Get Ny Bls Inh Naloxone Administration Quality Improvement Call Review Form - Suffolk County 2014-2025
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How to fill out the NY BLS INH Naloxone Administration Quality Improvement Call Review Form - Suffolk County online
Completing the NY BLS INH Naloxone Administration Quality Improvement Call Review Form is essential for documenting the administration of Naloxone in a pre-hospital setting. This guide will provide you with a step-by-step approach to accurately fill out the form online.
Follow the steps to complete the form effectively:
- Press the ‘Get Form’ button to download the form and open it in your preferred document viewer.
- On the form, begin by entering the agency name in the designated field.
- If a different ambulance service transported the patient, indicate the name of that service.
- Record the call date and time in the appropriate sections.
- Specify the receiving hospital where the patient was taken.
- Fill in the name of the BLS provider who administered Naloxone, selecting either EMT-B or CFR as applicable.
- Provide the patient's age and gender by filling in the respective fields.
- Input the initial vital signs, including Glasgow Coma Scale (GCS), heart rate, blood pressure, respiratory rate, blood glucose, and pupil response.
- Document the final vital signs in the corresponding fields after administration.
- Indicate how the airway was maintained by checking the appropriate method used.
- State the suspected opioid used by the patient and note the source of this information.
- Respond to the questions about the number of doses administered, documentation of times for each dose, and any hazards or complications encountered.
- Indicate whether an Advanced Life Support (ALS) response was requested and if they were present on the scene.
- Provide information regarding any additional Naloxone given by ALS, if applicable.
- Use the space provided for any other pertinent information or comments related to the event, and check the box if you utilized the back of the page for additional comments.
- Once you have completed all sections of the form, save your changes, and choose to download, print, or share the form as needed.
Complete the NY BLS INH Naloxone Administration Quality Improvement Call Review Form online today!
Naloxone for BLS administration must be supplied in appropriate dosage forms, such as ready-to-use intranasal sprays or pre-filled syringes. Ensuring that naloxone is easily accessible in these forms improves the chances of providing timely assistance to individuals experiencing an overdose. The NY BLS INH Naloxone Administration Quality Improvement Call Review Form - Suffolk County reinforces the importance of having these supplies readily available.
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