Chapter 4 - Documentation Flashcards
1
Q
Minimum Data Set
A
Set of Data the DOT recommends including on all PCRs. (P.69)
2
Q
Pertinent Negatives
A
Signs or symptoms that might be expected, based on the chief complaint, but that the patient denies having.
3
Q
Pre-Hospital Care Report (PCR)
A
Most common type of record that is prepared and submitted.
4
Q
Triage Tag
A
Chief complaint, vital signs, and treatment provided.
