MIRF REPORT

Request:
Medical

Campus:
San Marcos/Escondido

Location/Building:
[68]

Date of Incident:
October 16, 2022

Time of Incident:
9:36 AM

Number of Patients for this Incident:
[75]

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

Sully Collins (male)
10 years old

Tamar (mom)
760-533-8128

Describe Medical Event:

-Playing a game in classroom 4/5 called “steal the bacon”
-Hit his head on the ground twice in rapid succession
-Head hurts, was a little dizzy

Actions Taken by Team Members:
[79]

Number of NCSM Team Members Involved:
[81]

List Name(s) of NCSM Team Members Involved:

Aaron Via (medical)
Steve Harvey

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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