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(as springleaf ANAESTHESIA RECORD ne ORC ON for Diegnosis| (fenediation Age: > Sox: Operation Done > Hosp No: &y wars No: SP ‘Syrgeon Ry Raw oe 5 ha on Anaesthetist Tine Dawe CIRCLE AS INDICATED PREMEDICATION “Too Depressed Yes ‘Won of 5 ‘Apprehensive Inadadoauate INDUCT Exctament Lanyngospasm ‘ertng Gyanosis [MAINTANANGE Seckemant Lenmgospesm ‘Sweating Mus Masi Endovachaa ‘Nasal Oat "Tracheosiomy [Endobroncha ut Local Spray Pack 23 2 100 Ratiex . Ratonng ‘Extent ‘oriing BP. Pulse ‘Condon 60 a0 20 Respiration {ontancous sisted Contoieg DETAILS: Eslimaied Blood Loss "otal Fluids Given in ‘other Bleed SA R. 3 i 8; ae FAS Ss ee! — 3 aos A Oey NOT Set Qn ied, as Des DURATION OF ANAES POSITION hor o— —>* —— springleaf ANAESTHESIA RECORD 90: Ils Operation Sox: Hosp No Ward No \ass Date Time Pre OP Risk (ASA) 2 3 E 1-9 E Fathane 5 N20 Lit 02 Min. "Thiopenty CIRCLE AS INDICATED PREMEDICATION MAINTANANCE Eratomert ‘Lanypqosoasm [30| Sweating Mucus 25] Mask Endovachea: a (2328 See Nasal Oat Yes. Tracheosiony Yes Encobronchia! ut cal Spray k Yes) Yor: Yes Rolex Ratchng Excitement Yes Vomiting Yes: BP. Pulse ‘Gondor Yes Yes Temp. 40 20 Fatma Blood Loss Total Fluids Gven in OR Ober: Blo: Respiration ‘Spontaneous Assisted Controlled + VP. “ee ere oe hk ees St Neer a Sees @ wwe Ain oe ¢ aa wee, a Ot Praghantha Kure Sal Oe : ; DURATION OF ANAES MC-31009 postoX one Syciigleaf Healthcare Pvt Lia” ea

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