Motor Vehicle Accident History

Motor Vehicle Accident
This was a [text] velocity impact. The vehicle impact was at the [text].
[select value="no|YES"] <-- Air bags deployed

Before the accident, the patient was seated [text] in relation to the vehicle.
Vehicle Restraints (e.g. seat belt): [text].
Extrication at the scene: [text]

[select value="no|YES"] <-- inside the vehicle after the accident.
[select value="no|YES"] <-- able to ambulate after the accident
[select value="no|YES"] <-- conscious during the accident
[select value="no|YES"] <-- remembers the impact
[select value="no|YES"] <-- remembers after the accident

Injury [text] prior to evaluation
Onset while: [text]
Episode location: [text]
Episode description: [text]

Associated Injuries: [text]
ROS
[select value="no|YES"] <-- seizure
[select value="no|YES"] <-- extremity weakness
[select value="no|YES"] <-- headache
[select value="no|YES"] <-- sensory changes (vision, hearing)
[select value="no|YES"] <-- shortness or breath
[select value="no|YES"] <-- chest pain
[select value="no|YES"] <-- nausea/vomiting
[select value="no|YES"] <-- incontinence of urine or stool