Call Cards

Name: _____________________________________________ Name: _____________________________________________
ID# _______________________________________________ ID# _______________________________________________

Location ___________________________________________ Location ___________________________________________
Problem Problem
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
Caller Caller
Name: ____________________________________ Name: ____________________________________
Pager #: ___________________________________ Pager #: ___________________________________
Rank: _____________________________________ Rank: _____________________________________
Service: ___________________________________ Service: ___________________________________
Attending: _________________________________ Attending: _________________________________
Meds:______________________________________________ Meds:______________________________________________
Allergies: __________________________________________ Allergies: __________________________________________
Coags/Labs:________________________________________ Coags/Labs:________________________________________
Is pt consentable (language, obtunded, intox, etc)? _______ Is pt consentable (language, obtunded, intox, etc)? _______
If not, is family/interpreter available? ____________ If not, is family/interpreter available? ____________
Has procedure been discussed with family/pt? ___________ Has procedure been discussed with family/pt? ___________
Is pt hemodynamically stable? ________________________ Is pt hemodynamically stable? ________________________
Have they been seen by VIR before? ___________________ Have they been seen by VIR before? ___________________
Is pt NPO? ________________ Is pt NPO? _________________
ED Radiology 46628 ED Radiology 46628

VIR 46890 VIR 46890
Name: _____________________________________________ Name: _____________________________________________

ID# _______________________________________________ ID# _______________________________________________
Problem Problem
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
Caller Caller
Name: ____________________________________ Name: ____________________________________
Pager #: ___________________________________ Pager #: ___________________________________
Rank: _____________________________________ Rank: _____________________________________
Service: ___________________________________ Service: ___________________________________
Meds:______________________________________________ Meds:______________________________________________
Is pt NPO? ________________ Is pt NPO? __________________
ED Radiology 46628
ED Radiology46628
VIR 46890
VIR 46890
Name: _____________________________________________ Name: _____________________________________________
ID# _______________________________________________ ID# _______________________________________________
Problem Problem
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
Caller Caller
Name: ____________________________________ Name: ____________________________________
Pager #: ___________________________________ Pager #: ___________________________________
Rank: _____________________________________ Rank: _____________________________________
Service: ___________________________________ Service: ___________________________________
Meds:______________________________________________ Meds:______________________________________________
Is pt NPO? ________________ Is pt NPO? _________________
ED Radiology 46628 ED Radiology 46628

VIR 46890 VIR 46890
Name: _____________________________________________ Name: _____________________________________________

ID# _______________________________________________ ID# _______________________________________________
Problem Problem
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
Caller Caller
Name: ____________________________________ Name: ____________________________________
Pager #: ___________________________________ Pager #: ___________________________________
Rank: _____________________________________ Rank: _____________________________________
Service: ___________________________________ Service: ___________________________________
Meds:______________________________________________ Meds:______________________________________________
Is pt NPO? ________________ Is pt NPO? __________________
ED Radiology 46628
ED Radiology46628
VIR 46890
VIR 46890

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Call Cards

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Name: _ Name: _

ID# _ ID# _

If not, is family/interpreter available? If not, is family/interpreter available?

Is pt hemodynamically stable? Is pt hemodynamically stable?

Is pt NPO? Is pt NPO? _

ED Radiology 46628 ED Radiology 46628

Name: _ Name: _

If not, is family/interpreter available? If not, is family/interpreter available?

Is pt hemodynamically stable? Is pt hemodynamically stable?

Is pt NPO? Is pt NPO? __

If not, is family/interpreter available? If not, is family/interpreter available?

Is pt hemodynamically stable? Is pt hemodynamically stable?

Is pt NPO? Is pt NPO? _

ED Radiology 46628 ED Radiology 46628

Name: _ Name: _

If not, is family/interpreter available? If not, is family/interpreter available?

Is pt hemodynamically stable? Is pt hemodynamically stable?

Is pt NPO? Is pt NPO? __

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