Get Mn Burn Injury Report 2021-2026

The MN Burn Injury Report is a crucial document required by the Minnesota Department of Public Safety. This guide will help you navigate the process of filling out the form online, ensuring that all necessary information is accurately provided for effective reporting.

Follow the steps to successfully complete the MN Burn Injury Report online.

1. Click ‘Get Form’ button to obtain the form and access it in the online editor.
2. Begin by providing the nearest city or town where the burn incident occurred. This helps to establish the exact location for record-keeping.
3. Next, input the date and time of the injury. Make sure to format this information correctly to avoid any confusion.
4. Select the state as Minnesota and specify the county where the event took place.
5. Indicate the patient's status by checking the appropriate box for either discharged or admitted.
6. Select the patient's gender by checking either male or female.
7. Fill in the shade of the burned area(s) and the patient's zip code to provide further details.
8. Enter the patient’s date of birth and provide estimates for initial burns, as well as 12+ hour and 24+ hour burn estimates where applicable.
9. Document the medical record number along with the percentages of burn extent for first, second, and third-degree burns.
10. Check any applicable boxes if the patient sustained airway burns, had compromised vision, or if burns were limited to fingers or toes.
11. Record any toxicology results at the time of hospital admission, including drug and alcohol use.
12. Specify the location or activity at the time of the burn injury by checking all relevant options such as sleeping, at work, or at home.
13. Identify the causes of the burn injury by checking all relevant options, such as hot liquid contact, electrical, explosion, and provide descriptions if necessary.
14. Fill out the reporting facility's name, address, city, and zip code, along with the attending physician's name.
15. Indicate the reporting person's name and the date when the report was created.
16. Once all fields have been completed, review the information for accuracy. Save your changes, and you can opt to download, print, or share the completed report.

Complete your MN Burn Injury Report online today to ensure timely and accurate reporting.