Providence OR Surgery Program

Simplified Testing Grid 09-28-2022-ORLT1043108

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STEP 2: Conditions / Medications identified based on patient chart review ECG CBC (no diff) BMP CMP Cr PT/INR PTT CAD, Chest pain, Dysrhythmias, MI, H/O Coronary stents/PTCA, Valvular disease, Previous cardiac surgery within 1 yr within 180 d Congestive heart failure (CHF) within 1 yr within 180 d Pulmonary hypertension (PHTN) within 1 yr within 180 d Pacemaker/AICD within 1 yr Hx of Cerebrovascular Accident/TIA within 1 yr Peripheral Vascular Disease within 1 yr CARDIAC CO-MORBID CONDITIONS if current chest pain, stent or cardiac surgery within 12 months or severe valvular heart disease X X X if CVA or TIA within past 12 m Step 2: Determine additional laboratory test and consults needed based on patient's medical history in Epic. LIP Consult Other Tests / Notes

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