Trauma Clinic Patient Record
Emergency Medical Services Documentation
Attendant Information
Attendant Name
Phone Number
Patient Information
Patient Name
Gender
Select gender
Male
Female
Other
Age
Phone Number
Centre Name
Select centre
Emali
Kinungi
Sultan Hamud
Lari
Limuru
Date
Time
Type of Injury
Abrasion
Laceration (Cut)
Contusion (Bruise)
Fracture
Sprain
Strain
Dislocation
Burn
Scald
Concussion
Puncture Wound
Crush Injury
Amputation
Animal/Insect Bite
Insect Sting
Penetrating Trauma
Blunt Trauma
Electrical Injury
Chemical Exposure
Near Drowning
Poisoning
Gunshot Wound
Stab Wound
Asphyxia
Hypothermia
Heat Stroke/Exhaustion
Seizure-related Fall
Allergic Reaction (Anaphylaxis)
Other
Interventions Taken
Materials Used
Material/Medication
Quantity
Unit
Pieces
ml
mg
g
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Additional Notes
Clinical Notes
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