MIRF REPORT

Request:
Fall

Campus:
Vista

Location/Building:
[68]

Date of Incident:
January 12, 2020

Time of Incident:
11:00 AM

Number of Patients for this Incident:
[75]

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

Mackenzie bell 7 March 26
Erica and Joshua bell 816-520-2224

Describe Medical Event:

Pt attempted hand stand and collapsed to her head. No LOC no seizure activity. No signs of trauma.

Actions Taken by Team Members:
[79]

Number of NCSM Team Members Involved:
[81]

List Name(s) of NCSM Team Members Involved:

Jeanie
Adrian

Was medical attention accepted?”:
Yes

Medical attention was refused by (name and relationship to… :
No

Was 911 emergency service called?:
No

Was patient transported via 911 emergency services?:
No

What hospital was victim transported to?:
Palomar

NCS team lead:
[249]


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