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Name: A to Z
Name: Z to A
Room No.
Room No.
$9.00
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Return To: Anesthesia Department
Return To: Anesthesia Department
$29.95
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Do Not Throw Away
Do Not Throw Away
$22.75
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Anesthesia Dept.
Anesthesia Dept.
$22.75
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Date Opened
Date Opened
$22.75
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Doctor Please (Communicate Next Process)
Doctor Please (Communicate Next Process)
$24.25
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Surgery
Surgery
$17.75
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Hold For Surgery
Hold For Surgery
$12.75
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SURGERY
SURGERY
$14.75
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Surgery
Surgery
$14.75
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PLEASE RE-ORDER
PLEASE RE-ORDER
$12.75
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Vial Opened/Date ___/Time ___
Vial Opened/Date ___/Time ___
$12.75
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RE-ORDER ANTIBIOTICS
RE-ORDER ANTIBIOTICS
$12.75
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SURGERY
SURGERY
$8.75
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$10.75/Roll
IV Tubing: Day Change Labels
IV Tubing: Day Change Labels
$70.25
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Acetaminophen (Dosage Label)
Acetaminophen (Dosage Label)
$15.75
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CLEAN - Date ___ Initials ___
CLEAN - Date ___ Initials ___
$24.20
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Return To Surgery
Return To Surgery
$20.75
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Return To Anesthesia Dept
Return To Anesthesia Dept
$20.75
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Surgery
Surgery
$20.75
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"Surgery/Date___/Time___" Communication Labels
"Surgery/Date___/Time___" Communication Labels
$20.75
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Return to O.R.
Return to O.R.
$20.75
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Caution Epidural Narcotic
Caution Epidural Narcotic
$20.75
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Family Waiting
Family Waiting
$20.75
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Warning: This Item Is Not Disposable
Warning: This Item Is Not Disposable
$20.75
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OR
OR
$20.75
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Intrathecal Anesthesia
Intrathecal Anesthesia
$10.40
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Return To: Anesthesia Department
Return To: Anesthesia Department
$20.75
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Valuables Enclosed
Valuables Enclosed
$25.00
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Surgery ___ /Time ____ / Date ____
Surgery ___ /Time ____ / Date ____
$31.50
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Glutaraldehyde - 28 Day Solution
Glutaraldehyde - 28 Day Solution
$22.75
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TIME OUT (Orange Fluorescent with Black Print)
TIME OUT (Orange Fluorescent with Black Print)
$32.50
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Warning: Paralyzing Agent
Warning: Paralyzing Agent
$20.75
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Dry Set Up
Dry Set Up
$28.25
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Wet Set Up
Wet Set Up
$28.25
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Assembled and Checked/ By____ / Date ____ Time ____
Assembled and Checked/ By____ / Date ____ Time ____
$20.75
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Pre-Operative Checklist - Contact for Quote
Pre-Operative Checklist - Contact for Quote
$0.00
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Surgical Checklist - Contact for Quote
Surgical Checklist - Contact for Quote
$0.00
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Peripheral Line
Peripheral Line
$14.75
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Central Venous Line
Central Venous Line
$14.75
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Other/Change Tubing On (Circle Day)
Other/Change Tubing On (Circle Day)
$21.75
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_____Additive/Date___ Initials___
_____Additive/Date___ Initials___
$21.75
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TIME OUT (Green)
TIME OUT (Green)
$16.75
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Patient Given Injection of Iodinated Medium
Patient Given Injection of Iodinated Medium
$22.25
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Please Allow 48 Hours For Refill
Please Allow 48 Hours For Refill
$13.75
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Drug Name, Strength, Exp. Dt./Tm. Label
Drug Name, Strength, Exp. Dt./Tm. Label
$24.43
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Medication Added
Medication Added
$30.00
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Medication Added To IV
Medication Added To IV
$14.85
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Processed / Reprocessed
Processed / Reprocessed
$28.75
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