Escolar Documentos
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Sistematika Emergency
Medicine
TRIASE
SURVEI PRIMER
SURVEI SEKUNDER
STABILISASI
RUJUKAN
TERAPI DEFINITIF
Survei sekunder
Pemeriksaan kepala
Fungsi motorik
Fungsi sensorik
Refleks-refleks
Secondary Survey
Head
Unconscious patient
Periorbital edema
Secondary Survey
The
complete
history and
physical
examination
Secondary Survey
Key Components
History
Reevaluation
Secondary Survey
History
A Allergies
M Medications
P Past Illnesses
L Last meal
E Events/Environment
Secondary Survey
Mechanisms of Injury
ACS
Lihat / inspeksi
Palpasi (nyeri tekan,
deformitas)
Anggap leher cedera
Imobilisasi pada posisi netral
Secondary Survey
Cervical Spine
Pitfalls
Palpate for
Altered LOC for
tenderness
any reason
Complete motor/
Other severe ,
sensory exams
painful injury
Reflexes
C-spine imaging
Secondary Survey
Neck (soft tissues)
Mechanism : Blunt
vs penetrating
Symptoms : Airway
obstruction ,
hoarseness
Findings :Crepitus
hematoma ,stridor
bruit
Pitfalls
Delayed
symptoms
and signs
Progressive airway
obstruction
Occult injuries
Secondary Survey
Maxillofacial
Bony crepitus/stability
Palpable deformity
Pitfalls
Pemeriksaan dada
mencari ulang kerusakan
Lihat / inspeksi
Palpasi
Perkusi
Auskultasi
Foto sinar-X dada (jika
ada)
ECG ( jika ada)
Secondary Survey
Chest
Inspect
Palpate
Percuss
Auscultate
X-ray
Pitfalls
Elderly
Children
Secondary Survey
Abdominal Evaluation
Blunt trauma
Penetrating trauma
Secondary Survey
Abdomen
Reevaluate frequently
Special studies
Pitfalls
Hollow viscus and retroperitoneal injuries
Excessive pelvic manipulation
Secondary Survey
Perineum
Contusions, hematomas,
lacerations, urethral blood
Rectum
Vagina
Pitfalls
Blood lacerations
Urethral injury in women,
pregnancy
Inspeksi
Palpasi
Palpasi nadi arteria distal
Ingat compartment syndrome
Jangan lupa periksa punggung
Log-roll
Log-roll
Cari luka, robekan, memar, nyeri tekan,
deformitas tulang belakang
4 orang
Pemberi
komando
instruksi
yang jelas
Foto sinar-x
Secondary Survey
Musculoskeletal : Extreminities
Contusion , deformity
Pain
Perfusion
X- rays as needed
Secondary Survey
Musculoskeletal : Pelvis
Pain on palpation
Symphysis width
Instability
X-rays as needed
Secondary Survey
Musculoskeletal
Pitfalls
Potential blood loos
Missed fractures
Soft-tissue or ligamentous injury
Occult compartement syndrome
(especially with altered LOC /
hypotension)
Secondary Survey
Neurologic
Spine / Cord
CNS
Complete motor
Frequent
and sensory exams
reevaluation
Imaging as
Prefent
indicated
secondary brain
Reflexes
injury
Early neurosurgical
consultation
Adjuncts to Secondary
Survey
Secondary Survey
Neurologic
Pitfalls
Incomplete immobilization
Suble in ICP with
manipulation
Rapid deterioration
Reevaluation
Minimizing Missed Injuries
High index of suspicion
Frequent reeveluation and
monitoring
Reevaluation
Pain Management
Relief of pain /anxiety as
appropriate
Administer intravenously
Careful monitoring is
essential
Definitive Care
Local Facility
??
Transfer agreements
?? Local resources ??
??
Trauma
Specialty
Center Facility
Record , Legal
Considerations
Concise, chronologic
documentation
Consent for treatment
Forensic evidence
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