Luka bakar
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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


De rajat kedalaman grade luka bakar

Derajat Kedalaman (Grade) Luka Bakar:


Luka bakar

EPIDERMIS

Gr I

Gr IIA

Gr IIB

Gr III

DERMIS


Partial t hickness b urns

Partial ThicknessBurns


Full t hickness b urns

Full ThicknessBurns


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 PARTADULTCHILD

  • Head & Neck 9 18

  • Arms 9 (2) 9 (2)

  • Front & Back 18 (2) 18 (2)

  • Legs 18 (2) 13.5 (2)

  • Genitalia 1 1


Luka bakar

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


Luka bakar

  • (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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