Lembar Observasi Pasien Intensive Care Unit 673c6l
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LEMBAR OBSERVASI PASIEN INTENSIVE CARE UNIT Hari/Tanggal: Selasa, 8 Januari 2019
NO. RM:
Tgl Masuk ICU: 6 Januari 2019 Hari Rawat ICU: 2 ALERGI: YA/TIDAK,.......... RESIKO JATUH: YA/TIDAK BB:
L/P
Nama Pasien: Tn A Tanggal Lahir: Alamat:
Uraian/ Jam 07 T T v
R S P EKG
S S P
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
01
02
03
04
05
06
JML/ SISA
24 Jam
TD HR S RR SPO2 Jenis Ventilasi FiO2/RR PEEP/P S Gamb EKG kesadaran Besar/Reaksi Pupil G E C M S V JML/ SISA Infus 1 Infus 2 Transfusi SP 1 SP 2 SP 3 Injeksi Makan/Minum 1jam/komulatif Urine NGT Muntah BAB
JML/ SISA
Drain IWL 1jam/1jam/komula
tif BALANCE CAIRAN PENGOBATAN Injeksi
Oral
DIIT CATATAN ALAT INVASIF & INoS
INFUS 1 INFUS 2 DC NGT DRAIN
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
01
02
03
04
05
06
TRAKHEOSTOM I PLEBITIS ILI IDO DEKUBITUS ISK
NO. RM:
Tgl Masuk ICU: 6 Januari 2019 Hari Rawat ICU: 2 ALERGI: YA/TIDAK,.......... RESIKO JATUH: YA/TIDAK BB:
L/P
Nama Pasien: Tn A Tanggal Lahir: Alamat:
Uraian/ Jam 07 T T v
R S P EKG
S S P
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
01
02
03
04
05
06
JML/ SISA
24 Jam
TD HR S RR SPO2 Jenis Ventilasi FiO2/RR PEEP/P S Gamb EKG kesadaran Besar/Reaksi Pupil G E C M S V JML/ SISA Infus 1 Infus 2 Transfusi SP 1 SP 2 SP 3 Injeksi Makan/Minum 1jam/komulatif Urine NGT Muntah BAB
JML/ SISA
Drain IWL 1jam/1jam/komula
tif BALANCE CAIRAN PENGOBATAN Injeksi
Oral
DIIT CATATAN ALAT INVASIF & INoS
INFUS 1 INFUS 2 DC NGT DRAIN
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
01
02
03
04
05
06
TRAKHEOSTOM I PLEBITIS ILI IDO DEKUBITUS ISK
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