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HYPOTENSIVERESCUCITATION ON
HEMORRHAGIC SHOCK
Kelompok 11
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Anggota
■ Ab!l ba"#$t ba%a&al
■ A'$an"#a&
■ C$t'anggana P'a(n#a )e*$
■ N!'"&a'$na HK
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Pena&!l!an
■ S#ok &emo'ag$k $e+n$"$kan "ebaga$ "!at! kon$"$ be'k!'angpe'%!"$ ke o'gan ,$tal #ang menga'a& ke t'an"po' ok"$gen an#ang t$ak aek!at #ang $b!t!&kan !nt!k %!ng"$ "el an (a'$nno'mal-
■ T$nakan pe'tama a'$ "#ok &emo'ag$k aala& engan mengo"!mbe' pe'a'a&an "e.epat m!ngk$n an menggant$ .a$'an #a
&$lang-
■ Tindakan penanganan awal (Resusitasi) dan penegakandiagnosis yang cepat merupakan langkah paling tepat dmenghadapi kasus Kegawatdaruratan seperti Syok.
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)e+n$"$
■ Al$'an a'a& #ang t$ak aek!at !nt!k memen!&$ keb!t!&an (
■ Gangg!an pe'%!"$ / ok"$gena"$ (a'$ngan ak$bat gangg!an "$'k
■ 0$ka t$ak $tangan$ engan ba$k
Gagal M!lt$ O'gan
Kema
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Ep$em$olog$
■ Pal$ng "e'$ng te'(a$ ak$bat pen#ak$t a"a' an (!ga ak$bat t'a
■ 12 a'$ angka ke(a$an3 men#ebabkan kemat$an
■ P'e,alen"$ be'tamba& paa m!"$m pen#ak$t #ang be'at
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Kla"$+ka"$
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ETIO4OGI
■ T'a!ma
5 Laserasi
5 Luka tembus pada abdomen dan toraks
5 Ruptur pembuluh darah besar
■ Te'ap$ ant$t'ombo"$"
■ Koag!lopat$
■ Pe'a'a&an "al!'an pen.e'naan
■ Pe'a'a&an akan men!'!nkan tekanan peng$"$an "$'k!la"$ an "ebak$batn#a akan men!'!nkan al$'an bal$k ,ena- Sebaga$ &a"$ln#a3 .
(ant!ng men!'!n $ ba*a& no'mal an t$mb!l kon$"$ "#ok-
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6$"$olog$
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■ 7a'o'e"epto' paa atrium anarkus aorta
■ Simpatis – ,a"okon"t'$k"$ an 8HR
■ Ginjal – RAA "#"tem■ H#po+"$" – A!
■ Adrenal – alo"te'one
Pato+"$olog$
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7ata" Kompen"a"$
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peme'$k"aan
■ Sebel!m $lak!kan peme'$k"aan tamba&an3pe'$k"a keaaan pengan tel$t$ an pa"t$kan &emo$nam$k "tab$l
■ Selal! "$apkan pe'lengkapan 'e"!"$ta"$ $ ekat pene'$ta ka'epeme'$k"aan tamba&an b$a"an#a $lak!kan $ '!angan la$n
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Peme'$k"aan tamba&an #ang $pe'l!kan9
■ CT ".an kepala3 abomen
■ USG abomen3 t'an"oe"o%ag!"
■ 6oto ek"t'em$ta"
■ 6oto ,e'teb'a tamba&an■ U'og'a+ engan kont'a"
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ANA0EENINISIAS
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#. $reathing
Men$la$ pe'na%a"an .!k!p- Sementa'a $t! n$la$ !lang apaka& (alan na%beba"=
0$ka pe'na%a"an t$ak memaa$ maka lak!kan 9
■- )ekomp'e"$ 'ongga ple!'a ;pne!moto'ak"<
■- T!t!pla& ($ka aa l!ka 'obek paa $n$ng aa
■- Pe'na%a"an b!atan
$erikan oksigen !nt!k mempe'ta&ankan "at!'a"$ ok"$gen leb$& a'
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%. &irculation
■- mengenal$kan pe'a'a&an #ang (ela" te'l$&at3
■- mempe'ole& ak"e" $nt'a,ena #ang .!k!p3 an
■- men$la$ pe'%!"$ (a'$ngan-
■- Pe'a'a&an apat $kenal$kan engan tekanan lang"!ng pa
tempat pe'a'a&an
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0$ka "$'k!la"$ t$ak memaa$ maka lak!kan 9
■ Hent$kan pe'a'a&an ek"te'nal
■ Sege'a pa"ang !a (al!' $n%!" engan (a'!m be"a' ;1@ 1B G<
■ 7e'$kan $n%!" .a$'an
■ Pengobatan engan po"$"$ kepala $ ba*a& ;? $n.$ leb$& 'enaa'$paa kak$<
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'. isaility
■- )$lak!kan peme'$k"aan ne!'olog$ ;GCS<
■- pe'ge'akan mata an 'e"pon p!p$l3
■- %!ng"$ moto'$. an "en"o'$k-
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. *+posure
■- 4epa"kan ba(! an pen!t!p t!b!& pa"$en
■- Pemaka$an peng&angat .a$'an3 ma!p!n .a'a.a'a peng&anga$nte'nal ma!p!n ek"te'nal
■- 0$ka aa ke.!'$gaan .ee'a le&e' ata! t!lang belakang3 maka
$mob$l$"a"$ $nl$ne &a'!" $ke'(akan-
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Tatalak"ana
■ Terapi &airan ,nisial
Ca$'an 'e"!"$ta"$ #ang $g!nakan aala& .a$'an $"oton$k NaCl ata! '$nge' laktat-
■ Trans-usi darah
Pembe'$an PRC3 pla"ma an t'ombo"$t "e.a'a $n$ an mem$n
pembe'$an k'$"talo$ #ang ag'e"$% apat men$ngkatkan "!',$,a
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■ &airan yang dihangatkan (lasma dan Kristaloid)
■ /encegah Koagulopati
a- A"am t'anek"amat
b- 6akto' 'ekomb$nan VIIa
.- K'$op'e"$p$tat an +b'$nogen .on.ent'at
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Kompl$ka"$
■ Pene'apan poten"$,e 'e"!".$tat$on apat men#ebabkan penpe'%!"$ ke o'gan ,$tal "e&$ngga $kont'a$n$ka"$kan paa pa"$eengan T'a!mat$. 7'a$n In(!'# ;T7I< an pa"$en "#ok &emo'agIII an IV
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P'ogno"$"
■ 7ebe'apa penel$t$an men!n(!kkan aan#a "!',$,al 'ate #ang t$ngg$ paa pa"$en #ang men(alan$ poten"$,e 'e"!".$tat$on$ban$ngkan engan pa"$en #ang $be'$ 'e"!"$ta"$ .a$'an ent!(!an men(a$ no'moten"$,e
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S$"tem Pe'!(!kan
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R*0*R*1S,■ P'$.e S3 D$l"on 4- Pato+"$olog$ kon"ep kl$n$" p'o"e"p'o"e" pen#ak$t- Bt& e- Vol- 1- 0a
EGC 11F-
■ M!&$man M3 T&a$b MR3 S!nat'$o S3 )a&lan R- Ane"te"$olog$- 0aka'ta9 7ag$an Ane"te" Te'ap$ Inten"$%- 6KUI 11@-
■ Ame'$.an College o% S!'geon" Comm$ttee on T'a!ma- A,an.e T'a!ma 4$%e S!ppo)o.to'"- Un$te State" o% Ame'$.a 11@-
■ S!o#o A3 Set$#o&a$ 73 Al*$ I3 Set$at$ S3 S$ma$b'ata M- Ilm! Pen#ak$t )alam- 0$l$ I 0aka'ta9 11B
■ Uean$ 0o&n 1 Hemo''&ag$. S&o.k Ne* Yo'k9 )epa'tment o% Eme'gen.# MeC&a'le" )'e* Un$,e'"$t#: UC4A S.&ool o% Me$.$ne-
■ 0a.ob MC / K!ma' P- T&e C&allenge $n Management o% Hemo''&ag$. S&o.k $n T'a!m 0o!tnal A'me 6o'.e" In$a- 1@91BF1B>
■ G!t$e''e G3 Re$ne" H)3 D!l%G!t$e''e ME- Cl$n$.al 'e,$e*9 Hemo''&ag$. "&o.k- A,a&ttp9::***-n.b$-nlm-n$&-go,:pm.:a't$.le":PMC1B?F: - P!bl$"&e onl$ne n Ap'$l
■ )!tton RP- Haemo"tat$. 'e".!.$ta$on- 7'$t$"& 0 o% Anae"t&e"$a 1 $F>$@B
■ Go!'g$ot$" S3 Gemenet$" G3 Ko.&e' HM3 Alo$o" S3 Salem$" N / G'ammeno" S- Pe'mpoten"$on $n blee$ng t'a!ma pat$ent"9 Help%!l o' Not an D&en= Ame'$.an A"".C$t$.alCa'e N!'"e"3 11-
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1065003/http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1065003/
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■ El$e MC- T'a!mat$. Hemo''&ag$. S&o.k A,an.e" $n 6l!$Management- Eme'gen.# Me$.$ne P'a.t$.e 11-
■ 7o!gle A3 Ha''o$" A3 )!'antea! 0- Re"!".$tat$,e St'ateg$e" $n T'
Hemo''&ag$. S&o.k- Annal" o% Inten"$,e Ca'e 1F3 F91 a,a$la&ttp9::***-annal"o+nten"$,e.a'e-.om:.ontent:F:1:1
■ D$'(oatmo(o3 Ka'(a$- Ane"te"$olog$ an 'ean$ma"$ mo!l a"pen$$kan S1 keokte'an- 0aka'ta9 )$'ekto'at 0ene'al Pen$
T$ngg$ )epa'temen Pen$$kan Na"$onal 11-
http://www.annalsofintensivecare.com/content/3/1/1http://www.annalsofintensivecare.com/content/3/1/1