presentasi
TRANSCRIPT
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GIGITAN BINATANG BERBAHAYA DAN DROWNING
M. YusufFK UNSYIAH / SMF Bedah RSUD ZA
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1. Gigitan Anjing2. Gigitan Monyet3. Sengatan Bulu Babi4. Keracunan Ikan Buntal5. Sengatan Ikan Pari6. Gigitan Ular7. Insect Bite8. Drowning
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GIGITAN ANJING
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Gigitan Anjing Rabies
Kesehatan
Nasional
Zoonesis
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Inkubasi > 2 minggu
Saraf Pusat
Hipocampus, Purkinye dan kelenjar liur
Manusia infeksi lokal Sepsis.
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Pemeriksaan Histopatologi hypocampus Sel Negri Bodies oleh virus rabies
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Rabies Virus
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PENATALAKSANAAN
• Debrideman cuci dengan air mengalir + pembersihan dengan sabun.
• Laserasi tutup primer• Luka luas tindakan bedah• Imunisasi• Vaksin virus rabies
- injeksi lokal/infiltrasi lokal didaerah gigitan
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Gigitan Monyet
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Gejala klinis
Stadium prodormal
Stadium sensoris
Stadium eksitasi
Stadium paralisi
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PENATALAKSANAAN
Segera
Cuci luka dengan air megalir memakai sabun atau detergen
Antiseptik
Antitetanus & Antibiotik
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Sengatan bulu babi(echinoide)
700 Spesies
80 Berbahaya
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Reaksi antigen antibodi
Lokal
Nyeri, eritem
Abses & Infeksi
sistemik
Kelelehan, kelemahan dan
nyeri otot, kelumpuhan
dan kematian
DURI
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PENATALAKSANAAN
Rendam air hangat (30’ -
90’)
Gosok luka dengan sabun
Anestetik lokal
Debrideman
Antibiotik
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Sengatan Ikan Buntal(porcupine)
• Neurotoxin tetrodotoxin (TTX)• Taiwan, China, Jepang
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Gejala Klinis
Neurologis & Gastrointesti
nal
Parastesia
Disfungsi saraf
kranial
Kelemahan
Mual dan Muntah
serta Diare
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Fatal kelumpuhan & gangguan pernafasan
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PENATALAKSANAANAirway management
Antibodi monoklonal (USAM RIID)
Terapi Suportif
Nostigmin
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Sengatan Ikan pari(manta)
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• Sengatan ekor tajam
• Lokasi menentukan prognosa
• Efek lokal edema & eritem
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Gambaran Klinis
Sinkop
Hipotensi
Syok Kardiogenik
Mual & Muntah
Ansietas
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Efek Sistemik
Mual Muntah Hipotensi Sinkop Ansietas
Syok Kardiogenik
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Penatalaksanaan Awal
Lepaskan sisa sengatan perlahan
Sisa sengatan dada dan perut
biarkan tak tersentuh
Transfer ke RS
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Penatalaksanaan Lanjut
ABC Debrideman Suportif
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GIGITAN ULAR
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250 Berbis
a
2000 jenis
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Kepala segi empat
Gigi taring kecil
Luka halus bebrbentuk lengkung
Ciri ular berbisa
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Sifat Bisa Ular
TrombogenikHemoloitikSitotoksikAntifibrinAntikoagulanKardiotoksikMerusak pembuluh darah
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Gejala Klinis
Edema
Nyeri tekan
Ekimosis
LOKAL
Hematotoksik
Neurotoksik
Kardiotoksik
nekrosis
SISTEMIk
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PENATALAKSANAAN
• Awal• Lanjut– ABC– Laboratorium– SABU– Antitetanus– Adrenalin sesuai indikasi
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PENATALAKSANAAN
Awal
Imobilisasi
Menenangkan korban
Lanjut
ABC
SABU
Adrenaline (sesuai indikasi)
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SENGATAN SERANGGA
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• Reaksi Alergi
• Lebah Madu Afrika KILLER BEE Berbahaya
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Gejala Klinis
• Nyeri• Sensasi terbakar• Reaksi Alergi
Histamin
Kulit Kemerahan dan gatal
sistemik- Gangguan
nafas- syok
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PENATALAKSANAAN
ABC
Lidokain 2%
Kompres dingin
Torniquet
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Drowning
ILCOR Proses gangguan pernafasan primer akibat submersi / imersi pada media cair
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…Drowning
Laryngospasme dan hipoksia Bradikardi
Henti Jantung Kematian
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Pindahkan korban ke darat
Evakuasi
- Look- Feel- Listen
Nilai pernafasan
Pembersihan jalan nafas
30:2 C
PR
Penatalaksanaan Awal
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PENATALAKSAAN LANJUT
OKSIGEN
• Intubasi
UNRESPON
• Adekuat VENTILASI
• Ulang 15-30’
RESUSITASI
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Terima kasih