Professional Documents
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SINGKATAN
A
a
A&W
AAA
AAAAA
AB
ABD
ac
AC
ACE
ACLS
AD
Ad lib
ADH
AGA
ARF
AS
AR
ADL
AKI
AMI
Admisi
ADS
1
INGKATAN DIAGNOSA, TINDAKAN , SIMBOL DAN ISTILAH REKAM MEDIS REVISI II
RUMAH SAKIT UMUM DAERAH KABUPATEN SUMEDANG TAHUN 2016
PENJELASAN
A
ante (before)
Alive and well
Antibiotik
alat bantu dengar
admitting diagnosis
sesuka bayi
Aorta Regurgitasion
activities for daily living
2
AHF
ASO
ADO
ADHF
AH
AHD
AIDS
Afluut
AIHA
ACS
AF
APB
AM
AMC
AMS
AMD
AR
ARE
ARR
AK
AKA
ALI
ALL
ALN
ALP
ALS
3
Acute Heart Failure
Amplanzter Septal Occluder
abdominal hysterectomy
ateriosclerotic heart disease
atrial fibrillasi
ante partum bleeding
astigmat mixtus
astigmat myop compositus
ablation retina
ablation retina exudative
4
ALT
AMI
AMC
AML
AMML
ARMD
AAA
ASD
AVSD
AAS
AVR
Avr
ANP
AP
APH
APOTEK
APS
APS
AR
ARA
ARC
ARD
ARDS
ARF
ARE
ARI
5
acute laryngitis and tracheitis
acute myocard infarct
artificial respiration
atherosclerosis of renal arteholes
6
ARR
ART
AS
ASA
ASCVD
ASD
ASH
ASHD
ASSEMBLING
ATN
Aus©
AVNRT
AVRT
AT
AV blok 1-3
A-V BLOCK
B
B/O
B/G
BB
BCC
BG
Bid
Bil(at)
BBLR
BCC
7
ablation retina regmatogen
ablation retina traksi
aortic stenosis
acetyl salycylic acid / aspirin
astigmatism hypermetropic
athero sklerosis heart disease
auscultation
Atrioventricular Nodal Reentrant Tachycardia
B
because of
twice daily
bilateral
8
BO
BP
BPH
BW
BK
BKA
BLE
BM
BNO
Bol
BOR
BP
BPH
BPJS
BPPV
BR
BRAO
BRVO
BMS
BAS
BMV
BRM
Bronch
BRPN
BS
9
blight ovum
bells palsy
blood pressure
benigna prostat hypertrofi
buta warna
below knee
bone marrow
blaas nier ovemicht
bolus
Bed Occupancy ration
bathroom privileges
benign prostatic hypertrophy
bed rest
BRANCH RETINAL ARTERIAL OCCLUSION
broncopneumonia
blood sugar
10
BSA
BSN
BTO
C
C/A
C/P
CA
CP
CRT
CRS tipe 1-5
CRVO
CA CN
CAB
CABG
CAD
cad
CAL
CAP
CAPD
CAT
Cath
CCS Fc I-IV
CC
CCRN
CCU
CE
11
body surface area
bachelor of science in nursing
Conjungtiva Anemic
Cor dan Pulmo
Carcinoma
cerebral palsy
calculnus
Community Acquired Pneumonia
catheter
Canadian Cardiovascular Socieaty Function Class I-IV
common cold
Certified critical care registered nurse
12
CAD
CAS
CEU
CH
CHB
CHD
CHF
CHL
CICU
CKD
CI
CLD
CLL
CMD
CML
CN
CNM
CNSN
COMCER
COPD
CORPAL
CP
CLI
CCLI
CVI
CPAP
13
Coronary Artery Disease
Carotid Artery Stenosis
cardiac insufficiency
chronic liver disease
commotion cerebri
chronic obstructive pulmonary disease
corpus allineum
cerebral palsy
14
CPD
CRAO
CRVO
CSC
CSF
CT SCAN
CTEV
CKD
CTS
CVA
CVD
CXR
D
D/C
DAT
DB
DC
DCFC
DD
DES
DECUB
DHF
DJ
DKA
DKI
DKM
15
cephal pelvis disproportion
CENTRAL RETINAL ARTERIAL OCCLUSION
cerebrospinal fluid
computerized tomo scanning
D
discharge (unacceptable abbreviation)
diet as tolerated
dog bite
de discontinue
Decompensation cordis functional class
differential diagnosis
Drug Eluting stent
decubitus ulcer
dengue haemorrhagic fever
16
DM
DM T1
DMT2
DNR
DOA
DOB
DCFC
DC
DCM
DKD
DM
DUB
DOCF
DOE
DON
DPJP
DPK
DRG
DSM
DSS
DT
DVR
DVT
DW
Dx
E
17
diabetes mellitus
diabetes mellitus type 1 (IDDM)
Death on arrival
date of birth
Dilated Cardiomyopaty
Diabetic Kidney Disease
Diabetes Mellitus
dysfunctional uterine bleeding
director of nurses
DOKTER PENANGGUNG JAWAB PASIEN
delirium tremens
Double Valve Replacement
diagnosis
E
18
E
E coli
EBL
EC
ECCE
ICCE
ECF
ECG
ECD
Echo
ECMO
ECV
ECW
ED
EDC
EDH
Edent
EEG
EENT
ENT
EEP
EF
Eff PER
EFA
EGA
EKG
19
etiology
Escherichia coli
edentulous
electro encephalogram
Efusiperikard
essential fatty acid
20
ELISA
EMG
EN
EOMB
EPAP
EPI
EPO
EPS
ERS
ESLD
ESRD
ET
ETD
ETM
\ETOH
Exp
ey
eo
F
F
FA
FMD
F/O
FAS
FBG
FBS
21
enzyme linked immunosorbent assay
elektro myelo grafi
enteral nutrition
explanation of medical benefits
erythropoetin
extra pyramidal symptoms
ethyl alcohol
expired
eye drop
eye ointment
F
female
fluor albus
foot hand mouth disease
follow up
fetal alcohol syndrome
22
FC
FOB
FTN
FTP
FTT
FUO
FV
Fx
G
G
GALT
GB
GBD
GBS
GNC
GP
GC
GDR
GD
GDP
GDPP
GEA
GE
GERD
GI Tract
GMKG
23
febris convultion
foot of bed
fibrosis vitreus
fracture
G
gravid
gonococcus
gross death rate
Gula Darah
Gula Darah Puasa
Gastro Enteritis
gastro esophageal reflux disease
24
GNAPS
GNA
GSW
GTT
GU
H
H&N
H&P
H/L
H/O
HA
HAP
HCAP
HCO3
HCT
HHD
HCU
HF
HD
HDN
HEENT
HCM
HIE
HOCM
HONK
HT
25
Glomerulonefritis Acute Post Streptococcus
Glumerulo Nefritis Acute
genitor urinary
H
head ache
Hospital Acquired Pneumonia
hydrochloro thiazide
Hypertensive Heart disease
hemodialysis
haemolytic disease of the new born
26
HH
HHD
HHNKS
HI
HIV
Hamil IUH
Hamil IUFD
Hamil PEB
Hamil PER
HIL
HNP
HSP
HT
HVA
HL
HLHS
HOB
HOH
HP
HPP
HR
HRD
HS
HZO
Ht
Hx
27
hiatal hernia
hypertension heart disease
hypertensi
homo vanilat acid
hearing loss
hypoplastic lef heart syndome
head of bed
hard of hearing
hypertensi pulva
Hemorrhagic Post Partum
heart rate
Hypertension Renal Disease
hypermetrop simplex
herpes zosterophthalmica
hypertension
history
28
I
I&O
IBD
IBS
ICD
ICD
ICPM
ICU
ICW
IE
IGD
IGT
IHD
IMH
INH
IPF
ISK
ITP
IUD
ISPA
ISVD
IUGR
IVB
IVFD
IVP
IVPB
29
I
intake and output
isoniazide
Idiopatic Pulmonary Fibrosis
30
J
JCAHO
JPKMM
JOAG
JUKLIS
K
K
KAD
KCl
KDC
KENANGA
KLCPM
KLS
KET
KPD
KSM
KSI
KP
KSI
KSM
KUB
KVO
L
Lab
Lap
LBP
31
J
joint commission on accreditation of health care organization
petunjuk teknis
K
kalium
Ketoacidosis Diabeticum
kalium chloride
infant warming bed
L
laboratorium
laparotomy
low back pain
32
LBW
LA Myxoma
LCSW
LES
LFT
LGL
LAFB
LPFB
LAD
LGA
LLQ
LMP
LOC
LOKET
LOS
LP
LPR
LRQ
LTC
LUQ
LBBB
LVH
Lytes
M
M
M&M
33
low birth weight
Lef Atrial Myxoma
long of stay
lumbal function
laringopharingitis
low right quadrant
electrolytes
M
male
morbidity & mortality
34
MAS
MAT
MAOI
MDD
MDR
MCTD
MDS
Mec
Medsurg
MELATI
mEq
mEq/L
met(s)
MHL
MI
MICU
mM
mmHg
MO
MOM
Mono
Mosm
MR
MRI
MG
MRSA
35
Meconium Aspirasi Syndrome
Multifocal Atrial Tachycardia
Myelodysplastic Syndrome
meconium
medical surgery
ruang perawatan untuk kasus bayi
milliequivalents
milliequivalents per liter
metastasis
mix hearng loss
myocardial infarction
medical intensive care unit
millimole
millimeters of Hg (mercury)
mineral moil
milk of magnesia
monocyte
milliosmol
magnetic resonance
magnetic resonance imaging
myop graviar
methicillin resistant staphilococcusaureus
36
MR
MS
Ms
MSW
MT
MVR
MVr
MVA
MVP
N
N&V
N/A
NAD
NAS
NH
NHML
NPDR
NCCP
NDR
NEC
NG(T)
NHL
NH(P)
NICU
NKA
NI
37
Mitral Regurgitasion
mitral stenosis
multiple sclerosis
master of social work
medical technologist
Mitral Valve Replacement
NO ACUTE DISTRESS
NO ADDED SALT
neonatal hiperbilirubin
non hodgkin lymphoma
nasogastric (tube)
non hodgkin lymphoma
no known allergies
normal
38
NOS
NPO
NpOp
Ns
NS
NSAID
NSTEMI
NVR
NVD
NPDR
O
ODNL
OD
OHO
OS
OSAS
OSNA
OMSK
OMI
OMP
O2 Sat
OB
OBS
OC
OE
OF
39
not otherwise specified
nile per os (nothing by mouth)
nasopharing oropharing
nurse
nephritic syndrome
non steroid anti-inflammatory drug
O
obstruksi ductus naso lakrimal
occuli dextra
Obat Hipoglikemik Oral
occuli sinistra
obstructive sleep apnoea syndrome
Oxygen Saturation
Obstetrics
Otitis externa
Observasi febris
40
OMA
OOB
OR
Ortho
OT
OTC
P
PACG
PC IOL
PDR
POAG
P
P&A
P.C.
P/Y;PY
PA
PACU
PAT/SUT
PAU
Path
PCI
PCA
PCH
POC
PCOD
PJB
41
Otitis media acute
Out of bed
Operating room
Ortopedics
Occupational therapy
Over the counter
P
primary angle closure glaucoma
42
PDA
PE
PEEP
PERRLA
PFT
PE
PH
PH
PICC
PICU
PID
PIP
PKBRS
PKU
PMH
PN
PNC
PO;
POD#
POST OP
PP
pp
PPCM
pulpak
PPBS
PR
43
Patent ductus arteriousus
Pelvic exam
Pulmonary Hypertension
Past history
Pyelonephritis chronice
Po per os (by mouth); phone order
Postoperative day#
Postopperative
Post partum
postprandial
Paripartum Cardiomyopaty
Pulang paksa
44
Preop
PNA
PPM
PAD
PNC
PPOK
PRN
PROG
PS
PR
PSA
PT
PTI
PTA
PUD
PULM
PVC
PVN
Q
Q
QD;qd
QH;qh
QOD;qod
R
R
R/O
45
Preoperative
pyelo nephritis acute
Pulmonic Stenosis
Pulmonic Regurgitasion
Preterm Infant
Prior to admission/arrival
Q
Every
respiration
rule out
46
RAD
RA
RAJAL
RANAP
RBBB
RDS
Re
RHD
rhd
RHF
RESUM
RETENSI
RHC
Rh
RI
RIA
RJ
RL
RLE
RLL
RLQ
RM
RN
ROM
ROP
47
Right Axis Defiation
rheumatoid arthritis; right atrium; room air
rawat jalan
rawat inap
concerning
Rhematic Heart Disease
radiommunoassay
rawat jalan
ringkasan laporan
right lower extremity
rekam medis
registered nurse
range of motion
Retinopathy Of Prematurity
48
ROS
RQ
RR
RRR
RT
RUE
RUQ
RVH
RBBB
RVHD
RVR
RX
S
S
S/I
S&S, S/S
S/O
S/P;s/p
SADT
SAH
SAKURA
SB
SBE
SABE
SBO
SC
49
review of symptoms
respiratory quotien
recovery room
regular rate and rhytm
Radiation therapy
right upper extremity
S
Suhu
Sclera Ikterik
signs and symptoms
sign et out
status post
50
SCN
SDH
SEP
SGA
SH
SIADH
SICE
SIDS
SIRS
SLE
SA blok 1-3
SNF
SNHL
SO
SOAP
SOB
SOL
SPO
SQ
Ss;SS;SSE
SR
SB
ST
Staph
Stat
SVR
51
special care nursery
Subdural Hematome
sirosis hati
syndrome of inappropriate antidiuretic hormone
subcutaneous
soapsuds(enema)
Sinus Rhythm
Sinus Bradicardya
sinus tachycardia
staphyloccus
statim (immediately)
Slow Ventricular Response
52
SVT
SAB
SAP
SBP
STEMI
STGO
STD
Strep
Subq
Supp
SVES
SSS
Susp
T
T
Tab
T&C
TAC
TI
TR
TS
Tachy
TAH
TAVB
TB
53
supra ventricular tachycardia
subarachnoid bleeding
subcutaneous
suppository
Supraventricle extrasystole
Sick Sinus Syndrome
suspension
T
Tensi/tekanan darah
tablet
type and crossmatch
Tricuspid Regurgitasion
Tricuspid Stenosis
tachycardia
total abdominal hysterectomy
54
THD
TJL
TM
TTH
TV
TB
TBLC
TBSA
TBW
TE
TEN
TFA
TF
THD
THR
TIA
Tid
TOF
TVr
TO
TOI
Tol
Top
TPM
TPN
TPPRI
55
thyroid heart disease
tumor jaringan lunak
tumor mammae
tension type headache
tinea ventricular
tinggi badan
tube feeding
typoid heart disease
topically
Tempory Pace Maker
56
TPPRJ
TSA
TTH
TTN
TURP
TWE
Tx
U
U.u
UAP
UAC
UAO
UMC
Unk
UOP
Up ad lib
UR
URI
Urol
US; U/S
USP
UTI
V
V
V/D
Vent
57
tempat pendafaran pasien rawat jalan
tonsilopharingitis acute
treatment
U
unit(unacceptable abbreviation)
Unstable Angina Pectoris
urinary output
up (out of bed) as desired (adlibitum)
utilization review
upper respiratory infection
urology; urologist
ultrasound
united pharmacopeia
urinary tract infection
V
Ventricular
58
VT
VF
VES
VHD
VH
Viz
VKC
VLBW
VO
VO2
Vol
VP
VRSA
VS
VSD
W
W/
Wo/
w/d
W/U;w/u
WB
WBN
WC; w/c
WD
WF;wf
WFL
59
Ventricular Tachycardia
Ventricular Fibrillation
Ventricle Extrasystole
Valvular Heart Disease
vaginal hysterectomy
that is, namely
verbal order
oxygen consumption
Volume
venous pressure
With
Without
well developed
workup
weight bearing
well baby nursery
wheelchair
well developed
white female
within functional limits
60
WN;w/m
WN;w/n
WNL
WPW
WSD
Wt
X
X
Xmatch
Y
YO;y/o
YTD
Z
ZD
ZIFT
NYHA Fc I-IV
1-3 VD
61
well male
well nourished
X
time
cross match
Y
year(s) old
year to date
Z
zine deficiency
62
Ruang Perawatan
ANGGREK
Aster A & B
CEMPAKA
DAHLIA
Kenanga
Melati
Sakura
TANJUNG
TULIP
VK
Wijaya kusumah
PONEK
Symbols
↓
1o
2o
ά
ᵦ
ᵧ
∆
µ
63
ruang perawatan untuk kasus bedah
decrease
increase
famale
male
primary
secondary
lowercase alpha;
64
TAK
65
tidak menemukan pemeriksaan yang signifikaan
tidak ada kelainan
66
SIMBOL YANG ADA DI
67
SIMBOL YANG ADA DI RUANGAN
68
69
70
EKSPEDISI DAFTAR SINGKATAN DIAGNOSA
NO NAMA DOKTER
1 ANDRI MULYA T Dr, SppD
2 ANY ANDJAJANI,Dr.Sp.M
3 Pipih A , spog.dr
4 ENCENG dr.Sp.B
6 NENDEN SS.Dr.Sp.A
9 TOTO SUGIARTO,Drg
R SINGKATAN DIAGNOSA
PARAF
1.
2.
3.
4.
5.
6.
7.
8.
9.
SINGKATAN PENJELASAN
AAA abdominal aortic aneurysm
anterior chamber
BG Blood glaucose
Bone graf
BM bowel movement
bone marrow
BP blood pressure
bathroom privileges
bedpan
Bronch bronchoscopy
CA cancer
Carcinoma
Cath catheter
catheterize
CN charge nurse
Cavum nasi
Ns nurse
Normal saline
P Para
Phosphorus
pulse
Post/afer
PA Pernicious anemia
physician’s Assistant
PE Pelvic exam
Physical exam
PP Post partum
postprandial
Pulang paksa
PROG Prognosis
Progress
Resp respiratory
respiration
RR respiratory rate
recovery room
RT respiratory therapist
radiation therapy
T max maximum
Temperatur
T. temp temperature
time
UR upper respiratory
utilization review
V ventricular
volume
Vent ventral
ventricularl
ventilator
W white
widowed
w/d well developed