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Profil Kegawatdaruratan Pasien Berdasarkan Start Triage Scale di Instalasi Gawat Darurat RSUP Prof. Dr. R. D. Kandou Manado Periode Januari 2018 sampai Juli 2018 Bazmul, Muhammad F.; Lantang, Eka Y.; Kambey, Barry I.
e-CliniC Vol 7, No 1 (2019): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v7i1.23538

Abstract: Emergency Department provides first emergency services to patients with threats of death and disability in an integrated manner involving multi disciplines. Patients who come to the Emergency Department are always assessed as 3 priorities, namely priorities 1, 2 and 3. Priority 1 is case/disease with life-threatening emergency or severe emergency; Priority 2 is case/disease with mild emergency; and Priority 3 is non-emergency case/disease. This study was aimed to obtain the Triage profile of patients at Emergency Department of Prof. Dr. R. D. Kandou Hospital Manado. This was a retrospective descriptive study using patientsâ€™ medical records. Samples were all patients treated at the Emergency Department of Prof. Dr. R. D. Kandou Hospital from January 2018 until July 2018. The results showed that there were 19,229 patients as samples. Based on sex, most patients were male, meanwhile based on age most were 51-70 years, with the highest number of patients in March 2018. There were 6,913 patients (35.9%) in the orange or emergency category (Priority 2) and 6,130 patients (31.8%) in the yellow category (Priority 3). Conclusion: Based on the Start Triage in Emergency Department, the majority of patients were in Priority 2 category, followed by Priority 3 category.Keywords: Emergency Department, Start TriageÂ Abstrak: Instalasi Gawat Darurat (IGD) memberikan pelayanan pertama yang bersifat emergency pada pasien dengan ancaman kematian dan kecacatan secara terpadu dengan melibatkan multi disiplin ilmu. Pasien yang datang di IGD selalu dinilai kegawatannya menja-di 3 prioritas, yaitu prioritas 1, 2, dan 3. Prioritas 1 yaitu kasus/penyakit dengan kegawat-daruratan yang mengancam jiwa atau gawat darurat berat. Prioritas 2 untuk kasus/penyakit dengan gawat darurat ringan. Prioritas 3 untuk kasus/penyakit yang bukan gawat darurat. Penelitian ini bertujuan untuk mengetahui profil skala Triase pasien yang masuk di IGD RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif-retrospektif, menggunakan data rekam medis pasien. Sampel penelitian ialah seluruh pasien yang dirawat di IGD RSUP Prof. Dr. R. D. Kandou Manado periode Januari 2018 sampai Juli 2018. Hasil penelitian mendapatkan data pasien yang masuk ke Ruang IGD RSUP Prof. Dr. R. D. Kandou Manado terhitung sejak Januari hingga Juli 2018 sebanyak 19.229 orang. Distribusi pasien terbanyak berdasarkan jenis kelamin ialah laki-laki, dan berdasarkan usia ialah 51-70 tahun, dengan jumlah pasien terbanyak pada bulan Maret 2018. Pasien IGD terbanyak ialah kategori jingga yaitu emergency (Prioritas 2) berjumlah 6.913 orang (35,9%) serta kategori kuning (Prioritas 3) berjumlah 6.130 orang (31,8%). Simpulan: Berdasarkan skala Triase di IGD, pasien terbanyak ialah Prioritas 2, disusul dengan Prioritas 3.Kata kunci : Instalasi Gawat Darurat, skala Triase

Perbandingan Perubahan Kadar Gula Darah Sebelum Pembedahan, 30 Menit dan 60 Menit Saat Pembedahan dengan Anestesi Umum dan Anestesi Spinal Yaqin, Muh A.N; Tambajong, Harold F.; Kambey, Barry I.
e-CliniC Vol 5, No 2 (2017): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v5i2.18539

Abstract: Anesthesia and surgery could cause stress response within the body that affects blood glucose level. This study was aimed to compare blood glucose levels at 30 minutes and 60 minutes during surgery using general anesthesia and spinal anesthesia. This as an observational prospective analytical stdy with a cross-sectional design performed on 12 patients gathered through consecutive sampling that fulfilled inclusion and exclusion criteria. The patients were divided into 2 groups: those undergoing surgery with general anesthesia and those with spinal anesthesia. Measurement of blood glucose level was done 3 times, 2 hours before premedication induction, 30 minutes and 60 minutes during surgery. Data were analyzed statistically by using the Shapiro-Wilk test, the T-independent test, and the Mann Whitney. The results showed that there was no significant difference between blood glucose level at 30 minutes during surgery using general anesthesia and spinal anesthesia (P = 0.23), however, there was a significant difference between blood glucose level at 60 minutes during surgery using general anesthesia and spinal anesthesia (P=0.03). Mean blood glucose level at30 minutes during surgery with general anesthesia was 103 mg/dl and at 60 minutes during surgery was 116.7 mg/dl, while mean blood glucose level at 30 minutes during surgery using spinal anesthesia was 93.50 mg/dl and at 60 minutes during surgery was 94.50 mg/dl. Conclusion: There was a significant difference in blood glucose level between general anesthesia and spinal anesthesia at 60 minutes during surgery.Keywords: stress response, blood glucose level, general anesthesia, spinal anesthesiaÂ Abstrak: Anestesi dan pembedahan dapat menyebabkan terjadinya suatu respon stres pada tubuh yang memengaruhi kadar gula darah. Penelitian ini bertujuan untuk membandingkan kadar gula darah 30 menit dan 60 menit saat pembedahan dengan anestesi umum dan anestesi spinal. Jenis penelitian ialah observasional analitik prospektif dengan desin potong lintang. Penelitian dilakukan terhadap 12 pasien yang didapatkan secara consecutive sampling dan memenuhi kriteria inklusi dan eksklusi, lalu dibagi menjadi 2 kelompok, yaitu kelompok yang menjalani pembedahan dengan anestesi umum dan kelompok yang menjalani menjalani pembedahan dengan anestesi spinal. Pengukuran kadar gula darah dilakukan 3 kali, yaitu 2 jam sebelum induksi premedikasi, serta 30 menit dan 60 menit saat pembedahan. Analisis statistik dilakukan dengan uji Shapiro-Wilk, uji T-Independen,, dan uji Mann Whitney. Hasil penelitian menunjukkan tidak terdapat perbedaan bermakna antara kadar gula darah 30 menit saat pembedahan dengan anestesi umum dan anestesi spinal (P=0,23) sedangkan pada 60 menit saat pembedahan menunjukkan adanya perbedaan bermakna antara kadar gula darah 60 menit saat pembedahan dengan anestesi umum dan anestesi spinal (P=0,03). Rerata kadar gula darah 30 menit saat pembedahan dengan anestesi umum yaitu 103 mg/dl dan 60 menit saat pembedahan yaitu 116,7 mg/dl, sedangkan rerata kadar gula darah 30 menit saat pembedahan dengan anestesi spinal yaitu 93,50 mg/dl dan 60 menit saat pembedahan yaitu 94,50 mg/dl. Simpulan: Perubahan kadar gula darah yang bermakna antara anestesi umum dan anestesi spinal terjadi pada 60 menit saat pembedahan.Kata kunci: respon stres, kadar gula darah, anestesi umum, anestesi spinal

Perbandingan kadar gula darah pasca pembedahan dengan anestesia umum dan anestesia spinal Lumanauw, Fabiola I.; Tambajong, Harold F.; Kambey, Barry I.
e-CliniC Vol 4, No 2 (2016): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.4.2.2016.14484

Abstract: Anesthesia and surgery could evoke stress response that can affect blood glucose levels. The purpose of this study is to compare the blood glucose levels after surgery with general anesthesia and spinal anesthesia. This was an analytic prospective observational research with cross-sectional design. Researched on 32 patients by consecutive random sampling who meet inclusion and exclusion criteria, then divided into two groups, namely the group undergoing surgery with general anesthesia and the group undergoing surgery with spinal anesthesia. Measurements of blood glucose levels was done in 1 hour before induction of premedication and 4 hours after surgery. The statistical analysis were done using Shapiro-Wilk Test to determine the normal distribution of samples, and independent t-test to compare blood glucose levels after surgery with general anesthesia and spinal anesthesia. The result showed there was significantly different between blood glucose levels after surgery with general anesthesia and spinal anesthesia (p-value = 0.006 or p <0.05). Mean of blood glucose level after surgery in general and spinal anesthesia were 96 mg/dl and 79,4 mg/dl. Conclusion: General anesthesia had more influence on the increase in blood glucose levels after surgery compared to spinal anesthesia.Keywords: stress response, blood glucose levels, general anesthesia, spinal anesthesiaÂ Abstrak: Anestesia dan pembedahan akan menyebabkan timbulnya respon stres yang dapat mempengaruhi kadar gula darah. Penelitian ini bertujuan untuk mengetahui perbandingan kadar gula darah pasca pembedahan dengan anestesia umum dan anestesia spinal. Metode penelitian ini menggunakan desain observasional analitik prospektif dengan rancangan cross-sectional. Penelitian dilakukan terhadap 32 pasien yang didapatkan secara consecutive random sampling yang memenuhi kriteria inklusi dan eksklusi, lalu dibagi menjadi 2 kelompok, yaitu kelompok yang menjalani pembedahan dengan anestesia umum dan kelompok yang menjalani pembedahan dengan anestesia spinal. Pengukuran kadar gula darah dilakukan 2 kali, yaitu 1 jam sebelum induksi premedikasi dan 4 jam setelah pembedahan. Analisis statistik dilakukan dengan uji Shapiro-Wilk untuk mengetahui normalitas distribusi sampel, dan uji-t independen untuk membandingkan kadar gula darah pasca pembedahan dengan anestesia umum dan anestesia spinal. Hasil penelitian menunjukkan perbedaan yang bermakna antara kadar gula darah pasca pembedahan dengan anestesia umum dan anestesia spinal (nilai p = 0,006 atau p < 0,05). Rerata kadar gula darah pasca pembedahan dengan anestesia umum sebesar 96 mg/dl, sedangkan pada anestesia spinal sebesar 79,4 mg/dl. Simpulan: Anestesia umum lebih berpengaruh terhadap peningkatan kadar gula darah pasca pembedahan dibandingkan dengan anestesia spinal. Kata kunci : respon stres, kadar gula darah, anestesia umum, anestesia spinal

Hubungan antara Waktu Tindakan Intubasi dengan Outcome Pasien Stroke di RSUP Prof. Dr. R. D. Kandou Manado: Kajian terhadap Glasgow Coma Scale, Ventilator Associated Pneumonia, Length of Stay, dan Angka Kematian Poluan, Timothy M.; Lalenoh, Diana C. H.; Kambey, Barry I.
e-CliniC Vol 6, No 2 (2018): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v6i2.22126

Abstract: Stroke patients with decreased consciousness, airway disorders, hypoxia, apnea or therapeutic initiation of hyperventilation must be intubated. The delay in intubation time in stroke patients with a deteriorating general condition is very dangerous because it is related to higher mortality within the first 24 to 48 hours and will affect the length of stay (LOS). One of the indications for intubation in stroke patients is the decrease in consciousness, namely the Glasgow Coma Scale (GCS) score <9. Albeit, intubation and mechanical ventilation can cause a person 6 to 21 times more likely to develop pneumonia, commonly referred to as ventilator associated pneumonia (VAP). This study was conducted at Prof. Dr. R. D. Kandou Hospital Manado and was aimed to obtain the correlation between time of intubation and stroke patientâ€™s outcome based on GCS, VAP, LOS, and mortality. The results showed that there was no relationship between time of intubation <48 hours or â‰¥48 hours after stroke and improvement of GCS (0%); between time of intubation <48 hours or â‰¥48 hours after stroke and the occurence of VAP (P=0.698); and between time of intubation <48 hours or â‰¥48 hours after stroke and LOS (r=0.265; P=0.054); as well as between time of intubation <48 hours or â‰¥48 hours after stroke and mortality in the first two days after intubation (P=0.313).Keywords: stroke, time of intubation, outcome.Â Abstrak: Pasien stroke dengan penurunan kesadaran, gangguan jalan napas, hipoksia, apnea atau inisiasi terapetik hiperventilasi harus diintubasi. Penundaan waktu tindakan intubasi pada pasien stroke dengan keadaan umum yang memburuk sangat berisiko karena berkaitan dengan mortalitas dalam waktu 24-48 jam pertama dan akan memengaruhi length of stay (LOS). Indikasi dilakukannya intubasi terhadap pasien stroke salah satunya ialah penurunan kesadaran yang dinilai dengan skor Glasgow Coma Scale (GCS) <9. Intubasi dan ventilasi mekanik dapat menyebabkan seseorang 6 sampai 21 kali lipat cenderung terkena pneumonia (ventilator associated pneumonia/VAP). Penelitian ini bertujuan untuk mendapatkan hubungan antara waktu tindakan intubasi dengan outcome pasien stroke di RSUP Prof. Dr. R. D. Kandou Manado dengan menggunakan kajian terhadap GCS, VAP, LOS, dan angka kematian. Hasil penelitian memperlihatkan tidak terdapat hubungan antara waktu tindakan intubasi <48 jam atau â‰¥48 jam setelah serangan stroke dengan perbaikan GCS (0%); dengan kejadian VAP (P=0,698); dengan LOS (r=0,265; P=0,054); dan dengan angka kematian pada 2 hari pertama setelah diintubasi (P=0,313).Kata kunci: stroke, waktu tindakan intubasi, outcome

Gambaran Kepuasan Pasien terhadap Pelayanan Klinik Perioperatif Terintegrasi di RSUP Prof. Dr. R. D. Kandou Datu, Muliana E.; Kumaat, Lucky T.; Kambey, Barry I.
e-CliniC Vol 7, No 2 (2019): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v7i2.26783

Abstract: Satisfaction is closely related with expected service and reality of the service available at the hospital. Satisfaction will be achieved if the performance is in line with the expectation of the patient. This study was aimed to obtain an overview of patient satisfaction towards the service provided by the Integrated Perioperative Clinic of Prof. Dr. R. D. Kandou Hospital. This was a descriptive study using questionnaire. Respondents were patients/families who received services at the clinic. The results showed a total of 100 respondents involved in this study, consisting of 30 females (30%) and 70 males (70%). Most respondents aged early to late adulthood numbering as many as 46 respondents (46%). The majority of respondents numbering 44 respondents (44%) had high school education level. Based on the analysis, high calculation results were obtained categorized as very good or very satisfied. In conclusion, the level of patient satisfaction towards the service provided by the Integrated Perioperative Clinic of Prof. R. D. Kandou Central Hospital based on the quality of service scale measuring direct evidence (tangibles), reliability, comprehension (responsiveness), assurance, and empathy was very high. It means that patients are very satisfied with the services provided by the clinic.Keywords: patient satisfaction, quality of service, perioperative clinicÂ Abstrak: Kepuasan sangat berkaitan dengan pelayanan yang diharapkan dan kenyataan pelayanan yang telah diberikan di rumah sakit. Kepuasan akan terpenuhi bila pelayanan yang diberikan dirasakan telah sesuai dengan harapan pasien. Penelitian ini bertujuan untuk mengetahui gambaran kepuasan pasien terhadap pelayanan klinik perioperatif terintegrasi di RSUP Prof Dr. R. D. Kandou. Jenis penelitian ialah deskriptif dengan menggunakan kuesio-ner. Responden penelitian ialah pasien yang mendapatkan pelayanan di klinik perioperatif. Hasil penelitian mendapatkan total 100 responden yang terdiri dari 30 orang perempuan (30%) dan 70 orang laki-laki (70%). Responden berusia dewasa awal dan dewasa akhir yang terbanyak yaitu 46 orang (46%). Sebagian besar responden memiliki tingkat pendidikan SMA sebanyak 44 orang (44%). Hasil analisis mendapatkan hasil perhitungan yang tinggi dan masuk dalam kategori sangat baik atau sangat puas. Simpulan penelitian ini ialah tingkat kepuasan pasien terhadap pelayanan klinik perioperatif terintegrasi di RSUP Prof. Dr. R. D. Kandou Manado berdasarkan skala kualitas pelayanan yaitu bukti langsung (tangibles), kehandalan (reliability), daya tangkap (responsiveness), jaminan (assurance), dan empati (empathy) sangat tinggi yang berarti pasien merasa sangat puas atas pelayanan yang diberikan oleh klinik perioperatif terintegrasi.Kata kunci: kepuasan pasien, kualitas pelayanan, klinik perioperatif

Perbandingan antara ondansetron 4 mg iv dan deksametason 5 mg iv dalam mencegah mual-muntah pada pasien laparotomi dengan anestesia umum Yanhil, Sitti I.; Kambey, Barry I.; Tambajong, Harold F.
e-CliniC Vol 4, No 2 (2016): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v4i2.14559

Abstract: Nausea and vomiting are the most frequent side effects which occur postoperatively as a result of general anesthesia. Postoperative nausea and vomiting may increase morbidity and extend the duration of patient to stay at the recovery room. Ondansetron drug that has the effect as 5-HT3 antagonist receptor and dexamethasone administration might be the drug of choice in preventing postoperative nausea and vomiting. This study was aimed to compare the effect of 4 mg ondansetron and 5 mg dexamethasone administration on the incidence of postoperative nausea and vomiting in laparotomy surgery with general anesthesia. This was a prospective analytical study with an experimental method. Samples were obtained by using consecutive random sampling. There were 32 patients aged 18 to 60 years old, ASA I-II clasification, divided into two treatment groups as follows: ondansetron group given at the end of operation and dexamethasone group given before the induction of anesthesia. The resultas showed that complaints of postoperative nausea and vomiting mostly occured at the 5 mg dexamethasone group (37.5%) rather than 4 mg ondansetron group (12.5%). The Mann-Whitney test showed that there were no significant difference between both groups (p>0.05). Conclusion: Administration of 4 mg ondansetron intravenously has the same effectivity as 5 mg dexamethasone intravenously in reducing the incidence of postoperative nausea and vomiting after laparotomy with general anesthesia. Keywords: nausea and vomiting, ondansetron, dexamethasoneÂ Abstrak: Mual-muntah merupakan efek samping yang paling sering didapatkan pasca operasi akibat pemberian anestesia umum. Mual-muntah pasca operasi dapat meningkatkan morbiditas dan memperpanjang masa rawat pasien dari ruang pulih. Pemberian obat ondansetron yang berefek 5-HT3 reseptor dan deksametason dapat menjadi obat pilihan dalam mencegah terjadinya mual muntah pascaoperasi. Penelitian ini bertujuan untuk membandingkan pemberian ondanetron 4 mg dan deksametason 5 mg terhadap kejadian mual-muntah pasca operasi pada bedah laparotomi dengan anestesia umum. Jenis penelitian ialah analitik prospektif dengan metode eksperimental. Sampel didapatkan secara consecutive random sampling yang dilakukan pada 32 pasien dengan rentang usia 18-60 tahun, klasifikasi ASA I-II, yang dibagi menjadi dua kelompok perlakuan: kelompok ondansetron yang diberikan di akhir operasi dan kelompok deksametason sebelum induksi anestesia. Hasil penelitian mendapatkan keluhan mual muntah pascaoperasi lebih banyak terjadi pada kelompok deksametason 5 mg (37,5%) dibandingkan kelompok ondansetron 4 mg (12,5%). Uji Mann-Whitney mendapatkan tidak ada perbedaan bermakna antara keduanya (p >0,05). Simpulan: Pemberian ondansetron 4 mg intravena memiliki efektivitas yang sama dengan deksametson 5 mg iv dalam menurunkan kejadian mual-muntah pasca operasi laparotomi dengan anestesia umum.Kata kunci: mual muntah, ondansetron, deksametason

Gambaran Pasien Stroke Iskemik Akut dengan COVID-19 yang Masuk Ruang Perawatan Intensif Thambas, Anastasia T.; Lalenoh, Diana Ch.; Kambey, Barry I.
e-CliniC Vol 9, No 1 (2021): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.9.1.2021.32302

Abstract: Acute ischemic stroke (AIS) has been reported in patients with coronavirus disease 2019 (COVID-19). The cause of AIS in COVID-19 patients has not been fully understood, but COVID-19 is known to cause hypercoagulation characterized by increased d-dimer levels, and cytokine storms. Â Some AIS patients with COVID-19 require intensive care. This study was aimed to determine the description of AIS patients with COVID-19 admitted to the intensive care unit. This was a literature review study using three databases, as follows: Pubmed, ClinicalKey, and Science Direct. The keywords used were acute ischemic stroke AND COVID-19 AND intensive care unit. The results showed that after being selected based on inclusion and exclusion criteria, 10 literatures were obtained. There were 20 subjects and most were female (55%) and age group of 60-69 years old (35%). The most common cardiovascular risk factor was hypertension (80%, n=10). There were some increases in the levels of LDH, CRP, d-dimer, ferritinin, and fibrinogen. On radiological examination performed, there were cases with bilateral pulmonary infiltrate (33%) and ground-glass opacities (67%) (n = 6). In conclusion, the characteristics of AIS patients with COVID-19 admitted to the intensive care room were mostly female, age group 60-69 years, had cardiovascular risk factors for hypertension, had elevated levels of LDH, CRP, d-dimer, ferritinin, and fibrinogen, and had ground-glass opacity on radiological imaging.Keywords: acute ischemic stroke, COVID-19, intensive care unitÂ Abstrak: Stroke iskemik akut telah dilaporkan pada pasien dengan coronavirus disease 2019 (COVID-19). Penyebab stroke iskemik akut pada COVID-19 belum diketahui secara menyeluruh, tetapi COVID-19 dapat menyebabkan kejadian hiperkoagulasi ditandai dengan peningkatan kadar d-dimer serta menyebabkan badai sitokin. Beberapa pasien stroke iskemik akut dengan COVID-19 membutuhkan perawatan di ruang perawatan intensif. Penelitian ini bertujuan untuk mengetahui gambaran pasien stroke iskemik akut dengan COVID-19 yang masuk di ruang perawatan intensif. Jenis penelitian ialah literature review dengan pencarian data menggunakan tiga database yaitu Pubmed, ClinicalKey dan Science Direct dengan kata kunci acute ischemic stroke AND COVID-19 AND intensive care unit. Hasil penelitian mendapatkan 10 literatur dengan jumlah subyek penelitian sebanyak 20 orang, jenis kelamin terbanyak ialah perempuan (55%) dengan kelompok usia terbanyak ialah 60-69 tahun (35%). Faktor risiko kardiovaskular yang paling banyak dimiliki subyek penelitian ialah hipertensi (80%, n=10). Terdapat peningkatan kadar LDH, CRP, d-dimer, ferritinin, dan fibrinogen. Pada pemeriksaan radiologi ditemukan bilateral pulmonary infiltrate (33%) dan ground-glass opacitiy (67%) (n=6). Simpulan penelitian ini ialah karakteristik pasien stroke iskemik akut dengan COVID-19 yang masuk ruang perawatan intensif paling banyak ialah perempuan, usia 60-69 tahun, memiliki faktor risiko kardiovaskular hipertensi, mengalami peningkatan kadar LDH, CRP, d-dimer, ferritinin, fibrinogen, dan ditemukan ground-glass opacitiy pada gambaran radiologi.Kata kunci: Stroke iskemik akut, COVID-19, ruang perawatan intensif

Fungsi Kognitif Skala MOCA-INA pada Peserta PPDS Anestesiologi dan Terapi Intensif: Perbandingan Sebelum dan Setelah Jaga di Rumah Sakit Wonggo, Tesalonika; Kambey, Barry I.; Lalenoh, Diana C.
Medical Scope Journal Vol. 7 No. 1 (2025): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v7i1.56407

Abstract: Shift duty can negatively impact cognitive function among residents of Specialist Program. This study aimed to obtain the differences in cognitive function of Anesthesiology and Intensive Therapy (ATI) residents at Universitas Sam Ratulangi before and after on-call duty at Prof. Dr. R. D. Kandou General Hospital Manado. This was a descriptive observational study with a cross-sectional design. Samples were residents of ATI who completed the Indonesian version of the Montreal Cognitive Assessment (MoCA-INA) before and 24 hours after on-call duty. The results showed a total of 31 residents as samples with a proportion of 24 (77.4%) males and seven (22.6%) females. There was a decline in most cognitive domains, with a statistical analysis demonstrating a decrease in the mean MoCA-INA score from 26.8387 to 25.0000, accompanied by a p-value of 0.000 (<0.05) and a Z-score < -2 obtained from the Wilcoxon test. In conclusion, there is a significant difference in cognitive function of residents of Anesthesiology and Intensive Therapy Specialist Program of Universitas Sam Ratulangi before and after on-call duty at the hospital. This is possibly due to cognitive overload caused by the shift duty. Keywords: cognitive function; MoCA-INA; shift duty; specialist program Abstrak: Tugas jaga yang berat dapat berdampak negatif terhadap fungsi kognitif peserta Program Pendidikan Dokter Spesialis (PPDS). Penelitian ini bertujuan melihat perbedaan fungsi kognitif PPDS Anestesiologi dan Terapi Intensif (ATI) Universitas Sam Ratulangi sebelum dan sesudah jaga di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif observasional dengan desain potong-lintang pada PPDS ATI yang mengisi Montreal Cognitive Assesment versi Indonesia (MoCA-INA) sebelum dan 24 jam setelah jaga. Penelitian ini bertujuan untuk mengidentifikasi apakah terdapat perbandingan antara fungsi kognitif pada PPDS sebelum dan setelah menjalani tugas jaga 24 jam. Hasil penelitian mendapatkan 31 sampel dengan proporsi laki-laki sebanyak 24 (77,4%) orang dan perempuan sebanyak tujuh (22,6%) orang. Penurunan pada sebagian besar domain kognitif dengan hasil analisis statistik menunjukkan penurunan rerata skor MoCA-INA dari 26,8387 menjadi 25,0000 disertai dengan nilai p<0,05 (p=0,000) dan Z-score <-2 yang diperoleh melalui uji Wilcoxon. Simpulan penelitian ini ialah terdapat perbedaan fungsi kognitif PPDS Anestesiologi dan Terapi Intensif Universitas Sam Ratulangi yang bermakna antara sebelum dan setelah jaga di rumah sakit. Hal ini diduga disebabkan kelebihan beban kognitif akibat tugas jaga. Kata kunci: fungsi kognitif; MoCA-INA; tugas jaga; residen pendidikan dokter spesialis

Profil Pasien dengan Gangguan Elektrolit yang Dirawat di Ruang Perawatan Intensif Sumule, Vania S. P.; Laihad, Mordekhai L.; Kambey, Barry I.
Medical Scope Journal Vol. 7 No. 2 (2025): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v7i2.58877

Abstract: Electrolyte disturbance is a common health problem in critical patients in the Intensive Care Unit (ICU). These disorders can cause serious complications and contribute to increased morbidity and mortality. This study aimed to determine the description of electrolyte disturbances experienced by patients in the ICU of Prof. Dr. R. D. Kandou Hospital. This was an observational study with a retrospective design involving 252 patients admitted to the ICU with electrolyte disturbances from January to June 2023. Data were obtained from medical records and analyzed descriptively. The results showed that hyponatremia was the most common electrolyte disorder (65.1%), followed by hypokalemia (48%), hypochloremia (53.6%), hypocalcemia (61.5%), and hyperphosphatemia (40.5%). The highest incidence was in the age group >65 years (18.7% for hyponatremia and hypocalcemia). The majority of patients were male. The most common disease diagnosis was sepsis. In conclusion, hyponatremia and hypocalcemia are the main electrolyte disorders in critical patients in the ICU of Prof. Dr. R. D. Kandou Hospital. The high-risk group is elderly men with sepsis. Close monitoring of electrolytes needs to be done especially in patients with these conditions to prevent fatal complications. Keywords: electrolyte disturbance; hyponatremia; hypocalcemia Abstrak: Gangguan elektrolit merupakan masalah yang sering terjadi pada pasien kritis di Intensive Care Unit (ICU). Penelitian ini bertujuan mengetahui profil pasien dengan gangguan elektrolit di ICU RSUP Prof. Dr. R. D. Kandou. Jenis penelitian ialah observasional retrospektif dan pendekatan kuantitatif. Sampel penelitian ialah 252 pasien dengan gangguan elektrolit yang dirawat di ICU RSUP Prof. Dr. R. D. Kandou periode Januari-Juni 2023. Pengambilan sampel dilakukan secara purposive sampling. Variabel yang diteliti meliputi jenis gangguan elektrolit, karakteristik pasien (usia, jenis kelamin), diagnosis penyakit, dan lama rawat inap. Data dikumpulkan dari rekam medis dan dianalisis secara deskriptif. Hasil penelitian mendapatkan gangguan elektrolit terbanyak ialah hiponatremia (65,1%) dan hipokalsemia (61,5%). Kelompok usia >65 tahun (18,7%) dan laki-laki lebih banyak mengalami gangguan elektrolit, dan diagnosis tersering ialah sepsis. Rerata lama rawat inap pasien 1-7 hari. Simpulan penelitian ini ialah hiponatremia dan hipokalsemia merupakan gangguan elektrolit yang paling umum terjadi pada pasien ICU RSUP Prof. Dr. R. D. Kandou. Pasien usia lanjut dan sepsis berisiko tinggi mengalami gangguan elektrolit. Kata kunci: gangguan elektrolit; hiponatremia; hipokalsemia

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