SCL ECMO

Show hidden and conditional rows

Post Vascular Procedure	7/1/2020
	1100	1400
Post Vascular Procedure
Procedure	List	List	+
List options: Arteriogram Cardiac Cath Ablation Impella 2.5 Impella 5.0 Impella CP Impella RP Other (Comment) Synonyms: PROCEDURE Row type: Data Value type: Custom List Multi-select Condition: Ablation Condition: Default groups/rows added when conditions are met Pupils Left Pupil Size (mm) Left Pupil Reaction Right Pupil Size (mm) Right Pupil Reaction Glasgow Coma Scale Eye Opening Best Verbal Response Best Motor Response GCS Total Does patient meet donor criteria? Limb Motion Limb Motion - Left Upper Limb Motion - Left Lower Limb Motion - Right Upper Limb Motion - Right Lower Neuro Checks Comment Neuro Checks Comment Condition: Default groups/rows added when conditions are met Hematuria Present Impella 2.5 P-Perf Level Flow: (L/min) Placement Signal (mmHg) Placement Signal (Home Screen) Purge Pressure (mmHg) LV Signal (mmHg) Motor Current (Amp Purge Flow (ml/hr) CPO (watt) Heparin Dose Impella (Units/hr) Coagulation Check Sidearm Pressure bag @300 mmHg/Flushed Centimeter Marking Power Condition: Default groups/rows added when conditions are met Impella 5.0 P-Perf Level Flow: (L/min) Placement Signal (mmHg) Placement Signal (Home Screen) Purge Pressure (mmHg) LV Signal (mmHg) Current Motor (Amp) Purge Flow (ml/hr) CPO (watt) Heparin Dose Impella (Units/hr) Coagulation Check Centimeter marking Power Condition: Default groups/rows added when conditions are met Impella CP P-Perf Level Flow: (L/min) Placement Signal (mmHg) Placement Signal (Home Screen) Purge Pressure (mmHg) LV Signal (mmHg) Motor Current (Amp) Purge Flow (ml/hr) CPO (watt) Heparin Dose Impella (Units/hr) Coagulation Check Sidearm Pressure bag @300 mmHg/Flushed Centimeter marking Power
Puncture (Hidden by default)			Duplicable
Incision Properties (Hidden by default)	Properties Group	Properties Group	+
Pre-Existing Wound Location* Wound Location Orientation* Wound Description (Comments) Number of Sutures Placed Number of Staples Placed Removal Reason Row type: Properties Group Allow completion Add to all templates where this row is start removed Placement date display name: Date First Assessed Placement time display name: Time First Assessed Removal date display name: Final Assessment Date Removal time display name: Final Assessment Time *Changes LDA Group name
Site Assessment (Hidden by default)	List	List	+
List options: Clean Dry Intact Bleeding Black Brown Dark edges Drainage Dusky Edema Epithelialization Excoriated Fragile Granulation tissue Light purple Painful Pale Pink Red Swelling Tan White Yellow UTA=Unable to assess Other (Comment) Synonyms: SITE ASSESSMENT Row type: Data Value type: Custom List Show abbreviation Allow completion Allow copy forward Display all list choices in Navigator Multi-select Add to all templates where this row is start removed *Changes LDA Group name
Peri-wound Assessment (Hidden by default)	List	List	+
List options: Clean Dry Intact Black Blanchable erythema Bleeding Brown Burgundy Dark edges Denuded Edema Excoriated Fragile Hyperpigmented Induration Maceration Non-blanchable erythema Painful Pale Pink Purple Red Swelling Tan White Yellow-brown=Hemosiderin staining UTA=Unable to assess Other (Comment) Row type: Data Value type: Custom List Show abbreviation Allow completion Allow copy forward Display all list choices in Navigator Multi-select Add to all templates where this row is start removed *Changes LDA Group name
Wound Length (cm) (Hidden by default)	Number	Number	+
Unit: cm Synonyms: WOUND LENGTH Row type: Data Value type: Numeric Type Allow completion Add to all templates where this row is start removed Can be graphed *Changes LDA Group name
Wound Width (cm) (Hidden by default)	Number	Number	+
Unit: cm Synonyms: WOUND WIDTH Row type: Data Value type: Numeric Type Allow completion Add to all templates where this row is start removed Can be graphed *Changes LDA Group name
Wound Depth (cm) (Hidden by default)	Number	Number	+
Synonyms: DEPTH, WOUND Row type: Data Value type: Numeric Type Allow completion Add to all templates where this row is start removed Can be graphed *Changes LDA Group name
Calculated Wound Size (cm^3) (Hidden by default)	Formula (Read Only)	Formula (Read Only)	+
Unit: cm^2 Formula: {Wound Length (cm)}{Wound Width (cm)}{Wound Depth (cm)} Synonyms: CALCULATED WOUND SIZE, WOUND Row type: Custom Formula Value type: Numeric Type Allow completion Can be graphed *Changes LDA Group name
Drainage Amount (Hidden by default)	List	List	+
List options: Copious Large Moderate Small Scant None UTA=Unable to assess Other (Comment) Row information: Copious = Excessive amountLarge = Wound tissues filled with fluidModerate = Wound tissues wetSmall = Wound tissues very moistScant = Wound tissues moistNone = Wound tissues dry Row type: Data Value type: Custom List Show abbreviation Allow completion Allow copy forward Display all list choices in Navigator Add to all templates where this row is start removed *Changes LDA Group name
Drainage Description (Hidden by default)	List	List	+
List options: Black Brown Clear Foul purulent Green Purulent Sanguineous Serosanguineous Serous Tan Yellow UTA=Unable to assess Other (Comment) Row information: Foul purulent = Thick opaque yellow to green with offensive odor Purulent = Thick or thin, opaque tan to yellow Sanguineous = Thin, bright red Serosanguineous = Thin, watery, pale red to pink Serous = Thin, watery, clear Synonyms: DRAINAGE DESCRIPTION Row type: Data Value type: Custom List Show abbreviation Allow completion Allow copy forward Display all list choices in Navigator Multi-select Add to all templates where this row is start removed *Changes LDA Group name
Drainage Odor (Hidden by default)	List	List	+
List options: None/Absent Mild Odor Foul Odor Pungent Sweet Musky Sour UTA=Unable to Assess Synonyms: DRAINAGE ODOR Row type: Data Value type: Custom List Show abbreviation Allow completion Allow copy forward Display all list choices in Navigator Multi-select Add to all templates where this row is start removed *Changes LDA Group name
Treatments (Hidden by default)	List	List	+
List options: Cleansed Heat applied Ice applied Irrigation Moisturizing cream Papain-urea debridement Pharmaceutical agent Site care Special tape Tape change Zinc - oxide paste Debridement Other (Comment) Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select *Changes LDA Group name
Dressing (Hidden by default)	List	List	+
List options: ABD=Abdominal dressing Ace Wrap Adaptic Adhering Gauze Roll Alginate Antimicrobial Bandaid Barrier Film Cadexomer Collagen Composite Compression Dressing/Wrap Dermabond Dry dressing Elastic Bandage Eye shield Foam Gauze Pads Gauze Roll/Wrap Hydrocolloid Hydrofiber Hydrogel Impregnated foam Manuka Honey Medicated Gauze Pad Moist to dry Moist to moist Moisture barrier Non adherent NPWT White Foam NPWT Black Foam NPWT Silver Foam Open to air Packing Pressure dressing Prineo Protective barrier Scrotal support Silicone dressing Silver dressing Silverlon Split gauze Steri Strips Stockinette Transparent Triad hydro Unna boot Vacuum dressing Vaseline gauze Water based Wound gel Xeroform Pico Telfa Other (Comment) Synonyms: DRESSING Row type: Data Value type: Custom List Show abbreviation Allow completion Allow copy forward Display all list choices in Navigator Multi-select Add to all templates where this row is start removed *Changes LDA Group name
Dressing Changed (Hidden by default)	List	List	+
List options: New Changed Reinforced Other (Comment) Synonyms: DRESSING CHANGED Row type: Data Value type: Custom List Show abbreviation Allow completion Display all list choices in Navigator Add to all templates where this row is start removed *Changes LDA Group name
Dressing Status (Hidden by default)	List	List	+
List options: Clean Dry Intact New drainage Old drainage Removed Bio patch Initials w/ date and time Other (Comment) Synonyms: DRSG STATUS Row type: Data Value type: Custom List Allow completion Allow copy forward Display all list choices in Navigator Multi-select Add to all templates where this row is start removed *Changes LDA Group name
Adhesive Closure Strips (Hidden by default)	List	List	+
List options: Applied Intact Changed Other (Comment) Synonyms: STERI-STRIPS Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator *Changes LDA Group name
Number of Adhesive Closure Strips (Hidden by default)	Number	Number	+
Synonyms: STERI-STRIPS Row type: Data Value type: Numeric Type Allow completion Can be graphed *Changes LDA Group name
Sutures Removed Intact (Hidden by default)	List	List	+
List options: Yes No (Comment) Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator *Changes LDA Group name
Number of Sutures Removed (Hidden by default)	Number	Number	+
Row type: Data Value type: Numeric Type Allow completion Can be graphed *Changes LDA Group name
Bleeding
Bleeding at Site	List	List	+
List options: Yes No Synonyms: BLEEDING AT SITE Row type: Data Value type: Custom List Allow completion Allow copy forward Display all list choices in Navigator Add to all templates where this row is start removed
Bleeding Amount	List	List	+
List options: Copious Moderate Minimal Scant Synonyms: BLEEDING AMOUNT Row type: Data Value type: Custom List Allow completion Allow copy forward Display all list choices in Navigator Add to all templates where this row is start removed
Bleeding Description	List	List	+
List options: Dark Red Bright Red Pink Synonyms: BLEEDING DESCRIPTION Row type: Data Value type: Custom List Allow completion Allow copy forward Display all list choices in Navigator Add to all templates where this row is start removed
Ecchymosis Present	List	List	+
List options: Yes No Synonyms: ECCHYMOSIS PRESENT Row type: Data Value type: Custom List Allow completion Allow copy forward Display all list choices in Navigator Add to all templates where this row is start removed
Ecchymosis Edges Marked	List	List	+
List options: Yes No Synonyms: ECCHYMOSIS EDGES MARKED Row type: Data Value type: Custom List Allow completion Allow copy forward Display all list choices in Navigator Add to all templates where this row is start removed
Hematoma Present	List	List	+
List options: Yes No Synonyms: HEMATOMA PRESENT Row type: Data Value type: Custom List Allow completion Allow copy forward Display all list choices in Navigator Add to all templates where this row is start removed
Size of Hematoma	Number	Number	+
Unit: cm Synonyms: SIZE OF HEMATOMA Row type: Data Value type: Numeric Type Allow completion Allow copy forward Add to all templates where this row is start removed Can be graphed
Hematoma Edges Marked	List	List	+
List options: Yes No Synonyms: HEMATOMA EDGES MARKED Row type: Data Value type: Custom List Allow completion Allow copy forward Add to all templates where this row is start removed Can be graphed
Hemostatis Achieved	List	List	+
List options: Yes No Synonyms: HEMOSTATIS ACHIEVED Row type: Data Value type: Custom List Allow completion Allow copy forward Add to all templates where this row is start removed Can be graphed
Bleeding Comment	Free Text	Free Text	+
Synonyms: BLEEDING COMMENT Row type: Data Value type: String Type Allow completion Allow copy forward Add to all templates where this row is start removed
Hematuria Present (Hidden by default)	List	List	+
List options: Yes No Synonyms: HEMATURIA PRESENT Row type: Data Value type: Custom List Display all list choices in Navigator Add to all templates where this row is start removed
Limb Assessment
Location Site(S)	List	List	+
List options: Left Arm Right Arm Left Hand Right Hand Left Leg Right Leg Left Foot Right Foot Left Fingers Right Fingers Left Toes Right Toes Synonyms: LOCATION, LOCATION SITE, LOCATION SITE(S) Row type: Data Value type: Custom List Multi-select Condition: Left Arm Condition: Default groups/rows added when conditions are met Left Arm Appearance Left Arm Sensation Condition: Default groups/rows added when conditions are met Right Arm Temperature Right Arm Appearance Right Arm Sensation Condition: Default groups/rows added when conditions are met Left Hand Temperature Left Hand Appearance Left Hand Sensation Condition: Default groups/rows added when conditions are met Right Hand Temperature Right Hand Appearance Right Hand Sensation Condition: Default groups/rows added when conditions are met Left Leg Temperature Left Leg Appearance Left Leg Sensation Condition: Default groups/rows added when conditions are met Right Leg Temperature Right Leg Appearance Right Leg Sensation Condition: Default groups/rows added when conditions are met Left Foot Temperature Left Foot Appearance Left Foot Sensation Condition: Default groups/rows added when conditions are met Right Foot Temperature Right Foot Appearance Right Foot Sensation Condition: Default groups/rows added when conditions are met Left Fingers Temp Left Fingers Appearance Left Fingers Sensation Condition: Default groups/rows added when conditions are met Right Fingers Temp Right Fingers Appearance Right Fingers Sensation Condition: Default groups/rows added when conditions are met Left Toes Temperature Left Toes Appearance Left Toes Sensation
OTHER
Left Arm Temperature (Hidden by default)	List	List	+
List options: Cold Cool Warm Hot Synonyms: LEFT ARM TEMPERATURE Row type: Data Value type: Custom List
Left Arm Appearance (Hidden by default)	List	List	+
List options: Cyanotic Dusky Mottled Pale Pink Purple Appropriate for ethnicity Other (Comment) Synonyms: LEFT ARM APPEARANCE Row type: Data Value type: Custom List Multi-select
Left Arm Sensation (Hidden by default)	List	List	+
List options: Burning coldness Heaviness Itching Numbness Pain Pins & Needles Tingling Unable to assess Other (comment) Synonyms: LEFT ARM SENSATION Row type: Data Value type: Custom List Multi-select
Right Arm Temperature (Hidden by default)	List	List	+
List options: Cold Cool Warm Hot Synonyms: RIGHT ARM TEMPERATURE Row type: Data Value type: Custom List
Right Arm Appearance (Hidden by default)	List	List	+
List options: Cyanotic Dusky Mottled Pale Pink Purple Appropriate for ethnicity Other (Comment) Synonyms: RIGHT ARM APPEARANCE Row type: Data Value type: Custom List Multi-select
Right Arm Sensation (Hidden by default)	List	List	+
List options: Burning coldness Heaviness Itching Numbness Pain Pins & Needles Tingling Unable to assess Other (comment) Synonyms: RIGHT ARM SENSATION Row type: Data Value type: Custom List Multi-select
Left Leg Temperature (Hidden by default)	List	List	+
List options: Cold Cool Warm Hot Synonyms: LEFT LEG TEMPERATURE Row type: Data Value type: Custom List
Left Leg Appearance (Hidden by default)	List	List	+
List options: Cyanotic Dusky Mottled Pale Pink Purple Appropriate for ethnicity Other (Comment) Synonyms: LEFT LEG APPEARANCE Row type: Data Value type: Custom List Multi-select
Left Leg Sensation (Hidden by default)	List	List	+
List options: Burning coldness Heaviness Itching Numbness Pain Pins & Needles Tingling Unable to assess Other (comment) Row information: Synonyms: LEFT LEG SENSATION Row type: Data Value type: Custom List Multi-select
Right Leg Temperature (Hidden by default)	List	List	+
List options: Cold Cool Warm Hot Synonyms: RIGHT LEG TEMPERATURE Row type: Data Value type: Custom List
Right Leg Appearance (Hidden by default)	List	List	+
List options: Cyanotic Dusky Mottled Pale Pink Purple Appropriate for ethnicity Other (Comment) Synonyms: RIGHT LEG APPEARANCE Row type: Data Value type: Custom List Multi-select
Right Leg Sensation (Hidden by default)	List	List	+
List options: Burning coldness Heaviness Itching Numbness Pain Pins & Needles Tingling Unable to assess Other (comment) Row information: Synonyms: RIGHT LEG SENSATION Row type: Data Value type: Custom List Multi-select
Left Hand Temperature (Hidden by default)	List	List	+
List options: Cold Cool Warm Hot Synonyms: LEFT ARM TEMPERATURE, LEFT HAND TEMPERATURE Row type: Data Value type: Custom List
Left Hand Appearance (Hidden by default)	List	List	+
List options: Cyanotic Dusky Mottled Pale Pink Purple Appropriate for ethnicity Other (Comment) Synonyms: LEFT HAND APPEARANCE Row type: Data Value type: Custom List Multi-select
Left Hand Sensation (Hidden by default)	List	List	+
List options: Burning coldness Heaviness Itching Numbness Pain Pins & Needles Tingling Unable to assess Other (comment) Row information: Synonyms: LEFT HAND SENSATION Row type: Data Value type: Custom List Multi-select
Right Hand Temperature (Hidden by default)	List	List	+
List options: Cold Cool Warm Hot Synonyms: RIGHT HAND TEMPERATURE Row type: Data Value type: Custom List
Right Hand Appearance (Hidden by default)	List	List	+
List options: Cyanotic Dusky Mottled Pale Pink Purple Appropriate for ethnicity Other (Comment) Synonyms: RIGHT HAND APPEARANCE Row type: Data Value type: Custom List Multi-select
Right Hand Sensation (Hidden by default)	List	List	+
List options: Burning coldness Heaviness Itching Numbness Pain Pins & Needles Tingling Unable to assess Other (comment) Row information: Synonyms: RIGHT HAND SENSATION Row type: Data Value type: Custom List Multi-select
Left Foot Temperature (Hidden by default)	List	List	+
List options: Cold Cool Warm Hot Synonyms: LEFT FOOT TEMPERATURE Row type: Data Value type: Custom List
Left Foot Appearance (Hidden by default)	List	List	+
List options: Cyanotic Dusky Mottled Pale Pink Purple Appropriate for ethnicity Other (Comment) Synonyms: LEFT FOOT APPEARANCE Row type: Data Value type: Custom List Multi-select
Left Foot Sensation (Hidden by default)	List	List	+
List options: Burning coldness Heaviness Itching Numbness Pain Pins & Needles Tingling Unable to assess Other (comment) Row information: Synonyms: LEFT FOOT SENSATION Row type: Data Value type: Custom List Multi-select
Right Foot Temperature (Hidden by default)	List	List	+
List options: Cold Cool Warm Hot Synonyms: RIGHT FOOT TEMPERATURE Row type: Data Value type: Custom List
Right Foot Appearance (Hidden by default)	List	List	+
List options: Cyanotic Dusky Mottled Pale Pink Purple Appropriate for ethnicity Other (Comment) Synonyms: RIGHT FOOT APPEARANCE Row type: Data Value type: Custom List Multi-select
Right Foot Sensation (Hidden by default)	List	List	+
List options: Burning coldness Heaviness Itching Numbness Pain Pins & Needles Tingling Unable to assess Other (comment) Row information: Synonyms: RIGHT FOOT SENSATION Row type: Data Value type: Custom List Multi-select
Left Fingers Temp (Hidden by default)	List	List	+
List options: Cold Cool Warm Hot Synonyms: LEFT FINGERS TEMP Row type: Data Value type: Custom List
Left Fingers Appearance (Hidden by default)	List	List	+
List options: Cyanotic Dusky Mottled Pale Pink Purple Appropriate for ethnicity Other (Comment) Synonyms: LEFT FINGERS APPEARANCE Row type: Data Value type: Custom List Multi-select
Left Fingers Sensation (Hidden by default)	List	List	+
List options: Burning coldness Heaviness Itching Numbness Pain Pins & Needles Tingling Unable to assess Other (comment) Synonyms: LEFT FINGERS SENSATION Row type: Data Value type: Custom List Multi-select
Right Fingers Temp (Hidden by default)	List	List	+
List options: Cold Cool Warm Hot Synonyms: RIGHT FINGERS TEMP Row type: Data Value type: Custom List
Right Fingers Appearance (Hidden by default)	List	List	+
List options: Cyanotic Dusky Mottled Pale Pink Purple Appropriate for ethnicity Other (Comment) Synonyms: RIGHT FINGERS APPEARANCE Row type: Data Value type: Custom List Multi-select
Right Fingers Sensation (Hidden by default)	List	List	+
List options: Burning coldness Heaviness Itching Numbness Pain Pins & Needles Tingling Unable to assess Other (comment) Row information: Synonyms: RIGHT FINGERS SENSATION Row type: Data Value type: Custom List Multi-select
Left Toes Temperature (Hidden by default)	List	List	+
List options: Cold Cool Warm Hot Synonyms: LEFT TOES TEMPERATURE Row type: Data Value type: Custom List
Left Toes Appearance (Hidden by default)	List	List	+
List options: Cyanotic Dusky Mottled Pale Pink Purple Appropriate for ethnicity Other (Comment) Synonyms: LEFT TOES APPEARANCE Row type: Data Value type: Custom List Multi-select
Left Toes Sensation (Hidden by default)	List	List	+
List options: Burning coldness Heaviness Itching Numbness Pain Pins & Needles Tingling Unable to assess Other (comment) Row information: Synonyms: LEFT TOES SENSATION Row type: Data Value type: Custom List Multi-select
Right Toes Temperature (Hidden by default)	List	List	+
List options: Cold Cool Warm Hot Synonyms: RIGHT TOES TEMPERATURE Row type: Data Value type: Custom List
Right Toes Appearance (Hidden by default)	List	List	+
List options: Cyanotic Dusky Mottled Pale Pink Purple Appropriate for ethnicity Other (Comment) Synonyms: RIGHT TOES APPEARANCE Row type: Data Value type: Custom List Multi-select
Right Toes Sensation (Hidden by default)	List	List	+
List options: Burning coldness Heaviness Itching Numbness Pain Pins & Needles Tingling Unable to assess Other (comment) Synonyms: LEFT TOES SENSATION, RIGHT TOES SENSATION Row type: Data Value type: Custom List Multi-select
Cardiovascular Pulses (Hidden by default)
Central (Hidden by default)	List	List	+
List options: +1 +2 +3 Absent Bounding Doppler Strong Weak UTA=Unable to assess Other (Comment) Synonyms: CENTRAL Row type: Data Value type: Custom List Allow completion Multi-select Add to all templates where this row is start removed
Peripheral (Hidden by default)	List	List	+
List options: +1 +2 +3 Absent Bounding Doppler Strong Weak UTA=Unable to assess Other (Comment) Synonyms: PERIPHERAL Row type: Data Value type: Custom List Allow completion Multi-select Add to all templates where this row is start removed
RUE (Hidden by default)	List	List	+
List options: +1 +2 +3 Absent Bounding Doppler Strong Weak UTA=Unable to assess Other (Comment) Synonyms: RUE Row type: Data Value type: Custom List Allow completion Multi-select Add to all templates where this row is start removed
LUE (Hidden by default)	List	List	+
List options: +1 +2 +3 Absent Bounding Doppler Strong Weak UTA=Unable to assess Other (Comment) Synonyms: LUE Row type: Data Value type: Custom List Allow completion Multi-select Add to all templates where this row is start removed
RLE (Hidden by default)	List	List	+
List options: +1 +2 +3 Absent Bounding Doppler Strong Weak UTA=Unable to assess Other (Comment) Synonyms: RLE Row type: Data Value type: Custom List Allow completion Multi-select Add to all templates where this row is start removed
LLE (Hidden by default)	List	List	+
List options: +1 +2 +3 Absent Bounding Doppler Strong Weak UTA=Unable to assess Other (Comment) Synonyms: LLE Row type: Data Value type: Custom List Allow completion Multi-select Add to all templates where this row is start removed
Cardiovascular Pulses
Pulse(s) Location (Hidden by default)	List	List	+
List options: Rt Radial Lt Radial Rt Dorsalis Pedis Lt Dorsalis Pedis Rt Post Tibial Lt Post Tibial Rt Femoral Lt Femoral Other (Comment) Synonyms: PULSE(S) LOCATION Row type: Data Value type: Custom List Allow completion Multi-select Add to all templates where this row is start removed Condition: Rt Radial Condition: Condition: Default groups/rows added when conditions are met Pulse: Lt Radial Condition: Default groups/rows added when conditions are met Pulse: Rt Dorsalis Pedis Condition: Default groups/rows added when conditions are met Pulse: Lt Dorsalis Pedis Condition: Default groups/rows added when conditions are met Pulse: Rt Post Tibial Condition: Default groups/rows added when conditions are met Pulse: Lt Post Tibial Condition: Default groups/rows added when conditions are met Pulse: Rt Femoral
Pulse: Rt Radial	List	List	+
List options: +1 +2 +3 Absent Bounding Doppler Strong Weak UTA=Unable to assess Other (Comment) Synonyms: PULSE: RT RADIAL Row type: Data Value type: Custom List Allow completion Multi-select Add to all templates where this row is start removed
Pulse: Lt Radial	List	List	+
List options: +1 +2 +3 Absent Bounding Doppler Strong Weak UTA=Unable to assess Other (Comment) Synonyms: PULSE: LT RADIAL Row type: Data Value type: Custom List Allow completion Multi-select Add to all templates where this row is start removed
Pulse: Rt Dorsalis Pedis	List	List	+
List options: +1 +2 +3 Absent Bounding Doppler Strong Weak UTA=Unable to assess Other (Comment) Synonyms: PULSE: RT DORSALIS PEDIS Row type: Data Value type: Custom List Allow completion Multi-select Add to all templates where this row is start removed
Pulse: Lt Dorsalis Pedis	List	List	+
List options: +1 +2 +3 Absent Bounding Doppler Strong Weak UTA=Unable to assess Other (Comment) Synonyms: PULSE: LT DORSALIS PEDIS Row type: Data Value type: Custom List Allow completion Multi-select Add to all templates where this row is start removed
Pulse: Rt Post Tibial	List	List	+
List options: +1 +2 +3 Absent Bounding Doppler Strong Weak UTA=Unable to assess Other (Comment) Synonyms: PULSE: RT POST TIBIAL Row type: Data Value type: Custom List Allow completion Multi-select Add to all templates where this row is start removed
Pulse: Lt Post Tibial	List	List	+
List options: +1 +2 +3 Absent Bounding Doppler Strong Weak UTA=Unable to assess Other (Comment) Synonyms: PULSE: LT POST TIBIAL Row type: Data Value type: Custom List Allow completion Multi-select Add to all templates where this row is start removed
Pulse: Rt Femoral	List	List	+
List options: +1 +2 +3 Absent Bounding Doppler Strong Weak UTA=Unable to assess Other (Comment) Synonyms: PULSE: RT FEMORAL Row type: Data Value type: Custom List Allow completion Multi-select Add to all templates where this row is start removed
Pulse: Lt Femoral	List	List	+
List options: +1 +2 +3 Absent Bounding Doppler Strong Weak UTA=Unable to assess Other (Comment) Synonyms: PULSE: LT FEMORAL Row type: Data Value type: Custom List Allow completion Multi-select Add to all templates where this row is start removed
Pulse: Rt Popliteal	List	List	+
List options: +1 +2 +3 Absent Bounding Doppler Strong Weak UTA=Unable to assess Other (Comment) Synonyms: PULSE: RT POPLITEAL Row type: Data Value type: Custom List Allow completion Multi-select Add to all templates where this row is start removed
Pulse: Lt Popliteal	List	List	+
List options: +1 +2 +3 Absent Bounding Doppler Strong Weak UTA=Unable to assess Other (Comment) Synonyms: PULSE: LT POPLITEAL Row type: Data Value type: Custom List Allow completion Multi-select Add to all templates where this row is start removed
Neuro Checks - Speech (Hidden by default)
Speech (Hidden by default)	List	List	+
List options: Clear Aphasic Delayed Excessive Garbled Inappropriate Incoherent Intubated Loud Non-verbal Rambling Slurred Soft Synonyms: SPEECH Row type: Data Value type: Custom List Multi-select
Pupils (Hidden by default)
Left Pupil Size (mm) (Hidden by default)	List	List	+
List options: 1 2 3 4 5 6 7 8 9 Other (Comment) Size button width to each choice Synonyms: SIZE L PUPIL (MM), PUPIL, LEFT PUPIL SIZE (MM) Row type: Data Value type: Custom List Allow completion Allow copy forward Display all list choices in Navigator Add to all templates where this row is start removed
Left Pupil Reaction (Hidden by default)	List	List	+
List options: Brisk Sluggish Nonreactive Unable to assess Other (Comment) Synonyms: REACTION L PUPIL, PUPIL, LEFT PUPIL REACTION Row type: Data Value type: Custom List Allow completion Allow copy forward Display all list choices in Navigator Add to all templates where this row is start removed
Right Pupil Size (mm) (Hidden by default)	List	List	+
List options: 1 2 3 4 5 6 7 8 9 Other (Comment) Size button width to each choice Synonyms: SIZE R PUPIL (MM), PUPIL, RIGHT PUPIL SIZE (MM) Row type: Data Value type: Custom List Allow completion Allow copy forward Display all list choices in Navigator Add to all templates where this row is start removed
Right Pupil Reaction (Hidden by default)	List	List	+
List options: Brisk Sluggish Nonreactive Unable to assess Other (Comment) Synonyms: REACTION R PUPIL, PUPIL, RIGHT PUPIL REACTION Row type: Data Value type: Custom List Allow completion Allow copy forward Display all list choices in Navigator Add to all templates where this row is start removed
Glasgow Coma Scale (Hidden by default)
Eye Opening (Hidden by default)	List	List	+
List options: 4=Spontaneous 3=To speech 2=To pain 1=None Min age (days): 1826 Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Add to all templates where this row is start removed
Best Verbal Response (Hidden by default)	List	List	+
List options: 5=Oriented 4=Confused 3=Inappropriate words 2=Incomprehensible speech 1=None Min age (days): 1826 Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Add to all templates where this row is start removed
Best Motor Response (Hidden by default)	List	List	+
List options: 6=Obeys commands 5=Localizes pain 4=Withdraws from pain 3=Flexion to pain 2=Extension to pain 1=None Min age (days): 1826 Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Add to all templates where this row is start removed
GCS Total (Hidden by default)	Formula (Read Only)	Formula (Read Only)	+
Decimal places: 0 Min age (days): 1826 Row information: A Coma Score of 13 or higher correlates with a mild brain injury, 9 to 12 is a moderate injury, and 8 or less is a severe brain injury. Formula: {Eye Opening}+{Best Verbal Response}+{Best Motor Response} Synonyms: GCS TOTAL Row type: Custom Formula Value type: Numeric Type Add to all templates where this row is start removed Can be graphed
Does patient meet donor criteria? (Hidden by default)	List	List	+
List options: Yes, patient meets criteria No, patient does not meet criteria Synonyms: DOES PATIENT MEET DONOR CRITERIA? Comments: This row is built for CHC's Clinical Program: Identifying Potential Organ Donor Candidates. Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Limb Motion (Hidden by default)
Limb Motion - Left Upper (Hidden by default)	List	List	+
List options: 5 Complete motion, overcomes gravity with full resistance 4 Complete motion, overcomes gravity with some resistance 3 Complete motion, barely overcomes gravity 2 Visible movement, but cannot overcome gravity 1 Palpable muscle movement, no joint motion 0 No evidence of muscle contraction F Abnormal flexion E Abnormal extension Synonyms: LIMB MOTION - LEFT UPPER Row type: Data Value type: Custom List
Limb Motion - Left Lower (Hidden by default)	List	List	+
List options: 5 Complete motion, overcomes gravity with full resistance 4 Complete motion, overcomes gravity with some resistance 3 Complete motion, barely overcomes gravity 2 Visible movement, but cannot overcome gravity 1 Palpable muscle movement, no joint motion 0 No evidence of muscle contraction F Abnormal flexion E Abnormal extension Synonyms: LIMB MOTION - LEFT LOWER Row type: Data Value type: Custom List
Limb Motion - Right Upper (Hidden by default)	List	List	+
List options: 5 Complete motion, overcomes gravity with full resistance 4 Complete motion, overcomes gravity with some resistance 3 Complete motion, barely overcomes gravity 2 Visible movement, but cannot overcome gravity 1 Palpable muscle movement, no joint motion 0 No evidence of muscle contraction F Abnormal flexion E Abnormal extension Synonyms: LIMB MOTION - RIGHT UPPER Row type: Data Value type: Custom List
Limb Motion - Right Lower (Hidden by default)	List	List	+
List options: 5 Complete motion, overcomes gravity with full resistance 4 Complete motion, overcomes gravity with some resistance 3 Complete motion, barely overcomes gravity 2 Visible movement, but cannot overcome gravity 1 Palpable muscle movement, no joint motion 0 No evidence of muscle contraction F Abnormal flexion E Abnormal extension Synonyms: LIMB MOTION - RIGHT LOWER Row type: Data Value type: Custom List
Neuro Checks Comment (Hidden by default)
Neuro Checks Comment (Hidden by default)	Free Text	Free Text	+
Synonyms: NEURO CHECKS COMMENT Row type: Data Value type: String Type
Vitals
Heart Rate Source	List	List	+
List options: Monitor Apical Automatic Pulse Right Left Radial Brachial Dorsalis pedis Femoral Carotid Popliteal Posterior tibial Other (Comment) Size button width to each choice Row type: Data Value type: Custom List Show abbreviation Allow completion Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
MAP (mmHg)	Number	Number	+
Decimal places: 0 Minimum value: 0 Row information: MAP=Mean Arterial Pressure. Enter value from monitor/device. Synonyms: MEAN ARTERIAL PRESSURE Row type: Data Value type: Numeric Type Allow completion Add to all templates where this row is start removed Can be graphed
BP Location	List	List	+
List options: Right arm Left arm Right leg Left leg Other (Comment) Size button width to each choice Synonyms: BP LOCATION Row type: Data Value type: Custom List Show abbreviation Allow completion Display all list choices in Navigator Add to all templates where this row is start removed
BP Method	List	List	+
List options: Automatic Manual Doppler Other (Comment) Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Add to all templates where this row is start removed
Patient Position	List	List	+
List options: Lying Sitting Standing Held Other (Comment) Size button width to each choice Synonyms: PATIENT POSITION Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Add to all templates where this row is start removed
Cardiac Rhythm	List	List	+
List options: NSR=Normal sinus rhythm SB=Sinus bradycardia ST=Sinus tachycardia A-Paced=Atrial paced V-Paced=Ventricular paced A/V Paced=A-V Sequential paced A-fib=Atrial fibrillation A-fib w RVR=Atrial fibrillation w/ rapid ventricular response A-flutter=Atrial flutter Heart block Junctional=Junctional rhythm PEA=Pulseless electrical activity SVT=Supraventricular tachycardia Torsades=Torsades de Pointes VF=Ventricular fibrillation VT=Ventricular tachycardia Asystole Other (Comment) Size button width to each choice Synonyms: CARDIAC RHYTHM Comments: added abbreviations and selected show abbreviation to allow STEMI quickbar to display properly on smaller screens as well as to consolidate navigator sections with this row. Row type: Data Value type: Custom List Show abbreviation Allow completion Allow copy forward Display all list choices in Navigator Add to all templates where this row is start removed Condition: Heart block Condition:
Heart Block Type (Hidden by default)	List	List	+
List options: 1st degree AVB 2nd degree AVB (Mobitz I, Wenckebach) 2nd degree AVB (Mobitz II) 3rd degree AVB Bundle branch block Idioventricular Other (Comment) Size button width to each choice Synonyms: HEART BLOCK TYPE Row type: Data Value type: Custom List Show abbreviation Allow completion Allow copy forward Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Ectopy	List	List	+
List options: Premature ventricular contractions Unifocal PVCs Multifocal PVCs Couplet PVCs Triplet PVCs Premature atrial contractions Aberrent conduction Ectopic beats Fusion beats Junctional escape beats Non-conducted PACs Paroxysmal atrial tachycardia Paroxysmal supraventricular tachycardia Premature junctional contractions Torsades de Pointes Ventricular escape beats Ventricular tachycardia Other (Comment) Row type: Data Value type: Custom List Allow completion Allow copy forward Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Ectopy Frequency	List	List	+
List options: Rare Occasional Frequent Bigeminal Trigeminal Quadrigeminal Non-Sustained Sustained Other (Comment) Row information: Rare: 1 - 3 /min. Occasional: 4 - 10/min. Frequent: > 10/min. Synonyms: ECTOPY FREQUENCY Row type: Data Value type: Custom List Allow completion Allow copy forward Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Fever Medication Reassessment Outcome	List	List	+
List options: Decreased Improved No change Increased Relieved Provider notified Synonyms: FEVER MEDICATION OUTCOME, FEVER REASSESSMENT MED OUTCOME, FEVER REASSESSMENT MEDICATION OUTCOME, FEVER MEDICATION REASSESSMENT OUTCOME Row type: Data Value type: Custom List Multi-select
Blood Pressure Medication Reassessment Outcome	List	List	+
List options: Decreased Improved No change Increased Relieved Provider notified Synonyms: BLOOD PRESSURE MEDICATION OUTCOME, BLOOD PRESSURE MEDICATION REASSESSMENT OUTCOME Row type: Data Value type: Custom List Multi-select
Art Line (Hidden by default)
Arterial Line BP (Hidden by default)	Blood Pressure	Blood Pressure	+
Synonyms: ARTERIAL LINE BP Row type: Data Value type: Blood Pressure Allow completion Add to all templates where this row is start removed Can be graphed
Arterial Line MAP (mmHg) (Hidden by default)	Number	Number	+
Decimal places: 0 Minimum value: 0 Unit: mmHg Abbreviation: MAP Synonyms: MEAN, ARTERIAL PRESSURE Row type: Data Value type: Numeric Type Allow completion Add to all templates where this row is start removed Can be graphed
Arterial Line Location (Hidden by default)	List	List	+
List options: Right femoral Left femoral Right radial Left radial Other (Comment) Row type: Data Value type: Custom List Show abbreviation Allow completion Display all list choices in Navigator Add to all templates where this row is start removed
Art Line Waveform (Hidden by default)	List	List	+
List options: Appropriate waveforms Dampened Rezeroed Whip Other (Comment) Synonyms: ART LINE WAVE FORM Row type: Data Value type: Custom List Show abbreviation Allow completion Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Art Line (2) (Hidden by default)
Arterial Line BP 2 (Hidden by default)	Blood Pressure	Blood Pressure	+
Row type: Data Value type: Blood Pressure Allow completion Display all list choices in Navigator Add to all templates where this row is start removed Can be graphed
Arterial Line MAP (mmHg) (Hidden by default)	Number	Number	+
Decimal places: 0 Minimum value: 0 Unit: mmHg Abbreviation: MAP Synonyms: MEAN, ARTERIAL PRESSURE Row type: Data Value type: Numeric Type Allow completion Add to all templates where this row is start removed Can be graphed
Arterial Line Location 2 (Hidden by default)	List	List	+
List options: Right femoral Left femoral Right radial Left radial Other (Comment) Row type: Data Value type: Custom List Show abbreviation Allow completion Display all list choices in Navigator Add to all templates where this row is start removed
Art Line Waveform 2 (Hidden by default)	List	List	+
List options: Appropriate waveforms Dampened Rezeroed Whip Other (Comment) Synonyms: ART LINE WAVE FORM 2 Row type: Data Value type: Custom List Show abbreviation Allow completion Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Impella 2.5 (Hidden by default)
P-Perf Level (Hidden by default)	List	List	+
List options: P0 P1 P2 P3 P4 P5 P6 P7 P8 P9 Synonyms: P-PERF LEVEL Row type: Data Value type: Custom List Allow completion
Flow: (L/min) (Hidden by default)	Number	Number	+
Unit: L/min Synonyms: FLOW: (L/MIN) Row type: Data Value type: Numeric Type Can be graphed
Placement Signal (mmHg) (Hidden by default)	Blood Pressure	Blood Pressure	+
List options: Aortic 2.5 Differential 5.0 Synonyms: PLACEMENT SIGNAL, PLACEMENT SIGNAL (MMHG) Row type: Data Value type: Blood Pressure Can be graphed
Placement Signal (Home Screen) (Hidden by default)	List	List	+
List options: Ok Unknown Wrong Synonyms: PLACEMENT SIGNAL (HOME SCREEN) Row type: Data Value type: Custom List
Purge Pressure (mmHg) (Hidden by default)	Number	Number	+
Unit: mmHg Synonyms: PURGE PRESSURE, PURGE PRESSURE (MMHG) Row type: Data Value type: Numeric Type Can be graphed
LV Signal (mmHg) (Hidden by default)	Number	Number	+
Unit: mmHg Synonyms: LV SIGNAL (MMHG) Row type: Data Value type: Numeric Type Can be graphed
Motor Current (Amp (Hidden by default)	Free Text	Free Text	+
Synonyms: MOTOR CURRENT, MOTOR CURRENT (AMP Row type: Data Value type: String Type
Purge Flow (ml/hr) (Hidden by default)	Number	Number	+
List options: Hgh Low Unit: ml/hr Synonyms: PURGE FLOW (ML/HR) Row type: Data Value type: Numeric Type Can be graphed
CPO (watt) (Hidden by default)	Number	Number	+
Unit: watt Synonyms: CPO (WATT) Row type: Data Value type: Numeric Type Can be graphed
Heparin Dose Impella (Units/hr) (Hidden by default)	Number	Number	+
List options: Ok Unknown Wrong Unit: Units/hr Synonyms: HEPARIN DOSE IMPELLA (UNITS/HR) Row type: Data Value type: Numeric Type Can be graphed
Coagulation Check (Hidden by default)	List	List	+
List options: ACT PTT Synonyms: COAGULATION CHECK Row type: Data Value type: Custom List
Sidearm Pressure bag @300 mmHg/Flushed (Hidden by default)	List	List	+
List options: Yes No Synonyms: SDEARM PRESSURE BAG @300 MMHG/FLUSHED, SIDEARM PRESSURE BAG @300 MMHG/FLUSHED Row type: Data Value type: Custom List
Centimeter Marking (Hidden by default)	Free Text	Free Text	+
List options: Arteriogram Cardiac Cath Ablation Impella 2.5 Impella 5.0 Other (Comment) Synonyms: PUMP POSITION (CM MARKER DEPTH), CENTIMETER MARKING Row type: Data Value type: String Type
Power (Hidden by default)	List	List	+
List options: AC Batt=Battery Synonyms: BATTERY, POWER Row type: Data Value type: Custom List
Impella 5.0 (Hidden by default)
P-Perf Level (Hidden by default)	List	List	+
List options: P0 P1 P2 P3 P4 P5 P6 P7 P8 P9 Synonyms: P-PERF LEVEL Row type: Data Value type: Custom List
Flow: (L/min) (Hidden by default)	Number	Number	+
Unit: L/min Synonyms: FLOW: (L/MIN) Row type: Data Value type: Numeric Type Can be graphed
Placement Signal (mmHg) (Hidden by default)	Blood Pressure	Blood Pressure	+
List options: Aortic 2.5 Differential 5.0 Synonyms: PLACEMENT SIGNAL, PLACEMENT SIGNAL (MMHG) Row type: Data Value type: Blood Pressure Can be graphed
Placement Signal (Home Screen) (Hidden by default)	List	List	+
List options: Ok Unknown Wrong Synonyms: PLACEMENT SIGNAL (HOME SCREEN) Row type: Data Value type: Custom List
Purge Pressure (mmHg) (Hidden by default)	Number	Number	+
Unit: mmHg Synonyms: PURGE PRESSURE, PURGE PRESSURE (MMHG) Row type: Data Value type: Numeric Type Can be graphed
LV Signal (mmHg) (Hidden by default)	Number	Number	+
Unit: mmHg Synonyms: LV SIGNAL (MMHG) Row type: Data Value type: Numeric Type Can be graphed
Current Motor (Amp) (Hidden by default)	Free Text	Free Text	+
Synonyms: CURRENT MOTOR, CURRENT MOTOR (AMP) Row type: Data Value type: String Type
Purge Flow (ml/hr) (Hidden by default)	Number	Number	+
List options: Hgh Low Unit: ml/hr Synonyms: PURGE FLOW (ML/HR) Row type: Data Value type: Numeric Type Can be graphed
CPO (watt) (Hidden by default)	Number	Number	+
Unit: watt Synonyms: CPO (WATT) Row type: Data Value type: Numeric Type Can be graphed
Heparin Dose Impella (Units/hr) (Hidden by default)	Number	Number	+
List options: Ok Unknown Wrong Unit: Units/hr Synonyms: HEPARIN DOSE IMPELLA (UNITS/HR) Row type: Data Value type: Numeric Type Can be graphed
Coagulation Check (Hidden by default)	List	List	+
List options: ACT PTT Synonyms: COAGULATION CHECK Row type: Data Value type: Custom List
Centimeter marking (Hidden by default)	Free Text	Free Text	+
List options: Arteriogram Cardiac Cath Ablation Impella 2.5 Impella 5.0 Other (Comment) Synonyms: PUMP POSITION (CM MARKER DEPTH), PUMP POSITION (CENTIMETER MARKING), CENTIMETER MARKING Row type: Data Value type: String Type
Power (Hidden by default)	List	List	+
List options: AC Batt=Battery Synonyms: POWER Row type: Data Value type: Custom List
Impella CP (Hidden by default)
P-Perf Level (Hidden by default)	List	List	+
List options: P0 P1 P2 P3 P4 P5 P6 P7 P8 P9 Synonyms: P-PERF LEVEL Row type: Data Value type: Custom List
Flow: (L/min) (Hidden by default)	Number	Number	+
Unit: L/min Synonyms: FLOW: (L/MIN) Row type: Data Value type: Numeric Type Can be graphed
Placement Signal (mmHg) (Hidden by default)	Blood Pressure	Blood Pressure	+
List options: Aortic 2.5 Differential 5.0 Synonyms: PLACEMENT SIGNAL, PLACEMENT SIGNAL (MMHG) Row type: Data Value type: Blood Pressure Can be graphed
Placement Signal (Home Screen) (Hidden by default)	List	List	+
List options: Ok Unknown Wrong Synonyms: PLACEMENT SIGNAL (HOME SCREEN) Row type: Data Value type: Custom List
Purge Pressure (mmHg) (Hidden by default)	Number	Number	+
Unit: mmHg Synonyms: PURGE PRESSURE, PURGE PRESSURE (MMHG) Row type: Data Value type: Numeric Type Can be graphed
LV Signal (mmHg) (Hidden by default)	Number	Number	+
Unit: mmHg Synonyms: LV SIGNAL (MMHG) Row type: Data Value type: Numeric Type Can be graphed
Motor Current (Amp) (Hidden by default)	Number	Number	+
List options: Hgh Low Unit: Amp Synonyms: MOTOR CURRENT (AMP) Row type: Data Value type: Numeric Type Can be graphed
Purge Flow (ml/hr) (Hidden by default)	Number	Number	+
List options: Hgh Low Unit: ml/hr Synonyms: PURGE FLOW (ML/HR) Row type: Data Value type: Numeric Type Can be graphed
CPO (watt) (Hidden by default)	Number	Number	+
Unit: watt Synonyms: CPO (WATT) Row type: Data Value type: Numeric Type Can be graphed
Heparin Dose Impella (Units/hr) (Hidden by default)	Number	Number	+
List options: Ok Unknown Wrong Unit: Units/hr Synonyms: HEPARIN DOSE IMPELLA (UNITS/HR) Row type: Data Value type: Numeric Type Can be graphed
Coagulation Check (Hidden by default)	List	List	+
List options: ACT PTT Synonyms: COAGULATION CHECK Row type: Data Value type: Custom List
Sidearm Pressure bag @300 mmHg/Flushed (Hidden by default)	List	List	+
List options: Yes No Synonyms: SDEARM PRESSURE BAG @300 MMHG/FLUSHED, SIDEARM PRESSURE BAG @300 MMHG/FLUSHED Row type: Data Value type: Custom List
Centimeter marking (Hidden by default)	Free Text	Free Text	+
List options: Arteriogram Cardiac Cath Ablation Impella 2.5 Impella 5.0 Other (Comment) Synonyms: PUMP POSITION (CM MARKER DEPTH), PUMP POSITION (CENTIMETER MARKING), CENTIMETER MARKING Row type: Data Value type: String Type
Power (Hidden by default)	List	List	+
List options: AC Batt=Battery Synonyms: POWER Row type: Data Value type: Custom List
Impella RP (Hidden by default)
P-Perf Level (Hidden by default)	List	List	+
List options: P0 P1 P2 P3 P4 P5 P6 P7 P8 P9 Synonyms: P-PERF LEVEL Row type: Data Value type: Custom List
Flow: (L/min) (Hidden by default)	Number	Number	+
Unit: L/min Synonyms: FLOW: (L/MIN) Row type: Data Value type: Numeric Type Can be graphed
Placement Signal (mmHg) (Hidden by default)	Blood Pressure	Blood Pressure	+
List options: Aortic 2.5 Differential 5.0 Synonyms: PLACEMENT SIGNAL, PLACEMENT SIGNAL (MMHG) Row type: Data Value type: Blood Pressure Can be graphed
Placement Signal (Home Screen) (Hidden by default)	List	List	+
List options: Ok Unknown Wrong Synonyms: PLACEMENT SIGNAL (HOME SCREEN) Row type: Data Value type: Custom List
Purge Pressure (mmHg) (Hidden by default)	Number	Number	+
Unit: mmHg Synonyms: PURGE PRESSURE, PURGE PRESSURE (MMHG) Row type: Data Value type: Numeric Type Can be graphed
LV Signal (mmHg) (Hidden by default)	Number	Number	+
Unit: mmHg Synonyms: LV SIGNAL (MMHG) Row type: Data Value type: Numeric Type Can be graphed
Motor Current (Amp) (Hidden by default)	Number	Number	+
List options: Hgh Low Unit: Amp Synonyms: MOTOR CURRENT (AMP) Row type: Data Value type: Numeric Type Can be graphed
Purge Flow (ml/hr) (Hidden by default)	Number	Number	+
List options: Hgh Low Unit: ml/hr Synonyms: PURGE FLOW (ML/HR) Row type: Data Value type: Numeric Type Can be graphed
Coagulation Check (Hidden by default)	List	List	+
List options: ACT PTT Synonyms: COAGULATION CHECK Row type: Data Value type: Custom List
CPO (watt) (Hidden by default)	Number	Number	+
Unit: watt Synonyms: CPO (WATT) Row type: Data Value type: Numeric Type Can be graphed
Heparin Dose Impella (Units/hr) (Hidden by default)	Number	Number	+
List options: Ok Unknown Wrong Unit: Units/hr Synonyms: HEPARIN DOSE IMPELLA (UNITS/HR) Row type: Data Value type: Numeric Type Can be graphed
Centimeter marking (Hidden by default)	Free Text	Free Text	+
List options: Arteriogram Cardiac Cath Ablation Impella 2.5 Impella 5.0 Other (Comment) Synonyms: PUMP POSITION (CM MARKER DEPTH), PUMP POSITION (CENTIMETER MARKING), CENTIMETER MARKING Row type: Data Value type: String Type
Power (Hidden by default)	List	List	+
List options: AC Batt=Battery Synonyms: POWER Row type: Data Value type: Custom List
Oxygen Therapy
Pulse Oximetry Type	List	List	+
List options: Intermittent Continuous Synonyms: INTERMITTENT PULSE OXIMETRY, CONTINUOUS PULSE OXIMETRY Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Condition: Continuous
Patient Activity	List	List	+
List options: Walking At rest Other (Comment) Row type: Data Value type: Custom List Allow completion Allow copy forward Display all list choices in Navigator Add to all templates where this row is start removed
SpO2: Pre-Ductal (Right Hand)	Number	Number	+
Decimal places: 0 Minimum value: 0 Maximum value: 100 Minimum warning value: 90 Maximum warning value: 100 Unit: % Synonyms: SPO2, PRE-DUCTAL, DUCTAL Comments: Pulse oximetry Row type: Data Value type: Numeric Type Allow completion Can be graphed
SpO2: Post-Ductal (Left Hand/Foot)	Number	Number	+
Synonyms: SPO2: POST-DUCTAL (LEFT HAND/FOOT) Row type: Data Value type: Numeric Type Allow completion Can be graphed
Oxygen Therapy	List	List	+
List options: None (Room air) Supplemental oxygen Size button width to each choice Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Condition: Supplemental oxygen
O2 Delivery Method (Hidden by default)	List	List	+
List options: Room Air Nasal cannula Simple mask Aerosol mask High flow nasal cannula Heated high flow nasal cannula Blow-by Endotracheal tube Face tent Non-rebreather mask Partial rebreather mask T-Piece Trach mask Transtracheal catheter Trach tube Venturi mask CPAP/Bi-PAP mask CPAP prongs Oxyhood Optiflow Face mask Other (comment) Synonyms: O2 DELIVERY METHOD Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Condition: Endotracheal tube
FiO2 (%) (Hidden by default)	Number	Number	+
Decimal places: 1 Minimum value: 0 Maximum value: 100 Minimum warning value: 21 Unit: % Row type: Data Value type: Numeric Type Allow completion Add to all templates where this row is start removed Can be graphed
ETCO2 (mmHg) (Hidden by default)	Number	Number	+
Decimal places: 0 Minimum value: 0 Unit: mmHg Synonyms: ETCO2 (MMHG) Row type: Data Value type: Numeric Type Add to all templates where this row is start removed Can be graphed
O2 Flow Rate (L/min) (Hidden by default)	Number	Number	+
Decimal places: 2 Minimum value: 0 Unit: L/min Synonyms: O2 FLOW RATE Row type: Data Value type: Numeric Type Allow completion Add to all templates where this row is start removed Can be graphed
Humidification (Hidden by default)	List	List	+
List options: Cool humidifier Heated humidifier Synonyms: HUMIDIFICATION Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Vent Mode (Hidden by default)	List	List	+
List options: APRV=Airway pressure release ventilation BIPAP=Bilevel positive airway pressure BCPAP=Bubble continuous positive airway pressure CPAP=Continuous positive airway pressure HFOV=High frequency oscillation ventilation NPIMV=NPIMV NAVA=NAVA PC/AC=Pressure control/assist control PRVC/AC=Pressure regulated volume control/assist control PS=Pressure support SIMV/PC=Synchronized intermittent mandatory ventilation/pressure control SIMV/PRVC=Synchronized intermittent mandatory ventilation/pressure regulated volume control SIMV/VC=Synchronized intermittent mandatory ventilation/volume control Tube compensation VC/AC=Volume control/assist control BiLevel PAV+=Proportional assist ventilation Synonyms: VENTILATOR MODE Row type: Data Value type: Custom List Allow completion Allow copy forward Display all list choices in Navigator Condition: NAVA Condition: Suggested groups/rows NAVA Backup PC NAVA Backup Rate NAVA Backup I Time NAVA EDi Peak NAVA EDi Mean NAVA Catheter Placement Depth NAVA Catheter Change Due Date Prong Size Prong Type Condition: Suggested groups/rows Resp Rate (Set) Waveform PEEP High (cm H2O) PEEP Low (cm H2O) Minute Ventilation (L/min) Insp Rise Time (%) Trigger Sensitivity Flow (L/min) Trigger Sensitivity Pressure (cm H2O) Disconnect Sensitivity (%) Humidification Heater Temperature Vt Spontaneous (mL) MAP (cm H2O) PEEP Intrinsic (cm H2O) Plateau Pressure (cm H2O) Static Compliance (L/cm H2O) Dynamic Compliance (L/cm H2O) Airway Resistance Vt Observed (ml) I:E Ratio Condition: Suggested groups/rows PEEP/CPAP (cm H2O) Peak Insp Flow (L/min) Auto PEEP Observed (cm H2O) Pressure Support Condition: Suggested groups/rows Hertz Delta P (Amplitude) Mean Airway Pressure Set Insp Time (sec) Flow (Obs) (L/min) Condition: Suggested groups/rows PIP Set (cm H2O) Vt Mandatory Exp (mL) PIP Observed (cm H2O) Condition: Condition: Suggested groups/rows Expiratory Sensitivity (%) Condition: Suggested groups/rows Pressure Support (cm H2O) Condition: Suggested groups/rows Vt (Set, mL) Vt (observed, mL) Condition: Condition: Condition: Condition: Suggested groups/rows Interface Set Rate Total Rate Oxygen Percent Flow Rate
SpO2 Alarm Limit High (Hidden by default)	Number	Number	+
Row information: Enter set high alarm for SpO2 on pulse ox monitor. Synonyms: SPO2 HIGH ALARM LIMIT Row type: Data Value type: Numeric Type Allow completion Add to all templates where this row is start removed Can be graphed
SpO2 Alarm Limit Low (Hidden by default)	Number	Number	+
Row information: Enter set SpO2 low alarm on pulse ox monitor. Synonyms: SPO2 LOW ALARM LIMIT POX Row type: Data Value type: Numeric Type Allow completion Add to all templates where this row is start removed Can be graphed
Oximetry Probe Site Changed (Hidden by default)	List	List	+
List options: Yes No Synonyms: PULSE OXIMETRY, CONTINUOUS Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Pain Assessment
Pain Assessment	List	List	+
List options: No/denies pain 0-10 Wong-Baker FACES Critical-Care Pain Observation Tool FLACC Unable to assess Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Condition: 0-10 Condition: Default groups/rows added when conditions are met Pain Score (Intensity) Pain Duration Pain Type Pain Location Effect of Pain on Daily Activities Retired: Effect of Pain on Daily Activities Pain Interventions Response to Interventions Multiple Pain Sites Pain Medication Reassessment Outcome Condition: Default groups/rows added when conditions are met Patient's Stated Pain Goal Wong-Baker FACES Pain Rating Condition: Default groups/rows added when conditions are met FLACC (Face, Legs, Activity, Crying, Consolability) Pain Rating: FLACC (Rest) - Face Pain Rating: FLACC (Rest) - Legs Pain Rating: FLACC (Rest) - Activity Pain Rating: FLACC (Rest) - Cry Pain Rating: FLACC (Rest) - Consolability Score: FLACC (Rest) Pain Rating: FLACC (Activity) - Face Pain Rating: FLACC (Activity) - Legs Pain Rating: FLACC (Activity) Pain Rating: FLACC (Activity) - Cry Pain Rating: FLACC (Activity) - Consolability Score: FLACC (Activity) Condition: Default groups/rows added when conditions are met Critical-Care Pain Observation Tool Facial Expression Body Movements Complicance with the Ventilator (Intubated Patients) Vocalization (Extubated Patients) Muscle Tension Critical-Care Pain Observation Score
Patient's Stated Pain Goal (Hidden by default)	List	List	+
List options: No pain 1 2 3 4 5 6 7 8 9 10 n/a (CPOT/FLACC/FACES scale) Other (Comment) Size button width to each choice Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Score (Intensity) (Hidden by default)	List	List	+
List options: 0 - No pain 1 - Mild pain 2 - Mild pain 3 - Mild pain 4 - Moderate pain 5 - Moderate pain 6 - Moderate pain 7 - Severe pain 8 - Severe pain 9 - Severe pain 10 - Severe pain Synonyms: PAIN SCALE, PAIN SCORE (INTENSITY) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Pain Duration (Hidden by default)	List	List	+
List options: Less than 15 minutes 15 - 30 minutes 31 - 60 minutes 1 - 3 hours 3 - 6 hours Greater than 6 hours Other (Comment) Synonyms: PAIN DURATION Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Pain Type (Hidden by default)	List	List	+
List options: Acute pain Chronic pain Surgical pain Neuropathic pain Contraction pain Deep somatic pain Intractable pain Phantom pain Referred pain Superficial somatic pain Visceral pain Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Pain Location (Hidden by default)	List	List	+
List options: Abdomen Ankle Arm Back Breast Buttocks Calf Chest Coccyx Ear Elbow Eye Face Finger (Comment which one) Foot Generalized Groin Hand Head Hip Incision Jaw Knee Leg Mediastinum Mouth Neck Nose Pelvis Perineum Penis Pretibia Rib cage Rectum Sacrum Sclera Shin Shoulder Scrotum Sternum Tibia Thigh Throat Toe (Comment which one) Teeth Umbilicus Vagina Wound Wrist Other (Comment) Size button width to each choice Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Orientation (Hidden by default)	List	List	+
List options: Right Left Anterior Distal Inner Lower Mid Outer Posterior Proximal Upper Other (Comment) Size button width to each choice Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Effect of Pain on Daily Activities (Hidden by default)	List	List	+
List options: No effect Decreased ability to perform daily activities n/a (CPOT/FLACC/FACES scale) Size button width to each choice Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Wong-Baker FACES Pain Rating (Hidden by default)	List	List	+
List options: 0=No hurt 2=Hurts little bit 4=Hurts little more 6=Hurts even more 8=Hurts whole lot 10=Hurts worst Row information: Wong-Baker Faces Pain Rating Scale Wong-Baker FACES Pain Rating Scale, From: Wong D.L., Hockenberry-Eaton M., Wilson D., Winkelstein M.L., Schwartz P.: Wong’s Essentials of Pediatric Nursing, ed. 6, St. Louis, 2001, p. 1301 Copyrighted by Mosby, Inc. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Radiating Towards (Hidden by default)	Free Text	Free Text	+
Row information: Optional - Enter patient's description of where the pain is radiating. Row type: Data Value type: String Type Allow completion Cross encounter Add to all templates where this row is start removed
Pain Descriptors (Hidden by default)	List	List	+
List options: Aching Burning Contraction Cramping Crushing Discomfort Dull Headache Heaviness Itching Jabbing Nagging Numbness Penetrating Pins and needles Pounding Pressure Radiating Sharp Shooting Sore Spasm Squeezing Stabbing Tolerable Tender Throbbing Tightness Tingling Tiring Patient unable to describe Other (Comment) Size button width to each choice Synonyms: PAIN QUALITY Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Pain Frequency (Hidden by default)	List	List	+
List options: Constant/continuous Rarely Once a week Several days a week Intermittent Other (Comment) Synonyms: PAIN FREQUENCY Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Onset (Hidden by default)	List	List	+
List options: Awakened from sleep Gradual Ongoing Progressive Sudden Unable to tell Unable to assess Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Clinical Progression (Hidden by default)	List	List	+
List options: Not changed Gradually worsening Gradually improving Rapidly worsening Rapidly improving Resolved Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Interventions (Hidden by default)	List	List	+
List options: Medication (See MAR) Home medication Continuous epidural Heat applied Cold applied Compression Repositioned Nursing notified (Comment) MD notified (Comment) Patient has PCA Patient medicated prior to therapy Acupressure Acupuncture Ambulation/increased activity Aromatherapy Back rub Cold pack Cutaneous stimulation Declines Distraction Elevated Emotional support Environmental changes Food Guided imagery Herbal therapy Massage Music Pet therapy Prayers Relaxation technique Rest Shower Sitz bath Spiritual care consult Splinting TENS Therapeutic presence Therapeutic touch Traction Tub bath Warm moist pack Warm pack Other (Comment) Size button width to each choice Synonyms: PAIN INTERVENTIONS Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Response to Interventions (Hidden by default)	Free Text	Free Text	+
Row information: Optional - Enter patient's description of responses to previous pain interventions. Synonyms: RESPONSE TO INTERVENTIONS Row type: Data Value type: String Type Allow completion Cross encounter Add to all templates where this row is start removed Condition:
Multiple Pain Sites (Hidden by default)	List	List	+
List options: Two Three Four Five Six Seven Eight Synonyms: PAIN ASSESSMENT Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed Condition: Two Condition: Condition: Default groups/rows added when conditions are met Pain 2 Patient's Stated Pain Goal 2 Pain Score 2 Pain Duration 2 Pain Type 2 Pain Location 2 Pain Orientation 2 Effect of Pain on Daily Activities 2 Wong-Baker FACES Pain Rating 2 Pain Radiating Towards 2 Pain Descriptors 2 Pain Frequency 2 Pain Onset 2 Clinical Progression 2 Pain Intervention(s) 2 Response to Interventions 2 Pain 3 Patient's Stated Pain Goal 3 Pain Score 3 Pain Duration 3 Pain Type 3 Pain Location 3 Pain Orientation 3 Effect of Pain on Daily Activities 3 Wong-Baker FACES Pain Rating 3 Pain Radiating Towards 3 Pain Descriptors 3 Pain Onset 3 Clinical Progression 3 Pain Frequency 3 Pain Intervention(s) 3 Response to Interventions 3 Condition: Default groups/rows added when conditions are met Pain 4 Patient's Stated Pain Goal 4 Pain Score 4 Pain Duration 4 Pain Type 4 Pain Location 4 Pain Orientation 4 Effect of Pain on Daily Activities 4 Wong-Baker FACES Pain Rating 4 Pain Radiating Towards 4 Pain Descriptors 4 Pain Onset 4 Clinical Progression 4 Pain Frequency 4 Pain Intervention(s) 4 Response to Interventions 4 Condition: Default groups/rows added when conditions are met Pain 5 Patient's Stated Pain Goal 5 Pain Score 5 Pain Duration 5 Pain Type 5 Pain Location 5 Pain Orientation 5 Effect of Pain on Daily Activities 5 Wong-Baker FACES Pain Rating 5 Pain Radiating Towards 5 Pain Descriptors 5 Pain Frequency 5 Pain Onset 5 Clinical Progression 5 Pain Intervention(s) 5 Response to Interventions 5 Condition: Default groups/rows added when conditions are met Pain 6 Patient's Stated Pain Goal 6 Pain Score 6 Pain Duration 6 Pain Type 6 Pain Location 6 Pain Orientation 6 Effect of Pain on Daily Activities 6 Wong-Baker FACES Pain Rating 6 Pain Radiating Towards 6 Pain Descriptors 6 Pain Frequency 6 Pain Onset 6 Clinical Progression 6 Pain Intervention(s) 6 Response to Interventions 6 Condition: Default groups/rows added when conditions are met Pain 7 Patient's Stated Pain Goal 7 Pain Score 7 Pain Duration 7 Pain Type 7 Pain Location 7 Pain Orientation 7 Effect of Pain on Daily Activities 7 Wong-Baker FACES Pain Rating 7 Pain Radiating Towards 7 Pain Descriptors 7 Pain Frequency 7 Pain Onset 7 Clinical Progression 7 Pain Intervention(s) 7 Response to Interventions 7
Pain Medication Reassessment Outcome (Hidden by default)	List	List	+
List options: Decreased Improved No change Increased Relieved Provider notified Synonyms: PAIN MEDICATION OUTCOME, PAIN MEDICATION REASSESSMENT OUTCOME Row type: Data Value type: Custom List Multi-select
Pain 2 (Hidden by default)
Patient's Stated Pain Goal 2 (Hidden by default)	List	List	+
List options: No pain 1 2 3 4 5 6 7 8 9 10 Other (Comment) Synonyms: PATIENT STATED PAIN GOAL 2 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Score 2 (Hidden by default)	List	List	+
List options: 0 - No pain 1 2 3 4 5 - Moderate pain 6 7 8 9 10 - Worst possible pain Row information: Acute Pain Management: Operative or Medical Procedures and Trauma, Clinical Practice Guideline No. 1. AHCPR Publication No. 92-0032; February 1992. Agency for Healthcare Research & Quality, Rockville, MD; pages 116-117. AHCPR renamed Agency for Healthcare Research and Quality [AHRQ] by Congress in 1999. Synonyms: PAIN RATING 2, PAIN SCALE 2 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Duration 2 (Hidden by default)	List	List	+
List options: Less than 15 minutes 15 - 30 minutes 31 - 60 minutes 1 - 3 hours 3 - 6 hours Greater than 6 hours Other (Comment) Synonyms: PAIN DURATION 2 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Pain Type 2 (Hidden by default)	List	List	+
List options: Acute pain Chronic pain Surgical pain Neuropathic pain Deep somatic pain Intractable pain Phantom pain Referred pain Superficial somatic pain Visceral pain Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Pain Location 2 (Hidden by default)	List	List	+
List options: Abdomen Ankle Arm Back Breast Buttocks Chest Coccyx Ear Elbow Eye Face Finger (Comment which one) Foot Generalized Groin Hand Head Hip Incisional Jaw Knee Leg Mediastinum Mouth Neck Nose Pelvis Perineum Penis Pretibial Rib cage Rectum Sacrum Scleral Shoulder Scrotum Shin Sternum Tibial Thigh Throat Toe (Comment which one) Teeth Umbilicus Vagina Wound Wrist Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Orientation 2 (Hidden by default)	List	List	+
List options: Right Left Anterior Distal Inner Lower Mid Outer Posterior Proximal Upper Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Effect of Pain on Daily Activities 2 (Hidden by default)	List	List	+
List options: No effect Decreased ability to perform daily activities n/a (CPOT/FLACC/FACES scale) Size button width to each choice Synonyms: EFFECT OF PAIN ON DAILY ACTIVITIES 2 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Wong-Baker FACES Pain Rating 2 (Hidden by default)	List	List	+
List options: 0=No hurt 2=Hurts little bit 4=Hurts little more 6=Hurts even more 8=Hurts whole lot 10=Hurts worst Row information: Wong-Baker Faces Pain Rating Scale Wong-Baker FACES Pain Rating Scale, From: Wong D.L., Hockenberry-Eaton M., Wilson D., Winkelstein M.L., Schwartz P.: Wong’s Essentials of Pediatric Nursing, ed. 6, St. Louis, 2001, p. 1301 Copyrighted by Mosby, Inc. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Radiating Towards 2 (Hidden by default)	Free Text	Free Text	+
Row information: Optional - Enter patient's description of where the pain is radiating. Row type: Data Value type: String Type Allow completion Cross encounter Add to all templates where this row is start removed
Pain Descriptors 2 (Hidden by default)	List	List	+
List options: Aching Burning Cramping Crushing Discomfort Dull Headache Heaviness Itching Jabbing Nagging Numbness Penetrating Pins and needles Pounding Pressure Radiating Sharp Shooting Sore Spasm Squeezing Stabbing Tender Throbbing Tightness Tingling Tiring Patient unable to describe Other (Comment) Synonyms: PAIN QUALITY 2, PAIN DESCRIPTION 2 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Pain Frequency 2 (Hidden by default)	List	List	+
List options: Constant/continuous Rarely Once a week Several days a week Intermittent Other (Comment) Synonyms: PAIN DURATION 2 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Onset 2 (Hidden by default)	List	List	+
List options: Awakened from sleep Gradual On-going Progressive Sudden Unable to tell Unable to assess Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Clinical Progression 2 (Hidden by default)	List	List	+
List options: Not changed Gradually worsening Gradually improving Rapidly worsening Rapidly improving Resolved Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Intervention(s) 2 (Hidden by default)	List	List	+
List options: Medication (See MAR) Home medication Heat applied Cold applied Repositioned Nursing notified (Comment) MD notified (Comment) Patient has PCA Patient medicated prior to therapy Acupressure Acupuncture Ambulation/increased activity Aromatherapy Back rub Cold pack Cutaneous stimulation Declines Distraction Elevated Emotional support Environmental changes Food Guided imagery Herbal therapy Massage Music Pet therapy Prayers Relaxation technique Rest Shower Sitz bath Spiritual care consult Splinting TENS Therapeutic presence Therapeutic touch Traction Tub bath Warm moist pack Warm pack Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Response to Interventions 2 (Hidden by default)	Free Text	Free Text	+
Row information: Optional - Enter patient's description of responses to previous pain interventions. Row type: Data Value type: String Type Allow completion Cross encounter Add to all templates where this row is start removed MyChart patient instructions: List the patient's response to previous interventions.
Pain 3 (Hidden by default)
Patient's Stated Pain Goal 3 (Hidden by default)	List	List	+
List options: No pain 1 2 3 4 5 6 7 8 9 10 Other (Comment) Synonyms: PATIENT STATED PAIN GOAL 3 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Score 3 (Hidden by default)	List	List	+
List options: 0 - No pain 1 2 3 4 5 - Moderate pain 6 7 8 9 10 - Worst possible pain Row information: Acute Pain Management: Operative or Medical Procedures and Trauma, Clinical Practice Guideline No. 1. AHCPR Publication No. 92-0032; February 1992. Agency for Healthcare Research & Quality, Rockville, MD; pages 116-117. AHCPR renamed Agency for Healthcare Research and Quality [AHRQ] by Congress in 1999. Synonyms: PAIN RATING 3, PAIN SCALE 3 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Duration 3 (Hidden by default)	List	List	+
List options: Less than 15 minutes 15 - 30 minutes 31 - 60 minutes 1 - 3 hours 3 - 6 hours Greater than 6 hours Other (Comment) Synonyms: PAIN DURATION 3 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Pain Type 3 (Hidden by default)	List	List	+
List options: Acute pain Chronic pain Surgical pain Neuropathic pain Deep somatic pain Intractable pain Phantom pain Referred pain Superficial somatic pain Visceral pain Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Pain Location 3 (Hidden by default)	List	List	+
List options: Abdomen Ankle Arm Back Breast Buttocks Chest Coccyx Ear Elbow Eye Face Finger (Comment which one) Foot Generalized Groin Hand Head Hip Incisional Jaw Knee Leg Mediastinum Mouth Neck Nose Pelvis Perineum Penis Pretibial Rib cage Rectum Sacrum Scleral Shin Shoulder Scrotum Sternum Thigh Tibial Throat Toe (Comment which one) Teeth Umbilicus Vagina Wound Wrist Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Orientation 3 (Hidden by default)	List	List	+
List options: Right Left Anterior Distal Inner Lower Mid Outer Posterior Proximal Upper Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Effect of Pain on Daily Activities 3 (Hidden by default)	List	List	+
List options: No effect Decreased ability to perform daily activities n/a (CPOT/FLACC/FACES scale) Size button width to each choice Synonyms: EFFECT OF PAIN ON DAILY ACTIVITIES 3 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Wong-Baker FACES Pain Rating 3 (Hidden by default)	List	List	+
List options: 0=No hurt 2=Hurts little bit 4=Hurts little more 6=Hurts even more 8=Hurts whole lot 10=Hurts worst Row information: Wong-Baker Faces Pain Rating Scale Wong-Baker FACES Pain Rating Scale, From: Wong D.L., Hockenberry-Eaton M., Wilson D., Winkelstein M.L., Schwartz P.: Wong’s Essentials of Pediatric Nursing, ed. 6, St. Louis, 2001, p. 1301 Copyrighted by Mosby, Inc. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Radiating Towards 3 (Hidden by default)	Free Text	Free Text	+
Row information: Optional - Enter patient's description of where the pain is radiating. Row type: Data Value type: String Type Allow completion Cross encounter Add to all templates where this row is start removed
Pain Descriptors 3 (Hidden by default)	List	List	+
List options: Aching Burning Cramping Crushing Discomfort Dull Headache Heaviness Itching Jabbing Nagging Numbness Penetrating Pins and needles Pouding Pressure Radiating Sharp Shooting Sore Spasm Squeezing Stabbing Tender Throbbing Tightness Tingling Tiring Patient unable to describe Other (Comment) Synonyms: PAIN QUALITY 3, PAIN DESCRIPTION 3 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Pain Onset 3 (Hidden by default)	List	List	+
List options: Awakened from sleep Gradual On-going Progressive Sudden Unable to tell Unable to assess Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Clinical Progression 3 (Hidden by default)	List	List	+
List options: Not changed Gradually worsening Gradually improving Rapidly worsening Rapidly improving Resolved Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Frequency 3 (Hidden by default)	List	List	+
List options: Constant/continuous Rarely Once a week Several days a week Intermittent Other (Comment) Synonyms: PAIN DURATION 3 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Intervention(s) 3 (Hidden by default)	List	List	+
List options: Medication (See MAR) Home medication Heat applied Cold applied Repositioned Nursing notified (Comment) MD notified (Comment) Patient has PCA Patient medicated prior to therapy Acupressure Acupuncture Ambulation/increased activity Aromatherapy Back rub Cold pack Cutaneous stimulation Declines Distraction Elevated Emotional support Environmental changes Food Guided imagery Herbal therapy Massage Music Pet therapy Prayers Relaxation technique Rest Shower Sitz bath Spiritual care consult Splinting TENS Therapeutic presence Therapeutic touch Traction Tub bath Warm moist pack Warm pack Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Response to Interventions 3 (Hidden by default)	Free Text	Free Text	+
Row information: Optional - Enter patient's description of responses to previous pain interventions. Row type: Data Value type: String Type Allow completion Cross encounter Add to all templates where this row is start removed MyChart patient instructions: List the patient's response to previous interventions.
Pain 4 (Hidden by default)
Patient's Stated Pain Goal 4 (Hidden by default)	List	List	+
List options: No pain 1 2 3 4 5 6 7 8 9 10 Other (Comment) Synonyms: PATIENT STATED PAIN GOAL Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Score 4 (Hidden by default)	List	List	+
List options: 0 - No pain 1 2 3 4 5 - Moderate pain 6 7 8 9 10 - Worst possible pain Row information: Acute Pain Management: Operative or Medical Procedures and Trauma, Clinical Practice Guideline No. 1. AHCPR Publication No. 92-0032; February 1992. Agency for Healthcare Research & Quality, Rockville, MD; pages 116-117. AHCPR renamed Agency for Healthcare Research and Quality [AHRQ] by Congress in 1999. Synonyms: PAIN RATING 4, PAIN SCALE 4 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Duration 4 (Hidden by default)	List	List	+
List options: Less than 15 minutes 15 - 30 minutes 31 - 60 minutes 1 - 3 hours 3 - 6 hours Greater than 6 hours Other (Comment) Synonyms: PAIN DURATION 4 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Pain Type 4 (Hidden by default)	List	List	+
List options: Acute pain Chronic pain Surgical pain Neuropathic pain Deep somatic pain Intractable pain Phantom pain Referred pain Superficial somatic pain Visceral pain Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Pain Location 4 (Hidden by default)	List	List	+
List options: Abdomen Ankle Arm Back Breast Buttocks Chest Coccyx Ear Elbow Eye Face Finger (Comment which one) Foot Generalized Groin Hand Head Hip Incisional Jaw Knee Leg Mediastinum Mouth Neck Nose Pelvis Perineum Penis Pretibial Rib cage Rectum Sacrum Scleral Shin Shoulder Scrotum Sternum Tibial Thigh Throat Toe (Comment which one) Teeth Umbilicus Vagina Wound Wrist Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Orientation 4 (Hidden by default)	List	List	+
List options: Right Left Anterior Distal Inner Lower Mid Outer Posterior Proximal Upper Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Effect of Pain on Daily Activities 4 (Hidden by default)	List	List	+
List options: No effect Decreased ability to perform daily activities n/a (CPOT/FLACC/FACES scale) Size button width to each choice Synonyms: EFFECT OF PAIN ON DAILY ACTIVITIES 4 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Wong-Baker FACES Pain Rating 4 (Hidden by default)	List	List	+
List options: 0=No hurt 2=Hurts little bit 4=Hurts little more 6=Hurts even more 8=Hurts whole lot 10=Hurts worst Row information: Wong-Baker Faces Pain Rating Scale Wong-Baker FACES Pain Rating Scale, From: Wong D.L., Hockenberry-Eaton M., Wilson D., Winkelstein M.L., Schwartz P.: Wong’s Essentials of Pediatric Nursing, ed. 6, St. Louis, 2001, p. 1301 Copyrighted by Mosby, Inc. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Radiating Towards 4 (Hidden by default)	Free Text	Free Text	+
Row information: Optional - Enter patient's description of where the pain is radiating. Row type: Data Value type: String Type Allow completion Cross encounter Add to all templates where this row is start removed
Pain Descriptors 4 (Hidden by default)	List	List	+
List options: Aching Burning Cramping Crushing Discomfort Dull Headache Heaviness Itching Jabbing Nagging Numbness Penetrating Pins and needles Pounding Pressure Radiating Sharp Shooting Sore Spasm Squeezing Stabbing Tender Throbbing Tightness Tingling Tiring Patient unable to describe Other (Comment) Synonyms: PAIN QUALITY 4, PAIN DESCRIPTION 4 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Pain Onset 4 (Hidden by default)	List	List	+
List options: Awakened from sleep Gradual On-going Progressive Sudden Unable to tell Unable to assess Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Clinical Progression 4 (Hidden by default)	List	List	+
List options: Not changed Gradually worsening Gradually improving Rapidly worsening Rapidly improving Resolved Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Frequency 4 (Hidden by default)	List	List	+
List options: Constant/continuous Rarely Once a week Several days a week Intermittent Other (Comment) Synonyms: PAIN DURATION 4 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Intervention(s) 4 (Hidden by default)	List	List	+
List options: Medication (See MAR) Home medication Heat applied Cold applied Repositioned Nursing notified (Comment) MD notified (Comment) Patient has PCA Patient medicated prior to therapy Acupressure Acupuncture Ambulation/increased activity Aromatherapy Back rub Cold pack Cutaneous stimulation Declines Distraction Elevated Emotional support Environmental changes Food Guided imagery Herbal therapy Massage Music Pet therapy Prayers Relaxation technique Rest Shower Sitz bath Spiritual care consult Splinting TENS Therapeutic presence Therapeutic touch Traction Tub bath Warm moist pack Warm pack Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Response to Interventions 4 (Hidden by default)	Free Text	Free Text	+
Row information: Optional - Enter patient's description of responses to previous pain interventions. Row type: Data Value type: String Type Allow completion Cross encounter Add to all templates where this row is start removed MyChart patient instructions: List the patient's response to previous interventions.
Pain 5 (Hidden by default)
Patient's Stated Pain Goal 5 (Hidden by default)	List	List	+
List options: No pain 1 2 3 4 5 6 7 8 9 10 Other (Comment) Synonyms: PATIENT STATED PAIN GOAL Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Score 5 (Hidden by default)	List	List	+
List options: 0 - No pain 1 2 3 4 5 - Moderate pain 6 7 8 9 10 - Worst possible pain Row information: Acute Pain Management: Operative or Medical Procedures and Trauma, Clinical Practice Guideline No. 1. AHCPR Publication No. 92-0032; February 1992. Agency for Healthcare Research & Quality, Rockville, MD; pages 116-117. AHCPR renamed Agency for Healthcare Research and Quality [AHRQ] by Congress in 1999. Synonyms: PAIN RATING 5, PAIN SCALE 5 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Duration 5 (Hidden by default)	List	List	+
List options: Less than 15 minutes 15 - 30 minutes 31 - 60 minutes 1 - 3 hours 3 - 6 hours Greater than 6 hours Other (Comment) Synonyms: PAIN DURATION 5 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Pain Type 5 (Hidden by default)	List	List	+
List options: Acute pain Chronic pain Surgical pain Neuropathic pain Deep somatic pain Intractable pain Phantom pain Referred pain Superficial somatic pain Visceral pain Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Pain Location 5 (Hidden by default)	List	List	+
List options: Abdomen Ankle Arm Back Breast Buttocks Chest Coccyx Ear Elbow Eye Face Finger (Comment which one) Foot Generalized Groin Hand Head Hip Incisional Jaw Knee Leg Mediastinum Mouth Neck Nose Pelvis Perineum Penis Pretibial Rib cage Rectum Sacrum Scleral Shin Shoulder Scrotum Sternum Tibial Thigh Throat Toe (Comment which one) Teeth Umbilicus Vagina Wound Wrist Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Orientation 5 (Hidden by default)	List	List	+
List options: Right Left Anterior Distal Inner Lower Mid Outer Posterior Proximal Upper Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Effect of Pain on Daily Activities 5 (Hidden by default)	List	List	+
List options: No effect Decreased ability to perform daily activities n/a (CPOT/FLACC/FACES scale) Size button width to each choice Synonyms: EFFECT OF PAIN ON DAILY ACTIVITIES 5 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Wong-Baker FACES Pain Rating 5 (Hidden by default)	List	List	+
List options: 0=No hurt 2=Hurts little bit 4=Hurts little more 6=Hurts even more 8=Hurts whole lot 10=Hurts worst Row information: Wong-Baker Faces Pain Rating Scale Wong-Baker FACES Pain Rating Scale, From: Wong D.L., Hockenberry-Eaton M., Wilson D., Winkelstein M.L., Schwartz P.: Wong’s Essentials of Pediatric Nursing, ed. 6, St. Louis, 2001, p. 1301 Copyrighted by Mosby, Inc. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Radiating Towards 5 (Hidden by default)	Free Text	Free Text	+
Row information: Optional - Enter patient's description of where the pain is radiating. Row type: Data Value type: String Type Allow completion Cross encounter Add to all templates where this row is start removed
Pain Descriptors 5 (Hidden by default)	List	List	+
List options: Aching Burning Cramping Crushing Discomfort Dull Headache Heaviness Itching Jabbing Nagging Numbness Penetrating Pins and needles Pounding Pressure Radiating Sharp Shooting Sore Spasm Squeezing Stabbing Tender Throbbing Tightness Tingling Tiring Patient unable to describe Other (Comment) Synonyms: PAIN QUALITY 5, PAIN DESCRIPTION 5 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Pain Frequency 5 (Hidden by default)	List	List	+
List options: Constant/continuous Rarely Once a week Several days a week Intermittent Other (Comment) Synonyms: PAIN DURATION 5 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Onset 5 (Hidden by default)	List	List	+
List options: Awakened from sleep Gradual On-going Progressive Sudden Unable to tell Unable to assess Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Clinical Progression 5 (Hidden by default)	List	List	+
List options: Not changed Gradually worsening Gradually improving Rapidly worsening Rapidly improving Resolved Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Intervention(s) 5 (Hidden by default)	List	List	+
List options: Medication (See MAR) Home medication Heat applied Cold applied Repositioned Nursing notified (Comment) MD notified (Comment) Patient has PCA Patient medicated prior to therapy Acupressure Acupuncture Ambulation/increased activity Aromatherapy Back rub Cold pack Cutaneous stimulation Declines Distraction Elevated Emotional support Environmental changes Food Guided imagery Herbal therapy Massage Music Pet therapy Prayers Relaxation technique Rest Shower Sitz bath Spiritual care consult Splinting TENS Therapeutic presence Therapeutic touch Traction Tub bath Warm moist pack Warm pack Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Response to Interventions 5 (Hidden by default)	Free Text	Free Text	+
Row information: Optional - Enter patient's description of responses to previous pain interventions. Row type: Data Value type: String Type Allow completion Cross encounter Add to all templates where this row is start removed MyChart patient instructions: List the patient's response to previous interventions.
Pain 6 (Hidden by default)
Patient's Stated Pain Goal 6 (Hidden by default)	List	List	+
List options: No pain 1 2 3 4 5 6 7 8 9 10 Other (Comment) Synonyms: PATIENT STATED PAIN GOAL Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Score 6 (Hidden by default)	List	List	+
List options: 0 - No pain 1 2 3 4 5 - Moderate pain 6 7 8 9 10 - Worst possible pain Row information: Acute Pain Management: Operative or Medical Procedures and Trauma, Clinical Practice Guideline No. 1. AHCPR Publication No. 92-0032; February 1992. Agency for Healthcare Research & Quality, Rockville, MD; pages 116-117. AHCPR renamed Agency for Healthcare Research and Quality [AHRQ] by Congress in 1999. Synonyms: PAIN RATING 6, PAIN SCALE 6 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Duration 6 (Hidden by default)	List	List	+
List options: Less than 15 minutes 15 - 30 minutes 31 - 60 minutes 1 - 3 hours 3 - 6 hours Greater than 6 hours Other (Comment) Synonyms: PAIN DURATION 6 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Pain Type 6 (Hidden by default)	List	List	+
List options: Acute pain Chronic pain Surgical pain Neuropathic pain Deep somatic pain Intractable pain Phantom pain Referred pain Superficial somatic pain Visceral pain Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Pain Location 6 (Hidden by default)	List	List	+
List options: Abdomen Ankle Arm Back Breast Buttocks Chest Coccyx Ear Elbow Eye Face Finger (Comment which one) Foot Generalized Groin Hand Head Hip Incisional Jaw Knee Leg Mediastinum Mouth Neck Nose Pelvis Perineum Penis Pretibial Rib cage Rectum Sacrum Scleral Shin Shoulder Scrotum Sternum Tibial Thigh Throat Toe (Comment which one) Teeth Umbilicus Vagina Wound Wrist Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Orientation 6 (Hidden by default)	List	List	+
List options: Right Left Anterior Distal Inner Lower Mid Outer Posterior Proximal Upper Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Effect of Pain on Daily Activities 6 (Hidden by default)	List	List	+
List options: No effect Decreased ability to perform daily activities n/a (CPOT/FLACC/FACES scale) Size button width to each choice Synonyms: EFFECT OF PAIN ON DAILY ACTIVITIES 6 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Wong-Baker FACES Pain Rating 6 (Hidden by default)	List	List	+
List options: 0=No hurt 2=Hurts little bit 4=Hurts little more 6=Hurts even more 8=Hurts whole lot 10=Hurts worst Row information: Wong-Baker Faces Pain Rating Scale Wong-Baker FACES Pain Rating Scale, From: Wong D.L., Hockenberry-Eaton M., Wilson D., Winkelstein M.L., Schwartz P.: Wong’s Essentials of Pediatric Nursing, ed. 6, St. Louis, 2001, p. 1301 Copyrighted by Mosby, Inc. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Radiating Towards 6 (Hidden by default)	Free Text	Free Text	+
Row information: Optional - Enter patient's description of where the pain is radiating. Row type: Data Value type: String Type Allow completion Cross encounter Add to all templates where this row is start removed
Pain Descriptors 6 (Hidden by default)	List	List	+
List options: Aching Burning Cramping Crushing Discomfort Dull Headache Heaviness Itching Jabbing Nagging Numbness Penetrating Pins and needles Pounding Pressure Radiating Sharp Shooting Sore Spasm Squeezing Stabbing Tender Throbbing Tightness Tingling Tiring Patient unable to describe Other (Comment) Synonyms: PAIN QUALITY 6, PAIN DESCRIPTION 6 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Pain Frequency 6 (Hidden by default)	List	List	+
List options: Constant/continuous Rarely Once a week Several days a week Intermittent Other (Comment) Synonyms: PAIN DURATION 6 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Onset 6 (Hidden by default)	List	List	+
List options: Awakened from sleep Gradual On-going Progressive Sudden Unable to tell Unable to assess Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Clinical Progression 6 (Hidden by default)	List	List	+
List options: Not changed Gradually worsening Gradually improving Rapidly worsening Rapidly improving Resolved Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Intervention(s) 6 (Hidden by default)	List	List	+
List options: Medication (See MAR) Heat applied Cold applied Repositioned Nursing notified (Comment) MD notified (Comment) Patient has PCA Patient medicated prior to therapy Acupressure Acupuncture Ambulation/increased activity Aromatherapy Back rub Cold pack Cutaneous stimulation Declines Distraction Elevated Emotional support Environmental changes Food Guided imagery Herbal therapy Massage Music Pet therapy Prayers Relaxation technique Rest Shower Sitz bath Spiritual care consult Splinting TENS Therapeutic presence Therapeutic touch Traction Tub bath Warm moist pack Warm pack Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Response to Interventions 6 (Hidden by default)	Free Text	Free Text	+
Row information: Optional - Enter patient's description of responses to previous pain interventions. Row type: Data Value type: String Type Allow completion Cross encounter Add to all templates where this row is start removed MyChart patient instructions: List the patient's response to previous interventions.
Pain 7 (Hidden by default)
Patient's Stated Pain Goal 7 (Hidden by default)	List	List	+
List options: No pain 1 2 3 4 5 6 7 8 9 10 Other (Comment) Synonyms: PATIENT STATED PAIN GOAL Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Score 7 (Hidden by default)	List	List	+
List options: 0 - No pain 1 2 3 4 5 - Moderate pain 6 7 8 9 10 - Worst possible pain Row information: Acute Pain Management: Operative or Medical Procedures and Trauma, Clinical Practice Guideline No. 1. AHCPR Publication No. 92-0032; February 1992. Agency for Healthcare Research & Quality, Rockville, MD; pages 116-117. AHCPR renamed Agency for Healthcare Research and Quality [AHRQ] by Congress in 1999. Synonyms: PAIN RATING 7, PAIN SCALE 7 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Duration 7 (Hidden by default)	List	List	+
List options: Less than 15 minutes 15 - 30 minutes 31 - 60 minutes 1 - 3 hours 3 - 6 hours Greater than 6 hours Other (Comment) Synonyms: PAIN DURATION 7 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Pain Type 7 (Hidden by default)	List	List	+
List options: Acute pain Chronic pain Surgical pain Neuropathic pain Deep somatic pain Intractable pain Phantom pain Referred pain Superficial somatic pain Visceral pain Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Pain Location 7 (Hidden by default)	List	List	+
List options: Abdomen Ankle Arm Back Breast Buttocks Chest Coccyx Ear Elbow Eye Face Finger (Comment which one) Foot Generalized Groin Hand Head Hip Incisional Jaw Knee Leg Mediastinum Mouth Neck Nose Pelvis Perineum Penis Pretibial Rib cage Rectum Sacrum Scleral Shin Shoulder Scrotum Sternum Tibial Thigh Throat Toe (Comment which one) Teeth Umbilicus Vagina Wound Wrist Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Orientation 7 (Hidden by default)	List	List	+
List options: Right Left Anterior Distal Inner Lower Mid Outer Posterior Proximal Upper Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Effect of Pain on Daily Activities 7 (Hidden by default)	List	List	+
List options: No effect Decreased ability to perform daily activities n/a (CPOT/FLACC/FACES scale) Size button width to each choice Synonyms: EFFECT OF PAIN ON DAILY ACTIVITIES 7 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Wong-Baker FACES Pain Rating 7 (Hidden by default)	List	List	+
List options: 0=No hurt 2=Hurts little bit 4=Hurts little more 6=Hurts even more 8=Hurts whole lot 10=Hurts worst Row information: Wong-Baker Faces Pain Rating Scale Wong-Baker FACES Pain Rating Scale, From: Wong D.L., Hockenberry-Eaton M., Wilson D., Winkelstein M.L., Schwartz P.: Wong’s Essentials of Pediatric Nursing, ed. 6, St. Louis, 2001, p. 1301 Copyrighted by Mosby, Inc. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Radiating Towards 7 (Hidden by default)	Free Text	Free Text	+
Row information: Optional - Enter patient's description of where the pain is radiating. Row type: Data Value type: String Type Allow completion Cross encounter Add to all templates where this row is start removed
Pain Descriptors 7 (Hidden by default)	List	List	+
List options: Aching Burning Cramping Crushing Discomfort Dull Headache Heaviness Itching Jabbing Nagging Numbness Penetrating Pins and needles Pounding Pressure Radiating Sharp Shooting Sore Spasm Squeezing Stabbing Tender Throbbing Tightness Tingling Tiring Patient unable to describe Other (Comment) Synonyms: PAIN QUALITY 7, PAIN DESCRIPTION 7 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Pain Frequency 7 (Hidden by default)	List	List	+
List options: Constant/continuous Rarely Once a week Several days a week Intermittent Other (Comment) Synonyms: PAIN DURATION 7 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Onset 7 (Hidden by default)	List	List	+
List options: Awakened from sleep Gradual On-going Progressive Sudden Unable to tell Unable to assess Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Clinical Progression 7 (Hidden by default)	List	List	+
List options: Not changed Gradually worsening Gradually improving Rapidly worsening Rapidly improving Resolved Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Intervention(s) 7 (Hidden by default)	List	List	+
List options: Medication (See MAR) Heat applied Cold applied Repositioned Nursing notified (Comment) MD notified (Comment) Patient has PCA Patient medicated prior to therapy Acupressure Acupuncture Ambulation/increased activity Aromatherapy Back rub Cold pack Cutaneous stimulation Declines Distraction Elevated Emotional support Environmental changes Food Guided imagery Herbal therapy Massage Music Pet therapy Prayers Relaxation technique Rest Shower Sitz bath Spiritual care consult Splinting TENS Therapeutic presence Therapeutic touch Traction Tub bath Warm moist pack Warm pack Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Response to Interventions 7 (Hidden by default)	Free Text	Free Text	+
Row information: Optional - Enter patient's description of responses to previous pain interventions. Row type: Data Value type: String Type Allow completion Cross encounter Add to all templates where this row is start removed MyChart patient instructions: List the patient's response to previous interventions.
Pain 8 (Hidden by default)
Patient's Stated Pain Goal 8 (Hidden by default)	List	List	+
List options: No pain 1 2 3 4 5 6 7 8 9 10 Other (Comment) Synonyms: PATIENT STATED PAIN GOAL Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Score 8 (Hidden by default)	List	List	+
List options: 0 - No pain 1 2 3 4 5 - Moderate pain 6 7 8 9 10 - Worst possible pain Row information: Acute Pain Management: Operative or Medical Procedures and Trauma, Clinical Practice Guideline No. 1. AHCPR Publication No. 92-0032; February 1992. Agency for Healthcare Research & Quality, Rockville, MD; pages 116-117. AHCPR renamed Agency for Healthcare Research and Quality [AHRQ] by Congress in 1999. Synonyms: PAIN RATING 8, PAIN SCALE 8 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Duration 8 (Hidden by default)	List	List	+
List options: Less than 15 minutes 15 - 30 minutes 31 - 60 minutes 1 - 3 hours 3 - 6 hours Greater than 6 hours Other (Comment) Synonyms: PAIN DURATION 8 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Pain Type 8 (Hidden by default)	List	List	+
List options: Acute pain Chronic pain Surgical pain Neuropathic pain Deep somatic pain Intractable pain Phantom pain Referred pain Superficial somatic pain Visceral pain Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Pain Location 8 (Hidden by default)	List	List	+
List options: Abdomen Ankle Arm Back Breast Buttocks Chest Coccyx Ear Elbow Eye Face Finger (Comment which one) Foot Generalized Groin Hand Head Hip Incisional Jaw Knee Leg Mediastinum Mouth Neck Nose Pelvis Perineum Penis Pretibial Rib cage Rectum Sacrum Scleral Shin Shoulder Scrotum Sternum Tibial Thigh Throat Toe (Comment which one) Teeth Umbilicus Vagina Wound Wrist Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Orientation 8 (Hidden by default)	List	List	+
List options: Right Left Anterior Distal Inner Lower Mid Outer Posterior Proximal Upper Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Effect of Pain on Daily Activities 8 (Hidden by default)	List	List	+
List options: No effect Decreased ability to perform daily activities n/a (CPOT/FLACC/FACES scale) Size button width to each choice Synonyms: EFFECT OF PAIN ON DAILY ACTIVITIES 8 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Wong-Baker FACES Pain Rating 8 (Hidden by default)	List	List	+
List options: 0=No hurt 2=Hurts little bit 4=Hurts little more 6=Hurts even more 8=Hurts whole lot 10=Hurts worst Row information: Wong-Baker Faces Pain Rating Scale Wong-Baker FACES Pain Rating Scale, From: Wong D.L., Hockenberry-Eaton M., Wilson D., Winkelstein M.L., Schwartz P.: Wong’s Essentials of Pediatric Nursing, ed. 6, St. Louis, 2001, p. 1301 Copyrighted by Mosby, Inc. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Radiating Towards 8 (Hidden by default)	Free Text	Free Text	+
Row information: Optional - Enter patient's description of where the pain is radiating. Row type: Data Value type: String Type Allow completion Cross encounter Add to all templates where this row is start removed
Pain Descriptors 8 (Hidden by default)	List	List	+
List options: Aching Burning Cramping Crushing Discomfort Dull Headache Heaviness Itching Jabbing Nagging Numbness Penetrating Pins and needles Pounding Pressure Radiating Sharp Shooting Sore Spasm Squeezing Stabbing Tender Throbbing Tightness Tingling Tiring Patient unable to describe Other (Comment) Synonyms: PAIN QUALITY 8, PAIN DESCRIPTION 8 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Pain Frequency 8 (Hidden by default)	List	List	+
List options: Constant/continuous Rarely Once a week Several days a week Intermittent Other (Comment) Synonyms: PAIN DURATION 8 Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Onset 8 (Hidden by default)	List	List	+
List options: Awakened from sleep Gradual On-going Progressive Sudden Unable to tell Unable to assess Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Clinical Progression 8 (Hidden by default)	List	List	+
List options: Not changed Gradually worsening Gradually improving Rapidly worsening Rapidly improving Resolved Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain Intervention(s) 8 (Hidden by default)	List	List	+
List options: Medication (See MAR) Heat applied Cold applied Repositioned Nursing notified (Comment) MD notified (Comment) Patient has PCA Patient medicated prior to therapy Acupressure Acupuncture Ambulation/increased activity Aromatherapy Back rub Cold pack Cutaneous stimulation Declines Distraction Elevated Emotional support Environmental changes Food Guided imagery Herbal therapy Massage Music Pet therapy Prayers Relaxation technique Rest Shower Sitz bath Spiritual care consult Splinting TENS Therapeutic presence Therapeutic touch Traction Tub bath Warm moist pack Warm pack Other (Comment) Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Response to Interventions 8 (Hidden by default)	Free Text	Free Text	+
Row information: Optional - Enter patient's description of responses to previous pain interventions. Row type: Data Value type: String Type Allow completion Cross encounter Add to all templates where this row is start removed MyChart patient instructions: List the patient's response to previous interventions.
PAINAD (Pain Assessment in Advanced Dementia) (Hidden by default)
Breathing (Hidden by default)	List	List	+
List options: 0=Normal 1=Occasional labored breathing, short period of hyperventilation 2=Noisy labored breathing, long periods of hyperventilation, Cheyne-Stokes respirations Row information: Warden, W., Hurley, A. & Volicer, L. (2003). Development and psychometric evaluation of the pain assessment in advanced dementia (PAINAD) Scale. Journal of the American Medical Directors Association, 4(1). PP. 9 – 15. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Negative Vocalization (Hidden by default)	List	List	+
List options: 0=None 1=Occasional moan/groan, low speech, negative/disapproving quality 2=Repeated troubled calling out, loud moaning/groaning, crying Row information: Warden, W., Hurley, A. & Volicer, L. (2003). Development and psychometric evaluation of the pain assessment in advanced dementia (PAINAD) Scale. Journal of the American Medical Directors Association, 4(1). PP. 9 – 15. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Facial Expression (Hidden by default)	List	List	+
List options: 0=Smiling or inexpressive 1=Sad, frightened, frown 2=Facial grimacing Row information: Warden, W., Hurley, A. & Volicer, L. (2003). Development and psychometric evaluation of the pain assessment in advanced dementia (PAINAD) Scale. Journal of the American Medical Directors Association, 4(1). PP. 9 – 15. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Body Language (Hidden by default)	List	List	+
List options: 0=Relaxed 1=Tense, distressed pacing, fidgeting 2=Rigid, fists clenched, knees up, pushing/pulling away, strikes out Row information: Warden, W., Hurley, A. & Volicer, L. (2003). Development and psychometric evaluation of the pain assessment in advanced dementia (PAINAD) Scale. Journal of the American Medical Directors Association, 4(1). PP. 9 – 15. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Consolability (Hidden by default)	List	List	+
List options: 0=No need to console 1=Distracted or reassured by voice/touch 2=Unable to console, distract or reassure Row information: Warden, W., Hurley, A. & Volicer, L. (2003). Development and psychometric evaluation of the pain assessment in advanced dementia (PAINAD) Scale. Journal of the American Medical Directors Association, 4(1). PP. 9 – 15. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
PAINAD Score (Hidden by default)	Formula (Read Only)	Formula (Read Only)	+
Row information: The PAINAD Score is calculated by adding the following rows: Breathing + Negative Vocalization + Facial Expression + Body Language + Consolability.Warden, W., Hurley, A. & Volicer, L. (2003). Development and psychometric evaluation of the pain assessment in advanced dementia (PAINAD) Scale. Journal of the American Medical Directors Association, 4(1). PP. 9 – 15. Formula: {Breathing} + {Negative Vocalization} + {Facial Expression} + {Body Language} + {Consolability} Synonyms: PAINAD SCORE Row type: Custom Formula Value type: Numeric Type Cross encounter Add to all templates where this row is start removed Can be graphed
Adult Non-Verbal Pain Score (Hidden by default)
Facial Expression (Hidden by default)	List	List	+
List options: 0=No particular expression or smile 1=Occasional grimace, frown 2=Frequent grimacing, frowning or crying Synonyms: ADULT NONVERBAL PAIN SCALE Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Activity/Movement (Hidden by default)	List	List	+
List options: 0=Laid quietly, normal position 1=Seeks attention through movement, slow cautious movements 2=Restless, excessive activity and/or withdrawal reflexes Synonyms: ADULT NONVERBAL PAIN SCALE Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Guarding (Hidden by default)	List	List	+
List options: 0=No positioning of hands over specific areas of body 1=Slight to moderate tenseness 2=Rigid/stiff Synonyms: ADULT NONVERBAL PAIN SCALE Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Vital Signs (Hidden by default)	List	List	+
List options: 0=Vital signs within individual patient's baseline parameters as set by anaesthetist 1=Changes in last 4 hours, SBP>20mmHg, HR >20bpm 2=Changes in last 4 hours, SPB>30mmHg, HR>30bpm Synonyms: ADULT NONVERBAL PAIN SCALE Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Respiratory Function (Hidden by default)	List	List	+
List options: 0=Tolerating ventilation 1=Mild asynchrony with ventilator/coughing 2=Severs asynchrony with ventilator Synonyms: ADULT NONVERBAL PAIN SCALE Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Adult Nonverbal Pain Score (Hidden by default)	Formula (Read Only)	Formula (Read Only)	+
Row information: Score 0 = no painScore 1-3 = mild painScore 4-7 = moderate painScore 8-10 = severe pain Formula: {Facial Expression}+{Activity/Movement}+{Guarding}+{Vital Signs}+{Respiratory Function} Row type: Custom Formula Value type: Numeric Type Can be graphed
Critical-Care Pain Observation Tool (Hidden by default)
Facial Expression (Hidden by default)	List	List	+
List options: 0=Relaxed, neutral 1=Tense 2=Grimacing Row information: Facial Expression Description:0=Relaxed, neutral - No muscle tension observed1=Tense - Presence of frowining, brow lowering, orbit tightening and levator contraction or any other change (e.g. opening eyes or tearing during nociceptive procedures)2=Grimacing - All previous facial movements plus eyelid tightly closed (the patient may present with mouth open or biting the endotracheal tube) Copyright © 2006 by the American Association of Critical-Care Nurses Synonyms: CRITICAL-CARE PAIN OBSERVATION TOOL Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Body Movements (Hidden by default)	List	List	+
List options: 0=Abssence of movements or normal position 1=Protection 2=Restlessness/agitation Row information: Body Movement Descriptions:0=Absence of movements or normal position - Does not move at all (doesn't necessarily mean absence of pain) or normal position (movements not aimed toward the pain site or not made for the purpose of protection)1=Protection - Slow, cautious movements, touching or rubbing the pain site, seeking attention through movements2=Restlessness/agitation - Pulling tube, attempting to sit up, moving limbs/thrashing, not following commands, striking at staff, trying to climb out of bed Copyright © 2006 by the American Association of Critical-Care Nurses Synonyms: CRITICAL-CARE PAIN OBSERVATION TOOL Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Complicance with the Ventilator (Intubated Patients) (Hidden by default)	List	List	+
List options: 0=Tolerating ventilator or movement 1=Coughing but tolerating 2=Fighting ventilator Row information: Compliance with Ventilator Descriptions:0=Tolerating ventilator or movement - Alarms not activated, easy ventilation1=Coughing but tolerating - coughing, alarms may be activated but stop spontaneously2=Fighting ventilator - Asynchrony, blocking ventilation, alarms frequently activated Copyright © 2006 by the American Association of Critical-Care Nurses Synonyms: CRITICAL-CARE PAIN OBSERVATION TOOL Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Vocalization (Extubated Patients) (Hidden by default)	List	List	+
List options: 0=Talking in normal tone or no sound 1=Sighing, moaning 2=Crying out, sobbing Row information: Vocalization Descriptions: 0=Talking in mormal tone or no sound 1=Sighing, moaning 2=Crying out, sobbing Copyright © 2006 by the American Association of Critical-Care Nurses Synonyms: CRITICAL-CARE PAIN OBSERVATION TOOL Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Muscle Tension (Hidden by default)	List	List	+
List options: 0=Relaxed 1=Tense, rigid 2=Very tense or rigid Row information: Muscle Tension Descriptions:0=Relaxed - No resistance to passive movements1=Tense, rigid - Resistance to passive movements2=Very tense or rigid - Strong resistance to passive movements or incapacity to complete them Evaluation by passive flexion and extension of upper limbs when patient is at rest or evaluation when patients is being turned. Copyright © 2006 by the American Association of Critical-Care Nurses Synonyms: CRITICAL-CARE PAIN OBSERVATION TOOL Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Critical-Care Pain Observation Score (Hidden by default)	Formula (Read Only)	Formula (Read Only)	+
Row information: Total Scores range from 0 = no pain to 8 = most pain.Copyright © 2006 by the American Association of Critical-Care Nurses Formula: {Facial Expression}+{Body Movements}+{3040104656;;0}+{3040104657;;0}+{Muscle Tension} Synonyms: CRITICAL-CARE PAIN OBSERVATION SCORE Row type: Custom Formula Value type: Numeric Type Can be graphed
Behavioral Pain Scale (BPS) (Hidden by default)
Facial Expression (Hidden by default)	List	List	+
List options: 1=Relaxed 2=Partially tightened (e.g., brow lowering) 3=Fully tightened (e.g., eyelid closing) 4=Grimacing Row information: Payen JF, et al. Crit Care Med. 2001;29:2258-2263. Synonyms: BEHAVIORAL PAIN SCALE Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Upper Limbs (Hidden by default)	List	List	+
List options: 1=No movement 2=Partially bent 3=Fully bent with finger flexion 4=Permanently retracted Row information: Payen JF, et al. Crit Care Med. 2001;29:2258-2263. Synonyms: BEHAVIORAL PAIN SCALE Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Compliance with Ventilation (Hidden by default)	List	List	+
List options: 1=Tolerating movement 2=Coughing but tolerating ventilation for most of the time 3=Fighting ventilator 4=Unable to control ventilation Row information: Payen JF, et al. Crit Care Med. 2001;29:2258-2263. Synonyms: BEHAVIORAL PAIN SCALE Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Behavioral Pain Scale Total Score (Hidden by default)	Formula (Read Only)	Formula (Read Only)	+
Row information: Behavioral Pain Scale score ranges from 3 (no pain) to 12 (maximum pain). Payen JF, et al. Crit Care Med. 2001;29:2258-2263. Formula: {Facial Expression}+{Upper Limbs}+{Compliance with Ventilation} Synonyms: BEHAVIORAL PAIN SCALE TOTAL SCORE Row type: Custom Formula Value type: Numeric Type Can be graphed
Pain Interventions (Hidden by default)	List	List	+
List options: Medication (See MAR) Home medication Heat applied Cold applied Compression Repositioned MD notified (Comment) Acupressure Acupuncture Ambulation/increased activity Aromatherapy Back rub Cold pack Cutaneous stimulation Distraction Elevated Emotional support Environmental changes Food Guided imagery Herbal therapy Massage Music Pet therapy Prayers Relaxation technique Rest Shower Sitz bath Spiritual care consult Splinting TENS Therapeutic presence Therapeutic touch Traction Tub bath Warm moist pack Warm pack Other (Comment) Synonyms: BEHAVIORAL PAIN SCALE PAIN INTERVENTIONS Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
FLACC (Face, Legs, Activity, Crying, Consolability) (Hidden by default)
Pain Rating: FLACC (Rest) - Face (Hidden by default)	List	List	+
List options: 0=No particular expression or smile 1=Occasional grimace or frown, withdrawn, disinterested 2=Frequent to constant frown, clenched jaw, quivering chin Row information: FLACC Pain Assessment Tool, from: Merkel, S., Voepel-Lewis T., Shayevitz, J. & Malviya, S. (1997). The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatric Nursing 1997, 23:293-297.© 2002, the Regents of the University of Michigan. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Pain Rating: FLACC (Rest) - Legs (Hidden by default)	List	List	+
List options: 0=Normal position or relaxed 1=Uneasy, restless, tense 2=Kicking, or legs drawn up Row information: FLACC Pain Assessment Tool, from: Merkel, S., Voepel-Lewis T., Shayevitz, J. & Malviya, S. (1997). The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatric Nursing 1997, 23:293-297.© 2002, the Regents of the University of Michigan. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Pain Rating: FLACC (Rest) - Activity (Hidden by default)	List	List	+
List options: 0=Lying quietly, normal position, moves easily 1=Squirming, shifting back and forth, tense 2=Arched, rigid or jerking Row information: FLACC Pain Assessment Tool, from: Merkel, S., Voepel-Lewis T., Shayevitz, J. & Malviya, S. (1997). The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatric Nursing 1997, 23:293-297.© 2002, the Regents of the University of Michigan. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Pain Rating: FLACC (Rest) - Cry (Hidden by default)	List	List	+
List options: 0=No cry (awake or asleep) 1=Moans or whimpers, occasional complaint 2=Crying steadily, screams or sobs, frequent complaint Row information: FLACC Pain Assessment Tool, from: Merkel, S., Voepel-Lewis T., Shayevitz, J. & Malviya, S. (1997). The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatric Nursing 1997, 23:293-297.© 2002, the Regents of the University of Michigan. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Pain Rating: FLACC (Rest) - Consolability (Hidden by default)	List	List	+
List options: 0=Content, relaxed 1=Reassured by occasional touch, hug or being talked to 2=Difficult to console or comfort Row information: FLACC Pain Assessment Tool, from: Merkel, S., Voepel-Lewis T., Shayevitz, J. & Malviya, S. (1997). The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatric Nursing 1997, 23:293-297.© 2002, the Regents of the University of Michigan. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Score: FLACC (Rest) (Hidden by default)	Formula (Read Only)	Formula (Read Only)	+
Row information: FLACC Pain Assessment Tool, from: Merkel, S., Voepel-Lewis T., Shayevitz, J. & Malviya, S. (1997). The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatric Nursing 1997, 23:293-297.© 2002, the Regents of the University of Michigan.© 2002, the Regents of the University of Michigan. Formula: {Pain Rating: FLACC (Rest) - Face}+{Pain Rating: FLACC (Rest) - Legs}+{Pain Rating: FLACC (Rest) - Activity}+{Pain Rating: FLACC (Rest) - Cry}+{Pain Rating: FLACC (Rest) - Consolability} Row type: Custom Formula Value type: Numeric Type Cross encounter Can be graphed
Pain Rating: FLACC (Activity) - Face (Hidden by default)	List	List	+
List options: 0=No particular expression or smile 1=Occasional grimace or frown, withdrawn, disinterested 2=Frequent to constant frown, clenched jaw, quivering chin Row information: FLACC Pain Assessment Tool, from: Merkel, S., Voepel-Lewis T., Shayevitz, J. & Malviya, S. (1997). The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatric Nursing 1997, 23:293-297.© 2002, the Regents of the University of Michigan. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Pain Rating: FLACC (Activity) - Legs (Hidden by default)	List	List	+
List options: 0=Normal position or relaxed 1=Uneasy, restless, tense 2=Kicking, or legs drawn up Row information: FLACC Pain Assessment Tool, from: Merkel, S., Voepel-Lewis T., Shayevitz, J. & Malviya, S. (1997). The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatric Nursing 1997, 23:293-297.© 2002, the Regents of the University of Michigan. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Pain Rating: FLACC (Activity) (Hidden by default)	List	List	+
List options: 0=Lying quietly, normal position, moves easily 1=Squirming, shifting back and forth, tense 2=Arched, rigid or jerking Row information: FLACC Pain Assessment Tool, from: Merkel, S., Voepel-Lewis T., Shayevitz, J. & Malviya, S. (1997). The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatric Nursing 1997, 23:293-297.© 2002, the Regents of the University of Michigan. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Pain Rating: FLACC (Activity) - Cry (Hidden by default)	List	List	+
List options: 0=No cry (awake or asleep) 1=Moans or whimpers, occasional complaint 2=Crying steadily, screams or sobs, frequent complaint Row information: FLACC Pain Assessment Tool, from: Merkel, S., Voepel-Lewis T., Shayevitz, J. & Malviya, S. (1997). The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatric Nursing 1997, 23:293-297.© 2002, the Regents of the University of Michigan. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Pain Rating: FLACC (Activity) - Consolability (Hidden by default)	List	List	+
List options: 0=Content, relaxed 1=Reassured by occasional touch, hug or being talked to 2=Difficult to console or comfort Row information: FLACC Pain Assessment Tool, from: Merkel, S., Voepel-Lewis T., Shayevitz, J. & Malviya, S. (1997). The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatric Nursing 1997, 23:293-297.© 2002, the Regents of the University of Michigan. Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Score: FLACC (Activity) (Hidden by default)	Formula (Read Only)	Formula (Read Only)	+
Row information: FLACC Pain Assessment Tool, from: Merkel, S., Voepel-Lewis T., Shayevitz, J. & Malviya, S. (1997). The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatric Nursing 1997, 23:293-297.© 2002, the Regents of the University of Michigan. Formula: {Pain Rating: FLACC (Activity) - Face}+{Pain Rating: FLACC (Activity) - Legs}+{Pain Rating: FLACC (Activity)}+{Pain Rating: FLACC (Activity) - Cry}+{Pain Rating: FLACC (Activity) - Consolability} Row type: Custom Formula Value type: Numeric Type Cross encounter Can be graphed
NIPS (Neonatal/Infant Pain Scale) (Hidden by default)
Facial Expression (Hidden by default)	List	List	+
List options: 0=Relaxed muscles 1=Grimace Min age (days): 0 Max age (days): 365 Row information: Neonatal Infant Pain Scale, from Lawrence, J. et al (1993) The Development of a Tool to Assess Neonatal Pain. Neonatal Network, 12, 59-66 (Used with permission of Children’s Hospital of Eastern Ontario). Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Cry (Hidden by default)	List	List	+
List options: 0=No cry 1=Whimper 2=Vigorous cry Min age (days): 0 Max age (days): 365 Row information: Neonatal Infant Pain Scale, from Lawrence, J. et al (1993) The Development of a Tool to Assess Neonatal Pain. Neonatal Network, 12, 59-66 (Used with permission of Children’s Hospital of Eastern Ontario). Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Breathing Patterns (Hidden by default)	List	List	+
List options: 0=Relaxed 1=Change in breathing Min age (days): 0 Max age (days): 365 Row information: Neonatal Infant Pain Scale, from Lawrence, J. et al (1993) The Development of a Tool to Assess Neonatal Pain. Neonatal Network, 12, 59-66 (Used with permission of Children’s Hospital of Eastern Ontario). Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Arms (Hidden by default)	List	List	+
List options: 0=Relaxed/restrained 1=Flexed/extended Min age (days): 0 Max age (days): 365 Row information: Neonatal Infant Pain Scale, from Lawrence, J. et al (1993) The Development of a Tool to Assess Neonatal Pain. Neonatal Network, 12, 59-66 (Used with permission of Children’s Hospital of Eastern Ontario). Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Legs (Hidden by default)	List	List	+
List options: 0=Relaxed/restrained 1=Flexed/extended Min age (days): 0 Max age (days): 365 Row information: Neonatal Infant Pain Scale, from Lawrence, J. et al (1993) The Development of a Tool to Assess Neonatal Pain. Neonatal Network, 12, 59-66 (Used with permission of Children’s Hospital of Eastern Ontario). Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
State of Arousal (Hidden by default)	List	List	+
List options: 0=Sleeping/awake 1=Fussy Min age (days): 0 Max age (days): 365 Row information: Neonatal Infant Pain Scale, from Lawrence, J. et al (1993) The Development of a Tool to Assess Neonatal Pain. Neonatal Network, 12, 59-66 (Used with permission of Children’s Hospital of Eastern Ontario). Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
NIPS Score (Hidden by default)	Formula (Read Only)	Formula (Read Only)	+
Min age (days): 0 Max age (days): 365 Row information: 0-2 = Mild to no pain 3-4 = Mild to moderate pain >4 = Severe pain Neonatal Infant Pain Scale, from Lawrence, J. et al (1993) The Development of a Tool to Assess Neonatal Pain. Neonatal Network, 12, 59-66 (Used with permission of Children’s Hospital of Eastern Ontario). Formula: {Facial Expression}+{Arms}+{Breathing Patterns}+{Cry}+{Legs}+{State of Arousal} Row type: Custom Formula Value type: Numeric Type Cross encounter Can be graphed
Interventions (Hidden by default)	List	List	+
List options: None Pharmacological See Comfort and Environment Interventions Other (Comment) Min age (days): 0 Max age (days): 365 Synonyms: INTERVENTIONS Row type: Data Value type: Custom List Allow completion Multi-select
N-PASS (Neonatal Pain, Agitation and Sedation) (Hidden by default)
Pain/Agitation - Crying/Irritability (Hidden by default)	List	List	+
List options: 0=No pain/agitation signs 1=Irritable/crying at intervals, consolable, intermittent silent cry if intubated 2=High-pitched cry, inconsolable, silent continuous cry if intubated Min age (days): 0 Max age (days): 365 Row information: NPASS Scale (Neonatal Pain, Agitation & Sedation Scale), used with permission from Pat Hummel, RNC, MA, NNP, PNP. Synonyms: NEONATAL PAIN, AGITATION, AND SEDATION Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain/Agitation - Behavior State (Hidden by default)	List	List	+
List options: 0=No pain/agitation signs 1=Restless, squirming, awakens frequently with minimal/no stimuli 2=Arching, kicking, constantly awake or arouses minimally/no movement (not sedated) Min age (days): 0 Max age (days): 365 Row information: NPASS Scale (Neonatal Pain, Agitation & Sedation Scale), used with permission from Pat Hummel, RNC, MA, NNP, PNP. Synonyms: NEONATAL PAIN, AGITATION, AND SEDATION Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain/Agitation - Facial Expression (Hidden by default)	List	List	+
List options: 0=No pain/agitation signs 1=Any pain expression, observed intermittently 2=Any pain expression, continual Min age (days): 0 Max age (days): 365 Row information: NPASS Scale (Neonatal Pain, Agitation & Sedation Scale), used with permission from Pat Hummel, RNC, MA, NNP, PNP. Synonyms: NEONATAL PAIN, AGITATION, AND SEDATION Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain/Agitation - Extremities Tone (Hidden by default)	List	List	+
List options: 0=No pain/agitation signs 1=Intermittent clenched toes/fists/finger splay, body not tense 2=Continual clenched toes/fists/finger splay, body tense Min age (days): 0 Max age (days): 365 Row information: NPASS Scale (Neonatal Pain, Agitation & Sedation Scale), used with permission from Pat Hummel, RNC, MA, NNP, PNP. Synonyms: NEONATAL PAIN, AGITATION, AND SEDATION Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain/Agitation - Vital Signs (Hidden by default)	List	List	+
List options: 0=No pain/agitation signs 1=HR, RR, BP 10-20% above baseline - minimal/moderate desaturation (SaO2 76-85%) w/stimulation, quick recovery 2=HR, RR, BP 20% above baseline - severe desaturation (SaO2 equal/less than 75%) w/stimulation, slow recovery, out of sync w/ventilator Min age (days): 0 Max age (days): 365 Row information: NPASS Scale (Neonatal Pain, Agitation & Sedation Scale), used with permission from Pat Hummel, RNC, MA, NNP, PNP. Synonyms: NEONATAL PAIN, AGITATION, AND SEDATION Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
Pain/Agitation - Premature Pain Assessment (Hidden by default)	List	List	+
List options: 0=Equal to or greater than 30 weeks gestation/corrected age 1=Less than 30 weeks gestation/corrected age Min age (days): 0 Max age (days): 365 Row information: NPASS Scale (Neonatal Pain, Agitation & Sedation Scale), used with permission from Pat Hummel, RNC, MA, NNP, PNP. Synonyms: NEONATAL PAIN, AGITATION, AND SEDATION Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator Add to all templates where this row is start removed
N-PASS Pain/Agitation Score (Hidden by default)	Formula (Read Only)	Formula (Read Only)	+
Min age (days): 0 Max age (days): 365 Row information: NPASS Scale (Neonatal Pain, Agitation & Sedation Scale), used with permission from Pat Hummel, RNC, MA, NNP, PNP.Assessment of Pain/Agitation - Pain assessment is the fifth vital sign - assessment for pain should be included in every vital sign assessment. Pain is scored from 0 - +2 for each behavioral and physiological criteria, then summed. Points are added to the premature infant's pain score based on the gestational age to compensate for the limited ability to behaviorally communicate pain. Total pain score is documented as a positive number (0 to +11). Treatment/interventions are suggested for scores >3. Interventions for known pain/painful stimuli are indicated before the score reaches 3. The goal of pain treatment/intervention is a score equal to or less than 3. More frequent pain assessment indications - indwelling tubes or lines which may cause pain, especially with movement (chest tubes) at least every 2-4 hours; receiving analgesics and/or sedatives at least every 2-4 hours; 30 - 60 minutes after an analgesic is given for pain behaviors to assess response to medication; and post-operative at least every 2 hours for 24 - 48 hours, then every 4 hours until off medications.The NPASS Pain/Agitation Score = Sum of the scores for each of the following components of the NPASS Pain/Agitation Scale: R N-PASS PAIN/AGITATION - CRYING/IRRITABILITY [7090720] + R N-PASS PAIN/AGITATION - BEHAVIOR STATE [7090730] + R N-PASS PAIN/AGITATION - FACIAL EXPRESSION [7090740] + R N-PASS PAIN/AGITATION - EXTREMITIES TONE [7090750] + R N-PASS PAIN/AGITATION - VITAL SIGNS [7090760] + R N-PASS PAIN/AGITATION - PREMATURE PAIN ASSESSMENT [7090770] Formula: {Pain/Agitation - Crying/Irritability} + {Pain/Agitation - Behavior State} + {Pain/Agitation - Facial Expression} + {Pain/Agitation - Extremities Tone} + {Pain/Agitation - Vital Signs} + {Pain/Agitation - Premature Pain Assessment} Synonyms: NEONATAL PAIN, AGITATION, AND SEDATION Row type: Custom Formula Value type: Numeric Type Cross encounter Add to all templates where this row is start removed Can be graphed
Sedation - Crying/Irritability (Hidden by default)	List	List	+
List options: 0=No sedation signs -1=Moans, sighs, cries (audible or silent) minimally with painful stimuli -2=No response to painful stimuli Min age (days): 0 Max age (days): 365 Row information: NPASS Scale (Neonatal Pain, Agitation & Sedation Scale), used with permission from Pat Hummel, RNC, MA, NNP, PNP. Synonyms: NEONATAL PAIN, AGITATION, AND SEDATION Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Sedation - Behavior State (Hidden by default)	List	List	+
List options: 0=No sedation signs -1=Arouses briefly/minimally to stimuli - little spontaneous movement -2=No arousal/reaction to any stimuli - no spontaneous movement Min age (days): 0 Max age (days): 365 Row information: NPASS Scale (Neonatal Pain, Agitation & Sedation Scale), used with permission from Pat Hummel, RNC, MA, NNP, PNP. Synonyms: NEONATAL PAIN, AGITATION, AND SEDATION Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Sedation - Facial Expression (Hidden by default)	List	List	+
List options: 0=No sedation signs -1=Minimal expression with stimuli -2=Mouth lax, drooling, no expression at rest or with stimuli Min age (days): 0 Max age (days): 365 Row information: NPASS Scale (Neonatal Pain, Agitation & Sedation Scale), used with permission from Pat Hummel, RNC, MA, NNP, PNP. Synonyms: NEONATAL PAIN, AGITATION, AND SEDATION Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Sedation - Extremities (Hidden by default)	List	List	+
List options: 0=No sedation signs -1=Weak grasp reflex, decreased muscle tone -2=No grasp reflex, flaccid tone Min age (days): 0 Max age (days): 365 Row information: NPASS Scale (Neonatal Pain, Agitation & Sedation Scale), used with permission from Pat Hummel, RNC, MA, NNP, PNP. Synonyms: NEONATAL PAIN, AGITATION, AND SEDATION Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
Sedation - Vital Signs (HR, RR, BP, SaO2) (Hidden by default)	List	List	+
List options: 0=No sedation signs -1=Less than 10% variability from baseline with stimuli -2=No variability with stimuli, hypoventilation, apnea, no spontaneous respiratory effort (ventilated infant) Min age (days): 0 Max age (days): 365 Row information: NPASS Scale (Neonatal Pain, Agitation & Sedation Scale), used with permission from Pat Hummel, RNC, MA, NNP, PNP. Synonyms: NEONATAL PAIN, AGITATION, AND SEDATION Row type: Data Value type: Custom List Allow completion Cross encounter Display all list choices in Navigator
N-PASS Sedation Score (Hidden by default)	Formula (Read Only)	Formula (Read Only)	+
Min age (days): 0 Max age (days): 365 Row information: Assessment of Sedation - Sedation is scored in addition to pain for each behavioral and physicological criteria to assess the infant's response to stimuli. Sedation does not eed to be assessed/scored with every pain assessment/score. Sedation is scored from 0 to -2 for each behavioral and physiological criteria, then summed and noted as a negative score (0 to -10). A score of 0 is given if the infant has no signs of sedation, does not under-react. Desired levels of sedation vary according to the situation. "Deep sedation" = goal score of -10 to -5. "Light Sedation" = goal score of -5 to -2. Deep sedation is not recommended unless an infant is receiving ventilatory support, related to the high potential for hypoventilation and apnea. A negative score without the administration of opoids/sedatives may indicate: The premature infant's response to prolonged or persistent pain/stress and/or Neurologic depression, sepsis, or other pathology, paralysis/neuromuscular blockade. It is impossible to behaviorally evaluate a paralyzed infant for pain. Increases in heart rate and blood pressure at rest or with stimulation may be the only indicator of a need for more analgesia. Analgesics should be administered continuously by drip or around the clock dosing. Higher, more frequent doses may be required if the infant is post-op, has a chest tube, or other pathology (such as NEC) that would normally cause pain. Opioid doses should be increased by 10% every 3-5 days as tolerance will occur without symptoms of inadequate analgesia.The NPASS Sedation Score = Sum of the scores for each of the following components of the NPASS Sedation Scale: Sedation-Crying/Irritability + Sedation-Behavior State + Sedation-Facial Expression + Sedation-Extremities + Sedation-Vital Signs (HR, RR, BP, SaO2) NPASS Scale (Neonatal Pain, Agitation & Sedation Scale), used with permission from Pat Hummel, RNC, MA, NNP, PNP. Formula: {Sedation - Crying/Irritability} + {Sedation - Behavior State} + {Sedation - Facial Expression} + {Sedation - Extremities} + {Sedation - Vital Signs (HR, RR, BP, SaO2)} Synonyms: NEONATAL PAIN, AGITATION, AND SEDATION Row type: Custom Formula Value type: Numeric Type Cross encounter Can be graphed
Provider Notification
Reason for Communication	List	List	+
List options: Change in status Critical lab value Evaluate Family request IDUC Necessity Patient request Rapid response team Review case Sepsis/Potential Sepsis Urgent request Initial OBED evaluation MEWS notification Other (Comment) Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Condition: Urgent request
Provider Name	Free Text	Free Text	+
Synonyms: PROVIDER NAME Row type: Data Value type: String Type Allow completion Condition:
Provider Role	List	List	+
List options: Attending physician Consulting physician Residents Nurse practitioner Neonatologist Nurse Rapid response team Other (Comment) Synonyms: PROVIDER ROLE Row type: Data Value type: Custom List Display all list choices in Navigator
Method of Communication	List	List	+
List options: Call Face to face Overhead Page Other (Comment) Synonyms: METHOD OF COMMUNICATION Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Response	List	List	+
List options: At bedside En route In department No new orders See orders Waiting for response Other (Comment) Synonyms: RESPONSE Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Notification Date	Date	Date	+
Synonyms: NOTIFICATION DATE Row type: Data Value type: Date
Notification Time	Time	Time	+
Synonyms: NOTIFICATION TIME Row type: Data Value type: Time
Provider at Bedside Date	Date	Date	+
Synonyms: PROVIDER AT BEDSIDE DATE Row type: Data Value type: Date
Provider at Bedside Time	Time	Time	+
Synonyms: PROVIDER AT BEDSIDE TIME Row type: Data Value type: Time
Shift Event	List	List	+
List options: Code Elope Fall without injury Fall with injury Security Seizure Downtime Other (Comment) Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select Condition: Downtime Condition: Default groups/rows added when conditions are met Downtime Finished
Fall with Injury Type (Hidden by default)	List	List	+
List options: Ecchymosis Laceration Loss of consciousness Skin tear Swelling Verbalizes pain Other (Comment) Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select
Downtime Begin (Hidden by default)	Time	Time	+
Synonyms: DOWNTIME BEGIN Row type: Data Value type: Time Allow completion Condition:
Downtime Finished (Hidden by default)	Time	Time	+
Synonyms: DOWNTIME FINISHED Row type: Data Value type: Time Allow completion Condition:

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MHS POST VASCULAR PROCEDURE