Post on 08-Jan-2016
7/17/2019 tatalaksana luka bakar- ankes 2012.pptx
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Dr. Widi Yuli Harianto
Tata laksanaLuka Bakar
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Menjelaskan prosedur penatalaksanaanluka bakar thermis, kimia dan listrik
Tujuan:
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Severity Klasifkasi Luka Bakar Emergency Medical Care Luka Bakar Kimia
Luka Bakar Listrik Dressing and Bandaging Trauma Inhalasi
Overview:
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Ditentukan oleh:
- derajat kedalaman
- luas
- critical areas yang terkena
- medical condition atau trauma
- umur pasien
SeverityLuka Bakar
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Derajat Kedalaman (Grade)Luka Bakar:
Derajat kedalaman(Grade)
Struktur yg terkena Gejala dan Keluhan
rade I!"uperf#ial Burns$
Han%a men&enailapisan atas kulit
!epidermis$
-Hiperemi-'%eri (-
Bullae )
rade II!*artial Thi#knessBurns$
Men&enai epidermisdan seba&ian dermis
-)lembab, mottled,kulit merah + memutih-) '%eri ((-)Bullae (
rade III
!ull Thi#kness Burns$
Men&enai seluruh
lapisan kulit
))) kerin&
))) putih-#oklattua-hitam)))#harred))) tdk n%eri
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DERMIS
EPIDERMIS
Gr I
Gr IIA
Gr IIB
Gr III
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Partial Thikness Burns
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!ull Thikness Burns
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Ditentukan olehpercentage!$ dari body area%an& terbakar
Telapak tan&an pasien ( / 0rule o1 nines2 dari Walla#e
Luas Luka Bakar
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Memba&i tubuh menjadi beberapa ba&ian Di&unakan untuk men&kalkulasi
permukaan tubuh %an& terbakar
"ule o# nines o# $allae
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B3DY *45T 4D6LT 7HILD Head 8 'e#k 9 /: 4rms 9 !;$ 9 !;$ ront 8 Ba#k /: !;$ /: !;$
Le&s /: !;$ /
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Rule of Nines(Wallace)
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Meliputi critical areas !>ajah, upper airway, hands, &enitalia$
*re e?istin& medi#al #onditions
Lokasi Luka Bakar
DM
py. Cardiopulmonum
!an!!uan psikia"rik dll
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@ /A tahun =A tahun
#mur $asien
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major burns moderate burns
minor burns
SeverityLuka Bakar& di'agi
menjadi:
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Deasaajor Burns oderate
BurnsinorBurns
LB &r II;= LB &r II /=);= LB &r II @/=
LB &r III/A LB &r III ;)/A!C$
LB &r III @;
LB men&enai mata, telin&a,
>ajah, tan&an, kaki atauperineum %an& men&akibatkan&an&&uan kosmetik atau 1un&si
Electrical burns
LB disertai trauma inhalasi
LB disertai 0underlying diseases2
Chemical burns
LB disertai trauma pen%erta lain% &anpa resiko !!n fun!si a"au kosme"ik pada ma"a "elin!a 'aa "an!an kaki a"au perine
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*sia +, th dan . /th
ajor Burns oderate Burns inor Burns
LB &r II ;A LB &r II /A);A LB &r II @ /A
LB &r III /A LB &r III ;)/A !C$ LB &r III @ ;
Lainn%a de>asa
% &anpa resiko !!n fun!si a"au kosme"ik pada ma"a "elin!a 'aa "an!an kaki a"auperineum
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*asien De>asa
Stop the burning process0 egah edera l'h lanjut
Bahan isolator onitor airway1 'eri 23 4egah kontaminasi le'ih
lanjut
Emergency Medical Care
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Indikasi M5"E semua derajat III
Major Burns dan Moderate Burns
Indikasi poliklinis !ra>at jalan$E Minor Burns !ke#. Derajat III$
Luka Bakar
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Selimuti dengan 'ahankering 0 5steril6
No ointments lotion orantiseptic
!o not brea" blisters Transport 7S7P
8mergeny edial 4are
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*asien *ediatrik Greater surface area in relationship to the total
body size
luid and heat loss
5isk o1 sho#k, air>a% and h%pothermia F
Consider child abuse
8mergeny edial 4are
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Transport ) Gscoop and run
Pasien Pediatrik
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Disebabkan karena adan%a kontak kulitden&an bahan toksik
Luka Bakar Kimia
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Disebabkan oleh alkali, asam dan#ampuran
*rote#t %oursel1 1rom e?posure or injur%
Luka Bakar Kimia
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"top the burnin& pro#ess
(,) 9mmediately ush ith
large amounts o# ater (3) Do not ontaminateuninjured areas
(;) 4ontinue ushinghile enroute to hospital
Luka Bakar Kimia Emergency
Care
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!$ 7oJer >ith dr% sterile dressin& or#lean sheet
!=$ "pe#ial #are o1 the e%es
Gently
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5ea#tion >ith >ater #an >orsen burn
(,) =Brush - then ush> (3) "emo?e ?itims
lothing (shoes 0 soks)
Dry hemials
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"#ene "a1et% Do not ontat high ?oltageires
4onsider all ires li?e Do not handle don lines Do not ome in ontat ith
patient i# the eletrial soureis li?e
Luka Bakar Listrik
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Ma% be more serious than it seems ntr% >ound is usuall% a small burn area Look 1or an e?tensiJe e?it >ound *ossible tissue dama&e underneath !#urrent
spreads out as it traJels throu&h the bod%$
8mergeny edial 4are
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*ossible 7ardia# arrest *ossible 5espirator% arrest
"plint possible 1ra#turesTreat >ounds >ith a dr%, sterile dressin&Transport
8mergeny edial 4are
ont:
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Treat an% major #ompli#ations frst
8letrial Burns
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ntr% >ound on head ?it >ound on 1oot
8letrial 9njuries
Luka Masuk Luka *eluar
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"top bleedin& *rote#t >ound 1rom 1urther dama&e *reJent 1urther #ontamination and in1e#tion
Dressing and Bandaging
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7hemi#al 1umes
2'?ious #umes in the air 9nhaled #umes
Trauma 9nhalasi
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Deadl% poison
4ar'on ono@ide (42)
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Dierent than smoke inhalation
2dorless
Tasteless %ot an irritant
4ar'on ono@ide
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a. D%spnea !di#ult% in breathin&$ b. 5espirator% arrest #. 7herr% red skin
Signs and symptoms
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Burnt almonds D%spnea !di#ult% in breathin&$ 5espirator% arrest
4yanide
Signs and Symptoms
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a. /AA o?%&en throu&h a non)rebreathin&mask
b. Be prepared to do basi# li1e support #. Transport
Treatment
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ormula Ba?ter De>asa
## ? luas LB ? k& BB N.....## lar. 5L
diberikan E O ba&ian pada : jam I
O ba&ian pada/P jam berikutn%adiberikan lar. koloid =AA)/AAA## pd jam ke /:);
Pem'erian airan pada LukaBakar
Pem'erian airan pada Luka
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ormula !modifkasi$ Ba?ter 4nak
;## ? luas LB ? k& BBN...## lar. 5L
diberikanE O ba&ian pada : jam I
O ba&ian pada /P jam berikutn%a larutan koloid /QE< !sejak jam ke)A$
Hari berikutn%a diberikan #airan maintenan#e
Pem'erian airan pada LukaBakar