Code White
Code White
Code White
TROP T
Troponin T
.MeMuR)a,
NARAYANI
(A Unit of Narayav I.aa.
Behala Manton, 85. (Mail - 601), Diamond Hartbour Road, Kolkata - 34 CERTIFIED
MC3625
Ph: 033-6640-0000 Website : www.narayanmemorialhospital.com
MoLKA
PRIMARY SURVEY
Airway : Breathing: Circulation:
BPatent RR DPulse ..... min
OProtected
OMaintained
DLabored /Dyspnea
... mm
tA0...M
OPoripherai Hg
Pylse Kal pek.
LNormal OTemp...A8 FIC
OCompromised Spo,..H % on RA/ Rhythm ...
Disability:
GCS :
CBG
Pupil :
Right Left Rectne
Planter Right Left
General
Pallor
*,..
Jaundice Cyanosis Oedema
NMH/COPIFM/ERIni Ass/Ver.2/0424 Page 1 of 4
SECONDARY SURVEY
ALLERGIES:
MEDIÇATÊON :
LAST MEAL:
|s, &S,:
NEURO: w EXT:
INVESTIGATION
ECG
JABG
LABORATORY:
Roche No, 2
RADIOLOGY: TROP T
TroponinT Patient:
Page2 o
NMH/COP/FM/ER_Ini Ass/Ver.2/0324
MEDICATION CHART
Administered by Time
Route
Advised by Time
Name of Drug Dose
32
Provisional
Diagnosis
Ward
CHDU
Shifted to /
Outcomne
ODischarged to Home JLAMA to OExpiry
Reg)HN
- 23159
Patient's I NOK's Name &Sign with Rglatidn : NARAYAN
Date & Time MEMQRJAL
HOSPITA;
2 o f4
NARAYAN MEMORIAL HOSPITAL
(A Unit of Narayan Health Services Pvt. Ltd.)
Behala Manton, 85,(Mail -601), Diamond Harbour Road, Kolkata -34 CERTIFIFD
MC3623
Ph:033-6640-0000 Website : www.narayanmemorialhospital.com
Name
PARVERN D1i Age Sex: M(F)
412181 Bed No.
UHID No. IPIOP No.
Others, if any
NPO Since
Pulse 9.A..
Allergies ..Ne.NCA..
Blood Pressure : ..1.SQ.. Chest with axial -
Shave:Femoral - Brachlal - Whole Body -
TIME GIVEN GIVEN BY CHECKED BY
PRE-CATHETER DRUGS PRESCRIBER'S SIGNATURE
Signatur .KAaYA
POST -CATHETERIZATION CHECK LIST
Procedure: CAgPTCA.
Approach :Femoral Brachial Redia Rt Subclavian
Circulating Nurse
".Meg.khatum
Event Time
Act (Sec.)
Act (Sec.)
given to Patient
+Put on Music System
7F
8F tots
+ Injection Haparin givèn
’Canulisation done by Medieingv
Single Prick
Multi Prick
Double Prick DI
3. P.P. of Haemo-dynamically unstable 3.’ Continuous Cardiac Monitoring Done 3.
doe
’ Crash Trolly ready with Defibrillator