Patient Handover Form - Clinical Departments - clinicaldepartments musc 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling in the 'Patient came from' section, selecting the appropriate option: Home, Floor, or ICU.
3. In the Endotracheal Tube section, specify the size and whether it is cuffed or uncuffed. Also, indicate the depth at gums/teeth.
4. For Difficult Intubation, select 'Yes' or 'No' as applicable. Complete the PIV and Central Line sections by entering their sizes.
5. Indicate if a Pacemaker is required and provide target BP and RAP/CVP values.
6. Fill out the Blood Products Administered section with units for Platelets, Cryo, FFP, PRBCs, and Factor VII doses.
7. List any drips administered along with their dosages in micrograms per kilogram per minute or hour as needed.
8. Document the time of last antibiotic administration and any drugs currently affecting consciousness and movement.
9. Finally, summarize hemodynamics at conclusion of surgery and provide details about the anesthesia team involved.

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