Download - PPT 28-2-2016
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Sunday, February 29th,
2016
RSUDZA
Team on duty
dr Andria Saputra !"aga #$
dr Muna%ar !"aga ##$
dr T Rona&'y !"aga ###$
dr Sumrahadi !"aga ###$
dr (obby )ermi !"aga #*$
dr +a& Muyadi !"aga #*$dr )erdi -unanta !"aga *$
dr M Ta.%a !"aga *#$
dr Syahmardani #bnu !"aga
*#$
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/961912
oDi&tribution o &urgery
patientRoom
1 mergen3y room patient 15 Patients
2 )o&pitai4e 9 Patients
3 5ut o 3ini3 5 Patients
4 Reu&e medi3a adi3e 1 Patient
5 7a&&ed a%ay -
6 )o&pitai4e room Jeumpa 1 28/28 bed
Jeumpa 2 28/28 bed
Jeumpa 3 28/28 bed
Jeumpa 4 26/26 bed
ICU 2 Patients
ICUC 1 Patients
PICU 1 Patients
NICU 2 Patients
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#8UADUT
• Usman/M/51 yo/Post P s!unt ai "t#o$e
%aemo#a&!i' ( I%/P)* 28
• +a#!an ,ndi$a/M/1 yo/Poost C#anie'tomy ai
e.a$uasi IC%/P)* 1
#8U • y ,ssi0a Naa "asabia/+/12 do/Post $sisi%ioma Coi/P)* 3
• y ,!mad ,0aya/M/13 do/"usp %i#s'!sp#un&s
disease/,* 3
#8U8ardia
3
• Nu#anna!/+/5 yo/7usi peu#a biate#a e' CaMamae post ,"/P)* 5
7#8U • aisa ,:isa/M/5 yo/Post ;apa#otomy e
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7atient identity
• Name = >andi$a• ,&e = 34 yea#s od
• "e< = Mae
•
,dd#ess = *s #an Meutia#a? ab"imeueu
• M@ = 1A822A
• %P = A823A58868
• *#i.in& i'en'e = B(
• ,dmission time = at 1=55 PM
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Time Re&pon&e
Date/hourpatie
nt3ameto R
:amination
hour
aboratory
:amination
Radioogy:aminati
on
)ouro
Diagno&ti
3&
Date/hourpatient outromR
Superi&or
Send Re&ut Send Re&ut
28-2-2A16
A155PM
A2A3PM
A21A PM
A33A PM
A23APM
A3AA PM
A3AAPM
28-2-2A16
A4AAPM
)@
d#ustami
"p"
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8hie 3ompaint
•
*e'#ease o0 'ons'iousness
7atient ine& )i&tory
• !e patient #e7e#ed 0#om "imeueudist#i' !ospita to Dainoe ,bidineme#&en'y #oom it! '!ie0 'ompaintde'#ease o0 'ons'iousness 0o# 3 days
!e 'ompaint sta#ted !en t!epatient as #idin& moto#'y'e it!out!emet? suddeny st#u'$ed a 'o %e
0et don to t!e st#eet and !is !ead !it
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7hy&i3a e:amination
7rimary &urey• , = Cea#? C-spine 'ont#o
• = "pontaneous? @@ = 22 b#eat!s/min
•
C = P = 146/86 mm%&? Puse = 8beats/min
• * = EC" = 9 = 2 M5 2 ? pupi F3mm/3mm?
i&!t #eGe< B(/(? no ate#ai:ation
• = ;/" at t!e #i&!t pa#ieta #e&ion
I = !ematome B(? ound B-
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Se3ondary &urey
• )ead region ;
;/" at t!e #i&!t pa#ieta #e&ion
I = !ematome B(? ound B-
• e3' region ; in no#ma imit
• Thora: region ; in no#ma imit
• Abdomina region ; in no#ma imit
• 7ei3 region ; in no#ma imit
• Upper e:tremity ; in no#ma imit
• o%er e:tremity ; in no#ma imit
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A&&e&&ment&;
• Mode#ate !ead inu#y
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Management
• "top o#a inta$e
• %ead up 3A H
• U#ine 'at!ete# 'ea# Binitia 5A ''
• )2 8 ;/minutes .ia 0a'emas$
• I+* NaC A?9 2A d#ips/minutes
• In Ce0t#ia
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aboratory re&ut
• %b = 13?8 /d
• !ite bood 'ount = 124AA /u
• Pateet = 112AAA /u
• C = 9 minute
• = 3 minute
• %t = 42
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Radioogy :amination re&ut
)ead 8T
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Diagno&e
1Mode#ate !ead inu#y BIC* 1A CM "A6A
2"*% at t!e #i&!t 0#onto-tempo#o-pa#ieta#e&ion BIC* 1A CM I621
3 IC% at t!e #i&!t 0#onto-tempo#o-pa#ieta
#e&ion BIC* 1A CM I611
4",% at t!e #i&!t 0#onto-tempo#o-pa#ieta#e&ion BIC* 1A CM I6AA
8on&ut to euro&urgery Dii&ion
•.C#aniotomy de'omp#ession eme#&en'y
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5peratie report ;
• Pe#0o#med tempo#o-0#onta e
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7o&t 5peratie Diagno&ed ;
1Mode#ate !ead inu#y BIC* 1A CM "A6A2"*% at t!e #i&!t 0#onto-tempo#o-pa#ieta
#e&ion BIC* 1A CM I621
3 IC% at t!e #i&!t 0#onto-tempo#o-pa#ieta#e&ion BIC* 1A CM I611
4",% at t!e #i&!t 0#onto-tempo#o-pa#ieta#e&ion BIC* 1A CM I6AA
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Foo% upDat
e
S 5 A 7
29/2/
2A16P)*
1
*e'#eas
e o0'ons'iousness
*ita Sign ;
P = 14A/9Amm!&%@ = 6beats/min@@= 2Ab#eat!s/minit! .entiato#IPP
= 45APP = 5
emp = 3?2 A C
EC" = on.entiato#
S/ at theright temporo<
parieta ;I d
7o&t 3raniotomy
de3ompre&&ion!SD) ea3uation$
1Mode#ate !eadinu#y BIC* 1A CM"A6A
2"*% at t!e #i&!t0#onto-tempo#o-pa#ieta #e&ionBIC* 1A CM I621
3IC% at t!e #i&!t
0#onto-tempo#o-pa#ieta #e&ionBIC* 1A CM I611
4",% at t!e #i&!t0#onto-tempo#o-pa#ieta #e&ion
BIC* 1A CM I6AA
• %ead Up 3Ao
• I+* NaCA?9 2Ad#ips/min
• InCe0t#ia