EMS Patient Care Worksheet - Wisconsin Department of Health - dhs wisconsin 2025

1. Click ‘Get Form’ to open the EMS Patient Care Worksheet in our editor.
2. Begin by entering the Service Name and Run Number at the top of the form. This information is crucial for tracking and compliance.
3. Fill in the Incident Date and Location, along with En-route, On-scene, and Leave Scene Times to provide a timeline of the ambulance run.
4. Complete patient details including Name, DOB, Age, Sex, and Weight. Ensure this information is accurate for proper documentation.
5. Document Provider Impression and Time of Onset. Include details about the Nature of Illness (NOI) or Mechanism of Injury (MOI) as applicable.
6. Assess and record vital signs such as GCS, Respiratory Rate, Pulse Rate/Quality, and Blood Pressure in their respective fields.
7. Indicate any Allergies and Past Medical History by checking relevant boxes. This helps in understanding patient history for better care.
8. Finally, document Treatments provided during the run along with responses observed. Ensure all sections are completed legibly before saving your work.

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