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Initial Assessment

This document provides an overview of initial assessment procedures for emergency patients. It defines key terms like primary and secondary surveys. The primary survey involves assessing the patient's airway, breathing, circulation, disability, and exposure. Steps are outlined for managing issues in each of these areas. The secondary survey involves taking a full medical history and examining the patient head to toe. Reevaluation involves ongoing monitoring of vital signs and collaboration with other specialists. The document provides guidelines for preparation at both pre-hospital and intra-hospital stages, and determines whether referral to another hospital is needed. Sources are cited to support the assessment methodology.

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61 views38 pages

Initial Assessment

This document provides an overview of initial assessment procedures for emergency patients. It defines key terms like primary and secondary surveys. The primary survey involves assessing the patient's airway, breathing, circulation, disability, and exposure. Steps are outlined for managing issues in each of these areas. The secondary survey involves taking a full medical history and examining the patient head to toe. Reevaluation involves ongoing monitoring of vital signs and collaboration with other specialists. The document provides guidelines for preparation at both pre-hospital and intra-hospital stages, and determines whether referral to another hospital is needed. Sources are cited to support the assessment methodology.

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Initial Assessment

Ns. I Made Suindrayasa, S.Kep, M.Kep


Tujuan Pembelajaran

• Definis initial assessment


• Persiapan prehospital dan intrahospital
• Primer survey
• Secondary survey
• Reevaluasi
• Rujukan
DIFINISI (Keyword)
Step

Sistematis Problem solving

Primer & secondary survey

Identifikasi Management Evaluasi monitoring


Preparation
Pre hospital Intra hospital

• 3A (aman diri, aman lingkungan aman pasien)


• Koordinasi dan komunikasi
• ABCDE paten
• Imobilisasi pasien
• Informasi
Cont..
Resusitation facility
Intra hospital

RS rujukan (SBARM)

• Area resusitasi
• Peralatan ABCDE
• Cairan kristaloid hangat
• Alat monitoring
• SOP
• Surat persetujuan rujuk
PRIMARY SURVEY
• D : denger
• A : airway • R : respon
• B : breathing • S : shout for help
• C : circulation
• D : disability
• E : exposure Versus
AHA 2015
DRSCAB + D
Airway
• Cek nadi + cek nafas
• Kontrol cervikal
Gargling Logroll
Suction
Snoring Head tilt + chin lift
Jaw trust
OPA
NPA
Crowing Intubasi endotracheal (ETT)
Needle cryco-thyroidotomy
Abdominal thrust
heimlich manuver
Chest Thrust
Back blow + Chest thrust
OPA & NPA
Endo Tracheal Tube
Needle cricothyroidotomi
Breathing
Normal x/menit Abnormal x/menit
Dewasa 12-20 < 8 dan > 24
Anak 15-30 < 15 dan > 35
Bayi 25-50 < 25 dan > 60
Circulation
• Syok
• Perdarahan
Disability
• GCS & reflek pupil
Exposure
Tambahan primary survey

• Folley catheter
• Gastric tube
• Heart monitoring
• AGD / darah lengkap
• TTV
• Pemeriksaan penunjang (CT scan, X-Ray, USG, Dsb)
event Triage Primare survey

Reevaluasi dan Secondary survey Pertimbangan


monitoring kebutuhan rujuk

Rujuk
Rawat inap
ICU/ICCU
Pulang
Secondary survey
• anamnesa riwayat pasien

SAMPLE
Sign and symptom
Allergies
Medication currently use
Past ilness / pregnancy
Last meal
Event / environtmental related to the injury

• Head to toe
Reevaluasi
• Monitoring ABCDE
• Heart monitoring
• TTV
• SpO2
• Urine output
• Kolaborasi analgetik (obat lainnya)
Hospital to hospital
S : Situation
B : Backgraund
A : Assessment
R : Recommendation
M : Medication
event Triage Primare survey

Reevaluasi dan Secondary survey Pertimbangan


monitoring kebutuhan rujuk

Conclusion
Rujuk
Rawat inap
ICU/ICCU
Pulang
• YAGD. (2010). Basic Trauma Life Support dan Basic Cardiac
Life Support ed. III.Jakarta : Yayasan ambulans Gawat Darurat
118.
• Health Association. (2020). Guide Line 2020 for
Cardiopulmonary Resuscitation and Emergency
Cardiovascular Care. Supplement to Circulation, 102.
• Fildes, J. (2008). Advanced Trauma Life Support for Doctors
eight edition. Amerika : American College of Surgeons
Committe on Trauma.
• Scott, H. R., Blyth, K.G., Jones, J. B. (2009). Davidson's
Foundations of Clinical Practice, 1st Edition. England:
Churchill Livingstone. eBook ISBN: 9780702048135
• Tim Bantuan Medis BEM IKM FKUI. (2015). Modul bantuan
hidup dasar dan penanganan tersedak. Jakarta: Universitas
Indonesia.

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