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Order Form Pediatric Intensive Care Unit UKM - Pharmacy Order

1 forms  
Patient Information
Description

Patient Information

Alias
UMLS CUI-1
C1955348
Name of the patient:
Description

Patient's name

Data type

text

Alias
UMLS CUI-1
C1299487
Date of birth:
Description

Date of birth

Data type

date

Alias
UMLS CUI-1
C0421451
Medication
Description

Medication

Alias
UMLS CUI-1
C0013227
Partition note:
Description

Partition note

Data type

integer

Name of the Infusion's solution and its composition:
Description

Solution name and composition

Data type

text

Alias
UMLS CUI-1
C1272893
UMLS CUI-2
C0574032
In ml/24 h:
Description

Amount

Data type

float

Alias
UMLS CUI-1
C2348070
Dose g/ kg or mmol/ kg:
Description

Amount

Data type

float

Alias
UMLS CUI-1
C0560740
Dose kcal/ kg:
Description

Amount

Data type

float

Alias
UMLS CUI-1
C0560602
Infusion Special Arterial or Venous Administration Routes
Description

Infusion Special Arterial or Venous Administration Routes

Name and dose of Infusion:
Description

Infusion

Data type

text

Alias
UMLS CUI-1
C1289919
Application in/ by:
Description

Application

Data type

text

Alias
UMLS CUI-1
C0185125
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Similar models

Order Form Pediatric Intensive Care Unit UKM - Pharmacy Order

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Patient Information
C1955348 (UMLS CUI-1)
Patient's name
Item
Name of the patient:
text
C1299487 (UMLS CUI-1)
Date of birth
Item
Date of birth:
date
C0421451 (UMLS CUI-1)
Item Group
Medication
C0013227 (UMLS CUI-1)
Partition note
Item
Partition note:
integer
Solution name and composition
Item
Name of the Infusion's solution and its composition:
text
C1272893 (UMLS CUI-1)
C0574032 (UMLS CUI-2)
Amount
Item
In ml/24 h:
float
C2348070 (UMLS CUI-1)
Dose g/ kg or mmol/ kg:
Item
Dose g/ kg or mmol/ kg:
float
C0560740 (UMLS CUI-1)
Dose kcal/ kg
Item
Dose kcal/ kg:
float
C0560602 (UMLS CUI-1)
Item Group
Infusion Special Arterial or Venous Administration Routes
Infusion
Item
Name and dose of Infusion:
text
C1289919 (UMLS CUI-1)
Item
Application in/ by:
text
C0185125 (UMLS CUI-1)
Application
Code List
Application in/ by:
CL Item
Artery (1)
CL Item
Umbilical artery catheter (2)
CL Item
Left artery pressure  (3)
CL Item
Pulmonary artery pressure (4)
CL Item
Central venous pressure (5)
CL Item
KCL-Bypass (6)
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