• Simple Triage and Rapid Treatment START; have developed by Hoag Hospital and Newport Beach Fire department in USA, a triage metode that can applied less than 60 second. The assesment based on :
    1. Respiration
    2. Perfusion (Circulation)
    3. Mental status

    These assessments are very ideal in a mass casualties condition. A rapid assessment made pre hospital personnel could make a rapid evacuation for the victims that need an intensive care. Treatment will only give to victims that have obstruction in the airway and or have massive bleeding from arteries.

    START Categories
    Start classifies the victims more rapidly and more accurate to one of four categories for treated. First step Of start is disparted victims with consious and can walk conditions. The victim will be asked to move from the danger area to the safe area, an area that have been marked as treatment area. The victims categorized as ”walking wounded” and tagged ”Green”. They will be treated after the severe victims treated.

    • Red (immediate)
    Assess breathing after airway checked and repositioned. The Victims that categorized in this if the breathing more than 30 time/minute, capillary refill delayed (more than 2 second), or the victim can not do a simple command

    • Yellow (Delayed)
    All victims that not in Red or Green

    • Black Hitam (Deceased)
    There are no breathing founded after cleared the airway.


    START Procedure
    1. Check Respiration
    Assess the breathing frequency and adequately. If the victim does not breath, check the airway, clean the air way immediately as soon as found any obstruction. Head reposition sometimes needed for made airway clear, but must have attention with control of cervical. If the victim still does not breathe spontaneous, categorize as “Black”. But, if the victim breathes more than 30 times/minute, tagged as Red. If the victim breathe less than 30 times/minute, check perfusion immediately.

    2. Check perfusion

     The best metode taht could used to check perfusion is by checking capillary refill on the nail. The capillary refill more than 2 seconds is a sign for a bad circulation condition, tagged as Red. If the Capillary refill less than 2 seconds, check mental status immediately.

    In a condition where capillary refills could not assessed, palpate the radialis artery. If the artery unpalpable, that probably mean the sistolic pressure is under 80mmHg and the victim probably in shock condition. Control bleeding immediately with direct pressure and elevate lower extremity. We can ask to another victim to do it.

    3. Mental Status
    Mental status used for the patient with adequate breathing and perfusion. For checking, use a siple command such as open and close your eyes, handful my hand. If the victim can nit follow the command, tagged as red. If the victim can follow the command, tagged as yellow. In this assessment, victim that have been tagged as green could assessed again.

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  • Triage (taken from my own article for Training Of Trainer for Emergency Response Training in Banda Aceh)

    Triage (triase) berkembang dari kebutuhan akan perioritas penanganan cedera pada prajurit di medan perang. Konsep ini diperkenalkan di Perancis pada awal abad ke-19. Kata triase sendiri berasal dari bahasa Perancis “Triage” (trier), yang berarti pemilahan. Seiring perkembangan zaman, konsep ini terus berkembang dan dipergunakan hampir diseluruh dunia. Saat ini, triase dipergunakan sebagai standar penyeleksian korban oleh unit-unit gawat darurat rumah sakit di berbagai negara.

    Definisi
    Triase adalah usaha pemilahan korban sebelum ditangani, berdasarkan tingkat kegawatdaruratan trauma atau penyakit dengan mempertimbangkan prioritas penangnanan dan sumber daya yang ada.

    Tujuan
    Memberikan penanganan terbaik pada korban dalam jumlah yang banyak untuk menurunkan angka kematian dan kecacatan maupun resiko cedera bertambah parah.

    Prinsip Triase
    Pada keadaan bencana massal, korban timbul dalam jumlah yang tidak sedikit dengan resiko cedera dan tingkat survive yang beragam. Pertolongan harus disesuaikan dengan sumber daya yang ada, baik sumber daya manusia maupun sumber daya lainnya. Hal tersebut merupakan dasar dalam memilah korban untuk memberikan perioritas pertolongan.

    Pada umumnya penilaian korban dalam triage dapat dilakukan dengan:
    • Menilai tanda vital dan kondisi umum korban
    • Menilai kebutuhan medis
    • Menilai kemungkinan bertahan hidup
    • Menilai bantuan yang memungkinkan
    • Memprioritaskan penanganan definitif
    • Tag Warna

    Triase dilakukan tidak lebih dari 60 detik/pasien dan setiap pertolongan harus dilakukan sesegera mungkin.

    Kategori
    Setelah melakukan penilaian, korban dikategorikan sesuasi denagn kondisinya dan diberi tag warna, sebagai berikut:
    MERAH (Immediate)
    Setiap korban dengan kondisi yang mengancam jiwanya dan dapat mematikan dalam ukuran menit, harus ditangani dengan segera.

    KUNING (Delay)
    Setiap korban dengan kondisi cedera berat namun penganannya dapat ditunda.

    HIJAU (Walking Wounded)
    Korban dengan kondisi yang cukup ringan, korban dapat berjalan

    HITAM (Dead and Dying)
    Korban meninggal atau dalam kondisi yang sangat sulit untuk diberi pertolongan.

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  • Obesity Treatment : An Overview Obesity is a frustrating condition for people alike. Its underlying cause is rarely clear, and its treatment is fraught with difficulty and failure. Very little is known about the etiology of obesity. There are probably many different causes, and some may even coexist in one individual. Obviously excess lipid deposition occurs because energy intake exceeds energy expenditure. An obese individual may have increased intake, decreased expenditure, or both.

    Obesity is very difficult to treat, because the primary emphasis must be on active people self-control rather than on passive drug therapy. The three approaches to weight control are life style change, diet, and drugs. Lifelong lifestyle changes (e.g., exercise, behavior modification) and diet modification are necessary to control weight in obese people. Behavior modification (e.g., keeping a food journal, eating a diet low in total and saturated fats, beginning an exercise program, and counseling to change eating and exercise habits) can be effective. Special emphasis should be placed on what has and has not been successful in the past.

    Drug therapy, such as herbal diet pills, maybe appropriate for patients with a high body mass index or can lower, but with additional factors, such as diabetes. In some diet pills reviews, we can found there is diet pills that work effectively when combined with exercise. The reviews itself can give us description which’s the best diet pills that related and can work for obesity people, in some case the patient need consultation with their doctor before start to consume the pills.

    Although, the most important that need to do is prevention. The propensity toward obesity is partially inherited, but a large component is also environmental. Obesity leads to an increased morbidity and mortality from a number of diseases, especially for those who are younger than 45 years. Being overweight in early adult life is more dangerous than it is at older ages.

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  • Team Sport Stuffs Become Easy to Get We do not need to take much time anymore for searching in every online store just for comparing the prices or looking for another color and type of stuffs for our team sports. We will not need to open the online stores one by one just for comparing the prices, if we can found anything that we need including the price comparison in one site.

    If we looking for any stuff for our team sport, there are available menu for team sports, such as soccer, football, cricket, etc witch are contain of links for products that related with them. The entire product from major brand, such as Spalding, Nike, and Wilson etc, are listed in. Those make us easier to choice stuffs that we needs. Or, you just need to type what you looking for in the search menu. It will show you the product including price comparison and details from each shop.

    I call this "Shopping Encyclopedia". It’s very easy to access from anywhere and anytime. The thing that impresses is there are no advertising that can make us confuse. In traditional online shops, you can confuse by so many advertising that some times not related with the thing that we were looking for. It’s very different with this one. The advertising is only by text and minimalist that is not contrast with the site design. And also, that’s make it easy to access. Now, Every thing must become easy including this one

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