(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.
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St Neer
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oe ¢
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Sal Oe :
; DURATION OF ANAES MC-31009
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