|
Surgical Pre-Operative Note
|
Insert Patient Info
|
|
Diagnosis
|
|
|
Procedure
|
|
|
|
Consent Form Obtained?
|
|
Risk, Benefits, Alt. Explained
|
|
|
Blood Type
|
Type & Screen in last 72hr?
|
|
PT, PTT, INR
|
|
|
Urinalysis Findings
|
Hgb & Hct
|
|
Chem7 Profile
|
EKG Findings
|
|
CXR Findings
|
Medical / Cardiology Clearance?
|
|
Plan:
|
NPO after 12am
|
|
Heparin gtt
|
IV Fluids TKO
|
|
ETA OR Time
|
|
