FORM Laporan Anestesi Ketikan
4
8/19/2019 FORM Laporan Anestesi Ketikan http://slidepdf.com/reader/full/form-laporan-anestesi-ketikan 1/4 RUMAH SAKIT SYAFIRA Jl. Jend. Sudirman No. 134 Pekanbaru Riau Tel!. "#$%1& 3'3%# ('%'1$ Fa). "#$%1& 41(($ No. MR Kl* + R, LAPORAN ANESTESI Ke- Si*-ole ) ˅ Mulai Ane*-e*i Kom!lika*i / Tindakan 0ok-er Ane*-e*i 0ia*-ole o ˄ Mulai !era*i Nadi ) Ak2ir Ane*-e*i Re*!ira*i Ak2ir !era*i "..& Nama Jela* Nama Pa*ien Kelamin Umur 0ok-er Ane*-e*i A*i*-en 0iano*i* Pre P Jeni* !era*ianal 0iano*i* Po*- P 0ok-er !era-or A*i*-en TEHNIK ANESTESI Umum Semi 5lo*e + 5lo*e + !en + Ja6*on Ree* Jalan Na!a* Ma*ker Muka Perna!a*an Kon-rol + S!on-an + A*i*-ed 7T+NT+No. .............. ........ Reional S!inal + 7!idural + ,lok S8ara9 + .............. ..... ............... .............. .............. Po*i*i Telen-an + Mirin +:i-o-omi + ............ .......... PEMERIKSAAN PRE – OPERATIP K+U Penun;an Hb Ten*i 7K< Nadi Ro Fo-o Na9a* ,, Su2u :ain :ain ASA +7 MONITORING SELAMA ANESTESI Tanal Premedika*i Mulai Ane*-e*i Induk*i Mulai !era*i Sele*ai !era*i Sele*ai Ane*-e*i :ama Ane*-e*i JAM = =## N= HA: 1(# 7NF ISF 1%# 14# 1=# ` • >5airan Ma*uk R: 1## Na5I 0ara2 (# ................. >5airan Keluar %# Urine 0ara2 4# .................. =#
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Transcript of FORM Laporan Anestesi Ketikan
8/19/2019 FORM Laporan Anestesi Ketikan
http://slidepdf.com/reader/full/form-laporan-anestesi-ketikan 1/4
RUMAH SAKIT SYAFIRA Jl. Jend. Sudirman No. 134 Pekanbaru Riau
Tel!. "#$%1& 3'3%# ('%'1$ Fa). "#$%1& 41(($
No. MR Kl* + R,
LAPORAN ANESTESI
Ke- Si*-ole )˅ Mulai Ane*-e*i Kom!lika*i / Tindakan 0ok-er Ane*-e*i
0ia*-ole o˄ Mulai !era*i
Nadi ) Ak2ir Ane*-e*i
Re*!ira*i Ak2ir !era*i
"..&
Nama Jela*
Nama Pa*ien
Kelamin
Umur
0ok-er Ane*-e*i
A*i*-en
0iano*i* Pre P
Jeni* !era*ianal
0iano*i* Po*- P
0ok-er !era-or
A*i*-en
TEHNIK ANESTESI
Umum Semi 5lo*e + 5lo*e + !en + Ja6*on Ree* Jalan Na!a* Ma*ker Muka
Perna!a*an Kon-rol + S!on-an + A*i*-ed 7T+NT+No. ......................
Reional S!inal + 7!idural + ,lok S8ara9 + ................... ...........................................
Po*i*i Telen-an + Mirin +:i-o-omi + ......................
PEMERIKSAAN PRE – OPERATIP
K+U Penun;an Hb
Ten*i 7K<
Nadi Ro Fo-o
Na9a* ,,
Su2u :ain :ain
ASA +7
MONITORING SELAMA ANESTESI Tanal
Premedika*i Mulai Ane*-e*i
Induk*i Mulai !era*i
Sele*ai !era*i
Sele*ai Ane*-e*i
:ama Ane*-e*i
JAM
= =##
N=
HA: 1(#7NF
ISF 1%#
14#
1=#
`
•
>5airan Ma*uk R: 1##
Na5I0ara2 (#
.................>5airan Keluar %#
Urine
0ara2 4# ..................
=#
8/19/2019 FORM Laporan Anestesi Ketikan
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Perma*ala2an *elama duran-e ane*-e*i
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In*-ruk*i !o*-?o!
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0ok-er Ane*-e*i
" & Nama Jela*
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