Get 101d Skills And Medication Usage Form.doc - Norcalems

The 101D Skills And Medication Usage Form is an essential document utilized by medical professionals to record skills and medication administration in the field. This guide provides comprehensive, step-by-step instructions on how to accurately fill out this form online.

Follow the steps to complete the 101D Skills And Medication Usage Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the date in the designated field marked 'Date __/__/__'. Ensure the correct format is used.
3. Next, fill in the 'Provider Agency' field with the name of the agency you represent.
4. Enter your 'Accreditation/Cert #' in the specified section to confirm your qualifications.
5. Complete the 'Name' field by providing your full name as the medical professional filling out the form.
6. Input the patient information by accurately recording their age and sex where indicated.
7. Document the 'Chief Complaint' by clearly stating the primary issue the patient is experiencing.
8. In the 'Field Assessment/Treatment Indicators' section, note any relevant observations and the PCR number.
9. Detail the procedures performed by checking the appropriate boxes for intubation, ETTI (Bougie), King Airway, and others as applicable.
10. Indicate 'Yes' or 'No' for the success of each procedure and include specifics on attempts and outcomes.
11. Record any medication usage during the encounter, ensuring to note dosages, routes, and patient responses appropriately.
12. Address 'Pre-existing vascular access' to provide details about any IV access established.
13. Complete the 'Patient Outcome Data' section by indicating the final status of the patient.
14. Once all sections are filled out, review the information for accuracy and completeness.
15. After verifying the details, you can save changes, download the form, print it, or share it as required.

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