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    1 views17 pages

    Triase Dan Pananganan Gawat Darurat PDF

    Uploaded by

    Nadyaekaf

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 17

    Triase dan Pananganan Gawat

    Darurat
    Hendro Wartatmo
    PMPK – FK UGM
    Triase ( Triage ) … to sort
    • “ Doing the greatest good for the greatest number of people 
    using the available resources “
    using the available resources 
    • Chaotic situation ‐‐‐‐‐‐ a system that is simple and clear is 
    most likely to succeed
    • Triage should be a tool by which a seemingly unmanageable, 
    overwhelming situation can be organized. 
    • Triage should be a dynamic process carried out at several 
    h ld b d d l
    levels throughout the system.
    • One of the goals of triage should be to diagnose critical 
    One of the goals of triage should be to diagnose critical
    injuries requiring life saving treatment in the shortest possible 
    time.
    • To
    To this end patients are categorized into groups to determine 
    this end patients are categorized into groups to determine
    their priority for treatment and transport to definitive care 
    facilities.
    • "priority one," "emergency," or the color red indicates the 
    need for immediate care; 
    • "priority two," "urgent," or the color yellow indicates that care 
    "priority two " "urgent " or the color yellow indicates that care
    may be delayed for a limited period of time without significant 
    mortality; 
    • "priority three," "nonurgent," or the color green indicates that 
    care may be delayed until the patients in the other categories 
    have been dealt with
    have been dealt with. 
    • A fourth group, described with the term "expectant" or the 
    color black, has been advocated by some to denote patients 
    who are dead or expected to die. 
    Trunkey’ss curve
    Trunkey curve

    Trauma deaths

    IImmediate
    di t Early deaths Late deaths
    deaths

    0 1 2 3 4 5 6 1 2 3 4

    hours weeks
    Single Triage ( SIT )
    Single Triage ( SIT )

    • Untuk pasien yang datang


    yang datang satu persatu
    • Sesuai situasi di UGD sehari‐hari

    * Triage: Techniques and Applications in Decision Making .
    Katharyn Kennedy, MD Richard V Aghababian, MD Lucille Gans, MD C Phuli
    Lewis, MD
    Annals of Emergency Medicine. August 1996 • Volume 28 • Number 2 
    20 Luka Tdk ada
    Lecet Tindakan
    segera
    50
    15 CKR Paliatif
    KORBAN
    Triage
    Officer
    -# femur Tindakan
    tertutup
    - # terbuka
    Life saving
    -Ruptur
    hepar
    5 -Tension
    Pnthorax
    -Multiple
    trauma dg
    syok

    Mening Km
    10
    -gal Mayat
    Tdk ada
    20 Luka
    Tindakan
    Lecet
    segera

    50 Paliatif
    15 CKR
    KORBAN
    Triage
    -Multiple Tindakan
    Officer 1 t
    trauma dg
    d Intensif
    syok

    -# femur Tindakan
    4 tertutup
    - # terbuka Life saving
    -Ruptur
    hepar
    -Tension
    Pnthorax

    Mening Km
    10
    -gal Mayat
    Luka Rawat
    Lecet Jalan

    KORBAN CKR Obser


    Ob
    vasi
    Triage
    Officer
    -# femur Ti d k
    Tindakan
    tertutup
    - # terbuka Operasi
    -Ruptur
    1000 0rang !! hepar Operasi
    -Tension
    Pnthorax Operasi

    - CKB
    GCS = 3 R.Khusus

    Mening Km
    -gal Mayat
    Luka
    Tertunda
    Lecet

    KORBAN CKR Penampungan


    P
    seadanya
    Triage
    Officer
    -# femur A ti
    Antri
    tertutup
    1000 0rang - # terbuka Antri
    -Ruptur
    hepar Antri
    -Tension
    Pnthorax Antri

    CHAOS !!
    - Multiple
    M lti l
    trauma dg Terlantar
    syok

    Mening Penuh,Iden
    -gal tifikasi ?
    Luka Dipulangkan
    Lecet / Pindahkan

    KORBAN CKR Ruang rwtt


    R
    Yang layak
    Triage
    Officer
    -# femur Ti d k
    Tindakan
    tertutup
    - # terbuka Operasi-2
    -Ruptur
    1000 0rang hepar Operasi-3
    -Tension
    Pnthorax Operasi-1

    - CKB Ruang
    GCS = 3 khusus

    Mening Km
    -gal Mayat
    Single Triage :

    • Untuk pasien tunggal
    • Kategori pasien
    – Immediate  
    • ( AMI, Perdarahan dalam )
    – Urgent  
    U t
    • ( Stroke, Apendisitis )
    – Non Urgent 
    • ( Luka, Dislokasi, Fraktur )
    ( , , )
    Simple Triase And Rapid Transport  
    ( START )
    ( START )

    • Proposes five categories. 
    • Using a color‐coded system, it includes a blue category for 
    patients who are unlikely to survive or whose survival would
    patients who are unlikely to survive or whose survival would 
    depend on receiving extensive or complicated treatment 
    rapidly. Patients in this category would receive treatment after 
    priority one but before priority two cases, provided their 
    numbers were not so large as to detract from the treatment 
    of the urgent patients.
    g p
    Re Triage !!
    Re  Triage !!
    Secondary Assessement
    Secondary Assessement for Victims Endpoint 
    for Victims Endpoint
    ( SAVE )

    • Dilakukan bila jumlah korban luar biasa dan jauh melampaui


    kapasitas penolong.
    • Kategori korban :
    – Yang akan selamat apapun tindakan yang dilakukan
    – Yang akan tidak selamat apapun tindakan yang dilakukan
    – Yang tidak
    Yang tidak termasuk kedua golongan diatas , keselamatannya
    keselamatannya sangat
    tergantung intervensi yg dilakukan tim penolong
    Medical Emergency Response
    Medical Emergency Response 

    Hospitalisation Transportation Damage


    area ‐ Transfer area
    Red Cross

    Public
    Health Post
    Hospital 

    Damaged
    Area
    Puskesmas

    Field Hospital

    Regional Response
    Regional Response
    of  Health Sector
    Terima Kasih

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