01. Uji Emerg Ima.ppt

Ujian 1

emergency ortho

UNS – RSO - RSDM

ATLS 1. 2. 3. 4. 5. 6.

Airway, cervical control Breathing Circulation, Control hemorrhage Drugs, Allergy, Disability Eating & Exposure Foley cath : urine output ren function

6 B prioritas penanganan P3K 1. 2. 3. 4. 5. 6.

Breath Bleed Brain Bowel Bladder Bone

Ample“ OBSERVATION • • • • •

Allergy MEDICATION Past Illness/History Last Meal Environment/Event

Why emergency ? • Save the soul / life threatened/ life saving , prevent mortality • Save the limb/ prevent morbid • Prevent permanent disability/ function

Limb threatening emergency 1. Dislokasi 2. Compatment syndrome 3. Traumatic amputasi

Life threatening emergency • • • • • •

Open Fracture Ruptur AV besar Unstable pelvis Fat emboly Acute Osteomyelitis Septic Arthritis

1. Open Fr • • • • • • • • •

Why Emergency ? Apley testimony Gustillo Andersons class Apa tujuan klasifikasi How to debrid ( 4 C : capacity /condition for bleed, consistency ,color , contractility) ATS : indikasi, beda dg TT , Allergy : Besredka methode Tx : apa beda debrid before & After Gold P Berapa lama ext fix , what is Bridging callus ? Teori Gristina

Macam2 tehnik ek fix • Shiro inoue : cara entry point, sejajar ? • AO : kapan dynamisasi

Truetta procedure ? • • • • •

Persiapan ? Temporary pinning ? Minimal implant Beda sofban closed fr & op fr ? Incorporating cast ?

Tx? Dimana letak a.digitalis

Tx Op fr cruris w/ skin defect 1. Prox part 2. Midle part 3. Distal part

Macam Non Union : 1. Atrophic NU 2. Hypertrophic NU

4. Ruptur A & V besar • • • • • • •

Fr Malgaigne ? Sacroiliac disruption ? Bahaya mana A & V Resusitasi caranya Abd lavage USG for Retroperitoneal bleed Management Perdarahan MUE

Anatomi Pelvis Ring

6. Ganz C Clamp • • • • •

Indikasi Op tek : entry point ? LA / GA Bagaiman persiapan ? Keuntungan dibandingkan ext fix Berapa lama dipasang ?

Vertical shearing

F

Fr Intercondyler Femur dg lesi A. Poplitea • • • • •

Robekan intima (Ball valve effect?) Embolectomi, cath Fogarty Vena Saph magna graft ?/ shunting Implant vena Heparinisasi ?

7. Fat • • • •

emboly

Patofisiology ? Klinis Lab thrombo , lemak urine, BGA Tx supportive O2, ventilasi mek, steroid, heparin • X ray