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FINAL ANNOUNCEMENT
INDONESIAN SOCIETY OF INTENSIVE CARE MEDICINE (ISICM) AND
INDONESIAN SOCIETY OF PARENTERAL AND ENTERAL NUTRITION (INASPEN)
Endorsed by:
Indonesian Society of Anesthesiology & Intensive Therapy (PERDATIN)
Department Anesthesia & Intensive Care, Faculty of Medicine Padjadjaran University,
Dr. Hasan Sadikin General Hospital Bandung
proudly present and organize,
Joint Symposiums
National Annual Meeting
of ISICM
National Annual Meeting
of INASPEN
Hyatt Regency Hotel – Bandung
05-06, 07-08, 09-10 November 2015
Thursday – Friday, 05 – 06 November 2015
PRE SYMPOSIUM WORKSHOPS:
- Technique of Parenteral & Enteral Nutrition Workshop
- ESPEN LLL Programmes in Nutrition and Metabolism
CONTINUING EDUCATIONAL PROGRAM OF ISICM
- Workshop on Mechanical Ventilation:
From Basic Theory to Clinical Practice
- Fluid Therapy, Electrolyte, and Acid Base Balance
- Basic Assessment & Support in Intensive Care (BASIC Course)
Saturday - Sunday, 07 – 08 November 2015
JOINT SYMPOSIUM & EXHIBITION
Monday – Tuesday, 09 – 10 November 2015
POST SYMPOSIUM WORKSHOPS:
- Fundamental Critical Care Support (FCCS)
WELCOME MESSAGE
Dear Colleagues,
Joint Symposiums Indonesian Society of Intensive Care Medicine (ISICM) and Indonesian Society of Parenteral and
Enteral Nutrition (INASPEN) have been increasingly recognized as an interesting educational meeting. One important
step is that, since the passing year ISICM and INASPEN have been establish an educational partnership in joint meeting
organized every year. We engage in a broad range of a culture of best practice in critical care nutrition. Ultimately to
deliver the highest quality of clinical outcomes for critically ill patients and increase efficiencies to our healthcare systems.
This year’s program promises to provide practitioners the latest information on implementing nutrition care in the ICU
with the wide range of essential best practices of Intensive Care Medicine
Through ESPEN LLL Programme in Nutrition & Metabolism and Technique of Enteral & Parenteral Nutrition, INASPEN
dedicated to deliver a globalize practice in clinical nutrition and nurture the clinical nutrition peculiar in Indonesia. While
the Continuing Educational Program (CEP) of ISICM, which are setting as the Pre-Joint Symposium Workshops from 0506 November 2015 promises to optimize the delivery of critical care for critically ill and injured patients.
As the venue place, the Joint Symposium of the 6th National Annual Meeting of ISICM & the 4th National Annual
Meeting of INASPEN, which will be held on 07-08 November 2015 will come back to Bandung as a melting pot of artdeco cultures and wide variety culinary, the combination of beauty of Paris van Java you should not missed.
See you all in Bandung in November 2015.
Chairman,
Joint Symposiums 6th National Annual Meeting of ISICM & 4th National Annual Meeting of INASPEN
Ruli H. Sitanggang
FINAL ANNOUNCEMENT
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ORGANIZING COMMITTEE
ADVISORY BOARD
• Dean Faculty of Medicine, Padjadjaran University
• Head Department Anesthesia & Intensive Care, Faculty of Medicine Padjadjaran University,
Dr. Hasan Sadikin General Hospital Bandung
• President of Indonesian Society of Anesthesiology & Intensive Therapy (PERDATIN),
Andi Wahyuningsih Attas
• President of Indonesian Society of Intensive Care Medicine (ISICM),
Oloan E. Tampubolon
• President of Indonesian Society of Parenteral and Enteral Nutrition (INASPEN),
Christian Johannes
CHAIRMAN
Ruli H. Sitanggang
SECRETARY
TREASURER
Ardi Zulfariansyah
Nelwati Sajoeti
Erniody
Zuswahyuda Samsu
SCIENTIFIC COMMITTEE
COORDINATOR
Ike Sri Redjek
Nancy Margarita Rehatta
MEMBERS
Ari Fachrial Syam
Rachmi Untoro
Bambang Wahjuprajitno
Razak Thaha
Dwi Panca Wibowo
Rudy Manalu
Hartono
Rupi’i
Nancy Margarita Rehatta
Tinni T. Maskoen
Paul Tahalele
Toar J.M. Lalisang
Prananda Surya Airlangga
Yefta Moenadjat
Pratista Hendarjana
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I FINAL ANNOUNCEMENT
GENERAL INFORMATION
Joint Symposium
6th National Annual Meeting of ISCM & 4th National Annual Meeting of INASPEN
Place
HYATT REGENCY HOTEL - BANDUNG
Organized By
INDONESIAN SOCIETY OF INTENSIVE CARE MEDICINE (ISICM)
and INDONESIAN SOCIETY OF PARENTERAL AND ENTERAL NUTRITION (INASPEN)
Audience
Physicians:
Intensivists,
Anesthesiologist,
Internists,
General
Practitioner,
Fellow,
Clinical
Nutritionists,
General Surgeon, Neuro-
Dietician, Pharmacists, Scientists, Technologists, Trainee &
Surgeon, Digestive Surgeon, Cardiologist, Pulmonologist,
Student, Health Practitioners and Nurse –whose interested
Neurologist, Clinical Pathologist, Clinical Microbiologist,
in Intensive Care Medicine and Clinical Nutrition Therapy
Hematologist, Onclologists,
Physical Therapists, Pharmacologists
Agenda
Thursday - Friday, 05 – 06 November 2015
PRE SYMPOSIUM WORKSHOPS:
•
Technique of Enteral & Parenteral Nutrition Workshop
•
ESPEN LLL
CONTINUING EDUCATIONAL PROGRAM OF ISICM
•
Workshop on Mechanical Ventilation: From Basic Theory to Clinical Practice
•
Fluid Therapy. Electrolyte and Acid Base Balance
•
Basic Assessment and Support in Intensive Care (BASIC Course)
Saturday - Sunday, 07 – 08 November 2015
JOINT SYMPOSIUM & EXHIBITION
Monday - Tuesday, 09 – 10 November 2015
POST SYMPOSIUM WORKSHOPS:
•
Fundamental Critical Care Support (FCCS)
FINAL ANNOUNCEMENT
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Registration Secretariat & Mailing Address
ISICM & INASPEN have chosen a cooperate organizer, who will ensure a smooth and efficient management of the
scientific exhibition, hotel accommodation, registration management and other programs linked to the Joint Symposium.
For any further information about these services, do not hesitate to contact the Secretariat & Mailing Address:
c/o. Global Echo Organizer convex
Registration
: secretariat@geoconvex.com
Homepage
: www.geoconvex.com
Registration & Accommodation:
Office Hours: 021.3149318 – 3149319 - 2305835
Registration Hotline: 0811.882080
Fax: 021.3153392
EXHIBITION
Joint Symposium will host a scientific exhibition on 07-08 November 2015 including the latest technology, equipment for
clinical management & research and literature.
OFFICIAL LANGUAGE
The official languages of the Joint Symposium are English & Indonesian. English will be used for all printed materials,
presentation with overseas speakers and discussions. Any simultaneous translation will not be provided.
DISCLAIMER
Every attempt will be made to present the program as printed. However, Organizers and its agent reserve the right to alter
or cancel, without prior notice, any of the arrangements, timetables, plans or other items relating directly or indirectly to
the Scientific Meeting, for any cause beyond its reasonable control. In the event of cancellation of the Scientific Meeting,
all pre-paid fees will be refunded in full. The Organizers and its agent are not liable for any loss or inconvenience caused
as a result of such alteration and cancellation.
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PRE-SYMPOSIUM PROGRAM
TECHNIQUE OF ENTERAL & PARENTERAL NUTRITION WORKSHOP
Thursday - Friday, 05 – 06 November 2015
INTRODUCTION
While the enteral nutrition provides the safest, most cost-effective approach with some options for permanent access, the
parenteral nutrition should be reserved for patients in whom enteral nutrition is contradicted. Standardization of clinical
procedures has become a desirable objective in contemporary medical practice in nutrition therapy. In responded to this
skillful management demand in population, the INASPEN as a multidisciplinary association has endeavored to create clinical
practice course and dedicated to advancing the safe and effective management and technique of parenteral and enteral
nutrition therapy through professional teaching module, development of guidelines, and accreditation.
Parenteral and Enteral Nutritional Access & Techniques Course analyzes enteral access devices options in the mal nutrient
patient, reviews the levels of evidence and provides the team-members’ experience. Similarly, it details general and specific
indications for enteral parenteral support, current techniques, care guidelines, methods of administration and complications
of each enteral parenteral access.
OBJECTIVES
After completing this course, the participants will be able
1. To select an appropriate nutritional access route based on several consideration ie:
• GI tract function and anatomical problems
• The length of time needed for artificial nutrition
• Level of consciousness
• The difficulty level of placement technique
2. To describe the indication and the contraindication associated with each access route.
3. To choose the appropriate formula and type of parenteral and enteral nutrient formula based on the patient`s illnesses
or special disease
4. To describe the preparation of the formula with regard to hygienic aspects
5. To describe SGA and advantages regarding its implementation
6. To calculate the energy needs and the pitfall in setting up the related nutritional formula
7. To decide the appropriate pattern of time frame in providing the formula (bolus/intermittent, continuously)
8. To insert the parenteral and enteral access (on simulator)
WHO SHOULD ATTEND
Clinicians, whose interested in nutritional support
therapy particularly in parenteral nutrition
ORGANIZED BY
Indonesian Society of Parenteral and Enteral Nutrition
(INASPEN)
COURSE LANGUAGE
Indonesian
PROGRAM
Course Directors: Nancy Margarita Rehatta & Prananda
Surya Airlangga
COURSE CAPACITY
Limited to 30 participants upon first payment basis
FINAL ANNOUNCEMENT
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Thursday - Friday, 05 - 06 November 2015
TECHNIQUE OF ENTERAL & PARENTERAL
NUTRITION WORKSHOP
DAY 1 - THURSDAY, 05 NOVEMBER 2015
TIME
PROGRAM
OVERVIEW PARENTERAL AND ENTERAL NUTRITION
08.00 - 08.30
Pretest & Introduction
08.30 - 09.00
Safety and Quality
09.00 - 09.30
Hygienic Aspect
09.30 - 10.00
Coffee Break
10.00 - 10.45
Type of Enteral and Parenteral Nutrition
10.45 - 11.30
Advantage and Disadvantage: Continuous, Intermittent, Bolus
HOW TO DELIVER ENTERAL NUTRITION
11.30 - 12.15
A. The Different Type of Tube and Access
12.15 - 13.00
B. Technical Aspect of Percutaneus Gastronomy and Jejenostomy
13.00 - 13.30
Lunch
13.30 - 14.15
Central Catheter
14.15 - 15.00
Peripheral Inserting Catheter (PICC)
15.00 - 15.45
Preparation and Complication
HOW TO DELIVER PARENTERAL NUTRITION
Coffee break
DAY 2 - FRIDAY, 06 NOVEMBER 2015
TIME
PROGRAM
ENERGY REQUIREMENT
08.00 - 08.45
Overview SGA
08.45 - 09.30
Calculated Calories and Pitfall.
09.30 - 10.00
Coffee Break
CASE DISCUSSION
10.00 - 10.45
A. Case Discussion 1
10.45 - 11.30
B. Case Discussion 2
SKILL STATION
11.30 - 12.15
A. CVC
12.15 - 13.00
B. PICC
13.00 - 13.30
LUNCH
SKILL STATION
13.30 - 14.45
A. Enteral Feeding Technique (Oral, Nasal, Drip, Continuous)
14.45 - 15.30
B. Endoscopic Assistance Enteral Tube Placement
15.30 - 16.15
C. Percutaneous Gastrotomy
16.15 - 17.00
Post test & Discussion
17.00 -17.15
Closing & Certification
INSTRUCTOR TEAM
Prof. DR. Nancy Margarita Rehatta, dr, SpAn KNA KIC KMN
Christian Johannes, dr, SpAn KIC
Prof. DR. Tatang Bisri, dr, SpAn KNA
J. Iswanto, dr, SpB KBD
DR. H. Ari Fahrial Syam, dr, SpPD-KGEH, MMB, FACP
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A. Firmansyah, dr., SpGK, MKes
DR. Tinni T. Maskoen, dr, SpAn KIC KMN
Prananda Surya Airlangga, dr, SpAn. KIC., MKes.
Bambang Wahjuprajitno, dr, SpAn KIC
ESPEN LLL PROGRAMMES IN NUTRITION
AND METABOLISM
INTRODUCTION
The ESPEN Leonardo da Vinci Life Long Learning Project is an ESPEN - EU is an innovative and effective educational
programme for medical doctors and health specialists offering training on-line and at live courses, by a variety of modern
training methodologies and resources to improve daily practice in Clinical Nutrition and Metabolism and develop quality
care in nutrition by means of an innovative educational initiative.
The Life Long Learning (LLL) programme in Clinical Nutrition and Metabolism LLL programme in Clinical Nutrition
and Metabolism is based on an Educational Curriculum offering more than 120 training modules created and peer
reviewed by recognized experts.
It was developed as the project BG-03-B-F-PP-166039 of Leonardo da Vinci Programme by ESPEN and a number of
European universities with the support of European Union as the a global effort to provide post-graduate qualification
in Clinical Nutrition and thus to improve daily practice. LLL Programme in Nutrition and Metabolism was accredited by
Union Européenne des Médecins Spécialistes (UEMS), which is recognized for Continuing Medical Education (CME) in most
countries.
OBJECTIVES AND CME POINTS
To improve knowledge, competence and skills of health professionals and students in Clinical Nutrition and Metabolism
while providing 3 ESPEN LLL CME credits upon passing a self-assessment test after each module and European certification
for medical doctors.
LLL PROGRAMMES
The main educational unit of LLL-Programme is the module. Each module consists of an updated review on a certain
problem, clinical case, self-assessment test and grading quiz upon the Topic of subject area.
Modules on related subject areas are grouped into 1 day programme, making it easier for the user to select modules in a
particular field of interest per day preferred, which packed into 3 - 4 module daily.
WHO SHOULD ATTEND
Clinicians who are interested in nutritional support therapy particularly in parenteral nutrition
COURSE LANGUAGE
English
COURSE CAPACITY
ORGANIZED BY
Aesculap Academy
CANCELLATION
Any cancellation or replacement must be conveyed to the Secretariat in written on 7 (seven) days prior the dates. An
administrative fee of 20% of the registration fee will be charged for cancellation and any replacement will be proceeded as
a new chargeable registration. Cancellation after this deadline will not be entitled to any refund.
PROGRAM
Course Director: Ike Sri Redjeki
FINAL ANNOUNCEMENT
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ESPEN LLL PROGRAMMES IN NUTRITION
AND METABOLISM
TIME
PROGRAM
08.00 - 08.10
Welcome Address
08.10 - 08.30
Introduction to ESPEN & LLL Courses
08.30 - 09.00
Nutritional Support in Acute Liver Failure
09.00 - 09.30
Nutritional Support in Chronic Liver Disease
09.30 - 10.00
Coffee Break
10.00 - 10.30
Nutritional Support in Acute Pancreatitis
10.30 - 11.00
Nutritional Support in Chronic Pancreatitis
11.00 - 12.00
Test
12.00 - 13.00
Lunch
"Nutritional Support in Liver Disease and Pancreatitis"
"Nutritional Support in the Perioperative Period"
13.00 - 13.30
Metabolic Responses to Surgical Stress
13.30 - 14.00
Enhanced Recovery : Principles
14.30 - 15.00
Coffee Break
15.00 - 15.30
Fluid Balance and Metabolism in Surgery
15.30 - 16.00
Nutritional Goals in Perioperative Period
16.00 - 17.00
Test
TIME
PROGRAM
"Nutritional Support in Cancer Patients"
08.30 - 09.00
Mechanism of Wasting in Cancer Cachexia
09.00 - 09.30
Cancer Anorexia
09.30 - 10.00
Coffee Break
10.00 - 10.30
Benefits and Limitations of Conventional Nutritional Support
10.30 - 11.00
Pharmacologic Therapy
11.00 - 12.00
Test
12.00 - 13.00
Lunch
"Nutritional Support in ICU"
13.00 - 13.30
Promoting Homeostasis During Nutrition Support
13.30 - 14.00
Specific Substrates for Artificial Nutrition in the ICU
14.00 - 14.30
Barriers to Oral, Enteral Nutrition, Parenteral Nutrition
14.30 - 15.00
Clinical Priorities for Solving ICU Nutritional Problems
15.00 - 15.30
Coffee Break
15.30 - 16.30
Test
16.30 - 17.30
Pembagian Sertifikat
INSTRUCTOR TEAM
Jesus Fernando B. Inciong, MD, MSc, FPCS, FACS
(Philippine)
Dr. dr. Ike Sri Redjeki, SpAn KIC
Dr. dr. Kiki Lukman, Msc, SpB, KBD
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Dr. dr. Noorwati Soetandyo, SPPD KHOM
Dr. Irsan Hasan, SpPD KGEH
Dr. Sugiyono, SpPD KHOM
WORKSHOP ON MECHANICAL VENTILATION :
FROM BASIC THEORY TO CLINICAL PRACTICE
LEARNING OBJECTIVES
• Review from physiology of respiration, oxygen & gas transport, volume & pressure mechanism, initiating & setting as
well as the lung recruitment & management from the simple method to the most recent method
• Describe the complications, practice the recent and new mode & NIV and learn the current management strategies and
practical management of acute respiratory failure, including weaning and pediatric management.
WHO SHOULD ATTEND
The comprehensive curriculum from basic to advances for Intensivists, Anesthesiologists, ICU General Practitioners, other
Multi-disciplines -who are interested in Intensive Care Medicine field, for better horizon in ventilatory support. Urge
registration for KIC Fellows.
COURSE LANGUAGE
Indonesian
ORGANIZED BY
Indonesian Society of Intensive Care Medicine (ISICM)
COURSE CAPACITY
PROGRAM
Course Directors: Bambang Wahjuprajitno & Philia Setiawan
TIME
TOPIC
TIME
TOPIC
08.00 - 08.15
Introduction
08.00 - 08.30
Prevention of Nosocomial Infection in MV
08.15 - 08.45
Physiology 1: Gas Exchange
08.30 - 09.00
Non-Invasive Ventilation (NIV)
08.45 - 09.15
Physiology 2 :Mechanic of Respiration
09.00 - 09.30
Weaning
09.15 - 09.45
Acute Respiratory Failure
09.30 - 10.00
Monitoring Patient with Mechanical Ventilation
09.45 - 10.00
Coffee/ Tea Break
10.00 - 10.15
Coffee/ Tea Break
10.00 - 10.30
Heart and Lung Interaction
10.15 - 10.45
VAP
10.30 - 11.00
Mode of Ventilator I (Basic)
10.45 - 11.15
ALI / ARDS
11.00 - 11.30
Mode of Ventilator II (Alternative)
11.15 - 11.45
MV in COPD Patient
11.30 - 12.00
Sedation and Paralysis in Patient with MV
11.45 - 12.15
Pediatric Consideration
12.00 - 13.00
Lunch
12.15 - 13.30
Lunch
13.00 - 13.30
Trouble Shooting of MV
13.30 - 14.00
Oxygen Therapy
13.30 - 14.00
How Mechanical Ventilation Work
14.00 - 14.30
Ventilator Graphic
SKILL STATION
14.30 - 15.20
CASE DISCUSSION
A. Ventilator Mode I : CMV, ACMV, PC, PS
15.20 - 15.35
Coffee/Tea Break
14.00 - 15.20
15.20 - 15.40
SKILL STATION
B. Ventilator Mode II : BIPAP, APRV
Coffee/Tea Break
15.35 - 16.55
A. Trouble Shooting
B. MV in COPD, ARDS
INSTRUCTOR TEAM
Bambang Wahjuprajitno, dr, SpAn KIC
Prof. Achsanuddin Hanafie, dr, SpAn KIC
Christian Johannes, dr, SpAn KIC
Dr. Tinni Maskoen, dr, SpAn KIC
Oloan Tampubolon, dr, SpAn KIC
Philia Setiawan, dr, SpAn KIC
Rupi’i, dr, SpAn KIC
Tantani Sugiman, dr, SpAn KIC
FINAL ANNOUNCEMENT
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FLUID THERAPY, ELECTROLYTE, & ACID
BASE BALANCE
LEARNING OBJECTIVES
• To understand the Stewart Approach to complete Haselbach method
• To understanding the formula of Stewart Approach, the ion based calculation that defines Stewart Approach’s formula.
• To interpret the measurement physiology of ion gap, VA & SIG at bedside
• To interpret the balance solution physiology, fluid resuscitation, lactic acidosis, hyperchloremia and pediatrics in sepsis
and shock cardiogenic
• To interpret the physiology of gut, diet liver and the interactions.
• To interpret the physiology in early hemorrhage that caused trauma
All lectures are completed with evidence based and journals.
WHO SHOULD ATTEND
The comprehensive curriculum with more Clinical Applications for Intensivists, Anesthesiologists, ICU General Practitioners,
other Multi-disciplines -who are interested in Intensive Care Medicine field, for better horizon in giving fluid therapy and
acid-base management. Urge registration for KIC Fellows.
COURSE LANGUAGE
Indonesian
COURSE CAPACITY
ORGANIZED BY
PROGRAM
Course Directors: Ike Sri Redjeki
TIME
08.30 - 09.00
Introduction & Body Fluid Composition and Basic Physiology of Fluid Balance
09.00 - 09.30
New Paradigm of Fluid Therapy
09.30 - 09.45
Coffee / Tea Break
09.45 - 10.15
Type of Fluid Used in Clinical Practice
10.15 - 10.45
Fluid Therapy in Critically ill Patients
10.45 - 11.15
Fluid Therapy in Dengue Shock Syndrome
11.15 - 11.45
Basic Principle of Fluid Therapy in Pediatrics
11.45 - 13.00
Lunch
13.00 - 13.30
Pathophysiology and Basic Principle of Fluid Therapy in Trauma Patients
13.30 - 14.00
Physiology of Electrolyte Imbalance
14.00 - 15.30
15.30 - 15.45
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TOPIC
Case Discussion : Monitoring of Fluid Therapy and Fluid Responsiveness
Case Discussion : Monitoring of Fluid Therapy and Fluid Responsiveness
Coffee / Tea Break
FLUID THERAPY, ELECTROLYTE, & ACID
BASE BALANCE
TIME
TOPIC
08.00 - 08.30
Introduction to Acid Base Balance Physiology
08.30 - 09.00
Hendersen Hasselbach Approach in Clinical Setting
09.00 - 09.30
Stewart Approach of Acid Base Balance Interpretation in Clinical Setting
09.30 - 10.00
Clinical Interpretation of Acid Base Balance in Many Clinical Situations
10.00 - 10.15
Coffee / Tea Break
10.15 - 10.45
Influence of Fluid Therapy on Acid Base Balance
10.45 - 11.15
Influence of Acute and Chronic Kidney Injury to Acid Base Balance in Many Clinical
Interpretation
11.15 - 11.45
Acid Base Balance in the Critically ill Patients
11.45 - 12.15
Influence of Nutrition to Acid Base Balance
12.15 - 13.00
Lunch
13.00 - 15.00
15.00 - 15.15
Skill Station 1: Interpretation and Management of Acid Base Balance Disturbance in the Most
Common Cases
Skill Station 2: Interpretation and Management of Acid Base Balance Disturbance in the Most
Common Cases
Coffee / Tea Break
INSTRUCTOR TEAM:
DR. Ike Sri Redjeki, dr, SpAn KIC KMN Mkes
Anang Achmadi, dr, SpAn KIC
Ardi Zulfariansyah, dr, SpAn, KIC, M Kes
Bambang Pujo Semedi, dr, SpAn KIC
Erwin Pradian, dr, SpAn KIC, M Kes
Ezra Oktaliansyah, dr, SpAn KIC, MKes
Indro Mulyono, dr, SpAn KIC
Ruli H. Sitanggang, dr, SpAn KIC, KAP, M Kes
FINAL ANNOUNCEMENT
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BASIC ASSESSMENT & SUPPORT IN INTENSIVE CARE
(BASIC) COURSE
LEARNING OBJECTIVES
1. Mampu mengenal pasien-pasien dengan penyakit kritis
2. Mengenali pasien gagal napas dan menanganinya
3. Mampu memantau hemodinamik pasien
4. Mampu melakukan Resusitasi Jantung dan Paru
5. Mampu mengenal dan menangani pasien trauma berat
6. Mampu mengenal dan menangani pasien syok
7. Mampu mengenal dan menangani pasien dengan sepsis berat dan syok sepsis
8. Mampu memberikan terapi cairan
9. Mampu mengenal dan menangani pasien gagal ginjal akut
10. Mampu mengenal dan menangani pasien anak dengan penyakit kiritis
11. Mampu mengenal dan menangani pasien dengan kegawatan neurologik
12. Mampu memberikan sedasi dan analgesia yang diperlukan pasien dengan penyakit kritis
13. Mampu mengenal dan menangani pasien dengan gangguan metabolic dan elektrolit
14. Mampu mengenal pasien dengan risiko penyakit tromboembolik dan pemberian profilaksis
15. Mampu memberikan bantuan nutrisi pada pasien kritis
16. Mengetahui cara yang benar melakukan transportasi pasien kritis
17. Mampu mengenal dan memakai ventilasi mekanis pada pasien kritis; melakukan pemantauan dan mengatasi permasalahan.
COURSE LANGUAGE
Indonesian
WHO SHOULD ATTEND
The BASIC comprehensive curriculum specially conducted by PERDICI to equip doctors starting out in ICU or doctors who
interested in the critically ill with relevant skills and knowledge. Urge registration for General Practitioners in ICU and or
Emergency Unit.
ORGANIZED BY
PROGRAM
Course Director: Rudy Manalu
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BASIC ASSESSMENT & SUPPORT IN INTENSIVE CARE
(BASIC) COURSE
TIME
TOPIC
08.00 - 08.10
Introduction
08.10 - 08.30
Assessment of The Seriously ill Patient
08.30 - 09.30
Acute Respiratory Failure
09.30 - 10.00
Airway Management & Airway Obstruction
10.00 - 10.30
Coffee/Tea break
10.30 - 11.00
Basic Haemodynamic Monitoring
11.00 - 11.40
Shock
11.40 - 12.20
Cardiopulmonary Resuscitation
12.20 - 13.00
Severe Sepsis & Septic Shock
13.00 - 13.30
Lunch
13.30 - 14.00
Oliguria and Acute Renal Failure
14.00 - 14.30
Fluids
14.30 - 15.00
Paediatrics
15.00 - 15.30
Coffee/Tea break
15.30 - 17.00
Skill Stations
1. Airway Management & Airway Obstruction (30 minute)
2. CPR (30 minute)
3. Severe Sepsis & Septic Shock (30 minute)
TIME
TOPIC
08.00 - 08.45
Neurological Emergencies
08.45 - 09.30
Sedation, Nutrition, Tromboembolic Disease-Risk & Prophylaxis
09.30 - 10.00
Coffee/Tea break
10.00 - 10.45
Mechanical Ventilation – The Basics
10.45 - 11.30
Mechanical Ventilation – Common Modes
11.30 - 12.15
Mechanical Ventilation - Settings
12.15 - 13.00
Mechanical Ventilation – Monitoring & Troubleshooting
13.00 - 13.30
Lunch
13.30 - 14.00
Severe Trauma
14.00 - 14.30
Transport of The Critically ill Patient
14.30 - 17.30
Skill Stations
1. Mechanical Ventilation -1 (1 hour)
17.30 - 18.00
18.00
Post Test
Closing
INSTRUCTOR TEAM:
Rudy Manalu, dr, SpAn KIC
DR. Hori Hariyanto, dr, SpAn KIC KMN
Bambang Pujo, dr, SpAn KIC
Oloan E. Tampubolon, dr, SpAn KIC,KNA, MHKes
Pantja Wibowo, dr, SpAn KIC
Ruli H Sitanggang, dr, SpAn KIC, KAP, M Kes
FINAL ANNOUNCEMENT
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SATURDAY - SUNDAY, 07 - 08 NOVEMBER 2015
BALLROOM I - II , HYATT REGENCY HOTEL BANDUNG
SCIENTIFIC PROGRAM
6 th National Annual Meeting of Indonesian Society of Intensive Care Medicine (ISICM)
4 th National Annual Meeting of Indonesian Society of Parenteral and Enteral Nutrition (INASPEN)
DAY 1, SATURDAY, 07 NOVEMBER 2015
TIME
THE BALLROOM
08.00 - 08.30
Opening Ceremony
KEYNOTE LECTURE
Chairperson: Indro Mulyono (Jakarta)
08.30 - 09.00
1. Should We Centralize ICU Care?
Oloan E. Tampubolon (Jakarta)
09.00 - 09.30
2. Target Control Infusion in Critical Care
Martin Westphal (Germany)
09.30 - 10.00
3. High Flow CPAP, Is It Effecosiuos?
Younsuck Koh (Korea)
10.00 - 10.30
4. How Far Is the Evidence of Immunonutrition
Jesus Fernando B. Inciong, MD, MSc, FPCS, FACS (Philippine)
10.30 - 11.00
Coffee/Tea Break
LUNCH SYMPOSIUM
Chairperson: Christian Johannes (Jakarta)
11.00 - 11.20
1. Long Term Sedation with Dexmedetomidin in Critically ill Patients
TBA
11.20 - 11.40
2. Pharmacological Prevention & Treatment of Delirium
11.40 - 12.00
3. The Latest Innovation in Parenteral Nutrition: A New Generation of Lipid Emulsions
Ike Sri Redjeki (Bandung)
12.00 - 12.30
Discussion
12.30 - 13.30
Lunch
MECHANICAL VENTILATION UPDATES
Chairperson: Achsannudin Hanafie (Medan)
NUTRITION UPDATES
Chairperson: Ardi Zulfariansyah (Bandung)
13.30 - 13.50
1. Patient-ventilator Asynchrony: How to Fix It
1. Enteral Nutrition: How Aggressive Should We Be?
Christian Johannes (Jakarta)
13.50 - 14.10
2. Weaning Protocols: Pick Your Criteria
Tantani Sugiman (Jakarta)
2. Enteral versus Parenteral Route for Calories
Abdullah Firmansah (Bandung)
14.10 - 14.30
3. Update in ARDS
Bambang Wahjuprajitno (Surabaya)
3. Nutritional Metabolomics, Do We Need to Assess?
Prananda Surya Erlangga (Surabaya)
14.30 - 14.40
Discussion
Discussion
ICU UPDATES
Chairperson: Amir S. Madjid (Jakarta)
14.40 - 15.00
1. Are Blood Transfusion the Only Effective Therapy to
Improve Oxygenation?
Syafri K. Arief (Makassar)
4. Nutritional Support versus Autocannibalism
Frans J.V. Panglila (Jakarta)
15.00 - 15.20
2. Hemogobulin Thresholds in Acute Brain Injury
Tatang Bisri (Bandung)
5. Is Hypocaloric Feeding Strategy Adequate for
Critically ill Patients?
Tinni T. Maskoen (Bandung)
15.20 - 15.40
3. Coagulopathy in Trauma and Sepsis
6. The Obese Patients: How to Feed Them
Pratista Hendarjana (Jakarta)
15.40 - 15.50
Discussion
Discussion
PRO CON DEBATE
Blood Gas Analysis:Steward Approach vs
Step-wise
Chairperson: Rudy Manalu (Jakarta)
14
NUTRITION UPDATES
Chairperson: Hartono (Jakarta)
PRO CON DEBATE
Renal Failure: It Has To Be CRRT?
Chairperson: Philia Setiawan (Surabaya)
15.50 - 16.00
Steward Approach
Anang Achmadi (Bandung)
Pro
Tinni T. Maskoen (Bandung)
16.00 - 16.10
Step-wise
Rupi'I (Semarang)
Con
Hardiono (Surabaya)
16.10 - 17.00
DEBATE
DEBATE
SCIENTIFIC PROGRAM
SATURDAY - SUNDAY, 07-08 NOVEMBER 2015
BALLROOM I - II , HYATT REGENCY HOTEL BANDUNG
DAY 2, SUNDAY 08 NOVEMBER 2015
TIME
THE BALLROOM
KEYNOTE LECTURE
Chairperson: Achsannudin Hanafie (Medan)
08.30 - 09.00
5. Enteral Nutrition, How Aggressive Should We Be?
Eddy Rahardjo (Surabaya)
09.00 - 09.30
6. Nutritional Biomarkers
Nancy Margarita Rehatta (Surabaya)
09.30 - 10.00
7. Long Term Quality of Life for the Frail Patient
10.00 - 10.30
8. End of Life Issue: Integrating Palliative and Critical Care
10.30 - 11.00
Coffee/Tea Break
INFECTION UPDATE
Chairperson: Paul Tahalele (Surabaya)
11.00 - 11.20
1. Management of Complicated Intra-Abdominal Infections
Nurhayat Usman (Bandung)
11.20 - 11.40
2. Is EGDT Still Relevant in Fluid Resuscitation in Severe Sepsis & Septic Shock Patients?
Ruli H. Sitanggang (Bandung)
11.40 - 12.00
3. Hemodynamic Effect of Arginine Vasopressin
12.00 - 12.15
Discussion
12.15 - 13.00
Lunch
NUTRITIONISTS/PHARMACISTS TRACK
CALORIES & PROTEIN
Chairperson: Nur Pudji Astuti (Makassar)
NURSING TRACK
Chairperson: Titin Mulyati (Bandung)
13.00 - 13.20
1. How to Assess Body Composition
Widjaya Lukito (Jakarta)
1. Clinical Condition of Patient when Start Administration
of Parenteral and Enteral Nutrition in Critically Ill
Patients in ICU
Indirasari (Bandung)
13.20 - 13.40
2. How to Assess Energy Expenditure
Ruly Sjambali (Bandung)
2. Administering the Right Composition of Carbohydrates,
Fats and Protein in Nutrition of Critically Ill Patients in
ICU
13.40 - 14.00
3. We Need to Assess Nutritional Metabolomics
Agus Salim Bukhari (Makassar)
3. Parenteral Nutrition Administration Technique in
Critically Ill Patients in ICU
Yono Taryono (Bandung)
14.00 - 14.10
Discussion
Discussion
14.10 - 14.30
4. Calculating Energy Expenditure:
A Shot in The Dark
Dadang Arief Primana (Bandung)
4. Enteral Nutrition Administration Technique in Critically
Ill Patients in ICU
Titin Mulyati (Bandung)
14.30 - 14.50
5. Caloric Needs Are Lower Than Energy
Expenditure
Luciana B. Sutanto (Jakarta)
5. Nursing Care Plan for Patient with Parenteral and
Enteral Nutrition in Critically Ill Patients in ICU
Mamik Sri S (Bandung)
14.50 - 15.10
6. Proteins Are The Most Important Nutrients
Ida Gunawan (Jakarta)
6. Monitoring of Patients During Administration of
Parenteral and Enteral Nutrition in Critically Ill Patients
in ICU
Ayatullah Hamami (Bandung)
15.10 - 15.30
7. Non-Protein Calorie: Is It Relevant?
Abdullah Firmansah (Bandung)
15.30 - 15.40
Discussion
15.40 - 16.00
Closing Remark
Chairperson: Rachmi Untoro (Jakarta)
Chairperson: Yono Taryono, (Bandung)
Discussion
FINAL ANNOUNCEMENT
I
15
POST SYMPOSIUM PROGRAM
FUNDAMENTAL CRITICAL CARE SUPPORT
Monday - Tuesday, 09 – 10 November 2015
PENGANTAR
Sesuai dengan Keputusan Menteri Kesehatan Republik Indonesia No : 1778/Menkes/SK/XII/2010 tanggal 13 Desember 2010 bahwa
Standar Ketenagaan Tenaga Kesehatan yang bekerja di ICU harus mempunyai sertifikat FCCS dan juga tuntutan pelayanan
kesehatan (termasuk pelayanan di ICU) yang semakin hari dituntut untuk lebih berkualitas tinggi demi keselamatan pasien (patient
safety). Untuk kepentingan tersebut diperlukan standar pelayanan dasar yang memadai dan universal namun “up to date”.
Pedoman dasar pelayanan pasien di ICU yang universal dan bersifat mendunia adalah FCCS.
PERDICI yang merupakan organisasi / wadah dari dokter dokter intensive care (intensivist) di Indonesia yang menggeluti dalam
bidang ilmu kedokteran intensive care (Intensive Care Medicine) dan pemegang lisensi kursus FCCS, bertanggung jawab demi
tercapainya tujuan tersebut diatas.
Dengan diselenggarakan kursus FCCS diharapkan peserta mempunyai pengetahuan dan ketrampilan dasar untuk bisa mengelola
pasien di ICU secara up to date dibawah supervisi dokter intensivist. Dalam kursus FCCS ini pengantar bahasa yang digunakan
adalah Bahasa Indonesia, sedangkan bahasa dalam Textbook FCCS, soal pre dan post test menggunakan Bahasa Inggris.
MANFAAT KURSUS BAGI PESERTA
• Mengerti dan memahami dasar dari ilmu kedokteran intensive care.
• Mengerti dan memahami ketrampilan dasar dari ilmu kedokteran intensive care.
• Mampu mengelola pasien di ICU dibawah supervisi intensivist.
MATERI KURSUS
• Recognition and Assessment of the Seriously Ill Patient
• Airway Management
• Cardiopulmonary / Cerebral Resuscitation
• Monitoring Blood Flow, Oxygenation and Acid Base
•
•
•
•
Status
Diagnosis and Management of Shock
Diagnosis and Management of Acute Respiratory Failure
Mechanical Ventilation
Acute Coronary Syndromes
• Management of Life-Threatening Electrolyte and
Metabolic Disturbances
• Life-Threatening Infections: Diagnosis and Antimicrobial
•
•
•
•
•
•
SKILL STATIONS
• Integrated Airway Management and Hypovolemic Shock Scenario
• Recognition and Assessment of the Seriously ill Patient
• Mechanical Ventilation
• Non-Invasive Positive Pressure Ventilation (NPPV)
• Integrated Hemorrhagic Shock Scenario
• Integrated Traumatic Brain Injury
• Integrated Sepsis Scenario
• Integrated Severe Sepsis Scenario
PESERTA
• Tenaga kesehatan yang bekerja di Emergency Department.
• Tenaga kesehatan yang bekerja di ICU.
• Dokter Spesialis.
• Dokter Umum.
• Fellow Critical Care.
• Resident.
16
Therapy Selection
Special Considerations
Critical Care in Pregnancy
Neurological Support
Critical Care in Infants and Children The Basics
Basic Trauma and Burn Management
Ethics in Critical Care Medicine
SERTIFIKAT
• Society of Critical Care Medicine (SCCM) yang belaku secara Internasional selama 4 (empat) tahun.
• Sertifikat PERDICI berakreditasi IDI.
REGISTRASI PENDAFTARAN :
1. Membaca Tata Cara Pendaftaran di website PERDICI www.perdici.org
2. Dapat menghubungi Sekretariat PERDICI :
+62 21 29614393 / 68599155 / 36898231 - Fax: +62 21 29614393 / e-mail: infoperdici@yahoo.co.id / info@perdici.org
BATAS WAKTU PENDAFTARAN
Tercapai 35 orang peserta.
BIAYA PENDAFTARAN :
Rp 4.000.000,- (empat juta rupiah) / orang
CARA PEMBAYARAN FCCS:
Transfer ke :
Bank MANDIRI - Cabang RS.Pusat Jantung Harapan Kita - Jakarta
Account No : 116.00.0593235.6
A/n
: PERHIMPUNAN DOKTER INTENSIVE CARE
Bukti transfer dapat di fax / email to Sekretariat PERDICI:
+62 21 29614393 / Email : infoperdici@yahoo.co.id / info@perdici.org Attn. Mrs. Lily
TATA CARA PENDAFTARAN PESERTA KURSUS
1. Peserta membayar biaya pendaftaran kursus ke bank sebagaimana tersebut diatas, baik melalui atm / menggunakan form
setor tunai.
2. Bukti transfer di fax atau di email dengan menyertakan :
a. Nama Lengkap beserta title
b. Nomor Handphone
c. Rumah Sakit / Instansi tempat peserta bekerja.
d.Email.
e. Khusus luar kota, mohon cantumkan juga alamat pengiriman buku.
3. Peserta dianggap terdaftar sebagai peserta FCCS apabila telah melakukan pembayaran sebagaimana tersebut diatas.
4. Bagi peserta FCCS yang telah membayar, akan mendapat Textbook FCCS (yang dipakai untuk belajar) dari Society Critical
Care Medicine, Amerika.
5. Pembatalan/pengunduran diri dilakukan sebelum tanggal batas akhir pendaftaran, maka biaya registrasi akan dikembalikan
dengan potongan sebesar Rp 1.000.000,- (satu juta rupiah). Biaya pendaftaran tidak akan dikembalikan jika pembatalan /
pengunduran diri dilakukan setelah tanggal batas akhir registrasi.
TATA TERTIB PELAKSANAAN KURSUS
1. Peserta harus tiba dilokasi tepat pukul 7.30 untuk melakukan registrasi ulang dengan membawa Pas Foto berwarna 4X6
sebanyak 1 lembar.
2. Pre-Test akan dilaksanakan pada pukul 08.00. Jika peserta datang terlambat, tidak diberikan perpanjangan waktu.
3. Kuliah akan dimulai pada pukul 08.15 WIB, jika peserta terlambat maka yang bersangkutan tidak diperkenankan mengikuti
kuliah sampai dengan pelaksanaan kursus selesai, sehingga dengan demikian peserta tidak memenuhi jam kehadiran, berarti
dinyatakan TIDAK LULUS.
4. Peserta wajib mengikuti Pre dan Post Test.
5. Peserta wajib mengikuti seluruh kuliah dan skill station. Jika peserta tidak mengikuti 1 (satu) mata kuliah dan/atau 1 (satu) skill
station saja dianggap TIDAK LULUS dan yang bersangkutan dapat mengikuti kursus pada waktu dan tempat yang akan
datang dengan membayar uang pendaftaran kembali.
6. Peserta kursus tidak diperkenankan mendokumentasikan slide dan soal-soal dalam bentuk apapun.
FINAL ANNOUNCEMENT
I
17
REGISTRATION & ACCOMMODATION
HOW TO GET THE REGISTRATION FORM
1. From our website:
• Download the PDF file of the updated “Announcement” by logged into http://www.geoconvex.com/upcoming
event/and click further to mentioned related event.
• Find the last pages of Announcement to print the Registration Form for fax purpose. You may also save the soft copy
in your personal PC for your perusal and further use.
2. From our secretariat address:
You may get the soft/hard copy of Announcement to be delivered to your email/ home address by sending the request
to secretariat@geoconvex.com or SMS to +62811882080
HOW TO REGISTER
Registration By Fax
1. Complete the Registration Form to the secretariat Fax address at 021.3153392 along with proof of payment (e.g. copy
of bank transfer slip). Photocopied forms are acceptable.
2. Payment Proof is strongly recommended to be done along with your Registration Form faxed submission.
3. The Registration Form will not be acknowledged until the appropriate Payment Proof has been received to the Secretariat
by Fax to 021-3153392 as soon as possible, following the Registration Form submission.
4. You may bring along your payment proof to proceed at the Re-Registration counter. Essentially, the name tag
issued is an initial confirmation of registrants. Fax of an official receipt is upon request to Secretariat address at
021.3149318 - 3149319.
Registration By Email
You may submit your Personal and/or Group Registration by email to secretariat@geoconvex.com along with the enclosed
scanned payment proof as well as detail of personal data and participations.
Notification: For group registration from pharmaceutical companies as payers may contact the Secretariat email address
for appropriate procedure.
REGISTRATION PAYMENT
A. Bank Transfer
Bank transfer is strongly recommended rather than any other payment method. See event bank account in the mentioned
Announcement.
Bank remittance must be paid by registrant, otherwise the registration receipt or badge will not be issued due
to the less payment.
REGISTRATION BANK ACCOUNT FOR JOINT SYMPOSIUM
Bank Name Branch Address No. Account Account Holder
: CIMB Niaga
: Kemang Branch
: Jalan Kemang Raya No. 4, Jakarta Selatan
: 253.01.00005.008
: PERDICI/ Global Echo Organizer Convex
B. Cash to Secretariat Address
Cash may be paid directly to the Secretariat Address(s). Rooms and Workshops payments must be full paid in advanced
due to secure the seat and bookings.
C. On Site Payment
On site payment shall be brought upon arrival either by Cash or Bank Draft. The Bank Draft is to be made payable to
“GEO convex”. Please indicate your “On Site Payment” remark on the Registration Form.
On site payment is only valid for conference registration, not eligible for workshops and rooms.
Please acknowledge that Organizing Committee reserve the right not to guarantee any on-site registrant
obtain its complete Symposium documents nor materials that therefore we strongly encourage to make an urge
Registration.
18
Payment by Credit Card with EDC Machine will only be provided at the venue hotel during event by signing yourself
authorization. The Credit Card transaction charges (if any) will be applied based on venue hotel’s regulation. The
Organizing Committee holds no responsibility for any exchange rates applied by the Credit Card vendor when the
statement converted into local currency.
REGISTRATION CONFIRMATION
1. Registered participants will receive Registration Official Receipt (upon request) after the fees have been cashed and
effectively in the Event bank account.
2. Registered Participants are strongly suggested to make Re-Confirmation due to incoming facsimiles and/or payment
made to our Registration Division.
Domestic Participant: Fax To: 021.3153392; Reconfirm To: 021.3149318 – 19 and 021.2305835 Mobile: 0811.88.2080
Registration re-confirmation especially for Course/Workshop and/or Room Reservation is a must due the
availability of space. Organizing Committee reserve the right not to guarantee any unconfirmed Course/
Workshop registration at the Event and the payment made will be returned by bank transfer only to the Payer
Bank Account after the event.
CANCELLATION & REFUND POLICY
REGISTRATION
Notification of the registration cancellation for workshop and scientific symposium must be made in writing or emailed to
the Secretariat. Registration Fee is refundable with the following cancellation policy:
• One month before event – 50% refund of fee paid
• On and after the date – No refund
• No-show registration can not be refunded.
ACCOMMODATION
• Hotel room rate is net for room only.
• Please note that official check-in time is 14.00 local time and check-out time is 12.00 local time. Approval of early
check-in and late check-out is at discretion of the hotel.
• No reservation will be made without full deposit of nights booking due to room availability.
• Any changes and cancellations regarding to room reservation in pre-registration period must be done in writing to the
Secretariat at least 168 hours prior to arrival. After the date, guaranteed payment for 1 night will be charged.
• No Show will be applied on the first night for delayed or postpone staying that causes the loss of 1 night room deposit
made.
• In the event of materialization, the hotel will charge the full amount duration of stay upon check-out that causes the
loss of mentioned deposit made.
Refund may only be made after event by bank transfer. Official letter should be submitted to Secretariat address
mentioning its payer’s Bank Account.
REGISTRATION FEE INCLUDE
• Name Badge & Symposium Kit.
Name Badge MUST BE worn entering to all scientific sessions and lunch/break programmed by the Organizing
Committee.
• Symposium documents and materials (Proceeding Book and Note Pad)
• Admission to the function room, lunch programmed and scientific exposure from Pharmaceutical and Health-Care
Companies.
• Certificate of Attendance with IDI Accreditation will be issued for eligible participants at the last day of the Symposium.
RE-REGISTRATION SERVICE
The Re-Registration will be handed out to the participants from registration counters during the opening hours at 07.00
– 12.00 during the event dates.
ON SITE REGISTRATION
Applicants that not registered in event Registration List will be treated as New Registrants and will have to register on-site,
for which only payment by Cash or Credit Card are accepted.
FINAL ANNOUNCEMENT
I
19
Note
20
Note
FINAL ANNOUNCEMENT
I
21
Note
22
REGISTRATION & ACCOMMODATION FORM - A
05-06, 07-08 November 2015
HYATT REGENCY HOTEL BANDUNG
WORKSHOP REGISTRATION
PARTICIPANT (Kindly completed)
Full Name & Title
:
___________________________________________________________
Institution :
___________________________________________________________
Home Address
:
___________________________________________________________
City / Post Code :
___________________________________________________________
Phone (Mobile)
:
_______________________ Fax : ______________________________
Email:___________________________________________________________
SPONSOR (Kindly completed if any)
Full Name & Position
:
___________________________________________________________
Company / City
:
___________________________________________________________
Phone (Mobile)
:
________________________ Fax : _____________________________
Email:___________________________________________________________
PRE-SYMPOSIUM FEE ( kindly √ appropriate circle/box)
Workshop Registration, 05-06 November 2015
ESPEN LLL Programmes in Nutrition and Metabolism
Technique of Enteral & Parenteral Nutrition
Mechanical Ventilation: From Basic Theory to Clinical Practice
Fluid Therapy, Electrolyte, and Acid Base Balance
Basic Assessment & Support in Intensive Care (BASIC Course)
IDR 4.000.000
IDR 3.000.000
IDR 3.000.000
IDR 3.000.000
IDR 3.000.000
Note: FCCS are regular courses coordinated by ISICM Secretariat, therefore the direct registration is recommended to
(021)29614393; 36898231, 68599155 CP. Ms. ADE for further detail updated due to the limited seats.
PAYMENT BY
BANK TRANSFER IN FULL AMOUNT
TO EVENT BANK ACCOUNT
REGISTRATION BANK ACCOUNT
Account Holder (Beneficiary) :
PERDICI/Global Echo Organizer Convex
No. Account : 253.01.00005.008
Bank Name : CIMB Niaga
Branch : Kemang Branch
CASH TO SECRETARIAT ADDRESS
ON SITE
CONFIRMATION TO:
Global Echo Organizer Convex
Jl. Kebon Sirih Timur Dalam No. 4 Jakarta Pusat
Phone
: +6221- 2305835/3149318/3149319
Fax
: +6221- 3153392
Mobile : +62811882080
Email
FINAL ANNOUNCEMENT
I
23
05-06, 07-08 November 2015
HYATT REGENCY HOTEL BANDUNG
REGISTRATION & ACCOMMODATION FORM - B
REGISTRATION & ACCOMMODATION FORM
PARTICIPANT (Kindly completed)
Full Name & Title
:
___________________________________________________________
Institution :
___________________________________________________________
Home Address
:
___________________________________________________________
City / Post Code :
___________________________________________________________
Phone (Mobile)
:
_______________________ Fax : ______________________________
Email:___________________________________________________________
SPONSOR (Kindly completed if any)
Full Name & Position
:
___________________________________________________________
Company / City
:
___________________________________________________________
Phone (Mobile)
:
________________________ Fax : _____________________________
Email:___________________________________________________________
SYMPOSIUM REGISTRATION FEE ( kindly √ appropriate circle/box)
Joint Symposium Registration, 07-08 November 2015
EARLY BIRD
Before 30 Sep 2015
Nutritionists/Pharmacists/Nurses/Health Practitioners/
Trainee/Student
General Practitioners
Specialists
NORMAL
After 30 Sep 2015
IDR 500.000
IDR 750.000
IDR 2.000.000
IDR 2.500.000
IDR 2.750.000
IDR 3.500.000
HOTEL RESERVATION
HOTEL NAME
ROOM TYPE
HYATT REGENCY BANDUNG
Deluxe Room
ROOM RATE
Rate in Net/Room/Night– Single Basis,
Include Max 2 Breakfast
IDR 1.100.000
Check-In Date
Total Night(s) :
Check-out Date
Total Accommodation Payment:
IDR
PAYMENT BY
BANK TRANSFER IN FULL AMOUNT
TO EVENT BANK ACCOUNT
REGISTRATION BANK ACCOUNT
Account Holder (Beneficiary) :
PERDICI/Global Echo Organizer Convex
No. Account : 253.01.00005.008
Bank Name : CIMB Niaga
Branch : Kemang Branch
24
CASH TO SECRETARIAT ADDRESS
ON SITE
CONFIRMATION TO:
Jl. Kebon Sirih Timur Dalam No. 4 Jakarta Pusat
Phone
: +6221- 2305835/3149318/3149319
Fax
: +6221- 3153392
Mobile : +62811882080
Email
SECRETARIAT
Co- Organizer
Jl. Kebon Sirih Timur Dalam No. 4
Jakarta Pusat 10340
Registration Hot Line: +6221 2305835/3149318/3149319/0811882080
Fax
: +6221 3153392
Email
Website : www.geoconvex.com
INDONESIAN SOCIETY OF INTENSIVE CARE
MEDICINE (ISICM)
Apartemen Menteng Square - Tower A 3rd Floor Unit A0-11
Jl. Matraman Raya No.30 Jakarta Pusat
Phone
: (021) 29614393, 36898231, 68599155
Fax
: (021) 29674393
Email
: infoperdici@yahoo.co.id
Website
: www.perdici.org
PIC
: Ade Syariah +6221 6859 9155
DEPARTMENT OF ANESTHESIA AND
INTENSIVE CARE
Faculty of Medicine Padjadjaran University,
Hasan Sadikin General Hospital Bandung
Jl. Pasteur 38, Bandung
Phone: (022) 2038285 – Fax: (022) 2038306
PIC: Mrs. Tini Rohijah
INDONESIAN SOCIETY OF PARENTERAL &
ENTERAL NUTRITION (INASPEN)
Main Building, 5th Floor Gatot Subroto Army Hospital
Jl. Abdul Rahman Saleh 24, Central Jakarta

Cover WEB - GEO Convex

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