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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