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  • MR 1 Lembar Triage

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    Ayu Rachmadany
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    This document is a triage form used to assess patients in a medical setting. It contains sections to evaluate a patient's airway, breathing, circulation, disability, and vital signs. Conditions are categorized as requiring resuscitation, emergency treatment, urgent treatment, non-urgent treatment, or if the patient has no emergency condition. Based on findings in each section, the form determines the priority level of treatment needed.

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    lembar triage rs

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    Mr 1 Lembar Triage (2)

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    This document is a triage form used to assess patients in a medical setting. It contains sections to evaluate a patient's airway, breathing, circulation, disability, and vital signs. Conditions are categorized as requiring resuscitation, emergency treatment, urgent treatment, non-urgent treatment, or if the patient has no emergency condition. Based on findings in each section, the form determines the priority level of treatment needed.

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    © All Rights Reserved
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    36 views1 page

    MR 1 Lembar Triage

    Uploaded by

    Ayu Rachmadany
    This document is a triage form used to assess patients in a medical setting. It contains sections to evaluate a patient's airway, breathing, circulation, disability, and vital signs. Conditions are categorized as requiring resuscitation, emergency treatment, urgent treatment, non-urgent treatment, or if the patient has no emergency condition. Based on findings in each section, the form determines the priority level of treatment needed.

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    © All Rights Reserved
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    of 1

    MR. 2/IGD/Rev.

    01/2019
    LEMBAR TRIAGE
    Nama Pasien : No. RM :

    Tanggal Lahir : Jenis Kelamin : L/P

    PRIMARY SURVEY

    TANDA
    PEMERIKSAAN FALSE
    RESUSITASI EMERGENCY VITAL URGENT NON URGENT
    (Examination) EMERGENCY
    (Vital Sign)

    JALAN NAFAS Bebas TD: Bebas


    (Airway) Sumbatan Bebas
    (Patent) (BP) (patent) Bebas
    (obstruction) (patent)
    ……..mmHg (patent)

    Henti nafas
    PERNAFASAN (breathing Arrest) Frek Nafas (RR) >32 x/mnt Frek nafas Frekuensi nafas (RR)
    (Breathing) (RR) 24-32 x/mnt
    Frek. nafas (RR) <10x/mnt Wheezing
    ……....x/mnt Wheezing
    Sianosis Normal Normal
    Apneu/megap-megap Neonatus: >80x/mnt atau Neonatus:>60x/mnt
    <40x/mnt
    Neonatus: <60x/mnt
    Sinosis
    Sinosis sentral,menetap Sinosis sentral,menetap sentral,menghilang
    dengan O2 dengan O2 dengan O2

    SIRKULASI Henti jantung Nadi teraba lemah Frek nadi Frek Nadi (HR)
    (Circulation) (Cardiac Arrest) (Weakness pulse) (HR) 120- 150 x/mnt
    ……....x/mnt
    Frek nadi (HR)
    Nadi tidak teraba Frek Nadi (HR)
    <50 x/mnt
    (Pulsene) Neonatus >160 x/mnt
    Frek nadi (HR)
    >150 x/mnt (Dws) TD Sist > 160 mmHg

    Frek. Nadi Neonatus Frek nadi (HR)


    <60x/mnt Neonatus: <100x/mnt Normal Normal
    TD Diast > 100 mmHg
    Pucat (pale) Pucat (Pale)

    Akral dingin Akral Dingin (Clammy)


    (Clammy)
    CRT < 2 detik

    Neonatus: CRT>3 detik Neonatus: CRT>3 detik


    Neonatus: CRT>3 detik
    KESADARAN GCS < 9 GCS 9-12 GCS >13 GCS 15 GCS 15
    (Disability) SUHU:……..
    Neonatus: < 36,5 °c Neonatus: < 36,5 °c (Tempt) >37,5 °c atau< 36,5 °c 36,5 °c - 37,5 °c 36,5 - 37,5 °c

    HAND OVER TIM JAGA : ★★


    RESUSITASI/BEDAH/INTERNA/KARDIO/OBGYN/
    ANAK/THT/NEURO/MATA/SYARAF
    Nyeri Luka bakar
    Keterbatasan gerak Gigitan
    Deformitas Tusuk
    Abrari V.Appetum
    Laserasi Ptichiae
    Konstusio Lainnya :

    ★★ Lingkari Kesimpulan

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