Get Uva Downtime Iv Contrast (dye) Screening Form 2013-2025

This guide provides comprehensive instructions on how to fill out the UVA Downtime IV Contrast (DYE) Screening Form online. By following these steps, users can ensure that all required information is accurately provided to facilitate the screening process.

Follow the steps to complete the UVA Downtime IV Contrast (DYE) Screening Form online.

1. Press the ‘Get Form’ button to access the UVA Downtime IV Contrast (DYE) Screening Form and open it in your designated editor.
2. Begin by entering the patient's name and medical record number in the designated area labeled 'PLACE LABEL HERE.' If no label is available, write this information clearly.
3. Indicate the reason for deferring contrast screening by checking the appropriate box for traumatic injury, stroke alert, medical necessity, or any other reason that may apply. If selecting medical necessity, provide a description in the space provided.
4. Verify the physician's order for allergies, contraindications, and the correctness of the exam. Select the individual responsible for verification—either the technologist or the radiologist—and write their name in the given space.
5. Obtain and fill in relevant information regarding the patient's medical history. Answer whether the patient is on dialysis and if they have had prior contrast material. Note any discomfort experienced, if applicable.
6. Continue documenting information about the patient's medical conditions, including heart disease, vascular disease, asthma, allergies, sickle cell anemia, kidney disease, diabetes, or multiple myeloma. Provide specific answers as required.
7. In the comments section, add any additional notes pertinent to the patient's condition or concerns regarding the procedure.
8. For nursing staff, review laboratory values, particularly BUN and creatinine levels. If recent values are not obtained, ensure to order these labs.
9. Complete the venipuncture section, including the site, number of sticks, type of needle used, and injection details. Ensure all fields are accurately filled and necessary signatures obtained.
10. Finalize the form by ensuring that all sections are properly completed. Users can then save changes, download, print, or share the form as necessary.

Take the next step and complete the UVA Downtime IV Contrast (DYE) Screening Form online today.