Wellston FD EMS Patient Care Report

This EMS Patient Care Report template from the Wellston Fire Department helps crews capture complete patient information from dispatch to transfer of care. Record incident details, timestamps, crew members and roles, patient demographics, chief complaint and level of consciousness. Document full vitals including airway, respirations, breath sounds, SpO2, CO2, carbon monoxide, pulse, blood pressure, temperature, and blood glucose. Capture SAMPLE history, symptoms, onset, provocation, quality, radiation, and pain severity. Log interventions and procedures such as IV access, airway adjuncts, CPR, defibrillation, EKG, bandaging, tourniquet, splinting, immobilization, irrigation, bleeding control, and wound packing, including outcomes and provider certifications. Track medication administration routes and effects, oxygen delivery and flow rates, and include a clear narrative. Collect patient consent and all required signatures to ensure accurate, compliant documentation.