Tolerated previous doses well close

Tolerated previous doses well close

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with HR-ALL, admitted for 3rd dose of HD-MTX with Leucovorin rescue. Tolerated previous doses well. Hydration/alkalinization/antiemetics, close monitoring of MTX level. Tim Garrington, MD Associate Professor, Pediatrics Leader, Solid Tumor Team Center for Cancer and Blood Disorders Children's Hospital Colorado (MR # Printed by [103311] at 10/11/13 10:21 AM Page 12 Electronically signed by Smolik, Suzanne B. at 8/4/2013 5:55 PM Electronically signed by Smolik, Suzanne B. at 7/23/2013 4:14 PM Electronically signed by Garrington, Timothy P. at 7/23/2013 10:22 PM
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IP Encounter Report MRN: DOB: Sex: M Adm:7/23/2013, D/C:7/25/2013 Procedures - All Notes is a 16 year old male who had the following procedure(s) performed today: Procedure(s): Lumbar Puncture with Intrathecal Chemotherapy Procedure Technique: Lumbar Puncture with Intrathecal Chemotherapy: The procedure site over the lumbar spine was prepped and draped in sterile fashion. Once adequate analgesia was achieved, a 3 1/2 inch 22 gauge spinal needle was inserted thru the skin and into the lumbar interspace. Upon entering the dural sac, the needle stylette was removed and samples of spinal fluid for the tests listed below were collected and placed in sterile tubes. The chemotherapy syringe then was attached to the needle and the medication was slowly instilled into the intrathecal space. The needle then was removed and a Band-Aid was applied to skin at the entry site. Volume of CSF removed: 4 mL Medication(s) (Dose): Methotrexate 15 mg Performed by: Lesley C. Arland, PA-C Attending Physician Supervising Procedure: N/A Present for entire procedure: N/A Anesthesia/Sedation: Propofol Complications: None Tests Obtained: CSF cell count and CSF cytology (MR # Printed by [103311] at 10/11/13 10:21 AM Page 13 Procedure Orders: 1. Lumbar Puncture with Intrathecal Drug [39054186] ordered by Arland, Lesley C. at 07/23/13 1434 Author: Arland, Lesley C. Service: Oncology Author Type: Procedures 1. LUMBAR PUNCTURE W INTRTHECAL DRUG [96450 (CPT®)] Physician Assistant Filed: 7/23/2013 2:34 PM Electronically signed by Arland, Lesley C. at 7/23/2013 2:34 PM Note Time: 7/23/2013 2:32 PM Procedures signed by Arland, Lesley C. at 7/23/2013 2:34 PM
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