BAGAN ALUR

Tanggal 14 November 2017 (Hari Perawatan ke 1)

Tanggal 20 November 2017 (Hari Perawatan ke 7)
S: Sulit bernafas, Lemah, gelisah, keempat anggota gerak kesemutan , kedua kelopak
mata sulit si buka terutama sebelah kiri. Bicara pelo (+), S: Nyeri di tempat pemasangan DL, kesemutan berkurang, bicara pelo (+), coba minum
O: Kesadaran : GCS = E4M6V5, KU tampak sakit berat tidak tersedak
T = 140 / 80, HR = 90x, RR = 28, temp = 36.5, SpO2 : 98% O: Kesadaran : GCS = E4M6V5, KU tampak sakit berat
Mata : pupil, bulat isokor 5mm/5mm, RC menurun T = 130 / 80, HR = 90x, RR = 20, temp = 36,6 c SpO2 : 99%
Leher : kaku kuduk (-) Mata : pupil, bulat isokor 5mm/5mm, RC menurun
Nn.Craniales : parese NIII,IV,VI bilaeral, Parese NVII,XII dextra sentral, Parese IX,X, Leher : kaku kuduk (-)
Motorik : Tetraparese flacid Nn.Craniales : parese NIII,IV,VI bilaeral, Parese NVII,XII dextra sentral, Parese IX,X,
Sensibilitas : Stocking and gloves syndrome
Motorik : Tetraparese flacid
Vegetatif : DC (+)
A : 1. Susp SGB varian Miller Fisher Sindrom Sensibilitas : Stocking and gloves syndrome
P: O2 10 lpm NRM Vegetatif : DC (+)
IVFD RL 20 tpm A : 1. Susp SGB varian Miller Fisher Sindrom
Inj Ranitidin 50 mg / 12 jam (iv) P: O2 10 lpm NRM
Vit B1B6B12 1 tab / 8 jam po IVFD RL 20 tpm
Program : Inj Ranitidin 50 mg / 12 jam (iv)
Konsul ICU Vit B1B6B12 1 tab / 8 jam po
EMG
Program
LP
Prostigmin tes TPE 1

Tanggal 16 November 2017 (Hari Perawatan ke 3)

Tanggal 18 November 2017 (Hari Perawatan ke 5)
S: lemah keempat anggota gerak, kadang masih sulit bernafas, lemas seluruh
tubuh, kesemutan (+), bicara pelo (+) S: keempat anggota gerak lebih kuat, nafas mulai membaik, sudah mulai bosa membuka
O: Kesadaran : GCS = E4M6V5, KU tampak sakit berat mata, kesemutan (+), bicara pelo (+)
T = 130 / 70, HR = 98x, RR = 24, temp = 36.6, SpO2 : 99% O: Kesadaran : GCS = E4M6V5, KU tampak sakit berat
Mata : pupil, bulat isokor 5mm/5mm, RC menurun T = 130 / 100, HR = 70x, RR = 20, temp = 36,7c SpO2 : 99%
Leher : kaku kuduk (-) Mata : pupil, bulat isokor 5mm/5mm, RC menurun
Nn.Craniales : parese NIII,IV,VI bilaeral, Parese NVII,XII dextra sentral, Parese IX,X, Leher : kaku kuduk (-)
Motorik : Tetraparese flacid Nn.Craniales : parese NIII,IV,VI bilaeral, Parese NVII,XII dextra sentral, Parese IX,X
Sensibilitas : Stocking and gloves syndrome
Vegetatif : DC (+)
Motorik : Tetraparese flacid
A : 1. Susp SGB varian Miller Fisher Sindrom Sensibilitas : Stocking and gloves syndrome
P: O2 10 lpm NRM Vegetatif : DC (+)
IVFD RL 20 tpm A : 1. Susp SGB varian Miller Fisher Sindrom
Inj Ranitidin 50 mg / 12 jam (iv) P: O2 10 lpm NRM
Vit B1B6B12 1 tab / 8 jam po IVFD RL 20 tpm
Program : Inj Ranitidin 50 mg / 12 jam (iv)
Konsul ICU Vit B1B6B12 1 tab / 8 jam po
EMG
LP
Program : Pro DL dan TPE
 BAGAN ALUR
Tanggal 23 November 2017 (Hari Perawatan ke 10)
Tanggal 28 November 2017 (Hari Perawatan ke 7)
S: Kesemutan berkurang, makan tidak tersedak, bicara pelo (+)
S: Kesemutan pada telapak tangan berkurang, Sulit BAB
O: Kesadaran : GCS = E4M6V5, KU tampak sakit berat
T = 120 / 80, HR = 84x, RR = 18, temp = 36,5 c SpO2 : 99% O: Kesadaran : GCS = E4M6V5, KU tampak sakit berat
Mata : pupil, bulat isokor 5mm/5mm, RC menurun T = 130 / 80, HR = 90x, RR = 20, temp = 36,6 c SpO2 : 99%
Leher : kaku kuduk (-) Mata : pupil, bulat isokor 5mm/5mm, RC menurun
Nn.Craniales : parese NIII,IV,VI bilaeral, Parese NVII,XII dextra sentral, Parese IX,X, Leher : kaku kuduk (-)
Motorik : Tetraparese flacid Nn.Craniales : parese NIII,IV,VI bilaeral, Parese NVII,XII dextra sentral, Parese IX,X,
Sensibilitas : Stocking and gloves syndrome Motorik : Tetraparese flacid
Vegetatif : DC (+) Sensibilitas : Stocking and gloves syndrome
A : 1. Susp SGB varian Miller Fisher Sindrom
Vegetatif : DC (+)
2. Hiperkalemia
3.Hiponatremi A : 1. Susp SGB varian Miller Fisher Sindrom
4. pioderma 2 .Hiponatremi
P: O2 10 lpm NRM 3. pioderma
IVFD RL 20 tpm P:
Inj Ranitidin 50 mg / 12 jam (iv) NaCl Capsul 500mg//8jam (po)
Vit B1B6B12 1 tab / 8 jam po Ranitidin 150 mg / 12 jam (iv)
KALitake 1 sach / 8 jam (po) Vit B1B6B12 1 tab / 8 jam po
Program : Program
Konsul kulit Rawat jalan
TPE 3

Tanggal 25 November 2017 (Hari Perawatan ke 12)

S: sudah BAB, Kesemutan di telapak tangan, makan dan minum baik, tidak tersedak
O: Kesadaran : GCS = E4M6V5, KU tampak sakit berat
T = 130 / 80, HR = 92x, RR = 20, temp = 36,4c SpO2 : 99%
Mata : pupil, bulat isokor 5mm/5mm, RC menurun
Leher : kaku kuduk (-)
Nn.Craniales : parese NIII,IV,VI bilaeral, Parese NVII,XII dextra sentral, Parese IX,X,
Motorik : Tetraparese flacid
Sensibilitas : Stocking and gloves syndrome
Vegetatif : DC (+)
A : 1. Susp SGB varian Miller Fisher Sindrom
2. Hiperkalemia perbaikan
3.Hiponatremi
4. pioderma
P: O2 3 lpm NK
IVFD RL 20 tpm
Inj Ranitidin 50 mg / 12 jam (iv)
Vit B1B6B12 1 tab / 8 jam po
Nacl capsul 500mg/8jam (po)
Program :
Konsul kulit
TPE 3