laporan pendahuluan gadar vulnus punctum abdomen

7/21/2019 Laporan Pendahuluan Gadar Vulnus Punctum Abdomen

1/39

HMH B

NMQGXMO QFO@MJVNVMO

B. Pboimumo Vlul Pfotmoc NudmM. Qfocfrtbmo

Nudm m`mnmj sfhumj boiurb pm`m imrbocmo ymoc lfoccmoccu prgsfs sfnunmr ogrlmn,

nudm `mpmt iucm `bimhmrdmo `focmo m`moym dfrusmdmo pm`m duotboubtms/dfsmtumo

imrbocmo tuhuj ymoc hbmsmoym `bsfrtmb `focmo dfjbnmocmo suhstmosb imrbocmo

(Lmosigfr, 811=)

H. Ftbgngcb=. Lfdmobd

m. Hfo`m tmimlLfrupmdmo nudm tfrhudm ymoc tfrim`b mdbhmt hfo`m ymoc lflbnbdb sbsb tmiml

mtmu ruokboc. Lbsmnoym nudm brbs, nudm hmkgd, `mo nudm tusud

h. Hfo`m tulpunNf`mdmo mtmu tflhmdmo, Lbsmnoym nudm dmrfom tflhmdmo sfoimtm mpb

8. Ogo Lfdmobdm. Hmjmo dblbm

Pfrim`b mdbhmt fefd dgrgsb `mrb msml dumt mtmu hmsm dumt

h. Prmulm ebsbdm=) Nudm mdbhmt suju tboccb8) [uju tboccb `mpmt lfocmdbhmtdmo tfrim`boym jfmt fxjmustbgo prblfr, jfmt

fxjmustbgo sfduo`fr, jfmt strgdf, suo strgdf, `mo jfmt krmlps.

;) Nudm mdbhmt suju rfo`mj0) @frmimt Nudm ymoc tfrim`b pm`m dunbt dmrfom suju `bocbo `bmotmrmoym

jypfrflbm, f`flm `mo vfsbdfn,

6) Nudm mdbhmt trmulm nbstrbd5) Nudm mdbhmt pftbr3) Nudm mdbhmt pfruhmjmo tfdmomo u`mrm (Lmosigfr, 811= mnml Xmtom,

811: )

k. Xm`bmsb


2/39

8

K. Dnmsbebdmsb=. Hfr`msmrdmo `frmimt dgotmlbomsb

m. Nudm hfrsbjNudm hfrsbj m`mnmj nudm ymoc tb`md tfr`mpmt boenmlmsb `mo boefdsb, ymoc

lfrupmdmo nudm smymt fnfdtbe `mo stfrbn `blmom nudm tfrsfhut hfrpgtfosb

uotud tfrboefdsb. Nudm tb`md m`m dgotmd `focmo grgemrboc, trmdtus

rfspbrmtgrbus lmupuo trmdtus cfobtgurbomrbus. @focmo `flbdbmo dgo`bsb nudm

tfrsfhut tftmp `mnml dfm`mmo hfrsbj. Dfluocdbomo tfrim`boym boefdsb nudm

sfdbtmr =%-6%.

h. Nudm hfrsbj tfrdgotmlbomsbNudm hfrsbj tfrdgotmlbomsb m`mnmj nudm pflhf`mjmo `blmom smnurmo

pfromemsmo, smnurmo pfokfrommo `mo smnurmo pfrdflbjmo `mnml dgo`bsb

tfrdgotrgn. Qrgsfs pfoyflhujmo nudm mdmo nfhbj nmlm omluo nudm tb`md

lfouoiuddmo tmo`m boefdsb. Dfluocdbomo tblhunoym boefdsb nudm sfdbtmr

;% - ==%.

k. Nudm tfrdgotmlbomsbNudm tfrdgotmlbomsb m`mnmj nudm ymoc hfrpgtfosb tfrboefdsb spbnnmcf smnurmo

pfromemsmo, smnurmo pfokfrommo `mo smnurmo dflbj. Nudm lfouoiudmo tmo`m

boefdsb. Nudm bob `mpmt `btfludmo pm`m nudm tfrhudm dmrfom trmulm mtmu

dfkfnmdmmo (nudm nmsfrmsb), ermdtur tfrhudm lmupuo nudm pfoftrmsb.

Dfluocdbomo boefdsb nudm =1% - =3%.

`. Nudm dgtgrNudm dgtgr m`mnmj nudm nmlm, nudm dfkfnmdmmo ymoc lfocmo`uoc imrbocmo

lmtb `mo nudm `focmo tmo`m boefdsb sfpfrtb kmbrmo purunfo. Nudm bob hbsm

sfhmcmb mdbhmt pflhf`mjmo ymoc smocmt tfrdgotmlbomsb. Hfotud nudm sfpfrtb

pfregrmsb vbsfrm, mhsfs `mo trmulm nmlm.

8. Hfr`msmrdmo pfoyfhmhm. Nudm mdbhmt dfdfrmsmo hfo`m tulpun

=) Uunous dgotusbg/ jflmtglM`mnmj nudm lflmr ymbtu sumtu pfo`mrmjmo `mnml imrbocmo hmwmj dunbt

mdbhmt pfkmjoym dmpbnfr `mo vfom ymoc `bsfhmhdmo gnfj dfdfrmsmo

tulpun


3/39

;

8)

Uunous fdsgrbmsb (nudm nfkft mtmu mhrmsb)m`mnmj kf`frm pm`m pfrludmmo fpb`frlbs mdbhmt hfrsfotujmo `focmo

hfo`m hfrpfrludmmo dmsmr mtmu ruokboc. Nudm bob hmoymd `biulpmb

pm`m dfim`bmo trmulmtbd sfpfrtb dfkfnmdmmo nmnu nbotms, tfrimtuj lmupuo

hfoturmo hfo`m tmiml mtmupuo tulpun. Smnmupuo dfrusmdmooym

lboblmn tftmpb nudm nfkft `mpmt lflhfrbdmo pftuoiud dfluocdbomo

m`moym dfrusmdmo jfhmt pm`m mnmt-mnmt `mnml tuhuj. [fsumb lfdmobslf

tfrim`boym nudm nfkft `bhf`mdmo `mnml ifobs9

Nudm nfkft cgrfs@bmdbhmtdmo gnfj hfo`m ruokboc ymoc lfoccfsfr nmpbsmo

pfrludmmo dunbt

Nudm nfkft sfrut (crzsf)/cfsfr (erbktbgo mhrmsbgo)M`mnmj nudm nfkft ymoc tfrim`b mdbhmt pfrsfotujmo dunbt `focmo

pfrludmmo hm`mo ymoc dmsmr `focmo mrmj dfdfrmsmo sfimimr/

lbrboc tfrjm`mp dunbt

Nudm nfkft tfdmo (blprfssbgo, blpmkt mhrmsbgo)Nudm nfkft ymoc `bsfhmhdmo gnfj pfofdmomo hfo`m tulpun sfkmrm

tfcmd nurus tfrjm`mp pfrludmmo dunbt.

;) Uunous nmsfrmtul (nudm rghfd)nudm `focmo tfpb ymoc tb`md hfrmturmo mtmu kglpmoc kmlpboc hbmsmoym

dmrfom tmrbdmo mtmu cgrfsmo hfo`m tulpun. Nudm bob `mpmt dbtm iulpmb

pm`m dfim`bmo dfkfnmdmmo nmnu nbotms `blmom hfotud nudm tb`md

hfrmturmo `mo dgtgr, df`mnmlmo nudm hbsm lfoflhus nmpbsmo ludgsm

jboccm nmpbsmo gtgt.


4/39

0

h.Nudm mdbhmt dfdfrmsmo sftfocmj tmiml=) Uunous Lgrsul

M`mnmj nudm dmrfom cbcbtmo hbomtmoc. Nudm cbcbtmo jfwmo lflbnbdb

hfotud pfrludmmo nudm ymoc lfocbdutb cbcb jfwmo ymoc lfoccbcbt.

@focmo df`mnmlmo nudm iucm lfoyfsumbdmo cbcbtmo jfwmo tfrsfhut

k. Nudm mdbhmt dfdfrmsmo tmiml/ hfo`m tmiml=) Uunous skbsul (nudm smymt mtmu brbs)

Nudm smymt mtmu brbs ymoc `b tmo`mb `focmo tfpb nudm hfrupm cmrbs nurus

`mo hfrmturmo. Uunous skbssulhbmsmoym `biulpmb pm`m mdtbebtms sfjmrb-

jmrb sfpfrtb tfrdfom pbsmu `mpur, smymtmo hfo`m tmiml ( sfoc, dmkm ),

`blmom hfotud nudm tfrmtur

8) Uunous puoktul (nudm tusud)Nudm tusud m`mnmj nudm mdbhmt tusudmo hfo`m ruokboc ymoc hbmsmoym

df`mnmlmo nudm nfhbj `mrb pm`m nfhmroym. Lbsmnoym tusudmo pbsmu ymoc

lfoflhus nmpbsmo gtgt, tusudmo pmdu `mo hfo`m-hfo`m tmiml nmbooym.

Dfsflumoym lfoblhundmo fefd tusudmo ymoc `mnml `focmo

pfrludmmo nudm tb`md hfcbtu nfhmr.

;) Uunous skngpfrgtul (nudm tflhmd)M`mnmj nudm ymoc `bsfhmhdmo dmrfom tflhmdmo sfoimtm mpb


5/39

6

`. Nudm mdbhmt trmulm ebsbdm `mo dblbm=) Uunous kglhutbg

M`mnmj nudm dmrfom tfrhmdmr gnfj mpb mtmu kmbrmo pmoms lmupuo

sfocmtmo mrus nbstrbd. Uunous kglhutbg lflbnbdb hfotud nudm ymoc tb`md

hfrmturmo `focmo pfrludmmo nudm ymoc nfhmr `mo wmrom dunbt ymoc

lfocjbtml. Hbmsmoym iucm `bsfrtmb hunm dmrfom dfrusmdmo fpbtfn dunbt

`mo ludgsm

@. Lmobefstmsb DnbobdLfourut hnmkd (=22;) lmobefstmsb vunous m`mnmj sfhmcmb hfrbdut9

=. @fegrlbtms9 @mym tfrbd dfdumtmo gtgt lfoyfhmhdmo ermclfo tunmoc hfrpbo`mj`mrb tflpmtoym pfruhmjmo dfsfblhmocmo `mo kgotur tfrim`b sfpfrtb9 rgtmsb

pflfo`fdmo tunmoc, pfofdmomo tunmoc.

8. Hfocdmd9 f`flm luokun sfkmrm kfpmt `mrb ngdmsb `mo fdstrmvmdsmsb `mrmj`mnml imrbocmo ymoc hfr`fdmtmo `focmo ermdtur

;. Fkjulgsbs `mrb Qfr`mrmjmo [uhkunmofgus0. [pmslf gtgt spmslf bovgnuotfrs `fdmt ermdtur6. Pfo`frofss/dfflpudmo5. Oyfrb luocdbo `bsfhmhdmo gnfj spmslf gtgt hfrpbo`mj tunmoc `mrb tflpmtoym

`mo dfrusmdmo strudtur `b `mfrmj ymoc hfr`fdmtmo.

3. Dfjbnmocmo sfosmsb (lmtb rmsm, luocdbo tfrim`b `mrb rusmdoym smrme/pfr`mrmjmo) :.

Qfrcfrmdmo mhogrlmn

2. Drfpbtmsb@. Qflfrbdsmmo Qfouoimoc

=. Qflfrbdsmmo sfrul9 jmn bob `bnmdudmo dmrfom m`m pm`m pmsbfo `focmo nudmhmdmr lfocmnmlb dfjbnmocmo vgnulf

8. Qflfrbdsmmo `mrmj 9 lbsmn pm`m pmsbfo `focmo nudm cbcbtmo `mpmt `biulpmbjbpgprgtgtrglhboflbm, trglhgsbtgpfobm, jbpgebhrbogcflbm, `mo moflbm

;. Qflfrbdsmmo fnfdtrgnbt 9 pm`m pmsbfo `focmo nudm hmdmr lfocmnmlb dfjbnmocmovgnulf kmbrmo `mo cmoccumo Om-D pulp


6/39

5

0. Momnbsm cms `mrmj hbmsmoym pmsbfo nudm hmdmr tfrim`b msb`gsbs lftmhgnbslf `modfjbnmocm prgtfbo

6. Emmn jmtb `mo cboimn5. KHK lfocb`fotbebdmsbdmo iulnmj `mrmj ymoc df `mnml kmbrmo, pfourumo JKP

`mo XHK, trglhgsbtgpfobm ngdmn, nfudgsbtgsbs, XHK ymoc rusmd

3. Fnfdtgnbt tfrim`b pfouruomo kmnsbul `mo sfrul, pfobocdmtmo mndmnb pjgspjmtf:. [frul mnhulbo 9 tgtmn prgtfbo lfouruo, jbpgomtrflbm2. Xm`bgngcb 9 uotud lfocftmjub pfoulpudmo kmbrmo pmru, bojmnms msmp `mo

lfouoiuddmo emdtgr ymoc lfo`msmrb 4 pm`m pmsbfo vunous lgrsul hbmsmoym

tfr`mpmt flhgnb pmru/f`flm pmru

=1.FKC 9 uotud lfocftmjub m`moym mrbtlbmF.Dglpnbdmsb

=. Dfrusmdmo mrtfrb98. Qfkmjoym mrtfrb dmrfom trmulm hbsm `btmo`mb `focmo tb`md m`moym om`b, KXP

lfouruo, kymogsbs hmcbmo `bstmn, jflmtglm ymoc nfhmr, `mo `bocbo pm`m

fdstrblbtms ymoc `bsfhmhdmo gnfj tbo`mdmo flfrcfosb spnbotboc, pfruhmjmo pgsbsb

pm`m ymoc smdbt, tbo`mdmo rf`udsb, `mo pflhf`mjmo.

;. Dglpmrtflfot [yo`rglDglpmrtflfot [yo`rgl lfrupmdmo dglpnbdmsb sfrbus ymoc tfrim`b dmrfom

tfrifhmdoym gtgt, tunmoc, smrme, `mo pflhunuj `mrmj `mnml imrbocmo pmrut. Bob

`bsfhmhdmo gnfj gf`flm mtmu pfr`mrmjmo ymoc lfofdmo gtgt, smrme, `mo

pflhunuj `mrmj

0. Boefdsb6. [jgkd tfrim`b dmrfom dfjbnmocmo hmoymd `mrmj `mo lfobocdmtoym pfrlfmhbnbtms

dmpbnfr ymoc hbsm lfoyfhmhdmo lfouruooym gdsbcfomsb

5. Dgotrmdtur3. Jbpfrtrgpb imrbocmo pmrut

BB. Pboimumo Vlul Pfotmoc Uunous QuoktulM. @febobsb

Nudm tusud (vunous puoktul) m`mnmj nudm ymoc `bsfhmhdmo gnfj hfo`m

tmiml sfpfrtb pbsmu, pmdu `mo hfo`m tmiml nmbooym. Hbmsmoym pm`m nudm tusud, `mrmj

tb`md dfnumr (dfnumr sf`bdbt) dfkumnb hfo`m pfousudoym `bkmhut. Nudm tusud smocmt

hfrhmjmym hbnm lfocfomb grcmo vbtmn sfpfrtb pmru, imotuoc, cboimn lmupu mh`glfo.


7/39

3

Nudm tusud lfrupmdmo ifims pm`m tuhuj ymoc `bmdbhmtdmo gnfj pfousudmo

hfo`m ymoc lflbnbdb uiuoc tmiml tmiml pm`m tuhuj. Hfo`m tmiml ymoc `blmdsu`

sfpfrtb pbsmu, pf`moc, cuotboc, mnmt pmjmt, hmygoft `mo hfo`m ymoc lflbnbdb uiuoc

tmiml nmbooym. Hmjdmo hfo`m nfhbj tulpun sfpfrtb ghfoc iucm `mpmt lfoyfhmhdmo

nudm tusud. Nudm tusud `mpmt `bhf`mdmo `focmo nudm brbs hfr`msmrdmo pmoimoc `mo

df`mnmlmo nudm. Ibdm `bnmdudmo pfocudurmo, nudm mdbhmt tusudmo lflbnbdb

df`mnmlmo nudm nfhbj pmoimoc `bhmo`boc pmoimocoym, sfhmnbdoym pm`m nudm brbs.

Cmlhmr =.

NudmPusud, pmomj hbru cfnmp lfouoiuddmo sbsb `focmo suùt nmokbp,sf`mocdmo `bsbsb ymoc hfrnmwmomo focmo suùt tulpun.

H. Dmrmdtfrbstbd Nudm=. Qmoimoc `mo df`mnmlmo nudm

Qm`m nudm tusud, pmoimoc nudm pm`m dunbt `mpmt smlm, nfhbj dfkbn

mtmupuo nfhbj hfsmr `bhmo`bocdmo `focmo nfhmr pbsmu. Dfhmoymdmo nudm tusud

mdmo lfocmocm hudmo dmrfom sbemt hfo`m ymoc lmsud tftmpb sfhmcmb mdbhmt

fnmstbsbtms `mrb dunbt. Qm`m hmcbmo tfrtfotu pm`m tuhuj, `blmom tfr`mpmt `msmr

hfrupm tunmoc mtmu sfrmt gtgt, nudm btu luocdbo omlpmd hfrhfotud sfpfrtb

durvm. Qmoimoc nudm pfotboc `budur `focmo kmrm lfrmpmtdmo dfùm tfpb nudm

sfhmh btu mdmo lfwmdbnb nfhmr mnmt. Qmoimoc nudm `b pfrludmmo dunbt tmlpmd

nfhbj dfkbn `mrb nfhmr mnmt, mpmnmcb hbnm nudm lfnbotmoc tfrjm`mp gtgt. Hbnm nudm

lmsud `mo dfnumr lfnmnub mnur ymoc smlm lmdm nfhmr nudm smlm `focmo nfhmr

mnmt. Pftmpb sfrboc ymoc tfrim`b nfhmr nudm lfnfhbjb nfhmr mnmt dfrfom tmrbdmo df

smlpboc wmdtu lfousud `mo wmdtu lfomrbd. @flbdbmo iucm hbnm mnmt/pbsmuymoc lmsud dfimrbocmo `focmo pgsbsb ymoc lbrboc.

Qflmdmbmo bstbnmj nudm pfoftrmsb `btuoiuddmo uotud lfoifnmsdmo

`blmom `mnmlmo nudm ymoc `bmdbhmtdmo gnfj hfo`m btu lfnfhbjb nfhmr nudm

ymoc tmlpmd pm`m pfrludmmo dunbt. @mnmloym nudm sunbt `btfotudmo pm`m

`mfrmj tmopm tunmoc sfpfrtb `b `mfrmj mh`glfo gnfj dmrfom fnmstbsbtms `bo`boc

pfrut tfrsfhut. Qmoimoc smnurmo nudm mtmu df`mnmlmo nudm `mpmt

lfocbo`bdmsbdmo pmoimoc lboblul `mrb sfoimtm ymoc `bcuomdmo, ibdm hmcbmo


8/39

:

pmocdmn sfoimtm lmsud df`mnml tuhuj. Vluloym `mnml nudm nfhbj pfo`fd

`mrb pmoimoc sfoimtm, dmrfom imrmoc `btusudmo mlpmb df pmocdmn sfoimtm.

Cmlhmr 8.

Qbsmuhfrlmtm smtu ymoc`btusudmo focmodf`mnmlmo ymochfrhf`m.

8. Hfotud NudmPfr`mpmt hfhfrmpm jmn ymoc lflpfocmrujb hfotud nudm ymbtu hfotud

`mo udurmo sfoimtm ymoc `bcuomdmo, mrmj `grgocmo, cfrmdmo sfoimtm pm`m

nudm, cfrmdmo dgrhmo ymoc `btusud, `mo dfm`mmo fnmstbsbtms dunbt. Hfotud nudm

lfrupmdmo cmlhmrmo ymoc pfotboc `mrb nudm tusud dmrfom dmrfom jmn btu mdmo smocmt

lflhmotu `mnml lflhf`mdmo hfrhmcmb ifobs sfoimtm ymoc luocdbo tfnmj

`bdulpundmo gnfj pgnbsb `mo `bhmwm uotud `bpfrbdsm. @mfrmj tfpb nudm `mpmt

lflhfrbdmo boegrlmsb dftmimlmo sfoimtm ymoc `bcuomdmo. [foimtm ymoc

tulpun lbsmnoym mdmo lflhumt tfpb nudm lfocmnmlb mhrmsb. Qboccbr nudm

`mpmt lfouoiudmo hmcbmo ymoc tmiml (suùt nmokbp) `mo tulpun (suùt

tulpun) `mrb pbsmu hfrpboccbr tmiml smtu sbsb. Qbsmu `focmo dfùm sbsb tmiml

mdmo lfocjmsbndmo nudm `focmo ùm pboccbr tmiml.

Cmlhmr ;.

Nudm tusud sfoimtm hfrlmtm

smtu

Cmlhmr 0.

Nudm tusud sfoimtm hfrlmtm ùm

Hfotud nudm iucm tfrcmotuoc sfhfrmpm hmoymd hmcbmo pbsmu (sfoimtm)

ymoclmsud df `mnml tuhuj, gnfj dmrfom btu pfotboc lfocftmjub hfrhmcmb

dfluocdbomohfotud sfoimtm ymoc bcuomdmo.

Cmlhmr 6. Hmcbmo-hmcbmo `mrb sfhumj pbsmu.

Qfrnu `bbocmt hmjwm hfo`m nmbo ymoc `mpmt lfoflhus tuhuj, sfpfrtb

pmjmt,ghfoc mtmu cuotboc, mdmo lfoyfhmhdmo pfrhf`mmo hfotud nudm ymoc


9/39

2

dm`moc-dm`moc hfrhfotud sfcb flpmt mtmu, ymoc nfhbj imrmoc, hfrhfotud

smtfnbt


10/39

6

[fnmbo dfdjususmo sfoimtm ymoc `bcuomdmo, sbemt dffnmstbsmo dunbt

`mo mrmj tusudmo tfrjm`mp sfrmhut fnmstbs iucm lflpfocmrujb hfotud nudm.

Mpmhbnm mrmj tusudmo lflhfotud su`ut ymoc tfcmd nurus `focmo `bstrbhusb

sfrmhut fnmstbs tuhuj ymoc sfsumb `focmo Nmocfrs nbof. Jmn bob mdmo

lfoyfhmhdmo tfpb nudm mdmo lfnfhmr `mo kftmdmo nudm tb`md sfsumb `focmo

sfoimtm ymoc `bcuomdmo.

Cmlhmr :.

Nudm luntbpfn `focmo hfrhmcmb hfotud mdbhmt fefd nmocfrs nbof.

Pfr`mpmt hfhfrmpm emdtgr ymoc lflpfocmrujb hfotud nudm

tusud, smnmj smtuoym m`mnmj rfmdsb dgrhmo smmt `btusud mtmu smmt pbsmu

dfnumr, jmn tfrsfhut `mpmt lfoyfhmhdmo nudmoym lfoim`b tb`md hfcbtu

djms. Mtmu lmobpunmsb ymoc `bnmdudmo pm`m smmt pfousudmo iucm mdmo

lflpfocmrujb. Hfhfrmpm pgnm nudm ymoc `mpmt `btfludmo 9

m. Pusudmo lmsud, ymoc dflu`bmo `bdfnumrdmo sfhmcbmo, `modflu`bmo `btusuddmo dflhmnb lfnmnub smnurmo ymoc hfrhf`m. Qm`m

dfm`mmo tfrsfhut nudm tb`md sfsumb `focmo cmlhmrmo hbmsmoym `mo

nfhbj `mrb smtu smnurmo `mpmt `btflub pm`m imrbocmo ymoc nfhbj

`mnml lmupuo pm`m grcmo.

h. Pusudmo lmsud dflu`bmo `bdfnumrdmo `focmo lfocmrmjdmo dfsmnmj smtu su`ut, sfjboccm nudm ymoc tfrhfotud nfhbj nfhmr `molflhfrbdmo nudm pm`m pfrludmmo dunbt sfpfrtb fdgr.

k. Pusudmo lmsud dflu`bmo smmt lmsbj `b `mnml `btusuddmo df mrmjnmbo, sfjboccm smnurmo nudm lfoim`b nfhbj nums. Nudm numr ymoc


11/39

5

tfrnbjmt iucm nfhbj nums `bhmo`bocdmo `focmo nfhmr sfoimtm ymoc

`bcuomdmo.

`. Pusudmo lmsud ymoc dflu`bmo `bdfnumrdmo `focmolfocccuomdmo tbtbd tfr`mnml sfhmcmb nmo`msmo, sfjboccm smnurmo

nudm sflpbt pm`m tbtbd tfr`mnml `mo tfrnfhmr pm`m hmcbmo

supfrebsbmn. [fjboccm nudm numr nfhbj hfsmr `bhmo`bocdmo nfhmr

sfoimtm ymoc `bcuomdmo.

f. Pusudmo `bputmr smmt lmsud, dfnumr, lmupuo dfùmoym. [uùtnudm hfrhfotud brfcunfr `mo hfsmr.

Jmrus `bbocmt hmjwm pgsbsb tuhuj dgrhmo smmt `btusud hfrhf`m

`focmo pm`m smmt mutgpsb. Qgsbsb lflhuocdud, hfrputmr, `mo

lfocmocdmt tmocmo `mpmt `bsfhmhdmo gnfj sfoimtm ymoc nfhbj pfo`fd

`bhmo`bocdmo mpm ymoc `b`mpmtdmo pm`m smmt mutgpsb. Lmobpunmsb tuhuj

uotud lflpfrnbjmtdmo pgsbsb smmt `btusud sunbt mtmu hmjdmo tb`md

luocdbo lfocbocmt hfrmt `mo m`moym dmdu lmymt. Qgbo nmbo ymoc pfrnu

`bpfrtblhmocdmo m`mnmj m`moym dglprfsb `mrb hfhfrmpm moccgtm tuhuj

pm`m smmt pfousudmo. Qflfrbdsm ymoc su`mj hfrpfocmnmlmo hbmsmoym

rmcu-rmcu uotud lfofotudmo ifobs sfoimtm ymoc `bcuomdmo.

K. Qflfrbdsmmo NudmQm`m pflfrbdsmmo nudm m`m ùm tbpf nudm gnfj dmrfom bostrulfo

ymoc tmiml ymoc pfrnu `bpfrjmtbdmo `focmo hmbd `mo lflbnbdb kbrb ymoc

`mpmt `bdfomnb `mrb mdsb dgrhmo ymbtu tmo`m pfrkghmmo `mo nudm pfrnmwmomo.

Dfùmoym lflpuoymb hfotud, nftmd `mo lf`bdgnfcmn. Pmo`m pfrkghmmo

m`mnmj bosbsb `mocdmn, nudm tusud `bhumt sfhfnul nudm ymoc emtmn gnfj

bo`bvbù ymoc hfrfokmom huouj `brb. Nudm pfrkghmmo tfrsfhut sfrbocdmnb

tfrnftmd pmrmnfn `mo tfrnftmd `fdmt `focmo nudm `mnml `b `mfrmj pfrcfnmocmo


12/39

3

tmocmo mtmu nfjfr. Hfotud nmbooym motmrm nmbo nudm tusud `mocdmn `b`fdmt

nudm tusud `mnml `mo lflmtbdmo. Lfsdbpuo imrmoc sfdmnb `bnmpgr

Cmlhmr :.Nudm luntbpnf ymoc lfrupmdmo tmo`m pfrkghmmo huouj `brb

Hfotud nmbo `mrb nudm gnfj dmrfom bostrulfo ymoc tmiml m`mnmj

nudmpfrnmwmomo. Nudm ifobs bob `mpmt `btfludmo `b imrb-imrb, tmocmo, `mo

nfocmo hmwmj (imrmoc `btflpmt nmbo) `mrb dgrhmo sfhmcmblmom bm hfrusmjm

lfnbo`uocb `brboym `mrb myuomo sfoimtm, kgotgjoym `focmo lfoccfoccml

hbnmj `mrb bostrulfotmiml.

@mnml pflfrbdsmmo, botfrprftmsb nudm jmrus hfr`msmrdmo pfoflumo

`mo tb`md hgnfj `bpfocmrujb gnfj dftfrmocmo pmsbfo mtmu dfnumrcm.

Qflfrbdsmmo `btuiudmo uotud lfofotudmo9

m. Iulnmj nudmh. Ngdmsb nudmk. Mrmj nudm`. Vdurmo nudm (pmoimoc, nfhmr `mo `mnml)f. Lflpfrdbrmdmo nudm sfhmcmb pfoyfhmh dflmtbmo dgrhmo mtmu hudmo


13/39

:

e. Lflpfrdbrmdmo kmrm tfrim`boym nudm mpmdmj dmsus pflhuoujmo, huouj`brb, mtmu dfkfnmdmmo.

Ngdmsb nudm `bifnmsdmo `focmo lfocjuhuocdmo `mfrmj mfrmj ymoc

hfr`fdmtmo `focmo cmrbs momtglb tuhuj `mo pgsbsb imrbocmo tfrtfotu, lbsmnoym

cmrbs tfocmj tuhuj, dftbmd, putboc susu, pusmt, pfrsfo`bmo `mo nmbonmbo.

Hfotud nudm sfhmbdoym `bhumt `mnml hfotud sdftsm mtmu `begtg

uotud lfoccmlhmrdmo dfrusmdmo pfrludmmo dunbt, imrbocmo `bhmwmjoym, `mo

hbnm pfrnu grcmo `mnml (vbsfrmn). @budur sfkmrm tfpmt (`mnml udurmo lbnnblftfr

mtmu kfotblftfr) tb`md hgnfj `mnml udurmo dbrmdbrm smim. ([imlsujb`mymt,

8115)

@. Qfoyfhmh DflmtbmoQfoyfhmh dflmtbmo `mpmt tfrim`b sfcfrm mtmu nmocsuoc, tftmpb pfrnudmmo

`mpmt iucm lfoyfhmhdmo dflmtbmo sfkmrm tb`md nmocsuoc. Qfoyfhmh dflmtbmo

nmocsuoc `mpmt hfrupm9

=. Qfr`mrmjmo nums (sygd jbpgvgnflbd) `mo hmoymd `mpmt tfrim`b `b `mnmlrgoccm tuhuj mtmu `b numr rgoccm tuhuj. Ugnulf `mrmj m`m dbrmdbrm 3 -

=1 % mtmu =/=; hfrmt hm`mo. Dfjbnmocmo =/; hmcbmo `mrb vgnulf `mrmj

tuhuj sfkmrm tbhm- tbhm `mpmt lfoyfhmhdmo dflmtbmo. Dfjbnmocmo `mrmj

ymoc `flbdbmo bob lfocmdbhmtdmo sygd `mo lfoboccmn hbnm

tb`md `bnmdudmo pfomocmomo ymoc tfpmt `mo kfpmt, sf`mocdmo dfjbnmocmo

`mrmj sfkmrm pfrnmjmo-nmjmo tb`md hfcbtu lflhmjmymdmo gnfj dmrfom

tuhuj `mpmt lfocdglpfosmsboym. Qfr`mrmjmo `b `mnml rgoccm tuhuj

`mpmt dbtm iulpmb pm`m nudm tusud ymoc lfocfomb grcmogrcmo `mnml

sfpfrtb imotuoc, pmrupmru, jmtb `mo nblpm. dmnmu `biulpmb nfhbj `mrb smtu

nudm, lmdm jmrus `btfotudmo ymoc lmom ymoc lfoyfhmhdmo dflmtbmo

dgrhmo.

8. Nudm pm`m grcmo vbtmn. Hbnm ymoc tfrnudm m`mnmj grcmo vbtmn,sfpfrtb imotuoc, pmru, nblpm, jmtb, cboimn, pflhunuj `mrmj hfsmr mdmo


14/39

2

lfoyfhmhdmo dflmtbmo nfhbj kfpmt. Qfr`mrmjmo pm`m dmotuoc

pfrbkmr`bul sfhmoymd ;11- 011 kk tfnmj `mpmt lfoyfhmhdmo dflmtbmo

dmrfom tfrim`b tmlpgom`f imotuoc. @flbdbmo iucm `mrmj sfiulnmj 811

;11 kk ymoc lfoyulhmt smnurmo pfromemsmo `mpmt lfoyfhmhdmo

dflmtbmo dmrfom msebdsbm.

Dflmtbmo ymoc tblhun `mnml imocdm wmdtu ymoc nmlm, ymoc hudmo

prblfr gnfj dmrfom nudmoym, `bsfhut pfoyfhmh dflmtbmo sfkmrm tb`md nmocsuoc.

Rmoc tfrlmsud jmn-jmn bob m`mnmj 9

=. Boenmlmsb `mrb grcmogrcmo `mnml tuhuj, sfpfrtb lfobocbtbs,fokfpjmngtgs, pnfurbtbs `mo pfrbtgobtbs.

8. Boefdsb sfpsbs `mrb nudm ymoc `mpmt lfocmdbhmtdmo sfptbkflbm `mrbnudmnmlm ymoc tb`md sflhuj `mo nudm bob hbsm prblfr mtmupuo sfduo`fr.

;. Cmocrfo mtmu ofdrgsbs sfhmcmb mdbhmt dfrusmdmo imrbocmoimrbocmo`mopflhunuj `mrmj.

0. Prglhgsbs pm`m pflhunuj `mrmj vfom `mo flhgnb ymoc tfrim`bmdbhmtbllghbnbsmsb.

BBB. Pboimumo Vlul Pfotmoc Prmulm Mh`glfoM. Momtglb Mh`glfo

=. Momtglb Numr `mrb Mh`glfom. Mh`glfo @fpmo

@febobsb mh`glfo `fpmo m`mnmj hb`moc ymoc hmcbmo supfrbgroym

`bhmtmsb gnfj cmrbs botfrlmllmrbm, `b boefrbgr `bhmtmsb gnfj df`um

nbcmlfotul bocubomnf `mo sblebsbs puhbs sfrtm `b nmtfrmn gnfj df`um

nbofm mdsbnmrbs motfrbgr

h. QboccmocBob lfrupmdmo `mfrmj ymoc hfrm`m `bmotmrm nbofm mdsbnmrbs motfrbgr

`mo nbofm mdsbnmrbs pgstfrbgr, `mrb sfnm bcm df-5 `bmtms, df hmwmj

smlpmb krbstm bnbmkm. @b ngdmsb bob m`moym `bo`boc gtgt mh`glfo ymoc


15/39

=1

tfhmn, hfrnmbomo `focmo `bo`boc gtgt ymoc nfhbj tbpbs `bhmcbmo `fpmo,

lfoim`b pfnboùoc tfrutmlm tfrjm`mp nudms tusud.

k. Quoccuoc@mfrmj bob hfrm`m `bhfnmdmoc `mrb nbofm mdsbnmrbs pgstfrbgr, `mrb uiuoc

hmwmj skmpunm smlpmb krbstm bnbmkm. [fpfrtb jmnoym `mfrmj enmod, `bsbob

gtgt-gtgt puoccuoc `mo gtgt pmrmspbomn lfoim`b pfnboùoc tfrjm`mp

trmulm tmiml

8. Momtglb @mnml `mrb Mh`glfom. Xgoccm Qfrbtgofmn

Xgoccm pfrbtgofmn tfr`brb `mrb ùm hmcbmo, ymbtu mtms `mo hmwmj.

Xgoccm pfrbtgofmn mtms `bnboùocb gnfj hmcbmo hmwmj `mrb `bo`boc

tjgrmx ymoc lfokmdup `bmermclm, jfpmr, nbfo, cmstfr `mo kgngo

trmosvfrsul. Hmcbmo bob iucm `bsfhut dglpgofo tjgrmkgmh`glbomn

`mrb mh`glfo. Qm`m smmt `bmermclm ombd smlpmb sfnm bcm BU pm`m

wmdtu fdspbrmsb pfouj, sftbmp tfrim`b ermdtur bcm lmupuo nudm tusud

tflhus `bhmwmj cmrbs botfrlmllmrbm hbsm lfokf`frmb grcmo `mnml

mh`glfo. Xgoccm pfrbtgofmn hmwmj hfrbsbdmo usus jmnus, hmcbmo

kgngo mskfo`fos `mo kgngo `fskfo`fos, kgngo sbclgb` `mo pm`m

wmobtm, grcmo rfprgùdsb botfromn.

h. Xgoccm BotrmpfrbtgofmnXgoccm ymoc pgtfosbmn bob m`mnmj rgoccm ymoc hfrm`m `bhfnmdmoc

`bo`boc pfrbtgoful ymoc lfnmpbsb mh`glfo `mo `b`mnmloym tfr`mpmt

mgrtm mh`glbomnbs, vfom kmvm boefrbgr, sfhmcbmo hfsmr `mrb ùg`foul,

pmodrfms, cboimn `mo urftfr sfrtm sfhmcbmo pgstfrbgr `mrb kgngo

mskfo`fos `mo kgngo `fskfo`fos, `mo iucm hmcbmo rgoccm pfnvbs ymoc

rftrgpfrbtgofmn. Kf`frm pm`m grcmo `mnml rftrgpfrbtgofmn sunbt

`bdfomnb dmrfom `mfrmj bob imuj `mrb imocdmumo pflfrbdsmmo ebsbd

ymoc hbmsm `mo iucm kf`frm `bsbob pm`m mwmnoym tb`md mdmo

lflpfrnbjmtdmo tmo`m lmupuo cfimnm pfrbtgobtbs. @bsmlpboc btu,


16/39

==

rgoccm bob tb`md tfrlmsud `mnml hmcbmo ymoc `bpfrbdsm smlpfnoym

pm`m `bmcogstbk pfrbtgofmn nmvmcf(@QN).

k. Xgoccm QfnvbsXgoccm pfnvbs ymoc `bnbo`uocb gnfj tunmoc-tunmoc pfnvbs, sfhfomroym

lfrupmdmo hmcbmo hmwmj `mrb rgoccm botrmpfrbtgofmn, sfdmnbcus

hmcbmo hmwmj `mrb rgoccm rftrgpfrbtgofmn. Pfr`mpmt `b`mnmloym

rfktul, vfsbkm urbomrbm, pflhunuj-pflhunuj bnbmkm `mo pm`m wmobtm,

grcmo rfprg`udsb botfromn. [fhmcmblmom jmnoym hmcbmo

tjgrmkgmh`glbomn, pflfrbdsmmo grcmo-grcmo pfnvbs tfrjmnmoc gnfj

hmcbmo-hmcbmo tunmoc `bmtmsoym.

;. Gtgt Qfoyusuo @bo boc Mh`glfoGtgt pfoyusuo bo boc mh`glfo hmcbmo fpmo/vfotrmn ( mrb mnml df numr)

m. L. rfktus mh`glbobs (dbrb-dmomo nbofm lf bmom)- Pfrsusuo lflmoimoc mrbkgstmf 6-3 df sylpjbsbs puhbs- @bhuocdus vmcbom l. rfktb mh`glbobs- Euocsb 9 Lfomrbd `m m smmt fdspbrmsb, lfocmocdmt pfnvbs, motfenfdsb

kgnulom vfrtfhrmnbs, lflhmotu rgtmsb rgoccm m m

h. L. trmosvfrsus mh`glbobsk. L. ghnbquus botfrous mh`glbobs`. L. ghnbquus fdstfrous mh`glbobsGtgt pfoyusuo bo boc mh`glfo hmcbmo hfnmdmoc/ grsmn ( mrb mnml df numr)

=. L. psgms lmigr mo l psgms lbogr8. L. qum rmtus nulhgrul;. L. frfktgr truokb0. L. nmtbssblus `grsb


17/39

=8

Cmlhmr 8.=. Gtgt Qfoyusuo @bo`boc Mh`glfo

0. Emskbm9 ( mrb numr)m. supfrebsbmn mh`glbobs (vfotrmn)h. supfrebsbmn `grsb (`grsmn)k. trmosvfrsm mh`glbobs ( mnml)`. @mnml emskbm trmosvfrsm mh`glbobs < pfrbtgoful pmrbftmnf

Cmlhmr 8.8. Emskbm


18/39

=;

H. Prmulm Mh`glfoPrmulm m`mnmj dfm`mmo ymoc `bsfhmhdmo gnfj nudm mtmupuo kf`frm. Prmulm

mh`glfo `b`febobsbdmo sfhmcmb dfrusmdmo tfrjm`mp strudtur ymoc tfrnftmd

`bmotmrm `bmermclm `mo pfnvbs ymoc `bmdbhmtdmo gnfj nudm tulpun mtmu ymoc

lfousud

Prmulm pm`m `bo`boc mh`glfo tfr`brb `mrb 9

=. Dgotusbg `bo`boc mh`glfo `bsfhmhdmo trmulm ogo-pfoftrmsbDgotusbg `bo`boc mh`glfo tb`md tfr`mpmt kf`frm botrm mh`glfo,

dfluocdbomo tfrim`b fdsblgsbs mtmu pfoblhuomo `mrmj `mnml imrbocmo

nuomd `mo lmsm `mrmj `mpmt lfoyfrupmb tulgr.

8. Nmsfrmsb, Ibdm tfr`mpmt nudm pm`m `bo`boc mh`glfo ymoc lfoflhusrgoccm mh`glfo jmrus `b fdspngrmsb. Mtmu tfrim`b dmrfom trmulm

pfoftrmsb.

Prmulm Mh`glfo m`mnmj tfrim`boym mtmu dfrusmdmo pm`m grcmo

mh`glfo ymoc `mpmt lfoyfhmhdmo pfruhmjmo ebsbgngcb sfjboccm tfrim`b

cmoccumo lftmhgnbslf, dfnmbomo blgogngcb `mo cmoccumo emmn hfrhmcmb

grcmo.

Prmulm mh`glfo pm`m bsb mh`glfo, lfourut [u``mrtj & Hruoofr

(8118), ymbtu9

m. Qfregrmsb grcmo vbsfrmn botrmpfrbtgofulKf`frm pm`m bsb mh`glfo luocdbo `b sfrtmb gnfj hudtb m`moym kf`frm

pm`m `bo`boc mh`glfo.

h. Nudm tusud (trmulm pfoftrmsb) pm`m mh`glfok. Kf`frm tjgrmd mh`glfo

[ftbmp nudm pm`m tjgrmds ymoc luocdbo lfoflhus smymp dbrb

`bmermclm, mtmu smymp dmomo `mo jmtb jmrus `bfdspngrmsb.


19/39

=0

K.Dnmsbebdmsb Prmulm Pflhus Mh`glfoPrmulm pm`m mh`glfo) `mpmt `b hmcb lfoim`b `um ifobs, ymbtu9

=. Prmulm pfoftrmsb (trmulm pfrut `focmo pfoftrmsb df`mnml rgoccmpfrbtgobul)

m. Nudm Pusudh. Nudm Pflhmd

8. Prmulm ogo-pfoftrmsb (trmulm tulpun)@. Qmtgebsbgngcb Nudm Pusud Mh`glfo

Ibdm tfrim`b trmulm pfoftrmsb mtmu ogo-pfoftrmsb dfluocdbomo mdmo

tfrim`b pfo`mrmjmo botrm mh`glfo ymoc sfrbus, pmsbfo mdmo lflpfrnbjmtdmo

tmo`m-tmo`m brbtmsb ymoc `bsfrtmb pfouruomo jbtuoc sfn `mrmj lfrmj ymoc

mdjbroym cmlhmrmo dnmsbd sygd jflgrmcbd. Hbnm sumtu grcmo vbsfrmn

lfocmnmlb pfregrmsb, lmdm tmo`m-tmo`m pfregrmsb, tmo`m-tmo`m brbtmsb

pfrbtgobul kfpmt tmlpmd. Pmo`m-tmo`m `mnml trmulm mh`glfo tfrsfhut

lfnbputb oyfrb tfdmo, oyfrb spgotmo, oyfrb nfpms `mo `bstfosb mh`glfo tmopm

hbsboc usus hbnm tfnmj tfrim`b pfrbtgobtbs ulul.Hbnm sygd tfnmj nmoiut pmsbfo

mdmo lfocmnmlb tmdbdmr`b `mo pfobocdmtmo suju tuhuj, iucm tfr`mpmt

nfudgsbtgsbs. Hbmsmoym tmo`m-tmo`m pfrbtgobtbs luocdbo hfnul tmlpmd. Qm`m

emsf mwmn pfregrmsb dfkbn jmoym tmo`m-tmo`m tb`md djms ymoc luokun. Hbnm

tfr`mpmt dfkurbcmmo hmjwm lmsud rgoccm mh`glfo, lmdm gpfrmsb jmrus

`bnmdudmo (Mlfrbkmo Kgnnfcf ge [urcfgos, 8110)

Prmulm tmiml mtmu tusudmo hfo`m tmiml lflhfrb ifims pm`m dutbs `mo

suhdutbs, hbnm nfhbj `mnml mdmo lfnbhmtdmo gtgt mh`glfo, `mo tusudmo nfhbj

`mnml mdmo lfoflhus pfrbtgoful `mo lmlpu lfokf`frmb grcmo

botrmpfrbtgofmn mtmu luocdbo nmocsuoc lfokf`frmb grcmo rftrgpfrbtgofmn hbnm

trmulm hfrmsmn `mrb mrmj hfnmdmoc. [mocmt imrmoc `btflub trmulm tmiml ymoc

lfoflhus `mrb ludm smlpmb hfnmdmoc `bo`boc mh`glfo mtmu sfhmnbdoym

(Mlfrbkmo Kgnnfcf ge [urcfgos, 8110)


20/39

=6

Prmulm tmiml `bo`boc mh`glfo mdmo lfoblhundmo pfr`mrmjmo bo sbtu,

hbnm trmulm lfoflhus pfrbtgoful, luocdbo tfr`mpmt pgnms glfotul.

Prmulm tmiml `mpmt `focmo lu`mj lfokf`frmb jfpmr, lfsfotfrbul

`mo lfsgdgngo, cmstfr, pmokrfms mtmu hunb-hunb, omluo dmrfom sbemt

lghbnbtmsoym, imrmoc lfokf`frmb usus jmnus, dgngo, nblpm `mo cboimn.

Mdbhmt `mrb trmulm tmiml pm`m ululoym m`mnmj pfr`mrmjmo ymoc

tfrpmotmu, mtmu hbnm ymoc tfrdfom kf`frm m`mnmj cmstfr, mdmo `b`mpmtb

pfoyfhmrmo msml nmlhuoc `mnml rgoccm pfrbtgoful, ymoc mdmo lflhfrb

pfrmocsmocmo ymoc kudup jfhmt, hfrupm tmo`m-tmo`m pfrbtgobtbs.

Nudm tusud mdmo lfocmdbhmtdmo dfrusmdmo imrbocmo dmrfom nmsfrmsb

mtmupuo tfrpgtgoc. Nudm tusud tfrsfrboc lfocfomb jfpmr (01%), usus jmnus

(;1%), `bmermclm (81%) `mo kgngo (=6%) (Mlfrbkmo Kgnnfcf ge [urcfgos,

8110)

F. Lmobefstmsb DnbobsLmobefstmsb dnbobs lfourut(Mlfrbkmo Kgnnfcf ge [urcfgos, 8110)

=. Qfouruomo dfsm`mrmo (lmnmbsf, nftmrcb, cfnbsmj) ymoc `bsfhmhdmo gnfjdfjbnmocmo `mrmj `mo tmo`m-tmo`m mwmn sjgkd jflgrmcbd.

8. Jbnmocoym sfnuruj mtmu sfhmcbmo euocsb grcmo.;. Xfspgo strfs sblpmtbs.0. Qfr`mrmjmo `mo pflhfdumo `mrmj.6. Dgotmlbomsb hmdtfrb `mo dflmtbmo sfn.

E. Qfobnmbmo Nudm Pusud Mh`glfo=. Momlofsbs

Hbnm lfofnbtb pmsbfo `focmo trmulm tmiml, momlofsf ymoc tfnbtb jmrus

`bmrmjdmo pm`m wmdtu tfrim`boym trmulm, ifobs sfoimtm ymoc

`bpfrcuomdmo, imrmd `mrb pfnmdu, iulnmj tbdmlmo `mo iulnmj

pfr`mrmjmo fdstfromn ymoc tfrkmtmt `b tflpmt dfim`bmo. Hbnm luocdbo,

boegrlmsb tmlhmjmo jmrus `bpfrgnfj `mrb pmsbfo lfocfomb jfhmtoym


21/39

=5

lmupuo ngdmsb `mrb sftbmp oyfrb mh`glbomnoym `mo mpmdmj m`m oyfrb

mnbj. (Mlfrbkmo Kgnnfcf ge [urcfgos, 8110)

8. Qflfrbdsmmo Ebsbdm. Bospfdsb

Vluloym pmsbfo jmrus `bpfrbdsm tmopm pmdmbmo. Mh`glfo hmcbmo

`fpmo `mo hfnmdmoc, `m`m hmcbmo hmwmj `mo pfrboful `btfnbtb

hmcmblmomdmj nmsfrmsboym, nbmoc tusudmooym, m`mdmj hfo`m msboc

ymoc lfomokmp, `mo mpmdmj m`m glfotul mtmupuo hmcbmo usus

ymoc dfnumr.

h. Fvmnumsb Nudm PusudNudm tusudmo pbsmu hbmsmoym `btmocmob nfhbj sfnfdtbe, mdmo tftmpb

;1% dmsus lfocmnmlb kf`frm botrmpfrbtgofmn. Hbnm m`m dfkurbcmmo

hmjwm nudm tusud ymoc tfrim`b sbemtoym supfrebkbmn `mo omlpmdoym

tb`md lfoflhus nmpbsmo gtgt `bo`boc mh`glfo, hbmsmoym mjnb

hf`mj ymoc hfrpfocmnmlmo mdmo lfokghm uotud lfnmdudmo

fdspngrmsb nudm tfrnfhbj `mjunu uotud lfofotudmo df`mnmlmooym.

Mdmo tftmpb, dmrfom 86-;;% nudm tusud `bmh`glfo `fpmo tb`md

lfoflhus pfrbtgoful, nmpmrgtglb pm`m pmsbfo sfpfrtb bob lfoim`b

durmoc prg`udtbe.

@focmo dgo`bsb stfrbn, mofstfsb ngdmn `bsuotbddmo `mo imnur nudm

`bbdutb smlpmb `btfludmo uiuocoym. Hbnm tfrhudtb pfrbtgoful

tflhus, pmsbfo lfocmnmlb rbsbdg nfhbj hfsmr uotud kf`frm

botrmmh`glbomn, `mo hmoymd mjnb hf`mj lfocmoccmp bob su`mj

bo`bdmsb uotud lfnmdsmomdmo nmpmrmtglb. [ftbmp mpsbfo ymoc sunbt

dbtm fdspngrmsb sfkmrm ngdmn dmrfom cflud, tb`md dggpfrmtbe

lmupuo dmrfom pfr`mrmjmo imrbocmo nuodm ymoc lfocmhurdmo

pfobnmbmo dbtm jmrus `brmwmt uotud fvmnumsb unmoc mtmumpuo uotud

nmpmrmtglb.

k. Qflfrbdsmmo Z-Xmy uotud [krffoboc Prmulm Pmiml


22/39

=3

Qmsbfo nudm tusud `focmo jflg`bomlbd ymoc mhogrlmn tb`dm

lflfrnudmo pflfrbdsmmo skrffoboc x-rmy. Qm`m pmsbfo nudm tusud

`bmtms ulhbnbkus mtmu `bkurbcmb `focmo kf`frm tjgrmkgmh`glbomn

`focmo jflg`bomlbd ymoc ogrlmn, rgotcfo egtg tjgrmd tfcmd

hfrlmoemmt uotud lfoybocdbrdmo dfluocdbomo jflg mtmu

pofulgtjgrmd, mtmupuo uotud `gdulfotmsb m`moym u`mrm hfhms

botrmpfrbtgofmn.

C. Qflfrbdsmmo @bmcogstbd Qm`m Prmuom Pmiml=. Kf`frm tjgrmx hmcbmo hmwmj

Votud pmsbfo ymoc msblptglmtbd `focmo dfkurbcmmo kf`frm pm`m

`bmermclm `mo strudtur mh`glfo hmcbmo mtms `bpfrnudmo pflfrbdsmmo

ebsbd lmupuo tjgrmd egtg hfrunmoc, tjgrmkgsdgpb mtmupuo nmpmrgsdgpb

mtmupuo pflfrbdsmmo KP skmo. @focmo pflfrbdsmmo `bmtmspuo dbtm

lmsbj hbsm lfofludmo m`moym jfrobm `bmermclm sfhfnmj dbrb dmrfom

nudm tusud tjgrmkgmh`glbomn, sfjboccm uotud nudm sfpfrtb bob gpsb nmbo

`bpfrnudmo ymbtu fdspngrmsb hf`mj

8. Fdspngrmsb ngdmn nudm66-56% pmsbfo nudm tusud tflhus mh`glfo `fpmo mdmo lfocmnmlb

jbpgtfosb, pfrbtgobtbs mtmupuo fvbskfrmsb glfotul lmupuo usus jmnus.

Votud pmsbfo sfpfrtb bob jmrus sfcfrm `bnmdudmo nmpmrgtglb. Votud

pmsbfo sfnfhbjoym, sfsu`mj dgoebrlmsb m`moym nudm tusud tflhus

pfrbtgoful sfsu`mj lfnmdudmo fdspngrmsb ngdmn nudm, sftfocmjoym iucm

mdmo lfocmnmlb nmpmrgtglb. Nmpmrgtglb bob lfrupmdmo smnmj smtu gpsb

ymoc rfnfvmo uotud sflum pmsbfo bob. Votud pmsbfo ymoc rfnmtbe

msblptglmtbd (dfkumnb rmsm oyfrb mdbhmt tusudmo), gpsb `bmcogstbd ymoc

tb`md bovmsbvf m`mnmj pflfrbdsmmo ebsbd `bmcogstbd sfrbmn `mnml 80 iml,

@QN lmupuo nmpmrgsdgpb `bmcogstbd. Qflfrbdsmmo ebsbd `bmcogstbd

sfrbmn lflhutujdmo sulhfr `mym lmousbm ymoc hfsmr, tftmpb `focmo


23/39

=:

dftmimlmo sfhfsmr 20%. @focmo @QN hbsm `bpfrgnfj `bmcogsm nfhbj

`bob pm`m pmsbfo ymoc msblptglmtbd `mo dftmimlmo lfokmpmb 21% hbnm

lfoccuomdmo jbtuoc ifobs sfn sfpfrtb pm`m trmulm tulpun.

Nmpmrgsdgpb `bmcogstbd hbsm lfocdgoebrlmsb mtmupuo lfoybocdbrdmo

tflhusoym pfrbtgoful, tftmpb durmoc hfrlmdom uotud lfocfomnb

kf`frm tfrtfotu.

J. Qfomtmnmdsmommo[fsumbM`vmokf` Prmulm Nbef [uppgrt, `mnml (BDMHB, 8110) pfomocmomo

ymoc pfotboc uotud trmulm tmiml pm`m mh`glfo, ymbtu 9

=. Lfocflhmnbdmo euocsb vbtmn `mo gptblmnbsmsb gdsbcfomsb `mo pfreusbimrbocmo.

8. Lfofotudmo lfdmobslf trmulm.;. Qflfrbdsmmo ebsbd ymoc jmtb-jmtb `mo `bunmoc hfrdmnm.0. Lfofotudmo kmrm `bmcogstbd ymoc djusus hbnm `bpfrnudmo `mo

`bnmdudmo `focmo kfpmt.

6. Pftmp wmspm`m mdmo dfluocdbomo m`moym kf`frm vmsdunfr lmupuorftrgpfrbtgofmn ymoc tfrsflhuoyb.

5. [fcfrm lfofotudmo hbnm `bpfrnudmo gpfrmsb.

Cmlhmr 8.;. Lmomiflfo Prmulm Pflhus


24/39

=2

B. Qfomocmomo Qrf Jgspbtmn mo Jgspbtmnm. Qrf Jgspbtmn

=) Mbrwmy8) @focmo dgotrgn tunmoc hfnmdmoc. Lflhudm imnmo ompms

lfoccuomdmo tfdobd jfm` tbnt kjbo nbet mtmu lfofocm`mjdmo

dfpmnm `mo lfocmocdmt `mcu, pfrbdsm m`mdmj hfo`m msboc ymoc

`mpmt lfocmdbhmtdmo tfrtutupoym imnmo ompms. Luotmjmo,

lmdmomo, `mrmj mtmu hfo`m msboc nmbooym

;) Hrfmtjboc0) @focmo vfotbnmsb ymoc m`fdumt. Lflfrbdsm pfrompmsmo `focmo

lfoccuomdmo kmrm nbjmt-`focmr-rmsmdmo tb`md nfhbj `mrb =1 `ftbd

uotud lflmstbdmo mpmdmj m`m ompms mtmu tb`md. [fnmoiutoym

nmdudmo pflfrbdsmmo stmtus rfspbrmsb dgrhmo (dfkfpmtmo, rbtlf `mo

m`fdumt tb`mdoym pfrompmsmo).

6) Kbrkunmtbgo5) @focmo dgotrgn pfr`mrmjmo jfhmt. Ibdm pfrompmsmo dgrhmo

tfrsfocmn-sfocmn `mo tb`md m`fdumt, lmdm hmotumo ompms `mpmt

`bnmdudmo. Ibdm tb`md m`m tmo`m-tmo`m sbrdunmsb, nmdudmo rfsusbtmsb

imotuoc pmru sfcfrm. Xmsbg dglprfsb `m`m `mo hmotumo ompms

`mnml XIQ m`mnmj ;1 9 8 (;1 dmnb dglprfsb `m`m `mo 8 dmnb hmotumo

ompms).

Qfoftrmsb (trmulm tmiml)

=) Hbnm tfrim`b nudm tusud, lmdm tusudmo (pbsmu mtmu hfo`m tmimlnmbooym) tb`md hgnfj `bkmhut dfkumnb `focmo m`moym tbl lf`bs.

8) Qfomocmomooym hbnm tfrim`b nudm tusud kudup `focmo lfnbnbtdmo`focmo dmbo dmssm pm`m `mfrmj motmrm pbsmu uotud lflebdsmsb

pbsmu sfjboccm tb`md lflpfrpmrmj nudm.

;) Hbnm m`m usus mtmu grcmo nmbo ymoc dfnumr, lmdm grcmo tfrsfhuttb`md `bmoiurdmo `blmsuddmo dflhmnb df`mnml tuhuj, dflu`bmo


25/39

81

grcmo ymoc dfnumr `mrb `mnml tfrsfhut `bhmnut dmbo hfrsbj mtmu hbnm

m`m vfrhmo stfrbn.

0) Blghbnbsmsb pmsbfo.6) Pb`md `bmoiurdmo lflhfrb lmdmo `mo lboul.5) Mpmhbnm m`m nudm tfrhudm nmbooym lmdm hmnut nudm.3) Dbrbl df rulmj smdbt.

h. Jgspbtmn=) Hbnm m`m `ucmmo hmjwm m`m nudm tflhus `bo`boc mh`glfo,

sfgrmoc mjnb hf`mj ymoc hfrpfocmnmlmo mdmo lflfrbdsm nudmoym

sfkmrm ngdmn uotud lfofotudmo `mnmloym nudm. Qflfrbdsmmo bob

smocmt hfrcuom hbnm m`m nudm lmsud `mo nudm dfnumr ymoc

hfr`fdmtmo.

8) [drbooboc pflfrbdsmmo rgotcfo.Egtg rgotcfo tgrmd tfcmd hfrcuom uotud lfoybocdbrdmo

dfluocdbomo jflg mtmu pofulgtgrmds mtmu uotud lfofludmo

m`moym u`mrm botrmpfrbtgobul. [frtm rgotcfo mh`glfo smlhbn tb`ur

(supbof) uotud lfofotudmo imnmo pfnuru mtmu m`moym u`mrm

rftrgpfrbtgoful.

;) BUQ mtmu Vrgcrml Fxkrftgry `mo KP [kmoobocBob `b nmdudmo uotud lfocftmujb ifobs kf`frm cboimn ymoc m`m.

I. DglpnbdmsbMdbhmt `mrb trmulm tmiml pm`m ululoym m`mnmj pfr`mrmjmo ymoc

tfrpmotmu, mtmu hbnm ymoc tfrdfom kf`frm m`mnmj cmstfr, mdmo `b`mpmtb

pfoyfhmrmo msml nmlhuoc `mnml rgoccm pfrbtgoful, ymoc mdmo lflhfrb

pfrmocsmocmo ymoc kudup jfhmt, hfrupm tmo`m-tmo`m pfrbtgobtbs, [ygd iucm

mdmo tfrim`b mpmhbnm pmsbfo tb`md `bnmdudmo rfsusbtmsb sfkfpmt luocdbo sfrtm

boefdsb.


26/39

8=

BU. Dgosfp DfpfrmwmtmoM. Qfocdmibmo

B`fotbebdmsb Lfnbputb9

=. Pcn lmsud Xulmj [mdbt8. Iml lmsud Xulmj [mdbt;. Oglgr Xfcbstfr0. Ifobs dmsus (hf`mj/ogo hf`mj)6. @bmcogsm Lf`bs (@bmcogsm lf`bd smmt dnbfo lmsud `mo smmt pfocdmibmo5. Hbg`mtm

m. B`fotbtms Qmsbfo (omlm nfocdmp, ifobs dfnmlbo, ulur / tmoccmn nmjbr,dmwbo / hfnul dmwbo, mcmlm, sudu / hmocsm, pfo`b`bdmo, pfo`mpmtmo,

pfdfrimmo, oglgr msdfs, mnmlmt)

h. B`fotbtms Dfnumrcm/Qfocmotmr (omlm nfocdmp, ifobs dfnmlbo, ulur /tmoccmn nmjbr, mcmlm, sudu / hmocsm, pfo`b`bdmo, pfo`mpmtmo,

pfdfrimmo, juhuocmo `focmo pmsbfo, mnmlmt)

3. Xbwmymt Dfsfjmtmom. Dfnujmo Lmsud

Dfnujmo lmsud m`mnmj dfnujmo ymoc lfocbrbl dnbfo uotud `brmwmt `b

X[.

h. Xbwmymt Dfnujmo Lmsud:. [urvfy Qrblfr

Mbrwmy 9

Mpmdmj m`m tmo`m-tmo`m sulhmtmo imnmo omems Mpmdmj tfr`focmr huoyb strb`gr Mpmdmj m`m tmo`m-tmo`m dfhfrm`mmo hfo`m msboc, `mrmj, luotmj

`mnml lunut

Mpmdmj imnmo ompms pmtfo


27/39

88

Hrfmtjboc

Mpmdmj m`m jflhusmo u`mrm `r jb`uoc (effn) Qfocflhmocmo `m`m (nggd) Mpmdmj tfr`focmr sumrm ompms (nbstfo) Erfdufosb ompms Xftrmdsb botfrkgstmn Huoyb ompms (ocgrgd, hfrsbun, lfcmp, `nn) Qfoccuommo gtgt-gtgt mdsfsgrb pfrompmsmo [umrm ompms tmlhmjmo (Xgokjb, wjffzboc, Xmnfs, `nn)Kbrkunmtbgo

Mpmdmj m`m pfr`mrmjmo/tb`md Mpmdmj m`m punsm dmrgtbs, om`b rm`bmn Mpmdmj om`b tfrmhm/tb`md Dumnbtms om`b (nflmj/dumt/dfkbn) Mdrmn (Jmocmt/`bocbo) Qfocbsbmo dmpbnfr (> ; `ftbd / ? ; `ftbd) Mpmdmj m`m tmo`m-tmo`m sygd (om`b nflmj `mo kfpmt, om`b nfhbj `mrb

=11x/lfobt pm`m `fwmsm)

Mpmdmj dunbt tfrmhm `bocbo mtmu jmocmt Mpmdmj dunbt tmlpmd pukmt mtmu dfhbru-hbrumo Mpmdmj pmsbfo tb`md sm`mr mtmu omlpmd lfocmotud@bsmhbnbty 4 cuomdmo MUQV

MMnfrt(imcm)mpmdmj dnbfo lfocfrtb mpm ymoc mo`m smlpmbdmo UUgbkf(sumrm)mpmdmj lfrfdm hbsm hfrhbkmrm pm`m mo`m QQmbo(oyfrb)mpmdmj dnbfo hfrfspgo tfrjm`mp oyfrb


28/39

8;

V Vorfspgosbvf(tb`md hfrfspgo) mpmdmj pmsbfo tb`md sm`mr mtmutb`md hfrfspgo

Kfd udurmo pupbn, mpmdmj udurmo smlm/tb`md, mpmdmj hfrfmdsbtfrjm`mp kmjmym (lfocfkbn).

CK[ (Cnmscgw Kglm [kmnf)2. [urvfy [fduo`fr

m. MLQNF Mnnfrcbfs(mnfrcb) Lf`bkmtbgo(ghmt-ghmtmo) Qmst jbstgry (rbwmymt sbocdmt pfoymdbt, dfkfnmdmmo, tbo`mdmo

pflhf`mjmo, `mo pfrmwmtmo sfnmlm smdbt

Nmst tblf mtf gr `rmod(wmdtu tfrmdjbr lmdmo `mo lboul) Fvfot (mpm ymoc lfoyfhmhdmo tfrim`boym dfkfnmdmmo7

Dfkfnmdmmo dfo`mrmmo, nudm hmdmr, `nn

h. Qflfrbdsmmo Ebsbd (Fdspgsurf) Dfm`mmo ulul 9

Bospfdsb smmt dgotmd pfrtmlm `focmo dnbfo (Pmlpmd dfm`mmo

ulul tb`md smdbt, dfm`mmo smdbt rbocmo, smdbt sf`moc, mtmu

nflmj)

PPU (Pfdmomo `mrmj, Om`b, Qfrompmsmo, [uju) Hfrmt Hm`mo Pboccb Hm`mo Dfpmnm

=) Xfmdsb pupbn tfrjm`mp kmjmym, udurmo8) Mpmdmj m`m nudm, @fegrlbtms/kmkmt, lflmr, pflhfocdmdmo,

tunmoc ymoc pfoyfd df `mnml

;) Mpmdmj m`m kmbrmo ymoc dfnumr `mrb tfnbocm mtmu jb`uoc0) Qfrbdsm m`moym oyfrb tfdmo


29/39

80

6) Vdur Cnmscgw Kglm [kmn

Nfjfr=)Pmo`m-tmo`m boiury spbomn8)Mpmdmj m`m nudm, `fegrlbtms, lflmr, `mo pflhfocdmdmo;)Mpmdmj m`m `bstfosb/pfoccflhuocmo `mrb vfom nfjfr0)Qfrjmtbdmo pgsbsb trmdjfm mpmdmj `btfocmj-tfocmj mtmu

tfr`grgoc df smnmj smtu sbsb

6)Xmsmdmo mpmdmj m`m u`mrm `b hmwmj dunbt (flpbsflmsuhdutmo)

@m`m=)Jmsbn pflfrbdsmmo FDC8)Dfkfpmtmo omems, upmym omems;)Qfocflhmocmo `m`m (sblftrbs/tb`md)0)Mpmdmj m`m nudm, `fegrlbtms, lflmr, hfocdmd, mtmu `fprfsb

tunmoc (tunmoc lmsud df `mnml)

6)Huoyb ompms

Qfrut=)Mpmdmj m`m nudm, lflmr, hfocdmd pm`m dunbt, mtmu

pflhfsmrmo pm`m sfnuruj pfrut (`bstfosb)

8)Mpmdmj m`m sdmr (hfdms nudm) ymoc nmlm, Hbsboc usus,prbstmntbd usus

;)Oyfrb pm`m dum`rmo mh`glfo, dfdmdumo, mtmu tmlpmd sbdmplfoimcm mrfm pfrut ymoc lfocbo`bdmsb pfr`mrmjmo pm`m pfrut.

Qfnvbs, Xfdtul `mo Cfobtmn=)Mpmdmj m`m nudm, `fegrlbtms, mtmu lflmr8)Mpmdmj m`m pfr`mrmjmo `mrb urftjrm;)Mpmdmj m`m pfr`mrmjmo sfdbtmr sdrgtul, rfdtul, mtmu vmcbom


30/39

86

0)Mpmdmj m`m ermdtur mtmu `bsngdmsb Nfocmo `mo tuocdmb

=)Mpmdmj m`m nudm, `fegrlbtms, lflmr, mtmu pflhfocdmdmo8)Mpmdmj m`m oyfrb tfdmo7 Mpmdmj pmsbfo `mpmt lfrmsmdmo

sfosmsb sfotujmo ymoc mo`m nmdudmo7 Qfrcfrmdmo sfo`b

;)Om`b pfrbefr m`m/tb`md0)[uju moccgtm cfrmd, tmocmo, `mo dmdb7 Qmoms mtmu `bocbo

Quoccuoc=)Mpmdmj m`m nudm, `fegrlbtms, lflmr, pflhfocdmdmo, `fprfsb

tunmoc

8)Mpmdmj m`m pfr`mrmjmo ymoc hfrmsmn `mrb mous;)Mpmdmj m`m oyfrb tfdmo

;. Qflfrbdsmmo `bmcogstbd Qflfrbdsmmo Z-Xmy uotud [krffoboc Prmulm Pmiml Qflfrbdsmmo sfrul9 jmn bob `bnmdudmo dmrfom m`m pm`m pmsbfo

`focmo nudm hmdmr lfocmnmlb dfjbnmocmo vgnulf

Qflfrbdsmmo `mrmjlbsmn pm`m pmsbfo `focmo nudm cbcbtmo `mpmt `biulpmb

jbpgprgtgtrglhboflbm, trglhgsbtgpfobm, jbpgebhrbogcflbm, `mo

moflbm

Qflfrbdsmmo fnfdtrgnbt 9 pm`m pmsbfo `focmo nudm hmdmrlfocmnmlb dfjbnmocmo vgnulf kmbrmo `mo cmoccumo Om-D pulp

Momnbsm cms `mrmj hbmsmoym pmsbfo nudm hmdmr tfrim`b msb`gsbslftmhgnbslf `mo dfjbnmocm prgtfbo

Emmn jmtb `mo cboimn KHK lfocb`fotbebdmsbdmo iulnmj `mrmj ymoc df `mnml kmbrmo,

pfourumo JKP `mo XHK, trglhgsbtgpfobm ngdmn, nfudgsbtgsbs,

XHK ymoc rusmd


31/39

85

Fnfdtgnbt tfrim`b pfouruomo kmnsbul `mo sfrul, pfobocdmtmomndmnb pjgspjmtf

[frul mnhulbo 9 tgtmn prgtfbo lfouruo, jbpgomtrflbm Xm`bgngcb 9 uotud lfocftmjub pfoulpudmo kmbrmo pmru, bojmnms

msmp `mo lfouoiuddmo emdtgr ymoc lfo`msmrb 4 pm`m pmsbfo

vunous lgrsul hbmsmoym tfr`mpmt flhgnb pmru/f`flm pmru

FKC 9 uotud lfocftmjub m`moym mrbtlbmH.@bmcogsm dffrmwmtmo `mo Xfokmom dfpfrmwmtmo (Mpnb dmsb Omo`m, OB K

`mo OGK)

=. Hfrsbjmo imnmo omems, Dftb`mdfefdtbemo@febobsb9Dftb`mdlmlpumo uotud lflhfrsbjdmo sfdrfsb mtmu ghstrudsb `mrb

smnurmo pfromemsmo uotud lflfnbjmrm imnmo omems ymoc hfrsbj

Hmtmsmo dmrmdtfrbstbd

[uhyfdtbe

@bspofm

Qfruhmjmo pm`m brmlm `mo rmtm-rmtm pfromemsmo

[bmogsbsDfsunbtmo uotud hfrsumrm

Dftfrhmtmsmo sumrm pfromemsmo

Pb`md `mpmt hfrbstbrmjmt

Emdtgr ymoc hfrjuhuocmo

Imnmo omems tfrghstrudsb9spmslf imnmo omems, pfoculpunmo sfdrfsb, ludus

hfrnfhbj, m`moym imnmo omems humtmo, tfr`mpmt hfo`m msboc pm`m imnmo omems,

sfdrfsb pm`m hrgodjb, fdsu`mt pm`m mnvfgnb

Jmsbn ymoc @b smrmodmo OGK

[tmtus pfromemsmo9 Ufotbnmsb9pfrcfrmdmo u`mrm lmsud `mo dfnumr pmru-pmru

Qfrbnmdu lfocgotrgn cfimnm9 tbo`mdmo pfrsgomn uotud lflboblmndmo

pfruhmjmo smlpbocmo ymoc `b`mpmt pm`m euocsb ebsbd `mo flgsb


32/39

83

Qfrbnmdu pfrmwmtmo9 Qfoymdbt mtmu kf`frm9 tbo`mdmo pfrsgomn uotud

lfocurmocb mtmu lfocjbnmocdmo pmtgngcb

Qrbgrb tms B otfrvfosb OB K

Mdtbebtms Dfpfrmwmtmo

Qfocdmibmo9

Qfocfngnmmo imnmo omems (OBK)9

=. Dmib `mo `gdulfotmsbdmo jmn-jmn hfrbdut bob9Dffefdtbemo pflhfrbmo gdsbcfo `mo pfrmwmtmo ymoc nmbo

Dffefdtbemo lf`bdmsb ymoc `brfsfpdmo

Dfkfo`fruocmo pm`m cms `mrmj mrtfrb

8. Musduntmsb hmcbmo `m`m motfrbgr `mo pgstfrbgr uotud lfocftmjubm`moym pfouruomo mtmu tb`md m`moym vfotbnmsb `mo m`moym sumrm-

sumrm tmlhmjmo

(OBK) [mdsbgo imnmo omems9

;. Pfotudmo dfhutujmo smdsbgo grmn `mo/mtmu trmdfmn0. Lgobtgr stmtus gdsbcfo pmsbfo (tbocdmt [mG8 `mo [vG8) `mo stmtus

jflg`bomlbd (tbocdmt LMQ Tlfmo mrftfrbmn prfssurf\ `mo brmlm

imotuoc) sfcfrm sfhfnul, sfnmlm `mo sftfnmj smktbgo

6. Qfrjmtbdmo tbpf `mo iulnmj sfdrfsb ymoc `bdulpundmoQfo`b`bdmo uotud pmsbfo/Dfnumrcm9

5. Ifnmsdmo pfoccuommo pfrmnmtmo pfo`uduoc `focmo hfomr (lbsmnoymgdsbcfo, smdsbgo,spbrglftfr, bojmnfr, botofrlbttfot pgsbtbvf prfssurf

hrfmtjboc TBQQH\Boegrlmsbdmo pm`m pmsbfo `mo dfnumrcm hmjwm

lfrgdgd lfrupmdmo dfcbmtmo ymoc `bnmrmoc `b `mnml rumocmopfrmwmtmo

3. Bostrudsbdmo pm`m pmsbfo `mo dfnumrcm `mnml rfokmom pfrmwmtmo `brulmj (lbsmnoym lf`bdmsb, jb`rmsb, ofhunbzmtbgo, pfrmnmtmo, `rmbomsf

pgsturmn, tmo`m `mo cfimnm dglpnbdmsb, sulhfr-sulhfr `b dgluobtms)


33/39

8:

:. Bostrudsbdmo pm`m pmsbfo tfotmoc hmtud `mo tfdobd omems `mnml uotudlflemsbnbtmsb dfnumroym sfdrfsb

2. Mimrdmo pm`m pmsbfo/dfnumrcm tfotmoc pfotbocoym pfruhmjmo pm`msputul, sfpfrtb wmrom, dmrmdtfrbstbd, iulnmj `mo hmu

(OBK) [mdsbgo imnmo omems 9

=1.Bostrudsbdmo pm`m pmsbfo `mo/mtmu dfnumrcm tfotmoc hmcmblmomlfosmdsbgo imnmo omems, sfsumb dfhutujmo

Mdtbebtms dgnmhgrmtbe9

==.Xuo`bocdmo `focmo mjnb tfrmpb pfromemsmo, sfsumb dfhutujmo=8.Duosuntmsbdmo `focmo `gdtfr tfotmoc dfhutujmo uotud pfrdusb

`mo/mtmu pfrmnmtmo pfoùduoc

=;.Hfrbdmo julbebfr/gdsbcfo sfsumb `focmo dfhbimdmo bostbtusb=0.Pmlpbndmo/hmotu `mnml pflhfrbmo mfrgsgn, untrmsgobk ofhunbzfr,

`mo pfrmwmtmo pmru nmbooym sfsumb `focmo dfhbimdmo `mo prgtgdgn

bostbtusb

=6.Hfrbtmju `gdtfr tfotmoc jmsbn cms `mrmj ymoc mhogrlmn

8. Boefdsb, Xfsbdg@febobsb9 [umtu dgo`bsb bo`bvbù lfocmnmlb pfobocdmtmo rfsbdg uotud

tfrsfrmoc grcmobslf pmtgcfobd

Emdtgr-emdtgr Xfsbdg

Qfrtmjmomo tuhuj ymoc tb`md lflm`mb (dunbt tfrnudm, pfruhmjmo pJ pm`m

sfdrfsb, pfrbstmnsbs ymoc hfruhmj)

Qfrtmjmomo nmpbs dfùm ymoc tb`md lflm`mb (jflgcnghbo turuo,

nfudgpfobm)

Dfrusmdmo imrbocmo `mo pfobocdmtmo pflmpmrmo tfrjm`mp nbocduocmo

Prmulm

Jmsbn -jmsbn ymoc @b smrmodmo OGK


34/39

82

Qfocftmjumo9Qfocfo`mnbmo Boefdsb9 Qflmjmlmo lfocfomb pfokfcmjmo

`mo pfocfo`mnbmo boefdsb

Qfocfo`mnbmo Xfsbdg9Pbo`mdmo uotud lfocjbnmocdmo mtmu lfocurmocb

mokmlmo dfsfjmtmo mdtumn lmupuo pfrsgomn

Qrbgrbtms B otfrvfosb OB K

Mdtbebtms-mdtbebtms Dfpfrmwmtmo

Qfocdmibmo9

=. Lgobtgr tmo`m-tmo`m/cfimnm boefdsb (suju tuhuj, `foyut imotuoc,pflhumocmo, pfomlpmdmo nudm, sfdrfsb, pfomlpmdmo urbo, suju

dunbt, dfnfnmjmo, dfifoujmo)

8. Mlmtb emdtgr-emdtgr ymoc lfobocdmtdmo sfrmocmo boefdsb (usbm,dfdfhmnmo tuhuj, lmnoutrbsb)

;. Lgobtgr jmsbn-jmsbn nmhgrmt (KHK, mocdm crmoungkytf mhsgnut, jmsbn-jmsbn `befrfosbmn, prgtfbo sfrul, `mo mnhulbo)

0. Mlmtb dbofrim dfsfjmtmo pfrsgomn uotud pfrnbo`uocmo tfrjm`mpboefdsb

Qfo`b`bdmo uotud Qmsbfo/Dfnumrcm9

=. Ifnmsdmo lfocmpm smdbt `mo pfocghmtmo lfobocdmtdmo rfsbdgtfrjm`mp boefdsb

8. Bostrudsbdmo uotud lfoimcm dfsfjmtmo pfrsgomn uotud lfnbo`uocbtuhuj tfrjm`mp boefdsb

;. Boegrlmsbdmo pm`m grmoc tum lfocfomb im`wmn bluobsmsb uotud`yptjfrbm, tftmous, pfrtussbs, pgnbg, kmlpmd `mo ruhfnnm

0. Ifnmsdmo mnmsmo/dfuotuocmo `mo fefd smlpboc bluobsmsb6. Mimrdmo lftg`f mlmo pfomocmomo lmdmomo /pfoybmpmo/

pfoyblpmomo

(OBK)Qfocfo`mnbmo Boefdsb

=. Mimrdmo pmsbfo tfdobd-tfdobd pfokukbmo tmocmo


35/39

;1

8. Mimrdmo dfpm`m pfocuoiuoc uotud lfokukb tmocmo sfwmdtu lmsud`mo lfoboccmndmo rumoc pmsbfo

;. Mimrdmo dfpm`m pmsbfo `mo dfnumrcmoym tmo`m-tmo`m/cfimnm boefdsb`mo dmpmo jmrus lfnmpgrdmooym df pusmt dfsfjmtmo

Mdtbebtms Dgnmhgrmtbe9

=. Xuiud pmsbfo/dfnumrcm df nmymomo sgsbmn, dfnglpgd-dfnglpgdpfo`uduoc uotud pfocfngnmmo rulmj ymoc sfjmt

8. Bdutb prgtgdgn pfnmpgrmo tfrjm`mp boefdsb;. Xuiud df nflhmcm-nflhmcm pfnmymomo sgsbmn lfocfomb pflhbmymmo

bluobsmsb (msurmosb `mo dnbobd-dnbobd `fpmrtflfo dfsfjmtmo)

(OBK)Qfocfo`mnbmo Boefdsb9

=. Hfrbdmo tfrmpb motbhbgtbd

;. Oyfrb@febobsb9 pfocmnmlmo sfosgrb `mo flgsbgomn ymoc tb`md

lfoyfomocdmo ymoc lfobocdmt mdbhmt m`moym dfrusmdmo imrbocmo ymoc

mdtumn mtmu pgtfosbmn mtmu `bcmlhmrdmo `mnml bstbnmj sfpfrtb dfrusmdmo

(Botfromtbgomn Mssgkbmtbgo egr tjf [tu`y ge Qmbo)4 dfim`bmo ymoc tbhm-

tbhm mtmu pfrnmjmo `mrb botfosbtms `mrb rbocmo smlpmb hfrmt `focmo mdjbr

ymoc `mpmt `bmotbsbpmsb mtmu `mpmt `brmlmndmo `mo `urmsboym durmoc

`mrb 5 hunmo

Hmtmsmo dmrmdtfrbstbd

[uhyfdtbe

Lfocuocdmpdmo sfkmrm vfrhmn mtmu lfnmpgrdmo `focmo bsymrmt

Ghyfdtbe

Motmncbk cfsturfs

Qgsbsb motmncbd

Qfruhmjmo gtgoglbd `mrb tgous gtgt (`mpmt `mnml rfotmoc nbsnfss

smlpmb rbcb`)


36/39

;=

Xfspgo-rfspgo gtgoglbd (lbsmnoym `bmegrfsbs4 tfdmomo `mrmj,

pfromemsmo, mtmu pfruhmjmo om`b4 `bnmtmsb pupbn)

Qfruhmjmo pm`m omesu lmdmo `mo lmdmo

Qfrbnmdu `bstrmdsb (lbsmnoym pmkboc, lfokmrb grmoc nmbo `mo/mtmu

mdtbebtms nmbo, mdtbebtms hfrunmoc)

Qfrbnmdu fdsprfsbe (lbsmnoym tb`md `mpmt bstbrmjmt, lfrbotbj, lfomocbs,

vbcbnmokf, pfdm tfrjm`mp rmocsmoc, sbocjboc)

Pgpfoc wmimj (oyfrb)

Qfrbnmdu lfoimcm mtmu lfnbo`uocb

Egdus lfoyflpbt (lbsmnoym pfruhmjmo pm`m pfrsfpsb wmdtu,

pfruhmjmo prgsfs ebdbr, pfocurmocmo botfrmdsb `focmo grmoc nmbo mtmu

nbocduocmo)

Emdtgr ymoc hfrjuhuocmo

Mcfo-mcfo ymoc lfoyfhmhdmo kf`frm (lbsmnoym hbgngcbs, dblbm, ebsbd,

psbdgngcbs)

Jmsbn ymoc bsmrmodmo OGK

Pbocdmt dfoymlmomo9pfrmsmmo lu`mj sfkmrm ebsbd `mo psbdgngcbs

Qrbgrbtms B otfrvfosb OB K

Mdtbebtms Dfpfrmwmtmo

Qfocdmibmo 9

=. Cuomdmo nmpgrmo `mrb `brb pmsbfo sfhmcmb pbnbjmo pfrtmlm uotudlfoculpundmo boegrlmsb pfocdmibmo

8. Pmoym pmsbfo uotud rmtm-rmtm oyfrb/dftb`mdoymlmomo pm`m sdmnm 1smlpmb =1 (1


37/39

;8

0. Dmib pfocmruj mcmlm, hu`mym, dfpfrkmymmo, `mo nbocduocmotfrjm`mp oyfrb `mo rfspgo pmsbfo

6. @mnml lfocdmib oyfrb pmsbfo, cuomdmo dmtm-dmtm ymoc dgosbstfo`focmo usbm `mo tbocdmt pfrdflhmocmo pmsbfo

(OBK) pfocfngnmmo oyfrb

5. Pmlpbndmo pfocdmibmo dglprfjfosbe tfotmoc oyfrb ymoc lfnbputbngdmsb, dmrmdtfrbstbd, dfim`bmo/`urmsb, erfdufosb, dumnbtms, botfosbtms

mtmu dfpmrmjmo oyfrb, `mo emdtgr-emdtgr prfsbpbtmsboym

3. Ghsfrvmsb bsymrmt ogovfrhmn m`moym dftb`mdoymlmomo, djususoympm`m lfrfdm ymoc tb`md lmlpu uotud lfocdgluobdmsbdmooym

sfkmrm fefdtbe

Qfo`b`bdmo uotud pmsbfo/dfnumrcm

=. Lmsuddmo pm`m bostrudsb pm`m smmt pflunmocmo pmsbfo tfotmoclf`bdmsb djusus ymoc jmrus `bdgosulsb, erfdufosb pflhfrbmo,

pgtfosbmn fefd smlpboc, pgtfosbmn botfrmdsb ghmt, pfrjmtbmo djusus

smmt lfocdgosulsb ghmt tfrsfhut (lbsmnoym pflhmtmsmo mdtbebtms

ebsbd, pflhmtmsmo `bft), `mo omlm grmoc ymoc jmrus `bjuhuocb hbnm

`biulpmb oyfrb ymoc tb`md tfrtmjmodmo

8. Bostrudsbdmo pmsbfo uotud lfocboegrlmsbdmo pm`m pfrmwmt ibdmpfocurmoc oyfrb tb`md `mpmt `bkmpmb

;. Boegrlmsbdmo pm`m pmsbfo tfotmoc prgsf`ur ymoc `mpmtlfobocdmtdmo oyfrb `mo tmwmrdmo smrmo dgpboc

Mdtbebtms Dgnmhgrmsb

=. Dfngnm oyfrb pgstgpfrmsb mwmn `focmo pflhfrbmo gpbmt ymoctfrim`wmn (lbsmnoym tbmp 0 iml mtmu ;5 iml) mtmu QKM

(OBK) pfocfngnmmo oyfrb9

8.hfrbtmju `gdtfr ibdm mnmt tb`md hfrjmsbn mtmu ibdm oyfrb `brmsmdmopmsbfo hfrhf`m sfkmrm hfrlmdom `focmo pfocmnmlmo oyfrb pmsbfo `b

lmsm nmnu


38/39


39/39

;0

@MEPMX QV[PMDM

Mlfrbkmo Kgnnfcf ge [urcfgos. 8110. M`vmokf` Prmulm Nbef [uppgrt Egr@gktgrs. 3tj f`. BDMHB.

Lmosigfr, Mrbe. 811=.Dmpbtm [fnfdtm Df`gdtfrmo. Lf`bm Mfskunmpbus, Imdmrtm 9

EDVB.

[imlsujb`mymt. 8115.Hudu Mimr Hf`mj. Imdmrtm 9 FCK

[ofnn, X [. 8115Momtglb Dnbobd Votud Lmjmsbswm Df`gdtfrmo. Imdmrtm 9 FCK.

@u`nfy, J. M. E. 8110. Jmlbntgo Hmbnfy's Flfrcfoky [urcfry. Rgcymdmrtm 9

VCL Qrfss.

Efn`lmo, C. 8115 Hnuot Mh`glbomn Prmulm 9 Fvmnumtbgo. @bmdsfs pm`m 85

Lmrft 81=; `mrb jttp9//www.`gkstgk.kgl/`gks/;1;8=5:0/Hnuot-

Mh`glbomn-Prmulm-Fvmnumtbgo.

[rbvmtjsmo. 8112 Mh`glbomn Prmulm. [krbh`. [krbh`. @bmdsfs pm`m 18 Mprbn

81=; `mrbjttp9//www.skrbh`.kgl/`gk/=66560;2/Mh`glbomn-Prmulm-

Mcuoc, B. C. O. 81=1Momtglb Mh`glfo. Kmtmtmo Xm`bgcrme. @bmdsfs pm`m 18

Mprbn 81=; `mrbjttp9//kmtmtmorm`bgcrme.hngcspgt.kgl/81=1/1:/momtglb-

mh`glfo.jtln.

Mogobl. 811: Dfcmwmt`mrurmtmo [bstfl Qfokfrommo pm`m Prmulm Mh`glfo.

@bmdsfs pm`m : Efhrumrb 81== `mrb jttp9//pustmdm.uopm`.mk.b`/wp-kgotfot/upngm`s/8112/=1/dfcmwmt`mrurmtmo.p`e.

Sbndbosgo, Omoky. 81==.Hudu [mdu @bmcogsm Dfpfrmwmtmo. Imdmrtm9 FCK

Omo`m Botfromtbgomn. 81=;. @bmcogsm dfpfrmwmtmo Pmdsgoglb `mo Dnmsbebdmsb

.Imdmrtm9FCK

Xmtom, 811:. Xfermt Nudm Pusud. Mvmbnmhnf ergl jttp9 //ln.skrbh`.kgl/`gk

/=1=868::1/nudm- tusud `bmdsfs tmoccmn 81 Iuob 81=0
http://www.docstoc.com/docs/30321684/Blunt-Abdominal-Trauma-Evaluationhttp://www.docstoc.com/docs/30321684/Blunt-Abdominal-Trauma-Evaluationhttp://www.scribd.com/doc/15565439/Abdominal-Trauma-http://www.scribd.com/doc/15565439/Abdominal-Trauma-http://catatanradiograf.blogspot.com/2010/08/anatomi-abdomen.htmlhttp://catatanradiograf.blogspot.com/2010/08/anatomi-abdomen.htmlhttp://catatanradiograf.blogspot.com/2010/08/anatomi-abdomen.htmlhttp://pustaka.unpad.ac.id/wp-content/uploads/2009/10/kegawatdaruratan.pdfhttp://pustaka.unpad.ac.id/wp-content/uploads/2009/10/kegawatdaruratan.pdfhttp://pustaka.unpad.ac.id/wp-content/uploads/2009/10/kegawatdaruratan.pdfhttp://ml.scribd.com/doc/101252880/luka-tusukhttp://ml.scribd.com/doc/101252880/luka-tusukhttp://ml.scribd.com/doc/101252880/luka-tusukhttp://ml.scribd.com/doc/101252880/luka-tusukhttp://ml.scribd.com/doc/101252880/luka-tusukhttp://pustaka.unpad.ac.id/wp-content/uploads/2009/10/kegawatdaruratan.pdfhttp://pustaka.unpad.ac.id/wp-content/uploads/2009/10/kegawatdaruratan.pdfhttp://catatanradiograf.blogspot.com/2010/08/anatomi-abdomen.htmlhttp://catatanradiograf.blogspot.com/2010/08/anatomi-abdomen.htmlhttp://www.scribd.com/doc/15565439/Abdominal-Trauma-http://www.docstoc.com/docs/30321684/Blunt-Abdominal-Trauma-Evaluationhttp://www.docstoc.com/docs/30321684/Blunt-Abdominal-Trauma-Evaluation

laporan pendahuluan gadar vulnus punctum abdomen

Documents