Effective MAIS Reporting and Documentation

Effective MAIS Reporting and Documentation by: Carol L. Mitlacher, NREMT-P JoAnn M. Yost, BS NREMT-P United Steam Fire Engine Company Number 3     I. Effective MAIS Reporting and Documentation...


Effective

MAIS Reporting

and

Documentation

by: Carol L. Mitlacher, NREMT-P

JoAnn M. Yost, BS NREMT-P

United Steam Fire Engine Company Number 3

 

 

I. Effective MAIS Reporting and Documentation

Instructor Guide

 

Session 1

Lesson 1:1

Title of Topic: MAIS Form Completion

Time: .75 hours

Teaching/Learning Level: Cognitive

Learning/Teaching Aids:

   • Lesson 1:1 Transparencies

   • Lesson 1:1 Handout

   • Overhead

   • Screen

   • White Board

   • Transparency Markers

   • Dry Erase Markers

Behaviors to Foster:

Active participation and discussion to enable the students to effectively complete MAIS forms.

Task:

Completing Reports

Given:

Information related to MAIS Form Components

Standard:

MAIS User’s Manual Guidelines

Prerequisite Knowledge:

Basic writing skills

Successful completion of EMT-B Module III Exam

Prerequisite Skills:

Enhancement of MAIS Form Completion Skills

Resources/References:

MAIS User’s Guide Manual

Attention: (Call to Order)

Motivation: (State Need to Know)

Student Performance Objective (SPO): Given the information related to MAIS form components, the student will be able to complete an entire MAIS form according to the MAIS User’s Manual guidelines.

Enabling Objectives (EO):

EO 1-1-1 Review general rules for completing MAIS forms.

EO 1-1-2 List and discuss the different components of a MAIS form.

EO 1-1-3 Describe how to complete the three refusal forms.

EO 1-1-4 Identify upcoming changes to the MAIS form.

Overview/Main Points:

MAIS Form Completion

   • General Rules

   • Components of MAIS Form

   • Refusal Forms

   • Upcoming Changes to MAIS Forms

Opener: Call to Order; start with a motivator (need to know) related to objectives and the lesson; state objectives and main points.

Teaching Points

I. General Rules (1-1-1)

  A. Black Ink Only

  B. No Stray Marks On Forms

  C. Keep Your Writing in the Designated Areas

  D. Move Carbon Paper for Refusals

 

II. Components of MAIS Form (1-1-2)

  A. Station, Response, Patient, and Provider Information

      1. Station Run Number

      2. Jurisdiction Incident Number

      3. Suppl

      4. Box Number

      5. District

      6. Receiving Facility

      7. Other Units on Scene

      8. Response Location

      9. Zip Code

     10. Inc Type

     11. Occup

     12. Action

     13. Disp

     14. Patient Name

     15. Parent/Guardian

     16. Patient Address

     17. Home Phone

     18. Provider ID Number

     19. Provider ID Name

  B. Date/MAIS Form Information

      1. Date

      2. Serial Number

  C. Response Times

      1. 911 Call

      2. Ambulance Call

      3. Depart Station

      4. Arrive Location

      5. Depart Location

      6. Arrive Hospital

      7. Return To Service

  D.  Response Identification, No Care Rendered, Priority

      1.  County/City Code

      2.  Unit Code

      3. Highest Staffed

      4. Dispatch

      5. First Due

      6. No Care Rendered

      7. Priority

  E. Patient Demographics

      1. Patient Age

      2. Patient Race

      3. Patient Gender

  F. Vital Signs

      1. First Vital Signs

      2. Glucometer

      3. Loss of Consciousness-Prior to Arrival

      4. Lungs

      5. Glasgow Coma Scale

      6. Safety Equipment Used

      7. Trauma ID

      8. Mechanism(s) of Injury

      9. Documentation of Care Rendered

            a. SaO2

            b. ET Size

            c. O2 Liters Per Minute

            d. Total cc’s

            e. Glucose Number

            f. Gauge Site

            g. Mileage

            h. On Line Physician

            i. Hospital Signature

            j. Provider Signature

           k. EMS Reviewer Signature

           l. Written Vital Signs

  G. Physical Findings

      1. Signs and Symptoms

      2. Injury Type

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