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121	Public Health	ABS-132
KNOWLEDGE AND ATTITUDES ABOUT THE USEGE OF SELF-PROTECTIVE EQUIPMENT OF HEALTHCARE WORKER IN 13 PRIMARY HEALTHCARE CENTERS KOTA CIMAHI ON THE ERA OF COVID-19 Anastasia Yani Triningtyas, Lutfhi Nurlaela, Henny Juliastuti, Astri Pradini Medical Faculty, Universitas Jenderal Chmad Yani Abstract The COVID-19 pandemic has a profound impact on various areas of life, especially in the health sector. Changes in services and an increase in morbidity and mortality due to COVID 19 are very striking. COVID 19 is very contagious from person to person. Protection is very important in dealing with these patients. The boom in this case, of course, creates problems, especially the procurement of personal protective equipment (PPE) for health workers who are very minimal. In addition to the minimum number, how to use and wear PPE correctly also greatly affects the transmission rate of COVID-19. This research is a quantitative descriptive study which aims to deteprmine the knowledge and attitudes about the use of PPE on health workers at the in the primary heathcare centers Cimahi City area. Respondents in this study were 72 health workers who were directly tasked with handling COVID-19 at 13 puskesmas in Cimahi city, both in contact tracing, taking swab samples, and handling COVID-19 patients who came to the puskesmas. The results of the research on knowledge of health workers about PPE showed that most of the respondents had a fairly good knowledge (75%) and a fairly good attitude (63%). The knowledge is still poorly understood by respondents, especially the use of PPE during face-to-face contact tracing, indications for the use of PPE, procedures for using PPE level 3, PPE in examining patients with ARI. Attitudes that still need to be improved are the importance of implementing health protocols during work breaks, using shoe covers, and the used of masks under the chin, and prioritizing the use of appropriate PPE compared to convenience. Knowledge and attitudes are predisposing factors that encourage or inhibit the behavior of health workers in using PPE. Knowledge and good attitudes affect the correct use of PPE and are expected to provide optimal protection for health workers. Keywords: attitude, knowledge, personal protective equipment Share Link | Plain Format | Corresponding Author (Anastasia Yani Triningtyas)

122	Public Health	ABS-136
THE CORRELATION BETWEEN EXPECTATION WITH MOTIVATION OF ADOLESCENTS TO IMPROVE KNOWLEDGE ABOUT PROMISCUITY AND SEXUAL HEALTH Fransiska Ambarukmi Pontjosudargo FK Unjani Abstract Adolescence is a transition period from childhood to adulthood, during which time individuals undergo changes both physically and psychologically, including the development and maturation of organs and functions of the reproductive system. Knowledge of reproductive health is important for adolescents, in order to know the proper and healthy function of reproductive organs responsibly. Adolescents who have a correct and proportionate understanding of reproductive health tend to understand the risks of free sex as well as alternatives that can be used to channel their sexual desires. This study aims to assess the correlation of adolescent percentions and their attitude after getting educated about adolescent promiscuity and sexual health. A total of 143 new students from Jenderal Achmad Yani University who participated in the webinar filled out a questionnaire that assessed the perception of their expectations with the motivation to deepen knowledge about the materials given. There are 9 educational themes given to improve adolescent knowledge about adolescent promiscuity and reproductive health. The data obtained was analyzed with Spearman^s correlation test, with a 95% degree of confidence. Spearman^s test results showed the meaningful relationship between the perception of expectations and the motivation of participants to improve knowledge. The R value of 8 educational themes is more than 0.75, indicating a strong positive relationship and 1 theme indicates an R=0.445 value indicating a moderate positive relationship. The conclusion of this study, the more appropriate adolescent expectations about adolescent social education and reproductive health, the higher the motivation to improve their knowledge. Keywords: Keywords: Adolescent Promiscuity, Sexual Health, Education, Students Share Link | Plain Format | Corresponding Author (Fransiska Ambarukmi Pontjosudargo)

123	Update Emergency Assesment and Management	ABS-4
EMERGENCY RETROGRADE INTUBATION IN MANDIBULAR ABSESS WITH DIFFICULT TO INTUBATE Baginda Aflah (a*), M. Budi Kurniawan (b), Iwan Fuadi (b), Erwin Pradian (b), Suwarman (b), Reza W. Sudjud (b) (a) Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Padjadjaran University (b) Dr. Hasan Sadikin General Hospital Bandung Abstract Introduction: Fiberoptics are the main choice in difficult intubation cases but they are still constrained by the availability and difficulty of operating the equipment. Retrograde intubation is an old technique but can be an option in difficult to intubate cases. Case: Male 50 years old, BMI 21.5 kg / m2 planned to have evacuate mandibular abscess operation in emergency setting. Difficult airway is obtained on patient by the presence of the mouth not being able to open even after administration of analgesia and sedation making laryngoscopy is impossible. In the absence of fiberoptic availability. Then it was decided to perform an emergency retrograde intubation by wire guidance through abocath insertion of the cricothyroid membrane. The operation went successful and at the end of the operation patient was extubated. Discussion: The retrograde intubation technique can be easy and minimally invasive alternative in limited facilities setting. Retrograde intubation can be performed blindly without visualizing the airway. Keywords: Retrograde intubation, difficult airway, difficult intubation Share Link | Plain Format | Corresponding Author (Baginda Aflah)

124	Update Emergency Assesment and Management	ABS-5
Severe Trigeminocardiac Reflex During Neurosurgery- What Should We Do Muhammad Luthfi (a), Budiana Rismawan(b), Iwan Fuadi (b), Erwin Pradian (b), Suwarman (b), Reza W. Sudjud (b) (a) Resident of Anesthesiology and Intensive Care Department , Faculty of Medicine Universitas Padjadjaran Hasan Sadikin Hospital Bandung Bandung West Java (b) Consultant of Anesthesiology and Intensive Care Department , Faculty of Medicine Universitas Padjadjaran Hasan Sadikin Hospital Bandung Bandung West Java Abstract Introduction : Trigeminocardiac reflex (TCR) is one of the brainstem reflexes that can cause sudden onset of parasympathetic activity, sympathetic hypotension, apnea, and gastric hypermotility during central or peripheral stimulation from sensory branch of the trigeminal nerve. In some cases, the effect can lead to severe bradycardia, asystole, and arterial hypotension that need interventions. Case : We reported a case of 58 years old female who underwent tumor removal surgery in cerebellopontine angle area. The patient had two episodes of TCR. The first one was well handled by stopping the manipulation of surgery and was given sulfas atropine. In the second episodes of TCR, the patient had refractory bradycardia and led to asystole, then the patient was given adrenaline. We performed a cycle of cardiac resuscitation and the patient^s circulation returns spontaneously. Then, the patient was admitted to intensive care unit and was given continuous infusion of adrenaline and noradrenaline. After five days of hospitalizations, the patient was extubated and discharged, then scheduled for cranioplasty. Discussion : The most important management of the TCR episodes is an early detection of bradycardia or hypotension with strict and continuous hemodynamic monitoring and to stop direct stimulus from all surgical manipulations. Key word : Trigeminocardiac reflex, Cerebellopontin angle, Bradycardia, asystole Keywords: Key word : Trigeminocardiac reflex, Cerebellopontin angle, Bradycardia, asystole Share Link | Plain Format | Corresponding Author (Muhammad Luthfi Hidayat)

125	Update Emergency Assesment and Management	ABS-16
NO SLEEPING BEAUTY: DELAYED EMERGENCE UNDER GENERAL ANESTHESIA AN EMERGENCY CASE AFTER ANESTHESIA Lusy Saputri, Gezy Giwangkancana, Erwin Pradian, Iwan Fuadi, Suwarman, Reza Sudjud Department of Anesthesiology and Intensive Care Faculty of Medicine Padjajaran University Abstract Introduction: Delayed emergence from anesthesia is defined as failure to regain consciousness within 20-30 min after a surgical procedure. The most common causes of delayed emergence are benign and mostly related to residual anesthetic effects. However, some causes are uncommon. Low incidence impedes the design of meaningful clinical trials investigating potential mechanisms and risk factors. Case Resume: A 9 years old girl came to the hospital for elective mouth preparation. She has Atrial Septal Defect (ASD) but was overall in good physical condition. She was induced by general anesthesia technique and she was intubated and her ventilation was assisted manually using a pediatric bain circuit. Surgery lasted for 40 minutes with stable hemodynamic. Six hours after the end of the surgery, the patient remained apneutic and there was no respond to pain stimulation. Upon consultation a complete blood work was done including blood gas analysis, electrolytes, ureum and bedside blood glucose. An etCO2 was placed and etCO2 was shown at 105 mmHg. The treatment for hypercapnia was given and within 5 minutes ETC02 was normalized to 43. The patient was transferred to the PICU and after 4 hours was awake and extubated. After 8 hours all symptoms was reversed and the patient was released home the 2 days after without any neurological symptomps Discussion: Delayed recovery from anesthesia is often multifactorial, and anesthetic agents may not always be the causes. Primary management is supportive and meticulous programed approach of causal detection must be followed. Keywords: delayed emergence, emergency, general anaesthesia, hypercapnia, risk factor Share Link | Plain Format | Corresponding Author (Lusy Octavia Saputri)

126	Update Emergency Assesment and Management	ABS-17
PREMANAGEMENT OF ELECTROLYTE AND FLUID DISORDERS FOR PITUITARY TUMOURS: A CASE REPORT Kambria Erdi1, Reza W. Sudjud2, Erwin Pradian2, Iwan Fuadi2, Suwarman2 1. Resident, Department of Anesthesiology and Intensive Care, Padjadjaran University 2. Consultant, Department of Anesthesiology and Intensive Care, Padjadjaran University Abstract Introduction: Pituitary macroadenoma is a benign tumor in the suprasellar region that most commonly occurs in adults where it can exceed 10 mm in size. Pituitary hormone deficiency leading to severe hyponatremia as a result of nonfunctional pituitary macroadenoma is quite rare presentation in clinical practice. Case: A 54 years old man complained of headache since 6 months ago and visual field disturbances since 1 month ago. On physical examination, it was found that the patient was in a polyuric condition, showed signs of dehydration, and bitemporal hemianopy. On laboratory examination, it was found that there was a decrease in sodium levels and plasma osmolarity. On Contrast MRI, tumor was found in the sellar region due to pituitary macroadenoma. The patient was diagnosed with SOL Supratentorial at Sellar Region due to Pituitary Macroadenoma and Hyponatremia due to Cerebral Salt Wasting Syndrome (CSW). Discussion: Some cases with NFPA have several symptoms, including the main complaints related to mass effects and pituitary insufficiency. Hyponatremia is often a manifestation of serious underlying disorder and requires careful preoperative evaluation. SIADH and CSW are very difficult to distinguish so that the diagnosis must be made precisely because the management of the two conditions is very different. Conclusion: The preoperative assessment of patients with pituitary macroadenoma undergoing pituitary surgery requires multidisciplinary cooperation to assess the patient^s condition and accompanying diseases, both chronic disease and tumor induced disease. Improper assessment will lead to inappropriate management. Optimal preparation will increase the success of the operation. Keywords: Cerebral salt wasting syndrome, hyponatremia, hypopituitarism, pituitary macroadenoma Share Link | Plain Format | Corresponding Author (Kambria Erdi)

127	Update Emergency Assesment and Management	ABS-20
EPIDURAL ANESTHESIA IN PATIENT WITH EISENMENGER SYNDROME UNDERGOING CAESAREAN SECTION: SERIAL CASE REPORTS Tresna Kusumah Natapraja, Dhanny Budipratama, Erwin Pradian, Iwan Fuadi, Suwarman, Reza W. Sudjud Department of Anesthesiology and Intensive Care Faculty of Medicine Padjadjaran University Hasan Sadikin General Hospital Bandung Abstract Abstract Background: Management of anesthesia in pregnant patient undergoing cesarean section with Eisenmenger syndrome. Objective: The patient had undergone cesarean section with epidural regional anesthesia has a good outcome and cared postoperatively in Cardiac Intensive Center Unit. Methods: This case reported patient who was admitted to the hospital with Eisenmenger syndrome, shortness of breath, bluish at the extremities with ASA III E physical status. Oxygen demand in pregnancy will increase along with gestational age, this condition can cause hypoxemia in pregnancy and the fetus. Therefore, we need to balance between pulmonary vascular resistance and systemic vascular resistance to avoid hemodynamic changes resulting in hypoxemia through the right-to-left shunt. Regional anesthesia techniques have the advantage of maintaining hemodynamics. Result: This patient was performed cesarean section with epidural regional anesthesia in 1.5 to 2 hours of surgery with no changes in hemodynamics status and was prepared for postoperative care in Cardiac Intensive Care Unit Conclusion: The main goal of anesthesia in patients with congenital heart defects in pregnancy is to maintain maternal and fetal hemodynamics. Keywords: Eisenmenger syndrome, pulmonary hypertension, epidural regional anesthesia Keywords: Eisenmenger syndrome, pulmonary hypertension, epidural regional anesthesia Share Link | Plain Format | Corresponding Author (Tresna Kusumah Natapraja)

128	Update Emergency Assesment and Management	ABS-21
ANESTHESIA MANAGEMENT IN HEMORRAGIC SHOCK DUE TO UTERINE RUPTURE AFTER SPONTANEOUS DELIVERY Odih Fahruzi, Doddy Tavianto, Iwan Fuadi, Erwin Pradian, Suwarman, Reza Sujud Departement of Anesthesiology and Intensive Care Faculty of Medicine Padjajaran University Abstract Introduction : The American College of Surgeons has identified 4 classes of bleeding, class I is a blood loss of less than 15%, class II is a blood loss of 15-30%, class III is a blood loss of 30-45%, and in class IV there is a blood loss of more than 40%. Case summary : A 30-year-old woman, with hemorrhagic shock after uterine rupture. On examination in the resusitation room, there were signs of shock, then a large infusion access was installed for fluid resuscitation. After fluid resuscitation and stable hemodynamics was established, the patient was transferred to the operating room with blood supply for prepared. Intraoperative induction was carried out in a rapid sequence induction using ketamine and rocuronium, maintenance of sevoflurane, O2 and air. There was intraoperative bleeding of 8000 cc. We give 3000 cc crystalloid, 3000 coloids, PRC 8 bags, FFP 8 bags, TC 8 bags. The bleeding was still occured, damage control was done by packing. The patient was transferred to ICU. Discussion : In the above case, the patient was in a hemorrhagic shock. The patient was subjected to damage resusitation from the resuscitation room to the operating room. When the bleeding condition cannot be stopped, damage control is done to stop the bleeding temporarily until the patient^s condition is stable and improves the bleeding condition due to heavy bleeding. Conclusion : Management of a patient with hemorrhagic shock must be done quickly and simultaneously, from perioperative, intraoperative to postoperative. Keywords: damage control, damage resuscitation, uterine rupture, hemorrhagic shock Share Link | Plain Format | Corresponding Author (Odih Fahruzi)

129	Update Emergency Assesment and Management	ABS-44
The diference of Self Efficacy in Medical Emergency Skills among Undergraduate and Clinical Students Sylvia Mustika Sari, Daswara Djajasasmita, Andri Anugerah, Saviera Adison Faculty of Medicine, Universitas Jenderal Achmad Yani Abstract Self-efficacy is the main driving force for shaping the character of self-directed learning in medical education. One of the clinical skills that must be achieved in a doctor^s competence is medical emergency skills. The Faculty of Medicine of Unjani has a local content of medical emergency which is achieved in the undergraduate and the clinical stage. This study aims to determine the differences in the self-efficacy of undergraduate and clinical students on emergency medical skills and its influencing factors. This study used a mixed-method with an explanatory design. The quantitative method uses a Bandura^s self-efficacy questionnaire with a total of 40 respondents in each group. The qualitative method used FGD with 9 respondents at the undergraduate stage and 12 respondents at the clinical stage. The results of quantitative research showed a significant difference (p>0,05) and higher self-efficacy scores in clinical students. In quantitative data analysis we found that the influencing factors to increase their efficacy among undergraduate students was the skills laboratory and clinical simulation method- while the clinical students tend to have more efficacy due to clinical authority, feedback from the clinical instructor, and the sense of their local content. Further research should explore more about the impact of students^ self-efficacy in their performance. Keywords: self efficacy, mixed method, emergency skill Share Link | Plain Format | Corresponding Author (Sylvia Sari)

130	Update Emergency Assesment and Management	ABS-68
Elevated Cardiac Marker Enzymes with the Incidence of Complications in ACS Patients: Is it Related? Prihati Pujo Waskito, Muhammad Aldiast Alhadiyanto, Wida Vianita Aziz, Muhammad Hanif Baswedan Medical Faculty, Jenderal Achmad Yani University Abstract Acute coronary syndrome (ACS) is a condition that describes the condition of the heart muscle infarction so that the heart is damaged. Ongoing damage to the heart muscle may result in a new condition known as a complication. Based on this condition, the aim of this study was to determine the relationship between elevated cardiac marker enzymes and the incidence of complications in ACS patients. This study is an observational analytic study based on secondary data, namely medical record data. The subjects of this study were data from medical records of SKA patients who experienced complications recorded in the medical records at the Dustira Cimahi Hospital in 2018. The number of cases found in the Dustira hospital in 2018 was 105 cases, the most age was over 45 years, the sex that often experienced complications was women with a total of 58 people (55.2%), cardiac enzymes both troponin and CKMB in cases experienced a significant increase, patients with troponin increase was 86 people (81.9%) while patients with increased CKMB were 88 people (92.6%), complications were obtained by patients with heart failure as many as 38 cases, cardiogenic shock as many as 16 people, arrhythmia as many as 30 people, as many as 11 people, and cardiac arrest as many as 10 people. In this study, it was concluded that there was a significant relationship between the increase in cardiac marker enzymes both troponin and CKMB (p-value <0.05) on the incidence of complications in ACS patients. Keywords: ACS, CKMB, cardiac marker enzymes, complications, troponin Share Link | Plain Format | Corresponding Author (Prihati Pujowaskito)

131	Update Emergency Assesment and Management	ABS-73
Coherence between Degree of Hypertension and Incidence of Acute Coronary Syndrome in Cardiac Departement of Dustira Cimahi Hospital Jusron Iriawan, Nanda Maulana, Yanti Nurrokhmawati, Danial Ahmad Dzulfikri Medical Faculty, Universitas Jenderal Achmad Yani Abstract Acute coronary syndrome (ACS) is a syndrome consist of several coronary disease such as unstable angina pectoris (UAP), non-ST-elevation myocardial infarction (NSTEMI), and ST- elevation myocardial infarction (STEMI). ACS risk factors are devided into two main categories, the conventional risk factors and recently known atherothrombosis-associated risk factors. Hypertension is one of ACS major risk factors. This study aims to determine the relationship of the stage of hypertension with the incidence of ACS in the Cardiac Inpatient Room Dustira Cimahi Hospital in 2018. This study was an analytical study with a cross-sectional method approach, the population in this study were all ACS patients that recorded in medical record, while the respondents were ACS patients with a history of hypertension recorded in medical record and treated at Dustira Cimahi Hospital with total 112 samples, by using systematic random sampling. Based on the research, there were 48 male patients (42.90%), while female patients were 64 (57.10%). The average age of patients was 61.75 years old. Obtained from 19 people with normal-high blood pressure degree, 10 people (52.63%) were ACS-UAP, from 24 patients with first stage of hypertension as many as 15 people (62.50%) were ACS-UAP, from 29 patients with second stage of hypertension as many as 18 people (62.07%) were ACS NSTEMI, and from 40 patients with third stage of hypertension as many as 29 people (72.50%) were ACS STEMI. A p-value of 0.000 showed a significant relationship between the stage of hypertension and the incidence of acute coronary syndrome at Dustira Hospital Cimahi in 2018. Keywords: acute coronary syndrome, stage of hypertension Share Link | Plain Format | Corresponding Author (Yusron Iriawan)

132	Update Emergency Assesment and Management	ABS-76
Comparison of Post-Stroke Ischemic Depression of Right Hemisphere Lesion with Left Hemisphere Lesion at Dustira Cimahi Hospital Ainun Nur Kamilah, Yustiani Dikot, Arlisa Wulandari Medical faculty, Universitas Jenderal Achmad Yani Jl. Terusan Jend. Sudirman, Cibeber, Kec. Cimahi Sel., Kota Cimahi, Jawa Barat 40531, Indonesia Abstract Post-stroke depression is a complication often occurs after stroke and can give a negative impact on the patient^s recovery. Post-stroke depression cause negative impact on the recovery of daily activities of stroke patients, so the effective treatment for stroke patient with depressive symptoms result a marked improvement in the living activities of patients. One theory regarding post-stroke depression states that post-stroke depression results from specific lesions in the brain. Cases of Post-stroke depression are closely related to the location of lesions in the hemisphere of the brain, only a few cases are related to intellectual impairment, the severity of physical impairment, quality of social support, and age. This study aims to compare the incidence of Post- ischemic stroke depression in right hemisphere lesions with left hemisphere lesions in RS Dustira Cimahi. This research is a comparative study with a cross-sectional study approach, with a sample of 40 stroke patients, the samples were taken by consecutive sampling. Data were analyzed and mann-whitney test performed. The results showed that there was a significant difference between the incidence of depression after ischemic stroke in right and left hemisphere lesions (p = 0,000), where the incidence of post-stroke depression was higher in ischemic stroke patients with left hemisphere lesions. These results indicate that stroke patients with left hemisphere lesions have a higher risk of experiencing depression which can cause a negative impact on the recovery of daily activities of stroke patients. This research is expected to be able to encourage depression risk assessment in post-stroke patients so we can give comprehensive treatment. Keywords: post-stroke depression, depression, hemisphere, ischemic stroke Share Link | Plain Format | Corresponding Author (Ainun Nur Kamilah)

133	Update Emergency Assesment and Management	ABS-77
The Overview of Mahalata Unjani Members Knowledge Level of Hypothermia First Aid Djoni Kusumah Himsani Pohan, Alfian Ramadhan, Ania Kurniawati Purwa Dewi, Danial Ahmad Dzulfikri Medical Faculty, Universitas Jenderal Achmad Yani Abstract Hypothermia is a common condition in the mountain and is very dangerous problem due to an unnatural decrease in body temperature caused by long and humid exposure to cold temperatures. Lack of climbing knowledge causes climbers not to be able to perform proper assistance hence it can be risky for a climber. First aid for hypothermia is the basic and foremost skill to have for Nature Lover Students to prevent the adverse effects of hypothermia. This study aims to describe the level of knowledge about the first aid for hypothermia. This study used a descriptive method and the study subjects consisted of 57 members of Mahatala Unjani. The data collection method used a questionnaire, then it was processed and analyzed based on percentage. The data results of 57 participants showed that 10 participants (17.5%) had good knowledge, 26 participants (45.6%) had moderate knowledge and 21 participants (36.8%) had poor knowledge. The knowledge level results from the age of 20-25 years showed that 9 participants (18%) had good knowledge. The knowledge level results based on the length of the membership who have been participated more than 3 years showed that 6 participants (22.22%) had good knowledge. The knowledge level results based on the experience performing first aid for hypothermia in 41 participants showed that 8 participants (19.511%) had good knowledge. From 16 participants who have not been performing first aid for hypothermia, 2 of them (12.50%) had good knowledge. The study results showed that most of the participants have a moderate level of knowledge. Keywords: first aid, hypothermia, level of knowledge Share Link | Plain Format | Corresponding Author (Djoni Kusuma)

134	Update Emergency Assesment and Management	ABS-88
Comparison of Quality of Life for STEMI Patients Who Underwent Percutaneous Coronary Intervention (PCI) with Non-PCI at Dustira Hospital Prihati Pujowaskito, Dinda Dwi Lazuardi Emha, Ilma Fiddiyanti, Rizki Bunawan Medical Faculty, Universitas Jenderal Achmad Yani Abstract ST Segment Elevation Myocardial Infarction (STEMI) is one of the types Acute Coronary Syndrome (ACS) that often causes sudden death and one of the medical emergency cases that requires immediate reperfusion treatment. Reperfusion treatment are Percutaneous Coronary Intervention (PCI) or non-PCI (pharmacological therapy). According to the previous studies, both of the treatments differed in quality of life after the treatment. Changes in quality of life can be measured by the Seattle Angina Questionnaire (SAQ) which has five clinical dimensions, those are physical activity, frequency of pain, pain stability, patient satisfaction, and perception of the disease. The purpose of this study is to determine the difference in quality of life of STEMI patients with PCI action compared to non- PCI at Dustira Hospital Cimahi. This study used a comparative analytical method with a cross sectional study approach. Data was obtained from primary data with a questionnaire that was filled by 17 STEMI patients who were treated with PCI and 17 STEMI patients \with non-PCI in Dustira Hospital Cimahi. The data were analyzed statistically by an independent T test. The result showed that the average quality of life scores of STEMI patients who were treated by PCI in Dustira Hospital Cimahi (66.06) was 13.88 points higher than STEMI patients who were treated with non-PCI (52.18). The quality of life of the PCI group in Dustira Hospital Cimahi is better than the non-PCI group because the mechanism of breakdown of atherosclerotic plaque by PCI-treated can immediately improve coronary blood flow so that tissue reperfusion can be restored. Statistically there is a very significant difference with P-value lower than 0.01 (p <0.01) that is P-value equal to 0,000 (p=0,000). Keywords: STEMI, PCI, Non-PCI, Quality of life, SAQ Share Link | Plain Format | Corresponding Author (Prihati Pujowaskito)

135	Update Emergency Assesment and Management	ABS-91
Knowledge Level of General Practitioners at RS Tingkat II Dustira About Primary Survey in Trauma Cases Rizki Bunawan, Alexander Siagian, Andri Anugerah Kusuma Medical Faculty, Universitas Jenderal Achmad Yani Abstract The high incidence of trauma caused by traffic accidents and other causes resulting in the the high mortality of trauma. A general practitioner(GP)^s primary survey knowledge and management could minimalized the risk of the death. RS Tingkat II Dustira has an emergency department so the GPs ought to have knowledge in primary survey. The GPs have some levels of knowledge in primary survey. The aim of the study was to find out the knowledge of GPs in RS Tingkat II Dustira about primary survey in trauma patients. This study used observational descriptive method using primary data collected from the quetionaire filled by 39 GPs in RS Tingkat II Dustira. The data was analyzed univariately. The result of the study was there were mostly 26-30 years old respondents with the oldest^s age was more than 51 years old. The respondents^ length of work mostly were 1-10 years (26 respondents). The respondents which underwent some trainings were 34GPs, from which 20GPs underwent ATLS training and 14 GPs underwent a non-ATLS training. There were 5 GPs who didn^t undergo any trainings. From this study, 51% of the GPs had a good knowledge. 40% of the GPs who went through ATLS training before had a good knowledge and 72% of the GPs who didn^t go through ATLS had a good knowledge. The GP^s who had a good knowledge about primary survey^s first component, airway, were 27% GPs, in the breathing componen t were 13%, the circulation component were 49%, disability component were 92%, and 87% respondents in exposure component. This is an interesting study as an addition to RS Tingkat II Dustira to refresh the knowledge for the GPs. The levels of knowledge in primary survey is better descriptively in the GPs which underwent the Non-ATLS training but with good experience because it was influenced by the length of work in the emergency department. Keywords: : general practitioner, levels of knowledge, primary survey Share Link | Plain Format | Corresponding Author (Rizki Bunawan)

136	Update Emergency Assesment and Management	ABS-111
Challenges and Readiness for Covid-19 Therapy at Central Army Hospital Agus Harsoyo Unit Cardiology Intervention andClinical Electrophysiology Intervention, Department of Cardiology, Faculty of Medicine, Universitas of General Achmad Yani Gatot SoebrotoArmy Central Hospital Jakarta Abstract Coronavirus disease 2019 (Covid-19) is caused by the severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2), a newly emergent coronavirus, that was first recognized in Wuhan, Hubei province, China, in December 2019. SARS-CoV-2 is a positive-sense single-stranded RNA virus that is contagious in humans. Epidemiology and virologic studies suggest that transmission mainly occurs from both symptomatic and asymptomatic by close contact through respiratory droplets infected persons, or by aerosols, in enclosed indoors, crowded and inadequately ventilated spaces, where infected persons spend long periods such as workplace offices.The most common symptoms include fever, cough, fatigue, anorexia, dyspnea, sputum production and myalgia. The beginning pathogenesis due to the binding of spike protein SARS-CoV-2 to ACE-2 receptor of host cells. Clinical manifestation of covid-19 is no longer limited to the pulmonary system but also extra-pulmonary systems since ACE-2 receptor abundantly distributed on the other organs. Further, genetic variations of region binding protein of viral spike protein and ACE-2 receptor may predispose clinical manifestation of covid-19.The classification based on symptom such as asymptomatic, mild, moderate, severe, and critical. The diagnostic criteria is divided as suspect, probable, confirmation, and close contact. The basing management and treatment such as supportive therapy, antivirus, antibiotic, corticosteroid, symptomatic therapy, and consider additional therapy for severe/critical covid-19 such as convalescent plasma, IV Immunoglobulin, Anti IL-6 (Tocilizumab), Anti IL-1 (Anakinra), Mesenchymal Stem Cell (MSC).Covid-19 complications almost involve many organ such as respiratory system, cardiovascular, kidney, hematologic, coagulopathy, liver, endocrine, central nervous system, skin, and others system whole body. Keywords: ACE-2 receptor, Covid-19 classification, Diagnostic and Management, Multi organ complication Share Link | Plain Format | Corresponding Author (Agus Harsoyo)

137	Update Emergency Assesment and Management	ABS-119
Influence On The NIHL Of Miners At PT. Windoe Andesit Utama (PT. Wau) with Age, Sex, And The Duration Of Work Yanti Nurrokhmawati, Leni Herlina, Irwanto Ichlas, Siti Endah Virajati Buana Medical Faculty, Universitas Jenderal Achmad Yani Abstract Noise Induced Hearing Loss (NIHL) is a serious problem caused by the extreme loud sound in the working place. According to Occupational Health and Safety Administration (OSHA), twenty two billion workers in USA are at risks of NIHL because they are exposed to loud noise in their working place. The aim of this study is to find out the association between age, sex, and the duration of work to NIHL of miners at PT. Windoe Andesit Utama (PT. WAU). The method was cross-sectional analytic. The primary data collected using quetionaire, otoscopic examination and audiometry examination. Eighty six miners of subject was take with simple random sampling. Data was analyzed univariately, continued using chi square test. The result of the chi square test was tested with Wald Test to find out the influence of the variable. The result showed that 33 workers had NIHL (38,37%), 17 workers (51,52%) were below 40 years old, all 100% were men and 19 workers (57,58%) worked nor longer than 5 years. The number of NIHL case showed significant score statistically with age (p=0,022, PR=1,850) and duration of work (p=0,031, PR=1,798). Wald test showed that there are no free variable influenced the NIHL. Keywords: Noise, noise induced hearing loss, miners Share Link | Plain Format | Corresponding Author (Yanti Nurrokhmawati)

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