[604] | 1 | English French Notes Complete/Exclude
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| 2 | TOTAL VPBS,
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| 3 | % OF BTS
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| 4 | TOTAL ECTOPICS,
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| 5 | AVE/HOUR
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| 6 | MAX/HOUR
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| 7 | BLOCKED APCS
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| 8 | BEATS IN RUNS
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| 9 | RUNS SV-T
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| 10 | BEATS IN LONGEST RUN
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| 11 | BEATS FASTEST RUN AT
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| 12 | BTS FASTEST RUN AT
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| 13 | PERFORMED BY:
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| 14 | DATE PERFORMED:
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| 15 | APPROVED BY:
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| 16 | DATE APPROVED:
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| 17 | DATE OF ORIGINAL CONSULT:
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| 18 | INDICATION(S) FOR PERFORMANCE:
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| 19 | PERIPHERAL BLOOD SMEAR:
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| 20 | NO. CELLS COUNTED:
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| 21 | NEUTROPHILS:
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| 22 | ORTHOCHROMATIC NORMOBLASTS:
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| 23 | BANDS:
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| 24 | POLYCHROMATIC NORMOBLASTS:
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| 25 | METAMYELOCYTES:
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| 26 | BASOPHILIC NORMOBLASTS:
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| 27 | MYELOCYTES:
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| 28 | PRONORMOBLASTS:
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| 29 | PROMYLOCYTES:
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| 30 | LYMPHOBLASTS:
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| 31 | MYELOBLASTS:
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| 32 | PLASMA CELLS:
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| 33 | EOSINOPHILS:
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| 34 | MONOCYTES:
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| 35 | BASOPHILS:
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| 36 | HISTIOCYTES:
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| 37 | LYMPHOCYTES:
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| 38 | CELLULARITY:
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| 39 | BLOOD PRESSURE:
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| 40 | VENT RATE:
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| 41 | PR INTERVAL:
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| 42 | INSTRUMENT DX:
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| 43 | CONFIRMATION STATUS:
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| 44 | COMPARISON:
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| 45 | INTERPRETED BY:
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| 46 | Ward/Clinic:
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| 47 | Bronchoscopist:
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| 48 | Fellow:
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| 49 | 2nd Fellow:
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| 50 | SERIAL NUMBER:
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| 51 | ATTENDING PHYSICIAN:
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| 52 | FELLOW-1st:
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| 53 | FELLOW-2nd:
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| 54 | THRESHOLD (VOLTS):
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| 55 | RESISTANCE (OHMS):
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| 56 | P WAVE AMPLITUDE (mV):
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| 57 | PSA USED:
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| 58 | LEAD EXPLANT REASON:
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| 59 | PACING INDICATION:
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| 60 | RISK FACTORS:
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| 61 | PSC STATUS:
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| 62 | SUDDENESS:
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| 63 | COMMENTS AND RECOMMENDATIONS:
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| 64 | INTERPRETED BY:
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| 65 | REVIEWED BY:
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| 66 | HOSPITAL WHERE IMPLANTED:
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| 67 | FIRST SCHEDULED FOLLOW-UP:
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| 68 | NON-MAG RATE
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| 69 | MAGNET RATE
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| 70 | NON-MAG PULSE WIDTH
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| 71 | MAGNET PULSE WIDTH
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| 72 | OTHER INDICATOR
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| 73 | NUMBER OF PULSE GENERATORS:
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| 74 | LAST PREVIOUS IMPLANT:
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| 75 | INCIPIENT MALFUNCTION:
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| 76 | PACING FAILURE:
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| 77 | GENERATOR EXPLANT DATE:
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| 78 | REASON FOR CHANGE:
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| 79 | SUDDENESS:
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| 80 | CALLER:
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| 81 | BASIC RHYTHM:
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| 82 | PERCENT OF PACED BEATS:
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| 83 | PULSE INTERVAL (mSec)
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| 84 | RATE (BPM)
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| 85 | PULSE WIDTH (mSec)
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| 86 | MEASURED LEAD AMPLITUDE (mV)
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| 87 | RATIO (T/L)
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| 88 | THRESHOLD WIDTH
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| 89 | THRESHOLD AMPLITUDE
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| 90 | RATE UPPER LIMIT:
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| 91 | HYSTERESIS:
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| 92 | PULSE WIDTH (ATRIAL mSec):
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| 93 | PULSE WIDTH (VENT. mSec):
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| 94 | SENSITIVITY (ATRIAL mV):
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| 95 | SENSITIVITY (VENT. mV):
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| 96 | REFRACTORY PERIOD (ATRIAL):
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| 97 | REFRACTORY PERIOD (VENT.):
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| 98 | BATTERY VOLTAGE:
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| 99 | BATTERY RESISTANCE:
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| 100 | REASON FOR REPROGRAMMING:
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| 101 | R WAVE AMPLITUDE (mV):
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| 102 | PACING INDICATION:
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| 103 | ICD9 CODE
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| 104 | BACK GROUND INFORMATION
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| 105 | Home phone:
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| 106 | Work phone:
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| 107 | Maritus status:
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| 108 | Employment status:
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| 109 | Occupation:
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| 110 | DEATH - ADMIN.
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| 111 | Lost or death status:
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| 112 | Death date:
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| 113 | Disease activity:
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| 114 | Autopsy available:
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| 115 | Cause of Death:
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| 116 | Chart type:
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| 117 | Observer:
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| 118 | DEC number:
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| 119 | Visit number:
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| 120 | Rheumatic:
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| 121 | Measurements:
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| 122 | SYMMETRICAL ARTHRITIS:
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| 123 | GRIP STRENGTH-LEFT:
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| 124 | SUB-CUTANEOUS NODULES:
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| 125 | GRIP STRENGTH-RIGHT:
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| 126 | SYNOVIAL (BAKER'S) CYST:
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| 127 | SCHOBER TEST (10 cm BASE):
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| 128 | TOPHI:
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| 129 | CHEST EXPANSION:
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| 130 | TENOSYNOVITIS(TENDON RUBS):
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| 131 | OCCIPUT-WALL:
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| 132 | TEMPORAL ARTERY TENDERNESS:
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| 133 | FINGER-TO-PALM CREASE-LEFT:
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| 134 | COSTOCHONDRITIS:
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| 135 | FINGER-TO-PALM CREASE-RIGHT:
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| 136 | INTERINCISOR DISTANCE:
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| 137 | Miscellaneous:
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| 138 | SCHIRMER TEST:
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| 139 | FUNCTIONAL CLASS (ACR):
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| 140 | DISEASE SEVERITY-PAT. ESTIMATE:
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| 141 | DISEASE SEVERITY-PHY. ESTIMATE:
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| 142 | Joint Examination:
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| 143 | Left
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| 144 | Right
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| 145 | FINGERS-DIP
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| 146 | MCPS:
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| 147 | 1st CARPOMETACARPAL:
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| 148 | WRIST:
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| 149 | ELBOW:
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| 150 | SHOULDER:
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| 151 | TMJ:
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| 152 | COSTOCHONDRAL:
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| 153 | SACROILIAC:
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| 154 | HIP:
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| 155 | KNEE:
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| 156 | ANKLE:
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| 157 | MTP:
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| 158 | TOES-PIP:
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| 159 | CERVICAL SPINE:
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| 160 | THORACIC SPINE:
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| 161 | LUMBAR SPINE:
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| 162 | PATIENT PHYSICAL EXAMINATION
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| 163 | Systolic pressure
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| 164 | Diastolic pressure
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| 165 | Uveitis
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| 166 | Lymph Node Enlargement
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| 167 | Cataract
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| 168 | Muscle Tenderness
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| 169 | Iritis
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| 170 | Muscle Weakness - Dital
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| 171 | Oral Ulcers
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| 172 | Hepatomegaly
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| 173 | Rales
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| 174 | Splenomegoly
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| 175 | Pleural Rub
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| 176 | Muscle Weakness - Proximal
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| 177 | Pleural Effusion
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| 178 | Muscle Atrophy
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| 179 | Pericardial Rub
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| 180 | Psychosis
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| 181 | Systolic Murmur
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| 182 | Organic Brain Syndrome
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| 183 | Diastolic Murmur
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| 184 | Motor Neurophathy
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| 185 | Sensory Neurophathy
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| 186 | Heliotrope Eyelids
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| 187 | Telangiectasis
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| 188 | Rash - Malar
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| 189 | Cutaneous Vasculitis
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| 190 | Psoriasis
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| 191 | Periungal Erythema
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| 192 | Rash - Discoid
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| 193 | Keratodermia Blennorrhagica
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| 194 | Rash - JRA
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| 195 | Knuckle Erythema
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| 196 | Palpable Purpura
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| 197 | Digital Ulcers
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| 198 | Sclerodactyly
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| 199 | Nail Pitting
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| 200 | Scleroderma - Extremity
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| 201 | Skin Ulcers
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| 202 | Scleroderma - Generalized
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| 203 | Erythema Nodosum
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| 204 | Morphea
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| 205 | Sysmmetrical Arthritis
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| 206 | Dactylitis
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| 207 | Tophi
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| 208 | Sub-Cutaneous Nodules
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| 209 | Synovial (Baker's) Cyst
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| 210 | Heel Pain
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| 211 | Tenosynovitis (Tendon Rubs)
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| 212 | Temporal Artery Tenderness
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| 213 | Costochondritis
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| 214 | Grip Strength - left
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| 215 | Grip Strength - Right
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| 216 | Schober Test (10 cm Base)
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| 217 | Chest Expansion
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| 218 | Occiput - Wall
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| 219 | Finger-to-Palm Crease - left
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| 220 | Finger-to-Palm Crease - Right
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| 221 | Interincisor Distance
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| 222 | Schirmer Test
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| 223 | Walk Time (50 feet)
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| 224 | Functional Class (ARA)
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| 225 | Disease Severity - Patient Estimate
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| 226 | Disease Severity - Physician Estimate
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| 227 | Fingers - DIPs
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| 228 | Fingers - PIPs
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| 229 | MCPs
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| 230 | First Carpomentacarpal
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| 231 | Wrist
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| 232 | Elbow
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| 233 | Shoulder
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| 234 | Sternoclavicular
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| 235 | Knee
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| 236 | Ankle
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| 237 | Toes - PIP
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| 238 | Cervical Spine
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| 239 | Lumber Spine
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| 240 | Patient History
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| 241 | Head,Eyes,Ears,Nose,Mouth:
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| 242 | BLURRED VISION:
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| 243 | DRY EYES:
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| 244 | Musculosketal:
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| 245 | RINGING IN EARS:
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| 246 | STIFF IN THE MORNING HOW LONG:
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| 247 | HEARING DIFFICULTIES:
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| 248 | JOINT PAIN:
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| 249 | MOUTH SORES:
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| 250 | JOINT SWELLING:
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| 251 | DRY MOUTH:
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| 252 | LOW BACK PAIN:
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| 253 | LOSS,CHANGE IN TASTE:
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| 254 | MUSCLE PAIN:
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| 255 | HEADACHE:
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| 256 | NECK PAIN:
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| 257 | DIZZINESS:
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| 258 | NUMBNESS OR TINGLING:
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| 259 | FEVER:
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| 260 | SWELLING OF LEGS:
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| 261 | NIGHT SWEATS:
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| 262 | WEAKNESS OF MUSCLES:
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| 263 | Chest, Lung, and Heart:
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| 264 | Neurologic and Psychologic:
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| 265 | CHEST PAIN/TAKING DEEP BREATH:
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| 266 | DEPRESSION:
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| 267 | SHORTNESS OF BREATH:
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| 268 | INSOMNIA:
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| 269 | WHEEZING(ASTHMA):
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| 270 | NERVOUSNESS:
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| 271 | SEIZURES OR CONVULSION:
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| 272 | TIREDNESS:
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| 273 | TROUBLE REMEMBERING/THINKING:
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| 274 | Gastrointestinal Tract:
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| 275 | Skin:
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| 276 | LOSS OF APPETITE:
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| 277 | EASY BRUISING:
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| 278 | DIFFICULTY SWALLOWING:
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| 279 | FACIAL SKIN TIGHTENING:
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| 280 | NAUSEA:
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| 281 | HIVES OR WELTS:
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| 282 | HEARTBURN,INDIGESTION,BELCHING:
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| 283 | LOSS OF HAIR:
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| 284 | VOMITING:
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| 285 | ITCHING:
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| 286 | PAIN/DISCOMFORT UPPER ABDOMEN:
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| 287 | RASH:
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| 288 | JAUNDICE:
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| 289 | RASH OVER CHEEKS:
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| 290 | LIVER:
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| 291 | SKIN COLOR CHANGE IN FINGERS:
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| 292 | PAIN/CRAMPS LOWER ABDOMEN:
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| 293 | SUN SENSITIVITY:
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| 294 | DIARRHEA(FREQUENT,WATERY):
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| 295 | CONSTIPATION:
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| 296 | BLK/TARRY STOOL(NOT FROM IRON:
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| 297 | Genitourinary:
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| 298 | Blood:
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| 299 | URINE PROTEIN:
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| 300 | LOW WHITE BLOOD COUNT:
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| 301 | BLOOD IN URINE:
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| 302 | LOW PLATELETS:
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| 303 | #################### #################### ####################
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| 304 | #################### #################### ####################
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| 305 | #################### #################### ####################
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| 306 | #################### #################### ####################
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| 307 | #################### #################### ####################
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