Pencegahan cedera

Definisi Cedera

Cedera adalah kerusakan tubuh yang terjadi secara

tidak diinginkan ataupun diinginkan karena
terpapar secara akut dengan suhu, mekanis, listrik
atau kimia atau dari tidak adanya unsur penting
seperti panas atau oksigen.
Piramida cedera

|-------------------------------
|
| 1/18
Deaths
|
147,891
1/400 ______________
| Hospital discharges 1/14
| 2,591,000
| ____________________________
| Emergency department visits
| 36,961,000
2/3
|------- ________________________________________
Episodes of injuries reported
59,127,000
Model umum pengontrolan cedera
Model Epidemiologi
 Haddon Phase-Factor Matrix

Phase Host Vector Physical Cultural

(Human) (Vehicle) Environment Environment

Pre-
Event

Event

Post-
Event
 Haddon Phase-Factor Matrix
Motor vehicle crash

Phase Host Vector Physical Cultural

(Human) (Vehicle) Environment Environment

Pre- Alcohol Brake Nigh, Acceptance of

Experience status Rain Drinking and
Event Judgment Tires Icy road Driving

Event No seat belt No air bag Tree too close to Speed limits
Hardness of road, Enforcement of
surfaces No guard rail seat belt

Post- Physical Fuel system Distance of Support for

condition integrity emergency Trauma
Event Cell Phone response systems,
EMS standard
Strategi pencegahan cedera
1. Preventing creation of the agent: stop production of
the agent before it can present a hazard
• Examples:

• Highly toxic pesticides

• Fireworks
Strategi pencegahan cedera
2. Reducing the amount of the agent: identifying a
hazard and reducing its presence in an environment.

• Package toxic drugs in smaller, safe amounts

• Reduce speed limits

Strategi pencegahan cedera
3. Preventing release of the agent;
reduce exposure by deterring it from entering
the environment

• Ban very speedy cars

• Make bathtubs less slippery

Strategi pencegahan cedera
4. Modifying the rate or spatial distribution of the
agent;
altering the mechanism by which energy is transferred to the host

• Adjust the design

• Require automobile seatbelts and air bags
• Require soft playground surfaces
Strategi pencegahan cedera
5. Separating the host and agent, in time and
space: eliminating contact between energy
source and host
• Install pedestrian sidewalks
• Reroute high speed traffic around residential
neighborhoods or slow it with speed bumps and
roundabouts
• Spray pesticides at a time of day when people aren’t
around
• use red light cameras
Strategi pencegahan cedera
6. Separating the agent from a susceptible host by
interposition of a material barrier
• Install fences around pools
• Install cover guards on dangerous machinery
• Install proper guardrails along roads
• Use child-proof packaging
• Store handguns in a locked metal box
• Use extension cords with good insulation
Strategi pencegahan cedera
7. Modifying relevant qualities of the agent
Make crib slat spacing too narrow to strangle a child
• Modify equipment by rounding sharp corners
Strategi pencegahan cedera

8. Strengthening the susceptible host

• Improve physical condition through proper
nutrition and regular exercise
Strategi pencegahan cedera

9. Countering the injury already caused by the

agent
• Provide emergency medical care
Strategi pencegahan cedera
10. Stabilizing, repairing and rehabilitating the
injured host
• Provide of appropriate acute care and
rehabilitation facilities and make them available all
over the country
Prevention Through Leading a Healthy Life
The 5 “Es” of Incident Prevention
• Epidemiology: you can’t prevent it if you don’t understand it.
Data collection is key.
• Education: awareness, attitudes, cultural beliefs
• Enforcement: rules, life safety codes etc.
• Engineering: changing the environment to make it safer
• Evaluation: did the changes made in education,
enforcement, and engineering have the desired outcome on
incidence?
Pencegahan cedera pada
remaja
Pencegahan Cedera pada Remaja
• Di AS, cedera yang tidak diharapkan merupakan
penyebab kematian utama pada remaja dan
penyebab pembiayaan kesehatan pada usia 11-18
tahun
• Kebanyakan cedera dapat dicegah, dan biaya
pencegajan lebih murah dari biaya pengobatan
• Pemerintah perlu menginvestasikan dana untuk
pencegahan cedera untuk menurunkan angka
kematian dan mengurangi pembiayaan kesehatan
Faktor resiko
• Perilaku berisiko: tidak menggunakan sabuk
pengaman, berkendara dalam keadaan mabuk,
membawa senjata, tidak menggunakan peralatan
pelindung saat olah raga, berkelahi
• Faktor sosial ekonomi: pendapatan keluarga,
pendidikan dalam keluarga, struktur keluarga,
akomodasi
• Jenis kelamin laki-laki: laki-laki melakukan kegiatan
berisiko tinggi, memiliki tingkat aktivitas tinggi,
perilaku impulsif
Tindakan pencegahan cedera
• Peningkatan pencegahan cedera oleh dokter
• Pencegahan cedera sebagai bagian dari kunjungan konseling remaja
• Skrining depresi, pelecehan, pengabaian dan penggunaan zat
terlarang
• Konseling bagi remaja yang mendapat pengobatan berisiko untuk
disalah gunakan dan keracunan
• Insentif dan subsidi pembelian dan penggunaan peralatan
pengaman: helm bersubsidi
• Dukungan bagi aktivitas komunitas untuk pencegahan
cedera
• Advokasi untuk kebijakan pencegahan cedera
• Pembatasan kendaraan bermotor, system ijin mengemudi,
pembatasan mengemudi malam hari
• Pembatasan akses pembelian obat tertentu, program pemantauan
obat
• Pendidikan kesehatan pada remaja dan keluarga
Pencegahan Trauma
pada lansia
RISK OF GERIATRICS

• PRONE FOR INFECTIONS

• PRONE FOR INJURIES
• NEED SPECIAL ASSISTANCE
• PRONE FOR PSYCHOLOGICAL PROBLEMS
• PRONE FOR DEGENERATIVE DISORDERS
• INCREASED RISK FOR DISEASE
• INCREASED RISK OF DISABILITY
• INCRASED RISK OF DEATH
GERIATRIC PEOPLE PROBLEMS
• HEALTH PROBLEMS
1.Joint problems
2.Impairment of special senses
3. Cardio vascular disease
4.Hypothermia
5.Cancer, Prostate enlargement, Diabetes&
Accidental falls
• Psychological problems
1. Emotional problems
2. Suicidal tendency
3.& Senile dementia, Alzheimer’disease
• Social problems
• Poverty, Loneliness, Dependency, Isolation, Elder
abuse, Generation Gap
Mechanisms
• Falls
• Motor Vehicle Crashes (MVC)
• Pedestrian vs. Motor Vehicle
• Burns
• Assaults
CONSIDERATIONS
PHYSIOLOGIC EFFECTS OF AGING
• Stiffening of myocardium
• Decrease in pulmonary compliance
• Atrophic mucosa = decrease clearance sputum
• Loss renal reserve (creatinine clearance)
• Brain atrophy
• Decrease senses: vision and hearing
• Muscle mass, immune system, glc intol.
CONSIDERATIONS
MECHANISMS OF INJURY
• Falls are most common
• Decrease in senses, postural stability(age or from other
events)
• 70% all deaths in geriatric
• syncope as cause should be investigated
• cardiac, CVA, metabolic, anemia, psychogenic
• consultation to specialists may be necessary
CONSIDERATIONS
MECHANISM OF INJURY
• MVA follows
• Only newest drivers higher rate
• more accidents per mile, despite less driving
• more accidents in daytime or good weather
• Decrease vision, hearing and longer reaction
• Pedestrian
• Highest mortality
• 46% in designated crossing areas
Prevention
• Safe environment (rugs, cords, lighting, etc)
• Home modifications (tubs, rails, etc)
• Medications (benzos and narcotics)
• Driving Safety
• Not driving
• Strength and balance therapy
How to Help Seniors Drive Safely
Longer- 8 Functional Areas (AAA)
• Leg strength and • Working Memory
flexibility (directions and traffic
• Head and neck rules)
flexibility • Visualization of missing
• High contrast visual info (recognize hazards)
acuity (signs/marks) • Visual search (find
• Low visual acuity signs)
• Useful field of vision
(peripheral threats)
• Home Modification
• Keep stairs and walkways clear of clutter and phone and electrical
cords.
• Use non-slip mats in the tub/shower. Install grab bars in tub and
near toilet.
• Use only throw rugs with rubber, nonskid backing.
• Make sure stairways are well lit from both top and bottom. Have
easy-to-grip handrails on both sides of the whole staircase.
• Wear sturdy, well-fitted, low-heeled shoes with non-slip soles.
These are safer than high-heels, thick-soled athletic shoes,
slippers or stocking feet.
• Take your time. Being rushed or distracted greatly increases your
chance of falling. Get your balance when first standing up.