Narrative Review: Acute Kidney Injury: Difference between revisions

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Revision as of 16:16, 14 June 2018

Site:

AE:

Complication:

Event date:

Adverse event code:

  • Demograghic: [age] year old [gender]
  • Past Medical History: [eg. diabetes, CAD,...]
  • Index Procedure Date/Time: xx/xx/xxxx at xx:xx [insert date and time]
  • Index Procedure Detail:
    • On xx/xx/xxxx at xx:xx [insert date and time] the subject underwent a [select surgical correction] for [select etiology].
    • Enter access site details
    • The site reported that there were/were not procedural complication(s).
  • Event: MI
  • Site Reported Event Onset Date: xx/xx/xxxx
  • Event summary:
    • Symptoms and sign: Subject presented with [sign and symptom] on xx/xx/xxxx.
    • Important characteristics of the chief complaint such as severity, site, and duration.
    • Other important symptoms related to the chief compliant.
    • Physical assessment:
    • Vital signs
    • Positive physical examinations or related negative examinations.
  • Lab studies:
    • Bun/Cr levels
Date Time BUN/Cr Na/K Urine output
xx/xx/xxx xx:xx
xx/xx/xxx xx:xx
xx/xx/xxx xx:xx
    • Other labratory:
      • Date/ name/ value
  • ECG / date:
  • ECHO / date:
  • CXR / date:
  • Other imaging and diagnostic tests / date:
  • Consults:
    • Date / result:
  • Clinical course:
  • Dialysis:
    1. xx/xx/xxxx at xx:xx
    2. xx/xx/xxxx at xx:xx
    3. xx/xx/xxxx at xx:xx
    4. xx/xx/xxxx at xx:xx
  • Treatment / date:
  • Outcome: [Discharge / Hospice / Death]