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Order Form (833) 4701448 Fax completed form to: ___PATIENT INFORMATION Patient Name: Address: Home Phone: Secondary Contact: Patient Diagnosis & ICD10: Allergies:Date of Birth: Cell Phone: Height:Referral
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How to fill out gout flare prophylaxis infusion

01
Gather all necessary supplies such as the gout flare prophylaxis infusion solution, infusion tubing, alcohol swabs, and gloves.
02
Wash your hands thoroughly with soap and water.
03
Open the package of the gout flare prophylaxis infusion solution and check for any signs of damage or contamination. Discard if necessary.
04
Attach the infusion tubing to the solution bag according to the manufacturer's instructions.
05
Remove the protective cap from the end of the infusion tubing and connect it to the infusion site on the patient's body.
06
Take a new alcohol swab and clean the infusion site using a circular motion. Allow it to air dry.
07
Put on gloves to ensure sterility.
08
Open the clamp on the infusion tubing and slowly start the infusion. Follow the prescribed rate of infusion as directed by the healthcare provider.
09
Monitor the patient closely during the infusion for any adverse reactions or complications.
10
Once the infusion is complete, properly dispose of all used materials and wash your hands again.

Who needs gout flare prophylaxis infusion?

01
Patients who have a history of gout flares or are at high risk of experiencing gout flares may require gout flare prophylaxis infusion.
02
This treatment option is typically recommended for individuals who have recurrent gout flares despite other preventive measures.
03
It is usually prescribed by a healthcare provider who will assess the patient's medical history and determine the need for gout flare prophylaxis infusion.
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Gout flare prophylaxis infusion refers to a treatment procedure designed to prevent gout flares in patients by administering medication intravenously to manage uric acid levels.
Patients diagnosed with gout who are receiving the gout flare prophylaxis infusion treatment are usually required to file the corresponding documentation.
To fill out gout flare prophylaxis infusion documentation, patients must provide details such as personal identification, medical history, treatment plan, and any other required medical information.
The purpose of gout flare prophylaxis infusion is to prevent the occurrence of painful gout flares by regulating uric acid levels in the body.
Information required includes patient identifying information, dosage information, administration dates, response to treatment, and any adverse reactions.
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