Government of Tamilnada Department of Health and Family Welfare ‘Tamilnadu Accident and Emergency Care Initiative (TAEI) Government Chengalpatu Medical College Hospital Pre Arrival Intimation From Scene / IFT... PAI Coll Received on _/_/201_at_:_ AM/PM by Patient received on _/_/201_at_: _AM/PMby.... s+ Hospital PAI Not Received / Not Applicable for this patient Triage (Refer to Criteria on Page 8) Pulse: ___/min BP: /__mm Hg Patient sorted into Criteria on Date sPo2: GCS:E VM -foveel201__ ot Time by Primary Survey & Resuscitation done by AVPU (Alert Voice Pain Unconsciousness) Scale .at_:_ AM/PM, To Look for Findings Do as per Need A| Airway Airway Airway Potent Cheek cervical spine ‘Airway filled with Head Tit/ Chin Lit /Jaw Thrust / fluds or Airway OPA// NPA / Intubation / obstructed Tracheostomy Cervical Spine Cervical spine stable | Check Breathing Cervical spine ‘Apply Philadelphia Collar and Unstable or stoblity | Check Breathing doubtful B [Breathing Breathing, SPO, Spontaneous ireulati and Ventilation Breathing Shack Crcalation ‘Abnormal Breathing | aMBU Giype of Abnormal or Brecthing) No Ventilator Support Spontaneous Breathing ? Ventilation Hemothorax ? Mobile, X Ray, eFast and ICD Pneumothorax ? Cardiac Tamponade ?_| Pericardiocentesis ‘reulati Pulse Pulse? Peripheral Venous Access, Central 7 ——, BP BP? Venous Access, Intra Osseous oatrol ? Access, Venous Cut Down, Blood — Transfusion D [Disobitity: Neurological Status, | LOC CT Brain Plain Consiciousness, Fits Focal Neurological Heodeche Deficit ENT Bleed Power, Reflexes, Weakness, Stiffness | Spine Board, X Ray Spine Sens Impared sensation —_| MRI Spine Abnormal Relexes Exposure = Temperature, Hypothermia Temperature Control & [Peposure Poisons, Trauma Hyperthermia, Poisons _| Washing, detoxification Hidden Injuries Pelvic Binder Pelvic Injuries (Our Endeavour is to Improve the TAEI / ER Cose Sheet. Please give your Suggestions, Additions, Deletions, Medificctions, Clorifications, Copy Editing, Proof Reading ot hitp://www.tasionli moil@toeionline.com by mentioning Page Number.ae Government of Tamilnadu Gy: Department of Health and Family Welfare ~—— ‘Tamilnadu Accident and Emergency Care Initiative (TAEI) Government Chengalpatu Medical College Hospital No Moderate Worst Pain Pain Pain