17.Checklist Persiapan Operasi (Ok)

RM. 10A RUMAH SAKIT BRAYAT MINULYA

 .*+

# .. ..   . . . Fax. (0271) 72730, !-"ail# r$b"$lo%indo$at.net.id gl /air /air"ur "ur # . .   . .tbl tblr r Sura&arta-'713 la"at # ..   .. Jeni$ 5ela"in # /a&i-/a&i  ere"puan * CHECK LIST PERSIAPAN OPERASI Jl.dr. Setiabudi no.106, telp. 0271-716646 (Hunting )

inggi ba badan erat badan 8ol. 9ara

#  . " " # . 5g # ..

 a"a a$ien a$ien

anggal anggal pera$i pera$i #     . ... +a:a" +a:a" pera pera$i $i #      .. .. *i;a
IBS

Keterangan

1. Persiaan A!"inistrasi •

rogra" &e =S

>a  ida&

>a  ida&

•

er$etu?uan pera$i /eng&ap @ eri$i

>a  ida&

>a  ida&

•

*e&a" +edi$

>a  ida&

>a  ida&

•

/aporan pera$i

>a  ida&

>a  ida&

•

/aporan ne$te$i

>a  ida&

>a  ida&

•

Ha$il /aboratoriu"

>a  ida&

>a  ida&

•

Ha$il *adiologi

>a  ida&

>a  ida&

•

Ha$il  S:an

>a  ida&

>a  ida&

•

Ha$il S8

>a  ida&

>a  ida&

•

Ha$il !58

>a  ida&

>a  ida&

•

Ha$il lain-lain #

>a  ida&

>a  ida&

2. Persiaan #isi$ % •

ua$a

>a  ida&

>a  ida&

•

/aAe"ent  8ara" =nggri$

>a  ida&

>a  ida&

•

a$ang 9

>a  ida&

>a  ida&

•

u&ur dan ber$i&an daera opera$i

>a  ida&

>a  ida&

•

*a"but pal$u, gigi pal$u, :onta:t len$, $uda dilepa$

>a  ida&

>a  ida&

•

at &u&u dan "a&e up "u&a $uda diber$i&an

>a  ida&

>a  ida&

•

eria$an dan arlo?i dll, $uda dilepa$

>a  ida&

>a  ida&

•

er$iapan dara untu& tranBu$i #

>a  ida&

>a  ida&

>a  ida&

>a  ida&

5antong #

>a  ida&

>a  ida&

5antong #

>a  ida&

>a  ida&

5antong #

>a  ida&

>a  ida&

>a  ida&

>a  ida&

1) Cole lood ( C ) 2) * 3) FF •

re"edi&a$i

•

ntibioti: pre D op

3. Persiaan K&'s's •

9+ D =n$ulin re p

>a  ida&

>a  =da&

•

Hiperten$i-obat anti iperten$i re p

>a  ida&

>a  ida&

•

$"a-bat $"a:orti:o$teroid re p

>a  ida&

>a  ida&

Se?a&# o#

+a:a" #

9iberi&an ?a" #

C=

S

•

bat lain # .

>a  ida&

>a  ida&

•

bat-obatan $ebelu" idur 

>a  ida&

>a  ida&

•

a$ang inBu$

>a  ida&

>a  ida&

•

e&anan 9ara

>a  ida&

>a  ida&

•

 adi

>a  ida&

>a  ida&

•

Suu

>a  ida&

>a  ida&

•

ernaBa$an

>a  ida&

>a  ida&

•

bat
>a  ida&

>a  ida&

•

Ha$i $&inte$t obat #

>a  ida&

>a  ida&

9o&ter eda

>a  ida&

>a  ida&

9o&ter ne$te$i

>a  ida&

>a  ida&

9o&ter 5on$ul ter&ait #

>a  ida&

>a  ida&

9o&ter &on$ul ter&ait #

>a  ida&

>a  ida&

9o&ter &on$ul ter&ait era;at

>a  ida&

>a  ida&

=E at o #

o$itiB  egatiB  

4. er$iapan +ental 5un?ungan  Ai$it do&ter pra beda

1) 2) 3) 4) 5)

era;at =S

 ( . )

( . )

anda tangan @ a"a terang

anda tangan @ a"a terang

*Coret yang tidak perlu