MIRF REPORT ENTRIES | North Coast Safety

MIRF REPORT

Request:

Campus:
Vista

Location/Building:
[68]

Date of Incident:
December 12, 1976

Time of Incident:
3:48 AM

Number of Patients for this Incident:
[75]

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

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Describe Medical Event:

Actions Taken by Team Members:
[79]

Number of NCSM Team Members Involved:
[81]

List Name(s) of NCSM Team Members Involved:

Was medical attention accepted?”:

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

Was 911 emergency service called?:

Was patient transported via 911 emergency services?:

What hospital was victim transported to?:
Palomar

NCS team lead:
[249]

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