Example Ambulance Care Summary for General Practices

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Advice of Ambulance Contact *** ATTENTION GP *** If this patient is not enrolled in your practice or if you believe you have received this information in error or for further information, please contact the St John Referrals Coordinator at referrals@stjohn.org.nz or by phoning 0800 ST JOHN (0800 473 876) and asking to speak to the Referrals Coordinator.

Doctor Proctor Taihape Health, 3 Hospital Rd, Taihape (06)388 0926

Patient Information NHI Number:

ZCJ7684

Name:

Anne Smith

Sex:

Female

DoB:

01/06/1968

Address:

18 Main Highway, Taihape, 4720, New Zealand

Age:

50

Year(s)

Incident Information Date and time of call

08/07/2018 06:16

Incident Location:

18 Main Highway, Taihape

Ambulance Master Incident Number:

0104-2-2018/07/08

Home

Location Type: ACS access code:

TP-RFA-KBZ-BE

ACC Claim Number:

Note to GP We recommended that Anne contacts your practice ASAP if her flu-like symptoms worsen.

Advice to Patient Family advised to phone ambulance back if Anne becomes difficult to rouse, cannot mobilise, develops a headache unrelieved with pain relief or develops a rash.

Advice to GP of Ambulance Contact

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ZCJ7684

Anne Smith 08/07/2018 06:16


History Presenting Complaint:

Flu-like symptoms

Incident history:

Feeling unwell for several days with cough and aching in joints. Tried to sleep yesterday but kept being woken with cough. Went out Friday night but unwell. Came back to Taihape on Saturday morning. This morning was going to head to Whanganui Hospital for assessment as coughing had become worse but decided to call ambulance

Date/time of onset:

07/07/2018 17:30

Primary Survey Status at Scene:

4 – No threat to life

Responsiveness:

Alert

Airway

Patent (Clear)

Breathing:

Effective

Circulation:

Normal

Blood Loss:

Nil

Past Medical History Past medical history:

Hypertension

Medications:

Accuretic

Allergies:

NKA

Last oral intake:

Pizza Hut last night

Clinical Impression Primary clinical impression:

ILI - Influenza-like illness

Notes:

Sitting on couch wrapped in two blankets. States never felt this sick before. Warm to touch. Dry cough present since yesterday. No headache. No sore throat, no rash. No localised pain. General aches in body. Lung sounds clear with equal entry. Been up to toilet without pain or offensive urine. Abdo soft and no abdominal pain. Taking paracetamol 4 hourly but unable to sleep due to coughing. Given ibuprofen 400mg and discussed where to purchase and how to use in conjunction with paracetamol.

Advice to GP of Ambulance Contact

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ZCJ7684

Anne Smith 08/07/2018 06:16


Disposition Final patient status:

4 – No threat to life

Notes:

Patient asleep on the couch once paperwork completed.

Disposition:

Treat or Assist only

Vital Signs and Treatment Time

GCS

Heart Rate

Resp Rate

BP

SpO2

Rhythm

BGL

Cap Refill

Temp

Pain

08/07/2018 06:30

4+5+6=15

86

16

155/94

98

Sinus Rhythm

6.2

P=1

36.40 C (Tympanic)

2

08/07/2018 06:51

4+5+6=15

85

16

145/91

98

Sinus Rhythm

08/07/2018 06:55

Medication: Ibuprofen 400 mg Per oral

Advice to GP of Ambulance Contact

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Pupil (mm L/R)

ETCO2

Skin

Normal

37.20 C (Tympanic)

ZCJ7684

Anne Smith 08/07/2018 06:16


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