UFEME FBC

Glu : DM WBC: 4-11

Bilirubin : Hepar problem (Negative) NEU: Bacteria infection (2.0-7.5,54-62%)
Ketone: Carbohydrate problem (Nil) LY: increase=virus (1.0-3.5,25-33%)
Specific Gravity : Kepekatan Urine (1.005-1.025) MO :poisoning (0.2-0.8,3-7%)
EO: parasit (0.0-0.4)
Blood : UTI (Nil)
BA: Allergic reaction (0.0-0.2,0-0.75%)
pH: Calculi (4.5-8, normal acidic)
RBC: 4.5-6.5
Protein: Renal, Glomerulus problem (<150mg/d) HGB: M=13.5-18, F=11.5-16.5
Urobilinogen : Hepar problem (0.5-1mg/dl) HCT: M=48-54, F=35-41
Nitrate :Increase-infection(Negative) MCV: 10-96
WBC: infection, keruh (<2-5) MCH: warna darah (26-39)
Leu:infection (negative) PLT:150-450

IV DRIP ECG
Jumlah amount x drop factor (20 titis/min) 1) Heart rate: 60-100,300/kotak besar,1500/kotak
Jumlah masa (minit) kecil, 3-4 kotak besar normal

2) Rhythm: ada PQRST, xde P=junctional rhytm

IV INFUSION PUMP
3) P wave : Atrial Flutter, Bifid
Jumlah amount (ml) / 60 x ?cc =
Jumlah masa (jam) ? hour 4) Q wave: tinggi P+Q=0.08=deep Q=old infact
(2 kotak kecil)
MEDICATION DOSAGE
Req dose(mg) X stock volume(ml) = Volume 5) QRS :PVC=ectopic, RBBB=MiRRor, LBBB=WiLLiam
stock dose(mg) given

6) ST Segment: Angina (depress 2 kotak), MI PAEDRIATRIC V/S

( elevate 2 kotak), Pericarditis: curve ST Respiratory Rate Blood Pressure(mmhg)
<1 = 30-40/min < 1 years =80-90
7) RR interval : 1st degree =PR prolonged(xlebih 1-2=25-35/min 1-2 years = 85-95
1 kotak besar) , 2nd degree , Mobitz 1= PR+1QRS, 2-5=25-30/min 2-5 years = 85-100
Mobitz 2= PR+2QRS, 3rd degree =complete heart 5-12=20-25/min 5-12 years = 90-110
block(P+QRSx related) Heart (Pulse)/min >12 years = 100-120
Newborn = 125 6= 100
8) T wave: Tall T : hypercalemia (5 kotak kecil) , T 1-11=120 8= 90
inverted: Angina 2 = 110 10=90
4 = 100

LIFE THREATENING CONDITION OF LIFE THEARTENING (6H5T)

Hypovolumic Hyper/Hypocalemia
A = Airway Obstruct Hypoglycemia Hydrogen ion (acidosis)
T = Tension Pneumothorax Hypothermia
O = Open Chest Wound Hypoxia
M = Massive Haemothorax
F = Flail Chest Tamponade Trauma
C = Cardiac Tamponade Toxins
Thrombosis
Tension Pneumothorax

~ Ikhlas Daripada Harith Baharudin’Ritz .. Selamat Maju Jaya kawan kawan 

GCS COCKTAIL FOR HYPERKALEMIA
EYE VERBAL 1) 10mg Calcium Gluconate run in 10min (1g in
Spontaneous =4 Orientated =5 1min)
To call = 3 Confused =3 2) 50cc Dextrose 50%
To pain = 2 Inappropriate word =3 3) 10 unit Insulin
No response =1 Inappropriate sound
No response =1 FAST CORRECT FOR HYPOCALEMIA
MOTOR 1g of KCL + 100cc N/S
Obey command =6 Flexion to pain = 3
Localize pain =5 Extension to pain = 2
Withdrawl pain =4 No response = 1

HEAD INJURY ( BP High + Pulse Low) TYPES OF BLOOD LOSS

 GCS drop  Type I – 1-15% 1 blood : 3 kristaloid
 Pupil unequal  Type II – 15-30% 1 blood : 1 koloid
 Altered mental status  Type III – 30-40%
 ENT bleed  Type IV - >40%
 Racoon eye STOP BLEEDING = compress, bandage, elaveta,
ice pack, tornique, t&s,direct pressure,adrenaline
INTRAABDOMINAL INJURY pack,cambac bac,cautherazation,ligate,tranxemix
(BP Low + Pulse High) acid,glu stich,splint
 Hypovolumic Shock TANDA2= pallor(CRT<2s), BP low, tanda2
shock,tachy,cold/clamines

CERVICAL SIGN SECONDARY SURVEY ( SAMPLE)

1) NSAID S- Sign and Symptoms P –Past Medical
 N- Neurological deficit (confused) A – Allergic L- Last oral intake
 S- Spinal Tenderness M- Medication E - Event lead to injury
 A- Above clavicle injury
 I – Intoxicity (mabuk)  Rapid Assestment = head – toe
 D – Distracting pain  Focus Assestment = Fast scan (nak tengok
2) Hematoma di kepala 5) CFS fluid dlm darah internal organ)
3) Ada battle sign ( tengok bila letak gauze x  V/S monitoring
4) ENT Bleeding x campur dengan darah)  Pulse Rate= Rate+Rhythm

FEVER INFECTION SASARAN GLUKOSA (mmol/L)

Neutrophil High + Lymphosite Low = Viral Sebelum makan (puasa) = 4-6
Neutrophil Low + Lymphosite High = Bacteria 1 ½ -2 jam selepas makan = 4-8
Sebelum tidur (snack) = 7-8
ATRIAL BLOOD GASES (ABG) 3-4 pagi = 3.5-7
pH CO2
 Respiratory Acidosis Low High SYRUP PCM FOR PAED
 Respiratory Alkolosis High Low
 Metabolic Acidosis Low Normal Body weight (Kg) x 15mg = ? ml
 Metabolic Alkolosis High Normal 24

~ Ikhlas Daripada Harith Baharudin’Ritz .. Selamat Maju Jaya kawan kawan 

7Ps INTUBATION
1) Prepaartion: ( look for difficult intubation) look
externally,malampati,obstruction,neck mobility
2) Pre Oxygenation – 100% O2 by NBM
3)Pre Treatment = LOAD
(Lignocaine,Opiate,Atropine,Depolarizing(Suxa))
5) Pressure: BURP
(Backward,Upward,Rightward,Pressure)
6)Placement :Auscultation
7) Rest intubate care : cardiac monitoring , V/S
monitoring, CBD , Ryle Tube , Suction , Sedation,
Fluid, Temperature

4) Paralysis

INTUBATION (LEMON + SOAP + ME) PUPIL

L = look (obesity,short neck,facial trauma)  Look for = Size / Equality for both /
E = Evaluate( Difficult intubate 2:3:2) Reaction to light
M = Mallampati  Normal size = 3mm
O = Obstruction (Foreign Body)  Confirm death =Fixed dilated (8mm)
N = Neck Mobility  Change when
M= Monitoring (V/S) 1. Coma
S = Suction E = Equipment 2. Drug Overdose(pin point)
O = O2 3. Less O2 supply (1 kecil,1 besar)
A = Airway equipment 4. Medication =midracyl
P = Pre Medication

SHOCK AIRWAY DEVICES

Jenis = Hypovolumic, Cardiogenic, Septic, 1) Nasal Pronge: 1-6L
Neurogenic, Anafilaktik 2) Face Mask :5-10L
Tanda2 = 3) Venti Mask: adjustable
1) Cold and Clamines (<35°c) 7) Pallor/ CRT <2s 4) High Flow mask
2)Berpeluh sejuk 8) Cyanosis
1. Rebreather: 80-90% O2(include O2 luar),
3) BP Low
4)PR High contraindication : apnea pt
5) Pt Confuse 2. Non Rebreather : 90-100% 02 supply
6) Dehydration(Skin turgor,cutted bud,Shanken 5)BVM : Max 1.5L , Adult=700m, Clamp
Eye,bibir kering)

ADJUNT AIRWAY (Backup Airway) 3) Laringeal Mask Airway (LMA)

1) Oropharangeal Airway (OPA) // Airway Girdle - Ukur – Sukat ikot berat badan
- Ukur = middle of mouth to angle of jaw - Dewasa – Size 4 to Size 5 , >70Kg =Size 4
- Indikasi = buka airway, pt unconscious - Indikasi = difficult intubation , no gag reflex
- Contra = pt ada gag reflex, facial injury - Cuff Ballon = 20 to 30cc udara

2) Nose Pharngeal Airway (NPA)

-Ukur = tip of nose to tragus
-Indikasi = pt unconscious, pt ada gag reflex, OPA
xleh guna

~ Ikhlas Daripada Harith Baharudin’Ritz .. Selamat Maju Jaya kawan kawan 

SIMPLE MANAGEMENT FAST MANAGEMENT (Synchronize 50,100,150)
AMI APO 1) Fast AF
M = Morphine L = Lasix 1. Synchronized
O = O2 M = Morphine 2. Pharmocology =
N = Nitrate (GTN) N = Nitrate (isoket)  Digoxin (0.2 @ 0.5mg in 50cc NS)
A = Aspirin O = O2 run ½ @ 1 hour
C = Clopidogrel (Plavix) P = Posture  Amidarone 150mg (10min)
2) SVT
DEFIBRILATION (200J)  Adenosine 6mg,12,12 then
VF defib(synchronize)
VT Pulseless  Adenosine 6mg, flush 20ml

TAGGING (Triage at Site) ECG ANATOMIC GROUP

R (Respiration)
 < 30 =Yellow I aVR V1 V1
 > 30 = Red Lateral None Septal Anterior
P (Perfussion)
 < 2 Sec = Yellow II aVL V2 V5
 > 2 sec = Red Inferior Lateral Septal Lateral
M ( Mental Status)
 Orientated = Yellow III aVF V3 V6
 X Orientated = Red Inferior Inferior Anterior Lateral

~ Ikhlas Daripada Harith Baharudin’Ritz .. Selamat Maju Jaya kawan kawan 