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LAPORAN KASUS: TATALAKSANA PASIEN LUKA BAKAR BERAT DENGAN TRAUMA INHALASI DI UNIT PERAWATAN INTENSIF Aziz, Arif Aminudin; Sobaryati
E-Journal Widya Kesehatan dan Lingkungan Vol. 2 No. 1 (2020)
Publisher : E-Journal Widya Kesehatan dan Lingkungan

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Severe burns are burns with an area of > 25% of the body surface area that often require treatment in the Intensive Care Unit (ICU). This is especially so when inhalation trauma is suspected. The diagnosis of inhalation trauma needs to be made immediately to avoid life-threatening airway obstruction. In severe burns, there are physiological changes involving multiple organs. The handling must also involve multidisciplinary disciplines. Coagulopathy occurs immediately after burns, causing a microvascular reaction around the dermis resulting in expansion of the injury. This paper is a literature review for the requirements for intensive care consultant education exams. Case reports were obtained from ICU patients at Hasan Sadikin Hospital. The patient was treated for 5 days on a ventilator then burns treatment until he was in the High Care Unit room. The conclusion is that burns activate a systemic response due to loss of skin barrier, release of vasoactive mediators from the wound and subsequent infection. The result of this process is interstitial edema of organs and soft tissues. This process requires individual resuscitation treatment, depending on the parameters of the individual patient.
TATALAKSANA TETANUS GENERALISATA GRADE III YANG DISERTAI DENGAN COMMUNITY ACQUIRED PNEUMONIA DI RUANG PERAWATAN INTENSIF (LAPORAN KASUS) Nasution, Nur Intan; Sobaryati
E-Journal Widya Kesehatan dan Lingkungan Vol. 2 No. 2 (2020)
Publisher : E-Journal Widya Kesehatan dan Lingkungan

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Tetanus is an acute toxemia due to neurotoxins produced by Clostridium tetani characterized by periodic and severe muscle rigidity and spasme, which threatens life and is world health problem. Goals of tetanus management include: (1) neutralization of unbound toxin; (2) eradication of tetanospasmin source; (3) muscle spasm control and treatment of autonomic dysfunction; and (4) general supportive management. The purpose of this paper is to report and describe the successful management of tetanus with complications due to muscle spasm, autonomic dysfunction and respiratory failure in intensive care unit. The method used is case report with retrospective approach and analyzed descriptively. Male, 34 years old, was admitted with complaints of wholebody rigidity 1 day before admission accompanied with trismus, dysphagia, hypertension, tachycardia, risus sardonikus, opistotonus and spasm of all muscles. Patient was diagnosed with tetanus generalisata grade 3 and admitted for 18 days in intensive care unit using mechanical ventilation. Tracheostomy was performed on the sixth day. The patient was fully recovered and discharged after 35 days of hospitalization. It can be concluded that tetanus mortality rate remains high because of its complications and longterm care for critical illness. Immediate diagnosis, identification of complications, complication management, and quality of supportive management are keys in determining outcome.
Co-Authors Aziz, Arif Aminudin Nur Intan Nasution, Nur Intan