Patient Information:
Name:
Age:
Date of Birth:
Time of Initial Symptoms:
Progress Notes:
Date & Time Stage Symptoms Notes
Stage:
Early (12-24 hours)
Later (24-48 hours)
Ruptured Appendix (after 48 hours)
Symptoms (check all that apply):
Pain: (location, intensity, character)
Nausea
Vomiting
Loss of appetite
Fever
Abdominal swelling
Notes:
Include any additional observations, vitals, laboratory results, imaging studies, or treatment provided.
Follow Up:
Planned next steps (e.g., further diagnostics, surgery, discharge planning)
Disclaimer: This template is for informational purposes only and should not be used as a substitute for professional medical advice. Always consult with a healthcare professional for diagnosis and treatment of appendicitis.