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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