Ruang ………IGD………….
KONDISI
NO NAMA BARANG JUMLAH ED KETERANGAN
BAIK TIDAK
LACI 1
1 Aminophylline inj 5 Aug-24 √
2 Amiodarone inj 5 Jun-23 √
Asam Tranexamat inj 500 mg/5 Apr-23 &
3 5 √
ml Dec-22
4 Atropin Sulfas inj 5 Dec-22 √
5 Calcium Gluconas inj 5 Jan-23 √
6 Dexamethasone inj 5 Mei-23 √
7 D 40% ampul 5 Mei-23 √
8 Diazepam inj 5 mg 5 Jan-23 √
9 Dobutamine inj 50mg/ml 5 Jan-23 √
10 Dopamine inj 200mg/ml 5 Sept-22 √
11 Ephedrin inj 5 Apr-22 √
12 Ephinephrin inj 5 Aug-23 √
13 Furosemide inj 20 mg 5 Jul-23 √
Apr-23 (3)
14 Heparin inj 5 √
Jun-23 (2)
Juli-22 (3)
15 Lidocain inj 5 √
Des-23 (2)
16 Meylon 8,4% ampul 5 Apr-22 √
17 MgSO4 40% ampul 5 Mei-23 √
18 Nikardipin inj 5 Apr-22 √ Tukar ED
19 Nikardipin inj 5 Mar-23 √
Oct-22 (1)
20 Norephinephrin inj 5 √
Dec-22 (4)
21 WFI 25 ml 5 Feb-23 √
Jun-23 (1)
22 Midazolam 5 √
Jul-23 (4)
23 Propofol 5 Apr-23 √
24 Fentanyl 5 Mar-23 √
25 Clopidogrel 75 mg 6 Aug-23 √
26 ISDN 5 Mar-23 √
27 Miniaspi 80 mg 5 Nov-22 √
28 Nalaxon (nokoba) 2 TAP √
29 Stesolid rektal tube 10 mg 2 Feb-24 (1) √
Jan-24 (1)
30 Stesolid rektal tube 5 mg 5 √
Jan-23 (4)
KONDISI
NO NAMA BARANG JUMLAH ED KETERANGAN
BAIK TIDAK
LACI 2
KONDISI
NO NAMA BARANG JUMLAH ED KETERANGAN
BAIK TIDAK
LACI 3
1 Spuit 1 cc 5 Mei-25 √
2 Spuit 3 cc 5 Mei-26 √
3 Spuit 5 cc 5 Jun-26 √
4 Spuit 10 cc 5 Jun-26 √
Jan-25 (4)
5 Spuit 20 cc 5 √
Sept-23 (1)
6 Spuit 50 cc 5 Nov-24 √
7 Spuit 60 cc catheter trip 1 Sept-24 √
8 Elektroda 5 Mar-24 √
9 IV Catheter No. 18 5 Sept-23 √
Jul-23 (3)
10 IV Catheter No. 20 5 √
Mei-26 (2)
Mei-23 (3)
11 IV Catheter No. 22 5 √
Mei-26 (2)
Feb-26 (4) √
26 Urine Bag 5 Sept-22 (1)
√
Apr-26 (4)
27 Infus set macro 5
Apr-22 (1)
28 Infus set Micro 5 Mei-24 √
LACI 5
1 Dextrose 10% 500 ml 5 Jan-23 √
2 NaCl 0,9% 500 ml 5 Feb-25 √
3 Ringer Laktat 500 ml 5 Mei-23 √
4 Gelofusal 1 Aug-22 √
5 Handscoon steril No 6,5 1 Sept-24 √
Handscoon steril No 7 (exam √
6 1 Jul-25
glove)
7 Handscoon Steril 7,5 1 Sept-24 √
8 LMA No. 3 1 Sept-24 √
9 LMA No. 4 1 Sept-22 √
10 ETT No 3,0 Uncuff 2 TAP √
11 ETT No 3,5 UNCUFF 2 TAP √
12 ETT No 4,0 2 TAP √
13 ETT No 4,5 CUFF 1 Aug-24 √
14 ETT No 4,5 UNCUFF 1 TAP √
15 ETT No 5,0 UNCUFF 1 Apr-22 √
16 ETT No 5,5 CUFF 2 Apr-22 √ Tukar ED
Mengetahui
Kepala Instalasi Farmasi
RSUD Kebayoran Lama
Arnelia, Apt
SIPA : 15/B.19/31.74.05.1006.07.010.S.2/3/-1.779.3/e/2020