_00650_anesthesia_eval - ANESTHESIA EVALUATION Previous...

Info icon This preview shows page 1. Sign up to view the full content.

View Full Document Right Arrow Icon
AGE: _______ SEX: _______ HT.: _______ WT.: _______ B.P.: _______ TEMP.: _______ PULSE: _______ RESP.: _______ RA SpO 2 : ______ LAB: ____________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Chest X-Ray: ____________________________________ EKG: ___________________________________________ ASA Physical Status: Class 1 2 3 4 5 E PLAN OF ANESTHESIA: ____________________________________________________________________________ ________________________________________________________________________________________________ Explained to Pt. (parents): No Yes _____________________________________________________________ Discussion of Risks / Alternatives & Complications of Anesthesia to Pt. (parents): No Yes _________________ ________________________________________________________________________________________________ DATE: TIME:_________________ SIGNATURE: ____________________________________ POST-ANESTHESIA COURSE: Satisfactory: Yes No Complications – specify: ___________________________________________________ Comments / Follow-up: ______________________________________________________________________________ DATE: TIME:_________________ SIGNATURE: ____________________________________ Anesthesia Evaluation 00650 (7/6/06) Sutter Medical Center, Sacramento A Sutter Health Affiliate ANESTHESIA EVALUATION Previous Anesthetics: _____________________________ Surgical Diagnosis: _______________________________ Complications:___________________________________
Image of page 1
This is the end of the preview. Sign up to access the rest of the document.

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern