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STATUS COASS

Orthopedic Department
Fakultas Kedokteran
Universitas Alkhairaat Palu
I.

Identity
Name
Age
Gender
Address

Job

Date
:
:

:
:

Room
Hospital

:
:

General Condition :
II.

Anamnese (Auto/Allo)
Chief Complaint
:

Trauma mechanism :

III.

Physical Examination:
Primary Survey
A :
B

: Lungs
Inspection

Palpation:

Percussion

Auscultation:

: TD

mmHg ,

Pulse

x/m

Secondary Survey
Head :
Neck :
Thorax

Abdomen
:
Inspection

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STATUS COASS
Orthopedic Department
Fakultas Kedokteran
Universitas Alkhairaat Palu

Auscultation:

Palpation:

Percussion

Genital

Extremity :
Superior :
Inferior :
Located State
Look

Feel

ROM

IV.

Resume

V.

Early Diagnose

VI.
Laboratory:

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STATUS COASS
Orthopedic Department
Fakultas Kedokteran
Universitas Alkhairaat Palu
Radiology:

VII.

Therapy

VIII.

Prognose

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