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The EFFECTIVENESS OF THE RAPID EMERGENCY MEDICINE SCORE (REMS) TRIAGE MODEL IN DETERMINING MORTALITY RISK IN DISASTER AREAS: A Literature Review BASHOR, FURQON ABDULLAH; Rahmadinie, Amalia
Journal of Diverse Medical Research: Medicosphere Vol. 2 No. 4 (2025): J Divers Med Res 2025
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33005/jdiversemedres.v2i4.83

Indonesia is one of the countries with a high risk of natural disasters with a total of 20,380 cases between 2020-2024. The high number of disasters that occur will have an impact on the high number of casualties that must be handled by medical personnel. In the event of a disaster, the number of health workers is often less than the need to cause an increase in the mortality rate of victims, therefore as an effort to increase the efficiency of the number of health workers to provide treatment, it is necessary to apply triage, one of which is the Rapid Emergency Medicine Score (REMS) triage model. The purpose of writing this article is to determine the effectiveness of triage with the REMS model used by medical personnel and volunteers in disaster areas on disaster victims. The method used is a literature review taken from several sources with a limit of 2019- 2024. From the literature review, it is found that the application of the REMS triage model has proven effective during disasters. As during the Covid 19 pandemic, this is because the REMS triage method is simple and fast; flexible and has good prognostic value; and uses Vital Signs (TTV) parameters so that it can be applied to various situations and conditions. REMS is an effective triage model for non-trauma disaster victims.

Enhancing Emergency Fracture Diagnosis with Point-of-Care Ultrasound (Pocus) : A Rapid and Efficient Alternative: A Literature Review Agastya, Wayan Dhea; Rahmadinie, Amalia; Aulia, Khansa Tsabitah; Anrofi, Fakhirah Nailah; Al Habsyi, Alya Raguan; Firdausiyah, Shofie Ayu Nur; Winangest, Bisarda Kanira Permata Putri
Journal of Diverse Medical Research: Medicosphere Vol. 2 No. 5 (2025): J Divers Med Res 2025
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33005/jdiversemedres.v2i5.177

Abstract Introduction: Fracture diagnosis is a crucial aspect of trauma and musculoskeletal injury management, traditionally relying on imaging modalities such as X-ray, CT scan, and MRI. However, these methods have limitations, including high costs, long waiting times, radiation exposure, and limited accessibility in remote areas. Point-of-Care Ultrasound (POCUS) has emerged as a diagnostic alternative that is more portable, cost-effective, radiation-free, and provides real-time results, making it a potential solution in emergency situations or resource-limited healthcare facilities. Methods: This study employs a literature search approach based on the PICO framework to evaluate the effectiveness of Point-of-Care Ultrasound (POCUS) in detecting fractures compared to X-ray, CT scan, and MRI. Literature sources were obtained from Scopus, ScienceDirect, Google Scholar, and PubMed using relevant keywords. Seven English-language journals were selected for further analysis. Results and Disscussion: POCUS is a rapid, non-invasive, and effective diagnostic tool for fracture and musculoskeletal injury. It allows fracture identification within an average of 3.9 minutes, with a sensitivity exceeding 85%, reaching up to 100% in children, while its specificity exceeds 90%. Although its accuracy is still lower than that of MRI, POCUS excels in terms of speed and patient convenience. Conclusion: POCUS serves as a safe and rapid alternative to conventional methods, particularly for children and patients with limited access to radiographic imaging. It provides a more patient-friendly diagnostic method, especially in medical settings requiring high safety and speed. While X-ray remains the gold standard, POCUS can be utilized in emergency situations. However, its effectiveness depends on operator skill and is less optimal for detecting complex fractures. Keywords: Point-of-Care-Ultrasound, POCUS, Fracture, Diagnosis, Medical Imaging

Efektivitas Blok Saraf Tepi Transversus Abdominis Plane (TAP) terhadap Nyeri Pascaoperasi Seksio Sesarea Darurat dalam Kondisi Bencana: Penelitian Kohort Retrospektif Agastya, Wayan Dhea; Rahmadinie, Amalia; Sepviyanti Sumardi, Fitri
Jurnal Anestesi Obstetri Indonesia Vol 8 No 2 (2025): Juli
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v8i2.226

Latar Belakang: Tsunami Palu 2018 menyebabkan peningkatan tajam tindakan seksio sesarea darurat di RSUD Undatta. Dalam kondisi keterbatasan, pendekatan analgesia regional seperti blok saraf tepi Transversus Abdominis Plane (TAP) block dapat menjadi strategi efektif untuk menekan kebutuhan opioid dan mempercepat pemulihan pasien. Tujuan: Menilai efektivitas Blok saraf tepi TAP dalam mengurangi nyeri pascaoperasi dan konsumsi opioid pada pasien seksio sesarea darurat dalam situasi bencana. Metode: Penelitian kohort retrospektif terhadap 100 pasien yang menjalani seksio sesarea darurat selama Oktober–November 2018. Dibandingkan dua kelompok: Blok saraf tepi TAP (n=50) vs analgesia sistemik konvensional (n=50). Parameter evaluasi: skor Visual Analog Scale (VAS) pada 1, 6, 12, 24 jam; konsumsi morfin ekuivalen; dan komplikasi. Hasil: Skor nyeri VAS kelompok TAP signifikan lebih rendah di semua titik waktu (p<0.01), dengan rata-rata skor VAS 24 jam: 2.0 ± 0.9 (vs 4.7 ± 1.3). Penggunaan morfin juga berkurang secara signifikan (1.5 mg vs 4.3 mg; p<0.01). Tidak ada komplikasi berat; 4% pasien TAP mengalami parestesia ringan. Simpulan: Blok TAP efektif dan aman sebagai analgesia pascaoperasi untuk seksio sesarea darurat dalam kondisi bencana. Teknik ini layak diintegrasikan ke dalam protokol anestesi kebencanaan

Optimizing Acute Pain Management After Trauma in the Emergency Department: the Role of Regional Nerve Blocks by Anesthesiologists: A Literature Review Agastya, Wayan Dhea; Rahmadinie, Amalia
Journal of Diverse Medical Research: Medicosphere Vol. 2 No. 7 (2025): J Divers Med Res 2025
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

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Abstract Background: Acute pain management remains a critical challenge in emergency departments (EDs), particularly in trauma cases. Traditional systemic analgesics, especially opioids, pose risks of adverse effects and dependency. Regional nerve blocks (RNBs), administered by anesthesiologists, offer a promising alternative. This literature review explores the efficacy, safety, and practical considerations of RNBs in trauma-related acute pain within ED settings. Evidence suggests that RNBs significantly reduce pain scores and opioid consumption while maintaining a favorable safety profile. Collaborative implementation of RNBs in EDs can improve patient outcomes and reduce opioid-related risks. Method: This research employs a literature analysis approach by reviewing relevant theoretical and empirical sources, including Google Scholar, PubMed, and ScienceDirect. Discussion: The findings reveal that RNBs, particularly when guided by ultrasound and performed by anesthesiologists, significantly reduce pain scores, opioid use, and side effects compared to systemic analgesia. Despite logistical barriers in ED settings, collaborative approaches between emergency physicians and anesthesiologists enhance feasibility and patient outcomes. Conclusion: Regional nerve blocks by anesthesiologists offer fast, targeted, and safer pain relief in trauma care, reducing opioid dependence and improving outcomes. Integrating RNBs into emergency protocols enhances patient care and should be prioritized. Keywords: Regional Nerve Block, Trauma Pain, Emergency Department, Anesthesiologist

Implementasi Program Pendayagunaan Dokter Spesialis sebagai Salah Satu Bentuk Pengabdian Masyarakat di Daerah Rahmadinie, Amalia; Agastya, Wayan Dhea
Jurnal Peduli Masyarakat Vol 7 No 4 (2025): Jurnal Peduli Masyarakat: Juli 2025
Publisher : Global Health Science Group

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/jpm.v7i4.6875

Kesenjangan akses pelayanan kesehatan antara daerah perkotaan dan pedesaan masih menjadi tantangan serius di Indonesia. Program pendayagunaan dokter spesialis atau disingkat PGDS dirancang untuk mengatasi kekurangan tenaga dokter spesialis di daerah. Artikel ini bertujuan untuk menggambarkan implementasi program PGDS, khususnya dokter spesialis anestesi, sebagai bentuk pengabdian masyarakat di daerah. Metode yang digunakan adalah studi deskriptif kuantitatif, data dikumpulkan secara retrospektif dari rekam medis pasien, dan meliputi seluruh pasien yang mendapatkan pelayanan anestesi oleh dokter PGDS selama masa penempatan dari Desember 2021 sampai dengan Nopember 2022. Literatur yang digunakan dibatasi pada publikasi dalam 10 tahun terakhir untuk menjaga keterkinian informasi dan relevansi konteks kebijakan. Dapat terlihat bahwa program ini telah memberikan kontribusi positif terhadap akses layanan kesehatan di daerah, walaupun menghadapi berbagai tantangan seperti keterbatasan infrastruktur dan fasilitas serta keberlanjutan penempatan dokter yang masih perlu dibenahi. Pelaksanaan PGDS di daerah adalah strategi efektif dalam pemerataan layanan kesehatan di Indonesia sekaligus sebagai salah satu bentuk pengabdian terhadap masyarakat.

Evaluating the Role of Atropine Sulphate in Preventing Motion-Related Postoperative Nausea and Vomiting in Patients Undergoing Cesarean Section using ERACS Protocol Rahmadinie, Amalia; Agastya, Wayan Dhea
Jurnal Kesehatan Islam : Islamic Health Journal Vol. 14 No. 1 (2025): Jurnal Kesehatan Islam : Islamic Health Journal
Publisher : Publikasi oleh Fakultas Kedokteran Universitas Islam Malang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33474/jki.v14i1.24123

ABSTRACT Background: PONV is common after cesarean section using ERACS protocol. Motion-related PONV during early mobilization can impair comfort and delay recovery. Anticholinergic agents such as atropine sulphate have antiemetic effects via muscarinic receptor antagonism, especially when vestibular pathways are involved, but their intravenous use for motion-related PONV prevention remains underexplored. Objective: To evaluate the effectiveness of intravenous atropine sulphate in reducing motion-related PONV within two hours postoperatively in patients undergoing cesarean section. Methods: A retrospective cross-sectional analysis was carried out involving 30 patients at a private hospital in Sidoarjo, Indonesia (May–June 2025). Patients were assigned to either control (no atropine) or treatment (0.5 mg atropine IV after cord clamping). The primary outcome was a combined PONV score: (1) vomiting episodes ≥ 1, (2) moderate-to-severe nausea/vomiting (VAS > 4), and (3) rescue antiemetic use. Secondary outcomes included atropine-related adverse effects. Results: The treatment group had significantly lower mean combined PONV scores (p < 0.001), fewer vomiting episodes (p = 0.035), less moderate-to-severe nausea (p = 0.002), and borderline reduced rescue antiemetic use (p = 0.05). No significant adverse effects were observed. Conclusion: IV atropine sulphate 0.5 mg after cord clamping effectively reduces motion-related PONV in ERACS cesarean patients without notable side effects. Keywords: atropine sulphate, cesarean section, ERACS, PONV vestibular pathway.

A Current Perspective of Systemic Lupus Erythematosus: A Literature Review Wibowo, Cakraningrum Jakti Giza; Rahmadinie, Amalia
Journal of Diverse Medical Research: Medicosphere Vol. 1 No. 6 (2024): J Divers Med Res
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33005/jdiversemedres.v1i3.46

Background. Systemic lupus erythematosus (SLE), is a chronic autoimmune disease that affects various organ systems in the body. This disease is characterized by an abnormal immune reaction, in which the body's immune system attacks the body's own tissues, resulting in inflammation and damage. Symptoms of lupus vary greatly, ranging from fatigue, joint pain, skin rashes, to serious complications such as kidney and heart damage. Systemic lupus erythematosus (SLE) is characterized by dysfunction of the immune system and is clinically heterogeneous, presenting with renal, dermatological, neuropsychiatric, and cardiovascular. Methods. The research method used was literature review using electronic databases through national and international journals such as Google scholar and ScienceDirect as well as health articles such as Cleveland Clinic. The inclusion criteria used by the authors were to limit articles or journals published in the last five years starting from 2019 to 2024. Disscusion. Systemic lupus erythematosus (SLE) classification criteria are often chosen based on tradition, consensus and statistics, without considering deeper etiological and pathogenetic aspects. This process can result in a lack of scientific objectivity, as it does not explore causal relationships between criteria and disease mechanisms. Conclusion. Systemic Lupus Erythematosus (SLE) is a systemic autoimmune disease characterized by aberrant immune system reactions, affecting various organs in the body. Genetic, environmental and hormonal factors contribute significantly to the development of this disease, which is more common in women of reproductive age. Keywords: Systemic Lupus Erythematosus (SLE), Autoimmune, Symptoms, Diagnosis

Current Perspective of Diagnostic and Treatment of Rabies: A Literature Review Pratama, Nauval Lazuardi; Rahmadinie, Amalia
Journal of Diverse Medical Research : Medicosphere Vol. 1 No. 2 (2024): J Divers Med Res 2024
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33005/jdiversemedres.v1i2.142

Background. Rabies is a zoonotic disease caused by the rabies virus (RABV) from the Lyssavirus genus. Transmitted through saliva, typically via bites or scratches, it causes fatal neurological disorders if untreated. Annually, rabies claims 59,000 lives, with most cases in rural Africa and Asia, where dogs are the primary reservoirs. Despite available vaccines, low coverage in resource-limited settings makes rabies a persistent public health issue. Effective prevention requires vaccination programs, public awareness, and animal population control. Methods. This study was conducted through a literature review using PubMed and Google Scholar as primary sources. Relevant peer-reviewed articles and research papers on rabies epidemiology, clinical features, pathophysiology, and management published in the last five years (2019–2024) were selected. Keywords such as "rabies," "Lyssavirus," and "vaccination" guided the search. Discussion. Rabies is a deadly disease with a high fatality rate once symptoms appear, making prevention through vaccination critical. Early post-exposure treatment, such as wound cleaning and immunoglobulin administration, reduces infection risks. Despite advancements in diagnostics and cost-effective vaccination methods, challenges remain in controlling rabies transmission, particularly from dogs and bats. Public awareness, improved vaccine access, and effective animal control are essential to eliminating rabies. Conclusion. Rabies is a fatal zoonotic disease with almost no chance of survival once symptoms appear. Prevention through vaccination and post-exposure treatment, including wound cleaning and immunoglobulins, is crucial. Efforts to control rabies require increased vaccination coverage, public education, and better management of animal reservoirs, especially dogs.

Opioid-Sparing and Multimodal Analgesia in Cesarean Delivery: A Systematic Review of Evidence and Implementation Across High and Low-Middle Income Countries: A Systematic Review Agastya, Wayan Dhea; Rahmadinie, Amalia
Journal of Diverse Medical Research: Medicosphere Vol. 2 No. 9 (2025): J Divers Med Res 2025
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar

ABSTRACT Introduction: Cesarean delivery is a common surgical procedure worldwide, often accompanied by significant postoperative pain that can negatively impact recovery, early breastfeeding, and maternal mobility. Opioids have traditionally been central to post-cesarean analgesia but are associated with side effects such as nausea, vomiting, pruritus, sedation, and respiratory depression. Recently, opioid-sparing and multimodal analgesia strategies—combining neuraxial opioids, regional blocks (e.g., transversus abdominis plane [TAP] block), and non-opioid systemic agents (NSAIDs, acetaminophen)—have been increasingly adopted to reduce opioid consumption while maintaining effective analgesia. Methods: A systematic literature search was conducted in PubMed, Scopus, Web of Science, and Google Scholar for studies published from January 2021 to August 2025. Eligible studies included randomized controlled trials, cohort studies, and quality improvement projects evaluating opioid-sparing multimodal analgesia in women undergoing cesarean delivery in both high-income countries (HICs) and low- and middle-income countries (LMICs). Primary outcomes were postoperative opioid consumption and pain scores; secondary outcomes included opioid-related side effects, recovery milestones, maternal satisfaction, and neonatal safety. Data extraction and quality assessment were performed independently by two reviewers following PRISMA 2020 guidelines. Discussion: The review included nine studies from diverse settings. Multimodal analgesia regimens consistently reduced opioid consumption and pain scores, improved maternal satisfaction, and decreased opioid-related adverse effects. Regional techniques such as TAP block were effective adjuncts or alternatives to neuraxial opioids, especially in LMICs where opioid availability and monitoring are limited. Adoption of multimodal protocols was more widespread in HICs, often integrated within enhanced recovery after cesarean (ERAC) pathways. Barriers in LMICs included limited regional anesthesia expertise, drug availability, cost, and institutional protocols, highlighting the need for capacity building and context-specific guidelines. Conclusion: Opioid-sparing multimodal analgesia is effective, safe, and feasible across various healthcare settings, improving postoperative pain control and recovery after cesarean delivery. Addressing implementation gaps between HICs and LMICs through training, resource allocation, and simplified protocols is essential to optimize global obstetric analgesia. Future research should focus on standardizing regimens, evaluating long-term maternal and neonatal outcomes, and overcoming implementation challenges to facilitate broader adoption.

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