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Anaesthetic Monitoring Chart

Patient information

Date: Owner's Name: Contact Number: Animal's Name: Species: Breed: Weight: / / Vet: Nurse: Pre GA bloods: Diagnosis/Procedure: Age: kg Sex:

M N F

Risk:

1

Low

2

3

4

5

6

High

Medium

Comments:

Premeds

Drugs used: 1. 2. 3.

Dose:

Route:

Time:

Effect:

Induction details: Agent: Dose: Rate of administration: Quality of induction:

Time Agent CRT O2/min N2O/min Temperature Pre-Op

Induction

Tube Size: Circuit: Posture: Peri-op medication details:

Events: G RR HR

Other post-op

Other post-op medication details: Dose: Drugs used: 1. 2. 3. 4.

Route:

Time:

Times: Anaesthetic: Start Time: Finish Time: TOTAL: EXTUBATION TIME: TIME TO STANDING:

Surgery:

Alfaxan® is a trademark of Jurox Pty Limited, Rutherford NSW 2320, Australia. ART2616

200 190 180 170 160 150 140 130 120 110 100 90 80 70 60 50 40 30 20 10 0

Events

Times

Information

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