RSU BUNGA BANGSA MEDIKA

Jl.Lili, Kembang, Maguoharjo Kec.Depok,

Kabupaten Sleman, Yogyakarta
Telp 02742803000
CHECKLIST EMERGENC
TAHUN 2023
Bulan :
Ruangan : Kamar Bedah

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TOP SHELF
1 Ambubag anak 1 Set
2 Ambubag dewasa 1 Set
3 DC-Shock 1 Set
4 Elektroda anak 5 Pcs
5 Elektroda dewasa 5 Pcs
6 Laringoscope anak 1 Set

7 Laringoscope Dewasa 1 Set

8 Pen light 1 Pcs

9 Refleks hammer 1 Pcs
10 Stetoskop anak 1 Pcs
11 Stetoskop dewasa 1 Pcs
12 Tounge spatel besi 1 Pcs
DRAWER 1
1 Aminopillin Inj 240 mg 2 Amp

2 Ca Glukonas inj 2 Amp

3 Cordarone inj 2 Amp
4 Dobuject inj 2 Amp
5 Dopamin inj 2 Amp

6 Epinephrine 1 mg / 1ml 20 Amp

7 Herbesser inj 50 mg 2 Amp

8 Kalmethasone inj 2 Amp
9 Lasix inj 20 mg 2 Amp
10 Lidocaine 20mg/ml 2 Amp
11 Ns 0,9% 25 Ml 5 Pcs
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12 Phenitoin Inj 100 mg 2 Amp

13 Raivas Inj 4 mg 2 Amp
14 SA inj 0,25 mg / ml 20 Amp
15 Sedacum Inj 1 Amp
16 Syringe 1 ml 5 Pcs
17 Syringe 3ml 5 Pcs
18 Syringe 5ml 5 Pcs
19 Syringe 10ml 5 Pcs
20 Syringe 20ml 3 Pcs
21 Syrnige 50ml 3 Pcs
22 Valisanbe Inj 5 mg 2 Amp

DRAWER 11
1 Alkohol swab 10 Pcs
2 Blood set infus 2 pcs
3 Ekstension tube 150 2 pcs
4 Intrafix Safeset 2 pcs
5 Michropore 0.5 inci 1 Roll
6 Michropore 1.0 inci 1 Roll
7 Needle no. 18 G 2 pcs
8 Needle no. 20 G 2 pcs
9 Needle no. 23 G 2 pcs
10 Neoflon No. 24G 2 pcs
11 Neoflon No. 26G 2 pcs
12 Tegaderm 1610 2 pcs
13 Tegaderm 1633 2 pcs
14 Three way biasa 2 pcs
15 Three way buntut 2 pcs
16 Torniquet 1 Pcs
17 Vasofix No 16G 1 Pcs
18 Vasofix No 18G 2 pcs
19 Vasofix No 20G 2 pcs
20 Vasofix No 22G 2 pcs

DRAWER 111

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1 ETT Cuff No 5 1 Pcs

2 ETT Cuff No 5.5 1 Pcs
3 ETT Cuff No 6.0 1 Pcs
4 ETT Cuff No 6.5 1 Pcs
5 ETT Cuff No 7 1 Pcs
 6 ETT Cuff No 7.5 1 Pcs
7 ETT Cuff No 8 1 Pcs
8 ETT Uncuff No 2.5 1 Pcs
9 ETT Uncuff No 3 1 Pcs
10 ETT Uncuff No 3.5 1 Pcs
11 ETT Uncuff No 4 1 Pcs
12 ETT Uncuff No 4.5 1 Pcs
13 Goedel No. 0 1 Pcs
14 Goedel No. 1 1 Pcs
15 Goedel No. 2 1 Pcs
16 Goedel No. 3 1 Pcs
17 Goedel No. 4 1 Pcs
18 Goedel No. 5 1 Pcs
19 Gunting kassa 1 Pcs
20 Hipavix 10 x 5 1 Pcs
21 Mandrain Adult 1 Pcs
22 Mandrain Anak 1 Pcs
23 Mandrain Bayi 1 Pcs
24 Margil forcep anak 1 Pcs

25 Margil forcep Dewasa 1 Pcs

26 NPA No. 6 1 Pcs

27 NPA No. 7 1 Pcs
28 O2 Nasal anak 1 Pcs
29 O2 Nasal dewasa 1 Pcs

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30 O2 NRM anak 1 Pcs

31 O2 NRM Dewasa 1 Pcs
32 O2 RM anak 1 Pcs
33 O2 RM dewasa 1 Pcs
34 O2 SM anak 1 Pcs
35 O2 SM Dewasa 1 Pcs
36 Pressure Cuff 1 Pcs
37 Suction cateter no. 6 1 Pcs
38 Suction cateter no. 8 1 Pcs
39 Suction cateter no. 10 1 Pcs
40 Suction cateter no. 12 1 Pcs
41 Suction cateter no.14 1 Pcs
42 Suction cateter no.16 1 Pcs
43 Xylocaine Spray 1 Pcs

DRAWER IV
1 Bethadine 15 Ml 1 Pcs
2 Cateter tip 50 ml 1 Pcs
 3 Folley cateter no.6 1 Pcs
4 Folley cateter no.8 1 Pcs
5 Folley cateter no.10 1 Pcs
6 Folley cateter no.12 1 Pcs
7 Folley cateter no.14 1 Pcs
8 Folley cateter no.16 1 Pcs
9 Folley cateter no.18 1 Pcs
10 Folley cateter no.20 1 Pcs

11 Hand scoen Steril no.6 1 Pcs

12 Hand scoen Steril no.6.5 1 Pcs

13 Hand scoen Steril no.7 1 Pcs

14 Hand scoen Steril no.7.5 1 Pcs

15 Hand scoen Steril no.8 1 Pcs

16 Naso gastric tube no.3 1 Pcs

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Naso gastric tube
17 1 Pcs
no.5
Naso gastric tube
18 1 Pcs
no.8
Naso gastric tube
19 1 Pcs
no.10
Naso gastric tube
20 1 Pcs
no.12
Naso gastric tube
21 1 Pcs
no.14
Naso gastric tube
22 1 Pcs
no.16
Naso gastric tube
23 1 Pcs
no.18
Naso gastris tube
24 1 Pcs
no.20
25 Urine bag 2 Pcs

26 WFI Inj 25 Ml 2 Pcs

27 Xylocaine Jelly 2 Pcs

DRAWER V
1 Dextrose 5% 500 ml 2 Kolf
2 Dextrose 5% 100 ml 2 Kolf
3 Dextrose 5% 250 ml 2 Kolf
4 Gelofusal 500 ml 1 Kolf
5 Nacl 0,9% 100 ml 2 Kolf
6 Nacl 0,9% 250 ml 2 Kolf
7 Nacl 0,9% 500 ml 2 Kolf
8 Ringer Laktat 500 ml 2 Kolf
Nama Pasien
Farmasi

Perawat

No.Seri Kunci
CHECKLIST EMERGENCY TROLLEY
TAHUN 2023

TANGGAL

TANGGAL
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