AIRWAY OBSTRUCTION ALLERGIC REACTION Can patient speak/forcibly cough of reaction Is patient moving air Dyspnea Inspiratory stridor Facial/airway What caused obstruction Chest pain Duration of obstruction Rash/Itching Treatment/reassessments Report given and signature of RN Treatment/reassessments Report given and signature of RN ANIMAL BITE/STING ATRAUMATIC GI BLEED Type of animal or insect Nausea, vomiting, diarrhea, constipation Location of bite(s)/Sting Active bleeding Edema at site Bloody emesis/stool, how long? Rabies/immunization status of animal if Abdominal pain, location and quality appropriate Treatment/reassessments Treatment/reassessments Report given and signature of RN Report given and signature of RN BURN CARDIAC ARREST Burn source chemical, electricity) Events prior to onset Environment (enclosed, outside) Description/location of patient on arrival Entrance/exit wounds if appropriate Estimated down time Burn surface area and thickness Treatment/reassessments Facial, oral, nasal areas singed Report given and signature of RN pain/dyspnea Treatment/reassessments Consider Cyanide Antidote Report given and signature of RN CHEST PAIN CHF/PULMONARY OPQRST and SAMPLE as appropriate Chest pain Factors relieving or increasing pain Dyspnea Dyspnea, cough Nausea, vomiting Nausea, vomiting Diaphoresis Diaphoresis JVD/lower extremity edema Aspirin within past 12 hours Treatments/reassessments Treatments/reassessments Report given and signature of RN Report given and signature of RN DEATH DIABETIC Last time patients seen or talked to OPQRST and SAMPLE as appropriate Position/Location of body Nausea/vomiting/recent illness Any movement of body made by EMS Pre/Post treatment of blood glucose level Any injuries noted Treatment/reassessments Dependent lividity/ mortis Report given and signature of RN EKG strip in two leads attached Released to HYPERTENSION HYPER/HYPOTHERMIA
AIRWAY OBSTRUCTION Can patient speak/forcibly cough Is patient moving air Inspiratory stridor What caused obstruction Duration of obstruction Treatment/reassessments Report given and signature of RN ALLERGIC REACTION of reaction Dyspnea Facial/airway Chest pain Rash/Itching Treatment/reassessments Report given and signature of RN ANIMAL BITE/STING Type of animal or insect Location of bite(s)/Sting Edema at site Rabies/immunization status of animal if appropriate Treatment/reassessments Report given and signature of RN ATRAUMATIC GI BLEED Nausea, vomiting, diarrhea, constipation Active bleeding Bloody emesis/stool, how long? Abdominal pain, location and quality Treatment/reassessments Report given and signature of RN BURN Burn source chemical, electricity) Environment (enclosed, outside) Entrance/exit wounds if appropriate Burn surface area and thickness Facial, oral, nasal areas singed pain/dyspnea Treatment/reassessments Consider Cyanide Antidote Report given and signature of RN CARDIAC ARREST Events prior to onset Description/location of patient on arrival Estimated down time Treatment/reassessments Report given and signature of RN CHEST PAIN OPQRST and SAMPLE as appropriate Factors relieving or increasing pain Dyspnea, cough Nausea, vomiting Diaphoresis Aspirin within past 12 hours Treatments/reassessments Report given and signature of RN CHF/PULMONARY Chest pain Dyspnea Nausea, vomiting Diaphoresis JVD/lower extremity edema Treatments/reassessments Report given and signature of RN DEATH Last time patients seen or talked to Position/Location of body Any movement of body made by EMS Any injuries noted Dependent lividity/ mortis EKG strip in two leads attached Released to DIABETIC OPQRST and SAMPLE as appropriate Nausea/vomiting/recent illness Pre/Post treatment of blood glucose level Treatment/reassessments Report given and signature of RN HYPERTENSION HYPER/HYPOTHERMIA