Defnisi Cedera OtakDefnisi Cedera OtakCedera Kepala (Head Injury)Cedera Kepala (Head Injury)Physical injuries to the skull, facial Physical injuries to the skull, facial fractures or soft tissue damae to the fractures or soft tissue damae to the face or head face or head withoutwithout neuroloical neuroloical conse!uencesconse!uencesCedera Otak ("rain Injury)Cedera Otak ("rain Injury)Physical injuries to the face or head or Physical injuries to the face or head or others #ith others #ith neurologicalneurological conse!uencesconse!uencesKlasifkasi (Head $ "rain Klasifkasi (Head $ "rain Injury)Injury)"erdasar%"erdasar%&ekanisme&ekanisme'e(erity'e(erity&orpholoi&orpholoiMekanisme)uka penetrasi )uka tem*ak&otor*ike accidentPenetrasi+umpul(Blunt)"lunt assault,alls-utomo*ile collisionDepends on the presence ofdural penetrationSeverity'e(ere (.C'% /01)&ild (.C'% 23024)&oderate (.C'% 502/)MorfologiDi6use,ocal7aultIntracraniallesions'kull,racture"asilairLinier/ satelliteDepressed/ non depressedOpen/ CloseWith or w/o CSF leakageWith or w/o N VII palsy-Vascular inury !D"#SD"#IC"-$%onal inury-Contusion-LacerationDi&&use a%onal inury'ild# classic concussion( di&&use a%onal inuryDi&&use )ascular inury 'ultiple s*all he*orrhage?SDHEDHINTRACRANIALSECONDARY INSULTSYSTEMIC SECONDARYINSULTCEDERA OTAKSEKUNDER ICP, CPPISKEMIK-HIPOKSIKMORTALITASMORBIDITASCEDERA OTAKPRIMERCEDERA KEPALAPatofisiologi Cedera OtakPatofisiologi Cedera OtakNormalTx adequad'ystemic 'econdary'ystemic 'econdary Insult InsultHypo8emia Hypo8emiaHypotension HypotensionHypercapnea HypercapneaHypocapnea HypocapneaHyperthermia HyperthermiaHyperlycemia HyperlycemiaHypolycemia HypolycemiaHyponatremia HyponatremiaIntracranial 'econdaryIntracranial 'econdary Insult InsultICPICP 9 9"rain herniation "rain herniation&ass lesion % :DH,&ass lesion % :DH, 'DH, ICH 'DH, ICH:dema :demaHydrocephalus Hydrocephalus7asospasme 7asospasme'ei;ures 'ei;uresInfection InfectionHypo8ic $ Ischemic Hypo8ic $ IschemicPrinsip PenangananPrinsip PenangananClose observationClose observationPrompt diagnosis and treatmentPrompt diagnosis and treatment little can be done about the primary brain injury, but that a lot can be done to minimize secondary brain injury )ankah0lankah +atalaksana )ankah0lankah +atalaksana Cedera Otak di = 'ta*ilisasi -ir#ay, "reathin, Circulation 'ta*ilisasi -ir#ay, "reathin, Circulation/= /= 'ur(ey sekunder (pemeriksaan status eneral'ur(ey sekunder (pemeriksaan status eneral terdiri dari anamnesa dan pemeriksaan fsik seluruhterdiri dari anamnesa dan pemeriksaan fsik seluruh oran) oran)3= 3= Pemeriksaan ?eurolois Pemeriksaan ?eurolois4= 4= &enentukan dianosis klinis dan pemeriksaan&enentukan dianosis klinis dan pemeriksaan tam*ahan tam*ahan@= @= &enentukan tahapan tatalaksana selanjutnya &enentukan tahapan tatalaksana selanjutnya!!S"a#$l$%a%$ ABCS"a#$l$%a%$ ABCPemer$&%aa' E(alua%$ Per)a"$&a', *er#a$&$-= -ir#ay Patensi A'uara +am*ahan AO*struksi"= "reathin :fektif A ,rekuensi dan kedalaman.erakan dada-ir :ntry'ianosisC= Circulation -dekuat A ?adi dan PenisianBarna kulitCapilary refllin timePerdarahan+ekanan darahD= Disa*ility(status neurolois)?ormal A +inkat kesadaran (.C')= >= A'am'e%aA'am'e%a0 Identitas Penderita % 0 Identitas Penderita %nama, umur, se8, suku, aama, pekerjaan, alamat nama, umur, se8, suku, aama, pekerjaan, alamat0 &ekanisma +rauma 0 &ekanisma +rauma0 Baktu +rauma 0 Baktu +rauma0 Pernah Pinsan0 Pernah Pinsan 0 -mnesia0 -mnesia 0 Keluhan % nyeri kepala ,kejan, (ertio 0 Keluhan % nyeri kepala ,kejan, (ertio0 = -namnesa, ,isik Dianostik/= Pemeriksaan 3 Fam)0 Puasa @ Fam0 O*at 'imptomatik I7 atau 'upp0 O*ser(asi ketat0 Catat keadaan (ital dan neurolois saat akan dikirim ke ruan pera#atan0 'erah terima penderita serta informasi lenkap keadaan penderitaOperasiICKK