Brain sheet · 4 patients

A quarter of the page per patient, the same layout in every quarter. Letter, fits on one sheet — print at 100%, do not scale.

Hourly timeline →
Date Shift Unit Tech Charge
Rm Name · age
Dx
Allergies
Diet Activity
Lines · drains
FullDNRDNIIsoFallTele

Vitals

Time
BP
HR
RR
Temp
SpO₂
Pain

Meds

TimeMed due

Labs · tests

To do

Notes

Rm Name · age
Dx
Allergies
Diet Activity
Lines · drains
FullDNRDNIIsoFallTele

Vitals

Time
BP
HR
RR
Temp
SpO₂
Pain

Meds

TimeMed due

Labs · tests

To do

Notes

Rm Name · age
Dx
Allergies
Diet Activity
Lines · drains
FullDNRDNIIsoFallTele

Vitals

Time
BP
HR
RR
Temp
SpO₂
Pain

Meds

TimeMed due

Labs · tests

To do

Notes

Rm Name · age
Dx
Allergies
Diet Activity
Lines · drains
FullDNRDNIIsoFallTele

Vitals

Time
BP
HR
RR
Temp
SpO₂
Pain

Meds

TimeMed due

Labs · tests

To do

Notes

Not a medical record. Shred at end of shift. Fold in four · one patient per quarter

Free to print and use. Nothing on it says where it came from, so it is safe to carry on the floor. It is blank working paper — do not write a patient's details on it and leave it lying around. All the sheets →
Related reading: What the handoff note has to carry.