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Get Id Trauma Medical Record Review Form 2015-2024

Gender: EMS POV ED Arrival Date: ED Arrival Time: Funeral Home: ED Discharge Time: LOS: Unit/Room # 0 Mechanism of Injury: Pre-Hospital Information Provider: EMS Scene Time: BP HR Extrication? Oxygen? Resp Yes Yes No No minutes Intubation? GCS Spinal Immobilization? Yes Run Sheet Present? Yes IV: Method? Notes/Comments: Clinical Information Trauma Team activation? Yes No Appropriate? ED provider notified Tra.

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