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Z NAC End of Tour Report
Shift Start Date
- Select -
04/24/2020
04/25/2020
04/26/2020
04/27/2020
04/28/2020
04/29/2020
04/30/2020
05/01/2020
05/02/2020
05/03/2020
05/04/2020
05/05/2020
05/06/2020
05/07/2020
05/08/2020
05/09/2020
05/10/2020
05/11/2020
05/12/2020
05/13/2020
05/14/2020
05/15/2020
05/16/2020
05/17/2020
05/18/2020
05/19/2020
05/20/2020
05/21/2020
05/22/2020
05/23/2020
05/24/2020
05/25/2020
05/26/2020
05/27/2020
05/28/2020
05/29/2020
05/30/2020
05/31/2020
Shift Start Time
- Select -
07:00
07:30
08:00
08:30
09:00
09:30
10:00
10:30
11:00
11:30
12:00
12:30
13:00
13:30
14:00
14:30
15:00
15:30
16:00
16;30
17:00
17:30
18:00
18:30
19:00
19:30
20:00
20:30
21:00
21:30
22:00
22:30
23:00
23:30
00:00
00:30
01:00
01:30
02:00
02:30
03:00
03:30
04:00
04:30
05:00
05:30
06:00
06:30
Please enter the 30 minute closest to the actual time shift is starting.
Shift End Date
- Select -
04/24/2020
04/25/2020
04/26/2020
04/27/2020
04/28/2020
04/29/2020
04/30/2020
05/01/2020
05/02/2020
05/03/2020
05/04/2020
05/05/2020
05/06/2020
05/07/2020
05/08/2020
05/09/2020
05/10/2020
05/11/2020
05/12/2020
05/13/2020
05/14/2020
05/15/2020
05/16/2020
05/17/2020
05/18/2020
05/19/2020
05/20/2020
05/21/2020
05/22/2020
05/23/2020
05/24/2020
05/25/2020
05/26/2020
05/27/2020
05/28/2020
05/29/2020
05/30/2020
05/31/2020
Shift End Time
- Select -
15:00
15:30
16:00
16:30
17:00
17:30
18:00
18:30
19:00
19:30
20:00
20:30
21:00
21:30
22:00
22:30
23:00
23:30
00:00
00:30
01:00
01:30
02:00
02:30
03:00
03:30
04:00
04:30
05:00
05:30
06:00
06:30
07:00
07:30
08:00
08:30
09:00
09:30
10:00
10:30
11:00
11:30
12:00
12:30
13:00
13:30
14:00
14:30
Please enter the 30 minute closest to the actual time shift is ending.
Crew #1 Name
Crew #2 Name
Level of Unit
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Basic Life Support
Advanced Life Support
Critical Care Transport
FEMA Placard
NYS Placard
NYS SONIM Phone ID #
FDNY ID (if applicable)
Primary Assignment
- Select -
IFT
NYC 911
Nassau 911
Dedicated Javits Emergency
Dedicated Javits Sick Call
Dedicated BJK Tennis Stadium
Task Force
- Select -
Task Force 1
Task Force 2
Task Force 3
Task Force 4
Task Force 5
Task Force 6
Task Force 7
Task Force 8
Task Force 9
Task Force 10
Nassua County
IFT
# of 911 Calls Dispatched to:
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0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
# of 911 Calls Resulting in Patient Transport:
- Select -
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
# of 911 Calls Treated and Released or Refused Transport:
- Select -
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
# of 911 Calls Cancelled:
- Select -
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
# of IFT Calls Dispatched to:
- Select -
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
# of IFT Calls Resulting in Patient Transport:
- Select -
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
# of IFT Calls Cancelled:
- Select -
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Total # of N95 Used and Discarded Today
- Select -
0
1
2
3
4
5
6
7
8
9
10
11
12
Total number of N95 masks used and discarded by the entire crew during this shift.
Total # of Face Masks Used and Discarded Today
- Select -
0
1
2
3
4
5
6
7
8
9
10
11
12
Total number of face masks used and discarded by the entire crew during this shift. This should include any masks used on patients during this shift.
Total # of Gowns Used and Discarded Today
- Select -
0
1
2
3
4
5
6
7
8
9
10
11
12
Total number of gowns used and discarded by the entire crew during this shift.
Total # of Eye Protection Used and Discarded Today
- Select -
0
1
2
3
4
5
6
7
8
9
10
11
12
Total number of eye protection used and discarded by the entire crew during this shift.
Any Unusual Incidents
Yes
No
An unusual incident may include any event the crew considers outside the norm in a traditional day (e.g. a motor vehicle crash involving the ambulance, the crew receiving a traffic ticket or parking summons, as examples).
Unusual Incident Description (if applicable)
Please describe the incident in your own terms, be objective in your observations and state facts only. Please do
not
include any PHI or PII in this statement.
Crew Injuries / Illnesses / Exposures
Yes
No
Potential
Illness / Injury / Exposure Report Filed
Yes
No
Comments or Observations During Today's Shift
Submit