1. 213 INCLUDES CURRENT STS 2.73 DATA FIELDS PDS PERFUSION PRO STEPHEN PETERSON CEO/PRESIDENT & OWNER CALL 812-535-3333 - OFFICE SPETERSON@PDSMEDICALSOLUTIONS.COM

2. MENU

3. PATIENT INFORMATION

4. PRE-OP HISTORY

5. CORONARY ARTERY STENOSIS AND BYPASSES

6. PRE-POST OP LABS

7. OPERATIVE/CABG INFORMATION

8. VALVE SURGERY INFORMATION

9. EQUIPMENT / DISPOSABLES

10. DRUGS / FLUIDS INTAKE

11. FLUID LOSS / CELL SAVER

12. EVENT SCREEN FOR ON - BYPASS EVENTS

13. ADDITIONAL PRE-OP HISTORY

15. ADDITIONAL OPERATIVE INFORMATION

16. ADDITIONAL POST-OP INFORMATION

17. AUTOTRANSFUSION BASIC INFO

18. AUTOTRANSFUSION PLATELET RICH PLASMA

19. AUTOTRANSFUSION CHECK LIST

20. AUTOTRANSFUSION EVENTS

21. AUTOTRANSFUSION RECORD

22. PERFUSION PRO CHECKLIST - PAGE 1

23. PERFUSION PRO CHECKLIST – PAGE 2

24. PAGE 1 – SHORT PERFUSION RECORD

25. PAGE 2 – SHORT PERFUSION RECORD

26. PAGE 3 – SHORT PERFUSION RECORD

27. PAGE 4 – SHORT PERFUSION RECORD

28. PAGE 5 – SHORT PERFUSION RECORD

29. PAGE 1 – LONG PERFUSION RECORD

30. PAGE 2 – LONG PERFUSION RECORD

31. PAGE 3 – LONG PERFUSION RECORD

32. PAGE 4 – LONG PERFUSION RECORD

33. PAGE 5 – LONG PERFUSION RECORD

34. PAGE 6 – LONG PERFUSION RECORD

35. AMERICAN BOARD REPORT

36. CONTINUOUS QUALITY INDICATORS

37. BLOOD PRODUCT USAGE

38. CASE LISTINGS FOR MONTHLY REPORTS