Formulir Pemakaian Obat Kamar Operasi
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Pemakaian Obat-Obat Kamar Operasi No. Reg No. RM Tgl Operasi Umur Pasien Kelas Kamar Jenis Operasi : : : : : : : : : Dr. Operator Dr. Anaesthesi Dr. Anak Dr. Konsultasi Ass. Bedah Ass. Bius Ass. Instrument Omploop : : : : : : : : No OBAT-OBAT ALKES 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Santosin / Pitogin Metergin / Bledstop / Gastrul Tab Transamin 500 / Kalnex 500 Kalmethason / Dexamenthason Ranitidine / Primperan / Zantac Ondancentron 4 Mg / Ondancentron 8 Mg Fentanil / Pethidine Safol / Deprivan / Recofol Dormicum / Miloz / Anesfar Novalgin / Tramal 100 Atropine Sulfat DHBP / Ephedrine Nasovel Supp / Suprafenit Supp / Kaltrofen Supp Ketalar Aminophilin / Catapres Bisolvon / Bricasma Ketorolac 30 / Toradol 30 Lidodex / Lidocain Ns 25 Cc / Aquades 25 Cc Spinocan No. ….. : Curaspon : Bunascan Spinal / Buvanest Mucus Lotus / Jms Umbilical Klem : Catheter No….. : Urinbag : NGT : Triway ETT : Venflon 18 / Surflo 18 : Blodset : Masker : Topi : Schort Plastic : Mess No….. : Handscoen Gamex : Handscoen Biasa : Underpad Steril : Underpad Biasa : Spuit 10 Cc / 5 Cc Spuit 3 Cc / 1 Cc Lomantul / Sofratul Lain-lain - BHP : (Kasa, bethadine, alcohol, savlon, hibiscrub) : - Sewa Couter : Benang 1 2 3 4 5 Monocryl no. 1 Vicryl rapide no Catgut plain no. 0 / 01 Catgut plain no. 02 / no. 2 Zyde no. : : : : : Cairan RL : Aquades 1 liter :
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Jenis dan jumlah obat-obatan yang di pakai operasi
Transcript of Formulir Pemakaian Obat Kamar Operasi
Pemakaian Obat-Obat Kamar Operasi
No. RegNo. RMTgl OperasiUmur PasienKelasKamarJenis Operasi:::::::::Dr. OperatorDr. AnaesthesiDr. AnakDr. KonsultasiAss. BedahAss. BiusAss. InstrumentOmploop::::::::
NoOBAT-OBATALKES
1234567891011121314151617181920Santosin / PitoginMetergin / Bledstop / Gastrul TabTransamin 500 / Kalnex 500Kalmethason / DexamenthasonRanitidine / Primperan / ZantacOndancentron 4 Mg / Ondancentron 8 MgFentanil / PethidineSafol / Deprivan / RecofolDormicum / Miloz / AnesfarNovalgin / Tramal 100Atropine SulfatDHBP / EphedrineNasovel Supp / Suprafenit Supp / Kaltrofen SuppKetalarAminophilin / CatapresBisolvon / BricasmaKetorolac 30 / Toradol 30Lidodex / LidocainNs 25 Cc / Aquades 25 CcSpinocan No. .. : Curaspon :Bunascan Spinal / BuvanestMucus Lotus / JmsUmbilical Klem :Catheter No.. : Urinbag :NGT :TriwayETT :Venflon 18 / Surflo 18 :Blodset :Masker :Topi :Schort Plastic :Mess No.. : Handscoen Gamex :Handscoen Biasa :Underpad Steril :Underpad Biasa :Spuit 10 Cc / 5 CcSpuit 3 Cc / 1 CcLomantul / Sofratul
Lain-lain BHP : (Kasa, bethadine, alcohol, savlon, hibiscrub) : Sewa Couter : Oxygen :
Benang
12345Monocryl no. 1 Vicryl rapide no Catgut plain no. 0 / 01 Catgut plain no. 02 / no. 2 Zyde no. :::::
Cairan
RL :RD :NS :Aquades 1 liter HAES VOLUVEN:::
