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Interfacility Pediatric Trauma
and Critical Care Consultation
and/or Transfer Guidelines
Emergency Medical Services Authority
California Health and Human Services Agencies #183
February 1994EMSA #183INTERFACILITY
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How to fill out interfacility pediatric trauma

How to fill out interfacility pediatric trauma
01
Step 1: Begin by gathering all necessary information about the pediatric trauma.
02
Step 2: Open the interfacility pediatric trauma form.
03
Step 3: Fill in the patient details, such as name, age, and contact information.
04
Step 4: Provide a summary of the trauma incident, including the location, date, and time.
05
Step 5: Document the presenting symptoms and initial assessment findings.
06
Step 6: Record any interventions or treatments provided during transport.
07
Step 7: Include the names and contact information of any healthcare providers involved in the transfer.
08
Step 8: Add any additional notes or observations that are relevant to the trauma case.
09
Step 9: Review the completed form for accuracy and completeness.
10
Step 10: Submit the interfacility pediatric trauma form to the appropriate healthcare facility or department.
Who needs interfacility pediatric trauma?
01
Interfacility pediatric trauma forms are needed by healthcare professionals, such as doctors, nurses, and paramedics, who are involved in the transfer and care of pediatric trauma patients between healthcare facilities or departments.
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What is interfacility pediatric trauma?
Interfacility pediatric trauma refers to the transfer or referral of a pediatric patient from one healthcare facility to another for a higher level of care.
Who is required to file interfacility pediatric trauma?
Healthcare facilities and providers involved in the transfer or referral of pediatric trauma patients are required to file interfacility pediatric trauma reports.
How to fill out interfacility pediatric trauma?
Interfacility pediatric trauma forms can be filled out by providing detailed information about the patient, the referring and receiving facilities, and the reason for transfer or referral.
What is the purpose of interfacility pediatric trauma?
The purpose of interfacility pediatric trauma reporting is to track and improve the quality of care provided to pediatric trauma patients during transfers or referrals between healthcare facilities.
What information must be reported on interfacility pediatric trauma?
Information such as patient demographics, medical history, injury details, treatment provided, and outcomes of the transfer or referral must be reported on interfacility pediatric trauma forms.
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