{"id":1084,"date":"2016-11-15T23:38:27","date_gmt":"2016-11-15T23:38:27","guid":{"rendered":"http:\/\/doktermuslim.com\/?p=1084"},"modified":"2017-04-22T03:30:08","modified_gmt":"2017-04-22T03:30:08","slug":"rumus-baxter-perhitungan-luka-bakar","status":"publish","type":"post","link":"https:\/\/doktermuslim.com\/rumus-baxter-perhitungan-luka-bakar\/","title":{"rendered":"Rumus Baxter Perhitungan Luka Bakar"},"content":{"rendered":"

Luka Bakar Adalah Kerusakan \/ kehilangan jaringan akibat kontak dengan sumber panas : api, air panas, bahan kimia, listrik dan radiasi. Prognosis penderita diramalkan jelek bila = luas luka bakar + umur penderita > 80<\/em><\/strong>.<\/p>\n

\n

LUAS LUKA BAKAR<\/u><\/strong><\/h3>\n

Dewasa : Hukum 9\u00a0 (Rule Of Nine(s))<\/em><\/strong>\u00a0 atau anak Table Lund & Bowder<\/em><\/strong><\/p>\n

– Permukaan kepala \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0\u00a0 :\u00a0 9 %\u00a0\u00a0 – Permukaan pinggang :\u00a0 9 %
\n<\/em>– Permukaan setiap lengan :\u00a0 9 % \u00a0 – Permukaan paha\u00a0\u00a0\u00a0\u00a0\u00a0 :\u00a0 9 %
\n<\/em>– Permukaan dada \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0:\u00a0 9 %\u00a0\u00a0 – Permukaan betis\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 :\u00a0 9 %
\n<\/em>– Permukaan perut \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 :\u00a0 9 %\u00a0\u00a0 – Perineum & genital\u00a0 :\u00a0 9 %
\n<\/em>– Permukaan punggung \u00a0 \u00a0 \u00a0:\u00a0 9 %\u00a0\u00a0 – Telapak tangan\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 :\u00a0 1 %<\/em><\/p>\n

Bayi\u00a0\u00a0 : Rumus 10,\u00a0<\/em><\/strong>Anak\u00a0 : Rumus 10-15-10
\n<\/em><\/strong>Atau menggunakan tabel Lund & Browder
\n– Kepala leher \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0:\u00a0 15 %
\n– Depan belakang \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 :\u00a0 20 %
\n– Ekstermitas atas kanan kiri\u00a0 :\u00a0 10 %
\n– Ekstremitas bawah ka\/kiri\u00a0\u00a0\u00a0 :\u00a0 15 %<\/p>\n

\n

\"luas-area-luka-bakar\"<\/p>\n

\n

KATEGORI PENDERITA LUKA BAKAR<\/u><\/strong><\/h4>\n

1. Luka Bakar Berat \/ kritis<\/em><\/strong><\/span><\/h4>\n

–\u00a0 Derajat II-III\u00a0 > 40%
\n–\u00a0 Derajat III pada muka, tangan, kaki
\n–\u00a0 Trauma jalan nafas tanpa memikirkan luas luka bakar
\n–\u00a0 Trauma listrik
\n–\u00a0 Disertai trauma lainnya , misal fraktur<\/p>\n

2. Luka Bakar Sedang<\/em><\/strong><\/span><\/h4>\n

–\u00a0 Derajat II\u00a0 15-40%
\n–\u00a0 Derajat\u00a0 III < 10%\u00a0 , kecuali muka, tangan dan kaki<\/p>\n

3. Luka Bakar Ringan<\/em><\/strong><\/span><\/h4>\n

–\u00a0 Derajat\u00a0 II < 15%
\n–\u00a0 Derajat\u00a0 III < 2%<\/p>\n

Kategori ini untuk kepentingan prognosis berhubungan dengan angka morbiditas dan mortalitas.<\/p>\n

\n

PROGNOSIS<\/u><\/strong> BERAT RINGANNYA LUKA BAKAR DITENTUKAN OLEH<\/u><\/strong><\/h3>\n
    \n
  1. Kedalaman sebesar derajat I, II atau III<\/li>\n
  2. Luasnya untuk ditentukan prosentase<\/li>\n
  3. Daerah yang terkena<\/li>\n
  4. Usia<\/li>\n
  5. Keadaan kesehatan<\/li>\n<\/ol>\n
    \n

    INDIKASI RAWAT INAP<\/u><\/strong><\/h3>\n
      \n
    1. Dewasa derajat II > 15 %<\/li>\n
    2. Anak & orang tua derajat II >\u00a0 10 %<\/li>\n
    3. Derajat III > 10 %<\/li>\n
    4. Luka pada : wajah, tangan, genital\/perineal<\/li>\n
    5. Penyebabnya : kimia dan listrik<\/li>\n
    6. Menderita penyakit lain : DM, hipertensi<\/li>\n<\/ol>\n

      Penderita dengan luka bakar\u00a0 > 40% diusahakan pemasangan CVP
      \n<\/em><\/strong>Bila Luas luka bakar :
      \n–\u00a0 <\u00a0 20% \u00a0 artinya tubuh masih bisa kompensasi
      \n–\u00a0\u00a0 >\u00a0 20% \u00a0akan terjadi \u00a0shock hipovolemik (perpindahan cairan intra ke ekstravasculer)<\/p>\n

      \n

      PRINSIP PENANGANAN<\/u><\/strong><\/h3>\n
        \n
      1. Api masih hidup, Jika api masih hidup penderita disuruh berhenti lalu jatuhkan diri dan kemudian berguling di lantai \/ tanah (stop drop roll)<\/li>\n
      2. Hilangkan heat-restore \u00e0 bila < 15 menit siram air dingin<\/li>\n
      3. Lakukan pengecekkan ABC, Airway menentukan ada tidaknya trauma inhalasi, pasang ET. Breathing, bila terjadi Eschar (kulit kaku), lakukan Escharektomi<\/em><\/strong>, karena dapat menimbulkan sukar nafas. Bila perlu lakukan zebra incision<\/em><\/strong> pada tulang iga dan Circulation dengan menggunakan formula Baxter dengan larutan Ringer Laktat, jangan memakai NaCl karena Cl memperberat asidosis.<\/li>\n<\/ol>\n
        \n

        FORMULA BAXTER<\/u><\/strong><\/h3>\n

        Formula Baxter : 4 cc\/24jam x BB x %LB
        \n<\/em>Cara pemberian :
        \n–\u00a0 8 jam pertama 50%\u00a0 (sejak kejadian LB)
        \n<\/strong>–\u00a0 16 jam kedua 50%
        \n<\/strong>Untuk anak-anak :\u00a0\u00a0\u00a0 2 cc x BB x % LB\u00a0 =\u00a0 a cc
        \n<\u00a0 1 tahun\u00a0\u00a0\u00a0 : BB x 100 cc
        \n1 \u2013 3 tahun\u00a0 : BB x\u00a0\u00a0 75 cc
        \n3 \u2013 5 tahun\u00a0 : BB x\u00a0\u00a0 50 cc
        \nKebutuhan total\u00a0 =\u00a0 a x b , memakai lar RL : Dextran\u00a0 = 17:3<\/p>\n

        \n

        PERAWATAN LUKA BAKAR<\/u><\/strong><\/h3>\n\n\n\n\n\n\n
        DERAJAT<\/strong><\/td>\nKETERANGAN<\/strong><\/td>\n<\/tr>\n
        Derajat I<\/td>\n– \u00a0Cuci NaCl 500 cc<\/p>\n

        – Zalf Bioplasenton, dapat cegah kuman masuk\/infeksi<\/td>\n<\/tr>\n

        Derajat II<\/td>\n– Cuci dengan larutan savlon 5 cc dalam NaCl 500 cc<\/p>\n

        – Sufratul<\/p>\n

        – segera tutup dengan kassa dan perban steril\u00a0, ganti tiap minggu<\/td>\n<\/tr>\n

        Derajat III<\/td>\n\u00a0– Segera cuci dengan larutan savlon yang dilarutkan dalam NaCl dengan perbandingan 5 cc Savlon : 500 cc NaCl tiap hari<\/p>\n

        – Lakukan Debridemen\u00a0Setiap Hari<\/p>\n

        – Oles salep burnazin\/sulfadiazin setiap hari<\/p>\n

        – Dapat dilakukan Escharektomi<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

        Kemudian setelah hari ke tujuh, pasien dimandikan seperti biasa dengan air biasa, setelah dimandian area luka bakar dioles cairan disinfektan sol savlon dengan perbandingan 1 banding 30. Kemudian luka dibuka 3-4 hari apabila tidak ditemukan nekrosis jaringan dan tanda infeksi.<\/p>\n

        POSISI PENDERITA<\/u><\/em><\/p>\n\n\n\n\n\n
        Ekstremitas sendi yang luka posisi fleksi \/ ekstensi maksimal<\/td>\n<\/tr>\n
        Leher & muka\u00a0 defleksi, semi fowler (bantal di punggung)<\/td>\n<\/tr>\n
        Eskarektomi dilakukan bila luka melingkar atau berpotensi penekanan<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
        \n

        SKIN GRAFT DILAKUKAN BILA<\/u><\/strong><\/h3>\n

        – Luka grade II dalam 3 minggu tak sembuh
        \n– Luka grade III setelah eksisi
        \n– Terdapat granulasi luas ( diameter > 3 cm)<\/p>\n

        \n

        MEDIKASI<\/u><\/strong><\/h3>\n

        –\u00a0 Antibiotika ( bila < 6 jam), diberikan Sefalosporin generasi III
        \n– Analgetika
        \n– Antasid (H2 blocker ), diberikan untuk mencegah stress ulcer
        \n– ATS \/ Toxod<\/p>\n

        \n

        NUTRISI DAN ROBORANTIA<\/u><\/strong><\/h3>\n

        – TKTP\u00a0 diberikan oral secepat mungkin
        \n– Kebutuhan kalori menurut Formula Curreri<\/em><\/strong> :
        \n–\u00a0 Dewasa\u00a0 =\u00a0\u00a0 25 cal\/KgBB + 40 cal% LB
        \n–\u00a0 Anak\u00a0\u00a0\u00a0\u00a0\u00a0 =\u00a0\u00a0 60 cal\/KgBB + 35 cal% LB
        \n– Roboransia \u00a0berupa vit C (setelah 2 minggu), vit b, vit A 10.000 IU<\/p>\n

        \n

        PEMERIKSAAN LABORATORIUM<\/u><\/strong><\/h3>\n

        –\u00a0 Hb, Ht, albumin pada hari I, II, III
        \n–\u00a0 Elektrolit setiap hari pada minggu I
        \n–\u00a0 RFT & LFT\u00a0 pada hari ke II\u00a0 dan setiap minggu
        \n–\u00a0 Kultur kuman hari I, II, III<\/p>\n

        \n

        CATATAN DAN PERHATIAN KHUSUS<\/u><\/strong><\/h3>\n

        –\u00a0 Bila terjadi Ileus, segera stop makan\/minum, pasang NGT
        \n–\u00a0 LB > 40% segera pasang CVP selama 4 hari, bila sampai 1 minggu ganti kateter
        \n–\u00a0 Oliguri + cairan cukup (CVP normal), lakukan tes terapi manitol
        \n–\u00a0 Dewasa = 10 cc\/10-20 menit diulang tiap 6 jam
        \n–\u00a0 Anak\u00a0\u00a0\u00a0\u00a0 =\u00a0 0,2 mg\/KgBB \/ 14-20 menit<\/p>\n

        \n

        REFERENSI<\/u><\/strong><\/h3>\n

        Charles et al. 2009. Schwartz\u2019s : principles of surgery 9th edition<\/em><\/strong>. McGraw-Hill
        \nHall P M. Nephrolithiasis: Treatment, causes and prevention<\/strong>. Cleveland Clinic Journal of Medicine Vol. 76. Num. 10. October 2009.
        \nMoore, et al, 2016. Clinical Oriented of Anatomy<\/strong>, 7th Edition.
        \nTim Penulis, 2002. Bedah Reveald<\/em><\/strong>.
        \nTownsend. 2007. Sabiston : Textbook of Surgery 18 edition<\/em><\/strong>. Saunders<\/p>\n","protected":false},"excerpt":{"rendered":"

        Luka Bakar Adalah Kerusakan \/ kehilangan jaringan akibat kontak dengan sumber panas : api, air panas, bahan kimia, listrik dan radiasi. Prognosis penderita diramalkan jelek [Read more]<\/a><\/p>\n","protected":false},"author":1,"featured_media":1085,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[26,31],"tags":[282,154,283,285,284,287,286,280,279,281],"newstopic":[],"yoast_head":"\nRumus Baxter Perhitungan Luka Bakar | Dokter Muslim<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/doktermuslim.com\/rumus-baxter-perhitungan-luka-bakar\/\" \/>\n<meta property=\"og:locale\" content=\"id_ID\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Rumus Baxter Perhitungan Luka Bakar | Dokter Muslim\" \/>\n<meta property=\"og:description\" content=\"Luka Bakar Adalah Kerusakan \/ kehilangan jaringan akibat kontak dengan sumber panas : api, air panas, bahan kimia, listrik dan radiasi. 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