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  • SBAR Brain Report Sheet

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    eeenabean
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    Brain Report Sheet for Nurses

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    Brain Report Sheet for Nurses

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    131 views2 pages

    SBAR Brain Report Sheet

    Uploaded by

    eeenabean
    Brain Report Sheet for Nurses

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    Code Status: _________________

    Allergies: __________________________

    Code Status: _________________

    Allergies: __________________________

    Attending MD: _____________________

    Consultants: _____________________________________________________

    Attending MD: _____________________

    Consultants: _____________________________________________________

    Dx: ______________________________________________________________________________________________________

    Dx: ______________________________________________________________________________________________________

    Hx: ______________________________________________________________________________________________________

    Hx: ______________________________________________________________________________________________________

    Important information/Special instructions:

    Important information/Special instructions:

    Head/Neuro:

    Pulmonary:

    Head/Neuro:

    Pulmonary:

    Cardio:

    GI:

    Cardio:

    GI:

    Pelvic/Urinary:

    Musculoskeletal/Skin:

    Pelvic/Urinary:

    Musculoskeletal/Skin:

    IV/Arterial Access:

    IV Therapy/Drips:

    IV/Arterial Access:

    IV Therapy/Drips:

    Labs:

    Procedures:

    Labs:

    Procedures:

    Hgb
    WBC

    Hct

    Hgb
    Plt

    PT

    PTT

    WBC

    Hct

    Plt

    PT

    INR

    Ca

    Na
    K

    Cl
    CO2

    Ca

    BUN
    Creat

    PTT

    INR

    Na
    Glu

    Mg

    Cl
    CO2

    BUN
    Creat

    Glu

    Mg

    Pending:

    Pending:

    Code Status: _________________

    Allergies: __________________________

    Code Status: _________________

    Allergies: __________________________

    Attending MD: _____________________

    Consultants: _____________________________________________________

    Attending MD: _____________________

    Consultants: _____________________________________________________

    Dx: ______________________________________________________________________________________________________

    Dx: ______________________________________________________________________________________________________

    Hx: ______________________________________________________________________________________________________

    Hx: ______________________________________________________________________________________________________

    Important information/Special instructions:

    Important information/Special instructions:

    Head/Neuro:

    Pulmonary:

    Head/Neuro:

    Pulmonary:

    Cardio:

    GI:

    Cardio:

    GI:

    Pelvic/Urinary:

    Musculoskeletal/Skin:

    Pelvic/Urinary:

    Musculoskeletal/Skin:

    IV/Arterial Access:

    IV Therapy/Drips:

    IV/Arterial Access:

    IV Therapy/Drips:

    Labs:

    Procedures:

    Labs:

    Procedures:

    Hgb
    WBC

    Hct

    Hgb
    Plt

    PT

    PTT

    WBC

    Hct

    Plt

    PT

    INR

    Ca

    Na
    K

    Cl
    CO2

    Ca

    BUN
    Creat

    PTT

    INR

    Na
    Glu

    Mg

    Cl
    CO2

    BUN
    Creat

    Glu

    Mg

    Pending:

    Pending:

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