MIRF REPORT
Request:
Epistaxis (non traumatic)
Campus:
Carlsbad
Location/Building:
[68]
Date of Incident:
July 11, 2024
Time of Incident:
6:40 PM
Number of Patients for this Incident:
[75]
List Patient(s) Name, Age, Parent/Guardian (if under 18),… :
Conor Daugherty, 13 y/o
Katherine Daugherty (951) 760-9888
Describe Medical Event:
Epistaxis due to nasal dryness
Actions Taken by Team Members:
[79]
Number of NCSM Team Members Involved:
[81]
List Name(s) of NCSM Team Members Involved:
Scott Johnson
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