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Call Identifier: Recent calls:
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Call identifier: Communicator id: Alternate Call ID: Final call status: Select call status 1C 1D 2 3 M.D. Name: Call Level: Choose a Call Level ALS BLS 3CIFT IFT CCT Patient age: Patient age (units): Select an item Years Months Days Hours Not Known Not Available Patient sex: Select the Sex Female Male Unknown Chief complaint (brief): Select the Chief Complaint Trauma Medical Deceased on Scene Other Start Date and time of Call: Communication type: Select a Communication Type Cell Phone Other Land Line UHF VHF IRP Satellite radio 800 MHZ Other Type: Agency: Select an agency Filter By MedCom Provider WV Number: Invalid WV Number Not Collected: (requires QI) Provider Name: Provider Certification: Receiving Destination State: Select an item AK AL AR AS AZ CA CO CT DC DE FL FM GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UM UT VA VI VT WA WI WV WY Destination type: Select Facility Type Hospital No Transport ALS Squad Landing Zone Funeral Home/Mortuary Morgue Receiving Destination: Filter By MedCom Report is after-fact? Yes ETA (mins) to destination: Dest. Notification Date and Time: Alert issued? Yes Alert type: Select alert type Trauma P1 Trauma P2 Stroke STEMI Other Cardiac Respiratory Sepsis Diverted for Acute LVO? Yes Quality Improvement? Enter Quality Improvement Data
QI Topic: Choose Skill Proficiency Protocol Compliance Medication Complications Patient Death Mass Casualty Events Other Protocol Type: 4000 Series (Paramedic) 6000 Series (EMT) 5000 Series (ACT) 3000 Series (3CIFT) 1000 and 2000 Series (CCT) Special Conditions Special Operations Specification: Notes: Add Clear
Upgraded? Yes Upgraded by: Select an item Provider Communicator MCP Upgraded from: Select call status 1C 1D 2 3 Diverted? Yes State diverted from: Select an item AK AL AR AS AZ CA CO CT DC DE FL FM GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UM UT VA VI VT WA WI WV WY Diverted from: State diverted to: Select a State AK AL AR AS AZ CA CO CT DC DE FL FM GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UM UT VA VI VT WA WI WV WY Diverted to: Reason diverted: Diverting M.D.:
See Medcom Record Yes
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