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Emergency Management Console
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Note Type
Initial
Initial
Follow-Up
Discharge
EMS Handoff
Visit Type
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Injury
Illness
Medication
Preventive
Mental Health
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Date / Time
Provider Name
Provider Role
CHO
CHO
Physician
Nurse
Paramedic
EMT-Advanced
EMT
First Aider
Other
Chief Complaint
S — Subjective
Patient's History / Description of Symptoms
O — Objective / Vitals
Temp (°F)
Heart Rate
Resp Rate
O₂ Sat (%)
BP Systolic
BP Diastolic
Pain Scale (0-10)
Weight (lbs)
Physical Exam Findings
🩹 Injury Details
Mechanism of Injury
Injury Location (body part)
Injury Type
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Laceration
Abrasion
Contusion
Sprain
Strain
Fracture (suspected)
Burn
Puncture
Head Injury
Eye Injury
Other
🤒 Illness Details
Onset
Duration
Symptoms
Fever
Chills
Nausea
Vomiting
Diarrhea
Headache
Sore Throat
Cough
Shortness of Breath
Rash
Abdominal Pain
Dizziness
Fatigue
Chest Pain
Allergic Reaction
A — Assessment & P — Plan
Assessment / Clinical Impression
Plan / Treatment Rendered
Medications Given
Return to Activity
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Full Activity
Limited Activity
Rest Only
No Activity
Pending Evaluation
Follow-Up Instructions
EMS Activation
EMS was activated / called
Parent / Guardian Notification
Parent / Guardian was notified
Provider Signature
Provider Signature
Type
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Supervisor Review
Supervisor has reviewed this note
Incident Report Generated
(BSA Form 680-016 — required for injuries, illnesses, and property damage)
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