Major Hospital
Patient Discharge Information
Deep Vein Thrombosis (DVT)/ Pulmonary Embolism (PE)
Patient/Family Member received written discharge information for Deep Vein Thrombosis (DVT)/Pulmonary Embolism (PE) covering the following:
1. When to call the Doctor or 911(Chest pain, shortness of breath, coughing up blood)
2. Adverse drug reactions
3. Follow-up monitoring of the blood clotting (INR)
4. Dietary Advice
5. Compliance with Coumadin (Warfarin) and regular blood draws for monitoring
Information given via Krames On Demand written Health Sheets.
Signed: Patient Name________________________________Date__________________
Other:_________________________ Relationship:_______________________
Nurse: ___________________________________________Date:__________________
***Place this signed copy (of this sheet only)in the chart under CONSENTS***