DAFTAR KELENGKAPAN OBAT DAN ALKES TROLLEY EMERGENCY

BULAN : NAMA TROLLEY :

NO PERLENGKAPAN JML Tgl : Tgl : Tgl: Tgl: Tgl:

P S M P P S M S M P S M P S M
LACI A
1  Adrenalin/epinefrin 0,1% 10 amp
2  Asam tranexamat 2 amp
3  Bicnat / meylon 2 amp
4  Ca Gukonas 2 amp
5  Dexamethason 2 amp
6  Dextrosa 40% 4 flac
7  Diazepam / stesolid 2 amp
8  Forusemid / farsix/ uresix 5 amp
9  Heparin / inviclot / Vaxel 1 vial
10  ISDN 5 mg (Isosorbid Dinitrat) 5 tab
11  Lidocain 2 % 4 amp
12  Sulfas Atropin 10 amp
13  Amiodaron / Cordaron 3 amp
14  Norepinefrin / Raivask 1 amp
15  KCL 2 flac
16  MgSo4 2 flac
17  Aminophilin 1 amp
18  Dopamin / Udopa 1 amp
LACI B
1  Dobutamin/Doburan 1 amp
2  ISDN / Cedocard inj 1 amp
3  Vit K 3 amp
4  Water for Injection 1 vial
5  Midazolam / sedacum 1 amp
6  Morphin 1 amp
7  Fentanyl 1 amp
8  Selektroda/elektroda dewasa 6 pcs
9  Venflon 18 2 pcs
10  Venflon 20 2 pcs
11  Venflon 22 2 pcs

NO PERLENGKAPAN JML Tgl : Tgl : Tgl: Tgl: Tgl:

 P S M P P S M S M P S M P S M
LACI B
12  Venflon 24 2 pcs
13  Three way stop cook 2 pcs
14  Alkohol swab 10 ocs
15  Extention tube 1 pcs
LACI C 2 amp
1  Suction catheter no 8 1 pcs
2  Suction Catheter no 10 1 pcs
3  Suction Catheter no 12 1 pcs
4  Masker Rebreathing 1 pcs
5  Masker Non Rebreathing 1 pcs
6  Nasal kanul 1 pcs
7  Simple mask 1 pcs
8  Sarung tangan steril no 7.5 2 psg
9  Sarung tangan nin steril 1 box
10  Opha/Guedel 110 1 pcs
11  Opha/Guedel 90 1 pcs
12  Opha/Guedel 80 1 pcs
13  Opha/Guedel 70 1 pcs
LACI D
1  Spuit disposible 1 cc 2 pcs
2  Spuit disposible 3 cc 10 ocs
3  Spuit disposible 5 cc 5 pcs
4  Spuit disposible 10 cc 4 pcs
5  Spuit disposible 20 cc 2 pcs
6  Spuit disposible 50 cc 2 pcs
7  ETT no 3,5 1 pcs
8  ETT no 5 1 pcs
9  ETT no 5,5 1 pcs
10  ETT no 6 1 pcs
11  ETT no 6,5 1 pcs

NO PERLENGKAPAN JML Tgl : Tgl : Tgl: Tgl: Tgl:

 P S M P P S M S M P S M P S M
LACI D
12  ETT no 7 1 pcs
13  ETT no 7.5 1 pcs
14  Xillocain jelly 1 tube
15  Folley Catheter 2way no 16 1 pcs
16  Folley Catheter 2way no 18 1 pcs
17  NGT no 14 1 pcs
18  NGT no 16 1 pcs
19  NGT no 18 1 pcs
20  Urin bag 1 pcs
21  Dispo Catheter tip 50 cc 1 pcs
22  Feeding tube no 10 1 pcs
23  Jelly USG 1 pcs
24  Plester coklat 1 roll
25  Hypafix 1 roll
LACI E 1 pcs
1  Dextrose 5% 100 ml 1 kolf
2  Dextrose 5% 500 ml 1 kolf
3  Dextrose 10% 500 ml 1 kolf
4  Nacl 0.9% 100 ml 2 klof
5  Nacl 0.9% 500 ml 1 kolf
6  Gelofusin 500 ml 2 kolf
7  Manitol 250 ml 1 kolf
8  Ringer Laktat 500 ml 1 kolf
9  Mikro drip / infuset pediatrik 1 pcs
10  Bloodset 2 pcs
11  Infusset dewasa / makro 2 pcs
12  Methylergometrin 2 amp
13  Oxitosin 4 amp
14  Profofol / Recofol 1 amp
15  Nutrisium / Atracium besylate 1 amp