Post on 13-Apr-2018
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PRESENTASI KASUSNEARMISS
P3104 Ab000Post Partum Luar < 24 jam
denan Retens!o P"a#enta $S%o#& '!(o)o"em!
7/23/2019 Presentasi Nearmiss Ny. Darmi
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I*ENTITAS PASIEN
Re!ster + 3,31-4
Nama + N./ *arm!
Umur + 40 ta%un
A"amat + oomu".an T!rto.udo
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P datan &e I*tana" 30,201- Pu&u"05/006K!r!man 7PMSu&art! denanretens!o ("a#enta
ANAMNESA + T" 30,201-
Pu&u" 03/10 + (as!enme"a%!r&an ba.! d!ruma% d!to"on &e"uara
send!r!Pu&u" 03/30 + d!ba8a &e7PM Su&art! d!"a&u&an(emotonan ta"! (usat
Ar! ar! t!da& "a%!r "eb!%dar! 30 men!t*!ruju& &e RSU*
Kanjuru%an
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*! IR*
• Pemer!&saan 9!s!& + – Keadaan umum + #u&u(
– T* + 4:;1 mm'
–
Nad! + 142 ;mnt – SP=2 + :0>
• Ke(a"a+ &onju#t!)a anem!s $;$
• Abdoment + T9U set!n! (usat U? "embe&
• eneta"!a + @T + );) dara% $ sto"se"
(embu&aan 4#m teraba("a#enta
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T!nda&an
•
Pasan o&s!en sun&u( 10 "(m• Pos!s! s%o#&
• Perba!&an &u atas! s%o#&
• Pasan !nBus 2 "!ne dr!( o&s!tos!n 2 am(u"
• Pasan *?
• Pasan bedset mon!tor
• La(or dr I7P a;( + –
Atas! s%o#& – Inje&s! &a"ne 1 am(u"
– ?%e#& "ab
– TranBus! dara% 3 PR? dan 2 C7
–
7!"a &u ba!& (!nda% &e &amar bersa"!n
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'as!" "aborator!um
• HB : 4 gram %
• Leuko : 34.430 cell/cmm
• Trombo : 227.000 cell/cmm
• PCV : 11,8• r!"ro#!" : 1,$$ 10/cmm
• &'( : 2)8
• (&*T : 30
• (&PT: 10
• +reum : 1$
• rea"!-!- : 0,3
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am 0,/00
S : pusingO : ku lemah anemis +/+
TD : 70/60mmHg nadi :112x/mnt
Tindakan :• Infus 2 line lanut• T!anfusi la"u ke 2
"e!langsung• O"se!#asi ketat• $en%ana pindah
kama! "e!salin
*I KAMAR 7ERSALIN 30 , 201- j
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*I KAMAR 7ERSALIN 30,201- jam0/00a/ Pemer!&saan Umum
Keadaan umum + #u&u(
&esadaran +?=MP=SMENTIS
Te&anan dara% + 0;50 mm'Nad! + 100 ;men!t
Su%u + 35-RR + 20 ;men!tS(=2 + 5 >b/ &eme!iksaan 'isik • ("d)men :
Inspeksi : anemis +/+
&alpasi : T'* setinggi pusat u%"aik #/ &eme!iksaan dalam :
#/# da!ah + st)lsel pe!da!ahan tidak aktif
p) "uka ,%m te!a"a se"agian pla%enta
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Tindakan
1/ InBus 2 "!ne dr!( o&s!to#!n 2 am(u"d!"anjut&an
2/ =2 sun&u( 10 "(m ter(asan
3/ Pasan mon!tor TT@
4/ TranBus! "abu &e 4 sedan ber"ansun
-/ Ko"aboras! S(/= a;( +
– La&u&an Manua" ("a#enta
– Inje&s! ant!b!ot!&a 1 ram
– =bser)as! (erdara%an
–
?%e#& 'b (ost tranBus!
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jam 10.00
Ku + #u&u( T* + 100;50
Nad! + 2;mnt
SP=2 + >P"e#enta "a%!r manua" bers!%
T!nda&an +
• TranBus! "abu &e - sedan ber"ansun
• =bser)as! U? PP@
• Member!&an m!num man!s %anat
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-.(*(SI
Tanggal 02013 am 12400S : O : k/u %ukup kesada!an :%)mp)smentis
T : 1,0/ mmHg 5 :
100x/mnt&&. n)!mal
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Tindakan :• Infus 2 line + D lan%a!
• m)nit)! TT. te!pasang
• Oksigen te!pasang
• T!anfusi la"u ke 3 ha"is am 11400
• ek H" 6 am p)st t!anfusi dgn hasil :
– HB : $,) gram %
– Leuko : 18.200 cell/cmm
– Trombo : 107.000 cell/cmm
– PCV : 2,2 %
– r!"ro#!" : 3,23 10/cmm
P31004Ab000 (ost (artum "uar < 24 jam denan (ost
manua" ("a#enta
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P31004Ab000 (ost (artum "uar %ar! I denan (ost manua"
("a#enta
Tana" 31,201-
&;u #u&u( T + 140;0 u# $6 ba!& (() $6
norma" 'b (ost tranBus! ->
Tx :
Infus + D lan%a! m)nit)! TT. te!pasang m)"ilisasi 8+9 diit 5STT&
#isite d! DSO; a/p :• (nti"i)tik ta" x1 ta"• $)")!antia 2x1 ta"• &indah !uang pe!a<atan
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P31004Ab000 (ost (artum "uar %ar!
II denan (ost manua" ("a#enta
k/u %ukup T : 120/0 u% 8+9 "aik pp#8+9 l)%hea !u"!aTindakan : Infus + D a= m)"ilisasi Diit 5STT&
tx /)s :• >p!ex x1 ta"• ;!af)la 2x1 ta"
• .isite d! SpO; a/p : ?&