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DATE/TIME

PT: MRN:
O/N events: Subjective:
BP: RR: BG: UOP: MAP: O2sat: I/Os: Drains:

* ICU PROGRESS NOTE* ICU Room:

Meds:

Pulse (art /cuff): Tm/Tc: Bal:

Ventilator Mode: Vent rate: Tv: PIP/Pplat: / PEEP: PS: FiO2:

Drips:

Gen: Neuro: HEENT: Resp: CV: Abd: Ext: Skin: Lines: Labs:

Prophylaxis:

Micro: Radiology/Studies: Lines/d#:

IVF: Diet:

ASSESSMENT/PLAN: 1. Neuro/Psychiatric: 2. Cardiovascular: 3. Pulmonary: 4. Gastrointestinal: 5. Renal: 6. Hematologic: 7. Infectious Disease: 8. Endocrine: 9. F/E/N: 10. Dermatology: ________________________________________ # _________

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