Multiple Trauma

Terminology:
Multiple trauma terjadi ketika mengalami
cidera lebih dari satu secara simultan.
Contoh: fraktur, laserasi, kerusakan organ
dalam seperti ginjal, hepar, pankreas dll.
Sering terjadi pada kasus kecelakaan mobil,
jatuh, crush injuri.
Penanganan secara umum
Prinsip
Kenali Situasi Tempat Kejadian
1.Aman/ Tidak aman
2.Berbahaya
Identifikasi Kasus
1.Trauma ?
2.Non Trauma ?
3.Identifikasi Keadaan Pasien
Assessment of the injured patient

Primary survey and resuscitation

A = Airway and cervical spine
B = Breathing
C = Circulation and haemorrhage control
D = Dysfunction of the central nervous system
E = Exposure
Secondary survey
Definitive treatment

Call for help

Airway and cervical spine

1.Hanya 4 6 Menit bila Obstruksi total

2.Selalu Pikirkan C Spine Control Curiga fractur
servikal bila:
Setiap trauma kapitis
Setiap multi trauma
Setiap ada luka(tumpul) diatas klavikula
Biomekanik trauma mendukung
Airway

Airway
OkstruksiParsial
Cairan(gurgling) Suction
Lidahjatuhkebelakang: Snoring
Breathing
Circulation

Assess pulse, capillary return and state of neck veins

Identify exsanguinating haemorrhage and apply direct pressure

Place two large calibre intravenous cannulas

Give intravenous fluids (crystalloid or colloid)
Attach patient to ECG monitor
Dysfunction

Assess level of consciousness using AVPU method

A = alert
V = responding to voice
P = responding to pain
U = unresponsive

Assess pupil size, equality and responsiveness

Exposure

Avoid hypothermia

Fully undress patients

Avoid hypothermia
Multiple casualties

several causalties at the same time.

1. Alarm ER services
2. Assess the scene - without puting your safety at risk.
3. Triage
'do the most for the most'
Triage

Ability to walk
Airway
Respiratory rate
Pulse rate or capillary
return
Road accidents

fall from a bicycle . major incident with many causalties.

serious risks to safety - traffic