ࡱ> 685Y 0bjbjWW <8==0 ]$$lxxxxxxxx$~xxxxxxxxxxxx,x\3ylF HEALTH RECORDCHRONOLOGICAL RECORD OF MEDICAL CAREDATESYMPTOMS, DIAGNOSIS, TREATMENT, TREATING ORGANIZATION (Sign each entry)Provider:62nd Medical Group (AMC), McChord AFB, WA, 98438Date:Laceration OverprintTime:S:B/P: ______ yo male/female presents with __________ cm simple/stellate/other__________ laceration Pulse: Located _______________. Mechanism of injury:Resp:Temp: Wound is clean/dirty, initial treatment prior to my evaluation included:Ht:Wt: Patients current medical problems include diabetes, immune supression, steroid use, other _________, noneAge: Last tetanus as noted, needs/does not need a boosterTobacco: YES NOO:LMP: ___________ cm simple/setllate/other________________ laceration located ______________. Bleeding is Last Pap: active/controlled/absent. Wound extends down to dermal/subcutaneous/muscle/epidermis.Tetanus: If laceration on extremity: distal pulses are full/decreased/absent, capillary refill is brisk/slow/absent; Allergies: Sensation is full/decreased/absent. Movement is full/decreased/absent distal to the laceration.  Procedure: Wound anesthetized with approx. ______ cc of 1%/2% lidocaine without/with epi  Wound cleansed with approx. ______mL of sterile NS/LR/Water. Meds: Wound closed in a single/multiple layer(s) using _______ throws of ethilon/silk/nylon  Deep layers closed with ______ throws of vicryl/monopryl/other _________. Hemostatis obtained via suturing/pressure/other __________. Patient did/did not tolerate procedure well. No complications/following complications encountered: Covered with bacitracin/neosporin/none/other_______ and bandaged. Tech: Written/verbal wound care instructions were/were not given to patient.PATIENTS IDENTIFICATION (Use this space for Mechanical Imprint)RECORDS MAINTAINED AT:PATIENTS NAME ( Last, First, Middle initial )SEX RELATIONSHIP TO SPONSOR: STATUSRANK/GRADESPONSORS NAME ORGANIZATIONDEPART./SERVICE SSN/IDENTIFICATION NO.DATE OF BIRTH62nd MDG OVERPRINT CHRONOLOGICAL RECORD OF MEDICAL CARE STANDARD FORM 600 (EF) DATESYMPTOMS, DIAGNOSIS, TREATMENT, TREATING ORGANIZATION (Sign each entry)Provider:Laceration Overprint, cont.Date:A:Time: Simple/Complex __________ cm laceration of the ________ repaired with ____________ suture.B/P:P:Pulse: F/U for suture removal on ____________ and prn for any complicationsResp: Td booster was/was not given/not needed (UTD)Temp: Written/verbal wound care instructions given to patient Ht: Other:Wt:Age:Tobacco: YES NOP: LMP:Last Pap:Tetanus:Allergies:Meds:Tech: STANDARD FORM 600 BACK (REV. 5-84) (EF-V1) 345pJKRVW\$~mnor|   ɿɴɬɬɬɬɬɬɬɴɬɬɬɬɬɬ 5CJEHCJEHEH5EH EHOJQJ5CJEHOJQJ CJOJQJ EHOJQJ6CJEHOJQJCJEHOJQJOJQJ 5OJQJ5CJOJQJEHA45:8bp/$$TH    0%*$-D-$$l    0*-$$l    0*    $$-D$ 45:JKRVW\$~mno   y z { |    z { | } ~    ` t x y z {      \JKRV(ʘ Hx$-D$-D1$$THH    0*$VW\$~lm\ͼ͔x$-D$-D1$$THH    0*mno    y z { |    z { ͈͔H ͬ x$-D$-D1$$THH    0* z { |    z { | } ~    8 L _ ` t x z {   & û˯˯x5CJH*OJQJ5CJEHH*OJQJ5CJEHOJQJ5CJEHOJQJ56CJEHH*OJQJ5CJEHH*OJQJ5CJOJQJ5CJOJQJOJQJ6CJEHOJQJ6CJEHOJQJCJEHOJQJ CJOJQJ EHOJQJCJEH/{ | } ~    0T]l1$$THH    0*  1$$TH/    0*1$$THH    0*x$-D$-D  ` t x y z { y8$$l    F$*$:$$l    F*$$-D$$-D   & 4 5       $ "`fs  a   & 4 |z8$$l    F'!*$-DC$$l    \ $*$ & 4 5 7 9        $ "abfstxyzCJ5 CJOJQJCJ5CJ6CJOJQJ CJOJQJCJCJH*OJQJ CJOJQJOJQJN4 5  }t$x$-D$-D-$$l    0*$$-D-DC$$l    \$*         $ "`abfs(Ϝ$LHx$-D$-D/$$HH    0*stxyzd0,4x$-D$-D/$$HH    0* x$-D$-D/$$HH    0* /$$HH    0*x$-D$-D)./06CJOJQJ CJOJQJOJQJ CJOJQJCJ CJOJQJ00-D/$$HH    0*  / =!"#$%/ =!"#$% [(@(NormalCJmH F@F Heading 1 $-D@&5CJEHH*OJQJH@H Heading 2$$-D@&5CJEHOJQJD@D Heading 3$$x-D@& 5CJEH<A@<Default Paragraph Font>B@> Body Text $-D5CJOJQJ0 8 8 & 0Vm{  4  s0  0 %-'1fm 2 5Ik   / 2  sean s stout*C:\TEMP\AutoRecovery save of Document1.asd sean s stout:C:\WINNT\Profiles\stouts\Personal\Laceration overprint.doc sean s stoutA:\ Laceration overprint.docSteve Alan OliverVC:\Program Files\Microsoft Office\Templates\SF 600 Overprints\Laceration overprint.dot@ 0 @GTimes New Roman5Symbol3& Arial"phƛEƛE[*9 Y20dS  HEALTH RECORD sean s stoutSteve Alan OliverOh+'0 ( D P \ ht|HEALTH RECORDoEAL sean s stoutoeanLaceration overprint8Steve Alan Olivernt2evMicrosoft Word 8.0t@@""@Mj@Mj9 ՜.+,D՜.+,< hp  USAFRS  HEALTH RECORD Title 6> _PID_GUIDAN{F7228887-6E45-11D2-B777-00E029028A6E}  !"#$&'()*+,./012347Root Entry F`yWLy91TableWordDocument<8SummaryInformation(%DocumentSummaryInformation8-CompObjjObjectPoolWLyWLy  FMicrosoft Word Document MSWordDocWord.Document.89q