Pt was administered
[select name="variable_1" value="24 mg|56 mg|82 mg"] of esketamine via intranasal insufflation in clinic today under my direct medical supervision.
Esketamine administration was observed by :
[text name="variable_1" default="sample text"]
Initial BP:
[text name="variable_1" default="sample text"]
BP at 40 min post administration:
[text name="variable_1" default="sample text"]
BP at discharge from clinic:
[text name="variable_1" default="sample text"]
Time Treatment Started:
BP at discharge from clinic:
[text name="variable_1" default="sample text"]
Time Treatment Ended:
BP at discharge from clinic:
[text name="variable_1" default="sample text"]
Time pt was ready to leave:
BP at discharge from clinic:
[text name="variable_1" default="sample text"]
Pt experienced dissociation:
[checkbox name="variable_1" value="yes|no"]
Pt experienced sedation:
[checkbox name="variable_1" value="yes|no"]
Pt experienced SAE:
[checkbox name="variable_1" value="yes|no"]
Pt left the clinic stable after treatment and with a ride:
[checkbox name="variable_1" value="yes|no"]
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