H. Cardiac Arrest Related
1. Cardiac Arrest Witnessed
2. CPR Started By
3. AED Started By
4. Return of Spontaneous Circulation at ED
I. Airway, Procedures, Other Care Rendered
3. Other Care Rendered
K. Hospital Codes
L. Transportation/Communication/Special Purpose
1. Transported By
2. Reason Hospital Chosen
4. Special Purpose
6. Provider Exposure
III. Refusal Forms (1-1-3)
A. Refusal for IV Therapy
B. Refusal of Services and Transportation
C. Refusal of Services Not Transportation
1. Procedure Addition – Combitube Dot Added
2. Condition Change - Exposure to Environmental
IV. Upcoming Changes to MAIS Form (1-1-4)
A. Web Based Data Entry System (Pilot)
B. Current MAIS Document Changes
Lesson 1:1 MAIS Form Completion
Student Performance Objective (SPO):
Given 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.
II. MAIS Form Completion
• General Rules
• Components of MAIS Form
• Refusal Forms
• Upcoming Changes to MAIS Form
Oral Review: Under each review point, recall and list three features from the discussion. Make a note of these points or highlight points in your notes as you may use them for exam review.
Other Evaluation: Use course quizzes, if any, or create and use lesson quizzes and other learning reinforcements. Quizzes are diagnostic and may be given as in-class group assignments to generate discussion or as home assignments and used as review prior to starting the next session.
III. Effective MAIS Reporting and Documentation
Title of Topic: Written Narrative Completion
Time: .75 hours
Teaching/Learning Level: Cognitive
• Lesson 1:2 Transparencies
• Lesson 1:2 Handout
• White Board
• Transparency Markers
• Dry Erase Markers
Behaviors to Foster: Active participation and discussion to enable the students to effectively formulate written narratives and utilize abbreviations.
Task: Completing Reports
Given: Information and Knowledge about Narrative Formats and Abbreviations
Standard: Medically Accepted Abbreviations and Narrative Formats
Prerequisite Knowledge: Basic writing skills
Successful completion of EMT-B Module III Exam
Prerequisite Skills: Enhancement of Narrative Report Writing Skills
Resources/References: Report Writing Formats (as needed)
Attention: (Call to Order)
Motivation: (State Need to Know)
Student Performance Objective (SPO): Given the information and knowledge about narrative formats and abbreviations, the student will be able to formulate effective written narratives utilizing medically accepted abbreviations in accordance with medically accepted narrative formats.
Enabling Objectives (EO):
EO 1-2-1 Discuss effective narratives and some important items to include when documenting.
EO 1-2-2 List and discuss the components of the CHART format.
EO 1-2-3 List and discuss the components of the SOAP(IER) format.
EO 1-2-4 List and discuss the components of the Chronological format.
EO 1-2-5 Discuss effective documentation of patient refusals.
EO 1-2-6 Review common medical abbreviations and symbols.
IV. Written Narrative Completion
• Effective Narrative
• CHART format
• SOAP(IER) format
• Chronological format
• Refusal Documentation
• Abbreviations, Acronyms and Symbols
Opener: Call to order; start with a motivator (need to know) related to objectives and the lesson; state objectives and main points.
I. Effective Narrative (1-2-1)
A. Tells a story