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Buffalo General Hospital DeGraff Memorial Hospital Millard Fillmore Gates Circle Hospital Millard Fillmore Suburban Hospital Millard Fillmore Surgery Center Women & Children’s Hospital of Buffalo Others: ADULT PATIENT KARDEX 1 of 2 Patient ID Area DO NOT USE THESE UNSAFE ABBREVIATIONS “U” and “IU” should be unit, “Ug” should be mcg, “QD” should be daily, “QOD” should be every other day, “BIW” should be two times a week, “TIW” should be three times a week, “AU,” “AS,” “AD,” “OS,” and “OD” should be written out in full. Correct Use of Leading and Trailing Zeros - Always Leading Never Trailing .1 should be 0.1 and 1.0 should be 1 ADMISSION DATE: AGE: Code Status [ check] DIAGNOSIS: ADVANCE DIRECTIVES: Special Considerations Full DNR Date: PREVIOUS MEDICAL/SURGICAL HISTORY: Patient goal to be achieved: ALLERGIES: Language Barrier: Current Invasive Procedures/ Operation: VACCINES (Date Given): Pneumoccocal: Other: Influenza: Diet: Feed Assist Fluid Restriction: Order Date Recurring Lab ÌKHÇÂ=È4Â1ÂOFÂ2&Î KH00294 Rev. 09/18/07 Renew Date Order Date Consults/Tests/Procedures Date Completed ADULT PATIENT KARDEX 2 of 2 Patient ID Area STANDING ORDERS (indicate date of order) Vital Signs: Neuro Checks: Intermittent Infusion Device: Oxygen: Incentive Spirometry: Pulse Ox: Cough & Deep Breathe: Telemetry: Bedrest: Bathroom Privileges: Chair: Up ad lib: Assistive Device: Sequential Compression Device: Anti-Embolism Stockings: Foot Pumps: Weight (indicate units): Indwelling Catheter: PT/OT: Intake & Output: Treatments: ADDITIONAL PHYSICIAN STANDING ORDERS Date Ordered (indications must be included for all medications) ÌKHÇÂ=È4Â2ÂOFÂ2/Î KH00294 Rev. 09/18/07 Date Discontinued