Emergency Room Patient Data Flowsheet- Dr. Cross

Use this data flowsheet or spreadsheet as a tool for handling the data and care
process efficiently on unstable patients in the emergency room of small hospitals.

(Use the scroll bars to view complete form above.)

Click here for close-up view of data flowsheet:

Also: Click here for a view of the comprehensive body diagram for your E.R.
(the back side of this flow sheet is blank for use of patient's demographic data)

I have used flowsheets or spreadsheets in patient care since 1957*. As an ER physician, I have made modifications of the tool (spreadsheet) adapting it to ER conditions (brief time frame, large amount of data, several care-givers).

This E.R. Flow Sheet is open source. This means that I implore you to use it, free of charge. Spread the word, and help others use it. Let's all help make every E.R. a safe and efficient E.R.
*Bjorn, JC and HD Cross. Problem Oriented Practice. Chicago, Mc-Graw Hill. p. 57-63. 1970.

Harold D Cross MD
Emergency Medicine Physician

E-mail address:	hdcross@islc.net
Mailing address:	2809 W. Royal Oaks Drive Beaufort, SC, 29902 843-524-0959

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ER EMERGENCY ROOM PATIENT DATA FLOWSHEET

EMERGENCY ROOM CARE OF UNSTABLE PATIENTS in the small hospital (trauma level II & III) A tool (notation system) for recording the events during ER stay SPREADSHEET (DATA FLOWSHEET)* The main purposes of the tool are: facilitate good care for unstable patients efficient & meaningful information transfer portray the patient's course during the ER stay (patient data, nurses, resp. tech., and physician interventions). Emergency room care of unstable patients, e.g. severe pain, dysrhythmias, respiratory distress, heat illness, altered mental status, multiple injuries, drug OD, etc., while caring for other not-seriously ill patients(1) can be difficult. The amount of data that accumulates in the first hour, and the challenge of communicating the course of events to the next provider is taxing. Sending 10+ pages of data does not communicate the course of events. With the plethora of data and multiple people providing care, a common vehicle/tool is needed to track and respond to data. When care is provided in a trauma unit flowsheets are in common use. Most ICU, PCU and trauma units use spreadsheets. Other disciplines use notation systems, e.g. music and math. Most ERs use code sheets for unresponsive patients. Some code sheets do not include parameters such as ABG's, K+, & Hct in time sequence. I have used flowsheets or spreadsheets on patients since 1957(2). As an ER physician for the past 10 years, I have made modifications of the tool for the ER situation. Caution: keeping data in an organized fashion may make it evident that a change in intervention is indicated. If the data are not dealt with, one's oversight or neglect is more noticeable. That is the purpose of the tool, to guide and teach, and provide the best possible care. A powerful tool in differential diagnosis is the Problem Knowledge Coupler (3), a computerized software program designed to integrate patient findings with the literature. This gives the user (physician, nurse practitioner) and patient the opportunity to consider all the diagnostic possibilities that their unique set of symptoms/findings and the literature suggest, not merely the "top 5". Information on this system is the available on a web page: an ideal tool would be a computerized spreadsheet, with the capability of displaying the data on a large screen for all providers to see as well as provide a paper printout.