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ID
17505
Description
Hospital Routine Documentation Form at the University Hospital Muenster. Original Form name: Herzkatheteranmeldung MS.
Keywords
Versions (3)
- 9/19/16 9/19/16 -
- 10/11/16 10/11/16 -
- 12/6/16 12/6/16 -
Uploaded on
September 19, 2016
DOI
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License
Creative Commons BY-NC 3.0
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Herzkatheteranmeldung MS University Hospital Muenster (UKM)
Herzkatheteranmeldung MS University Hospital Muenster (UKM)
- StudyEvent: ODM
Similar models
Herzkatheteranmeldung MS University Hospital Muenster (UKM)
- StudyEvent: ODM
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Order number
Item
Auftragsnummer
text
Name of patient
Item
Name
text
Date of birth
Item
geb.
date
Date of admission
Item
Stationär aufgenommen am
date
Treating physician
Item
Behandelnder Arzt
text
Telephone number of treating physician
Item
Tel. des Arztes
integer
Date of request
Item
Angefordert am
date
Sender of request
Item
Angefordert durch
text
Telephone number of ward
Item
Tel. der Abteilung
integer
CL Item
(Angiographie)
CL Item
(Elektrophysiolog. Unters. / Katheterablation)
CL Item
(Schrittmacher / Defibrillatoren)
Anamnesis/Clinical information
Item
text
Comments
Item
text
Height
Item
float
C0005890 (UMLS CUI [1])
Weight
Item
float
C0005910 (UMLS CUI [1])
Date of last catheter
Item
date
Vitamin K antagonist
Item
boolean
Unfractioned heparin
Item
boolean
Low molecular heparin
Item
boolean
Dabigatran
Item
boolean
Acetylsalicylic acid
Item
boolean
Clopidogrel
Item
boolean
Prasugrel
Item
boolean
Other
Item
boolean
Other text
Item
text
None
Item
boolean
None
Item
boolean
Unknown
Item
boolean
Hepatitis B
Item
boolean
Hepatitis C
Item
boolean
Tuberculosis (TB)
Item
boolean
HIV
Item
boolean
Vancomycin-resistant enterococci (VRE)
Item
boolean
MRSA
Item
boolean
Other infections
Item
boolean
Other infections text
Item
text
CL Item
(Notfall)
CL Item
(dringend)
CL Item
(normal)
Requested date: immediately
Item
boolean
Requested date
Item
datetime
CL Item
(gehfähig)
CL Item
(sitzend)
CL Item
(liegend)
CL Item
(beatmet/intensic)
CL Item
(in med. Begleitung)
No known allergies
Item
boolean
Contrast agent allergy
Item
boolean
Other allergies
Item
boolean
Other allergies, text
Item
text
CL Item
(Ja)
CL Item
(Nein)
CL Item
(Nicht sicher ausgeschlossen)
Anesthesia necessary
Item
boolean
Subsequent dialysis
Item
boolean
Cardiac defect
Item
boolean
Hemoglobin value
Item
text
Creatinine value
Item
text
PTT value
Item
text
PT/Quick value
Item
text
TSH value
Item
text