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Critical Values - EKG
Critical Values - EKG
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Created by Qualaris Staff
Critical Access Hospital
Quality
Table of Contents
Audit Form
Audit Form
Critical Values - EKG
Required
Observed Date
Unit
ED
ICU
Med-Surg
PACU
Rehab
Time EKG Performed
Do not enter protected health information (PHI)
Time Critical Value Reported to Provider
Do not enter protected health information (PHI)
Critical Values - EKG Checklist
Mark all as...
Was ordering physician notified of value?
Yes
No
No, but reason given
If unable to reach ordering physician, was patient encouraged to go to the ED?
Yes
No
N/A
January
February
March
April
May
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Mon
Tue
Wed
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Sat
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30
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1
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