Get Anaesthetic Allergy Testing Referral Form - Midcentraldhb Govt

Completing the anaesthetic allergy testing referral form is vital for documenting reactions to anaesthetic agents and ensuring appropriate testing is conducted. Follow this comprehensive guide to fill out the form accurately and efficiently.

Follow the steps to successfully complete the anaesthetic allergy testing referral form.

1. Press the ‘Get Form’ button to obtain the anaesthetic allergy testing referral form and open it in your preferred online editor.
2. In the 'Referring doctor' section, enter the full name and credentials of the referring clinician. Ensure that the contact details are accurate for prompt communication.
3. Specify the procedure being performed in the relevant field. This information is crucial for context regarding the anaesthetic reaction.
4. Document the date and time when the reaction occurred clearly, as well as the time elapsed from the last exposure to the onset of the reaction.
5. List all agents the patient was exposed to prior to the reaction, ticking the appropriate checkboxes for each agent, such as chlorhexidine, latex, and others.
6. If applicable, indicate the patient's regular medications and whether they were on antihistamines prior to the event.
7. Provide detailed information regarding the specifics of the reaction by answering the series of questions related to symptoms, such as tachycardia, hypotension, contractions, and respiratory issues.
8. Document any treatments given during the reaction, including the use of endotracheal intubation, IV fluids, or medications like adrenaline, detailing the agents and doses administered.
9. Note any investigations conducted, such as serum tryptase, specifying the timing of samples taken post-reaction.
10. In the outcome section, indicate whether the procedure was discontinued and provide any further comments or complications observed.
11. Complete the checklist at the end of the form to ensure all necessary documents and information are included before finalizing.
12. Once all sections are filled out, save your changes, then download, print, or share the form as needed.

Fill out the anaesthetic allergy testing referral form online today to ensure a thorough and accurate referral process.