Page 456 - 2021 IDMT Digital
P. 456
Interventions
Vitals
Time: BP: P: R: T: SpO2 RA/O2
Time: BP: P: R: T: SpO2 RA/O2
Time: BP: P: R: T: SpO2 RA/O2
Peak Flow
Peak Flow: Peak Flow:
Time: _________/_________/_________ Time: _________/_________/_________
O2
Time: Mask: NRB/SFM/NC/Neb LPM: Pt tolerate: Y/N
Time: Mask: NRB/SFM/NC/Neb LPM: Pt tolerate: Y/N
IV Therapy
Time: Gauge: Site: # Attempts: Solution: Rate: Volume Infused:
Lot # Lot #
Time: Gauge: Site: # Attempts: Solution: Rate: Volume Infused:
Lot # Lot #
Time: Gauge: Site: # Attempts: Solution: Rate: Volume Infused:
Lot # Lot #
Medication
Time: Medication: Dose: Route: Pt Tolerate: Y/N Effect:
Time: Medication: Dose: Route: Pt Tolerate: Y/N Effect:
Time: Medication: Dose: Route: Pt Tolerate: Y/N Effect:
Labs
Time: Name: Result: Time: Name: Result:
Time: Name: Result: Time: Name: Result:
Radiology
Time: Name: Impression:
Time: Name: Impression:
Procedures
Time: Name: Indication: Consent: Y/N Complications: Pt Tolerate: Y/N
Time: Name: Indication: Consent: Y/N Complications: Pt Tolerate: Y/N
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