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MONITORING PASIEN TRANSFER

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Tabel Monitoring Pasien Transfer

<p><br></p><table class="table table-bordered"><tbody><tr><td style="text-align: center; "><b>KONDISI PASIEN</b></td><td style="text-align: center; "><p><b>SEBELUM TRANSFER</b></p><p style="text-align: left; ">Jam : .............................</p></td><td style="text-align: center; "><p><b>SELAMA TRANSFER</b></p><p><span style="text-align: left;">Jam : .............................</span><b><br></b></p></td><td style="text-align: center; "><p><b>SETELAH TRANSFER</b></p><p><span style="text-align: left;">Jam : ...............................</span><b><br></b></p></td></tr><tr><td><b>Keadaan Umum</b></td><td>Baik</td><td>Baik</td><td>Baik</td></tr><tr><td><b>Kesadaran</b></td><td><p>[  ] Compos Mentis</p><p><span style="background-color: transparent;">[  ]</span><span style="background-color: transparent;"> </span>Apatis</p><p><span style="background-color: transparent;">[  ]</span><span style="background-color: transparent;"> </span>Somnolen</p><p><span style="background-color: transparent;">[  ]</span><span style="background-color: transparent;"> </span>Sopor</p><p><span style="background-color: transparent;">[  ]</span><span style="background-color: transparent;"> </span>Koma</p></td><td><p>[  ] Compos Mentis</p><p><span style="background-color: transparent;">[  ]</span><span style="background-color: transparent;"> </span>Apatis</p><p><span style="background-color: transparent;">[  ]</span><span style="background-color: transparent;"> </span>Somnolen</p><p><span style="background-color: transparent;">[  ]</span><span style="background-color: transparent;"> </span>Sopor</p><p><span style="background-color: transparent;">[  ]</span><span style="background-color: transparent;"> </span>Koma</p></td><td><p>[  ] Compos Mentis</p><p><span style="background-color: transparent;">[  ]</span><span style="background-color: transparent;"> </span>Apatis</p><p><span style="background-color: transparent;">[  ]</span><span style="background-color: transparent;"> </span>Somnolen</p><p><span style="background-color: transparent;">[  ]</span><span style="background-color: transparent;"> </span>Sopor</p><p><span style="background-color: transparent;">[  ]</span><span style="background-color: transparent;"> </span>Koma</p></td></tr><tr><td><b>Tanda Vital</b></td><td><p>T : ...............</p><p>N : ...............</p><p>RR : ................</p><p>HR : ................</p><p>Skala Nyeri : .............</p><p>Tools :</p><p>[ v ] WONG BAKER</p><p><span style="background-color: transparent;">[  ]</span><span style="background-color: transparent;"> </span>NUMERIK</p><p><span style="background-color: transparent;">[  ]</span><span style="background-color: transparent;"> </span>CPOT</p><p>Lama Nyeri : ...........</p></td><td><p>T : ...............</p><p>N : ...............</p><p>RR : ................</p><p>HR : ................</p><p>Skala Nyeri : .............</p><p>Tools :</p><p>[  ] WONG BAKER</p><p><span style="background-color: transparent;">[ v ]</span><span style="background-color: transparent;"> </span>NUMERIK</p><p>Lama Nyeri : ...........</p></td><td><p>T : ...............</p><p>N : ...............</p><p>RR : ................</p><p>HR : ................</p><p>Skala Nyeri : .............</p><p>Tools :</p><p>[  ] WONG BAKER</p><p><span style="background-color: transparent;">[ v ]</span><span style="background-color: transparent;"> </span>NUMERIK</p><p>Lama Nyeri : ...........</p></td></tr><tr><td><b>Pemeriksaan Fisik</b></td><td><br></td><td><br></td><td><br></td></tr><tr><td><b>Catatan Hal Penting</b></td><td><br></td><td><br></td><td><br></td></tr><tr><td><b>Petugas</b></td><td><p><br></p><p><br></p><p style="text-align: center; ">....................................</p><p style="text-align: center; ">(Nama dan Tanda Tangan)</p></td><td><p style="text-align: center;"><br></p><p style="text-align: center;"><br></p><p style="text-align: center;">....................................</p><p style="text-align: center;">(Nama dan Tanda Tangan)</p></td><td><p style="text-align: center;"><br></p><p style="text-align: center;"><br></p><p style="text-align: center;">....................................</p><p style="text-align: center;">(Nama dan Tanda Tangan)</p></td></tr></tbody></table><p><br></p>

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