KONDISI TRAUMATIK SUBJEK ORTOPEDIK KOD MOR 2323 FRAKTUR SPINA & TORAK.

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Presentation transcript:

KONDISI TRAUMATIK SUBJEK ORTOPEDIK KOD MOR 2323 FRAKTUR SPINA & TORAK

FRAKTUR TULANG SPINA Definisi: Kecederaan/kerosakan pada turus vertebra & tisu neural

TULANG SPINA Cervical vertebral Thoracic vertebrae Lumbar vertebra Sacrum Coccyx

Jenis – jenis kecederaan Fraktur dan dislokasi spina Fraktur servikal spina Kecederaan korda servikal spina Fraktur toracik spina T2 – T10 Torakolumbar fraktur Lumbar fraktur

Klasifikasi Anterior, medial & posterior colum Tetap Tak tetap

Mekanisma kecederaan Hiperekstensi Fleksi Peralihan axial (compression) Fleksi dan memusing Hyperektensi Fleksi

Diagnosa dan ciri klinikal Kes kemalangan major Kes tak sedar diri selepas kemalangan Kesakitan. Kaku dlm keadaan leher/belakang Kebas

Investigasi X-ray CT scan MRI

Pengurusan dan rawatan Rawatan kecemasan Larang gerak – kolar servikal Penjagaan kejururawatan Traksi tengkorak Pembedahan

Traksi Skull traction Halo-torasik

Komplikasi fraktur teruk Fraktur C1 – C2 membawa maut Fraktur C3 – C4 gangguan pernafasan Fraktur C5 – C7 Tetraplegia & Quadraplegia

FRAKTUR TORasiK Definisi: Fraktur yang melibatkan anggota torasik dan organ yang berkaitan.

The thoracic cage includes the thoracic vertebrae Thoracic vertebral manubirum Body Xiphoid process True ribs Sternum Costal cartilage False ribs

Organ-organ yang terlibat Tulang rusuk Paru-paru Jantung

Insiden Salah satu penyebab kematian trauma 15% memerlukan pembedahan 85% memerlukan prosidur pengurusan kecemasan

Pengurangan isipadu darah & oksigen di paru – paru Patofisiologi Kecederaan dada Pengurangan isipadu darah & oksigen di paru – paru Hipoksia tisu

Kecederaan boleh mengancam nyawa Penyumbatan salur udara Tension pneumotorak Open pneumotorak Massive hemotorak Flail chest Kardiak tamponade

Kecederaan lain Subkutaneous emphysema Kecederaan remuk pada dada Simple pneumotorak Hemotorak Fraktur tulang rusuk

Rawatan dan pengurusan Kajian primer Resusitasi Kajian sekundar Penjagaan khusus

Pengurusan dan rawatan Thoracentesis – tension pneumotorak Chest tube insertion Pericardiocentesis Tranfusi darah Oksigen Analgesik Penjagaan kejururawatan

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