Penanganan Trauma Geriatri

STASE RSUD DAYA

FAKULTAS KEDOKTERAN
UNIVERSITAS MUSLIM INDONESIA
2018
KATA PENGANTAR
• Faktanya, pada tahun 2050, 1,5 populasi dunia
dalam setiap negara 20% adalah populasi usia >60
tahun.
• Trauma adalah penyebab kematian kelima utama
pada pasien tua.
• Peningkatan mortalitas pada pasien tua dengan
trauma kebanyakan disebabkan ketepatan triase.
American College of Surgeons Committee on Trauma. Advanced Trauma Life Support 10th Edition. Chicago, IL: American
College of Surgeons Committee on Trauma; 2018
 • Kegagalan triase pada pasien tua disebabkan berbagai
faktor: penuaan organ baik secara anatomi dan
fisiologi, riwayat penyakit sebelumnya, dan
kelemahan. Begitu pula, faktor depresi, penganiayaan,
dan penyalahgunaan obat.
• Pada studi terbaru, investigator mengidentifikasi lima
riwayat penyakit yang mempengaruhi outcomes pada
pasien trauma: sirosis, koagulopati, PPOK, Ischemic
Heart Disease, dan DM.
American College of Surgeons Committee on Trauma. Advanced Trauma Life Support 10th Edition. Chicago, IL: American College of Surgeons Committee on
Trauma; 2018
American College of Surgeons Committee on
Trauma. Advanced Trauma Life Support 10th
Edition. Chicago, IL: American College of
Surgeons Committee on Trauma; 2018
 MEKANISME TRAUMA
• Mekanisme trauma yang pada umumnya terjadi pada
pasien tua:
1. Jatuh
2. Kecelakaan lalu lintas
3. Luka bakar
4. Trauma tajam

American College of Surgeons Committee on Trauma. Advanced Trauma Life Support 10th Edition. Chicago, IL: American College of Surgeons Committee on
Trauma; 2018
 Trauma
• Terjadinya jatuh dan trauma lainnya ada hubungannya dengan
bertambahnya usia karena pada lanjut usia terjadi penurunan
proprioseptif, kelemahan otot, akibat penyakit yang diderita seperti
stroke, fungsi penglihatan yang menurun, maupun akibat faktor
lingkungan misalnya penerangan yang kurang, lantai yang licin dan
faktor lainnya. Penatalaksanaan ditujukan mengobati lukanya dan
mencari penyebab jatuhnya.

American College of Surgeons Committee on Trauma. Advanced Trauma Life Support 10th Edition. Chicago, IL: American College of Surgeons Committee on
Trauma; 2018
PRIMARY SURVEY DAN RESUSITASI

1. AIRWAY
American College of Surgeons Committee on Trauma. Advanced Trauma Life Support 10th Edition. Chicago, IL: American College of Surgeons Committee on
Trauma; 2018
American College of Surgeons Committee on Trauma. Advanced Trauma Life Support 10th Edition. Chicago, IL: American College of Surgeons Committee on
Trauma; 2018
2. BREATHING

American College of Surgeons Committee on Trauma. Advanced Trauma Life Support 10th Edition. Chicago, IL: American College of Surgeons Committee on
Trauma; 2018
 3. CIRCULATION

American College of Surgeons Committee on Trauma. Advanced Trauma Life Support 10th Edition. Chicago, IL: American College of Surgeons Committee on
Trauma; 2018
American College of Surgeons Committee on Trauma. Advanced Trauma Life Support 10th Edition. Chicago, IL: American College of Surgeons Committee on
Trauma; 2018
 4. DISABILITY

American College of Surgeons Committee on Trauma. Advanced Trauma Life Support 10th Edition. Chicago, IL: American College of Surgeons Committee on
Trauma; 2018
American College of Surgeons Committee on Trauma. Advanced Trauma Life Support 10th Edition. Chicago, IL: American College of Surgeons Committee on
Trauma; 2018
 5. EXPOSURE AND ENVIRONMENT

American College of Surgeons Committee on Trauma. Advanced Trauma Life Support 10th Edition. Chicago, IL: American College of Surgeons Committee on
Trauma; 2018
 TRAUMA SPESIFIK
FRAKTUR COSTA • Komplikasi primer: Pneumonia
Treatment:
• Pain control (transdermal local anesthetics)
• Pulmonary hygiene
• Mempertimbangkan alternatif non narkotik,
menggunakan dosis rendah pada short acting
narcotics
TRAUMATIC BRAIN INJURY (TBI) • Pasien dalam terapi anti koagulan dan/atau anti
platelet memiliki faktor mortalitas >>
• Diagnosis = CT Scan
• Pemberian PCC, plasma, dan vitamin K

FRAKTUR PELVIS • >> Usia 60 tahun, mengalami osteoporosis

• Resiko mortalitas 4x lebih tinggi pada usia tua
• Memerlukan transfusi darah meskipun tampakan
fraktur stabil

American College of Surgeons Committee on Trauma. Advanced Trauma Life Support 10th Edition. Chicago, IL: American College of Surgeons Committee on
Trauma; 2018
 ELDER MALTREATMENT

American College of Surgeons Committee on

Trauma. Advanced Trauma Life Support 10th
Edition. Chicago, IL: American College of
Surgeons Committee on Trauma; 2018
SYUKRON