MEDS 3.8 Software User Guide

American Medical Response
Multi Emergency Medical Services Data System (MEDS)

User Guide Release 3.8
Contents
About This Guide ............................................................................................................................ 1 Overview ..................................................................................................................................... 1 MEDS Installation .................................................................................................................. 1 MEDS Users ........................................................................................................................... 2 Intended Audience .................................................................................................................. 2 Issue Date and Change History ............................................................................................... 2 How to Use This Document .................................................................................................... 2 Document Organization .......................................................................................................... 3 Conventions Used ................................................................................................................... 3 Typographic Conventions ................................................................................................... 3 Symbolic Conventions ........................................................................................................ 3 Compatible Computer Aided Dispatch Software .................................................................... 4 Compatible Devices ................................................................................................................ 4 Computer Devices ............................................................................................................... 4 Defibrillation Devices ......................................................................................................... 4 Related Documentation ........................................................................................................... 4 General Dynamics Intronix devices: ................................................................................... 4 Motion Computing devices: ................................................................................................ 5 Introduction ..................................................................................................................................... 6 Multi-EMS Data System ............................................................................................................. 6 Multi-EMS Data System Terminology ....................................................................................... 6 Using MEDS on a Computer Device .......................................................................................... 8 Logon .............................................................................................................................................. 9 Introduction ................................................................................................................................. 9 Logging on .................................................................................................................................. 9 Login to MEDS: ................................................................................................................ 10 Navigating MEDS ......................................................................................................................11 Using the Home Menu ...........................................................................................................11 Using the Main Menu ............................................................................................................11
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Incidents ........................................................................................................................................ 14 Introduction ............................................................................................................................... 14 Working with Incidents ............................................................................................................. 14 Incidents and Patient Care Reports ........................................................................................... 14 Incidents ................................................................................................................................ 14 Patient Care Reports ............................................................................................................. 14 The Incidents Menu .................................................................................................................. 15 The Incidents Categories....................................................................................................... 16 Create New PCR ............................................................................................................... 16 Show Recent Calls ............................................................................................................ 16 Refresh CAD Calls ........................................................................................................... 16 New Patient Care Report ...................................................................................................... 17 Creating a New Patient Care Report: ................................................................................ 17 Creating a New Incidents ...................................................................................................... 18 CAD Incidents .................................................................................................................. 18 Non-CAD Incidents .......................................................................................................... 18 Creating a New Incident: .................................................................................................. 18 Updating Incidents from the CAD: ................................................................................... 21 Patient Care Reports ..................................................................................................................... 22 Introduction ............................................................................................................................... 22 Working with Patient Care Reports .......................................................................................... 22 Patient Care Reports and Incidents ........................................................................................... 22 Patient Care Reports ............................................................................................................. 22 Incidents ................................................................................................................................ 22 The PCR Menu ......................................................................................................................... 23 The Patient Care Report Categories ...................................................................................... 24 Edit .................................................................................................................................... 24 Verify................................................................................................................................. 25 Reports .............................................................................................................................. 25 Transmit ............................................................................................................................ 25 Park ................................................................................................................................... 25
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Delete ................................................................................................................................ 25 Import Responders PCR .................................................................................................. 25 Update CAD Data ............................................................................................................. 25 Find ................................................................................................................................... 25 Status ................................................................................................................................. 25 Creating a Patient Care Report ................................................................................................. 26 Documenting a Patient Care Report using Type of Call Templates ...................................... 26 Entering Type of Call data: ............................................................................................... 26 Entering Crew data: .......................................................................................................... 27 Entering Incident Times data: ........................................................................................... 28 Entering Pickup Location data: ......................................................................................... 29 Entering Reason of Call data: ........................................................................................... 30 Entering Other Responders data: ...................................................................................... 35 Entering Disposition data:................................................................................................. 30 Entering Destination data:................................................................................................. 32 Entering Mileage data: ...................................................................................................... 33 Entering Other Unit Transporting data: ............................................................................ 34 The Patient Menu .................................................................................................................. 35 Entering Patient data: ........................................................................................................ 36 Entering Mailing Address data: ........................................................................................ 38 Entering Guarantor data: ................................................................................................... 38 Entering Insurance data: ................................................................................................... 39 Entering Work Injury data: ............................................................................................... 40 The Subjective and SOAP Menus ......................................................................................... 41 Entering the Type of Injury or Illness data: ...................................................................... 41 Entering the Chief Complaint data: .................................................................................. 42 Entering Secondary Complaint data: ................................................................................ 43 Entering Other Complaints data: ...................................................................................... 43 Entering OB/GYN data: .................................................................................................... 43 Editing Physician data: ..................................................................................................... 45 Editing Medical History data: ........................................................................................... 45
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Editing Patient Medication data: ....................................................................................... 46 Entering the Cause of Injury data: .................................................................................... 47 The Objective Menu ............................................................................................................. 48 Entering Physical Exam data: ........................................................................................... 48 Entering the Contributing Factors data: ............................................................................ 50 Entering Safety Equipment data: ...................................................................................... 50 Entering Environmental Factors data: .............................................................................. 51 Entering Delivery of Care data: ........................................................................................ 51 Entering Trauma Triage data:............................................................................................ 51 The Assessment Menu .......................................................................................................... 52 Entering Cardiac Arrest data: ............................................................................................ 54 The Plan and SOAP Menus .................................................................................................. 57 Entering Treatment and Response (Tr & Rx) data:........................................................... 57 Entering Monitor (Defibrillation) data: ............................................................................ 58 Entering Supplies data: ..................................................................................................... 60 Entering Narrative data: .................................................................................................... 63 Entering Refuse Service data: ........................................................................................... 64 The Signatures Menu ............................................................................................................ 65 Entering Patient Signatures: .............................................................................................. 66 Entering Assignment of Benefits Representative Signature: ............................................ 66 Entering the Facility Signature: ........................................................................................ 67 The Attachments Menu ......................................................................................................... 67 Creating Attachments: ....................................................................................................... 67 Creating Addenda: ............................................................................................................ 68 Editing the Patient Care Report ................................................................................................ 69 Using the Edit Button: ...................................................................................................... 69 Verifying the Patient Care Report ............................................................................................. 70 To Verify a PCR: ............................................................................................................... 70 Using MEDS Reports ............................................................................................................... 71 Transmitting and Parking Patient Care Reports ........................................................................ 73 To Transmit a PCR: ........................................................................................................... 73
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To Park a PCR:.................................................................................................................. 75 Deleting a Patient Care Report ................................................................................................. 75 To Delete a PCR: .............................................................................................................. 75 Importing Responders Patient Care Report ............................................................................. 76 To Import a PCR: .............................................................................................................. 76 Finding a Patient Care Report ................................................................................................... 76 To Find a PCR:.................................................................................................................. 76 Verifying the Status of a Patient Care Report ........................................................................... 77 To Verify the PCR Status: ................................................................................................. 77 Appendix A ................................................................................................................................... 78
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About This Guide

Overview
Multi-EMS Data System (MEDS) is installed on tablet or laptop computers in ambulances and caregiver vehicles. MEDS captures the same information that is gathered on a typical paper patient care report (PCR) electronically. MEDS enables caregivers to collect, store, and transmit data quickly and efficiently. MEDS proprietary software integrates computer-aided dispatch (CAD) information and patient information in order to: Capture transport, as well as, patient clinical and demographic data and uses it to provide consistent and efficient medical documentation. Store patient data and keep it secure. Due to privacy laws, it is important that information about patients be kept confidential. MEDS ensures that only authorized users have the capability of entering, modifying, viewing, and transmitting data. Extract pertinent data for billing purposes. MEDS provides caregivers with assessment, medication, and procedure lists, making it easier to input standardized data. As a result, this ensures that billing is performed more accurately. Provide access to pre-programmed and customizable reports. Various users have different reasons for requiring MEDS data in report format. For example, clinicians may want to review data to ensure that certain protocols are performed correctly. Supervisors may use reports to provide additional training to caregivers. Enable automatic notification of site-defined events to appropriate departments and agencies in the event of an unusual occurrence or death. For example, one operational area may want to be notified in the event of a teen suicide. MEDS can provide these notifications automatically.
MEDS Installation
MEDS technology is comprised of hardware and software used to collect, store, summarize, secure, and transmit data. MEDS may include any or all of the following components: Installed software on rugged tablet or laptop computers in every ambulance. Air cards enable wireless capability, and charging units in the vehicles ensure that the equipment is ready when needed. Defibrillator cables to connect the defibrillator device to the MEDS device. Scanners to scan trailing documents. For example, ID cards, hospital face sheets, etc.
Printers to print reports and hard copies of PCRs. Interfaces, or connections, between MEDS and computer-aided dispatch (CAD) systems, billing systems, and EMS agency databases. A web-based reconciliation interface ensures that there is a PCR generated for every CAD record. Data file extracts to support national and state reporting requirements.
MEDS Users
MEDS users are referred to as caregivers and include the following: Caregivers and other responders that transfer or treat patients. Support personnel install and test MEDS, respond to technical problems, and act as liaisons to the software development team. AMR Operations and Clinical Education Services (CES) personnel provide MEDS training and perform audits. AMR Patient Business Services (PBS) personnel are responsible for using MEDS data to properly bill insurance companies and responsible parties for service rendered. Emergency medical service (EMS) agencies that must be notified if certain events specified in the business rules occur.
Intended Audience
This document is intended for caregivers, including paramedics and emergency medical technicians (EMT). This document is also intended for local fire department first responders. This document is not intended to be a technical reference for the computer device, a medical emergency, or a technical administrative guide.
Issue Date and Change History

This is the current version of this document, Issue 7, August 2011 for software release 3.7.
How to Use This Document

This guide is organized to help you find topics in a logical manner. Read it from start to finish for a thorough understanding of how to use the MEDS software. Or, use the Table of Contents or Index to locate information specific to a task or function.
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Document Organization
This guide contains the following sections: Section
Introduction Logon
Summary of Section Describes each element in the MEDS menu ribbon. Also, covers MEDS navigation, applications, and features. Provides instructions for logging on to MEDS and user permissions. Describes how to create a new incident report. Explains how to create a new electronic patient care report (PCR), including selecting the incident type, entering required patient data, and transmitting the PCR. This section also includes finding an existing PCR, editing data, and verifying the PCR. Provides an overview of PCR menu and subsequent category menus.
Incidents Patient Care Reports
Appendix A
Conventions Used
This guide uses the following textual, typographic, and symbolic, conventions to help you interpret information. Typographic Conventions Bold type indicates information to enter in a data field. Symbolic Conventions NOTE: Notes include helpful information to consider when using MEDS. IMPORTANT: Important notes include information you must consider when using MEDS.
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Compatible Computer Aided Dispatch Software

The MEDS application is compatible with the following computer aided dispatch (CAD) software systems: Tritech Software Systems VisiNet Command Enroute Emergency Systems Enroute Fire/EMS CAD Zoll RescueNet Dispatch Intergraph I/CAD Tiburon CommandCAD JefBar Software Services AMBPAC
Compatible Devices
The MEDS application supports the following devices: Computer Devices General Dynamics Itronix 8000 Motion Computing C5v Panasonic Toughbook CF-19 Defibrillation Devices Medtronic LifePak 12 Medtronic LifePak 15 Philips HeartStart MRx Zoll E Series
Related Documentation
For additional information regarding your computer device, use the following links: General Dynamics Intronix devices: http://www.gd-itronix.com/
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Motion Computing devices: http://www.motioncomputing.com/ Panasonic Toughbook devices: http://www.panasonic.com/
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Introduction
This chapter introduces you to the MEDS software. It provides a sample of function buttons and other software characteristics, briefly describes each MEDS application, and provides basic instructions for navigating MEDS screens.
Multi-EMS Data System

The Multi-EMS Data System (MEDS) software is installed on mobile computer devices in emergency medical vehicles. MEDS integrates computer-aided dispatch (CAD) information with caregiver information to expedite patient data collection. MEDS provides caregivers with an ease-of-use solution to create, edit, and transmit electronic patient care reports (PCR). Each electronic PCR captures the same information typically found on a traditional paper PCR. MEDS allows caregivers to gather additional patient data, store information on a secure server, and transmit the data quickly and efficiently. MEDS assists caregivers with accurately documenting patient care with Type of Call templates and patient care wizards. The patient care wizards prompt caregivers to document the most commonly used procedures and medications for a selected impression. MEDS provides caregivers with standardized drop-down lists, such as medical supplies and medication, which allow caregivers to input standardized information and ensures that billing is performed more accurately. MEDS also includes an electronic version of many forms.
Multi-EMS Data System Terminology

MEDS uses terminology that caregivers may be familiar with; however, other terms are MEDS specific. Following is a list of terms used in MEDS: MEDS Term Caregiver Definition Any medical professional that provides patient care, such as paramedics, emergency medical technicians (EMT), and registered nurses. The CAD is a dispatch system that is connected to MEDS in a defined geographical area. CAD provides incident information including, caller name, reason unit was dispatched; time the call was received, etc. When MEDS and CAD are linked, CAD can prepopulate patient information and dispatch fields. MEDS provides caregivers with an ease-of-use solution to create, edit, and transmit electronic patient care reports (ePCR). Each PCR captures the same
Computer-aided dispatch (CAD)
Electronic Patient Care Report (ePCR)
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MEDS Term
Definition information typically found on a traditional paper PCR. For the purposes of this document, PCR refers to ePCRs. If a PCR cannot be completed and transmitted at the end of an incident, the caregiver can park, or save, the PCR to the MEDS server. This allows the caregiver to pull the PCR back to any tablet or PC to complete and transmit. P - Provoked: What provoked the SOB? A - Associated: Is there associate chest pain? S - Sputum: Is there sputum production and color? T - Talking: Is the patient speaking in full sentences or only able to get 1to2 words out? E - Exercise: What is the patients exercise tolerance? P - Provoked : What started the pain? Q - Quality : What does the pain feel like? R - Radiation : Does the pain move anywhere? S - Severity : Using 1to10 scale, how bad is the pain? T - Time : How long have you had the pain?
Park
PASTE
PQRST
MEDS uses icons that caregivers may be familiar with; however, other icons are MEDS specific. Following is a list of icons used in MEDS: Icon Description The MEDS Home Menu button is displayed in the upper-left corner of the application. The Home Menu is used to return to the MEDS Main Menu (Incidents, PCR, and Messages). You can also use this button to display the About MEDS screen and view the release notes, download the All-D lists, exit the application, select the default theme, and configure a new device. You can customize the quick access toolbar by selecting the down arrow next to the home menu button. You can show the arrow above or below menu ribbon. You can also minimize or expand the menu ribbon. The blue caption bubble displays in data fields. This bubble accommodates data that is larger than the field allows. When the data field contains more data, the field will display an ellipse () indicating that there is more data in the field than is displayed.
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The look-up button is used to retrieve patient information. If this icon appears on an address field and is selected, the field is populated with the incident address. If this icon appears on a phone number field, MEDS performs a reverse phone look-up. If the look-up information is correct, the caregiver can accept the information. The blue-flag icon in a data field indicates that entering data in the field is highly recommended. The green-flag icon in the PCR list indicates that a PCR exists for the selected Incidents.
The red-flag icon in a data field indicates that entering data in the field is required to complete, print, or transmit the PCR.
Using MEDS on a Computer Device

Various agencies and medical professionals have different reasons for using MEDS on mobile computer devices. Some of these reasons include: Increased mobility, accessibility, and productivity all of which can lead to higher patient satisfaction Increased efficiency by enabling faster patient transfer between the different stages of care Ability to document at the point of care Mobile computer devices include tablet PCs and laptop computers that enable caregivers and first responders to carry and access up-to-the-minute patient data at the point of care. Using a mobile computer device saves time, reduces errors, and ensures that the most up-to-date patient data is available to ensure that the patient receives optimal care at the scene, in the ambulance, and as the caregivers transfer the patient to the hospital, or other medical facility. Depending on the MEDS device, you can input or select data by using an attached standard keyboard and mouse, using the devices stylus pen, or by touching the device screen. These configurations allow screen navigation and data input to be fast and simple.
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Logon
Introduction
This section describes the MEDS logon procedure and defines the logon identities.
Logging on
MEDS provides three logon identities. Your logon identity is determined by your user level and necessary privileges. Following are the three logon identities: Log on Identity Supervisor Privileges The supervisor logon identity has special privileges to access MEDS. Supervisor logon allows you to see all PCRs created on the device, regardless of who created them. You can transmit completed and successfully verified PCRs that have not been transmitted, as well as delete PCRs that have been transmitted. The supervisor logon cannot create, edit, or complete a PCR created by another user on that device. NOTE: To create a PCR, you must logon as a regular user. In MEDS 3, the supervisor identity does not have administrative privileges and cannot change or reset logon passwords. If necessary, ask your MEDS administrator to reset your password. Regular Regular logon allows you to create, edit, find, and transmit PCRs. You can also find and retrieve PCRs that you have created under your logon from the server. However, you can only see PCRs that you have created on that device. Trainee Trainee logon allows you to create, edit, and transmit PCRs in a secure training environment. This ensures hands-on learning using PCRs that are not processed by the company billing system.
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Login to MEDS: 1. Select the MEDS icon to launch the application. The login screen displays. 2. The Login screen includes the option to select the input mode. The input mode options include touch or keyboard. The touch mode allows caregivers to enter patient data using the MEDS device touch screen. The keyboard mode allows caregivers to use the device keyboard, or attach an external keyboard and mouse to enter patient data.
3. Select the Input Mode. You can change the input mode at any time prior to logging in. To change the input mode after login, exit MEDS and re-launch the application. 4. Verify that the correct county displays. If the county is incorrect, select the County field and select the correct county from the list. 5. Select the Unit for your current shift. It is important that you enter the unit information that corresponds with the shift you are currently working. The unit may change as you move from shift to shift. 6. Enter you User Name and Password. 7. Select Login. 8. The MEDS Main Menu displays.
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Navigating MEDS
Once the MEDS Main Menu displays, the Home menu is accessible and the following category menus are available: Incidents, PCR, and Messages. Each menu displays the available functionality. The following figures include the home menu, main menu, and menu category options in touch and keyboard modes.
Home menu Main menu Menu category
Figure 1: Touch Mode, Main Menu with categories Home menu Main menu Menu category
Figure 2: Keyboard Mode, Main Menu with categories
Using the Home Menu

The MEDS Home Menu includes various administrative settings. It is not recommended that the caregiver modify the settings included on the MEDS Home Menu. IMPORTANT: Always check with your local IT technician prior to modifying any settings on the MEDS Home Menu.
Using the Main Menu

The MEDS Main Menu includes the primary menu and categories to create a PCR. Table 1 includes the main menu options and descriptions.
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Table 1: Main Menu Descriptions
Menu Incidents
Description Use this menu to enter or update incident information, including case number, time, date, and location. You can also use this menu to create a PCR. Use this menu to edit or update an existing PCR. You can verify, transmit, and delete. You can also check the status of a PCR. Use this menu to retrieve MEDS Mail messages from Operations, PBS, CES, and IT. MEDS Mail is readonly. Caregivers cannot reply to messages.
PCR
Messages
Each MEDS category displays the data fields and selection tabs used to create a PCR. After entering data successfully into MEDS, the cursor automatically moves to the next field. If the information is not accepted, an error message displays. You must correct the error before you can move to subsequent fields. Once you have completed the last field on the screen, MEDS automatically displays the next category and data fields. MEDS caregivers are presented with various ways to enter the required patient information. At times, the required information may be in the form of a drop-down list, button to select, or to enter data using the alpha keypad, or keyboard. Caregivers may select the input mode they desire. At log logon, caregivers can select Touch Mode or Keyboard Mode.
Figure 3: Touch mode icon
Figure 4: Keyboard mode icon
The touch mode allows caregivers to enter patient data using the MEDS device touch screen. The keyboard mode allows caregivers to use the device keyboard, or attach an external keyboard and mouse to enter patient data. Table 1Table 2 includes the shortcut keys available in keyboard mode.
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Table 2: Shortcut Keys in Keyboard Mode
Keyboard Action Tab
Shortcut Keys Moves forward to the next data field. Use the Tab key to highlight an Incident or PCR to select, to move through the horizontal categories. Moves backward to the previous data field. When data field is highlighted orange and the input area is blue, this key combination enters the current date or time. This key combination represents the Now function. When using the Alt key, you can display the shortcut keys for the current menu. For example, on the main menu select Alt. The shortcut key F, S, I, P, M display. Select M and the Message screen displays. Use the right and left arrows to move from one data field to the next. Combine the Tab or Enter keys with an arrow key to select the data field. Use the up and down arrows to move from one data field to the next. Combine the Tab or Enter keys with an arrow key to select the data field. Use the down arrow to move from the main menu to the categories.
Shift +Tab Shift+
Alt
Right and Left Arrows Arrows + Tab or Enter
Up and Down Arrow Arrows + Tab or Enter
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Incidents
Introduction
The Incidents menu includes menu category buttons to create a new patient care report (PCR), get recent calls, show call history, refresh computer aided dispatch (CAD) calls, and to create a new incident.
Working with Incidents

When creating an incident in an operational area that is connected to a CAD system, fields within the Incidents screen will automatically populate with incident information. For example, the CAD can populate data, such as, the case number, the incident date and location, and dispatch times. When working with incidents in an area that is not connected to a CAD interface or the interface is temporarily unavailable, the caregiver must manually enter incident information. MEDS automatically saves the incident data received from the CAD or entered manually.
Incidents and Patient Care Reports

MEDS includes menus for both Incidents and Patient Care Reports (PCR). In order for caregivers to take full advantage of MEDS, you must understand the characteristics of Incidents and PCRs.
Incidents
The Incident menu collects dispatch information pertaining to emergency and non-emergency calls. An incident must be created by the CAD or the caregiver before a PCR can be generated.
Patient Care Reports

The Patient Care Reports (PCR) menu collects information pertaining primarily to the patient. An Incident must be created by the CAD or the caregiver before a PCR can be generated.
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The Incidents Menu

The Incidents menu is available from the MEDS main menu. Incidents are displayed based on the unit number used during logon. If Incidents are not displayed as expected, verify the unit number selected during logon. Select the Incidents menu to display the recent calls received by your unit. The Incidents list displays. The highlighted row indicates the selected incident.
Input mode indicator
Table update indicator
Table 3
describes the fields in the Incidents list.
Table 3 Incidents List Descriptions
Column Stylus pen Case Number PCR Exists Unit Number (#) Incident Date
Description Select the stylus pen to modify the current case number. The case number is assigned by the CAD or dispatch for an incident. The green flag indicates that a PCR already exists in MEDS. Select the PCR menu to open this PCR. The unit number dictates the current Incidents for the unit currently logged in to MEDS. The date of the incident.
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Incident Address Table Update Indicator
The address or location of the incident. Select the look-up table indicator icon to download the most current MEDS look-up tables. Keeping your MEDS application look-tables up-to-date allows caregivers to accurately document PCRs.
From the Incidents list, select a row to perform a task, or select a category button from the menu to perform another function.
The Incidents Categories

Use the Incidents categories to create a new PCR, update recent emergency and historical calls, refresh CAD calls, and create a new incident report.
Create New PCR To create a new PCR, there must be a corresponding incident created in the Incidents list. If the incident was CAD generated, the PCR is populated with CAD information. Confirm the information provided by the CAD and, edit or complete blank fields as necessary. For more information regarding PCRs, go to Patient Care Reports. Show Recent Calls Recent CAD Calls refer to the maximum number of calls, or incidents, that display in the incidents list. MEDS is configured to display a maximum of 10 recent incidents. NOTE: It is recommended that you check for recent calls frequently to keep your system up-to-date. It is also recommended that you create PCRs during or soon after completing patient care how History Calls Show History Calls to displays all incidents received during the caregivers shift. MEDS is configured to display a maximum of 30 incidents received. Refresh CAD Calls Refresh CAD Calls to ensure that you have the most up-to-date CAD information. The Refresh CAD Calls button updates the entire Incidents list.
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New Patient Care Report

The Patient Care Report (PCR) collects patient data pertaining to the emergency. An incident must be created by the CAD or the caregiver before a PCR can be created. Creating a New Patient Care Report: From the Incidents menu, select the incident that the new PCR will be associated with. The selected incident highlights in orange. IMPORTANT: If the incidents do not display as expected, verify your current unit number. 1. Select Create New PCR. The Create New PCR Confirmation message box displays.
2. Confirm that you are creating a PCR for the correct case number.
3. Click Yes to create the PCR. When you click Yes to create the PCR, MEDS will take you to the PCR Menu to begin documenting patient care. Based on the Type of Call selected, MEDS will display the appropriate patient care template. For more information regarding patient care templates, go to Documenting a Patient Care Report using Type of Call Templates.
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Creating a New Incidents

New Incidents in MEDS are either CAD generated or entered manually by the caregiver. CAD Incidents The CAD can populate incident fields with call-specific information and incidents can be refreshed as new information becomes available. The CAD has the ability to populate the incident data. This is helpful to the caregivers because it simplifies the amount of information that must be populated on the dispatch screen in the PCR. This is particularly helpful when creating multiple PCRs for the same incident. If multiple PCRs are required for one incident, each PCR will be populated with the incident information on the dispatch screens. Non-CAD Incidents You must create a new incident and populate the dispatch screens if your operational area is not connected to a CAD interface or the CAD interface is temporarily unavailable. Creating a New Incident: 1. From the Incidents tab, select Create New Incident.
Create New Incidents
2. The Incidents screen display. You must enter all incident information in the data fields.
Figure 5: Touch Mode Create New Incident
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Figure 6: Keyboard Mode Create New Incident
NOTE: The displayed data fields may differ from one operational area to next. 3. Enter the incident Case Number from the dispatch information. Use Tab to move to the Incident Date field. 4. Enter the Incident Date in the MM/DD/YYYY format. In touch mode, you can select Now to enter the current date, or enter the date using the date pad. In keyboard mode, enter the data using the keyboard or short-cut keys. You can use the Now function when the field is orange and the input area is blue. Use the Shift + to enter the current date. IMPORTANT: In keyboard mode, you can use the Now function only when the field is highlighted orange and blue. 5. Enter the Time Dispatched in the HH:MM:SS, or military format. In touch mode, you can select Now to enter the current time, or enter the dispatch time using the time pad. In keyboard mode, enter the time dispatched using the keyboard or short-cut keys. You can use the Now function when the field is orange and the input area is blue. Use the Shift + to enter the current time. IMPORTANT: In keyboard mode, you can use the Now function only when the field is highlighted orange and blue. 6. Enter the Time Enroute in the HH:MM:SS, or military format. In touch mode, you can select Now to enter the time enroute using the time pad.
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In keyboard mode, enter the time enroute using the keyboard or short-cut keys. You can use the Now function when the field is orange and the input area is blue. Use the Shift + to enter the current time. IMPORTANT: In keyboard mode, you can use the Now function only when the field is highlighted orange and blue. 7. Enter the Time on Scene in the HH:MM:SS, military format. In touch mode, you can select Now to enter the time on scene, or enter the time on scene using the time pad. In keyboard mode, enter the time on scene using the keyboard or short-cut keys. You can use the Now function when the field is orange and the input area is blue. Use the Shift + to enter the current time. IMPORTANT: In keyboard mode, you can use the Now function only when the field is highlighted orange and blue. 8. Enter the Time at Patients Side in the HH:MM:SS, or military format. In touch mode, you can select Now to enter the time at patients side, or enter the time at patients side using the time pad. In keyboard mode, enter the time at patients side using the keyboard or short-cut keys. You can use the Now function when the field is orange and the input area is blue. Use the Shift + to enter the current time. IMPORTANT: In keyboard mode, you can use the Now function only when the field is highlighted orange and blue. 9. Enter the time Enroute to Hospital the HH:MM:SS, or military format. In touch mode, you can select Now to enter the current time, or enter the time enroute to hospital using the time pad. In keyboard mode, enter the time enroute to hospital using the keyboard or short-cut keys. You can use the Now function when the field is orange and the input area is blue. Use the Shift + to enter the current time. IMPORTANT: In keyboard mode, you can use the Now function only when the field is highlighted orange and blue. 10. Enter the Time at Hospital in the HH:MM:SS, or military format. In touch mode, you can select Now to enter the current time, or enter the time at hospital using the time pad.
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In keyboard mode, enter the time at hospital using the keyboard or short-cut keys. You can use the Now function when the field is orange and the input area is blue. Use the Shift + to enter the current time. IMPORTANT: In keyboard mode, you can use the Now function only when the field is highlighted orange and blue. 11. Enter the Incident Address from the dispatch information. 12. Enter the Incident City from the dispatch information. 13. Enter the Incident Zip code from the dispatch information. 14. Touch or select Save. Updating Incidents from the CAD: 1. When your CAD connection is restored, select Refresh CAD Calls. MEDS updates all incidents in the Incidents table.
2. Once the Incidents list is updated, you can create the PCR for that incident. For more information on creating PCRs, go to Patient Care Reports.
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Introduction
This chapter describes the Patient Care Reports (PCR) menu. The PCR menu includes creating, editing and verifying PCRs. Patient Care Reports are template based. Each template is based on the Type of Call selected. This chapter also includes printing reports, transmitting, parking, and deleting PCRs. You can also import a caregiver PCR, update CAD data, find and check the status of a PCR.
Working with Patient Care Reports

When working with PCRs, it is important to remember that you cannot create a PCR without an existing incident in MEDS. It is also important to remember that caregivers must logon using their own user name and password in order to view PCRs they have created.
Patient Care Reports and Incidents

MEDS includes menus for both PCRs and Incidents. In order for caregivers to take full advantage of MEDS, you must understand the characteristics of PCRs and Incidents.

The Patient Care Reports (PCR) menu in MEDS collects information pertaining to the patient. The PCR menu includes type of call information, dispatch information, patient information, and menus that correspond to the SOAP (Subjective, Objective, Assessment, and Plan) method of patient care record keeping. The PCR menu also includes the collection of signatures, and any pertinent attachments. Documents, such as face sheets and insurance cards, can be a scanned into MEDS and attached to the PCR. Patient care reports are displayed on the computer device based on user name and password, regardless of your current unit number. If PCRs are not displayed as expected, verify the current user name and password. If your partner logged on using his or her user name and password, you will not see the PCRs created using your logon information.
Incidents
The Incident menu in MEDS collects dispatch information pertaining to emergency and nonemergency calls. Incidents are displayed by unit number. If Incidents are not displayed as expected, verify your current unit number.
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The PCR Menu

The PCR menu is available from the MEDS main menu. PCRs are displayed based on the user name and password used during logon. If PCRs do not display as expected, verify the current user name and password. Select PCR to display the patient care reports created using the current user name and password. The PCR list displays. The highlighted row indicates the selected PCR.
PCR Menu
Selected PCR
Transmitted PCR Printed PCR
The following table describes the fields in the PCR list. Column Transmitted Printed Not in CAD Case Number Unit Entry Incident Date Patient Name Incident Address Description The green check mark indicates a transmitted PCR. The green check mark indicates a printed PCR. Indicates that the incident case number was not found in CAD. This might indicate an incorrect case number. The case number is assigned by the CAD or dispatch for an incident. The unit number dictates the incidents shown for the unit currently logged in to MEDS. The entry number is assigned to the PCR. If multiple PCRs are created for the Incidents, the PCRs will display sequentially in the PCR table. The date of the incident. Name of patient involved with the incident. The location address with the street name of the
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incident. Incident City Time on Call Time On Scene Time Transferred Time Arrived Region State County Zone Agency Employee Name Reporter Clear and Complete Score (CCScore) The location city of the incident. The time the caregivers were dispatched to the incident. The time the caregivers arrived at the incident. The time the patient was transferred and released from the caregivers. The time the caregivers arrived at the transfer destination. The geographical region of the incident. The state of the incident. The county of the incident. The zone of the incident. The name of the agency responding to the incident. The name of the agency employee responding to the incident. The employee identification number of the caregiver creating the PCR. The clear and complete score indicate how well the caregiver documented the 15 mandatory patient fields. The clear and complete score can range from 70 to 100.
From the PCR list, select the row corresponding to the PCR and select the applicable category button from the menu.
The Patient Care Report Categories

Use the PCR buttons to complete a PCR, edit an existing PCR, and update information from the CAD.
Edit Use the edit button to edit information in an existing PCR that has not been printed or transmitted to the MEDS server.
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Verify Use the verify button to confirm that the PCR data is valid. This button confirms all mandatory fields are completed and that the business rules are not violated. Reports Use the reports button to generate reports including, PCR, refusal of service, and supplies used. Transmit Use the transmit button to transmit the completed PCR to the MEDS server. Park Use the park button to save the PCR to the MEDS server. You can un-park a PCR at a later time and from a different MEDS device using your MEDS logon and password. Delete Use the delete button to remove a PCR that has been transmitted. A PCR cannot be deleted by a caregiver until it has been transmitted to the MEDS server. A supervisor can delete PCRs from MEDS devices. Import Responders PCR Use the import responders PCR button to import PCRs from another MEDS device. Update CAD Data Use the update CAD data button to refresh CAD information to ensure that you are using the most upto-date information. The Update CAD Data button updates the entire PCR list. Find Use the find button to locate parked and transmitted PCRs on the MEDS server. Status Use the status button to check the status of an existing PCR.
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Creating a Patient Care Report

The Patient Care Report (PCR) collects data pertaining to the patient. An incident must be created by the CAD or the caregiver before creating a PCR.
Documenting a Patient Care Report using Type of Call Templates

MEDS assists caregivers with accurately documenting patient care with Type of Call templates and patient care wizards. The Type of Call templates include:

911 Non-Emergency Critical Care Lift Assist Specialty Call
The patient care wizard compliments the Type of Call templates and prompts caregivers to document the most commonly used procedures and medications for a selected impression. When creating a new PCR from a CAD incident, much of the PCR is populated from CAD data. However, the Other Responders, or initial responder, and Other Unit Transporting data must be entered by the caregiver. Entering Type of Call data: 1. On the Dispatch menu, select the Type of Call menu category. 2. From the drop-down menu, select 911, Non-Emergency, Critical Care, Lift Assist, or Specialty Call. When using touch mode, select the type of call displayed. When using keyboard mode, select expand to display the type of call data fields. Once the type of call is entered and based on the selection, the corresponding New PCR menu categories display.
Expand Figure 7: Keyboard Mode Expand Button
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Corresponding categories
Figure 8: Keyboard Mode with Menu Categories
3. Select True in the Patient Contact Made field if patient contact occurred, or select False if patient contact did not occur. 4. If patient contact is False, you must enter a reason patient contact did not occur. The reasons for no patient contact are: no patient found, cancelled enroute, or cancelled on scene. Entering Crew data: 1. Select Crew Info menu category. 2. For Crew Member 1, select the crew members name from the list or you can enter then names using the touch screen or device keyboard. 3. Select the applicable crew member 1 role description. For example, possible descriptions are intern, observer, or driver. Select the keyboard icon at the bottom of the screen to open a freetext box and enter another description. Crew member descriptions can vary between operational sites. 4. Select the crew member 1 certification. For example, possible roles are emergency medical responder, EMT advanced, EMT basic, EMT intermediate, first responder, intern, non-healthcare professional, physician, RN, RN-CCT, and third rider. Select the keyboard icon at the bottom of the screen to open a free-text box and enter another role. Crew member roles can vary between operational sites. 5. Obtain the caregivers signature. 6. For Crew Member 2, select the crew members name from the list or you can enter then names using the touch screen or device keyboard. 7. Select the applicable crew member 2 role description. For example, possible descriptions are intern, observer, or driver. Select the keyboard icon at the bottom of the screen to open a freetext box and enter another description. Crew member descriptions can vary between operational sites.
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8. Select the crew member 2 certification. For example, possible roles are emergency medical responder, EMT advanced, EMT basic, EMT intermediate, first responder, intern, non-healthcare professional, physician, RN, RN-CCT, and third rider. Select the keyboard icon at the bottom of the screen to open a free-text box and enter another role. Crew member roles can vary between operational sites. 9. Obtain the caregivers signature. 10. For Crew Member 3, select the crew members name from the list or you can enter then names using the touch screen or device keyboard. 11. Select the applicable crew member 3 role description. For example, possible descriptions are intern, observer, or driver. Select the keyboard icon at the bottom of the screen to open a freetext box and enter another description. Crew member descriptions can vary between operational sites. 12. Select the crew member 3 certification. For example, possible roles are emergency medical responder, EMT advanced, EMT basic, EMT intermediate, first responder, intern, non-healthcare professional, physician, RN, RN-CCT, and third rider. Select the keyboard icon at the bottom of the screen to open a free-text box and enter another role. Crew member roles can vary between operational sites. Obtain the caregivers signature. Entering Incident Times data: 1. Select Incident Times. The incident times screen displays. 2. If the new PCR is being created from a CAD incident, verify that the CAD information populated the incident time data fields. If the data fields are not populated, the caregiver must enter the incident times in the data fields. IMPORTANT: If you have entered the incident times manually, updating the CAD information will overwrite the manually entered incident times.
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Entering Pickup Location data: 1. Select or expand Pickup Location. The pickup location screen displays.
Figure 9: Touch mode pick-up location
Figure 10: Keyboard mode pick-up location
2. In touch mode, select the location. The added location displays in the data field. In keyboard mode, Tab from the Pick-up Location category to the disposition list. Use the down-arrow to highlight the location. To make a selection, press Enter. The added selection displays in the data field. 3. Use the keypad, or keyboard, to enter the pick-up address, city, state, zip, and department. 4. In touch mode, select the next menu category. In keyboard mode, Tab to the next category.
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Entering Reason for Call data: 1. Select or expand Reason of Call. The reason of call screen displays. 2. For 911 calls, select the agency the performed the ALS Assessment. The agencies are AMR EMT-P, Fire EMT-P, AMR EMT-I, AMR-RN, Fire EMT-I, or None. 3. For 911 calls, enter the Number of Patients. 4. Enter the Initial Response Mode. The initial response modes are lights and siren, no light and siren, downgrade to no lights and siren, or upgrade to lights and siren. 5. Enter the Final Response Mode. The final response modes are lights and siren, no light and siren, downgrade to no lights and siren, or upgrade to lights and siren. 6. Enter the Caller information. The caller can be an emergency agency (911) or a patient-care facility that has scheduled a patient transfer. 7. Select the Nature of Call from the list. 8. Enter the MCI Declaration. The declaration are disaster +50, expanded 3-15, level 1, level 2, level 3, major 16-50, no, and yes. Entering Disposition data: Document this category data to capture the patients disposition, including cancellations, interfacility transfer, and refusal of service. You can also document transport types and air requests. 1. Select or expand Disposition. The disposition data fields display.
Figure 11: Touch mode disposition
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Figure 12: Keyboard mode disposition
2. Select the disposition. The added disposition displays in the data field. In keyboard mode, Tab from the Disposition category to the disposition list. Use the downarrow to highlight each disposition type. To make a selection, press Enter. The added selection displays in the data field. 3. Select the destination decision. 4. Select the air request by agency. This option is not available on the Critical Care template. 5. Select the reason for air transport. This option is not available on the Critical Care template. 6. In the ground transport first responder assist, select True or False. This option is not available on the Critical Care template.

Select True if the first responder assisted with patient transport. Select False if the first responder did not assist with patient transport.
7. Select initial mode. Initial mode is the code or priority assigned to the transported patient by the caregiver to the receiving facility. 8. Select the final mode. Use final code if the initial code or priority changed during transit.
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Entering Destination data: 1. Select or expand Destination. The destination data fields display.
Figure 13: Touch mode destination
Figure 14: Keyboard mode destination
2. In touch mode, select the destination. The added location displays in the data field. In keyboard mode, Tab from the Destination category to the destination list. Use the downarrow to highlight the location. To make a selection, press Enter. The added selection displays in the data field. 3. Select the destination, receiving facility. 4. Enter another destination, if applicable. 5. Select the destination type.
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6. Enter the destination department. To enter, use the keypad, or keyboard. 7. Enter the destination address, department city, state, county, and zip code. To enter other information, use the keypad, or keyboard. 8. Select the hospital diverted from, if applicable. 9. Obtain a destination received by signature. 10. In touch mode, select the next menu category. In keyboard mode, Tab to the next category. Entering Mileage data: Document this category for 911, Non-Emergency, Critical Care, and Specialty Calls only. 1. Select or expand Mileage. The mileage data fields display.
Figure 15: Touch mode mileage
Figure 16: Keyboard mode mileage
2. Enter the mileage at the scene.
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3. Enter the ending hospital mileage. MEDS will calculate the total billable mileage. 4. Enter the total mileage if MEDS does not calculate the total billable mileage. Entering Other Unit Transporting data: Document this category for 911 and Non-Emergency calls only. 1. Select or expand Other Unit Transporting. The data fields display.
Figure 17: Touch mode other unit transporting
Figure 18: Keyboard mode other unit transporting
2. In touch mode, select the other unit transporting. In keyboard mode, Tab from the Other Unit Transporting category to the other unit transporting list. Use the down-arrow to highlight the location. To make a selection, press Enter. The added selection displays in the data field. 3. In the other unit transporting field, select True or False.
Select True if the patient was transported by another unit.
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Select False if the patient was not transported by another unit.
4. Select the transfer reason from the list. 5. Enter the transfer time in the HH:MM:SS, or military format. In touch mode, you can select Now to enter the current time, or enter the dispatch time using the time pad. In keyboard mode, enter the time dispatched using the keyboard or short-cut keys. You can use the Now function when the field is orange and the input area is blue. Use the Shift + to enter the current time. IMPORTANT: In keyboard mode, you can use the Now function only when the field is highlighted orange and blue. 6. Select the transporting agency. 7. Enter the transporting unit number. 8. Enter the transporting case number. 9. Enter the new primary caregiver. Entering Other Caregiver data: Document this category for 911, Non-Emergency, and Lift Assist calls only. 1. Select or expand Other Caregiver. The other responders data fields display. 2. Enter the caregiver name. 3. Touch or select the caregiver agency from the list that performed the patient care. The agencies are AMR, EMS mutual aid, Fire, Hazmat, Law enforcement, Other, Other health care provider, Rescue, and Utilities. To remove the selection in touch mode, highlight the specialist in the lower section of the screen and touch delete. To remove the selection in keyboard mode, use the mouse to select the red X. The top red X deletes all items in the list, and the smaller red Xs after each item deletes the individual selection. 4. In touch mode, select the other responder and touch Add Selected. The added responder displays in the lower section of the screen. In keyboard mode, Tab from the Other Responder category to the Responder list. Use the downarrow to highlight each responder. To select, press Enter. The added selection displays in the right section of the screen. 5. Select the applicable caregiver role description.
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6. Obtain the caregiver signature.
The Patient Menu

Use the patient menu to enter all patient related data into the PCR. Entering Patient data: 1. On the PCR menu, touch or select Patient. The patient general screen displays. The number of data fields to complete will vary depending on the incident call type. For example, a lift assist call requires the patients first and last names; whereas, a 911 call requires many more fields to be completed.
Data fields
Figure 19: Touch Mode Patient Menu
Data fields
Corresponding categories Figure 20: Keyboard Mode Patient Menu
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IMPORTANT: You must complete the patient general data whenever patient contact is made. 2. Enter the patients last name and first name in the data fields. Use Tab to move to the next data field. As you begin to enter the patients name, MEDS will attempt to reconcile with a name previously entered. For example, if the patients last name is Jones, enter J-O-N. The names window moves to display names that correspond with the letters you have entered. If MEDS reconciles the patients name, touch or select the Get Patient Info button at the top of the data fields to populate the remaining patient data fields with data stored in the MEDS server. If MEDS does not reconcile the patients name, the caregiver must enter all patient data manually. 3. Enter the patients middle initial (M.I.). 4. Enter the gender of the patient. The choices are Female, Male, or Unknown. Touch or use the down-arrow with the Enter key to select gender. Use Tab to move to the next data field. 5. Enter the patients date of birth (DOB). MEDS will calculate the patients age. If you are unable to obtain the patients DOB, use the Age Estimated field. 6. Touch or select Age Estimate field. If the caregiver does not know the data of birth, touch or select True. If the caregiver does know the date of birth, touch or select False. When date of birth is entered, this field may be blank. 7. Enter the estimated age in the Years, Months, or Days fields. Touch or tab to the next patient menu category. 8. Use the keypad, or keyboard, to enter the patients personal items. 9. Enter the patients social security number (SSN). 10. Enter the patients weight and weight units. The weight units are kilogram (Kg) and pounds (Lbs.). 11. Enter the patients phone number. MEDS requires 10 digit phone numbers. 12. Enter the ethnicity. MEDS provides an ethnicities list to choose from. Touch or use the downarrow, Enter keys to select the ethnicity. Use Tab to move to the next data field.
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Entering Mailing Address data: You must enter the patients mailing address only when it is different from the billing address. 1. On the PCR menu, Patient category. Touch Mailing Address or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and select Enter. 2. Touch or select the look-up button in the address 1 field to populate the address data. IMPORTANT: This function should be used only if the patients address is the same as the incident address. 3. If the look-up button is not used, enter the patients mailing address beginning with the zip code. MEDS allows caregivers to enter complete addresses, including two-line addresses and apartment numbers. 4. Enter the city, state, and country of the patients billing address. Entering Guarantor data: Document this category for 911, Non-Emergency, and Critical Care calls. 1. On the PCR menu, Patient category. Touch Guarantor or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. 2. Touch or select the guarantor relationship from the list. The guarantor is the person responsible for medical costs or who holds the insurance policy that covers the patient. The choices are self, spouse, father, guardian, mother, son or daughter, not known, or other. When the guarantor and the patient are the same, select Self. MEDS will populate the patients address and phone number from the general data fields. When the guarantor is the spouse of the patient, MEDS will automatically populate the patients address. You must confirm that the guarantors data is correct. You must document the spouses first name. 3. Enter the guarantors first name and last name. 4. Enter the guarantors social security number (SSN). 5. Enter the guarantors phone number. 6. Touch or select the look-up button in the address 1 field to populate the address data. IMPORTANT: This function should be used only if the patients address is the same as the incident address.
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7. If the look-up button is not used, enter the guarantors mailing address. MEDS allows caregivers to enter complete addresses, including two-line addresses and apartment numbers. 8. Enter the city, state, zip code, and county of the guarantors billing address. Entering Insurance data: Use this category to document data regarding the patients medical insurance, including employer-paid insurance, automobile insurance, and patient private pay. You can also document workers compensation and Medicare. 1. On the PCR menu, Insurance category. Select Insurers or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter.
Figure 21: Touch mode insurance
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Figure 22: Keyboard mode insurance
2. In touch mode, select the insurance company and touch Add Selected. The added agency displays in the lower section of the screen. In keyboard mode, Tab from the Insurers category to the list. Use the down-arrow to highlight each insurer. To select, press Enter. The added selection displays in the right section of the screen. 3. In touch mode, touch Edit to enter the data in the data fields. In keyboard mode, Tab to select the agency. Press Enter to select. 4. Enter all the insurer information. In touch mode, touch Save. In keyboard mode, the data is automatically saved. 5. In touch mode, touch Add to return to the previous screen. In keyboard mode, Tab to the next category. Entering Work Injury data: Document this category for 911 and Non-Emergency calls. 1. On the PCR menu, Patient category. Select Work Injury or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter.
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Figure 23: Touch Mode Work Injury
Figure 24: Keyboard Mode Work Injury
2. Touch or select the work related injury from the list. If the injury occurred at work, collect the work relate data. The choices are no, not applicable, not available, not known, not recorded, not reporting, and yes. 3. Enter the name of employer and the employers phone number. 4. Select Subjective to move to the next category.
The Subjective and SOAP Menus

Use the Subjective and SOAP menus to enter all patient illness or injury related data into the PCR. The patient care wizard compliments the Type of Call templates and prompts caregivers to document the most commonly used procedures and medications for a selected impression. IMPORTANT: All menus and categories are documented; however, due to configuration difference between MEDS sites the order of the menus and categories may be different than documented in this guide. Entering the Type of Injury or Illness data: Document this category for 911, Non-Emergency, Lift Assist, and Specialty calls. 1. On the Subjective menu, touch Type of Injury or Illness or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter.
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2. Determine if the patient is a medical or trauma patient. Most medical problems have no specific trauma. If there is not associated trauma with your medical patient you can move to the next category. 3. In the Medical Patient field, touch or select True if the patients distress is cause by an illness. Touch of select False if the patients distress is cause by an injury. 4. In the Trauma Patient field, touch or select True if the patients distress is caused by a trauma. Touch or select False if the patients distress is caused by an illness. Entering the Chief Complaint data: Document this category for 911, Non Emergency, Lift Assist, and Specialty calls. 1. On the Subjective menu, touch Chief Complaint or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. Use this menu to enter patient data regarding the patients main complaint. For example, abdominal pain, choking, seizure, etc. 2. In touch mode, select the complaint and touch Enter. The added selection displays in the data field. Only one selection can be made. In keyboard mode, Tab from the Chief Complaint category to the list. Use the down-arrow to highlight each factor. To make a selection, press Enter. The added selection displays in the data field. More than one selection can be made. Only one selection can be made. 3. In the onset, provocations, and quality fields, select the complaint factors. In keyboard mode, you can enter more detail about the complaint in each of these fields. 4. Select the region of the body the pain radiates from the list. In keyboard mode, you can enter more detail in the data field. 5. In the recurrence field, touch or select True or False.

Select True if the patient has previously had the current complaint. Select False if the patient has never had the current complaint.
6. Enter the level of severity of the pain. The severity range is based on a scale from 1 to 10 with, 10 being the highest severity. 7. Enter the duration of pain. 8. Select the complaint onset units that the patient has experienced pain. For example, seconds, minutes, hours, days, weeks, etc. 9. Use the remarks field to document any additional complaint information that is not categorized by the pre-defined complaint criteria.
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Entering Secondary Complaint data: Document this category for 911, Non-Emergency, and Specialty calls. 1. On the Subjective menu, touch Secondary Complaint or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. Use this menu to enter patient data regarding the patients secondary complaint. For example, abdominal pain, choking, seizure, etc. 2. Enter the secondary complaint data. The secondary complaint data requires the same patient data as the chief complaint. For more information about the data fields, see Entering Chief Complaint data. Entering Other Complaints data: Document this category for 911, Non-Emergency, and Specialty calls. 1. On the Subjective menu, touch Other Complaints or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. Use this menu to enter data regarding other complaints that the patient may be experiencing. 2. Enter other patient complaints that could not be captured in the chief complaint or the secondary complaint data. 3. Use the keypad, or keyboard, to enter the other complaints data. Entering Cervix Exam data: Use this menu to enter data regarding Cervical concerns. This screen will display only if the patient is female and age 9 or older. Document this category for Critical Care calls only. 1. On the SOAP menu, touch Cervix Exam or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. 2. Enter the date of last exam. 3. Enter the time of last exam. 4. Enter who performed the exam. 5. Enter the cervix dilation in centimeters. 6. Enter the percentage of effacement.
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7. Select the station amount from the list. 8. Select the consistency from the list. 9. In the membrane ruptured field, select True or False.

Select True if the cervix membrane is possibly ruptured. Select False if the cervix membrane is not possibly ruptured.
10. Enter the time that membrane ruptured. 11. Select the color of membrane fluid from the list. 12. Enter the amount of membrane fluid in milliliters. 13. Select the Fern test results from the list. Entering OB/GYN data: Use this menu to enter data regarding OB/GYN illness or injury. This screen will display only if the patient is female and age 9 or older. Document this category for 911, Critical Care, and Specialty calls. 1. On the Subjective menu, touch OB/GYN or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. 2. Enter the number of times the patient has been pregnant. 3. Enter the patients number of live births. 4. Enter the number of patient miscarriages. 5. Enter the patients duration of contractions. 6. Enter the patients frequency of contractions. 7. Enter the patients estimated delivery date. 8. Enter the date of the patients last menstrual period. 9. In the possible pregnant field, select True or False.

Select True if the patient is possibly pregnant. Select False if the patient is not possibly pregnant.
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Editing Physician data: Document this category for 911, Non-Emergency, and Critical Care calls. 1. On the SOAP menu, touch Physician or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and select Enter. 2. Enter the physicians names. Include the physicians last name, first name, and middle name in the data fields. As you begin to enter the physicians name, MEDS will attempt to reconcile with a name previously entered into the system. For example, if the physicians last name is Wright, enter WR-I-G. The names window moves to display names that correspond with the letters you have entered. 3. If MEDS does not reconcile the physicians name, the caregiver must enter all physician data manually. Editing Genital/Urinary data: Document this category for Critical Care calls only. 1. On the SOAP menu, touch Genital/Urinary or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. 2. In the Foley field, select Yes or No. 3. In the Diapered field, select Yes or No. 4. Enter the time the patients diaper was changed. 5. In the Urinary field, select the catheter type. 6. In the Urinary Color field, select the fluid color. 7. In the Turbidity field, select fluid turbidity. 8. Enter the volume of fluid output in milliliters (ml). Editing Gastro data: Document this category for Critical Care calls only. 1. On the Subjective menu, touch Gastro or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. 2. Enter the type of diet the patient follows.
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3. Enter the time of the patients last meal. 4. Enter the patients bowel sounds. 5. Enter the patients GI symptoms. 6. Select the patients bowel care type. 7. In the Bowel Color field, select the color. 8. In the Bowel Consistency field, select the consistency. 9. Enter the Bowel Volume output. Editing Medical History data: Document this category for 911, Non-Emergency, and Critical Care calls only. 1. On the Subjective menu, touch Medical History or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. 2. Select the person that provided the patients medical history. 3. Select the medical history from the list or use the keypad or keyboard to enter other medical issues. More than one medical issue can be selected. 4. Use the Other data field to enter additional medical history information. Editing Patient Medication data: Document this category for 911, Non-Emergency, and Critical Care calls. 1. On the Subjective menu, touch Patient Medications or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. The most common medications are included in the provided list. The list is organized alphabetically. Use the alpha buttons to quickly locate the medication. 2. In touch mode, touch the alpha button to display medications. For example, if you are looking for ibuprofen, select the I-J button to display the medications beginning with the letters I and J. In keyboard mode, Tab from the Medication Taken category to the Medication list. Use the down-arrow to highlight each allergy. To select, press Enter. The added medication displays in the right section of the screen. More than one medication can be selected. 3. In touch mode, touch Edit to enter the medication data in the data fields. In keyboard mode, Tab to select the medication. Press Enter to select.
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4. Enter all the medication information. In touch mode, select Save. In keyboard mode, the data is automatically saved. 5. In touch mode, select Add to return to the previous screen. In keyboard mode, Tab to the next category. Entering the Cause of Injury data: Document this category for 911 calls only. 1. On the Subjective menu, touch Cause of Injury or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. 2. Touch or select the injury category from the list. More than one injury can be selected by double-touching or selecting and pressing Enter for each injury. To cancel the selection in touch mode, double-touch the selected injury. To cancel the selection in keyboard mode, select the red X.
Injury Category Selected Injury
Added Injury
Figure 25: Touch Mode Cause of Injury
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Figure 26: Keyboard Mode Cause of Injury
3. In touch mode, select the injury type and touch Add Selected. The added injury displays in the lower section of the screen. In keyboard mode, Tab from the Cause of Injury category to the injury type list. Use the downarrow to highlight each injury type. To select an injury, press Enter. The added injury displays in the right section of the screen. 4. In touch mode, touch Edit to enter the injury data in the data fields. In keyboard mode, Tab to select the injury. Press Enter to select. 5. Enter all the injury information. In touch mode, touch Save. In keyboard mode, the data is automatically saved. 6. In touch mode, touch Add to return to the previous screen. In keyboard mode, Tab to the next category.
The Objective and SOAP Menus

Use objective menu to enter all patient complaints and related data into the PCR. Entering Physical Exam data: Use this menu to document your findings during the patients physical exam. Document this category for 911, Non-Emergency, and Critical Care calls. 1. On the Objective menu, touch or select Treatment and Response (Tx & Resp). The Treatment and Response Physical Exam screen displays.
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Categories
Selected body part
Added body part
Figure 27: Touch Mode Physical Exam
Delete all Delete one
Categories
Add finding Figure 28: Keyboard Mode Physical Exam
2. Select the physical exam category. The categories are head, neck, chest, abdomen, pelvis, back, extremities, head-to-toe, and show all. 3. Touch or select the physical injury location from the list. More than one injury can be selected by double-touching or selecting and using Enter for each injury. To remove the selection in touch mode, highlight the specialist in the lower section of the screen and touch delete. To remove the selection in keyboard mode, use the mouse pad to select the red X. The top red X deletes all specialists in the list, and the smaller red Xs after each specialist deletes the individual specialists.
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4. In touch mode, select the injury and select Add Selected. The added injury displays in the lower section of the screen. In keyboard mode, Tab from the Physical Exam category to the Exam list. Use the down-arrow to highlight each body part. To select a body part, press Enter. The added body part displays in the right section of the screen. 5. In touch mode, select Edit to enter the exam findings in the data fields. In keyboard mode, Tab to select the injury. Press Enter to select. 6. Enter all the treatment information. In touch mode, select Save. In keyboard mode, the data is automatically saved. 7. In touch mode, select Add to return to the previous screen. In keyboard mode, Tab to the next menu category. Entering the Contributing Factors data: Document this category for 911 calls only. 1. On the Objective menu, touch Contributing Factors or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. 2. In touch mode, select the contributing factor and touch Enter. The added factor displays in the data field. More than one factor can be selected. In keyboard mode, Tab from the Contributing Factors category to the factors list. Use the down-arrow to highlight each injury type. To select a factor, press Enter. The added factor displays in the data field. More than one factor can be selected. 3. In touch mode, use the keypad to enter Other Contributing Factors. In keyboard mode, use the keyboard to enter Other Contributing Factors in the data field. Entering Safety Equipment data: Document this category for 911 calls only. 1. On the Objective menu, touch Safety Equipment or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. 2. In touch mode, select the safety equipment and touch Enter. The added selection displays in the data field. More than one selection can be made. In keyboard mode, Tab from the Safety Equipment category to the equipment list. Use the down-arrow to highlight each equipment type. To make a selection, press Enter. The added selection displays in the data field. More than one selection can be made.
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3. In touch mode, use the keypad to enter Other Safety Equipment. In keyboard mode, use the keyboard to enter Other Safety Equipment in the data field. Entering Environmental Factors data: Document this category for 911 calls only. 1. On the Objective menu, touch Environment Factors or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. 2. In touch mode, select the environmental factors and touch Enter. The added selection displays in the data field. More than one selection can be made. In keyboard mode, Tab from the Environmental Factors category to the list. Use the downarrow to highlight each factor. To make a selection, press Enter. The added selection displays in the data field. More than one selection can be made. 3. In touch mode, use the keypad to enter Other Environmental Factors. In keyboard mode, use the keyboard to enter Other Environmental Factors in the data field. Entering Delivery of Care data: Document this category for 911 calls only. 1. On the Objective menu, touch Delivery of Care or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. 2. In touch mode, select the delivery factors and touch Enter. The added selection displays in the data field. More than one selection can be made. In keyboard mode, Tab from the Delivery of Care category to the list. Use the down-arrow to highlight each factor. To make a selection, press Enter. The added selection displays in the data field. More than one selection can be made. 3. In touch mode, use the keypad to enter Other Delivery Factors. In keyboard mode, use the keyboard to enter Other Delivery Factors in the data field. Entering Trauma Triage data: Document this category for 911 calls only. 1. On the Objective menu, touch Trauma Triage or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. The Trauma Triage screen documents the criteria used to define a patient as a major trauma victim.
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2. In touch mode, select the trauma triage data field that best fits the trauma. 3. There are four basic criteria:
Physiologic The patient displays significant sign of illness or injury. Anatomic The patient has a significant blunt injury or extensive burns. Mechanism The incident was a high-impact crash where another passenger was fatally wounded. Discretionary Base hospital physician judgment.
4. In touch mode, select the triage criteria and touch Enter. The added selection displays in the data field. More than one selection can be made. In keyboard mode, Tab from the Trauma Triage category to the list. Use the down-arrow to highlight each factor. To make a selection, press Enter. The added selection displays in the data field. More than one selection can be made. 5. If you determine that a patient should be categorized as a Major Trauma Victim but there are no pre-defined criteria, enter the justification in the Paramedic Judgment field.
The Assessment and SOAP Menus

Use this menu to enter data regarding your clinical impression or assessment of the patients presenting illness or injury. The template provides caregivers a condensed and expedient way to document patient care. 1. When documenting a 911, Lift Assist, or Specialty Call, use the Assessment menu, touch Impressions or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. 2. When documenting a Non-Emergency or Critical Care call, use the SOAP menu, touch Patient Condition/Monitoring or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. 3. Select the primary impression associated with the complaint from the list, or use the keypad, or keyboard, to enter the impression. 4. Select the secondary impression from the list or use the keypad, or keyboard, to enter the impression. You can select more than one secondary impression.
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5. Select the other impression from the list or use the keypad to enter symptoms. You can select more than one symptom. IMPORTANT: When entering other impressions, enter pertinent impressions that are associated to the patient complaint. 6. Once the non-emergency clinical impressions are selected, MEDS will prompt you to document the commonly used procedures and medications for the selected impressions. The MEDS primary impression wizard will display.
The primary impression wizard displays the required procedures, as indicated by red flags, and the suggested procedures. 7. In the left column, select the procedures to be performed. Click Next.
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Selected procedure
Enter Reason Not Performed
If you will not complete a required procedure, you must enter a reason in the Reason Not Performed column. If a reason the procedure is not performed is not documented, the following message displays.
8. Click OK, enter the Reason Not Performed. Click Next. 9. Depending on the selected primary impression, the selected procedures are loaded to the Physical Exam screen or the Treatment and Response (Tr & Rx) screen. For example, when the caregiver selects chemical restraint as the primary impression and clicks Next, the Physical Exam screen displays. However, when the caregiver selects cardiac monitoring and clicks Done, the procedures are loaded into the Treatment and Response screen. 10. Continue to document the patients care Entering Cardiac Arrest data: Use this menu to enter data regarding the patients cardiac arrest. You can also document if CPR was performed, if CPR was abandoned, or if an automated external defibrillator (AED) was used.
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1. On the PCR menu, Assessment category. Touch Cardiac Arrest or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. 2. Select the reason for arrest of the cardiac arrest from the list, or use the keypad, or keyboard, to enter another cardiac factor. 3. In the arrest indication field, determine if the patient is displaying indicators of cardiac distress. Select the arrest indication from the list. The choices are: no, not known, yes, after EMS arrival, or yes, prior to EMS arrival. 4. In the breathing and palpable pulse fields, select True or False.

Select True if the patient is breathing and has a pulse. Select False if the patient is not breathing and has no pulse.
5. Enter the Time of Collapse/Recognition in the HH:MM:SS, or military format. In touch mode, you can select Now to enter the time of collapse/recognition. In keyboard mode, enter the time of collapse/recognition using the keyboard or short-cut keys. You can use the Now function when the field is orange and the input area is blue. Use the Shift + to enter the current time. 6. In the witnessed arrest bystander and bystander CPR fields, select True or False.

Select True if the patient cardiac arrest was witnessed and no CPR was administered. Select False if the patients cardiac arrest was not witnessed and no CPR was administered.
7. In the bystander CPR field, select True of False.

Select True if patient received CPR from the bystander. Select False if the patient did not receive CPR from the bystander.
8. Enter the time the patient received CPR by the bystander. In touch mode, you can select Now to enter the time of CPR by bystander. In keyboard mode, enter the time the patient received CPR by bystander using the keyboard or short-cut keys. You can use the Now function when the field is orange and the input area is blue. Use Shift + to enter the current time. 9. Enter the time the patient first received CPR by the caregiver. 10. In the pulse returned field, select True or False.

Select True if the patients pulse returned after CPR was administered. Select False if the patients pulse did not return after CPR was administered.
11. Enter the time the patients pulse returned.
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In touch mode, you can select Now to enter the time the pulse returned. In keyboard mode, enter the time the pulse returned using the keyboard or short-cut keys. You can use the Now function when the field is orange and the input area is blue. Use Shift + to enter the current time. 12. In the return spontaneous respiration field, select True or False.

Select True if the patients respiration returned. Select False if the patients respiration did not return
13. Enter the time the patients respiration returned. In touch mode, you can select Now to enter the time respiration returned. In keyboard mode, enter the time respiration returned using the keyboard or short-cut keys. You can use the Now function when the field is orange and the input area is blue. Use Shift + to enter the current time. 14. Enter the time the caregiver abandoned CPR or time of death. In touch mode, you can select Now to enter the time CPR was abandoned or time of death. In keyboard mode, enter the time CPR was abandoned or time of death using the keyboard or short-cut keys. You can use the Now function when the field is orange and the input area is blue. Use Shift + to enter the current time. 15. In the AED field, select True or False.

Select True if an AED was used on the patient. Select False if an AED was not used on the patient.
16. In the AED by field, select the person who administered the AED. 17. In the Dptmt (Department) field, enter the department of the person who administered the AED. 18. In the # Shock PTA (prior to arrival) field, enter the number of AED shocks the patient received prior to caregivers arriving at the emergency scene. 19. In the # Shock on Scene field, enter the number of AED shocks the patient received at the emergency scene. 20. In the # Shock During Transit field, number of AED shocks the patient received during transport to a medical facility.
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The Plan and SOAP Menus

Use the plan menu to enter patient physical exams, treatment and related data into the PCR. Entering Treatment and Response (Tr & Rx) data: Use this menu to document data regarding the patients treatment. Document this category for 911, Non-Emergency, and Critical Care calls. 1. On the PCR menu, Tx & Resp category. Select Tr & Rx or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. 2. Select the treatment category. The categories are airway procedures, assessment, cardiac, medication, procedure, vital signs, and show all. 3. Touch or select treatment from the list. More than one treatment can be selected by doubletouching or selecting and using Enter for each treatment. To remove the selection in touch mode, highlight the treatment in the lower section of the screen and touch delete. To remove the selection in keyboard mode, use the mouse pad to select the red X. The top red X deletes all treatment in the list, and the smaller red Xs after each treatment deletes the individual treatment. NOTE: The Tr & Rx categories and buttons are configurable by your administrator according to your county protocols. The Tr & Rx menu displayed in the following screen shots may display differently in your MEDS configuration.
Categories
Selected treatment
Added Treatments
Figure 29: Touch Mode Treatment & Response
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Delete all Delete one
Figure 30: Keyboard Mode Treatment & Response
4. In touch mode, select the treatment and select Add Selected. The added treatment displays in the lower section of the screen. In keyboard mode, Tab from the Tr & Rx category to the Treatment list. Use the down-arrow to highlight each treatment. To select a treatment, press Enter. The added treatment displays in the right section of the screen. 5. In touch mode, select Edit to enter the exam findings in the data fields. In keyboard mode, Tab to select the treatment. Press Enter to select. 6. Enter all the treatment information. In touch mode, select Save. In keyboard mode, the data is automatically saved. 7. In touch mode, select Add to return to the previous screen. In keyboard mode, Tab to the next menu category. IMPORTANT: All data fields in the Tr & Rx menu are important. The data fields with the blue outline and blue-flags are highly recommended. The data fields with the red outline and the red-flags are required to print or transmit the PCR. Entering Monitor (Defibrillation) data: Document this category for 911, Non-Emergency, and Critical Care calls. 1. Prior to importing data from the defibrillation device, confirm that your defibrillation device is connected to your MEDS device. IMPORTANT: If this is the first time you are connecting your defibrillation device to your MEDS device, consult your defibrillation device documentation for correct connection procedures.
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2. On the PCR menu, Plan category. Select Monitor or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. Use this menu to import defibrillation device data. You can import defibrillation procedure reports and vital signs from the device.
Date range Device type
Import EKG/ECG
Attach EKG/ECG
Delete imported EKG/ECG
Progress indicator Figure 31: Touch and keyboard mode defibrillation screen
3. Enter the date range to query the applicable records on the device. Patient records are displayed based on the date range entered. 4. Select your defibrillation device from the drop-down list. 5. Select Import. The patient records download from the defibrillation device to the MEDS device. The progress indicator displays the import progress. 6. Select the patient record to attach to the PCR.
Patient record
Import Attach Disconnect Connection (Zoll only) Delete
Progress bar
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IMPORTANT: The patient record will not include the patients first and last name unless you enter it. Confirm your defibrillation device record Incident ID selection with the MEDS Incident case number to ensure the correct record is selected. 7. Select Attach. Use Attach to attach the defibrillation device data to the PCR. When the function is complete, the save dialog box appears.
8. Select the checkboxes of the Defibrillation Reports and Procedures/Vitals to save. Select Save. Entering Supplies data: Use this menu to document the supplies used when treating the patient. The supplies screen displays all available supplies, used supplies, and supply quantity. Document this category for 911 and Non-Emergency calls only. 1. On the PCR menu, Plan category. Select Supplies or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter.
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Scroll bar
Figure 32: Touch mode supplies
Figure 33: Keyboard mode supplies
2. In touch mode, use the scroll bar to locate the supplies used in the Available Supplies list. In keyboard mode, use the down-arrow to locate the supplies used in the Available Supplies list. 3. Select the available supply. The item appears in the Used Supplies column. 4. To change the supply quantity: In touch mode, use the keypad to enter the supply. To change the quantity, select the supply. Select Clear and enter the correct quantity. In keyboard mode, select the supply again and press Enter. The following message displays.
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Figure 34: Keyboard mode increase supply quantity
5. Select Yes to increase the quantity. Select No not to increase the quantity.
Figure 35: Keyboard mode increased quantity
6. To remove an item from Used Supplies: In touch mode, select the supply and select Delete Supply, or select Clear All to clear all supplies in Used Supplies. In keyboard mode, select the supply and select the red X next to the selected supply, or select the red X at the top of the column to clear all supplies in Used Supplies. 7. Continue documenting all used supplies according to your county procedures. Entering Medical Consult data: Use the medical consult screen to document patient injury, illness, and care. Document this category for 911, Non-Emergency, Lift Assist, and Specialty calls. 1. On the PCR menu, Plan category. Select Medical Consult or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. 2. In the Medical Consult field, select True or False.

Select True if a medical consultation was completed. Select False if a medical consultation was not completed.
3. In the Which Hospital field, select the hospital where the medical consult was performed. 4. In the Consulting Physician/RN field, enter the name of the physician or RN that performed the medical consultation. 5. In the Consult Time field, enter the time the medical consultation was performed. 6. In the Physician Order field, enter the order in the space provided.
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7. In the Consult Sign Name field, enter the name of the person giving the order. 8. In Consult Sign Title field, select the title of the person giving the order. 9. In the Consult Sign Date field, enter the date the order was given. 10. In the Consult Signature field, obtain the signature of the person giving the order. Entering Narrative data: Use the narrative screen to document patient injury, illness, and care. Document this category for all calls. 1. On the PCR menu, Plan category. Select Narrative or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. 2. The top, gray, section of the narrative screen is read-only and reflects the data entered into MEDS during patient care.
Figure 36: Touch and keyboard narrative
IMPORTANT: Using the narrative edit function does not update the data field that MEDS uses to prepare the narrative. If you use the narrative edit function, you must also update the data fields to avoid conflicting data. 3. The bottom, white, section of the narrative screen is a free-text box where caregivers can enter additional patient information to be included with the automatic narrative.
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Entering Refuse Service data: Document this category for 911, Non-Emergency, and Critical Care calls. 1. On the PCR menu, Plan category. Select Refusal of Service or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter.
Figure 37: Touch and keyboard mode refusal of service
2. Select the refusal of service checkbox. 3. Select the refusal factor from the list. You can select more than one factor. Select the factor again to remove it from the data field. 4. Use the keypad, or keyboard, to enter the refusal factor. 5. Enter the patient name. 6. Enter the date. 7. Obtain the signature. 8. Select the relation of the person signing for the patient from the list. 9. Enter the date signed. 10. Enter the witness(es) names and time.
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11. Obtain signature of witness(es). Entering Vitals data: Document this category for Non-Emergency and Critical Care calls.
Figure 38: Vitals Button
The Vitals button is a shortcut for caregivers to see all patient vitals in one screen. As caregivers update the patients vital signs on the Treatment & Response screens, the data is updated and reflected on the Vitals screen. Likewise, if the Vitals screen is updated, the updated data is reflected on the Treatment & Response screen. Use this category to capture all the patients vital signs. IMPORTANT: Caregivers will only see the vitals that are configured for their MEDS site configuration. 1. Select Vitals. The vitals screen displays. Caregivers can take multiple vital assessments that display in the vitals screen. 2. Touch or expand applicable data fields in the lower section of the screen. 3. Enter the patient data in each applicable field. 4. Each vitals assessment includes the Complications field. Use the Complications field to enter multiple findings for each vitals assessment. In touch mode, select the complication, or multiple complications, and touch Add. In keyboard mode, select the complication, or multiple complications, select the + next to the field, or press Enter. 5. To add multiple vital findings, enter the data in the fields. Select Save. The vitals data is displayed in the vitals summary area of the screen. Entering a New Set of Vitals From the Vitals screen, caregivers can add a new set of patient vital signs. 1. Touch or select the Add button at the lower right section of the screen. A new vitals entry displays in the summary area. 2. Enter the vitals data. Touch or select Save.
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The Signatures Menu

Use this menu to document electronic signatures. You can obtain signatures from caregivers, patients, and medical facilities. Entering Patient Signatures: Document this category for 911, Non-Emergency, and Specialty calls only. 1. On the PCR menu, Signatures category. Select Assignment of Benefits or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter.
2. Select the patients primary language. 3. If the patient will not or cannot sign electronically, select True in the signature on paper field. IMPORTANT: When obtaining the patient signature on a paper signature form, you must remember to include the form with the PCR. Use the Attachments menu to attach the paper signature form. If the patient can sign electronically, select False in the signature on paper field. 4. Enter the date of signature. 5. Obtain the patients signature. Select the green check mark to accept the signature. Entering Assignment of Benefits Representative Signature: 1. Select the reason the patient is unable to sign from the list, or use the keypad to enter another reason. 2. If the representative will not or cannot sign electronically, select Yes that the signature is on paper field. 3. Enter the representatives first and last name. Use the keypad to enter the name.
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4. Select the representatives relation to the patient from the list, or use the keypad to enter another relation. 5. Enter the date of signature. 6. Obtain the representatives signature. Select the green check mark to accept the signature. Entering the Facility Signature: 1. If you are unable to obtain a facility signature electronically, select Yes in the signature is on paper field. IMPORTANT: When obtaining the facility signature on a paper signature form, you must remember to include the form with the PCR. Use the Attachments menu to attach the paper signature form. If the patient can sign electronically, select No in the signature on paper field. 2. Enter the Name of the Facility. Use the keypad to enter the facility name. 3. Enter the facility representatives first and last name. 4. Select the facility representative title. 5. Enter the date of signature. 6. Obtain the facility representatives signature. Select the green check mark to accept the signature.
The Attachments Menu

Use this menu to document electronic attachments. You can attach pictures from the incident, scanned insurance cards and patient identification, and EKG strips. You can also attach hospital cover sheets. Document this category for 911, Non-Emergency, Lift Assist, and Specialty calls. Creating Attachments: 1. On the PCR menu, Attachments category. Select Cover Sheet or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. The cover sheet that you created on the PCR menu in the Reports category, displays on the attachments screen. IMPORTANT: Confirm that the scanner is connected to your computer device. 2. Select the attachment device from the right side of the screen. The attachment devices are color scanner, black and white scanner, or digital camera.
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3. Select the attachment type from the left side of the screen. The attachment types are determined by your countys protocol. Some of the attachment types are card copy, EKG strip, face sheet, other, paper AMA, paper signature form, and paper PCS. 4. The attachment displays onscreen. To accept the attachment image, select the Save button. IMPORTANT: Select Save once to save the attachment. After you have saved the document, the save button is replaced with a delete button. Double selecting the save button deletes the attachment. Creating Addenda: 1. On the PCR menu, Attachments category. Select Addendum or use the keyboard short-cut keys to expand the category. To expand the category using short-cut keys, the category is outlined with orange, the expand box outline is dotted, and press Enter. Use this screen to add notes regarding the PCR. 2. In touch mode, select the keyboard button to display the keypad on the computer device. 3. Enter your addendum notes. 4. Select spell check. 5. Select accept, or the green check mark.
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Editing the Patient Care Report

Use the Edit button to complete a previously started PCR. You cannot edit a PCR that was printed or transmitted. Using the Edit Button: 1. On the PCR menu, select the PCR to edit. The selected PCR highlights orange.
Selected PCR
2. Select Edit. The dispatch screen appears.
Figure 39: Touch Mode Dispatch Screen
Figure 40: Keyboard Mode Dispatch Screen
3. On the Dispatch menu, select the data category to edit. For more information on documenting the Dispatch menu, go to New_Patient_Care_Report in the Incidents section.
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4. Confirm that the dispatch information is correct.
Verifying the Patient Care Report

A completed PCR is important. Use the Verify function to ensure that you have completed the required fields in the PCR. To Verify a PCR: 1. Select the PCR to verify. The selected PCR highlighted orange. 2. On the PCR menu, select Verify. 3. If the PCR is complete and ready to transmit. The Valid PCR message displays.
4. Select OK. The PCR is ready to transmit. It is recommended that you select Update CAD Data button to ensure that all CAD information is included in the PCR. For more information on transmitting PCRs, go Transmit a PCR. 5. If the PCR is not complete. The Invalid PCR message displays.
6. Select Yes to edit the invalid PCR fields. MEDS will display the required fields for you to complete. IMPORTANT: The required fields display with a red border and flag. The suggested fields display with a blue border and flag. The current field displays with a blue background. 7. When you have completed the required fields, MEDS prompts you to save the invalid fields. Select Yes. 8. Repeat the Verify process to ensure all required fields are valid.
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Using MEDS Reports

MEDS includes various forms and reports. You can obtain electronic signatures as well as attach reports to your PCR. 1. Select the PCR for the Report. The selected PCR highlighted orange. 2. On the PCR menu, select Reports. The available reports display.
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The following table describes MEDS reports and uses: Report Cover sheet Defib Device Description A standard cover sheet used when faxing. A defibrillation device collects patient data that can be imported into MEDS. A signature must be obtained when a patient is transported to or from a medical facility. The patient care report collects patient information. The hospital PCR is used when a hardcopy of the electronic PCR is requested. The interim patient care report collects patient information; however, the interim PCR is for review only. The patient, or legal guardian, must sign a refusal of service form prior to release. The patient must sign a refusal of service form prior to release. Uses Use this report when faxing trailing documents. Use this report when importing procedures, vital signs, and defibrillation data from your cardiac monitor. Use this report whenever you are unable to obtain the signature of the patient or authorized representative. Use this report when you have finalized the PCR. Use this report if the hospital requests a hardcopy of the PCR. The hospital PCR may not be the final Use the Interim PCR when you need to print the PCR for review prior to final transmittal. Use this report when a patient refuses medical treatment at the scene or transfer to a medical facility. Use this report when a patient refuses medical treatment at the scene or transfer to a medical facility. This report becomes part of the PCR.
Facility Signature
Final CPR Hospital PCR
Intern PCR
Refuse Service
Refuse Service Alternate
Supplies
Trailing Documents
Trip Reconciliation
The supplies report collects used supplies information entered by the caregiver on the Tx & Resp menu, Supplies category. Any document that is associated with the PCR. Trailing documents include drivers license, insurance card, etc. The trip reconciliation report tracks the number of incidents, or trips, caregivers respond to during their shift. The data in this report is based on caregiver logon and password.
Use this report to collect and transmit documents associated to the PCR. Use this report to confirm that each assigned incident has corresponding PCRs, and that the PCR was transmitted and received by
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To use trip reconciliation report, your county must be CAD enabled.
the MEDS server. Print this report at the end of your shift and submit it to your supervisor.
NOTE: Note that the PCR, Hospital PCR, and Interim PCR reports are used for different purposes. 3. Select the report to run MEDS generates the selected report and displays it on the screen.
Transmitting and Parking Patient Care Reports

Once the PCR is verified as complete, you can transmit the PCR to the central database. The central billing department will access the PCR. If for some reason you are unable to transmit a PCR upon verification, you must park, or save, the PCR on your laptop and transmit it at a later time. To Transmit a PCR: 1. Select the PCR to transmit. The selected PCR highlights orange. 2. On the PCR menu, select Transmit. The following message displays:
3. Select Yes. MEDS will evaluate the PCR and display a preliminary Clear and Complete (C&C) score.
4. Select Yes to correct the invalid fields and increase your C&C score. Select No to accept the C&C score and move through the transmission process. When you select Yes to increase your C&C score, MEDS will display the invalid fields that must be corrected to increase the C&C score.
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Validation message
Validation directions
5. Select the Validation Message. The selected validation message highlights orange. The validation directions display in the lower pane or the required data fields will display in the left pane of the screen. 6. Follow the validation directions. 7. Once the PCR is validated and is available to transmit, select Transmit from the PCR menu. Beginning with MEDS 3.7 and as part of the transmission process, mileage verification software verifies the total mileage based on beginning and ending mileage entered by the caregiver. If the mileage entered is greater or less than a 5 mile variance than the mileage calculated, MEDS will display the following message:
8. Select Yes. The Google mileage calculation will replace the total mileage that is sent to the billing server. 9. Select No. The Google mileage calculation will not replace the mileage entered by the caregiver. 10. Select a rejection reason from the drop-down list. The following rejection reasons are available:
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11. Click OK. To Park a PCR: 1. Select the PCR to park. The selected PCR highlights orange. 2. On the PCR menu, select Park. The following message displays:
3. Select Yes to park the selected PCR. 4. When a PCR is parked, you will need to complete it prior to transmitting to the central database. Use the Find function to find a parked PCR, go to The Find Button.
Deleting a Patient Care Report

Once the PCR is transmitted, you can delete the PCR from your computer device. The PCR will not be deleted from the MEDS server, or the central billing department. To Delete a PCR: 1. Select the PCR to delete. The selected PCR highlights orange. 2. On the PCR menu, select Delete. IMPORTANT: To delete a PCR, the selected PCR must be previously transmitted. If the selected PCR has not been previously transmitted, the delete button will be unavailable. 3. Confirm the PCR to delete. Select the Delete button.
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Importing Responders Patient Care Report

You may need to import another responders PCR in order to complete your PCR. To Import a PCR: 1. On the PCR menu, select Import Responders PCR. The Import PCR screen displays. All PCRs available for import display in the Import PCR list. If you do not see the PCR you are trying to import, contact the original caregiver that created the PCR. 2. Select the PCR to import. The selected PCR highlights orange. 3. Select Import. The PCR will display in the PCR menu grid.
Finding a Patient Care Report

You can find parked or transmitted PCRs on the MEDS server with identifying information, such as the case number, patient name, etc. You must find the parked PCR on the MEDS server, download the PCR to your computer device, complete the PCR, and transmit. You may also use this function to add and addendum to a transmitted PCR. To Find a PCR: 1. On the PCR menu, select Find. The Find PCR type screen displays.
Type of PCR
2. Select the PCR type. 3. Enter the case number or the patients first and last names. 4. Select Search. The system will find any PCRs that meet the search criteria.
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5. Select the PCR to download it to your compute device.
Verifying the Status of a Patient Care Report

To Verify the PCR Status: 1. On the PCR menu, select Status. MEDS displays a list of recent PCR activities.
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Appendix A
The following tables list the MEDS PCR menu and subsequent category menus. Use these tables to locate the desired category and enter the corresponding PCR data. Table 4: PCR, Dispatch Menu PCR>Dispatch Menu Use the Dispatch menu to enter the following PCR data: Type of call: 911, inter-facility, lift assist, or specialty Crew Info: names, roles, and signatures Incident times: call received, enroute, on scene and at patient side. This category also includes time patient was transported to a medical facility or hospital, and late arrival reasons. Pickup location: address, county, and map grid Reason of call: nature of call, number of patients, caller, and initial and final codes Other Responders: additional AMR unit, CHP, fire, police, or other first-in caregiver Disposition: destination decision, air transport requested, transport mode Destination: location type, receiving hospital, hospital bed number Mileage: emergency vehicle beginning, hospital, and ending mileage Other Unit Transporting: reason, time, agency, unit and case number For additional information regarding the Dispatch menu, go to The Dispatch Menu.
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Table 5: PCR, Patient Menu PCR>Patient Menu Use the Patient menu to enter the following PCR data: Patient general information: last and first name, social security number, phone number, sex, weight, and ethnicity Patient mailing addresses Patient guarantor relationship: dependent, guardian, other, self, spouse, father, mother, son, or daughter Insurers: patients insurance company, including Medicare, Workers Comp, and automotive Work injury: type of work related injury, employer name, and phone number For additional information regarding the Patient menu, go to The Patient Menu. Table 6: PCR, Subjective Menu PCR>Subjective Menu Use the Subjective menu to enter the following PCR data: Type of injury or illness: classify patient as medical or trauma Chief complaint: complaint type, onset provocation, severity, and organ system Secondary and other complaints: complaint type, onset provocation, severity, and patient complaint Other complaint: Enter any other complaint Obstetric or gynecological (OBGYN): OBGYN illness or injury, and female patients 9 years or older Primary Physician: first and last name of the patients primary physician Medical History: obtained from patient, bystander, family member, or health care professional Patient Medications: type of medication taken by patient, including dose and route taken Cause of injury: crash, burn, fall, environmental, machine, violent force For additional information regarding the Subjective menu, go to The Subjective Menu.
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Table 7: PCR, Objective Menu PCR>Objective Menu Use the Objective menu to enter the following PCR data: Physical exam: results of physical and mental exams Contributing Factors: alcohol use, drug use, suspected child abuse, work related, vehicular Safety Equipment: airbags deployed, child restraint, eye protection, helmets, personal flotation devices Environmental Factors: pool gate unsecured, nonfunctioning CO2 detector, no safety rail in bathroom Delivery of Care: adverse weather, hazardous materials, patient is hearing impaired Trauma Triage: physiologic, anatomic, mechanism, discretionary criteria, and caregiver judgment For additional information regarding the Objective menu, go to The Objective Menu. Table 8: PCR, Assessment Menu PCR>Assessment Menu Use the Assessment menu to enter the following PCR data: Impression: primary, secondary, and other clinical impressions Cardiac Arrest: etiology, arrest indication, time of collapse, CPR performed, or AED administered Risk Explanation: refusal factors and free text explanation For additional information regarding the Assessment menu, go to The Assessment Menu. Table 9: PCR, Plan Menu PCR>Plan Menu Use the Plan menu to enter the following PCR data: Tr & Rx: treatment based on physical exam includes clinical impression, medication, and procedures Monitor: import data to MEDS from defibrillation device Supplies: available supplies, used supplies, and quantity used Medical Consult: consulting physician or RN, hospital name, time, physician order, signature, title, data Refusal of Service: patient language, reason for patient refusal of service, and signature For additional information regarding the Plan menu, go to The Plan Menu.
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Table 10: PCR, Signatures Menu PCR>Signatures Menu Use the Signatures menu to enter the following PCR data: Reason Patient Could Not Sign: Includes various reason that a patient would be unable to sign. Assignment of Benefits: patient representative signs for patient include reason patient was unable to sign. For additional information regarding the Signatures menu, go to The Signatures Menu. Table 11: PCR, Attachments Menu PCR>Attachments Use the Attachments menu to enter the following PCR data: Cover Sheet: scanned copies of insurance cards, EKG strips, face sheets, other, paper AMA, paper signature, paper PCS Addendum: use the addendum feature to add any PCR data that was not captured in the patient data fields.
For additional information regarding the PCR Attachments, go to The Attachment Menu.
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Index
caregiver ........................................................... 5 clear and complete score ................................ 73 compatible CAD software ................................ 4 compatible devices ........................................... 4 computer-aided dispatch (CAD) ...................... 5 data fields ....................................................... 39 delete selected data......................................... 20 electronic patient care report ............................ 5 get patient information button ........................ 39 incidents categories ........................................ 15 incidents list descriptions ............................... 14 keyboard ........................................................... 8 touch ................................................................. 8 keyboard shortcut keys................................... 10 patient medical condition ............................... 67 MEDS reports and uses .................................. 72 caregiver ........................................................... 5 computer-aided dispatch (CAD) ...................... 5 electronic patient care report (ePCR) ............... 5 park .................................................................. 6 PASTE .............................................................. 6 PQRST ............................................................. 6 navigation ......................................................... 8 non-CAD incidents ........................................ 26 park .................................................................. 6 PASTE .............................................................. 6 patient care report categories ......................... 33 validation directions ....................................... 74 validation message ......................................... 74 PQRST ............................................................. 6 shortcut keys .................................................. 10 trauma triage criteria ...................................... 52
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MEDS 3.8 Software User Guide

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American Medical Response

Multi Emergency Medical Services Data System (MEDS)

MEDS User Guide 3.8

January 2012 Issue 7

January 2012 Issue 7

MEDS User Guide 3.8

MEDS User Guide 3.8

January 2012 Issue 7

January 2012 Issue 7

MEDS User Guide 3.8

MEDS User Guide 3.8

January 2012 Issue 7

About This Guide

Issue Date and Change History

How to Use This Document

MEDS User Guide 3.8

January 2012 Issue 7

Incidents Patient Care Reports

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MEDS User Guide 3.8

Compatible Computer Aided Dispatch Software

MEDS User Guide 3.8

January 2012 Issue 7

Motion Computing devices: http://www.motioncomputing.com/ Panasonic Toughbook devices: http://www.panasonic.com/

January 2012 Issue 7

MEDS User Guide 3.8

Multi-EMS Data System

Multi-EMS Data System Terminology

Computer-aided dispatch (CAD)

Electronic Patient Care Report (ePCR)

MEDS User Guide 3.8

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January 2012 Issue 7

MEDS User Guide 3.8

Using MEDS on a Computer Device

MEDS User Guide 3.8

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January 2012 Issue 7

MEDS User Guide 3.8

MEDS User Guide 3.8

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Figure 2: Keyboard Mode, Main Menu with categories

Using the Home Menu

Using the Main Menu

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MEDS User Guide 3.8

Table 1: Main Menu Descriptions

Figure 3: Touch mode icon

Figure 4: Keyboard mode icon

MEDS User Guide 3.8

January 2012 Issue 7

Table 2: Shortcut Keys in Keyboard Mode

Keyboard Action Tab

Shift +Tab Shift+

Right and Left Arrows Arrows + Tab or Enter

Up and Down Arrow Arrows + Tab or Enter

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MEDS User Guide 3.8

Working with Incidents

Incidents and Patient Care Reports

Patient Care Reports

MEDS User Guide 3.8

January 2012 Issue 7