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County of San Diego Emergency Medical Services Prehospital Patient Record (Paper Version, Bubble Form) Form: HHS: EMS 104 (07/2009) Instruction Manual Version 1 County of San Diego Health and Human
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Begin filling out the form by entering your personal information in the designated fields. This may include your full name, date of birth, address, and contact information.
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Next, provide any relevant medical information. This could include details about any pre-existing conditions or allergies that may be important for emergency responders to know.
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If applicable, indicate any medications you are currently taking. Be sure to provide the name of the medication, dosage, and frequency of use.
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In the event of an emergency, it is important to have an emergency contact listed. Provide the name, relationship, and contact information for someone who should be notified in case of an emergency.
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Who needs prehospbubbleformmanual fy0910bsdoc use this:
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Individuals who require emergency medical attention and may not be able to communicate their medical history or conditions themselves.
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Patients with chronic medical conditions or significant allergies that emergency responders need to be aware of.
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People who frequently participate in high-risk activities or occupations where there is an increased likelihood of needing immediate medical assistance.
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Individuals who want to ensure that their emergency medical information is easily accessible and accurately conveyed to healthcare professionals in case of an emergency.
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Caregivers, family members, or friends who are responsible for the well-being of someone who may be unable to provide their own medical information during an emergency situation.
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What is prehospbubbleformmanual fy0910bsdoc use this?
prehospbubbleformmanual fy0910bsdoc is used for documenting pre-hospital care provided to patients.
Who is required to file prehospbubbleformmanual fy0910bsdoc use this?
Emergency medical service providers are required to file prehospbubbleformmanual fy0910bsdoc.
How to fill out prehospbubbleformmanual fy0910bsdoc use this?
The prehospbubbleformmanual fy0910bsdoc should be filled out with accurate and detailed information about the pre-hospital care provided to the patient.
What is the purpose of prehospbubbleformmanual fy0910bsdoc use this?
The purpose of prehospbubbleformmanual fy0910bsdoc is to document and track the pre-hospital care provided to patients for record-keeping and analysis purposes.
What information must be reported on prehospbubbleformmanual fy0910bsdoc use this?
Information such as patient demographics, medical history, vital signs, treatments administered, and transport details must be reported on prehospbubbleformmanual fy0910bsdoc.
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