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Get Nevada Trauma Registry
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How to fill out the Nevada Trauma Registry online
This guide provides clear instructions on how to effectively fill out the Nevada Trauma Registry Data Collection Form. By following these steps, you will ensure that the necessary information is accurately reported for trauma cases.
Follow the steps to complete the Nevada Trauma Registry form online.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by entering the reporting hospital and the person reporting details at the top of the form. This section establishes the context for the data provided.
- In the demographics section, fill in the patient's last name, first name, social security number, and date of birth. Specify the patient's race, middle initial, and gender. Include their complete address and city details, as well as the state and zip code.
- Indicate whether the injury was work-related by selecting 'Yes' or 'No.' If 'Yes', document the patient's occupation and the county of injury. If the injury occurred out of state, specify 'Out of State County.'
- In the injury section, document the date and time of the injury, including the zip code and city of the injury. Specify the county of injury. Detail the mechanism of injury, whether it is blunt or penetrating, and provide information on specific accidents or events.
- Complete the prehospital information section by indicating the EMS company and whether the scene report is complete. Include dispatch date, time, vital signs at the scene, and any additional information from the transport service.
- In the ED admission section, document whether the patient was transferred, including details of the referring hospital, transport method, and arrival times.
- Proceed to the ED assessment section, recording the time the surgeon was requested and arrived, vital signs, and any relevant CT or imaging details.
- For the hospital diagnosis, list any ICD-9 codes or detailed descriptions of injuries. Ensure you accurately describe any complications.
- Document any operations or procedures performed on the patient, including dates, times, ICD-9 codes, and descriptions.
- Finalize by providing hospital outcome details, including discharge date, time, disposition, organ donation status, and days spent in ICU.
- After completing all sections, you can save changes, download, or print the form for your records or further submission.
Start filling out the Nevada Trauma Registry form online today to ensure accurate and timely reporting.
Yes, the Nevada Trauma Registry prioritizes data security to protect sensitive patient information. The platform employs advanced security measures, including encryption and access controls, to ensure compliance with health data protection regulations. This commitment helps maintain patient confidentiality while promoting effective trauma care.
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