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Appendices

Appendices 

  • Appendices A-J
  • Appendix A – Patient Disposition Form
  • Appendix B – OnScene Physician Form
  • Appendix C – Apgar Score
  • Appendix D – LA Prehospital Stroke Screen
  • Appendix E – Pain Scales
  • Appendix F – Restraint Checklist
  • Appendix G – Abbreviations
  • Appendix H – ReperfusionChecklist
  • Appendix I- Difficult Airway Evaluation
  • Appendix J- Burn Reference

Supplemental Appendices 

  • NCCEP Airway Evaluation Form (145 KB PDF) – Revised 4/1/2014
  • Preliminary Report Form  -Revised 11/8/2024
  • NC Medical Orders for Scope of Treatment (MOST) Form (930 KB PDF)
  • NC Do Not Resuscitate Form (131 KB PDF)
  • Recommended EMS Guidelines for Children and Youth with Special Health Care Needs (2009 NC EMSC Advisory Committee) (196 KB PDF)
  • PI Document (17 KB XLSX)
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