Aerosolized Procedure Notification
Identify procedures performed (Nebulizer, CPAP, Suction, BVM, Advanced Airway, CPR):
Identify Providers Present
Was the shower trailer used?
If trailer was used who used it?
Where there any issues with PPE? (I.E. Donning, Doffing, Malfunction)
Did the PT meet COVID-19 screening criteria or were they confirmed positive?
Was a viral filter and/or ambulance ventilation system used?
Anything else you want us to know:
To be completed by EMS Division
Exposure Level :
Further Action Needed
Should be Empty: