PREHOSPITAL DRUG AND IV BOX INCIDENT REPORT
INSTRUCTIONS
WHAT TO REPORT: Any perceived problem that could adversely affect pre-hospital care; any incident having occurred that represents a deviation from established policy or procedure; any infection control hazard; any unusual occurrence, regardless of whether harm or damage resulted.
WHO REPORTS: - Any individual ALS technician or ALS Agency representative.
- Representatives of hospital Emergency rooms.
- Representatives of hospital pharmacies.
- TEMS staff members
WHEN TO REPORT: An incident report should be generated as soon as a potential problem has been discovered or an incident has occurred. Reports should be forwarded to the TEMS office as soon as possible.
HOW TO REPORT: TEMS Drug/IV Box Incident On-line Form