bismillah Flail Chest - Conference Athaya.pptx

8/19/2019 bismillah Flail Chest - Conference Athaya.pptx

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CONFERENCE

FLAIL CHEST

Athaya Febriantyo Purnomo

115070100111014

Pembimbing :

dr. Artono Isharanto, SpB, SpB!"


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IDENTITAS

2

Nama : Tn. Sutrisno

Jenis Kelamin : Pria

Usia: 70 tahun

No Register : 11255330

Alamat: usun !en"eng RT 2#R$ 2 Ke%uh

Kan"ang& Pera'& Jom(ang

Pe'er"aan : S)astaAgama : *slam

+RS : 2, Se%tem(er 2015


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Primary Survey3

Air#ay

Breathing

Cir$u%ation

Disabi%ity

E&posure


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A'Air#ay ()Spine (ontro%*

4

Assessment

Look : tida+ ditemu+an benda asing di a%an na-as

Lise! : terdengar hembusan na-as

Fee" : erasa hembusan na-as a# thrust: tida+ ada sumbatan

(er/i$a%: eas ')*

!esimpu%an:

Air#ay paten


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#

anagement

Pasang $er/i$a% $o%%ar

eassessment

Sumbatan ')*

()spine: eas ')* $ontro%ed.

A'Air#ay ()Spine (ontro%*


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B'Breathing*

$

ASS2SS23

Look :

Pergera+an dada parado+sa%

espiratory ate &6menit, $epat dan dang+a%

eas '* di hemithora+s +anan ra+ea di tengah

2+spansi dada asimetris

Lise! :

Suara na-as 86/ h: )6) 9h: )6) 86/ )6) )6)

86/ )6) )6)

dada +anan redup

Fee" :

!repitasi , nyeri ,


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%

anagement

/enti%ator I(;

B'Breathing*


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('(ir$u%ation*

&

ASS2SS23

9arna +u%it : pu$at

BP: 1506


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'

anagement

I"F> 3S 14 tpm

('(ir$u%ation*


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>'>isabi%ity*

()

Assessment

A"P; : A%ert

?(S: 45@

Pupi% iso+or

( 6


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2'2&posure*

((

Assessment

Lokasi : V app frontotemporal (D)

Ukuran :p: 3 cm

Sifat : Wound


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(2

anagement

en$egah hipotermia denganmemberi+an se%imut pada pasien

a#at %u+a


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SECONDAR* S+R,E*


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(4

Keluhan Utama :

Nyeri dada sebelah kanan

Riwayat Penyakit Sekarang :

Pasien dibawa dalam keadaan sadar mengalami nyeri

dada kanan setelah terjatuh ditabrak motor 1 hari

SMRS. Tidak ingat kejadian (+), muntah (-), sesak (+),

kejang (-)

MOI :

Pasien ditabrak sepeda motor dari arah depan kanan

14

HETERO ANA-NESIS


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(#

!6: an ')*, I$t')*

(6P: S1 S sing%e, murmur ')*,:&6mnt

Abdomen: at, soe

2&tremitas: eas ')*, edema ')*, a+ra%hangat


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($

A%%ergies : disang+a%

-edi$ation : tida+ ada

Past i%%ness : tida+ ada Last mea% : tida+ ada E/ents : !, ditabra+ motor


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(%

Foto hora& AP

=ead ()s$an

;S? FAS6abd

aboratorium :

>, S2, F=, B?A, 6P, ;r6(r

RENCANA PE-ERI.SAANPEN+N/AN0


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HASIL PE-ERI.SAAN LABORATORI+- 2%1'12)(#

Hemao"oi

=emog%obin : 11,@< '1C,4)17,7*

2ritrosit 'B(*: C,@ '4,0)5,5*

eu+osit 9B(: ,04 '4,C)10,C*

=emato+rit : CC,7D '40)47*

rombosit P: 9:15,50D '11,5)14,5*

P>9 :11,<

P" :10,@ '7, E 11,1*

P ( : ,< D '15,0)5,0*

P( :0,10D

6P : 1764<

;r6(r :45,1060,71

Faa% =emostasis 'da%am batasnorma%*

P :10,10 deti+

AP : 4,0 deti+

(&

SE

3atrium : 14C

!a%ium : 4,54

!%orida :111

B0A

p=: 7,5

P(: 7,0 'C5)45*

P: 1@4, '0)100*

Bi$arbonat: 4,

!e%ebihan bassa: 0,C

Saturasi :


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('

HASIL PE-ERI.SAAN RADIOLO0I

Raio"ois :

Fr $ostae I",","I,"II,"III,I

(ontusio pu%monum '>*


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( S$an2)

SA= mengisisisternainterpedun$u%ar,

sisterna ambientdanGuadrigemina%,serta su%$ii regio

-ronta% +anan +iri 2dema $erebri

(! 45@


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2(

;S? FAS =ematothora& de+stra

=idrothora+s de+stra

!ongesti %i/er

ida+ tampa+ $airan

intraabdomen rgan so%id abdomen inta+


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22

=ematothora& de+stra


!ongesti %i/er

ida+ tampa+ $airan



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23

=ematothora& de+stra


!ongesti %i/er

ida+ tampa+ $airan



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2#

Flail Chest

Multiple Fracture Costae

Hemothoraks Dekstra

Kontusio ulmonum dekstra

CK! "#$

%AH

Cere&ral edema'&s

Multiple open ound at femur

ASSESS-ENT


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2$

/enti%ator I(;

I"F> 3S 14 tpm

S I(;

inda+an (I Shapp p%ate 'interna% H&ation*

edi+amentosa :Ine+si !etoro%a$ C0 mg

Ine+si (iproo&a$in &40mg

Ine+si etronidao% C&5 mg

Ine+si Pira$etam C&C g

Ine+si asam trane&amat C&500 mg

PLANNIN0


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2%

bser/asi Sube+ti- 'nyeri saat bernapas*

bser/asi ?(S, BP, P,

bser/asi tanda)tanda distress na-asbser/asi perbai+an -ra$ture hea%ing

RENCANA -ONITORIN0


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2&

2IA !ASI=

Documents

bismillah Flail Chest - Conference Athaya.pptx