostic Peritoneal
    Lavage

    Hasil positif
    Cairan lavase bocor ke drain thoraks
    atau kateter urine
    Aspirasi 5 ml darah tua
    RBC > 105/L
    Ada empedu, bakteri atau faeces

    Indikasi Laparotomi
    Foto Polos Abdomen

    Free air
    Retroperitoneal air
    Ruptured diaphragm

    Penetrating Injury
    Gun shot?
    Evisceration?
    Rigid silent abdomen?
    Free gas on radiography?

    Explore wound
    under local
    anesthesia

    No

    Is peritoneum
    intact?
    Yes

    Laparotom
    y

    Positiv
    e
    Negativ
    e
    Admit,
    observe

    DP
    L

    No

    Yes

    Debride suture
    Consider
    discharge

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