15.11 Buletin Analize Med Teste Ventilatorii

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Judeţul…………………………. Localitatea…………………….. Unitatea sanitară……………….. BULETIN DE ANALIZE MEDICALE Nr……. TESTE VENTILATORII CNP Data a a a a

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Numele…………………………Prenumele………… … Sexul M ; vârsta………greutatea…………… F Înalţimea…………………Domiciliul:judeţul,………… localitatea…………………………………….. Str………………..……………Nr……………………. Trimis de……………………………………………….. REZULTATE Capacitate vitală actuală (Cva)………..ml Capacitate vitală teoretică (CVt)………ml Volum expirator maxim pe secundă (VEMS)…………. ……..ml VEMSx100/CV…….. (val teoretică)………... …………+ …………..Ventilaţie maximă indirectă actuală (Vmax ind. a) l/mm Ventilaţie maximă indirectă teoretică ………….(Vmax ind. t) l/min Testul cu acetilcolină…………………………………... Testul cu bronhodilatator………………………………. Faţă 15..11 A6;t2

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continuare – CONCLUZII…………………………………………… ………………………………………………………… ………………………………………………………… ………………………………………………………… ………………………………………………………… ………………………………………………………… ………………………………………………………… ………………………………………………………… ………………………………………………………… INDICAŢII…………………………………………… ………………………………………………………… ………………………………………………………… ………………………………………………………… ………………………………………………………… …………………………………………………………. …………………………………………………………. Lucrat de: Semnătura şi parafa şefului de laborator, a medicului …………………………………

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