DAFTAR OBAT - OBATAN TROLI EMERGENSI

RUMAH SAKIT CUT MEUTIA (INTENSIVE CARE UNIT)

NO NAMA OBAT SATUAN JUMLAH KETERANGAN

1 ATROPIN SULFAT INJ AMP 4
2 LIDOCAIN INJ AMP 5
3 NICARDIPIN INJ AMP 2
4 DEX 40% PCS 2 LACI I
5 DOPAMIN INJ AMP 3
6 EPHINEPRIN INJ AMP 3
7 NOREPINEPRINE INJ AMP 3

8 FARSORBIT INJ AMP 2

9 FUROSEMIDE INJ AMP 2
10 AMINOPHYLIN INJ AMP 2
11 RL INFUS FLS 2 LACI II
12 DEXTROSE 5% INFUS FLS 2
13 NACL 500 ML INFUS FLS 2
14 DEXAMETHASONE INJ AMP 2

15 FOLLY CHATETER 18 CAB 2 FLS 1

16 SPUIT 50CC LUBANG TEPI PCS 1
17 URINE BAG PCS 1
18 VERBAN PCS 5
19 SPUIT 1CC PCS 5
20 SPUIT 3CC PCS 5
21 SPUIT 5CC PCS 5
LACI III
22 SPUIT 10CC PCS 5
23 EXTENTION TUBING PCS 1
24 NASAL CANULA DEWASA PCS 2
25 NGT 18 PCS 2
26 ETT 7.5 PCS 1
27 NASAL CANULA BAYI PCS 1
28 AMBU BAG PCS 1

Mengetahui,
Apoteker Rawat Inap Kepala Rumah Sakit Cut Meutia

( Apt. Ridha Kurnia Sari, S. Farm ) ( dr. Hanafi Nasution,M.KM )

 DAFTAR OBAT - OBATAN TROLI EMERGENSI DI IGD
(INSTALASI GAWAT DARURAT) RUMAH SAKIT CUT MEUTIA

NO NAMA OBAT SATUAN JUMLAH KETERANGAN

1 ATROPIN SULFATE INJ AMP 3
2 EPHINEPRIN AMP 3
3 DEX 40% FLS 2 LACI I
4 STESOLID SUPP SUPP 1
5 LIDOCAIN HCL AMP 5

6 FUROSEMIDE INJ AMP 2

7 RANITIDIN INJ AMP 2
8 RL INFUS FLS 2
9 DEXTROSE 5% INFUS FLS 1
LACI II
10 NACL 500 ML INFUS FLS 2
11 DEXAMETHASONE INJ AMP 2
12 NORAGES INJ AMP 2
13 KETOROLAC INJ AMP 2

14 FOLLY CHATETER 18 CAB 2 PCS 1

15 SPUIT 50CC LUBANG TEPI PCS 1
16 URINE BAG PCS 2
17 VERBAN ROLL 2
18 SPUIT 1CC PCS 5
19 SPUIT 3CC PCS 5
20 SOUIT 5CC PCS 5
21 SPUIT 10CC PCS 5
22 ABOCATH 18 PCS 2
23 ABOCATH 20 PCS 2
LACI III
24 ABOCATH 22 PCS 2
25 ABOCATH24 PCS 2
26 NASAL CANULA BAYI PCS 2
27 NASAL CANULA DEWASA PCS 2
28 NGT 16 PCS 2
29 NGT 18 PCS 2
30 AMBU BAG PCS 1
31 GUDEL HIJAU PCS 1
32 GUDEL MERAH PCS 1
33 SUCTION NO.12 PCS 1

Mengetahui,
Apoteker Rawat Inap Kepala Rumah Sakit Cut Meutia

( Apt. Ridha Kurnia Sari, S. Farm) ( dr. Hanafi Nasution,M.KM )

 DAFTAR OBAT - OBATAN TROLI EMERGENSI
RUMAH SAKIT UMUM CUT MEUTIA (KAMAR BEDAH)

NO NAMA OBAT SATUAN JUMLAH KETERANGAN

1 ATROPIN SULFATE INJ AMP 3
2 EPHINEPRIN AMP 3
3 LIDOCAIN HCL AMP 5 LACI I
4 TRAMADOL INJ AMP 3
5 EPHEDRIN INJ AMP 2

5 ASAM TRANEKSAMAT INJ AMP 2

6 KETOROLAC INJ AMP 3
7 RL INFUS FLS 2
8 DEXTROSE 5% INFUS FLS 1
LACI II
9 NACL 500 ML INFUS FLS 2
10 DEXAMETHASONE INJ AMP 2
11 ONDANCENTRON INJ AMP 2
12 AQUA INJ AMP 3

13 FOLLY CHATETER 18 CAB 2 PCS 2

14 TRANFUSI SET PCS 2
15 URINE BAG PCS 2
16 ETT NO.7 PCS 2
17 SPUIT 1CC PCS 5
18 SPUIT 3CC PCS 5 LACI III
19 SPUIT 5CC PCS 5
20 SPUIT 10CC PCS 5
21 NGT 18 PCS 2
22 NASAL CANULA DEWASA PCS 2
23 FOLLY CHATETER 10 CAB 2 PCS 1

Mengetahui,
Apoteker Rawat Inap Kepala Rumah Sakit Cut Meutia

( Apt. Ridha Kurnia Sari, S. Farm ) ( dr. Hanafi Nasution,M.KM)

 FORMULIR SUPERVISI TROLLEY EMERGENCY
BULAN :
APOTEKER SUPERVISOR :
TROLI EMERGENCY IGD
SUPERVISI
JLH 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 30 25 26 27 28 29 30 31
URAIAN KELOMPOK OBAT / ALAT KESEHATAN APOTEKER
ATROPIN SULFATE INJ 3
EPHINEPRIN 3
LACI I DEX 40 % 1
LIDOCAIN HCL 5
STESOLID SUP 1
FUROSEMIDE INJ 2
RANITIDIN INJ 2
RL INFUS 2
DEXTROSE 5% INFUS 1
LACI II
NACL 500 ML INFUS 2
DEXAMETHASONE INJ 2
NORAGES INJ 2
KETOROLAC INJ 2
FOLLY CHATETER 18 CAB 2 1
SPUIT 50CC LUBANG TEPI 1
URINE BAG 2
VERBAN 2
SPUIT 1CC 5
SPUIT 3CC 5
SPUIT 5CC 5
SPUIT 10CC 5
ABOCATH 18 2
ABOCATH 20 2
LACI III
ABOCATH 22 2
ABOCATH 24 2
NASAL CANUL BAYI 2
NASAL CANULA DEWASA 2
NGT 16 2
NGT 18 2
AMBU BAG 1
GUDEL HIJAU 1
GUDEL MERAH 1
SUCTION NO. 12 1

Rencana Tindak Lanjut

Petugas Supervisi Trolley Emergency
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