| Nama Item |
Nilai Item |
Urutan |
| Tanggal | 27/12/2024 | |
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| Asal | IGD | |
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| Tujuan | Ruang Cemara | |
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| Tabel Monitoring Pasien Transfer |
| KONDISI PASIEN | SEBELUM TRANSFER Jam : ............................. | SELAMA TRANSFER Jam : .............................
| SETELAH TRANSFER Jam : ...............................
| | Keadaan Umum | Baik | Baik | Baik | | Kesadaran | [ ] Compos Mentis [ ] Apatis [ ] Somnolen [ ] Sopor [ ] Koma | [ ] Compos Mentis [ ] Apatis [ ] Somnolen [ ] Sopor [ ] Koma | [ ] Compos Mentis [ ] Apatis [ ] Somnolen [ ] Sopor [ ] Koma | | Tanda Vital | T : ............... N : ............... RR : ................ HR : ................ Skala Nyeri : ............. Tools : [ v ] WONG BAKER [ ] NUMERIK [ ] CPOT Lama Nyeri : ........... | T : ............... N : ............... RR : ................ HR : ................ Skala Nyeri : ............. Tools : [ ] WONG BAKER [ v ] NUMERIK Lama Nyeri : ........... | T : ............... N : ............... RR : ................ HR : ................ Skala Nyeri : ............. Tools : [ ] WONG BAKER [ v ] NUMERIK Lama Nyeri : ........... | | Pemeriksaan Fisik |
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