INPUT (A)
OUTPUT (B)
Inform DR if Urine Output TRIGGERS
at less than 30ml/hr for
three consecutive hours
HOURLY BALANCE (A minus B) = C
CUMULATIVE BALANCE (D)
Time up to:
Oral
NG / TPN / PEG
IV
HOURLY IN (A)
Urine
Vomit
Stoma
NG
HOURLY OUT (B)
01.00
02.00
03.00
04.00
05.00
06.00
07.00
08.00
09.00
10.00
11.00
12.00
13.00
14.00
15.00
16.00
17.00
18.00
19.00
20.00
21.00
22.00
23.00
24.00