L/B IFT transfer, BLS-PIFT

DISPATCH:
[select name="responding_unit" value="UAS unit 4|UAS unit 1|UAS unit 10|UAS unit 2|BRAS unit 44|BRAS unit 45|BRAS unit 46|BRAS unit 47|"][text name="unit_number" default=""] was dispatched for for an [checkbox name="EornotE" value="stat|non emergent"] transfer from [checkbox name="sending_facility" value="St. Mary's|CMMC|Miles|Mid Coast|d'Youville"][text name="transferfrom" default=""] to [checkbox name="recieiving_facility" value="MMC-Portland|St. Mary's|CMMC|Miles|Mid Coast|d'Youville"][text name="transfertoo" default=""] for [text name="dispachreason" default=""].

RESPONSE: 
Crew responded [checkbox name="lights_and_sirens_use" value="no response required, crew was at sending facility when made aware of call|emergent without use of lights or sirens|non emergent without the use of lights or sirens|emergent with lights and sirens|initial non emergent without use of lights or sirens upgraded to emergent with use of lights and sirens|initial emergent with use of lights and sirens downgraded to non emergent and use of lights and sirens were stopped"].
    
    
ARRIVAL:
On arrival crew got a brief report from [text name="reportfrom" default="RN"]. [textarea name="report" default="pt came in with"].

    Vascular access[text name="IVs" default="Patient has no IV's"][checkbox name="ivstatus" value=",remained clean dry and intact for duration of transfer"].

    Orders:[textarea name="orders" default="No medications ordered for transport."]

Crew found patient [textarea name="found" default="laying semi fowlers in bed with no current complaints and denying pain"].

Pt was transferred from [checkbox name="moved_from" value="bed|recliner|chair|bedside commode|crib|giraffe isolette"] to stretcher via [checkbox name="moved_to_stretcher" value="assisted stand and pivot|without assistance|2 provider drawsheet|3 provider drawsheet|4 or more provider drawsheet|hoyer lift|backboard with several providers|carried|able to walk from hospital room to unit per PT request with no assistance"] Patient was secured with all seatbelts and rails raised. Pt was positioned [checkbox name="position" value="flat|low semi-fowlers|high semi fowlers|in a sitting position|on their left side|on their right side|with knees up|with legs raised|with the patients head at approximately 30 degrees|in patients carseat|in pedi-mate|neomate"][text name="position" default=""] and made as comfortable as possible. [checkbox name="hangingmeds" value="Medication pump(s) where placed on stretcher IV pole and where not altered or modified in anyway by crew|Medications where transferred from sending facility pumps to crews, the settings and dose/rates verified with RN|Gravity meds moved to stretcher, not altered by crew during transport"]
    

ASSESSMENT:
[checkbox name="assessment" value="alert & oriented x4|alert to person|alert to place|alert to situation|alert to time|in no acute distress|has a patient airway equal chest rise and fall|is warm, dry, and color appropriate|moves all extremities as appropriate|has clear and equal lung sounds|is a reported baseline|CMS intact and remained intact through duration of transport|"][textarea name="pt_reports" default=""]
    
Pt was attached to [checkbox name="monitoring" value="SPO2|NIBP|4 lead EKG|12 lead EKG|ETCO2|BGL was obtained via a finger stick|BGL obtained|at bedside|in unit"][comment memo="EKG strip showed if done click top checkbox"][checkbox name="EKG" value="4 lead EKG showed:|sinus rhythm|sinus bradycardia|sinus tachycardia|sinus arrhythmia|AFIB|AFIB W/RVR|supraventricular tachycardia|atrial flutter|junctional rhythm|first degree AV block|second degree type 1|second degree type 2|3rd degree block |VTach|VFIB|Asystole|PEA|Torsades|W/PVC'S|W/PAC'S|W/PJC'S|per paramedic|this rhythm has been consistent for this visit|this rhythm is normal for patient"][text name="ros_heme" default=""][comment memo="12 lead showed"][checkbox name="12_Lead" value="12 lead showed no ST elevation, depression, or other explanation of symptoms and was declared to be negative|12 lead showed ST elevation in leads INSERT    LEADS    and depression in leads    INSERT    LEADS|12 lead showed left bundle branch block-Unknown onset|12 lead showed left bundle branch block- known existence|12 lead showed right bundle branch block-Unknown onset|12 lead showed right bundle branch block- known existence|significant artifact present|per paramedic|no change from 12 leads obtained from this visit"][text name="12_lead_interpetation" default=""].

    
TREATMENT:
[checkbox name="tx_done" value="No further treatment indicated or preformed|4mg zofran administered IV patient reports improvement|4mg zofran administered PO patient reports improvement|1000mg IV tylenol hung on gravity patient reports improvement|50mcg fentanyl given IV patient reports improvement|100mcg fentanyl given IV patient reports improvement|0.4mg nitro adminsted SL|O2 titrated between XXXXXXXXX due to pt sleeping|"][textarea name="tx" default=""]
    
    
TRANSPORT:
Patient was transported to [select name="hospital" value="CMMC|St. Marys|Maine Medical-Portland|Miles|Mid Coast| "][text name="hospital" default=""]code [checkbox name="transcode" value="code 1 without use of lights or sirens|code 3 with use of lights and sirens|initial code 1 without use of lights and sirens, upgraded to code 3 with use of lights and sirens|initial code 3 with use of lights and sirens downgraded to code 1 and use of lights and sirens were stopped"]. [comment memo="Alerts called and relayed information"][textarea name="alerts_relays" default=""]
Enroute patient was monitored as recorded and [checkbox name="got_beter_or_worse" value="remained stable with no change in pt condition|improved with treatment|decompensated|decompinstated but was responsive to treatment|was talkative|attempted to rest and appeared comfortable, was easy to arouse with equal chest rise and fall|quiet but responded to questions as appropriate|was on phone|"][text name="impove_or_not" default=""].


TRANSFER OF CARE:
On arrival to the receiving facility crew was directed to [text name="ED_location" default="patient's room"] where [checkbox name="other_things" value="report|paperwork|EKG's|meds|nitro bottle|and care"] was given to [checkbox name="reprot_to" value="RN|Doctor|team in bay|and all questions were answered to the best of crew's ability"].
    
Patient was transferred via [checkbox name="moved_to_bed_via" value="assisted stand and pivot|without assistance|2 provider drawsheet|3 provider drawsheet|4 or more provider drawsheet|reeves with several providers and removed at doctors orders|backboard with several providers and removed at doctors orders|reeves with several providers and kept in place|backboard with several providers and kept in place|able to walk from unit to ED per PT request with no assistance|carried"] from stretcher to [checkbox name="trasnfered_to" value="room bed and made comfortable|hall bed and made comfortable|wheelchair|bay bed|walked in with the crew per pt request and walked to the chair at the direction of facility staff"].
    
[checkbox name="replaced" value="Meds replaced at hospital|Meds replaced at base|pump returned to sending facility|unit restocked at base"]    
Crew returned to service.

[checkbox name="off_times" value="
As a result of the dynamic pre-hospital environment in which limited resources are available the times noted in this patient care report may be approximated, extensive care was made to insure times are as accurate as possible."]

[shorthand name="pt" value="patient "]
[shorthand name="resp" value="respiratory"]