Forms • Hagerstown, MD • CivicEngage

EMS Documentation

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Name:*		City ID #:*
E-Mail Address:*		Date:*
Duty Assignment:*


1. What a reasonable provider of the same certification/licensure would do in the same or similar situation.*

2. What a state permits a certified or licensed provider do regarding assessments, treatment, and procedures.*

3. Most common areas for lawsuits against public safety personnel: Patient Care, Driving and ___________.*

4. When an important part of the assessment or care was left out.*

5. TRUE OR FALSE: QA/QI is designed as a disciplinary tool.*

6. TRUE or FALSE: If you are on scene and providing care, you CANNOT use “Operational Support” in EMEDS. *

7. Actions performed on the patient that were wrong or improper*

8. A minor has the same capacity as an adult to consent to medical treatment if the minor is married or _______________.*

9. TRUE or FALSE: Accurate & thorough documentation of patient information & treatment is an essential ingredient in maintaining overall quality of EMS.*

10. TRUE or FALSE: You are dispatched as a first responder unit and get canceled after responding, you still have to complete an EMEDS. Example: E1 and M26 alerted for trouble breathing. Units go responding and P755 responds and places E1 in service.*

* indicates required fields.