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  • DEATH CASE Romi Anak

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    RomiyantiSimak
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    Anugrah Lanes, a 2-year-old boy, was brought to the emergency room with decreased consciousness that had begun earlier. On examination, he had a fever, rapid heart rate, decreased consciousness, and yellowish skin pigmentation. Tests found anemia, leukocytosis, hyponatremia, and hypokalemia. He was diagnosed with meningoencephalitis, sepsis, and pneumonia but his family refused a transfer to another hospital. His condition deteriorated over the following days despite treatment until he went into cardiac arrest and was declared dead.

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    Multi organ failure ec sepsis

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    DEATH CASE romi anak

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    Anugrah Lanes, a 2-year-old boy, was brought to the emergency room with decreased consciousness that had begun earlier. On examination, he had a fever, rapid heart rate, decreased consciousness, and yellowish skin pigmentation. Tests found anemia, leukocytosis, hyponatremia, and hypokalemia. He was diagnosed with meningoencephalitis, sepsis, and pneumonia but his family refused a transfer to another hospital. His condition deteriorated over the following days despite treatment until he went into cardiac arrest and was declared dead.

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    © All Rights Reserved
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    14 views13 pages

    DEATH CASE Romi Anak

    Uploaded by

    RomiyantiSimak
    Anugrah Lanes, a 2-year-old boy, was brought to the emergency room with decreased consciousness that had begun earlier. On examination, he had a fever, rapid heart rate, decreased consciousness, and yellowish skin pigmentation. Tests found anemia, leukocytosis, hyponatremia, and hypokalemia. He was diagnosed with meningoencephalitis, sepsis, and pneumonia but his family refused a transfer to another hospital. His condition deteriorated over the following days despite treatment until he went into cardiac arrest and was declared dead.

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    © All Rights Reserved
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    of 13

    Death Case

    RSU MANADO MEDICAL CENTER


    Identitas Pasien
    Nama : Anugrah lanes

    Usia : 2 tahun

    Jenis Kelamin : Laki- Laki

    Alamat :

    MRS : 31 Juli 2021


    Keluhan Utama :
     Pasien datang dengan keluhan penurunan
    kesadaran. Penurunan kesadaran dialami
    pasien sejak..
    Physical Examination
    TD = 90/60 mmHg HR = 128 bpm, teratur, kuat RR = 24tpm, teratur T : 38 8°C
    angkat
    Keadaan umum tampak sakit berat

    Kepala Konjungtiva pucat(-/-), Sklera ikterik (-/-)


    Pembesaran KGB (-)
    Peningkatan JVP (-)
    Kulit Turgor cepat kembali, pigmentasi kulit kuning langsat

    Chest Jantung: BJ I-II reguler, Bising (-)

    Paru: I – simetris ki =ka


    P= SF ki=ka
    P = sonor +/+
    A= sp. Vesikuler rh +/+ wh -/-

    Abdomen I = datar
    A= Bu+
    P= lemas, NTE +
    P+ timpani
    Extremities Akral hangat, CRT <2”
    Follow Up ruangan tgl 31/07/2021
    Jam 20.30
    Subjek Objective Assessment P.Tx

    1. Kejang VS Penurunan kesadaran ec IVFD RL 14gtt


    2. Demam BP: 90/60 mmHg meningoensefalitis dd 02 1-2 lpm nc
    3. Penurunan HR: 128 x/m encephalitis dd sepsis Ceftriaxone 1x750mg iv
    kesadaran RR: 24x/m Sepsis ec pneumonia Dexametason 3x1 amp iv
    T: 38°C Ranitidin 2x15mg iv
    Paracetamol drips jika sb> 38,5
    Kep: ca - , si – Injeksi diazepam 1,5mg iv bila kejang
    Tho: rh+, wh-
    Abd: datar, lemas,
    bu(+)N, nte+
    Ext: akral hangat
    Laboratory Result 31/07/2021
    Items Result Normal Value Unit

    Hematology

    Hemoglobine 14,5 12.00 - 16.00 g/dl

    Leukocyte 13.100 4.0 – 10.5 thousand/ul

    Eritrocyte 4,82 4.50 – 6.00 million/ul

    Hematocrit 31,6 42.00 – 52.00 Vol%

    Trombocyte 208.000 150 – 450 Ribu/ul

    RDW-CV 11,2 11,5-14,7 %

    MCV 65,7 80.0 – 97.0 Fl

    MCH 30,0 27.0 – 32.0 Pg

    MCHC 45,8 32.0 – 38.0 %


    Laboratory Result 27/07/2021

    Items Result Normal Value Unit

    Natrium 131 135 - 150 Mmol / L

    Kalium 2,6 3,5 – 5,5 Mmol / L

    Chlorida 92,3 96,0 – 108,0 Mmol / L

    Rapid sarscov NR

    -
    Follow Up Ruangan tgl.

    Subjek Objective Assessment P.Tx

    1. Kejang VS Penurunan kesadaran ec Ceftriaxone ganti cefotaxime 3x500mg


    2. Demam BP: 90/60 mmHg meningoensefalitis dd iv
    3. Penurunan HR: 104 x/m encephalitis dd sepsis -Terapi lanjut
    kesadaran RR: 22x/m Sepsis ec pneumonia
    T: 36°C Keluarga menolak rujuk

    Kep: ca- si-


    Tho: rh- wh-
    Abd: datar, lemas,
    bu(+)n, nte –
    Ext: akral hangat
    Follow Up Ruangan tgl. 20/09/2020
    jam 08.00

    Subjek Objective Assessment P.Tx

    1. Kejang VS - Terapi lanjut


    2. Demam BP: 90/60 mmHg Penurunan kesadaran ec
    3. Penurunan HR: 104 x/m meningoensefalitis Keluarga menolak rujuk
    kesadaran RR: 22x/m dd encephalitis dd
    T: 36°C sepsis
    Sepsis ec pneumonia
    Kep: ca- si-
    Tho: rh- wh-
    Abd: datar, lemas,
    bu(+)n, nte –
    Ext: akral hangat
    Follow Up Ruangan tgl.

    Subjek Objective Assessment P.Tx

    1. Kejang VS - Terapi lanjut


    2. Demam BP: 90/60 mmHg Penurunan kesadaran ec
    3. Penurunan HR: 104 x/m meningoensefalitis
    kesadaran RR: 22x/m dd encephalitis dd
    4. BAB cair T: 36°C sepsis
    Sepsis ec pneumonia
    Kep: ca- si-
    Tho: rh- wh-
    Abd: datar, lemas,
    bu(+)n, nte –
    Ext: akral hangat
    Follow Up Ruangan

    Subjek Objective Assessment P.Tx

    Penuruna kesadaran VS Penurunan kesadaran ec IVFD guyur 250cc


    BP: 77/29 mmHg meningoensefalitis dd Obs ttv
    HR: 104 x/m encephalitis dd sepsis
    RR: 22x/m Sepsis ec pneumonia 02 6 lpm sungkup anak
    T: 36°C
    Menolak rujuk RS kandou
    Kep: ca- si-
    Tho: rh- wh-
    Abd: datar, lemas,
    bu(+)n, nte –
    Ext: akral hangat
    Follow Up Ruangan tgl. 21/09/2020
    jam 09.00

    Subjek Objective Assessment P.Tx

    1. Nadi carotis tidak VS Penurunan kesadaran ec - RJP 30 siklus


    teraba Ku berat meningoensefalitis dd
    Kesadaran coma encephalitis dd sepsis - Inj.epinefrin 1/2 amp jam 05.50
    Tensi tidak terukur TD : tidak terukur Sepsis ec pneumonia
    pada monitor N : tidak teraba Nadi carotis tidak teraba, pupil
    Gambaran ekg asistol R:- midriasis maksimal, ekg asistol
    pada monitor SB : -
    Pasien dinyatakan meninggal jam
    05.50
     TERIMA KASIH

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