{% extends 'base.html' %} {% load static %} {% block title %}{% if note.pk %}Edit{% else %}Create{% endif %} Surgical Note{% endblock %} {% block css %} {% endblock %} {% block content %}
Auto-saved

{% if note.pk %}Edit Surgical Note{% else %}Create Surgical Note{% endif %}

Back to List
{% csrf_token %} {% if not note.pk %}
Use Template

Start with a pre-defined template to speed up note creation

{% endif %}
Basic Information
{{ form.patient }} {% if form.patient.errors %}
{{ form.patient.errors.0 }}
{% endif %}
Search and select the patient for this surgical note
{{ form.surgeon }} {% if form.surgeon.errors %}
{{ form.surgeon.errors.0 }}
{% endif %}
Select the primary surgeon performing the procedure
{{ form.procedure_name }} {% if form.procedure_name.errors %}
{{ form.procedure_name.errors.0 }}
{% endif %}
Enter the name of the surgical procedure
{{ form.procedure_code }} {% if form.procedure_code.errors %}
{{ form.procedure_code.errors.0 }}
{% endif %}
CPT or ICD-10 procedure code (optional)
{{ form.surgery_date }} {% if form.surgery_date.errors %}
{{ form.surgery_date.errors.0 }}
{% endif %}
Date when the surgery was performed
{{ form.start_time }} {% if form.start_time.errors %}
{{ form.start_time.errors.0 }}
{% endif %}
Time when the surgery started
{{ form.end_time }} {% if form.end_time.errors %}
{{ form.end_time.errors.0 }}
{% endif %}
Time when the surgery ended
{{ form.status }} {% if form.status.errors %}
{{ form.status.errors.0 }}
{% endif %}
Current status of the surgical note
{{ form.priority }} {% if form.priority.errors %}
{{ form.priority.errors.0 }}
{% endif %}
Priority level for this surgical note
Surgical Team
{{ form.assistant_surgeon }} {% if form.assistant_surgeon.errors %}
{{ form.assistant_surgeon.errors.0 }}
{% endif %}
{{ form.anesthesiologist }} {% if form.anesthesiologist.errors %}
{{ form.anesthesiologist.errors.0 }}
{% endif %}
{{ form.scrub_nurse }} {% if form.scrub_nurse.errors %}
{{ form.scrub_nurse.errors.0 }}
{% endif %}
{{ form.circulating_nurse }} {% if form.circulating_nurse.errors %}
{{ form.circulating_nurse.errors.0 }}
{% endif %}
Pre-operative Information
{{ form.preoperative_diagnosis }} {% if form.preoperative_diagnosis.errors %}
{{ form.preoperative_diagnosis.errors.0 }}
{% endif %}
Enter the diagnosis before surgery
{{ form.indication }} {% if form.indication.errors %}
{{ form.indication.errors.0 }}
{% endif %}
Reason or indication for performing the surgery
{{ form.anesthesia_type }} {% if form.anesthesia_type.errors %}
{{ form.anesthesia_type.errors.0 }}
{% endif %}
{{ form.patient_position }} {% if form.patient_position.errors %}
{{ form.patient_position.errors.0 }}
{% endif %}
Operative Procedure
{{ form.procedure_description }} {% if form.procedure_description.errors %}
{{ form.procedure_description.errors.0 }}
{% endif %}
Detailed description of the surgical procedure performed
{{ form.technique }} {% if form.technique.errors %}
{{ form.technique.errors.0 }}
{% endif %}
Specific surgical techniques and approaches used
{{ form.findings }} {% if form.findings.errors %}
{{ form.findings.errors.0 }}
{% endif %}
Findings discovered during the surgical procedure
{{ form.specimens }} {% if form.specimens.errors %}
{{ form.specimens.errors.0 }}
{% endif %}
Description of any specimens removed during surgery
Post-operative Information
{{ form.postoperative_diagnosis }} {% if form.postoperative_diagnosis.errors %}
{{ form.postoperative_diagnosis.errors.0 }}
{% endif %}
Final diagnosis after surgery completion
{{ form.complications }} {% if form.complications.errors %}
{{ form.complications.errors.0 }}
{% endif %}
Any complications that occurred during or after surgery
{{ form.postoperative_instructions }} {% if form.postoperative_instructions.errors %}
{{ form.postoperative_instructions.errors.0 }}
{% endif %}
Instructions for post-operative care and recovery
{{ form.estimated_blood_loss }} {% if form.estimated_blood_loss.errors %}
{{ form.estimated_blood_loss.errors.0 }}
{% endif %}
{{ form.fluids_given }} {% if form.fluids_given.errors %}
{{ form.fluids_given.errors.0 }}
{% endif %}
Equipment and Implants
{{ form.equipment_used }} {% if form.equipment_used.errors %}
{{ form.equipment_used.errors.0 }}
{% endif %}
List of surgical equipment and instruments used
{{ form.implants }} {% if form.implants.errors %}
{{ form.implants.errors.0 }}
{% endif %}
Details of any implants or prosthetic devices used
{{ form.suture_materials }} {% if form.suture_materials.errors %}
{{ form.suture_materials.errors.0 }}
{% endif %}
Types and sizes of suture materials used
Additional Information
{{ form.additional_notes }} {% if form.additional_notes.errors %}
{{ form.additional_notes.errors.0 }}
{% endif %}
Any additional observations or notes
{{ form.is_emergency }}
Check if this was an emergency surgical procedure
{{ form.requires_followup }}
Check if patient requires follow-up care
{% if note.pk and note.status == 'completed' %}
Electronic Signature
Surgeon's Signature
{% endif %}
Cancel
{% endblock %} {% block js %} {% endblock %}