Case Review
Hospital:
Reviewer:
Medical Record Key Code #:
Pre-hospital/EMS
Run sheet/trip report in medical record?
Trauma team activated from the field?
EMS scene times appropriate?
Emergency Department/Initial Resuscitation
Trauma team activation (TTA) protocol
followed? ◄
Appropriate trauma team members arrived? ◄
Physician, NP or PA present at resuscitation
within 30 minutes of EMS notification? ◄
Flow sheet used?
Physician consulted by NP/PA?
1o & 2o surveys immediate and accurate?
ATLS guidelines followed?
Appropriate diagnostic tests ordered (lab, x-ray,
CT, etc.)?
Vital signs monitored completely and
periodically (GCS, BP, HR, Resp., SaO 2 , temp.)?
Fluids monitored?
Hypothermia prevention?
Pain level monitored?
Documentation of injuries, vitals, treatments,
fluids complete?
Time physician, NP or PA called:
Disposition?
Length of stay in ED:
◄ important indicators
Hospital PI:
Reviewer’s comments regarding PI:
Time Tracking
EMS
dispatched
EMS
en route
EMS
arrive
EMS
leave scene
Team
activated
Pt arrive
hospital
ED provider
arrive
Transfer
ordered
X-ray
CT
Lab
Transferred
↓ Notes ↓