HICS 254 - DISASTER VICTIM/PATIENT TRACKING
PURPOSE:
The HICS 254 Disaster Victim/Patient Tracking records the triage,
treatment, and disposition of victims/patients of the event
seeking
medical attention
NOTES
The form is completed upon arrival of the first patient and
updated
periodically. Copies of the form are sent to the Planning Section
Patient Tracking Manager each hour or as arranged, and at the end
of
each operational
period until disposition of the last victim(s) are known. If
additional
pages are needed, use another HICS 254 and repaginate as needed.
1. Incident Name:
Enter the name assigned to the incident.
2. Operational Period
Enter the start date (mm/dd/yyyy) and time (24-hour clock) and end
date
and time for the operational period to which the form applies.
3. Area
Enter the triage or specific treatment area (e.g., Triage,
Immediate
Treatment Area).
Field Tag Number
Enter field triage tag number.
Medical Record Number
Enter hospital medical record number if available.
Name
Enter the full name of victim/patient.
Sex
Enter sex: M for male, F for female, or leave blank.
DOB / Age
Enter date of birth and age, numbers only.
Triage Category
Enter the triage category assigned to patient:
Immediate - Delayed - Minor - Expectant - Expired
Location
Enter location of procedure.
Disposition
Enter the disposition category:
(D) Discharge (A) Admit (S) Surgery (T) Transfer (M) Morgue
Disposition Time
Enter the disposition Time, 24 hour clock.
Prepared by
Enter the name of the person preparing the form. Since this is a
radio
delivered form, a typed name is same as signature. Enter
date (m/d/y), time prepared (24-hour clock), and Facility.
More Information
You can save your completed HTML to a text file. This will allow you to reload the ICS 254
with ALL entered form data. You do this prior to submitting the form. Then you can open a new 254 and load the saved HTML form data.
NOTE: Date and Times will be the previous, so change if needed. This is much like using FireFox and the addon Formlet. It will save the info
as a text file with the Date and Time as a file name. Now you can use any browser, save your form, (as many versions as you like), and then re-populate.
This form also allows for pasting data from a spreadsheet with TAB delineation.
You would create a spreadsheet to MATCH the HTML template for data in "3. Area".
Do not exceed the data entry box input lengths or the info will not be seen properly if printed.
You can do 10 columns and up to 10 rows of data.
It is suggested you experiment and test to understand how this works.
Once mastered it can be a time saver in the field for data entry.
NOTE on printing.
Printing this form is dependent upon your selected
printer and its settings. Various Web Browsers and and their viewing
sizes are not all the same. Printing from a browsers print function
may be different from the operating systems default print mode.
Select what works for you, for both printing and viewing.
You may print direct to the printer as a HTML or save as a
PDF then print the PDF. In some instances Landscape mode may print
better than Portrait.