DRM : ..............

DINAS KESEHATAN TNI ANGKATAN LAUT

RUMKITAL DR RAMELAN
LEMBAR OBSERVASI PASIEN TINDAKAN PEMBEDAHAN
DENGAN MENGGUNAKAN LOKAL ANASTESI
Nama Pasien

Jam Mulai

Tanggal lahir / Umur

Jam Selesai

Jenis Operasi/Tindakan

Jenis Obat bius:

OBSERVASI
JAM

TD
^
V
Nadi

RR
O
Suhu
x

24
0
22
0
20
0
18
0
16
0
14
0
12
0
10
0
80
60
40
20
10

DRM : ..............
Kesadaran
Pernafasan
SpO2
Infus
Tranfusi
Perdarahan
Skala Nyeri

Komplikasi :
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Tindak lanjut :
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Surabaya,

2014
DPJP

Perawat

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