Askep Kmb Luka Bakar
Transcript of Askep Kmb Luka Bakar
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Anfis kulit• Epidermis
• Dermis
• Sub ut!neus
FUNGSI KULIT "
• #el!$!n infeksi LU%A &A%AR• 'r(teksi t)d b!kteri
• Is(l!si d!ri ider!
• 'en*!tur su)u tubu) +ERANU• Inder! per!b!
• ekskresi
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'ENER+IAN• Su!tu pen-!kit. luk! -!n* diseb!bk!n (le) p!n
sen*!t!n listrik !t!u b!)!n kimi! -!n* men*en!kulit.muk(s! d!n /!rin*!n -!n* lebi) d!l!m
• Efek ter)!d!p kulit "
• merus!k l!pis!n kulit infeksi
• )il!n*n-! !ir!n tubu)
• Efek t)d pemb D!r!) "
• 'erme!bilit!s k!piler !ir!n pr(tein
merembes )ip((lemik s)(k
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• &A;AN %I#IA
A9ID AL%ALIS
• RADIASI
Sin!r m!t!)!ri R!di!si Nuklir
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Di!*n(s! L& di te*!k!n
berd!s!rk!n
• %ed!l!m!n luk! b!k!r ked!l!m!n L&
• Lu!s luk! b!k!r B L&.&SA
• 'en-eb!b• L(k!si
• Usi!
• Ri$!-!t . mek!nisme luk!
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%ed!l!m!n luk! b!k!r
Dipen*!ru)i "• Sif!t d!ri b!)!n.subst!ne
C Su)u
C %(nsentr!si• L!m!n-! k(nt!k
• D!-! t!)!n kulit ter)!d!p eder!
C Sirkul!si C %eteb!l!n
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%l!sifik!si %ed!l!m!n luk! b!k!r
• Superfii!l t)iknes $(und
• '!rti!l t)iknes $(und
• @ull t)ikness $(und
SU'ER@I9IAL "• %erus!k!n )!n-! pd l!p Epidermis, sel epitel
ms) !d!
• 'en-eb!b " sen*!t!n m!t! )!ri
• +!nd! " er-tem!, sdkt (edem, n-eri, sensitip!n!s, men*elup!s 273 )r p(st burn
• Sembu) t!np! s!r " 3 C )!ri
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Luk! b!k!r der!/!t
• #elu!s ke f!si!, (t(t, tul!n*, tend(n
• +er/!din-! den*!n pemb!k!r!n -*
s!n*!t, sen*!t!n listrik, kimi! berb!)!-!
• +!nd! " ke)it!m!n, sens!si )il!n* s!m!
sek!li
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3 k!te*(ri ked!l!m L&• L& der!/!t I" superfii!l in/ur- L& )!n-! men*en!i
l!p Epidermis s!/!• L& der!/!t II "b!*i!n !*!k d!l!m, L& men*en!i
epidermisl!psuperfii!l dermis
• L& der!/!t III" rus!kn-! /!rin*!n d!ri l!p Dermis
s.d subkut!nU.%E&U+ 'E#&EDA;AN 'EN?L?NAN4A"
• Superfii!l p!rti!l7t)ikness"eder! pd dermis
• Deep p!rti!l t)ikness" L& pd l!p Dermis,!d! kerus!k!n
pd kelen/!r kerin*!tseb!se! ttp b*n dlmn-! ms) b!*us• @ull t)iknes" L& men*en!i semu! b*n kulit, susun!n kulit
rus!kterm!suk lem!k /* rus!k
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+!nd! *e/!l!• Der!/!t I 5 superfii!l :
C N-eri C Er-tem!
C N-eri tek!n t!np! blister
• Der!/!t II5 p!rti!l t)ikness burn:
C S!kit n-eri
C #elepu)
C !rn! /!rin*!n -* terken! b$!rn! puti) pu!t ke$!rn!kunin*
• Der!/!t III 5 full t)ikness burn : C #er!) *el!p !t!u puti) kel!bu
C +id!k !d! r!s! n-eri, insensitie
C +id!k berub!) $!rn!
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U%URAN
• R?LE ?@ NINES "
• %ep!l! le)er F B• EGtremit!s !t!s k!n!n F B
• EGtremit!s !t!s kiri F B
• +ubu) dep!n F 1>B
• +ubu) blkn* F 1> B
•EGtremit!s b!$!) k!n!n F 1> B
• EGtremit!s b!$!) kiri F 1>B
• 'erineum F 1 B
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!mb!r lu!s luk! b!k!r
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L(k!si
• &!*i!n !t!s tubu) " kep!l!, le)er, d!d!
H 'ulm(n!ri 9(mpli!ti(n
• muk! !br!si m!t! telin*!
• 'erineum risk Infeksi k(nt!min!siurine feses
• An**(t! b!d!n b!$!)
• ?klusi sirkul!si edem!
U i
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Usi!
• An!k 2 t!)un
• De$!s! J 60 t!)un
• %ulit tipis, tembus !)!-! s)* sulit dinil!i• Risk #?R+ALI+4 RA+E +INI
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%riteri! ber!tn-! luk! b!k!r
• Rin*!n . min(r "• De$!s! F der!/!t II 1B
F der!/!t III 2 B
• An!k F der!/!t II 10 B• 'en!n*!n!n "
C R!$!t /!l!n )!rus dip!nt!u (le) ten!*!
pr(fesi(n!l ti!p > /!m
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Lukm!n s(rensen 1>
• Luk! b!k!r min(r /ik! "
• Luk! b!k!r 10 B
• '!sien 3 t)n J t)n
• +dk !d! ri$!-!t pen-!kit kr(nik
pen-!kit ber!t
• L& tdk pd muk!, t!n*!n, k!ki, sert!
perineum
• +dk !d! keel!k!!n l!in -* men-ert!i L&
• &uk!n krn !lir!n listrik
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Sed!n*
• De$!s! F der!/!t II 1 C 2 B +&SA
F der!/!t III 10 B +&SA
• An!k F der!/!t II 10 C 20 B +&SA
d!p!t dit!n*!ni di RS umum
&ERA+ . %RI+IS
• De$!s! F der!/!t II J 2B +&SA
F der!/!t III J 10B +&SA
• An!k F der!/!t II J 20 B +&SA
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3 t!)!p!n pd riti!l burn
• +!)!p )-p((lemik s)(k
• +!)!p diuretik. diuresis
• +!)!p re)!bilit!si
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3 )!l -* )!rus diper)!tik!n• &urn s)(k > /!m pert!m! " )ip((lemik s)(k
t). pemberi!n !ir!n• %ekur!n*!n elektr(lit pr(tein pentin*
diper)!tik!n perb!ndin*!n 3 " 1
• N-eri timbul setel!) beber!p! /!m terb!k!r
+). m(rfin.petidin 7777777 )!ti C )!ti
• Infeksi " infeksi . sepsis tet!nus +)." A+S,
!ntibi(tik!
• Re)!bilit!si " dil!kuk!n stel!) ps pln* d*n tu/u!n "
C men*emb!lik!n bentuk
C #en*emb!lik!n fun*si
+ i i
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+er!pi !ir!n
• +u/u!n " memperb!iki sirkul!si !ir!n dlm
tubu) medmpert!)!nk!n-!• Indik!si " di berik!n pd L& der!/!t II III J 2
B d!n p!sien -!n* tid!k bis! minum
@?R#ULA EKANS "
• 2 /!m pert!m! "
• && G B LL& G 1 ml 5 !ir!n elektr(lit :
• && G B LL& G 1 ml 5 k(l(id,pl!sm!, d!r!):
• IL F 2000 5 deGtr(se 10 B:, IL pd !n!k =
1000 C 100
• 'r(duksi urine = 0 ml . /!m
2 / k d
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2 /!m kedu!
• && G B LL& G M ml 5 elektr(lit :
• && G LL& GM ml 5 k(l(id :
• IL " deGtr(se . *luk(s! 10 B• p!nt!u pr(duksi urine M 7 1 ml . /!m
• /!m pert!m!diberik!n sep!ru)n-! sis!n-! diberik!n
d!l!m 16 /!m berikutn-!
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@(rmul! br(ke•
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+er!pi !ir!n• '!rk!nd
De$!s! " LR ml G && GB &SA pd 2 /!mpert!m!,Md!ri pemberi!n pd >
/!m pert!m! d!ri t/dn-! L& d!n M
berikutn-!stl) 16 /!m
An!k C!n!k "
LR 3 ml G &&5k*: G B&SA pd 2 /!m ptm =m!inten!ne 5 deGtr(se B173ml.k*./!m:
Mn-! diberik!n pd > /!m ptm stl) ter/!din-! L&d!n Mn-! l* diberik!n stl) 16 /!m
9!ir!n m!inten!ne deGtr(se B
L / t
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L!n/ut!n
•
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'er!$!t!n luk!• +u/u!n " tdk ter/!di infeksi, luk! ep!t kerin*
men-!tu• 'rinsip ker/! "
• Dibersi)k!n d*n !ir )!n*!t steril
•
di*untin*5esk!r(t(mi :• Luk! dikerin*k!n, kmd di(lesi siler sul!
di!Pine 5 ssd:
• 'er!$!t!n terbuk! .tertutup
• Skin *r!ft dil!kuk!n setel!) *r!nul!si
?b t b t
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?b!t7 (b!t!n
• Antibi(tik " disesu!ik!n d*n )!sil kultur
• +(G(id C A+S " diberik!n pd semu! p!sien 1 ti!p2 min**u s.d 3 k!li
• Ant!sid " untuk men*ur!n*i tuk!k l!mbun*
ke!s!m!n l!mbun*'emberi!n nutrisi "
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'emeriks!!n l!b(r!t(rium• ;b, ;t, ti!p > /!m pd 2 )r pert!m! d!n ti!p 2 )!ri
p!d! 10 )!ri sel!n/utn-!
• @un*si )!ti, *in/!l, ti!p min**u• Elektr(lit ti!p min**u• 'em !s d!r!) /ik! frek$ensi n!p!s J
32G.menit
• %ultur /!rin*!n p!d! )!ri I, III, KIII%?#'LI%ASI "
;ip((lemik s)(k
Infeksi
'neum(ni!%(ntr!ktur
+uk!k urlin*s
' k /i
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'en*k!/i!n• %!p!n, b!*!im!n! ke/!di!n-!
• Identifik!si pen-eb!b• L!m!n-! k(nt!k
• %mk keel!k!!n men*en!i s!l N!p!s
• L(k!si• %e/!di!n -* men-ert!i
• 'en*(b!t! -* sd) diper(le)
• 'en-!kit -* men-ert!i• Inspeksi luk!
• ;itun* LL&, tentuk!n !re!. l(k!si
L!n/ut!n
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L!n/ut!n• #(nit(r st!tus respir!t(rius
• %!/i ++K, **n sirkul!si perifer, (utput
urine,
• %!/i !ir!n -* )il!n*,pemeriks!!n d!r!)
d '
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dG 'ern!p!s!n
• +id!k efektifn-! p(l! n!p!s, kebersi)!n /!l!n
n!p!s• *n pertuk!r!n *!s• %etid!kseimb!n*!n (lume !ir!n• Risk infeksi
• N-eri• *n . ketid!kseimb!n*!n nutrisi• %eterb!t!s!n per*er!k!n• *n k(nsep diri
• %ur!n*n-! pen*et!)u!n
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