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Emergency Observation Form Guidelines

The document provides instructions for completing a Medical Emergency/Arrest Observation and Audit Form used at Royal Brisbane & Women's Hospital. The form is to be filled out for any medical emergencies or cardiopulmonary arrests that occur. It collects important patient details and event information like time, condition, treatments, and outcome. The top copy goes in the patient's file and the bottom copy is sent to the hospital's Safety and Quality unit for record keeping and review.

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Youssef Mokdad
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100 views2 pages

Emergency Observation Form Guidelines

The document provides instructions for completing a Medical Emergency/Arrest Observation and Audit Form used at Royal Brisbane & Women's Hospital. The form is to be filled out for any medical emergencies or cardiopulmonary arrests that occur. It collects important patient details and event information like time, condition, treatments, and outcome. The top copy goes in the patient's file and the bottom copy is sent to the hospital's Safety and Quality unit for record keeping and review.

Uploaded by

Youssef Mokdad
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Royal Brisbane & Women’s Hospital

Medical Emergency / Arrest Observation and Audit Form

• The Medical Emergency / Arrest Observation and Audit Form is to be completed for all Medical Emergencies and Cardiopulmonary Arrests that occur in the
clinical area.
• The top copy of the form is to be filed in the patient’s medical record and the bottom sheet (yellow) is to be sent to the Safety and Quality Unit Level 7, Block 7.

How to complete the form:


1. Enter patient details or apply sticker on both sheets.
2. Identify date and location of event.
3. Indicate trigger for event.
4. Identify event times.
5. Indicate patient’s resuscitation status and indicate 1
if Next of Kin is contacted.
6. Indicate patient’s condition at time of event. 2
7. Indicate investigations conducted and list any
additional tests.
8. Identify patient outcome from event.
9. Record observations:
• Time observations were measured.
• Level of Consciousness (LOC), refer to 6
legend for AVPU mnemonic. 3
• Airway: - Use legend to indicate type of airway
and breathing adjuncts. 9
• Oxygen: - Indicate amount of oxygen 10
administered.
• Heart Rate:- Indicate heart rate or rhythm
4 7
• CPR: - Write ‘yes’ or ‘no’ to indicate if cardiac
compressions in progress.
• Defib: - Indicate if shock or no shock advised 11
by SAED. Identify joules delivered, if applicable.
10. Document time, type, dose and route of medications
initiated during event. 8
11. Provides a legal record of nursing and medical staff 12
prescribing and administering medication.
12. Provides room for further documentation of event 5
e.g. time of IV access, intubation.

Reviewed: May 2010


Review Date: May 2011
Example of completed form:

For further information please contact the District Clinical Emergency Response Coordinator, Safety & Quality Unit, Extension 65791.
Reviewed: May 2010
Review Date: May 2011

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