CH 5 Documentation

Question 1

The Department-issued Prehospital Care Report (PCR) is a three-part form and contains
protected health information, which by law is confidential. Where do the 3 parts go after completion ?

Answer 1

Part One, the original, is to be forwarded to the Office of Medical Affairs through the BAG by the end of each tour.

Part Two is the Research Copy and is to be retained at Quarters and must be secured by the Company Officer in the Company files at all times.

Part Three is the Hospital Patient Record Copy and if completed is to be given to the EMS at scene. If Part Three is not given to the EMS Unit, it shall be forwarded with the original to OMA.
Sec 1.1.1

Question 2

At any scene not requiring a PCR or a NYFIRS report, the Company Officer has
the option of completing an Unusual Occurrence Report.
Agree or Disagree

Answer 2

Agree

Sec 1.6.1

Question 3

A unit returns to quarters after a medical run in which the unit turned on and applied pads to the patient. The Lt took part one of the PCR and fowarded part one through the bag to the Office of Medical affairs. Agree or Disagree

Answer 3

Disagree!!
The original PCR (Part One) shall be immediately
faxed and forwarded to the OMA on return
to quarters.
A copy of the original PCR (Part one) shall be turned in to the CFR-D Depot
along with the AED module upon completion of the assignment.
The serial
number of the module shall be documented on the PCR.
Sec 2.1.1

Question 4

There are no check boxes on the PCR. Members shall press firmly and darken in all
circles completely (●). To make corrections on the PCR, for a darkened circle members shall ??

Answer 4

When correcting a darkened circle, place a single line
through the error and fill in the correct section.
The INITIALS of the member making the
correction shall be placed ABOVE the single line.
Sec 3.4

Question 5

Crew – Members shall document the names and certification numbers of the CFR-D
certified members who responded to the call and provided patient care. If there
are more than four CFR-D certified members on the call, list the additional names in the
comment section. Circle the name of the member completing the PCR.
Agree or Disagree

Answer 5

Agree!!

Sec 4.19

Question 6

PCR
The name of the
member in charge of the call shall be entered in the ___________ and the second CFR-D
certified member’s name shall be entered in the ______________

Answer 6

first box

second box (driver's name). 
If the chauffeur does not provide patient care, do not enter his or her name on the PCR.

Question 7

A PCR must be completed when patient care is provided by a CFR-D certified member regardless of response type and/or Unit assignment.
(e.g., CFR-D certified member on a non CFR-D unit performs patient care). This includes, but is not limited to:

Answer 7

Making patient contact (any instance in which a Certified First Responder
has visualized, approached, communicated with or initiated history taking
and/or a physical exam on any individual for whom help was requested).

Question 8

The CFR-D Company Officer is responsible for the accuracy, completeness and legibility
of the PCR, and shall assign a CFR-D certified member to complete the PCR.
agree / disagree

Answer 8

Agree

Question 9

At any scene NOT requiring a PCR or a NYFIRS report, the Company Officer has the option of completing an

Answer 9

Unusual Occurrence Report.

Question 10

All times recorded on the PCR are written in ?

Answer 10

military time

Question 11

There are no check boxes on the PCR. Members shall press firmly and darken in all
circles completely (●). To make corrections on the PCR, for words members shall ??

Answer 11

Place a single line through the word(s) to be omitted or corrected and write the accurate information
ABOVE the word(s) to be corrected

Question 12

If unable to obtain, a description of the patient’s gender preceded by
‘Unknown’ shall be written in these boxes (e.g., Unknown Male). This area shall never be ?

Answer 12

left blank and ‘JANE/JOHN DOE’ shall NOT be used

Question 13

Enter the patient’s age. The patient’s age must be entered even if the date of birth is documented. If unknown ?

Answer 13

enter the patient’s approximate age

Question 14

If the

patient’s age is less that 1 year, enter the number followed by the appropriate ?

Answer 14

letter (H - hours, D – days, W – weeks, M = months). A six day old infant shall be entered 06D)

Question 15

There are three sections available for recording sequential vital signs.
Members shall note the time each set of vital signs is taken, the patient’s Respiration,
Pulse, Blood Pressure (BP), and Level of Consciousness in the spaces provided.

Answer 15

true

Question 16

A minimum of _____________ is required for all adult patients except for Cardiac Arrests and DOAs. For cardiac arrests and DOAs,

Answer 16

one set of vital signs

Respiration and Pulse are documented as ‘0’, Blood Pressure is not taken and the space is left blank.

Question 17

Blood Pressure – Enter the Blood Pressure as systolic or diastolic pressure. If the
blood pressure is taken by palpation, record the ?

Answer 17

systolic pressure over P (e.g., 90/P).

Question 18

Level of Consciousness – documented according to the patient’s response to
stimuli utilizing AVPU.

Answer 18

A. ALERT – patients responsive and oriented to person, place and time.
B. VOICE – patients responding to verbal stimuli.
C. PAIN – patients responsive to painful stimuli.
D. UNRESPONSIVE – patients non-responsive to verbal or painful stimuli

Question 19

CUPS

C ?

Answer 19

Critical – The patient is either receiving CPR, in respiratory arrest or requiring and receiving life-sustaining ventilatory/circulatory support

Question 20

CUPS

U?

Answer 20

The patient is unstable, severe upper airway difficulties,
serious chest trauma, decompensated shock, rising intracranial pressure,
uncontrollable EXTERNAL hemorrhage, penetrating injury to head, neck, chest, abdomen, pelvis.

Question 21

CUPS

P?

Answer 21

Potentially Unstable – early signs of compensated shock, kinematics or injuries suggest “hidden injury”, major isolated injury, severe chest pain, especially with a systolic (UPPER) BP of less than 100 mm Hg, inability to move any part of the body.

Question 22

CUPS

S?

Answer 22

Stable – Minor illness, minor isolated injury, uncomplicated extremity
injuries, and/or any patient that cannot be categorized as Critical, Unstable or Potentially unstable.

Question 23

Time From Arrest Until CPR means the time FD started CPR or anyone ?

Answer 23

Document the best approximation of the

patient’s down time prior to CPR being administered by ANYONE

Question 24

CPR Started

Answer 24

Enter the time that CPR was first started by the CFR-D Company
responding to the scene OR if the Company assisted in CPR.