Skip to content
ApexRespiratory

Printable — Clinical Form

RT Brain Sheet

A respiratory therapist shift organizer built to carry a full assignment: a per-patient banner (room, diagnosis, airway, code status), ventilator/O₂ settings, the last ABG, scheduled treatments, and the checks and rounds due across the shift. Print one per assignment.

Letter · portrait · prints without site navigation
RT Brain Sheet
Date ____________Shift ____________RT ____________
Therapist
Date
Shift / Hours
Pager / Phone
1Patient
Room / Bed
Name · Age
Diagnosis
Code Status
Airway · ETT / Trach / None · Size
O₂ Device / Flow
SpO₂
Mode
FiO₂
PEEP
Vt
Rate
Last ABG · pH ____ / PaCO₂ ____ / HCO₃⁻ ____ / PaO₂ ____ · Drawn ____
TimeTreatment / Med Due✓
Notes / To-Do
2Patient
Room / Bed
Name · Age
Diagnosis
Code Status
Airway · ETT / Trach / None · Size
O₂ Device / Flow
SpO₂
Mode
FiO₂
PEEP
Vt
Rate
Last ABG · pH ____ / PaCO₂ ____ / HCO₃⁻ ____ / PaO₂ ____ · Drawn ____
TimeTreatment / Med Due✓
Notes / To-Do
3Patient
Room / Bed
Name · Age
Diagnosis
Code Status
Airway · ETT / Trach / None · Size
O₂ Device / Flow
SpO₂
Mode
FiO₂
PEEP
Vt
Rate
Last ABG · pH ____ / PaCO₂ ____ / HCO₃⁻ ____ / PaO₂ ____ · Drawn ____
TimeTreatment / Med Due✓
Notes / To-Do
4Patient
Room / Bed
Name · Age
Diagnosis
Code Status
Airway · ETT / Trach / None · Size
O₂ Device / Flow
SpO₂
Mode
FiO₂
PEEP
Vt
Rate
Last ABG · pH ____ / PaCO₂ ____ / HCO₃⁻ ____ / PaO₂ ____ · Drawn ____
TimeTreatment / Med Due✓
Notes / To-Do

Shift Checks & Rounds Due

Vent checks Circuit / HME Cuff pressures Suction / secretions SBT / RSBI ABG draws Bronchodilators Rounds / huddle Charting done Handoff given

Apex Respiratory · apexrespiratory.com — educational template; verify against facility policy. Not part of the medical record.

Educational use only. Brain sheets are personal organization aids — document care in your facility’s approved system, and dispose of patient-identifiable sheets per policy. This material supports respiratory therapy education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional protocols, or physician orders. Always follow facility policies and current provider orders, and verify calculations independently before clinical use.

Pairs well with

Ventilator Flow SheetHourly vent charting for a single ventilated patient
Open →
Respiratory Patient AssessmentThe systematic bedside assessment behind every box
Open →← All Printables