PCCM Frequently Used Medical Records Forms

Medical Records Forms Website:
http://ozone.ohsu.edu/healthsystem/HIS/a-zlist.htm

Forms Search Website:
http://ozone.ohsu.edu/healthsystem/HIS/cgi-bin/Formsearch.cgi

Cardiovascular Services

Cardiac Surgery Post-Op Open Heart Surgery Orders	PO-1587
Cardiac Transplant Post-op Admit Orders	PO-1666
*Cardiothoracic Surgery Insulin Infusion Orders (pilot)*	PO-7134
Cardiothoracic Surgery Orders for Transition from Insulin Infusion to Subcutaneious Insulin (pilot)	PO-7135
Chest Pain and Acute Coronary Syndrome Orders	PO-1568
Thoracic Surgery Post-Op Orders	PO-1595
HEPARIN: Cardiac Heparin IV Infusion	PO-1711
HEPARIN: Stroke/Rule Out Stroke/TIA Heparin IV Infusion Orders	PO-1558
HEPARIN: Venous Disease Heparin IV Infusion Orders	PO-1583

Medical Intensive Care

MICU Admission Orders	PO-1771
Intensive Care Physician Note	HP-2817
General Medicine Service: Admission or Transfer Orders	PO-1524
Adult ICU Sepsis Orders	PO-7156
Drotrecogin (Xigris) Orders	PO-1730
Blood Products Transfusion Orders for Inpatients	PO-7032
Diabetic Ketoacidosis or Hyperosmolar Hyperglycemic State Orders (Adult)	PO-7072
Adult Supplementary Insulin Orders	PO-1760
Orders for Transition from Insulin Infusion to Subcutaneous Insulin	PO-7123
Parenteral Nutrition: Adult Parenteral Nutrition Orders	PO-1641
Parenteral Nutrition: Orders for the Initiation of Central TPN (Adult)	PO-1652
Trauma Service: Rhabdomyolysis Orders	PO-1655
Hypothermia Orders for Adult Comatose, Resuscitated Cardiac Arrest Patients-For ICU Use Only	PO-7186
PICC Placement Orders	PO-1619
Supplemental Potassium Orders for Adult Critical Care	PO-1653

Pulmonary Services

Pulmonary & Critical Care Division Inpatient First Visit Note	HP-2847
Pulmonary & Critical Care Division Inpatient Subsequent Visit Note	HP-2844
Pulmonary & Critical Care Division Subsequent Outpatient Visit	OC-4535
Bronchoscopy with and without Biopsy Protocol	TR-3725
Epoprostenol (Flolan) Infusion Orders	PO-7139
Pre/Post Bronch Orders	PO-7169

Sedation and Analgesia/Antiemetics

Sedation/Analgesia/Delirium Orders for Adult ICU's	PO-1654
Alcohol Withdrawal Orders	PO-1712
Adult Patient Controlled Analgesia (PCA) Orders	PO-1520
Anesthesia Record -not available online	PO-1902
Pain Management: Ketamine Bolus Orders for Inpatient Adults	PO-7163
Pain Management: Ketamine Continuous Infusion Orders	PO-7096
Adult Antiemetic Orders	PO-7182
24 Hour Restraint Order for Medical-Surgical Care	PO-1651
Comfort Care Orders	PO-1596

Miscellaneous Forms

Frequently Used Forms

Procedures log form (verinform)