Paramedic Narrative Transport

Dispatched for:[text name="variable_1" default=" "]yo [select name="variable_2" value="M|F"] PT transport [checkbox name="variable_3" value="from"] [select name="variable_4" value=" |Maine Medical Center|Eastern Maine Medical Center|Maine General Hospital Augusta|Redington Fairview|Franklin Memorial Hospital|Northern Light Mayo Hospital"] to [select name="variable_5" value="the hospital|Maine Medical Center|Eastern Maine Medical Center|Maine General Hospital Augusta|Redington Fairview|Franklin Memorial Hospital|Northern Light Mayo Hospital"] due to [text name="variable_6" default=" "].
[select name="variable_7" value="Negative|Positive|Undetermined|inconclusive"] PUI.
On floor at [text name="variable_300" default= ]. Nurse report at [text name="variable_301" default= ].
All EMS personnel wore appropriate PPE before making contact with PT.[checkbox name="variable_8" value="Nurse states:|Family states:|Friend states:|EMS states:| Bystander states:"]
[textarea name="variable_9" default=" "]
[checkbox name="variable_10" value="Transfer orders per Doctor "][text name="variable_11" default=" "]       
[checkbox name="variable_12" value="Pt acuity: "][checkbox name="variable_13" value="Stable, No risk|Stable, Low risk|Stable, Medium Risk|Stable, High risk|Unstable"]     
[checkbox name="variable_14" value="EMT:"]
[checkbox name="variable_15" value="Oxygen to maintain O2 sat >= %|Saline lock only|Non-medicated fluids|Behavioral restraint(blue or white paper order)|Medical restraint (soft writ)|PCA pump|Patient Centric Devices"]     
[checkbox name="variable_16" value="VS q"][text name="variable_17" default=""][checkbox name="variable_18" value="15min"] [checkbox name="variable_19" value="AEMT:"]
[checkbox name="variable_20" value="Non-medicated fluids|Cardiac monitor(non-cardiac diagnosis)|Acetaminophen mg|Albuterol nebulized q |Albuterol/Ipratropium nebulized q |CPAP|Ondansetron ODT 4mg PO q min|Ondansetron 4mg via IV q min prn"]
[checkbox name="variable_200" value="Paramedic:"]
[checkbox name="variable_201" value="Cardiac monitoring (cardiac related diagnoses that will required EKG interpretation)|Full ACLS protocol|Fentanyl mcg IV q min prn|Ketamine mg/kg IV|Midazolam mg via IV q min|D10 ml/hr via IV pump|Diphenydramine mg IV q min|Dexamethasone mg IV q min|Magnesium Sulfate g IV q min|Norepinephrine 8mg in 250ml NS @ mcg/kg/min to maintain SBP , titrate 0.03mcg/kg/min every 3-5 minutes. Max dose 3mcg/kg/min"]    [checkbox name="variable_25" value="PIFT: "]
[checkbox name="variable_27" value="Esmolol ml/hr titrate for desired rate of |Heparin units/kg/hr (ml/hr)|Labetalol mg IV q min to maintain SBP range of |Nicardipine ml/hr titrate to maintain SBP range for |Nitroglycerin mcg/min |PCA with continuous infusion (medication @ ml/hr|central line|continuous bladder irrigation|Oxymizer liters per minute (lpm)|Central line|Continuous bladder irrigation|chest tube to water seal|chest tube to heimlich valve|OG\NG tube clamped or to suction|transvenous pacemaker|Wound vac non-patient centric|other: "][textarea name="variable_203" default=" "][checkbox name="variable_34" value="Scene size up:"]
[textarea name="variable_35" default=" "]
Pt has not had a fever, chills, cough, shortness of breath/difficulty breathing, fatigue, muscle/body aches, headache, new loss of taste/smell, sore throat, congestion/runny nose, nausea/vomiting, diarrhea, or contact with possible COVID 19. Pt vaccinated for COVID 19.
Found PT [select name="variable_36" value="semi-fowler's|supine|prone|right lateral|left lateral|sitting"] [checkbox name="variable_37" value="in chair|in recliner|in bed|on edge of bed|on floor|on the ground|on the toilet|in shower"]
PT dressed [checkbox name="variable_38" value="fully.|in hospital gown.|appropriate for the weather."]
[select name="variable_39" value=" |Applied face mask to PT|PT wearing face mask."]
[checkbox name="variable_40" value="PT has: "][checkbox name="variable_41" value="foley cath|g IV in|pacemaker|no implanted devices"]
[checkbox name="variable_42" value="PT alert "][checkbox name="variable_43" value="by verbal|by pain|Pt unresponsive"]. [checkbox name="variable_44" value="PT oriented "][checkbox name="variable_45" value="Person|Place|Time|Event|Mental status is baseline"].
Breathing: [select name="variable_46" value="Regular|Irregular||Fast|Slow|Apneic"]. [checkbox name="variable_47" value="Non-labored|Labored|deep|Shallow"]. Pulse [select name="variable_48" value="Regular|Irregular||Tachycardic|Bradycardic|Pulseless"], [select name="variable_49" value="Strong|Weak"],  Skin [select name="variable_50" value="Pink|Pale|Ashen|Cyanotic|Flush|Jaundiced|has lividity"], [select name="variable_51" value="Warm|Hot|Cool|Cold"], [select name="variable_52" value="Dry|Clammy|Diaphoretic"] with [select name="variable_53" value="good|poor"] skin turgor.  Neuro [checkbox name="variable_54" value="intact|unable to assess"] [checkbox name="variable_55" value="with general weakness"] [checkbox name="variable_56" value="Negative for"] Pain [select name="variable_57" value=" |1 of 10|2 of 10|3 of 10|4 of 10|5 of 10|6 of 10|7 of 10|8 of 10|9 of 10|10 of 10"][checkbox name="variable_58" value="Pt states:"][textarea name="variable_59" default=" "][checkbox name="variable_60" value="PT denies: "] [checkbox name="variable_61" value="N/V/D|Dizziness|Headache|Chest discomfort"]. [checkbox name="variable_62" value="PT able to take a deep breath "] [select name="variable_63" value=" |without difficulty|with difficulty|with pain"][checkbox name="variable_64" value="Assisted PT to stair chair, secured PT to stair chair with safety straps."]
[select name="variable_65" value="Sheet lifted PT|PT scooted himself/herself|Hover lifted Pt|Pt walked with assistance|Pt walked without assistance|PT stood and pivoted without assistance|Pt stood and pivoted with assistance"] to the stretcher.  Covered PT with a blanket.  PT [select name="variable_66" value="semi-Fowler’s|supine|right lateral|left lateral"].  Secured PT to stretcher with safety straps.  Stretcher to the truck
[checkbox name="variable_95" value="Partner doffed PPE at the foot of the stretcher and returned to the cab."][select name="variable_96" value="Non-emergent|Emergent"] transport. [textarea name="variable_97" default=" "]
BLS interventions: 
Vitals as noted.
[checkbox name="variable_98" value="BGL|Continued PT on O2 as stated above|lpm O2 via NC showing increase in SPO2|15lpm O2 via NRB showing improved change in CO level|15lpm O2 via BVM at 1 breath every 5-6sec showing improved change in CO level"]
     
ALS Interventions:
[checkbox name="variable_99" value="4-lead cardiac monitor|12-lead cardiac monitor|IV LOC successful.  No irritation was noted.  Flushed easily|IV lock unsuccessful|Nitro Tab via SL showing a decrease in pain to 10 of 10|Fentanyl via IVP showing a decrease in pain to 10 of 10|NS via IV gravity showing an increase in SBP|Zofran IVP showing a decrease in nausea|Continued Pt on as stated above|none required"]
Changes en route:  No other significant findings. [textarea name="variable_114" default=" "][checkbox name="variable_108" value="Pt verbalized no complaints."][checkbox name="variable_109" value="Pt states: "] [textarea name="variable_110" default=" "]
Partner wore appropriate PPE before opening doors for the stretcher.
Stretcher to [select name="variable_5" value=" "] [select name="variable_111" value="Sheet lifted PT|Pt scooted Pt scooted himself/herself|Hover lifted PT|PT stood and pivoted without assistance|Pt stood and pivoted with assistance|PT scooted over|Pt walked unassisted|Pt walked with assistance"] to bed.  Settled PT into bed.
Gave report and transferred care to staff.
[checkbox name="variable_112" value="PT refused transport.  PT advised of the risks and to seek medical attention for any abnormal changes.  PT signed the refusal form.|Left doors open to the ambulance. Fogged and deconned entire pt compartment of the truck."]
MJB 18813-P