Patient Configuration

Demographics & target calculations

Patient Name

Gender

Age (years)

Weight (kg)

Dobutamine (mg in 50ml syringe)

Protocol Type

Study Date

Patient on baseline Beta-Blockers

Age-Predicted Max HR

—

APMHR = 220 − Age

Target Heart Rate (85%)

—

THR = 85% × APMHR

Monitoring & Infusion Table

Record vitals, ECG & echo at each stage

ischemia Protocol

Concentration: 250 mg in 50ml syringe = 5,000 µg/ml

Enter patient weight and dobutamine concentration

to calculate infusion rates

Formula: Rate (ml/hr) = (Dose × Weight × 60) ÷ Concentration (µg/ml). ● = Consider Atropine

Medications, findings & physician credentials

Atropine Total (mg)

Recovery Metoprolol (mg)

DSE Conclusion

Doctor Name

Title

Qualifications