Page 8 - EMS CPR Manual V1

Where the incident occurs in a work environment, it is imperative the incident is reported and accurate details of the incident recorded as per the specific workplaces’ policies and procedures
An example of a First Aid report is pictured below.
Assessment Task 2 – Complete a Incident / Accident Report
You are required to complete a simple First aid / Incident / Accident Report using the details for Scenario 1.
Date of Incident
Time of Incident
Location of Incident
Date of Report
First Name of Casualty
Surname of Casualty
Date of Birth of Casualty
Incident Details and Observations (use the rear of form if you require more space)
OBSERVATIONS AND ASSESSMENT
Signs and Symptoms
Please mark all injuries using the key below
A – Abrasions B – Burn
C – Contusion D – Deformity F – Fracture
L – Laceration / Cuts P – Pain
S – Swelling
Allergies
Medications
Past / Present Medical Conditions
Last Meal
Observations and Assessment
Time
Time
Time
Time
Level Of Consciousness
A – Alert, V - Responds to voice, P – Responds to pain stimuli only, U - Unconscious
Pulse Rate Description
Beats per minute Weak / Strong / Irregular
Breathing Rate Description
Breaths per minute Shallow, Deep, Laboured
Skin Colour
Pale, Flushed, Clammy, Cold, Hot, Dry
Treatment Provided
Further Follow Up Treatment
£ Ambulance
£ Hospital
£ Medical Centre £ Doctor
£ Other (Specify)
First Aid Treatment Provided by
Signature of Treating First Aider
Date / Time
Report Completed By
Signature of Person Completing Report
Date / Time
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HLTAID001 Provide CPR - Enrolment and Assessment CPR V1.1.docx Page 3 of 5
LEGAL CONSIDERATIONS