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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 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


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