Tutorial Klinik Tetanus

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7/26/2019 Tutorial Klinik Tetanus

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DEVIANA SARIPUTRI

1420.2211.65

TUTORIAL KLINTETANUS

DEFINISI Infeksi aku !" #en!e$an" SSP ka$ena $a%un

ean&s'as#in !" (i)asi*kan &*e) Clostridium tetani(i%i$ikan (" s'as#e (an $i"i(ias && !an" '$&"$esi

EPIDEMIOLOGI

Di ne"a$a ,e$ke#,an" se'e$i In(&nesia+ insi(en -an"ka ke#aian (a$i 'en!aki eanus #asi) %uku'in""i.

P$ea*ensi *aki/ 'e$e#'uan :13

TETANUS

Clostridium tetani ake$i anae$&, 'en")asi* s'&$a

asi* "$a# 3

Die#ukan '( feses #anusia+

)ean (an ana) Eks&&ksin: Tean&s'as#in+

ean&*isin

7asa inku,asi: 820 )a$i

TETANUS - ETIOLOGI

P&$(9en$ee

Lukae$,uka

infeksi"i"i

infeksie*in"a

,ekasineksi

Iniia**! ,in(s & 'ene$e e$#ina*s

T$ans'&$e( i)inan( a%$&ss s!na'

uni* i $ea%)es )ene$&us s!se#.

e%&#es $a'i(*! <"an"*i&si(es a )e'$es!na'i% in)i,ine$e en(in"s+ )e

in& )e a;&n ,! e

Blocks the release of inhibitory neurotransmitters (glycine and gammaacid) across the synaptic cleft, which is required to check the nervous If nervous impulses cannot be checked by normal inhibitory mechanisms,

unopposed muscular contraction and spasms that are characteristic of tet

TETANUS7anifesasi k*inisTetanus generalisata:

8=i'e$&nus &&+s'as#e

8T$is#us

8Kaku *e)e$+ ,a)u+ e;$#

8A,(&#en 'a'an

8R)isus Sa$(&ni%us

8O'is&&nus

8S'as#e &&'e$na'asan

Tetanus lokal:

8ken%en"

8n!e$i && sekia$ *uka

8e$a(i ikke'a*a>

8ke*e#a)&& aa

8(isa$$ia

8(isfa"ia

8(isf&nia

RISUSSARDONI!U

OPISTOTO

7enu$u (e$aa $is#us+ eanus (' (i,a"i aas:

"# Tetanus ringan: $is#us %#+ ? (ise$ai kean" u#ua*au'un (i$an"san"

$# Tetanus se%ang: $is#us @%#+ (ise$ai kean" u#u#(i$an"san"

&# Tetanus 'erat: $is#us ku$an" (a$i 1 %# (an (ise$ai u#u# !an" s'&nan.

TETANUS

Dia"n&sis eanus (ie"akkan ,e$(asa$kan : Ria!a a(an!a *uka !an" sesuai (en"an #asa inku,a

ea*a k*inis

Ria!a i#unisasi

P( 'e#e$iksaan DR *ek&si N aau B3

Pe#e$iksaan #ik$&,i&*&"i *uka ,e$u'a 'us>a$in"an nek Pe#e$iksaan LCS (,n+ aau (i(a'akan ekanan B aki,

k&n$aksi &&.

TETANUS8DIANOSIS

7enin"iis ,a%e$ia*

Kean" e% )i'&ka*se#ia

E'i*e'si

TETANUS8DIANOSIS ANDIN

Anti Tetanus To(in Se*a#a infeksi+ &ksin eanus ,e$e(a$ (a*a# 2 ,enuk:

T&ksin ,e,as (a*a# (a$a)

T&ksin !" ,$"a,un" (" a$in"an sa$af.

Se,e*u# 'e#,e$ian ani&ksin )a$us (i*akukan:

8 Ana#nesa a'aka) a(a $ia!a a*e$"i

8 Tes ku*i (an #aa

8 =a$us se*a*u se(ia A($ena*in 1:1.000.

TETANUS8TATALAKSANA 7e(ika#en

Tes )ata Pa(a k&nun"ia ,a"ian ,aa) (ieeskan 1 ees *a$u

ani&ksin eanus 1:10 (a*a# *a$uan "a$a# faa*i+ 3 20 #eni+ a#'ak ke#e$a)an - ,en"kak '( k&nun"i

Tes kulitSunikan 0+1 %% *a$uan 1>1000 ani&ksin eanus (a*a# faa*i se%a$a in$akuan. Reaksi 3 ,i*a (*# 20#n $a(ike#e$a)an (an in(u$asi *e,i) (a$i 10 ##.

TETANUS8TATALAKSANA 7e(ika#en&s

ANTI TETANUS TO*SIN

ATS D&sis ATS u> (easa a(a*a) se,esa$ 10.000 20.000 IU I7

D&sis anak anak se,esa$ 10.000 IU I7

u)an Tetanus I)unnoglo'ulin +TIG#,./ertet D&sis (easa a(a*a) se,esa$ 00 IU 6000 IU I7

,a"i anak anak se,esa$ 000 IU I7.

Pe#,e$ian ani&ksin (&sis e$a'eik se*a#a 2 5 )a$i ,e$u$u

TETANUS8TATALAKSANA 7e(ika#en&C&n3

Anti'iotik Peni%i**in '$&%ain 1+2 ua IU seia' )a$i se*a#a 10 )a$i

7e$&ni(a&* 4 ; 500 #" aau e$asik*in 2 "$>)a$i se*a)a$i

Pe)'erian 0ita)in 1"$

TETANUS8TATALAKSANA 7e(ika#en&sa

Antikon2ulsan

TETANUS8TATALAKSANA 7e(ika#en&sa

Pe#,e$si)an *uka (an (e,$i(e#en *uka !an" k&&$

Ruan" $aa "e*a' (an i(ak ,isin"

Pe#asan"an NT+ (i,e$ikan (ie in""i ka*&$i

Oksi"enasi

Pen"e%e"a)an (eku,ius

TETANUS8TATALAKSANA N&n7e(ika#en&sa

7ena"a )!"iene (an saniasi

Penan"anan - Pe$aaan *uka !an" #e#a(ai E(ukasi enan" ,a)a!a 'en!aki eanus

I)unisasi aktif Teanus &ks&i( TFT G VST G aksin se$a' eanus3 (i,e$ikan

(en"an (&sis se,an!ak 0+5 %% I7+ (i,e$ikan 1 ; se,u*an se*a#,u*an ,e$u$u u$u.

DPT Dephteri Pertusis Tetanus3 e$ua#a (i,e$ikan 'a(a anakDi,e$ikan 'a(a usia 2 6 ,u*an (en"an (&sis se,esa$ 0+5 %% Ise,u*an se*a#a ,u*an ,e$u$u u$u. &&se$ (i,e$ikan 'a12 ,u*an+ 1 ; 0+5 %% I7+ (an ana$a u#u$ 5 6 a)un 1 ; 0+5 %

TETANUS8PENCEA=AN

I)unisasi /asif

ATS Anti Tetanus Serum3 D&sis !an" (i,e$ikan unuk &$an" (eaa(a*a) 1500 IU 'e$ I7+ (an unuk anak a(a*a) 50 IU 'e$ I7.

Human Tetanus Immunoglobuline/ =!'e$e. D&sis !an" (i,e$ikan&$an" (easa a(a*a) 250 IU 'e$ I7 sea$a (en"an 1500 IU ATS3+

unuk anak anak a(a*a) 125 IU 'e$ I7. =!'e$e (i,e$ikan ,i*a'en(e$ia a*e$"i e$)a(a' ATS

Pe#,e$ian i#unisasi 'asif e$"anun" (a$i sifa *uka+ k&n(isi 'en((an saus i#unisasi.

TETANUS8PENCEA=AN

Sa*. Na'as

• S'as#e

*a$in"• Pneu#&nia• As<ksia• as'i$asi

Ka$(i&asku*a

• Takika$(i

• =i'e$ensi• Vas&k&ns$ik

si 'e$ife$

Tu*an" (a&&

• F$. C&*u#e$e,$a*i• Pe$(a$a)a

KO7PLIKASI

Te$"anun": 7asa inku,asi

U#u$ Pe$i&(e &nse

Pen"&,aan A(a i(akn!a k&#'*ikasi

F$ekuensi+ (u$asi kean"

TETANUS8PRONOSIS

Tutorial Klinik Tetanus

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