Trauma Toraks 2011 GELS IGD
Trauma Toraks 2011 GELS IGD
TUJUAN
• Mengenal trauma toraks yang mengancam jiwa
• Tension pneumotoraks
• Tamponade jantung
• Hematotoraks masif
• Flail chest
Potensial Mengancam Jiwa
• Pneumotoraks
• Hematotoraks
• Trauma diafragma
• Trauma aorta
• Kontusio paru
Major Thoracic Injury
“Lethal six” “Hidden six”
Copyright © 2007, 2006, 2001, 1994 by Mosby, Inc., an affiliate of Elsevier Inc.
Pneumothorax
Tamponade Jantung
• Hemopericardium, krn perikard kaku maka terjadi gangguan
gerakan jantung.
• As noted previously
• Hemothorax: massive =
initial drainage more than
1,000 cc or
• Continuous bleeding of
200 cc/hr for 2 hrs
Open Pneumotoraks
• Defek pada dinding
dada dgn diameter >
2/3 trakhea shg
udara masuk melalui
dinding dada lbh bsr
d.p masuk trakhea
• Tampak deformitas
• Klinis hemoptisis,
sianosis, empisema
subkutis, intubasi sulit
karena distorsi
trakhea.
Initial CXR of Concern
Ruptur Aorta
• Sering bersifat fatal, bila partial/ kecil akan terdapat
hematom di mediastinum dapat menjadi sumbat
sementara
• Widened
mediastinum (>8cm)
Complete Aortogram
Ringkasan
• Trauma toraks dapat mengancam jiwa dengan
permasalahan perlu prioritas setelah airway
problem teratasi
• Results:
Prospectively collected database of patients with chest injury who were admitted to
Hadassah Hospital Level I trauma centre, in Jerusalem, Israel, from October 2000 to
December 2005.
There were many female victims after suicide bombing attacks (49.1%) compared with
GSW (21.8%) and blunt trauma (24.6%; p = 0.009). The number of body regions injured
was significantly higher in the terror group compared with the GSW and blunt groups
(median, 4, 2, and 3, respectively, p < 0.0001). The pattern of chest injury after suicide
bombing attacks was caused by a unique combination of the effects of the blast wave
and penetrating shrapnel. More than half (52.7%) of the terror victims suffered from
lung contusion and 25 (45.5%) required tube thoracostomy. Five patients (9.1%)
underwent thoracotomy for lung lacerations (n = 3), injury to great vessels (n = 2),
cardiac lacerations (n = 1), and esophageal injury (n = 1). Penetrating shrapnel was the
mechanism of injury in all these cases.
Radiology January 2010 254:285-291
Crush Thoracic Trauma in the Massive Sichuan Earthquake: Evaluation with
Multidetector CT of 215 Cases1
Zhi-Hui Dong, MD, Zhi-Gang Yang, MD, PhD, Tian-Wu Chen, MD, Yuan-Chun Feng, MD,
Zhi-Gang Chu, MD, Jian-Qun Yu, MD, Hong-Li Bai, MD and Qi-Ling Wang, MD