AGENCY: Salt Lake City (Utah). Fire Department

SERIES: 81756
TITLE: Utah Emergency Medical Services incident report
DATES: 1974-2018.
ARRANGEMENT: Numerical by assigned number in calendar year

DESCRIPTION: These report forms contain both statistical and patient information on all emergency medical service calls received by the fire department. The report is required by law (UCA 26-8-5) and a copy is submitted to the Bureau of Emergency Medical Services (Dept. of Health) for auditing compliance. This form serves as the medical chart for all patients treated by the department's paramedics. These forms include report number; incident location; patient name; address; unit location on dispatch; cause of injury; run number; date; time; patient age; sex; chief complaint; description of problem; past history; medication history; allergies; odometer reading; physiological status (pulse, blood pressure, respiratory, skin, neurological; Glasgow coma scale, results); medications administered; time and dosage; actions taken; type of EMS response; medical control; type of treatment; and related activity.


Retain for 25 year(s)




These records are in Archives' permanent custody.

APPROVED: 04/1987


Paper: Retain in Office for 25 years and then destroy.



This retention is based upon the administrative needs expressed by the department's fire surgeon. This form is seen as an important part of the patient's medical history and should be maintained for at least twenty-five years.