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The success of implementing patient safety in the emergency department cannot be separated from various factors that influence it, one of which is the workload of medical staff.The availability of facilities also plays a significant role in the implementation of patient safety.The objective of this study is to determine the relationship between nurse workload and the availability of facilities with the implementation of patient safety in the Emergency Department of RSUD ODSK, North Sulawesi Province.The research uses a cross-sectional design.The sample in this study consisted of 30 respondents using the purposive sampling technique.Data collection on workload, facilities, and patient safety was conducted using a questionnaire and analyzed using the chi-square statistical test.The research results showed that the highest workload was the light workload category, with 21 respondents (70%).The most available facilities and infrastructure were found, with 21 respondents (70%).The most common implementation of patient safety was the implementation of patient safety in the good category, with 22 respondents (73.3%).The chi-square test results obtained p values of 0.003 and 0.032, where < α 0.05.Conclusion: There is a relationship between nurse workload and the availability of facilities with the implementation of patient safety in the Emergency Room of RSUD ODSK, North Sulawesi Province.

Kwashiorkor is a form of protein energy malnutrition (MEP). Malnourished toddlers have short and long term effects, in the form of impaired growth and development, including impaired cognitive function, morbidity, risk of degenerative diseases in later life and death. The male patient aged 1 year and 2 months was brought by his parents to the emergency room of Cut Meutia Hospital on Tuesday, June 4, 2024 at 20:07 WIB with complaints of swelling on both backs of legs and hands and face. On the antopometric examination on the first day of treatment, the patient's nutritional status was found to be poor. Patients are given malnutrition management which is divided into 3 phases, namely stabilization, transition and rehabilitation.   Kata kunci: Antropometri, Kwashiorkor, Malnutrisi Energi Protein

Patients who come to the emergency room will be triaged. Categorization of patients based on triage often causes anxiety in the patient's family. Anxiety is a psychological condition of a person with fear accompanied by physical complaints. The purpose of this study was to determine the relationship between the level of patient emergency with the level of anxiety of the patient's family in the emergency room of RSI sultan agung Semarang. This study is a type of quantitative research with correlational research design and cross sectional method. Data collection was done with a questionnaire with a total of 300 respondents with accidental sampling technique. The data obtained is statistically processed using the sommers test. Based on the analysis obtained, 41 respondents in ATS 2 experienced very severe anxiety, 63 respondents in ATS 3 experienced severe anxiety, 47 respondents in ATS 4 experienced moderate anxiety, 10 respondents in ATS 5 experienced mild anxiety. The results of the sommers test showed a p value of 0.00, meaning that there was a relationship between the level of emergency of the patient and the level of anxiety of the patient's family in the emergency room of RSI sultan agung Semarang.

Admission services in the emergency department (IGD) are an important part of hospital operations that require effective management to support health services. Optimal medical record management requires human resource planning according to actual workload. This research was conducted to analyze the need for admission registration at the Duren Sawit Regional Special Hospital (RSKD) with a quantitative approach using descriptive methods. The research results show that RSKD Duren Sawit has Standard Operational Procedures (SPO) which refer to Minister of Health Regulation No. 33 of 2015 in planning health human resource needs (HRK). Health workload analysis indicates that the ideal requirement is seven admissions officers, while currently only five officers are available, so there is a shortage of two officers. Factors that influence the workload of admission registration include: Man, namely the limited number of officers in the medical records unit, Machine, namely the BPJS server down and power outages, Material, namely the mixed admissions work room with the cashier so the medical record files are still in one room, Method, namely the HR application process at RSKD Duren Sawit found no obstacles, Money, namely there is no budget planning for additional officers in the medical records unit.

Bronchopneumonia is a type of pneumonia that affects the bronchi and alveoli, usually starting in the terminal bronchioles. The terminal bronchioles become blocked with mucopurulent exudate forming patches of consolidation in adjacent lobules. 95% of pneumonia cases in children occur in developing countries. According to WHO estimates, the infant mortality rate due to pneumonia in developing countries is 40 out of 1000 live births or around 15-20% per year. A 5-year-old boy was brought to the Emergency Room of Cut Meutia Hospital with complaints of shortness of breath since 3 days before admission accompanied by a cough with phlegm and fever. The results of a physical examination of the thorax found nasal flaring breathing, chest wall retraction, and rhonchi (+/+). Based on laboratory tests, there was an increase in leukocytes, then a chest X-ray showed an impression of infiltration in the perihilar and paracardial. Based on history, physical examination, and supporting examinations, the patient was diagnosed with Bronchopneumonia. Non-medical management is done through bed rest, balanced nutrition, and adequate fluid balance. Then the patient's medical management is in the form of Cefotaxime injection 500 mg/12 hours, symptomatic management and supportive management for the bronchopneumonia..

Labor pain is a complex experience, with 65-80% of mothers in Indonesia experiencing severe pain during childbirth, requiring effective management. The SP6 (Sanyinjiao) acupressure technique offers a non-pharmacological, easy-to-apply, and safe alternative with minimal side effects for reducing labor pain. This study aimed to evaluate the effect of SP6 acupressure on labor pain in mothers giving birth at the Obstetrics Emergency Room of Tidore Islands City Hospital. A quasi-experimental design with a pre-test and post-test approach was used. The sample included 30 mothers in the active phase of labor (4-7 cm dilation), with singleton pregnancies and gestational ages of 37-42 weeks, selected through purposive sampling. The intervention involved applying acupressure at the SP6 point for 20 minutes with moderate pressure. Pain intensity was measured before and after the intervention using a Numeric Rating Scale (NRS) from 0-10. The Wilcoxon Signed Rank Test showed a significant decrease in pain intensity (p = 0.000), with 50% of participants reporting moderate pain post-intervention, and no participants experiencing uncontrolled severe pain. In conclusion, SP6 acupressure significantly reduced labor pain intensity and can be recommended as an effective, safe, and easy-to-apply method for managing labor pain.

Background:Gastritis is an inflammation of the stomach wall caused by irritation of the gastric mucosa. Gastritis caused by bacterial infections such as Helicobacteri pylory and irritant foods and drinks. The problem posed is acute pain. Nursing interventions to address this problem are pain management. Objective: This case study aims to describe the implementation of nursing pain management in gastritis patients with acute pain. Method: This case study design is a descriptive design in the form of a case study with a nursing care process approach. The case study subjects were 4 patients in the emergency room with the criteria of experiencing gastritis with problems acute pain. This case study was conducted at Muhammadiyah Palembang Hospital on March 16- 23, 2023. The nursing implementation provided was in the form of warm compress and deep breath relaxation to reduce pain in gastritis patients, in patient 1 before the implementation of the pain scale was 5 and fell to 3, the second patient initially had a pain scale of 4 decreasing to 2, in patient 3 the initial scale of 5 was reduced to a scale of 2, and finally patient 4 before the technique was carried out. out the pain scale in patients is 5 after being carried out down to a scale of 3. Using data collection techniques by means of observation, and interviews. Results: The research results describe the need for implementation of pain management (warm compress and deep breath relaxation) to reduce pain in gastritis patients from a moderate pain scale to a mild pain scale.Conclusion:There is an influence in implementing pain management on acute pain in gastritis patients.

Obstetric emergencies are a major cause of maternal mortality, most of which can be prevented through prompt and appropriate treatment. Midwives, as health workers assigned to the Emergency Department (ED) of PONEK, play a strategic role in early detection and initial management of obstetric emergencies, thus their knowledge level is an important factor in determining preparedness for treatment. This study aims to analyze the relationship between midwives' knowledge level regarding obstetric emergency management and their preparedness for handling obstetric emergencies in the Emergency Department (ED) of PONEK of Muara Teweh Regional Hospital. This study used an observational analytical design with a cross-sectional approach. The study sample consisted of 28 midwives selected using a total sampling technique. Data were collected using a structured questionnaire to measure their knowledge level and preparedness for handling obstetric emergencies. Data analysis was performed descriptively and inferentially using the Fisher's Exact Test. The results showed that more than half of the midwives had a good level of knowledge and preparedness for handling obstetric emergencies. Inferential analysis showed a highly significant relationship between midwives' knowledge level and their preparedness for obstetric emergencies (p < 0.001). It was concluded that midwives' knowledge level was closely related to their preparedness for obstetric emergencies in the PONEK Emergency Department of Muara Teweh Regional Hospital. This finding underscores the importance of strengthening midwives' knowledge through ongoing training, clinical simulations, and routine supervision to improve clinical preparedness and ensure the safety of mothers and babies in emergency obstetric care.

A Critical nursing care is a process for problem solving, decision making as well as an organized and systematic approach to nursing problems. Nursing care must be carried out completely and accurately because it is the nurse's self-defense against demands as well as proof that the correct nursing care has been carried out. The research objective is to find out the description of the implementation of critical nursing care in Emergency Room of Santa Elisabeth Hospital Medan 2023. The research design used is a descriptive research design. There are two populations in this study, namely nursing actions and documentation of critical nursing care, the sampling technique used purposive sampling 51 respondents and total sampling (critical nursing care documentation) as many as 68 respondents. The data collection instrument uses observation sheets for nursing actions consisting of infusions, ECG usage and oxygen therapy, as well as critical nursing care using observation sheets consisting of assessment, diagnosis, intervention/implementation and evaluation. The results show that the infusion was according to the SOP, the use of ECG was according to the SOP and sufficient oxygen therapy is according to the SOP for 51 respondents (100%). Critical nursing care complete review 65 (96%), diagnosis quite complete 48 (71%), complete intervention/implementation 65 (96%), complete evaluation 67 (99%) and documentation of critical nursing care majority complete 65 (96%) of 68 respondents. It is expected to be able to improve the accuracy and completeness of nursing care documentation through training for each officer.

A Critical nursing care is a process for problem solving, decision making as well as an organized and systematic approach to nursing problems. Nursing care must be carried out completely and accurately because it is the nurse's self-defense against demands as well as proof that the correct nursing care has been carried out. The research objective is to find out the description of the implementation of critical nursing care in Emergency Room of Santa Elisabeth Hospital Medan 2023. The research design used is a descriptive research design. There are two populations in this study, namely nursing actions and documentation of critical nursing care, the sampling technique used purposive sampling 51 respondents and total sampling (critical nursing care documentation) as many as 68 respondents. The data collection instrument uses observation sheets for nursing actions consisting of infusions, ECG usage and oxygen therapy, as well as critical nursing care using observation sheets consisting of assessment, diagnosis, intervention/implementation and evaluation. The results show that the infusion was according to the SOP, the use of ECG was according to the SOP and sufficient oxygen therapy is according to the SOP for 51 respondents (100%). Critical nursing care complete review 65 (96%), diagnosis quite complete 48 (71%), complete intervention/implementation 65 (96%), complete evaluation 67 (99%) and documentation of critical nursing care majority complete 65 (96%) of 68 respondents. It is expected to be able to improve the accuracy and completeness of nursing care documentation through training for each officer.

Liver cirrhosis is a pathological condition that describes the end stage of progressive hepatic fibrosis. More than 40% of cirrhosis patients are asymptomatic. Based on research, 4% of patients with fatty liver will develop non-alcoholic steatohepatitis, and 0.3% of these patients will end up experiencing liver cirrhosis. A 48 year old man came to the emergency room at Cut Meutia Hospital with complaints of an enlarged stomach accompanied by pain since ± 2 weeks. The patient also complained of swelling in both legs. The results of the physical examination of the abdomen revealed icteric sclera (+/+), shifting dulness and leg edema (+/+). Based on laboratory examinations, it appeared that there was an increase in liver function, then the ultrasound examination showed the impression of ascites and liver cirrhosis. Based on the history, physical examination and supporting examinations, the patient was diagnosed with hepatic cirrhosis, relative decompensated stage of hepatitis B + CHD. Non-medical management is carried out in the form of bed rest, balanced nutrition and consumption of a low sodium diet. Then the patient's medical management consists of a 500ml hepatic Aminofuscin infusion, symptomatic management and antiviral treatment for the hepatitis he is suffering from.  

Nasopharyngeal Carcinoma (NPC) is a squamous cell carcinoma (SCC) originating from the nasopharyngeal epithelium. In Indonesia, NPC is the 4th most common malignancy after breast cancer, cervical cancer, and lung cancer. A 40-year-old woman came to the Emergency Room of Cut Meutia Hospital with complaints of left-sided nosebleeds for approximately 2 weeks before entering the hospital. The results of the physical examination found hair that was easily pulled out, then from the results of the supporting examination in the form of a non-contrast head CT-Scan, an expansion of the mass in the nasopharynx was found. Based on the anamnesis, physical examination and supporting examinations, the patient was diagnosed with nasopharyngeal carcinoma. The management that can be given to patients is non-drug, namely consuming nutritious food, and managing stress and sleep patterns, in addition the patient is also given symptomatic management.

Relapsing Pulmonary Tuberculosis is a patient with pulmonary TB who has received TB treatment and has been declared cured or finished treatment, then re-diagnosed as positive pulmonary TB through BTA examination or sputum culture by Mycobacterium tuberculosis. In high incidence settings, this figure is as high as 7850 cases/100000 person-years. A 66 year old patient came to the emergency room at Cut Meutia Hospital with complaints of coughing up blood which had been felt since 3 days SMRS, and worsened after 1 day SMRS, phlegm was fresh red, blood was mixed with phlegm when coughing. Previously the patient had been coughing up phlegm without blood since 2022 coughing felt to come and go. The patient also complained of chest pain on the right side, shortness of breath when doing activities, the patient also complained of night sweats that soaked clothes and bed, denied nausea, vomiting, defecation and urination. there were no complaints, the patient had a history of DM. On physical examination it was found that the patient's general condition appeared to be moderately ill, consciousness was compos smentis, blood pressure was 110/70 mmHg, pulse rate was 66x/minute, respiration was 22x/minute, with a body temperature of 36.7°C and SpO2 98% on room air. Auscultation revealed vesicular breathing sounds (+/+), rhonchi (-/-), wheezing (-/-). Blood laboratory examination: HB decreased (12.00), MCV decreased (76.78 fL), MCH decreased (23.2 pg), MCHC decreased (30.30 thousand/uL).

Paranoid schizophrenia is a condition of mental and behavioral disorders characterized by disturbances in thoughts, perceptions, feelings and awareness of patients who are fully conscious and intellectually can still be maintained. According to WHO, the prevalence of schizophrenia in 2021 will reach 24 million people, and the prevalence of schizophrenia experienced from 2019-2021 has increased by 54%. The 47 year old patient was taken by his family to the emergency room at Cut Meutia Hospital with complaints that the patient often had tantrums. This complaint began 13 when the family felt a change in the patient's behavior. Based on the family's information, 2 days before entering the hospital, the patient took their child away for 1 day, without being given food, the patient also carried a sharp weapon. From the patient's confession, he said he wanted to go to Saudi Arabia with his child. The patient is also restless, pacing back and forth, without a clear goal. Patients also often wander around at night and have difficulty sleeping, patients often bring home objects that do not belong to the patient when they return home after wandering around. Psychiatric status obtained a general impression of appearance according to age with medium stature, brown skin, clear consciousness, dull affect, auditory hallucinations, non-realistic thought forms, coherent thought flow, and delusional thought content, view 1 (the patient completely denies that he is sick). The diagnosis was adjusted to PPDGJ III and the patient was diagnosed as paranoid schizophrenia. Inpatients at RSCM in the UPIP room are given therapy with lodomer 5mg/ml extra, risperidone 2x2mg, diazepam 1x2mg.

Cardiopulmonary Resuscitation (CPR) or CPR is help for patients experiencing a heart attack where basic living rock is needed by applying pressure to the chest. Nurses have an important role in implementing cardiopulmonary resuscitation (CPR), especially in the emergency room. Skills in carrying out actions can have a direct impact on patient safety. Steps can be taken to improve the overall quality of medical treatment by increasing the education, knowledge and skills of attached nurses. The aim of this research is to find out the relationship between education and PK level with the accuracy of nurses in carrying out cardiopulmonary resuscitation measures in the ICU and emergency rooms at Prikasih Hospital in 2024. The research method that will be used is an analytical research design with a correlational design with a cross-sectional approach, a population of 40 technical respondents total sample and sample size of 40 respondents. Using the non-parametric Rank Spearman Rho test. The results show a relationship between education and the accuracy of nurses in carrying out cardiopulmonary resuscitation (CPR) in the ICU and ER with a P-Value of 0.026 < 0.05. And there is a relationship between the PK level and the accuracy of nurses in carrying out cardiopulmonary resuscitation (CPR) in the ICU and ER with a P-Value of 0.002 < 0.05. The conclusion is that education and level PK are very important in carrying out actions, because a person's knowledge can be seen from the abilities or skills they have, therefore education and level PK greatly influence the accuracy of cardiac resuscitation actions.    

Vertigo is a sensation or sensation of movement from the body and surrounding environment that is described as a circular sensation, usually accompanied by complaints of nausea and vomiting, and balance disturbances. Vertigo is the third most common complaint by patients who come to general practice, after headaches, and strokes. A 31-year-old man came to the emergency room of Cut Meutia Hospital with complaints of dizziness since 5 days ago and disappeared. Patients also complained of nausea but were not accompanied by vomiting since complaints of dizziness appeared. Dizziness is felt by patients when looking at the surrounding environment and is not triggered by a change in head position. In addition, the patient also has a buzzing tingling tingling tingling along with spinning dizziness attacks. The patient's hearing begins to fade when the patient's ears ring and finally settle down. Based on anamnesis, physical examination and extenuation examination, the patient was treated with peripheral vertigo et causa meniere disease. Governance is carried out in the form of inf. RL 20 gtt/min, inj. Omeprazol 2x1, inj. Ondansetron 2x1 and oral in the form of betahistin 2x1 and hydrochlorothiazide 1x1.    

Liver cirrhosis and nephrolithiasis are significant health problems with different pathophysiological mechanisms. Liver cirrhosis, the final stage of chronic liver disease, is characterized by fibrosis and regenerative nodules, leading to severe complications, including portal hypertension and liver failure. Nephrolithiasis, commonly known as kidney stones, is a common urological condition characterized by the formation of stones in the renal system. Although these conditions are distinct, metabolic and physiological changes in cirrhotic patients may predispose to nephrolithiasis.  It was reported that a man came to the emergency room of RSUD Dr. Suhatman MARS with complaints of left-sided low back pain that had been felt for 1 week. The complaint was accompanied by shortness of breath which was getting worse over time. The patient also felt cough, headache, nausea, fatigue, urine slightly coloured like tea, weight loss. The patient has a history of untreated kidney stones. The patient has a history of hepatitis 31 years ago. The main objective of investigating the coexistence of liver cirrhosis and nephrolithiasis is to understand the relationship between these two conditions and to develop effective management strategies that can address their combined impact on patients.      

Diabetic ketoacidosis (DKA) is a life-threatening form of diabetes mellitus emergency. Rapid and appropriate management is needed to prevent worsening condition. Fluid management in DKA is important to improve tissue perfusion, correct electrolyte imbalance, reduce blood glucose concentration and counterregulatory hormones. This case report aims to describe the fluid management in a client with instability of blood glucose levels in DKA. A 42-year-old woman was rushed to the emergency room with decreased consciousness for 3 hours. Laboratory examination results: blood glucose >600mg/dL, Base Excess <-30mmol, urine ketones +3, urine protein +2, urine glucose +4, pH 6.8, HCO3 1.9mmol/L. The client had unstable blood glucose levels while in the treatment room. Fluid management was performed by combining 0.9% NaCl, WIDA 2A, 40% dextrose bolus, and continuous insulin drip, that was adjusted according to the client's blood glucose level. After receiving fluid management, the client's blood glucose levels are stable in the range of 100 - 200mg/dL on the fifth day until the client recovered. Providing fluid management tailored to the management of DKA and client needs can improve the stability of blood glucose levels so that this fluid management intervention can be utilized for DKA clients with similar complaints.

To prevent disability and even death, the emergency unit must immediately carry out medical action, therefore the need to implement an efficient and effective emergency response time is important in determining whether or not it is necessary to provide medical assistance from the time the patient arrives at the ER until the patient enters the operating room or hospital ward. . The aim of this research is to determine the effect of response time on patient and family anxiety in the emergency unit. The methods used in this secondary research are literature review, article search through the Google Scholar, PubMed, Science Direct, SINTA, and Garuda databases. The results found 7 articles in which there was an influence of response time on patient anxiety in the Emergency Unit and other factors that influenced patient anxiety in the emergency unit included gender, age, education, triage, and the role of nurses. Conclusion: The results of the synthesis of 7 research articles are that response time influences patient anxiety in the emergency unit. Other factor that influence patient and family anxiety when in the Emergency Unit are length of response time, gender, age, education, triage, and the role of the nurse.  

With the increasing need for medical services and developments in technology, doctors and patients are often faced with various legal issues related to health care. The role of doctors in society is crucial because of the knowledge and skills needed to diagnose and treat disease, as well as maintain patient health. A surgeon is a specialist doctor who treats diseases, injuries or emergency conditions in the body through surgical methods (operatives) carried out in the operating room installation. The doctor's legal responsibility towards patients in the operating room installation is based on several relevant legal principles, the principle of informed consent or consent in treatment is an important factor in determining whether the doctor is responsible or not. Patients must be given adequate information about the diagnosis, procedures, risks, and treatment alternatives before giving consent for medical treatment. What are the rights and obligations between the doctor and patient in the agreement before surgery, as well as the agreement between the doctor and patient after the patient has received this information. Research methods using normative law are methods used to study legal rules as a system that can be linked to certain legal events. Secondary data uses tertiary legal data, secondary legal data and tertiary legal data from books, literature, publications and statutory sources related to all discussions. From this research it was found that every human being has the human right to live a healthy life and a doctor has ethical and professional responsibilities in carrying out his duties. The relationship between doctors and patients is regulated by applicable laws and regulations. It can be concluded that the legal responsibility of doctors towards patients in operating rooms is very important in medical practice. As health professionals, physicians have an ethical and legal obligation to provide safe, competent, and responsible care to their patients. If a doctor fails to meet expected standards of care or commits negligence that results in injury or harm to a patient, they may be legally liable.