Well a unique issue for my current departments ePCR that I don't think any of you guys have to deal with is that it pretty much HAS to be written by the Paramedic on their iPad, and then transferred to our unit's iPad before we can transport BLS. In a decision that apparently made sense to the chief officers who decided on it,w hen they do so, the software on our BLS iPad locks out many features, including the narrative. I literally cannot go in and edit the narrative. IF I catch the engine medics before they leave I can push the form back to them and they can change/edit and then push back to me, but if they're already gone...well it is their signature on the form....Not my favorite answer by any means but sadly thats the way it is here.
But for the old paper PCR's we keep as backups, along with those of both the private companies I used to work for, the forms were of the ilk that you had to press hard while writing to transfer to three different pieces of paper (one stayed with the company for our records, one stayed with the patient for their medical records, one went to the County EMS office and so on) so if I REALLY wanted/needed to write a second page, I'd have to start a whole second PCR and include all the other bits of header data (Pt info, pickup and dropoff locations, dispatch/enroute/onscene/transport/transport complete times, vitals, EVERYTHING) would have to be replicated in order to do a narrative continuation on a second page, now where the narrative box will literally only fit one of those 5 paragraphs DE wrote....well you can see redoing 6-8 PCRs 5 times each over the course of a single shift would simply become a huge hassle that would have gotten me hauled into the supervisors office asking why I'm wasting so much paper to write out so much redundant detail already covered in other places on the PCR.
It was simply not realistic on routine PCRs to write out such a long and detailed narrative. The only official Page 2 we have is specifically for advanced ALS procedures like intubations and cardiac arrest resuscitation.
Since I'm not at work I don't have access to a blank copy of my current PCR software, but it's one of those programs designed to look just like a single page paper PCR that you then tap on a section and it brings up the appropriate boxes to edit info, and once your done is designed to look just like a paper PCR you scanned in (versus some others I've seen full of tabs and pages where you can write endless amounts of info). In fact our base hospital makes us print out a copy and since they're rather stingy with printer paper and toner we are supposed to keep it to the one page so that one paragraph box is all we have to work with.
I do have a blank PCR from my previous job so you can see the space I had to work with, and the lack thereof to write novels for every single patient. Also I'm attaching a copy of my current official narrative writing guidance.
(also, purely technically speaking, alcohol is bad to use. Methonal poisoning is a type of alcohol poisoning)
