Critical Incident Form
Complete this form to flag all critical incident calls. This form will also be used to upload all Glidescope intubation recordings.
OCA #
Employees on Call
Critical Incident Call Type (CHECK ALL THAT APPLY) :
CARDIAC ARREST
KETAMINE (RSI/DAI)
KETAMINE (BEHAVIORAL)
KETAMINE (PAIN MANAGEMENT)
INTUBATION (RSI/DAI)
INTUBATION (CARDIAC ARREST)
INTUBATION (NO DRUGS REQ.)
BIAD INSERTION
STEMI (SCENE)
STEMI (IFT)
STROKE (SCENE)
STROKE (IFT)
TRAUMA
SEPSIS
PROPOFOL
TXA (TRAUMA)
TXA (EPISTAXIS)
BLOOD TRANSFUSION
HELICOPTER USE
RESTRAINT USE
CARDIOVERSION/PACING
CHILDBIRTH
Notes:
Glidescope Video Recording
Browse Files
Upload full Glidescope video recording for your intubation attempt. If there are multiple video files please upload all.
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Glidescope Photo Uploads
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Upload all screenshots from patient encounter.
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AIRWAY FORM UPLOAD
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Upload Airway Form and ETCO2 Strip. Turn original form into M. Ledford.
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Submit
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