DEATH

CASE
Penurunan Kesadaran
 Identitas Pasien
DEATH CASE

● Nama : Tn.B
● Jenis Kelamin : Laki-Laki
● Umur : 51Tahun
● Alamat : Marisa
● Pekerjaan : Wiraswasta
● Status Perkawinan : Menikah
● Agama : Islam
● Masuk RS : 25 Maret 2023
● No. RM : 1796
 Anamnesis
ANAMNESIS

• Keluhan utama : Penurunan Kesadaran

• Anamnesis Terpimpin : Pasien masuk dengan keluhan penurunan kesadaran disertai

dengan lemas (+) terdapat luka pada kaki kiri,batuk (-) sesak (-) mual (-) dan

Muntah (-) BAB & BAK biasa

 Riwayat Penyakit Dahulu
DEATH CASE

● Riwayat penyakit yang sama : -

● Riwayat stroke : Tidak ada
● Riwayat hipertensi : ada
● Riwayat diabetes melitus : ada
● Riwayat Kolestrol : ada
● Riwayat Asam Urat : ada
● Riwayat penyakit jantung : tidak ada
● Riwayat penyakit hati : tidak ada
● Riwayat batuk lama : tidak ada
● Riwayat bronchitis :tidak ada
● Riwayat trauma : tidak ada
● Riwayat penyakit atopi : tidak ada
● Riwayat Alergi : tidak ada
Riwayat Kebiasaan
● Riwayat Merokok : Tidak ada
● Riwayat Konsumsi alkohol : tidak ada
PEMERIKSAAN FISIK

Pemeriksaan Fisik Pemeriksaan Fisik

● Keadaan Umum : Lemah/ Somnolen ● Pernapasan : 28x/m

● Status Kesadaran : Kuantitatif : GCS 9 ● Suhu : 36,4 º C
(E2V3M4) ● SpO² : 91 %
● Tekanan Darah : 110/70 mmHg ● BB : 98 Kg
● Nadi : 99x/m ● TB : 169 cm
 Pemeriksaan Fisik
PEMERIKSAAN FISIK

Kepala THT
• Bentuk : normocephal • Telinga : bentuk normal, simetris, lubang lapang,
• Simetris wajah : simetris serumen (-/-)
• Hidung : bentuk normal, sekret (-/-)
• Rambut : rambut hitam, tidak mudah di cabut.
• Bibir : candidiasis oral, sianosis (-), pucat (-)
• Deformitas : tidak ada • Tonsil : T1-T1 hiperemis (-)
• Faring : hiperemis (-)
Mata • Lidah : kotor (-), tremor (-)
• Eksoptalmus/enoptalmus : (-) • Mukosa mulut : koplik spot (-)
• Gerakan : segala arah baik
• Kelopak mata : edema palpebra (-)
• Konjungtiva : anemis (-/-)
• Sklera : ikterus (-/-)
• Kornea : jernih
• Pupil : bulat, isokor
PEMERIKSAAN FISIK Pemeriksaan Fisik
Thoraks
Auskultasi
Inspeksi
• Bunyi nafas : vesikuler
• Bentuk : simetris kiri dan kanan
• Bunyi tambahan : Ronchi +/+ wheezing -/-
• Sela iga dalam batas normal, retraksi (-)
Jantung
• Pembuluh darah tidak ada kelainan
• Inspeksi : Iktus cordis tidak tampak,
• ikterus(-)
Palpasi • Palpasi : Iktus cordis tidak teraba.

• Tidak ada nyeri tekan • Perkusi : batas jantung kanan ICS IV line parasternalis dekstra,

• Fremitus raba sama kuat kiri & kanan batas kiri jantung ICS V linea midclavicularis sinistra
Perkusi • Auskultasi : S1/S2 murni reguler, murmur tidak ada.
• Batas paru hepar : ics vi dekstra anterior
• Batas paru belakang kanan setinggi columna vertebra thorakal ix dekstra
• Batas paru belakang kiri setinggi kolumn vertebra thorakal x sinistra
PEMERIKSAAN FISIK Pemeriksaan Fisik

Abdomen
• Inspeksi : ascites (-), ikterus(-)
• Auskultasi : peristaltik (+), kesan normal
• Palpasi : hepar dan lien tidak teraba
• Perkusi : Timpani
Ektremitas
• Inspeksi : Tidak ada deformitas, edem tungkai bawah (-) ,
ikterus(-)
• Palpasi : Akral teraba hangat
 Nama Test Hasil Satuan Nilai normal
PEMERIKSAAN PENUNJANG

Leukosit (WBC) 10.6 Ribu/uL 4,8-10.8

Eritrosit (RBC) 2,63 Juta/uL 3.90-5.50

Hemoglobin (HGB). 6,5 g/dL 11.3-14.1

Hematokrit (HCT) 20,9 % 31-41

MCV 79,5 fL 76-96

MCH 24,7 pg 23-31

MCHC 31,1 g/dl 32-36

Trombosit (PLT) 251 Ribu/uL 150-450

Kolestrol Total 120 Mg/dl < 220

HDL 36 Mg/dl > 45

LDL 69 Mg/dl < 160

Trigliserida 76 Mg/dl < 150

 Nama Test Hasil Satuan Nilai normal
PEMERIKSAAN PENUNJANG

Ureum 181 Mg/dl < 50

Kreatinin 13,3 Mg/dl < 1,2

GFR 3,80 mL/min/1,73m² .> = 90

Asam urat 9,7 Mg/dl < 7,0

SGOT 102 U/L < 37

SGPT 94 U/L < 42

GDS 1 55 mg/dl < 200

GDS 2 50 mg/dl < 200

Na 133 mmol/l 135-154

K 4,7 mmol/l 3,5-5,5

Cl 103 mmol/ 98-108

Calcium 1,0 mmol/ 1,1-1,35

PEMERIKSAAN PENUNJANG
 Penatalaksanaan Awal
DEATH CASE ● O2 Via NRM 10 Lpm

● Saction

● Gudel

● IVFD Asering 8 tpm

● Inj.citicolin 2 amp/iv

● Inj.Pantoprazole 1 vial/iv

DIAGNOSIS
Penurunan Kesadaran e.c ● Inj.D40% 2 flakon via bolus
Hipoglikemia + Ulkus Penatalaksanaan dr.saifuddin,sp.PD :
Diabetik + CKD stage V ● + 1 flakon D40% Bolus

● Lanjut Cairan D10% + 2 Flakon

D40% drips dalam cairan D10%

● Metronidazole 3x500 mg/iv

● Ceftriaxone 2x1 gr/iv

● Anjuran HD

● Pantau GDS Tiap Jam

DEATH CASE

25 Maret 2023

Followup

Pkul 06.25 Pkul 11.05

Pkul 07.30 GDS : 22 mg/dl
GDS : 50 mg/dl GDS : 50 mg/dl Pkul 09.33
GDS : 47 mg/dl Inj.D40% 2 flakon bolus Pkul 12.25
Inj.D40% 2 flakon bolus Inj.D40% 2 flakon bolus
GDS : 21 mg/dl
Inj.D40% 2 flakon bolus
Inj.D40% 2 flakon bolus
DEATH CASE

Pada Pukul 12.35 EKG Flat, Pupil

Midriasis, RR (-)
01
ABOUT THE DISEASE
Here you could describe the topic of the section
ABOUT THE DISEASE

Despite being red, Mars is actually a

cold place. The planet is full of iron
oxide, which gives the planet its reddish
cast

Jupiter is a gas giant and the biggest

planet in our Solar System. It’s also the
fourth-brightest object in the sky

Venus has a beautiful name and is the

second planet from the Sun. It’s terribly
hot and its atmosphere is extremely
poisonous
ABOUT THE DISEASE

MARS SATURN JUPITER MERCURY

Despite being red, Mars is
actually a cold place. It’s full
of iron oxide dust, which
gives the planet its reddish
cast
Venus has a beautiful name Jupiter is a gas giant and the
and is the second planet biggest planet in our Solar
from the Sun. It’s terribly System. It’s also the fourth-
hot, even hotter than brightest object in the sky
Mercury
Mercury is the closest planet
to the Sun and the smallest
one in the Solar System—
it’s only a bit larger than our
Moon
SYMPTOMS OF THE DISEASE

SATURN MARS JUPITER

This is the ringed one. It’s a gas Despite being red, Mars is actually a Jupiter is a gas giant and the biggest
giant, composed mostly of cold place. The planet is full of iron planet in our Solar System
hydrogen and helium oxide dust
RISK FACTORS

MAIN CAUSES DISEASE SPREAD

RISK GROUPS

If you want to modify this graph, click on it, follow the link, change the data
and replace it
 “This is a quote. Words full of wisdom that
someone important said and can make the reader
get inspired.”
—Someone famous
DIAGNOSIS

NEPTUNE SATURN

Neptune is the farthest planet from the Yes, this is the ringed one. It’s a gas
Sun and the fourth-largest by diameter in giant, composed mostly of hydrogen and
our Solar System helium
PREVENTION

RELAX HEALTHY FOOD

Despite being red, Mars is Mercury is the closest planet
actually a cold place to the Sun

CHECKUPS SPORT
Venus has a beautiful name, Neptune is the farthest
but it’s very hot planet from the Sun
TREATMENT

Despite being red, Mars is

actually a cold place

Jupiter is a gas giant and the

biggest planet

Neptune is the farthest planet

from the Sun

Venus has a beautiful name, but

it’s terribly hot

Mercury is the closest planet to

the Sun
PREVALENCE

Despite being red, Mars is

actually a cold place. It’s full of
iron oxide dust, which gives the
planet its reddish cast
CONCLUSIONS

MARS VENUS
Despite being red, Mars is Venus has a beautiful name,
actually a cold place but it’s very hot

MERCURY SATURN
Mercury is the closest planet Saturn is the ringed one. It’s
to the Sun a gas giant

JUPITER NEPTUNE
It’s the biggest planet in our Neptune is the farthest
Solar System planet from the Sun
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