ALUR PEMBERIAN VAKSIN COVID

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Dr. Yulia Novita Ningrum
￮ PRINSIP PELAKSANAAN VAKSINASI COVID-19

￮ Prinsip dalam pelaksanaan vaksinasi COVID-19 yaitu:

￮ 1. Pemberian vaksinasi COVID-19 dilakukan oleh dokter, perawat atau bidan yang
memiliki kompetensi.
￮ 2. Pelaksanaan pelayanan vaksinasi COVID-19 tidak menganggu pelayanan imunisasi
rutin dan pelayanan kesehatan lainnya;
￮ 3. Melakukan skrining/penapisan terhadap status kesehatan sasaran sebelum
dilakukan pemberian vaksinasi;
￮ 4. Menerapkan protokol kesehatan; serta
￮ 5. Mengintegrasikan dengan kegiatan surveilans COVID-19 terutama dalam
mendeteksi kasus dan analisa dampak.

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Meja 1 :Petugas meminta sasaran untuk menunjukkan eticket / KTP untuk dilakukan verifikasi
Verifikasi dilakukan dengan menggunakna app Pcare Vaksinasi

Meja 2 : Petugas kesehatan melakukan anamnesa untuk melihat kondisi kesehatan dan mengidentifikasi
kondisi penyerta (komorbid) serta melakukan pemeriksaan fisik sederhana. Pemeriksaan meliputi suhu
tubuh dan tekanan darah.

“
Vaksinasi COVID-19 tidak diberikan pada sasaran yang memiliki riwayat konfirmasi COVID-19, wanita
hamil, menyusui, usia di bawah 18 tahun dan beberapa kondisi komorbid yang telah disebutkan dalam
format skrining (Tabel 8).
Berdasarkan data yang dimasukkan oleh petugas, aplikasi akan mengeluarkan rekomendasi hasil skrining
berupa: sasaran layak divaksinasi (lanjut), ditunda atau tidak diberikan.

Meja 3 : Sasaran duduk dengan nyaman. Petugas memberikan vaksinasi secara intra muskular sesuai
prinsip penyuntikan aman, Petugas menuliskan nama sasaran, NIK, nama vaksin dan nomor batch vaksin
pada sebuah memo. Memo diberikan kepada sasaran untuk diserahkan kepada petugas di Meja 4.
Selesai penyuntikan, petugas meminta dan mengarahkan sasaran untuk ke Meja 4 dan menunggu selama
30 menit

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￮ Meja 4 :Petugas menerima memo yang diberikan oleh petugas Meja 3
￮ Petugas memasukkan hasil vaksinasi yaitu jenis vaksin dan nomor batch vaksin yang diterima masing-
masing sasaran ke dalam aplikasi Pcare Vaksinasi.
￮ . Petugas dapat mencetak kartu vaksinasi elektronik melalui aplikasi Pcare Vaksinasi. Kartu tersebut
ditandatangi dan diberi stempel lalu diberikan kepada sasaran sebagai bukti bahwa sasaran telah

“
diberikan vaksinasi.
￮ Petugas mempersilakan penerima vaksinasi untuk menunggu selama 30 menit di ruang observasi dan
diberikan penyuluhan dan media KIE tentang pencegahan COVID-19 melalui 3M dan vaksinasi

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 CASE
CR REPORT

Terimakasih
PATIENT
￮ A patient, 7 months old boy refered from
Langsa General Hospital to Adam Malik
General Hospital June 25th 2017 And some text
￮ main complaint patients cry when trying to
drink breast milk and vomiting when finished
drinking
Radiograph also showed radioopaque foreign body.

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 he accidentally consumed earring 6 hours before coming to hospital while
he was playing

There was history of vomit 10 minutes after he accidentally consumed the earring.
There are no history of coughing, choking, dispone, retraction , stridor, cyanosis.

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The physical examination

we found no abnormality in oropharyng and laryng.

The rontgen from June 25rd 2017 showed there was
foreign body metal at the projection as high as
vertebra cervicalis 5-7.We diagnosed the patient with
foreign body on the esophagus and planned
esophagoscopy for this patient.
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planned esophagoscopy for this patient

The patient The patient was The result of chest x-

underwent some fasting for 8 ray on June 25th 2017
examination e.g hours before showed there was
foreign body metal at
blood laboratory test this procedure. the projection as high
and repeat the chest as vertebra cervicalis
x ray before the the 5-7 and then he was
esophagoscopy. brought to the
operating theatre.

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 The operation was done on June 25rd
2017 in Adam Malik General Hospital
Operating Theater
￮ Patient was anasthesized with ETT and IVFD well attached,
￮ Then the operation area was desinfected using bethadine and alcohol 70%,
￮ The area around the operated area was covered with sterile doek.
￮ Patient on supine position with shoulder in the edge of the table the insert the
esophagoscope carefully in vertical position through the oropharyng.
Simultaneously we slowly lifted his head and we can evaluate valecula, epiglottic,
pharyngo-epiglottica plica and laryng.
￮ We entered the right pyriform sinus by inserting esophagoscope through right side
of tongue until posterior pharyngeal wall. When we entered the pyriform sinus we
found the lumen was unseen because the cricopharyngeal muscle always contracted
expect for swallowing.
￮ When passing through the cricopharyngeal, We saw the metal yellow goldish metal
in cricopharyngeal area and inserted the forcep into the esophagoscope and clipped
the earring thightly, then pulled out simultaneously the esophagoscope and the
forcep. The earring pulled out succesfully and we evaluate the esophagus to reassure
there were not any laceration or abnormality.
￮ Post operation, we inserted nasogastric tube and evaluate for 2 days.

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FOREIG Place your screenshot here

‘EARRING’.
N BODY

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After the surgery

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After the surgery the patient was given antibiotic, analgetic and
diet via nasogastric tube for two days. On third day we took off
the nasogastric tube and he went home.

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 DISCUSSION

Children less than 5 years of age routinely explore their

environment by placing objects in their mouths.

In this case our patient was 7 months and the

foreign body accidentally ingested and lodged in
esophagus tract

Patients cry when trying to drink breast milk and

vomiting when finished drinking. Radiograph also
showed radio-opaque foreign body.

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 DISCUSSION

In the Unites States and Europe, coins are the

mostcommonly ingested pediatric foreign body.
Other commonly ingested items include toy parts,
sharp object, batteries, fish bones, and food.
Approximately 60% to 70% become lodged at the
upper esophageal sphincter or cricopharyngeus
muscle, 10% to 20% impact in the midesophagust
the level of the aortic notch, and 20% are held up by
the lower esophageal sphincter

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 DISCUSSION

In this case the patient ingested earring and lodged

at upper esophageal sphincter or cricopharyngeus
muscle which was the most common lodged area.

Evaluation of patients with a suspected esophageal

foreign body should include both anteroposterior and
lateral x-rays to verify that the object is indeed in the
esophagus rather than in the airway

For this patient we performed anteroposterior and

lateral x-rays and found the foreign body was in
esophagus area.

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 DISCUSSION
Endoscopy under general anesthesia with a protected
airwayis the mainstay of esophageal foreign body
management with esophagoscopy is not without risk,
including pharyngeal bleeding, accidental extubation,
hypoxia, esophageal perforation, and mediastinitis
The procedure performed in general anesthesia and there
weren’t any complication post operation.

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 CONCLUSION

￮ We report a case of foreign body ‘earring’ and performed esophagoscopyand the outcome was satisfying.

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Thanks!
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