PercCentPress (4990) Right Internal Jugular Yes No Left Internal Jugular Yes No PCPLocRJug (5000) PCPLocLJug (5010) Right Subclavian Yes No Left Subclavian Yes No PCPLocRSub (5020) PCPLocLSub (5030) Right Femoral Vein Yes No Left Femoral Vein Yes No PCPLocRFem (5040) PCPLocLFem (5050) Other Yes No PCPLocOth (5060) CVP Placed by Anesthesia Yes No CVPPlaced (5070) Swan-Ganz Catheter Yes No SGCath (5080) Oximetric Central Line Yes No ScVO2 (5090) Ultrasound Guidance Used for Line Placement: None Central venous line Arterial line Both arterial & venous lines UltraDopGuide (5100) Monitoring Yes No Neurologic NeuroMonitor (5110) Bispectral Index Yes No (If Yes →) NeuroMonBIS (5130) Yes No Transcranial Doppler Yes No NeuroMonTCD (5140) Yes No NIRS (Cerebral) NeuroMonNIRS (5141) Other NeuroMonOth (5150) Lowest Recorded Intraoperative Temperature: _________ ° C LowIntraopTemp (5160) Lowest Intraoperative Temperature Site: Nasal Esophageal Bladder Rectal Axillary Skin Tympanic Other IntraopTempSite (5170) Transesophageal Echocardiography Yes No TEE (5180) ANESTHESIA Anesthetic Technique Date and Time of Induction: _ _ / _ _ / _ _ _ _ _ _:_ _ mm/ dd/ yyyy hh : mm InductionDT (5190) Induction Type: Inhalation Yes No Sevoflurane Yes No (If Yes →) IndTypeInh (5200) (5220) Isoflurane Yes No
PercCentPress (4990) Right Internal Jugular PCPLocRJug (5000) Yes No Left Internal Jugular PCPLocLJug (5010) Yes No Right Subclavian PCPLocRSub (5020) Yes No Left Subclavian PCPLocLSub (5030) Yes No Right Femoral Vein PCPLocRFem (5040) Yes No Left Femoral Vein PCPLocLFem (5050) Yes No Other PCPLocOth (5060) Yes No CVP Placed by Anesthesia CVPPlaced (5070) Yes No Swan-Ganz Catheter SGCath (5080) Yes No Oximetric Central Line ScVO2 (5090) Yes No Ultrasound Guidance Used for Line Placement: UltraDopGuide (5100) None Arterial line Central venous line Both arterial & venous lines Neurologic Monitoring NeuroMonitor (5110) Yes No (If Yes →) Bispectral Index NeuroMonBIS (5130) Transcranial Doppler NeuroMonTCD (5140) NIRS (Cerebral) NeuroMonNIRS (5141) Other NeuroMonOth (5150) Yes No Yes No Yes No Yes No Lowest Recorded Intraoperative Temperature: LowIntraopTemp (5160) _________ ° C Lowest Intraoperative Temperature Site: IntraopTempSite (5170) Nasal Esophageal Bladder Rectal Axillary Skin Tympanic Other Transesophageal Echocardiography TEE (5180) Yes No ANESTHESIA Anesthetic Technique Date and Time of Induction: mm/ dd/ yyyy hh : mm _ _ / _ _ / _ _ _ _ _ _:_ _ InductionDT (5190) Induction Type: Inhalation IndTypeInh (5200) Yes No (If Yes →) Sevoflurane (5220) Yes No Isoflurane Yes No
Congenital_DCF_Anesthesia_Sheet.docx