The Pennington First Aid Squad in curly text

Pop-up helps for emsCharts Page 3

Kirk Schmitt 30-Jan-2009

To use these helps, move your mouse over a box or a symbol like the magnifying glass. A window with an explanation should pop up. If you see something that needs explaining, but there is no pop-up window, contact Kirk Schmitt.

Page 3 continues your report of your initial patient assessment. What you enter on this page does not need to be repeated in the activities narrative unless you need to explain something in more detail or the assessment changes.

Level of consciousness is to be entered for all patients.

Note that LOC on a chart stands for "Level of Consciousness," not LOSS of consciousness.

Enter orientation for all patients.

This is the sensation part of "PSM" (NOT abbreviated PMS in charts). Enter text or use the defaults.

The defaults have a grammatical error ("if" instead of "of") which you should change.

Check that your entry is consistent with the extremity Motor/Sensory pull downs to the right.

This is the motor part of "PSM" (NOT abbreviated PMS in charts). Enter text or use the defaults.

Check that your entry is consistent with the extremity Motor/Sensory pull downs to the right.

Initial assessment of AAO.

If you select normal from the list do not select anything else (like "Oriented-person") or you will get an error when you try to advance the chart. This is a NEMSIS problem and not the fault of emsCharts.

Initial assessment.

This block documents the neurological factors that go into your stroke scale (Cincinnati or LA) in the pull down to the right.

If you select normal from the list do not select anything else (like "Speech-normal") or you will get an error when you try to advance the chart. This is a NEMSIS problem and not the fault of emsCharts.

Initial assessment.

This helps explain the Glasgow Coma scale. A patient who is drunk, has overdosed on heroin, or just pulled from a chemical spill may be chemically paralyzed and this would affect their Glasgow scale.

Initial assessment. Loss of Consciousness prior to your arrival.

Initial assessment. A yes means immobilized prior to your arrival.

The section on immobilization below will only appear after you check yes. (Examples are EMT on scene applies collar, 159 is on scene ahead of you and has patient on long board).

Initial assessment

This section only appears if you check yes on "Was Pt. Immobilized". DO NOT check yes unless the patient was immobilized prior to your arrival (PTA).
CID = head blocks
Mast = no longer used
LBB = long board

Initial assessment

Notice that the verbal and motor entries change according to the age of the patient. For example, Motor changes from "obeys command" to "spontaneous" for infants.

Initial assessment.

Airway status and actions taken before you arrived. For example, did police insert oral airway? Did family remove food blockage or reposition patient's head?

If you select defaults, please correct the built-in error in the sensory. Change "if" to "of."

If you logout before you click one of these, your changes will be lost.

Initial assessment

If you did not assess, select the blank lines at the top of all pull downs or type in "not assessed."

Most pen lights have a pupil size scale on the body of the light.

Initial assessement

PSM for left and right arms and legs. The choices are inconsistent and do not include all reasonable possibilities. Do the best you can.

Initial assessment for stroke

Cincinnati positive requires all three factors (facial droop, motor drift, speech problems)

LA stroke scale requires ALS skills (EKG, blood sugar). Do not use.

Optional. Measure from tape. Broselow color appears according to patient age.

Optional. Don't enter unless you are certain who made the 911 call.

Ambulance on the scene.

How patient got from scene to ambulance. If they walked, select "assisted walk."

Position of the patient on the stretcher.

The list is incomplete, there is no Trendelenberg and you cannot specify left or right lateral recumbent. Best to handle this in activities.

Fowlers and semi-Fowlers are the most common positions of a patient "sitting" on the stretcher.

Almost always "Hosp."

If the ambulance breaks down in route or is involved in an accident, it may be necessary to transfer to other "EMS". In that case, use the search routine to find the name of the squad.

For pre-arranged transports from a hospital to home, select other. The window to fill in is much like the "Referring" windows above. If you need help, call the software administrators (Williams, Schmitt).

Name of the hospital from the drop down list.

Click on the magnifying glass. If there is no drop down menu, click on whatever icon you get and you will be presented with a search. Enter some part of the name in the format %name%, enter the state, select the hospital by clicking on its full name.

Where you delivered the patient at the hospital. Usually Emergency Department but other locations, particularly OB/GYN, also are used.

Response in route to the hospital.

These are not always distinct. If the crew chose to go to the closest hospital for example, you could choose "crew choice" or "closest facility." Probably best to choose the more impersonal choice (closest over crew choice, for example).

This is the recommended place to put your care transfer statement. For example, you might write something like "care and info to ED staff, bed 7 hallway, nurse Ratched." If you prefer, you may put the care statement in the activity section on page 8.

The first time you work on page 1, click on "Add Patient" to move on.

The next time you return to page 1, the display changes to a list of patients with the clickable "+" to add more patients. Adding multiple patients to an MVA with several releases is a way to avoid some repetitious data entry but can easily become confusing and hard to keep track of. I recommend avoiding multiple patients on a chart, but that is your choice.

Optional

Get these times from LifeCom. Expected times:

Normal call:
Dispatch
Enroute
On scene
Leave for hospital
Arrive hospital
Available

Cancelled call:
Dispatch
Enroute (if not cancelled before enroute)
Cancelled
Available

Scratched call:
Dispatch
Available

Not used.

Get these times from LifeCom. "Dep Ref" is leave for hospital. "Arv Rec" is arrive at hosital. Expected times:

Normal call:
Dispatch
Enroute
On scene
Leave for hospital
Arrive hospital
Available

Cancelled call:
Dispatch
Enroute (if not cancelled before enroute)
Cancelled
Available

Scratched call:
Dispatch
Available

Not used.

Get these times from LifeCom. Expected times:

Normal call:
Dispatch
Enroute
On scene
Leave for hospital
Arrive hospital
Available

Cancelled call:
Dispatch
Enroute (if not cancelled before enroute)
Cancelled
Available

Scratched call:
Dispatch
Available

Not used.