YAYASAN AL-ARIF CIAMIS
RUMAH SAKIT UMUM AL-ARIF
Jl. RE Martadinata No. 158B Baregbeg-Ciamis
Telp. (0265) 77391-772994
FORM CEKLIS MONITORING OBAT EMERGENCY
Hari dan Tanggal :
Lokasi :
JADWAL PEMANTA
NO. NAMA OBAT/ALKES KOMPOSISI ; NETTO JUMLAH PAGI
13.00
1 Asam Tranexamat Injeksi Asam Tranexamat 250mg/5ml ; 5ml 5
2 Atrofine Sulfas Injeksi Atrofin Sulfas 0,25 mg/ml ; 1 ml 5
3 Dexamethason Injeksi Dexamethason 5mg/ml ; 1ml 5
4 Diphenhydramine Injeksi Diphenhidramine 150mg/15ml ; 15 ml 2
5 Dobutamin Injeksi Dobutamine 250mg/5ml ; 5ml 1
6 Dopamin Injeksi Dopamine 200mg/5ml ; 5ml 4
7 Epinefrin Injeksi Epinefrin 1mg/ml ; 1 ml 5
8 Furosemid Injeksi Furosemid 10mg/ml ; 2ml 2
9 Inviclot Injeksi Heparin 5000 UI/ml ; 5ml 5
10 Ketorolac Injeksi Ketorolac 10mg/ml ; 1ml 5
11 Lidocain Injeksi Lidocain 2% ; 2 ml 5
12 Neo K Injeksi Phytomenadion 2mg/ml ; 1ml 5
13 Ondancentron Injeksi Ondancentron 4mg/2ml ; 2ml 5
14 Tramadol Injeksi Tramadol 50mg/ml ; 2ml 5
15 Valisanbe Injeksi Diazepam 5mg/ml ; 2ml 3
1 D 10% Dextrose 10% ; 500 ml 2
2 D 40% Dextrose 40% ; 25 ml 5
3 D 5% Dextrose 5% ; 500 ml 2
4 KCL 7,46% Potassium Chloride 7,46% ; 25 ml 5
5 Meylon 8,4% Natrium Bicarbonate 8,4% ; 25 ml 5
6 MgSO4 20% Magnesium Sulfat 20% ; 25 ml 5
7 NaCl Natrium Chloride 0,9% ; 500 ml 2
8 RL Ringer Lactat ; 500 ml 2
1 Abbocat No. 16 2
2 Abbocat No. 18 2
3 Abbocat No. 20 2
4 Abbocat No. 22 2
5 Abbocat No. 24 2
6 Abbocat No. 26 2
7 Folley Catheter No. 16 2
8 Folley Catheter No. 18 2
9 Macro Set 2
10 Micro Set 2
11 Nasal Cannula Anak 2
12 Nasal Cannula Dewasa 2
13 NRM Dewasa 1
14 Sarung Tangan Steril No. 7 2
15 Sarung Tangan Steril No. 7,5 2
16 Sarung Tangan Steril No. 8 2
17 Selang NGT No. 14 2
18 Selang NGT No. 16 2
19 Selang NGT No. 18 2
20 Selang NGT No. 3,5 2
21 Selang NGT No. 5 2
22 Selang NGT No. 8 2
23 Simple Mask 1
24 Spuit 1 cc 2
25 Spuit 10 cc 2
26 Spuit 20 cc 2
27 Spuit 3 cc 2
28 Spuit 5 cc 2
29 Spuit 50 cc 2
30 Transfusi Set 2
31 Urine Bag 2
Petugas Farmasi
Petugas IGD
MIS
ARIF
g-Ciamis
GENCY
JADWAL PEMANTAUAN
SORE MALAM KET.
19.00 07.00
