Fon ae Srevidone Seca cies oe kaesanrnamercrt LOCATION oF CHEST TUBE: (is towetpa cate] lesen: <= hin tat Its, compan 2 =Vafane es iadsspinay le YeYes N=No NA=rotapplese ae; Time: Tationt Asseasineva jr Dressing Change Nove swage daze Subeutaneous emphysema palate: (0) YN ‘Smal bore/pgtall drainage catheter: Scpeckepen sas) yn ‘Chest Tube Connections: Spiel ipadescied| va Tubing: Freecfkikscbstusns pencils YN Head of Bed: esta 30" yn ‘Deep Breathing and Coughing aiw2n om Pleur-Evacr 1 Sects pig bsowleelt naan ete YN ‘Suction Control Dia oj: Arutaf ton erredeg, 20 em Honsuon orange caerosentinwhdcw YR I ‘ir oak Meter Filed 220m wl ‘A Leak erage (0) Low(t) Fgh) Teairghicining cert Ya Negative Pressure indicator (0, | LSet noun nes i sane Sha susion soon conus Drainage Collection Chamber OF (hart on Fuld Balance Record Desrage tin expec its yn Daiage $=eoais SA engihon SSaserosagurous Peper Nenana i “Emergency Equipment: ‘Mast be win patont a all timas Ble ttle air, 2 en oomed txcepathat be, 7 T oT Pie gaze es Pinch tubing er aecontinue suction assess uncartmin) ‘Asseas foros" Inthe Negative Pressure lnicsor Window Initials ou Ina this frm you mut completo the ntrdesiptinary Signature Sheet a the Font ofthe paliont chart Fem Na, PHENE24 28-18) Page tot) ) “are uta a fa Mepeans noysper nyo oud Dever on COUR “aunvorelijanqereecd pesos ol deena ey emo cot ern seroma ‘apse ceren pana > toss 0 unt ay 1.0 petyjouanyc extn ss Keun iro Saunier pansiopan sgh + ee San ene Ran LAY «| asec rome ame ule kop sun | PM asuneproeeomeg + tunoimep oecscyameioumey +| — ypptcticpaimnyaiiy + cmon] “Sly som Osa ia Ineapunraneauprucnano | onmaontnv og amon SH | my penn sams a er oe shsimoens HS HONS = atu sos tegen y sone prune noeatin | oameqemp sak.mmpuensed | pamose Ngee snay ster cereofeuumgaioneeicgbifone «| Puaiotmen seg aiztepetijada| “optarag Supa wean = sino 2207 create *| ssiepmemnins hcg anja | “Deed rattga fpamat mstanp acinar ceed, + _nour oo 10 sBeuep sms anon ns 0 co8Hep SOLFO ‘Sion ag spore ebevEP popmds ee se YR. « ny soureg pry aq un weap (tua) ow wa g RECO Ta HEROD PRMENYN | cue Ay AISNE ~~ owssossy wane "WRIBLIIO LNAWSSASSY ‘suonuoasouypue yraussossy wored ‘sweysks oBeesg att Pue saqny 150. ow s04 soezceo00001