Brady V2 Ch6

A written record of an EMS response that can be used for medical, administrative, research or legal purposes.

The time elapsed from when a unit is alerted until it arrives on scene.

The PCR provides the basis for continuously improving patient care in the EMS system.

Complete identification of all additional resources and personnel.

• Coronary artery bipass graft
• Paroxysmal nocturnal dyspnea
• After eating
• Before eating
• Post operative/Taken orally

Draw a single line through the error, write the correct information besides it and initial the change.

An addition or supplement to the original report.

• Chief complaint
• History
• Assessment
• Rx=treatment
• Transport

Patients retain the right to refuse treatment if they're competent to do so. This requires excellent documentation regarding the patients status.

A thorough patient assessment

Documenting patient competency

Explaination to the patient possible causes of refusing care, including possibility of death when appropriate.

Your willingness to return if they change their mind.

Patients understanding of statements and suggestions and apparent competence to refuse care based on that understanding.

Obtainig complete patient information or completing documentation before moving on to the next patient. Document as much as possible, as quick as possible then move on to the next patient, keeping the patients best interest in mind.

encourage or lead to frivolous lawsuits.