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Patch Review Process (backup)
A. Instructions
Peer Reviewers (Level 1) review patch recordings alongside ACRs
The Patch Audit Tool is used to record whether the patch meets criteria, using a checklist
If criteria are not met, the call is escalated to level 2
If the Peer Reviewer has any relevant comments that are not included in the Patch Audit Tool, the ALS button should be toggled from “Acceptable” to “Found Issues” and notes made in the “ALS Comments” box.
B. Patch Audit Tool v1
For each criteria one option must be selected.
“Yes”: criteria is applicable and has been met appropriately
“No”: criteria is applicable and has NOT been met appropriately
If “No” is selected, reasons will appear; one or more reasons must be selected.
This triggers an escalation to Level 2 (Coordinator)
“N/A”: criteria is NOT applicable.
“CNO”: criteria is applicable but paramedic was unable to obtain the information
1. Timely BHP Answer
(*)
1. Timely BHP Answer
Yes
No
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
>30 seconds to answer
No answer
Answer required
2. Call Quality acceptable
(*)
2. Call Quality acceptable
Yes
No
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
Call dropped
Paramedic hung up
Poor receptions Paramedic
Poor reception Physician
Answer required
3. Patch number CPSO number
(*)
3. Patch number CPSO number
Yes
No
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
CPSO number not provided
Patch number not provided
Answer required
4. Paramedic EHS Number and Level of certification
(*)
4. Paramedic EHS Number and Level of certification
Yes
No
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
Paramedic EHS number not provided
Level of certification not provided at beginning of patch
Level of certification not provided at all
Answer required
5. Reason for Patch Provided
(*)
5. Reason for Patch Provided
Yes
No
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
Reason for patch not provided
Answer required
6. Patient Age
(*)
6. Patient Age
Yes
No
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
Age or approximation not provided
Answer required
7. Patient Weight
(*)
7. Patient Weight
Yes
No
N/A
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
Patient weight not provided for pediatric related patch
Patient weight not provided when requesting medications
Answer required
8. Incident history
(*)
8. Incident history
Yes
No
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
Information regarding bystander CPR not provided when requesting TOR
Witnessed or unwitnessed cardiac arrest not provided when requesting TOR
Any shocks delivered by first responders not provided when requesting TOR
ROSC at any time not provided when requesting TOR
MOI not provided if applicable
Other relevant Incident history not provided (ALS Comments box)
Answer required
9. Relevant Past medical History
(*)
9. Relevant Past medical History
Yes
No
CNO
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
Relevant PMHx not provided
Answer required
10. Current medications
(*)
10. Current medications
Yes
No
CNO
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
Rx Anticoagulant medications not provided if applicable
Rx Narcotic medications not provided if applicable
Other pertinent medications not provided
Answer required
11. Medication Allergies
(*)
11. Medication Allergies
Yes
No
CNO
N/A
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
Not provided when requesting medications
Answer required
12. Physical Exam
(*)
12. Physical Exam
Yes
No
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
Physical examination insufficient for patient condition or incident
Answer required
13. Vital signs
(*)
13. Vital signs
Yes
No
CNO
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
Heart rate not provided
Respiratory rate not provided
Blood pressure not provided
SpO2 not provided
ETCO2 not provided if applicable
GCS not provided
Temperature not provided
Pain assessment not provided if applicable
Pupil assessment not provided if applicable
Answer required
14. ECG Assessment
(*)
14. ECG Assessment
Yes
No
CNO
N/A
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
QRS width, heart rate and regularity not provided if applicable
ST segment assessment not provided if applicable
Asystole not assessed in two leads if applicable
Answer required
15. Treatment provided and response
(*)
15. Treatment provided and response
Yes
No
N/A
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
Medications administered by paramedic prior to patch not provided
Medications administered by patient, or other, prior to patch not provided
Other procedures provided by paramedic prior to patch not provided
Answer required
16. Physician orders
(*)
16. Physician orders
Yes
No
N/A
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
Orders not within paramedic scope of practice
Orders not appropriate for patient
Orders against RPPEO clinical position
Answer required
17. Readback occurs and confirmed
(*)
17. Readback occurs and confirmed
Yes
No
N/A
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
Not read back in full
Readback not confirmed by BHP
Readback incorrectly
Readback error caught by either BHP or Paramedic
Answer required
18. Orders documented on ePCR and delivered to the patient
(*)
18. Orders documented on ePCR and delivered to the patient
Yes
No
N/A
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
Not documented as ordered by BHP
No orders documented
Orders from BHP not administered to the patient
Orders from BHP not administered to the patient but with an explanation
Answer required
19. Paramedic Patch Quality
(*)
19. Paramedic Patch Quality
Issue
No issue
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
Paramedic needed to obtain patch criteria during patch
Paramedic required frequent BHP prompting
Patch was unorganized/disjointed
Patch did not follow SBARR format
Paramedic appears unprofessional
Answer required
20. Patient Disposition Provided
(*)
20. Patient Disposition Provided
Yes
No
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
Patient disposition not provided
Answer required
21. ETA
(*)
21. ETA
Yes
No
N/A
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
ETA to destination not provided
ETA not prompted by physician
Answer required
22. Physician Patch Quality
(*)
22. Physician Patch Quality
Issue
No issue
Answer required
Note if criteria not met and suggestions
Note if criteria not met and suggestions
Physician interrupted paramedic
Physician put paramedic on hold for more than 30 seconds
Physician did not introduce themselves
Physician appears unprofessional
Physician appears distracted/unprepared
Physician provides advice inconsistent with ALS PCS
Answer required
All Criteria-Met
Criteria was not met
Submit Review
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