CEKLIST OBAT & ALKES AMBULANCE RS MH THAMRIN CILEUNGSI

BULAN …………………….. 2017

Nama perbekalan farmasi Jumlah Sesuai Tiidak Ket

Sesuai
Stetoskop 1 ................ ................ ................
Tensimeter 1 ................ ................ ................
Endotracheal tube ( ETT )
Ukuran 6,5 | 7 | 7.5 1|1|1 ................ ................ ................
Laringoscope
blade besar | sedang | kecil 1|1|1 ................ ................ ................
Airway

Magill forceps dewasa | anak 1|1 ................ ................ ................

Xylocain spray 1 ................ ................ ................
Spuit 3 cc 2 ................ ................ ................
Spuit 5 cc 2 ................ ................ ................
Spuit 10 cc 2 ................ ................ ................
Spuit 20 cc 2 ................ ................ ................
Suction catheter
Ukuran 8 | 10 | 12 1|1|1 ................ ................ ................
Gunting 1 ................ ................ ................
Hypafix 5 x 5 cm 1 ................ ................ ................
Micropore 1 inch 1 ................ ................ ................
Intubation stylet/Mandrain
Ukuran M | L 1|1 ................ ................ ................
Sarung tangan 10 pasang
................ ................ ................
Ambu bag dewasa 1 ................ ................ ................
Ambu bag anak 1 ................ ................ ................
Gudel
Ukuran 8 1 ................ ................ ................
Breathing

Ukuran 7 1 ................ ................ ................

Face mask dewasa 1 ................ ................ ................
Face mask anak 1 ................ ................ ................
Selang oksigen dewasa 2 ................ ................ ................
Selang oksigen anak 2 ................ ................ ................
Non rebreathing mask (dewasa) 1 ................ ................ ................
Non rebreathing mask (anak) 1 ................ ................ ................
Infus set 1 ................ ................ ................
Blood set 1 ................ ................ ................
Circulation

Vasofix
Ukuran 18 | 20 | 22 | 24 | 26 1|1|1|1|1 ................ ................ ................
Alcohol swab 10
Threeway stop cock 2
- Epinephrine inj 10
- Valisanbe inj (Diazepam) 2
- Farsix inj (Furosemid) 5
Obat-obatan

- Aminophilin inj 2
- Cortidex inj 5
- Ondansentron 8mg inj 3
- Acran inj 3
- Atropin sulfat inj 20
- Phenytoin inj 2
- Water Injection 2