Penatalaksanaan Cedera Otak Traumatik

Oleh :

dr.Samuel Bungaran Partahi Saud Manalu

Penatalaksanaan cedera otak traumatik pada unit gawat darurat mengikut protokol advanced trauma life support (ATLS). Pasien penurunan kesadaran harus selalu dilakukan manajemen jalan napas, pemberian ventilasi dan oksigen yang adekuat, dan pemberian cairan. Imobilisasi spinal harus dilakukan kecuali jika sudah dilakukan pemeriksaan penunjang yang mengindikasikan bahwa imobilisasi dapat dihentikan. Penilaian skor glasgow coma scale (GCS) dilakukan dan secepatnya diputuskan apakah memerlukan pemeriksaan CT-Scan kepala atau tidak.

Penatalaksanaan Gawat Darurat

Penanganan suatu cedera otak sebaiknya dimulai pada lokasi kejadian, dengan manuver ataupun instrumen paling memungkinkan yang tersedia saat kejadian atau pada unit gawat darurat.

Referensi

6. Gwinnutt CL, Driscoll P. Advanced trauma life support. Vol. 48, Anaesthesia. 1993. 441–442 p.
9. Vedantam A, Gopinath SP, Robertson CS. Acute Management of Traumatic Brain Injury. Rehabil After Trauma Brain Inj. 2018;1–11.
22. CRASH-3 trial collaborators. Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial. Lancet 2019; 394:1713
26. David A Olson. Head injury. Medscape. 2018.
27. Hawryluk GWJ, Rubiano AM, Totten AM, O'Reilly C, Ullman JS, Bratton SL, Chesnut R, Harris OA, Kissoon N, Shutter L, Tasker RC, Vavilala MS, Wilberger J, Wright DW, Lumba-Brown A, Ghajar J. Guidelines for the Management of Severe Traumatic Brain Injury: 2020 Update of the Decompressive Craniectomy Recommendations. Neurosurgery. 2020 Sep 1;87(3):427-434. doi: 10.1093/neuros/nyaa278. PMID: 32761068; PMCID: PMC7426189.
28. Kochanek PM, Tasker RC, Carney N, et al. Guidelines for the Management of Pediatric Severe Traumatic Brain Injury, Third Edition: Update of the Brain Trauma Foundation Guidelines. Pediatr Crit Care Med 2019; 20:S1.
29. Kochanek PM, Tasker RC, Bell MJ, et al. Management of Pediatric Severe Traumatic Brain Injury: 2019 Consensus and Guidelines-Based Algorithm for First and Second Tier Therapies. Pediatr Crit Care Med 2019; 20:269.
30. Szaflarski JP, Sangha KS, Lindsell CJ, Shutter LA. Prospective, randomized, single-blinded comparative trial of intravenous levetiracetam versus phenytoin for seizure prophylaxis. Neurocrit Care 2010; 12:165.
31. Xu JC, Shen J, Shao WZ, et al. The safety and efficacy of levetiracetam versus phenytoin for seizure prophylaxis after traumatic brain injury: A systematic review and meta-analysis. Brain Inj 2016; 30:1054.
32. Devlin JW, Skrobik Y, Gélinas C, et al. Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. Crit Care Med 2018; 46:e825.
33. Rajajee V, Riggs B, Seder DB. Emergency Neurological Life Support: Airway, Ventilation, and Sedation. Neurocrit Care 2017; 27:4.
34. Smith H, Sinson G, Varelas P. Vasopressors and propofol infusion syndrome in severe head trauma. Neurocrit Care 2009; 10:166.
35. Edwards P, Arango M, Balica L, et al. Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury-outcomes at 6 months. Lancet 2005; 365:1957.

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Masuk atau Daftar

Nomor Ponsel Sudah Terdaftar

Masuk dengan Email

Masuk dengan Email

Masuk dengan Facebook

Penatalaksanaan Cedera Otak Traumatik

Referensi

Masuk atau Daftar

Artikel Terkait