Survey Penyebab Kematian Berdasarkan Prosedur Advance Trauma Life Support (ATLS) pada Pasien Multiple Trauma di Instalasi Gawat Darurat (IGD) Bedah Rumah Sakit Hasan Sadikin Bandung Periode Januari – Juli 2014

2018 ◽  
Vol 9 (1) ◽  
pp. 10
Author(s):  
Gamal Ramadiputra ◽  
Yoyos Dias Ismiarto ◽  
Herry Herman
Keyword(s):  
Multiple Trauma ◽  
Life Support ◽  
Advance Trauma Life Support ◽  
Advanced Trauma Life Support ◽  
Golden Hour

Trauma adalah penyebab kematian utama pada usia di bawah 44 tahun di Amerika Serikat (AS).  Di Indonesia, trauma menjadi penyebab kematian utama pada kelompok umur 15 – 24 tahun, dan nomor 2 pada kelompok usia 25 – 34 tahun.  Penyebab umumnya ialah kecelakaan lalulintas, diikuti jatuh dari ketinggian, luka bakar dan karena kesengajaan (usaha pembunuhan atau kekerasan lain dan bunuh diri). Salah satu perintis pelayanan kedaruratan medik termasuk kasus trauma adalah Dr. Adams R. Cowley, dari beliau muncul konsep “The golden hour”. Pelatihan Advanced Trauma Life Support (ATLS) dimulai pada tahun 1980 di Alabama, AS, dan atas prakarsa Dr. Aryono D. Pusponegoro, Ketua Komisi Trauma IKABI pusat, mulai 1995 kursus ATLS terselenggara di Indonesia. Penelitian ini dilakukan secara retrospektif dalam kurun waktu Januari sampai Juli 2014 dengan jumlah pasien meninggal di instalasi gawat darurat bedah Rumah Sakit Hasan Sadikin Bandung sebanyak 58 pasien. Melalui penelitian ini akan ditelusuri penyebab kematian dilihat dari segi pertolongan pertama ketika pasien datang ke instalasi gawat darurat, dengan mengacu kepada prosedur Advanced Trauma Life Support (ATLS) yang biasa diterapkan. Hasilnya, pasien meninggal di instalasi gawat darurat bedah Rumah Sakit Hasan Sadikin Bandung dari Januari sampai Juli 2014 sebanyak 58 pasien, sebanyak 6 pasien (10,34%) meninggal pada satu jam pertama, 12 pasien (20,68%) meninggal pada satu sampai enam jam pertama. Dinilai dari segi prosedur Advanced Trauma Life Support (ATLS), mayoritas mengalami kegagalan pada tahap disability (D), yaitu sebanyak 41 pasien meninggal (70,06%), pada tahap circulation (C) sebanyak 10 pasien (17,24%), pada tahap breathing (B) sebanyak 6 pasien (10,34%) dan tahap airway (A) sebanyak 1 pasien (1,72%). 

scholarly journals The rescue of the polytraumatized victims due to violence in transit in the city of Chapecó-SC: the “golden hour”

2020 ◽  
Vol 13 (7) ◽  
pp. 102
Author(s):  
G. A. S. Moser ◽  
D. C. M. Aguiar ◽  
B. C. Franciscon ◽  
J. F. Lima ◽  
F. B. Haag
Keyword(s):  
Customer Service ◽  
Hospital Care ◽  
Life Support ◽  
Fire Department ◽  
Modern Society ◽  
Advanced Trauma Life Support ◽  
Structured Interviews ◽  
The West ◽  
Golden Hour ◽  
Delay Of Care

Trauma is considered the third cause of death, being understood as a disease with endemic character in modern society is not only affecting the field of public health, but also, the socio-political society. According to the Advanced Trauma Life Support - ATLS, in emergencies, the first hour, called the "Golden Hour" (Golden hour), this is the moment in which more deaths occur. However, this is also the time for more if you can avoid them. This study aimed to understand how the pre-hospital care and hospital conducted both by the Fire Department of the west of SC, and by nurses from the emergency department of a regional hospital in the west of Santa Catarina, whereas the reception and customer service in the first hour of trauma ("golden hour") the polytraumatized patients. It is a qualitative, with data collection in the first half of October 2016, through semi structured interviews held with nine Militarized Firemen and four nurses to an emergency room, using as analytical method to Content Analysis of Bardin. In this study, it was observed that within 60 minutes that comprise the golden hour, first medical care which is since the so-called redemption until the reached the hospital, is done quickly and properly in most of the times, ignoring the factors that may delay the answer, as transit, incarceration and away from the occurrence, being the victim transported in a timely manner. This delay in care is often caused by delay of complementary examinations, delay of care by the medical team, deficiency of structure and overcrowding, these factors generate a cascade of delay, which consequently worsen the situation of the patient, increasing morbidity and mortality. You will notice that the golden hour is valuable in that it concerns the maintenance of life and consequences for patients. A quick and effective way can increase the chances of survival of same. It is known that the development of services of APH, whether public or private, culminate with the need for trained and qualified professionals that meet the specific needs of the nursing care during the pre-hospital care, with a view to prevention, protection and recovery to healthIt is of great importance to discuss more about the topic and conduct further studies to develop mechanisms that reduce this time-response thus lowering the risk of sequelae and mortality due to trauma.

Trauma surgery

2014 ◽  
Author(s):  
Sebastian Dawson-Bowling ◽  
Serena Ledwidge
Keyword(s):  
Life Support ◽  
Trauma Surgery ◽  
Clinical Signs ◽  
Tension Pneumothorax ◽  
Trauma Team ◽  
Definitive Treatment ◽  
Advanced Trauma Life Support ◽  
Mortality And Morbidity ◽  
Golden Hour ◽  
The Uk

Appreciation of the ‘golden hour’ for resuscitation, and adoption of prin­ciples of the advanced trauma life support (ATLS) system are key factors in improving outcome for the patient with major injuries. Adherence to the strict protocols of the ABCDEs of the primary survey enables the trauma team to identify and deal with life-threatening conditions, prior to definitive treatment of problems with lesser immediacy. The clinician who understands the mechanism of injury will main­tain heightened levels of suspicion for clinical signs which point to well-recognized conditions resulting in early mortality and morbidity, for instance, tension pneumothorax, cardiac tamponade, and rising intrac­ranial pressure. This chapter will probe your grasp of the principles of trauma manage­ment. You will also be tested on common patterns of thoracic, abdomi­nal, vascular, and cranial injuries. Whilst clinical presentations of civilian trauma have remained consist­ent in recent years, the impact of military trauma in worldwide theatres of conflict has stimulated numerous advances in the management of trauma. The current impetus for reorganization of trauma services in the UK is tacit acknowledgement of the improvement in outcomes that can be achieved by adherence to recognized protocols in this challenging and demanding field of surgery.

Major trauma

2021 ◽  
pp. 581-596
Keyword(s):  
Major Trauma ◽  
Life Support ◽  
Head Injuries ◽  
Initial Assessment ◽  
Advanced Trauma Life Support ◽  
Thoracic Injuries ◽  
Golden Hour ◽  
Secondary Survey ◽  
Time Periods ◽  
Second Peak

This chapter discusses the management of major trauma. Trauma is the leading cause of death in the first four decades of life, and every minute, more than nine people die from injuries and violence. Trimodal distribution of death implies death from injury occurs in one of three time periods: first peak (within seconds to minutes), second peak (within minutes to several hours), and third peak (after several days to weeks). The ‘golden hour’ refers to the period when medical care can make the maximum impact on death and disability. A systematic, rapid initial assessment is essential and this includes preparation, triage, primary survey (ABCDE), resuscitation, secondary survey, continued monitoring, and reevaluation and definitive care. The chapter then looks at the advanced trauma life support (ATLS) system. It also considers thoracic injuries, abdominal trauma, vascular injuries, and head injuries.

Case Report: FAST Ultrasound Interpretation in Trauma Resuscitation

POCUS Journal ◽  
2016 ◽  
Vol 1 (3) ◽  
pp. 13-14
Author(s):  
Stuart Douglas, PGY4 ◽  
Joseph Newbigging, MD ◽  
David Robertson, MD
Keyword(s):  
Case Report ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Life Support ◽  
Advanced Trauma Life Support ◽  
Trauma Patients ◽  
Ultrasound Probe ◽  
Trauma Resuscitation ◽  
Highly Sensitive ◽  
Pouch Of Douglas

FAST Background: Focused Assessment with Sonography for Trauma (FAST) is an integral adjunct to primary survey in trauma patients (1-4) and is incorporated into Advanced Trauma Life Support (ATLS) algorithms (4). A collection of four discrete ultrasound probe examinations (pericardial sac, hepatorenal fossa (Morison’s pouch), splenorenal fossa, and pelvis/pouch of Douglas), it has been shown to be highly sensitive for detection of as little as 100cm3 of intraabdominal fluid (4,5), with a sensitivity quoted between 60-98%, specificity of 84-98%, and negative predictive value of 97-99% (3).

Sechs Jahre Advanced Trauma Life Support (ATLS) in Deutschland

2010 ◽  
Vol 113 (7) ◽  
pp. 561-567 ◽  
Author(s):  
M. Münzberg ◽  
L. Mahlke ◽  
B. Bouillon ◽  
T. Paffrath ◽  
G. Matthes ◽  
...  
Keyword(s):  
Life Support ◽  
Advanced Trauma Life Support

Pediatric Emergency Medicine: A Developing Subspecialty

PEDIATRICS ◽  
1989 ◽  
Vol 84 (2) ◽  
pp. 336-342
Author(s):  
Marilyn Li ◽  
M. Douglas Baker ◽  
Leland J. Ropp
Keyword(s):  
Emergency Medicine ◽  
Emergency Care ◽  
Emergency Departments ◽  
Life Support ◽  
Pediatric Emergency ◽  
Advanced Trauma Life Support ◽  
Full Time ◽  
Pediatric Emergency Medicine ◽  
Pediatric Hospitals ◽  
Pediatric Emergency Care

Questionnaires were sent to 245 North American institutions with pediatric residency programs. There was a 69% response rate. Pediatric emergency care is provided in three types of facilities: emergency departments in pediatric hospitals, separate pediatric emergency departments or combined pediatric and adult emergency departments, in multidisciplinary hospitals. There are at least 262 pediatricians practicing full-time pediatric emergency medicine. The majority work in pediatric emergency departments, an average of 30.7 clinical hours per week. There are 27 pediatric emergency medicine programs with 46 fellows in training and 117 full-time positions available for emergency pediatricians throughout North America. Varying qualifications for these positions include board eligibility in pediatrics, certification in Basic Life Support or Advanced Trauma Life Support, and a fellowship in pediatric emergency medicine. The demonstrated need for pediatricians, preferably trained in emergency care, clearly indicates that pediatric emergency medicine is a rapidly developing subspecialty of Pediatrics that will be an attractive career choice for future pediatricians.

Injuries to the Neck

2015 ◽  
Author(s):  
David H. Wisner ◽  
Joseph M. Galante
Keyword(s):  
Vertebral Artery ◽  
Carotid Arteries ◽  
Life Support ◽  
Jugular Vein ◽  
Penetrating Trauma ◽  
Operative Management ◽  
Advanced Trauma Life Support ◽  
Neck Trauma ◽  
Anatomical Structures ◽  
Initial Management

Injuries to the neck can be the result of blunt and penetrating trauma. Both mechanisms can cause devastating injuries, with high associated rates of morbidity and mortality. Airway management in trauma does not differ based on the mechanism of injury, and so the initial priority is to ensure an adequate airway through cricothyrotomy or tracheotomy. For penetrating neck trauma, initial management is evaluated in accordance with Advanced Trauma Life Support (ATLS) guidelines. Thereafter, the management of penetrating trauma of the stable patients is provided and includes carotid artery exploration and repair, vertebral artery exploration and repair, endovascular repair, jugular vein injuries, treatment of the pharynx and esophagus, and treatment of the larynx and trachea. Blunt trauma is described and includes injuries to the aerodigestive tract and cerebrovascular and vertebral injuries. Figures show an algorithm outlining operative management of known or suspected injuries to the carotid arteries, jugular vein, pharynx, and esophagus; the three separate zones of the neck; common incisions made along the sternocleidomastoid muscle; important anatomical structures of the neck; and an algorithm outlining management of known injuries to the vertebral artery. This chapter contains 31 references.

Disaster Reanimatology Potentials: A Structured Interview Study in Armenia I. Methodology and Preliminary Results

1989 ◽  
Vol 4 (2) ◽  
pp. 135-152 ◽  
Author(s):  
Miroslav Klain ◽  
Edmund Ricci ◽  
Peter Safar ◽  
Victor Semenov ◽  
Ernesto Pretto ◽  
...  
Keyword(s):  
Intensive Care ◽  
Life Support ◽  
Medical Personnel ◽  
The United States ◽  
Structured Interview ◽  
Advanced Trauma Life Support ◽  
Mass Casualties ◽  
Medical Systems ◽  
Preliminary Results ◽  
Medical Teams

AbstractIn general, preparations for disasters which result in mass casualties do not incorporate a modern resuscitation approach. We explored the life-saving potential of, and time limits for life-supporting first aid (LSFA), advanced trauma life support (ATLS), resuscitative surgery, and prolonged life support (PLS: intensive care) following the earthquake in Armenia on 7 December 1988. We used a structured, retrospective interview method applied previously to evaluation of emergency medical services (EMS) in the United States. A total of 120 survivors of, and participants in the earthquake in Armenia were interviewed on site (49 lay eyewitnesses, 20 search-rescue personnel, 39 medical personnel and records, and 12 administrators). Answers were verified by crosschecks. Preliminary results permit the following generalizations: 1) a significant number of victims died slowly as the result of injuries such as external hemorrhage, head injury with coma, shock, or crush syndrome; 2) early search and rescue was performed primarily by uninjured covictims using hand tools; 3) many lives potentially could have been saved by the use of LSFA and ATLS started during extrication of crushed victims. 4) medical teams from neighboring EMS systems started to arrive at the site at 2-3 hours and therefore, A TLS could have been provided in time to save lives and limbs; 5) some amputations had to be performed in the field to enable extrication; 6) the usefulness of other resuscitative surgery in the field needs to be clarified; 7) evacuations were rapid; 8) air evacuation proved essential; 9) hospital intensive care was well organized; and 10) international medical aid, which arrived after 48 hours, was too late to impact on resuscitation. Definitive analysis of data in the near future will lead to recommendations for local, regional, and National Disaster Medical Systems (NDMS).

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