MIRF REPORT

Request:
Fall

Campus:
Vista

Location/Building:
[68]

Date of Incident:
March 24, 2023

Time of Incident:
7:01 PM

Number of Patients for this Incident:
[75]

List Patient(s) Name, Age, Parent/Guardian (if under 18),… :

Savannah Beth 12 yrs

Describe Medical Event:

Fell running in plaza. Minor abrasion right knee with no defecits. Able to ambulate without pain.

Actions Taken by Team Members:
[79]

Number of NCSM Team Members Involved:
[81]

List Name(s) of NCSM Team Members Involved:

Jeani
Rich
Kim

Was medical attention accepted?”:
Yes

Medical attention was refused by (name and relationship to… :

Was 911 emergency service called?:
No

Was patient transported via 911 emergency services?:
No

What hospital was victim transported to?:

NCS team lead:
[249]


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