BSI 0001
PROTOCOLO SALIDA DE AMBULANCIA PARA BRIGADISTA RESPONSABLE1.
Brigadista
responsable:____________________________________________________________2.
Paciente:________________________________________________________
Edad: ___________3.
Acompaante:______________________________________________No. De
Telfono: ____________4. Diagnostico del medico de
planta:_____________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________5.
Control de signos vitales durante el
traslado:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________________6.
Nombre del medico que
recibe:______________________________________________________7.
Diagnostico del medico que
recibe:________________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
8. Insumos utilizados en
traslado:________________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
9. Observaciones:
_________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Firma:
_____________________________Fecha:
_____________________________
