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Log Hauling & Lowbedding Safe Driving Practices And Operating ...

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(Revised October 2006)<br />

DISPATCH INFORMATION FOR HOSPITAL / AIR AMBULANCE<br />

Who is calling? ________________________________<br />

Contact Phone __________________________________<br />

Contact frequency/name __________________________<br />

Latitude __________ Longitude __________ (on all maps)<br />

Geographic Description: ___________________________<br />

Destination: _____________________________________<br />

Number of persons injured? _________________________<br />

Age: _____ Sex: _______ Approx. Weight lbs. / kg.<br />

Nature of injury:<br />

_______________________________________________<br />

Breathing Problems? _____yes _____no<br />

Is the patient unconscious? _____yes _____no<br />

Is there uncontrolled bleeding? _____yes _____no<br />

Position of Patient (lying, sitting, standing)<br />

________________________________________________<br />

Is stretcher required? _____yes ____no<br />

Is First Aid Attendant on Site? _____yes ____no<br />

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