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DEPARTMENT OF PEDIATRIC RADIOLOGY PROCEDURAL SEDATION /ANESTHESIA REQUISITION (To Be Completed by Requesting Physician) Today's Date Requesting ...
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How to fill out procedural sedation anesthesia requisition
How to fill out procedural sedation anesthesia requisition:
01
Start by entering the date and your name in the designated spaces on the form.
02
Provide the patient's details such as their name, age, gender, and any relevant medical history information.
03
Indicate the reason for the procedural sedation anesthesia and provide a brief explanation of the procedure being performed.
04
Specify the duration of the procedure and the expected recovery time.
05
Include any specific medications or equipment requirements for the sedation process.
06
If there are any allergies or known adverse reactions to anesthesia, clearly state them on the requisition.
07
In the appropriate section, outline any pre-operative instructions that need to be followed by the patient.
08
Lastly, sign and date the requisition form, indicating your approval and authorization for the sedation anesthesia.
Who needs procedural sedation anesthesia requisition:
01
Patients undergoing medical or dental procedures that require sedation.
02
Individuals with anxiety or phobia towards certain medical procedures.
03
Patients who require a painless or comfortable experience during a procedure that may cause discomfort or anxiety otherwise.
04
Individuals with medical conditions that require sedation or anesthesia to safely perform a procedure.
05
Patients who are unable to comfortably tolerate the procedure due to physical or psychological reasons.
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