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Tgl : STATUS PASIEN Ruang: IP 25


Diagnosis: NAMA: UMUR:
Follow up laboratorium

Hb
Ht
Leukosit
Trombosit
B
E
NB
NS
L
Subjektif: M
LED
GDR
pH
pCO2
Objektif:
pO2
KU Kes TD Nd Nf T VAS SpO2 HCO3-
BE
SO2
PaO2/FiO2
Lactat
Alb
Glob
SGOT
qSOFA = SGPT
Bil. Total
SOFA score =
Bil I
SIRS criteria = Bil II
Ca
NEWS-2 score = Na
K
Cl
Terapi: Ur
Kr
PT
APTT
D-dimer
CRP
PCT
HIV = HbsAg = AntiHCV=
CD4 =
Viral Load
Urinalisa:

Kultur :
□ Sputum
□ Urin
□ Pus
□ Darah

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