Trauma Abdomen

MAKALAH KEPERAWATAN TRAUMA TRAUMA ABDOMEN

DISUSUN OLEH: Kelompok 8

IRA ANDIKA PUTRI

1311311012

RAHMI KUMALA

1311311034

GUSRINDALIANI

1110323064

GESTI

131131106

D!I KURNIA P"

1311311060

SARI#ATHUL AINI

1311311080

#AKULTAS KEPER KE PERA! A!A ATAN UNI$ERSITAS ANDALAS TAHUN TAHUN 2016 20 16

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KATA KATA PENGANTAR  PENG ANTAR 

P%&' ()%k%* ke+,-'*,. T%+,/ ,/ M,+, E(, ),/ .el,+ mel'mp,+k,/ *,+m,. -,/ k,*%/',N), (e+'/, pe/%l'( -,p,. me/)ele(,'k,/ m,k,l,+ -e/,/  &%-%l “Trauma “Trauma Abdomen”. Abdomen ”. D,l,m me/)ele(,'k,/ m,k,l,+ '/' pe/%l'( .el,+ e*%(,+, %/.%k me/5,p,' +,('l +,('l ),/ ),/ m,k( m,k('m 'm,l ,l .e.,p .e.,p'' -e/ -e/,/ ,/ ke.e* ke.e*, ,., .,(,/ (,/ ,,(, ,,(,/ / pe/ pe/e., e.,+% +%,/ ,/  pe/,l,m,/ -,/ kem,mp%,/ ),/ -'m'l'k' pe/%l'( me/),-,*' ,+, m,k,l,+ '/' m,('+ &,%+ -,*' (emp%*/," Ole+ k,*e/, '.% pe/%l'( me/+,*,pk,/ k*'.'k -,/ (,*, / -,*' pem,5, -em'  pe*,'k,/ -,/ (emp%*/,/), m,k,l,+ '/' (e+'/, -,p,. e*m,/7,,. ,' pe/%l'( -,/ p,*, pem,5,"

P,-,/ 8 #e*%,*' 2016

Kelompok 8

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KATA KATA PENGANTAR  PENG ANTAR 

P%&' ()%k%* ke+,-'*,. T%+,/ ,/ M,+, E(, ),/ .el,+ mel'mp,+k,/ *,+m,. -,/ k,*%/',N), (e+'/, pe/%l'( -,p,. me/)ele(,'k,/ m,k,l,+ -e/,/  &%-%l “Trauma “Trauma Abdomen”. Abdomen ”. D,l,m me/)ele(,'k,/ m,k,l,+ '/' pe/%l'( .el,+ e*%(,+, %/.%k me/5,p,' +,('l +,('l ),/ ),/ m,k( m,k('m 'm,l ,l .e.,p .e.,p'' -e/ -e/,/ ,/ ke.e* ke.e*, ,., .,(,/ (,/ ,,(, ,,(,/ / pe/ pe/e., e.,+% +%,/ ,/  pe/,l,m,/ -,/ kem,mp%,/ ),/ -'m'l'k' pe/%l'( me/),-,*' ,+, m,k,l,+ '/' m,('+ &,%+ -,*' (emp%*/," Ole+ k,*e/, '.% pe/%l'( me/+,*,pk,/ k*'.'k -,/ (,*, / -,*' pem,5, -em'  pe*,'k,/ -,/ (emp%*/,/), m,k,l,+ '/' (e+'/, -,p,. e*m,/7,,. ,' pe/%l'( -,/ p,*, pem,5,"

P,-,/ 8 #e*%,*' 2016

Kelompok 8

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DAFTAR II

"""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""" """""""""""""""""""""""""""""""""' """"""""""' KATA KATA PENGANTAR  PENG ANTAR """"""""""""""""""""""""""""""""""""""""""""" DAFTAR II """"""""""""""""""""""""""""""""""""""""""""" """""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""" """""""""""""""""""""""""""""""""""""""""""""""""'' """"""""""""""""""""""""""''

BAB I PENDAHULUAN

A" L,.,* el,k,/ """"""""""""""""""""""""""""""""""""""""""""""""""""" """""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""1 """"""""""""""""""""""""""""""""""1 " R%m%(,/ M,(,l,+ """"""""""""""""""""""""""""""""""""""""""" """""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""" """"""""""""""""""""""""""""""""""""""" 2 9" T%&%,/ Pe/%l'(,/ """"""""""""""""""""""""""""""""""""""""""""" """""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""" """"""""""""""""""""""""""""""""""""""" 2 BAB II TIN!AUAN TEORI

2"1 Pe/e*.',/ T*,%m, A-ome/"""""""""""""""""" A-ome/""""""""""""""""""""""""""""""""""""""""" """""""""""""""""""""""""""""""""""""""""""""""4 """"""""""""""""""""""""4 2"2 A/,.om' -,/ #'('olo' T*,%m, T*,%m, A-ome/ A-ome/ """"""""""""""""""""""""""""""""""""""""""""" """"""""""""""""""""""""""""""""""""""""""""" 2"3 E.'olo' T*,%m, A-ome/""""""""""""" A-ome/"""""""""""""""""""""""""""""""""""" """"""""""""""""""""""""""""""""""""""""""""""""""""""""8 """""""""""""""""""""""""""""""""8 2"4 Kl,('7'k,(' T*,%m, A-ome/"""""""""""""""""""""""" A-ome/""""""""""""""""""""""""""""""""""""""""""""""""""""""""""" """"""""""""""""""""""""""""""""""" """"" 2" M,/'7e(.,(' Kl'/'( T*,%m, A-ome/"""""""""""""""""""""""""""""""""""""""""""""""""" A-ome/"""""""""""""""""""""""""""""""""""""""""""""""""" 12 2"6 Ep'-emolo' T*,%m, T*,%m, A-ome/""""""""""""""""""""""""""" A-ome/""""""""""""""""""""""""""""""""""""""""""""""""""""""""""" """""""""""""""""""""""""""""""" 12 2"; P,.o7'('olo'""""""""""""""""""""" P,.o7'('olo'"""""""""""""""""""""""""""""""""""""""""""" """""""""""""""""""""""""""""""""""""""""""""" """""""""""""""""""""""""""""""""""""""""""" """"""""""""""""""""""13 "13 2"8 !O9"""""""""""""""""""""""""""""""""""""""" !O9""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""" """""""""""""""""""""""""""""""""""""""""""""""""""""""""""" """"""""""""""""""""""""""""""""""""" 14 2" 9e-e*,5e-e*, 9e-e*,5e-e*, O*,/ A-ome/14 A-ome/14 2"10 Kompl'k,('""""""""""""""""""""""""""""""""""""""" Kompl'k,('"""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""" """"""""""""""""""""""""""""""""""""""""""""""""""16 """""""""""""""""""""""""""16 2"11 Peme*'k(,,/ D',/o(.'k""""""""""""""""""""""""""""""""""""" D',/o(.'k"""""""""""""""""""""""""""""""""""""""""""""""""""""""""""" """"""""""""""""""""""""""""""""16 """""""""16 2"12 Peme*'k(,,/ R,-'olo'"""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""" R,-'olo'"""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""" 18 2"13 Pe/,.,l,k(,/,,/p,-, .*,%m, ,-ome/""""""""""""""""""""""""""""""""""""""""""""""1 ,-ome/""""""""""""""""""""""""""""""""""""""""""""""1 2"14 Pe/,.,l,k(,/,,/%m%m""""""""""""""""" Pe/,.,l,k(,/,,/%m%m"""""""""""""""""""""""""""""""""""""""" """""""""""""""""""""""""""""""""""""""""""""""""""""20 """"""""""""""""""""""""""""""20 2"1 A(%+,/ Kepe*,,.,/%m%m T*,%m, T*,%m, A-ome/"""""""""""""""""" A-ome/"""""""""""""""""""""""""""""""" """""""""""""" 24 BAB "AUHAN KEPERAWATAN

3"1 K,(%("""""""""""""""""""""""""""""""""""""""""""""" K,(%(""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""" """""""""""""""""""""""""""""""""""""""""""""" """""""""""""""""""""""""""""""33 """"""""33 3"2 Pe/k,&',/ D,(,*"""""""""""""""""""""""""""""""""""""""""""""""""" D,(,*""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""" """"""""""""""""""""""""""""""" """""""""""" 33

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3"3 P*'m,*) S%*
4"1 Ke('mp%l,/"""""""""""""""""" Ke('mp%l,/""""""""""""""""""""""""""""""""""""""""" """""""""""""""""""""""""""""""""""""""""""""" """"""""""""""""""""""""""""""""""""""""""""" """"""""""""""""""""""""""43 """"43 4"2 S,*,/""""""""""""""""""""""""""""""""""""""""""""" S,*,/"""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""" """""""""""""""""""""""""""""""""""""""""""" """""""""""""""""""""""""""""""" """""""""""43 43 DAFTAR PUTAKA

BAB $ PENDAHULUAN $.$ La%ar La%ar Be&a'an Be&a'an( ( Ak.'<' Ak.'<'.,( .,( -,l,m -,l,m ke+'-% ke+'-%p,/ p,/ (e+,*' (e+,*'+, +,*' *' mem%/ mem%/k'/ k'/ (e(eo*, (e(eo*,/ / %/.%k  %/.%k 

.e*ke/, '/&%*) ),/ '(, (,&, me*%(,k ke%.%+,/ '/.e*'.,( k%l'. (el,m, '/' k'., m%/k'/ m%/k'/ +,/), me/e/,l me/e/,l l%k, *oek ,.,% l%k, (,),.,/ (,&," N,m%/ .e*/),., .e*/),.,

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-' l%,* '.% m,('+ ,/),k l,' l%k,=.*,%m, ),/ -,p,. .e*&,-' p,-, -,e*,+ ,-ome/"A-ome/ ,-,l,+ (e%,+ *o/, e(,* ),/ -'l'l'/k%p' ole+ o.o. o.o. pe*%. p,-, ,',/
e*,-,

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kem,.',/

k,*e/,

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,/%,/

+emo-'/,m'k ,-,l,+ .*,%m, ,-ome/ -' m,/, (e5,*, ,/,.om' o*,/o*,/ ),/ e*,-, -' *o/, ,-ome/ ,-,l,+ o*,/o*,/ pe/5e*/,,,/" Sel,'/ .*,%m, ,-ome/ k,(%(k,(%( ke,,.-,*%*,.,/ p,-, ()(.em pe/5e*/,,/ (,l,+ (,.%/), pe*-,*,+,/ (,l%*,/ 5e*/, ,'k (,l%*,/ ,',/ ,.,( ,.,%p%/ (,l%*,/ 5e*/, ,',/ ,,+ 'l, -' ',*k,/ .e/.% e*,k',. 7,.,l ,' ko*,/ ,.,%  p,('e/ ,+k,/ '(, me/'m%lk,/ kem,.',/" Ke5el,k,,/ ,.,% .*,%m, ),/ .e*&,-' p,-, ,-ome/ %m%m/), ,/),k  -',k',.k,/ ole+ .*,%m, .%mp%l"P,-, ke5el,k,,/ ke/-,*,,/ e*mo.o* ke5ep,.,/ -e(ele*,(' ),/ .'-,k .e*ko/.*ol me*%p,k,/ kek%,.,/ ),/ me/)e,k,/ .*,%m, ke.'k, .%%+ kl'e/ .e*p%k%l (e.'* mo'l ,.,% e/-, .%mp%l l,'//)," T*,%m, ,k',. e/-, .,&,m %m%m/), -'(e,k,/ ole+ l%k, .em,k ),/ me/)e,k,/ ke*%(,k,/ ),/ e(,* -'-,l,m ,-ome/" Sel,'/ l%k, .em,k .*,%m, ,-ome/ -,p,. &%, -',k',.k,/ ole+ l%k, .%(%k ,k,/ .e.,p' l%k, .%(%k (e-'k'. me/)e,k,/ .*,%m, p,-, o*,/ '/.e*/,l -',-ome/ >S%*,.%/ ? L%(',/,+" 2010@ " I/('-e/ .*,%m, ,-ome/ me/'/k,. -,*' .,+%/ ke .,+%/"Mo*.,l'.,(  ',(,/), le'+ .'/' p,-, .*,%m, .%mp%l ,-ome/ -,*' p,-, .*,%m, .%(%k" T*,%m, ,-ome/ ,k,/ -'.em%k,/ p,-, 2  pe/-e*'., m%l.'.*,%m, e&,l, -,/ .,/-, ),/ -'.'m%lk,//), k,-,/k,-,/ l,m,. (e+'/, meme*l%k,/ .'/k,. ke,(p,-,,/ ),/ .'/' %/.%k -,p,. me/e.,pk,/ -',/o('(" $.) Rumu*an Ma*a&a+ 1" Ap, pe/e*.',/ .*,%m, ,-ome/B 2" ,,'m,/, A/,.om' -,/ #'('olo' A-ome/B 3" ,,'m,/, e.'olo' .*,%m, ,-ome/B 4" ,,'m,/, kl,('7'k,(' .*%m, ,-ome/ B " ,,'m,/, m,/'7e(.,(' kl'/'( -,*' .*,%m, ,-ome/ B 6" ,,'m,/, ep'-emolo' -,*' .*,%m, ,-ome/B ;" ,,'m,/, p,.o7'('olo'-,*' .*,%m, ,-ome/B 8" ,,'m,/, !O9 -,*' .*,%m, ,-ome/ B " Ap, (,&, 5e-e*, C 5e-e*, o*,/ p,-, .*,%m, ,-ome/B 10" Ap,k,+ kompl'k,(' .*,%m, ,-ome/B

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11" 12" 13" 14" 1" 16"

,,'m,/, peme*'k(,,/ -',/o(.'k p,('e/ -e/,/ .*,%m, ,-ome/B ,,'m,/, peme*'k(,,/ *,-'olo' -,*' .*,%m, ,-ome/ B ,,'m,/, pe/,.,l,k(,/,,/ p,-, p,('e/ -e/,/ .*,%m, ,-ome/B ,,'m,/, pe/,.,l,k(,/,,/ %m%m p,-, p,('e/ -e/,/ .*,%m, ,-ome/B ,,'m,/, ,(%+,/ kepe*,,.,/ %m%m p,('e/ -e/,/ .*,%m, ,-ome/B ,,'m,/, ,(%+,/ kepe*,,.,/ e*-,(,*k,/ k,(%( -e/,/ .*,%m, ,-ome/B

$." Tu,uan Penu&-*an 1" U/.%k me/,.,+%' ,p, pe/e*.',/ .*,%m, ,-ome/ 2" U/.%k me/e.,+%' ,,'m,/, A/,.om' -,/ #'('olo' ,-ome/" 3" U/.%k me/e.,+%' e.'olo' -,*' .*,%m, ,-ome/" 4" U/.%k me/e.,+%' kl,('7'k,(' -,*' .*,%m, ,-ome/" " U/.%k me/e.,+%' m,/'7e(.,(' kl'/'( -,*' .*,%m, ,-ome/" 6" U/.%k me/,.,+%' ,,'m,/, ep'-emolo' .*,%m, ,-ome/" ;" U/.%k me/,.,+%' ,,'m,/, p,.o7'('olo'-,*' .*,%m, ,-ome/" 8" U/.%k me/e.,+%' !o5 -,*' .*,%m, ,-ome/" " U/.%k me/,.,+%' 9e-e*,5e-e*, ,p, (,&, -,*' .*,%m, ,-ome/" 10" U/.%k me/,.,+%' ,p,k,+ kompl'k,(' .*,%m, ,-ome/" 11" U/.%k me/,.,+%' ,,'m,/, peme*'k(,,/ -',/o(.'k p,('e/ -e/,/

.*,%m, ,-ome/" 12" U/.%k me/e.,+% ,,'m,/,

peme*'k(,,/ *,-'olo'

p,-, .*,%m,

,-ome/" 13" U/.%k me/,.,+%' ,,'m,/, pe/,.,l,k(,/,,/ p,-, p,('e/ -e/,/ .*,%m, ,-ome/" 14" U/.%k me/e.,+%' ,,'m,/, pe/,.,l,k(,/,,/ %m%m p,-, p,('e/ -e/,/ .*,%m, ,-ome/ 1" U/.%k me/,.,+%' ,,'m,/, ,(%+,/ kepe*,,.,/ %m%m p,('e/ -e/,/ .*,%m, ,-ome/ 16" U/.%k me/e.,+%' ,'m,/, ,(%+,/ kepe*,.,/ e*-,(,*k,/ k,(%( -e,/ .*,%m, ,-ome/

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BAB ) TIN!AUAN PUTAKA ).$ Pen(er%-an Me/%*%. *ooke* >2001@ .*,%m, ,-,l,+ l%k, ,.,% 5e-e*, 7'('k l,'//),

,.,% 5e-e*, 7'('olo'( ,k',. ,/%,/ emo('o/,l ),/ +e,." T*,%m, ,-,l,+ 5e-e*, 7'('k -,/ p('k'( keke*,(,/ ),/ me/,k',.k,/ 5e-e*, >S&,m(%+'-,),. 18@" A-ome/ ,-,l,+ ,',/ .%%+ ),/ e*e/.%k *o/, .e*le.,k -',/.,*, .o*,k( -,/ pel<'("Ro/, '/' e*'(' <'(5e*, -,/ -'%/k%( -'/-'/ >abdominal wall @ ),/ .e*e/.%k -,*' -,*' o.o.o.o. ,-ome/ 5ol%m/, G%'lo/ 2011 -,l,m A/-'l,  2014@" T*,%m, ,-ome/ -'-e7'/'('k,/ (e,,' ke*%(,k,/ .e*+,-,p (.*%k.%*  ),/.e*le.,k -',/.,*, -',7*,m, -,/ pel<'( ),/ -',k',.k,/ ole+ l%k, .%mp%l ,.,% ),/ me/%(%k >I/,.'<'5%( ? !o*km,/ 2006@"

7|Page

).) Ana%om- dan F-*-o&o(- abdomen

Kuadran K,/,/ ,.,(

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>He/*) M 2006 @ Mo()( G%'-e To P+)('5',l E,m'/,.'o/ P,-,
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m,k,/,/ %/.%k m,(%k ke -,l,m l,m%/" l,m%/ >,(.e*@ G,(.e* me*%p,k,/ ,',/ (,l%*,/ pe/5e*/,,/ ),/ e*-'l,.,(' -',/.,*, e(o7,%( -,/ %(%(+,l%( 7%/(' l,m%/ ,-,l,+ me/5,mp%* m,k,/,/ -e/,/ 5,'*,/

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l,m%/ (epe*.' pep('/ ,(,m l,m%/ m%5%( > S/ell2006@ %(%( +,l%( U(%( +,l%( .e*e/.,/ -,*' p)lo*%( (,mp,' k%,l,'leo5,e5,l'( .emp,. Ile%m  e*(,.% -e/,/ %(%( e(,*" P)lo*%( mem,, '(' ,(.e* ke -,l,m -o%-e/%m ),/ me*%p,k,/,',/ pe*.,m, '/.e(.'/%m .e/%e -%, ,',/ l,'//), ',l,+ &e&e/%m D,/ 'le%m" >Moo*e 2002@

•

%(%( e(,*  >kolo/@ U(%( e(,* mem'l'k' p,/&,/ 1" m -e/,/ ,',/,',/ 5e5%m 5olo/ *e5.%m -,/ ,/,l 5,/,l >,/%(@" Se-,/k,/ 5olo/ .e*-'*' -,*' (eme/ 5olo/ ,(5e/-e/ .*,/(
 e(,* ,-,l,+ ,(o*p(' ,'* -,/ elek.*ol'. %m,' 5,5'/ ,.,% ,ppe/-'" • 2" O*,/ pele/k,p -,*' (,l%*,/ 5e*/, (epe*.': H ,.' >+ep,*@ • Hep,* memp%/),' 7%/(' ),/ e*+%%/,/ -e/,/ me.,ol'(m -,/ +ep,*  •

me/)'mp,/ lokoe/ ),/ me/+,l'lk,/ empe-% K,/.%/ empe-% K,/.%/ empe-% e*e/.%k %,+ p'* ),/ melek,. p,-, pe*m%k,,/ ,,+ lo%( +ep,.'( k,/,/ > S/ell2006@

9|Page

•

 p,/k*e,(" P,/k*e,( mem'l'k' 7%/(' e/-ok*'/ -,/ ek(ok*'/" #%/(' e/-ok*'/ (el e.,  p,/k*e,( me/(ek*e(' p,/k*e,( -,/ memp%/),' 7%/(' *e%l,(' le
3" O*,/ (,l%*,/ kem'+ (epe*.': G'/&,l • G'/&,l e*7%/(' %/.%k me/),*'/ -,*,+ ),/ ,-, -'-,l,m .%%+ m,/%(', -,/ &%, me/el%,*k,/ ('(',('(, F,. 5,'*,/ ),/ ,-, -'-,l,m .%%+ ),/ •

 e*l'+,/" %*e.e*  Me/,l'*k,/ %*'/ -,*' '/&,l ke
•

lome*%l%(" P,/&,/ %*e.e*  2 5m k,/.%/ kem'+ >
(e*'/ -'p,k,' ,-,l,+ pem,',/ ,-ome/ ole+ -%, %,+ '-,/ ,),/,/ +o*'Fo/.,l -,/ -%, '-,/ ,),/,/ regiones@"D%,  '-,/ -',/.,*,/), e*&,l,/ +o*'Fo/.,l mel,l%' (e.'/' .%l,/ *,,/ ', ke(em'l,/ ),/ ,,+ (e.'/' ,',/ ,.,( 5*'(., 'l',5, -,/ -%, '-,/ l,'//),
10 | P a g e

'-,/ ,),/ pem,',/ ,-ome/

P*o)ek(' le.,k o*,/ ,-ome/ ),'.%: 1" H)po5o/-*',5, -e.*, mel'p%.' o*,/: lo%( k,/,/ +ep,* k,/.%/ empe-% (e,',/ -%o-e/%m 7lek(%*, +ep,.'k kolo/ (e,',/ '/&,l k,/,/ -,/ kele/&,* (%p*,*e/,l k,/,/" 2" Ep',(.*'5, mel'p%.' o*,/: p'lo*%( ,(.e* -%o-e/%m p,/k*e,( -,/ (e,',/ +ep,*" 3" H)po5o/-*',5, ('/'(.*, mel'p%.' o*,/: ,(.e* l'e/ ,',/ k,%-,l p,/k*e,( 7lek(%*, l'e/,l'( kolo/ ,',/ p*ok('m,l '/&,l k'*' -,/ kele/&,* (%p*,*e/,l k'*'" 4" L,.e*,l'( -e.*, mel'p%.' o*,/: kolo/ ,(5e/-e/ ,',/ -'(.,l '/&,l k,/,/ (e,',/ -%o-e/%m -,/ &e&e/%m" " Um'l'5,l'( mel'p%.' o*,/: Ome/.%m me(e/.e*'%m ,',/ ,,+ -%o-e/%m &e&e/%m -,/ 'le%m" 6" L,.e*,l'( ('/'(.*, mel'p%.' o*,/: kolo/ ,(5e/-e/ ,',/ -'(.,l '/&,l k'*' (e,',/ &e&e/%m -,/ 'le%m" ;" I/%'/,l'( -e.*, mel'p%.' o*,/: (ek%m ,pe/-'k( ,',/ -'(.,l 'le%m -,/ %*e.e* k,/,/" 8" P%'5, mel'p%.' o*,/: 'le%m p,-, ke+,m'l,/@" " I/%'/,l'( ('/'(.*, mel'p%.' o*,/: kolo/ ('mo'- %*e.e* k'*' -,/ o<,*'%m k'*'"

11 | P a g e

)." E%-o&o(- Trauma Abdomen

Ke5el,k,,/ l,l% l'/.,( pe/,/',),,/ ke5el,k,,/ ol,+*,, -,/ .e*&,.%+ -,*' ke.'/',/"Me/%*%. (&,m(%+'-,),. pe/)e, .*,%m, ,-ome/ ,-,l,+ (e,,' e*'k%. : 1" Pe/)e, .*,%m, pe/e.*,(' L%k, ,k',. .e*ke/, .em,k,/ • L%k, ,k',. .'k,m,/ e/-, .,&,m" • L%k, ,k',. .%(%k,/ •

2" Pe/)e, .*,%m, /o/pe/e.*,(' Te*ke/, komp*e(' ,.,% .ek,/,/ -,*' l%,* .%%+ • H,/5%* >.e*.,*,k mo'l@ • Te*&ep'. (,%k pe/,m,/ k,*/, .e*l,l% me/ek,/ pe*%. • 9'-e*, ,k(ele*,(' = -e(e*,(' k,*e/, ke5el,k,,/ ol,+ *,, • ).# K&a*--'a*- Trauma Abdomen T*,%m, ,-ome/ p,-, ,*'( e(,*/), -',' me/&,-' .*,%m, .%mp%l

-,/ .*,%m, .,&,m" Ke-%,/), memp%/),' 'omek,/'k, -,/ kl'/'( ),/  e*e-, (e+'/, ,lo*'.m, pe/,/,/,//), e*e-," T*,%m, ,-ome/ -,p,. me/)e,k,/ l,(e*,(' o*,/ .%%+ (e+'/, meme*l%k,/ .'/-,k,/  pe*.olo/,/ -,/ pe*,'k,/ p,-, o*,/ ),/ me/,l,m' ke*%(,k,/" Trauma /ada abdomen da/a% d- ba(- men,ad- dua ,en-*0 a. T*,%m, pe/e.*,(' T*,%m, pe/e.*,(' -',' me/&,-' 2 ),'.% : T*,%m, .em%( • T*,%m, .em%( >.*,%m, pe*%. -e/,/ pe/e.*,(' ke-,l,m

*o/, pe*'.o/'%m@" D'(e,k,/ ole+ : l%k, .%(%k l%k, .em,k  -,/ e/-, .,&,m"L%k, .%(%k ,.,%p%/ l%k, .em,k >ke5ep,.,/ *e/-,+@ ,k,/ me/,k',.k,/ ke*%(,k,/ &,*'/,/ k,*e/, l,(e*,(' ,.,%p%/ .e*po.o/" L%k, .em,k mem'l'k' *'('ko mo*.,l'.,( le'+ .'/' k,*e/, ke*%(,k,/ o*,/ -,l,m ,-ome/ ),/ le/'+ e*,."Ke*%(,k,/ -,p,. e*%p, pe*-,*,+,/ 'l, me/e/,' pem%l%+ -,*,+ ,.,%o*,/ ),/ p,-,." 'l, me/e/,' o*,/ ),/ e*o/,

12 | P a g e

'('/), ,k,/ kel%,* ke-,l,m *o/, pe*%. -,/ me/'m%lk,/ '*'.,(' p,-, pe*'.o/e%m" T*,%m, ,k',. e/-, .,&,m -'ke/,l -,l,m .', e/.%k l%k, ),'.%: l%k, '*'( ,.,% l%k, (,),. > vulnus  scissum@ l%k, .%(%k >vulnus punctum@ ,.,% l%k, ,5ok >vulnus caesum@"

Ak',. -,*' .*,%m, .em%( ),'.% : ,@ H'l,//), (el%*%+ ,.,% (e,',/ 7%/(' o*,/  @ Re(po/ (.*e(( ('mp,.'( 5@ Pe*-,*,+,/ -,/ pemek%,/ -,*,+ -@ Ko/.,m'/,(' ,k.e*' e@ Kem,.',/ (el Pe/)e, kem,.',/ ,k',. .*,%m, .em%( : ,@ S)ok H'po.*,%m, pe*%. .,/p, pe/e.*,(' ke-,l,m *o/,  pe*'.o/'%m@"T*,%m, .%mp%l ,-ome/ ,-,l,+ pe/)e, %.,m, mo*'-'.,( ),/ -'(e,k,/ ole+ .*,%m, p,-, (em%, kelompok  %('," D'(e,k,/ ole+ : Te*ke/, komp*e(' ,.,% .ek,/,/ -,*' l%,*  .%%+ > le-,k,/ e/.%*,/ ,.,% p%k%l,/ @ H,/5%* >.e*.,*,k mo'l@ Te*&ep'. (,%k pe/,m,/ k,*/, .e*l,l% me/ek,/ pe*%. 9'-e*, ,k(ele*,(' = -e(e*,(' k,*e/, ke5el,k,,/ ol,+ *,," T*,%m, .%mp%l k,-,/ .'-,k me/'m%lk,/ kel,'/,/ ),/ &el,( p,-, pe*m%k,,/ .%%+ .e.,p' -,p,. me/,k',.k,/ 5e-e*, e*%p, ke*%(,k,/ -,e*,+ o*,/ (ek'.,* p,.,+ .%l,/ ', 5e-e*, pe*l,m,.,/ >-e(ele*,('@ 5e-e*, komp*e(' pe/'/k,.,/ me/-,-,k .ek,/,/ -,*,+ pe5,+/), <'(k%( e*o/, ko/.%(' ,.,% l,(e*,(' &,*'/,/ m,%p%/ o*,/ -',,+/)," Mek,/'(me .e*&,-'/), .*,%m, p,-, .*,%m, .%mp%l -'(e,k,/ ,-,/), -e(ele*,(' 5ep,. -,/ ,-,/), o*,/o*,/ ),/ .'-,k  memp%/),' kele/.%*,/ >non complient organ@ (epe*.' +,.' l'e/  p,/k*e,( -,/ '/&,l"

13 | P a g e

Se5,*, %m%m mek,/'(me .e*&,-'/), .*,%m, .%mp%l ,-ome/ ),'.%: 1" S,,. pe/%*,/,/ ke5ep,.,/ me/)e,k,/ pe*e-,,/ e*,k -' ,/.,*, (.*%k.%*" Ak',./), .e*&,-' .e/,, po.o/ -,/ me/)e,k,/ *oek/), o*,/  e*o/, o*,/ p,-,. o*,/ <'(5e*,l -,/ pem%l%+ -,*,+ k+%(%(/), p,-,  ,',/ -'(.,l o*,/ ),/ .e*ke/," 9o/.o+ p,-, ,o*., -'(.,l ),/ me/e/,' .%l,/ .o*,k,l me/,k',.k,/ ,), po.o/ p,-, ,o*., -,p,. me/)e,k,/ *%p.%*" S'.%,(' ),/ (,m, -,p,. .e*&,-' p,-, pem%l%+ -,*,+ '/&,l -,/ p,-, cervicothoracic junction" 2" I(' '/.*, ,-om'/,l +,/5%* -',/.,*, -'/-'/ ,-ome/ ,/.e*'o* -,/ 5ol%m/,
9e-e*, ),/ m%/k'/ .e*k,'.

#*,k.%* ko(., k,/,/

9e-e*, +ep,* 

#*,k.%* ko(., k'*'

R%p.%* l'e/

Ko/.%('o m'-ep',(.*'%m R%p.%* l'e/ #*,k.%* p*o(e((%( .*,/
Ke+'l,/+,/ -,*,+ Mem,( -,/ &e&,( p,-, -'/-'/ pe*%. Ke*%(,k,/ o*,/o*,/ N)e*' .ek,//)e*' ke.ok/)e*' lep,( -,/ kek,k%,/ -'/-'/ pe*%. I*'.,(' 5,'*,/ %(%( > #KUI1@

14 | P a g e

).2 Man-e*%a*- '&-n-* %rauma abdomen Me/%*%. >H%-,k ? G,llo 2001@ .,/-, -,/ e&,l, .*,%m, ,-ome/ ),'.% : ,"  N)e*'  N)e*' -,p,. .e*&,-' m%l,' -,*' /)e*' (e-,/ (,mp,' ),/ e*,." N)e*'

-,p,. .'m%l -' ,',/ ),/ l%k, ,.,% .e*(e,*" Te*-,p,. /)e*' (,,. -'.ek,/ -,/ /)e*' lep,(/)e*' .ek,/ -',.,( -,e*,+ ,-ome/  " D,*,+ -,/ 5,'*,/ A-,/), pe/%mp%k,/ -,*,+ ,.,% 5,'*,/ -'*o/, pe*'.o/'%m ),/ -'(e,k,/ ole+ '*'.,(' 5" 9,'*,/ ,.,% %-,*, -',,+ -',7*,m,  N)e*' -'(eel,+ k'*' ),/ -'(e,k,/ ole+ pe*-,*,+,/ l'mp," T,/-, '/' ,-, (,,. p,('e/ -,l,m po('(' *ek%me/" -" M%,l -,/ m%/.,+ e" Pe/%*%/,/ ke(,-,*,/ >m,l,'(e le.,*' el'(,+@ ,/ -'(e,k,/ ole+ ke+'l,/,/ -,*,+ -,/ .,/-,.,/-, ,,l (+o5k  +emo*,'" ).3 E/-demo&o(- dar- %rauma abdomen I/('-e/ .*,%m, ,-ome/ me/'/k,. -,*' .,+%/ ke .,+%/"Mo*.,l'.,(

 ',(,/), le'+ .'/' p,-, .*,%m, .%mp%l ,-ome/ -,*' p,-, .*,%m, .%(%k"e&,( p,-, ,-ome/ -,p,. -'(e,k,/ ole+ .*,%m, .%mp%l ,.,% .*,%m, .,&,m"P,-, .*,%m, .%mp%l -e/,/ m'(,l/), ,k',. .'/&%@  ',(,/), me/'m%lk,/ ke*%(,k,/ (,.% o*,/"Se-,/k,/ .*,%m, .%mp%l 40 @ +,.' >34@ -,/ %(%( +,l%( >10@ >9+o e. ,l 2012@" Se-,/k,/ p,-, *e.*ope*'.o/e,l o*,/ ),/ p,l'/ (e*'/ 5e-e*, ,-,l,+ '/&,l -,/ o*,/ ),/ p,l'/ &,*,/ 5e-e*, ,-,l,+ p,/k*e,( -,/ %*e.e*  >Deme.*',-e( 2000@" P,-, .*,%m, .,&,m ,-ome/ p,l'/ (e*'/ me/e/,' +,.'>40@ %(%( ke5'l >30@ -',7*,m, >20@ -,/ %(%( e(,* >1@ >Ame*'5,/ 9ollee o7 S%*eo/( 9omm'..ee o/ T*,%m, 2008@"

).4 Pa%o-*-o&o(- Trauma Abdomen 'l, (%,.% kek%,.,/ ek(.e*/,l -'e/.%*k,/ p,-, .%%+ m,/%(',

>,k',. ke5el,k,,/ l,l% l'/.,( pe/,/',),,/ ke5el,k,,/ ol,+ *,, -,/ .e*&,.%+ -,*' ke.'/',/@ m,k, e*,./), .*,%m, me*%p,k,/ +,('l -,*' '/.e*,k(' ,/.,*, 7,k.o* C 7,k.o* 7'('k -,*' kek%,.,/ .e*(e%. -e/,/

15 | P a g e

 &,*'/,/

.%%+" e*,.

.*,%m,

),/ .e*&,-'

e*+%%/,/

-e/,/

kem,mp%,/ o)ek (.,.'( >),/ -'.%*%k@ %/.%k me/,+,/ .%%+" P,-, .emp,. e/.%*,/ k,*e/, .e*&,-'/), pe*e-,,/ pe*e*,k,/ -,*' &,*'/,/ .%%+ ),/ ,k,/ me/'m%lk,/ -'(*%p(' &,*'/,/" H,l '/' &%, k,*,k.e*'(.'k -,*' pe*m%k,,/ ),/ me/+e/.'k,/ .%%+ &%, pe/.'/" T*,%m, &%, .e*,/.%/ p,-, el,(.'.'('.,( -,/ <'(ko('.,( -,*' &,*'/,/ .%%+"El,(.'('.,( ,-,l,+ kem,mp%,/ &,*'/,/ %/.%k

kem,l' p,-, ke,-,,/ ),/ (eel%m/),"$'(ko('.,(

,-,l,+

kem,mp%,/ &,*'/,/ %/.%k me/&,, e/.%k ,(l'/), ,l,%p%/ ,-,  e/.%*,/"Tole*,/(' .%%+ me/,+,/ e/.%*,/ .e*,/.%/ p,-, ke-%, ke,-,,/ .e*(e%." e*,./), .*,%m, ),/ .e*&,-' .e*,/.%/ kep,-, (ee*,p, &,%+ ,), ),/ ,-, ,k,/ -,p,. mele,.' ke.,+,/,/ &,*'/,/" Kompo/e/ l,'/ ),/ +,*%( -'pe*.'m,/k,/ -,l,m e*,./), .*,%m, ,-,l,+ po('(' .%%+ *el,.'7 .e*+,-,p pe*m%k,,/ e/.%*,/" H,l .e*(e%. -,p,. .e*&,-' 5'-e*, o*,/ '/.*, ,-om'/,l ),/ -'(e,k,/ ee*,p, mek,/'(me : Me/'/k,./), .ek,/,/ '/.*, ,-om'/,l ),/ me/-,-,k -,/ +e,. ole+ • ,), .ek,/ -,*' l%,* (epe*.' e/.%*,/ (e.'* ,.,% (,%k pe/,m,/ ),/ le.,k/), .'-,k e/,* -,p,. me/,k',.k,/ .e*&,-'/), *%p.%* -,*' o*,/ •

•

 p,-,. m,%p%/ o*,/ e*o/," Te*&ep'./), o*,/ '/.*, ,-om'/,l ,/.,*, -'/-'/ ,-ome/ ,/.e*'o* -,/
me/-,-,k

-,p,.

me/)e,k,/ ,), *oek p,-, o*,/ -,/ pe-'kel <,(k%le*" 'k, .e*&,-' .*,%m, pe/e.*,(' ,.,% /o/p/e.*,(' kem%/k'/,/ .e*&,-'  pe/-,*,+,/ '/.*, ,-ome/ ),/ (e*'%( p,('e/ ,k,/ mempe*l'+,.k,/ .,/-, .,/-, '*'.,(' ),/ -'(e*.,' pe/%*%/,/ +'.%/ (el -,*,+ me*,+ ),/ ,k+'*/), ,m,*,/ kl,('k ()ok +emo*,'k" 'l, (%,.% o*,/ <'(e*,l me/,l,m'  pe*7o*,(' m,k, .,/-,.,/-, pe*7o*,(' .,/-,.,/-, '*'.,(' pe*'.o/'%m 5ep,. .,mp,k" T,/-,.,/-, -,l,m .*,%m, ,-ome/ .e*(e%. mel'p%.' /)e*' .ek,/ /)e*' (po/.,/ /)e*' lep,( -,/ -'(.e/(' ,-ome/ .,/p, '('/ %(%( 'l, .el,+ .e*&,-' pe*'.o/'.'( %m%m"'l, ()ok .el,+ l,/&%. p,('e/ ,k,/ me/,l,m' .,k'k,*-' -,/ pe/'/k,.,/ (%+% .%%+ &%, .e*-,p,. le%ko('.o('(" ',(,/),

16 | P a g e

.,/-,.,/-, pe*'.o/'.'( m%/k'/ el%m .,mp,k" P,-, 7,(e ,,l pe*7o*,(' ke5'l +,/), .,/-,.,/-, .'-,k k+,( ),/ m%/5%l" 'l, .e*-,p,. ke5%*',,/  ,+, m,(%k *o/, ,-ome/ m,k, ope*,(' +,*%( -'l,k%k,/ >M,/(&oe* 2001@" ).5 WO6 7 Terlampir 8 ).9 6edera Pada Or(an Abdomen 1" 9e-e*, p,-, H,.'

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17 | P a g e

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P,-, p.*,%m, .,&,m 9e-e*, l,m%/ -,p,. me/,k',.k,/ '(' l,m%k/ kel%,* -,*' l,m%/ k,*e/, ,-,/), *oek,/ p,-, -'/-'/ l,m%/" Roek,/ .e*(e%. mem%,. '(' l,m%/" 'k, +,l '/' .'-,k  -,p,. -'.,/,/' -e/,/ (ee*, m,k, -,p,. me/,k',.k,/ .e*&,-'/),  pe*'.o/'.'(" 9,'*,/ ,(.*o'/.e(.'/,l ,.,% -,*,+ ;" 9e-e*, p,/5*e,(

18 | P a g e

Pe*l%k,,/ p,-, p,/k*e,( mem'l'k' .'/k,. kem,.',/ ),/ .'/'" Pe*l%k,,/ p,-, -%o-e/%m ,.,% (,l%*,/ k,/-%/ empe-% &%, mem'l'k' .'/k,. kem,.',/ ),/ .'/'"5o/.o+/), p,-, e/.%*,/ (.,/ (epe-, mo.o* ,.,% e/.%*,/ (e.'* mo'l" ).$: Kom/&-'a*- %rauma abdomen See*, : +emo*,' ()ok -,/ 5e-e*," • L,m,. : '/7ek(' >Smel.Fe* 2001@" • ).$$ Pemer-'*aan D-a(no*%-' Trauma Abdomen 1" #o.o .+o*,k(

U/.%k mel'+,. ,-,/), .*,%m, p,-, .+o*,k" 2" Peme*'k(,,/ -,*,+ *%.'/ Peme*'k(,,/ H -'pe*l%k,/ %/.%k base-line data 'l, .e*&,-' pe*-,*,+,/ .e*%( me/e*%(" Dem'k',/ p%l, -e/,/ peme*'k(,,/ +em,.ok*'." Peme*'k(,,/ le%ko('. ),/ mele'+' 20"000=mm .,/p, .e*-,p,./), '/7ek(' me/%/&%kk,/ ,-,/), pe*-,*,+,/ 5%k%p ,/),k kem%/k'/,/ *%p.%*, l'e/,l'(" Se*%m ,m'l,(e ),/ me/'/' me/%/&%kk,/ kem%/k'/,/ ,-,/), .*,%m, p,/k*e,( ,.,%

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19 | P a g e

D,p,. mem,/.% me/em%k,/ ,-,/), -,*,+ ,.,% 5,'*,/ %(%( -,l,m *o/,  pe*%." H,('l/), -,p,. ,m,. mem,/.%" Te.,p' DPL '/' +,/), ,l,. -',/o(.'k" 'l, ,-, ke*,%,/ ke*&,k,/ l,p,*,.om' >ol- (.,/-,*-@" I/-'k,(' %/.%k mel,k%k,/ DPL ,-,l,+ (e,,' e*'k%. : ,"  " 5" -"

N)e*' ,-ome/ T*,%m, p,-, ,',/ ,,+ -,*' -,-, H'po.e/(' +em,.ok*'. .%*%/ .,/p, ,l,(,/ ),/ &el,( P,('e/ 5e-e*, ,-om'/,l -e/,/ ,/%,/

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Ko/.*, '/-'k,(' *el,.'7 mel,k%k,/ DPL ,-,l,+ (e,,' e*'k%. : • • •

H,m'l Pe*/,+ ope*,(' ,-om'/,l Se,,' peme*'k(,,/ .,m,+,/ p,-, pe/-e*'., ),/ el%m -'ope*,(' -,/ -'(,/('k,/ ,-,/), .*,%m, p,-, +ep,* -,/ *e.*ope*'.o/e%m"

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Pemer-'*aan Rad-o&o(- /ada Trauma Abdomen Peme*'k(,,/ JR,) %/.%k (5*ee/'/ .*,%m, .%mp Ro/.e/ %/.%k (5*ee/'/ ,-,l,+ Ro7o.o 5e*<'5,l l,.e*,l .+o*, AP-,/

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),/

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20 | P a g e

-e/,/+emo-'/,m'k

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).$"

Pena%a&a'*anaan /ada Pa*-en Trauma Abdomen a. Pena%a&a'*anaan Med-* 0 1" A-om'/,l p,*,5e/.e('( Me/e/.%k,/ ,-,/), pe*-,*,+,/ -,l,m *o/, pe*'.o/'%m me*%p,k,/

'/-'k,(' %/.%k l,p,*o.om'" 2" Peme*'k(,,/ l,p,*o(kop' Me/e.,+%' (e5,*, l,/(%/ pe/)e, ,-ome/ ,k%." 3" Pem,(,/,/ NGT Meme*'k(, 5,'*,/ ),/ kel%,* -,*' l,m%/ p,-, .*,%m, ,-ome/" 4" Peme*',/ ,/.''o.'k  Me/5e,+ '/7ek('" " L,p,*o.om' b. Pena%a&a'*anaan 'e/era;a%an $. M%l,' p*o(e-%* *e(%('.,(' >mempe*,'k' &,l,/ /,p,( pe*/,p,(,/ ('*k%l,('@ (e(%,' '/-'k,('" 2" Pe*.,+,/k,/ p,('e/ p,-, *,/k,* ,.,% .,/-% p,p,/  e*,kk,/ -,p,. me/)e,k,/ 7*,me/.,(' ek%,/ p,-, p,-, pem%l%+ -,*,+ e(,*  -,/ me/'m%lk,/ +emo*,' m,('7" 3" P,(.'k,/ kep,.e/,/ &,l,/ /,p,( -,/ ke(.,'l,/ pe*/,p,(,/ (e*., ('(.em (,*,7" 4" 'k, p,('e/ kom, e,. le+e* (,mp,' (e.el,+ ('/,*  le+e* -'-,p,.k,/" ," G%/.'/ ,&% -,*' l%k,"  " H'.%/ &%ml,+ l%k," 5" Te/.%k,/ lok,(' l%k, m,(%k -,/ kel%,*" -" K,&' .,/-, -,/ e&,l, +emo*,'" e" Ko/.*ol pe*-,*,+,/ -,/ pe*.,+,/,/
21 | P a g e

6" T%.%p' <'(e*, ,-ome/ ),/ kel%,* -e/,/ ,l%.,/ (.e*'l ,l%.,/ (,l'/ ,(,+ %/.%k me/5e,+ keke*'/,/ <'(e*," ;" P,(,/ k,.e.e* %*e.*, me/e.,p %/.%k me/-,p,.k,/ kep,(.',/ ,-,/), +em,.%*', -,/ p,/.,% +,l%,*,/ %*'/e" 8" S',pk,/ p,('e/ %/.%k peme-,+,/ &'k, .e*-,p,. %k.' ,-,/), ()ok ke+'l,/,/ -,*,+ ,-,/), %-,*, e,( -',,+ -',7*,m, e<'(e*,(' ,.,% +em,.%*'," ).$#

Pena%a&a'*anaan umum /ada Pa*-en Trauma Abdomen a. Primary Survey Pada Trauma Abdomen $. Airway

Airway harus dijaga dengan baik pada semua penderia rauma abd!men" #embuka ja$an napas menggunakan eknik head i$ % &hin $i' aau jaw hrus % periksa adakah benda asing yang dapa mengakibakan eruupnya ja$an napas" (i$a penderia idak sadar dan idak ada re)eks berahak * gag re)e+ , dapa dipakai !r!pharyngea$ ube" (i$a ada keraguan mengenai kemampuan menjaga airway% $ebih baik memasang airway de-nii'" .ika ada diserai dengan &edera kepa$a% $eher aau dada maka u$ang $eher *&er/i&a$ spine, harus di$indungi dengan im!bi$isasi in$ine" 2. Breathing

!nr!$ ja$an na'as pada penderia rauma abd!men yang

airway erganggu

karena

'ak!r mekanik%

ada

gangguan /eni$asi aau ada gangguan kesadaran% di&apai dengan inubasi end!rakea$" eiap penderia rauma diberikan !ksigen" (i$a anpa inubasi% sebaiknya diberikan dengan 'a&e mask" Pemakaian pu$se !+imeer baik unuk meni$ai saurasi 2 yang adekua" 3. Circulation

esusiasi pasien dengan rauma abd!men penerasi dimu$ai segera see$ah iba" airan harus diberikan dengan &epa" a$ aau inger aka dapa digunakan unuk 22 | P a g e

resusiasi krisa$!id" ue akses inra/ena ada$ah pening%  pasang kaeer inra/ena peri'er berukuran besar *minima$ 2, di eksremias aas unuk resusiasi &airan" Pasien yang daang dengan hip!ensi sudah berada di ke$as  sy!k *30 40 /!$ume darah yang hi$ang, dan harus menerima pr!duk darah sesegera mungkin% ha$ yang sama ber$aku pada pasien dengan perdarahan yang signi-kan je$as" :paya yang harus di$akukan unuk men&egah hip!ermia% ermasuk

menggunakan

se$imu

hanga

dan

&airan

prewarmed" 4. Disability

;i$akukan e/a$uasi erhadap keadaan neur!$!gis se&ara &epa"
Penderia harus dibuka kese$uruhan pakaiannya dengan &ara

mengguning

unuk

memeriksa

dan

e/a$uasi

penderia" Paparan $engkap dan /isua$isasi head!!e pasien ada$ah wajib pada pasien dengan rauma abd!men   penerasi" ni ermasuk bagian b!k!ng% bagian p!seri!r dari

kaki%

ku$i kepa$a% bagian

be$akang

perineum" ee$ah pakaian dibuka

$eher% dan

pening penderia

dise$imui agar penderia idak kedinginan"

b. Secondary Survey #ada trauma abdomen

ur/ei ekunder hanya di$akukan bi$a A( pasien sudah sabi$"(i$a

sewaku

sur/ei

sekunder

k!ndisi

pasien

memburuk maka kia harus kemba$i mengu$angi P#A< :=><"emua pr!sedur yang di$akukan harus di&aa dengan baik"Pemeriksaan dari kepa$a sampai ke jari kaki

23 | P a g e

*head!!e e+aminai!n, di$akukan dengan perhaian uama" 1" Pemeriksaan kepa$a dan wajah • • • • •

• •

'/(pek(' ,-,/), l,(e*,(' ko/.%('o -,/ .*,%m, p,/,( P,lp,(' ,-,/), 7*,k.%*  E<,l%,(' %l,/ p%p'l #%/(' /e*<%( 5*,/',l M,., : pe*-,*,+,/ pe/e.*,.'/ '/&%*) -'(lok,(' le/(,pem,k,',/ 5o/.,5. le/(e( I/(pek(' .el'/, -,/ +'-%/ %/.%k me/5,*' 9S# le,k,e I/(pek(' m%l%. %/.%k me/5,*' pe*-,*,+,/ -,/ 9S#

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•

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Pe/,.,l,k(,/,,/ : 1 Pe*.,+,/k,/ 'mmo'l'(,(' 5e*<'5,l (p'/e '/l'/e ),/ ,-ek%,. 3" Peme*'k(,,/ D,-, I/(pek(' : .*,%m, .%mp%l -,/ .,&,m pe/%/,,/ o.o. pe*/,7,(,/ • • • •

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24 | P a g e

Pe/,.,l,k(,/,,/ : 1

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2

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45 | P a g e

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maupun pus% $uka di uup

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12%4ribu?u$%Eem!g$!bin 10"2g?d$ @ k!nr!$ resik!% k!nr!$ resik!@pr!ses in'eksi @ k!nr!$ in'eksi% per$indungan in'eksi

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erhadap

BAB I PENUTUP #.$ Ke*-m/u&an Me/%*%. *ooke* >2001@ .*,%m, ,-,l,+ l%k, ,.,% 5e-e*, 7'('k l,'//), ,.,%

5e-e*, 7'('olo'( ,k',. ,/%,/ emo('o/,l ),/ +e,." T*,%m, ,-,l,+ 5e-e*, 7'('k -,/ p('k'( keke*,(,/ ),/ me/,k',.k,/ 5e-e*, >S&,m(%+'-,),. 18@" P*'/('pCp*'/('p pe/k,&',/ p,-, .*,%m, ,-ome/ +,*%( e*-,(,*k,/  >A'*,)@  >*e,.+'/@ 9 >9'*5%l,.'o/@ D >D'(,'l'.)@ E >Epo(%*e@" P,-, k,(%( -' ,.,( T/"  me/,l,m' T*,%m, ,-ome/ ,k',. .e*.'mp, ,lok k,)% ),/ ', .e,/" M,(,l,+ kepe*,,.,/ ),/ .'m%l p,-, kl'e/ ,/.,*, l,'/:/)e*' ,k%. e*+%%/,/ -e/,/ ,e/ '/&%*) 7'('k >l%k, po(. op +,*' 1@ *e('ko '/7ek('  e*+%%/,/ -e/,/ .*,%m, &,*'/,/ -,/ '/.ole*,/(' ,k.'<'.,( e*+%%/,/ -e/,/ .*,%m, &,*'/,/" #.) aran D,l,m pem%,.,/ m,k,l,+ '/' &%, pe/%l'( me/),-,*' ,+, -,l,m

 pem%,.,/ m,k,l,+ m,('+ .e*-,p,. ,/),k ke(,l,+,/ kek%*,/,/ (e*., ke&,/,l,/ ,'k -,l,m pe/%l'(,/ m,%p%/ -,l,m pe/o/(ep,/ m,.e*'" U/.%k  '.% pe/%l'( (,/,. me/+,*,pk,/ k*'.'k -,/ (,*,/ ),/ mem,/%/ ,,*  ke-ep,/ le'+ ,'k -,/ pe/%l'( e*+,*,p kep,-, (em%, pm,5, m,+,('(, k+%(%(/), %/.%k le'+ -'.'/k,.k,/ -,l,m pem%,.,/ m,k,l,+ ),/ ,k,/ -,.,/"

47 | P a g e

DAFTAR PUTAKA

Te**)

Lee

9)/.+',

-,/

A%*o*,

!e,
2011" KeperawatanKritisEdisi1

"o),k,*.,: R,p+, P%l'(+'/" S%--,*.+? *%//e*" 2002" Buku Ajar Keperawatan Medikal Bedah" ,k,*., : EG9 #KUI"1. Kumpulan KuliahIlmu Bedah ,k,*.,: '/,*%p,Ak(,*, *ooke* 9+*'(.'/e" 2001 Kamus!akuKeperawatan E-"31" ,k,*.,: EG9 H%-,k ? G,llo" 2001 Keperawatan Kritis " #endekatan $olistik " ,k,*., : EG9 S&,m(%+'-,),." 18" Buku Ajar Bedah %akarta : EG9 Smel.Fe* S%F,//e 9" 2001"  KeperawatanMedikal-Bedah Brunner and !uddarth  E-"8 $ol"3" : ,k,*.,: EG9 M,/(&oe* A*'7" 2001" Kapita !elekta Kedokteran Me-', Ae(5%l,p'%( #KUI : ,k,*.,

S/ell R'5+,*-" S" 2006" Anatomi KlinisuntukMahasiswaEdisi&   "EG9" ,k,*.," +,l" 1;3210

Moo*e Ke'.+" L A//e M" R" A%*" 2002" AnatomiKlinik'asar  $iopokrates",k,*.,"H,l 80 101 10106 1012

Te**) Lee 9)/.+', -,/ A%*o*, !e,
48 | P a g e