AMINO IMSTC 2020: Scientific Poster, Public Poster, Photography, and Videography by AMSA-Indonesia

AMINO | IMSTC 2020

Glial Fibrillary Acidic Protein (GFAP) as A Promising Serum Biomarker in Detecting Mild Traumatic Brain Injury (mTBI) in Emergency Settings: A Systematic Review David Nugraha – I Made Agus Dwipayana – Zefo Kiyosi Wibowo Introduction: The diagnosis of Mild Traumatic Brain Injury (mTBI) generally use Glasgow Coma Scale (GCS) score and CT scan of the brain. However, overuse of CT scan for evaluating patient increasing awareness of potential hazards of ionizing radiation exposure. This study examined the performance of serum glial fibrillary acidic protein (GFAP) as a promising biomarker for brain injury which have high sensitivity and specifity to prevent overuse of CT scan. Method: Literature search with keyword (Glial fibrillary acidic protein OR GFAP) AND (Traumatic brain injury OR TBI OR Brain trauma) AND CT) were conducted on Pubmed, Cochrane, and ScienceDirect based on PRISMA statement with criteria available full text, published in the last five years, and in humans. Result and discussion: A total of six studies consist of 1.969 subjects; 1387 mild and moderate TBI patients ; and 582 control were included as follow had traumatic mechanism of injury not involving the head and healthy person. The area under receiver operating characteristics (ROC) curves (AUC) were created to detect intracranial lesions on CT finding and determine GFAP increased to compare between control and mTBI findings. Based on the data, all AUC value is between 0.77 – 0.85 with normal 95% confidential interval. All studies were confirmed that there were statistically significant increase in GFAP serum level in patient with TBI than in control (p < 0.05). GFAP also increase in CT negative with MRI positive finding. It shows that an increase in GFAP blood serum has a huge potential to show the presence of mTBI. GFAP cutoff level of 0.15 ng/ml can detect intracranial lesion with sensitivity 94% and specificity 47%. Conclusion: GFAP may act as a promising biomarker to show the presence of mTBI and may reduce the use of CT scan as well as a noninvasive yet reliable diagnostic tools.

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INTRODUCTION

RESULT

In 2016, Traumatic Brain Injury (TBI) had a global age-standardized prevalence of 759 (95% UI 731 788) per 100 000.[1] The diagnose of the TBI was generally followed by CT scan. Besides, TBI also classified by its Glasgow Coma Scale (GCS) score as mild (GCS 13 15), moderate (GCS 9 12) and severe (GCS 3 8)[2,5] , with over 80% of injuries classiﬁed as mild TBI (mTBI).[3,4] The mTBI could show negative image of CT scan,[10] but there was a significant increase of a biomarker namely Glial Fibrillary Acidic Protein (GFAP) that only appear in the serum of the patient with brain injury. GFAP, is an intermediate filament-III protein uniquely found in astrocytes, play critical role in astroglia cell activation (astrogliolisis) following CNS injury.[11] This study aims to prove that the increase of GFAP serum level indicates any lesion on the brain and decreasing the use of unnecessary CT scan.

Table 1. Characteristic of Studies Author and year

Study design

Location

Mean age (years)

Yue JK,et al; 2019

Prospective cohort study

USA

36.3

Gill J,et al; 2018

Prospective cohort study

Philadelphia

USA

13.6

Finland

45.1

Florida

Prospective cohort study Prospective 2-center Posti JP,et al;2016 study Rhine T,et al; 2016

Papa L,et al;2015

Prospective cohort study

GFAP Measurement technique Immunoassay i-STAT POCT

Sample size Control Patient 331

450

Single Molecule Array

277

ELISA

Randox Biochip Immunoassay

324

ELISA

114

Prospective cohort Papa L,et al;2015 ELISA 60 197 Florida 12 study GFAP, glial fibrillary acidic protein; ELISA, enzyme-linked immunosorbent assay; POCT, Poin-of-care test; ED, emergency department; mTBI, mild traumatic brain injury

METHODS

Table 2. Glial Fibrillary Acidic Protein assessment outcomes Author and year

Systematic review based on PRISMA statement

Studies on GFAP as a biomarker in traumatic brain injury from PubMed, Science Direct, and Cochrane

Inclusion and exclusion criteria screening

Total of six studies included

Sample in total: 1,969 subjects

Patient GCS score

Time of assessed 24 h 48 h 6h 24 h 6h 6h

AUC-ROC 0.77 0.77 * 0.729 0.85 0.82

Outcomes 95% CI 0.726-0.829 0.70-0.84 * 0.577-0.847 0.72-0.98 0.71-0.93

p-value Yue JK,et al; 2019 13-15 p < 0.0001 Gill J,et al; 2018 13-15 p < 0.001 Rhine T,et al; 2016 13-15 p < 0.01 Posti JP,et al;2016 9-15 p < 0.001 Papa L,et al;2015 9-15 p < 0.001 Papa L,et al;2015 13-15 p < 0.001 *Not mentioned in their result GCS, glasgow coma scale; AUC, area under curver; ROC, receiver operating characteristics

Literature search was conducted through PubMed, Science Direct, and Cochrane using keyword "Glial fibrillary acidic protein" OR "GFAP" AND "Traumatic brain injury" OR "TBI" OR "Brain trauma" AND "CT" Inclusion criteria: 1. Observational or clinical trial 2. Define GFAP as biomarker 3. Conducted in past five years 4. In mild-moderate traumatic brain injury setting 5. Available CT findings Exclusion criteria: 1. Not available control group 2. Inappropriate study type 3. Irretrieveable full-text 4. Non-human study

Table 3. Plasma GFAP concentration by imaging modality and findings [5]

IDENTIFICATION

Figure 1. Conceptual Framework Records identified through database searching (n=306) PubMed = 98 Cochrane = 78 ScienceDirect =130

Figure 3. The AUC-ROC curve for discriminating between CT positive and CT scan negative.[9]

Additional records identified through other sources (n = 0)

DISCUSSION

SCREENING

Records after duplicates removed (n=298) Titles and abstract screened (n=298)

ELIGIBILITY

Full-text articles assessed for eligibility (n=40)

INCLUDED

Studies included in qualitative synthesis (n=13)

A total of six studies were reviewed. Total sample size are 1.969 subjects; 1387 patient were grouped in mild traumatic brain injury (mTBI) and moderate traumatic brain injury; and 582 control were included as follow had traumatic mechanism of injury not involving the head and healthy person. Glasgow Coma Scale (GCS) scores of 13 to 15 were considered mild; scores of 9 to 12 were considered moderate; and scores of 3 to 8 were considered severe.[2,5] A prospective cohort study was conducted in all articles, except Posti JP, et al. (2016). Three of six studies measured Glial Fibrillary Acidic Protein (GFAP) serum level within 6 hours after injury using enzyme-linked immunosorbent assay (ELISA). In contrast, with study by Posti JP, et al. (2016) and Yue JK, et al. (2019) which assessed GFAP serum level in 24 hours after injury. Only Gill J, et al. (2018) assessed 48 hours after injury and using Single Molecule Array method. The area under receiver operating characteristics (ROC) curves (AUC) were created to detect intracranial lesions on CT finding and determine GFAP increased in compare between control and mTBI findings. AUCs of less than 0.7 were considered poor, 0.7 0.8 fair, 0.8 0.9 good, and 0.9 1.0 excellent.[7] Based on the data, all AUC value is between 0.77 0.85 with normal 95% confidential interval. However, Rhine T, et al (2016) did not mentioned their AUC and CI value. All studies were confirmed that there were statistically significant increase in GFAP serum level in patient with TBI than in control (p < 0.05). Moreover, Gill J, et al. (2018), Yue JK, et al. (2019), and Papa L, et al. (2015) mentioned that GFAP also increase in CT negative with MRI positive finding. It shows that an increase in GFAP blood serum has a huge potential to show the presence of mTBI. Papa L, et al. (2015) also mentioned GFAP cutoff level of 0.15 ng/ml can detect intracranial lesion with sensitivity 94% and specificity 47%.

Records excluded (n=258) -Irrelevant topic (n=198) -Irrelevant abstract (n=53) -No access for full-text (n=7)

Full-text article excluded (n=27) - Not define GFAP as biomarker (n=10) -irretrievable full-text (n=5) -Inappropriate study type (n=5) -Not in mild-moderate traumatic brain injury (n=3) -Conducted before 2015 (n=1) -Not human study (n=1) -No CT findings (n=2)

Studies excluded (n=7) -No control group (n=7) Studies included in qualitative synthesis (n=6)

Figure 2. Diagram Flow of Literature Search Strategy REFERENCES: 1.

James SL, Theadom A, Ellenbogen RG, Bannick MS, Montjoy-Venning W, Lucchesi LR, Abbasi N, Abdulkader R, Abraha HN, Adsuar JC, Afarideh M. Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990 2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Neurology. 2019 Jan 1;18(1):56-87. 2. Braine ME Cook N The Glasgow Coma Scale and evidence informed practice a critical review of where we are and where we need to be. Journal of clinical nursing. 2017 Jan;26(1-2):280-93. 3. Levin HS, Diaz-Arrastia RR. Diagnosis, prognosis, and clinical management of mild traumatic brain injury. The Lancet Neurology. 2015 May 1;14(5):506-17. 4. Gill J, Latour L, Diaz-Arrastia R, Motamedi V, Turtzo C, Shahim P, Mondello S, DeVoto C, Veras E, Hanlon D, Song L. Glial fibrillary acidic protein elevations relate to neuroimaging abnormalities after mild TBI. Neurology. 2018 Oct 9;91(15):e1385-9. 5. John K Yue. 2019. Association between plasma GFAP concentrations and MRI abnormalities in patients with CT-negative traumatic brain injury in the TRACK-TBI cohort: a prospective multicentre study 6. Papa L, Zonfrillo MR, Ramirez J, Silvestri S, Giordano P, Braga CF, Tan CN, Ameli NJ, Lopez M, Mittal MK. Performance of glial fibrillary acidic protein in detecting traumatic intracranial lesions on computed tomography in children and youth with mild head trauma. Academic Emergency Medicine. 2015 Nov;22(11):1274-82. 7. Posti JP, Takala RS, Runtti H, Newcombe VF, Outtrim J, Katila AJ, Frantzén J, Ala-Seppälä H, Coles JP, Hossain MI, Kyllönen A. The levels of glial fibrillary acidic protein and ubiquitin C-terminal hydrolase-L1 during the first week after a traumatic brain injury: correlations with clinical and imaging findings. Neurosurgery. 2016 Mar 8;79(3):456-64. 8. Rhine T, Babcock L, Zhang N, Leach J, Wade SL. Are UCH-L1 and GFAP promising biomarkers for children with mild traumatic brain injury?. Brain injury. 2016 Aug 23;30(10):1231-8. 9. Papa L, Mittal MK, Ramirez J, Ramia M, Kirby S, Silvestri S, Giordano P, Weber K, Braga CF, Tan CN, Ameli NJ. In children and youth with mild and moderate traumatic brain injury, glial fibrillary acidic protein out-performs S in detecting traumatic intracranial lesions on computed tomography Journal of neurotrauma. 2016 Jan 1;33(1):58-64. 10. Kobeissy FH. Brain neurotrauma: molecular, neuropsychological, and rehabilitation aspects. Crc Press; 2015 Feb 25. 11. Yang Z, Wang KK. Glial fibrillary acidic protein: from intermediate filament assembly and gliosis to neurobiomarker. Trends in neurosciences. 2015 Jun 1;38(6):364-74.

CONCLUSION In conclusion, the levels of serum glial fibrillary acidic protein (GFAP) significantly correlated with the finding of mild traumatic brain injury (mTBI) and may become a promising biomarker to decrease the use of unnecessary CT scan in diagnosing mild traumatic brain injury

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Performance of Glial Fibrillary Acidic Protein as A Biomarker for Mild Traumatic Brain Injury Among Children: A Systematic Review and Meta-Analysis of Cohort Studies Gideon Hot Partogi Sinaga, Ugiadam Farhan Firmansyah, Rania Rifdah Taufiq Introduction: Around the world, 69 million people suffer from traumatic brain injury. TBI is one of the most common head injuries in children, occurring in over 837,000 children. TBI is caused by a bump, blow, or jolt to the head that disrupts the normal function of the brain. CT scan was the gold standard diagnostic tool for detecting TBI. Unfortunately, this modality has negative impact to children, especially the radiation exposure. Therefore, we would like to analyse the alternative diagnostic tool, glial fibrillary acidic protein (GFAP), as new biomarker for mTBI diagnosis. Objectives: To explore the utility of GFAP in mTBI detection by analyzing the serum level of the biomarker post-injury and evaluating the sensitivity and specificity when used as a diagnostic tool Materials and Methods: We searched literatures from PubMed, Scopus, ScienceDirect, EBSCOHost, and ProQuest then found 3145 literatures. We found four full-text articles that matches with our inclusion and exclusion criteria. Those journals are included for quantitative analysis. Further, we assess the quality of studies with STROBE checklist for cohort. Results and Discussion: We analysed from several journals and found that GFAP serum level significantly higher in children with mild traumatic brain injury (mTBI) compared with control (p<0.0001). Nevertheless, those journals are considerable heterogeneity studies. Moreover, we also discover that GFAP has high sensitivity but low specificity in detecting mTBI among children. Conclusion: From our systematic review and meta-analysis, we conclude that there is significant difference of GFAP serum level in children with mild traumatic brain injury versus control. However, further researches across the world with large of samples are needed to be conducted to discover this novel biomarker for diagnosis mTBI among children. Keyword: Mild traumatic brain injury, concussion, children, glial fibrillary acidic protein

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Biodegradable Magnesium Screw as an Alternative Implant for Trauma-Related Fractures William Wiradinata1, Audrey Patricia Tandayu2 and Brenda Kristi3

Abstract Introduction: Fracture is one of the most frequent condition caused by high-energy trauma. This traumatic injuries accounted for the increase of injury-related death rate over the last 10 years. Open Reduction Internal Fixation (ORIF) is a procedure that requires an implant which is usually made of titanium to treat fractures that cannot be reduced with conventional method. Biodegradable implants which are made of materials that would be degraded inside the body, appears as an alternative to eliminate the need of secondary operations to remove nonbiodegradable implants. Magnesium alloys are an example of biodegradable materials that could be used as implants. This review aims to identify the advantages and viabilities of magnesium alloys in its uses as a biodegradable implant. Materials and Methods: The method used in this paper is literature review and the materials are relevant scientific journals or reports. Results: The mechanical strength of magnesium screws is similar to titanium-based screws and higher compared to other biodegradable implants. The ions delivered by magnesium based implants are essential for the physiological metabolism of the bone. The degradation products of magnesium stimulates the proliferation of osteoblasts and induce apoptosis in osteoclasts. Magnesium alloys could also inhibit infection caused by bacteria after implantation. In order to improve the resistance of magnesium alloys corrosions inside the body, combination of Mg with zinc and manganese with additional coatings such as triethoxy(octyl)silane or hydroxyapatite (HA) have been used. This prolong degradation and corrosion can reduce inflammatory reaction and increase surface biocompatibility based on pathological examination. Conclusion: Magnesium is a biodegradable material with many advantages compared to metallic implants and other biodegradable materials to treat trauma-related fracture due to its

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mechanical strength, osteoanabolic activity, and biocompatibility. Combination of Mg with Zn and Mn and coating Mg with triethoxy(octyl)silane or hydroxyapatite can increase corrosion resistance and prolong degradation. Keyword: Magnesium, Biodegradable implant,Internal Fixation

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EFFECTIVITY OF AIRWAY MANAGEMENT IN OHCA SUBJECTS USING LARYNGEAL MASK AIRWAY PERFORMED BY NON-PHYSICIAN Name of Authors: 1. Muhammad Haris Munandar 2. Muhammad Dipo Muharram 3. Lilyana Aritonia Ahmad 4. Alfiyyah Hastari Syaf Introduction: Laryngeal Mask Airway (LMA) is an alternative airway adjunct that maintains respiratory ventilation, which may enable rapid and effective airway control in comparison with BVM when used by inexperienced personnel. The early use of ILMA by trained prehospital emergency nurses during OHCA is feasible and effective. The primary outcome was the rate of successful lung ventilation upon placement of the ILMA during OHCA Materials and methods: A comprehensive search of online database was performed. A literature review by reading and taking summarize of each references and then comparing a successful rate of ILMA insertion of non-physician. Results and discussion: In the first reference the effectivity of ventilation after ILMA insertion of non-physician that already guided well was obtained in 94% at the first attempt (63/67) and 97% after the second attempt (65/67). Rate of successful endotracheal intubation was lower than LMA. In the second reference, the primary outcome is the intubation success rate was 73.63% (1078 of 1464 cases). We counted 321 failures of intubation (210 failures of ILMA insertion and 111 failures of ventilation through the TT). After intubation, the ventilation was effective in 1020 (69.67%) cases after the first attempt whereas only in 50 (3.41%) cases after the second attempt In these prospective series of 1464 OHCA, the success rate at ventilation through the ILMA was 85.38%. Among these 1464 cases, 73.63% could be properly ventilated after tracheal intubation through the ILMA. The most common complication was regurgitation, which was found in 16.18% of cases, mostly during BLS.

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Conclusion: In conclusion, the use of ILMA is feasible and allows effective airway management when performed by trained non-medical health care professionals during OHCA.

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Systematic Review of Effect of Extracorporeal Shock Wave Therapy for Burn Patients Michele Indrawan1, Herbert Deji1, Angeline Tancherla1 1

Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia

Introduction: Burn is damage to the skin which can be caused by fire/flame, scalds. In Indonesia, burn is ranked 6th for unintentional injuries in 2014 with mortality rate of 34% and annually causing approximately 195,000 deaths. All degree of burn can be healed, but deep partial-thickness and full-thickness burn cause scarring to occur which can be minimized by plastic surgery and physical therapy measures. Extracorporeal shock wave therapy (ESWT) is a method, tested as a potential way of injuries management in burn patients. ESWT were less prominent as an option for burn scar management due to the lack of knowledge and systematised study oriented in ESWT efficacy for burn scar treatment. On that account, this sytematic review was carried out to evaluate the further efficacy of Extracorporeal Shock Wave Therapy in burn patients. Materials and Methods: Data are collected from Online Resources that has an Open Access, such as Pubmed, Google Scholar, and Science Direct. Systematic analysis is done using PICO and MeSH terminology. Results and Discussions: This systematic review analyses 7 studies, which consists of 2 experimental studies and 5 randomized clinical trials. The studies evaluated the healing, scar size and appearance, itching or pruritus, mobility, and pain in 254 burn patients after ESWT by using VAS, VSS, NRS, 5-D Itch Scale, Leuven Itch Scale, measurement of scar appearance, mobility, size in mm, and completion of epithelization time. All these studies informed that groups with usage of ESWT in their treatment have superior reduction of pain, itching or pruritus, better scar appearance and size, more mobility on burned area, and faster healing time. Conclusion: All of the studies that we have analysed had found that ESWT is effective in the process of treatment for burn patients. Extracorporeal shock wave therapy is a method proficient in treating post burn scar pain and appearance, itching or pruritus, improve movement on burned area, and reduction of epithelization time. Keyword: Extracorporeal shock wave therapy, burn

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EFFECTS OF EXTRACORPOREAL SHOCK WAVE THERAPY FOR BURN PATIENTS A Systematic Review

Michele Indrawan1, Herbert Deji1, Angeline Tancherla1 1 Faculty

of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia

INTRODUCTION

Burn is damage to the skin which can be caused by fire or scalds. In Indonesia, burn is ranked 6th for unintentional injuries in 2014 with mortality rate of 34% and annually causing approximately 195,000 deaths. All degree of burn can be healed, but deep partial-thickness and full-thickness burn cause scarring to occur. Extracorporeal shock wave therapy (ESWT) is a method, tested as a potential way of injuries management in burn patients. ESWT were less prominent as an option for burn scar management due to the lack of knowledge and systematised study oriented in ESWT efficacy for burn scar treatment. On that account, this systematic review was carried out to evaluate the further efficacy of ESWT in burn patients.

MATERIALS AND METHODS

Data are collected from Online Resources that has an Open Access, such as Pubmed, Google Scholar, and Science Direct. Systematic analysis is done using PICO and MeSH terminology.

CONCLUSION

From the 7 studies that we have analysed, we found out that Extracorporeal Shock Wave Therapy (ESWT) is a method proficient in treating post burn scar pain and appearance, itching or pruritus, improve movement on burned area, and reduction of epithelization time. Through this systematic review, we hope that ESWT will serve to improve our knowledge in damage management for burn patients. Therefore could help burn patients to achieve recovery and a good quality of life.

RESULTS AND DISCUSSIONS

This systematic review analyses 7 studies, which consists of 2 experimental studies and 5 randomized clinical trials. The studies evaluated the healing, scar size and appearance, itching or pruritus, mobility, and pain in 254 burn patients after ESWT by using VAS, VSS, NRS, 5-D Itch Scale, Leuven Itch Scale, measurement of scar appearance, mobility, size in mm, and completion of epithelization time. All these studies informed that groups with usage of ESWT in their treatment have superior reduction of pain, itching or pruritus, better scar appearance and size, more mobility on burned area, and faster healing time. PARAMETER

RESULT

Taheri et al.1 (2018)

AUTHOR (YEAR)

Prospective experimental

STUDY

Burn scars in extremities

100 impulses per cm2, E = 0.1 J/mm2, 4 Hz, 6 sessions

Improving pain, itching, and appearance of burn scar (decreased VAS and VSS score) after treatment and 1 month after treatment. Following 3 months after treatment, no changes in pain relief and itching, but better scar appearance

Fioramonti et al. (2012)

Experimental

Burn scars contractures in extremities, face, trunk

100 impulses per cm2, E = 0.037 mJ/mm2/ cm2.12, 4 Hz, 12 sessions

Improved VAS score, scar appearance (scars appeared more pliable, and color mismatch was less evident) and movement after treatment.

Ottoman et al. (2012)

Prospective randomized clinical trial

Reepithelization of superficial

100 impulses per cm2, E = 0.1 mJ/ mm2, 1 session

Patients with ESWT showed significantly reduced mean time to c le e ( 95%) ec d-degree burn wound epithelialization (9.6 1.7 vs. 12.5 2.2 days; P < 0.0005) compared to the control group without ESWT.

Cho et al. (2016)

Randomized clinical trial

Burn scars

100 impulses per cm2, E Scar pain was reduced more = 0.05-0.15 mJ/ mm2, 4 significantly. NRS score significantly Hz frequency, 3 sessions decreased (7.80 1.54 to 3.80 2.35 points, P < 0.001)

Zaghloul et al. (2016)

Randomized clinical trial

Burn scars contractures, hypertrophic scars, or keloids

2500 3000 impulses per 10-15 minutes, 12 sessions

Samhan, AT, Abdelhalim, Randomized NM clinical trial (2019)

Burn scars in upper and lower extremities

100 impulses per cm2, E Study group patients showed more = 0.05-0.20 mJ/mm2, 4 prominent result than placebo group Hz frequency, 4 sessions. in pain reduction with NRS median 7 (6- 10) in pre-treatment and median 2 (0-4) post-treatment.

Joo et al. (2017)

Burn pruritus

100 impulses per cm2, E Results measured in 3 scales = 0.05-0.20 mJ/mm2, 4 (NRS, 5-D Itch Scale, and Leuven Hz frequency, 3 sessions. Itch Scale) indicated a better improvement in post burn skin pruritus of patients in experimental group compared to control group.

Prospective randomized clinical trial

REFERENCES

OBJECT/INJURY

second-degree burn wounds

Patients in study group experience 42.55% f i e e i ca thickness, result was higher compared to 12.15% of improvement in control group. A significant improvement was also seen in results obtained using VSS in both groups.

1. Taheri P, Khosrawi S, Mazaheri M, Parsa M, Mokhtarian A. Effect of extracorporeal shock wave therapy on improving burn scar in patients with burnt extremities in Isfahan, Iran. J Res Med Sci [Internet]. 2018 [cited 2019 Nov 16];23(1):81. Available from: http://www.jmsjournal.net/text.asp?2018/23/1/81/242091 2. Fioramonti P, Cigna E, Onesti MG, Fino P, Fallico N, Scuderi N. Extracorporeal shock wave therapy for the management of burn scars. Dermatologic Surg. 2012 May;38(5):778 82. 3. Ottomann C, Stojadinovic A, Lavin PT, Gannon FH, Heggeness MH, Thiele R, et al. Prospective randomized phase II trial of accelerated reepithelialization of superficial second-degree burn wounds using extracorporeal shock wave therapy. Ann Surg. 2012 Jan;255(1):23 9. 4. Cho YS, Joo SY, Cui H, Cho SR, Yim H, Seo CH. Effect of extracorporeal shock wave therapy on scar pain in burn patients: A prospective, randomized, single-blind, placebo-controlled study. Med (United States). 2016 Aug 1;95(32). 5. Zaghloul MS, Khalaf MM, Thabet WN, Asham HN. Effect of Extracorporeal Shock Wave Therapy on Post Burn Scars. 6. Samhan AF, Abdelhalim NM. Impacts of low-energy extracorporeal shockwave therapy on pain, pruritus, and health-related quality of life in patients with burn: A randomized placebo-controlled study. Burns [Internet]. 2019 Aug [cited 2019 Dec 4];45(5):1094 101. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0305417918310222 7. Joo SY, Cho YS, Seo CH. The clinical utility of extracorporeal shock wave therapy for burn pruritus: A prospective, randomized, single-blind study. Burns. 2018 May 1;44(3):612 9.

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Hyaluronic Acid Potency as Antibiotic-loaded Biomaterials for Staphylococcus aureus Strain on Surgical Site Infection. Maghfira Arviola Nona Hariyadi, Ahmad Shofiyul Labib, Siti Zahra Arfiani. Introduction: Surgical site infection (SSI) is one of the most common issues of healthcareassociated infections (HCAIs) during the postoperative phase. SSIs incidence in Orthopedic Surgery and Trauma is 79 out of 3096 patients, with 43 cases are from Intremedullary nailing. The treatment of SSIs depends on antibiotics as prophylaxis and postoperative treatment, but Methicillin-resistant Staphylococcus aureus (MRSA) strains is limiting the efficacy of antibiotic and the systemic disadvantage of antibiotics, such as diarrhea and nausea. Hyaluronic acid (HA) is non protein glycosaminoglycan which act to accelerate wound healing, anti-inflammatory, proliferation, cells migration, angiogenesis, and re-epithelization. Injection of HA with intravenous or intraperitoneal antibiotics in wound healing in mice are being observed in literature. Method: The method that is used technically review of sources as articles and journals in The International Journal of Lower Extremity Wounds, Front Vet Sci, European Surveillance System (TESSy), Biomaterial Journals, etc. Published all around the last 10 years. Our ke

ord are H al ronic acid , S. a re

, SSI .

Result and Discussion: Usage of HA with antibiotic shows significant rate of decreased wound in gross pathology, bacterial count, and histological findings, compared to the control group. Based on the results, it suggests that S. aureus tend to break the bond of injected HA, instead of extracellular matrix (ECM) HA. ECM HA is not interrupted by exoenzyme hyaluronidase from S. aureus, and can works properly on re-epithelization and antiinflammation on wound healing. Conclusion: Injection of HA acts by deceiving S. aureus, led to increase of antibiotic efficacy and faster wound healing because ECM HA will not be interrupted by Hyaluronidase enzyme from S. aureus.

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Handling Trauma in Elderly Patient Marito Lenni Tin Sianipar and Chatrine Angelica Dwi Christy AMSA-Universitas Kristen Indonesia Introduction Trauma is the seventh leading cause of death in older adults. Trauma can occur in any age-groups. The elderly suffer the same injuries that young people suffer; However, due to various age-related processes, the elderly suffer more severe consequences from this injury. Death and morbidity due to injury can be influenced by many factors including age, physical condition, and comorbidity. Management of elderly trauma patients can present several unique challenges compared to young patients. Methods Search strategies and criteria for selecting articles Systematic literature study searches were conducted with a database in Pubmed, Google for articles published between 2011 and 2018. We use the following terms in the search field: “Trauma AND Handling and “Trauma AND Elderly . Search results are downloaded into a personal database. The results from the four databases are then cited and combined. Results All 926 eligible patients were included in the analyses: 344 MT-HI patients and 582 minor trauma without head injury. After six months, the functional decline was similar in both groups: 10.8% and 11.9%, respectively (RR = 0.79 [95% CI: 0.55–1.14]). The proportion of patients with mild cognitive disabilities was also similar: 21.7% and 22.8%, respectively (RR = 0.91 [95% CI: 0.71–1.18]). Furthermore, for the group of patients with an MT-HI, the functional outcome was not statistically different with or without the presence of a co-injury (RR = 1.35 [95% CI: 0.71–2.59]). Conclusion This study did not demonstrate that the occurrence of an MT-HI is associated with a worse functional or cognitive prognosis than other minor injuries without a head injury in an elderly population, six months after injury. Keyword: Injury, Trauma, Elderly, Management

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S T ea

e e

a c Re e f The Effec e e f Pha ac g ca f P T a a cS e D de D ag ed Pa e C a ed P aceb

Johan Wibowo , Jonathan Juniard Anurantha , Nadia Khoirunnisa Her adi Facult of Medicine, Universit of Pelita Harapan, Tangerang, Banten, ndonesia

Post Traumatic Stress Disorder (PTSD) is a chronic ps chiatric disorder which causes someone to re-e perience past traumatic events such as war, natural disaster, a violent personal assault that affects his/her personalit for a long period usuall longer than a month . n research published b Cambridge Universit , it is stated that a low level of serotonin is related to the prevalence of PTSD and thus serotonergic agents such as sertraline can be used to possibl reduce the s mptoms of PTSD. Sertraline is a t pe of antidepressant that fall under the class selective serotonin reuptake inhibitor(SSR ) . We wanted to evaluate the effectiveness of the sertraline compared to the placebo group in a PTSD patient.

n our s stematic review, we collected our data from an online journal which includes Pubmed and Google Scholar. S stematic Anal sis approaches were used in this stud , for e ample, the P CO method.

B using the inclusion and e clusion criteria, we have found 5 articles that were relevant. Panahi et al, Davidson et al, Austin et al, Brad et al stated in their studies that there were significant improvements and consistent numeric advantages of sertraline compared with placebo. There s onl 1 stud , conducted b Friedman et al, which stated that there were no significant differences between sertraline and placebo.

the use of sertraline is effective and safe in reducing s mptoms of PTSD. As there are onl 1 out of 5 studies that state that there is no significant differences and effect given b sertraline compared with placebo.

1.American Ps chiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM- V-TR. Washington, DC: American Ps chiatric Association, 2000. 2. Connor K, Davidson J. The Role of Serotonin in Posttraumatic Stress Disorder: Neurobiolog and Pharmacotherap . CNS Spectrums. 1998;3(S2):42-51. 3. K S. An evidence-based review of the clinical use of sertraline in mood and an iet disorders. - PubMed - NCB [ nternet]. Ncbi.nlm.nih.gov. 2019 4.Friedman MJ e. Randomi ed, double-blind comparison of sertraline and placebo for posttraumatic stress disorder in a Department of Veterans Affairs setting. - PubMed - NCB [ nternet]. Ncbi.nlm.nih.gov. 2019 5. Panahi Y e. A randomi ed, double-blind, placebo-controlled trial on the efficac and tolerabilit of sertraline in ranian veterans with post-traumatic stress ... - PubMed - NCB [ nternet]. Ncbi.nlm.nih.gov. 2019 6.Davidson JRT, Rothbaum BO, van der Kolk BA, Sikes CR, Farfel GM. Multicenter, Double-blind Comparison of Sertraline and Placebo in the Treatment of Posttraumatic Stress Disorder. Arch Gen Ps chiatr . 2001;58(5):485 492. doi:https://doi.org/10.1001/archps c.58.5.485 7. Austin; Double-Blind Placebo-Controlled Pilot Stud of Sertraline in Militar Veterans With Posttraumatic Stress Disorder [ nternet]. nsights.ovid.com. 2002 8. Brad K, Pearlstein T, Asnis GM, et al. Efficac and Safet of Sertraline Treatment of Posttraumatic Stress Disorder: A Randomi ed Controlled Trial. JAMA. 2000;283(14):1837 1844. doi:https://doi.org/10.1001/jama.283.14.1837

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Can We Really Become The Iron Man Doctors ? Virtual Reality Application For Traumatic Surgery Training Reynaldo Aryesta Oka Prastica , Zahratul Noreizsa Rakhmadi , Vita Xaviera Hendrata Faculty of medicine , Universitas Hang Tuah Introduction Surgery requires great skills in order to avoid errors. Surgery training using conventional methods, such as using a cadaver, require funds and have limited access. The solution for this problem is using a Virtual Reality (VR) simulation. As we see, VR simulations allow prac i ioners o engage on a s rger and prac ice as if he re handling a real pa ien ,

i ho

involving any life threatening risks. Materials and methods The method we are using for this research is literature review from journals taken from Google Scholar and Mendeley.

Results

311

Discussion Studies shows that successful surgeries has increased after using the VR simulation. It shows that the simulation group performs well in doing a surgery, compared to the control group where they use the conventional method. Many advantages could be achieved by this: VR is easy to understand and to use, aloows multiple trainigs, requires less resources, minimalizes surgery failure, reduces rework fees because errors in the system are detected in the initial software development stage, and requires less duration for surgery training. Compared to the conventional training, VR simulations is much more efficient in terms of skill trainings and resources. VR simulations could increase the visuospatial ability of a doctor so their knowledge about the human anatomy increases. Another advantage is that VR simulations allow doctors to practice new methods without fear of destroying the cadaver, this is good because it lets doctors to become more proactive.

Conclusion Usage of Virtual Reality in the medical field has not been used completely, even though there are many advantages in using this technology, whether i s about the price which is less expensive than other methods, or its easy application compared to other methods. We hope that by implementing this VR simulation, it could increase the surgical skills for doctors.

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Comparison of Serum and CSF Levels of S100B Protein as Biomarkers in Detection and Outcome Prediction of Traumatic Brain Injury: A Systematic Review Farah Aisha Shabrina1, Dhia Lintang Setya Wijoyo2, Valerie Afiyah Marzuki3 Introduction: The severity of patients with traumatic brain injury (TBI) primarily Glasgow Coma Scale (GCS) is a contentious issue. Recent studies are exploring the potential of biomarkers in the use of identification for TBI. Biomarkers may aid in determining whether a mild TBI patient requires a CT scan to identify intracranial pathology. The clinical outcome for a missed epidural hematoma in which the patient is either discharged or admitted is catastrophic; 25% are left severely impaired or dead. S100B protein is one of the proteins that has been profusely used as specific biomarkers of CNS tissue damage. Objectives: (1) To comparatively assess serum and CSF samples used to evaluate S100B as a useful biomarker of TBI; (2) To recognize outcome prediction of S100B after TBI. Methods: Our systematic review was conducted according to PRISMA flow diagram through PubMed database (n = 13). There were four relevant journals which meet our inclusion and exclusion criteria. We include studies within 5 years of publication dates and exclude paediatric and geriatric cases. Results and Discussion: This systematic review discusses measurements of serum and CSF levels of S100B to evaluate TBI cases. One study stated that a threshold of 0,7 g/dl in serum S100B was associated with 100% mortality, while another study showed that the median of 1 g/dl in CSF S100B was identified in survival time between 4h and 4d. However, this review was still unable to determine the most valuable measurement in detecting traumatic brain injury and its outcome. Conclusion and Recommendation: S100B has been shown to be able to grade the severity of injuries, as well as the outcome prediction. But the reference values of S100B concentration in CSF and serum are still debatable and need further investigations. We suggest that it is preferable to include other protein biomarkers in the evaluation of TBI cases.

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Unfavourable Prognosis Predictors of Traumatic Brain Injury Patients in Asian: A Systematic Review Elizabeth Marcella , Michelle Imanuelly 1Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia ABSTRACT Introduction Traumatic brain injury (TBI) is a ‘silent epidemic’, the main cause of hospitalization, death, and disability more than any other traumatic insult in the world. Surprisingly, TBI burden study in Asia is the highest compared to all other global regions due to TBI-related outcomes as a result of falls (77%) and other intentional injuries. Currently, no study has comprehensively reviewed the factors related to TBI prognostic specifically in Asian settings, though such review is desperately needed considering the high Road Traffic Injury (RTI) induced TBI prevalence in Asian population. Objective To assess comprehensive set of predictive TBI prognostic indicators in Asian Methods A systematic review was conducted through PubMed, Scopus, and CENTRAL, searching for cohort studies which analyze factors contributing to related with unfavorable prognosis of TBI Patients in Asia. Studies selected were then assessed for bias risk with STROBE’s criteria. Results The search yielded seven studies with a total of 1,940 subjects, consisting 6 cohort studies. Sociodemographic factors and clinical factors are two categories of factors associated with unfavorable prognosis of traumatic brain injury patients in Asian countries. The most consistent factors are age, GCS Score, and neurological comorbidity. Conclusions To conclude, the factors associated with unfavorable prognosis of traumatic brain injury patients in Asian countries are Age, Gender, Glasgow Coma Scale (GCS), neurological comorbidity, pH bleeding, pH respiratory distress, raised intracranial pressure (ICP), hypotension/ blood pressure, heart rate, hypoxia, and motor response. Future evaluation of current triage criteria in ED is hoped to establish the updated triage system in clinical setting, thereby helping to reduce the unfavorable prognosis of TBI patients in Asian countries. Keyword: traumatic brain injury, unfavorable outcome, Asia

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Unfavorable Prognostic Predictors of Traumatic Brain Injury Patients in Asia: A Systematic Review Elizabeth Marcella , Michelle Imanuelly 1Faculty

of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia

INTRODUCTION Traumatic brain injury (TBI) is a ‘silent epidemic’, the main cause of hospitalization, death, and disability more than any other traumatic insult in the world. Surprisingly, TBI burden study in Asia is the highest compared to all other global regions due to TBIrelated outcomes as a result of falls (77%) and other intentional injuries. Currently, no study has comprehensively reviewed the factors related to TBI prognostic specifically in Asian settings, though such review is desperately needed considering the high Road Traffic Injury (RTI) induced TBI prevalence in Asian population.

MATERIALS AND METHODS A systematic review was conducted through PubMed, Scopus, and CENTRAL, searching for cohort studies which analyze factors contributing to related with unfavorable prognosis of TBI Patients in Asia. Studies selected were then assessed for bias risk with STROBE’s criteria.

CONCLUSIONS To conclude, the factors associated with unfavorable prognosis of traumatic brain injury patients in Asian countries are Age, Gender, Glasgow Coma Scale (GCS), neurological comorbidity, pH bleeding, pH respiratory distress, raised intracranial pressure (ICP), hypotension/ blood pressure, heart rate, hypoxia, and motor response. Future evaluation of current triage criteria in ED is hoped to establish the updated triage system in clinical setting, thereby helping to reduce the unfavorable prognosis of TBI patients in Asian countries.

RESULTS AND DISCUSSIONS The search yielded seven studies with a total of 1,940 subjects, consisting 6 cohort studies. Sociodemographic factors and clinical factors are two categories of factors associated with unfavorable prognosis of traumatic brain injury patients in Asian countries. The most consistent factors are age, GCS Score, and neurological comorbidity. Author and Year (STROBE’s score)

Study Design

Study Population and Location

Predictor and Predicted P value Outcome

Ram et al, 2019 (_/22)

Cohort Prospective ( May to October 2017), data obtained from medical records

447 adult patients with TBI in King George Hospital, India

GCS, neurological injury, pH bleeding, pH respiratory distress. Lower GCS and presence of neurological injury, pH bleeding, and pH respiratory distress are indicative of unfavorable prognosis.

GCS <0.05, neurological injury <0.05, pH bleeding <0.05, pH respiratory distress <0.05

Lee et al, 2019

Cohort Retrospective (June 2011 to January 2017), data obtained from patients’ medical records

43 pediatric TBI patients in the National University Hospital of Singapore

Raised ICP and hypotension indicates unfavorable prognosis.

Raised ICP 0.008, hypotension 0.010

Ziaeirad et al, 2018 (_/22)

Cross-sectional, retrospective study (March 20, 2014 to March 19, 2015), data obtained from medical records

267 adult patients with severe TBI in three trauma centres of Isfahan University of Medical Sciences (IUMS)

Age, gender, GCS, Pupillary reflex, Hypernatremia, Raised ICP. Older age, male, lower GCS, abnormal pupillary response, hypernatremia, and raised ICP means unfavorable prognosis.

Age 0.001, gender 0.0054, GCS 0.001, Pupillary reflex 0.0005, Hypernatremia 0.0185, Raised ICP 0.0447

Okazaki et al, 2016 (_/22)

Cohort Retrospective (January 1, 2008 to October 31, 2015), data obtained from medical records

140 Patients ≥65 years old with severe TBI in Kagawa University Hospital

CCI, Age, GCS, Pupillary response, neurological deficit. Older age, lower GCS, abnormal pupillary response, and the presence of neurological disorder indicates unfavorable prognosis.

CCI 0.01, age <0.01, GCS <0.01, Pupillary response <0.001, neurological deficit <0.001

Park et al, 2009 (_/22)

Cohort Prospective (December 2004 to March 2006), data obtained from initial clinico-radiological data.

115 TBI Patients in Korea

Age, GCS, Pupillary response, neurological deficit, systolic blood pressure, heart rate, motor response. Older age, lower GCS, abnormal pupillary response, presence of neurological deficit, hypotension, and bad motor response indicates unfavorable prognosis

Age <0.001, GCS <0.001, pupillary response <0.001, neurological deficit <0.001, systolic blood pressure <0.05, heart rate 0.05, motor response <0.05

Oh HS et al, 2006 (_/22)

Cohort Prospective (1and 6- months period), data obtained from medical records

82 TBI patients in Neurological Intensive Care Unit at a university hospital

Age <0.05, intracranial hematoma <0.05, systolic blood pressure <0.05, heart rate 0.05, motor response <0.05

Jiang et al, 2002 (_/22)

Cohort Retrospective 846 Patients in China (January 1991December 1998), data obtained from medical records

Age, intracranial hematoma, systolic blood pressure, heart rate, motor response. Older age, presence of intracranial hematoma, low blood pressure/ hypotension, and bad motor response were indicative of unfavorable prognosis. GCS Score, Age, Pupillary response, Hyperthermia, Hypoxia, High ICP. Lower GCS, older age, abnormal pupillary response, hyperthermia, hypoxia, and high ICP indicates unfavorable prognosis

REFERENCE 1. 2. 3. 4. 5. 6.

Lee E, Hung Y, Wang L, Chung K, Chen H. Factors Influencing the Functional Outcome of Patients with Acute Epidural Hematomas. The Journal of Trauma: Injury, Infection, and Critical Care. 1998;45(5):946-952. Alimohammadi N, Ziaeirad M, Irajpour A, Aminmansour B. Association between Outcome of severe traumatic brain injury and demographic, clinical, injury-related variables of patients. Iranian Journal of Nursing and Midwifery Research. 2018;23(3):211. Park J, Kim S, Yoon S, Cho K, Kim S. Risk Factors Predicting Unfavorable Neurological Outcome during the Early Period after Traumatic Brain Injury. Journal of Korean Neurosurgical Society. 2009;45(2):90. Ram K, VaraPrasad K, Krishna M, Kannan N, Sundar V, Joseph M et al. Prehospital Factors Associated with Discharge Outcomes: Baseline Data from the Andhra Pradesh Traumatic Brain Injury Project. World Neurosurgery: X. 2019;2:100020. Oh H, Seo W, Lee S, Song H. Comparisons of the Prognostic Predictors of Traumatic Brain Injury According to Admission Glasgow Coma Scale Scores-Based on 1- and 6-month Assessments. Journal of Korean Academy of Nursing. 2006;36(4):621. Jiang J, Gao G, Li W, Yu M, Zhu C. Early Indicators of Prognosis in 846 Cases of Severe Traumatic Brain Injury. Journal of Neurotrauma. 2002;19(7):869-874.

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GCS Score, Age, Pupillary response, Hyperthermia, Hypoxia, High ICP <0.05

THE APPLICATION OF CARBOXYMETHYL CELLULOSE FOR CORNEAL EPHITELIAL WOUND HEALING A Systematic Review Maudy Rominar Br Tobing, Michelle Gracella, Clara Siahaan Faculty of Medicine and Health Science, University of Jambi â&#x20AC;&#x201C; Jambi, Indonesia

Aim: to present references for health-care provider in Indonesia can use to arrange Disaster Medicine. Background: Carboxymethylcellulose (CMC), a high-molecular-weight polysaccharide, is one of the most common viscous polymers used in artificial tears to achieve their prolonged residence efficacious in the treatment of aqueous tear-deficient dry eye symptoms and ocular surface staining. The physical properties of CMC such as its viscous and mucoadhesive properties, that contributes to its prolonged retention time in the ocular surface. CMC can also effectively reduce the incidence of epithelial defects through stimulating epithelial cell migration. Materials and Method: We use systematic review from PubMed as source. Keywords: carbxylmethyl cellulose, corneal epithelial cells, wound healing. Criteria for the literature searching: (1) free full text, (2) from the last 5 years Results and Discussions: According to research conducted by Lee (2015) it is showed that CMC stimulated reepithehlialization of human corneal epithelial cells scratched. In research by Moon (2016), a focal desquamation of the corneal epithelial lining was significantly increases in the damaged epithelial regions compared with the intact control. Vinklarkova also conducted a research in 2015 and found that observation of microscopic appearance of prepared films confirmed that partially substituted CMC maintained fibrous natureâ&#x20AC;&#x201D; digital images showed well-marked microfibrous structures. The concentration of ibuprofen which was incorporated as an acetone solution or as a suspension in a sodium carboxymethylcellulose dispersion was 0.5 mg/cm2 and 1.0 mg/cm2 of film. Results showed that developed films had adequate mechanical and swelling properties and an advantageous acidic surface pH for wound application.

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Conclusion: CMC showed more wound healing effect, presumably due to relatively high concentration and more balanced electrolytes. From all the studies above, we conclude that CMC can be an alternative for wound healing agent for epithelial corneal injury. Also, we recommend for a further study.

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TILAPIA SKIN AS A XENOGRAFT FOR SKIN BURN Indrawati1, Stefanie Belinda2, Josephine Passareta R.F.N.3 Introduction Skin burns are ranked fourth of all injuries in Indonesia. A large skin burns may increase disability-adjusted life years, physical, psychological and economic loss, as well as mortality. Marine and freshwater biota in Indonesia are natural resources for various illness. This study aimed to determine the use of tilapia (a freshwater fish) skin as a xenograft for skin burn. Materials and Methods This study used literature review with keywords skin burns and natural resources, critical appraisal and epidemiology of burns in Indonesia. There were seven articles from international journal that met critical appraisal of evidence-based, including validity, results and applicability. Tilapia is cultivated in 83 countries, and Indonesia was ranked third for approximately 20.3%

tilapiaâ&#x20AC;&#x2122;s

production

worldwide.

Treatment of burns using tilapia is quite easy. Tilapia skin is cleaned and sterilized, followed by irradiation to kill harmful microorganism using UV rays emitted by radionuclides or electron beam of electrical charged particles. The processed tilapia skin is then placed directly on the affected part of the burn and covered with a bandage. Results and Discussion Several case reports and clinical trials indicated that tilapia skin as a xenograft yielded a similar mean treatment time, reduced pain, and did not require dressing replacement at any time during treatment, compared to silver-based hydrofiber dressing in the treatment of second degree burns in adults. This is possible since Tilapia skin contains high type 1 of collagen, which is useful for creating new networks to replace burned tissue. In addition, tilapia skin is also rich in omega 3 antioxidant to reduce inflammation. This remedy can be used for second and third-degree burns.

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Conclusion This study gives a comprehensive overview on the use of tilapia skin as a xenograft for skin burns. Tilapia skin speed up the healing process, reduced pain and cost compared to standard treatment. Keywords: Tilapia skin, xenograft, natural resources References 1. Abdullah, M. and Firmansyah, M.A., 2012. Critical appraisal on journal of clinic trials. Acta medica Indonesiana, 44(4), pp.337-343. 2. Alves, A.P.N.N., Lima Júnior, E.M., Piccolo, N.S., de Miranda, M.J.B., Lima Verde, M.E.Q., Ferreira Júnior, A.E.C., de Barros Silva, P.G., Feitosa, V.P., de Bandeira, T.J.P.G., Mathor, M.B. and de Moraes, M.O., 2018. Study of tensiometric properties, microbiological and collagen content in nile tilapia skin submitted to different sterilization methods. Cell and Tissue Banking, 19(3), pp.373-382. 3. Costa, B.A., Lima Júnior, E.M., De Moraes Filho, M.O., Fechine, F.V., De Moraes, M.E.A., Silvia Júnior, F.R., Do Nascimento Soares, M.F.A. and Rocha, M.B.S., 2019. Use of Tilapia Skin as a Xenograft for Pediataric Burn Treatment: A Case Report. Journal of Burn Care and Research, 40(5), pp. 714-717. 4. Lima-Junior, E.M., de Moraes Filho, M.O., Costa, B.A., Fechine, F.V., de Moraes, M.E.A., Silvia-Junior, F.R., Soares, M.F.A. do N., Rocha, M.B.S. and Leontsinis, C.M.P., 2019. Innovative treatment using tilapia skin as a xenograft for partial thickness burns after a gunpowder explosion. Journal of Surgical Case Reports, 6, pp.1-4. 5. Miranda, Marcelo J.B., 2018. Nile tilapia skin xenograft versus silver-basedhydrofiber dressing in the treatment of second-degree burns in adults. Original Articles, pp.80-85 6. Nurainas, Hidayat I., Gustiano R., Thontowi A., Yulita K.S., Siregar E.S., Lisdiyanti P., Mahfud M.C., Mirmanto E., Syahid S.F., Tanjung L.R., Ali F. Berita Biologi - Jurnal Ilmu-Ilmu Hayati. 16th ed. Bogor: Pusat Penelitian Biologi - LIPI; 2017. 7. Wardhana, A., Basuki, A., Prameswara, A.D.H., Rizkita, D.N., Andarie, A.A. and Canintika, A.F., 2017. The epidemiology of burns in Indonesia’s national referral burn center from 2013 to 2015. Burns Open, 1, pp.67-73.

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The Efficacy of Blood Transfusion in Damage Control Resuscitation (DCR) As a Non Invasive Life Saving Procedure for Severely Hemorrhagic Patients Anju Nadine Tiarma Putri Pardede1, Bethaniel Roy Matthew1 1Faculty

of Medicine, Universitas Kristen Indonesia Abstract

Injuries contribute to around 10% of total deaths and 15% of disability-adjusted life-years. Road traffic injuries (RTIs) place a huge burden on the health sector in terms of prehospital care, acute care, and rehabilitation. According to Indonesia Health Profile 2017. Health crisis due to natural disasters was the most frequent incident in Indonesia in 2017 with a percentage of 72%. The remaining 27% were non-natural disasters, and only 1% of all disasters was included in social disasters. Most of the deaths occur due to poor decision and inappropriate interventions. Studies search were conducted by using search engine such as PubMed, Google Scholar, and NCBI â&#x20AC;&#x153;massive transfusion protocolâ&#x20AC;? with the criteria of studies which published 2005-2019 and related to this topic. An estimated 10-20% of these deaths are potentially preventable with better control of bleeding.The mortality rate associated with Acute Trauma Coagulopathy (ATC) is increasing along with ISS (Injury Severity Score).Recent study that has been conducted by Holcomb JB et al found the evidence of the primary trial outcomes of mortality at 24 hours and 30 days were obtained on 100% and 99.4% of patients, respectively. No significant differences in mortality were detected at 24 hours. The pioneering data for a balanced ratio of PRBCs and FFPs came from military experience, where the survival of combat hospital patients receiving variable ratios of FFP:PRBC was studied. The survival of patients receiving FFPs in a 1:8 ratio compared to PRBCs was dramatically higher than those receiving FFPs in a 1:1.4 ratio (92.5% vs 37%, p < 0.001). DCR methods to resuscitate correcting coagulopathy and has shown to improve the chances of survival in the exsanguinating trauma patient by reversing the lethal trias of death by including permissive hypotension, body rewarming, minimization of fluid resuscitation, and early balanced administration of blood and blood products.

324

The Efficac Re ci a i P ced e f

f Bl d T a f i i Damage C l (DCR) A a N I a i e Life Sa i g Se e el Hem hagic Pa ie

A j Nadi e Tia ma P Fac l

10%

f Medici e, U i e i a K i e I d

15%

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i Pa dede, Be ha iel R

HO, RTI , I H

2017,

72%. T

2017

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.R , I 2,263

Figure 2. Survival time of severe haemorrhage patient with Massive Transfusion (MT)

Figures 3. Precentage mortalit associated with low, medium, and high plasma to RBC rati

T .T ,

. E .D

CNS

. D

(DCR) (IC ). DCR IC

DCS.5 DCR

, .A .20 T

DCR

, , ,

, .

The traditional view of resuscitation is focussed on fulfilling the loss of volume rather than the clotting process itself. The use of cr stalloid or colloid fluid can t be used to replace the loss of coagulation factors that has been reduced b the blood loss. Thus, this will increase the mortalit rate of the patient with sever haemorrhagic condition. The mortalit rate associated with Acute Trauma Coagulopath (ATC) is increasing along with ISS (Injur Severit Score) (Figure 1).Recent stud that has been conducted b Holcomb JB et al found the evidence of the primar trial outcomes of mortalit at 24 hours and 30 da s were obtained on 100% and 99.4% of patients, respectivel . No significant differences in mortalit were detected at 24 hours (12.7% in the 1:1:1 group vs 17.0% in the 1:1:2 group; difference, 4.2% [95% CI, 9.6% to 1.1%) or at 30 da s (22.4% vs 26.1%, respectivel ; difference, 3.7% [95% CI, 10.2% to 2.7%).

Studies search were conducted b using search engine such as PubMed, Google Scholar, and NCBI with ke word Damage Control Resuscitation , hemorrhagic shock , fluid resuscitation , massive transfusion protocol with the criteria of studies which published 2005-2019 and related to this topic.

One of the main pillars of DCR is earl and aggressive transfusion of blood products aiming for a ratio of PRBCs, FFP, and platelets that appro imates 1:1:1. The pioneering data for a balanced ratio of PRBCs and FFPs came from militar e perience, where the survival of combat hospital patients receiving variable ratios of FFP:PRBC was studied. In this retrospective stud , the survival of patients receiving FFPs in a 1:8 ratio compared to PRBCs was dramaticall higher than those receiving FFPs in a 1:1.4 ratio (92.5% vs 37%, p < 0.001) Balanced blood product administration in haemorrhagic patients has shown results of augmentation of coagulation factors, lower chance of e acerbation of dilutional coagulopath , and less bleeding. Earl administration of blood products in addition to packed red blood cells (PRBCs) can help prevent trauma-related coagulopath once the patient is recogni e to have massive haemorrhage.

The successful resuscitation of the massivel bleeding and unstable trauma patient will depend on effective trauma team leadership, identification of earl trauma-related coagulopath , sound decision-making in the emergenc and operating rooms . DCR methods to resuscitate correcting coagulopath and has shown to improve the chances of survival in the e sanguinating trauma patient b reversing the lethal trias of death (trauma) b including permissive h potension, bod rewarming, minimi ation of fluid resuscitation, and earl balanced administration of blood and blood products.

The mortalit rate associated with Acute Trauma Coagulopath (ATC) is increasing along with ISS (Injur Severit Score) (Figure 1).

1. Chatrath V, Khetarpal R, Ahuja J. Fluid management in patients with trauma: Restrictive versus liberal approach. J Anaesthesiol Clin Pharmacol. 2015;31(3):308 316. 2. Indonesia Health Profile 2017. Ministr of Health Indonesia Republic. 2018 3. Ball, CG, Dente, CJ, Sha , B: The impact of a massive transfusion protocol (1:1:1) on major hepatic injuries: Does it increase abdominal wall closure rates? Can J Surg 2013;56(5):E128 E134. 4. Khan, S, Allard, S, Weaver, A: A major haemorrhage protocol improves the deliver of blood component therap and reduces waste in trauma massive transfusion. Injur 2013;44(5):587 592. 5. J Trauma. Brooke Arm Medical Centre. 2007 Oct;63(4):805-13 6. M

M. A

M . 2010;1(1):12 21.

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â&#x20AC;&#x153;Effectiveness of Damage Control Resuscitation in Trauma Managementâ&#x20AC;? Ardhito Rahadian, Chatrine Angelica D C, Kharisa Octosari Introduction Damage control resuscitation (DCR) is known as a strategy used to restore homeostasis in a short time in patients suffering from hemorrhagic shock. These strategies include permissive hypotension and restrictive fluid administration, hemostatic resuscitation, reheating, acidosis correction and early bleeding control.. DCR begins immediately after a rapid initial assessment in the emergency room and is developed through the operating room to the ICU in combination with Damage control surgery (DCS). Materials and methods This research is based on literature review that were collected from several journal in PubMed and Research Gate. The keywords used for this literature are "damage control resuscitation", "trauma" and "effectiveness". This literature review aims to evaluate effectiveness of DCR in trauma case. Results and discussion DCR directly addresses the trauma-induced coagulopathy immediately upon patient admission or in the pre-hospital setting. DCR consists of balanced resuscitation, hemostatic resuscitation, and prevention of acidosis, hypothermia, and hypocalcemia. In children with severe trauma, complications after aggressive resuscitation with volume 22 have also been reported. Thus, in a study evaluating resuscitation practices in 139 children with closed trauma and ISS â&#x2030;Ľ 12, it was observed that 12% presented complications attributable to resuscitation with fluids. In children with severe trauma and hemorrhagic shock , the administration of high volumes of crystalloids during resuscitation negatively influenced the clinical course, which could imply a higher mortality, as well as causing early coagulopathy Conclusion DCR helps immediate correction of specific coagulopathies induced by hemorrhage and management of several extreme homeostatic imbalances that may appear in the aftermath of resuscitation. Trauma resuscitation must address all three components of the "lethal triad":

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coagulopathy, acidosis and hypothermia. Damage control resuscitation integrates permissive hypotension, haemostatic resuscitation, and damage control surgery

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The Future Prospect of Combination between Dynamic Intraligamentary Stabilization (DIS) and Bio-Enhancement Technique for Treatment of Anterior Ligament Injury Junoretta Haviva Ernanto1, Abdullah Farooqi2, Arini Nurul Hidayah3 Faculty of Medicine, Universitas Sriwijaya ABSTRACT Introduction The anterior cruciate ligament (ACL) is one of two cruciate ligaments which aids in stabilization of the knee joint.1,2 Injury to the anterior cruciate ligament (ACL) is one of the most devastating and frequent injuries of the knee.2 ACL sprains and tears are common knee injuries with a reported incidence of 100,000 to 200,000 000 in the United States and 48 out of 1000 cases of knee injury in Indonesia every year, making ACL injury the most common ligament injury.2,3

600

Number of cases

500 400 300 200 100 0 10-14

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

Age (years) Men

Woman

Figure 1. Distribution of patient in Norwegian knee ligament registry by age and gender indicates number of ACL reconstructions.4

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Currently, gold standard treatment for an ACL injury is ACL reconstruction (ACLR). Although the majority of ACLR surgeries successfully restore gross joint stability, post-traumatic osteoarthritis is commonplace following these injuries, even with ACLR. 1,2,5,6 Recently, primary ACL repair, one of surgical treatment of ACL injury, has become an option to perhaps better restore native ACL anatomy, biomechanics, and neurosensory function.7,8 Inspite of ACLR and ACL repair are the current treatment now, both of the treatment have not gone through significant development and refinement. In order to improve the outcomes and reduce re-ruptures, combination of mechanical especially dynamic inttraligamentary stabilization (DIS) and biological environment will be compared in this poster.7,8,9 Materials and Method This research will be carried out using literature review related to ACL injury, and management therapy of ACL injury from NCBI, Sciencedirect, and Pubmed. Only studies conducted from 2009-2019 included in this review. Result and Discussion Compared clinical and radiographic outcomes between primary ACL repair and reconstruction at a minimum 2-year follow-up concluded that primary repair could restore stability and yield good functional outcomes compare to that of reconstruction. Combination of ACLR and internal bracing allowed for an effective biologic-synthetic hybrid load-sharing ACL construct and prevented early failure. Beside, ACL repair augmented by internal brace allowed patient to have functional stability near-normal knee function.7 Study

Design Patients

Avarage

Bio-

Surgical

Rate of

age (yr)

enhancement

Procedure

reoperation

techniques

on ACL

Bone marrow

ACL

stimulation

perforation

Bone marrow

ACL

stimulation

perforation

Included

Study Steadman et al. Case

series Steadman et al. Case

series

330

23.1% 8.9%

Wasmaier et

Case

al.

series

Evangelopoulo

Case

us et al.

control Control:3

Study: 23

30.5 30

Bone marrow

ACL

36%

stimulation

perforation

Collagen

DIS repair

Microfracturin

Suture and

2.9%

DIS

Microfracturin

Suture and

DIS

BEAR

Suture

membrane

3 Henle et al.

Case

32.4

series Eggli et al.

Case

23.3

series Murray et al

Cohort Study:10

Control:1

20% 0%

Scaffolded

0 Table 1. Summary of clinical studies about the non-reconstructive treatment of complete ACL tear with biological enhancement in clinical and preclinical studies.9 Conclusion Although, the efficacy of biological enhancement cannot be validated because of low level of evidence of included studies, combination between biological enhancement and primary ACL repair with dynamic intraligamentary stabilization has potential to become the treatment of ACL injury in future. The combination of collagen membrane and DIS repair has the lowest rate of reoperation in this poster.

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The new trauma score (NTS): a modification of the revised trauma score for better trauma mortality prediction. Jin Hee Jeong,Yong Joo Park,Dong Hoon Kim, Tae Yun Kim, Changwoo Kang,Soo Hoon Lee, et al I.

Introduction : An method for assessing the severity of a wound qualitatively that use to determine the degree of injury, because the assessment of the degree of injury can provide objective information. RTS is a convenient tool for trauma triage and initial severity estimation does not require medical tests or devices and especially useful in emergency department. This physiological scoring system consists of (GCS), systolic blood pressure (SBP) and respiratory rate (RR). The parameters are converted to coded values (0-4), This study was to evaluate the performance of the NTS for in-hospital mortality compared to RTS, MGAP and GAP and to provide a proper triage tool during the initial phase of trauma management because RTs still experience weaknesses in components, so NTS has more perfect components.

II.

Materials and Methode a. Materials

Therefore, this new trauma score based on recent developments in the trauma setting. the revision of the systolic blood pressure interval used for the code value and the incorporation of SpO instead of RR. We termed this measure NTS. b. Methode Use study design and participants

this is a prospectively recorded

registry-based observational study using data from the trauma registry of a tertiary hospital located in Jinju, Republic of Korea.

333

III.

Results and Discussion a. Results The NTS vs. the RTS, MGAP, GAP. NTS showed better discrimination than the RTS. In cohort, MGAP, and GAP (Table 2)

b. Discussion We found that the NTS significantly outperformed the RTS in mortality prediction of trauma patients but did not exceed the MGAP and GAP. At the fixed rate of 5% undertriage (sensitivity 95%).1234 IV.

Conclusion The NTS predicts in-hospital mortality substantially better than the RTS and not inferior. We hope that NTS will be useful for triage in trauma patients and will lead to an improvement in trauma management.

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Outcome of Cervical Spinal Cord Injury Treatment in Developed and Developing Countries A Systematic Review Fandi Hendrawan, Prasista Ariadna Kusumadewi Background

Cervical spinal cord injury (CSCI) is the most catastrophic event with the highest rates of morbidity and mortality. Thus, CSCI patients need neurosurgery treatment which is costly and burdened low-income communities and countries. This systematic review aims to compare the outcome of CSCI management between developing and developed countries.

300

350

Post-Operative Patients Status

250

300 200

250

Methods

This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Pre-Operative Patients Status

400

Cases

Developing Countries

Developed Countries

Result

Cases

200 150

150

100

100 Records identified through MEDLINE using PUBMED (n = 351)

Additional records identified through EBSCO (n = 13)

0 Records after duplicates removed (n = 364)

4 Records excluded (n = 300)

Records screened (n = 64) Full text articles excluded 1) Non-cohort studies 2) Non traumatical subaxial cervical SCI case 3) Studies unrelated to subaxial cervical SCI treatment (n = 49)

Full-text articles assessed for eligibility (n = 15) Full-text articles excluded due to not using AIS Grade (n = 2)

Studies included in qualitative synthesis (n = 13)

50 AIS A

AIS B

AIS C

AIS D

Discussion

RTA is the most common cause of CSCI cases. Because of the RTA usually gives a high energy to spinal vertebra, the injury of cervical spinal cord may occur. In developed countries, RTA is common. Meanwhile, in developing or low income countries, RTA is often either never happened. But, CSCI also can be occurred when a person accidentally injured their neck, like falling from a tree. The severity of injury can be measured with American Spinal Injury Association Impairment Scale (AIS) with range from grade A to E. AIS grade A is the most severe form of spinal cord injury which affects both motor and sensory system of the body. Hence, tetraplegia is occurred. From the result, AIS grade A is commonly found in developing and low-income countries. This indicates in developing countries, CSCI treatment is needed. To give a best outcome of CSCI treatment, there are some factors which contribute in for a better outcome: facilities, pre-hospital treatment, time for surgery, transportation, and expert neurosurgeon. In low-income and developing countries, these components are limited, especially in rural areas. Insufficient paramedics, faraway hospital

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Better Outcome

No Progress

Worse Outcome

Death

Conclusion

Most high-income and developed countries can give a better treatment for CSCI patients. Therefore, patients’ quality of life can be improved even can not be perfectly improved since the limited repairing system of neuron itself. Meanwhile, low-income and developing countries still have limited facilities to give a better outcome for CSCI patient.

Recommendation

from the accident location, poor public facilities Development of non-surgery treatment is and transportation in these countries may play a role in AIS grade before treatment. Lack of these needed to prevent more complication in CSCI pacomponents may worse the patient condition and tients, especially in low-income and developing give a higher chance to develop to AIS grade A. In countries. This treatment can be used in develdeveloped countries, AIS grade A is also common oped countries since the existence of low-income happened, but, with better pre-hospital manage- communities also needs a cheap treatment if they ment in these countries, the number of patients is accidentally injure their spinal cord. lower than in developed countries. 7 Limitation Currently, surgery is the most favorable The limitation of this study that the evitreatment for CSCI patient. Therefore, limited dences and reports from developed countries are expert neurosurgeon also plays a role in AIS grade still low. after treatment. A better outcome is also not References promised since in the developed countries face a 8 Adeolu AA, Ukachukwu A-EK, Adeolu JO, Adeleye AO, Ogbole GI, Malomo AO, et al. Clinical outcome of closed similar, but a better, condition. Perhaps, medical 1.reduction of cervical spine injuries in a cohort of Nigerians. Spinal Cord Series and Cases [Internet]. 2019 Dec 2019 Oct 1];5(1). Available from: http://www.nature.com/articles/s41394-019-0158-z facilities, like magnetic resonance imaging (MRI), [cited 2.Dru AB, Reichwage B, Neal D, Vaziri S, Lockney DT, Fox WC, et al. Race and socioeconomic disparity in treatment outcome of traumatic cervical spinal cord injury with fracture: Nationwide Inpatient Sample database, operation room, in developing countries are also and 1998–2009. Spinal Cord [Internet]. 2019 Apr 16 [cited 2019 Oct 1]; Available from: http://www.nature.com/artilimited in these countries arise a worse outcome cles/s41393-019-0280-6 3.Furlan JC, Craven BC, Massicotte EM, Fehlings MG. Early Versus Delayed Surgical Decompression of Spinal Cord after Traumatic Cervical Spinal Cord Injury: A Cost-Utility Analysis. World Neurosurgery. 2016 Apr;88:166–74. than pre-operative condition. Meanwhile, in devel- 4.Kreinest M, Ludes L, Türk A, Grützner PA, Biglari B, Matschke S. Analysis of prehospital care and emergency room treatment of patients with acute traumatic spinal cord injury: a retrospective cohort study on the implementaof current guidelines. Spinal Cord. 2017 Jan;55(1):16–9. oped countries, a better outcome is expected since tion 5.Löfvenmark I, Norrbrink C, Nilsson-Wikmar L, Hultling C, Chakandinakira S, Hasselberg M. Traumatic spinal cord in Botswana: characteristics, aetiology and mortality. Spinal Cord. 2015 Feb;53(2):150–4. the availability of these facilities and neurosur- injury Medress Z, Arrigo RT, Hayden Gephart M, Zygourakis CC, Boakye M. Cervical Fracture Stabilization within 72 Hours Injury is Associated with Decreased Hospitalization Costs with Comparable Perioperative Outcomes in a geons are adequate. But, in both countries, death ofPropensity Score-Matched Cohort. Cureus [Internet]. 2015 Jan 28 [cited 2019 Oct 1]; Available from: http://www.cur e u s . c o m / a r t i c l e s / 2 7 0 5 - c e r v i c a l - f r a c t u r e - s t a b i l i zation-within-72-hours-of-injury-is-associated-with-decreased-hospitalization-costs-with-comparable-periope rative-outcomes-in-a-propensity-score-matched-cohort

Effectiveness of Novel Trauma Scoring Systems in Predicting Survival of Patients with Traumatic Injury: A Systematic Review Wahyuda Nuzul Fahmi1, Paulina Lusty Artanti2, Azyumar Luthfi Muhammad Alfariz3 1

Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada

Introduction: Trauma still becomes the main concern in the medical field to reduce its number and increase patientsâ&#x20AC;&#x2122; survival. To objectify this goal, trauma scoring systems were invented. One of them is the Revised Trauma Score (RTS). In the last decade, a better scoring, MGAP (Mechanism, Glasgow Coma Scale, Age, and Arterial Blood Pressure) and GAP (Glasgow Coma Scale, Age, and Arterial Blood Pressure), start to replace RTS in use. This systematic review aims to compare the effectivity of novel trauma scoring system, MGAP or GAP, with RTS or TRTS to predict the survival of patients with a traumatic injury. Materials and Methods: This systematic review is organized according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement 2009 Checklist and applied Population, Intervention, Comparison, and Outcome (PICO) approach. The databases used are Scopus, PubMed, ScienceDirect, ClinicalKey, EBSCOhost, and PMC by using specific keywords. The risk of bias was assessed using the JBI Systematic Reviews Checklist for Case Series and Cohort Studies. Oxford Centre for Evidence-Based Medicine â&#x20AC;&#x201C; Level of Evidence was used to determine the level of evidence of the studies. Results and Discussion: Searches yielded 41 studies, 8 studies met the inclusion criteria. There were 3 prospective studies and 5 retrospective studies. The studies evaluated in correlation with in-hospital and prehospital mortality, mortality and severity prediction accuracy, and discrimination ability. 6 studies showed MGAP had the highest AUC compare to GAP, RTS, and T-RTS. MGAP and GAP showed no significant differences in performance. Conclusion: MGAP and GAP have better performance than RTS statistically in prehospital and in-hospital mortality and severity. This score potentially provides a more feasible mean of estimating injury severity in low-middle income countries, further validation required to applicate the score.

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The Role of Tranexamic Acid (TXA) in Minimizing Mortality of Traumatic Brain Injury Amalia Dwi Mulyani, Satria Angga Widitama, M. Abdurrahman Ar-Rizqi AMSA-Universitas Padjadjaran INTRODUCTION Traumatic brain injury (TBI) has a high mortality and disability rate, therefore, constitutes a major problem worldwide. The condition seriously impacts the life quality and health of young adults, with a disproportionate burden of disability and death occurring in low-income countries including Indonesia. Intracranial bleeding is a common complication in patients with TBI. Some intracranial hemorrhages expand after hospital admission, leading patients to undergo surgery and even higher mortality rates. MATERIALS AND METHODS Literatures were obtained through online databases (Google Scholar, NCBI, Clinical Key, and Lancet) published until December 2019. Search terms include Tranexamic acid, traumatic brain injury, and intracranial bleeding. RESULTS AND DISCUSSION No adverse events related to TXA was reported in CRASH-2 (Clinical Randomization of an Antifibrinolytic in Significant Haemorrhage) Intracranial Bleeding Study. There are four cases of in hospital thromboembolic events were documented in the placebo group, but none was reported in the TXA group, in the study by Yutthakasemsunt et al. There was no significant increased risk of thromboembolic events in patients allocated to TXA in CRASH-3. Our results show that tranexamic acid is safe in patients with TBI and that treatment within three hours of injury more effectively reduces head injury-related death. CONCLUSION Traumatic Brain Injury is commonly caused by road-traffic accident, falls, sports injuries, and assaults. It is one of the most common causes of death in traffic accidents. The cause of mortality of TBI is intracranial bleeding and cerebral ischemia. Tranexamic acid is an antifibrinolytic agent that can prevent complications from happening. The effects to minimize death and safety of this drug to TBI patient has been proven.

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Combining Protein as Biomarker for Detecting Brain Lesion in Mild Traumatic Brain Injury : Foundation of Point-Of-Care Testing (POCT) Tool Putu Dipa Septa Irawan, Dreimahlon Tumonggor, Satria Addienul Haq, Annnisa Nur Insani

Introduction Mild Traumatic Brain Injury (mTBI) reported internationally from 100 to 749 cases per 100,000 people per year. Currently, mTBI prevalence in Indonesia also has risen sharpy, the patients are taken to hospital to check for any lesion in brain, which can lead to fatal damage in the future. Until now, the only reliable diagnostic tool in mTBI cases are CT scan. Unfortunately, CT scan in mTBI patients are widely overused in Indonesia, as 100% results with no brain detected. This is lead high medical costs and exposed patients to unnecessary irradiation. Therefore, an alternative biomarker is needed. Interestingly, combination of some proteins result in a great performance in detecting brain lesion in mTBI. Materials and Method The articles collected were thoroughly selected and assessed, resulting in seven literatures correlating with our focus of topic. Result and Discussion After some research, we found out two best study that represent the best performance. From both study, we comparing the best performing protein panels is H-FABP, GFAP, and IL-10 and H-FABP, S100B, and Tau. Overall, based on our analysis, combination of H-FABP, GFAP, and IL-10 in 90-100% sensitivity is the best performing biomarker as it shows highest specificity than any other protein combinations, we are sure that as the sensitivity is high enough, a slight decrease in sensitivity is better if it increase the specificity as it ensure that the proteins comes from brain, there is also less research about Tau protein. Hopefully, this finding may later be the foundation for a point-of-care testing tool. Conclusion From this literature review, we were able to conclude that combining of H-FABP, GFAP and IL-10 results the best in performance to detect the brain lesion in mTBI. This biomarker may

343

then develop and improve In erna ional

health system including Indonesia in the treatment of

mTBI patients.

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Combining Protein as Biomarker for Detecting Brain Lesion in Mild Traumatic Brain Injury (mTBI) : Foundation of Point-Of-Care Testing (POCT) Tool Putu Dipa Septa, Dreimahlon Tumonggor, Satria Addienul Haq, Annisa Nur Insani

1 Mild Traumatic Brain Injury (mTBI) is an acute brain injury diagnosed from clinical symptoms (loss of consciousness for 30 minutes less and a post-traumatic amnesia for less than 24 hours) and Glasgow Coma Scale (GCS) scores between 13 and 15.1 Internationally, reported rates of mTBI vary widely, from 100 to 749 cases per 100,000 people per year and it accounts for 80-90% of all TBI. 2,3 In Indonesia, TBI has risen sharply including mTBI. However, until now, the only reliable diagnostic tool in any TBI cases is CT scan, which is widely overused in mTBI patients as a study in Indonesia showed 100% result in no brain lesion detected. It lead to high medical costs and exposed patients to unnecessary irradiation.4,5 Therefore, an alternative biomarker is needed. Current studies are evaluating various kinds of proteins in CT-positive and CT-negative mTBI patients results in which some proteins are found to be higher in CT-positive. Interestingly, combination of those proteins result in a great performance by increasing it sensitivity and specificity as biomarker to detect the brain lesion. Furthermore, this combination may be useful to develop a point-of-care testing tool.6

MATERIALS & METHODS The method used for this study is literature review. The authors conducted a literature search in Science Direct, Medline, PLOS ONE and Google Scholar. Keywords included ‘mild-Traumatic Brain Injury’ and ‘biomarkers’. The articles collected were thoroughly selected and assessed, resulting in seven literatures correlating with our focus of topic.

RESULTS & DISCUSSION Table 1. The best-performing panel combinations in Geneva, Seville, and Barcelona. 6

Sensitivity (95% CI)

Panel Size

Biomarkers

2 Parameters

H-FABP & GFAP

100 (100-100)

3 Parameters

H-FABP, GFAP, & IL-10

100 (100-100)

Specificity (95% CI) 46,9 (36,0 - 55,0) 52,3 (43,2 - 61,3)

Table 2. The best-performing panel combinations in Finland. 7

Sensitivity (95% CI)

Specificity (95% CI)

Panel Size

Biomarkers

2 Parameters

H-FABP & Tau

100 (100-100)

58,3 (41,7 - 75,0)

3 Parameters

H-FABP, GFAP, & IL-10

94,7 (84,2-100)

69,4 (55,6 - 83,3)

100 (100-100)

66,7 (50,0 - 80,6)

H-FABP, S100B, & Tau

After evaluating some proteins as biomarker, we found out that combining proteins result in significantly higher specificity which can be an efficient way to avoid CT-scan. The proteins used in the panels are up to three proteins to avoid higher medical cost.5 From both study, we found out that at 100% sensitivity, there are two studies that show great performances as biomarker, first is H-FABP, GFAP, and IL-10 with 52,3% specificity (Table 1), the other study is H-FABP, S100B, and Tau with 66,7% specificity (Table 2). At 90-100% sensitivity, there is also H-FABP, GFAP, and IL-10 that has 69,4% specificity (Table 2). Second study shows higher specificity, but there are still consideration about which one we have to choose between higher specificity or sensitivity.5,7 Finally, based on the analysis that we have conducted, combination of H-FABP, GFAP, and IL-10 in 90-100% sensitivity is the best performing biomarker as it shows highest specificity than any other protein combinations, we are sure that as the sensitivity is high enough, a slight decrease in sensitivity is better if it increase the

specificity. In other hand, we also considering there are still less research about the Tau protein. In further studies, we are suggested to do more research against these protein widely in population and time in order to develop these proteins as biomarker. Hopefully, this finding may later be the foundation for a point-of-care testing tool which is easy to perform, require low medical costs, and lead to greatly reduce in time spent analyzing and deciding.

CONCLUSION From this literature review, we were able to conclude that combining of H-FABP, GFAP and IL-10 results the best in performance than any protein combination to detect the brain lesion in mild traumatic brain injury (mTBI). This biomarker may then develop and improve International’s health system including Indonesia in the treatment of mTBI patients.

REFERENCE 1. Ruff RM, Iverson GL, Barth JT, Bush SS, Broshek DK. Recommendations for diagnosing a mild traumatic brain injury: A national academy of neuropsychology education paper. Arch Clin Neuropsychol. 2009;24(1):3–10. 2. Maas AIR, Menon DK, Adelson PD, Andelic N, Bell MJ, Belli A, et al. . Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. Lancet Neurol. 2017; 16:987–1048. 3. Nguyen R, Fiest KM, McChesney J, Kwon CS, Jette N, Frolkis AD, et al. . The international incidence of traumatic brain injury: a systematic review and meta-analysis. Can J Neurol Sci. 2016; 43:774–85. 4. Rosyidi RM, Priyanto B, Laraswati NKP, Islam AA, Hatta M, Bukhari A, et al. Characteristics and clinical outcome of traumatic brain injury in Lombok, Indonesia. Interdiscip Neurosurg Adv Tech Case Manag [Internet]. 2019;18 Feb:100470. Available from: https://doi.org/10.1016/j.inat.2019.04.015 5. Lagerstedt L, Egea-Guerrero JJ, Bustamante A, Rodríguez-Rodríguez A, Rahal A El, Quintana-Diaz M, et al. Combining H-FABP and GFAP increases the capacity to differentiate between CT-positive and CT-negative patients with mild traumatic brain injury. PLoS One. 2018;13(7):1–13. 6. Bogoslovsky T, Gill J, Jeromin A, Davis C, Diaz-Arrastia R. Fluid biomarkers of traumatic brain injury and intended context of use. Diagnostics. 2016;6(4):1–22. 7. Posti JP, Takala RSK, Lagerstedt L, Dickens AM, Hossain I, Mohammadian M, et al. Correlation of blood biomarkers and biomarker panels with traumatic findings on computed tomography after traumatic brain injury. J Neurotrauma. 2019;36(14):2178–89.

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Platelet-Rich Plasma as a Booster in Anterior Cruciate Ligament Injury Recovery Jeanette Sefanya Yefta, Michelle Joshalyn Natasha, Jessica Amadea Sutrisno Universitas Kristen Krida Wacana

Introduction The anterior cruciate ligament is the most frequently injured knee ligament.1,2,3 To treat an ACL tear, reconstruction can be done although reruptures can still happen. Lately, there has been some studies that indicates biologics might increase the success of ACL reconstruction. One of them being the platelet-derived growth factor that is procured from a concentrate derived from autologous blood centrifugation called platelet-rich plasma (PRP).4 Methods A systematic search was conducted on selected databases (PubMed, ProQuest, Google Scholar). Twenty three articles were found using ACL and PRP keywords. Ten articles were removed after the review. Reasons for exclusion were non-human subjects and unrelated primary outcome. Eight articles were removed for not fulfilling our inclusion criteria. Full text reports of 5 articles were extracted and critically appraised by authors. Results and Discussion Platelet-rich plasma (PRP) enhances tissue repair by releasing growth factors although the clinical significance itself is still being questioned. Two studies supported the claim that PRP could be used to boost the recovery of ACL injury. Almeida A., et al found that PRP improved patellar tendon gap area and reduce pain in patients that receive ACL reconstruction. 6 While Orrego M., et al found that patients that were given PRP had better MRI maturation criteria results.7 Three other studies claimed that PRP had no significant effect on enhancing range of knee motion, muscle torque, International Knee Documentation Committee, or kneeling pain in ACL injury and reconstruction patients.5, 8, 9 Conclusion In conclusion, the effects of PRP in ACL tear repair are still up for debate as some research shows that PRP use demonstrates no significant effect while others demonstrate potential benefits. Nonetheless, PRP still remains as a promising biologics to be used in aiding the healing of an ACL tear.

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References 1. Sanders TL, Maradit-Kremers H, Bryan AJ, Larson DR, Dahm DL, Levy BA et al. Incidence of Anterior Cruciate Ligament Tears and Reconstruction. The American Journal of Sports Medicine. 2016;44(6):1502-1507. 2. Singh N. International Epidemiology of Anterior Cruciate Ligament Injuries. Orthopedic Research Online Journal. 2018;3(3). 3. Gans I, Retzky J, Jones L, Tanaka M. Epidemiology of Recurrent Anterior Cruciate Ligament Injuries in National Collegiate Athletic Association Sports: The Injury Surveillance Program, 2004-2014. Orthopaedic Journal of Sports Medicine. 2018;6(6):232596711877782. 4. Figueroa D, Figueroa F, Calvo R, Vaisman A, Ahumada X, Arellano S. Platelet-Rich Plasma Use in Anterior Cruciate Ligament Surgery: Systematic Review of the Literature. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2015;31(5):981-988. 5. Nin JR, Gasque GM, Azcรกrate AV, Beola JD, Gonzalez MH. Has Platelet-Rich Plasma Any Role in Anterior Cruciate Ligament Allograft Healing?. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2009;25(11):1206-1213. 6. de Almeida AM, Demange MK, Sobrado MF, Rodrigues MB, Pedrinelli A, Hernandez AJ. Patellar Tendon Healing With Platelet-Rich Plasma. The American Journal of Sports Medicine. 2012;40(6):1282-1288. 7. Orrego M, Larrain C, Rosales J, Valenzuela L, Matas J, Durruty J et al. Effects of Platelet Concentrate and a Bone Plug on the Healing of Hamstring Tendons in a Bone Tunnel.

Arthroscopy:

The

Journal

Arthroscopic

Surgery.

2008;24(12):1373-1380. 8. Walters BL, Porter DA, Hobart SJ, Bedford BB, Hogan DE, McHugh MM et al. Effect of Intraoperative Platelet-Rich Plasma Treatment on Postoperative Donor Site Knee Pain in Patellar Tendon Autograft Anterior Cruciate Ligament Reconstruction: A Double-Blind Randomized Controlled Trial. The American Journal of Sports Medicine. 2018;46(8):1827-1835. 9. Mirzatolooei F, Alamdari MT, Khalkhali HR. The impact of platelet-rich plasma on the prevention of tunnel widening in anterior cruciate ligament reconstruction using quadrupled autologous hamstring tendon. The Bone & Joint Journal. 2013;95-B(1):6569.

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Pla ele Rich Pla aa aB e i C cia e Liga e I j

e i Rec e

Jeanette Sefan a Yefta, Michelle Joshal n Natasha, Jessica Amadea Sutrisno

Universitas Kristen Krida Wacana

INTRODUCTION The anterior cr ciate ligament is the most freq entl 1,2,3

inj red knee ligament.

To treat an ACL tear,

reconstr ction can be done altho gh rer pt res can still happen. Latel , there has been some st dies that indicates biologics might increase the s ccess of ACL reconstr ction. One of them being the platelet-deri ed gro th factor that is proc red from a concentrate deri ed from a tologo s blood centrif gation called platelet-rich plasma (PRP).

Fig re 1. Normal ACL and torn ACL

Re eache ide ified h da aba e ( = 23)

METHODS

gh A s stematic search

as cond cted on selected databases

(P bMed, ProQ est, Google Scholar). T ent ere fo nd sing ACL and PRP ke

three articles

ords. Ten articles

remo ed after the re ie . Reasons for e cl sion h man s bjects and articles

Re ea ch c ee ed ( = 13)

nrelated primar

ere

ere non-

o tcome. Eight

ere remo ed for not f lfilling o r incl sion criteria.

F ll te t reports of 5 articles

ere e tracted and criticall

appraised b a thors.

RESULT & DISCUSSION S

die i c ded a d a ( = 5)

e ed

Platelet-rich plasma (PRP) enhances tiss e repair b releasing gro th factors altho gh the clinical significance itself is still being q estioned. T o st dies s pported the claim that PRP co ld be sed to boost the reco er of ACL

CONCLUSION

inj r . Almeida A., et al fo nd that PRP impro ed patellar

In concl sion, the effects of PRP in ACL tear repair are

tendon gap area and red ce pain in patients that recei e

still p for debate as some research sho s that PRP se

ACL reconstr ction.6 While Orrego M., et al fo nd that

demonstrates

patients that

significant

effect

hile

others

ere gi en PRP had better MRI mat ration 7

demonstrate potential benefits. Nonetheless, PRP still

criteria res lts. Three other st dies claimed that PRP had

remains as a promising biologics to be

no significant effect on enhancing range of knee motion,

sed in aiding

the healing of an ACL tear.

m scle

torq e,

Committee,

International kneeling

pain

Knee in

Doc mentation

ACL

inj r

and

5,8,9

reconstr ction patients.

REFERENCES

1. Sanders TL, Maradit-Kremers H, Br an AJ, Larson DR, Dahm DL, Le

BA et al. Incidence of Anterior Cr ciate Ligament Tears and Reconstr ction. The American Jo rnal of Sports Medicine. 2016;44(6):1502-1507.

2. Singh N. International Epidemiolog of Anterior Cr ciate Ligament Inj ries. Orthopedic Research Online Jo rnal. 2018;3(3). 3. Gans I, Ret k

J, Jones L, Tanaka M. Epidemiolog

of Rec rrent Anterior Cr ciate Ligament Inj ries in National Collegiate Athletic Association Sports: The Inj r

S r eillance Program, 2004-2014. Orthopaedic Jo rnal of Sports Medicine.

2018;6(6):232596711877782. 4. Fig eroa D, Fig eroa F, Cal o R, Vaisman A, Ah mada X, Arellano S. Platelet-Rich Plasma Use in Anterior Cr ciate Ligament S rger : S stematic Re ie

of the Literat re. Arthroscop : The Jo rnal of Arthroscopic & Related S rger . 2015;31(5):981-988.

5. Nin JR, Gasq e GM, A c rate AV, Beola JD, Gon ale MH. Has Platelet-Rich Plasma An Role in Anterior Cr ciate Ligament Allograft Healing?. Arthroscop : The Jo rnal of Arthroscopic & Related S rger . 2009;25(11):1206-1213. 6. de Almeida AM, Demange MK, Sobrado MF, Rodrig es MB, Pedrinelli A, Hernande AJ. Patellar Tendon Healing With Platelet-Rich Plasma. The American Jo rnal of Sports Medicine. 2012;40(6):1282-1288. 7. Orrego M, Larrain C, Rosales J, Valen

ela L, Matas J, D rr t J et al. Effects of Platelet Concentrate and a Bone Pl g on the Healing of Hamstring Tendons in a Bone T nnel. Arthroscop : The Jo rnal of Arthroscopic & Related S rger . 2008;24(12):1373-1380.

8. Walters BL, Porter DA, Hobart SJ, Bedford BB, Hogan DE, McH gh MM et al. Effect of Intraoperati e Platelet-Rich Plasma Treatment on Postoperati e Donor Site Knee Pain in Patellar Tendon A tograft Anterior Cr ciate Ligament Reconstr ction: A Do ble-Blind Randomi ed Controlled Trial. The American Jo rnal of Sports Medicine. 2018;46(8):1827-1835. 9. Mir atolooei F, Alamdari MT, Khalkhali HR. The impact of platelet-rich plasma on the pre ention of t nnel

idening in anterior cr ciate ligament reconstr ction sing q adr pled a tologo s hamstring tendon. The Bone & Joint Jo rnal. 2013;95-B(1):65-69.

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Bone Marrow Stromal Cells Therapy for Traumatic Brain Injury (TBI): A Systematic Review of Preclinical Studies Ariestiana A. A. Latifa1, Syailendra K. Sugito1, Jennifer S. Sunukanto1 Faculty of Medicine, Universitas Indonesia ABSTRACT INTRODUCTION: Traumatic brain injury (TBI) has been one major problem with 69 million individuals are estimated to suffer from TBI every year. One recommended treatment for TBI is using bone marrow stromal cells with neuroprotective effects to help facilitate the functional recovery of the brain. MATERIAL AND METHODS: We conducted a search through Pubmed, Scopus, and ScienceDirect and filter the articles with a set of inclusion criteria: randomized control preclinical trial and studies that show how bone marrow stromal cell effects traumatic brain injury. RESULTS AND DISCUSSION: Six studies show that the use of BMSCs significantly improve the TBI recovery and only two studies show insignificant differences. CONCLUSION: Administration of bone marrow stromal cells is potentially effective for TBI treatment in rats but there are more studies and clinical trial needed to be conducted to prove the effectivity and safety of this method on humans. Keywords: traumatic brain injury, TBI, bone marrow stromal cells, BMSCs

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AMINO | IMSTC 2020

PREVENT HYPOTHERMIA WITH JAKET Bagas Danadipa1, Nadhiva Nur A1, 1

Aim

: Increase community knowledge on how to prevent hypothermia when climbing

mountains Background : Indonesia has about 128 mountains from Sabang to Merauke. Approximately 5 million people live nearby. The natural beauty makes a lot of people interested in climbing the mountain. For one mountain alone can reach tens of thousands of visitors annually. Hypothermia is one of the obstacles that often threaten the life of Hikers when it affects its foot in the mountain. Hypothermia occurs when a decrease in the body's core temperature below 36 Â° C. Therefore, Hikers should know how to prevent this hypothermia. This Poster aims to improve public knowledge on how to prevent hypothermia when climbing mountains. This poster aimed to increase community knowledge on how to prevent hypothermia when climbing mountains with "JAKET". From 2015-2019 he e Hikers based on BASARNAS data. Key Finding : Hypotermia, Hikers, Prevention

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an increasement of Hypotermia cases on

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SPRAIN VS STRAIN remember THE RECIPE! Dara Ariqah, Shafira Nur Fauziah, Dwinanda Tsania Lailaturrahamh Abstract Sprains and strains are form of injuries that common affecting the musculoskeletal system. Both of these things often occur in our everyday life. Falls and motor vehicle accidents, excessive exercise, improper footwear, inadequate warm-up before activity, and prior sprain or strain may result in a sprain or strain. Although, both are often interpreted as the same things, in fact these two things are different. A sprain is a type of joint injury that typically involves tearing of the ligaments and capsule. While, a strain is an injury to muscles or tendons. Sprains and strains can have similar signs and symptoms ha can be

o e if he don ge

ell ea men . Fortunately,

most of which can be treated at home without seeing doctor. The treatment has two same main goals. The first goal is to reduce swelling and pain, the second is to speed recovery and ehabili a ion. The RECIPE i a

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inflammation of sprains and strains.

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o manage ain and

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Treat Early Recover Quickly Authors : Aditya Kristiaji & Avini Mawarni Soedarsono

Fracture is defined as a break or crack that occurs when the bone bends beyond its flexibility and cannot withstand some outside force

[1]

. According to Riset Kesehatan Dasar (2013), 8

million people in Indonesia had bone fracture, with various types and causes. Femoral and humeral fracture, respectively are the most frequently found fracture among other types, with the most common causes including vehicle accident (62,6%) and falling (37,3%) addition, 45% of the fracture incidents ended in permanent physical disability

[2]

. In

[3]

. Since early

stabilization in patients with femoral fracture is associated with fewer complications and shorter hospital stay, early management is important to maximize fracture healing [4][5]. This poster is aimed to raise peopleâ&#x20AC;&#x2122;s knowledge on how to do early treatment for bone fracture by performing â&#x20AC;&#x153;Stop Bleeding and Immobilizeâ&#x20AC;?. The first step, stop bleeding, can be done by applying pressure to the bleeding area with clean cloth. Pressure will decrease blood flow thus promoting blood to clot faster. Furthermore, the use of clean cloth will also decrease the probability of infection. The second step, immobilize, can be done by sealing the wound with sterile dressing and immobilize the limb in a splint. Immobilization is purposed to prevent excessive motions as it could prevent establishment of new capillaries and also make new damages caused by friction of movements, which retards healing process. Even though, micromotion has been shown to stimulate blood flow to fracture site and induce angiogenesis [6][7]

. Therefore, immobilization here means to limit, but not completely restraining movement.

Thus stimulating fracture healing. After seeing this poster, we are hoping that people would be able to know how to do early treatment for bone fracture. Hence, promoting successful bone healing and reducing the number of permanent physical disability.

1. The Cause of Fractures [Internet]. American Bone Health. 2019 [cited 5 December 2019]. Available from: https://americanbonehealth.org/fracture/the-cause-of-fractures/

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2. Desiartama A, Aryana IW. Gambaran Karakteristik Pasien Fraktur Femur Akibat Kecelakaan Lalu Lintas Pada Orang Dewasa Di Rumah Sakit Umum Pusat Sanglah Denpasar Tahun 2013. E-Jurnal Medika Udayana. 2017;6(5). 3. Kementrian Kesehatan RI. Riset Kesehatan Dasar (Riskesdas) 2013. Jakarta: Badan Penelitian dan Pengembangan Kesehatan. 2013. 4. Bone LB, Johnson KD, Weigelt J, Scheinberg R. Early versus delayed stabilization of femoral fractures. A prospective. J Bone Joint Surg Am. 1989;71:336-40. 5. Lefevre-Colau MM, Babinet A, Fayad F, Fermanian J, Anract P, Roren A, Kansao J, Revel M, Poiraudeau S. Immediate mobilization compared with conventional immobilization for the impacted nonoperatively treated proximal humeral fracture: a randomized controlled trial. JBJS. 2007 Dec 1;89(12):2582-90 6. Mav i B, Antoli V. Optimal mechanical environment of the healing bone fracture/osteotomy. International orthopaedics. 2012 Apr 1;36(4):689-95. 7. Marsh DR, Li G. The biology of fracture healing: optimising outcome. British medical bulletin. 1999 Jan 1;55(4):856-69.

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Treatment of burns with tilapia skin Author: Bonifasia Felia, Natasha Princess Luddu, Casey Christiany

According to WHO, there are 310,000 people died from burns. Based on the 2013 Basic Health Research, the prevalence of burns that occurred in Indonesia was 0.7%. Burns that often occur are grade two. There are various types of treatment of burns, one of which is being developed is the use of tilapia fish skin or Nile Tilapia Fish Skin (NTFS). This fish skin can be used as an alternative treatment for burns because it has a lot of water content and type 1 collagen protein that is similar to human skin. The action of installing fish skin has been proven to heal burns in cases of second-degree burns. It aims to prevent scarring and to reduce the healing time of burns. NTFS undergoes a strict process of chemical sterilization, glycerolization and irradiation which is then followed by microbiological tests for bacteria and fungi, before being stored in refrigerated sterile packages. Before being used in patients, the skin is washed in 0.9% sterile saline for 5 minutes and this process is repeated for three times in a row. Before installing the skin of the fish, the patient is given anesthesia and analgesia first, namely 150 mg ketamine, 10 mg midazolam, and 200 mg tramadol. After cleaning the lesion with tap water and 2% chlorhexidine gluconate and removing necrotic tissue and fibrosis, biomaterial (NTFS) was applied to the limbs of the patient who suffered burns. Coverage of at least 1 cm of healthy skin from the wound border and covered by bandages and gauze. Handling of burns can be done in various ways. The latest innovation that is being developed by experts using Tilapia skin. This method has been applied to many patients and proven to heal burns.

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ai e

ea me

A new treatment for burns using Tilapia skin, an unusual procedure that is considered to be able to ease the pain of victims and cut medical costs.

ILA

HIGH M I

There are various t pes of treatment of burns, one of which is being developed is the use of tilapia fish skin or Nile Tilapia Fish Skin (NTFS). The action of installing fish skin has been proven to heal burns in cases of second-degree burns.

KIN? HIGH C LLAGEN

Tilapia skin contains a lot of water so it can maintain the humidit of the area of the skin that is burned

Tilapia skin has high levels of collagen t pe 1 protein which is similar to human skin and can promote healing

DI EA E E I

ANCE

Tilapia skin provides stead pressure to wounds, keeping bacteria out and sta ing on better and longer than an kind of regular, s nthetic bandage

E? Fi h

e ili a i

Tilapia skin is washed in 0.9% sterile saline for 5 minutes and this process is repeated for three times in a row.

A e he ia Patient is given anesthesia and analgesia, namel 150 mg ketamine, 10 mg mida olam, and 200 mg tramadol.

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Clean the lesion with water and 2% chlorhe idine gluconate then remove the necrotic tissue and fibrosis

A achme Appl on burn limbs. Cover at least 1 cm of health skin from the wound border and covered b bandages and gau e.

Bonifa ia Felia - Na a ha P ince

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- Ca e Ch i ian

Did ou know? B using Tilapia skin, the cost of the treatment is reduced up to 75% per application

Treat Your Wound with Bubble Bush Wound is damage that occurs in body tissue and generally occurs on the skin. The skin is the largest organ that protects the body from germs. When the skin is injured, germs can easily enter the body and cause infection. Wound infections cannot be considered trivial. Starting from infections that are considered small to infections that can cause interference with important organs such as the heart and brain. What is fatal about the infection of the wound itself is amputation and even death. Because it is important to treat wounds quickly and precisely to prevent infection. Bubble Bush or Latin names (Jatropha curcas) are traditional plants that can be easily found. This plant turned out to have many benefits, even some scientists in the world have done a lot of research on the efficacy of bubble bush. Among the characteristics of bubble bush, which help treat wounds. The method is very easy. Treatment can be done by taking a few leaves of bubble bush, then mashed using warm water. After that it can be affixed to the bruised or injured body part. Then this can be repeated several times until the bruise or wound looks better and shows changes. Compressants with bubble bush leaves can also help to reduce mild bleeding. Infection due to wound can be very fatal. so do not leave the wound untreated, especially there are bubble bush plants that in fact can be used to treat wounds. besides being easy to get, treatment with bubble bush is also very easy to apply.

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TREAT YOUR WOUND RIGHT! Alya Mutiara A, Muthia Alifina H, Salma Firdaus ABSTRACT According to WHO biennal report 2010/2011, burns caused approximately 195,000 death anually in Indonesia. During the 2-year period from January 2011 until December 2012, out of 275 patients admitted in a local hospital, 203 patients were adults. Number of death in adult patients were 76 patients (27,6%). Among the death of patients, seventy-eight percent were caused by flame, electrical burn injury (14%), hot water (4%), chemical (3%), metal (1%). Almost all burn extents was deep dermal (2nd degree) and full thickness (3rd degree). The cause of death including septicaemia (42,1%), multiple organ failure (31,6%), systemic inflammatory response syndrome (17,6%), and acute respiratory distress syndrome (8,7%). In contrast to the high prevalence of second degree burn wounds, some people are still uneducated on the mechanism of the right treatment. Products toothpaste, which may have adverse effects, continue to be used on burns especially in Asian countries such as Indonesia. This poster is designed to educate the community on treating a specific trauma care, which is burn with comprehensive procedure which are 1. Remove all burned clothing and jewellery 2. Immerse the site with cool water 3. Go on wrap with applying a clean wrap 4. Heal the wound moist by applying an ointment 5. Take care of the wound by keeping it moist

Through this poster, we hope that the community are educated with the basic trauma care that are not misleading but with the right treatment.

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TREAT O R O ND

RIGH ! REMO E IMMERSE GO ON

RAP

HEAL AKE CARE 370

CRUCIAL PHENOMENON RELIEVE Amalia Indah Wardani, Sabilal Muhammad Faaris, Clarisa Tungabdi.

Trauma cardiac arrest have low survival rates. Given the low survival figures, all the efforts that could be achieved by an emergency team in the face of severe trauma had to be oriented towards the maintaining of the vital functions. The incidence of cardiac arrest ranges from 10 out of 100,000 people and annually reaches around 300,000-350,000 events. Otherwise, in previous study 18 of 78 (24%) patients who underwent resuscitation for traumatic cardiac arrest survived.(Education for Patient | Perhimpunan Dokter Spesialis Kardiovaskuler Indonesia (PERKI), 2015) In cardiac arrest, high quality cardiopulmonary resuscitation (CPR) is a key determinant of patient survival. Hight quality CPR starts from checking the consciousness of the patients, get in the right position to do the resuscitation. Determine the compressions by press straight down at least one-third of chest depth for 30 minutes until help arrives. Open the airway with the head-tilt chin-lift motion and permit rescue breath. Eventhough this is a momentous event, personal safety is still extensive such as breathing barrier and gloves if exist. Increased the mortality risk factor of sudden death, basic life support is very important. Therefore, we have to elevate the knowledge about CPR and save more lifes.(Poole et al., 2018)

References Education for Patient | Perhimpunan Dokter Spesialis Kardiovaskuler Indonesia (PERKI) (no date). Available at: http://www.inaheart.org/education_for_patient/2015/5/7/henti_jantung (Accessed: 26 November 2019). Poole, K. et al. (2018) M

CPR: W ? W

Ltd. doi: 10.1186/s13054-018-2059-0.

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? , Critical Care. BioMed Central

Contact Details: Amalia Indah Wardani amaliaindahwardani@gmail.com +6282346118496

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BEAT THE HEAT WITH THIS WAY!! ( Amelia Minarfah Salim, Gita Safitri Amalia, Almas Dwi Anggena) Abstract As in many other countries, burn injuries are a challenging healthcare problem in Indonesia. Burns, most commonly caused by fire, can also result from chemicals, electricity, and other heat accidents, such as scalding hot water or steam.Initial management of burn patients is very important for future morbidity and mortality. The first step that you can do when you got burn injuries are dont panic and stay away from heat source. Secondly, the burned area should be kept under running tap water for 20 minutes. The last step is get some help from medical staff you can call emergeny assistance. Once the patient has arrived in hospital make sure airway, breathing, circulation, disability, and exposure should be assessed. In a multiple trauma patient, the â&#x20AC;&#x2DC;forget the burnâ&#x20AC;&#x2122; principle is valid and the management of life threatening injury has priority. Therefore, patient who get burn injuries should be treated with comprehensive treatment.

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ABSTRACT Title

: Sa e Someone Life Wi h OMGS!

Authors : 1. Angelie Tirza Suryanto 2. Rania Belva Syafitri 3. Teofilo Vincent F. S. Road traffic accident (RTA) is something unexpected that can happen anytime and anywhere, which may leads to injuries, disabilities, or even death of the victims. In Indonesia, three people die every hour because of RTA (Kominfo, 2017). It can be caused by many factors; one of them is because the don t get an proper first-aid before they get to the hospital. WHO (2016) said that in low- and middle-income countries, death before reaching the hospital is over twice than in high-income countries, while Indonesia s one of the middleincome countries. Lack of knowledge about the right first aid becomes the main reason why this can happen. Because the frequent user of roads is mostly youth and working-age people, we made this poster especially for those age groups, although it can still be aimed at the public in general. We raise the tagline OMGS! as an acron m, since word OMG is commonl used when people are surprised, either it just in mind or actually shouted. As RTA is certainly a surprise, hopefull , with all the OMG s being shouted, people will remember OMGS! and take action to help the victims according to the steps of OMGS! . This poster is designed using Adobe Photoshop CC 2018 with gin blue as the main color to create a calming atmosphere, while important information is colored red to further enunciate its importance. The illustrations are made with three main colors: blue, orange, and gre . Its contrasting hue is intended to grab the audience s attention. We also made it simple without many ornaments, so that the audience will focus on the roadmap in the poster. Through this poster, we hope it s easier for people to remember the steps to help RTA victims, so they can prevent deaths and reduce the risks of injuries or disability of the victims. REFERENCES Kementrian Komunikasi dan Informatika Republik Indonesia. 2017. Rata-rata Tiga Orang

376

Meninggal

Setiap

Jam

Akibat

Kecelakaan

Jalan.

Available

from:

https://kominfo.go.id/content/detail/10368/rata-rata-tiga-orang-meninggal-setiapjamakibat-kecelakaan-jalan/0/artikel_gpr [Accessed 22 November, 2019] Gopalakrishnan, S. 2012. A Public Health Perspective of Road Traffic Accidents. Journal of Family Medicine and Primary Care vol. 1, pp. 144-150. Available from: https://dx.doi.org/10.4103%2F2249-4863.104987 [Accessed 22 November, 2019] Hammett, E. 2017. How to help in a road traffic accident. Available from: https://firstaidforlife.org.uk/road-traffic-accident/. [Accessed 22 November, 2019] Thim, T., Krarup, N. H., Grove, E. L., Rohde, C. V., & LĂ¸fgren, B. 2012. Initial assessment and treatment with the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach. International Journal of General Medicine vol. 5, pp. 117 121. Available from: http://dx.doi.org/10.2147/IJGM.S28478 [Accessed 23 November, 2019] World Health Organization. 2016. Post-Crash Response: Supporting Those Affected by Road Traffic

Crashes.

Switzerland:

World

Health

Organization.

Available

https://www.who.int/violence_injury_prevention/publications/road_traffic/postcrashresponse/en/ [Accessed 23 November, 2019]

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from:

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Title of Poster: The Proper Ways to Remove Helmet From Casualty Author: 1. Anglila Siddha Paramarthastri 2. Aura Nisa Alfira 3. Messa Ramadhanti Abstract: One of the causes of traumatic injuries is traffic accident. In Indonesia, 72.7% of traffic accidents occur to people who ride motorcycles (Riskesdas, 2018). It implies that motorcycle accidents are the most accident that is witnessed by the society. Therefore, society need to know how to properly treat the casualty, so that the casualty's life chances will be higher. The injuries that often happened on motorcycle accident is injuries on the head. Eventhough the casualty wear helmet when driving, the injuries could be worsen if the helmet is unproperly removed. Unfortunately, most of the society don't know how to properly remove helmet from the casualty. Therefore, this poster is created to inform the society how to properly remove helmet from a casualty in order to avoid another possibilities of injuries, such as cervical spine injury, so that the casualty's life chances wil be higher. Conclusion: The poster is important to inform the society about how to properly remove helmet from a casualty in order to avoid any other traumatic injuries possibilities, such as cervical spine injury that could make casualtyâ&#x20AC;&#x2122;s condition worse.

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HELP: Break the Barrier of Ignorance, Helping More People Ardhito Rahadian1, Chatrine Angelica D. C.2

Background Trauma can happen everywhere and every time. At present the cause of death due to injury is a traffic accident, accounting for a quarter of all deaths due to injury trauma. It is estimated that up to 1.3 million people die in traffic accidents each year and as many as 78.2. This number will increase by about 65% over the next 20 years and this can have a big effect on developing countries. Nowadays, people are less aware of their surroundings, making trauma invisible and hurting worse than before. How can we overcome this? How to cure trauma whether seen or not? Start caring, seek knowledge, break the barrier of ignorance, spread and start helping everyone who needs your help. Conclusion Trauma is one of the health problems especially a traffic accident. But sometimes, many things that make everyone not care about their surroundings and ultimately do not know that other people are traumatized and need help. With this poster we want to share that when trauma happens, we should recognize it, and we should know how to handle it.

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AMBULANSA: Get Your Ambulance With AMSA Arini Nh, Brian Jordan Yuwono, Rohan Sabloak For too long, trauma has been one of the leading health problems of the world. In addition to all that needs to be done is to improve road safety and other aspects of injury prevention, efforts to improve care of the injured are essential. Trauma care represents a major challenge to the clinician. However, many lives can be saved through inexpensive modifications in communication and availability of ambulances. Such changes greatly simplify decisions and actions. People are often confused. Who manages the ambulance in our city? To what number should we call if we need an ambulance service? There is no single channel that we can call. Ambulances are managed by many institutions, including hospitals. Of course, the service phone numbers are different. The most fundamental thing is a matter of how long the ambulance will arrive after we called. If we call, it may be that the new ambulance will arrive 30 minutes later, or even longer. And this is a problem, considering 50% of accident victims have really high risks of death a few minutes after the incident. To overcome this problem, we can use the mobile app AMBULANSA to get an ambulance fast. AMBULANSA will have features that can be abbreviated as AMSA. Accompanying, this app will never leave you n ma e

hen

he e

e g ing. Maps

feature, so you will always know where you are based on GPS. S.O.S. button, to contact the nearest medical help with just one tap f

h ne

c een. Ambulance then will come your

way as soon as possible. In conclusion, we are certain that by using AMBULANSA, we can simplify the way to call for an ambulance and shorten the time for medical help to arrive. Because we believe in he hil

Time Sa ing I Life Sa ing .

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Aura Masyitha Devina Bunga Mawarni Early Isnaeni Nur Fauziah S i al C d I j

Le O he Die, Help with ABCD!

Spinal cord plays an important role as the center of our nervous system. It

nearly

hard to imagine how our body system works properly if this spinal cord injury occurs. Basically, spinal cord injury is an injury to parts of spine that can cause fracture or displacement of vertebrae causing a neurological deficit. It is known that the incidence of spinal cord injury all over the world reach 10 to 83 cases per 1 million population each years. According to Ducker and Perrot, 40% spinal cord injury cases happened because of traffic accident and the rest results from falling, violence, and sport injury (Barret et al., 2012) . In each of injury cases, there is a term called 10 minutes golden time rules. During this short but crucial time, death and disability of victim can be prevented by effective and efficient treatment. We can get the them treatments with ABCD techniques. But first, we need to see if there is any spinal cord injury and if we suspect them so, immediately keep the neck in rigidmotionless position. After that, use the ABCD techniques by checking the Airway and watch out for blockages, check whether the victim is still Breathing, check the Ciculation to see if there is bleeding, and check the Disability whether the victim has muscle weakness or decreasing in consciousness. The urgency of spinal cord injury it self encourage us to take this theme. Hopefully, this poster can give many people idea and also can be their references of what they should do if they meet that kind of situation with spinal cord injury suspected victim. We also expect many people to be more aware of the 10 minutes golden time, so they can immediately act by doing the ABCDs and thus the number of death caused by these cases will lessen. References Barret, K. E., Barman, S. M., Boitano, S. & Brooks, H. L. 2012. Ganong's Review of Medical physiology. 24 ed. New york: McGraw Hill. Trauma Victoria 2019, Major Trauma Guidelines & Education : Victorian State Trauma System,

State

Victoria,

viewed

November

https://trauma.reach.vic.gov.au/guidelines/spinal-trauma/primary-survey>

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2019,

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Title of Poster : Be A Hero, Save A Life! Authors

: 1. Bagus Amartya Yudhananto 2. Gustin Raoul Beniah Haryono 3. Gabriella Christie Purnama

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adult population in the world (WHO, 2018). In Indonesia, there are 103.228 accidents happened in 2017 (BPS, 2017). It is also one of the biggest causes of physical trauma to the younger generation. One of the important pillars to reduce road traffic deaths and injuries are by improving the post-crash response as specified in WHO Global Plan 2011-2020. Time is crucial in regards to post-accident treatment. Appropriate treatment within the first hour postaccident significantly increase the chance of survival in road accident victims (WHO, 2018). Most people, unfortunately, are prone to suffer from Bystander Effect which prevents them from acting as fast as they should, partly due to their lack of knowledge regarding first aid (Fischer, 2006; Hall, 2013). If the knowledge of first aid is more widespread, bystanders would be more willing to deliver first aid adequately (Larsson, 2002). Thus, the purpose of our poster is to educate the public about first aid and to invite people to act and to help the victim in an accident. Our poster contains the basic steps of what should be done in case of an accident, with the intention to spread the knowledge of first aid to the public masses. Our target is the common masses, with focus to the young adult to adult age group. By educating the public, we hope that more people would be more willing to give aid to accident victims and increase their chance of survival. People need to increase their awareness about the importance of delivering first aid to traffic accident victims. We hope that our poster would be able to achieve this target and help achieving national target to lower mortality rate due to traffic incidents. Be a hero, save a life!

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References : Badan Pusat Statistik. 2017. Retrieved from https://www.bps.go.id/linkTableDinamis/view/id/1134 Cowley, R.A. 1975. A total emergency medical system for the state of Maryland. Md State Med J. 45:37-45. Fischer, P., et al. 2005. The Unresponsive Bystander: Are Bystanders More Responsive in Dangerous Emergencies? European Journal of Social Psychology. 36:276-278. Hall, A., Wotton, K., Hutton, A. 2013. Bystander Experiences at and after a Motor Vehicle Accident: A review of the Literature. Australasian Journal of Paramedicine. 10(4). Larsson, E. M., Martensson, N. L., Alexanderson, K.A. 2002. First-aid Training and Bystander Actions at Traffic Crashes--A Population Study. Prehospital and Disaster Medicine. 17(3):134-141. World Health Organization. 2018. Fact Sheet: Road Traffic Injuries. Retrieved from https://www.who.int/news-room/fact-sheets/detail/road-traffic-injuries World Health Organization. 2018. Global Status Report on Road Safety. Retrieved from https://www.who.int/violence_injury_prevention/road_safety_status/2018/en/

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Your Body is Your Biggest Treasure Salsabil Umsy Alfarabyn, Beno Bernardino Bramantyo2, Andreas Dexter Geson2

Increasing popularity of sports participation and physical exercise is almost certainly followed by an increase of athletic injuries. Over million sport related injuries cases are reported globally with one out of five people experience sport related injury. Sports injuries can affect the athlete's daily activities, performance on the pitch, and even their sports life. Sport injuries may reduce the beneficial aspects associated to sports activities if the athlete is unable to continue to participate due of sequalae effects of injury. It is reported that 500.085 people experienced injuries while playing basketball with strain and sprains are the most abundant ones. On soccer, 218.926 people were injured with fractures are the most often cases. 457.266 people were injured while cycling. Fractures are most likely to be seen in this sport. Last but not the least, 51.653 people suffer from injury while playing volleyball. Strain and sprains are often reported on those injured people. Most sport related injury can be resolved with RICE. The methods are confirmed to have an effective immediately after an injury on the first 72 hours. In order to prevent sport related injuries, some actions must be taken such as stretching. The most common method used for warm-up before exercise is stretching muscles. People often stretch their bodies before or after playing sports. Generally, the purpose is reducing risk of injury, reducing soreness post-exercise, or enhancing the performance while doing sports. Other ways of preventing the injury is to control the caloric intake. Finally, by paying more attention and encouraging people to sports injury in Indonesia, we hope that it may reduce the incidence numbers of sport related injuries.

KEYWORDS: RICE, stretching, caloric intake

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Herbiotic Exemplum, an Alternative to Antivenom Reactions Authors: Brian Luke Salim, Juliana Susantio, Magdalena

Snake envenomation is a trauma that occurs suddenly and requires quick and precise handling. In fact, mortality rate caused by this trauma, in Indonesia, is quite high. On 2017, Remote Envenomation Consultant Service have recorded that the incidence due to snake-bite reaches 135,000 cases per year, more than the incidence due to Cancer which reached 133,000. This was resulted from inadequate or slow first aid during anaphylactic shock. The 5th International Symposium on ASEAN Marine Animals and Snake Environment En enoming Managemen 2018 al o

a ed he

blic doe n

ehend he co ec

pre-treatment on this trauma and the lack of treatment existing in Indonesia. The emergency treatment conducted by the community still involves sucking blood out or to tie up strongly he inj ed a ea, de i e i ho ldn be done a i endange A long a he nake enom doe n

ead

ickl

he ic im and he hel e . h o gh he blood, he a ien co ld

be saved properly, especially by avoiding anaphylactic shock. The venom is capable of extend itself throughout the body within 15 minutes, leading to other side effects. Thus, we ca

he logan 15 min e fo 15+ ea

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ea men in o de o

save more than 15 years of lifespan. Our innovative ti le He bio ic E em l m, an Al e na i e o An i enom Reac ion

HEAR is to amend a potential of natural resources from the environment as antitoxin, antivenom, and antiinflammation and empower society with this possibility. It has been proven that Eclipta prostata ( U ang A ing ), Allium cepa (Red Onion), Curcuma longa (Turmeric), and other plants can counter antivenom reactions. Thus in an isolated location away from any medical facilities, this alternative could be considered within 15 minutes.

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MARCHing Towards Brain Injury

Background Traumatic brain injury (TBI)—the “silent epidemic”—contributes to worldwide death and disability more than any other traumatic insult. The pre-hospital evaluation and management of TBI is a vital link between insult and definitive care and can have dramatic implications for subsequent morbidity. Following a TBI the brain is at high risk for further ischemic injury, with prehospital interventions targeted at reducing this secondary injury while optimizing cerebral physiology. Therefore, knowledge of these variables and timely management of the disease at the pre-hospital period can significantly improve the outcome and decrease the mortality. Conclusion The MARCH (massive hemorrhage, airway, respiration, circulation, hypo-/hyperthermia, hike/heli) should be assessed. MARCH is used instead of the of the standard ABCDE, since it’s more applicable to the wilderness setting. Keywords Traumatic Brain Injury; Pre-hospital evaluation; MARCH

Authors Brilianti Viapita Halimatusadiah Maudy Rominar Br. Tobing

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MATTERS: No More Eldery Falls Chatrine Angelica D. C.1, Marito L. T. Sianipar2

Background Within a year, falling elderly often occurs with rates reaching 33% in a year which can be said 1 in 3 elderly falls every year and is associated with major morbidity and mortality. Falling is a major cause of injury in older adults, broken bones, loss of trust and independence, depression to death. Broadly speaking, the causes of falls can be categorized into three broad categories: accidental falls that can occur due to slipping, tripping or minor accidents that result in falls, anticipated physiologic falls that are often associated with age, disease, medication or procedure and are usually reflected in the patient's risk factors, and unexpected physiological falls. Anticipation of physiological falls is the most common, accounting for 78% of all falls. For the elderly, health conditions can be a risk factor for falling, but not only that, many other factors can cause an elderly person to fall. Things that are generally a risk factor for the elderly to fall include health conditions, environmental factors, light sources, to the footwear used. Fall prevention may not be an interesting topic, but it is important. As we get older, health and physical conditions also change. Of these causes, by knowing the various factors that cause falls in the elderly makes falls can be easy to avoid. Conclusion Falls are the most common cause of traumatic injury in older adults which can cause various aspects that affect physical and mental health. Therefore, preventive action to avoid falls is important so as not to happen on the elderly. Prevention efforts include moving forward, maintaining light conditions, exercising regularly, and always maintaining and consulting about health and it have been summarized in MATTERS.

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Title : Don t do it like a MASTER Author : Citra Kembangsari Juan Reynaldy Gotama Nindar Amelia Prabandari

Traumatic Brain Injury (TBI) is one of the most common causes of death in people under 45 years old worldwide. In Indonesia, TBI cause 6,5% of deaths in all group of age (Riskesdas 2007). The morbidity and mortality of TBI is increasing in Indonesia and the worst outcomes are related to the presence of pre-hospital secondary brain insults. This fact needs attention, e eciall

TBI

pre-hospital management, in order to prevent

compications and mortality. We have a moral virtue to help others. However, we should be careful when we help with suspected TBI that shows slow breathing rate, blurred vision, vomiting, headache, or reduce hearing ability. When we are going to evacuate the victim of traffic accidents or other trauma to safer and comfortable place, then we should not shake them too much. During evacuation, we must suspect a cervical spine injury and must mobilize the victim carefully. If the victim experience bleeding, clean the wound to prevent infection. One of the most important things is

kee

a e i

he ic i

a d i al ig , such as

respiration rate and pulse, to prevent complication and death. In our poster, we show some things that are not allowed to be done to victims with suspected TBI. The reason we choose this tittle is that many people still think that any help is correct, but actually it may enda ge

he ic i

life. We h e hi

ter can educate

general society about what should not do when they are going to help any victims with suspected TBI.

Reference : https://medlineplus.gov/ency/article/000028.htm https://www.ncbi.nlm.nih.gov/m/pubmed/24665251/

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Post Traumatic Stress Disorder Beatrice Julieta Theresa Juliet Petra Damiana Anindita

PTSD is a mental condition in which you experience a panic attack triggered by trauma past experience. Experiencing traumatic events is a heavy thing for anyone. However, a number of people have suffered from PTSD after experiencing painful or shocking events, such as accidents, lifethreatening incidents, or war. He may have thought about this traumatic incident all the time and this can affect his life. It's hard to fit in and accept changes after traumatic events, but there's always a way to make you feel better. PTSD is common. PTSD generally affects women more than men because most women are more sensitive to change than men, so they experience more intense emotions. PTSD can affect patients in all ages, even children. However, you should remember that PTSD is able to heal. The earlier you seek treatment, the faster PTSD will be cured. PTSD is not diagnosed until at least a month has elapsed since the presence of traumatic events. If during the month after the incident you have experienced the above symptoms, you should see a doctor. Some therapies that can be applied in the treatment of PTSD are cognitive therapy, exposure therapy, play therapy, and psychology education. Besides this therapy there are also several other treatments that we can apply ourselves at home like don't misuse alcohol or drugs to turn off feelings, which give more problems and prevent actual healing, simply rest, eat healthy food, exercise, and take the time to relax, etc. Regardless of all that matters is how to recognize your own feelings. Also understand that your feelings are a normal reaction to abnormal situations. So you yourself insoluble in a PTSD circle.

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IT HAPPENS WITHIN US Clarisa Tungabdi, Sabilal Muhammad Faaris, Amalia Indah Wardhani.

Trauma in someones early life can have a big impact to their upcoming life. It comes in divergent way such as being neglected, physical and physocology abuse, even sexual abuse. These cases are commonly known as child maltreatment. Trauma, including one-time, multiple, or long-lasting repetitive events, affects everyone differently. In some cases, victims of child maltreatment are in risk factor for developing Post Traumatic Stress Disorder (PTSD). Unfortunately, thousands of people didn’t give more attention to this matter and it comes not only from social enviroment but also from your closest ones.(World Health Organization, 2017) The number of child abuse victim reached 2.29 million, or 3%, with more cases happened in rural than urban areas. From that number, 61.4% of the perpetrators were parents, followed by neighbor (6.7%), family member (3.8%), and teacher (3%)(Handayani, Windiarti and Sari, 2016). Given the high risk to depression, sexual behaviors, unintended pregnancies, harmful uses of tobacco, drugs, and alcohol. It is crucial for us to do prevention against this issue. Having parents or caregivers who misuse drugs or alcohol, living in communities that have lack support services for families, socio-economic inequality and health policies that lead to poor living standards, increases the risk factor of child maltreatment. Regarding to this issue, child maltreatment prevented with counseling and empowerment of family or social society. The victim should be treat by professional, control their psychological problems also restrose the biological function(Mardia, 2018). We can elevate alertness about child maltreatment to save our future.

References Handayani, S. S. D., Windiarti, R. and Sari, W. F. (2016) ‘Domestic Violence: Parent’s Perception about Child Abuse’, Indonesian journal of early childhood education studies, 5(2), pp. 110–117. doi: 10.15294/ijeces.v5i2.13924.

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Mardia, R. (2018) ‘infoDATIN (pusat data informasi kementrian kesehatan RI kekerasan terhadap

anak

dan

remaja’,

11.

Available

at:

https://www.depkes.go.id/resources/download/pusdatin/infodatin/Kekerasanterhadapanak.pdf. World Health Organization (2017) ‘Child Maltreatment infography’, Journal of Digestive Endoscopy, 3(5), p. 53. doi: 10.4103/0976-5042.95033.

Contact Details: Clarisa Tungabdi clarisatungabdi@gmail.co m +6289518109613

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TREAT FRACTURES LIKE SIA! Devi Nurhalizah Atjo, Helena Arnetta Puteri, Frizka Widyana Widjanarko Every year, millions of people across the globe suffer from physical trauma, one of the most common being fractures. Fractures is an issue that transcends race, age and gender. A simple fall that happens in a heartbeat could make one limited in function and capacity for months. The absence of proper care and emergency management poses a significant threat. For open fractures, the patient is at risk of infections that could impair function or cause muscle stiffness and spasms. Additionally, delayed management of fractures could disrupt the healing process, causing deformities, misalignment and damage. Despite the urgency of prompt management, emergency treatment of fractures remain widely disregarded by society. Recognising its urgency, medical students are challenged to create innovative strategies to enable society to remember steps to manage fractures. Called to the challenge, the authors came up with “Treat fractures like SIA”, utilising pop culture icon Sia to attract the public’s attention and improve memory retention. With the jingle, “One, two, three, one, two, three, treat!”, a direct adaptation from the lyrics of Sia’s 2014 Grammy-nominated hit “Chandelier”, the authors hope to reach out to the target audience, the younger generation, to make them better educated regarding emergency management of fractures. It covers the essential steps of emergency management. First, stopping the bleeding using available tools if necessary. Next, cleansing of fracture to reduce risk of infections. Lastly, stabilization of the injured area, by immobilization using a splint, to prevent further damage and to provide a stable scaffold for the bone’s healing process. “Treat fractures like SIA”, is a simple and unique way of promoting emergency management of fractures, aiming to improve the prognosis of the patient and ensure that even post-fracture, they are able to return to their normal functions and continue to live life to their full potentials.

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REFERENCES 1. National Institute for Health and Care Excellence (NICE), Fractures (Non-Complex: Assessment

and

Management

[NG38].

2016

Feb.

Available

from:

https://www.ncbi.nlm.nih.gov/books/NBK368158/ [Accessed 2019 Nov 14]. 2. Swiontkowski M, Cross III W. Treatment principles in the management of open fractures. Indian Journal of Orthopaedics. 2008;42(4):377. 3. Singaram S, Naidoo M. The physical, psychological and social impact of long bone fractures on adults: A review. African Journal of Primary Health Care & Family Medicine. 2019;11(1). 4. First aid for fractures and dislocations [Internet]. Australia: Government of Western Australia;

[date

unknown]

[Accessed

2019

Nov

15].

Available

https://healthywa.wa.gov.au/Articles/F_I/First-aid-for-fractures-and-dislocations

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from:

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Title: MANAGE BURN WOUND WITH ABCD: D

Wai ! Ge Ca e!

Content/Abstract Poster: A burn is tissue damage that results from scalding, overexposure to the sun or other radiation, contact with flames, chemicals or electricity, or smoke inhalation. The first step in treating a burn injury is determining whether the burn is a minor or major one. That determination will direct action and treatment. Therefore, it is critical that treatment be started immediately. In the great majority of cases, the management of burns. For management of burn exposures, it is helpful to make people understand about burn wound management. Our content i ba ed

WHO g ide i e ab

Ma age e

i h i e Ma age e

.S ,

we conclude the most important first aid of burn wound with A.B.C.D and here are: A : Assure you stop the burning B : Begin with ABCDE C : Check he

e f9

D : Do early fluid replacement Conclusion The most important first aid of chemical burn injury concluded become A.C.I.D. and he e a e :A

he b

i g, Begi

i h ABCDE, Check he

replacement.

408

e f 9 , D ea

f id

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Stop The Burns with RECIPE Fathiyya Nabilah, Lita Latifah Rahmatullah, Amalia Dwi Mulyani Abstract Burns are one of the most devastating conditions encountered in medicine. The injury gives burden on all aspects of the patient, from the physical to the psychological. It affects all ages, from babies to elderly people, and is an issue in both the developed and developing countries. Females have slightly higher rates of death from burns compared to males. The higher risk for females is associated with open fire cooking, or unsafe cookstoves. Burns are the fifth most common cause of non-fatal childhood injuries. Burns occur mainly in the home and workplace. Approximately 180,000 deaths annually worldwide are caused by burn injury, mostly in low- to middle-income countries. Almost two thirds of deaths occur in the African and South-East Asia regions. In addition to death, non-fatal burns are a leading cause of morbidity, including prolonged hospitalization, disfigurement and disability, often with social stigma and rejection. Fortunately, burns are preventable. Prevention strategies should address for specific burn injuries, education for vulnerable populations, and training of first aid. This poster aims to improve awareness and knowledge of burn injury by providing informations about the first aid of minor burn injury and what kind of burns need medical attention immediately.

Conclusion Burns are tissue damage that results from heat, radiation, or chemical or electrical contact. Burns can be minor medical problems or life-threatening emergencies. The treatment of burns depends on the location and severity of the damage. Prevention strategies for burn injury should address for specific burn injuries, education for vulnerable populations, and training of first aid.

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VIVA : An App to Save Your Life, His and Hers Felisitas Sinta W., Rasikha Tsamara F., Melisa Canggra

Abstract As the fourth most populated countries and due to its geographic condition, Indonesia is very vulnerable for any-kind of disaster, natural and man-made disaster. These kind of disasters are inevitable, but it’s possible to anticipate. One of the way to do it is by preparing our Emergency Medical Service (EMS) far before it happen. EMS is a system that provides emergency medical care.1 Globally, emergency medicine are studied and applied as an act to prevent every kind of disaster or trauma. Indonesia has working EMS system by dailing 188 as an emergency call number, but due to lack of information, interest, and this number is difficult to reach out, public doesn’t use this number. The 188 call center only receive 50-75 calls/day, compared to 911 in Los Angeles, which receives more than 9,000 calls/day.2 According to WHO, in countries that have limited access to emergency medical services, protocols for mobile phone notification of communitybased responders have been shown effective as a bridge to formal prehospital care.3 We came with the idea of a comprehensive emergency services application that we hope could become more effective EMS system for Indonesia. We called it “Viva”, means long live. The purpose of this application is to help someone in every emergency situations and make it easier for people to receive first aid and treatment at the scene. This application has several languages, including local languages such as bahasa jawa, sunda, etc that make it more user friendly. For disability people, this application support sign language system. We are aware that not every part of Indonesia have an excellent internet connectivity, so this applications offers offline features. We hope Indonesia will become a better place for every emergency situation and public welfare through “Viva”. Viva is more than just an application, It’s life.

https://www.ems.gov/whatisems.html https://www.thejakartapost.com/academia/2018/05/18/emergency-medical-system-unprepared-forattacks.html 3 https://www.who.int/violence_injury_prevention/publications/road_traffic/Postcrash_response_booklet.pdf 2

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ORTHOKUN Alyauma Akmal, Intan Chaharunia Mulya, Intan Qanita Abstract Indonesia is a country with high interest towards the culture. Culture has influenced a lot of aspects including health. One of the way to show socio-culture influence is people treating their illness with traditional way first before they go to see the doctor, for instance, traditional bonesetter. According to Green SA in Orthopaedic Surgeons (1999), traditional bone setting is practiced in most of developing countries in the world especially in Asia, Africa, and South America that have less health source. Approximately, between 10 to 40% of patient with fracture and dislocation in the world are managed by unorthodox practitioners. Basic knowledge, socialculture, behaviour, earnings, and mistrust to doctors are the most common causes that made people will choose traditional treatment. Most of people will go to bonesetter because they believe they will gain a quicker, cheaper, and better treatment than the orthopaedic can do, whereas not all of the bone problem can be cured by a traditional method. This gap between modern and traditional medication can lead to late-right treatment, permanent disablement, or even death. Indonesia has to manage its healthcare service to provide both of traditional and modern treatment facilities in e lace i

c ea e a di ec a d be e

ea me . The ef e,

e c ea ed O h k

remove the gaps between traditional bonesetter and orthopaedic. Each professional is well-trained about their rights and responsibilities. Patient will be triage by medical doctor based on the case and they will be referred to traditional bonesetter or orthopaedic to have a further examination, they also can choose to be treated in traditional or modern way. By forming Orthokun, people knowledge will be increased, complications can be prevented, mistrust will be gone, the gap will be eradicated, and sustainable treatment will be happened.

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Title of Public Poster BITCOIN : Burn Trauma Comprehession and Interception Author of public poster: Karmenita Christina

Based on WHO report, an estimated 180 000 deaths every year are caused by burns â&#x20AC;&#x201C; the vast majority occur in low- and middle-income countries. Even though most of the cases are nonfatal, burn trauma can lead to severe morbidities or even deaths if not treated correctly. Burn is an injury or a trauma to the skin or other organic tissue in the body that are primarily caused by heat such as fire, chemicals and several kinds of radiation. Most of burn injuries are caused by skin contact to a hot liquid, hot solids, and flames. There are three grading of burn trauma that are divided into : 1st grade (mild), 2nd grade (Moderate), and 3rd ( Severe ) There are a lot of misconception and misinformation regarding how to deal with burn trauma. These issues are caused by myths about burn trauma such as put toothpaste, oil, ice cubes to the wound, and pop the blisters. Therefore, we would like to present the differences between the myths and facts about burn trauma, and first aid of burn trauma. In making this poster, we want to portray the right way in dealing burn trauma, thus minimizing the risk of complication and deaths.

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N AND

W AT NOT TO DO

P OO HPA E IN FRE H O ND P ICE C BE O CALM HE O ND POP BLI ER O IM LA E HEALING

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A ER

TRAFFIC ACCIDENT-CAUSING TRAUMA ON THE DRIVER WITHOUT A LICENSE Authors : Ketut Shri Satya Wiwekananda

(19/438963/KU/21269)

Ketut Shri Satya Yogananda

(19/438964/KU/21270)

Kadek Egadia Calisto

(19/438962/KU/21268) ABSTRACT

According to the data from Headquarters of the Republic of Indonesia National police Traffic Corps (2013), 56% of traffic accidents involve without a license. From this data, we can conclude that ownership of a driving license does affect the traffic accident cases. Besides that, based on data from Indonesian Republic Police Traffic Corps, traffic accident is raising in every 3 months in 2018. In many low until middle-income countries, 30% until 86% trauma cases are caused by traffic accidents. Based on that problem, we took the initiative to encourage people to drive only when they have a license to prevent traffic accident-causing trauma. We make a tagline Dri e hen o ha e a license to appeal society to drive only when they have license. The tagline is white colored with a bigger font than other words, so the readers will be focused on the tagline. We took a black background to make a serious impression to the reader, because this problem is often underestimated by the public. We give pictures of children who ride motorcycles with contrast colors, so the reader will focus on this object. The picture is taken from https://images.app.goo.gl/acWBL68FHiP1RyKy9. Our data is displayed in mustard yellow; it s fit the ca tion s mbol on the street to attract public attention. The number of 56% is made large to show how big the number of traffic accidents because of drivers without a license. We also use graphic for the number of traffic accident in 2018 every 3 months to make it easier for readers to understand the data. We also attach the percentage of trauma caused by traffic accident to show the correlation between trauma and traffic accident. With this poster, we educate society to drive only when they have a license so we can prevent traffic accident-causing trauma.

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MORE REST, More Life to be Saved Khansa Nida, Astrid Alma, Salsabila Shofa

Abstract Indonesia as the fourth most populous country in the world whose daily life is inseparable from the use of transportation, is no stranger to feeling congested. Asian Development Bank (ADB) have just released the Asian Development Outlook Update September 2019: the city of Bandung is ranked 14 th in the table of cities with populations above 5 million (2016 data) with the highest levels of congestion. Furthermore, congestion will increase the risk for traffic accident. Based on Global Status Report on Road Safety WHO (2018), global rate of road traffic death achieve 18.2 per 100,000 population and South-East Asia is the second highest regional rates of road traffic deaths (20.7 deaths per 100,000 population). It occurs mostly in children and young adults aged 5â&#x20AC;&#x201C;29 years and its not only affect the driver and passenger but also another road users (pedestrian 14%, cyclist 2%, motorcyclist 43%, and others 41%). In Indonesia (2017), three people die every hour due to road accident with human factors as the biggest cause (61%) on average. The human factors include the ability and characteristics of the drivers. One of the biggest factor in human error that results as a traffic accident is drowsy driving, so we choose â&#x20AC;&#x153;MORE RESTâ&#x20AC;? as the prevention. We can prevent the accident by wearing a standardize motorcycle helmet, not drinking alcohol while driving, using child restraint in the car for children under ten years of age, managing your speed, and always using a seat belt in the car. We sometimes underestimate how important these simple things are until we feel the consequences. So, do it now or regret it later! Conclusion: By implementing this in our daily life, we hope that we can decrease the number of traffic accident, which also decrease the number of people who got affected by it.

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Reference: Global status report on road safety 2018: summary. Geneva: World Health Organization; 2018 (WHO/NMH/NVI/18.20). Licence: CC BY-NC-SA 3.0 IGO). World

Health

Organization.

2018.

Road

Traffic

Injuries.

Retrieved

https://www.who.int/news-room/fact-sheets/detail/road-traffic-injuries Kementrian Komunikasi dan Informatika Republik Indonesia. 2017. Rata-rata Tiga Orang Meninggal Setiap Jam Akibat Kecelakaan Jalan. Retrieved from: https://kominfo.go.id/index.php/content/detail/10368/rata-rata-tiga-orangmeninggalsetiap-jam-akibat-kecelakaan-jalan/0/artikel_gpr

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from:

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112: One Call Away Every day thousands of people are killed and injured on the roads through many reasons. Among these are due to traffic accidents, negligence of drivers, damage to vehicle engines, inadequate road facilities or sudden natural disasters. Men, women or children have high risk to be involved in an accident. Approximately 1.35 million people die each year as a result of road traffic crashes and poor emergency care services. Emergency care services is at the core of post-crash response for patients in the prehospital or out of hospital environment. Effective care of the injured requires a series of timesensitive actions, beginning with activation of the emergency care system, and continuing with care at the scene, transport, and facility-based emergency care. However, even the most sophisticated emergency care system is ineffective if bystanders fail to recognize a serious injury or do not know how to call for help. Ideally, there should be a single nationwide or regional telephone number that is valid throughout the country to call for help. It is a critical component of the health systems and is necessary to improve outcomes of injuries. Thus, Indonesian government come up with the idea of an accessible numbers and available as a free call from every telephone, that is 112. With the hope for those who are in need of help can just dial in one call away because even short delays to critical moments can mean lives lost. Unfortunately, it is only available in several big cities like Surabaya, Semarang, etc. Where it should be available in every part of the nation. Not many people know about this new system and also they do not knoe how to seek for help because of lacking of counseling and education. Hence, there should be a concrete movement to spread the words about “112”. Therefore, the aim of this project is to raise awareness of the society in dealing with trauma caused by traffic crashes and how to call for help to improve community health. Also to introduce a tool of the pre-hospital emergency care system from Indonesian government using the World Health Organization (WHO) health system framework.

Authors’ name: Khofifah Bela Rachmanu Hayati Salsabela Fitri Mardhianingrum

423

Fresya Tamara Nilamsari

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ONE SECOND ONE LIFE Le

Oc a ia; Ade

P a i i SM; Da

Khai

One in a ten thousand people under 35 years old in a year will have a cardiac arrest. This is one of major trauma that have low survival rates. In United States, the cardiac arrest incident reaches 359.400 people. From that number, 40,1% get Cardiopulmonary Resusitation (CPR) by people around victims, and it is found that the numbers of the survival that get CPR action in location is 9.5%. So, tt is necessary nowadays to increase the importance and the skill of CPR in general public. One way is to introduce CPR training using traditional teaching method, tutorial (AHA, 2014). While there is a cardiac rest patient, the hiqh quality of CPR is a key to get a patient being survive. By Airway-Breathing-Circulation-Disability-Exposure Untreated airway obstruction can rapidly lead to cardiac arrest. All health care professionals, regardless of the setting, can assess the airway as described and use a head-tilt and chin-lift maneuver to open the airway. If breathing is insufficient, assisted ventilation must be performed by giving rescue breaths with or without a barrier device. Trained personnel should use a bag mask if available. An intravenous access should be obtained as soon as possible and saline should be infused by make the circulation back. The best immediate treatment for patients with a primary cerebral condition is stabilization of the airway, breathing, and circulation. Ultimately, intubation may be required. Pupillary light reflexes should be evaluated and blood glucose measured. Body temperature can be estimated by feeling the skin or using a thermometer when available (Thim et al, 2012)

References American Heart Association. (2014). Cardiac Arrest Statistic. American Heart Association, Inc. Thim, Troeis et al. (2012) Initial Assesement and Treatment with Airway, Breathing, Circulation, Disability, Exposure (ABCDE) Approach. Int J Gen Med. Doi :10.2417/IJGM.S28478

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Contact Details : Leony Octavia Leonyoctavias@gmail.com +6282193087212

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ACOUSTIC TRAUMA M ic i

a e e ai me , i

al ead a a

f life

le. Everywhere,

anytime, finding someone with headphones on is a common thing. Particularly in crowded places, some people tends to wear headphones so they could avoid the stress by hearing music with loud volume. Or just to boost up their moods by listening to cheerfull musics. With this, comes another probability as becoming too exited about the music that leads to increasing the music volume. Such thing could bring to negative impact to the ear. Exposure to loud noises will effect ear function due to partial or even permanent hearing loss. This is called acoustic trauma. Usually it starts with i gi g ea

f ll

ed b

a ial hea i g l

if i

ea ed

ell, i

could end up as permanent hearing loss. For this we conclude a series of treatment as HEAR that stands for : Hearing assistance, Ear protection, Avoid loud noises, take a Rest.

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Maharani Suradi Putri //Katherine Alycia Zam // Khalimatus Saâ&#x20AC;&#x2122;diyah

is an injury to the hearing mechanism in the inner ear due to very loud noise

T R E AT W I T H

use hEARING ASSISTANCE

Wear EAR PROTECTION

AVOID LOUD NOISES

Take a rest

IF IT GETTING WORSE, RING THE DOCTOR!

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REACT : Responsive, Encourage, Active, Clear, Treat Author : Melani Sinastri Renagupita, Devira Rosinta Sari, Claudia Roudlotul Jannah Most of common emergency situations can come to anybody such as accidents and disasters. Thi

i a ion need an immedia e ea men in o de o a e he pa ien

life. The fi

aid o

an emergency situations are fundamental for the next medical treatment that will be given to the patient. A person could lost their life because of the delays of the first aid that should be given at the first moment in that emergency situation. This statement supported by the data that shows the total number of death already reached 5,1 million peoples in the past few years and now it becomes 8,4 million peoples with the percentage 9,2% total number of death in the world. More than 30% the cause of death comes from traumatic and bleeding. Patient with traumatic issues needs evaluation and airways breathing management quickly, efficiently and safely from the accident location to the hospital. Based on how fundamental first aid is, not only paramedics but also the society should be aware about emergency protocol and first aid methods. By learning about it, even if the society find any emergency situation and he e i no pa amedic in he a ea, omeone

life doe n ha e o

be gone due to unawareness of the people who found body in the emergency situation about the importance of a first aid. Conclusion To overcome this situations a poster called REACT: Responsive, Encourage, Active, Clear, Treat has been made. REACT was meant to educate society about what to do during the emergency situation and how a little caring from a little bit of know-ho

can a e omeone

life. So that the witnesses can respond quickly and appropriately if there's ever an emergency situation.

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The Effect Of Salt Water On Wound Healing Michelle Putri1, Dimas Hafizh2, Fauzan Nandana3

Abstrak Salt water has anti-inflammatory abilities that can make the wound healing process faster and easier. Salt water baths help kill bacteria and prevent skin irritation. Salt water is also able to increase the level of skin hydration so that the wound healing process can be faster. Because healing from wounds depends on the method of treatment, here we use salt water because there are still many people who do not know the benefits of salt water in wound care, salt consists of 80% NaCl and other mixtures and also salt and salt water can kill bacteria that can attack the wound healing process can be faster. Reference: 1. Angkasa M H, Adi T,Hartono M, Pengaruh Rendaman Garam Terhadap Proses Penyembuhan Luka. Politekes Kemenkes Semarang, vol.4, no.2, 2017

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Motor Vehicle Accident is More than Just Being a Mere Disaster Mohammad Robitul Anwar Habibi1, Muhammad Chaidaru Dinil Islam1, Andreas Dexter Geson2

Motor vehicle accidents are a very serious problem in Indonesia. In 2014, it was reported approximately 28,000 fatalities due to accidents on the streets and roadways of Indonesia and the fatality rate from motor vehicle accidents per 100,000 population in Indonesia was about 12. The numbers are more than twice to neighboring countries such as Singapore (4.8) and Australia (5.2). Do primary survey immediately after meeting an injured person due to motor vehicle accident. Before assessing the primary survey, ensure the area is safe for the victim, he hel , a d

he . Ne , check f

ee i g hi /he h

he ic i

lde . If he ic i d e

s response such as asking his/her name or e

d ell, call 119 for ambulance as soon

as possible. While waiting for the ambulance to come, do the primary survey. The primary survey is designed to assess and treat any life-threatening injuries quickly. It should be completed very rapidly. The main causes of death in a trauma patient are airway obstruction, respiratory failure, shock from hemorrhage, and brain injuries. Therefore, these are the areas targeted during the primary survey. While doing the primary survey, make sure to fixate cervical spine. Moving someone who has a suspected spinal cord injury is prohibited since could further damage the spinal cord. Let emergency professionals evaluate the injured person. Lastly, there is an effective way to prevent motor vehicle accident, by using full-face helmet. Helmet use can reduce up to 51% for head injury, 33% for face injury, and 69% for serious head injury. By wearing full-face helmet motor correctly, can reduce the risk of severe injury by over 70% (WHO, 2017). Eventually, giving more concern to motor vehicle accident in Indonesia may reduce its incidence because everyone has the same risk for the injury. KEYWORDS: Primary survey, emergency, call 119, full-face helmet

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IS MORE THAN JUST BEING A MERE DISASTER

Call 119

e Head Ca ele

S am

Always wear full-face helmet

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C-S i e Fi a i

age

Dea

i h A gk e S ai U i g RIPE

Khoirina Rahma, Nadhira Kartika, Nuha Amalia Ankle sprains are the most common type of sprain, accounting for 10% to 15% of sportrelated injuries and are responsible for 7% to 10% of all emergency room visits. Ankle sprain is an injury of the ligament of the ankle (that surround and connect the bones of the leg to the foot.) when the ankle is forced to bend more than normal. It is estimated that one ankle sprain occurs per 10.000 person per day. Most of this injury occur in person under 35 years old. The symptoms of this injury like mild ache to sudden pain, swelling, bruising, and inability to move the ankle normally. The treatment to this injury can be managed with the RIPE. R for Rest, rest will help prevent further injury and allow the healing process to begin. Do not putting any weight on the injured area for 48 to 72 hours, so you may need to use crutches. I for Ice, ice can help reduce swelling and reduce pain. Put an ice pack on your injured ankle for 10 minutes every 2 hours, for the first couple of days after the injury. Then use the ice pack 3 times a day until the swelling goes down. P for Painkiller, its important to take regular painkiller. It is to reduce the pain and help you keep moving around. E for Elevation, this helps to decrease the swelling and pain. Not recommended to compression bandages for sprain because they appear to have no beneficial effect on how quickly or fully you recover.

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Title: How To Not Break a Neck! Author: Najla Mumtaza Regina Amanda Sahla Amalia Trauma occurred post-traffic accidents are one of the leading cause of deaths at any age around the world. One of the most severe type of injuries that can occur are neck, head, and spinal injuries. Cervical and head injury often occur in motorcycle accidents and it has a strong correlation with the data that 88% of head injury deaths happen in low- to middle-income countries. Indonesia itself has an increasing number of motorcycle accident occurrence in this past few years. Victims with traumatic spinal cord injuries have worst outcomes and increased overall mortality compared with the general injuries, this is due to the neurological segmental levels on the spinal cord that correspond to the nerve roots which exit the spinal column between each of the vertebrae, and at the cervical region it has specific nerve that regulate heart rate and breathing. Prevention of these injuries death could be done by a competent first responders on emergency pre-hospital medical services at the accident scene. This poster is aimed to educate society the importance of conducting a correct procedure of a pre-hospital care specifically on victims with suspected head, neck, or spinal injuries. This include, identifying emergency and the occurrence of spinal injuries by a quick observe of the situation and chronology of accident. Call for professional or the nearest ambulance. Clarifying the necessity of moving the victim, if it is not necessary, the first responders should hold the victims head and neck to minimize movement until professional help arrives. If moving is necessary, gather people to help move the victim with hammock methods, with a note not to move their head and neck. As a conclusion, this poster is meant to prevent deaths by traumatic spinal injuries by educating society as the first responders to conduct a correct pre-hospital care.

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Name : Naomi Natasha Putri Napitupulu, Haura Pradhyta Balqis, Rizqiko Pandai Hamukti

Blowing Your Eye is a Myth A topic that we choose to make a poster for this IMSTC is about corpus alienum conjunctiva or in Baha a i kno n a kelilipan Kelilipan is a kind of trauma in the eye caused by strange materials that entering the eyes. Why do we choose this topic is because almost every person has experienced kelilipan, but many people underestimate its effect. Moreover, many people not know yet how to deal with kelilipan in the proper ways, and do the wrong method instead. For example, many people will blow or rub off their eyes when facing kelilipan. That method will make additional irritation in their eyes instead of heal them. Based on the previous problems, we want to make a poster with the objective to clarify and inform how to deal with kelilipan in the proper ways. The first step is by blink the eye repeatedly so increase secretion of tears that will ease strange materials exit from the eyes. Step two is by pulling the eyelids to ease the movement of strange particles to the corner of the eyes. Step three, use the right tools such as cotton bud to ease the removal of strange materials in the corner of the eyes. After that, give a proper dose of eye drops to avoid irritation and infection into the eyes.

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Traumatic Brain Injury Care with THANOS Ima Herdiyanti - Natasya Putri Imam Rahmawati â&#x20AC;&#x201C; Natasia Yekti Mahanani Why we choose this case? Because Traumatic brain injury in Indonesia expecially in Cipto Mangunkusumo Hospital noted since 2005 there are 749 patient have a traumatic brain injury and 23 of them died. That in one hospital, if we see the case in Indonesia surely there will be more than thet. Definition of traumatic brain injury is brain damage condition that caused by hard blow or shock on head or object from outside that penetrate brain issues. Mild traumatic brain injury can affect brain cells a little time, while moderate to severe traumatic brain injury can lead to more serious conditions like bruises, brain tissues damage, bleeding, even can lead long-term complication, coma, even until death. General cause of traumatic brain injury is blow and jerk hard on head. The following conditions that may cause traumatic brain injury: 1. When someone fall from higher place like fall from bed, fall from stairs, slip, etc. From that condition, head likely will be bump or will be shock and then have a traumatic brain injury. 2. Crash induced collision is a common cause traumatic bbrain injury, Almost every case is caused by collision. 3. Sports injuries. Some types of sports that potentially cause traumatic brain injury is soccer, boxing, hockey, baseball, and many hard ekstrem sports. 4. Blast and battle injuries. This condition most common happen in military members who are actively tasked with the battlefield. 5. Violent acts like beating, gunshot wound, include puncture wounds that damage the skull and brain tissues. Brain is the most influential organs in the body. Brain damage can be an effect on a person's physical or psychological. The most common symptoms is vomiting, lethargic, headache, confusion, paralyzed, loss of consciousness, enlarged pupil, vision change, loss of balance, pulse slowing, breathing slowed, increased blood pressure, ear rings, cognitive disorders, emotional changes, Difficulty talking, difficulty swallowing, numbness, pale face, glazed eyes, etc. Symptoms that arise in each person may vary. The worse the trauma condition, the more and more severe symptoms may also arise. Traumatic brain injury can be handled by THANOS: 1. Take a break to overcome minor/mild traumatic brain injury. It for mild traumatic injury that not severe. Physical activity and think should be limited to avoid more severe condition. Patient can have normally activity if the doctor allow him/her. 2. Have an analgesic to overcome minor traumatic brain injury. This serves to relieve existing pain, which patients with brain injury should not suffer from pain, because it will reduce the energy that should be used. 3. Announcement that patient have enough the oxygen. It aims to minimize secondary damage due to inflammation, bleeding, and reduced oxygen supply to the brain. 4. Notify the patient have enough blood supply. The blood supply have same role important with oxygen, is that to minimize secondary damage due to inflammation, bleeding, and reduced nutricion to the brain. 5. Organize drug administration to limit secondary damage to the brain like diuretic, anti-seizure medication, and coma-reducing drug. 6. Surgery on order to remove blood clots in the brain, repair broken skull bones, and open a window on the skull ro relieve pressure in the brain.

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Source: 1. Traumatic brain injury – https://www.mayoclinic.org/diseases-conditions/traumatic-braininjury/symptoms-causes/syc-20378557 accessed 24 November 2019 2. Basic Information about Traumatic Brain Injury – https://www.cdc.gov/traumaticbraininjury/basics.html accessed 24 November 2019 3. Traumatic Brain Injury – https://www.aans.org/en/Patients/Neurosurgical-Conditions-andTreatments/Traumatic-Brain-Injury accessed 24 November 2019

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TELE-ME SOMETHING GOOD: TELETRAUMA IS A NEW WAY! Naziha Abdullah Zarkasih (1st), Aurellia Rinnanda Putri, Moh. Fahmi Suratinoyo Public Poster Abstract Trauma registry studies show around a 15%-20% or great reduction in mortality as a result of improvements in the trauma care system. From WHO, it said that the effectiveness of trauma care services include of two factors: (1) verification of trauma services through hospital inspections include human resources, physical resources, and quality improvement; and (2) planning of systems for trauma management. From that, we know that should be at least one media to facilitate one hospital to communicate to another hospital to apply the elements of trauma care services to maximize the effectiveness in trauma management. As today is the technologycal era, we can use the technology in medicine for sure. One of the e am le i Telemedicine, hich li e all mean healing a a di ance , deli e f heal h ca e and the exchange of health-care information across distances. Teletrauma, sometimes called ele-ER ele-eme genc i a eciali ed f m f elemedicine ha ffe em e a ma care via telecommunications technology. Teletrauma allows expert clinicians to observe patients and communicate with other clinicians remotely. Perhaps the most significant effect is the decrease in time to treat trauma patients. Patients can be either treated locally with the assistance of a remote expert or quickly transferred to an appropriate center. As we know, Indonesia have so many islands. Teletrauma can be more usefull to connect the doctors when the trauma care centre is too far away from the rural hospital. We can prevent the mortality on trauma cases if the doctors can communicate well to another doctors at another hospital (specialist) so the GP at the rural hospital can perfectly manage the right things for the patient. As we know that the three important things on trauma and emergency care is 3R = three hours bringing the right patient to the right place at the right time.

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Treat A Burn with HONEY Nilam Nabilah Kusuma, Ahmad Fadhil Syahbani, dan Nurul Arifa

The skin is one the susceptible body organs, and one of cause when there is a burn. Burns gives a great effect on humans, especially in terms of human life, suffering, disability, and financial losses. Burns can be caused by thermal injuries (fire, liquid/ grease, and steam), radiation, electricity, chemistry . The burn is a common problem faced by the doctors, which burns itself consists of minor burns, moderate burns, and severe burns. Some studies say the healing of burns with honey effect rapid healing and effective, thus be an alternative choice. In this case we can use honey for mild to moderate degree burns, so it is very useful for life. As already known, honey has a high osmolarity, and also antibacterial properties. Honey mechanism as antibacterial can be classified as direct and indirect. Direct mechanism is based on honey components ability in killing bacteria. This mechanism consists of the formation hydrogen peroxide (H2O2), high osmolality, low ph, non-peroxide factor and fenol. Indirect mechanism is host antibacterial response which honey help stimulate. This mechanism consist of lymphocyte, antibody production, cytokine, immune response and nitrite oxide. The time healing wounds treated with honey faster than wounds treated with other drugs. Honey provides a moist environment, help cleaning the infection, reduce inflammation, edema, exudation, and promote the healing process by stimulating angiogenesis, granulation, and epithelialization so that provide excellent cosmetic results. Honey to be an effective as topical therapy for burns due to substances in it.

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Title : Is It Epidural Hematoma? Spot the AGENTS! Authors : Putu Astiswari Permata Kurniawan1, Maftuhatur Rizkiyah Putri1, Ravell Hansen Untono 1

Abstract Background : Epidural hematoma is when bleeding occurs between the tough outer membrane covering the brain (dura mater) and the skull. Epidural hematoma is a surgical emergency. Delayed surgery can result in permanent brain damage or death. Without surgery, death usually follows, due to enlargement of the hematoma, causing a brain herniation. Epidural hematoma complicates 2% of cases of head trauma (approximately 40,000 cases per year). Epidural hematoma occurred in 1% of head injury cases. The highest incident occurred in between the age of 20-30 and about 5-15% cases in patient with severe head injury. An epidural hematoma has a high risk of death without prompt surgical intervention. Even with prompt medical attention, a significant risk of death and disability remains and also a risk of permanent brain injury. Mortality rate associated with epidural hematoma has been estimated to be 5â&#x20AC;&#x201C;50%. We suggest this topic based on various need of urgency and the severity of epidural hematoma explained above. Objective : Sometimes epidural hematoma bleeding does not start after the occurrence of head injury. The symptoms of pressure on the brain also do not occur right away. This is why medical practitioner need reference to do screening to know the symptoms of epidural hematoma through this poster. Medical practitioner is expected to understand the procedures and execute before the symptoms worsen. Conclusion : Actually, epidural hematoma does not leave severe complications if treated properly. But due to the lack of awareness by medical personnel, epidural hematoma becomes severe over time. Due to

450

the absence of specific symptoms of this epidural hematoma, it is often considered trivial by medical personnel. We hope that by raising the topic, it can reduce the incidence rate of deaths from epidural hematomas. References : Binder H, Majdan M, Tiefenboeck TM, Fochtmann A, Michel M, Hajdu S, et al. Management and outcome of traumatic epidural hematoma in 41 infants and children from a single center. Orthop Traumatol Surg Res. 2016 Oct. 102 (6):769-74. Bir SC, Maiti TK, Ambekar S, Nanda A. Incidence, hospital costs and in-hospital mortality rates of epidural hematoma in the United States. Clin Neurol Neurosurg. 2015 Nov. 138:99-103. Khairat, Ali; Waseem, Muhammad (2018), "Epidural hematoma", StatPearls, StatPearls Publishing, PMID 30085524, retrieved 2019-02-13

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One Click for Save One Life R. Mohamad Javier1, Yusfiana Zura A.1, Cahya Rapelia1

Ambulance is a vehicle equipped with medical equipment to bring sick patients or postaccident patients who need first aid. In Kumamoto, Japan, an ambulance can call number 110. Five minutes after the call, an ambulance will arrive. Less than three minutes later the ambulance moved to the hospital. Ambulance is equipped with various equipment for first aid. At first glance the car looks like a walking hospital. Ambulance is managed by the City Fire Department. The location of the service office is in accordance with the plan of the urban planning office, so that the farthest distance from the service office in the service area is five minutes. Successfully, every citizen launches 110 services, requesting five minutes later an ambulance arrives. The condition is very different from in Indonesia. Ambulance in Indonesia can be activated through service numbers 118 and 119 and will arrive 30 minutes later or even longer. Many people prefer using private vehicles rather than requesting an ambulance service. Ambulance is managed by many parties, including hospitals, so the telephone service numbers are different. Long distance and traffic conditions in the city of Malang which are often jammed make ambulance services less than optimal. Therefore we have a new breakthrough to overcome this, the Ambulance Application. By using the ambulance application, we will know where to find the nearest ambulance for emergency needs. With the additional GPS service, an ambulance can be launched immediately to adjust the distance and location closest to the caller. So, the ambulance will come sooner. This application can be downloaded for free on iOS and Android. So, with just one click, we can save one life.

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First Aid Care for Fracture with LIMBS Rahmaniar Nurul Aini Setyawan Veronika Vita Kurniawati

Abstract A trauma is an injury that appears on the parts of body or the whole body as a result of physical impacts. A trauma occurring in bones might cause fracture or dislocation. Indonesia is a developing country which is in the middle of industrialization. Industrialization will affect the increasing of mobilization in the society which causes the high level of traffic accidents. It often causes bone fractures. According to WHO, there were 1.3 million people who died because of fractures caused by traffic accidents in 2011. There are two types of fractures: open and closed fractures. Open fractures damage skin tissues because the bone is seen in the surface, and there is wound. The first aid of open fractures is removing the damaged tissue or foreign objects from the wound and giving antibiotics. Closed fractures have no complication. Usually, the skin is woundless, and the bone does not protrude on the skin. Closed fractures are caused by injury mechanism like sprain, falling down, and struck down by a heavy object The danger of a trauma is that it does not always show noticeable symptoms. It seems okay, but actually the patient is bleeding and having organ damages inside. The main symptoms of traumatic fractures are: 1. 2. 3. 4.

Deformity (the changes of the body shape caused by bone dislocation) Inflammation (bruised, swollen, and skin gets reddish) Bleeding / hemorrhage (especially in open fractures) Shock (skin gets blueish because the capillary permeability increases, and the oxygen level gets down)

Conclusion: People kno ledge of he fi aid of f ac e i con ide ed no ade a e o lo . The bigge mistake is moving the patient carelessly. It can increase the death risk of fracture patients. The thing should be done is educating people about the first thing to do to handle a fracture.

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A STARTER Pack for Safer Sports: Remember Do CARE and Do Not HARM Raina Maharani Tasyandita, Alif Nurul Hikmat, Arina Vira Zharfan

Sports injury is an injury emerges during pre-match (exercise), in a match, or after match. The data states the high incidence of sports injuries in adults reaches 1.5 million times a year with half of them being serious injuries, while in children and adolescents it reaches 3 - 4.3 million times. This incidence rate is twice as high in contact sports than in non-contact sports. This relatively high incidence makes the socialization about the prevention and first aid steps in sports injuries is an important thing to prevent fatal complications. Pe e i g

i j

ca be ea il d

i h STARTER . Begi

i h Stretching to

prevent muscle strain. Mind your food and fluid inTake and do not let your cells suffer. Besides stretching, wARming up is a must. Learn the right Technique from professionals or coaches. Wear proper Equipment such as shoes or helmet. And last, do not forget to Rest in between your hard work. If a i j

ha e , d

•

Cooling

•

Apply pressure

he CARE a he fi

e :

put an ice pack on injured part for 20 minutes, 4-8 times a day give the injured part a light press by dressing it with soft and elastic

bandage to prevent it from moving too much. •

Rest

•

Elevation

rest the injured body part

Al , emembe •

elevate the injured part to help increasing blood flow HARM a he hi g

be a ided, a i ca

he i j ie .

Heat heat tends to dilate the tissue, it can be given approximately 48 hours after acute phase.

•

Alcohol

causing the patient to feel painless and keep using the damaged body part

which can worsen the injury •

Running

movements worsen swelling and pain

•

Massage

it worsen the damage by distressing the muscles and the nerves around it.

References:

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i, T i Ok a ia i. PENANGANAN CEDERA OLAHRAGA. Indonesia Fitness Trainer Association, https://www.apki.or.id/penanganan-cedera-olahraga/.

Supartono, Ba ki. Pe a alak a aa

Cede a Di Kej a aa

Olah aga.

Media Informasi

Rumah Sakit Olahraga Nasional (RSON) Edisi 5 Tahun II , 3 Dec. 2015, pp. 11 19. Retrieved from http://kemenpora.go.id/data_kliping/files/Majalah RSON/Majalah RSON Edisi 5.pdf

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Author : 1. Rea Sava Kinanti S 2. Nuzul Nur Hanifah 3. Yolanda Ruth F S LET'S BEAT ALZHEIMER WITH REMEMBER This poster was made because of the high amount of elderly in Indonesia, as alzheimer commonly happens at old-aged people. Based on national survey, on 2015, there were 22,7 million elderlies in Indonesia. Meanwhile, in the same year, there were about 5 millions elderly with alzheimer in Indonesia. From this data, we can conclude that the prevalence of alzheimer in Indonesian elderly is about 22,02%. Beside that, Indonesian people usually consider "forgetting something easily" as a trivial thing. They still have a low rate awareness of alzheimer. Alzheimer is a disease which can be caused by severe traumatic brain injury which happens for a long time and continuosly. Commonly, alzheimer happens because of protein sedimentation in brain. This sedimentation will obstruct the absorbtion of nutrition by brain cell and through unknown mechanisms, this process appears to provoke a gradual loss of synapses and, later, nerve cell bodies in hippocampus and cortex. The neurodegeneration produces a decline in cognitive capacities. Eventually this decline depletes compensatory or redundant brain circuitry (cerebral reserve), symptomps appear, then tend to ruin many processes in our body (Zandi & Breitner, 2001). Beside that, alzheimer can be caused by head bump too. Some symptomps of alzheimer, are: starting to forget somethings negligible, then sooner or later that negligible things will become crucial things. Not only that, alzheimer can change our personality and decrease our cognitive function. Through this poster, we want to educate others and invite them to prevent alzheimer, starts from small things, such as : reducing smoking, exercising, using personal protective equipment, and etc. Source : Zandi, P. P., & Brei ner, J. C. S. (2001). Do NSAID pre en Al heimer di ea e? And, if so, why? The epidemiological evidence. Neurobiology of Aging, 22(6), 811 817. https://doi.org/10.1016/S0197-4580(01)00297-4

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Title: TREAT ACID WITH A.C.I.D. Content/Abstract Poster: Chemical burns, which are often work-related, are unique injuries that require individualized treatment and management depending upon the causative agent. They account for 4 percent of admissions to burn units in developed countries and up to 14 percent in underdeveloped countries. A variety of chemicals are manufactured for household, agricultural, industrial, and military use, with an estimated 60,000 new chemicals produced each year. The potency and concentration of the toxic agent and the duration of contact primarily determine the degree of tissue destruction. Therefore, it is critical that treatment be started immediately. In the great majority of cases, the management of topical chemical burns. For management of toxic exposures, it is helpful to make people understand about chemical burn management. Our content is based on Robert et al., 2017 journal about Management of chemical burn with title Che ica B

. S

e conclude the most important first aid of chemical burn injury with

A.C.I.D. and here are: A : Ambulance Calling C : Carefully Remove Contaminated Clothe I : Immediately Rinse with Clean Water D:D

a i e he B

ihA ai

Conclusion The most important first aid of chemical burn injury concluded become A.C.I.D. and here are : Ambulance Calling, Carefully Remove Contaminated Clothe, Immediately Rinse with C ea Wa e , D

a i e he B

i h A a i.

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463

Do The Conch i A a e of C ab

o Sa e Li e

Abstract Road injury happens all the time, non-fatal road injury affects around 50 million people in the world every year, road crashes are also responsible for the loss of 1.2 million lives each year globally, half of them are pedestrians, cyclists, and motorcyclists. Road Injury has become top five killers globally, and it is predicted to continue increase as the number of vehicle increase too as example in developing countries. Road injury is also being a concern of united nations as it is listed as a target in the sustainable development goals (SDGs). Therefore, as a member of society we need to know some basic knowledge and some practical step to take when road injury happens. Here are the simple things you can do to save lives: 1. Check the Consciousness of the casualty. 2. Clear the area, make it secure from further dangers for you and the casualty 3. Call for help by dialing 119 or 118 for ambulance 4. Check the airway of the casualty 5. Observe the breathing of the casualty 6. Note his /her circulation 7. See if there are external bleeding, Wound, and Fractures 8. Make sure that the casualty remain still & Immobilized fracture by splinting to make all of these steps are easier to remember, they are made into a mnemonic, The Conch is Aware of Crabs Conclusion From the elaboration before, authors refer that traffic injury is one of the most crucial and urgent public health problem we as a society need to face. We have to educate, and guide the people to be a better prepared society when facing this problem by providing basic knowledge, and some practical step to take when traffic injury happens.

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Authors: - Rezky Adisatrio - Muhammad Abdurrahman Ar-Rizqi - Moch. Rizky Fathurochman

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Authors

: Rezky Ilham Yudhasaputra Rizqi Bagus Setyawan Shafina Armareta Yasmin

Title

: Don’t Get Freaked and Tricked by a Venomous Snake Don be F eaked and T icked b a Venomo Snake

According to World Health Organization (WHO), there are up to 1.8-2.7 million cases of venomous snake bites around the world, with 81,000-138,000 cases ended up fatal. 76 species of said venomous snake have been discovered in Indonesia, with effects of bites ranging from paralysations to death. Although official count is not available up to date, according to DR. dr. Tri Maharani, M. Si SP. EM, such case can occur up to 135,000 cases annually. Without proper care, there is high risk of serious trauma and even death for the lack of action needed towards the rapidly spreading snake venom. The reason behind our decision to choose the 4 th subtheme under the title of “Innovation System and Treatment in Emergency Medicine Regarding Traumatology” is the concern for the need of the people’s awareness regarding the danger of venomous snakes’ bites and the proper care for said cases in order to minimize the trauma and fatalities that might occur. The lack of government given intervention, quality care, and access to crucial antivenom, along with the minimum knowledge of venomous snakes’ bite treatment inside the common society resulted in many victims left untreated or minimally treated, hence the given WHO classification of “Neglected Tropical Disease”, both of the actors responsible being the target of our work. This work is also meant to clarify the myth and mistreatment in trauma care for the fact that there are still many faulty treatment mechanisms commonly found and done by the people, e.g. but not limited to incision, suction, tourniquet, chilling, and heating. In order to spread the awareness and knowledge of preventive and curative actions for cases of venomous snakes’ bites, thus this work is made, for both actions are essential to achieve the dive of number in trauma and fatalities of said case.

References :

467

Agustin, H., Hidayat, D. R. and Supriadi, D. (2019) ‘Anatomi Konflik Komunikasi dalam Penanganan Neglected Tropical Disease di Media Sosial’, Jurnal Ultimacom, 11(1). Longbottom, J. et al. (2018) ‘Vulnerability to Snakebite Envenoming: A Global Mapping of Hotspots’, 392. Medikanto, A. R. et al. (2017) ‘VIPERIDAE SNAKE BITE : KASUS SERIAL VIPERIDAE SNAKE BITE : CASE SERIES’, (April), pp. 361–374. Putra, L. M. (2017) ‘Kasus Gigitan Ular Makin Banyak, Pemerintah Bikin Program Penyelamatan’, Kompas.com, p. 2017. World Health Organization (2016) Guidelines for the Management of Snakebite. 2nd Edition. New Delhi: World Health Organization.

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DON’T BE FREAKED & TRICKED BY A VENOMOUS SNAKE

MYTH TOURNIQUETS

DID YOU KNOW ? There are up to 1.8-2.7 million cases of venomous snake bites around the world, with 81,000-130,000 cases ended up fatal (WHO,2009) No official count is available up to date, but with 76 species of said There is only one anti SUCTION venomous snake have been venom possessed by the discovered in Indonesia, there are government which treated estimated 135,000 cases take only up to three kinds of ! place annually ES snake venom up to the K (Kemenkes, 2017) S S NA publishing of this work U O EN OM (Kemenkes, 2017) V F O ZE THE CHAR A CTERISTICS OGNI REC THE SOUND AND BEHAVIOUR they make defense when they feel TRIANGULAR HEAD SHAPE threatened

A PAIR OF BIG FANGS

INCISIONS OR PRICKS

COLOURING AND PATTERNS - longitudinal rows of large - dark-rimmed - pale-centred spots - black and yellow circumferential bands

APPLICATIONS OF CHEMICALS OR USING HERBS

FACT PREVENTION USING ICE PACKS OR WARMING

Never handle, threaten or attack snakes !

THE FIRST MEDICAL ATTENTION Keep the victim calm !

Sleep under a well-tucked–in Make sure the bite is located mosquito net, ideally on a raised bed ! higher than the heart ! Clear rubbish and undergrowth from Immobilize the whole of the patient’s around the house ! body in the recovery position ! Immobilize the bitten limb with a Use a light and prod with a stick splint or sling ! when walking outside at night ! Do not attract snakes to homes by keeping livestock indoors. encouraging rodents !

Take images of the snake if possible to allow expert identification !

Solid shoes or boots are recommended especially during agricultural activities !

Transport the patient to a place where they can receive medical care as quickly !

REZKY ILHAM YUDHASAPUTRA

RIZQI BAGUS SETYAWAN 469

SHAFINA ARMARETA YASMINA

Antibiotics in open fracture Author: Richard Harris, Eliasyer, Jonathan Willam Goutama In dealing with fractures, treatment is usually more focused on healing the wound. But many people donâ&#x20AC;&#x2122;t realize that open fractures can be an entrance from bacteria that can cause infections to complications such as cellulitis, osteomyelitis. So there are fracture wounds need to use antibiotics in the treatment. So this abstract and public poster aims to provide information to the reader regarding the use of antibiotics in treating fracture wounds. Open fractures themselves are divided into grade 1 ie wounds less than 1 cm long and clean can be used cefazolin antibiotics, grade 2 wounds more than 2 cm without extensive soft tissue damage, grade 3 ie broad open fractures with extensive soft tissue damage, or until amputation. In grades 2 and 3 antibiotics are used cefazolin and gentamicin Before being given antibiotics the wound should be debrided. Provision of prophylactic antibiotics should be given as soon as possible to prevent gram-positive bacterial infections and in grade 3 injuries also need to be considered the use of antibiotics for gram-negative bacteria. In grade 1 and 2 fractures antibiotic use can be stopped after 24 hours of closed injury, whereas in grade 3 fractures, antibiotics are stopped if 72 hours have been closed or less than 24 hours if the soft tissue is closed.

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3C: An Extraordinary Way to Settle Tension Pneumothorax Rohimatul Alya Dewi Alfina1, Naufal A. Waskita1, Alieftya Paramitha1

Aim

: Using an unusual treatment regarding traumatic tension pneumothorax.

Background : Injury is an increasingly significant health problem throughout the world. Everyday, 16000 people die from injuries, and for every person who dies, several thousand more are injured, many of them with permanent sequelae. Injury accounts for 16% of the global burden of disease . Pneumothorax is one of an important complication of blunt chest trauma. The aim of this poster is to report explain the treatment strategy of traumatic pneumothorax . Tension pneumothorax is one the type of traumatic pneumothorax. It is an important case which have to resolve it immediately. Sign and symptoms of it are cyanosis, tachycardia, and hypotension. Generally, to solve this problem get to remember airway, breathing, circulation, disability and exposure approach. The recognition of tension pneumothorax, its primary treatment by needle thoracostomy and definitive treatment by tube thoracostomy are essential at all hospital-level facilities that handle trauma. Meanwhile, it is not only use a needle, but also can use a sharp contour like a pocket knife for emergency situation like if there is not any needle for used. For replacing the chest tube can use a pen. A search was conducted in PubMed with the search term used ee

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and , along hi

ea men .

Conclusion : This poster contain how to handle an emergency patient with tension pneumothorax using 3C (Comfort, Cut, and Carry). Besides, if there is none of needle and tube for thoracostomy, can use pocket knife and pen to do the treatment immediately. Key Finding : Traumatic Tension Pneumothorax, Signs and Symptoms of Tension Pneumothorax, Treatment

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Your Appearance Saves Your Feet Authors: 1. Ronald Wongkar 2. Ervin Widyantoro Pramono Diabetes mellitus is a chronic disease that affects almost 200 million people in the world. Americans note that diabetes mellitus treatment requires expensive costs. The International Diabetes Federation (IDF) noted 8.5 million Indonesians suffer from diabetes mellitus at the age of 20-79 years and will increase to 14.1 million by 2035. The Center for Disease Control and Prevention (CDC) in 2004 said 60-70% of people with diabetes mellitus experienced peripheral neuropathy with symptoms of loss of sensory sensation of the distal extremities so as to cause plantar ulcers. Plantar ulcers in patients with diabetes mellitus is caused by many factors such as blood vessel disorders, wound history, poor foot care, poor metabolic control and the use of inappropriate foot protection. Plantar ulcers can complicate to infection, sepsis to amputation Leg protective equipment is important for people with diabetes mellitus, the tool serves as a preventative measure for plantar ulcers by reducing pressure on the plantar foot so that it will prevent ulcers. In order for foot protective equipment to reduce pressure on the plantar, it is necessary to make modifications such as: 1. Insole Custom-made insole is needed, because it has the function of reducing pressure through the principle of "full contact", so soft materials are needed 2. Shoe height Differentiated into 3, namely high, bottie and low. To protect the toes, the low type is used 3. Outsole flexibility Differentiated into 2, namely stiff and springy. The springy shape should not be more springy than the contour of the foot because it will cause friction between the foot and the inside of the shoe 4. Leg

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Stiff outsole when combined with high and springy legs will cause the shoes to contract and friction in the feet. 5. Heel, made from elastic material to increase the ability of shock absorbance.

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YOUR APPEARANCE SAVES YOUR FEET What Is Diabetes Mellitus Diabetes mellitus is a chronic disease that affect almost 200 million people in the world. IDF noted 8.5 million Indonesia suffer from diabetes mellitus at the age of 20-79 years. CDC in 2004 said 60-70% of people with diabetes mellitus with loss of sensory sensation of distal extremities cause plantar ulcer.

COMPLICATION OF PLANTAR ULCER

INFECTION

PREVENT PLANTAR ULCER WITH

SEPSIS

AMPUTATION

HEIGHT

HEEL

OUTSOLE

1. Heel Made from elastic material to increase the ability of shock absorbance. 2. Shoe Height To protect the toes, the low type is used.

3. Insole custom-made insole is needed, because it has the function of reducing pressure throught the principle of “full contact”. So soft materials are needed. 4. Leg Stiff outsole when combined with high and springy legs will cause the shoes to contract and friction in the feet.

Authors: 1. RONALD WONGKAR 2. ERVIN WIDYANTORO PRAMONO

5. Outsole Flexibility The springy shape should not be more springy than the contour of the foot because it will cause friction between the foot and the inside of the shoe.

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DROMEDS: Assistance Is a Drone Away Sagung Ngurah Anindita Pradnya Dewi (1st), Astrid Cynthia Latief, Luna Azhria Public Poster Abstract The failure of emergency medical treatments in Indonesia can be caused by many factors, and those factors are; the lack of facilities on the hospital of some area, uneven distribution of medicine needed, geography factors, and a lack of distribution of medical personnel. Also based on prevalence, that we have over than 30% of death is caused by the delayed of emergency medical treatment due to limitations by situation itself. For example, the trauma injury due to natural disaster that regularly happens in Indonesia. Natural disaster usually cause some damage which will hamper access to the location. Based on cases that we have, we would like to bring something that will help our country to better the health services and increase the life figure rate. DroMeds (Drone of Medicines) is a convenience in medical needs. This technology is designed to facilitate medical needs by providing immediate distribution of medical needs such as medicines. This service can be accessed by all health agency or health personnel in Indonesia be it by phone call, radio or other modes of communication, then nearest drone station will receive the call and prepare all medical needs that have been requested and directly send it all with drone to the location.

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Pass De Crab and Splint Satria Angga Widitama, Fildza Intan Rizkia, Amirah Rana Aqilah AMSA-

Background: Over 3.700 people die on the world's roads every day and tens of millions of people are injured or disabled every year. Children, pedestrians, cyclists and older people are among the most vulnerable of road users, according to World Health Organization (2019). Not only death, traffic road accident also causes another 2.35 million people to be injured or disabled, and one of the examples is limb deformation that results in mobility impairment. This is important to notice, that the first aid by the bystanders to the victim may reduce the number of disability caused by the traffic road accident.

Objectives: Our objective is to give a brief education about how to treat bone fracture to someone who is the first one who arrive at the site of accident. The first thing we want people to know is how to notice a bone fracture. Pass de Crab is shortened so people remember that the signs of bone fracture are pain, swelling, tenderness, deforminity, crepitation and abnormal motion of the limbs. It is followed by a brief guideline to help those with bone fractures. It could be done with 6 steps included in the poster; Call, Identify, Prepare, Assess, Splint, and ReAssess. Our target audiences are people with any kind of educational background who are often use the road.

Conclusion: In conclusion, we believe that even with the most advanced emergency system will be ineffective if the first one who come to the site of accident can not recognize a serious injury. Bystanders can play an important role by giving first aid to bone fracture, to reduce the number of disability caused by road traffic accident

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Abstract Treat Burns Better Shafira Aulia, Adeela Sandria, Nadhirah Siti Lutfiyah

Background: Burns are one of the leading causes of accidental injury along with drowning, suffocation, choking, poisonings, falls, and fire arms. Accidental injury can lead to death. More than 600 children die every year in fires, or from other burn injuries. The degree of burn injury plays a lot of role in its complication and mortality. Most of the severe burn injuries originated from the incorrect treatment of mild burn injuries. The wrong treatment can lead to infection, repairment disturbed, damage of tissue, and worse burn. There are a lot of false information about the treatment for burn injury that causes worse conditions for the patient. The most popular myths are applying toothpaste, margarine, or ice cubes on the burns. In fact, those treatment will only worsen the condition of the wound. Objective: The purpose of this public poster is to correct false information that has been spreading around for a long time in society about the treatment of burn injury. We also provide informations about the reasons why those false information are false and dangerous. Through this poster, we also want to give education to people about what the correct things to do when they get burn so it can prevent the wound from becoming worse. Conclusion: People must be able to differentiate the right and wrong treatment for burn injury in order to decrease the risk of increased severity of burn injury. Therefore, it will also decrease the risk of unintentional death and injury.

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SMART Farmer Abstract : A workplace accident is one of the risky things in agroindustrial. Every year, more than 1,1 million people die from occupational accident in asia, especially in Indonesia. Remember, in Indonesia more than 40% of the workforce is dependent on this sector for their life. Based on ILO data, more than 1,3 million people working in agriculture around the world. Unfortunately, accident occurrence in this field is high since the increasing use of farm equipment which leads to the death of victim. Compare with developed country, the accident occurrence in developing countries is four times higher. Related to the statement above, the common types of occupational health hazard of agriculture are weather, chemical hazard such as pesticides, machinery & equipment or sharp tools. Indonesia has a tropical weather. The most common people in agriculture have not paying attention for personal protective equipment. Every people who work in agriculture have a high potential risk to expose skin cancer. In a

ide, ma

ag ic l

ae e

ed chemical

a dail ba i . If he d

observe proper precaution, illness or even death may ensue. Such as irritation injuries, acute polsohings and cancer. Agricultural workers often use hack, sickle and the other tools or machine. The equipment are potentially cause a workplace accident if not use properly. It can happen because a lack of knowledge, especially related to use personal protective equipment which will cause such as amputation, fracture, etc. Aim : Reduce workplace accident in agriculture areas Conclusion : To achieve this goal, we made an innovation for a farmers with the SMART farmer method which has the following content : S : Stay Safe In Agriculture Areas M: Making Sure Everybody is Good A: Ask People for Help R: Reduce High Risk T: use the right Technique

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Every Drop is Worth Tasya Wikassa, Valensia Irawan, Chelssi Gloria Abstract According to the World Health Organization, traumatic injuries worldwide are responsible for over 5 million deaths annually. Injuries worldwide cause more than 16,000 deaths per day. Bleeding is a leading cause of death following traumatic injury for those patients who are admitted to hospital. Bleeding to death can happen very quickly intervening. If the hemorrhaging is not stopped, a person can bleed to death in just five minutes. And if their injuries are severe, this timeline may be even shorter. More than half of people with traumatic injuries die within minutes of the accident or injury. As many as 20% of people who die from trauma injury could have survived with quick bleeding control. Despite these facts, awareness of this problem is insufficient and treatment options are fften unclear. Therefore, educating the public on how to stop bleeding is essential. Conclusion Knowing traumatic injuries can cause severe bleeding that can lead to death, we want to educate people about the things that can be done to stop the bleeding, so that it could be applied to oneself or to others when needed. References Rossaint, R., Bouillon, B., Cerny, V., Coats, TJ, Duranteau, J., Fernรกndez-Mondejar, E., ... & Nardi, G. (2013). The STOP the bleeding campaign.critical care,17(2), 136. World Health Organization. (2008). Violence, Injuries, and Disability: 2006-2007 Biennial Report. Geneva: World Health Organization.

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Abstract ELECTRICITY: CONTROL ITS SAFETY, BE A HERO! Shafira Aulia Hanifa, Tatyana Milenia, Muhammad Rizki Ramandha Background: Electricity is very important for modern life. However, electricity has the potential to cause fatal accidents. According to a cross sectional study of patients with burns admitted to the Burn Centre of Dr. Soetomo Hospital between January 2015 and December 2018, there were 16% of cases of burn injury (50%), which became the third highest etiology. The death rate due to electric shock is around 500 deaths per year in the United States. More than half of these occur at work and are the fourth leading cause of work-related deaths. Electrical injuries are also a cause of considerable morbidity. The incidence of burns due to electric shock accounts for about 2 -3% of all burns in children who need emergency care. Electrical injuries, not as often as other burns. But often associated with high morbidity and mortality. If not fatal, the damage can cause dysfunction of tissues and organs in a multisystem. Heart is one of the organs most vulnerable to electric shock injuries. Exposure to electric current can cause abnormalities such as structural damage, arrhythmias, and conduction disorders. and blood vessels are the best conductors for electrical current. That is because humans are good conductors of electricity. This electric accident is not only caused by high voltage, but also the electric current is very influential, where even a home with 100-200 amperes of electricity also has the potential to cause life-threatening electrical injuries. All age groups have a tendency to get electrical injuries. Children tend to experience low-voltage electrical injuries, adolescents with active exploration cause high-voltage electricity, while adults suffer electrical injuries due to work. So, electrical injury is uncommon but a life threatening. Based on those occurred conditions, we hope that through this poster, it can be an education for the community to prevent themselves, their children, their families, friends, and anyone else from experiencing electrical injury that is quite possible due to many risk factors around them, by CONTROL the safety of the electricity.

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Objective: The purpose of this poster is to create knowledge about electrical injuries, motivate people to prevent electrical injuries, and educate how to prevent electrical injuries. And we believe, with the achievement of these objectives, the community will be more alert to electrical injuries which are fatal, and can be avoided from the community. Conclusion: We made this poster to provide knowledge, and simple steps to prevent electrical injuries through attractive ways. So that people are easier to be attracted to, and encouraged to do the prevention. We hope that with this poster, the public will know and be increasingly aware of the dangers of electrical injury, so it will create a smart community, and a safe environment. Reference: Abstracts from the 12th Asia Pacific Burn Congress. (2019b). Burns & Trauma, 7(S1). https://doi.org/10.1186/s41038-019-0164-1 Electrical injury: MedlinePlus Medical Encyclopedia. (2018). Retrieved December 5, 2019, from Medlineplus.gov website: https://medlineplus.gov/ency/article/000053.htm Octaviani, D., & Wulan, A. J. (2016). Nomor 4 I Oktober 2016 I 60. Jantung MAJORITY I, 5(4), 60â&#x20AC;&#x201C;61. Retrieved from http://juke.kedokteran.unila.ac.id/index.php/majority/article/viewFile/885/793 Zemaitis, M. R., Foris, L. A., Lopez, R. A., & Huecker, M. R. (2019, July 31). Electrical Injuries. Retrieved from Nih.gov website: https://www.ncbi.nlm.nih.gov/books/NBK448087/

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SAFE : (S)mart (A)ctions to decrease (F)atality Rate in Traffic (E)xperience Timothy V. P. Reba, Joyna Getruida Sopaheluwakan, Angela Lady Kezia

Abstract Trauma is the fourth leading cause of death overall for all ages. It is predicted to become the third largest contributor to the global burden of disease by 2020. In trauma, road traffic accidents are considered the ninth leading cause of death and account for 2.2% of all deaths globally. Approximately, 1.3 million people die in road traffic accidents each year an average of 3287 deaths/day. In addition, 20â&#x20AC;&#x201C;50 million people are injured or disabled. In Indonesia, traffic accidents are dominated by motorcycles, which also contribute the highest portion of fatalities and major injuries (AIS score > 3). Most traffic accidents can be attributed to human, road and environmental, or vehicle factors. Careless driving and unruly behavior of the driver are the main causes of accidents in Indonesia. Meanwhile, the number of traffic accidents due to alcohol was not significant (1%). In other factor, a study carried out on prescription medication usage and their influence on road traffic accidents noticed that drivers who used centrally acting drugs had 2.16-times increased risk of accidents. Also, road and environmental factors that caused traffic accidents amounted to 8% were mainly due to road damage and potholes, slippery roads, sharp turns, and inadequate lighting.

Conclusion Based on the data of the main causes of traffic accidents dominated by human factors, it is critical to strengthen driving education to reduce careless and unruly driving behavior. Improvement of road infrastructure is also needed to reduce traffic accidents caused by driver fatigue and road conditions. It is critical that every effort be made to decrease the impact of injury on the global burden of the disease. We believe that trauma injury can be prevented and many lives saved by learning more about the causes of injury and implementing appropriate injury prevention strategies.

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Child Abuse Issues that Affect Growth in Traumatology Authors : Veronica Agrippina Franesta,Shindie Dona kezia lethulur

Abstract : Traumatology is the study of injuries caused by accident and repair of damage or violence to a person. Childhood and adolescence are vulnerable to psychological trauma. However, it is also possible for adults to experience psychological trauma. In children, psychological problems can occur due to poor parental treatment, witnessing parental divorce or quarrels, bullying cases, abuse, physical abuse, etc. The report "Global Report 2017: Ending Violence in Childhood" as many as 73.7% of Indonesian children aged 1-14 years experience discipline with psychological violence or aggression and physical punishment at home. Strengthened by the data of the Indonesian Child Protection Commission which recorded 4,294 cases of violence against children perpetrated by families and caregivers (from 2011-2016). The most cases occurred in 2013, namely 931 cases of child abuse. However, this number continues to decrease to 921 cases in 2014, 822 cases in 2015, and 571 cases in 2016. The cases of violence that occurred at home and care are ranked second on the top, after the problem of children involved in legal cases recorded as many as 7,698 cases . In an environment that should be the safest place, children are very vulnerable to becoming victims of violence. Physical violence against boys affects smoking behavior as much as 78% and drunk as much as 33%. While women are drunk (14%), self-harming (6.06%), and smoking 5.69%. On the other hand, emotional abuse will have an effect on smoking behavior (57.5% ) and intoxication (42.7%) in boys. Whereas girls hurt themselves 42.9%, attempted suicide 34.4% thought of suicide 32.6%, smoked 13.51%, and drunk 13.18%. Prevention that can be done is legal and psychological assistance. The rehabilitation that can overcome emotions due to conditions, sadness and severe pain is to love, forgive and start a new day for tomorrow when the sun rises again.

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"How to Handle the Initial Accident Trauma Victims"

Abstract handling trauma with the ABC approach (airway, breathing, circulation) is the first step that we can do to reduce the burden of injury. The purpose of this poster is to give information to the public about the priority order of handling trauma victims. This poster is a type of public poster with simple content. This poster manufacturing process is done by collecting material from various sources. The results of the poster contain the theme discussed, which is about Trauma Care with a comprehensive solution.The poster about handling trauma is very useful to understand how the optimal way to increase public knowledge about handling traumatic because trauma can happen anytime and anywhere. Keywords : trauma, ABC approach, first step to handle trauma

Conclution We hope this poster can increase knowledge of public about how to handle the initial accident trauma victims, so that public can do it if they find that which is often case we found because almost everyday an accident occurs.

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“Whiplash: Not Just A Pain in the Neck” Wilhelmina Wilma Wijaya, Bernadette Tissa Anggita, Prasista Ariadna Kusumadewi Abstract Trauma by traffic accidents is one of the top causes of death and disability in Indonesia. Police reports that every hour, an average of three people die because of road traffic accidents. A common type of accident being rear-end collision; where one car hits the rear of the car in front of it. A classic consequence of rear-end collisions is a trauma to the neck commonly called the “Whiplash” injury. This injury is a rapid high-force movement of the neck, similar to the cracking of a whip. Symptoms of whiplash include neck pain, dizziness, battle’s sign bruising, raccoon eyes bruising, bleeding from nose/ear, difficulty of breathing, and sensation loss. Prognosis of whiplash patients is unpredictable: 50% could recover fully while the remaining 50% would experience serious ongoing disability, such as post-traumatic stress symptoms, depression, anxiety, higher intensity of chronic neck pain and disability. Poor prognosis could very likely be attributed to initial first-aid treatment in the field before patient is treated in an emergency room. In whiplash injury, it is crucial to steady and fixate patient’s head to prevent further anatomical alterations that could lead to long-term medical complications. This first-aid step done by a layperson or bystanders, EMT, or paramedics, could change a patient’s prognosis drastically to be on a milder recovery trajectory. Conclusion The purpose of this poster is to raise awareness on how to recognize the particular case of “Whiplash” injury, a trauma mostly caused by traffic accidents, and more importantly emphasize how first-aid treatment and pre-hospital trauma care could make a drastic difference in patient prognosis and a solution in helping emergency departments treat road accident patients better. Another key message to take away is that implementing safety in driving motor vehicles could highly prevent this injury, as well as many others, from taking place.

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References 1. Arbon, P., Hayes, J. and Woodman, R. (2011). First Aid and Harm Minimization for Victims of Road Trauma: A Population Study. Prehospital and Disaster Medicine, 26(4), pp.276-282. 2. Bussières, A., Stewart, G., Al-Zoubi, F., Decina, P., Descarreaux, M., Hayden, J., Hendrickson, B., Hincapié, C., Pagé, I., Passmore, S., Srbely, J., Stupar, M., Weisberg, J. and Ornelas, J. (2016). The Treatment of Neck Pain–Associated Disorders and Whiplash-Associated Disorders: A Clinical Practice Guideline. Journal of Manipulative and Physiological Therapeutics, 39(8), pp.523-564.e27. 3. Griffin, A., Jagnoor, J., Arora, M., Cameron, I., Kifley, A., Sterling, M., Kenardy, J. and Rebbeck, T. (2019). Evidence-based care in high- and low-risk groups following whiplash injury: a multi-centre inception cohort study. BMC Health Services Research, 19(1). 4. Kominfo. (2018). Rata-rata Tiga Orang Meninggal Setiap Jam Akibat Kecelakaan Jalan. 5. Ritchie, C. and Sterling, M. (2016). Recovery Pathways and Prognosis After Whiplash Injury. Journal of Orthopaedic & Sports Physical Therapy, 46(10), pp.851-861.

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what is whiplash? soft-tissue injury Rear-End car accidents

sign and symptoms

WHIPLASH Not Just A Pain in the Neck

805,581

8.8 billion billion 8.8

“Every action has its own equal opposite reaction.”

every hour, three Indonesians die due to traffic accident.

what should i do?

you should know when you

1 Call for help (nearest hospital available) 2 fixed position

head rest

and how do i prevent it?

Sit upright seatbelt

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2 seconds

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AMINO | IMSTC 2020

A Special Yellow One Nitya Fithra Salsabila Alhaque

Background : Neither one of us wants to have an accident, so do the workers. But it can occur anytime, anywhere. Therefore, Occupational Safety and Health (as known as K3) is one of the government regulations that guarantees our safety and health at work. Objective : In this photo, a man standing with a broom on hi hand and he ello head. Yes that s a helme b

hing on hi

pecial and diffe en ! Actually, besides the yellow color,

people can enter this place with any different color to wear on their head. Red for the safetyman team, grey for workshop team, green for formwork and finishing team, white for the consultant or visitor, and this man on the photo wearing the yellow one, represent that he is a part of cleaning service team. The main point is : even a cleaning service who has a smallest risk of trauma since he don di ec l e po ed by the build up process of the construction- still guaranteed for his occupational safety and health as we can ee he

ea ing ha

ello

helmet, and boots for

working. That long green banner though, welcoming us to the area while reminding that we must wearing safety equipment to keep us protected by the unwanted possibility of accidents. Conclusion : Those all shows an excellent effort from the government in ensuring the safety of workers and preventing cases trauma in the work field. We can prove that by seeing even my closest environment has been implementing it. From the smallest possible exposure to the highe , o e en an one

gonna

ep in o he a ea i

e i ed o

hei

afe

equipment. That includes you! If you want to be a visitor, make sure your helmet, boot and safety belt are already settled, ok?

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Time is Life Author: Ali Habibi

ABSTRACT Background: The motorization era has enhanced the lives of many people, but the benefits have come with a price. In the world, the number of road traffic accidents is rising by each year. In developing countries, one of them is Indonesia, road traffic accidents are a serious problem. Road traffic accidents are the third killers in Indonesia. Each year an average of 30,000 lives are lost on the road. There is a lot of road traffic accidents that occurred in Indonesia which resulted in death and temporary or permanent physical disability. This incident can be caused by not or being late for getting first aid within a few seconds during an accident, like support the head and neck, also basic life support. When people see a road traffic accident, people usually panic and do not know what actions they should take, it is due to the lack of knowledge about how and the right techniques in providing first aid in a road traffic accident. Therefore, people need more education, socialization, and training about first aid in road traffic accidents. If we all do nothing, there will be more casualties because of road traffic accidents due to lack of public knowledge about first aid in road traffic accidents. Objective: The photo aims to show how important the education of first aid in road traffic accidents. By education, we can prevent more casualties of road traffic accidents resulted in death and physical disability due to not or being late for getting first aid within a few seconds. Conclusion: In this case, cooperation is needed between primary health care, the government, and also medical students to provide education, socialization, and training to communities about first aid in road traffic accidents.

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Be careful, Madam! Gammarezka Fitra Fajar

Background In this new era of technology, we know that public health services is one of the most important things to maintain health in the world, including Indonesia. General Directory of National Army said that the prevalence of road accident that lead to mortality is 3 people in one hour and 30% caused by the environment. So, we can conclude that zebra cross is very important thing to safe our life, especially in the metropolitan city like Jakarta, one of the busy and pop lo

in Indone ia, and i d like o a

Thank o

fo heal h ca e e ice ha can

reduce prevalence of road accident by creating a zebra pattern like traffic sign, also known as zebra cross. Sometimes people can be careless and this can lead to a very dangerous situation especially when they crossed a road, because road accident can happened everytime and can lead to trauma. So, what should we do to reduce the incident of trauma caused be road accident? I think the public health and the goverment can be collaborate to create a zebra cross in the small cities, because we know that not every cities have zebra cross, furthermore medical student can help the public health to share about how zebra cross can be a very important things to be our guardian angel when we cross the road.

Objective The aim of the photo is to remind the society and public health services about how important zebra cross for people when they cross a road.

Conclusion Zebra cross can reduce the prevalence of road accident and can decrease a change of mortality rate in Indonesia.

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MIRACLE SPICE TURMERIC: THE NEXT GENERATION OF HOME REMEDIES Yuliana Bernadetha Patangke Background: Injury is everywhere. It could be open or close, it could be small or wide injury. Based on Riskesdas 2013, the cause of most injuries is falling, of which the percentage is 40,9% of the citizens in Indonesia, followed by traffic accident with 40,6%. We see that in almost every family in this country, their children must have experienced the falling while running or playing outside. The result is a small wound but can hamper the children themselves. Small open wound could lead into an infection and even tissue necrosis that could lead into amputation. It could happen if the treatment is incorrect, including the delaying of treatment. In this situation, we actually could rely on our natural resources. We actually could use something which is always available in our kitchen to decrease the possibility of infection. And we can call it, a quirky-golden-miracle-spice, turmeric. Objectives: Turmeric has the bioactive component, curcumin, that can actually decrease the inflammation and oxidation. Knowing that open wound could invite all bacteria from outside, turmeric captures itself as natural antiseptic and antibacterial agent. So it can be used as an effective disinfectant. By mixing turmeric and hot water, it helps clot the blood and prevent the wound from bleeding further. So we can use it as our first step to treat wound if there is no betadine around us. By applying turmeric on wounds, it also helps the recovery quickly, because it can positively affect tissue and collagen. So there will be no scar once it is healed. Tha

e call i a mi acle pice fo

o nd ,

me ic.

Conclusion: The turmeric has bioactive component which is curcumin, that can be used by anybody to heal open wounds and prevent further possible complications just like infection.

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Revamping the Layperson By : Trisha Chereen Chang

Traffic accident is one of the most serious problem in Indonesia. Indonesia has a high incidence level of traffic accident. Police data of Republic of Indonesia shows that there are 3 people who died due to traffic accidents every hour. Traffic accident itself is the third major cause of death in Indonesia, after heart atack and Tuberculosis. One possible factor resulting in those numbers is the lack of knowledge and first aid ability in pre-hospital. Based on a research done in a city in Indonesia showed that almost half (46.7%) of the respondents had less knowledge about the initial emergency action and more than half (56.7%) of respondents did not perform basic life support well. It is a heart-breaking fact because in most cases, the layperson (non-medical personnel) is the one who found the victim first and their action will defind the victimâ&#x20AC;&#x2122;s survival rate. Therefore, improving the societyâ&#x20AC;&#x2122;s knowledge upon pre-hospital first aid provision is clearly a must. This photograph shows some high school students in a first aid competition. They are giving the first aid treatment to the victim. Holding a competition is one of the various ways to train and educate youngsters and layperson to give first aid treatment properly. Other possible ways includes seminars, training, demonstration, and many others. It is also a wise step to educate youngsters first, hoping that after they have a good understanding about first aid and able to practice them properly, they will have the ability to apply first aid in pre-hospital and be able to disseminate the knowledge to people nearby. Therefore, medical and educational institutions need to be more active in providing first aid training and education to laypersons, especially youngsters in order to reduce the mortality rate caused by traffic accidents and improve the community health in Indonesia.

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Prevention is The Best Solution Author: Salsabila Rahmani Background: Agriculture plays a vital role in the Indonesian economy. In 2016, National Labor Force Survey states 37.8 million people work in this sector. As one of the sectors that plays a role in changing the natural resources into industrial raw materials and food for the people, agricultural workers have an almost unlimited risk of occupational safety and health. Based on data from Asean OSHNET(Occupational Safety and Health Network), work accidents that occur in the Indonesian agricultural industry occupy the second place compared to other industries and in 2011 there were 48,511 cases of work accidents with the most types related to sharp objects which resulted in scratches, cuts, punctures and beatings. The use of machinery and heavy equipment such as tractors, harvesting machines and planting equipment in the agricultural sector is a source of danger that can result in injuries and fatal work accidents. The thing that affects the high number of work accidents is the lack of community perspective on the importance of maintaining occupational health and safety. The best solution to reduce trauma caused by work accidents is preventive steps, however, to maximize the solution, curative and rehabilitative steps also needed. The implementation can manifested in a way inform agricultural workers about the importance of using personal protective equipment(PPE). The use of PPE can provide protection for workers from the severity of work accident impacts and can support employee performance. Objective: The aim of the photo is to invites agricultural workers to prevent trauma by using personal protective equipment and also to improve awareness about work accidents in Agricultural industry. Conclusion: Promotion of the importance of personal protective equipment must be seriously increased to avoid trauma and lead to the better community health

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A Butterfly-Like Wound Ryan Fidel1

An extremely painful wound. eventhough i

onl ca ed b fell off a bike and

had a contact with a single rock. The abration it made was really, really painful. Even more painful than the vulnus punctum that I experienced back on my kindergarten days because I was arguing with one of my acqui ance . I hope ha I

on e pe ience ha

kind of wound again, even though that kind of wound is the most common kind of trauma that occured in the society.

oh shit that's feel so hurt, feel like i wanna to put a glass of alcohol 70% & push my soul out of my body to clean up my broken leg, by the way i need some bandages, could you give me some? please :)i want to smile when i looking on my leg, but other people nearby said thats a fake smile :( please , bring back my beautifull smile i need to give it to another and share happines with them, but pain makes me wanna cry and scream, could i used some NSAIDs ? or i just need some paracetamol to fix my hurt feelings?

c'mon

its

been

complicated

now

ibuprofen?,aspirin?,naproxen?,indometasol?, or paracetamol? NSAIDs are among the most common pain relievers in the world. And lately, they're among the most controversial. NSAIDs work on a chemical level. They block the effects of special enzymes, specifically Cox-1 and Cox-2 enzymes, these enzymes play a key role in making prostaglandins. by blocking the Cox enzymes, NSAIDs stop your body from making as many prostaglandins,this means less swelling and less pain, by the way how can paracetamol works ? Paracetamol seems to work by blocking chemical messengers in the brain that tell us we have pain. Paracetamol also reduces fever by affecting the chemical messengers in an area of the brain that regulates body temperature.

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Boys donâ&#x20AC;&#x2122;t get hurt. By: Ratu Tenny Leriva A wound/trauma/injury is something that is usually underestimated by the people of Indonesia. Sometimes they even mark it as a symbol of strength, especially for boys. If a little boy is hurt they will always be told to 'suck it up, you're a man' and then they will do nothing to care the wound even though they have no idea what complications could happen if some certain dangerous pathogenes enters the body through the wound. Because they think of it as a trivial matter. From young age, Indonesian people are rarely taught about what to do when someone is injured. So the result is that not many Indonesian houses have emergency care box or P3K box as they call it here. Therefore they can only rely on medical officers whenever someone is hurt in their houses. Also, there is almost never any socialization about Trauma care held by the Department of Public Health in our respective regions. It is a shame but this is whatâ&#x20AC;&#x2122;s happening up until now.

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Heist of an Existence

Scientific findings have clearly indicated that trauma becomes a major cause behind the death of many people. Trauma is a problem where certain individuals have been coping with it every single day. Trauma may be a caused by unexpected tragedies such as accident or psychological issues. Some among of the sufferer are able to accept the unfortunate fact while others have chosen to end their lives due to unspoken reasons of dilemma, worriment, economics, and so on. Those individuals who are not able to deal with their problems decide to at least try to make an appointment with psychiatrist. However, not all of them succeed or even consult because of economic problems.

On the other hand,

the case mentioned above is related to how societyâ&#x20AC;&#x2122;s point of view

regarding medical arrangement in Indonesia. Some people are still doubting regarding health program that is issued by government in Indonesia. Many people choose to seek medication in foreign countries in order to receive better treatment even if higher price is demanded, however we need to consider peole who cannot afford such high cost. Due to aforementioned reasons, people need to be encouraged about the fact that health systems in Indonesia are not as bad as other country. In order to raise those awarenesses, people need to be aware of themselves first. By doing so, they can be aware of other people around them. In addition, doctors are expected not to make a false diagnosis regarding patientâ&#x20AC;&#x2122;s health and not consider patients as a their source of money.

Consequently, caring to others must start from this moment because it is decisive not to only one medical branch, namely Traumatology but also other branches as well.

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ABSTRACT Low Back Pain: Be Aware because It is Right Behind You Anita Dominique Putri*, 20 years old, is a house assistant. She works in a female student boarding house for 8 hours every day. Besides doing all the house-work, he i

all he gi l clothes for

almost 4 hours per day sitting in a short chair. It has been a while until one day, she started to feel pain in her back. L

bac

(MSD) a ec

a e

(LBP) a de

ed a a

-traumatic musculoskeletal disorder

bac . I ca a ects people in all ages, but more common in

female and those aged 40-69 years old. LBP is widespread in both developed and developing countries. Occupational ergonomic factors, such as repetitive motion, contributes to this symptom. Occupations doing same movement frequently are in risk for LBP. Repetitive movements end up with repetitive trauma in the spine. The pain itself is a symptom with numerous underlying diseases. In fact, LBP is the leading cause of years lived with disability in both developed and developing countries. Moreover, it is associated with substantial financial costs and loss of quality of life. The pain itself is a symptom with numerous underlying diseases. This photo is documented in order to gain more concern towards LBP, as well as other MSDs. A lot of people do not realize the way they do things might contribute to their future conditions. However, there is a good news. Low back pain can be prevented simply by limiting exposure to risk factors. Modify any weird position and maintain a proper body posture to avoid low back pain, as well as other MSDs. Get aware of Low Back Pain because it is right behind you. *not a real name

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Effective Model for First Aid Training Anya Amadea Perlita Sari ABSTRACT Background : Human bodies are susceptible to various traumatic injuries. Thus, it will always be the better option to be prepared to take care of critical conditions. In Indonesia the number went as high as three deaths per hour due to road accidents as stated by the ministry of communication and information. The most important steps in handling a trauma is the first aid. First aid is an emergency assistance that is given to an injured or ill person until full medical treatment can be attained. By educating the public on how to do first aid of traumatic injuries it can enhance the probability of survival by these injuries. Objective : Education program is not a new idea, but it has always been done in conventional way of teaching, where it only relies on repetition and memorisation of information. While it is not a terrible system, there is a new system that offer better results, coaching program. Coaching is a new method of teaching when a coachee is guided by a supervisor. The approach is not to help and give directions directly, but to let them act on their own so it can challenge their creativity to make new solutions based on the problem. The process is based on communication, team work, and trust. The main goal is no different than the conventional way, to increase the knowledge of first aid, but thereâ&#x20AC;&#x2122;s also the benefit of increasing the self-confidence and performance of the coachee. Conclusion : With the rate of road injuries in Indonesia first aid is a necessity for everyone from different backgrounds, not solely for health care professionals. Coaching program, a hands-on training, might be the solution we need to increase the knowledge, performance, and self-confidence in performing first aid.

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â&#x20AC;&#x153;Break The Barrier of Ignorance, Helping More Peopleâ&#x20AC;? Ardhito Rahadian Background All kind of trauma happen everywhere, at any time. Consciously or not, trauma even exists around us, even at the people who we meet all the time. People today are less aware of their surroundings, making trauma invisible and hurting worse than before. How can we overcome this? How to cure trauma whether seen or not? Start caring, seek knowledge, spread and start helping everyone who needs your help. Objective This photo describe that it is very important to care for each other and always ready to giving help to people who in needs. When we talk about trauma, it is not always about doctors, ambulance, accidents, or all about the physical things that we see. Trauma can happen even inside the people. Have you ever see people who are in a deep mind, thinking something? Or even people who always laughing while they are with their friends? Maybe inside, they need our help, they need people who will care for them and provide settlement. With knowledge, awareness and courage, we can solve other people trauma. Conclusion To solve trauma, we must help others, bring the courage to start helping. Help one people, spread the courage and knowledge, and we will overcome any kind of trauma. To make a better world in the future. Trauma happen everywhere, recognize it, know to handle it, saving more life.

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Preventing Infection Following Trauma Or Surgery Azarya Sihite Trauma and surgery are inseparable. Surgery is often required following major trauma and surgery by its very nature causes trauma to the body. Both trauma and surgery trigger the inflammatory response, which may be either localized at the wound site or systemic. The latter is seen especially following large surgical procedures if the degree of trauma is extensive or setting of sepsis which is a common clinical complication shared by both. For hospitals in Indonesia, it is necessary to develop nursing planning, especially regarding wound care that is adjusted to the theories or standards that have been determined. And improve the quality and standard operating procedures, especially for wound care as an effort to optimize the prevention of surgical wound infection. The goal of this writing is to decrease the morbidity and mortality associated with postoperative by improvement programs require an integrative approach with measures taken during the pre-, intra- and postoperative care from the numerous stakeholders involved. The current SSI prevention strategies have focused mainly on the role of healthcare workers and procedure-related risk factors. Empowering patients with information they require to engage in the process of surgical site infection (SSI) prevention could play a major role in the implementation of recommendations. Actions for patients to participate in SSI prevention programs such as Staphylococcus aureus screening and decolonization. Diabetes mellitus check at least one month before your surgery, maintain stable blood glucose levels before during and after surgery. Make sure you know and understand how to care for your wound before leaving the hospital. Wound dressing should be kept in place for 48 h after surgery, if the change is necessary, this should be done under a clean technique. Report any redness, pain, swelling or fever to HCWs. Appropriate management of injuries is important to reduce the likelihood of wound infections.

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WHO LIVES SEES,WHO SAVE SEES MORE Charafy M.W

This picture was taken after an hectic situation at emergency room,where there is a patient came with thoracic trauma enter the emergency room in the middle of the night with loss of consciousness.Every physician were doing their best to help the patient.One of them is doctor Zega Agustian.He is a fresh graduate general practitian who happened to be on duty at the time.After the patient were stable,the nurses bring the patient to the inpatient room.Event after that hectic situation,doctor zega still can t let his guard down.Because,there is no rest in emergency room and for trauma center.In this picture we can see doctor zega is reading the result of electrocardiography of that patient to maintain the condition of the patient.

The objective of this photo was to show the public,how the doctor in Indonesia were always do their best to handle every patient.Especially in emergency room where there are a lot of different trauma inside it.The treatment of trauma patient need a very accurate and precise treatment and timing,that sometimes,drains a lot of our stamina or in other word “very tiring”. But at the same time,you have to think so fast and look forward to prevent complication and even the death of the patient.

The message of this picture is that every doctor in this country is the best suitable person for this job.As I mention earlier,a doctor that handle trauma in emergency room need s to think fast and has a big amount of stamina.Not everybody can do that.So my intention for this picture is,whenever someone has a grudge agains doctor and saying that ‘this doctor is not suitable for this job” please,read this article and see this photo.I hope everyone who has a bad experience with doctor in emergencies room can understand the situation forgive if they ever met a doctor that not met their expectation to save their relative.

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First Aid Treatment Simulation for Agricultural Workers: Health Promotion to Reduce Mortality and Morbidity due to Agricultural Accidents in Community Dandy Bachtiar Hidayat

Background: Agriculture is one of the most hazardous occupations worldwide. In several countries the fatal accident rate in agriculture is double the average for all other industries. According to ILO (International Labour Office) estimates, workers suffer 250 million accidents every year. Out of a total of 335,000 fatal workplace accidents worldwide, there are some 170,000 deaths among agriculture workers (ILO, 2000). A common type of injury is a wound caused by the cutting edge of implements such as axes, knives, sickles and machetes. Where preventive programmes are not available, or are not yet well developed, such injuries may well become infected. In addition, there is the risk of tetanus. Working barefoot and without hand and or arm protection increases the risk of this type of injury. Indonesia is one of the most affected countries in the world, due to farmers as the majority occupation, widespread agriculture activities, and the most important is lack of community awareness including wrong first-aid treatment of agriculture occupational accident. Therefore, Training First aid and medical assistance should be available to deal with the probable types of injury that might be expected in a particular workplace to reduce morbidity and mortality from occupational accident in Agriculture workers. Objective: The aim is to reduce mortality and morbidity due to wrong occupational accident treatment in the community by first aid simulation to achieve the vision of zero deaths. Conclusion : We as medical student needs to understand the problems that exist in the community, one of them is the health problem of agriculture workers, because the majority of Indonesian people work as farmers. Therefore we needs to give real action to reduce death and illness in agricultural communities Key Findings: Occ a ional Acciden , Ag ic l

e Wo ke

, fi

-aid treatment.

References World Health Organization, Regional Office for Eastern Mediterranean. (2003). Health of Worker in Agriculture. Cairo. International Labour Office, (2000). Safety and Health in Agriculture. Switzerland.

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Virtual Reality for PTSD Treatment and Trauma Prevention David Clinton Napitupulu Post-traumatic stress disorder (PTSD) is a mental health condition that’s triggered by a terrifying event that can be occurred after experiencing or witnessing some horrible events such as natural disasters, accidents, wars, etc. According to the data from the national center for PTSD, it concluded that PTSD occurs 6,8% in USA and happens more than 2 million times in Indonesia. PTSD may cause nightmares, anxiety, uncontrollable thoughts, and flashback than can interrupt the victim’s daily activity and social life. The victim usually needs a lot of time to get better and forget about the unwanted and distressing memories from the traumatic event. This photo represents someone using Virtual reality (VR) that somehow manages to change the mood of its user. The user can feel happy, sad, and even scared through the experience that happens on the virtual side. This photo gives me an idea about using VR to handle PTSD and also preventing someone from having trauma. Since then, I’ve been doing a lot of research and read lots of journal about VR for PTSD treatment. Lots of researchers claim that using VR for PTSD treatment is one of the best solutions to heal PTSD rapidly. But it is also important that the treatment using VR for PTSD already have standardized protocols with an emphasis on treatment adherence. Other than that VR also can be used to prevent someone from having trauma by making the person experiencing the terrifying event before it happens, for example, earthquake simulation in virtual reality. That’s why it is important for us to develop research about using VR for PTSD treatment and trauma prevention.

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The Usage of Knee Pads for Knee Bursitis Prevention for Badminton Athlete Farianti Wiranda

Abstract Knee bursitis is the inflammation of a bursa sac accompanied by swelling and thickening of the bursa walls most case occurs because the chronic or acute low trauma. With the high intensity of movement from badminton athlete during the game, and usually the player would accidently crash their knees to the grounds which adds extra preassure on knees. Thatâ&#x20AC;&#x2122;s why it is a common injury for badminton athlete. These injury would affect on athlete overall performa and their daily life. Knee pads are protective gear worn on knees to protect them from falling on the ground, or hitting an obstacle or to provide extended pad for kneeling. Knee pads could help the athelete to prevent the injury because when our body is kneeling, the bodyâ&#x20AC;&#x2122;s weight is distributed to femur, meanwhile with knee pads, the weight will be redistributed well into the upper body. It is important to make sure the knee pads not only comfortable to use but also comply the standard as the safety gear for the athlete to prevent them from fatal injury especially in lower body.

Keywords: knee bursitis, knee pads, injury, badminton athlete

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Your Concern, Itâ&#x20AC;&#x2122;s Powerful David Panahatan

Background You have strength in every thought, word, and deed. When do you think whether with words you can change someone? Can even small actions make a difference? Of course, the answer is yes. Every human being, of course, has passed trauma, and surely everyone has a sense of wanting to stop thinking about things that can remind us of the bad things that have happened in his life, and certainly not only for a moment but forever.

Objective I illustrate this importance of our care for the little things in the lives of our fellowmen, because there are enough incidents that we may know about violence, bullying, and possibly murder or suicide, and many people find the things done to be funny, or stupid, even considered trivial things, and worse again? They do not realize they are partly responsible for it.

Here I want to share that, every word, attitude of caring, and every small act of ours, is very meaningful, which we might consider small, maybe it is a very big thing, what we might consider trivial, maybe a very meaningful thing for him , things that might not make sense in our minds, might make very much sense in his mind, because he takes a perspective from what he had before with an experience he had felt himself. Conclusion To create a more beautiful community life, we must dare to care, dare to step to reach the fear of themselves and change that fear into a positive thing, he still has caring people who live among him, whether he is aware of who he did not realize. Don't be afraid to try to care. Because of your concern, it's powerful.

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New Modified Portable X-Ray For Immediate Emergency Action Nanda Ayu Sabrina

Background: All around the world are experiencing disasters or other emergency cases every day at every place. This would often result in a high risk of mortality. Because emergency cases are mostly happening at unexpected places, health workers are challenged in this situation due to the limitation of human resources and tools according to the emergency scenes. Death, injuries, diseases, disabilities, psychosocial problems, and other health impacts can be avoided or reduced by disaster risk management measures involving health and other sectors (WHO, 2019). Musculoskeletal injuries are still common and, hence, are routinely seen in the emergency department (Alsheikly, 2017). This requires high attention of physicians to understanding and be familiar with subtypes of these injuries and needs immediate action in order to prevent life-threatening damage and anticipate possible complications. But for now, it takes too long for knowing if there are any injuries of the musculoskeletal system if the injury happens in outdoor places especially when the patient doesnâ&#x20AC;&#x2122;t seem obviously injured. X-Ray is the most basic type for musculoskeletal screening and it used mostly as the first line of trauma examination and for now it defaultly can only be done in hospital. Although kinds of portable X-Ray are actually already available for now, but it still consists of components which are quite large and still cannot be used for critical conditions. Objective: The aim of this photo is to demonstrate the future possibility of modifed Portable X-Ray which is simple and easy to bring. So it will in the future, help any physicians to give an immediate action for musculoskeletal emergency situations. Conclusion: An easy and improved Portable X-Ray will help to reduce the mortality and morbidity risks of emergency cases especially for musculoskeletal traumas.

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Chest compressions have saved the lives of countless patients in cardiac arrest as they generate a small but critical amount of blood flow to the heart and brain. This is achieved by direct cardiac massage as well as a thoracic pump mechanism. In order to optimize blood flow excellent chest compression technique is critical. Thus, the quality of the delivered chest compressions is a pivotal determinant of successful resuscitation. If a patient is found unresponsive without a definite pulse or normal breathing then the responder should assume that this patient is in cardiac arrest, activate the emergency response system and immediately start chest compressions. Contra-indications to starting chest compressions include a valid Do Not Attempt Resuscitation Order. Optimal technique for adult chest compressions includes positioning the patient supine, and pushing hard and fast over the center of the chest with the outstretched arms perpendicular to the patient's chest. The rate should be at least 100 compressions per minute and any interruptions should be minimized to achieve a minimum of 60 actually delivered compressions per minute. Aggressive rotation of compressors prevents decline of chest compression quality due to fatigue. Chest compressions are terminated following return of spontaneous circulation. Unconscious patients with normal breathing are placed in the recovery position. If there is no return of spontaneous circulation, then the decision to terminate chest compressions is based on the clinical judgment that the patient's cardiac arrest is unresponsive to treatment. Finally, it is important that family and patients' loved ones who witness chest compressions be treated with consideration and sensitivity. Cardiac arrest is treated with cardiopulmonary resuscitation (CPR) and chest compressions are a basic component of CPR. The quality of the delivered chest compressions is a pivotal determinant of successful resuscitation. In spite of this, studies show that the quality of chest compressions, even if delivered by healthcare professionals, is often suboptimal. Therefore it is important that providers carefully familiarize themselves with this technique. Cardiac arrest represents a dramatic event that can occur suddenly and often without premonitory signs, characterized by sudden loss of consciousness and breathing after cardiac output ceases and both coronary and cerebral blood flows stop. Restarting of the blood flow by cardiopulmonary resuscitation (CPR) potentially re-establishes some cardiac output and organ blood flows. CPR has the potential of re-establishing spontaneous circulation, often in conjunction with electrical defibrillation, but CPR is likely to be successful only if it is instituted within 5 minutes after the heart stops beating.

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â&#x20AC;&#x153;Not Only Helping but also Saving Themâ&#x20AC;? Ida Romasta Novyanti Background Trauma can happen anytime and anywhere. How can we overcome this? How to cure trauma whether seen or not? Start helping by caring people arounds you. Objective This photo describes a community that had just been hit by a tsunami in Pandeglang some time ago. The disaster not only caused physical trauma to them but also psychological trauma. Have you ever thought of the trauma they experienced a little? Not only external trauma but also internal trauma. Maybe just by entertaining them can already help reduce their psychological trauma. Conclusion To help eliminate trauma, we can also help them by listening to them. Trauma is not something big and difficult. But that can be big if we cannot help them.

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AMINO | IMSTC 2020

Indonesian Medical Studentsâ&#x20AC;&#x2122; Training and Competition Against the Myth Aldy Bachtiar Hidayat1, Haniefatul Azzizah2, Faiza Nabila3 Aldybachtiarhidayat77@gmail.com Abstract Background: Indonesia is an agrarian country and most of its population depend their life in the agricultural sector as a farmer. However, many farmers do not know about the risks that can threat their life. According to International Labour Organization (ILO), there are two million people died due to work-accident every year in all around the world. And the most sector which contribute victims is the agricultural sector. Getting hurt because of the sharp tools and the wrong application of the machine still often happen in Indonesia. This is because some of farmers are still lack of knowledge about the correct way in using personal protective equipment and the first-aid treatment of injury. The wrong first-aid treatment which still often applied hereditary among the farmers is the using of kerosene as a first-aid treatment of the injury. Objectives of the video: The aim of the video is to educate the farmers by using BANTER method in order to reduce their morbidity due to wrong first-aid treatment of the injury. Conculusion: Thrustworthy treatment in the community environment is not necessarily appropriate. Evidence based sourceneed to be explore, so that undesirable things do not occur.

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How to survive from Venomous Snake Bites Videography Abstract Medhavini Tanuardi1*, Kareen Tayuwijaya1 1

Undergraduate program, Faculty of Medicine, Universitas Indonesia *

medhavinitan@gmail.com, (+62) 819 4471 4666

Background : Snakebite was declared by the World Health Organization as one of the neglected tropical diseases in the world1. Snakebite is closely related with environmental, occupational and climatic hazards in rural and urban areas of many countries in South-East Asia which are mainly tropical countries4. Every year, there are approximately 135.000 snakebite cases in Indonesia and some cases might even get worse and even lead to deaths2. The only definite therapy for snakebite is antivenom5. However, ironically antivenom production around the world, especially in indonesia, is still far below the needs4. Moreover, many Indonesians still got no clue on how to handle the situation that many conditions ends in deterioration. Objectives : We aim to reduce mortality rate due to snakebite by raising awareness especially for Indonesians. Therefore we can reduce 50% of deaths as WHO has targeted and also promote the well-being of global population as aimed by the third point of SDGS 20301,3. Conclusion : Prevention of snakebite becomes an important strategy to reduce the number of complicated or fatal cases. There are 2 groups that play the main roles in reducing the number of cases for this tropical disease, the society itself and healthcare providers. Both sides need to improve for the advancement of prevention and first aid management in the events of snakebite 4,6. Parallel with that, healthcare providers need to develop new findings about antivenom 7. Reference : 1.

https://www.who.int/news-room/detail/06-05-2019-snakebite-who-targets-50-reductionin-deaths-and-disabilities

Sufa T. Habitat for venomous vipers, Indonesia poorly prepared for snake bites [internet]. Bogor : the jakarta post. 2019 March 01 [cited 2019 December 03]. available from : https://www.thejakartapost.com/news/2019/03/01/habitat-for-venomous-vipersindonesia-poorly-prepared-for-snake-bites.html

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The united nations. Transforming our world: the 2030 Agenda for Sustainable Development [internet]. Geneva : the united nation. 2015 [Cited 2019 December 04]. Available from : http://sustainabledevelopment.un.org/post2015/transformingourworld

Warrel DA. Guidelines for the management of snake-bites [internet]. India : world health organization;

2010

[cited

2019

December

01].

18p.

available

from

http://apps.searo.who.int/PDS_DOCS/B4508.pdf 5.

Adiwinata R, Nelwan EJ. Snakebite in Indonesia. IJIM [internet]. 2015 October [cited 2019 Dec

01];47(4):358-63.

Available

from

http://www.actamedindones.org/index.php/ijim/article/view/30/28 6.

Ahmed SM, Ahmed M, Nadeem A, Mahajan J, Choudhary A, Pal J. Emergency treatment of a snake bite: Pearls from literature. J Emerg Trauma Shock [internet]. 2008 [cited 2019 December

01];1(2):97â&#x20AC;&#x201C;105.

available

from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2700615/ doi 10.4103/09742700.43190 7.

Mukherjee AK. Green medicine as a harmonizing tool to antivenom therapy for the clinical management of snakebite: the road ahead. Indian J Med Res [internet]. 2012 [cited 2019 Dec

01];136(1):10â&#x20AC;&#x201C;12.

available

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3461710/

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Deal the Burn with Rice Wrap Rani Permata, Ugiadam Farhan Firmansyah, Shafa Ayuthaya Background: A burn is a tissue physical trauma due to heat exposure, fire, steam, radiation, electricity, chemical substance, friction, or radioactivity. World Health Organization estimates that every year 180,000 deaths are caused by burns. Burn risk is associated with country socioeconomic status, where low to middle compared with high-income countries have a higher risk for burns. In Indonesia, burns caused 195,000 deaths annually. Adult women and children are the most vulnerable population to burns. It has a correlation with their activities, such as cooking with an open fire, unsafe cookstoves, and domestic violence. Burns in children could have resulted from lack of adult supervision and child maltreatment. If most of the family does not know about the early management of burns, it will promote hazardous cases later. Moreover, the impact of burn is not a joke. For example, the wound will remain the mark forever. Therefore, burns could cause defects and morbidness in a person often with rejection and stigma from society. We suggest the health promotion videography for early burn management among common people. We create this videography to raise awareness and educate society. We proudly introduce our idea for early burns management, deal the burn with RICE WRAP . RICE WRAP a d f

e g c

ga d e e

, I ga e c e

substances if any, Cool the burn with running water, Effective cooling to avoid hypothermia, Ward from infection, Relieve the pain, Apply lotion that contains moisturizer, and Put on plastic cling wrap around the wound. Objectives: To increase knowledge and awareness among society about early burn management and decrease the mortality rate due to non-fatal burn injury. Conclusion: The burn could be treated by RICE WRAP. We hope this kind of health promotion will impact the society through knowledge improvement and reduce the number of deaths by burn injury.

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SILENCE Salsabila Shofa S.P., Kartika Ayu S.H., Ramza Aurum K. Faculty of Medicine, Padjadjaran University Background: According to Indonesia’s Central Bureau of Statistics in 2015, there were at least 812 suicides all over the country with Central Java as the highest contributor reaching 331 of total cases. In 2016, Indonesia was in the 8th place according to WHO in terms of suicide rate among ASEAN countries. In the following year, suicide deaths in Indonesia reached 7,355 cases or 0.44% of total deaths. It’s not only occurs in young adults and teenagers but also the children can feel the intention for doing that. Background motive in teenagers for suiciding is related to emotional control and ability to overcome certain life problems and they can’t find the ways for manage it. Lower financial factors, disruption of the family and mental health disorder such an anxiety and depression, or work problems are the major cause for suicide in another age group. Feeling lonely and have nobody to support nor hear their concerns also leads to suicide behavior. Objectives: As a teenager and a student, our friends, siblings, or maybe yourself have thought of doing the same thing. By creating supporting society in the school, workplaces, and other community settings that enable people to have healthy relationship between peers, colleagues as well as family members will prevent this type of trauma from occurring. Some people who choose to be silent are actually people who save their own problems. It doesn't hurt if we, as their close relations, occasionally ask their situation at once good time before everything is too late. Conclusion: From this video, we expect everyone to be more concerned about their surroundings and not to hesitate by inviting someone to talk about his/her life experiences. We don’t have to always give them an advice, but listen to their story to help them calm their selves down.

Reference: Mubasyiroh, et all. 2018. Depression as a Strong Prediction of Suicide Risk. Global Journal of Health Science. 10 (12): 52-53. doi:10.5539/gjhs.v10n12p52

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Tarahita, D. and Muhammad Z.R. 2018. Some Facts about Suicide in Indonesia. Retrieved from: https://intpolicydigest.org/2018/10/01/some-facts-about-suicide-in-indonesia/

December 2019 Wirasto, R.T. 2012. Suicide Prevention in Indonesia: Providing public advocacy. Retrieved from: https://www.med.or.jp/english/journal/pdf/2012_01/098_104.pdf in 1 December 2019

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Before It Happens (Nabila Shaddad, Sitti Mujahidah, Ramli) Indonesia is an area that has many active faults that represent the earthquake. Earthquakes cannot be predicted anytime but we can prevent trauma from occurring. In Indonesia, there is still knowledge about help that must be done when an earthquake occurs. Because we live in earthquake-prone areas, we must consider ways of handling this disaster so that trauma can minimize. The purpose of making this video is so that the whole community can know and understand the handling when an earthquake occurs, and achieve improvement in traumatic conditions in Indonesia. Prevention efforts that can be done are by conducting counseling to the community about handling trauma caused by the earthquake by explaining to the wider community then delivered to small groups so that the message can be conveyed. Curative efforts namely various assistance coming from various parties to heal the victims of the earthquake, in the form of BASARNAS Team, Specialist Doctors, General Physicians, Medical and Medical Support. The role of the bone surgeon is needed in the handling of trauma such as amputation of the victim's organs which are crushed by building materials. Traumatic events such as natural disasters make victims vulnerable to post-traumatic stress disorder. Trauma recovery or what we are familiar with (trauma healing) is a recovery action that is done to help others to reduce or even eliminate the psychological disorders that are being experienced that are caused by shock or trauma. various activities carried out to make children happy, relieve the burden of thoughts, become excited again in carrying out activities, and more sensitive in responding to existing conditions. this is a rehabilitation action that can be done We cannot predict earthquakes but we can minimize the trauma that occurs by increasing public awareness about preventif, curative, and rehabilitative trauma from earthquakes.

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ABSTRACT Title of video : BTS (Break The Stigma) Authors

Abdullah Azzizi, Raynanda Sabta C. B., Malikul Saleh Faculty of Medicine, Universitas Airlangga, Indonesia AMSA Universitas Airlangga, AMSA-Indonesia Background: Traditional Bone Setter is a form of local wisdom that originated from an informal education in the form of life skills. These traditional ways of treating patients have been around even when no modern medical care was present in society. Traditional Bone Setter (TBS) is an amateur for the treatment of bone fracture or joint dislocation. They are an unqualified practitioner in trauma care or allopathic medicine that has taken up the practice of fracture medication from his forefather who has no formal training in modern orthopedics. Hence it is appropriate that we do not ignore this level of concern. Objective: In this video, two medical students are making a project together. This project tells how they want to change the community's stigma about trauma treatment, especially for victims of broken bones due to accidents with massage treatments at the Traditional Bone Setter. They conducted interviews in society about their opinions on the stigma. And also the scene of the accident as a comparison between treatment in the Traditional Bone Setter with treatment in the Hospital. In the epilogue of the video, they hope that the project can make the community switch from massage treatment into direct treatment to the Hospital. It is because as shown in the video that both of them are victims of such accidents, but with different kinds of treatments. Conclusions: We hope that the stigma of Indonesian people regarding massage in the Traditional Bone Setter for the treatment of fractures and trauma care is reduced. So that they are aware that traditional medicine is at risk of disability and a bad impact for the future. On the other hand, treatment in a hospital is guaranteed to be treated by medical professionals and eliminates bad risks. Reference

Yuniar, D., Supriyono, and Nasution, Z. (2019). Perilaku Pemagang Pengobatan Sangkal Putung. Jurnal Pendidikan: Teori, Penelitian, dan Pengembangan, Vol. 2, Issue (12), p.1156-1161.

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Khan, D., Saeed, D., Inam, D. and Arif, D. (2015). Traditional Bone Setters; Preference and Patronage. The Professional Medical Journal, Vol. 20, Issue (09), pp.1181-1185.

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Lets be a helper, everyone can be a helper Videography Abstract Denok Maretta Haq Lestari Ekaputri Wanti Muhammad Dhandy Ardhisyah Based on the National Police of Indonesia every day 80 people are dies by the traffic accident. Traffic accident become the most cause of death due to trauma. Most of traffic accident’s victim actually don’t have to suffer from their disability or death if their first aid right after the accident were conducted properly. This video aimed to show the proper of first aid to traffic accident victim it’s also showed the common situation that may lead victim’s disability caused by wrong action during the first aid by non medical personnel. We show how to do an initial assessment, lifting up the patient, checking awareness, open up the helmet, and what a non medical should do in response a fracture. By this video we hope that people may have an initiation to help a traffic accident victim in proper way and not to be worried because everyone can be a helper.

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The Unsettling Truth of Bone Setting Satria Angga Widitama, Indira Meidina Nafisa, Kiran Shadentyra Akbar AMSA-Universitas Padjadjaran

Background: More than 37.000 people die in traffic accidents. Another 2.35 million people are badly injured which causes permanent disabilities, including limb deformities that result in mobility impairment. But most of the time, people are often not seeking help from a qualified orthopaedist due to financial and irrational thoughts on surgery.

Objectives: Our objective is to give a brief depiction of how such practice by a traditional bonesetter could lead to a permanent disability rather than treating the trauma. Traditional bonesetter does not have a background in the medical field and the practice is not an evidence-based medicine We want to raise awareness in the community that seeing a doctor especially an orthopaedist is affordable and the treatment is not always going under the knife or surgery. Treatment given by a doctor is most certainly a lot safer than by traditional bone setter.

Conclusion: In conclusion, people should stop seeing traditional bonesetter for bone fracture remedy considering the safety issue, and to prevent further injury.

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Trauma: It Matters Joyna Getruida Sopaheluwakan1, Ardhito Rahadian2, Timothy V. P. Reba2 1

Second Year Medical Student, Universitas Kristen Indonesia 2

Third Year Medical Student, Universitas Kristen Indonesia

Background Trauma is an increasingly significant health problem occurring throughout the world where it is a leading cause of death and disability throughout the world. Trauma injuries kill more people each year than heart disease, cancer and HIV combined. Trauma can happen everywhere, even where we think it might not be. Homicide, suicide, and road traffic crashes are the leading cause of death due to trauma. Approximately 1.35 million people die each year as a result of road traffic crashes and its leading cause of death for children and young adults aged 5-29 years. Trauma can happen to anyone. An unknown person, someone we know, or even our own self. Not always when trauma occurs there are medical personnel. The first aid is important for everyone to know, not only for doctor or other medical personnel only. The decision to act appropriately with first aid can mean the difference between life and death. Objective Through this video, we aim to show that trauma is a cause of death and morbidity. By knowing that, then with the video, we want everyone who sees it to be open and sensitive to the circumstances surrounding the main in recognizing the existence of trauma and how we can deal with it also with this video we want to raise awareness of the society in dealing with traumatology to improve community health. Conclusion Trauma can happen everywhere and to save a life we should know what to do at the right time. So, with this video, We want to show that we should recognize and know how to handle it through first aid.

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Title of Video Facial Trauma : Dare To Face It? Authors Kasilda Pasha Devanda (first author), Anak Agung Ngurah Maheza Adnyana (second author), Sherina Ayu Pitaloka (third author) Background of the video Trauma is one of the leading causes of death among people under 40 years of age and men are likely to have bigger chances of getting trauma compared to women. One of the most common trauma associated with other traumas in emergency department is facial trauma or maxillofacial trauma. In developing countries such as Indonesia, the increasing number of motor vehicles and road traffic accidents (RTA) became the major causes of facial trauma. According to Badan Pusat Statistik in 2017, 14.395 people suffered from heavy injuries and 119.945 people suffered from light injuries due to RTA. Unfortunately, the urgency of many cases of facial trauma has not been fully offset by the ability of qualified medical personnel. This is why physicians and other medical personnel must first focus on the basics of trauma care, following the Advanced Trauma Life Support (ATLS) protocol that contains the initial assessment which include Airway, Breathing, Circulation, Disability, Exposure algorithm, followed by resuscitation, stabilization, and development of management plan, and thus other unwanted conditions can be avoided or minimized. The solution doesn't just stop there, however. As a society, we can contribute by seeking medical attention as soon as possible when we are near the location of the incident or when we are involved in the incident because treatment in the first hour of trauma can increase victimâ&#x20AC;&#x2122;s survival chance. Objectives of the video To give information for both medical personnel and the society regarding facial trauma, thus decreasing the amount of trauma and increasing the quality of trauma care. Conclusion By acknowledging the importance of Advanced Trauma Life Support (ATLS) protocol and â&#x20AC;&#x2DC;Golden Hourâ&#x20AC;&#x2122; we hope throughout this video we can decrease the burden of injury especially facial trauma.

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The Change Is In Our Hand Nathania Hadasa Tamar, Andhini Rajo Pujian Abstract Road traffic injuries and other kind of trauma is a threat to the society. It is a worldwide publichealth problem that reduce the quality of life of the victim. Traffic injuries kill as much as more than 1.25 million people per year. It’s also the number one cause of death among 15–29 year olds. Over 50 million people are also injured in non-fatal crashes every year, causing an enormous burden of disability.1 That’s why it’s important for countries to have a working system to prevent this matter. The cases of patients who die in prehospital care (before reaching the hospital) is happen over twice in low to middle-income countries other than in high-income countries. It shows how important it is for countries (especially low and middle-income countries) to strengthen their prehospital system. An Emergency Medical Service (EMS) need to be available all the time as the first respond in such accident. Other than that, the role of a bystanders is important in handling this kind of situation. Bystanders need to be able to recognize serious injury or know how to call for help. Several journals conclude that first aid training to general public lead to a more cautious in traffic and bystanders who provide immediate and more adequate response to trauma. 23 Those data inspire us to make this video. That was made as a depiction of current situation in Indonesia. It shows that people have lack of information and knowledge about how to give first aid for any kind of trauma, represented in this video with a crash accident. We wanted to raise awareness that even as a bystander we have to be responsible for what happen, and we have the ability to help the trauma victim to survive what happen and to improve their quality of life.

1 https://www.who.int/violence_injury_prevention/publications/road_traffic/Post-

crash_response_booklet.pdf 2 https://www.cambridge.org/core/journals/prehospital-and-disaster-medicine/article/firstaid-training-andbystander-actions-at-traffic-crashes-a-population-study/D91AAB427C7C18415B6BFC7D21DA9DAA 3 https://www.bmj.com/content/308/6936/1077.short

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A Guide to First Aid of Trauma Care First aid is the provision of immediate care to a victim with an injury of illness, usually effected by a lay person, and performed within a limited skill range. First aid is normally performed until the injury or illness is satisfactorily dealt with (such as in the case of small cuts, minor bruises, and blisters) or until the next level of care, such as an ambulance or doctor, arrives. The purpose of first aid, is often given in the mnemonic "3 Ps". These three points govern all the actions undertaken by a first aider, prevent further injury; preserve life; and promote recovery. The nature of first aid means that most people will only have a limited knowledge, and in emergency situations, first aiders are advised to first seek professional help. This is done by calling, or assigning an able bystander to call, an emergency number. In emergency situations, it is important that the responder seek help immediately, seeking professional help by other means, if telephone contact is unavailable. The risks of inadvertently doing further injury to a victim, and/or the responder sustaining injury themselves while applying aid, can often outweigh the benefits of applying immediate treatment. For too long, trauma has been one of the leading health problems of the world. In developed countries, every year a serious trauma experiences about 3% of the total population. Trauma affects significantly more males (more than 60%). Of the total number of injured 4% of them being permanently disabled and 1.5% die. It is important to note that death and disability due to trauma affecting mostly young adult segment of the population, people ages 1-45. In addition to all that needs to be done to improve road safety and other aspects of injury prevention, efforts to improve care of the injured are essential. Trauma care represents a major challenge to the clinician, no matter what his or her background. The life- and limb-threatening injuries that are daily parts of trauma care present some of the most difficult decisions that any clinician can face. However, many lives can be saved through inexpensive modifications in education, organization and availability of simple pieces of equipment. Such changes greatly simplify decisions and actions.

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In conclusion, first aid is important to educate the community because often the community does not know how to deal with situations or emergencies. Especially education about first aid in accidents due to trauma because this often happens in everyday life. First aid to trauma is to prevent the occurrence of complications or events that can be fatal to someone.

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First Aid For Fractured Bone In A Traffic Accident Authors : Fariz albarri, Santi rachmaniar, Tsana Makarim Traffic accidents are a health problem throughout the world, especially in developing countries, in this case, is Indonesia. Traffic accidents can result in physical damage to death. According to the Ministry of Health of the Republic of Indonesia in 2013 stated that of the number of accidents that occurred, there were 5.8% of injured victims or around eight million people had fractures with the most common type of fracture namely fractures in the lower extremities by 65.2%. From the Ministry of Health's team survey results found 25% of patients with fractures who died, 45% experienced physical records, 15% experienced psychological stress such as anxiety or even depression, and 10% experienced healing well (Ministry of Health RI 2013). 65.2% % of these accidents causing damage to the lower limb, we know the lower part of the motion is a very important part of daily activities. Here we have a very strong reason why fracture conditions must be diagnosed and treated appropriately to prevent disability and long-term complications. Seeing the problem of the high incidence of trauma and fractures in the lower extremities and the poor complications that will be experienced by the patient if this incident is not handled properly, In this video, we would like to encourage everyone to know at least how to do a first aid for closed fracture to minimize the physical damage or any other complications. We have a very strong reason why we have to encourage everyone to know how to do a first aid for closed fracture, so together, we could minimize physical damage or any other long-term complications.

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AMINO | IMSTC 2020