Presentasi Nearmiss Ny. Darmi

7/23/2019 Presentasi Nearmiss Ny. Darmi

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PRESENTASI KASUSNEARMISS

P3104 Ab000Post Partum Luar < 24 jam

denan Retens!o P"a#enta $S%o#& '!(o)o"em!



I*ENTITAS PASIEN

Re!ster + 3,31-4

Nama + N./ *arm!

Umur + 40 ta%un

A"amat + oomu".an T!rto.udo



P datan &e I*tana" 30,201- Pu&u"05/006K!r!man 7PMSu&art! denanretens!o ("a#enta

ANAMNESA + T" 30,201-

Pu&u" 03/10 + (as!enme"a%!r&an ba.! d!ruma% d!to"on &e"uara

send!r!Pu&u" 03/30 + d!ba8a &e7PM Su&art! d!"a&u&an(emotonan ta"! (usat

Ar! ar! t!da& "a%!r "eb!%dar! 30 men!t*!ruju& &e RSU*

Kanjuru%an



*! IR*

• Pemer!&saan 9!s!& + – Keadaan umum + #u&u(

– T* + 4:;1 mm'

–

Nad! + 142 ;mnt – SP=2 + :0>

• Ke(a"a+ &onju#t!)a anem!s $;$

• Abdoment + T9U set!n! (usat U? "embe&

• eneta"!a + @T + );) dara% $ sto"se"

(embu&aan 4#m teraba("a#enta



T!nda&an

•

Pasan o&s!en sun&u( 10 "(m• Pos!s! s%o#&

• Perba!&an &u atas! s%o#&

• Pasan !nBus 2 "!ne dr!( o&s!tos!n 2 am(u"

• Pasan *?

• Pasan bedset mon!tor

• La(or dr I7P a;( + –

Atas! s%o#& – Inje&s! &a"ne 1 am(u"

– ?%e#& "ab

– TranBus! dara% 3 PR? dan 2 C7

–

7!"a &u ba!& (!nda% &e &amar bersa"!n



'as!" "aborator!um

• HB : 4 gram %

• Leuko : 34.430 cell/cmm

• Trombo : 227.000 cell/cmm

• PCV : 11,8• r!"ro#!" : 1,$$ 10/cmm

• &'( : 2)8

• (&*T : 30

• (&PT: 10

• +reum : 1$

• rea"!-!- : 0,3



am 0,/00

S : pusingO : ku lemah anemis +/+

TD : 70/60mmHg nadi :112x/mnt

Tindakan :• Infus 2 line lanut• T!anfusi la"u ke 2

"e!langsung• O"se!#asi ketat• $en%ana pindah

kama! "e!salin

*I KAMAR 7ERSALIN 30 , 201- j



*I KAMAR 7ERSALIN 30,201- jam0/00a/ Pemer!&saan Umum

Keadaan umum + #u&u(

&esadaran +?=MP=SMENTIS

Te&anan dara% + 0;50 mm'Nad! + 100 ;men!t

Su%u + 35-RR + 20 ;men!tS(=2 + 5 >b/ &eme!iksaan 'isik • ("d)men :

Inspeksi : anemis +/+

&alpasi : T'* setinggi pusat u%"aik #/ &eme!iksaan dalam :

#/# da!ah + st)lsel pe!da!ahan tidak aktif

p) "uka ,%m te!a"a se"agian pla%enta



Tindakan

1/ InBus 2 "!ne dr!( o&s!to#!n 2 am(u"d!"anjut&an

2/ =2 sun&u( 10 "(m ter(asan

3/ Pasan mon!tor TT@

4/ TranBus! "abu &e 4 sedan ber"ansun

-/ Ko"aboras! S(/= a;( +

– La&u&an Manua" ("a#enta

– Inje&s! ant!b!ot!&a 1 ram

– =bser)as! (erdara%an

–

?%e#& 'b (ost tranBus!



jam 10.00

Ku + #u&u( T* + 100;50

Nad! + 2;mnt

SP=2 + >P"e#enta "a%!r manua" bers!%

T!nda&an +

• TranBus! "abu &e - sedan ber"ansun

• =bser)as! U? PP@

• Member!&an m!num man!s %anat



-.(*(SI

Tanggal 02013 am 12400S : O : k/u %ukup kesada!an :%)mp)smentis

T : 1,0/ mmHg 5 :

100x/mnt&&. n)!mal



Tindakan :• Infus 2 line + D lan%a!

• m)nit)! TT. te!pasang

• Oksigen te!pasang

• T!anfusi la"u ke 3 ha"is am 11400

• ek H" 6 am p)st t!anfusi dgn hasil :

– HB : $,) gram %

– Leuko : 18.200 cell/cmm

– Trombo : 107.000 cell/cmm

– PCV : 2,2 %

– r!"ro#!" : 3,23 10/cmm

P31004Ab000 (ost (artum "uar < 24 jam denan (ost

manua" ("a#enta



P31004Ab000 (ost (artum "uar %ar! I denan (ost manua"

("a#enta

Tana" 31,201-

&;u #u&u( T + 140;0 u# $6 ba!& (() $6

norma" 'b (ost tranBus! ->

Tx :

Infus + D lan%a! m)nit)! TT. te!pasang m)"ilisasi 8+9 diit 5STT&

#isite d! DSO; a/p :• (nti"i)tik ta" x1 ta"• $)")!antia 2x1 ta"• &indah !uang pe!a<atan



P31004Ab000 (ost (artum "uar %ar!

II denan (ost manua" ("a#enta

k/u %ukup T : 120/0 u% 8+9 "aik pp#8+9 l)%hea !u"!aTindakan : Infus + D a= m)"ilisasi Diit 5STT&

tx /)s :• >p!ex x1 ta"• ;!af)la 2x1 ta"

• .isite d! SpO; a/p : ?&



T-$I@( (SIHA

Presentasi Nearmiss Ny. Darmi

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