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DOB:

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yo M/F

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Admit date:

Rm: / ! HD/POD#! Tm! Tc! P! BP! RR! O2 s m t w r f s! I/O: ! / yest! UOP:! yest foley/st cth/void npo/s&c/clr/soft/reg! ! / today! ! today foley/st cth/void ! ! Drains: ABX po/iv! ! PAIN MEDS po/iv! ! AC MEDS! ! ! ! ! ! ! IVF c/o! ! PAIN Y/N N / V / CP / SOB atus / BM / belch OOB ABD S / TTP / NT / ND / BS INC C / D / I erythema/hematoma/seroma ! ! ! ! ! ! ! Plan:

Procedure:

CC: HPI:

Imaging Y/N PMH:! ! ! ! ! PSH: / ! HD/POD#! Tm! Tc! P! BP! RR! O2 s m t w r f s! I/O: ! / yest! UOP:! yest foley/st cth/void npo/s&c/clr/soft/reg! ! / today! ! today foley/st cth/void ! ! Drains: ABX po/iv! ! PAIN MEDS po/iv! ! AC MEDS! ! ! ! ! ! ! IVF c/o! ! PAIN Y/N N / V / CP / SOB atus / BM / belch OOB ABD S / TTP / NT / ND / BS INC C / D / I erythema/hematoma/seroma ! ! ! ! ! ! ! Plan:

Meds:! !

All:

FH: Imaging Y/N

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SH: tobacco Y/N ___PPDx___yr ! quit: EtOH Y/N subs Y/N PysEx:

Studies:!

Consults:

/ ! HD/POD#! Tm! Tc! P! BP! RR! O2 s m t w r f s! I/O: ! / yest! UOP:! yest foley/st cth/void npo/s&c/clr/soft/reg! ! / today! ! today foley/st cth/void ! ! Drains: ABX po/iv! ! PAIN MEDS po/iv! ! AC MEDS! ! ! ! ! ! ! IVF c/o! ! PAIN Y/N N / V / CP / SOB atus / BM / belch OOB ABD S / TTP / NT / ND / BS INC C / D / I erythema/hematoma/seroma ! ! ! ! ! ! ! Plan:

Imaging Y/N

Gibbon Surgical Society / P.Bucciarelli

/ ! HD/POD#! Tm! Tc! P! BP! RR! O2 s m t w r f s! I/O: ! / yest! UOP:! yest foley/st cth/void npo/s&c/clr/soft/reg! ! / today! ! today foley/st cth/void ! ! Drains: ABX po/iv! ! PAIN MEDS po/iv! ! AC MEDS! ! ! ! ! ! ! IVF c/o! ! PAIN Y/N N / V / CP / SOB atus / BM / belch OOB ABD S / TTP / NT / ND / BS INC C / D / I erythema/hematoma/seroma ! ! ! ! ! ! ! Plan:

/ ! HD/POD#! Tm! Tc! P! BP! RR! O2 s m t w r f s! I/O: ! / yest! UOP:! yest foley/st cth/void npo/s&c/clr/soft/reg! ! / today! ! today foley/st cth/void ! ! Drains: ABX po/iv! ! PAIN MEDS po/iv! ! AC MEDS! ! ! ! ! ! ! IVF c/o! ! PAIN Y/N N / V / CP / SOB atus / BM / belch OOB ABD S / TTP / NT / ND / BS INC C / D / I erythema/hematoma/seroma ! ! ! ! ! ! ! Plan:

Imaging Y/N / ! HD/POD#! Tm! Tc! P! BP! RR! O2 s m t w r f s! I/O: ! / yest! UOP:! yest foley/st cth/void npo/s&c/clr/soft/reg! ! / today! ! today foley/st cth/void ! ! Drains: ABX po/iv! ! PAIN MEDS po/iv! ! AC MEDS! ! ! ! ! ! ! IVF c/o! ! PAIN Y/N N / V / CP / SOB atus / BM / belch OOB ABD S / TTP / NT / ND / BS INC C / D / I erythema/hematoma/seroma ! ! ! ! ! ! ! Plan:

Imaging Y/N / ! HD/POD#! Tm! Tc! P! BP! RR! O2 s m t w r f s! I/O: ! / yest! UOP:! yest foley/st cth/void npo/s&c/clr/soft/reg! ! / today! ! today foley/st cth/void ! ! Drains: ABX po/iv! ! PAIN MEDS po/iv! ! AC MEDS! ! ! ! ! ! ! IVF c/o! ! PAIN Y/N N / V / CP / SOB atus / BM / belch OOB ABD S / TTP / NT / ND / BS INC C / D / I erythema/hematoma/seroma ! ! ! ! ! ! ! Plan:

Imaging Y/N / ! HD/POD#! Tm! Tc! P! BP! RR! O2 s m t w r f s! I/O: ! / yest! UOP:! yest foley/st cth/void npo/s&c/clr/soft/reg! ! / today! ! today foley/st cth/void ! ! Drains: ABX po/iv! ! PAIN MEDS po/iv! ! AC MEDS! ! ! ! ! ! ! IVF c/o! ! PAIN Y/N N / V / CP / SOB atus / BM / belch OOB ABD S / TTP / NT / ND / BS INC C / D / I erythema/hematoma/seroma ! ! ! ! ! ! ! Plan:

Imaging Y/N / ! HD/POD#! Tm! Tc! P! BP! RR! O2 s m t w r f s! I/O: ! / yest! UOP:! yest foley/st cth/void npo/s&c/clr/soft/reg! ! / today! ! today foley/st cth/void ! ! Drains: ABX po/iv! ! PAIN MEDS po/iv! ! AC MEDS! ! ! ! ! ! ! IVF c/o! ! PAIN Y/N N / V / CP / SOB atus / BM / belch OOB ABD S / TTP / NT / ND / BS INC C / D / I erythema/hematoma/seroma ! ! ! ! ! ! ! Plan:

Imaging Y/N

Imaging Y/N