Common EMS/Ambulance Flowchart Note Examples

Flowchart Notes is a flexible tool to capture relevant chronological information within a patient channel. This feature allows adding Notes that can be entirely free form or based on pre-defined templates containing prompts for common treatment questions. Every entry is logged with a timestamp and the name of the entity who added the note, enhancing tracing and accountability.

For information on how to add a Flowchart Note template in Pulsara MANAGER see How to Create Flowchart Notes Templates in MANAGER

Flowchart notes and flowchart note templates are designed to save your team valuable time during critical care emergencies. With just the tap of a button, you can communicate vital information across the entire care team. 

*This is not a comprehensive list and you should create your Flowchart Note templates from input from your teams and Hospital partners.  These are a few examples for your team to use.* 

STEMI

Template Title

Alert Text

Body Text

MED - ASA 324 mg (PO)

Aspirin 324 mg (PO) Administered

Aspirin 324 mg (PO)

MED - IV Bolus

IV Bolus

Administered ( ) ml ( ) L

MED - Nitroglycerin (SL)

Nitroglycerin (SL) Administered

Dose:         Route:

PROCEDURE - Defibrillation

Defibrillation Delivered

Joules ( ) Result ( )

PROCEDURE - Vascular Access

Vascular Access

Attempts ( ) Location ( ) Size ( )

 

Stroke

Template Title

Alert Text

Body Text

PROCEDURE - Airway Mgt

Airway Mgt

BVM ( ) OPA ( ) NPA ( ) King ( ) iGEl ( ) Intubation ( )

PROCEDURE - Vascular Access

Vascular Access

Attempts ( ) Location ( ) Size ( )

 

Cardiac Arrest

Template Title

Alert Text

Body Text

EKG - Initial Rhythm

EKG - Initial Rhythm

Initial Rhythm:

MED - Amiodarone (IV/IO)

Amiodarone (IV/IO) Administered

Dose:         Route:

MED - Atropine (IV/IO)

Atropine (IV/IO) Administered

Dose:         Route:

MED - Bicarbonate (IV/IO)

Bicarbonate (IV/IO) Administered

Dose:         Route:

MED - Calcium Chloride (IV/IO)

Calcium Chloride (IV/IO) Admin

Dose:         Route:

MED - Epinephrine (IV/IO)

Epinephrine (IV/IO) Administered

Dose:         Route:

MED - IV Bolus

IV Bolus

Administered ( ) ml ( ) L

MED - Lidocaine (IV/IO)

Lidocaine (IV/IO) Administered

Dose:         Route:

MED - Magnesium Sulfate

Magnesium Sulfate (IV/IO) Admin

Dose:         Route:

PROCEDURE - Airway Mgt

Airway Mgt

BVM ( ) OPA ( ) NPA ( ) King ( ) iGEl ( ) Intubation ( )

PROCEDURE - Defibrillation

Defibrillation Delivered

Joules ( ) Result ( )

PROCEDURE - Vascular Access

Vascular Access

Attempts ( ) Location ( ) Size ( )

 

Sepsis

Template Title

Alert Text

Body Text

CRITERIA - Sepsis Protocol

Sepsis Criteria Met

Adult: SBP <90 ( ) RR>22 ( ) HR>90 ( ) Temp >38C or <36C: ( ) SaO2 <92% ( ) GCS ( ) 

MED - IV Bolus COMPLETE

IV Bolus 30 ml/kg COMPLETE

Administered ( ) ml ( ) L

MED - IV Bolus INITIATED

IV Bolus 30 ml/kg INITIATED

Administered ( ) ml ( ) L

PROCEDURE - Vascular Access

Vascular Access

Attempts ( ) Location ( ) Size ( )

 

Trauma

Template Title

Alert Text

Body Text

ASSESSMENT - AVPU

AVPU

Alert ( ) Verbal ( ) Pain ( ) Unresponsive ( )

PROCEDURE - Airway 

Airway Mgt

BVM ( ) OPA ( ) NPA ( ) King ( ) iGEl ( ) Intubation ( )

PROCEDURE - Vascular 

Vascular Access

Attempts ( ) Location ( ) Size ( )

CRITERIA - Trauma (Step 1)

Trauma - Physiologic Criteria

DOCUMENT ONE OR MORE CRITERIA


( ) GCS - Less than or equal to 13


( ) SBP - Less than or equal to 90


( ) RR Less than 10 or greater than 29/min

( ) RR Less than 20 for Pediatrics less than 1 year

CRITERIA - Trauma (Step 2)

Trauma - Anatomic Criteria

DOCUMENT ONE OR MORE CRITERIA


PENETRATING INJURY:

( ) Head

( ) Neck

( ) Chest/Torso

( ) Above Elbow - Proximal Extremities

( ) Above Knee - Proximal Extremities


CHEST WALL INJURY

( ) Instability

( ) Deformity


TWO or MORE PROXIMAL LONG BONE FRACTURES

( # ) Humerus/Upper Arm - Proximal

( # ) Femur/Upper Leg - Proximal


SEVERE EXTREMITY INJURY

( ) Crushed Extremity

( ) Degloved Extremity

( ) Mangled Extremity

( ) Pulseless Extremity


PROXIMAL AMPUTATION

( ) Above the Wrist

( ) Above the Ankle


PELVIC INJURY

( ) Pelvic Fractures


SKULL INJURY

( ) Open Skull Fracture

( ) Depressed Skull Fracture


SPINAL TRAUMA

( ) Paralysis

CRITERIA - Trauma (Step 3)

Trauma - Mechanism of Injury Criteria

DOCUMENT ONE OR MORE CRITERIA


FALLS

( ) Adults: >20 feet

( ) Children: >10 feet

( ) Children: 2 or 3 Times the Height of the Child


HIGH-RISK AUTO CRASHES

( ) Intrusion - Including Roof: >12" Occupant Site; >18" Any Site

( ) Ejection from Automobile -Partial or Complete

( ) Death in Same Passenger Compartment

( ) Vehicle Telemetry Data Consistent with a High Risk of Injury


PEDESTRIAN/BICYCLIST

( ) Auto vs. Pedestrian

( ) Auto vs. Bicyclist Thrown

( ) Run Over

( ) Significant (>20 mph) Impact


MOTORCYCLE

( ) Motorcycle Crash >20 mph

CRITERIA - Trauma (Step 4)

Trauma - Special Considerations Criteria

DOCUMENT ONE OR MORE CRITERIA


OLDER ADULT

( ) Age 55+ Risk of Injury/Death Increases

( ) Age 65+ with SBP less than 110

( ) Low Impact Mechanisms (e.g. Ground Level Falls) May Result in Severe Injury


CHILDREN

( ) Should be Triaged Preferentially to Pediatric Capable Trauma Centers


ANTICOAGULANTS & BLEEDING DISORDERS

( ) Patients with Head Injury are at High Risk for Rapid Deterioration


BURNS

( ) Without Other Trauma Mechanism: Triage to Burn Facility

( ) With Trauma Mechanism: Triage to Trauma Center


PREGNANCY

( ) Greater Than 20 Weeks Pregnant


EMS JUDGEMENT

( ) Provider Judgment

 

General

Template Title

Alert Text

Body Text

ASSESSMENT - AVPU

AVPU

Alert ( ) Verbal ( ) Pain ( ) Unresponsive ( )

BELONGINGS - left with family

Belongings left with family

 

BELONGINGS - with patient

Belongings with patient

 

PRECAUTION - (Airborne): TB /Chicken Pox / Measles

AIRBORNE PRECAUTION: TB /Chicken Pox / Measles

 

PRECAUTION - (Special Respiratory) SARS / MERS / COVID

RESPIRATORY PRECAUTION: SARS / MERS / COVID

 

PROCEDURE - Airway Mgt

Airway Mgt

BVM ( ) OPA ( ) NPA ( ) King ( ) iGEl ( ) Intubation ( )

PROCEDURE - Vascular Access

Vascular Access

Attempts ( ) Location ( ) Size ( )

PROCEDURE - Restraints

Restraints

Physical ( ) MED ( )

PROCEDURE- CPAP

CPAP Applied

 

 

For more information on how to use Flowchart Notes in Pulsara MOBILE, 
check out this guide