luka bakar(combustio).ppt

8/10/2019 LUKA BAKAR(COMBUSTIO).ppt

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LUKA BAKARLUKA BAKAR

( COMBUSTIO )( COMBUSTIO )Dr. Syahrifl Syahar,Sp B.Dr. Syahrifl Syahar,Sp B.


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PENDAHULUANPENDAHULUAN

Lua !aar a"#a M$r!i%i&a' %a"Lua !aar a"#a M$r!i%i&a' %a"M$r&ali&a' &i"##i M$r&ali&a' &i"##i

RSUPN CM (**+) -,-+RSUPN CM (**+) -,-+

RSU Dr.S$/&$0$ (1222) 13,4RSU Dr.S$/&$0$ (1222) 13,4


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5ASE LUKA BAKAR5ASE LUKA BAKAR

1.FASE AKUT/FASE SYOK/FASE AWAL1.FASE AKUT/FASE SYOK/FASE AWAL

- Kejadian/IRD- Kejadian/IRD

- Problem Pernaa!an- Problem Pernaa!an

- L"#a- L"#a

$.FASE SU%AKUT$.FASE SU%AKUT

-Dalam &era'a(an-Dalam &era'a(an

-Problem l"#a)ine#!i)!e&!i!-Problem l"#a)ine#!i)!e&!i!

*.FASE LA+,UT*.FASE LA+,UT

-Se(ela beroba( jalan-Se(ela beroba( jalan -Problem &ar"() #on(ra#("r-Problem &ar"() #on(ra#("r


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PEN6EBAB LUKA BAKARPEN6EBAB LUKA BAKAR

.. ApiApi

1.1. Air pa"a'Air pa"a'

.. Baha" i0iaBaha" i0ia4.4. Li'&ri,p/&ir,ra%ia'iLi'&ri,p/&ir,ra%ia'i

7.7. S/"#a&a" 'i"ar 0a&ahariS/"#a&a" 'i"ar 0a&ahari

3.3. L/%aa" &u"#u pa"a'L/%aa" &u"#u pa"a'-.-. L/%aa" B$0L/%aa" B$0


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DERA8AT KEDALAMAN LUKADERA8AT KEDALAMAN LUKABAKARBAKAR

.. LUKA BAKAR DERA8AT ILUKA BAKAR DERA8AT I

9 Epi%/r0i'9 Epi%/r0i'

1.1. LUKA BAKAR DERA8AT IILUKA BAKAR DERA8AT II9 D/ra:a& IIA 'up/rf'ial 9 D/ra:a& IIA 'up/rf'ial

Sup/rf'ial %/r0i'Sup/rf'ial %/r0i'

Or#a" $r#a" uli& 0a'ih !aiOr#a" $r#a" uli& 0a'ih !aiP/"y/0!uha" Sp$"&a" 294 hariP/"y/0!uha" Sp$"&a" 294 hari


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9 DERA8AT IIB (%//p)9 DERA8AT IIB (%//p) Ha0pir '/luruh !a#ia" %/r0i'Ha0pir '/luruh !a#ia" %/r0i'

Or#a" $r#a" uli& '/!a#ia" !/'arOr#a" $r#a" uli& '/!a#ia" !/'ar0a'ih u&uh0a'ih u&uh

P/"y/0!uha" l/!ih %ari !ula"P/"y/0!uha" l/!ih %ari !ula"


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. LUKA BAKAR DERA8AT III. LUKA BAKAR DERA8AT III

Sa0pai $&$&;&ula"#Sa0pai $&$&;&ula"# Ti%a "y/ri %a" hila"# '/"'a'iTi%a "y/ri %a" hila"# '/"'a'i

T/r:a%i $a#ula'i pr$&/i" ESKART/r:a%i $a#ula'i pr$&/i" ESKAR

P/"y/0!uha" l/!ih la0aP/"y/0!uha" l/!ih la0a


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LUAS LUKA BAKARLUAS LUKA BAKAR

A.


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KRITERIA BERAT RIN=ANN6AKRITERIA BERAT RIN=ANN6A(AMERICAN BURN ASSOCIATION)(AMERICAN BURN ASSOCIATION)

. Lua !aar ri"#a". Lua !aar ri"#a"

9 LB %/ra:a& II > 79 LB %/ra:a& II > 7

9 LB %/ra:a& II > 2 pa%a a"a a"a9 LB %/ra:a& II > 2 pa%a a"a a"a

9 LB %/ra:a& III > 9 LB %/ra:a& III >

1. Lua !aar '/%a"#1. Lua !aar '/%a"#

9 LB %/ra:a& II 7917 ( D/?a'a)9 LB %/ra:a& II 7917 ( D/?a'a) 9 LB %/ra:a& II 2912 ( A"a a"a )9 LB %/ra:a& II 2912 ( A"a a"a )

9 LB %/ra:a& III > 29 LB %/ra:a& III > 2


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. Lua !aar !/ra&. Lua !aar !/ra&

9 LB %/ra:a& II @ 17 ( D/?a'a ) LB9 LB %/ra:a& II @ 17 ( D/?a'a ) LB

9 D/ra:a& II @ 12 ( A"a a"a )9 D/ra:a& II @ 12 ( A"a a"a )

9 LB %/ra:a& III @ 29 LB %/ra:a& III @ 29 LB 0/"#/"ai9 LB 0/"#/"ai

&a"#a",?a:ah,&/li"#a,0a&a&a"#a",?a:ah,&/li"#a,0a&a

, ai %a" #/"i&alia;p/ri"/u0., ai %a" #/"i&alia;p/ri"/u0.


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PENATALAKSANAANPENATALAKSANAANPENDERITA LUKA BAKARPENDERITA LUKA BAKAR

5ASE AKUT5ASE AKUT

I. PRIMAR6 SURE6I. PRIMAR6 SURE6

A. Air?ay %a" /rial 'pi"/ pr$&/'iA. Air?ay %a" /rial 'pi"/ pr$&/'i B. Br/a&hi"# %a" /"&ila'iB. Br/a&hi"# %a" /"&ila'i

C. Cirula'i %a" $"&r$l p/r%araha"C. Cirula'i %a" $"&r$l p/r%araha"

D. Di'a!ili&y p/0/ri'aa"D. Di'a!ili&y p/0/ri'aa""/ur$l$#i'."/ur$l$#i'.

E. Ep$'ur/E. Ep$'ur/


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II. SECONDAR6 SURE6II. SECONDAR6 SURE6

a. A"a0"/'aa. A"a0"/'a

B. P/0/ri'aa" f'i ( /pala9 ai )B. P/0/ri'aa" f'i ( /pala9 ai )

C. Pri"'ip p/"a"#a"a"C. Pri"'ip p/"a"#a"a"

. H/"&ia" p/"y/!a! LB. H/"&ia" p/"y/!a! LB

1. U"i/r'al pr/au&i$",HI,h/pa&i&i'.1. U"i/r'al pr/au&i$",HI,h/pa&i&i'.

. R/'u'i&a'i aira". R/'u'i&a'i aira"

194 RL BB Lua' LB194 RL BB Lua' LB

4. i&al 'i#"4. i&al 'i#"


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7. P/0a'a"#a" N=T7. P/0a'a"#a" N=T

3. P/0a'a"#a" uri"/ a&/&/r3. P/0a'a"#a" uri"/ a&/&/r

-. A''/''0/"& p/rFu'i /'&r/0i&a'-. A''/''0/"& p/rFu'i /'&r/0i&a'+. C$"&i"u/% /"&ila&$ry a''/''0/"&+. C$"&i"u/% /"&ila&$ry a''/''0/"&

*. Pai"& 0a"a#/0/"&*. Pai"& 0a"a#/0/"&

2. P'y$'$ial a''/''0/"&2. P'y$'$ial a''/''0/"&. P/0!/ria" T/&a"u' T$$i%. P/0!/ria" T/&a"u' T$$i%


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1. Ti0!a"# !/ra& !a%a"1. Ti0!a"# !/ra& !a%a". PENCUCIAN LUKA DI KAMAR. PENCUCIAN LUKA DI KAMAR

OPERASI ( Biu' T$&al ) OPERASI ( Biu' T$&al )


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PERA


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PEMERIKSAAN LABORATORIUMPEMERIKSAAN LABORATORIUM

.H&,HB.H&,HB1.Al!u0i"1.Al!u0i"

.R5T,L5T.R5T,L5T

4.El/&r$li&,Na,K,CL,HCO4.El/&r$li&,Na,K,CL,HCO7.BUN,Uri"ali'a,AB=7.BUN,Uri"ali'a,AB=

3.5$&$ &h$ra3.5$&$ &h$ra-.Car!$y h/0$#l$!i"-.Car!$y h/0$#l$!i"+.EC= ( Trau0a li'&ri )+.EC= ( Trau0a li'&ri )


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RESUSITASI CAIRANRESUSITASI CAIRAN

5$r0ula Ea"'5$r0ula Ea"'

5$r0ula Br$$/5$r0ula Br$$/

5$r0ula Parla"%5$r0ula Parla"%M$%ifa'i Br$$/M$%ifa'i Br$$/

5$r0ula M$"aF$5$r0ula M$"aF$


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5ORMULA BATER5ORMULA BATER

ari Per(ama ari Per(ama

De'a!a RL 0 2 %% 2 3 l"a! L%/$0 jamDe'a!a RL 0 2 %% 2 3 l"a! L%/$0 jam

Ana# RL De2(ran 4 15 *Ana# RL De2(ran 4 15 *

$ 2 %% 2 3 l"a! L% 6$ 2 %% 2 3 l"a! L% 6

Keb"("an Faali Keb"("an Faali

7 1 (a"n %% 2 188 7 1 (a"n %% 2 188

1 9 * (a"n %% 2 5: 1 9 * (a"n %% 2 5:

* - : (a"n %% 2 :8 * - : (a"n %% 2 :8

; ,"mla airan diberi#an dalam < jam &er(ama; ,"mla airan diberi#an dalam < jam &er(ama; Diberi#an 1= jam beri#"(n>a; Diberi#an 1= jam beri#"(n>a


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MONITORIN= RESUSITASIMONITORIN= RESUSITASICAIRANCAIRAN

. Pr$%u'i uri"/;:a0.. Pr$%u'i uri"/;:a0. D/?a'a 2,7 ;#!!;:a0(2972 ;:a0)D/?a'a 2,7 ;#!!;:a0(2972 ;:a0)1. Oli#uria1. Oli#uria

. Ha/0$hr$0$#/"uria(R/% pi#0/"&/%9. Ha/0$hr$0$#/"uria(R/% pi#0/"&/%9 Uri"/)Uri"/)4. Bl$$% pr/''ur/.4. Bl$$% pr/''ur/.

7. H/ar& Ra&/.7. H/ar& Ra&/.3. H& %a" H!.3. H& %a" H!.


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TRAUMA INHALASITRAUMA INHALASI

P/"y/!a! P/"y/!a!

9 Trau0a pa"a' la"#'u"#9 Trau0a pa"a' la"#'u"#

9 K/rau"a" A'ap;#a' &$i9 K/rau"a" A'ap;#a' &$i

9 Car!$" 0$"$i%a9 Car!$" 0$"$i%a

Kli"i' Kli"i'

9 P/"uru"a" K/'a%ara"9 P/"uru"a" K/'a%ara"

9 Di'&r/' "aFa'9 Di'&r/' "aFa'

9 Tahip"/u9 Tahip"/u


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PERNA5ASANPERNA5ASAN

U%ara pa"a'9999iri&a'i999/%/0a999U%ara pa"a'9999iri&a'i999/%/0a999$!'&ru'i$!'&ru'i

9999#a#al "aFa'.9999#a#al "aFa'.

EF/ &$i %ariEF/ &$i %aria'ap(H","$1,hl,!/"'i",a'ap(H","$1,hl,!/"'i",

999 iri&a'i 999 !r$"h$$"&ri'i 999 #a#al 999 iri&a'i 999 !r$"h$$"&ri'i 999 #a#al NaFa'.NaFa'.

CCO 9999 hip$'iaO 9999 hip$'ia


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TIPE TRAUMA INHALASITIPE TRAUMA INHALASI

K/rau"a" COK/rau"a" CO

Trau0a i"hala'i %ia&a' #l$&i'Trau0a i"hala'i %ia&a' #l$&i'

Trau0a i"hala'i %i!a?ah #l$&i'Trau0a i"hala'i %i!a?ah #l$&i'=AMBAR.=AMBAR.


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PENATALAKSANAANPENATALAKSANAAN

TANPA DISTRES PERNA5ASANTANPA DISTRES PERNA5ASAN

. I"&u!a'i. I"&u!a'i

1. O'i#/" 194 li&/r;0/"i&1. O'i#/" 194 li&/r;0/"i&. P/"#hi'apa" '/r/&. P/"#hi'apa" '/r/&

4. Hu0i%ifa'i %/"#a" N/!uliG/r;34. Hu0i%ifa'i %/"#a" N/!uliG/r;3

:a0:a07. Br$"h$%ila&$r.7. Br$"h$%ila&$r.

3. P/0a"&aua" %i'&r/' p/r"aFa'a".3. P/0a"&aua" %i'&r/' p/r"aFa'a".


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=E8ALA;TANDA=E8ALA;TANDADISTRES PERNA5ASANDISTRES PERNA5ASAN

=/:ala 'u!:/&iF #/li'ah,'/'a "aFa'=/:ala 'u!:/&iF #/li'ah,'/'a "aFa'=/:ala $!:/&iF =/:ala $!:/&iF

9 RR 0/"i"#a& ( @ 2 ;0/"i& )9 RR 0/"i"#a& ( @ 2 ;0/"i& )

9 Sia"$&i9 Sia"$&i9 A&if&a' $&$& p/r"aFa'a" 0/"i"#a&A&if&a' $&$& p/r"aFa'a" 0/"i"#a&9

A"ali'a #a' %arahA"ali'a #a' %arah

-.Th$ra 5$&$.-.Th$ra 5$&$.

+. B/% $!'/ra'i %u%u; %u%u.+. B/% $!'/ra'i %u%u; %u%u.


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DEN=AN DISTRESDEN=AN DISTRESPERNA5ASANPERNA5ASAN

.. Trah/$'&$0iTrah/$'&$0i

1.1. O'i#/" 19 4 li&/r ; 0/"i&O'i#/" 19 4 li&/r ; 0/"i&

.. Br$"hial ?a'hi"#.Br$"hial ?a'hi"#.4.4. Hu0i%ifa'i %/"#a" "/!uliG/rHu0i%ifa'i %/"#a" "/!uliG/r

7.7. Br$"h$%ila&$rBr$"h$%ila&$r

3.3. P/0a"&aua" %i'&r/' p/r"aFa'a"P/0a"&aua" %i'&r/' p/r"aFa'a"-.-. 5$&$ &$ra5$&$ &$ra


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LUKA BAKAR LISTRIKLUKA BAKAR LISTRIK

K/ru'aa" :ari"#a" %i'/!a!a" K/ru'aa" :ari"#a" %i'/!a!a"

.. Aru' !$la !ali.Aru' !$la !ali.

9 K/ru'aa" l$al ; 'i'&/0i9 K/ru'aa" l$al ; 'i'&/0i1.1. L$"a&a" /"/r#i.L$"a&a" /"/r#i.

.. Tr$0!$'i'.Tr$0!$'i'.


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PENAN=ANAN LUKA BAKARPENAN=ANAN LUKA BAKARLISTRIKLISTRIK

A.A. Pri0ary Sur/y.Pri0ary Sur/y.

B.B. S/$"%ary Sur/y S/$"%ary Sur/y

. P/0/ri'aa" 5i'i ( /pala9 ai ). P/0/ri'aa" 5i'i ( /pala9 ai )

1. Paaia" %a" p/rhia'a" %i!ua 1. Paaia" %a" p/rhia'a" %i!ua a. P/ri'a &i&i $"&aa. P/ri'a &i&i $"&a

!. E'&i0a'i lua' LB;D/ra:a& LB!. E'&i0a'i lua' LB;D/ra:a& LB

. S&a&u' N/ur$l$#i'. S&a&u' N/ur$l$#i' %. Trau0a lai", Fra&ur; %i'l$a'i%. Trau0a lai", Fra&ur; %i'l$a'i

/. ET/. ET


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C. RESUSITASIC. RESUSITASI

.. Bila LB, RL 1 4 ;#!!; lua' LBBila LB, RL 1 4 ;#!!; lua' LB

1.1. Ha/0$hr$#/" ( 0y$#l$!i" ), uri"/Ha/0$hr$#/" ( 0y$#l$!i" ), uri"/

$u& pu& %ip/r&aha"a" -7 22 ;:a0,$u& pu& %ip/r&aha"a" -7 22 ;:a0,

'a0pai uri"/ :/r"ih.'a0pai uri"/ :/r"ih.

.. Bi.Na&. %i&a0!aha" %i%ala0 RLBi.Na&. %i&a0!aha" %i%ala0 RL'a0pai'a0pai

pH @ 3.2pH @ 3.2

4. Ma"i&$l :ara"#4. Ma"i&$l :ara"#


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PATO=ENESIS LUKA BAKARPATO=ENESIS LUKA BAKAR

Pa%a lua !aar AR5 %apa& %i/#ahPa%a lua !aar AR5 %apa& %i/#ahara ara

. R/'u'i&a'i aira".. R/'u'i&a'i aira".

1. M/"/#ah i"F/'i.1. M/"/#ah i"F/'i.

. Hi"%ari $!a& $!a& N/Fr$&$'i.. Hi"%ari $!a& $!a& N/Fr$&$'i.

4. K$r/'i /l/&r$li& %a" /'/i0!a"#a"4. K$r/'i /l/&r$li& %a" /'/i0!a"#a"a'a0 %a" !a'aa'a0 %a" !a'a


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INDIKASI DIALISAINDIKASI DIALISA

9 Ur/u0 @ 22 72 0#;%l9 Ur/u0 @ 22 72 0#;%l

9 Cr/a&i"i"/ @ + 2 0#;%l9 Cr/a&i"i"/ @ + 2 0#;%l

MODALITAS DIALISA MODALITAS DIALISA . H/0$%ialy'a.. H/0$%ialy'a.

1. K$"&i"yu1. K$"&i"yu

H/0$%ialy'a;H/0$fl&ra'i.H/0$%ialy'a;H/0$fl&ra'i.. P/ri&$"/al %ialy'a.. P/ri&$"/al %ialy'a.


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S6STEMIC IN5LAMATOR6S6STEMIC IN5LAMATOR6RESPONSE S6NDROME ( SIRS )RESPONSE S6NDROME ( SIRS )

%a" MULTI9 'y'&/0 Or#a"%a" MULTI9 'y'&/0 Or#a"Dy'Fu"&i$" Sy"%r$0/Dy'Fu"&i$" Sy"%r$0/

SIRS SIRS

M/rupaa" r/'p$" li"i' !/r'iFa& 'i'&/0iM/rupaa" r/'p$" li"i' !/r'iFa& 'i'&/0i%a" /'a#/ra&iF &/rha%ap !/r!a#ai STIMULUS%a" /'a#/ra&iF &/rha%ap !/r!a#ai STIMULUSKLINIS !/ra& KLINIS !/ra&

JJ . I"F/'i . I"F/'i

9 "i%u' i"F/'i9 "i%u' i"F/'i 9 E"%$&$'i"9 E"%$&$'i" 9 E'$&$'i"9 E'$&$'i"

9 A"&i#/" iru'; :a0ur9 A"&i#/" iru'; :a0ur 1. N$" i"F/'i1. N$" i"F/'i

9 Trau0a9 Trau0a


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5a&$r pr/%i'p$'i'i Ti0!ul"ya5a&$r pr/%i'p$'i'i Ti0!ul"yaSIRSSIRS

.. 5a&$r i"&/r"al.5a&$r i"&/r"al.KU p/"%/ri&a, $"%i'i pr/0$r!i%. KU p/"%/ri&a, $"%i'i pr/0$r!i%.

1.1. 5a&$r /'&/r"al.(8/"i' &rau0a %a"5a&$r /'&/r"al.(8/"i' &rau0a %a"p/"a&ala'a"aa""ya), 0/"/"&ua"p/"a&ala'a"aa""ya), 0/"/"&ua"P/r:ala"a" p/"yai& %a" Pr$#"$'aP/r:ala"a" p/"yai& %a" Pr$#"$'a


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PERA


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1. Si" #raF&i"#.1. Si" #raF&i"#.

I00/%ia&/ ( '/#/ra )I00/%ia&/ ( '/#/ra )

D/lay/% P/"u"%aa" ),'a0pai %/"#a"D/lay/% P/"u"%aa" ),'a0pai %/"#a"4 hari pa'a %/!ri%/0/"&.4 hari pa'a %/!ri%/0/"&.


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P/ra?a&a" LB D/ra:a& II %ala0P/ra?a&a" LB D/ra:a& II %ala0%a" D/ra:a& III .%a" D/ra:a& III .

P/"yuli& "/r$'i' :ari"#a".P/"yuli& "/r$'i' :ari"#a".

.P/"uia" lua..P/"uia" lua.

1.N/r$&$0i %a" %/!ri%/0/"& .1.N/r$&$0i %a" %/!ri%/0/"& .E'ar/&$0i ( E'i'i &a"#/"'ial )E'ar/&$0i ( E'i'i &a"#/"'ial )'/%i"i 0u"#i" u"&u 0/"/#ah'/%i"i 0u"#i" u"&u 0/"/#ahSIRS %a" MODS, 94 hari pa'aSIRS %a" MODS, 94 hari pa'a

/%/ra a&au > 0i"##u./%/ra a&au > 0i"##u. Pr$'/%ur i"i %ilaua" 0a'i0al lua'Pr$'/%ur i"i %ilaua" 0a'i0al lua'

LB 7.LB 7.

luka bakar(combustio).ppt

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