Owner Name: Species: Canine Breed: Medical alert: PE: Patient Class Doctor Name: Anesthesia Premedication Induction Maintenance ER DRUGS Monitoring/ Time Surgery Time HR RR MM CRT BP SpO₂ ETCO2 Temp Fº O₂ Flow Rate Isoflurane Feline Alert Exited HR: ASA1 ASA2 TEMP: Color: Drug N: Normal A: Abnormal Anesthesia Start: Anesthesia End: .00 .05 _.10 Thermal Support Yes NO Tube size: Fluids IV Recovery Time _.00 _.15 _.30 HR RR MM CRT Temp Fº Alert Sternal Ambulatory Notes/Observations Patient Name: DOB: Depressed RR: ASA3 _.15 _.45 Procedure: Spay Age: Weight: Rate Recumbent Pulse: ASA4 ASA5 TP: Anesthesia Technician: Dose Mg **Suture: Ib Surgery Start: Surgery Ends: _.20 _.25 Sex: M kg Neuter Aggressive *MM: PCV: Doctor signature: ** Abs: Absorbible NAbs: Non-Absorbible C: Clips mL Start time Ending Time Date: Fasting hour: Dental Prophylaxis Nervous Other *CRT: BUN: CRN: Route System Rebreathing Intubation: Extubating: _.30 _.35 _.40 .45 .60 _.15 _.30 _.45 .60 _.15 *Skin: CREA: Nonrebreathing Cath: Time .50 .55 .30 _.45