§11-72-22 Prehospital Standard Medical Recordkeeping

A.   During or immediately after the time of patient care, an ambulance patient care report form shall be prepared for each patient,
       with at least copies as follows: original copy retained by the ambulance service, one copy to medical facility, if patient is
       transported to such, and one copy to be retained by the ambulance service to provide to the director of health, if requested by
       the director of  health. The ambulance patient care report shall include a copy of the dispatch card, if utilized, and the following
       information, on a department- approved standardized form:

      1. Patient identification/name;
      2. Residence;
      3. Date of birth, and age;
      4. Sex;
      5. Date and time call was received;
      6. Dispatch incident run number;
      7. Ambulance unit identification;
      8. Crew identification;
      9. Time of emergency vehicle departure;
      10. Location of incident;
      11. Time of arrival at incident location;
      12. Patient’s condition observed by arriving crew;
      13. Preliminary impression;
      14. Anatomical sites of injury or illness;
      15. Degree of urgency or severity of patient’s condition;
      16. Aid or treatment provided by crew;
      17. Time of departure from incident location;
      18. Outcome or destination of run; and
      19. Time of arrival at destination.

B.   Section 11-72-22(a) shall apply with equal force, for the data obtainable, in case any patient dies before being transported in the
       ambulance or dies while being transported in an ambulance or dies at any time prior to the acceptance of the patient into the
       responsibility of the hospital or medical or other authority if the patient is still under the care or responsibility of the ambulance

C.   The prehospital data to be recorded on the provided ambulance patient care report form and the available emergency room and
       hospital, inpatient data shall be used for the purposes of obtaining follow-up data. Any data recorded, collected, or evaluated for
       the prehospital emergency medical data system shall comply with applicable federal and state guidelines and statutes relating
       to the privacy of medical data and a patient’s condition.

       [Eff. AUG 12 1985] (Auth: HRS §321-233) (Imp: HRS §§321-224, 321-226)