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Incident Number: V2000360 Patient Name: M ercad o, Miguel <br />Incident Date/Time: 01 /20/2020 23:26:10 <br />(Ring)-Left, Finger-4th (Ring)-Right, Finger-5th (Sm allest)-Left, Finger-5th {Sma l lest)-Right, Hand-Dorsal-Left, Hand- <br />Dorsal-Right, Ha nd-Pa l m-Left, Hand-Palm-Right, Thumb-Left, Thumb-Ri ght) ; <br />Back/Spine ( Back-General, Cervical-Left, Cervical-Midline, Cervical-Right, Crush Injury, Lumbar-Left, Lumbar-Midline, <br />Lumbar-Ri ght, Sacral-Left, Sacral-M idline, Sacral-Right, Thoracic-Left, Thoracic-Midline, Thoracic-Right) ; <br />Not Done <br />Past Medical History <br />Medication Allergies Comments <br />Not Recorded/ Unknown <br />Environmental/Food Allergies Comments -··----·-·-··-----~------------····---~-----... --.-·.---·-···--·-------·--··------·-··-------··--------~----------------~~~---.. .--.... -... <br />Medication Dose Route <br />----···--.. ••----------•-,o ... ,_.,_ .. ___________ ~-----····---------·------··----·---·-·•-.---•--··- <br />None Reported/Patient Denies Meds <br />Medical History: Not Recorded/ Unknown <br />Onset Time: Not <br />Recorded <br />CPRPTA: No <br />First Monitored Asysto!e <br />Rhythm: <br />CPR Not <br />Discontinued: Applicable <br />Cause: Firearm <br />Injury, <br />Assault/lnte <br />ntional <br />(GSW) <br />Revised Trauma Score <br />0 <br />Cardiac Arrest <br />Cardiac Arrest: Yes, Prlor to <br />EMS Arrival <br />EMS CPR : Initiated <br />Chest <br />Compressio <br />ns <br />Witnessed By: Witnessed <br />by Lay <br />Person <br />AEDPTA: No <br />ROSC: Yes, Prior to <br />Arrival at <br />the ED <br />Trauma <br />MOI: Penetrati ng Triage Criteria: Blunt chest <br />injUl)'W/ <br />abnorma l <br />respiration <br />{<12 or <br />>30) <br />Triage Criteria : EMS <br />Provider <br />Judgment <br />Assess/Treat Timeline <br />Comments <br />Etiology: Trauma <br />Rhythm at Asystole <br />Destination: <br />Timetlne: _T_i_m~---------~---Type _____________________ .,. _______________ p~-~~~l~-------· Crew Member <br />01/20/2020 23:26:08 Dispat ch Notified <br />EMS Agency Name: Fo un ta in Valley Fire Depart me n t <br />PCR #: ca2a4d 0a46f1 453f81898d0d1ccf <br />eb65 <br />Transporting Agency: Ca re A mb ulance Service <br />(1 639 131436) <br />Printed: 01/22/2020 08:55 <br />Pa ge 4 of 9