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    Falsafah Penanggulangan Trauma 2012

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    ryan
    The document discusses the philosophy of trauma care. It states that trauma care should not be viewed as a linear process, but rather as a series of loops. Physicians must treat patients as they gather information by intervening when thresholds for action are met, such as with low blood pressure. Care involves rapidly assessing vital functions, intervening to stabilize abnormalities, and rechecking effects in a looping progression until the patient is fully stabilized. The goal is to prevent deaths that can occur immediately or within a few hours due to treatable injuries like hemorrhage.

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    Falsafah Penanggulangan Trauma 2012

    Uploaded by

    ryan
    39 views22 pages
    The document discusses the philosophy of trauma care. It states that trauma care should not be viewed as a linear process, but rather as a series of loops. Physicians must treat patients as they gather information by intervening when thresholds for action are met, such as with low blood pressure. Care involves rapidly assessing vital functions, intervening to stabilize abnormalities, and rechecking effects in a looping progression until the patient is fully stabilized. The goal is to prevent deaths that can occur immediately or within a few hours due to treatable injuries like hemorrhage.

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    Falsafah

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    2. Falsafah Penanggulangan Trauma 2012(1)

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    The document discusses the philosophy of trauma care. It states that trauma care should not be viewed as a linear process, but rather as a series of loops. Physicians must treat patients as they gather information by intervening when thresholds for action are met, such as with low blood pressure. Care involves rapidly assessing vital functions, intervening to stabilize abnormalities, and rechecking effects in a looping progression until the patient is fully stabilized. The goal is to prevent deaths that can occur immediately or within a few hours due to treatable injuries like hemorrhage.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    39 views22 pages

    Falsafah Penanggulangan Trauma 2012

    Uploaded by

    ryan
    The document discusses the philosophy of trauma care. It states that trauma care should not be viewed as a linear process, but rather as a series of loops. Physicians must treat patients as they gather information by intervening when thresholds for action are met, such as with low blood pressure. Care involves rapidly assessing vital functions, intervening to stabilize abnormalities, and rechecking effects in a looping progression until the patient is fully stabilized. The goal is to prevent deaths that can occur immediately or within a few hours due to treatable injuries like hemorrhage.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 22

    2.

    FALSAFAH
    PENANGGULANGAN TRAUMA
    R. Sjamsuhidajat
    Definitive Surgical Trauma Care
    Kolegium Ilmu Bedah Indonesia
    2018
    Referensi: Committee on Trauma, American
    College of Surgeons (2011)
    The TEAM Program
    TRAUMA EVALUATION AND MANAGEMENT
    (TEAM)

    The ATLS Committee strongly encourages the


    participation of ATLS instructors as they have
    the knowledge of the philosophy, intent, and
    content of the program.
    The TEAM program provides a standardized
    introductory course in the evaluation and
    management of trauma for medical students
    and multidisciplinary team members. The
    ATLS Committee strongly encourages the
    participation of ATLS instructors as they have
    the knowledge of the philosophy, intent, and
    content of the program.
    Deaths from trauma show three peaks:
    • immediate death;
    • later death due to hemorrhage or direct organ
    compromise;
    • and delayed death due to complications and
    organ failure.
    Death may occur within seconds of the injury,
    usually due to massive head injury, heart
    injury, or aortic injury.
    These deaths cannot be prevented.
    A second peak in deaths begins an hour or two
    after the injury. Deaths occurring in this
    second peak are usually due to subdural and
    epidural hematomas, hemo- or
    pneumothorax, organ rupture, or blood loss.
    These deaths are often preventable. This period
    is called the “golden hour” during which
    prompt intervention can save a life.
    The third peak in deaths occurs many days after
    the injury, and is usually due to sepsis or
    multi-organ failure.
    Prompt treatment of shock and hypoxemia
    during the “golden hour” can reduce these
    deaths.
    The Philosophy of Trauma Care
    In dealing with the trauma victim, the physician
    must treat as he or she gathers information.
    The approach cannot be routine “take a history,
    do an exam, order some tests, make a
    diagnosis, then treat the patient.”
    Therapeutic interventions must be made “on the
    fly,” before the full evaluation can be
    completed.
    For every possible injury, emergency physicians
    and trauma surgeons have a “threshold of
    action” — a point at which the physician will
    aggressively intervene even without
    traditional “proof” of the diagnosis.
    For example, the combination of low blood
    pressure, unilaterally decreased breath
    sounds, and respiratory distress triggers a
    response from the physician.
    A chest tube is placed immediately, rather than
    waiting until an x-ray can “prove” the
    diagnosis.
    As the trauma victim arrives, the physician
    assesses vital functions (the ABCs) rapidly,
    intervening when the patient’s status meets
    the “threshold of action.”
    The physician orders stabilization measures
    such as IV and oxygen as the primary survey
    is conducted.
    A Very Important Attitude:

    • The management of the trauma victim should


    NOT be viewed as a linear flow chart, with
    one action following another.

    • It should be viewed as a progression through


    a series of loops.
    The physician examines, takes action on a
    positive finding, then “loops” back to examine
    the effects of the action.
    For example,
    - weak air motion,
    - place oral airway,
    - recheck air motion.
    .
    If positive findings persist, the physician acts on
    the abnormal finding again, and again checks
    the effects.
    After stabilizing the abnormality, the physician
    progresses on to the next “loop.”
    Some loops may reside inside other large loops
    — for example, the physician may assess, take
    action on, and reassess other problems while
    waiting for the effects of fluid infusion.
    When the physician is confident that the patient
    is stable and adequately monitored, he
    performs a full patient assessment (often
    called the secondary survey).
    As sufficient historical, examination, and
    laboratory data becomes available, definitive
    care is arranged.
    HAVE A NICE DAY

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