Ratna Puji Priyanti, S.Kep., Ns., M.
Credited by: Ns. Senja Setiaka
Primary Care
A patient's main source for regular medical care,
ideally providing continuity and integration of
health care services. All family physicians, and many
pediatricians and internists, practice primary care.
The aims of primary care are to provide the patient
with a broad spectrum of preventive and curative
care over a period of time and to coordinate all the
care that the patient receives.
Emergency
Management
Primary Survey Triase Secondary Survey
Prmary Survey:
The first and key part of the assessment of patients
presenting with trauma is called the primary survey.
During this time, life-threatening injuries are identified
and simultaneously resuscitation is begun. A simple
mnemonic, ABCDE, is used as a memory aid for the
order in which problems should be addressed.
Primary Survey
Cardiac Arrest:
D,R,C,B,A,D,E
Others:
D,R,A,B,C,D,E
The Mnemonic
D: Danger Pastikan keselamatan Pasien, petugas, dan
masyarakat
R: Response periksa respon pasien dengan
menggunakan metode AVPU
A: Airway pastikan kepatenan jalan nafas pasien,
pastikan tidak ada gangguan jlan nafas selanjutnya
(stridor) bila perlu pasang alat bantu OPA, NPA, LMA
B: Breathing cek apakah oksigenasi pasiien adekuat
C: Circulation cek apakah pulsasi dan CRT pasien
adekuat
Setiap tahap harus mempertimbangan aktifitas selanjutnya
yang harus dilakukan
Secondary Survey
Pemeriksaan fisik secara menyeluruh setelah primary
survey
Meliputi inspeksi, palpasi, perkusi dan auskultasi
Head:
Inspect:
general: Laceration, deformity, facial muscle, asymetry
Eye: pupils, racoon eye
Ears: otorhea, battle sign
Hidung: deformitas, epitaksis
Mulut: maloklusi, pembengkakan lidah dan jalan nafas,
Siara: ngorok
Palpasi: krepitus, emfisema, nyeri tekan
Neck
Inspeksi:
deformitas, laserasi, peningkatan JVP
Palpasi:
Posisi trakhea, nadi karotis, emfisema, limphadenophati
Chest
Inspeksi:
Ekspansi paru, pergerakan parodoksikal, penggunaan
otot bantu nafas, laserasi, deformitas
Chest:
Palpasi:
nyeri, emfisema subkutan, krepitus, denyut apeks
jantung
Auskultasi:
Suara jantung, suara nafas, suara tambahan
Abdomen:
Inspeksi:
laserasi, memar (bruising), distensi, trauma spinal
Abdomen:
Palpasi:
nyeri, masa, tahanan, kekakuan
Auskulasi: suara bising usus
Pelvis:
Inspeksi:
laserasi, memar, deformitas
Palpasi:
nyeri
Ekstremitas atas dan bawah
Inspeksi:
laserasi, memar, deformitas, pemendekan, rotasi
Palpasi:
Status neurovaskular, krepitus, nyeri
Back
Inpeksi:
Laserasi deformitas, memar
Palpasi:
Emfisema subkutan, pergerakan tulang
Vital sign
Transportasi
THE SIXED-BARS AMBULANCE CALL
1
1. PREDISPATCH
2. DISPATCH
6 2 3. TRAVEL TO THE
SCENE
4. ACTIONS AT THE
SCENE
5. TRAVEL TO THE
5 3 HOSPITAL
6. ACTIONS AT
HOSPITAL
4
THE SIXED-BARS AMBULANCE CALL
1
TELPON
A 2 B 4AMB. C AMB. D AMB.
6 E
AMB. TIBA DI MENINGGAL- TIBA DI RS
MASUK BRGKAT TKP KAN TKP TUJUAN
F WAKTU
AKTIVASI
3
G WAKTU
MENUJU TKP
H DITINDAKAN
TKP
5
PERJALANAN
I KE RS
WAKTU TANGGAP WAKTU TINDAKAN
DUE TO THE AVAILABILITY OF COMMAND CONTROL CENTER,
THE NETWORK ARE WELL IMPROVED WITH NEARBY HOSPITAL
MEDICAL EQUIPMENTS
• SUPPORTING BASIC AND ADVANCED LIFE SUPPORT
CARE.
• MED EQUIPMENT ARE SUPOSSED TO BE MINISTRY
OF HEALTH STANDARD.
MED EQUIPMENT:
AIRWAY SUPPORT
BREATHING SUPP.
CIRCULATION SUPP.
DISABILITY SUPP.
EXPOSURE SUPP.
EVALUATION GUIDELINES
• NUMBER OF PATIENT’S, MONTHLY
• ABLE TO DO RESUSCITATION PRIOR TO
TRAVELLING.
• ABLE TO PERFORM RESUSCITATION
DURING ENROUTE.
• PATIENT’S MEDICAL REPORT
• HOSPITAL RESPONSE TIME
• TRAVELLING TIME
COMMAND CONTROL CENTER
MEDICAL RADIOCOMUNICATION
RADIOCOMUNICATION
BY HANDY TALKIE RADIO
24 HOURS
EMERGENCY PRE HOSPITAL CARE
SERVICE
24
HRS
THERE’S NO SUPERMAN
BUT SUPERTEAM
EMERGENCY CALL CALL IS RECEIVED BY
FROM PUBLIC. DIAL 118 RADIOMEDIC OPERATOR
RADIOMEDIC OPERATOR ON-BOARD MEDICAL
DISPATCH THE AMBULANCE RADICOMMUNICATION
TEAM DISPATCH
TRAVEL TO THE SCENE OF ACCIDENT
COMMUNICATION DURING ACTION WITH RADIO COMM.
STERILE AREA
HIGH TECH vs HIGH TOUCH
POTENTIALLY MIS-HUBS
AMBULANCE CREW PERFORMANCE AT THE SCENE
RESUSCITATION AND STABILIZATION A PATIENT INSIDE
AMBULANCE DURING TRAVELLING
THE COMPLETE MEDICAL EQUIPMENT AND WELL TRAINED CREW
SUPPORT THE PATIENT’S LIFE
PATIENT AT THE HOSPITAL, HANDING OVER AND REFERED TO THE
PROPER WARD, ICU, OR OTHER UNIT AT HOSPITAL
MAINTENANCE OF AMBULANCE CAR TO MAKE THE BODY AND THE
CABIN NEAT AND CLEAN
INTRODUCTION
• Critical care and emergency
medical care, must be
implemented in the field, where
crises occur.
TWMS2011
DEFINITION
SPGDT adalah suatu sistem berupa koordinasi dari
sektor kesehatan yang didukung oleh sektor lain
dan kegiatan kelompok profesional pada keadaan
kedaruratan medis sehari hari (SPGDT-S)dan
pelayanan kedaruratan medis pada saat kejadian
bencana (SPGDT-B).
IEMSS
• A System of coordination in health sector
supported by other sector and profesional
groups activity on daily medical emergency
and emergency medical services on disaster
events.
45
LINGKUP SPGDT
• Pelayanan kesehaan ( Health services)
dalam SPGDT (IEMSS) meliputi :
1. Sistem Pelayanan pra Rumah sakit
(Prehospital medical services system)
2. Sistem Pelayanan di Rumah sakit
(Hospital service system)
3. Sistem Pelayanan antar Rumah sakit
( Interhospital service system)
EMERGENCY
MEDICAL
SERVICE
Environmental
Demographic
SYSTEM
(IEMSS)
Inter
HOSPITAL
Daily Emg
Prehospital
Communication Hospital
Emergency Dep EMS
Population Transportation HCU, ICU, OR outcome
Disaster +
mass casualties
Resources :
Prevention Personnel, Facilities, Equipment
Programs Organization
30/04/2014 Procedures 47
http://lifeinthefastlane.com/trauma-initial-
assessment-management/
http://www.sja.org.uk/sja/first-aid-advice/what-
to-do-as-a-first-aider/how-to-assess-a-casualty/the-
primary-survey.aspx
