PRF Helper Template

Disclaimer: This is a suggested format only. Items may be missing or extras added. Use within your own clinical scope. No data is saved or retained – ensure you keep copies for your records.

Patient Details

Name

Provided Unknown Refused

Date of Birth

Provided Unknown Refused

Age Sex

Male Female Other Unknown

Address

Provided Unknown Refused

Postcode (type for full address)

Provided Unknown Refused

Past Medical History (PMHx) Taking medication?

Yes No

Medical conditions?

Yes No

Allergies?

Yes No

Known to social work?

Yes No Unknown

Presenting Complaint (PC) What is the main issue the patient needs help with right now?

History of Presenting Complaint (HPC) What led to this problem? (What happened, when/how long ago did it start, how has it changed over time?) Priority symptoms / mechanisms (tick all that apply)

How long have symptoms been present?

Was there a witness?

Any similar episodes before?

Pain score (0-10)

On Arrival (O/A) AVPU

A – Alert V – Voice P – Pain U – Unresponsive

Position / activity you found them in Who was already on scene? (tick all that apply, or leave blank if no one)

Family / friends Venue staff / security Police Scotland Other

Any treatment given before your arrival? (tick all that apply, or leave blank if none)

On Examination (O/E)

GCS Calculator (click to expand)

Eyes

Verbal

Motor

4 – Spontaneous

5 – Orientated

6 – Obeys commands

3 – To speech

4 – Confused conversation

5 – Localises pain

2 – To pain

3 – Inappropriate words

4 – Withdraws from pain

1 – No response

2 – Incomprehensible sounds

3 – Flexion to pain

1 – No response

2 – Extension to pain

1 – No response

Total GCS

Airway – what did you find? (tick all that apply)

Obstructed Maintained manually Adjunct in place (OPA/NPA)

Breathing – what did you find? (tick all that apply)

Fast (>20) Slow (<10) Noisy (wheeze / crackle) SpO₂ < 94 % on air

Circulation – what did you find? (tick all that apply) Disability – what did you find? (tick all that apply) Exposure – rapid head-to-toe (tick all that apply) Pupils

Equal and reactive Unequal

Size (mm)

Additonal Notes (elaborate on O/E findings) Observations (time + vitals) — add as many as required

Management / Treatment Given Additional management notes

Job Details Any additional job/scene information to record?

Yes No

Medical Centre Handover Handed over to Medical Centre?

Yes No

Discharge Outcome

▼ Extras (Social & Family History) — click to expand