Trauma Kepala
Trauma Kepala
Trauma Kepala
Trauma Kepala
1 / 40
ACS
Objektif
2 / 40
ACS
Trauma Kepala
Sering terjadi
Morbiditas dan mortalitas tinggi
Penanganan keliru:
Memperburuk prognosis
Yg seharusnya dpt selamat meninggal
3 / 40
ACS
4 / 40
ACS
10mm Hg =
Normal
>20 mm Hg =
Abnormal
>40 mm Hg =
Gawat
ICP Fungsi otak, prognosis
5 / 40
ACS
6 / 40
Ringan
Kegawatan
Sedang
ACS
High velocity
Low velocity
Luka tembak
Tusuk
GCS = 14-15
GCS = 9-13
Berat
GCS = 3- 8
7 / 40
ACS
CSF rhinorrhea :
anterior
CSF otorhea : Mid
Hemotympanum
Periorbital
ecchymosis
Retroaucricular
ecchymosis
Nervus Facialis
Tuli
Pneumocephalus
8 / 40
ACS
Epidural
Subdural
Trauma lokal
Intracerebral
Mild concussion/commotio
Kelainan difus
Classic concussion/contusio
Diffuse axonal injury
9 / 40
ACS
Epidural Hematoma
10 / 40
ACS
Epidural Hematom
11 / 40
ACS
Epidural Hematoma
12 / 40
ACS
Subdural Hematoma
13 / 40
ACS
Subdural hematom
14 / 40
ACS
Commotio cerebri
ACS
Coma dalam
Kerusakan otak diffuse
Posisi tubuh / motorik khas
Disfungsi sistem otonom
16 / 40
ACS
Observasi
17 / 40
ACS
18 / 40
ACS
19 / 40
ACS
Beri oksigen
20 / 40
ACS
Dorong rahang
Jaw thrust
21 / 40
ACS
Naso-pharingeal
Oro-pharingeal
22 / 40
ACS
Ukur panjang
Masukkan terbalik
Putar
23 / 40
ACS
ACS
BREATHING
Tidak sadar :
Menilai Pernafasan
baik
ACS
BREATHING
Katup 1
Katup 2
Kanul Hidung
Face Mask
Non Rebreathing
Mask
26 / 40
ACS
BREATHING
O2
Mulut - mulut
Mulut - Masker
27 / 40
ACS
BREATHING
AGD 118
29
BREATHING
O2=50%
O2
O2>90%
Valve
Mask
Bag
O2
ACS
30 / 40
ACS
GCS
Eye opening = membuka mata
Best motor response = respons motorik
Verbal response = respons verbal
Pupil, simetris?
ACS
32 / 40
ACS
ACS
ACS
Cause
IIIrd Nerve compression
bilaterally
Inadequate CNS
perfusion
ACS
Drugs
Pontine lesion
Injured sympathetic
pathway
36 / 40
ACS
Penanganan medis
Cairan intravena
Euvolemia
Isotonic
Hyperventilation, bila perlu
37 / 40
ACS
Medical Management
Mannitol
Dose : 0.5 1.0 g/kg IV bolus
Other
Anticonvulsants
Sedasi
Paralitik
38 / 40
ACS
39 / 40
ACS
Pertanyaan
?
40 / 40