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Incident Number: V2000360 <br />Incident Date/Time: 01 /20/2020 23:26:10 <br />01/21/2020 00:09:47 Needle Thoracostomy <br />01/21/202000:11:25 Vitals <br />01/21/2020 00:14:25 Patient Arrived at Destination <br />01/21/2020 00:15:20 Des tination Patient Transfer of <br />Care <br />01/21/2020 00:21:24 Unit Back in Service <br />Treatment -Procedures <br />Patient Name: Mercado, Miguel <br />Location: Chest Dale, Ryan (P38789) <br />size: 14 No. of <br />Attempts: 1 <br />Response: <br />Unchanged <br />Success: Yes <br />BP: 0/0 Pulse: 0 Dale, Ryan (P38789) <br />Resp: 0 <br />Reperfusion <br />Checklist: Not <br />Recorded <br />Compl Com <br />Atte Succ Respo icatio ment <br />Time PTA Crew Procedure Location Size mpts ess nse n Auth s ----------------------··-----·--·-·--------------------~--. -----------~------------------·-------·---··· .. -·- <br />23:38:33 Dale, Ryan Cardiac-Manual CPR <br />23:40:07 <br />23:40:36 <br />00:09:13 <br />00:09:47 <br />(P38789) <br />Dale, Ryan Venous Access- <br />(P38789) lntraosseous <br />Dale, Ryan Alrway-Bag Valve Mask <br />(P38789) Ventilat_lon (BVM) <br />Dale, Ryan Venous Access- <br />(P38789) lntr aosseous <br />Dale, Ryan Needle Thoracostomy <br />{P38789) <br />Time PTA crew Medication ·---------··- <br />23:40:07 Dale, Normal saline <br />Ryan <br />(P38789 <br />) <br />23:43:06 Da le, Epinephrine 0.1 <br />Ryan MG/ML <br />(P38789 (1:10,000) <br />) <br />Lower Extremity-Left <br />Lower Extremity-Left <br />15 1 <br />Lower Ex tremity-Right 15 <br />Lower Extremity-Right <br />14 <br />Treatment -Medications <br />Route Dose Response --··-·--------- <br />ln trave 1000 ml Not <br />nous (Milliliters) Applicabl. <br />(IV) e <br />lntraoss 1 mg Unchange <br />eous (Milligram d <br />(10) s) <br />Yes Un cha None Standing <br />nged Order/Proto <br />col <br />Yes Not None Standing <br />Applica Order/Proto <br />ble col <br />Uncha None Stan ding <br />nged Order/Proto <br />co l <br />Yes Not None Stan ding <br />Applica Order/Pr oto <br />ble col <br />Yes Uncha None Base <br />nged Hospital <br />Order <br />Complication Auth comments <br />-~----·•-.-... <br />None Standi <br />ng <br />Order/ <br />Proto <br />col <br />No ne Standi <br />ng <br />Order/ <br />Proto <br />col <br />EMS Agency Name: Fountain Valley Fire Departm ent <br />PCR #: ca2a4d0a46f 1453f81898d0d 1 ccf <br />eb65 <br />Tran sporting Agency : care Ambulance service <br />(1639 131436) <br />Printed: 01/22/2020 08:55 <br />Pa ge 7 of9