PCR

1550 - PCRIZH15032023

Summary Report

Patient & Incident Data
Patient Assessment & Management
Staff Data
Forms

Incident Data

Call Date

Call No

Dispatch Time

Accepted Time

On Scene Time

Leave The Scene

AT Health Care Facility Time

In Service Time

Total Call time

Call Type

Call Category

Call Sub Category

Governorate ID

Willayat

Incident Location

Station ID

Factors Affecting EMS

Other

Type of Hospital	Name of the Hospital	Reason ?	Action
Government Hospital	Al Seefa Health Center

Additional Resources On Scene

Royal Oman Police Formations

Military & Government Entities

Private Sector Entities

Case Category

Call Type

Call Category

Call Sub Category

Patient Care Data

Civil ID / Passport Number

Patient Name

Gender

Nationality

Age

Contact No

Address

Legal Guardian Name

Contact No

Relationship

Insurance Details - Medical

Policy Number

Insurance Status

Insurance Company

Medical Insurance Expiry Date

Insurance Details - Vehicle

Vehicle Plate No

Vehicle Plate Code

Insurance Status

Insurance Company

Policy Number

Patient Assessment

General Impression

LOC

Chief Complaint / MIO

Airway

Airway Not Clear

Breathing

Breathing Normal

Breathing Abnormal

Circulation

Circulation Pulse

Circulation Skin

Resuscitation Required

Head

Head Burns

Pupil Check

Comments

Neck

Neck Burns

Chest

Left Chest

Left Chest Burns

Right Chest

Right Chest Burns

Abdomen

Left Up Abdomen

Left Up Abdomen Burns

Right Up Abdomen

Right Up Abdomen Burns

Left Down Abdomen

Left Down Abdomen Burns

Right Down Abdomen

Right Down Abdomen Burns

Pelvic / Genitalia

Pelvic Burns

Back

Back Thoracic

Back Thoracic Burns

Back Lumbar

Back Lumbar Burns

Back Sacrum

Back Sacrum Burns

Upper EXT

Upper EXT Left

Upper EXT Left Burns

Upper EXT Right

Upper EXT Right Burns

NO DCAP BTLS PMS

Lw EXT

Lw EXT Left

Lw EXT Left Burns

Lw EXT Right

Lw EXT Right Burns

NO DCAP BTLS PMS

comments

History of Present illness

Describe what the patient has.

History of Present illness comments

Onset

Provocation

Quality

Radiation

Severity

Time

Signs & Symptoms

Allergies

Medications

Past Medical History

Last Oral Intake

Event

Time / Vs	AVPU	BP	Pulse	R.R	SPO₂	RBS	GCS	ECG	RHYTHM	ECG Attachment	APGAR	Total Burn Score %
1	Verbel	120/80	20	3	6	887	9	3L	6	4 images Attachmented	9
2	Verbel	120/80	20	3	6	887	9	12L	6	2 images Attachmented	9

Field Impression

Impacted Person

Seatbelt

Child Seatbelt

Airbag

Helmet

Severity of Accident

Pregnancy

Weeks

Accident Picture

#	File Name	Action
1	testimage.png

Transport Category

Transport

Health Care Facility

Government Health Care Facility

Private Health Care Facility

Non Transport

Crime scene comments

PDOA Type

Transport Type

Location Type

Management

AirWay

Oral Size

Oral Done By

Nasal Size

Nasal Done By

ETT Size

ETT Done By

LMA Size

LMA Done By

Combi Done By

Comments

Oxygen / LPM

Nasal

Nasal Done By

SFM

SFM Done By

NRM

NRM Done By

BVM

BVM Done By

Comments

Immobilization

C.COLLAR

C.COLLAR Done By

KED Done By

LBB Done By

Scoop Done By

Stair Done By

Comments

Splinting

Rigid Done By

Traction Done By

Comments

Electrical Intervention (Cardiac)

AED Shock Delivered

How many times?

AED Used Done By

Defibrillation Done By

ECG

ECG Done By

Others

Bandage Done By

Cold Pack Done By

Assist Delivery

Assist Delivery Done By

Warming Done By

Cooling Done By

Bleeding Control Done By

Irrigation Done By

Suction Done By

NGT (Size)

NGT Done By

Burn Care Done By

Comments

Actual Delivery

Time	Type	Gender
12:00 PM	A live	Male

I.V / IO / IM

Vital Type	Site	Time	Size	Attempt No	Done By
I.V	Loc	12:00 PM	2	2	EMS Provider 1

Cardioversion

Time	Dose	Done By
12:00 PM	2	EMS Provider 1

TCP

Time	Current	Done By
12:00 PM	2	EMS Provider 1

Medications Details

Time	Mediation	Dose	Route	Administered By	Narcotic Form
12:00 PM	Inj.Adenosine 3mg/1ml Injection	2	Oural	EMS Provider 1

Narrative

Patient Outcome

Written By

Ahlam Hilal Khamis Alrasbi

Signature:

Received By

Signature:

MD Comments

Signature:

Belonging Handover

Suspected Cause Of Arrest

Pre EMS Arrival Information

Pre EMS Arrival

Estimated Down Time

CPR Progress

Time Initiated

AED Applied

Time selection

Airway Indication & Procedures

Gag Reflex

Clear airway

Suctioned

Device Type

Tube Size

Location Performed

Number Of Attempts

Gag Reflex	Clear airway	Suctioned	Device Type	Size	Number Of Attempts	Location Performed
12:00 PM	120/80	120	1

Airway Placement Confirmation - Modes

Direct cord visualization

Bilateral Breath Sound

Pulse Oxymetry

Waveform Capnography

CO₂ Detector

Treatment

Time	B.P	Pulse	R.R	Rhythm	Intervention				Response	Done By
Time	B.P	Pulse	R.R	Rhythm	Ventilation	Chest Compressions (CPR)	Defibrillation	Medication	Response	Done By
12:00 PM	120/80	120	1							EMS Provider 1

Narrative

Resuscitation Outcome

Written By

Ahlam Hilal Khamis Alrasbi

Signature:

Received By

Signature:

MD Comments

Signature:

Staff	ID (Force Number)	Name
EMS Provider 1	P23456789	Ahlam Hilal Khamis Alrasbi
Attended	P3/14996	Dhiab bin Khalfan bin Said Al -Alawi
Called	P2/47095	Juma bin Said bin Nasser Al -Amri

Staff

ID (Force Number)

Name

Called

Attended

EMT Level Type

S.No	Form Name	PCR No
1	Personal Belonging (PB)	PCRIZH15032023
2	Refusal	PCRIZH15032023
3	PDOA	PCRIZH15032023

Narcotic

#	PCR No	Drug Name	Action
1	PCRIZH15032023	Narcotic 1
2	PCRIZH15032023	Narcotic 2

S.No	Description	Quantity	Remarks	Action
1	HandBag	1	---

Date & Time	User Comments	Request Status	Action From	Action To
Nov 29, 2023 3:07:45 PM		Transfer	Santosh	Balaram
Nov 29, 2023 9:32:58 AM	0707031/T/533476/2023 doesn't appear unites and floors in work completion	Transfer	Sri	Santosh
Nov 28, 2023 11:50:56 AM	المشكله انه عند تقديم اتمام البناء وتوصيل الخدمه لهذه الاباحة(0707031/T/533476/2023) تنعكس بيانات المالك ولكن لا تظهر بيانات المبني ولا نتستطيع كتابة البيانات للمبني	Received	System	Sri
Nov 28, 2023 11:50:56 AM	المشكله انه عند تقديم اتمام البناء وتوصيل الخدمه لهذه الاباحة(0707031/T/533476/2023) تنعكس بيانات المالك ولكن لا تظهر بيانات المبني ولا نتستطيع كتابة البيانات للمبني	Registered	Sys-PortalReq	N/A

Date & Time

User Comments

Request Status

Action From

Action To

Nov 29, 2023 3:07:45 PM

Transfer

Santosh

Balaram

Nov 29, 2023 9:32:58 AM

0707031/T/533476/2023 doesn't appear unites and floors in work completion

Transfer

Sri

Santosh

Nov 28, 2023 11:50:56 AM

المشكله انه عند تقديم اتمام البناء وتوصيل الخدمه لهذه الاباحة(0707031/T/533476/2023) تنعكس بيانات المالك ولكن لا تظهر بيانات المبني ولا نتستطيع كتابة البيانات للمبني

Received

System

Sri

Nov 28, 2023 11:50:56 AM

Registered

Sys-PortalReq

N/A

#	الاسم	الرقم المدني/العسكري	مقر العمل	صلة القرابة	التوقيع
1
2

#	الاسم	الرقم العسكري	المسمى الوظيفي	التوقيع
1
2

1550 - PCRIZH15032023

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Infection Control Exposure Report

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1550 - PCRIZH15032023

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Theme Customized

Layout

Vertical

Horizontal

Two Column

Color Scheme

Light

Dark

Layout Width

Fluid

Boxed

Layout Position

Topbar Color

Light

Dark

Sidebar Size

Default

Compact

Small (Icon View)

Small Hover View

Sidebar View

Default

Detached

Sidebar Color

Light

Dark