MIRF REPORT

Request:
Medical/Trauma

Campus:
Vista

Location/Building:
[68]

Date of Incident:
June 9, 2024

Time of Incident:
11:00 AM

Number of Patients for this Incident:
[75]

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

Michael Parizeau, 23, Discover 2-3 Leader

Describe Medical Event:

Patient states he had fallen on a music stand. Upon medical examination, patient has a half inch laceration on patient anterior side of head. Patient laceration is approximately half inch in length and running vertically on the back of head.

Actions Taken by Team Members:
[79]

Number of NCSM Team Members Involved:
[81]

List Name(s) of NCSM Team Members Involved:

Jackson Koehler

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]


If any revisions or updates are needed to be made to this incident, complete the form below.
Please select a valid form