Penanganan Cedera

Kepala dan Tulang

Belakang
Teori dan Aplikasi Klinis di Unit Gawat Darurat
Teori & Praktek
#1 : Pre-hospital Care
Animasi bergerak
menghubungi
rumah sakit
 Steroid?

Manitol?

MRI Brain?

Cairan Infus?
PRIMARY SURVEY
AND RESCUCITATION
Primary Survey
• Airway & Protection of Spinal Cord
• Breathing & Ventilation
• Circulation
• Disabillity
• Exposure & Control of the Environtment
Antibiotics which crosses BBB
• Ceftriaxone
• Cefotaxime
• Ampicillin
• Gentamycin sulfate
• Vancomycin
• Penicillin G
• Rifampicin
• Ciprofloxacin
How to measure hematoma volume?
Discussion
• Mannitol

• When the BBB is Intact, Mannitol may include brain relaxation by removing
water from brain tissue or by decreasing CBF.

• However, many adverse effect

• Electrolytes imbalance

• Volume concentration

• Renal failure
Adverse Effects of Hypertonic Saline
• The primary concerns with the use of HTS are the potential for
• Hypernatremia
• Osmotic demyelination syndrome (ODS)
• Pulmonaryedema, CCF, acute renal insufficiency
• Rebound brain edema
• Hematologic abnormalities including increased
• Hemorrhage, coagulopathy, & red cell lysis.
Causes of Secondary Brain Injury
• Hypotension • Intracranial hypertension
• Hypoxia • Cerebral edema
• Anemia • Compression from Expanding Masses
• Hyper/Hypoglycemia • Vasospasm
• Hyperthermia • Seizures
• Hyper/Hypocapnia
Glasgow Coma Scale
THANK YOU