Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Book

EMS Documentation

Matthew Short  1 , Scott Goldstein
In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.
.
Affiliations
Free Books & Documents
Book

EMS Documentation

Matthew Short et al.
Free Books & Documents

Excerpt

  1. For most emergency medical services (EMS), a prehospital care report (PCR) form records demographic data (name, address, billing information), vital signs (Glasgow Coma Scale, blood pressure, pulse and respiration rates, pain), a patient assessment, and details of any interventions that the EMS provider performed. The PCR can be on paper, electronic device (the ePCR), or sometimes a combination. PCR forms provide the details of patient care for handoff to other healthcare providers. The PCR also provides the documentation necessary for ambulance coders to create a bill to reimburse for the treatment provided. PCR forms are used in legal investigations, trauma registries, cardiopulmonary resuscitation (CPR) registries, research, and quality improvement initiatives.

PubMed Disclaimer

Conflict of interest statement

Disclosure: Matthew Short declares no relevant financial relationships with ineligible companies.

Disclosure: Scott Goldstein declares no relevant financial relationships with ineligible companies.

References

    1. Hagiwara MA, Magnusson C, Herlitz J, Seffel E, Axelsson C, Munters M, Strömsöe A, Nilsson L. Adverse events in prehospital emergency care: a trigger tool study. BMC Emerg Med. 2019 Jan 24;19(1):14. - PMC - PubMed
    1. Tweed J, George T, Greenwell C, Vinson L. Prehospital Airway Management Examined at Two Pediatric Emergency Centers. Prehosp Disaster Med. 2018 Oct;33(5):532-538. - PubMed
    1. Waldrop DP, McGinley JM, Dailey MW, Clemency B. Decision-Making in the Moments Before Death: Challenges in Prehospital Care. Prehosp Emerg Care. 2019 May-Jun;23(3):356-363. - PubMed
    1. Fernandez AR. Can Body Cameras Improve Documentation? Medics in this pilot study were allowed to review videos of calls and change their PCRs. EMS World. 2017 Jun;46(6):16-18. - PubMed
    1. Ramgopal S, Elmer J, Escajeda J, Martin-Gill C. Differences in Prehospital Patient Assessments for Pediatric Versus Adult Patients. J Pediatr. 2018 Aug;199:200-205.e6. - PMC - PubMed

Publication types

LinkOut - more resources