P.S.n...................................
SCHEDA TRIAGE
ROSSO |
GIALLO |
VERDE |
BIANCO |
AZZURRO |
| Cognome............................................................ |
Nome............................................................... |
Età......... |
GRANDI TRAUMI
|
PICCOLI TRAUMI |
- Autosufficiente
- In carrozzina
- In barella
|
PRESENZA MEZZO DI SOCC.
AVANZATO
NO
SI
Sigla
Codice
|
Specialista
competente
.
..
radio h
; h
..;
risposta h
; 1°visita h
. |
CAUSA DICHIARATA al momento dellaccettazione
........................................................................................................................
........................................................................................................................................................................................................................
PARAMETRI
VITALI
F.C
Ritmica
Aritmica
F.R
T.C.:
.
SAT. OSS
MUCOSE
. |
STATO DI
COSCIENZA
Lucido,
orientato
Amnesia
retrograda
Confuso
Amnesia
Coma |
PATOLOGIE CONCOMITANTI
|
ALLERGIE |
VALUTAZIONE INFERMIERISTICA
ALLACCETTAZIONE____________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________ |
PROVVEDIMENTI ADOTTATI__________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________ |
Firma I.P............................................................
Rivalutazioni
h
Codice
..Firma
I.P
.
Rivalutazioni
h
...Codice
. Firma
I.P
..
Esito visita medica____________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________ |
Terapia____________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________ |
Tempo di permanenza in P.S.
____________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________ |
|