SCL ECMO

Show hidden and conditional rows

Impella	6/1/2020
	1100	1400
Impella Initiation of Treatment
Impella Type	List	List	+
List options: Impella CP Impella 5.0 Impella LD Impella RP Other (comment) Synonyms: IMPELLA TYPE Row type: Data Value type: Custom List Allow completion Allow copy forward
Pump Serial #	Free Text	Free Text	+
Synonyms: PUMP SERIAL NUMBER Row type: Data Value type: String Type Allow completion Allow copy forward Condition:
Placement Date	Date	Date	+
Synonyms: PLACEMENT DATE Row type: Data Value type: Date Allow completion Allow copy forward Condition:
Placement Time	Time	Time	+
Synonyms: PLACEMENT TIME Row type: Data Value type: Time Allow completion Allow copy forward Condition:
Purge Cassette Change Date	Date	Date	+
Synonyms: PURGE CASSETTE CHANGE DATE Row type: Data Value type: Date Allow completion Allow copy forward Condition:
Purge Cassette Change Time	Time	Time	+
Synonyms: PURGE CASSETTE CHANGE TIME Row type: Data Value type: Time Allow completion Allow copy forward Condition:
Purge Cassette Serial #	Free Text	Free Text	+
Synonyms: PURGE CASSETTE SERIAL # Row type: Data Value type: String Type Allow completion Allow copy forward Condition:
Initiation Comments	Free Text	Free Text	+
Synonyms: INITIATION COMMENTS Row type: Data Value type: String Type Allow completion Allow copy forward Condition:
Vitals Signs
Temp	Temperature	Temperature	-
Minimum value: 0 Maximum value: 150 Minimum warning value: 92 Maximum warning value: 105 Synonyms: TEMPS Comments: Temperature Row type: Data Value type: Temperature After-file extension: IP - STANDARD VITALS FLOWSHEET AFTER FILING Can be graphed
Temp Source	List	List	+
List options: Axillary Temporal artery scan Oral Core Esophageal Pulmonary artery catheter Perfusion Rectal Skin Probe Bladder Tympanic Synonyms: TEMP SOURCE Comments: fixed spelling (Perfusion) - 9/10/15NrsgAdded Temporal to custom list to see how CPN can be interfaced. That is the same as Temporal Artery Scan, CPN only uses Temporal. SKS. This row and the temp row are linked to careplan goal 1636 & 1637, 1639 & 1652. pd Row type: Data Value type: Custom List Allow completion Allow copy forward Condition: Skin Probe
Pulse	Number	Number	+
Decimal places: 0 Minimum value: 0 Maximum value: 500 Minimum warning value: 50 Maximum warning value: 200 Synonyms: PULSE Comments: Pulse Row type: Data Value type: Numeric Type After-file extension: IP - STANDARD VITALS FLOWSHEET AFTER FILING Can be graphed
Art Line BP	Blood Pressure	Blood Pressure	+
Synonyms: ARTERIAL LINE BP, ART LINE BP Row type: Data Value type: Blood Pressure Allow completion Can be graphed Condition:
Arterial BP (MAP)	Formula (Read Only)	Formula (Read Only)	+
Row information: MAP = Mean Arterial Pressure Formula: M:(2{1814;D}+{1814;S})/3 Abbreviation:* MAP Synonyms: MEAN, ARTERIAL PRESSURE, MAP Comments: Formula = M:(2{1814;D}+{1814;S})/3 Row type:* Custom Formula Value type: Numeric Type Allow completion Can be graphed
Art Line BP #2	Blood Pressure	Blood Pressure	+
Synonyms: ARTERIAL LINE BP #2, ART LINE BP #2 Row type: Data Value type: Blood Pressure Allow completion Can be graphed Condition:
Arterial BP (MAP) #2	Formula (Read Only)	Formula (Read Only)	+
Unit: mmHg Formula: M:(2{1820;D}+{1820;S})/3 Abbreviation:* MAP Synonyms: MEAN, ARTERIAL PRESSURE, MAP Comments: Formula = M:(2{1820;D}+{1820;S})/3 Row type:* Custom Formula Value type: Numeric Type Can be graphed Condition:
Pulse Rate - SpO2	Number	Number	+
Decimal places: 0 Minimum value: 0 Maximum value: 500 Minimum warning value: 50 Maximum warning value: 200 Synonyms: PULSE Comments: Pulse Row type: Data Value type: Numeric Type After-file extension: IP - STANDARD VITALS FLOWSHEET AFTER FILING Can be graphed
O2 (LPM)$	Number	Number	+
Decimal places: 3 Minimum value: .01 Maximum value: 100 Drops charges Row information: O2=OxygenDo not enter zero (0) in this row. NICU SEE BELOW:16cc=1/64LPM25cc or 0.025LPM =1/40LPM32cc or 0.032LPM =1/32LPM 40cc or 0.04LPM =1/25LPM50cc or 0.05LPM =1/20LPM 63cc or 0.063LPM =1/16LPM 75cc or 0.075LPM =1/13LPM100cc or 0.1LPM =1/10LPM 125cc or 0.125LPM =1/8LPM 150cc or 0.15LPM = 1/7LPM 175cc or 0.175LPM = 1/6LPM 200cc or 0.2LPM = 1/5LPM250cc or 0.25LPM =1/4LPM 500 cc or 0.5LPM =1/2LPM 1000cc or 1LPM = 1LPM 2000cc or 2LPM = 2LPM Synonyms: O2 (LPM) Comments: RTNrsg, pedsDo not remove from nursingThis row is shared with goal record id 1553, 1353, 1345, 1622, 1509, 1631, 1373, 1620, 1553, 1556, 1548, 1303, 1499 &1621, 1297 1648. pd 1-28-09Row linked to Care Plan goal 1406 Row type: Charge Row Value type: Numeric Type Allow completion Charge trigger type: Once Per Day Quantity type: Qty by Spec Value Charge quantity: 1 Charge procedure: OXYGEN DAILY Can be graphed
O2 Delivery	List	List	+
List options: RA-room air NC-Nasal cannula Aerosol mask Bag valve mask BIPAP Blow-by CPAP End Tidal CO2 device Face tent (mist mask) Heated high flow oxygen therapy High flow cannula Hood Mist hood NRB-non-rebreather Oxymizer RAM cannula Simple mask Trans-Tracheal catheter T-piece Trach collar Ventilator Venti-mask Face tent Hiox mask Oxymask Tracheal collar Transtracheal catheter VM-venti mask Oxygen Initiated O2 initiated per RN request Mask Non-Rebreather Oxygen Discontinued Other (comment) Synonyms: O2 DELIVERY Comments: NrsgThis row is linked to care plan goal record id 1389. pdec Row type: Data Value type: Custom List Allow completion Allow copy forward Multi-select
End Tidal CO2 (Carbon Dioxide Exprd Gas Infrd) $	Number	Number	+
Minimum value: 10 Maximum value: 100 Minimum warning value: 30 Maximum warning value: 43 Drops charges Row information: mmHg Synonyms: END TIDAL CO2 (CARBON DIOXIDE EXPRD GAS INFRD) $ Comments: 11/8/19 CH-Changed CDM per request on SCTASK0027005. Row type: Charge Row Value type: Numeric Type Allow completion Charge trigger type: Once Per Day Quantity type: Qty by Spec Value Charge quantity: 1 Charge procedure: STATISTIC END TIDAL CO2 MONITORING Can be graphed
FiO2 (%)	Number	Number	+
Decimal places: 2 Unit: % Synonyms: FIO2 Comments: Nrsg, This row is linked to careplan goal 1631 Row type: Data Value type: Numeric Type Allow completion Can be graphed
Hemodynamics (Hidden by default)
Monitoring Line (Hidden by default)	List	List	+
List options: PA Catheter Arterial Catheter Synonyms: MONITORING LINE Row type: Data Value type: Custom List Allow completion
PA Pressure (Hidden by default)	Blood Pressure	Blood Pressure	+
Row information: Pulmonary Artery Pressure Synonyms: PULMONARY ARTERY , PA PRESSURE, PAP Row type: Data Value type: Blood Pressure Allow completion Can be graphed Condition:
MPAP (Hidden by default)	Formula (Read Only)	Formula (Read Only)	+
Row information: PAP=Pulmonary Artery PressureMPAP=Mean Pulmonary Artery Pressure((2 x diastolic PAP) + systolic PAP) / 3 = MPAP Formula: M:(2{4262;D}+{4262;S})/3 Synonyms:* MPAP Row type: Custom Formula Value type: Numeric Type Can be graphed Condition:
PCWP (mmHg) (Hidden by default)	Number	Number	+
Minimum value: 0 Unit: mmHg Row information: PCWP=Pulmonary Capillary Wedge Pressure Abbreviation: PCWP Synonyms: PCWP (MMHG) Row type: Data Value type: Numeric Type Allow completion Can be graphed Condition:
CVP (mmHg) (Hidden by default)	Number	Number	+
Minimum value: 0 Unit: mmHg Row information: CVP=Central Venous Pressure Abbreviation: CVP Synonyms: CVP (MMHG) Comments: This row is linked to careplan goal record id 1642, 1297, 1303, 1516, 1364. pd Row type: Data Value type: Numeric Type Allow completion Can be graphed Condition:
SVO2 (%) (Hidden by default)	Number	Number	+
Minimum value: 0 Unit: % Row information: SVO2 = Saturated Venous OxygenationEnter value from monitoring device. Abbreviation: SVO2 Synonyms: SVO2 Row type: Data Value type: Numeric Type Allow completion Can be graphed Condition:
ScvO2 (%) (Hidden by default)	Number	Number	+
Minimum value: 0 Unit: % Row information: ScvO2 = Central Venous SaturationEnter value from monitoring device. Abbreviation: ScvO2 Synonyms: SCVO2 Row type: Data Value type: Numeric Type Allow completion Can be graphed Condition:
CO (l/min) (Hidden by default)	Number	Number	+
Decimal places: 1 Minimum value: 0 Unit: l/min Row information: CO = Cardiac OutputEnter value from monitoring device. Abbreviation: CO Row type: Data Value type: Numeric Type Allow completion Can be graphed Condition:
CCO (l/min) (Hidden by default)	Number	Number	+
Decimal places: 1 Minimum value: 0 Unit: l/min Row information: CCO = Continuous Cardiac Output Abbreviation: CO Synonyms: CCO (L/MIN) Row type: Data Value type: Numeric Type Allow completion Can be graphed
CI (l/min/m2) (Hidden by default)	Number	Number	+
Decimal places: 1 Minimum value: 0 Unit: l/min/m2 Row information: CI = Cardiac IndexEnter value from monitoring device. Abbreviation: CI Synonyms: CARDIAC INDEX Row type: Data Value type: Numeric Type Allow completion Can be graphed Condition:
CCI (l/min/m2) (Hidden by default)	Number	Number	+
Decimal places: 1 Minimum value: 0 Unit: l/min/m2 Row information: CCI = Continuous Cardiac Index Abbreviation: CI Synonyms: CARDIAC INDEX Row type: Data Value type: Numeric Type Allow completion Can be graphed
SVR (dyne*sec)/cm5 (Hidden by default)	Number	Number	+
Unit: (dynesec)/cm5 Row information:* SVR = Systemic Vascular ResistanceEnter value from monitoring device. Abbreviation: SVR Synonyms: SVR Row type: Data Value type: Numeric Type Allow completion Can be graphed Condition:
SVRI (dyne*sec)/cm5 (Hidden by default)	Number	Number	+
Unit: (dynesec)/cm5 Row information:* SVRI = Systemic Vascular Resistance IndexEnter value from monitoring device. Abbreviation: SVRI Synonyms: SVRI Row type: Data Value type: Numeric Type Allow completion Can be graphed Condition:
PVR (dyne*sec)/cm5 (Hidden by default)	Number	Number	+
Unit: (dynesec)/cm5 Row information:* PVR = Pulmonary Vascular Resistance Enter value from monitoring device. Abbreviation: PVR Synonyms: PVR Row type: Data Value type: Numeric Type Allow completion Can be graphed Condition:
PVRI (dyne*sec)/cm5 (Hidden by default)	Number	Number	+
Unit: (dynesec)/cm5 Row information:* PVRI = Pulmonary Vascular Resistance IndexEnter value from monitoring device. Abbreviation: PVRI Synonyms: SVRI Row type: Data Value type: Numeric Type Allow completion Can be graphed Condition:
SV (ml) (Hidden by default)	Number	Number	+
Unit: ml Row information: SV = Stroke VolumeEnter value from monitoring device. Abbreviation: SV Synonyms: STROKE VOLUME (CALC) Row type: Data Value type: Numeric Type Allow completion Can be graphed Condition:
SVI (Hidden by default)	Number	Number	+
Row information: SVI = Stroke Volume IndexEnter value from monitoring device. Abbreviation: SVI Synonyms: SVI Row type: Data Value type: Numeric Type Allow completion Can be graphed Condition:
FICK Cardiac Output Calculator
Hgb	Free Text	Free Text	+
Synonyms: HGB Row type: Data Value type: String Type
SaO2 (O2, sat)	Number	Number	+
Synonyms: SAO2 (O2, SAT) Row type: Data Value type: Numeric Type Add to all templates where this row is start removed Can be graphed
SVO2	Number	Number	+
Row type: Data Value type: Numeric Type Allow completion Add to all templates where this row is start removed
BSA (Calculated - sq m)	Formula (Read Only)	Formula (Read Only)	+
Decimal places: 2 Unit: sq meters Row information: BSA=Body Surface Area. BSA (sq meters) = sqrt([Height (cm) x Weight (kg)]/3600) . BSA is calculated using the Mosteller Formula. Mosteller RD: Simplified Calculation of Body Surface Area. N Engl J Med 1987 Oct 22;317(17):1098. Formula: (({11}{14})/50000)^0.5 Synonyms:* BSA (CALCULATED - SQ M) Comments: This row utilizes the Mosteller Formula. Row type: Custom Formula Value type: Numeric Type Add to all templates where this row is start removed Can be graphed
Estimated Fick Cardiac Output (L/min)	Formula (Read Only)	Formula (Read Only)	+
Decimal places: 2 Unit: L/min Row information: Cardiac Output (Fick) in L/min = (125 ml O2/min/M2)BSA / (13.4 Hgb * (SaO2 - SvO2)) Formula: M:x,x=(125($$getLastFloVal^elibJULIB7(inpID,"""",instant,301060)))/(13.4{Hgb}(({SaO2 (O2, sat)}/100)-({SVO2}/100))) Synonyms:* FICK CO, FICK CARDIAC OUTPUT, FICK CARDIAC OUTPUT (L/MIN), MODIFIED FICK CARDIAC OUTPUT (L/MIN), ESTIMATED FICK CARDIAC OUTPUT (L/MIN) Row type: Custom Formula Value type: Numeric Type Allow completion Can be graphed
Estimated Fick Cardiac Index (L/min/m²)	Formula (Read Only)	Formula (Read Only)	+
Decimal places: 2 Unit: L/min/m² Row information: Fick Cardiac Index in L/min/m ² = (125 ml O2/min/M2) / (13.4 * Hgb * (SaO2 - SvO2)) Formula: 125/(13.4{Hgb}(({SaO2 (O2, sat)}/100)-({SVO2}/100))) Synonyms: ESTIMATED FICK CARDIAC INDEX, ESTIMATED FICK CARDIAC INDEX (L/MIN/M²) Row type: Custom Formula Value type: Numeric Type Allow completion Can be graphed
Additional Hemodynamics
CPO (Calculated)	Formula (Read Only)	Formula (Read Only)	+
Decimal places: 2 Row information: Cardiac Power Output = MAP (mmHg) x Cardiac Output Fick (Calculated)/ 451 Cardiac Power Output (CPO) = (MAP x Cardiac Output ) / 451, < 0.6 watt suggests severe LV dysfunction Formula: {MAP (mmHg)}{Cardiac Output FICK (Calculated)}/451 Synonyms:* CPO (CALCULATED) Row type: Custom Formula Value type: Numeric Type Can be graphed
PAPI (Calculated)	Formula (Read Only)	Formula (Read Only)	+
Decimal places: 2 Row information: PAPI = (Systolic PA pressure – Diastolic PA pressure) / CVP Pulmonary Artery Pulsatility Index (PAPI) = sPAP - dPAP / RA, < 1.0 suggests severe RV dysfunction Formula: M:$s({CVP (mmHg)}>0:({450100;S}-{450100;D})/{CVP (mmHg)},1:"""") Synonyms: PAPI (CALCULATED) Comments: 8/15/19 Updating formua per Epic's recommendations. JW Row type: Custom Formula Value type: Numeric Type Can be graphed
Labs
Last Calcium Result	Free Text	Free Text	+
Extension: EH RX LAST CALCIUM Synonyms: LAST CALCIUM Row type: Extension Value type: String Type Allow copy forward Condition:
Last Ionized Calcium Result	Number	Number	+
Extension: EH RX LAST IONIZED CALCIUM Synonyms: LAST IONIZED CALCIUM Row type: Extension Value type: Numeric Type Allow copy forward Can be graphed
Last UFH	Number	Number	+
Maximum warning value: 100 Extension: EH RX LAST UFH Synonyms: LAST UFH, UFH Row type: Extension Value type: Numeric Type Can be graphed Condition:
Last Potassium	Number	Number	+
Extension: EH RX LAST POTASSIUM Synonyms: LAST POTASSIUM Row type: Extension Value type: Numeric Type Allow copy forward Can be graphed Condition:
Last Magnesium Result	Free Text	Free Text	+
Extension: EH RX LAST MAGNESIUM Synonyms: LAST MAGNESIUM Row type: Extension Value type: String Type Allow copy forward Condition:
Last Phosphorus	Number	Number	+
Extension: EH RX LAST PHOSPHORUS Synonyms: LAST PHOSPHORUS Row type: Extension Value type: Numeric Type Can be graphed
Impella CP Controls (Hidden by default)
Impella CP Pump Serial # (Hidden by default)	Free Text	Free Text	+
Synonyms: IMPELLA PUMP (LEFT) SERIAL #, IMPELLA PUMP SERIAL #, IMPELLA CP PUMP SERIAL # Row type: Data Value type: String Type Allow completion
Time Impella CP on (Hidden by default)	Time	Time	+
Synonyms: TIME IMPELLA ON, TIME IMPELLA CP ON Row type: Data Value type: Time Allow completion
Performance Level (Hidden by default)	List	List	+
List options: P0 P1 P2 P3 P4 P5 P6 P7 P8 P9 Synonyms: PERFORMANCE LEVEL Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Can be graphed
Flow (L/min) (Hidden by default)	Number	Number	+
List options: Unit: L/min Row type: Data Value type: Numeric Type Allow completion Can be graphed
Placement Signal (mm Hg) (Hidden by default)	Blood Pressure	Blood Pressure	+
Unit: mm Hg Row type: Data Value type: Blood Pressure Can be graphed
Motor Current (Amps) (Hidden by default)	Number	Number	+
Unit: Amps Synonyms: MOTOR CURRENT (AMPS) Row type: Data Value type: Numeric Type Allow completion Can be graphed
Impella Pump Position (Hidden by default)	Free Text	Free Text	+
List options: Synonyms: IMPELLA PUMP POSITION Row type: Data Value type: String Type Allow completion
Purge Pressure (mmHg) (Hidden by default)	Number	Number	+
Unit: mm Hg Synonyms: PURGE PRESSURE (MMHG) Row type: Data Value type: Numeric Type Allow completion Can be graphed
Power (Hidden by default)	List	List	+
List options: A/C Battery Synonyms: POWER Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
PTT (Hidden by default)	List	List	+
List options: Grade 1=> 1 - 1.5 x ULN Grade 2=> 1.5 - 2 x ULN Grade 3=> 2 x ULN Row information: ALSO CONSIDER: Hemorrhage, CNS; Hemorrhage, GI - Select; Hemorrhage, GU - Select; Hemorrhage, pulmonary/upper respiratory - Select. Synonyms: PTT Row type: Data Value type: Custom List Show abbreviation Allow completion Add to all templates where this row is start removed
Marking at Hub (Hidden by default)	Number	Number	+
Row type: Data Value type: Numeric Type Allow completion Can be graphed
Plugged into RED outlet (Hidden by default)	List	List	+
List options: Yes No (Comment) Synonyms: PLUGGED INTO RED OUTLET Row type: Data Value type: Custom List Allow completion
Impella CP (Hidden by default)			Duplicable
Impella CP Properties (Hidden by default)	Properties Group	Properties Group	+
Insertion Site Inserted by PQRS Measures Followed: Sterile Technique Followed Sutured Balloon Size Verification by X-ray Removed By Removal Reason Initial Post Removal Assessment Time Pressure Held Synonyms: IMPELLA PROPERTIES, IMPELLA CP PROPERTIES Row type: Properties Group Allow completion
Site Observation (Hidden by default)	List	List	+
List options: Clean, dry, intact, with no signs of redness, swelling or blanching Clean Dry Intact Bleeding Draining Drainage Ecchymotic Edematous Extravasated Leaking Painful Pink Positional Red Streaking Tender Unable to view (Comment) Other (Comment) Synonyms: SITE ASSESSMENT Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Line Status (Hidden by default)	List	List	+
List options: Arterial fluids per protocol Intact and in place Blood return noted Positional Clotted Leaking No blood return Other (Comment) Synonyms: INTRA AORTIC BALLOON PUMP Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select
Treatment(Retired) (Hidden by default)	List	List	+
List options: Head of bed flat Leg movement deterrent off Leg movement deterrent on Other (Comment) Synonyms: INTRA AORTIC BALLOON PUMP Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Dressing (Hidden by default)	List	List	+
List options: Non-occlusive Occlusive Other (Comment) Synonyms: INTRA AORTIC BALLOON PUMP Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Dressing Status (Hidden by default)	List	List	+
List options: Clean Dry Intact New drainage Old drainage Other (Comment) Synonyms: INTRA AORTIC BALLOON PUMP Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select
Dressing Intervention (Hidden by default)	List	List	+
List options: Changed Reinforced Removed Other (Comment) Synonyms: DRESSING INTERVENTION Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Task template: WOUND DRESSING CHANGE TASK TEMPLATE Add to all templates where this row is start removed
Next Dressing Change Due (Hidden by default)	Date	Date	+
Row information: Enter the date the next dressing change is due. Synonyms: NEXT DRESSING CHANGE DUE Row type: Data Value type: Date Allow completion Add to all templates where this row is start removed
Art Line Interventions (Hidden by default)	List	List	+
List options: Zeroed and calibrated Leveled Tubing changed Connections checked and tightened Other (Comment) Synonyms: ART LINE CARE 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
Color/Movement/Sensation (Hidden by default)	List	List	+
List options: Capillary refill less than 3 sec Cool toes Capillary refill greater than 3 sec Dusky toes Numbness to toes Pale toes Tingling to toes Weakness to toes Other (Comment) Synonyms: COLOR/MOVEMENT/SENSATION Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select
Post Removal Complications (Hidden by default)	List	List	+
List options: None Tamponade Bleeding Bruising Draining Redness Swelling Other (Comment) Synonyms: INTRA AORTIC BALLOON PUMP, VENTRICULAR ASSIST DEVICE Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select
Interventions (Hidden by default)	List	List	+
List options: Pressure dressing applied MD notified Labs drawn X-ray Sand bag Other (Comment) Synonyms: INTRA AORTIC BALLOON PUMP Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select
Impella RP Controls (Hidden by default)
Impella RP Pump Serial # (Hidden by default)	Free Text	Free Text	+
Synonyms: IMPELLA PUMP (LEFT) SERIAL #, IMPELLA PUMP SERIAL #, IMPELLA CP PUMP SERIAL #, IMPELLA RP PUMP SERIAL # Row type: Data Value type: String Type Allow completion
Time Impella RP on (Hidden by default)	Time	Time	+
Synonyms: TIME IMPELLA ON, TIME IMPELLA RP ON Row type: Data Value type: Time Allow completion
Performance Level (Hidden by default)	List	List	+
List options: P0 P1 P2 P3 P4 P5 P6 P7 P8 P9 Synonyms: PERFORMANCE LEVEL, PERFORMANCE LEVEL (2ND SITE) Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Can be graphed
Flow (L/min) (Hidden by default)	Number	Number	+
Unit: L/min Synonyms: FLOW (L/MIN)- 2ND SITE, FLOW (L/MIN)- (2ND SITE), FLOW (L/MIN)-, FLOW (L/MIN) Row type: Data Value type: Numeric Type Allow completion Can be graphed
Placement Signal (mm Hg) (Hidden by default)	Blood Pressure	Blood Pressure	+
Unit: mm Hg Synonyms: PLACEMENT SIGNAL (MM HG)- 2ND SITE, PLACEMENT SIGNAL (MM HG)- (2ND SITE), PLACEMENT SIGNAL (MM HG) Row type: Data Value type: Blood Pressure Can be graphed
Motor Current (Amps) (Hidden by default)	Number	Number	+
Unit: Amps Synonyms: MOTOR CURRENT (AMPS), MOTOR CURRENT (AMPS)-2ND SITE, MOTOR CURRENT (AMPS)- (2ND SITE) Row type: Data Value type: Numeric Type Allow completion Can be graphed
Impella Pump Position (Hidden by default)	Free Text	Free Text	+
Synonyms: IMPELLA PUMP POSITION, IMPELLA PUMP POSITION- 2ND SITE, IMPELLA PUMP POSITION- (2ND SITE) Row type: Data Value type: String Type Allow completion
Purge Pressure (mmHg) (Hidden by default)	Number	Number	+
Unit: mm Hg Synonyms: PURGE PRESSURE (MMHG), PURGE PRESSURE (MMHG)-RIGHT, PURGE PRESSURE (MMHG)-2ND SITE, PURGE PRESSURE (MMHG)- (2ND SITE) Row type: Data Value type: Numeric Type Allow completion Can be graphed
Power (Hidden by default)	List	List	+
List options: A/C Battery Synonyms: POWER, POWER (2ND SITE) Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
PTT (Hidden by default)	List	List	+
List options: Grade 1=> 1 - 1.5 x ULN Grade 2=> 1.5 - 2 x ULN Grade 3=> 2 x ULN Row information: ALSO CONSIDER: Hemorrhage, CNS; Hemorrhage, GI - Select; Hemorrhage, GU - Select; Hemorrhage, pulmonary/upper respiratory - Select. Synonyms: PTT Row type: Data Value type: Custom List Show abbreviation Allow completion Add to all templates where this row is start removed
Marking at Hub (Hidden by default)	Number	Number	+
Synonyms: MARKING AT HUB (2ND SITE), MARKING AT HUB Row type: Data Value type: Numeric Type Allow completion Can be graphed
Plugged into RED outlet (Hidden by default)	List	List	+
List options: Yes No (Comment) Synonyms: PLUGGED INTO RED OUTLET, PLUGGED INTO RED OUTLET (2ND SITE) Row type: Data Value type: Custom List Allow completion
Impella RP (Hidden by default)			Duplicable
Impella RP Properties (Hidden by default)	Properties Group	Properties Group	+
Insertion Site Inserted by PQRS Measures Followed: Sterile Technique Followed Sutured Balloon Size Verification by X-ray Removed By Removal Reason Initial Post Removal Assessment Time Pressure Held Synonyms: IMPELLA PROPERTIES, IMPELLA RP PROPERTIES Row type: Properties Group Allow completion
Site Observation (Hidden by default)	List	List	+
List options: Clean, dry, intact, with no signs of redness, swelling or blanching Clean Dry Intact Bleeding Draining Drainage Ecchymotic Edematous Extravasated Leaking Painful Pink Positional Red Streaking Tender Unable to view (Comment) Other (Comment) Synonyms: SITE ASSESSMENT Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Line Status (Hidden by default)	List	List	+
List options: Arterial fluids per protocol Intact and in place Blood return noted Positional Clotted Leaking No blood return Other (Comment) Synonyms: INTRA AORTIC BALLOON PUMP Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select
Treatment(Retired) (Hidden by default)	List	List	+
List options: Head of bed flat Leg movement deterrent off Leg movement deterrent on Other (Comment) Synonyms: INTRA AORTIC BALLOON PUMP Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Dressing (Hidden by default)	List	List	+
List options: Non-occlusive Occlusive Other (Comment) Synonyms: INTRA AORTIC BALLOON PUMP Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Dressing Status (Hidden by default)	List	List	+
List options: Clean Dry Intact New drainage Old drainage Other (Comment) Synonyms: INTRA AORTIC BALLOON PUMP Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select
Dressing Intervention (Hidden by default)	List	List	+
List options: Changed Reinforced Removed Other (Comment) Synonyms: DRESSING INTERVENTION Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Task template: WOUND DRESSING CHANGE TASK TEMPLATE Add to all templates where this row is start removed
Next Dressing Change Due (Hidden by default)	Date	Date	+
Row information: Enter the date the next dressing change is due. Synonyms: NEXT DRESSING CHANGE DUE Row type: Data Value type: Date Allow completion Add to all templates where this row is start removed
Art Line Interventions (Hidden by default)	List	List	+
List options: Zeroed and calibrated Leveled Tubing changed Connections checked and tightened Other (Comment) Synonyms: ART LINE CARE 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
Color/Movement/Sensation (Hidden by default)	List	List	+
List options: Capillary refill less than 3 sec Cool toes Capillary refill greater than 3 sec Dusky toes Numbness to toes Pale toes Tingling to toes Weakness to toes Other (Comment) Synonyms: COLOR/MOVEMENT/SENSATION Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select
Post Removal Complications (Hidden by default)	List	List	+
List options: None Tamponade Bleeding Bruising Draining Redness Swelling Other (Comment) Synonyms: INTRA AORTIC BALLOON PUMP, VENTRICULAR ASSIST DEVICE Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select
Interventions (Hidden by default)	List	List	+
List options: Pressure dressing applied MD notified Labs drawn X-ray Sand bag Other (Comment) Synonyms: INTRA AORTIC BALLOON PUMP Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select
Impella 5.0 Controls (Hidden by default)
Impella 5.0 Pump Serial # (Hidden by default)	Free Text	Free Text	+
Synonyms: IMPELLA PUMP (LEFT) SERIAL #, IMPELLA PUMP SERIAL #, IMPELLA CP PUMP SERIAL #, IMPELLA RP PUMP SERIAL #, IMPELLA 5.0 PUMP SERIAL # Row type: Data Value type: String Type Allow completion
Time Impella 5.0 on (Hidden by default)	Time	Time	+
Synonyms: TIME IMPELLA ON, TIME IMPELLA RP ON, TIME IMPELLA 5.0 ON Row type: Data Value type: Time Allow completion
Performance Level (Hidden by default)	List	List	+
List options: P0 P1 P2 P3 P4 P5 P6 P7 P8 P9 Synonyms: PERFORMANCE LEVEL, PERFORMANCE LEVEL (2ND SITE) Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Can be graphed
Flow (L/min) (Hidden by default)	Number	Number	+
Unit: L/min Synonyms: FLOW (L/MIN)- 2ND SITE, FLOW (L/MIN)- (2ND SITE), FLOW (L/MIN)-, FLOW (L/MIN) Row type: Data Value type: Numeric Type Allow completion Can be graphed
Placement Signal (mm Hg) (Hidden by default)	Blood Pressure	Blood Pressure	+
Unit: mm Hg Synonyms: PLACEMENT SIGNAL (MM HG)- 2ND SITE, PLACEMENT SIGNAL (MM HG)- (2ND SITE), PLACEMENT SIGNAL (MM HG) Row type: Data Value type: Blood Pressure Can be graphed
Motor Current (Amps) (Hidden by default)	Number	Number	+
Unit: Amps Synonyms: MOTOR CURRENT (AMPS), MOTOR CURRENT (AMPS)-2ND SITE, MOTOR CURRENT (AMPS)- (2ND SITE) Row type: Data Value type: Numeric Type Allow completion Can be graphed
Impella Pump Position (Hidden by default)	Free Text	Free Text	+
Synonyms: IMPELLA PUMP POSITION, IMPELLA PUMP POSITION- 2ND SITE, IMPELLA PUMP POSITION- (2ND SITE) Row type: Data Value type: String Type Allow completion
Purge Pressure (mmHg) (Hidden by default)	Number	Number	+
Unit: mm Hg Synonyms: PURGE PRESSURE (MMHG), PURGE PRESSURE (MMHG)-RIGHT, PURGE PRESSURE (MMHG)-2ND SITE, PURGE PRESSURE (MMHG)- (2ND SITE) Row type: Data Value type: Numeric Type Allow completion Can be graphed
Power (Hidden by default)	List	List	+
List options: A/C Battery Synonyms: POWER, POWER (2ND SITE) Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
PTT (Hidden by default)	List	List	+
List options: Grade 1=> 1 - 1.5 x ULN Grade 2=> 1.5 - 2 x ULN Grade 3=> 2 x ULN Row information: ALSO CONSIDER: Hemorrhage, CNS; Hemorrhage, GI - Select; Hemorrhage, GU - Select; Hemorrhage, pulmonary/upper respiratory - Select. Synonyms: PTT Row type: Data Value type: Custom List Show abbreviation Allow completion Add to all templates where this row is start removed
Marking at Hub (Hidden by default)	Number	Number	+
Synonyms: MARKING AT HUB (2ND SITE), MARKING AT HUB Row type: Data Value type: Numeric Type Allow completion Can be graphed
Plugged into RED outlet (Hidden by default)	List	List	+
List options: Yes No (Comment) Synonyms: PLUGGED INTO RED OUTLET, PLUGGED INTO RED OUTLET (2ND SITE) Row type: Data Value type: Custom List Allow completion
Impella 5.0 (Hidden by default)			Duplicable
Impella Properties (Hidden by default)	Properties Group	Properties Group	+
Insertion Site Inserted by PQRS Measures Followed: Sterile Technique Followed Sutured Balloon Size Verification by X-ray Removed By Removal Reason Initial Post Removal Assessment Time Pressure Held Synonyms: IMPELLA PROPERTIES Row type: Properties Group Allow completion
Site Observation (Hidden by default)	List	List	+
List options: Clean, dry, intact, with no signs of redness, swelling or blanching Clean Dry Intact Bleeding Draining Drainage Ecchymotic Edematous Extravasated Leaking Painful Pink Positional Red Streaking Tender Unable to view (Comment) Other (Comment) Synonyms: SITE ASSESSMENT Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select Add to all templates where this row is start removed
Line Status (Hidden by default)	List	List	+
List options: Arterial fluids per protocol Intact and in place Blood return noted Positional Clotted Leaking No blood return Other (Comment) Synonyms: INTRA AORTIC BALLOON PUMP Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select
Treatment(Retired) (Hidden by default)	List	List	+
List options: Head of bed flat Leg movement deterrent off Leg movement deterrent on Other (Comment) Synonyms: INTRA AORTIC BALLOON PUMP Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Dressing (Hidden by default)	List	List	+
List options: Non-occlusive Occlusive Other (Comment) Synonyms: INTRA AORTIC BALLOON PUMP Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator
Dressing Status (Hidden by default)	List	List	+
List options: Clean Dry Intact New drainage Old drainage Other (Comment) Synonyms: INTRA AORTIC BALLOON PUMP Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select
Dressing Intervention (Hidden by default)	List	List	+
List options: Changed Reinforced Removed Other (Comment) Synonyms: DRESSING INTERVENTION Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Task template: WOUND DRESSING CHANGE TASK TEMPLATE Add to all templates where this row is start removed
Next Dressing Change Due (Hidden by default)	Date	Date	+
Row information: Enter the date the next dressing change is due. Synonyms: NEXT DRESSING CHANGE DUE Row type: Data Value type: Date Allow completion Add to all templates where this row is start removed
Art Line Interventions (Hidden by default)	List	List	+
List options: Zeroed and calibrated Leveled Tubing changed Connections checked and tightened Other (Comment) Synonyms: ART LINE CARE 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
Color/Movement/Sensation (Hidden by default)	List	List	+
List options: Capillary refill less than 3 sec Cool toes Capillary refill greater than 3 sec Dusky toes Numbness to toes Pale toes Tingling to toes Weakness to toes Other (Comment) Synonyms: COLOR/MOVEMENT/SENSATION Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select
Post Removal Complications (Hidden by default)	List	List	+
List options: None Tamponade Bleeding Bruising Draining Redness Swelling Other (Comment) Synonyms: INTRA AORTIC BALLOON PUMP, VENTRICULAR ASSIST DEVICE Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select
Interventions (Hidden by default)	List	List	+
List options: Pressure dressing applied MD notified Labs drawn X-ray Sand bag Other (Comment) Synonyms: INTRA AORTIC BALLOON PUMP Row type: Data Value type: Custom List Allow completion Display all list choices in Navigator Multi-select

There are no rows to display.

ESUMM IP