world sepsis day - perdici.org · dr. bambang pujo semedi, span kic welcome message. in conjunction...
TRANSCRIPT
FINAL ANNOUNCEMENT
INDONESIAN SOCIETY OF INTENSIVE
CARE MEDICINE (ISICM)
& GLOBAL SEPSIS ALLIANCE
Indonesian Society of Anesthesiology &
Intensive Therapy (PERDATIN) &
Department Anesthesia & Intensive Care,
Faculty of Medicine University of Airlangga,
Dr. Soetomo General Hospital
proudly present and organize,
In conjunction with
5th World Sepsis Day With the theme:
“Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”
Pullman Surabaya City Center – SURABAYA19-20, 21-22, 23-24 October 2016
PRE-CONGRESS WORKSHOPSCONTINUING EDUCATIONAL PROGRAM OF ISICMWEDNESDAY-THURSDAY, 19-20 OCTOBER 2016 Mechanical Ventilation: From Basic Theory to Clinical Practice
Pediatric Fundamental Critical Care Support (Ped-FCCS)
INTENSIVE CARE NURSING PROGRAM Nursing Course on Ventilator Management
WEDNESDAY, 19 OCTOBER 2016 Hemodynamic Monitoring in Emergency Situation
6th NATIONAL CONGRESS OF ISICM
FRIDAY-SATURDAY, 21-22 OCTOBER 2016 Scientific Exhibition
Free Paper Poster Presentation
SATURDAY, 22 OCTOBER 2016 EVENINGCase Mix Dinner
5th WORLD SEPSIS DAYSUNDAY, 23 OCTOBER 2016
POST-CONGRESS WORKSHOPSUNDAY-MONDAY, 23-24 OCTOBER 2016 Fundamental Critical Care Support (FCCS)
CALL FOR PAPERSUBMISSION
DEADLINE 15 SEPTEMBER 2016
1
In conjunction with
55thth World Sepsis Day World Sepsis Day with the theme
“Intensive Care for Every Doctors: “Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”How to Apply Theories to Clinical Practices”
Pullman Surabaya City Center – SURABAYAPullman Surabaya City Center – SURABAYA
19-20, 21-22, 23-24 October 201619-20, 21-22, 23-24 October 2016
11
Dear Colleagues,
It gives us great pleasure to invite all our colleagues to participate and join us at this major event,
the 6thNATIONAL CONGRESS OF INDONESIAN SOCIETY OF INTENSIVE CARE MEDICINE (ISICM)
in conjunction with: The 5thWorld Sepsis Day, with the theme:” Intensive Care for Every Doctors:
How to Apply Theories to Clinical Practices” being held in Surabaya on 21 – 22 October 2016., not
only to fulfi ll the organization duty, but also off ers doctors and nurses from around provinces of
Indonesia the opportunity to hearing presentations by internationally acclaimed experts and
participating in a highly innovative scientifi c program and clinical research results. In the support
for Global Sepsis Alliance, the Congress will provide a unique opportunity to share experiences,
sepsis learning and how to give a better sepsis management at national and international levels
further due to promote public awareness as the goals of WSD
The Continuing Educational Program (CEP) as Pre-Congress Workshops are also available on 19-20
October 2016 to optimize the delivery of critical care for critically ill and injured patients. Nursing
Ventilator Course Program also scheduled in pre-setting with the Congress, has been proven
in providing the fi nest education regarding critical care nursing to enhance patient care and
promoting the most valuable source of critical care teamwork.
We look forward to welcoming you to come and join us in the 6th National Congress of ISICM in
conjunction with 5th World Sepsis Day in the vibrant city of Eastern Java, Surabaya.
Warm Regards
Chairman,
dr. Bambang Pujo Semedi, SpAn KIC
WELCOME MESSAGE
In conjunction with
55thth World Sepsis Day World Sepsis Day with the theme
“Intensive Care for Every Doctors: “Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”How to Apply Theories to Clinical Practices”
Pullman Surabaya City Center – SURABAYAPullman Surabaya City Center – SURABAYA
19-20, 21-22, 23-24 October 201619-20, 21-22, 23-24 October 2016
22
ORGANIZING COMMITTEE
ADVISORY BOARD
• Director of Dr. Soetomo General Hospital Surabaya
• Dean Faculty of Medicine, University of Airlangga, Surabaya
• Head Department Anesthesia & Intensive Care, Faculty of Medicine Airlangga University, Dr. Soetomo General Hospital Surabaya
• President of Indonesian Society of Anesthesiology & Intensive Therapy (PERDATIN): dr. Andi Wahyuningsih Attas, SpAn KIC MARS
• President of Indonesian Society of Intensive Care Medicine (ISICM), dr. Oloan E. Tampubolon, SpAn KIC KNA MHKes
CHAIRMAN
• dr. Bambang Pujo Semedi, SpAn KIC
SECRETARY
• dr. Pesta Manurung, SpAn
• dr. Prananda Surya Airlangga, SpAn KIC M.Kes
TREASURER
• dr. Zuswahyuda Samsu, SpAn KIC
SCIENTIFIC COMMITTEE
Coordinator: dr. Bambang Wahjuprajitno,SpAn KIC
Members:
• Prof. dr. Achsanuddin Hanafie, SpAn KIC
• Prof. Dr. dr. Made Wiryana, SpAn KIC
• Dr. dr. Ike Sri Redjeki, SpAn KIC.,KMN.,MKes
• Dr. dr. Syafri K Arif, SpAn KIC
• dr. Dwi Panca Wibowo, SpAn KIC
• dr. Frans JV Pangalila, SpPD KIC
• dr. Hanindito, SpAn KIC KAP
• Dr. dr. Philia Setiawan, SpAn KIC
• dr. Rudy Manalu, SpAn KIC
• dr. Rupi’i, SpAn KIC
In conjunction with
55thth World Sepsis Day World Sepsis Day with the theme
“Intensive Care for Every Doctors: “Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”How to Apply Theories to Clinical Practices”
Pullman Surabaya City Center – SURABAYAPullman Surabaya City Center – SURABAYA
19-20, 21-22, 23-24 October 201619-20, 21-22, 23-24 October 2016
33
EVENT NAME6th National Congress of ISICM in conjunction with 5th World Sepsis DayWith the theme: “Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”
PLACEPullman Surabaya City Center
AGENDA
PRE-CONGRESS WORKSHOPS
CONTINUING EDUCATIONAL PROGRAM OF ISICM
WEDNESDAY-THURSDAY, 19-20 OCTOBER 20160 Mechanical Ventilation: From Basic Theory to Clinical Practice0 Pediatric Fundamental Critical Care Support (Ped-FCCS)
INTENSIVE CARE NURSING PROGRAM
0 Nursing Course on Ventilator Management
WEDNESDAY, 19 OCTOBER 20160 Hemodynamic Monitoring in Emergency Situation
6th NATIONAL CONGRESS OF ISICM
FRIDAY-SATURDAY, 21-22 OCTOBER 20160 Exhibition 0 Free Paper Poster Presentation
CASE MIX DINNER
SATURDAY, 22 OCTOBER 2016 EVENING
5th WORLD SEPSIS DAY
SUNDAY, 23 OCTOBER 2016
POST-CONGRESS WORKSHOP
SUNDAY-MONDAY, 23-24 OCTOBER 20160 Fundamental Critical Care Support (FCCS)
ORGANIZED BYIndonesian Society of Intensive Care Medicine (PERDICI)
AUDIENCE- Physicians: Intensivists, Anesthesiologist, Internists, Hematologist, Oncologists, General Surgeon, Neuro-Surgeon, Digestive
Surgeon, Cardiologist, Pulmonologist, Neurologist, Clinical Pathologist, Clinical Microbiologist, Physical Therapists, Pharmacologists
- General Practitioner, Fellow, Trainee & Student, Health Practitioners and Nurse –who interested in Intensive Care Medicine
CALL FOR PAPERSParticipants are invited to submit Free Paper for poster presentation not later than 15 September 2016. The eligible presenters must be registered as Participant. Free Paper Coordinator will select the eligible Abstract for the Poster during event.
GENERAL INFORMATION
In conjunction with
55thth World Sepsis Day World Sepsis Day with the theme
“Intensive Care for Every Doctors: “Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”How to Apply Theories to Clinical Practices”
Pullman Surabaya City Center – SURABAYAPullman Surabaya City Center – SURABAYA
19-20, 21-22, 23-24 October 201619-20, 21-22, 23-24 October 2016
44
REGISTRATION SECRETARIAT & MAILING ADDRESSISICM have chosen a cooperate organizer, who will ensure a smooth and effi cient management of the scientifi c 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 : [email protected] : www.geoconvex.com Registration & Accommodation:
Offi ce Hours: 021.293 15 470 (Hunting) Registration Hotline: +62811.882080 / +62819882080Fax: 021.293 15 471
FORMAT OF THE PROGRAMS6th National Congress of ISICM in conjunction with 5th World Sepsis Day will present a breakthrough sophisticated scientifi c program, which highlight recent advances and updates made in the fi eld of Intensive Care Medicine by national key expertsand well-known speakers
KEYNOTE LECTURES These are State-of-the Art lectures served in a plenary format consist of updated and newest highlights in Intensive Care
Medicine, which defi nitely useful to enhance ICU Practitioners horizon and experience.
MEET THE EXPERT: CLINICAL CASE INTERACTIVE SESSION This year congress, ISICM scientifi c committee came with the spectacular breakthrough scientifi c concept with fruitful
updated clinical practice topics, both intriguing issues and interesting cases presentation using the electronic voting system for more interactive discussion.
The clinical case interactive session covered a set of selected hot issues in Critical Care Medicine by focusing in active interaction between Case Presenter, Expert Panelist, and audience to ensure the most advantages of the scientifi c session, making lasting connections within audiences and colleagues who encounter similar issues.
CONTROVERSIES IN INTENSIVE CARE MEDICINE The Controversies in Intensive Care Medicine session is intended to provide insight into particular topics in intensive care
medicine, which gives consensus or unequivocal evidence to clinical guidelines and practice decisions. This special design session is the hottest program from ISICM, which includes a selected hot topic blended in a highlighted lecture, case, and panel discussion which will ensure that audience will fi nd their way through all of these particular issues for the daily practice implementation.
CASE MIX DINNER The Case Mix Dinner Session held on Saturday, 22 October 2016 is the special unique Session, which discuss and share the
ICU diffi cult cases and complex issues with the well -known ICU expertise. These fruitful topic highlights will widen your horizon as well as for practical guidelines in your ICU practice.
EXHIBITION The 6th National Congress of ISICM will host a scientifi c exhibition on 21-22 October 2016 including the latest technology,
equipment for clinical managemen t & research and literature.
OFFICIAL LANGUAGEThe offi cial languages of the 6th National Congress of ISICM is English & Indonesian. English will be used for all printed materials, presentation with overseas speakers and discussions. Any simultaneous translation will not be provided.
DISCLAIMEREvery 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 Congress, for any cause beyond its reasonable control. In the event of cancellation of the Congress, 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.
In conjunction with
55thth World Sepsis Day World Sepsis Day with the theme
“Intensive Care for Every Doctors: “Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”How to Apply Theories to Clinical Practices”
Pullman Surabaya City Center – SURABAYAPullman Surabaya City Center – SURABAYA
19-20, 21-22, 23-24 October 201619-20, 21-22, 23-24 October 2016
55
Pre-Congress Program
WORKSHOP ON MECHANICAL VENTILATION: FROM BASIC THEORY TO CLINICAL PRACTICEWednesday - Thursday, 19-20 October 2016
Singosari 1-2 Room, Pullman Surabaya City Center
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 AttendThe comprehensive curriculum from basic to advances for Intensivists, Anesthesiologists, ICU General Practitioners, other Multi-disciplines -who are interested in Intensive Care Medicine fi eld, for better horizon in ventilatory support. Urge registration for KIC Fellows.
Course LanguageIndonesian
Course CapacityLimited to 40 participants upon fi rst payment basis
Organized ByIndonesian Society of Intensive Care Medicine (ISICM)
ProgramCourse Directors: dr. Bambang Wahjuprajitno, SpAn KIC
Instructor Team:dr. Bambang Wahjuprajitno, SpAn KICdr. Oloan Tampubolon, SpAn KIC MHKesdr. Rupi’I, SpAn KICdr. Christian Johannes, SpAn KIC
dr. Rudy Manalu, SpAnKICDr. dr. Philia Setiawan, SpAn KICdr, Bambang Pujo Semedi, SpAn KIC
DAY 1 WEDNESDAY, 19 OCTOBER 2016
08.00 – 08.15 Introduction
08.15 - 08.45 Physiology 1: Gas Exchange
08.45 - 09.15 Physiology 2 :Mechanic of Respiration
09.15 - 09.45 Acute Respiratory Failure
09.45 - 10.00 Coff ee/ Tea Break
10.00 - 10.30 Heart and Lung Interaction
10.30 - 11.00 Mode of Ventilator I (Basic)
11.00 - 11.30 Mode of Ventilator II (Alternative)
11.30 - 12.00 Sedation and Paralysis in Patient with MV
12.00 - 13.00 Lunch
13.00 - 13.30 Trouble Shooting of MV
13.30 - 14.00 How Mechanical Ventilation Work
14.00 - 15.20 SKILL STATION
A. Ventilator Mode I : CMV, ACMV, PC, PS
B. Ventilator Mode II : BIPAP, APRV
15.20 - 15.40 Coff ee/ Tea Break
DAY 2 THURSDAY, 20 OCTOBER 2016
08.00 – 08.30 How to Use and Setting of PEEP
08.30 – 09.00 Non-Invasive Ventilation (NIV)
09.00 – 09.30 Weaning
09.30 – 10.00 Monitoring Patient with Mechanical Ventilation
10.00 – 10.15 Coff ee/ Tea Break
10.15 – 10.45 VAP
10.45 – 11.15 MV in ARDS / Hypoxemic RF
11.15 – 11.45 MV in COPD Patient
11.45 – 12.15 Pediatric Consideration
12.15 – 13.30 Lunch
13.30 - 14.00 Oxygen Therapy
14.00 - 14.30 Ventilator Graphic
14.30 - 15.20 CASE DISCUSSION
15.20 - 15.35 Coff ee/ Tea Break
15.35 - 16.55 SKILL STATION
Switch @40" A. Trouble Shooting
B. MV in COPD, ARDS
In conjunction with
55thth World Sepsis Day World Sepsis Day with the theme
“Intensive Care for Every Doctors: “Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”How to Apply Theories to Clinical Practices”
Pullman Surabaya City Center – SURABAYAPullman Surabaya City Center – SURABAYA
19-20, 21-22, 23-24 October 201619-20, 21-22, 23-24 October 2016
66
HEMODYNAMIC MONITORING IN EMERGENCY SITUATIONWednesday, 19 October 2016
Garden Terrace 2-3 Room – Pullman Surabaya City Center
Learning Objectives• To understand the Physiology of Cardiac Cycle • To understand the Triple Core Mechanism of Heart Function • To understand Oxygen Transport & Utilization• To understand Zeroing, Arterial Pressure, ad CVP Monitoring • To understand Tissue Perfusion Monitoring• To understand Cardiac Output Monitoring
Who Should AttendThe comprehensive curriculum specially conducted by PERDICI for better horizon in managing Hemodynamic Monitoring in Emergency Situation. Urge registration for General Practitioners in ICU and or Emergency Unit.
Course LanguageIndonesian
Course CapacityLimited to 40 participants upon fi rst payment basis
Organized ByIndonesian Society of Intensive Care Medicine (ISICM)
ProgramCourse Director: dr. Fajar Perdhana, SpAn
DAY 1 WEDNESDAY, 19 OCTOBER 2016
08:00 – 08:30 Back to Physiology: Cardiac Cycle
08:30 – 09:00 Triple Core Mechanism of Heart Function: Preload, Afterload, and Contractility
09:00 – 09:30 Oxygen Transport & Utilization
09:30 – 10:00 Coff ee/ Tea Break
10:30 – 11:00 Zeroing, Arterial Pressure and CVP Monitoring
11:00 – 11:30 Tissue Perfusion Monitoring
11:30 – 12:00 Cardiac Output Monitoring
12:00 - 13:00 ISHOMA
13:00 – 16:00 SKILL STATION
Zeroing, Arterial Pressure and CVP Monitoring
Cardiac Output Monitoring: Swan Ganz/Pulmonary Artery Catheter, Fick MethodEchocardiography, Flo Trac
Case Discussion
Pre-Congress Program
Instructor Team:dr. Fajar Perdhana, Sp.Andr. Ronggo Prakoso SpAn KIC KAKVdr. Prananda Surya Airlangga, M.Kes., Sp.An., KICdr. Bambang Pujo Semedi, Sp.An., KIC
In conjunction with
55thth World Sepsis Day World Sepsis Day with the theme
“Intensive Care for Every Doctors: “Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”How to Apply Theories to Clinical Practices”
Pullman Surabaya City Center – SURABAYAPullman Surabaya City Center – SURABAYA
19-20, 21-22, 23-24 October 201619-20, 21-22, 23-24 October 2016
77
NURSING COURSE ON VENTILATOR MANAGEMENTWednesday – Thursday, 19 – 20 October 2016
Rama Ballroom, Pullman Surabaya City Center
Who Should AttendComprehensive curriculum in Ventilator Management with more Hands-On in Nursing Care for ICU Nurses.
Course LanguageIndonesian
Course CapacityLimited to 60 participants upon fi rst payment basis
Organized ByIndonesian Society of Intensive Care Medicine (ISICM) & Department Anesthesia & Intensive Care, Faculty of Medicine University of Airlangga, Dr. Soetomo General Hospital Surabaya
ProgramCourse Directors: dr. Pesta Manurung, SpAn
DAY 1 WEDNESDAY, 19 OCTOBER 2016
08.00 – 08.30 Registrasi & Grand Opening
08.30 – 09.15 Cara Kerja Ventilator
09.15 – 09.45 Rehat Kopi
09.45 – 10.30 Pengenalan Mode Ventilator
10.30 – 11.15 Strategi Weaning Ventilator
11.15 – 13.00 ISHOMA
13.00 – 13.45 Suctioning Pada Pasien Dengan Pemasangan Ventilator
13.45 – 14.30 Setting Breathing Sirkuit dan Kalibrasi
14.30 – 15.00 Aplikasi AGD Pada Pasien Dengan Pemasangan Ventilator
15.00 – 15.30 Rehat Kopi
DAY 2 THURSDAY, 20 OCTOBER 2016
08.30 – 09.15 Pemantauan Pasien Selama Pemasangan Ventilator
09.15 – 10.00 Fisioterapi Dada Pada Pasien Dengan Pemasangan Ventilator
10.00 – 10.30 Rehat Kopi
10.30 – 11.15 Pemenuhan KDM (Kebutuhan Dasar Manusia) Pada Pasien Dengan Pemasangan Ventilator
11.15 - 12.00 Perawatan ETT/TC Pada Pasien Dengan Pemasangan Ventilator
12.00 – 13.00 ISHOMA
13.00 – 16.00 SKILL STATION
@45" - Setting Breathing Sirkuit Dan Kalibrasi Ventilator
- Setting Mode Ventilator
- Monitoring Pasien Dengan Pemasangan Ventilator
- Suctioning dan Fisioterapi dada
Pre-Congress Program
Instructor Team:dr. Pesta Manurung, SpAndr. Rupi’I, SpAn KICdr. Bambang Wahjuprajitno, SpAn KICAinur Rusdi, Ns, SKep Titin Suprihatin, SSTJuni, SSTRostika, SKepYuniar, Skep Ns
88
5th World Sepsis Day
“Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”
DAY 1, FRIDAY – 21 OCTOBER 2016
08.00 - 08.30 OPENING
KEYNOTE LECTURE
Chairperson: Indro Mulyono (Jakarta)
08.30 - 09.00 Ethical Consideration in End of Life Care
Oloan E. Tampubolon (Jakarta)
09.00 - 09.30 Tailored Therapy in ICU
Ike Sri Redjeki (Bandung)
CONTROVERSIES IN INTENSIVE CARE MEDICINEADVANCES LIFE SUPPORT & POST RESUSCITATION CARE
Chairperson: Bambang Pudjo Semedi (Surabaya)
09.30 - 09.50 Advanced Life Support Guidelines 2015: What Are Diff erences
April Purwanto (Surabaya)
09.50 - 10.10 Resuscitation in Life Threatening ACS
Jetty Sedyawan (Jakarta)
10.10 - 10.20 Panel Discussion
CONTROVERSIES IN INTENSIVE CARE MEDICINEFLUID & NUTRITION THERAPY
Chairperson: Christian Johannes (Jakarta)
10.20 - 10.40 Nutrition Therapy Goal in ICU: From Theory to Therapy
Prananda Surya Airlangga (Surabaya)
10.40 - 11.00 Fluid Resuscitation in Sepsis
Hori Haryanto (Jakarta)
11.00 - 11.10 Panel Discussion
11.10 - 13.00 Lunch & Friday Pray
SCIENTIFIC PROGRAM
99
In conjunction with
55thth World Sepsis Day World Sepsis Day with the theme
“Intensive Care for Every Doctors: “Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”How to Apply Theories to Clinical Practices”
PULLMAN SURABAYA CITY CENTERPULLMAN SURABAYA CITY CENTERFRIDAY-SATURDAY, FRIDAY-SATURDAY,
21-22 OCTOBER 201621-22 OCTOBER 2016
PROGRAM ILMIAHSABTU - 05 NOVEMBER 2016
DAY 1, FRIDAY – 21 OCTOBER 2016CONTROVERSIES IN INTENSIVE CARE MEDICINEANTIBIOTIC THERAPY IN ICU
Chairperson: Az Rifki (Padang)
13.00 - 13.20 De'Escalate or Not De'Escalate
Samsirun Halim (Jambi)
13.20 - 13.40 Prolong Prophylaxis Antibiotic in ICU
Tatang Eka (Bandung)
13.40 - 13.50 Panel Discussion
CONTROVERSIES IN INTENSIVE CARE MEDICINEMECHANICAL VENTILATION: VOLUME OR PRESSURE TARGETED
Chairperson: Rudy Manalu (Jakarta)
13.50 - 14.10 Volume Targeted
Calcarina Wisudarti (Yogyakarta)
14.10 - 14.30 Pressure Targeted
Hardiono (Surabaya)
14.30 - 14.40 Panel Discussion
14.40 - 15.10 Coff ee/Tea Break
CONTROVERSIES IN INTENSIVE CARE MEDICINENON INVASIVE AND SEMI INVASIVE HEMODYNAMIC MONITORING: HOW TO USE IT RATIONALLY?
Chairperson: Achsanuddin Hanafi e (Medan)
15.10 - 15.30 When We Can Do Minimally Non-Invasive Hemodynamic Monitoring
Philia Setiawan (Surabaya)
15.30 - 15.50 When We Do Invasive
Zuswahyuda Samsu (Jakarta)
15.50 - 16.00 Panel Discussion
DAY 1, FRIDAY – 21 OCTOBER 2016
1010
5th World Sepsis Day
“Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”
DAY 2, SATURDAY-22 OCTOBER 2016
KEYNOTE LECTURE
Chairperson: Amir S. Madjid (Jakarta)
08.00 - 08.30 Insurance and Reimbursment Program for ICU Patients in Indonesia
Andi Wahyuningsih Attas (Jakarta)
08.30 - 09.00 The Future Intensive Care Educational Program in Indonesia
Eddy Rahardjo (Surabaya)
09.00 - 09.30 Antibiotic Resistance: The New Challenge for Intensivists
Bambang Wahjuprajitno (Surabaya)
09.30 - 10.00 Out of Hospital Care Management
I Made Wiryana (Bali)
10.00 - 10.30 Coff ee/Tea Break
CONTROVERSIES IN INTENSIVE CARE MEDICINESEPSIS MANAGEMENT
Chairperson: Ruli Sitanggang (Bandung)
New Criteria in Sepsis: How to Apply in Clinical Practice
10.30 - 10.50 Frans J.V. Pangalila (Jakarta)
10.50 - 11.10 Jusak Nugraha (Surabaya)
11.10 - 11.20 Panel Discussion
11.20 - 13.00 Lunch
SCIENTIFIC PROGRAM
1111
In conjunction with
55thth World Sepsis Day World Sepsis Day with the theme
“Intensive Care for Every Doctors: “Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”How to Apply Theories to Clinical Practices”
PULLMAN SURABAYA CITY CENTERPULLMAN SURABAYA CITY CENTERFRIDAY-SATURDAY, FRIDAY-SATURDAY,
21-22 OCTOBER 201621-22 OCTOBER 2016
DAY 2, SATURDAY-22 OCTOBER 2016
DAY 2, SATURDAY-22 OCTOBER 2016
MEET THE EXPERTS: INTERACTIVE CASE & DISCUSSION(with Electronic Voting System)
Chairperson: Zulkifl i (Palembang)
How To Manage Shock: The Role of Vasopressin & Hydrocortisone
13.00 - 13.15 Syafri K. Arief (Makassar)
13.15 - 13.30 Rupi'I (Semarang)
13.30 - 13.50 Panel Discussion
MEET THE EXPERTS: INTERACTIVE CASE & DISCUSSION(with Electronic Voting System)
Chairperson: Philia Setiawan (Surabaya)
How To Manage Hypertension in ICU
13.50 - 14.05 Retnaningsih (Semarang)
14.05 - 14.20 Anang Achmadi (Bandung)
14.20 - 14.40 Panel Discussion
MEET THE EXPERTS: INTERACTIVE CASE & DISCUSSION(with Electronic Voting System)
Chairperson: Oloan E. Tampubolon (Jakarta)
The Role of Synthetic Colloid in Critically ill Patients
14.40 - 14.55 Bambang Pujo Semedi (Surabaya)
14.55 - 15.10 Tinni T. Maskoen (Bandung)
15.10 - 15.30 Panel Discussion
MEET THE EXPERTS: INTERACTIVE CASE & DISCUSSION(with Electronic Voting System)
Chairperson: Oloan E. Tampubolon (Jakarta)
What, Why and When Do We Need Apheresis?
15.30 - 15.45 Oloan E. Tampubolon (Jakarta)
15.45 - 16.00 Mursyid Bustami (Jakarta)
16.00 - 16.20 Panel Discussion
16.20 - 16.30 CLOSING
In conjunction with
55thth World Sepsis Day World Sepsis Day with the theme
“Intensive Care for Every Doctors: “Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”How to Apply Theories to Clinical Practices”
Pullman Surabaya City Center – SURABAYAPullman Surabaya City Center – SURABAYA
19-20, 21-22, 23-24 October 201619-20, 21-22, 23-24 October 2016
1212
CASE MIX DINNER Saturday Evening, 22 October 2016
Singosari 1-2 Room, Pullman Surabaya City Center
Learning ObjectivesPresentation and discuss of complex cases and diffi cult ICU issues with the review from ICU expertise panel will enhance participants’ horizon with the management strategies solution
Who Should AttendThe advances solution for Intensivists, Anesthesiologists, ICU General Practitioners, KIC Fellows, Other Multi-disciplines -who are interested in Intensive Care Medicine fi eld,
Course LanguageIndonesian
Course CapacityLimited to 50 participants upon fi rst payment basis
Organized ByIndonesian Society of Intensive Care Medicine (ISICM)
ProgramCoordinator: Dr. dr. Philia Setiawan, SpAn KIC
HOT TOPICS - Prolonged Septic Shock: When and How - When Extended Antibiotic Resistant - When Common Mode and Setting of Ventilatory Support Seems Doesn’t Work
CASE PRESENTERS & EXPERTISE PANELDr. dr. Ike Sri Redjeki, SpAn KICdr. Bambang Wahjuprajitno, SpAn KICdr. Oloan E. Tampubolon, SpAn KICdr. Christian Johannes, SpAn KICdr. Frans J.V. Pangalila, SpPD KICDr. dr. Philia Setiawan, SpAn KIC
In conjunction with
55thth World Sepsis Day World Sepsis Day with the theme
“Intensive Care for Every Doctors: “Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”How to Apply Theories to Clinical Practices”
Pullman Surabaya City Center – SURABAYAPullman Surabaya City Center – SURABAYA
19-20, 21-22, 23-24 October 201619-20, 21-22, 23-24 October 2016
1313
FUNDAMENTAL CRITICAL CARE SUPPORTSunday – Monday, 23-24 October 2016
Singosari 1-2-3 Room – Pullman Surabaya City Center
PENGANTARSesuai 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 sertifi kat 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 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
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.
Post-Congress Program
In conjunction with
55thth World Sepsis Day World Sepsis Day with the theme
“Intensive Care for Every Doctors: “Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”How to Apply Theories to Clinical Practices”
Pullman Surabaya City Center – SURABAYAPullman Surabaya City Center – SURABAYA
19-20, 21-22, 23-24 October 201619-20, 21-22, 23-24 October 2016
1414
SERTIFIKAT- Society of Critical Care Medicine (SCCM) yang belaku secara Internasional selama 4 (empat) tahun.- Sertifi kat PERDICI berakreditasi IDI.
REGISTRASI PENDAFTARAN :1. Membaca Tata Cara Pendaftaran di website PERDICI www.perdici.org2. Dapat menghubungi Sekretariat PERDICI :+62 21 29614393 / 085100599155 / 085218460095 – Fax: +62 21 29614393 / e-mail: [email protected] / [email protected]
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 – JakartaAccount No : 116.00.0593235.6A/n : PERHIMPUNAN DOKTER INTENSIVE CARE
Bukti transfer dapat di fax / email to Sekretariat PERDICI:+62 21 29614393 / Email : [email protected] / [email protected] Attn. Mrs. Lily
TATA CARA PENDAFTARAN PESERTA KURSUS1. 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 KURSUS1. 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.
In conjunction with
55thth World Sepsis Day World Sepsis Day with the theme
“Intensive Care for Every Doctors: “Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”How to Apply Theories to Clinical Practices”
Pullman Surabaya City Center – SURABAYAPullman Surabaya City Center – SURABAYA
19-20, 21-22, 23-24 October 201619-20, 21-22, 23-24 October 2016
1515
FREE PAPER GUIDELINES
CALL FOR POSTER PRESENTATIONTo emphasize the scientifi c value of 6th National Congress of ISICM in conjunction with 5th World Sepsis Day, the Organizing herewith cordially invites the young Intensivist to contribute in the Call for Paper.
Participants are invited to submit Abstracts for Poster Presentations not later than 15 September 2016. The presentations of research studies related to the Intensive Care Medicine
SUBMISSION CLOSING DEADLINE: 15 SEPTEMBER 2016
FORMALITYFree Paper Presenters need to complete the Symposium Registration formalities before submitting Free Paper Abstract.
GENERAL REGULATION• No abstracts will be considered after the closing deadline.• Abstracts must be typed in English• Abstracts are submitted by email to [email protected] with fi le attachment. Fax or mail will not be accepted or
acknowledged.• Presenting author of abstract must be registered as participant. Registration payment must be fi rstly completed before you
proceeded for abstract submission. Registration must be received by the Secretariat before the announced deadline to ensure inclusion of the abstract in the meeting publications and in order to be scheduled for presentation.
• Abstract must be original and must not be or have been published or presented at any other meeting prior to this meeting.• As condition of submission, Organizing Committee requires you to agree to such publication and to surrender any copyright
over the abstract s submitted to Secretariat• Other special request other than above procedures shall be submitted in written through email: [email protected]
ABSTRACT PREPARATIONPlease prepare the following information:• Abstract Title – limited 20 words in UPPER CASE• Author and co-author names – with the fi rst mentioned and underline for presenting author• Full name shall be written by fi rst name and followed by family name• Authors’ names must be in upper and lower case (J.J.C. Londa)• Affi liation details: department, institution/hospital, city, state (if relevant), country• Abstract text – limited to 250 words, including acknowledgements• It should consist of fi ve paragraphs, clearly stated/labeled in UPPER CASE: o Background o Objective o Methods o Results o Conclusions.
• They should briefl y describe, respectively, the problem and aim being addressed in the study, how the study was performed, the salient result, and what the authors conclude from the results.
• Avoid using non standard abbreviations, unfamiliar terms, symbols, or acronyms not easily understood by the general readers• Use generic names of drugs. Express numbers as numerals.• Tables – A Maximum of 3 Tables of up to 10 rows x 10 columns can be included per abstract• Graph and images – It is important to note that each image included in the abstract is worth 30 words. A maximum of 3
images can be included per abstract. The maximum pixel size of the graph/image is 600(w) x 800(h) pixel.• You may upload the fi le using word-processing software (e.g. Word) for editing your abstract and counting the number of
words. The words count is aff ected as graphs/tables/images are included.
In conjunction with
55thth World Sepsis Day World Sepsis Day with the theme
“Intensive Care for Every Doctors: “Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”How to Apply Theories to Clinical Practices”
Pullman Surabaya City Center – SURABAYAPullman Surabaya City Center – SURABAYA
19-20, 21-22, 23-24 October 201619-20, 21-22, 23-24 October 2016
1616
WITHDRAWAL / CHANGES• Revised abstracts is allowed for one time only and should be clearly stated as the subject of email and received by 15
September 2016 to be reviewed by the Free Paper Coordinator.• Withdrawal/changes will not be possible after the above mentioned date
ABSTRACT ACKNOWLEDGEMENT• Submission of abstract will be acknowledged by email reply to each nominated email address at the latest 7 (seven) working
days after received.• Submitted abstracts will be reviewed by the Free Paper Coordinator after 15 September 2016. The coordinator will review the
abstracts to be allocated in poster upon category, quality, clarity, and relevance for the audience, as well as the signifi cances of the paper.
• Notifi cation will be emailed to nominated email address at the latest 7 (seven) working days after closing deadline along with the detail, including instructions, place, date and time.
• The Poster Panel provided for Poster Presentation is in the size 120 x 90 cm (Portrait)
PUBLICATION• Abstracts accepted for Poster Presentations will appear in the offi cial Program Book. In order for abstract to be published, the
presenter must fulfi ll appropriate Registration Fee in term of administrative purpose.• The Organizing Committee has a right reserve to edit the format of abstract due to the printing task for publication in terms
of uniformity purpose.
REWARD FOR BEST PRESENTATIONS• All the Free Paper Presentations will be pre-sided by Panel of Juries upon schedule• The best paper presented will be rewarded the cash prizes• The result of winning presentations will be formally announced on Saturday, 22 October 2016. All presenters are expected to
attend the ceremony
In conjunction with
55thth World Sepsis Day World Sepsis Day with the theme
“Intensive Care for Every Doctors: “Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”How to Apply Theories to Clinical Practices”
Pullman Surabaya City Center – SURABAYAPullman Surabaya City Center – SURABAYA
19-20, 21-22, 23-24 October 201619-20, 21-22, 23-24 October 2016
1717
REGISTRATION & ACCOMMODATION
HOW TO GET THE REGISTRATION FORM1. From our website:
• Download the PDF fi le of the updated “Announcement” by logged into http://www.geoconvex.com/upcoming-event/ or http://www.perdici.org 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.
• You may also fi nd it at http://www.perdici.org2. 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 [email protected] or whatsapp to +62811882080
HOW TO REGISTER
Registration By Fax
1. Complete the Registration Form to the secretariat Fax address at 021.29315471 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 021-29315471 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
confi rmation of registrants. Fax of an offi cial receipt is upon request to Secretariat address at 021.29315470 (Hunting).
Registration By Email
You may submit your Personal and/or Group Registration by email to [email protected] along with the enclosed scanned payment proof as well as detail of personal data and participations.
Group Registration
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
Bank Name : CIMB Niaga Branch : Kemang Branch Address : Jalan Kemang Raya No. 4, Jakarta Selatan No. Account : 8000.7316.0800 Account Holder : PERDICI
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.
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.
In conjunction with
55thth World Sepsis Day World Sepsis Day with the theme
“Intensive Care for Every Doctors: “Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”How to Apply Theories to Clinical Practices”
Pullman Surabaya City Center – SURABAYAPullman Surabaya City Center – SURABAYA
19-20, 21-22, 23-24 October 201619-20, 21-22, 23-24 October 2016
1818
REGISTRATION CONFIRMATION1. Registered participants will receive Registration Offi cial Receipt (upon request) after the fees have been cashed and eff ectively in
the Event bank account.2. Registered Participants are strongly suggested to make Re-Confi rmation due to incoming facsimiles and/or payment made to
our Registration Division.
Domestic Participant: Fax To: 021.29315471; Reconfi rm To: 021.29315470 (Hunting) - Mobile: 0811.88.2080
Registration re-confi rmation 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 unconfi rmed 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
REGISTRATIONNotifi cation of the registration cancellation for workshop and scientifi c symposium must be made in writing or emailed to the Secretariat. Registration Fee is refundable with the following cancellation policy:
0 One month before event – 50% refund of fee paid 0 On and after the date – No refund 0 No-show registration can not be refunded.
ACCOMMODATION 0 Hotel room rate is net for room only. 0 Please note that offi cial 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. 0 No reservation will be made without full deposit of nights booking due to room availability. 0 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. 0 No Show will be applied on the fi rst night for delayed or postpone staying that causes the loss of 1 night room deposit
made. 0 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. Offi cial letter should be submitted to Secretariat address
mentioning its payer’s Bank Account.
REGISTRATION FEE INCLUDEo Name Badge & Symposium Kit. Name Badge MUST BE worn entering to all scientifi c sessions and lunch/break programmed by the Organizing Committee.
o Symposium documents and materials (Proceeding Book and Note Pad)o Admission to the function room, lunch programmed and scientifi c exposure from Pharmaceutical and Health-Care Companies.o Certifi cate of Attendance with IDI Accreditation will be issued for eligible participants at the last day of the Symposium.
RE-REGISTRATION SERVICEThe 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 REGISTRATIONApplicants 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.
In conjunction with
55thth World Sepsis Day World Sepsis Day with the theme
“Intensive Care for Every Doctors: “Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”How to Apply Theories to Clinical Practices”
Pullman Surabaya City Center – SURABAYAPullman Surabaya City Center – SURABAYA
19-20, 21-22, 23-24 October 201619-20, 21-22, 23-24 October 2016
1919
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 : _____________________________________________________________________________________
PRE-CONGRESS WORKSHOPS ( kindly √ appropriate circle/box)
Note: Nursing Course on Ventilator Management Participants are eligible to join the Congress 21-22 October 2016
SYMPOSIUM REGISTRATION ( kindly √ appropriate circle/box)
CASE MIX DINNER ( kindly √ appropriate circle/box)
Session 22 October 2016 Registration
POST-CONGRESS WORKSHOP ( kindly √ appropriate circle/box)
Workshop 23-24 October 2016 Registration
*Note: Ped-FCCS and FCCS are regular courses coordinated by ISICM Secretariat, therefore the direct registration is recommended to (021)29614393 / 085100599155 CP. Ms. ADE for further detail updated due to the limited seats.
PAYMENT BY ( kindly √ appropriate circle/box)
In conjunction with
55thth World Sepsis Day World Sepsis Day with the theme
“Intensive Care for Every Doctors: “Intensive Care for Every Doctors: How to Apply Theories to Clinical Practices”How to Apply Theories to Clinical Practices”
Pullman Surabaya City Center – SURABAYAPullman Surabaya City Center – SURABAYA
19-20, 21-22, 23-24 October 201619-20, 21-22, 23-24 October 2016
2020
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 : _____________________________________________________________________________________
HOTEL RESERVATION ( kindly √ appropriate circle/box)
Check In Date: ___ /___ / ___ Check Out Date: ___ / ___ / ___
Total Night(s) : _____
Total Accommodation Payment: IDR ____________________
PAYMENT BY ( kindly √ appropriate circle/box)
SecretariatC/O. Global Echo Organizer convexNAYA Kemang Selatan, Kav.15Jl. Madrasah Raya No. 11 G-H Kemang - Ampera, Jakarta Selatan 12560Tel : +62 21 293 15 470 (Hunting)Fax : +62 21 293 15 471Registration Hot Line: +62811882080 / +62819882080E-mail : [email protected] : www.geoconvex.com
INDONESIAN SOCIETY OF INTENSIVE CARE MEDICINE (ISICM)Apartemen Menteng Square Tower A 3rd Floor Unit A0-11Jl. Matraman Raya No.30 Jakarta PusatPhone (021) 29614393Fax (021) 29614393Email: [email protected]: www.perdici.orgPIC: Ms. Ade Syariah +6285100599155
DEPARTMENT OF ANESTHESIA AND INTENSIVE CAREFaculty of Medicine University of Airlangga, Dr. Soetomo General Hospital SurabayaJl. Mayjen Prof. Dr. Moestopo 47 SurabayaPIC: Ms. Priscilia +6285707282777