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Initial Assessment and
Trauma Management

Indah D. Pratiwi

Dept. of Emergency Nursing

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 General Trauma Assessment
1. Scene size up
2. Initial assessment/ primary survey
3. Rapid trauma survey or focus
assessment/ secondary survey

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 Scene size up
• Universal precaution?
• Lihat keadaan sekitar
– Prioritas utama: keselamatan penolong 
lingkungan yang aman untuk bekerja
• Initial triage. Berapa jumlah korban?
• Mekanisme cedera?
• Rapid extrication?
• Aktifkan EMS
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 Alat yang diperlukan
• Proteksi penolong
• Long back board/scoop stretcher
• Cervical collar
• OPT, ETT, suction
• Oksigen
• Bandage, splint, etc

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Cervical collar

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Oropharyngeal tube

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Breathing Equipment

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Dressing and Bandages

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Kendrick Extrication Device

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Long Back Board

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Scoop stretcher

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 Primary survey
• Gambaran umum korban
• Tentukan respon pasien  tingkat
kesadaran  AVPU
• Kaji airway, breathing & circulation 
lakukan tindakan jika terdapat gangguan
– bebaskan airway, stabilkan spine, support
pernafasan dan kontrol perdarahan mayor
• Tentukan prioritas  keputusan transfer
ke trauma centre
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 Rapid Trauma Survey
• Pemeriksaan secara sistematis dari
kepala, leher, dada, abdomen, pelvis dan
ekstremitas dengan Inspeksi, Palpasi,
Auskultasi dan Perkusi untuk menemukan
kasus life threatening

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 Secondary survey
• SAMPLE (Symptoms, Allergies, Medications,
Past medical history, Last oral intake, Events
preceding the incident)
• Vital sign
• Deformities, Contusion, Abrasion, Penetration,
Burn, Laceration, Swelling (DCAP-BLS)
• Tenderness, Instability, Crepitation (TIC)
• Pulse, Movement, Sensation (PMS)
• LOC  AVPU
• Pulse oxymetry
• Intervensi lanjut: balut & bidai 19
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 Critical Interventions and
Transport Decision
1. Initial assessment
– Penurunan kesadaran
– Respirasi abnormal
– Sirkulasi abnormal  syok, perdarahan tidak terkontrol
2. Rapid trauma survey
– Abnormal chest exam  flail chest, etc
– Tender/distended abdomen
– Pelvic instability
– Bilateral femur fractures
3. High risk group

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 Transport
• Jenis transportasi?
• Transfer ke trauma centre berdasar
prioritas pasien!

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QUESTION???