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On Following Antibiotics Last Dose given at : H/O Reaction / Allergy Known Case of IHD HTN DM Asthma TB HCV + HBV

+ Taken Morning dose of routine treatment. Morning Blood glucose in case of DM Omit oral hypoglycemic(eg dianil,glucophage) Started d/w 10% 500ml + 12units insulin + 10mmol KCl in pts with DM : Yes / No (No insulin/KCL if FBS > 100mg/dl) HB%:_________________________ Cross match: sent/not No of blood arranged:__________ To be filled by theatre staff Prophylactic Antibiotics
Name Dose Time

Preload Fluid

with Time

with Time