Pages_1054-1063_from_Dickstein_Medical_Files_folder_2_of_3_part_25_of_71.pdf

50-111 B LL NSN 7540-00-634-4121 DOCTOR'S ORDERS MEDICAL RECORD ee {Sign ail srdars) DATE AND TIME DOCTORS | NURSE'S RX DRUG CRDERS SIGNATURE | SIGNATURE START | STOP i SE— SA DIME 4] RESTRAINT INITIATION ORDERS FOR MEDICAL NECESSITY FOR FEEDING gio Place Detainse in Co Reason For Restraint. Medical Necessity for Feeding TH Ee Medical Restraints order expires after 12 hours TT — BN Line of Sight Observation while in restraints. _ BH Circulation checks every 15 mins for the first hour and then ev...