π€
CTAS Level (Canadian Triage & Acuity Scale)
Vital Signs
BP
mmHg
HR
bpm
RR
br/min
Temp
Β°C
SpOβ
%
Pain
NRS/10
Facility & Unit
Chief Complaint
π Chest Pain
π« Shortness of Breath
π€ Abdominal Pain
π Trauma
π‘οΈ Fever/Infection
π§ Headache
𧩠Mental Health
β οΈ Allergic Reaction
π€’ GI Issues
𦴠Back Pain
π§ Stroke/CVA
π΅ Syncope
π Overdose/Tox
πΌ OB/GYN
π° Urological
π©Ή Wound/Lac
π¦· Fracture/Ortho
ποΈ Eye/ENT
οΌ Other
Arrival & Transport
Primary Survey (ABCDE)
β
Medical History (SAMPLE)
Safety Checklist
0/10
Focused Assessment
Interventions & Orders
Diagnostic Orders
Alberta Trauma / Resuscitation Protocols
Medications Administered
β
Aspirin (ASA)
162-325mg PO
PO
β
Nitroglycerin
0.4mg SL q5min
SL
Morphine
2-4mg IV q4h PRN
IV
Ondansetron
4mg IV q6h PRN
IV
0.9% NaCl
500mL IV bolus
IV
Ketorolac
15-30mg IV/IM
IV/IM
Epinephrine
0.3mg IM (EpiPen)
IM
Diphenhydramine
25-50mg IV/PO
IV/PO
Disposition & Plan
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