Narrative Review: Death: Difference between revisions

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'''Site:'''
{| class="wikitable"
!Site
!Patient
!AE
!Complication
!Event date
!AE code
|-
|xxx
|xxx
|x
|
|xx/xx/xxxx
|xxx
|}


'''AE:'''
== Demographic / Medical history ==
* [age] year old [gender]
* '''Past Medical History:''' [eg. VHD, anticoagulant usage, diabetes, and CAD,.../ including date]
* '''Past Surgical History:''' [including date]


'''Complication:'''
== Procedure ==
* '''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].
** Access site details
** The site reported that there were/were not procedural complication(s).


'''Event date:'''
== Event ==
* '''Event''':


'''Adverse event code:'''
* '''Demograghic''': [age] year old [gender]
* '''Past Medical History:''' [eg. CAD, diabetes, former tobacco use, dyslipidemia, ...]
* '''Index Procedure Date/Time''': xx/xx/xxxx at xx:xx  [insert date and time]
* '''Index Procedure Detail''': 
** On [insert date and time] the subject underwent a [select surgical correction] for [select etiology].
** Enter access site details
** Baseline MR severity was classified as [select none, trace, mild, mild-moderate, moderate, moderate-severe-severe] and post-implant MR was classified as [select severity].
** The site reported that there were/were not procedural complication(s).
* '''Event''': MI
* '''Site Reported Event Onset Date:''' xx/xx/xxxx
* '''Site Reported Event Onset Date:''' xx/xx/xxxx
* '''Event summary''':  
* '''Event summary''':  
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** Other important symptoms related to the chief compliant.
** Other important symptoms related to the chief compliant.
** Physical assessment:   
** Physical assessment:   
** Vital sign
** Vital signs
** Positive physical examinations or related negative examinations.  
** Positive physical examinations or related negative examinations.  
== Laboratory data and Imaging ==
* '''Lab studies:'''
* '''Lab studies:'''
** Date/ name/ value [ as a list ]
*** Date/ name/ value


* '''ECG / date:'''
* '''ECG / date:'''


* '''ECHO / date:'''
* '''ECHO / date:'''
* '''CXR / date:'''  
* '''CXR / date:'''  
* '''Other relevant imaging and diagnostic tests / date:'''
* '''Other imaging and diagnostic tests / date:'''
* '''Clinical course''':
== Consults==
* '''Treatment:'''
*Date and time of consult
*Suggested treatments
==Clinical course==
*Date and time of events,
*Patient condition got worse or better.
==Treatment and outcome==
*List of relevant medical treatments
*Out come [Discharge / Hospice / Death]

Revision as of 17:59, 14 June 2018

Site Patient AE Complication Event date AE code
xxx xxx x xx/xx/xxxx xxx

Demographic / Medical history

  • [age] year old [gender]
  • Past Medical History: [eg. VHD, anticoagulant usage, diabetes, and CAD,.../ including date]
  • Past Surgical History: [including date]

Procedure

  • 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].
    • Access site details
    • The site reported that there were/were not procedural complication(s).

Event

  • Event:
  • 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.

Laboratory data and Imaging

  • Lab studies:
      • Date/ name/ value
  • ECG / date:
  • ECHO / date:
  • CXR / date:
  • Other imaging and diagnostic tests / date:

 Consults

  • Date and time of consult
  • Suggested treatments

Clinical course

  • Date and time of events,
  • Patient condition got worse or better.

Treatment and outcome

  • List of relevant medical treatments
  • Out come [Discharge / Hospice / Death]
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