Transcription of CRITICAL CARE FLOW SHEET - Hospital Forms
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CRITICAL CARE FLOW SHEET - Hospital Forms
START DATE:STOP DATE:WT Today:HT:WT Yesterday:PAST 24 BALANCE 24 OutputTIMETimeBS AlbuminBUN WBCCr HgbNa HctK PTCl INRCO2 PTTCa PlateletsPhos CPKM agnesium CK - MBCholesterol CPK IndexTotal Bili TroponinAlk. Phos Lactic AcidSGOT NH4 SGPT Pre-AlbuminTotal Protein DigoxinYES ISOLATIONNEGATIVE FLOWYESN/ANO TYPE:MAINTAINED:NOHEPAFILTERNOYES; If "YES", SPECIFY:FULL CODEDNROTHER:8850122 Rev. 05/05 PAGE 1 of 6 RESULTSLABWORKRESULTSC ritical care Flow Sheet_NURSING_CRITICAL care ISOLATION PATHWAY CODE STATUSPART OF THE MEDICAL RECORDCRITICAL care FLOW SHEET SIGNATURE / TITLE / INITIALSPA CatheterLAB DATAPATIENT IDENTIFICATIONSIGNATURE / TITLE / INITIALSTIMEINITIALSTIMESTAT MEDSSTAT MEDSINITIALSLABWORKO therArterial LineCentral LineCentral LineSheathIntakeKGLBSI nsertionDateInsertionSiteRemoval DateTYPE:00 BP Method PULSES (Code):O = AbsentD = Doppler1+ = Intermittent2+ = Weak3+ = Strong Hematoma Sandbag#1 DATE CORDIS TUBING DRESSING DRESSINGSITE PROX. TUBING PRESSURE TUBING PRESSURE TUBING#2 DATE MEDIAL TUBING FLUSH BAG FLUSH BAGSITE DISTAL TUBING CO SET TUBING TUBING#3 DATE DRESSINGSITE8850122 Rev.
0 0 BP Method PULSES (Code): O = Absent D = Doppler 1+ = Intermittent 2+ = Weak 3+ = Strong Hematoma Sandbag #1 DATE CORDIS TUBING DRESSING DRESSING
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