Meconium present Thrombolytic screening and stroke screen APGAR at 1 and 5 minutes Treatments/Reassessments General appearance Report given and signature of RN Treatments/Reassessments Report and signature of RN SYNCOPE/FAINTING/WEAKNESS TRAUMA OPQRST and SAMPLE as appropriate OPQRST and SAMPLE as appropriate Injuries, chest pain, dyspnea, nausea Description of Vertigo/postural/TILT changes Weapon (size, caliber, depth of New or changed medications penetration) if applicable Last meal Description of damage, estimated speed, Blood glucose level airbag deployment as applicable EKG Patient protection as applicable ETOH/Substance use Tourniquet use Treatments/Reassessments Level of or Loss of consciousness Report given and signature of RN Obvious injuries and area of pain Palpation/assessment of injured areas Disability (PMS/SMC intact) Treatments/reassessments Report given and signature of RN
Meconium present APGAR at 1 and 5 minutes General appearance Treatments/Reassessments Report and signature of RN Thrombolytic screening and stroke screen Treatments/Reassessments Report given and signature of RN SYNCOPE/FAINTING/WEAKNESS OPQRST and SAMPLE as appropriate Injuries, chest pain, dyspnea, nausea Vertigo/postural/TILT changes New or changed medications Last meal Blood glucose level EKG ETOH/Substance use Treatments/Reassessments Report given and signature of RN TRAUMA OPQRST and SAMPLE as appropriate Description of Weapon (size, caliber, depth of penetration) if applicable Description of damage, estimated speed, airbag deployment as applicable Patient protection as applicable Tourniquet use Level of or Loss of consciousness Obvious injuries and area of pain Palpation/assessment of injured areas Disability (PMS/SMC intact) Treatments/reassessments Report given and signature of RN
Tennessee-Guideline-07282016.docx