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Luka Bakar. Dr. Dewi Haryanti K, SpBP Sub Bagian Bedah Plastik RSUD dr. Moewardi/ FK UNS Ska. Tujuan :. Menjelaskan prosedur penatalaksanaan luka bakar thermis, kimia dan listrik. Overview :. Severity Klasifikasi Luka Bakar Emergency Medical Care Luka Bakar Kimia Luka Bakar Listrik

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luka bakar
Luka Bakar

Dr. Dewi Haryanti K, SpBP

Sub Bagian Bedah Plastik

RSUD dr. Moewardi/ FK UNS Ska

tujuan
Tujuan:

Menjelaskan prosedur penatalaksanaan luka bakar thermis, kimiadanlistrik

overview
Overview:
  • Severity
  • Klasifikasi Luka Bakar
  • Emergency Medical Care
  • Luka Bakar Kimia
  • Luka Bakar Listrik
  • Dressing and Bandaging
  • Trauma Inhalasi
severity luka bakar
SeverityLuka Bakar

Ditentukan oleh:

- derajat kedalaman

- luas

- critical areas yang terkena

- medical condition atau trauma

- umur pasien

slide6

EPIDERMIS

Gr I

Gr IIA

Gr IIB

Gr III

DERMIS

luas luka bakar
Luas Luka Bakar
  • Ditentukan olehpercentage(%) dari body area yang terbakar
  • Telapak tangan pasien + 1%
  • ‘rule of nines’ dari Wallace
rule of nine s of wallace
Rule of nines of Wallace
  • Membagi tubuh menjadi beberapa bagian
  • Digunakan untuk mengkalkulasi % permukaan tubuh yang terbakar
rule of nines
Rule of Nines

BODY PART ADULT CHILD

  • Head & Neck 9 18
  • Arms 9 (2) 9 (2)
  • Front & Back 18 (2) 18 (2)
  • Legs 18 (2) 13.5 (2)
  • Genitalia 1 1
slide12

Rule of Nines

(Wallace)

lo kasi luka bakar
Lokasi Luka Bakar
  • Meliputicritical areas

(wajah, upper airway, hands, genitalia)

Pre existing medical conditions

  • DM
  • py. Cardiopulmonum,
  • gangguan psikiatrik, dll
umur pasien
Umur Pasien
  • < 10 tahun
  • > 50 tahun
severity luka bakar dibagi menjadi
Severity Luka Bakar, dibagi menjadi:
  • major burns
  • moderate burns
  • minor burns
dewasa
Dewasa

* Tanpa resiko ggn fungsi atau kosmetik pada mata, telinga, wajah, tangan, kaki atau perineum

usia 10 th dan 50th
Usia <10 th dan > 50th

* Tanpa resiko ggn fungsi atau kosmetik pada mata, telinga, wajah, tangan, kaki atau perineum

emergency medical care
Emergency Medical Care
  • Pasien Dewasa
    • Stop the burning process &cegah cedera lbh lanjut
    • Bahan isolator
    • Monitor airway – beri O2
    • Cegah kontaminasi lebih lanjut
luka bakar1
Luka Bakar
  • Indikasi MRS:
    • semua derajat III
    • Major Burns dan Moderate Burns
  • Indikasi poliklinis (rawat jalan):
    • Minor Burns (kec. Derajat III)
emergency medical care1
Emergency Medical Care
  • Selimuti dengan bahan kering & ‘steril’
  • No ointments, lotion, or antiseptic
  • Do not break blisters
  • Transport ASAP
emergency medical care2
Emergency Medical Care
  • Pasien Pediatrik
    • Greater surface area in relationship to the total body size
    • Fluid and heat loss >>
    • Risk of shock, airway and hypothermia ↑
    • Consider child abuse
p asien p ediatri k
Pasien Pediatrik
  • Transport - “scoop and run”
luka bakar kimia
Luka Bakar Kimia
  • Disebabkan karena adanya kontak kulit dengan bahan toksik
luka bakar kimia1
Luka Bakar Kimia
  • Disebabkan oleh alkali, asamdan campuran
  • Protect yourself from exposure or injury
luka bakar kimia emergency care
Luka Bakar KimiaEmergency Care
  • Stop the burning process
    • (1) Immediately flush with large amounts of water
    • (2) Do not contaminate uninjured areas
    • (3) Continue flushing while enroute to hospital
slide26
(4) Cover with dry sterile dressing or clean sheet
  • (5) Special care of the eyes
    • Gently /continuously flush
    • For direct eye injury hold lids open and irrigate the eye
dry chemicals
Dry chemicals
  • Reaction with water can worsen burn
    • (1) “Brush - then flush”
    • (2) Remove victims clothing (shoes & socks)
luka bakar listrik
Luka Bakar Listrik
  • Scene Safety
    • Do not contact high voltage wires
    • Consider all wires live
    • Do not handle down lines
    • Do not come in contact with patient if the electrical source is live
emergency medical care3
Emergency Medical Care
  • May be more serious than it seems
  • Entry wound is usually a small burn area
  • Look for an extensive exit wound
  • Possible tissue damage underneath (current spreads out as it travels through the body)
emergency medical care cont
Emergency Medical Care cont:
  • Possible Cardiac arrest
  • Possible Respiratory arrest
  • Splint possible fractures
  • Treat wounds with a dry, sterile dressing
  • Transport
electrical burns
Electrical Burns
  • Treat any major complications first
electrical injuries
Electrical Injuries
  • Entry wound on head
  • Exit wound on foot

Luka Masuk

Luka Keluar

dressing and bandaging
Dressing and Bandaging
  • Stop bleeding
  • Protect wound from further damage
  • Prevent further contamination and infection
trauma inhalasi
Trauma Inhalasi
  • Chemical fumes
    • Obvious fumes in the air
    • Inhaled fumes
carbon monoxide co
Carbon Monoxide (CO)
  • Deadly poison
carbon monoxide
Carbon Monoxide
  • Different than smoke inhalation
    • Odorless
    • Tasteless
    • Not an irritant
signs and symptoms
Signs and symptoms
  • a. Dyspnea (difficulty in breathing)
  • b. Respiratory arrest
  • c. Cherry red skin
cyanide signs and symptoms
CyanideSigns and Symptoms
  • Burnt almonds
  • Dyspnea (difficulty in breathing)
  • Respiratory arrest
treatment
Treatment
  • a. 100% oxygen through a non-rebreathing mask
  • b. Be prepared to do basic life support
  • c. Transport
pemberian cairan pada luka bakar
Pemberian cairan pada Luka Bakar
  • Formula Baxter
    • Dewasa

4cc x % luas LB x kg BB =.....cc lar. RL

diberikan : ½ bagian pada 8 jam I

½ bagian pada16 jam berikutnya

diberikan lar. koloid 500-1000cc pd jam ke 18-24

pemberian cairan pada luka bakar1
Pemberian cairan pada Luka Bakar
  • Formula (modifikasi) Baxter
    • Anak

2cc x % luas LB x kg BB=...cc lar. RL

diberikan: ½ bagian pada 8 jam I

½ bagian pada 16 jam berikutnya

larutan koloid 17:3 (sejak jam ke-0)

Hari berikutnya diberikan cairan maintenance

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