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Injury Cart

年齡性別	男性女性
Allergy	Denied, NKA Yes
Medications / Past history	Denied Yes
Last meal	不需要NPO 需要NPO NPO 選擇未進食/喝水 > 8小時有進食/喝水
Event	機車機車騎士機車乘客 Helmet Helmet(+) Helmet(-) 安全帽脫落汽車汽車駕駛汽車乘客 Seat belt Seat-belt(+) Seat-belt(-) Airbag 安全氣囊未爆開安全氣囊爆開無安全氣囊
Sign and Symptoms	ILOC Denied Denied head trauma Yes 嘔吐 Denied Yes 顱底症狀 Raccoon eye Epistaxis Rhinorrhea Battle sign 頸部疼痛 Denied Neck soreness Yes 胸部疼痛 Denied Yes Pain over left chest Pain over mid chest Pain over right chest 腹部疼痛 Denied Yes Epigastric pain Hypogastric pain Left abd pain Right abd pain 背部疼痛 Denied Yes Upper back pain Low back pain Sacral pain Left flank pain Right flank pain Left buttock pain Right buttick pain 肢體疼痛 Denied Yes Pain over left clavicle Pain over right clavicle Pain over left shoulder Pain over right shoulder Left upper limb Pain over left arm Pain over left elbow Pain over left forearm Pain over left wrist Pain over left hand Right upper limb Pain over right arm Pain over right elbow Pain over right forearm Pain over right wrist Pain over right hand Left lower limb Pain over left hip Pain over left thigh Pain over left knee Pain over left leg Pain over left ankle Pain over left foot Right lower limb Pain over right hip Pain over right thigh Pain over right knee Pain over right leg Pain over right ankle Pain over right foot Wound Denied open wound 破傷風 Denied tetanus injection w/i 5 years Tetanus injection w/i 5 years Denied any discomfort before accident

區塊	部位	型態	描述(選填)
頭部	頭部 Unspecified	Contusion Abrasion Laceration	Redness Swelling Pain
	額頭 Forehead	Contusion Abrasion Laceration	Redness Swelling Pain
	左臉頰 Left cheek	Contusion Abrasion Laceration	Redness Swelling Pain
	右臉頰 Right cheek	Contusion Abrasion Laceration	Redness Swelling Pain
	下巴 Chin	Contusion Abrasion Laceration	Redness Swelling Pain
五官	左眼皮/眼睛周圍 Left eyelid and periocular area	Contusion Abrasion Laceration	Redness Swelling Pain
	右眼皮/眼睛周圍 Right eyelid and periocular area	Contusion Abrasion Laceration	Redness Swelling Pain
	左耳 Left ear	Contusion Abrasion Laceration	Redness Swelling Pain
	右耳 Right ear	Contusion Abrasion Laceration	Redness Swelling Pain
	鼻 Nose	Contusion Abrasion Laceration	Redness Swelling Pain
	嘴唇 Lip	Contusion Abrasion Laceration	Redness Swelling Pain
頸部	頸部 Neck	Contusion Abrasion Laceration	Redness Swelling Pain

區塊	部位	型態	描述(選填)
胸部	胸部 Unspecified thorax	Contusion Abrasion Laceration	Redness Swelling Pain
	左胸 Left thorax	Contusion Abrasion Laceration	Redness Swelling Pain
	右胸 Right thorax	Contusion Abrasion Laceration	Redness Swelling Pain
腹部	腹壁 Abdominal wall, unspecified (including flank)	Contusion Abrasion Laceration Burn	Redness Swelling Pain
背部/臀部/會陰	上背部 Back wall of thorax(upper back)	Contusion Abrasion Laceration	Redness Swelling Pain
	下背部/骨盆 Low back and pelvis	Contusion Abrasion Laceration	Redness Swelling Pain
	生殖器 Genital	Contusion Abrasion Laceration	Redness Swelling Pain

區塊	部位	型態	描述(選填)
左上肢	左肩 Left shoulder	Contusion Abrasion Laceration	Redness Swelling Pain Deformity Limited ROM
	左上臂 Left upper arm	Contusion Abrasion Laceration	Redness Swelling Pain Deformity
	左手肘 Left elbow	Contusion Abrasion Laceration	Redness Swelling Pain Deformity Limited ROM
	左前臂 Left forearm	Contusion Abrasion Laceration	Redness Swelling Pain Deformity Limited ROM
	左手腕 Left wrist	Contusion Abrasion Laceration	Redness Swelling Pain Deformity Limited ROM
右上肢	右肩 Right shoulder	Contusion Abrasion Laceration	Redness Swelling Pain Deformity Limited ROM
	右上臂 Right upper arm	Contusion Abrasion Laceration	Redness Swelling Pain Deformity
	右手肘 Right elbow	Contusion Abrasion Laceration	Redness Swelling Pain Deformity Limited ROM
	右前臂 Right forearm	Contusion Abrasion Laceration	Redness Swelling Pain Deformity Limited ROM
	右手腕 Right wrist	Contusion Abrasion Laceration	Redness Swelling Pain Deformity Limited ROM
左下肢	左髖 Left hip	Contusion Abrasion Laceration	Redness Swelling Pain Deformity Limited ROM
	左大腿 Left thigh	Contusion Abrasion Laceration	Redness Swelling Pain Deformity
	左膝 Left knee	Contusion Abrasion Laceration	Redness Swelling Pain Deformity Limited ROM
	左小腿 Left leg	Contusion Abrasion Laceration	Redness Swelling Pain Deformity Limited ROM
	左腳踝 Left ankle	Contusion Abrasion Laceration	Redness Swelling Pain Deformity Limited ROM
右下肢	右髖 Right hip	Contusion Abrasion Laceration	Redness Swelling Pain Deformity Limited ROM
	右大腿 Right thigh	Contusion Abrasion Laceration	Redness Swelling Pain Deformity
	右膝 Right knee	Contusion Abrasion Laceration	Redness Swelling Pain Deformity Limited ROM
	右小腿 Right leg	Contusion Abrasion Laceration	Redness Swelling Pain Deformity Limited ROM
	右腳踝 Right ankle	Contusion Abrasion Laceration	Redness Swelling Pain Deformity Limited ROM

區塊	部位	型態	描述(選填)
左手	左手 Left hand	Contusion Abrasion Laceration	Redness Swelling Pain Deformity
	左拇指 Left thumb	Contusion Abrasion Laceration 指甲受傷 With damage to nail	Redness Swelling Pain Deformity Limited ROM
	左食指 Left index finger	Contusion Abrasion Laceration 指甲受傷 With damage to nail	Redness Swelling Pain Deformity Limited ROM
	左中指 Left middle finger	Contusion Abrasion Laceration 指甲受傷 With damage to nail	Redness Swelling Pain Deformity Limited ROM
	左無名指 Left ring finger	Contusion Abrasion Laceration 指甲受傷 With damage to nail	Redness Swelling Pain Deformity Limited ROM
	左小指 Left little finger	Contusion Abrasion Laceration 指甲受傷 With damage to nail	Redness Swelling Pain Deformity Limited ROM
右手	右手 Right hand	Contusion Abrasion Laceration	Redness Swelling Pain Deformity
	右拇指 Right thumb	Contusion Abrasion Laceration 指甲受傷 With damage to nail	Redness Swelling Pain Deformity Limited ROM
	右食指 Right index finger	Contusion Abrasion Laceration 指甲受傷 With damage to nail	Redness Swelling Pain Deformity Limited ROM
	右中指 Right middle finger	Contusion Abrasion Laceration 指甲受傷 With damage to nail	Redness Swelling Pain Deformity Limited ROM
	右無名指 Right ring finger	Contusion Abrasion Laceration 指甲受傷 With damage to nail	Redness Swelling Pain Deformity Limited ROM
	右小指 Right little finger	Contusion Abrasion Laceration 指甲受傷 With damage to nail	Redness Swelling Pain Deformity Limited ROM
左腳	左腳 Left foot	Contusion Abrasion Laceration	Redness Swelling Pain Deformity
	左大拇趾 Left great toe	Contusion Abrasion Laceration 指甲受傷 With damage to nail	Redness Swelling Pain Deformity Limited ROM
	左腳第二趾(食趾) Left pointer toe	Contusion Abrasion Laceration 指甲受傷 With damage to nail	Redness Swelling Pain Deformity Limited ROM
	左腳第三趾(中趾) Left middle toe	Contusion Abrasion Laceration 指甲受傷 With damage to nail	Redness Swelling Pain Deformity Limited ROM
	左腳第四趾(無名趾) Left ring toe	Contusion Abrasion Laceration 指甲受傷 With damage to nail	Redness Swelling Pain Deformity Limited ROM
	左腳第五趾(小趾) Left little toe	Contusion Abrasion Laceration 指甲受傷 With damage to nail	Redness Swelling Pain Deformity Limited ROM
右腳	右腳 Right foot	Contusion Abrasion Laceration	Redness Swelling Pain Deformity
	右大拇趾 Right great toe	Contusion Abrasion Laceration 指甲受傷 With damage to nail	Redness Swelling Pain Deformity Limited ROM
	右腳第二趾(食趾) Right pointer toe	Contusion Abrasion Laceration 指甲受傷 With damage to nail	Redness Swelling Pain Deformity Limited ROM
	右腳第三趾(中趾) Right middle toe	Contusion Abrasion Laceration 指甲受傷 With damage to nail	Redness Swelling Pain Deformity Limited ROM
	右腳第四趾(無名趾) Right ring toe	Contusion Abrasion Laceration 指甲受傷 With damage to nail	Redness Swelling Pain Deformity Limited ROM
	右腳第五趾(小趾) Right little toe	Contusion Abrasion Laceration 指甲受傷 With damage to nail	Redness Swelling Pain Deformity Limited ROM