CLINIBORG
Home
Contents
Recent
Privacy Policy
Terms
About
Motor Vehicle Accident History
Nov 23, 2010
•
Mark Morgan
categories:
Injury & Poisoning
Subjective/History
Motor Vehicle Accident
This was a
velocity impact. The vehicle impact was at the
.
no
YES
<-- Air bags deployed
Before the accident, the patient was seated
in relation to the vehicle.
Vehicle Restraints (e.g. seat belt):
.
Extrication at the scene:
no
YES
<-- inside the vehicle after the accident.
no
YES
<-- able to ambulate after the accident
no
YES
<-- conscious during the accident
no
YES
<-- remembers the impact
no
YES
<-- remembers after the accident
Injury
prior to evaluation
Onset while:
Episode location:
Episode description:
Associated Injuries:
ROS
no
YES
<-- seizure
no
YES
<-- extremity weakness
no
YES
<-- headache
no
YES
<-- sensory changes (vision, hearing)
no
YES
<-- shortness or breath
no
YES
<-- chest pain
no
YES
<-- nausea/vomiting
no
YES
<-- incontinence of urine or stool
Calculate The Result!
Reset Form
Result - Copy and paste this output:
Copy to Clipboard
Please enable JavaScript to view the
comments powered by Disqus.