26 APRIL 2021

UPDATE LAPORAN JUMLAH PASIEN INTERMEDIATE CARE UNIT

RSDC WISMA ATLET KEMAYORAN JAKARTA PUSAT

TIM 5 SHIFT SORE

JUMLAH PASIEN 14 SUSPECT -

PRIA 12 PROBABEL -

WANITA 2 KONFIRMASI COVID-19 13

CLUSTER - KONFIRMASI (-) 1

KAPASITAS IMCU 40 PASIEN KRITERIA IMCU 14

JUMLAH BED 44 PASIEN KRITERIA HCU/ICU

1 SWAB NEGATIF RENCANA MASUK 5 NK

-/1 RENCANA RUJUK/HCU - TNI/POLRI 1 SM

-/- ATENSI/ NAKES RSDC - NAKES LUAR - NRM

3 PASIEN BARU - RENCANA PINDAH 2/-/- HFNC/NIV/INTUBASI

- RENCANA PULANG 1 SUDAH PINDAH/RUJUK - PASIEN PULANG

6 SYPMTOM RINGAN 6 SYPMTOM SEDANG 2 SYPMTOM BERAT

NO NAMA PASIEN KELUHAN VISITE TERAPI PENUNJANG

IMCU 1

IMCU 1 BED 1

IMCU 1 BED 2

IMCU 1 BED 3

IMCU 1 BED 4

IMCU 1 BED 5

IMCU 1 BED 6
 IMCU 2

1 Ny. Maria Sri Martini KELUHAN: TAK R/ P/ GDS 25/04/21

54 th/ - Observasi perdarahan dan - Prone position min. 12 233
keluhan jam/ hari
RM. 55605 TD 149/86 - fu DL,OT/PT,Ur/Cr, - Diit: ML RG Sliding scale
Elektrolit / 3 hari( 26/4/21) - O2 RA (25/04/21)
PB T6 LT7 HR 98 - GDS/ pagi - IVFD NaCl 0,9% 500cc/ 06.00 : 326 ( 6iu)
- fu Swab 26/4/21 24 jam 14.00 : 300 (4 iu)
RR 19 - Rontgen/ 5 hari (28/4/21) ====================== 22.00 : 245 (2iu)
IMCU 2 BED 7
- aPTT dan D-Dimer / 4 hari == 06.00 : 233 (2iu)
T 36.5 bila reagen sudah Antivirus:
BB: 79 tersedia - IV Remdesivir 1x100
TB: 171 ======================== mg (H4/5)
BMI: 27
SpO2 98 GDS tgl 24/4/21
F/U: 145
Antibiotik:
A: ======================== - IV Levofloxacin 1x750
- Conf. Covid-19 SS O2 RA Lab 23/4/21
Konsul Sliding Scale dr. (H4/5)
- Mild ARDS Harris Sp.PD (26/04/21) ) - Drip Ceftriaxon 1x2 gr Eri: 4.89
- Overweight pukul 7.44 : dalam nacl 100cc (H4/5) Hb: 14.2
IVFD NaCl 500cc/24 JAM Ht: 39.9
Advice:
- Insulin fixed dose Anti Inflamasi: MCV: 81.6
F/U SWAB 26-04-21 MCH: 29.0
6-6-4, - IV Dexametason 1x5
- metformin 2x500 mg. mg (H1/3) MCHC: 35,6
- Kgdh ulang Leukosit: 7.400
======================== Anti Diabetik: Trombo: 548.000
Konsul GDS dr. Haris, Sp.PD - Insulin Fixed dose B/E/N/L/M
25/4/21 (08.45): 6-6-4 0/1/60/31/8
Advive: - Metformin 2x500 mg OT/PT: 21/18
- Sliding Scale / 8 jam, Ur/Cr: 22/0.6
mulai 200-250 dg Imunomodulator: Na: 139
Novorapid 2 unit, naik - Drip Resfar 1X5 gr K: 5
50 naik 2 unit, buat (H4/5) Cl: 103
KGDH
======================== Antikoagulan: AGD tgl 23/4/21
Visite dr. Rohmat, Sp.P - SC Lovenox 2x0.4 dengan Nasal
25/4/21 (07.30): kanul 2LPM
Advice: Antihipertensi: pH 7.4
- IV Dexamethason turun - PO Amlodipin 1x10mg SaO2 98.2
1x5 mg (mulai 26/4/21) paCO2 32,9
- Terapi Lain Lanjut Multivitamin paO2 94.8
HCO3 25.9
======================== - PO Becefort 2x1 BE 3.5
- PO Zinc 1x20 mg P/F ratio 327
Advice dr.Siti Sp.KFR ==============
(23/4/21) hp 2 obat lain: =
pasien dimiringkan dulu, - IV Pantoprazol 1x1 Lab 17/4/21
tanggal 24/4/21 ke imcu jam 9. - PO Paracetamol 3x1 → Eri: 4.97
======================== K/P Hb: 14.3
Advice lapjag: (23/4/21) - lactulac 2x1 (pagi 1 Ht: 40.9
- Drip Ceftriaxon 1x2 gr (5 sdm, malam 2 sdm) K/P MCV 82.3
hari)nacl 100cc ====================== MCH 28.8
- Pantoprazol 1x1iv == MCHC 35.0
- Konsul dr Siti Chandra Sp. Obat Selesai: Leukosit 6.990
KFR Anti Inflamasi: Trombo 257..000
- Swab tgl 26/4/21 - IV Dexametason 2x5 B/E/N/L/M
======================== mg → 25/4/21 0/0/58/34/8
advice dr. Riana Sp.P Antivirus: GDS 163
- Remdesivir 1x200mg (H1), - Remdesivir 1x200mg OT/PT: 32/17
1x100 mg (H2-5) (H1) → 23/4/21 Ur/Cr: 37/1
- Levofloxacin 1x750 (H1/5) Antibiotik:
- Azitromisin 1x500 (5 hari) - Azitromisin 1x500 (5/5) Rontgen Thorax
selesai tgl (22/4/21) → 22/4/21 tgl 23/4/21
- Dexametason 2x5 mg iv
(H1/3)
- Resfar 1X5 gr (H1/5)
- Lovenox 2x04 sc

advice dr. Efriadi Sp.P

Acc IMCU 6

========================
Konsul drTina,Sp.P terkait
hasil lab dan AGD, advis:
Weaning O2 perlahan Rontgen Thorax
Prone position
tgl 17/4/21
2 Ny. Minarni Keluhan : sesak sejak satu R/ P/ R/
RM 56630 hari yll.. disertai dnegan batuk - Swab 05/05/21 - HFNC Flow 40 - Swab 05/05/21
sedikit berdahak sejak 3 hari - Cek DL, OT, PT, LPM, FiO2 60% - Cek DL, OT,
IMCU 2 BED 8 yll. Ur, Cr 30/04/21 - RL 500cc/24 jam PT, Ur, Cr
- RO Thorax 30/04/21
01/04/21 Antivirus - RO Thorax
PB dr IGD TD 103/59 - GDS/pagi - Remdesivir 01/04/21
26/04/21 - Prone Position min 1x200mg H1, - GDS/pagi
HR 74 12 jam/hari 1x100mg H2-5 - Prone Position
A: - ROX Index/ 2 jam (H0/5) min 12 jam/hari
- Confirmed RR 21 - FU Hasil lab DL, - ROX Index/ 2
Covid SB OT, PT, Ur, Cr Antibiotik jam
- Dyspnea e.c T 36.1 26/04/21 - IV Levofloxacin - FU Hasil lab
pneumonia - R/ cek AGD 1 jam 1x750mg H0/5 DL, OT, PT, Ur,
- overweight post HFNC. Cr 26/04/21
SP02 96
Antiinflamasi - R/ cek AGD 1
Advice Lapjag 26/04/21 - IV jam post
IVFD NaCl 0,9% 500 cc / 24 - HFNC Flow 40 Dexamtehasone HFNC.
jam LPM, FiO2 60% 2x5mg H0
- Lovenox 3x0.4 cc - Po Spironolactone Advice Lapjag
DC NO. 16 WI (30CC) - Pro HCU 1x100mg H0 26/04/21
26/4/21 - Edukasi prosedur - PO Colchisine - HFNC Flow 40
HCU 2x0.5mg H0 LPM, FiO2
60%
O2 HFNC : visite dr Ulfa Sp.P Antikoagulan - Lovenox 3x0.4
FIO2 : 60 % 26/04/21 - SC Lovenox cc
FLOW : 45 - Acc IMCU T6 3x0.4cc - Pro HCU
T : 36 - Ivfd RL 500 cc/12 - Edukasi
jam Immunomodulator prosedur HCU
- O2 NRM 12 lpm - Resfar 1x5gr H0
R/ HCU - Inj remdesivir 1x visite dr Ulfa Sp.P
200 mg (H1), Terapi lainnya 26/04/21
1x100 mg (h2-5) - IV Omeprazole - Acc IMCU T6
- Inj levofloxacin 1x 2x20mg - Ivfd RL 500
750 mg (h5) - PO Becefort 2x1 cc/12 jam
- Inj dexametason - O2 NRM 12
2x 5mg lpm
- Inj resfar 1x 5gram - Inj remdesivir
- Colchisin 2x 0,5mg 1x 200 mg
- Spironolakton (H1), 1x100 mg
1x100 mg (h2-5)
 - Inj omeprazole - Inj levofloxacin
2x20 mg 1x 750 mg (h5)
- Becefort 2x1 - Inj
- Inj lovenox 2x 0,4 dexametason
cc 2x 5mg
- Inj resfar 1x
5gram
- Colchisin 2x
0,5mg
- Spironolakton
1x100 mg
- Inj omeprazole
2x20 mg
- Becefort 2x1
- Inj lovenox 2x
0,4 cc

IMCU 2 BED 9

IMCU 2 BED 10

IMCU 2 BED 11

IMCU 2 BED 12

IMCU 2 BED 13

IMCU 2 BED 14

IMCU 2 BED 15

IMCU 2 BED 16
IMCU 2 BED 17

IMCU 2 BED 18

Ny Sularsih / 50 Thn Keluhan ; TAK R/ P: GDS pagi:

- GDS/hari - IVFD RL 500 19/4 : 151 mg/dl
RM 55190 - Cek D-Dimer/4 hari cc/24 jam 20/4 : 141 mg/dl
TD 103/59 (24/04/21) reagen - Prone position 21/4 : 163 mg/dL
habis min 12 jam/hari 22/4 : 148 mg/dL
HR 74 - Diet: MLRG 23/4 : 112 mg/dL
IMCU 2 BED 19 FU/ Swab (24/04/21) 1.876 KKal 24/4 : 123 mg/dL
RR 21 25/4 : 91 mg/dl
PB IGD 15-04-21 Advice Lapjag 24/4/21 Antivirus 26/4 :
T 36.1 - Lapor hasil lab -
BB :70 kg baru tgl 24/4/21 Elektrolit 24/4/21
TB: Terapi lanjutkan Antibiotik
SP02 96 Na 134 
IMT: untuk cairan - Levo 750 mg K 3.7
- IV Meropenem 7 po H1/7
Improve score : 1,5 Cl 102 
- IVFD NaCl 0,9% 500 cc / hari - Inj. Meropenem
TANPA INR SGOT : 23 U/L
24 jam - PO 3x1 IV (H7/7) SGPT : 52 U/L
Dexamethasone
CrCl: 94 mL/min Ur : 36 mg/dl
O2 RA stop Anti-Inflamasi
Cr : 0,7 
-  
P/F Ratio: 397 mmHg Advice dr. Mega Sp.P
(Not ARDS)
SWAB 24-04-21 POSITIF
terkait hasil DL u/ terapi Antikoagulan
Meropenem : Lovenox 1x0.4cc selang Lab 23/4/2021
A: SUDAH PINDAH LT 8 - Levo inj. ganti PO seling
TW 7 Eri 5.32
● Confirmed covid - Meropenem inj. Hb 14.3
19 SB lanjut Anti-Hipertensi: Ht 40.4
● HT Urgency - Cek DL 3 hari - PO Amlodipin 1 MCV 75,9
kemudian x 10 mg MCH 26,9
(Siang) MCHC 35.4
Visite dr. Mega, Sp. P - PO Leukosit 16,7
24/3/21: Candesartan Trombosit 198
- Pasang NK jika SpO2 1x16mg B/E/N/L/M
<95% RA (malam) 0/0/71/16/13
- DL Cito setelah - PO Bisoprolol
meropenem selesai 1x5 mg (pagi) Lab 21/4/21
- Rontgen besok 24/4/21 Eri 5.091
- Levofloxacin terakhir Multivitamin: Hb 14.5
besok - PO Vit D3 Ht 40.5
1x1000 iu MCV 76.6
Advice dr. Prasetyo, (TAO) MCH 27.4
Sp.PD 23/04/21 - PO Becefort 2 MCHC 35.8
Lovenox 1x0.4cc selang x1 Leukosit 17.86
seling - PO Lecozinc Trombosit 226
1x20 mg B/E/N/L/M
Visite dr. Erry Sp.P: 0/0/85/4/11
Terapi lanjut Lain-lain : OT/PT: 12/42
- Inj. Pantoprazole UR/CR: 36/0.43
Advice dr. Jublilette, 2x40mg (K/P) Na 136
Sp.P - Clozapine 1x12.5mg K 3.3
- Dexamethasone tapp of (KP) malam sulit tidur Cl 102
oral 2x0.5mg selama 3 (acc dr Katrin Nada
hari Sp.KJ) D-Dimer 20/4/2021 jam
- PO KSR 1x600mg - 10.00 WIB:
Selesai: 440
Jawaban FU grup Sp.KJ - Metilprednisolon
(dr. Sylvia, Sp.KJ IV Lab 18/4/21
Terapi lanjut - Alprazolam Eri 5.091
0-0-0,5 mg k/p Hb 14
Visite dr. Dini, Sp.P: (sulit tidur) → Acc Ht 39.7
- Weaning O2 & pantau dr. Tissy, SpAn MCV 78
Ku - PO MCH 27.5
- J ika sudah RA, acc Spironolactone MCHC 35.3
pindah ruangan biasa 2x50 mg (H5/5) Leukosit 23000
-> selesai Trombosit 324.000
Visite dr. Satria Sp.P - Resfar 1x5 B/E/N/L/M
20/4/21: gr (H5/5) -> 0/0/92/6/2
Weaning perlahan jika selesai OT/PT: 23/37
pasien stabil - Inj UR/CR: 36/0.7
Nicardipine Na 137
Advice dr.Prasetyo 1 mg/jam K 3.8
Sp.PD 20/4/2021 STOP Cl 104
Terapi lanjut, target - Inj.
D-Dimer <400 ng/mL Dexamethasone aPTT 18/4/21
2x5 mg (H7) 59.5
Lapor TD ke dr. Haris, - Drip Heparin
Sp. PD 20/4/21: 10.000 U/24 jam aPTT 18/4/2021 08.00:
Nikardipin stop, terapi (tanpa cek aPTT) 69.5
antihipertensi oral yang ?
Elektrolit 17/4/2021
lain masukkan, sesuai - Injeksi Na: 138
advice lapjag. Remdesivir K: 3
1x200 mg (H1), Cl: 104
Advis lapjag 19/4 / 21 1x100 mg (H2-5)
observasi TD / jam (H10/10) aPTT 17/4/2021 00.00:
titrasi nicardipin drip 1mg / - Inj 37.9
jam lanjut OAH oral Levofloxaci
malam n 1x750 mg GDS 17/4/21:
besok pagi laporkan TD (H10/10) 148
ke dr. Haris, Sp.PD untuk - PO ==============
terapi OAH berikutnya dexamethasone AGD 16/4/21 HFNC Flow
Bisoprolol naik 1x 5 mg 2x0.5mg (H3/3) 35, Fio2 50%
kalau sudah bisa terapi (STOP) ph 7.4
OAH oral - KSR 1x1 tab (H4) sat O2 99%
- PCO2 13
Visit dr. Ulfa, Sp.P: PO2 185
- weaning O2 1 HCO3 10
lpm / 2 jam BE -11
- aminofilin drip
stop D-Dimer 16/04/21
- aff cateter + 40
bladder training
apTT 16/4/2021 00.00:
Konsul hasil lab ke dr. 74,1
Ery Sp.P: 12.00: 61.7
- Levofloxacin dan ==============
Remdesivir lanjut AGD 15/4/21 NRM 15
sampai 10 hari LPM
- Meropenem 3x1 ph 7.5
IV 5 hari sat O2 99.9%
PCO2 22.5
Advis dr. Prasetyo Sp. PO2 238
PD 18/4/21: HCO3 21
- Kalium stop BE 1.9
- Jika sudah NK,
antikoagulan Lab 15/4/2021
diganti heparin Eri 5.81
10.000 IU/24 jam Hb 15.8
tanpa cek aPTT Ht 46.2
- Jika RA, lovenox MCV 79.5
1x0.4cc sampai MCH 27.2
pasien pulang MCHC 34.2
Leukosit 12.700
Advis dr. Katrin Nada Trombosit 324.000
Sp. KJ (18/4/21): B/E/N/L/M
- dx/ gangguan 0/0/72/19/9
penyesuaian OT/PT: 22/33
reaksi cemas UR/CR: 21/0.79
- Clozapine GDS: 153
1x12.5mg malam
KP Ro Thorax 15/4/21
- Awasi
tanda-tanda
perubahan
perilaku atau
kesadaran
- Alprazolam stop
- Follow up ke grup
psikiatri tgl
21/4/21

Konsul TD ke dr. Haris

Sp. PD 17/4/21 (jam
19.30):
- Nicardipin naik ke
2,5 mg/jam

Visit dr. Rachmat, Sp.P

17/4/21:
- Aminofilin turun
120 mg / 24 jam
- terapi lanjut

Konsul TD ke dr. Haris

Sp.PD 17/4/21:
- Nicardipin turun
ke 2mg/jam

Konsul dr. Efriadi, Sp.P

17/4/2021:
Boleh coba NRM 15 lpm

Advice dr. Prasetyo

Sp.PD 17/4/2021
- heparin dinaikkan
menjadi 12.500iu/ 12
 jam cek aPTT di jam
ke 10
- infus NaCl 0.9 % 500
CC diberikan kalium
50 mEq /24 jam
- Besok ulang elektrolit

Advice dr. Haris, SpPD

17/4/21, 03.40 via WA HP
2:
Nicardipine lanjut

Advice dr. Haris, Sp.PD

- Nicardipe start
5mg/jam
- terapi oral tunda dulu

advice dr. Hariyadi,

Sp.Jp
- ramipril stop ->
candesartan 1x16mg
- bisoprolol 1x2.5mg

advice dr. Prasetyo,

Sp.PD
- heparin 10.000IU/12
jam

visit dr. Tina, Sp.P

- methylprednisolon iv
stop
- terapi lanjut

Konsul Dr. dr. Satria,

Sp.P :
- A/ Alkalosis
Respiratorik
- terapi lanjut
- jika klinis memburuk
persiapkan rawat
HCU/ICU

Konsul dr. Tissy, Sp. An:

- Titrasi flow & fraksi
HFNC (flow 50lpm,
fraksi 35 %)
- jika suhu > 36,5 C,
berikan PCT 3 x 1
gram IV
- Alprazolam 0-0-0,5
mg k/p (sulit tidur)

Konsul ulang ke
dr.Efriadi Sp.P terkait
perubahan terapi :
- Pasang HFNC
(SM 7 lpm -> HFNC)

Lapjag 15/4/21:
- NRM ganti HFNC fi02
80% flow 50 lpm
- GDS tiap pagi
- PO Azithromycin
1x500 mg ⇒ STOP
- Inj Metilprednisolone
2x40mg

Advice dr. Erry, SpP

15/4/21:
● IVFD NaCl 0,9% 500
cc/24 jam +
aminophylline 240 mg
● Spironolactone 2x50
mg
● Azithromycin 1x500
mg
● Metilprednisolone
2x62,5 mg !V
● Vit d3 3x1000 iu
(TAO)

Advice dr. Haryadi, SpJP

15/4/21: Terapi lanjut

Advice dr. Pras, SpPD

15/4/21:
 ● Bolus Heparin 5000iu,
lanjut drip 12.500 U/12
jam
● Inj pantoprazole
2x40mg

Advice dr. Tomu, SpP

15/4/21:
● Pro imcu
● IVFD NaCl 0,9%
500cc/24j
● Remdesivir 5hr
● Levofloxacin 1x750mg
iv
● Dexa 2x5mg iv
● Resfar 1x5gr
● Vit D3 1x5000 unit
● Konsul TS IPD

IMCU 3

3 Tn. Suripto/ 64 tahun/ → KELUHAN ; TAK R/ P/ Elektrolit 26/4/21:

- KGDH / 8 jam - O2 on NK 4 lpm N/K/Cl: 139/3.7/103
RM. 55164 - Cek D-Dimer dan - IVFD RL 500cc+ KCL
aPTT (jika sudah bisa) 50meq/24jam
IMCU 3 BED 20 TD 118/85 - Cek elektrolit / 2 hari - Prone position min 12 KGDH 26/4/21*
18/4/21 (28/4/21) jam/hari - Diit ML DM 06.00 :121
HR 90 - Cek DL, OT/PT, Ur/Cr 14.00 :
Pasien pindahan dari (27/4/21) Antivirus : 22.00 :
IMCU Tower 7 RR 20 - Ro thorax (30/4/21) - IV Remdesivir 1x200mg
(H1), 1x100mg (H2-5) KGDH 25/4/21*
A/ T 36,3 F/ Up (H9/10) 06.00 113
Conf. COVID 19 SS 14.00 239
Moderate ARDS SP02 97 -Konsul ke dr.Haris Antibiotik: 22.00 174
DM Sp.PD terkait hasil - IV Ceftriaxone 1x2 gr
Renal Failure Grade 3a elektrolit 26/4/21 (H8/10) KGDH 24/4/21
IVFD RL 500cc/ 24 jam -Konsul hasil swab - IV Levofloxacin 1x750 06.00 116
BB : 63.5 kg 24/4/21 saat visite mg (H9/10) 14.00 144
TB : 165 cm O2 NK 4 lpm 22.00 132
IMT : 23 (Normoweight) Antiinflamasi :
 Swab 24/4/21 POSITIF =================== - IV Methylprednisolone Lab 24/4-21
Improve Score 2.5 == 2x40mg (H7/7), tappering Eri 4,23
tanpa INR off 1x40 mg (H2) Hb 13,1
MCV 86,3
CrCl : 53 26/4-21 Imunomodulator : MCH 31,0
Konsul dr.Haris SpPD - IV Resfar 1x5 gr MCHC 35,9
P/F Ratio 183 terkait hasil elektrolit (H8/10) Leukosit 9,24
(Moderate ARDS) 26/4/21: Trombosit 353
-STOP KSR Antikoagulan : B/E/N/L/M 0//1/77/15/7
- SC Lovenox 1x0,4 cc SGOT 66
Ro. Thorax 15/4/21 SGPT 85
Konsul dr Haris Sp.PD Anti-diabetik: Ur/Cr 63/1,0
perihal KGDH 25/4-21 - SC Novorapid 6-6-4 Na/K/Cl 138/3,3/105
- Merformin - PO Metformin 1x850
2x850, insulin mg -> 2x850 mg KGDH 23/4/21
lanjut 06.00 162
Konsul dr.Haris SpPD Inhalasi: 14.00 198
terkait hasil elektrolit - Ultibro 2x1 hisap / 22.00 162
26/4/21 symbicort 2x1 (TAO)
=================== - Berotec 3x1 puff (TAO) AGD 22/4/21 post NRM
Kesan : == 12 lpm
- Bronkopnemonia 25/4/21 Multivitamin: pH: 7.5
bilateral Visite dr. Rohmat, SpP - PO Becefort 2x1 SaO2: 99,9
- Kardiomegali (LVH) - Terapi lanjut - PO Zinc 1x1 paCO2: 30,8
tanpa tanda bendungan - PO Curcuma 3x1 paO2: 242,1
paru 24/4/21 - PO Vit D3 1x5000 iu HCO3: 27,7
advice dr. Haris SpPD BE: 6
RPD : HT (-) DM (-) terkait KGDH dan Obat lain : PF ratio: 351
Penyakit jantung dan metformin 500 mg TAO - PO Antasida 3x1 C
paru (-) Stroke (-) via WA HP1: - PO Codein 2x10 mg Hasil laboratorium
- Metformin 1x850 mg - PO Proliver 2x1 (TAO) serologi / imunologi
- PO Clozapin 1x6,25mg 23/4/21:
advice dr. Erry SpP via (malam, k/p) → dr. Sylvia, HBsAg: Non Reaktif
WA terkait balance SpKJ AntiHCV: Non Reaktif
cairan dan pemberian - PO KSR 2x1 STOP AntiHIV: Non Reaktif
cairan pasien: - Lasal 3x2mg (k/p bila
- Aminofilin stop dulu sesak) KGDH 22/4/21
- Beri lasal 3x2 mg bila 06.00 132
sesak k/p Diuretik: 14.00 202
- PO Furosemide 1x40 22.00 151
advis dr.Prasetyo mg
terkait hasil elektrolit UL 21/4/21
24/4/21: Obat Selesai: Glukosa (-)
- Infus RA diganti RL - PO Azitromisin 1x500 mg pH urine 6.0
500cc + KCL (H4/5) ganti → STOP Berat jenis 1.025
50meq/24jam 18/4/21 Warna kuning
- furosemide lanjut - PO NAC 3x400 mg → Kejernihan jernih
- cek elektrolit per 2 hari 18/4/21 Protein (+)
- IV Dexamethasone 2x5 Bilirubin (-)
Visite dr Syarif SpP mg (H2/5) STOP19/4/21 Keton (-)
24/4-21 - PO Glimepiride 1x2 mg → Nitrit (-)
- IV Mp dilanjut 7 hari, STOP 20/4/21 Darah (-)
tappering menjadi 1x40 - Drip dexmedetomidine Leukosit (-)
setelahnya selama 2 hari 0.15 mcg/kgBB/jam dalam Urobillinogen (-)
- Ceftriaxon dan Levo syringe pump → 0,228
lanjut 10 hari mg/24 jam dilarutkan KGDH 21/4/21*
=================== dalam 50 cc jalan 0.945 06.00 143
== cc/jam → Stop 21/4/21 14.00 184
-Drip Heparin 2500 IU/12 22.00 148
Konsul dr Efriadi Sp.P jam Stop 23/4/21
perihal Balance cairan - Aminofilin 360mg/24 Lab 21/4/21*
23/4-21 jam-> 25/4/21 Hb : 13.4g/dl
- Furosemide 1x40 mg Ht : 36.9%
Eri : 5.43
23/4/21 MCV : 85.0fl
Visite dr. Mega, SpP MCH : 30.9pg
- Terapi lanjut MCHC : 36.3g/dl
- Pertahankan terapi O2 Leu : 11720
- Weaning perlahan Tromb : 279.00
B/E/N/L/M
Advice dr. Prasetyo 0/0/80/14/6
terkait antikoagulan OT/PT : 91/71
11:32 (SM) Ur/Cr : 82/0.7
Lovenox 2x0,4 cc kalau Na/K/Cl
NK 1x0,4 cc 139/3.4/108

Advice dr. Prasetyo APPT 20/4/21:

terkait antikoagulan >180mg
06:32
Heparin stop ganti GD 20/4/21
Lovenox 2x0,6 cc atau GDP : 142
3x0,4 cc GD2PP : 214

Advice dr. Riana SpP AGD 19/4/21

dan dr. Prasetyo Sp.PD on HFNC FiO2 80% Flow
60
terkait balance cairan pH 7.5
06.32 SaO2 99,8
Injeksi Furosemid ekstra paCO2 24,9
paO2 194
Advice dr. Efriadi SpP HCO3 22,6
terkait AGD post NRM BE 1,8
05.00
-Resfar lanjutkan sampai 19/4/21
10 hari GDP : 135
-NRM turunkan jadi 10 GD2PP : 183
lpm aPTT 07.00 : 64,9
aPTT 19.04 : 64.6
Advice dr Haris SpPD D-Dimer : 770
terkait KGDH di HP 2
(23/4/21) 3.27 Lab 18/4/21
Metformin 2x500 mg Eri : 4.65
KGDH dilanjutkan Hb : 14.3
Ht : 39.4
Advice dr. Efriadi SpP MCV : 84,7
terkait post NRM 1 jam MCH : 30.8
MCHC : 36,3
Visite dr Erry Sp.P Leukosit : 7.84
22/4-21 Trombosit : 167
- Aminofilin 360mg/24 B/E/N/L/M :
jam 0/0/89/10/1
- Remdesivir, Ceftriaxon OT/PT : 112/52
dan Levofloxacin lanjut Ur/Cr : 64/1.2
10 hari
- Fisioterapi Elektrolit 18/4/21:
- Device ganti NRM 12 Na: 134
lpm K: 3.4
=================== Cl: 103
Advice dr. Haris, SpPD AGD 18/4/21*
untuk UL dan KGDH on NRM 15 lpm
(22/4/21): pH 7.5
Terapi lanjut SaO2 99,9
=================== paCO2 27,4
Advice lapjag 21/4/21: paO2 148,4
- Cek Urin Lengkap HCO3 22,9
- KSR 2x1 BE 1,6
- Stop dexmetomidin
- Ultibro 2x1 puff 18/4/21
GDP : 122
Advice dr. Sylvia Sp.KJ GD2PP : 209
(21/4/21/
- Belum ada terapi Lab 17/4/21
psikofarmaka dari GDS 237
psikiatri.
- Follow up keluhan AGD 17/4/21
pasien. pH 7.5
- Tambahan terapi: SaO2 95,9
Clozapin 1x6,25 mg paCO2 21
paO2 65,9
Visit dr. Dini Sp.P HCO3 18,8
21/4/21: BE -1,2
- Remdesivir lanju
sampai 7 hari Lab 15/4/21*
- Terapi lanjut Eri : 4.80
=================== Hb : 15,2
Konsul dr Haris Sp.PD Ht : 41
perihal GDP&GD2PP MCV : 84,6
20/4-21 MCH : 31,2
- Glimepiride stop, fixed MCHC : 36,9
dose 6-6-4, buat kgdh Leukosit : 5.440
Trombosit : 171000
Konsul dr Pras Sp.PD B/E/N/L/M :
perihal aptt 20/4-21 0/0/64/28/8
- Stop heparin 2 jam, GDS : 164
lanjut 3u.kgbb/jam = OT/PT : 86/47
2500/12 jam Ur/Cr : 64/1.26

Visite dr.Satria
Sp.P(20-04-21)
- Weaning 02 dan
observasi per 2-4 jam

Advice dr. Mega SpAn

via WA
- Drip dexmedetomidine
0.15 mcg/kgBB/jam
dalam syringe pump
hanya pukul 21.00-07.00
- Besok konsul psikolog
dan psikiatri
===================
Visit dr. Ulfa SpP
19/4/21:
-PO Proliver 2x1
-STOP Dexamethasone
ganti → IV
Methylprednisolone
2x40mg
-PO Vit D3 1x5000 iu
===================
Advice dr. Siti Chandra,
Sp.KFR, 18/4/21:
- Prone dengan posisi
bantal di pinggul dan
dada, bila perlu kepala
diganjal agar posisi
kepala relaks (seperti
gambar di WA HP 2)
Advis lapjag 18/4/21
- HFNC FiO2 80% Flow
40 → target SpO2
93-96%
- NAC ganti Resfar 1x5
gr
- Heparin naik jadi bolus
5000 U dan drip 12.500
U/ 12 jam
- Cek aPTT jam ke-10
- Dx PPOK
- Drip dexmedetomidine
0.15 mcg/kgBB/jam
dalam syringe pump
- Konsul Sp. KFR

Advice dr. Efriadi, SpP

- Azitromisin stop ganti
→ Ceftriaxone 1x2 gr 5
hari
- Cek DL, Ur/Cr, OT/PT
Elektrolit, D-Dimer 3 hari
lagi

Advis dr. Mega, SpP

- Acc pindah IMCU T6
 Advice dr. Syarif Sp.P
- PRO IMCU
- IV levofloxacin
2x750mg
- IV dexametasone
2x5mg
- SC heparin 2x5000 U
- Cek dpl dan crp besok
18/4/21

4 Tn. Bobby B. W Sarwono KELUHAN : batuk R/ P

RM 56406 Sedikit, tidak - Swab 01/05/21 - O2 SM 7 LPM
mengeluhkan sesak - Cek Dl, OT, PT, - IVFD RL
IMCU 2 BED 21 Ur, Cr, Elektrolit 500CC/24
29/04/21 jam
- RO THorax
PB dr Tw 5 /04/21 Antivirus
TD 131/66
- GDS/pagi - Oseltamivir
HR 86 - Prone Position 2x75 mg H3/5

RR 20 Antibiotik
FU/ - Azitromisin
T 36,4 Lab DL, OT, PT, Ur, Cr, 1x500 H3/5
Elektrolit, AGD
26/04/21 Antiinflamasi
SPO2 98
Ro. Thoraks 26/04/21 - Dexamethaso
ne 2x0,5mg
IVFD RL 500cc/ 24 jam
Antikoagulan
- PO Aspilet
O2 SM 7 LPM 1x80mg

Imunomodulator
-

Mutivitamin
- Becefort 2x1
- Biocal 2x1000
mg
- D3 1x1000 IU
 - Zinc 1x20mg

Obat-obat lain
- PO
Lansoprazole
1x30mg
- PO Sistenol
3x1 k/p

5 TN. Sarwoko / 54 KELUHAN : SESAK R/ P/ GDS jam 08.00

Thn SUDAH BERKURANG - Swab 30/4/21 - IVFD NaCl 500cc / (294mg/dL)
RM. 56099 - fu Rontgen toraks 24 jam
PB IGD 26/4/21 - Prone position 12 Sliding scale 25/4/21
TD 131/66 - Cek DL, OT/PT, jam/ hari 06.00 : 156
IMCU 3 BED 22
Ur/Cr, 27/4/21 -Bolus IV 50 cc 14.00 : 231 (5IU)
HR 86 Dextrose 40% (jam
A: 22.00 : 73
- Confirmed Visite dr.,Sp.P 07.00) (extra)
RR 20 06.00 : 66
Covid-19 SB (26/4/21)
- DMT2 Antivirus
T 36,4
- ARDS Severe
Konsul hasil sliding Remdesivir 1x200 mg CRP 24/04/21
- Hiperkalemia (5.4) 20.7
SPO2 98 scale ke dr. Haris (H1) lanjut 1x100 mg
BB 52 Sp.PD (26/4/21) (H2-5) → (H5/5)
TB 164 IVFD NACL 500 Bila gds sudah >200 Lab 24-4-21
IMT 19.3 mg/dL, Drip insulin Antibiotik -Eritrosit : 5.69
cc+Aminopilin/24 JAM
mulai dg 1 unit/jam - Inj. Levofloxacin -HB :16
O2 NK 2---RA saja, slidingnya skala 1x750 mg (H6/7) -Ht : 44.9
4 - IV Ceftriaxone 2x1gr -MCV : 78.9
DC NO 16 WI(30CC) ==================== (H2/5) -MCH : 28.1
22/04/2021 GANTI 29.04.21 ====
Visite dr. Rohmat, -MCHC : 35.6
Antiinflamasi -Leukosit :6.73
R/ SWAB TANGGAL Sp. P 25/4/21: - Inj.
30-04-21 - Aminofilin turun jadi -Trombosit : 224
Dexamethason
120mg/24 jam (Jika -B/E/N/L/M :
e 1x5 mg (H2)
Klinis membaik, 0/0/85/9/6
STOP) Immunomodulator SGOT 24
SGPT 12
- Resfar stop, levo - Drip Resfar Ur 57
lanjut, dexa tapp off 1x5 gr (H5/5) Cr 0,85
selesai 25/4/21
Advis lapjag Sliding Scale
drip insulin 2,5 U / jam Antikoagulan 24/4/21 :
weaning fraksi 5 % SC Lovenox 1x0,4 cc 06.00 : 241 (5 IU)
berkala selang seling 14.00 : 337 (15 IU)
====================
==== 22.00 : 317 (15 IU)
Antidiabetik
Visite dr Syarif SpP 06.00 :
Drip Insulin 1 unit/jam
24/4-21 Sliding Scale/8 jam
Azithromycin stop → skala 4 Sliding Scale
Ceftriaxone 2 x 1 gr 23/4/21 :
Jika CRP > 50 , Dexa Multivitamin 06.00 : 258 (10 IU)
diganti - PO Becefort 2x1 14.00 : 377 (20 IU)
Metilprednisolon 2 x - PO Zink 1x20 mg 22.00 : 314 (15 IU)
125 mg IV - PO Curcuma 3 x 1 06.00 : 241 (5 IU)
Konsul hasil sliding Obat Lain Elektrolit 23/04/21
scale ke dr. Haris - PO Omeprazole Na 142
Sp.PD: 2x20 mg K 4.1
Drip insulin naik 2 IU/ - PO Alprazolam Cl 103
jam 1x0,5 mg (malam) k/p
KGDH 22/4/21:
Advice Lapjag Obat selesai
23/4/21: 06.00: 289
- PO Metformin 2x850 14.00: 271
Ca glukonas stop mg 22.00: 449-
- SC Levemir 0-0-15
Visite dr. Mega, Sp. P IU
23/4/21: AGD on HFNC
- NaCl 3% 50 cc
- Besok weaning 60% 21/4/21
bolus pelan (22/4/21
HFNC pk 20.00) -> selesai pH 7,4
- Terapi lanjut - Inj. Ca glukonas 3x1 Saturasi O2 99,9
- Ca glukonas konsul gr bolus pelan (H2) -> PaCO2 34.2
ke dr. Sp. PD Stop PaO2 34.4
Bicarbonate 54,8
sekaligus lapor Sliding -PO Azitromicin BE 3,1
scale 1x500 mg (H3/5)
Lab 21/4/21
Advice dr. Prasetyo, Eri: 5.41
Sp.PD Hb: 15.5
Lovenox 2x0.6cc jika Ht: 42.8
tidak ada 3x0.4cc MCV 79.1
MCH 28.7
Advice dr. Haris, MCHC 36.2
Sp.Pd 22/4/21 TAB Leukosit 5770
IMCU → Lapor KGDH Trombo 168.000
Levemir dan B/E/N/L/M
metformin stop dulu, 0/0/76/15/9
drip insulin 1 unit/jam OT/PT: 31/12
plus sliding scale 8 Ur/Cr: 44/0.98
jam dg skala 5. Albumin : 4.6
200-250 insulin 5 unit, Na 137
naik 50 naik 5 K 5.4
Cl 102
Visite dr. Erry Sp.P
22/4/21: AGD on NRM
- Aminophilin 15lpm 21/4/21
240mg/ 24 jam pH 7,4
- NaCl 3% 50 cc Saturasi O2 89,8
bolus pelan
PaCO2 33.6
Advice. dr. Priscilla, PaO2 54.2
Sp.An 21/04/21 Bicarbonate 24,3
- HFNC flow 40, BE 0.3
Fraksi 60 P/F ratio : 60 mmHg
- koreksi kalium
dengan Ca
Glukonas 3x1 dr
bolus pelan
- extra Lasix 1x40mg
IV
 - Alprazolam
1x0.5mg Kp malam

6 TN. AMRUDIN KELUHAN:SESAK, R/ P/

BATUK SUDAH - GDS tiap pagi ● O2 on SM 8 lpm Lab 26/4/21*
RM. 54981 BRKURANG - Balance cairan / 8 jam ● IVFD RA 500 cc/24 Hb : g/dl
- Cek aPTT D-dimer bila jam Ht :
PB T7 LT19 sudah bisa ● Diit ML TETP T5 Eri :
- Ro Thorax (30/4/21) ● Terpasang DC No 18 MCV : fl
TD 154/98 - Cek DL, OT/PT, Ur/Cr, ● Prone position min MCH : pg
IMCU 3 BED 23 Elektrolit (29/4/21) 12 jam/hari MCHC : g/dl
HR 100 - Toillette training Leu :
(26/4/21) Antivirus: Tromb :
BB: 75 kg - Aff kateter (27/4/21) - IV Remdesivir 1x100 B/E/N/L/M
TB: 170 RR 22
- Tidak perlu Swab ulang mg (H7/7) -> acc dr Erry ////
IMT: 25,9 (acc dr. Riana, SpP) Sp.P OT/PT : /
T 36,1
Ur/Cr : /
IMPROVE Score: F/ U Antibiotik: Na/K/Cl
2,5 tanpa INR SpO2 99
- Expertise Ro Thorax - IV Levofloxacin
(25/4/21) 1x750mg (H7/7)
CrCl - Cek DL, OT/PT, Ur/Cr, - IV Ceftriaxone 1x2gr //
IVFD Asering 500 cc/24
jam Elektrolit (26/4/21) (H7/7) AGD 26/4/21 on SM 8
A/ Confirm Covid 19 SS -================== lpm
Mild ARDS ===== Imunomodulator: pH: 7,4
Obesitas Grade 1 O2 NRM 10 lpm
25/4/21: - Drip Resfar 1x5gr SpO2 99
Advice dr. Haris, SpPD (H7/7) PaCO2 33,9
P/F Ratio: on SM 8 lpm DC NO. 16 WI (30CC) terkait UL via WA HP 1: PaO2 120
256 20/4/21 R/ GANTI 27/4/21 - Terapi lanjut Antikoagulan: HCO3 26,5
- SC Lovenox 3x0,4cc, BE 3.8
P/F Ratio on HFNC Advis dr. Mega, SpP: bila SM 2x0,4 bila NK P/F Ratio on SM 8 lpm:
FiO2 75 - Aminofilin stop 1x0,4 cc 255 mmHg (Mild ARDS)
327
Advis dr. Haris, SpPD: Antiinflamasi: GDS 26/4-21 :
HASIL-SWAB - Drip SNMC lanjut 2 hari - PO Spironolactone 194
22-04-21 POSITIF 1x100 mg (H3/5)
CT E: 34,9 Visite dr. Rohmat, SpP - IV Dexamethasone AGD 25/4/21 on NRM 10
CT Rdp : 37,7 - Weaning ke NRM 10 2x10 mg (2/2), tappering lpm
lpm bila SpO2 >93% setelahnya 2x5 mg (2H) pH: 7,4
-================== SpO2 99
===== Multivitamin: PaCO2 30
24/4/21: - PO Becefort 2x1 PaO2 253
Advice dr. Erry Sp.P - PO Imugard 2x1 HCO3 24
terkait balance cairan - PO Zinc 1x20 mg BE 2.2
negatif P/F Ratio on NRM 10
- PO Furosemid 1x40 mg Lain-lain: lpm: 422 mmHg (Not
jadikan k/p - Inj Omeprazole 2x40 ARDS)
- PO Codein 2x10 mg mg
jadikan k/p - PO sucralfat syr 3x1 C UL 25/4/21*
- PO Furosemide 1x40mg Glukosa (+1)
Visite dr Syarif SpP (k/p) pH urine 7.5
24/4-21 - PO Atorvastatin 1x40mg Berat jenis 1.015
- Remdesivir, - PO Codein 2x10mg Warna: kuning
Levofloxacin, Ceftriaxone (k/p)-> dr Erry Sp.P Kejernihan: jernih
dan Resfar lanjut 7 hari - PO Cetirizine 1x5mg Protein (-)
- Dexamethasone naik (malam) Bilirubin (-)
Inj 2x10 mg 2 hari, lanjut - PO Lactulac 3x1 cth, Keton (-)
2x5 mg setelahnya malam 2 cth k/p jika tidak Nitrit (-)
bisa BAB Darah (-)
Konsul AGD 23/4-21 ke - PO CTM 1x4 mg (k/p) Leukosit (-)
dr Mega Sp.P 24/4-21 - PO Pct 3x1 (k/p) Urobillinogen (-)
- Terapi Lanjut - PO KSR 3x1
=================== - PO Curcuma 3x1 GDS 25/4/21: 188
===== - Drip SNMC 1x2 amp
23/4/21 dalam NaCl 100 cc/1 jam GDS 24/4/21: 118
Advis dr. Haris, SpPD (H3/4)
utk hasil lab AGD 23/4/21 on HFNC
- Spironolactone 1x100 Obat Selesai: FiO2 50% Flow 30
mg - Drip Heparin drip pH: 7,5
- Infus ringer laktat 12.500/12 jam-> STOP SpO2 99,4
1000/24 jam buat 2 hari - Spironolakton 2x100mg PaCO2 30.2
dulu. Setelah itu cek (H4/5) stop PaO2 136.5
urine ulang - IVFD Aminofilin HCO3 25.9
360mg/24 jam dalam BE 4.4
Advis lapjag: syringe pump (H3/3) →
- Pakai HFNC FiO2 50% stop UL 23/4/21*
Flow 30 lpm Glukosa (-)
- Nilai ROX Index pH urine 7.5
Berat jenis 1.015
Visite dr. Mega, SpP: Warna kuning tua
- ganti device NRM 8 lpm Kejernihan agak keruh
bila SpO2 <95% Protein (-)
- cek UL → bila leukosit Bilirubin (-)
(+) lepas kateter dan Keton (-)
pakai pispot Nitrit (-)
- Aminofilin 3 hari Darah (+)
- KSR 3x1 Leukosit (-)
- Curcuma 3x1 Urobillinogen (+)

Advice dr. Pras Sp.PD Lab 23/4/21*

- Lovenox 2x0,4 cc, bila Hb : 15 g/dl
NK 1x0,4 cc Ht : 42,3
- Elektrolit perbaiki intake Eri : 5.23
- SNMC 2 amp (2 hari) MCV : 80,9 fl
- OT/PT cek hari ke 3 MCH : 28.7pg
MCHC : 35.3g/dl
Advice dr. Riana SpP Leu : 13950
terkait hasil Tromb : 523.000
laboratorium B/E/N/L/M
Terapi lanjut 0/0/87/8/6
Weaning bila stabil ke OT/PT : 190/23
NK 4-5 lpm Ur/Cr : 22/1.02
Na/K/Cl
Advice dr. Riana Sp.P 133/3.4/97
via WA terkait hasil GDS: 140
swab GDS 23/4/21: 110
- Weaning ke SM 8 lpm
- Dexamethasone 2x0,5 GDS 22/4/21: 110
mg (H5)
Tidak perlu swab ulang GDS 21/4/21: 113

Advice dr. Prasetyo D-dimer 20/4/21:

terkait antikoagulan: reagen abis
23/4/21
Lovenox 2x0,6 cc atau Lab 20/4/21
Lovenox 3x0,4cc selama Eri: 4,87
pakai HFNC atau NRM, Hb: 14,1
selama aPTT tidak bisa Ht: 39,3
dicek MCV 80.7
=================== MCH 29.0
== MCHC 35,9
F/ Up: Leukosit 8,08
- Swab 22/4/21 Trombo 373
=================== B/E/N/L/M
Visite dr Erry Sp.P 0/1/78/13/8
22/4-21 OT/PT: 48/52
- Terapi lanjut Ur/Cr: 30/1.1
Na/K/CL: 133/3,9,100
 - Weaning FiO2
ke 40% Lab 19/4/21
=================== Eri: 5.12
Visite dr Dini SpP Hb: 15
21/4/21 Ht: 41.1
-Terapi lanjut MCV 80.3
MCH 29.3
Advice dr Pras Sp.PD MCHC 36.5
20/4-21 Leukosit 9.140
- Bolus Heparin 5000 Trombo 353.000
unit & drip 12.500/12 jam B/E/N/L/M
- Cek aptt jam 10 0/1/74/17/8
OT/PT: 52/55
Visite dr.Satria sp.P Ur/Cr: 21/1.2
20-04-21 :
- Weaning 02 dan AGD 20/4/21 on HFNC
observasi/2 jam FiO2 75% Flow 50
=================== pH: 7,5
Advis dr. Erry, Sp.P SpO2 99,9
- acc Pro IMCU 6 PaCO2 24
- Hfnc flow 50 fio2 75% PaO2 229
- Levofloxacin 1x750mg HCO3- 21
iv BE 0,7
- Resfar 5gr
- Remdesivir AGD on 8 lpm SM
- Nacl+aminofilin pH: 7,5
360mg/24jam SpO2 99,1
- Ceftriaxone 1x2gr PaCO2 26,2
- Cek agd, dpl, ot pt ur cr PaO2 115,2
- Heparin 2x7500mg HCO3- 21
- Spironolakton 2x100mg BE 0,7
- Furosemide 1x40mg
- Atorvastatin 1x40mg Lab 13/4/21
- Codein 2x10mg Eri 5.12
- Cetirizine 1x5mg Hb: 15,0
Ht: 41,1
Leukosit: 9.140
Trombo: 353.000
B/E/L/N//M
0,1/1/17,3/73,4/8.2
7 Tn. Muhamad KELUHAN ; PASIEN R/ P/ Lab 26/4/21
Nahrowi MENGATAKAN SESAK ● GDS per pagi - O2 on HFNC FiO2 45% Eri:
SAAT BATUK ● Balance cairan / 8 Flow 35 Hb:
RM. 55979 jam - Diet ML TETP Ht:
● Cek D-Dimer dan - IVFD RL 500cc/24 jam MCV
TD 143/97 aPTT (jika sudah - Prone position min 12 MCH
IMCU 3 BED 24
bisa) jam/ hari MCHC
HR 61 ● Cek DL, OT/PT, - Terpasang DC Leukosit
PB DARI TW 6 LT 04
23.04.21 Ur/Cr, elektrolit Trombo
RR 17 (29/4/21) Antivirus B/E/N/L/M
● Ro. Thorax - IV Remdesivir 1x100 ////
T 36,4 (01/5/21) mg (H4/5)
A/
● Swab (30/4/21) GDS 26/4/21:
SP02 99 Antibiotik 146
Conf covid Simp F/U - IV Levofloxacin 1x750
sedang ● Cek DL, OT/PT, mg (H4/5) GDS 25/4/21: 167
IVFD RL 500CC/24 JAM
Ur/Cr, elektrolit - IV Meropenem 3x1gr
ARDS moderate (26/4/21) (H2/5) GDS 24/4/21: 192
O2 SM 10 LPM ● Ro. Thorax
Overweight (26/4/21) Antiinflamasi AGD 23/4/21
R/SWAB 30.04.21 - IV Dexamethasone on HFNC FiO2 60%,
=================== 2x10 mg (H2/2) → 2x5 Flow 40
== mg (H2) pH: 7.5
DC NO. 16 WI (30CC) 25/4/21 SaO2: 98,5
BB 77 kg 23/4/21 R/ GANTI 30/4/21 Visite dr. Rohmat, SpP Immunomodulator paCO2: 28,9
- Tap off dexamethasone - Drip Resfar 1x5 gr paO2: 104.8
TB 162 cm R/SWAB 30.04.21 jadi 2x5 mg (H4/5) HCO3: 20.9
- Cetirizine 2x10 mg BE: -1,5
IMT 29.3 (overweight) - Tidak perlu tambahan Antikoagulan
furosemide terkait BC - SC Lovenox 3x0,4 cc AGD 23/4/21
+217 on NK 4 lpm
Multivitamin pH: 7.5
24/4/21 - PO Becefort 2x1 SaO2: 93,5
Visite dr Syarif Sp.P - PO Zink 1x20 mg paCO2: 29,9
24/4/21 - PO Curcuma 3x1 paO2: 60
- Azitromycin ganti - PO Imugard 2x1 HCO3: 24.7
Meropenem 3x1gr - PO Mecobalamin 2x1 BE: 1,6
(5hari)
Obat Lain Lab 23/4/21
- IV OMZ 1x40 mg Eri: 4.49
 - Dexamethasone 2x10 - PO PCT 3x1 (k/p) Hb: 14,4
mg 2 hari, lanjut - PO Cetirizine 2x10 mg Ht: 39
tappering - PO Lactulac 3x 1 cth MCV 86.9
(malam 2 sdm) MCH 32.1
Konsul AGD 23/4/21 ke MCHC 36.9
dr Mega Sp.P 24/4/21 Obat Selesai Leukosit 9.14
- Terapi lanjut Antivirus Trombo 169.000
=================== - IV Remdesivir 1x200 B/E/N/L/M
===== mg (H1) → 23/4/21 0/0/80/15/15
23/4/21
Advis lapjag: Antibiotik GDS 143
- HFNC FiO2 50% Flow - PO Azitromisin 1x500
30 T37 mg (H2/5) → 24/4/21 OT/PT 79/35
- Lovenox 3x0,4 cc Ur/Cr 38/1.3
Antiinflamasi
Visite dr. Mega, SpP - IV Dexamethasone 2x5 Na/K/Cl 135/3.9/103
- Ganti device jadi NRM mg (H2/5) → 24/4/21
8-10 lpm
- Azitromisin 1x500 mg 5
hari

8 Tn. Octo Sihombing KELUHAN ; TAK R/ P/ KGDH /8 jam 26/4/21

48 tahun - KGDH/ 8 jam O2 on NK 3 lpm 06.00: 258
RPD: DM, HT tidak ada - Cek D Dimer dan aPTT (bila IVFD RA 500 cc/24 jam 14.00:
RM. 55967 sudah bisa) Aminofilin 360 mg/24 22.00:
- Ro. Thoraks (01/5/21) jam (H5/5)
BED 25/ IMCU 3 - Cek DL, OT/PT, UR/CR, Diit: MB DM KGDH /8 jam 25/4/21
TD 115/81 Elektrolit (27/4/21) 06.00: 69 (-) → 273
PB DARI IDG - Swab (30/4/21) Antivirus: 14.00: 416 (setelah
21.04.21 HR 72 - IV Remdesivir 1x100 makan)
F/U mg (H6/7) 22.00: 337
RR 21
BB: 89 ===================== Antibiotik Lab 24/4//21*
TB: 174 T 36,3 26/4-21 - IV Levofloxacin 1x750 Eritrosit : 5.24
IMT: 29,4 Konsul dr Haris Sp.PD mg (H6/7) HB : 15.2
SP02 97 perihal KGDH 25/4-21 : - IV Ceftriaxone 1x2gr Ht : 42.8
CrCl: 167 - Novorapid 16-16-14, (H3/5) MCV : 81.7
IVFD RL 500CC/24 JAM lain2 lanjut MCH : 29
IMPROVE Score: ===================== Antiinflamasi: MCHC : 35.5
IVFD NACL 500CC+
2,5 tanpa INR 25/4/21 Leukosit : 9.47
 Aminopilin 360mg/24 JAM Advis dr. Mega, SpP - IV Dexamethasone Trombo : 332.000
DX. - Levo, Remde, Resfar lanjut 2x10mg (H2/2) --> Inj B/E/N/L/M :
Confirm Covid 19 SS O2 NK 3 LPM 7 hari lanjut tapering off 0/0/72/12/9
Obesitas Grade 1 setelahnya 2x5 mg (2H) OT/PT 28/55
R/SWAB 30.04.21 Advis dr. Haris, SpPD - PO Spironolactone Na/K/Cl: 142/3.4/109
- Cek GDS ulang 2x100 mg (H4/5)
P/F 370 - Bila hasil >200 Fixed Dose Sliding Scale/8 jam
Insulin 12-12-10 Antikoagulan 24/4/21
Rontgen Thoraks - Metformin tetap lanjut - SC Lovenox 1x0,4 cc 06.00 :203 (4U)
21/4/21 - KGDH lanjut 14.00: 291 (8U)
Imunomodulator 22.00: 130 (-)
Visite dr. Rohmat, SpP - Drip Resfar 1x5 gram
- Weaning (H6/7) 23/4/21:
Ur/Cr : 36/0.9
Advice dr. Haris Sp.PD Anti-diabetik:
terkait metformin 500 mg - SC Novoapid 12-12-10 Sliding Scale/8 jam
kosong: -> 16-16-14 Unit 23/4/21
Metformin 2x850 mg - PO Metformin 2x850 06.00 : 229 (4IU)
mg 14.00: 202 (4IU)
Advice dr. Erry Sp.P terkait 22.00: 279 (8IU)
pemberian aminofilin: Multivitamin:
-Aminofilin dilanjutkan hingga - PO Becefort 2x1 Sliding Scale/8 jam
5 hari - PO Zinc 1x1 22/4/21-23/4/21:
-Weaning O2 - PO D3 1x5000 iu 06.00: 274 (8 IU)
-Fisioterapi dada 14.00: 334 (12U)
==================== Lain-Lain: 22.00: 321 (12 IU)
- IV Omeprazole 2x40
advis lapjag 24/4/21: mg GDS 22/4/21: 274
-ksr 3x1 - PO Curcuma 3x1
- PO Codein 2x10 mg - GDS 21/4/21: 333
Advis konsul dr Prasetyo Acc dr Erry Sp.P
Sp.PD perihal antikoagulan - PO Furosemide 1x40 Lab 21/4//21*
dgn device NK 24/4/21: mg Eritrosit : 5.21
-Lovenox 1x0,4cc dan jika - PO Ceterizine 1x10 mg HB : 15.3
sudah RA diubah menjadi (k/p malam) Ht : 42.2
1x0,4cc selang seling/3x - PO KSR 3x1 MCV : 81.0
seminggu MCH : 30.1
Obat Selesai: MCHC : 36.3
Visite dr Syarif Sp.P - IV Dexamethasone Leukosit : 4,97
- Azitromycin ganti 2x5 mg (H3/3) → Trombo : 198.000
Ceftriaxone 1x2gr (5hari) 23/4/21 B/E/N/L/M :
- PO Glimepiride 1x2 mg 0/0/72/19/9
(22/4/21) OT/PT 76/87
- Dexamethasone naik PO Azitromisin 1x500 Ur/Cr 27/0,68
menjadi 2x10 mg 2 hari, mg (H4/5) stop
tappering setelahnya AGD 21/4/21
on SM 6 lpm
Advice dr. Haris, SpPD via pH: 7,5
WA (23/4/21): SpO2 99.7
- Drip insulin 2,5 U/jam PaCO2 27.9
PaO2 185
23/4/21 HCO3- 21
Advice lapjag BE 0.7
- Insulin lanjut

Visite dr. Mega, SpP

- Dexamethasone 2x5 mg
stop → tap off jadi 1x5 mg 3
hari

Advice dr. Haris Sp.PD

terkait Sliding Scale (07.54)
- Insulin naik jadi 2 unit/jam,
lain2 lanjut.
- Cek ureum kreatinin.
- Laporkan di laporan jaga

===================
Visite dr Erry Sp.P 22/4-21
- Aminofilin 360mg/24 jam
- Spironolactone 2x100 mg 5
hari
- Furosemide 1x40 mg PO
- Codein 2x10 mg
- Cetirizine 1x10 mg
===================
Advice dr. Haris, SpPD
(22/4/21):
- Glimepiride STOP
- Drip insulin 1 U/jam +
Sliding scale/ 8 jam (skala 4)
===================
Advice dr. Efriadi,SpP
- Pro IMCU 6
- Remdesivir 1x200 mg (H1),
Ramdesivir 1x100 mg (2-5)
 - Methisoprinol 4x500 mg →
stop
- Inj. Levofloxacin 1x750 mg
IV
- PO Azitromisin 1x500 mg
- Becefort 2x1
- Resfar 1x5 gram
- Lovenox 1x0,4 cc
- IV Omeprazol 2x40 mg
- Metformin 3x500 mg
- Glimepiride 1x2 mg
- Curcuma 3x1

Advice dr. Pras SpPD

- Insulin 1 unit/jam + sliding
scale/6 jam (TAO) naik skala
5 → ganti :
- Metformin 3x500 mg
- Glimepiride 1x2 mg
- Cek GDS/hari
- Lovenox 2x0,4 cc konsul
ulang bila hipoksia bertambah

IMCU 3 BED 26

9 Tn. Idrus/61th KELUHAN ; PASIEN R/ P/ Lab 26/04/21

MNGATAKAN SESAK - Cek GDS/hari - O2 HFNC FiO2 60% SGOT : 105
RM. 55979 ADA TAPI SUDAH - Rontgen 28/4/21 Flow 50 lpm SGPT: 63
BERKURANG, BATUK - Swab 01/5/21 - IVFD RL 500cc/24 jam Ureum: 97
- DL,OT/PT,Ur/Cr, Elektrolit - Prone position min. 12 Creatinine: 2.29
BED 27/ IMCU 3 ADA TAPI KADANG (28/4/21) jam/hari Na: 134
KADANG - Obs. TTV/Shif K: 4.3
PB DARI TW 7 LT Antivirus Cl: 103
24 RPD : Riw. operasi batu uretra FU/ - Drip Remdesivir 1x200 GDS: 166 mg/dl
2021 - Balasan konsul dr mg (H1) lanjut 1x100 mg
MASUK 25.04.21 HT (-), DM (-), Sakit jantung Rohmat Sp.P perihal hasil (H2-7) Lab 25/4/21
(-), sakit paru (-) lab (25/4/21) di HP 1 - PO Methisoprinol Eri : 5.26
DX. 4x500mg (H4/7) Hb: 17.1
Riwayat operasi Batu gunjal Ht: 45
2001
- Confirmed Advice dr. Harris Sp.PD l Antibiotik MCV: 86.5
Covid-19 SB OT/PT, Ur,Cr, Elektrolit Inj. Levofloxacin 1x750 mg MCH : 32.5
- Obesitas gr II TD 125/80 (26/04/21) (H2/5) MCHC 37.6
Advice: Leukosit : 9.12
BB 91 HR 81 - Ketosteril 3x1 Antiinflamasi Trombo: 165000
TB 159 (TAP) - Inj. Dexamethasone 2x5
IMT 36.2 RR 20 edukasi keluarga mg (H2/5) AGD 25/4/21 on HFNC
pasien beli obat - PO Colchisine 2x0.5 mg :
CrCl 42 mL/m T 36,2 sendiri (TAO) pH 7.4
SaO2 98
Improve Score SpO2 99 Advice dr. Ulfa, Sp. P Antikoagulan paCO2 22
3.5 tanpa INR - Pro HFNC SC Heparin 2x5000 IU paO2 108
- Pro IMCU (H2) HCO3 16
IVFD RL 500CC/24 JAM - Azitromicin stop BE -4.3
- Injeksi Levofloxacin Immunomodulator P/F ratio 180
TERPASANG HFNC 1x750 mg Drip Resfar 1x5 gr (H2/5) (Moderate ARDS)
FIO2 : 60 - Remdesivir 1x200 mg
FLOW ; 50 (H1) lanjut 1x100 mg Multivitamin Lab 22/4/21
T ; 37 (H2-7) → (H1) - POBecefort 2x1 Eri: 5.26
- Inj. Dexamethasone 2x5 - PO Curcuma 3x1 Hb: 17.1
mg - PO Vit. D3 1x5000 IU Ht: 45
R/ SWAB 01.04.21
- Drip Resfar 1x5 gr - PO Zink 1x20 mg MCV 86.5
- SC Heparin 2x5000 IU MCH 32.5
- Colchisine 2x0.5 mg Obat Lain MCHC 37.6
- Vit. D3 1x5000 IU - Inj. PCT 3x1 gr (k/p) Leukosit 9.120
- Terapi lain lanjut - PO CTM 3x1 Trombo 165000
- Inj. Omeprazole 2x1 B/E/N/L/M
Advice dr. Priscillia Sp. An : - PO Ketosteril 3x1 0/1/66/19/14
- 98-99% on HFNC FiO2 GDS 125
60% Flow 40 lpm → OT/PT: 49/56
naik jadi 50 lpm Ur/Cr: 61/2.41
Lapor hasil Lab dan AGD
ke dr. Rohmad Sp.P (via
hp WA 1) Belum ada Rontgen Thorax tgl
jawaban
23/4/21
10 Tn Mahfut / 51 thn KELUHAN ; PASIEN R/ P/ Lab 26/4/21
MENGATAKAN MASIH - GDS setiap pagi - Prone position 12 SGPT
RM.56048  BATUK SESEKALI - Swab (30/4/21) jam/ hari SGOT
  - Cek D-Dimer dan - Diit: MB TETP
aPTT/ 4 hari (bila - O2 NK 2lpm GDS 26/4/2021
BED 28/ IMCU sudah bisa) - IVFD RA 500cc/
TD 129/88 153 mg/dL
- Cek DL, Ur/Cr, 24jam
MASUK 23.04.21 =============
HR 88 Elektrolit/ 3 hari - Drip Aminofilin 1
PB DRI TW 7 LT 5 (27/4/21) ampul dalam 12 GDS 25/4/2021
- Observasi TD dan jam on syringe 148 mg/dl
RR 21
DX. HR → Bila TD<100 pump =============
S 36,2 konsul dan HR >100 ================== Lab 24/4/21
confirm covid-19 aminofilin jadi 1 ==== Eri: 5,14
SS SpO2 98 ampul/12 jam Antivirus: Hb: 15,9
- ro thorax 30/4/21 - Remdesivir 1x100 Ht: 45,5
=================== mg (H4/5) MCV 88,5
=== MCH 30,9
IVFD NACL 0,9 500 CC/24
FU/ - OT/PT (26/04/21) Antibiotik: MCHC 34,9
JAM Leukosit 73600
- Inj. Levofloxacin
Visite dr.,Sp.P 1x750 mg (H4/5) Trombo 229..000
O2 RA B/E/N/L/M
(26/4/21) - IV Ceftriaxone 1x2
=================== gr (H2/5) 0/0/74/19/7
R/SWAB 30.04.21
=== GDS 141
25/4/21 Antiinflamasi: OT/PT: 103/102
- IV Dexamethasone Ur/Cr: 33/10,97
Visite dr. Rohmat, Sp.P 2x5mg (H4/5)
- Weaning nasal kanul GDS 24/4/21: 131
5 lpm AntiHipertensi: =============
- Terapi lain lanjut - Amlodipin 1x5 mg GDS 23/4/21
=================== (Pagi) 127
=== - Ramipryl 1x 5mg
24/4/21 (Malam) AGD 23/4/21 on SM 8
lpm
Advice dr. Prasetyo, Imunomodulator:
pH 7,4
Sp.Pd (HP IMCU 1) - Inj. Resfar 1x5
Saturasi 2 98.8
- Lovenox 2 x 0.6 ml, gram (H4/5)
PaCO2 31.1
bila tdk ada Lovenox
Antikoagulan: PaO2 107
 3 x 0.4 ml , cek dulu - SC Lovenox Bicarbonate 24.6
skor improve. 1x0.4cc BE 2,3
- Pasien dalam NRM selang-seling P/F Ratio : 202
saran SNMC 2 hari, (Mild ARDS)
cek fungsi hati hari Multivitamin: Lab 21/4/21
ke 3 - PO Becefort 2x1 Eri: 5.39
- PO Zinc 1x1 Hb: 17
Visite dr.Syarif Sp.P Ht: 48,4
- PO Azitromisin ================== MCV 89.8
1x500 mg diganti ==== MCH 31.5
dengan Terapi Selesai/Stop: MCHC 35.1
Ceftriaxone 1x2 gr Antivirus: Leukosit 7250
- Inj.Ramdesivir Trombo 196..000
Konsul dr Ruswandiani 1x200 mg (H1) → B/E/N/L/M
Sp.JP perihal TD 23/4/21 0/0/67/27/6
- Amlodipin 1x5 mg - PO Methisoprinol GDS 144
(pagi) 4x500mg (H2/5) → OT/PT: 77/72
=================== 23/4/21 Ur/Cr: 42/1.3
=== Antibiotik: =============
23/4/21 - PO Azitromisin
Advis lapjag: 1x500 mg (H3/5) →
- NRM turunkan 8 lpm 24/4/21
Antikoagulan:
Visite dr. Mega, SpP - SC Heparin 2x5000
- Ganti device jadi NRM - SC Heparin 2x7500
8-10 lpm IU → 24/4/21
- Drip Aminofilin 1 ½ Imunomodulator:
ampul dalam 12 jam on - PO Erdomex
syringe pump 2x10cc
- Observasi TD dan HR. Multivitamin:
Bila TD<100 konsul dan - PO Curcuma 3x1→
HR >100 aminofilin jadi 1 (24/04/21)
ampul/12 jam - PO Ambroxol 3x30
mg
Advice dr. Prasetyo Hepatoprotektor:
SpPD terkait - IV SNMC dalam
antikoagulan 23/4/21 NaCl 100 cc (H2/2)
06.40 -> 25/4/21
SC Heparin 2x7500 IU
 Advice dr. Riana Sp.P
terkait terapi tambahan
(09.00)
Inj.Ramdesivir 1x200 mg
(H1), Ramdesivir 1x100
mg (H2-5) IV
Inj. Levofloxacin 1x750
mg IV (5H)
Inj. Resfar 1x5 gram
(5H)
Erdomex, Ambroxol,
Methisoprinol stop

===================
==
Pro IMCU 6 acc dr.
Deddy SpP
Cek AGD
Injeksi Dexametason 2x5
mg IV
Heparin 2x5000 IU SC
GDS/hari

11 Tn sudarnofa / 45 thn KELUHAN : PASIEN R/ P/ Sliding Scale/6jam skala

RM : 56473 MENGTAKAN SESAK DAN - DL, OT/PT, Ur/Cr, - Prone position min. 3 (25/04/21)
BATUK SUDAH Elektrolit (27/04/21) 12 jam/ hari sliding scale
BED 29 - aPTT dan D-Dimer / - O2 NK 2 lpm 06.00 : 247 ( 3 iu)
BERKURANG
IMCU3 4 hari bila reagen - IVFD RL 500cc/ 24 12.00 : 312 (9 iu)
PB IGD 24-04-21 sudah tersedia jam 18.00 : 316 ( 9 iu)
TD 122/68 - Swab (03/05/2021) =================== 00.00 :273 ( 6 iu)
DM TIPE II - cek KGDH per 6 ===== 06.00 : 306 (9 iu)
BB: 61 kg HR 66 jam dengan sliding Antivirus:
TB : 166 cm scale kelipatan 3 jk - IV Remdesivir Lab DL (24/04/2021)
RR 22 di atas 200 1x200mg ( h1), Eri: 5
CrCl: mL/m (26/04/21) 1x100 mg Hb: 15
T 36,1 (h2-5)(H3/5) Ht: 40
Improve Score 2,5 F/U MCV: 79
tanpa INR SpO2 99 Antibiotik: MCH: 29
 =================== - IV Levofloxacin MCHC: 36
RL 500cc / 24 jam = 1x750 (H3/5) Leukosit: 12.000
Konsul dr. Faisal Sp.PD - Azitromycin 1x500 Trombo: 333.000
hasil sliding scale mg (H3/5) B/E/N/L/M
02 NK 3 LPM
(26/04/21) pkl 09.28 0/0/80/10/10
Advice: Anti Inflamasi: OT/PT: 20/13
R-SWAB 03-05-21 - Berikan drip - IV Dexametason 2x5 Ur/Cr: 19/0.51
novorapid 1 unit mg (H3/5)
per jam, cek - Spironolactone KGDH pukul 21.00
kgdh per 6 jam 2x100 mg (H2) (24/04/21) : 351 mg/dL
dengan sliding
scale kelipatan 3 Imunomodulator: GDS (24/04/21)
jk di atas 200 - Drip Resfar 1X5 gr 353 mg/dl
(H3/5)
Visite dr. Rohmat, Sp.P - NAC 3x1 (H2)
25/4/21 (07.30):
Advice: Antikoagulan:
- Codein 1x1 - SC Lovenox 3x 0.4
(malam) TAO (H2)
- Cetirizine 1x10
mg (malam) Antihipertensi:
TAO
- Terapi Lain Antidiabetik:
Lanjut - Insulin sliding scale
skala 3 jika GDS >200
Advice Lapjag mg/dL
(24/04/2021) - Drip novorapid 1 unit
- Sliding Scale / 6 per jam
jam dengan insulin
kelipatan 3 Multivitamin
- SC Lovenox 3 x 0,4 - Becefort 2x1
=================== - Zinc 1x 20 mg
=====Konsul dr. Faisal,
Sp.PD hasil GDS 21.00 obat lain:
351 mg/dl, advis - paracetamol oral 3x1
Extra Novorapid 10 U (K/P)
SC (tgl 24/4) - IV Pantoprazol 1x1
- Codein 1x1 TAO
- Cetirizine 1x10 mg
TAO
12 Tn. Ramadhan Keluhan : SESAK SUDAH R/ P/ Lab 26/4/21
BERKURANG - Observasi - Prone position -Eritrosit :
RM. 54975 Perdarahan min.12 jam/hari -Hb :
- GDS/ pagi - Diit: ML TETP -Ht :
BED 30 / IMC 3 - Pindah ruangan - O2 RA -MCV :
TD 128/80
bila trerapi injeksi - IVFD NaCl 0,9%
-MCH :
PB T6 Lantai 17 HR 75 selesai 500cc/ 24 jam
-MCHC :
=================
20/4/21 ================== ===== -Leukosit :
RR 20 -trombosit :
LOS 8 hari ==== Antivirus:
IMCU 0 hari
T 36,2 FU/ - PO oseltamivir -B/E/N/L/M :
- hasil swab tgl 2x75 mg (H1/5) ////
A:
Spo2 96 25/4/21 -sgot :
- Confirmed Covid-19 SS
- Rontgen tgl 26/4/21 Antibiotik: -sgpt :
BB : 83 kg - Cek DL, OT/PT, - IV Levofloxacin -ureum :
IVFD NACL 0,9 500CC/ 24
TB : 162 cm Ur/Cr, elektrolit, 1x750 mg (H7/7), - kreatinin :
JAM
IMT : CRP (26/04/21) dilanjutkan PO CRP :
================== Levofloxacin Na:
CrCl: mL/m O2 RA
==== 1x500mg (5H) K:
Improve Score 1 tanpa Cl:
Antiinflamasi:
INR F/U -SWAB 25/04/21 Positf
Visite dr. Rohmat, Sp. - IV Dexamethasone
P: 25/4/21 1x5 mg (H7/7), Swab 25/4/21
P/F ratio: HASIL Swab tgl 22/04/21 positif
POSITIF CT E : 29,5 - IV Remdesivir dilanjutkan
CT Rdp : 33,6 1x100 mg → dengan PO CT:
STOP Dexamethason ORF1 ab gene : 32,7
- PO oseltamivir 2x0.5mg (5H) E gene : 32,5
2x75 mg (H5) ==============
- IV levofloxacin Antikoagulan: GDS 26/4/21
1x750 mh (H7) , - SC Lovenox 114
kemudian ganti 1x0.4cc ==============
dengan PO selang-seling GDS 25/4/2021
levofloxacin 111 mg/dl
1x500 mg (H5) Immunomodulator:
==============
- inj dexamethason - Erdostein 3x1 (H1)
1x5 mg (H7), GDS 24/2/21
kemudian ganti Multivitamin: 111mg/dl
dengan PO - PO Becefort 2x1 ==============
- PO Imugard 2x1 Lab 23/4/21
 dexamethason - PO Curcuma 3x1 -Eritrosit : 5.33
2x0,5 mg -HB : 15.3
- IV resfar 1x5 mg → Lain-lain: -Ht : 44.2
STOP - PO PCT 3x1 → -MCV : 82.9
- terapi lain lanjut K/P -MCH : 28,7
- rencana pindah - PO Cetirizine -MCHC : 34.6
ruangan bila trerapi 1x10mg → K/P -Leukosit : 5.33
injeksi selesai - IV Omeprazole
-trombosit : 305
- PO Erdostein 3x1 1x40mg
================== - IV Ondancentron -B/E/N/L/M :
==== 1x4mg → K/P 0/0.7/66/24/10
Visit dr. Syarif, Sp.P - PO Codein 2x1 -sgot : 23
24/4/21 - PO Lactulac 3x1 -sgpt : 29
- NK 2lpm jika SpO2 → K/P -ureum : 26
<= 94% ================= - kreatinin : 0.84
- cek DPL dan CRP ===== - Na 140
- Levofloxacin dan Obat selesai : - K 4.5
Dexametason Antivirus: - Cl 107
lanjut - IV Remdesivir
1x200 mg (H1) → GDS 23/4/21
Advice dr. Prasetyo, 20/4/21
121
Sp.PD 24/4/21 HP 1 - IV Remdesivir
==============
- lovenox 1x0.4 cc 1x100 mg (H5/5)
selang-seling, -> 25/4/21 SWAB tgl 22/4/21
saat pulang resepkan POSITIF
edoxaban 1 x 60 Antikoagulan: CT E-helicase 29.5
mg selama 7 hari - Lovenox CT RdRp & ORF 33.6
dan anjuran kontrol 2x0.4cc SK=>
sepulang 24/4/21 GDS 22/4/21:
perawatan Immunomodulator: 101
================== - Drip Resfar ==============
==== 1x5gr (H5/5)-> GDS 21/4/21:
Visit dr. Mega Sp.P 25/4/21 134
23/4/21
- Swab ulang
AGD 21/4/21
tanggal 25/4/21
- obs cegukan pH: 7,45
Saturasi O2: 98,7
PaCO2: 24,6
Lapor hasil swab ke PaO2: 112,3
dr. Riana Sp.P : Bicarbonate: 17,5
● tidak perlu swab BE: -4.4
ulang, bila sudah ==============
RA bisa langsung Lab 20/4/21
pulang -Eritrosit : 5.25
================== -HB : 15.1
====
-Ht : 42.7
Visite dr. Erry Sp.P
(22/4/21) -MCV : 81.3
- Th/lanjut -MCH : 28.8
- Breathing exercise -MCHC : 35.4
video -Leukosit : 7380
-trombosit : 221.000
Advice dr. Prasetyo, -B/E/N/L/M :
Sp.PD 22/4/21 by call 0.1/0.7/69.4/21.4/8.4
- Penggunaan NK -sgot : 46
awal Lovenox -sgpt : 18
2x0.4cc SK, jika -ureum : 26
sudah membaik -kreatinin : 0.9
(ancaman inflamasi
- Na: 136
menurun) boleh
- K:3.7
diberikan Lovenox
1x0.4 cc SK - Cl:103
- BE:0
Konsul dr. Riyadi, - aPTT: 39.7
Sp.P (AGD dan Ro
thoraks): Ro Thoraks 21//4/21
- Th/ Lanjut

Advice dr. Dini, Sp.P

21/4/21
- Terapi lanjutkan

Advice dr. Riyadi,

Sp.P 21/4/21
- Drip Resfar 1x5gr
 Advice dr. Prasetyo,
Sp.Pd 21/4/21
- Setuju lovenox 2 x
0.4 ml, nilai skor
improve, konsul
ulang bila hipoksia
bertambah berat
untuk penyesuaian
dosis antikoagulan
nya
==================
====
Visite dr. Satria Sp.P
(20/4/21)
- Rontgen Thorax
ulang 21/4/21
==================
===

13 Tn. Gunawan Saputro KELUHAN: Sessak saat R/ P AGD 26/4/21 on NK 5

RM 55151 aktivitas, gatal tenggorokan. - Swab 01/05/21 - O2 NK 4 LPM LPM :
- Cek Dl, OT, PT, - IVFD RL pH 7.5
IMCU 3 BED 31 Ur, Cr, Elektrolit 500CC/24 jam SaO2 99
TD 161/90 29/04/21 paCO2 24
- RO THorax Antivirus paO2 141
PB dr Lt 19 tw 6 HR 80 28/04/21 - Remdesivir HCO3 18
26/04/21 - GDS/pagi 1x200mg h1, BE 4
RR 20 - Prone Position 1x100 H2-5 P/F ratio 344
- nasal irigasi 2x (H0/5) (Not ARDS)
T 36,2 sehari dengan
NaCl 0.9% Antibiotik Lab DL (22/04/2021)
SpO2 98 - IV Levofloxacin Eri: 5
FU/ Lab DL, OT, PT, Ur, 1x750mg (H0’/5) Hb: 16.1
Cr, Elektrolit 26/04/21 Ht: 45
IVFD NACL 0,9 500CC/ 24 Antiinflamasi MCV: 83.9
JAM Advice dr. Prasetyo, - Dexamethasone MCH: 29.4
Sp.PD Via telpon 2x5mg MCHC: 35.1
26/04/21 Leukosit: 11.100
- SC Lovenox Antikoagulan Trombo: 353.000
O2 NK 3 LPM
2x0.4cc B/E/N/L/M
 - PO Aspilet - SC Lovenox 0/0/73/17/10
1x160mg 2x0.4cc OT/PT: 29/38
- PO Aspilet Ur/Cr: 18/1
Visite dr. Ulfa Sp.P 1x160mg
(26/04/21)
- IV Imunomodulator
Dexamethasone - Drip Resfar 1x5gr
2x5mg (H0/5)
- Inh Berotec 4x2
puff Inhalasi
- POTramenza 2x1 - Berotec 4x2 puff

advice dr. Lilia Ade, Obat-obat lain

Sp.P - IV Omeprazole
- Remdesivir 5 hari 1x40mg
- IV Levofloxacin - PO Becefort 2x1
1x750mg 5 hari - PO Zinc 1x20mg
- IV - PO Tramenza
dexamethasone 2x1
1x5mg - PO Vit D3 1x5000
- Drip Resfar 5 hari IU -> TAO
- IV Omeprazole
1x40mg
- PO becefort 2x1
- PO Zinc 1x20mg
- Nasal Irigatsi 2x
sehari dengan
NaCl 0.9%
- Azitromicin stop

IMCU 4

14 TN. PUJI KELUHAN: TAK R/ P/ Swab 25/4/21

- Obeservasi - Prone position Negatif
RM. 55701 Perdarahan min.12 jam/hari
 - GDS/ Pagi - Diit: ML TETP TS
PB T6 LT5 TD 148/100 - Cek D-Dimer dan - O2 RA GDS 26/4/2021:
aPTT/ 4 hari bila - IVFD NaCl 0,9%
HR 80 110 mg/dL
IMCU 4 BED 32 sediaan tersedia 500cc/ 24 jam
=================== ==============
RR 20 =================== ===== Lab 25/4/21
A:
- Confirmed Covid-19 SS === Antivirus: Eri: 5,23
- Obese grade 1 T 36,2 FU/ - IV Remdesivir 1x100 Hb: 15,4
- ARDS moderate - Swab tgl mg (H7/7), kemudian Ht: 42.2
SpO2 98 25/4/21 ganti dengan PO MCV 80.7
BB : 85 - Konsul TD oseltamivir 2x75 mg MCH 29.4
TB : 168 dr.Prasetyo, (H5)
IVFD NaCl 0.9% 500CC + Sp.PD 26/4/21
MCHC 36.5
IMT : 30.1 obese grade 1 Leukosit 12.690
AMINOPYLIN/24 JAM HP 1 Antibiotik:
=================== - IV Levofloxacin Trombo 257..000
=== 1x750 mg (H7/7), B/E/N/L/M
O2 RA Advice dr. Prasetyo kemudian lanjutkan 0/0/81/12/7
Sp.PD (26/4/21) dengan PO Na: 142
F/U -SWAB 25-04-21 lanjutkan kombinasi Levofloxacin 1x500 K: 4
Negatif ramipril dan amlodipin, mg (H5)
Cl: 107
target TD < 140/90, - IV Ceftriaxone 1x2
edukasi pasien supaya gr (H3/5)
jangan cemas GDS 25/4/2021:
=================== Antiinflamasi: 123 mg/dl
=== - methylprednisolone ==============
Advice dr. Prasetyo IV 1x40 mg (H2/3) Rontgen tgl 24/4/21
Sp.PD (25/4/21)
- SC Lovenox Antikoagulan:
1x0.4cc selang - SC Lovenox 1x0.4cc
seling bila RA selang seling

Visite dr. Rohmat, Sp. P Antihipertensi:

(25/4/2021) - PO Ramipril 1x10
- IV Remdesivir mg GDS 24/4/21:
1x100 mg (H7), - PO Amlodipine
152 mg/dl
kemudian ganti 1x10mg
dengan PO ===============
oseltamivir 2x75 mg Immunomodulator: AGD tgl 23 april 2021 on
(H5) - Drip Resfar 1x5 gr SM 6 lpm*
- IV levofloxacin (H7 pH: 7.5
1x750 mg (H7), /7) SaO2: 99.3
kemudian lanjutkan - PO Erdostein 3x1 paCO2: 25,1
dengan PO
 Levofloxacin 1x500 Multivitamin: paO2: 126.7
mg (H5) - PO Becefort 2x1 HCO3: 21,6
- IV - PO Zinc 1x20 mg BE: 0.8
methylprednisolon - PO Imugard 2x1->
1x62,5 mg (H1) TAO
kemudian 1x40 mg - PO Curcuma 3x1 tgl 23/4/21
(H2) GDS : 128
- PO cetirizine 1x10 Lain-lain: ==============
mg - PO OMZ 2x20 mg Lab 22-4-21
- terapi lain lanjutkan - PO Lactulac 3x1 Cth
Eritrosit: 5.5
=================== → K/P susah BAB
===== - PO KSR 3x1 Hb: 16.1
Visit dr. Syarif, Sp.P - PO Cetirizine Ht: 45
24/4/21 1x10mg MCV: 82.5
- Remdesivir, =================== MCH: 29.1
levofloxacin, dan ==
MCHC: 35.2
resfar lanjut Obat selesai :
- ceftriaxone 1x2gr IVFD: Leukosit: 16.100
- Aminofilin 360mg/ Trombosit: 360
Advice dr. Prasetyo, 24 jam (H4) → B/E/N/L/M:
Sp.PD 24/4/21 HP 1 23/4/21 0/0/88/8/4
- Ramipril 1x10mg Antivirus: SGOT: 38
- Lovenox 1x0.4cc - IV Omeprazole
1x40mg→ 23/4/21 SGPT: 57
Visit dr. Mega Sp.P - PO Oseltamivir 2x75 Ureum: 26
23/4/21 mg → 19/4/21 Kreatinin: 0.7
- aminofilin stop - IV Remdesivir 1x200 Na: 140
- infus nacl /24 jam mg (H1) → 20/4/21 K: 2.9
- weaning RA obs Antibiotik:
klinis - PO Azitromisin
Cl: 103
- Metilprednisolon 1x500 mg (H5/5) → GDS 159
tapp off 1x62,5 23/4/21
setelah selesai Imunomodulator: GDS 22/4/2: 131
- PO NAC 3x200 mg =============
Lapor hasil AGD ke dr. → 19/4/21
GDS 21/4/2: 146
Riana Sp.P, advice : Antiinflamasi:
● Weaning ke nasal - IV Metylprednisolone =============
canule, target 2x62,5 mg (H5/5) → aPTT tgl 20/4/21 pk
oksigen >95% 24/4/21 19:00
● Omeprazole ganti - IV Metylprednisolone 44.4
ke oral 1x62,5 mg (H1),->
25/4/21
*AGD 20/4/21*
Antikoagulan:
Advice dr. Prasetyo, - SC Heparin evaluasi 1 jam HFNC
Sp.PD terkait 2x5000iu → 20/4/21 pH 7.5
hipokalemia - Bolus heparin 5000 SaO2 99,5
- KSR 3x1 U lanjut 12.500/12 paCO2 30.7
jam → l 20/4/21 paO2 143,7
Advice dr. Erry, Sp.P - Drip Heparin 15.000/ HCO3 26.1
22/4/21 12 jam => 22/4/21 BE 3
- Konsul hasil lab - SC Lovenox 2x0.4cc =============
terbaru Th/ lanjut => 24//4/21 Lab 19-4-21
Eritrosit: 5.59
Visit dr. Erry, Sp.P
22/4/21 Antihipertensi Hb: 16.2
- terapi lanjut - Amlodipin 1x5 Ht: 45.3
- breathing exercise mg (extra) MCV: 81.0
video 24/4/21 MCH: 29
- Captopril 12.5mg
MCHC: 35.8
Advice dr. Pras, Sp.PD (extra) 25/4/21
22/4/21 By call 18:55 Leukosit: 7.90
- heparin stop ganti - Amlodipin Trombosit: 256
lovenox 2x0.4 cc SK 1x10mg (extra) B/E/N/L/M:
25/4/21 22:30 0/0/65/24/11
Visite dr.Dini Sp.P Lain-lain : SGOT: 51
21/4/21 - Vitamin D3 1x5000
- PO Erdostein 3x1 u → TAO
SGPT: 55
Ureum: 21
Advice dr.Pras, Sp.PD Kreatinin: 1.1
20/4/21 (hsl aPTT tgl Na: 139
19/4/21 pk 19:00) K: 3.1
- Drip heparin
Cl: 101
15.000/12jam

Visite dr. Satria Sp.P GDS 19/4/21: 124

(20/4/21)
- HFNC FiO2 60% *AGD 19/4/21* on NK 5
Flow 40 lpm lpm
=================== pH: 7.5
=== SaO2: 93,7
Lapor dr. Prasetyo paCO2: 30
Sp.PD terkait heparin paO2: 62.8
dan elektrolit HCO3: 23.7
- Bolus heparin 5000, BE: 2.2
drip 12500/12 jam
- cek aptt jam ke 10
 X-ray thorax tgl 19/4/21
Lapor dr. Erry Sp.P
terkait AGD dan HFNC
- Fio2 70 flow 45
- terapi lanjut

Lapor kondisi pasien ===============

ke dr. Erry, Sp.P (RR Lab 18-4-21
33-35 x/mnt, prone) -Eritrosit : 6.09
● Pro HFNC FiO2 -HB : 17.5
90% flow 60 -Ht : 49.8
● RL ganti NaCl 500 -MCV : 81.8
cc + aminofilin 360 -MCH : 28,7
mg per 24 jam -MCHC : 35.1
selama 5 hari
-Leukosit : 9.07
● PO Azitromisin
-trombosit : 245
1x500mg
-B/E/N/L/M :
0/0/73/18/9
-sgot :61
-sgpt : 67
-ureum : 20
-kreatinin : 1.1

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