MIRF REPORT
Request:
Fall
Campus:
Vista
Location/Building:
[68]
Date of Incident:
April 27, 2025
Time of Incident:
12:05 PM
Number of Patients for this Incident:
[75]
List Patient(s) Name, Age, Parent/Guardian (if under 18),… :
Grit Adams
Parent/ Mom: Cheyenne Adams
Describe Medical Event:
Fell backwards running on concrete indoors and hit back of the head right side scalp area, no redness, skin intact, no swelling or bumps, no pain on head or sacrum, or back, pupils equally reactive to light. V/S stable BP 110/70 , heart rate 68 bpm, O2 saturation 98% room air , respiration 18. Child’s mom with him the whole time.
Actions Taken by Team Members:
[79]
Number of NCSM Team Members Involved:
[81]
List Name(s) of NCSM Team Members Involved:
Marcela & Ela
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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