Dbccpcr 2.xls

DAYTONA STATE COLLEGE
E.M.S. PATIENT CARE REPORT
PATIENT CONTACT #
STUDENT NAME
PRECEPTOR
UNIT / FACILITY
TRANSPORT UNIT
PATIENT SEX
PATIENT AGE
MEDICAL HISTORY
PEDIATRIC BIRTH - 17 YEARS
O SEIZURES
ADULT 18 YEARS - 65 YEARS
GERIATRIC 65 + YEARS
O DEMENTIA
O HEPATITIS
DIABETIC
PATIENT CHIEF COMPLAINT
TRAUMA TYPE
ABDOMINAL PAIN
ANIMAL BITE
ALTERED MENTAL STATUS
ASSAULT / FIGHT
CARDIAC ARREST
BURN / SCALD
PATIENT MEDICATIONS
O NONE O UNKNOWN
CHEST PAIN
GENERAL MEDICAL
GUNSHOT WOUND
PREGNANCY / OB
MOTORCYCLE ACCIDENT
PSYCHIATRIC PROBLEM
MOTOR VEHICLE ACCIDENT
RESPIRATORY PROBLEM
PEDESTRIAN ACCIDENT
STABBING
DRUG ALLERGIES
O NONE O UNKNOWN
TRAUMATIC INJURY
REATMENT
TREATMENT PERFORMED
PERFORMED BY
REATMENT
TREATMENT YOU
YOU PERFORMED
PERFORMED
PERFORMED T
AIRWAY INTERVENTION
MEDICATION ADMINISTRATION
EKG MONITORING
ROOM AIR SPO2
BANDAGING
ADENOSINE
EKG MONITOR O O
CPR- AUTOPULSE
ALBUTEROL
12 LEAD EKG
CPR- MANUAL
ATROPINE
CARDIOVERT
O2 LITER FLOW
MANUAL VITALS
CALCIUM CHLOR.
DEFIBRILATION O O
NASAL AIRWAY
PEDI. IMMOB.
DEXTROSE 50%
ORAL AIRWAY
RADIO REPORT
DIAZEPAM
ASSESSMENT SKILLS
SCOOP STRETCHER
DILTIAZEM
SPINAL IMMOB.
DIPHENHYDRAMINE O O
COMBITUBE
SPLINTING
DOPAMINE INFUS.
EPI. 1:1,000
DCAPBTLS
STAIR CHAIR
EPI. 1:10,000
AUSCULTATION
TRACTION SPLINT
ETOMIDATE
INSPECTION
BLOOD DRAW
FUROSEMIDE
PALPATION
VENTILATOR
GLUCOMETER
GLUCAGON
SKILLS / TREATMENT
NEEDLE DECOMP.
IV ACCESS
LIDOCAINE
NOT LISTED
ADVANCED AIRWAY INFO
LIDOCAINE INFUS.
MAGNESIUM SULF. O O
ATTEMPTS
MORPHINE SULF.
VISUALIZED VOCAL CORDS O
NALOXONE
BILATERAL LUNG SOUNDS O
SODIUM BICARB.
IO ACCESS
SOLU MEDROL
IM MED. ADMIN
SQ MED. ADMIN
V3-010807
BREATHING
CIRCULATION Y
SKIN EYES
O DIMINISHE O
OBSTRUCTED O
LABORED O RHONCHI O
O CYANOTIC O
O WHEEZES O
CAPILLARY REFILL
NONREACTIVEO O
SHALLOW O
FLUSHED O TENTING O
VITAL SIGNS
ETCO2 SPO2 BGL
EYES VERBALMOTOR 0 - 10
A = SKILL / TREATMENT PERFORMED BY OTHER B = SKILL / TREATMENT YOU PERFORMED
TREATMENT LOG
TREATMENT
DOSE ROUTE COMMENTS
COMA SCORE
VERBAL MOTOR
ORIENTED
LOCALIZED
CONFUSED WITHDRAW
3 TO SPEECH INAPPROP. FLEXION
NARRATIVE
STUDENT SIGNATURE
REVIEWED BY:
V3-010807

Source: https://webapps.daytonastate.edu/ICS/icsfs/Paramedic_PCR.pdf?target=b3b48133-ac5d-43eb-9e7d-ecc5006ddede