Page 7 - Critical Care Notes

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Physical Assessment
Reusable Assessment Form

Pt. Identifier: Room: Age:
Diagnosis:

Surgeries/Past Hx:
Activity: Diet: DNR/DNI:
Allergies:
Neurological/MS:
ICP:
Cardiac:
VS/A-line:
ECG:
Hemodynamics: PAD PAS PCWP CVP
IABP:
Respiratory:
Ventilator:
ABGs/SpO 2 :
GI:
GU:
Wounds/Incisions:
Drainage tubes:

Treatments:
Special needs:
Other:

BASICS