58.
HCT (HEMATOCRIT): Report patient's latest hematocrit.
59.
WBC (WHITE BLOOD COUNT): Report patient's latest white blood cell count.
60.
ABG (BLOOD GASES): Report patient's latest blood gas analysis.
61.
Report medications required for patient while en route.
e.g., name of drug,
GENERAL DATA
62.
SI/VSI: State whether patient is seriously ill or very seriously ill or seriously injured or very seriously
injured.
63.
RON/#RON: Report whether patient's condition permits all remaining overnights while en route. If
no, report number of RON's permitted.
64.
EN ROUTE STOPS /#STOPS: Report whether patient's condition permits all en route stops. If no,
report the number of stops permitted.
65.
ALTITUDE RESTRICTION/MAXIMUM HEIGHT: Report whether patient's condition restricts
altitude
while en route and if so, maximum allowable altitude.
66.
CONDITION: Report patient's state of consciousness, e.g., comatose, etc.
SPECIAL EQUIPMENT
67.
OXYGEN/LPM: Report whether patient requires oxygen en route and if so, state flow requirements
in liters per minute.
68.
SUCTION: Report patient's requirement for suction while en route.
69.
NG/TUBE: Report patient's nasogastic tube requirements.
70. RESPIRATOR/TYPE: Report patient's requirement for respirator while en route. If
respirator is required, report type.
71.
FOLEY: Report whether Foley catheter is in place.
72.
STRYKER: Report whether patient requires Stryker frame while en route.
73.
TRACTION/LBS: Report patient's requirement for traction while en route. If traction is required,
report number of pounds.
74.
IMED: Report whether IMED is required.
75.
MONITOR: Report if patient requires monitor en route.
76.
INCUBATOR: Report patient's requirement for incubator.
Table 3-2. Telephone reporting format (continued).
MD0752
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