GSS Scutsheet
GSS Scutsheet
GSS Scutsheet
DOB:
!
/ /
!
=
!
yo M/F
!
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:
! ! ! ! ! !
! ! ! ! ! !
! ! ! ! ! !
! ! ! ! ! !
! ! ! ! ! !
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
/ ! 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