Professional Treatment Checklist
Patient Name: Edgar Spencer
Procedure: Appendectomy
Date of Surgery: May 15, 2050
Procedure Code: 49320
Pre-Operative Checklist
Task | Status | Notes |
|---|
Verify patient ID and medical history | | Confirm allergies and medications |
Consent form signed | | Ensure form is complete |
Sterilization of equipment | | Check sterilization logs |
Confirm anesthesia plan | | Review patient’s anesthesia risk |
Pre-surgery vital signs taken | | Blood pressure, heart rate |
Surgical Procedure Checklist
Task | Status | Notes |
|---|
Confirm surgical site marked | | Double-check with patient |
Prepare surgical tools | | Verify all tools required |
Anesthesia administered | | Confirm dosage and administration |
Sterile drapes applied | | Ensure sterile environment |
Begin procedure | | Start surgery |
Post-Operative Checklist
Task | Status | Notes |
|---|
Post-operative vitals monitored | | Hourly monitoring for 4 hours |
Pain management discussed | | Administer prescribed pain relief |
Recovery room preparation | | Ensure room is equipped |
Post-op instructions given to patient | | Review recovery steps with patient |
Schedule follow-up appointment | | Set for June 5, 2050 |
Patient Information
Patient's Name: Edgar Spencer
Patient's Email: edgar@you.mail
Patient's Phone Number: 222 555 7777
Hospital/Clinic Information
Hospital/Clinic Name: [YOUR COMPANY NAME]
Address: [YOUR COMPANY ADDRESS]
Phone Number: [YOUR COMPANY NUMBER]
Email: [YOUR COMPANY EMAIL]
Next Steps
Schedule Appointment: If this checklist is part of your treatment process, please schedule your next appointment as soon as possible.
Contact Us: If you have any questions about your procedure or post-operative care, reach out to us at [YOUR COMPANY EMAIL].
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