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VISI & MISI PROGRAM STUDI SPESIALIS BEDAH SARAF
FAKULTAS KEDOKTERAN UNIVERSITAS UDAYANA
VISI
• Menjadikan Program Studi Spesialis Bedah Saraf Fakultas Kedokteran Universitas Udayana Sebagai
Lembaga Pendidikan Kedokteran dan Kesehatan yang Unggul, Mandiri, dan Berbudaya serta Mempunyai
Daya Saing di Tingkat Nasional, Regional dan Global
MISI
• Menyelenggarakan kegiatan pendidikan spesialis bedah saraf yang bermutu dan menghasilkan lulusan yang
memiliki moral/etika/akhlak dan integritas yang tinggi sesuai dengan tuntutan masyarakat lokal, nasional,
dan internasional.
• Mengembangkan penelitian di bidang bedah saraf dan pengabdian kepada masyarakat sesuai dengan
kepentingan masyarakat dan bangsa.
• Memberdayakan Program Studi Spesialis Bedah Saraf sebagai lembaga yang menghasilkan dan
mengembangkan pengetahuan dan teknologi dalam bidang bedah saraf yang dapat dimanfaatkan untuk
kesejahteraan masyarakat.
• Menghasilkan karya inovatif dan prospektif dalam bidang bedah saraf bagi kemajuan Program Studi
Spesialis Bedah Saraf Fakultas Kedokteran Universitas Udayana serta perekonomian nasional.
Thursday, October 6rd 2022
Supervisor : Prof. Dr. dr. Sri Maliawan, Sp.BS(K)
JR : MBP
Chief : MOT
Bedah Saraf Lanjut : ASK
Bedah Saraf Dasar : AHA
Bedah Umum : AMK
Resume
Total patient : 4 patients
• Neurotrauma : 2 patients
• Neurovascular : 1 patient
• Neurospine : 0 patient
• Neurooncology : 1 patient
• Neurofunctional : 0 patient
• Neuropediatric : 0 patient
• Neuroinfection : 0 patient
Surgery : 1 patient
Consultation : 1 patient
Mortality : 0 patient
Triage (3)
a
No Identity Diagnosis Management
1. Ni Nyoman Murni /
F / 58 yo / 22048108
/ Neurooncology
• Multiple Tumors Intraaxial Right
Parietal Region, Right and Left
Cerebellum e.c Susp Metastases
• Non Communicating
Hydrocephalus post VP Shunt Left
Keen (29/09/2022)
• Severe Hypokalemia (2.32)
• Leukocytosis (18.49)
Neurosurgery
Craniotomy Tumor Resection
Urgent
- Head Up 30⁰
- IVFD NaCl 0.9% 20 dpm
- Dexamethasone bolus 10 mg
maintenance 5 mg/6 hours IV
- Omeprazole 40 mg/12 hours
IV
- Paracetamol 500 mg/8 hours
IO
- KSR 3 x 1 tab IO
Head MRI + C
Siloam Hospital
29/9/2022
Head MRI + C
Siloam Hospital
29/9/2022
Head MRI + C
Siloam Hospital
29/9/2022
Head MRI + C
Siloam Hospital
29/9/2022
Head MRI + C
Siloam Hospital
29/9/2022
Head MRI + C
Siloam Hospital
29/9/2022
Head CT Scan
Prof. I G.N.G.
Ngoerah Hospital
6/10/2022
Head CT Scan
Prof. I G.N.G.
Ngoerah Hospital
6/10/2022
Head CT Scan
Prof. I G.N.G.
Ngoerah Hospital
6/10/2022
Laboratory Result
Prof. I.G.N.G Ngoerah
Hospital
6/10/2022
a
No Identity Diagnosis Management
2. Desak Made Ema
Dwipayani / F / 22
yo / 22049068 /
Neurotrauma
• Mild TBI (E4V5M6) Neurosurgery
Conservative
Observe 24hours
- Head up 30⁰
- O2 on nasal cannula 2 lpm
- IVFD NaCl 0.9% 20 tpm
- Ranitidine 150 mg/12 hours
IO
- Paracetamol 500 mg/6 hours
IO
- Metoclopramide 10mg/8 hour
IV k/p
- Obs. GCS, vital signs and
signs of increased ICP. If GCS
decrease >2 points Head CT
Scan evaluate
Head CT Scan
Prof. I G.N.G.
Ngoerah Hospital
6/10/2022
Head CT Scan
Prof. I G.N.G.
Ngoerah Hospital
6/10/2022
Head CT Scan
Prof. I G.N.G.
Ngoerah Hospital
6/10/2022
Head CT Scan
Prof. I G.N.G.
Ngoerah Hospital
6/10/2022
Laboratory Result
Prof. I.G.N.G Ngoerah
Hospital
6/10/2022
a
No Identity Diagnosis Management
3. Solihin/ M / 24 yo /
22049087 /
Neurotrauma
• Mild TBI (E4V5M6)
• SDH Interhemispheric
• SDH Tentorium
• IVH Right and Left Lateral Ventricle
• Left ZMC Fracture
• Left Maxilla Fracture.
• Symphysis Mandibular Fracture
• Fracture of the left proximal third
clavicle (Allman group I)
• Left proximal third femur shaft
fracture
Neurosurgery
Conservative
- Head up 30⁰
- O2 on nasal cannula 2 lpm
- IVFD NaCl 0.9% 20 tpm
- Ranitidine 150 mg/12 hours IO
- Paracetamol 500 mg/6 hours IO
- Phenytoin 100 mg/8 hours IO
- Obs. GCS, vital signs and signs of increased
ICP. If GCS decrease >2 points Head CT
Scan evaluate
Trauma Division
- ORIF Miniplate
- Head up 30
- 02 via NC 3 LPM
- IVFD RL 20 tpm
- Non-chewing diet
- WT, Primary Hecting
- Tetagam 250mg IM
- Ceftriaxone 1 gr/12 hours IV
- Drip pethidine 100mg + ketorolac 60 mg in
NS 500ml/ 24 hours
- Omeprazole 40mg/12 hours IV
Orthopedic
- ORIF PS Elective
Head CT Scan
Wangaya Hospital
6/10/2022
Head CT Scan
Wangaya Hospital
6/10/2022
Head CT Scan
Wangaya Hospital
6/10/2022
Head CT Scan
Wangaya Hospital
6/10/2022
Head CT Scan
Wangaya Hospital
6/10/2022
Laboratory Result
Prof. I.G.N.G Ngoerah
Hospital
7/10/2022
Consultation (1)
a
No Identity Diagnosis Management
1. I Nyoman Wenga /
M / 87 yo / 22049083
/ Neurovascular
• Chronic SDH Right FrontoParietal
Region (thickness 23mm, MLS
6mm to the left)
• Anemia (Hb 8.5)
Neurosurgery
Right Burrhole Drainage 2 Holes
Neurology
- Head Up 30
- Bed Rest
- Tilt left and right every 2 hours
- IVFD NaCl 0.9% 20 tpm
- Citicoline 250 mg/12 hours IV
- Omeprazole 40 mg / 12 hours
IV
- Paracetamol 1000 mg / 8
hours IO
- Amlodipine 5 mg/24 hr IO
Head CT Scan
Prof. I G.N.G.
Ngoerah Hospital
6/10/2022
Head CT Scan
Prof. I G.N.G.
Ngoerah Hospital
6/10/2022
Head CT Scan
Prof. I G.N.G.
Ngoerah Hospital
6/10/2022
Laboratory Result
Prof. I.G.N.G Ngoerah
Hospital
7/10/2022
Surgery (1)
Assessments:
• Moderate TBI (E2V2M5)
• tICH Left temporal region ( Vol 27cc,
MLS 0mm)
• tICH Right temporal region (vol 25cc
MLS 0mm)
• tSAH Left Parietal region
• SDH Left temporal region
• Linear Fracture Right Temporoparietal
Bone
• Post Craniotomy Right and Left ICH
Evacuation (02/10/22)
• Hypoalbuminemia (Alb 2.82)
Procedure : Tracheostomy
Supervisor : Prof. Dr. dr. Sri Maliawan, Sp.BS(K)
Operator : GUD
As. Operator : AHA / AMK
Time Duration : 20.35-21.15 (40 Minutes)
Bleeding : 5cc
Durante OP
Mortality (0)
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Example.pptx

  • 1. VISI & MISI PROGRAM STUDI SPESIALIS BEDAH SARAF FAKULTAS KEDOKTERAN UNIVERSITAS UDAYANA VISI • Menjadikan Program Studi Spesialis Bedah Saraf Fakultas Kedokteran Universitas Udayana Sebagai Lembaga Pendidikan Kedokteran dan Kesehatan yang Unggul, Mandiri, dan Berbudaya serta Mempunyai Daya Saing di Tingkat Nasional, Regional dan Global MISI • Menyelenggarakan kegiatan pendidikan spesialis bedah saraf yang bermutu dan menghasilkan lulusan yang memiliki moral/etika/akhlak dan integritas yang tinggi sesuai dengan tuntutan masyarakat lokal, nasional, dan internasional. • Mengembangkan penelitian di bidang bedah saraf dan pengabdian kepada masyarakat sesuai dengan kepentingan masyarakat dan bangsa. • Memberdayakan Program Studi Spesialis Bedah Saraf sebagai lembaga yang menghasilkan dan mengembangkan pengetahuan dan teknologi dalam bidang bedah saraf yang dapat dimanfaatkan untuk kesejahteraan masyarakat. • Menghasilkan karya inovatif dan prospektif dalam bidang bedah saraf bagi kemajuan Program Studi Spesialis Bedah Saraf Fakultas Kedokteran Universitas Udayana serta perekonomian nasional.
  • 2. Thursday, October 6rd 2022 Supervisor : Prof. Dr. dr. Sri Maliawan, Sp.BS(K) JR : MBP Chief : MOT Bedah Saraf Lanjut : ASK Bedah Saraf Dasar : AHA Bedah Umum : AMK
  • 3. Resume Total patient : 4 patients • Neurotrauma : 2 patients • Neurovascular : 1 patient • Neurospine : 0 patient • Neurooncology : 1 patient • Neurofunctional : 0 patient • Neuropediatric : 0 patient • Neuroinfection : 0 patient Surgery : 1 patient Consultation : 1 patient Mortality : 0 patient
  • 5. a No Identity Diagnosis Management 1. Ni Nyoman Murni / F / 58 yo / 22048108 / Neurooncology • Multiple Tumors Intraaxial Right Parietal Region, Right and Left Cerebellum e.c Susp Metastases • Non Communicating Hydrocephalus post VP Shunt Left Keen (29/09/2022) • Severe Hypokalemia (2.32) • Leukocytosis (18.49) Neurosurgery Craniotomy Tumor Resection Urgent - Head Up 30⁰ - IVFD NaCl 0.9% 20 dpm - Dexamethasone bolus 10 mg maintenance 5 mg/6 hours IV - Omeprazole 40 mg/12 hours IV - Paracetamol 500 mg/8 hours IO - KSR 3 x 1 tab IO
  • 6. Head MRI + C Siloam Hospital 29/9/2022
  • 7. Head MRI + C Siloam Hospital 29/9/2022
  • 8. Head MRI + C Siloam Hospital 29/9/2022
  • 9. Head MRI + C Siloam Hospital 29/9/2022
  • 10. Head MRI + C Siloam Hospital 29/9/2022
  • 11. Head MRI + C Siloam Hospital 29/9/2022
  • 12. Head CT Scan Prof. I G.N.G. Ngoerah Hospital 6/10/2022
  • 13. Head CT Scan Prof. I G.N.G. Ngoerah Hospital 6/10/2022
  • 14. Head CT Scan Prof. I G.N.G. Ngoerah Hospital 6/10/2022
  • 15. Laboratory Result Prof. I.G.N.G Ngoerah Hospital 6/10/2022
  • 16. a No Identity Diagnosis Management 2. Desak Made Ema Dwipayani / F / 22 yo / 22049068 / Neurotrauma • Mild TBI (E4V5M6) Neurosurgery Conservative Observe 24hours - Head up 30⁰ - O2 on nasal cannula 2 lpm - IVFD NaCl 0.9% 20 tpm - Ranitidine 150 mg/12 hours IO - Paracetamol 500 mg/6 hours IO - Metoclopramide 10mg/8 hour IV k/p - Obs. GCS, vital signs and signs of increased ICP. If GCS decrease >2 points Head CT Scan evaluate
  • 17. Head CT Scan Prof. I G.N.G. Ngoerah Hospital 6/10/2022
  • 18. Head CT Scan Prof. I G.N.G. Ngoerah Hospital 6/10/2022
  • 19. Head CT Scan Prof. I G.N.G. Ngoerah Hospital 6/10/2022
  • 20. Head CT Scan Prof. I G.N.G. Ngoerah Hospital 6/10/2022
  • 21. Laboratory Result Prof. I.G.N.G Ngoerah Hospital 6/10/2022
  • 22. a No Identity Diagnosis Management 3. Solihin/ M / 24 yo / 22049087 / Neurotrauma • Mild TBI (E4V5M6) • SDH Interhemispheric • SDH Tentorium • IVH Right and Left Lateral Ventricle • Left ZMC Fracture • Left Maxilla Fracture. • Symphysis Mandibular Fracture • Fracture of the left proximal third clavicle (Allman group I) • Left proximal third femur shaft fracture Neurosurgery Conservative - Head up 30⁰ - O2 on nasal cannula 2 lpm - IVFD NaCl 0.9% 20 tpm - Ranitidine 150 mg/12 hours IO - Paracetamol 500 mg/6 hours IO - Phenytoin 100 mg/8 hours IO - Obs. GCS, vital signs and signs of increased ICP. If GCS decrease >2 points Head CT Scan evaluate Trauma Division - ORIF Miniplate - Head up 30 - 02 via NC 3 LPM - IVFD RL 20 tpm - Non-chewing diet - WT, Primary Hecting - Tetagam 250mg IM - Ceftriaxone 1 gr/12 hours IV - Drip pethidine 100mg + ketorolac 60 mg in NS 500ml/ 24 hours - Omeprazole 40mg/12 hours IV Orthopedic - ORIF PS Elective
  • 23. Head CT Scan Wangaya Hospital 6/10/2022
  • 24. Head CT Scan Wangaya Hospital 6/10/2022
  • 25. Head CT Scan Wangaya Hospital 6/10/2022
  • 26. Head CT Scan Wangaya Hospital 6/10/2022
  • 27. Head CT Scan Wangaya Hospital 6/10/2022
  • 28. Laboratory Result Prof. I.G.N.G Ngoerah Hospital 7/10/2022
  • 30. a No Identity Diagnosis Management 1. I Nyoman Wenga / M / 87 yo / 22049083 / Neurovascular • Chronic SDH Right FrontoParietal Region (thickness 23mm, MLS 6mm to the left) • Anemia (Hb 8.5) Neurosurgery Right Burrhole Drainage 2 Holes Neurology - Head Up 30 - Bed Rest - Tilt left and right every 2 hours - IVFD NaCl 0.9% 20 tpm - Citicoline 250 mg/12 hours IV - Omeprazole 40 mg / 12 hours IV - Paracetamol 1000 mg / 8 hours IO - Amlodipine 5 mg/24 hr IO
  • 31. Head CT Scan Prof. I G.N.G. Ngoerah Hospital 6/10/2022
  • 32. Head CT Scan Prof. I G.N.G. Ngoerah Hospital 6/10/2022
  • 33. Head CT Scan Prof. I G.N.G. Ngoerah Hospital 6/10/2022
  • 34. Laboratory Result Prof. I.G.N.G Ngoerah Hospital 7/10/2022
  • 36. Assessments: • Moderate TBI (E2V2M5) • tICH Left temporal region ( Vol 27cc, MLS 0mm) • tICH Right temporal region (vol 25cc MLS 0mm) • tSAH Left Parietal region • SDH Left temporal region • Linear Fracture Right Temporoparietal Bone • Post Craniotomy Right and Left ICH Evacuation (02/10/22) • Hypoalbuminemia (Alb 2.82) Procedure : Tracheostomy Supervisor : Prof. Dr. dr. Sri Maliawan, Sp.BS(K) Operator : GUD As. Operator : AHA / AMK Time Duration : 20.35-21.15 (40 Minutes) Bleeding : 5cc

Editor's Notes

  1. S: The patient came to his senses with complaints of weakness since 5 days ago which was said to be getting worse. The patient has a known history of brain tumor 2 weeks ago and with a history of vp shunt 7 days ago, after the procedure the patient was said to have good contact, but since 5 days ago the patient tends to be weak. Complaints Headache (+) is said to be persistent. Eating and drinking is reduced, so the patient must be placed on an NGT. Other complaints are vomiting (-) Nausea (+), seizures (-), fever (-). RPD: - History of surgery for VP shunt keen S at Siloam Hospital (29/09/2022) - History of HT, type II DM and other systemic diseases was denied
  2. S: A referral patient at Payangan Hospital came to his senses complaining of a headache after experiencing a traffic accident 12 hours from SMRS. History of unconsciousness (+) +-30 minutes, vomiting (+) 2x, seizures (-) MOI The patient is a motorcycle rider, wearing a helmet, falls by himself with an unknown mechanism
  3. S: The referral patient of Wangaya Hospital after the 2nd day of treatment came to his senses with complaints of pain in the face after experiencing a traffic accident 2 days ago before entering the hospital. History of unconsciousness (+) 10 minutes, vomiting (-), seizures (-). MOI: A motorcycle rider patient not wearing a helmet collided with another motorcyclist with an unclear fall mechanism
  4. S: The referral patient at Karangasem Hospital came to his senses complaining of weakness in the left half of his body since 1 week ago which was getting worse. The patient has a history of falling from bed as high as approximately 50 cm, 1 week ago. Headache (+) nausea (-) vomiting (-) convulsions (-) RPD - BPH surgery history (year 2021) - History of systemic diseases such as hypertension and type II diabetes was denied - History of using blood thinning drugs is denied