|
Procedure Attestation (performed by clinician)
|
Performed by MA/XRT, supervised by clinician
|
|
Location
|
Indication:
|
|
Type of Splint***
• • •
|
Material Used ****
• • •
|
|
Reduction technique
|
Post procedure films: successful reduction.
|
|
CSM intact. Pt tolerated procedure well.
|
Good alignment and positioning
|
|
Crutch training provided
|
***ORTHO SUPPLIES DISPENDSED***
• • •
|
|
Notes:
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|
