Hospital critical notice 1
Relatives:
The patient's gender, age, bed number and medical record number were diagnosed as being hospitalized. Although the patient has been actively treated, his condition is getting worse and may be life-threatening at any time. I hereby issue a critically ill notice. Nevertheless, we will still treat it positively, please understand and cooperate. If you have other requirements, please tell our department immediately after receiving the "notice of critical illness".
Doctor's signature:
Date: year, month, day and hour
Signature of relatives:
The relationship between relatives and patients:
ID number: Date: Year Month Day Hour.
Hospital department
(This notice is in duplicate, one for the hospital and one for the patient's relatives)
Hospital critical notice 2
Patient name: gender: age: hospitalization number:
Dear family members of patients or legal guardians and authorized clients of patients:
Hello! Your family is now hospitalized in the orthopedics department of our hospital.
The current diagnosis is:.
Although actively treated by medical staff, the patient is now in critical condition and may deteriorate further. One or more of the following life-threatening complications may occur at any time: 1. Pulmonary encephalopathy, severe arrhythmia, heart failure, myocardial infarction, hypertensive crisis;
2. Upper gastrointestinal bleeding leads to hemorrhagic shock, cerebral hemorrhage, cerebral infarction and cerebral hernia; 3. Toxic shock, anaphylactic shock and cardiogenic shock caused by infection; 4. Diffuse intravascular coagulation (DIC); 5. Multiple organ failure; 6. Diabetic ketosis, acidosis, hypoglycemia coma and hyperosmotic coma; 7. others.
Once the above situation happens, it will seriously threaten the patient's life, and the medical staff will do their best to rescue him, including tracheotomy, ventilator-assisted breathing, electric defibrillation, heart massage, installation of temporary pacemakers and other measures.
According to the law of our country, in order to rescue patients, doctors can take rescue measures without your consent according to the needs of rescue work, use necessary instruments, equipment and treatment methods to rescue them, and then fulfill the obligation of informing. Please understand and actively cooperate with the hospital for rescue treatment.
If you have other questions and requirements, please take the initiative to consult a doctor after receiving this notice. Please leave your accurate contact information so that the medical staff can communicate with you at any time.
In addition, limited by the current medical science and technology conditions, although the medical staff in our hospital have tried their best to treat patients, there is still the possibility that patients will die unfortunately because of the disease. Please forgive the patient's family.
Doctor's statement:
I have informed the patient's family or the patient's legal guardian and authorized client in detail about the patient's current critical condition, possible risks and consequences, and the treatment measures taken by the medical staff when the patient is in critical condition.
Doctor's signature: date of signature: year month day hour.
Opinions of the patient's family or the patient's legal guardian and authorized client:
The medical staff have told me in detail about the current critical condition of the patient, the possible risks and consequences, and the treatment measures taken by the medical staff when the patient is in critical condition. Knowing that the patient is in critical condition, agree with the medical staff (agree to tick, disagree to tick):
□ Tracheotomy □ Ventilator-assisted breathing □ Electrical defibrillation □ Temporary pacemaker □ Cardiac compression.
□ Other invasive treatment measures □ Drug treatment
We are responsible for all the consequences of refusing treatment.
Signature of the authorized client or legal guardian of the patient: _ _ _ _ _ _ _ _ _ _ Relationship with the patient: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Date of Signing: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Note: The critically ill notice is made in duplicate, one for the medical record and one for the patient.
Hospital critical notice 3
Dear animal owner:
Your domestic animal is now being treated in our hospital. The diagnosis is that although it has been actively treated, its condition is getting worse and worse, which may be life-threatening at any time. We hereby issue a critically ill notice. Nevertheless, we will take effective measures to actively treat it. At the same time, I inform you that in order to rescue sick animals, the hospital will use and adopt necessary instruments, equipment and treatment methods for emergency treatment according to the needs of rescue work, without your prior consent. Please understand, cooperate and support. If you have other requirements, please tell our hospital immediately after receiving the "notice of critical illness".
Signature of attending doctor:
Signature of the owner of the affected animal:
Signature time: year, month, day and hour.
Hospital critical notice 4
Relatives:
Hello! The patient comrades (Mr. and Ms.) are now getting worse in our hospital and may be life-threatening at any time. I hereby issue a critical (serious) notice. Nevertheless, we will take effective measures to actively treat it. At the same time, I would like to inform you that in order to rescue patients, the hospital will use and adopt the instruments, equipment and treatment methods needed for first aid according to the needs of rescue work, without your prior consent. Please understand, cooperate and support. If you have other requirements, please tell our department immediately after receiving the "notice of critical illness".
Signature of doctor: Date:
Signature of relatives/guardians: Date:
The relationship between relatives and patients:
Id card number: □□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□ □□□□□ -———————————
(This notice is in duplicate, one for the hospital and one for the patient's relatives)
Hospital emergency notice 5
Notice of critical illness of Xiangshui County People's Hospital Dear family members or legal guardians and authorized clients of patients,
Hello! Your family member Jiang is now hospitalized in ward 9 of our hospital. At present, the diagnosis is ischemic heart disease, atrial fibrillation, cardiac function grade III 2, gastrointestinal bleeding 3, pulmonary infection 4 and hypertension grade III (extremely high risk group). Although actively treated by medical staff, the patient's condition is now critical and may deteriorate further, and one or more of the following life-threatening complications may occur at any time:
Infection, multiple organ failure. Once the above situation happens, it will seriously threaten the patient's life, and the medical staff will do their best to rescue him, including medical treatment, tracheotomy, ventilator-assisted breathing, electric defibrillation, heart massage, installation of temporary pacemakers and other rescue measures. According to the law of our country, in order to save patients' lives, doctors can take rescue measures without your consent according to the needs of rescue work, use necessary instruments and treatment methods for emergency treatment, and then fulfill the obligation of informing. Please understand and actively cooperate with the hospital for rescue treatment.
If you have other questions and requirements, please take the initiative to consult a doctor after receiving this notice, and leave accurate contact information so that medical staff can communicate with you at any time.
In addition, due to the current medical technology conditions, although the medical staff in our hospital have tried their best to treat patients, there is still the possibility that patients may die unfortunately due to illness, so please forgive the patients' families.
Opinions of the patient's family or the patient's legal guardian and authorized client:
The medical staff have told me in detail about the current critical condition of the patient, the possible risks and consequences, and the treatment measures taken by the medical staff when the patient is in critical condition. Knowing that the patient is critically ill, I ("agree" or "disagree") use drugs for treatment, and the medical staff ("agree") implement (agree to tick √, allowing multiple choices): □ tracheotomy □ ventilator-assisted breathing □ defibrillation □ cardiac compression □ temporary pacemaker □ other invasive treatment measures. We are responsible for all the consequences that have happened.
Signature of authorized relatives of patients Jiang Guoxiang's relationship with patients Date of signature Year Month Day Doctor's statement:
I have informed the patient's family or the patient's legal guardian and authorized client in detail about the patient's current critical condition, possible risks and consequences, and the treatment measures taken by the medical staff when the patient is in critical condition.
Doctor's signature date year month day.
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