Medical Transfer Note
Medical Transfer Note
Patient Information:
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Patient Name: Cyrus Ortiz
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Date of Birth: January 1, 2050
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Medical Record Number: 123456
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Gender: Male
Transfer Information:
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Transfer Date: October 8, 2094
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Time of Transfer: 10:00 AM
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Transferring Facility/Unit: St. Mary's Hospital, Emergency Department
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Receiving Facility/Unit: Mercy General Hospital, Intensive Care Unit
Reason for Transfer:
Patient requires specialized care for severe respiratory distress not manageable at the transferring facility.
Medical History:
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Chronic Obstructive Pulmonary Disease (COPD)
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Hypertension
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Recent history of pneumonia
Current Medications:
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Albuterol 90 mcg inhaler (as needed)
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Lisinopril 20 mg daily
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Prednisone 10 mg daily
Vital Signs at Transfer:
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Blood Pressure: 150/90 mmHg
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Heart Rate: 110 bpm
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Respiratory Rate: 24 breaths/min
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Temperature: 98.6°F
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Oxygen Saturation: 85% on room air
Summary of Current Condition:
Patient is alert but in moderate respiratory distress. Auscultation reveals wheezing and diminished breath sounds bilaterally. The patient has been receiving oxygen therapy with a nasal cannula, which has not improved saturation levels.
Transfer Instructions:
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Monitor vital signs every 15 minutes during transport.
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Administer supplemental oxygen as needed to maintain SpO2 above 90%.
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Prepare for potential intubation upon arrival at the receiving facility.
Transferring Physician:
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Name: Dr. [Your Name]
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Date: October 8, 2094
Contact Information:
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Phone Number: [Your Company Number]
