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Filling out the Central New York EMS intubation confirmation form online can streamline the process of documenting each intubation attempt. This guide offers clear, step-by-step instructions to ensure you complete the form accurately and effectively.

Follow the steps to complete the Cnyems intubation confirmation form online.

1. Press the ‘Get Form’ button to access the Cnyems intubation confirmation form and open it for editing.
2. Enter the PCR or PRID number at the top of the form to identify the specific case.
3. Fill in the date of the intubation attempt to ensure accurate record-keeping.
4. Provide the agency name and agency number to signify which organization the report corresponds to.
5. Indicate the pre-hospital provider's designation, including their AEMT number.
6. Specify whether care was transferred from a first response agency by checking 'Yes' or 'No' and include the agency's name if applicable.
7. Indicate the location of the intubation by selecting either 'On-Scene' or 'Enroute'.
8. Select the provider level from the available options: AEMT-I, AEMT-CC, or AEMT-P.
9. If the intubation was unsuccessful, indicate if a Combitube was used, and record the number of attempts.
10. Categorize the patient type by selecting from Medical, Trauma, Adult, or Pediatric (for those under 14 years).
11. Confirm tube placement by checking all applicable methods: Visualization, Auscultation, and include notes as necessary.
12. Document whether Hospital capnography was utilized, choosing from Wave-Form Capnography, Color-Metric CO2, or EDD (and mark Yes or No accordingly).
13. Complete the physician confirmation section, providing the hospital code, receiving hospital name, physician's name, and signature.
14. List all documented confirmations for tube placement again, checking all that apply and providing any additional notes in the space provided.
15. Once all fields are completed, save your changes, then download, print, or share the form as needed.

Begin filling out your Cnyems intubation confirmation form online today!