Advanced Life Support (ALS)

• ET Tube
• NG Tube
• Needle Cricothyroidotomy
• EndoTracheal Tube (E/T)
• EKG Monitored [Rythm(s):]
• Cardioversion No. Times  Manual Semi-auto.
• Medication Administred
• IV Established Fluid  Cath. Gauge: :
• 12 Lead
• I.V.  
• I.O.
• Saline Lock
• Monitor


Basic Life Support (BLS)
• Abdominal/Chest Thrust
• HyperExtension
• Modified Jaw Thrust
• Airway Cleared
• Oral/Nasal Airway
• Esophageal Obturator/Gastric-Tube Airway (EOA/EGTAL)
• O2 Admin. @ : L.P.M. Method:
• Bag Valve Mask w/O2
• Nasal Cannula
• Nebulizer

Basic Life Support (BLS)
• Suction Used
• Artificial Ventilation Method:
• C.P.R. in progress on arrival by:
  Citizen PD/FD/Other First Responder Other
• C.P.R. started @  :  Time from Arrest til CPR: : 
• Defibrillation No. Times  Manual Semi-auto.
• Epi-Pen
• Insta-Glucose
• Irrigation
• Mast Inflated @ :
• Bleeding/Hemorrhage Controlled (Method: )
• Spinal Immobilization Neck and Back
• Limb Immobilized by  Fixation Traction
• Backboard Immobil.:  Long Short Cervical Collar
        Head Immobilizer KED Pediatric Immobilizer
• Heat or Cold Applied
• Vomiting Induced @ : Method: 
• Restraints Applied: 
• Baby Delivered @ : In County: 
        Alive Stillborn Male Female
• AED; #shocks:
• Bandaging
• Other: