ICU Presentation (H&P)

ONE LINER
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Date of Admission: 
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Admission Diagnosis: 
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1.) CHIEF COMPLAINT: 
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2.) HX OF PRESENT ILLNESS: 
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HOSPITAL COURSE
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24 HOUR EVENTS
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EKG EVENTS
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SUBJECTIVE
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REVIEW OF SYSTEMS:
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OBJECTIVE

3.)  PAST MEDICAL HISTORY
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VITALS
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4.)  PHYSICAL EXAM
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5.)  DIAGNOSTIC STUDIES 

LABS
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6.) IMAGING:

CXR 
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CT
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ECHO
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7.) PROCEDURES
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8.) ASSESSMENT
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9.) PLAN
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8.) Checklist

ANALGESIA:       
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SEDATION:   
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DIET:   
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DVT PPX:    
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GI PPX:     
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BOWEL REG:  
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GLYCEMIC CONTROL: 
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ABX:        
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LINES/DRAINS/FOLY: 
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DISPO (DOWNGRADABLE?):  
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CODE STATUS: 
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