Untitled FormCPFtidDischarge_Summary_MDUntitled Form22anaemiaAtelectasis-pulmonary-collapseConstipationDementiaDeliriumDrug-resistant-Infectionelectrolyte-distrubancerespiratory-failurerenal-failuresepsishypokalaemiahyperkalaemiahyponatraemiahypernatraemiayesnoyesnoyesnoinclude pre-existing and complicating allergies/side effectsyesnonewpre-existingcomplicatingPlease specify any infectious risk eg VRE, ESBLIf Yes, specify belowyesnoPlease document who is to follow this upIf Yes, specify below. If booked please state date bookedyesnoprivate-residence/accommodationagedcontinuing-caredeceasedleft-against-medical-advicemental-health-servicenorthern@homeother-acute-hospitalresident/internregistrarconsultanttruetruewithin-2-weekswithin-4-weekswithin-6-weeksother-(please-specify-below)yesnowithin-2-weekswithin-4-weekswithin-6-weeksother-(please-specify-below)yesnowithin-2-weekswithin-4-weekswithin-6-weeksother-(please-specify-below)startedstoppedModifiedyesnoyesnoif these details are incorrect please update iPM before commencing this discharge summaryOnly enter date on locking form when discharging patientyesnono-plan-to-readmit-within-28-daysreadmit-to-other-hosp-within-28-days-booking-arrangedreadmit-to-other-hosp-within-28-days-no-booking-arrangedreadmit-to-this-hosp-within-28-days-booking-arrangedreadmit-to-this-hosp-within-28-days-booking-arrangedthe diagnosis, established during episode chiefly responsible for this admission)Please document any falls or pressure injuries
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