Northbank Surgical Center
Physician's Order Sheet
PRE-OPERATIVE ORDERS
Allergies/Reactions:
or list below:
Diagnosis:
Other:
- Admit to Northbank Surgical Center
- Routine admitting vital signs
- Nurse Anethetist to evaluate patient if MAC
- Saline lock started
- H & P on chart
- PRE-OP MEDICATIONS
a.
Xanax PO per standing order on admission if local
7.
Check serum glucose level if on medication for diabetes
INTRA-OPERATIVE ORDERS
- Routine per preference card
- Other:
POST-OP APPOINTMENT:
Date:
Time:
PHYSICIAN ORDER SHEET - LIDS Rev. 7/06
(PATIENT LABEL)