| Systolic BP (mm Hg): |
|
| Diastolic BP (mm Hg): | |
| Heart rate (beat/min): | |
| Respiratory rate: | |
| PaO2/FiO2: | |
| PaCO2 (torr): | |
| Glasgow coma score: | |
| Pupillary reaction: | |
| PT/PTT: | |
| Total bilirubin (mg/dl): | |
| Potassium (mEq/L): | |
| Calcium (mg/dl): | |
| Glucose (mg/dl):s s s s s | |
| Bicarbonate (mEq/L):s s s | |