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PICNIC ACADEMIA
REGULAR COURSE 2017-2018
The Indonesian Pediatric Critical Care Foundation (Yayasan Pediatri Gawat Darurat Indonesia) is an independent non-profi t organization, plays an important role in this continuing learning journey by providing expertise and resources to complement existing pedagogy and strategic methodologies-blended-teaching and learning module in emergency and critical care fi elds. Through education and learning, The Indonesian Pediatric Critical Care Foundation (Yayasan Pediatri Gawat Darurat Indonesia) offers a wide spectrum of programmes covering pediatric and multidisciplinary topics in developing healthcare educations, creating the new-breed skilled manpower, and enhancing learning processes through a suite of its expertise and resources.
The Indonesian Pediatric Critical Care Foundation is the professional home of multi disciplines physicians and subspecialists as well as other child health providers, including general practitioners and nurses.
We provide continuing learning journey by expertise in tools, information and resources to help practitioners provide the highest quality health care and new-breed skilled manpower through existing pedagogy and strategic methodologies-blended-teaching and learning module in emergency and critical care fi elds.
SIGNUP AND REGISTER OUR FREE MEMBERSHIP TODAY WITH A DIRECT INVOLVEMENT IN OUR INNOVATION LEARNING JOURNEY AND UPDATES VIA http://www.picunicu.org/
THE FOUNDATIONThe Indonesian Pediatric Critical Care Foundation(Yayasan Pediatri Gawat Darurat Indonesia)
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PICNIC ACADEMIA
REGULAR COURSE 2017-2018
MANAGEMENT COMMITTEE
CO-CHAIR
Yani Akhyar KasimDarlan DarwisH. Munar Lubis
STRATEGIC TEAM
TRUSTEE
Susetyo Harry PurwantoDadang Hudaya Somasetia
Silvia Triratna
PRESIDENT
Abdul Latief
VICE-PRESIDENT
Antonius H. Pudjiadi
TREASURER
Eva Miranda Marwali
MEMBERS
Chairul YoelDzulfi kar Djalil Lukmanul Hakim
Novik Budi WardhanaRirie Fachrina Malisie
Irene YuniarRismala DewiNurnaningsih
Rinawati RohsiswatmoRisma Kerina Kaban
Lily RundjanRosalina Dewi Roeslani
Abdul LatiefAntonius H. PudjiadiRirie Fachrina Malisie
Rinawati RohsiswatmoLily Rundjan
To achieve learning excellence, The Indonesian Pediatric Critical Care Foundation (Yayasan Pediatri Gawat DaruratIndonesia) resources and expertises are set to make comprehensive range of educational needs
FOUNDER
Abdul LatiefAntonius H. Pudjiadi
Dadang Hudaya Somasetia Darlan Darwis
Dzulfi kar Djalil Lukmanul HakimH. Munar Lubis
Novik Budi WardhanaSilvia Triratna
Susetyo Harry Purwanto
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PICNIC ACADEMIA
REGULAR COURSE 2017-2018
VISION
Partnering and supporting the Pediatric Critical Care Working Group of Indonesian Pediatric Society, Hospitals, Associations, Healthcare Institutions, Corporations and Government Agencies, both at national and international level, The Indonesian Pediatric Critical Care Foundation (Yayasan Pediatri Gawat Darurat Indonesia) has a strong pursuit and networks that provides a vibrant and conductive environment to empower healthcare professionals with expertise and resources needed to advance clinical knowledge and expertise in the effort of providing high quality patient care at frontiers of medicine.
MISSION
The mission is accomplished by promoting the professional growth and development of its diverse membership, representing general health professionals in pediatric emergency medicine and critical care, child health research, pediatric medical educations and related disciplines.
PRO COMMUNITY
Pro Community is a forum platform of scientifi c publication reviews for medical professionals in multidisciplinary nature to exchange ideas and having brief communication in variety topics to enhance the outlook of recent development in the fi eld of critical care and emergency medicine. All students undergoing medical research and/or training are also welcomed. Get the privilege involvement in the forum for being our member through website.
PICNIC ACADEMIA
The Indonesian Pediatric Critical Care Foundation (Yayasan Pediatri Gawat Darurat Indonesia) is well poised to provide quality healthcare education and learning to nurture from physicians –primarily pediatricians and its subspecialties; professionals across the healthcare disciplines; doctors, nurses to allied healthcare professionals, with a holistic set of skills essential for professional development and growth through the benefi t of curriculum, teaching methodologies and learning effi ciencies, both on-line (webinars and mini courses) in E-Learnovation basis and off-line (Scientifi c Events and Regular Courses).
WHAT WE DO
JOIN OUR PROGRAM
PICNIC ACADEMIA
REGULAR COURSE 2017-2018
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REGULAR COURSE 2017-2018 The Regular Course is the entry-level healthcare educational programme developed by Strategic Team to creating the new-breed skilled manpower, and enhancing learning processes through a suite of its expertise and resources.
It is a reserve training program with the curriculum divided in individual topics, which contain the minimum requiredfoundational knowledge for given subjects with stimulating hands-on for skillful requirement.
Regular Course – Period 2017-2018 with new comer curriculums are set as an entry level to participate in the Symposium Workshops of 10th Indonesian PICU NICU Update 20-26 March 2018 at The Stones Hotel Legian Bali.
Participants, who joined the Regular Course Period 2017-2018 will be prioritized to participate theSymposium Workshops of 10th Indonesian PICU NICU Update 20 – 26 March 2018
AGENDA
SWISS-BELHOTEL MALEOSAN - MANADO
FRIDAY, 14 JULY 2017 SATURDAY, 15 JULY 2017
Basic Mechanical Ventilation in Critically ill Children - Day 1
Basic Mechanical Ventilation in Critically ill Children- Day 2
ARYADUTA HOTEL PALEMBANG
15 SEPTEMBER 2017SATURDAY, 16 SEPTEMBER 2017
SUNDAY, 17 SEPTEMBER 2017
Diffi cult Airway in Critically ill Children
Basic Mechanical Ventilation in Critically ill Children - Day 1
Basic Mechanical Ventilation inCritically ill Children - Day 2
GRAND SWISS-BELHOTEL, MEDAN
SATURDAY, 28 OCTOBER 2017 SUNDAY, 29 OCTOBER 2017
Basic Mechanical Ventilation in Critically ill Children - Day 1
Basic Mechanical Ventilation in Critically ill Children- Day 2
GRAND JATRA HOTEL, BALIKPAPAN
SATURDAY, 18 NOVEMBER 2017 SUNDAY, 19 NOVEMBER 2017
Basic Mechanical Ventilation in Critically ill Children - Day 1
Basic Mechanical Ventilation in Critically ill Children- Day 2
PICNIC ACADEMIA
REGULAR COURSE 2017-2018
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WISMA 76, SLIPI - JAKARTA
08 DECEMBER 2017SATURDAY, 09 DECEMBER 2017
SUNDAY, 10 DECEMBER 2017
Diffi cult Airway in Critically ill Children
Basic Mechanical Ventilation in Critically ill Children - Day 1
Basic Mechanical Ventilation inCritically ill Children - Day 2
SANTIKA PREMIERE HOTEL BINTARO, TANGERANG
FRIDAY, 23 FEBRUARY 2018 SATURDAY, 24 FEBRUARY 2018 SUNDAY, 25 FEBRUARY 2018
Diffi cult Airway in Critically ill Children
Basic Mechanical Ventilation in Critically ill Children - Day 1
Basic Mechanical Ventilation inCritically ill Children - Day 2
Post Resuscitation – StabilizationManagement- Day 1
Post Resuscitation – StabilizationManagement - Day 2
Comprehensive Pediatric SepsisManagement – Day 1
Comprehensive Pediatric SepsisManagement – Day 2
Basic Non-Invasive Ventilationin Newborn Infants
Basic Mechanical Ventilation in Newborn Infants
Basic Mechanical Ventilation inNewborn Infants: Clinical Practice
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REGULAR COURSE 2017-2018
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BASIC MECHANICAL VENTILATION IN CRITICALLY ILL CHILDREN WORKSHOP
INTRODUCTION To learn the indications; physiology; respiratory mechanism; and principal of mechanical ventilation in critically ill pediatrics, learn
about initial parameters; how to choose initial settings & adjustment as well as monitoring and weaning of mechanical ventilator support in sick children
TERM & CONDITION Basic Mechanical Ventilation in Pediatric Workshop is a compulsory entry level to join Advanced Modes on Mechanical Ventilation
in Children Workshop, which held as the Symposium Workshop of 10th Indonesian PICU NICU Update.
DATE Two Days Program *See above detail Agenda
PLACE *See above detail Agenda
COURSE DIRECTOR Dr. Ririe F. Malisie, dr, SpA(K)
PROGRAM
DAY 1 TOPIC
Opening Remark
08.15-08.45 Pre-Test
08.45-09.45 Basic Principles of Mechanical Ventilation in Children
09.45-10.00 Coffee Break
10.00-11.00 Ventilator Modes and Wave-Forms
11.00-11.45 Initial Setting and Adjusting of Mechanical Ventilation
11.45-12.00 Discussion
12.00-13.00 Lunch and Pray Time
13.00-16.00 SKILL STATIONS (1 hour rotated)
O2 and CO2 ProblemsInterpretation of Wave-FormsInitial Setting and Adjusting
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INSTRUCTOR TEAM Abdul Latief (Jakarta) Antonius Pudjiadi (Jakarta) Ririe Fachrina Malisie (Medan) Sri Martuti (Solo) G. Dharma Mulyo (Jakarta) Yusrina Istanti (Semarang) Saptadi Yuliarto (Malang)
DAY 2 TOPIC
Non-Invasive Ventilation in Critically ill Children
08.45-09.30 Monitoring of Children on Ventilatory Support
09.30-10.15 Weaning Strategies
10.15-10.30 Coffee Break
10.30-12.30 HANDS ON CASES SIMULATION (60” Rotated)Hypoxic Respiratory Failure (Severe Pneumonia)Hypercapnic Respiratory Failure (Asthma)Patient with Guillian Barre Syndrome
12.30-13.30 Lunch and Pray Time
13.30-14.30 HANDS ON CASES SIMULATION (Continued )Hypoxic Respiratory Failure (Severe Pneumonia)Hypercapnic Respiratory Failure (Asthma)Patient with Guillian Barre Syndrome
14.30-15.00 Post-Test
15.00-15.40 Evaluation & Course Wrap
15.40-16.00 Coffee Break
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DIFFICULT AIRWAY IN CRITICALLY ILL CHILDREN
INTRODUCTIONThe Pediatric Airway Skills Course equips learners with the tools necessary to manage a diffi cult pediatric airway in critically illchildren. The course will review patient positioning, techniques for improved airway visualization, as well as review skills and tools that can make a difference in the challenging airway patient. Learners will be exposed to laryngoscopic intubation, laryngealmask airways, bougies, GlideScopes, transtracheal jet ventilation as well as Seldinger and McIntyre cricothyroidotomies.
During the hands-on phase, learners will receive direct instruction and practice using this equipment. The learners will then apply their new knowledge by being placed into a high-fi delity simulation experience where they will be challenged to use these newtechniques.
This workshop is for trainees and consultants who wish to refresh and update skills in managing children in critically ill with a diffi cult airway. The course aims to discuss the management of the anticipated and unanticipated paediatric diffi cult airway. Theformat of the day is one of short interactive lectures, videos and hands-on small group workshops. The workshops cover careand basic use of the fi bre-optic laryngoscope, modifi ed airway and LMA access techniques using guidewires and exchange catheters.
DATEOne Day Program *See above detail Agenda
PLACE *See above detail Agenda
COURSE DIRECTOR: Dr. dr. Ririe Fachrina Malisie, SpA(K)CO-COURSE DIRECTOR Dr. dr. Dzulfi kar DLH, SpA (K), Mkes MMRS
PROGRAM
TIME TOPIC FACILITATOR
08.00 - 08.30 Registration
08.30 - 09.00 Pre-Test Ririe F Malisie
09.00 - 09.45 Introduction of Diffi cult Airway Management in Critically ill Children Abdul Latief
09.45 - 10.30 Recognition of Stridor and Diffi cult Airway in Pediatric Dzulfi kar DLH
10.30 - 11.30 Techniques and Galleries of Tools in Pediatric Diffi cult Airways Andi Ade Wijaya
11.30 - 12.00 Algorithm of Pediatric Diffi cult Airway Ririe F Malisie
12.00 - 13.00 Lunch & Pray
Skill Station: DRY WORKSHOP
13.00-16.00 The Devices to Maintain Open Airway in Critically ill Children Ririe F Malisie
Basic Airway Management & the Use of Video Laryngoscope Andi Ade Wijaya
Emergency Airway Management and Needle Cricothyroidotomy Dzulfi kar DLH
16.00 - 16.30 Post-Test Ririe F Malisie
16.30 - 16.45 Evaluation & Wrap Abdul Latief
16.45 - 17.00 Coffee/Tea Break
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POST RESUSCITATION - STABILIZATION MANAGEMENTINTRODUCTION Post-resuscitation care is a critical component of advanced life support. Patient mortality remains high after return of
spontaneous circulation and initial stabilization. Include the post-resuscitation care are: optimize hemodynamic, respiratory, and neurologic support; identify and treat reversible causes of arrest; and monitor temperature and consider treatment for disturbances of temperature regulation and metabolism. When spontaneous circulation is restored after cardiopulmonary arrest in critically ill children, these are the goals of treatment: • Avoid cardiopulmonary arrest recurrance• Restore perfusion and oxygenation• Evaluate and monitor neurologic functions• Support dysfunctioning organs• Resolve the situation that promoted cardiopulmonary arrestMulti organ failure secondary to hypoxic ischemic insult requires partial or complete support of each organ function.Strategies to keep systemic perfusion and oxygenation adequate are the rule. Maintaining and protecting neurologic function is essential for a good outcome.
DATE Two Days Program on 24 – 25 February 2018
PLACE Hotel Santika Premiere Bintaro – Tangerang Selatan
COURSE DIRECTOR & CO: Dr. dr. Dzulfi kar DLH, SpA(K) M.Kes MMRS & Dr. dr. Ririe Fachrina Malisie, Sp.A(K)
PROGRAM
DAY 1 SATURDAY, 24 FEBRUARY 2018 FACILITATOR08.00-08.15 Opening Remarks Dzulfi kar DLH
08.15-08.45 Pre-Test Ririe F Malisie
08.45-09.15 Mechanical Ventilation: Initial Setting and Adjusting Saptadi Yuliarto
09.15-09.45 Sedation & Analgesia Dzulfi kar DLH
09.45-10.00 Coffee break10.00-10.30 Management of Increased Intracranial Pressure Rismala Dewi
10.30-11.00 Hypo and Hyperglycemia Yusrina Istanti
11.00-12.00 SKILL SESSION
Divided to4 GroupsRotate
@60min
Mechanical Ventilation: Initial Setting and Adjusting Saptadi Yuliarto
Sedation & Analgesia Dzulfi kar DLH
Management of Increased Intracranial Pressure Rismala Dewi
Hypo and Hyperglycemia Yusrina Istanti
12.00-13.00 ISHOMA
13.00-16.00 SKILL SESSION…continued
Divided to4 GroupsRotate
@60min
Mechanical Ventilation: Initial Setting and Adjusting Saptadi Yuliarto
Sedation & Analgesia Dzulfi kar DLH
Management of Increased Intracranial Pressure Rismala Dewi
Hypo and Hyperglycemia Yusrina Istanti
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DAY 2 SUNDAY, 25 FEBRUARY 2018 FACILITATOR
08.00-08.30 Hemodynamic Assessment & Management Irene Yuniar
08.30-09.00 Fluid and Electrolytes Management Dzulfi kar DLH
09.00-09.15 Coffee Break
09.15-09.45 Disseminated Intravascular Coagulation Saptadi Yuliarto
09.45-10.15 Management of Systemic Infection Rismala Dewi
10.15-12.15 SKILL SESSION
Divided to 4 Groups
Rotate@60min
Hemodynamic Assessment & Management Irene Yuniar
Fluid and Electrolytes Management Dzulfi kar DLH
Disseminated Intravascular Coagulation Saptadi Yuliarto
Management of Systemic Infection Rismala Dewi
12.15-13.00 ISHOMA
13.00-16.00 SKILL SESSION (continued)
Divided to 4 Groups
Rotate@45min
Hemodynamic Assessment & Management Irene Yuniar
Fluid and Electrolytes Management Dzulfi kar DLH
Disseminated Intravascular Coagulation Saptadi Yuliarto
Management of Systemic Infection Rismala Dewi
16.00-16.30 Post-Test Ririe F Malisie
16.30-16.45 Evaluation & Course Wrap Dzulfi kar DLH
16.45-17.00 Coffee Break
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REGULAR COURSE 2017-2018
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COMPREHENSIVE PEDIATRIC SEPSIS MANAGEMENT
INTRODUCTIONTo enhance the updated knowledge and practical guidelines in the comprehensive management of sepsis in children included the understanding sepsis pathophysiology in children, the International standard for pediatrics sepsis & Surviving Sepsis Campaign as well as the Early Goals Directed Therapy for pediatric sepsis implementations upon the latest guidelines.
DATETwo Days Program on 24 – 25 February 2018
PLACEHotel Santika Premiere Bintaro – Tangerang Selatan
COURSE DIRECTOR & CO: Abdul Latief, dr, SpA(K)
PROGRAM
DAY 1 SATURDAY, 24 FEBRUARY 2018 FACILITATOR08.00 - 08.15 Introduction
08.15 - 08.45 Pre-Test Abdul Latief (Jakarta)
08.45 - 09.30 Overview of Indonesian Pediatric Sepsis Consensus Abdul Latief (Jakarta)
09.30 - 10.15 Surviving Sepsis Campaign Dadang Hudaya (Bandung)
10.15 - 10.30 Discussion
10.30 - 11.10 Coffee breakGROUP DISCUSSION[Participants are divided into 4 Groups @ 50 minutes Rotation]
11.10 - 12.00 Hemodynamic Support Strategy Irene Yuniar (Jakarta)
12.00 - 13.00 Lunch
13.00 - 13.50 Fighting Infections Rahma Mulya Karyanti (Jakarta)
13.50 - 14.40 Protective Ventilation Strategy M Supriatna (Semarang)
14.40 - 15.30 Glucose Control Nurnaningsih (Jogjakarta)
15.30 - 16.10 Coffee Break
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DAY 2 SUNDAY, 25 FEBRUARY 2018 FACILITATORGROUP DISCUSSION[Participants are divided into 4 Groups @ 50 minutes Rotation]
08.00 - 08.50 Sedative and Analgesic Dadang Hudaya (Bandung)
08.50 - 09.40 Coagulation Problems M Supriatna (Semarang)
09.40 - 10.00 Coffee Break
10.00 - 10.50 Pediatric Logistic Organ Dysfunction Score Abdul Latief (Jakarta)
10.50 - 11.40 Nutritional Support Nurnaningsih (Jogjakarta)
11.40 - 13.00 Lunch
13.30 - 14.30 Post Test Abdul Latief (Jakarta)
14.30 - 15.00 Course Wrap & Evaluation Abdul Latief (Jakarta)
15.00 - 15.30 Coffee Break
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REGULAR COURSE 2017-2018
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BASIC NON-INVASIVE VENTILATION IN NEWBORN INFANTS
DATEOne Day Program on Friday, 23 February 2018
PLACEHotel Santika Premiere Bintaro – Tangerang Selatan
COURSE DIRECTOR Risma K. Kaban, dr, SpA(K) - (Jakarta)
PROGRAM
DAY 1 FRIDAY, 23 FEBRUARY 2018 INSTRUCTOR08.00 - 08.15 Opening08.15 - 08.35 Basic Principles of Non Invasive Ventilation Rinawati Rohsiswatmo
08.35 - 08.55 CPAP Rosalina Roeslani
08.55 - 09.15 High Flow and Low Flow Nasal Cannulae Rosalina Roeslani
09.15 - 09.30 Discussion
09.30 - 09.50 Coffee break09.50 - 10.20 SiPAP: Complete Mode Rinawati Rohsiswatmo
10.20 - 10.50 Nursing Care of Non Invasive Ventilation Ns. Dian Anggur
10.50 - 11.20 Nasal IMV Adhi TP
11.20 - 11.50 Nasal HFO : New Modality Putri Maharani
13.20 - 15.35 SKILL STATION
Divided in to 3 groups @ 45 Minutes
CPAP (Buble, Ventilator), High Flow and Low Flow Putri Maharani/Ns. Dian Anggur
Nasal IMV Adhi TP
SiPAP and Nasal HFO Rinawati Rohsiswatmo
15.35 - 16.00 Coffee Break16.00 - 16.30 Summary
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BASIC MECHANICAL VENTILATION IN NEWBORN INFANTS
DATE One Day Program on Saturday, 24 February 2018
PLACE Hotel Santika Premiere Bintaro – Tangerang Selatan
COURSE DIRECTOR Dr. Rinawati Rohsiswatmo, dr, SpA(K) - (Jakarta)
PROGRAM
DAY 2 SATURDAY, 24 FEBRUARY 2018 INSTRUCTOR08.00 - 08.15 Opening08.15 - 08.45 Basic Principles of Mechanical Ventilation Adhi TP
08.45 - 09.15 Initial Setting and Adjusting Rinawati Rohsiwatmo
09.15 - 09.45 Ventilator Modes and Wave Forms Adhi TP
09.45 - 10.15 Coffee Break10.15 - 11.00 Volume Guarantee Adhi TP
11.00 - 11.30 Weaning Strategies Rinawati Rohsiwatmo
11.30 - 12.00 Blood Gas Analysis Rosalina Roeslani
12.00 - 13.00 Lunch13.00 - 13.30 Nursing Care of Ventilated Babies and Troubleshooting Ns. Selly Ramadhani
13.30 - 15.45 SKILL STATIONDivided in to 3 groups @ 45 Minutes
Volume Guarantee Rosalina Roeslani
Interpretation of Wave Forms Adhi TP
Initial Setting and Adjusting Rinawati Rohsiswatmo
15.45 - 16.10 Coffee Break
16.10 - 16.30 Summary
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REGULAR COURSE 2017-2018
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BASIC MECHANICAL VENTILATION IN NEWBORN INFANTS: CLINICAL PRACTICE
DATE One Day Program on Sunday, 25 February 2018
PLACE Hotel Santika Premiere Bintaro – Tangerang Selatan
COURSE DIRECTOR Dr. Rinawati Rohsiswatmo, dr, SpA(K) - (Jakarta)
PROGRAM
DAY 3 SUNDAY, 25 FEBRUARY 2018 INSTRUCTOR08.00 - 08.15 Opening08.15 - 08.45 Ventilation Management in RDS Babies Adhi TP
09.15 - 09.45 Management of MAS Rosalina Roeslani
09.15 - 09.45 Management of PPHN Putri Maharani
09.45 - 10.30 Coffee break10.30 - 11.00 Principle of HFOV Rinawati Rohsiwatmo
11.00 - 11.30 HFOV in Specifi c Diseases : CDH, Hidrops, etc Rinawati Rohsiwatmo
11.30 - 12.00 Extensive Use of Surfactant Therapy Adhi TP
12.00 - 13.00 LunchCASE STUDIES
Divided into 2 groups (@ 60 mins)
13.00 - 14.00 Case Studies Conventional MV Adhi TP/Rosalina Roeslani
14.00 - 15.00 Case Studies HFOV Putri Maharani/RinawatiRohsiswatmo
15.00 - 15.30 Summary and Wrap Up
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REGISTRATION & ACCOMMODATION
HOW TO REGISTER1. Fax the Registration Form to +6221. 29315471 or Email to [email protected] along with proof of
payment (e.g. copy of bank transfer slip). 2. Payment Proof is strongly recommended to be done along with your Registration Form submission.
Photocopied forms are acceptable.3. You may bring your payment proof as foreseen at the Re-Registration counter. Essentially, the name tag
issued is an initial confi rmation of registrants.
REGISTRATION CONFIRMATIONParticipants are strongly suggested to make Re-Confi rmation due to incoming facsimiles/Email and/or payment made to our Registration Department, hotline numbers at offi ce hours.
Confi rmation Hotline: 021. 29315470 / 0811882080 / 0819882080
WHO SHOULD ATTENDSpecialists and Health Practitioners-whose interested in Pediatric and Neonates Intensive and Critical Care,such as Specialists Neonates Intensivist • Pediatric Intensivist; Respiralogy; Hematology; Infectious Diseases;Neurology; Nutrition & Metabolism; Gastroenterology; Immunology; Cardiology • Pediatric Surgery • Pediatric Anesthesiologists • Trainee • Emergency Doctors • General Practitioners
CERTIFICATIONAccredited by IDI & CPD IDAI
COURSE CAPACITYLimited to 60 participants/batch
REGISTRATION INFO• Registration per batch will be closed 2 weeks before workshop held. No On-Site.• Registration Form could be obtained via Secretariat Ex-Offi cio contact numbers or email to secretariat@
picunicu.org • Allocation per batch would be made upon fi rst come fi rst payments. Secretariat Ex-Offi cio reserves the
rights to accommodate the participants to the next batch due to the full-seats• Registration confi rmation is a must after registration payments. Secretariat Ex-Offi cio reserves the right not
to guarantee any seats for any unconfi rmed registrations in the workshop held.• Registration payment proof (copy is eligible) must be shown when re-register • Re-Registration service will be handed out since 07.00 morning on the fi rst day of workshop at the venue• Certifi cate will be handed out to the participants at the end of the workshop with the pre and post-test
requirements
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CANCELLATION POLICY REGISTRATION
• Any cancellation or replacement must be conveyed to the Secretariat Ex-Officio in written at the latest 7 (seven) days prior the workshop dates without charge and changeable for substitution name and/or next batch allocation.
• An administrative fee 20% of the registration fee will be charged for cancellation 7 (seven) days prior the workshop held and still changeable for substitution name and/or next batch allocation.
• Any replacement/substitution name on the workshop dates will be preceded as a new chargeableregistration.
• No show on workshop dates would be considered as cancellation without refund.
ACCOMMODATION • Hotel room rate is net for room only. • 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. • 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 1night will be charged.
• No Show will be applied on the fi rst night for delayed or postpone staying that causes the loss of 1 nightroom 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 the event by bank transfer. Offi cial letter should be submitted toSecretariat address mentioning its payer’s Bank Account.
RE-REGISTRATION SERVICE The Re-Registration will be handed out to the participants from registration counters during the opening hours
at 07.00 – 09.00 on the fi rst day of the course schedule
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Notes
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REGISTRATION & ACCOMMODATION FORM
PARTICIPANTT (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 : _________________________________________________________________________________________
REGISTRATION (kindly √ appropriate box)
PERIOD REGULER COURSE NAME FIELD IDRFri-Sat, 14 – 15 July 2017Manado Basic Mechanical Ventilation in Critically ill Children PICU 3.000.000
Fri, 15 September 2017Palembang Diffi cult Airway in Critically ill Children PICU 2.000.000
Sat-Sun, 16–17 September 2017Palembang Basic Mechanical Ventilation in Critically ill Children PICU 3.000.000
Sat-Sun, 28 – 29 October 2017Medan Basic Mechanical Ventilation in Critically ill Children PICU 3.000.000
Sat-Sun, 18 – 19 November 2017Balikpapan Basic Mechanical Ventilation in Critically ill Children PICU 3.000.000
Fri, 08 December 2017Jakarta Diffi cult Airway in Critically ill Children PICU 2.000.000
Sat-Sun, 09–10 December 2017Jakarta Basic Mechanical Ventilation in Critically ill Children PICU 3.000.000
Fri, 23 February 2018Tangerang Diffi cult Airway in Critically ill Children PICU 2.000.000
Sat-Sun, 24–25 Februari 2018Tangerang Basic Mechanical Ventilation in Critically ill Children PICU 3.000.000
Sat-Sun, 24–25 Februari 2018Tangerang Post Resuscitation - Stabilization Management PICU 2.500.000
Sat-Sun, 24–25 Februari 2018Tangerang Comprehensive Pediatric Sepsis Management PICU 2.500.000
Fri, 23 February 2018Tangerang Basic NIV in Newborn Infants NICU 2.000.000
Sat, 24 February 2018Tangerang Basic Mechanical Ventilation in Newborn Infants NICU 2.000.000
Sun, 25 February 2018g gTangerang Basic Mechanical Ventilation in Newborn Infants: Clinical Practice NICU 2.000.000
*10% discount for Indonesian Pediatric Critical Care Foundation’s Member
SEKRETARIATThe Indonesian Pediatric Critical Care FoundationNAYA Kemang Selatan Kav. 15Jl. Madrasah Raya No 11 G-H, Kemang Ampera,Jakarta Selatan, 12560 • INDONESIAWebsite: http://www.picunicu.orgEmail: [email protected] : +62 811 88 2080 . +62 819 88 2080 Tlp : +62 21 293 15 470 (Hunting)Fax : +62 21 293 15 471
Nama Bank : CIMB NiagaNo. Rekening : 8000 4815 9300Cabang : Kebon Sirih JakartaAtas Nama : GEO convex
PAYMENT BY (Kindly √ appropriate circle)
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REGULAR COURSE 2017-2018
20
SEKRETARIATThe Indonesian Pediatric Critical Care FoundationNAYA Kemang Selatan Kav. 15Jl. Madrasah Raya No 11 G-H, Kemang Ampera, Jakarta Selatan, 12560 • INDONESIAWebsite: http://www.picunicu.orgEmail: [email protected] : +62 811 88 2080 . +62 819 88 2080 Tlp : +62 21 293 15 470 (Hunting)Fax : +62 21 293 15 471
Nama Bank : CIMB NiagaNo. Rekening : 8000 4815 9300Cabang : Kebon Sirih JakartaAtas Nama : GEO convex
PAYMENT BY (Kindly √ appropriate circle)
REGISTRATION & ACCOMMODATION FORM
PARTICIPANTT (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 : _________________________________________________________________________________________
ACCOMMODATIONHOTEL NAME IDR
Swiss-Belhotel Maleosan Manado 650.000,- net/night
Aryaduta Hotel Palembang 700.000,- net/night
Grand Swiss-Belhotel - Medan 825.000,- net/night
Grand Jatra Hotel - Balikpapan 825.000,- net/night
Santika Premiere Hotel Bintaro - Tangerang 700.000,- net/night
Check In Date: Check Out Date:
Total Night(s):
Total Accommodation Payment: IDR