| Product | Order | Assigned | Compatible | ||
| Date On Admission 1400 | Date | Date | Date | ||
| Blood Type | A – | ||||
| Antibody Screen | Negative | ||||
| Crossmatch | 2 units available for OR | ||||
| Hgb | 98 | ||||
| Hct | 44 | ||||
| Plt Count | 150 | ||||
| Other | |||||
| Date | Time | Blood Product | Unit# | Volume | |
Wound Type/Etiology (if known)Pressure ☐ Venous ☐ Arterial ☐ Diabetic ☐ Surgical 2°Intent X Skin Tear ☐ Other ☐ If Pressure Ulcer, chart stage: Stage 1_________ Stage 2_________ Stage3_________ Stage 4_________ Stage X(unstageable)_________ Stage SDTI (Suspected Deep Tissue Injury)_________ MARK LOCATION OF WOUND/ULCER WITH AN ARROW OR AN ”X” Legend: X or Blank Space = Not Applicable (as per agency) …
Confusion Assessment Method with PRISME Wound Resources Charting Formats SBAR vs IDRAW Video IDRAW Handover Report Parenteral Drug Therapy Manual -VCH: Syringe Compatibilty Chart -VCH: Y-Site Compatibilty Chart
