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Knowledge Center

Completing an ePCR - Disposition & EMS Narrative

Purpose Statement

To explain how to complete the Disposition & EMS Narrative section of an ePCR, which documents patient disposition throughout the incident and allows completion of the incident narrative. This section ensures proper documentation of patient outcomes, transport details, and provides space for comprehensive incident documentation required for compliance and quality assurance.

Background Information

The First Due ePCR workflow is designed to follow a typical EMS incident progression through eight sequential sections. The Disposition & EMS Narrative represents the seventh step in this workflow, capturing critical end-of-incident information including patient disposition, transport details, destination information, and the comprehensive incident narrative. This section is essential for NEMSIS compliance, billing accuracy, and quality improvement initiatives.

Required Permissions

Users must have ePCR Edit permissions to complete the Disposition & EMS Narrative section. Field users, supervisors, and administrators typically have access to modify ePCR records, while view-only users cannot make changes to this section.

Video
 

Step-by-Step Guide

Accessing the Disposition & EMS Narrative Section

  1. Within the ePCR, navigate to the Disposition & EMS Narrative Section
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Important Note:

All NEMSIS required fields are notated with an asterisk (*). Depending on your state protocols, additional information could be required.

 

Completing the Disposition Section

  1. The Disposition section documents patient disposition throughout the incident. Complete the following fields as applicable:
     
    1. Unit Disposition* - Select the type of patient contact made
       
    2. Crew Disposition - Select how care was provided (Initiated, Assumed from another crew, etc.)
       
    3. Patient Evaluation - Select if patient was evaluated and the outcome of the evaluation
       
    4. Transport Disposition - Enter how/if the patient was transported and document refusal/release (if applicable)
       
    5. Disposition Instructions - If applicable select instructions given to patient if no transport
       
    6. Transported To  - Select the facility the patient is being transported to; Address information will auto-populate if built out in set up.
       
    7. Reason for Choosing Destination - Select the reason the unit chose to deliver or transfer the patient to the destination
       
    8. Transport Mode From Scene - Indicate the type of transport from scene along with any additional descriptors for that mode
       
    9. How Pt. was Moved from Ambulance - Select the method by which the patient was moved from the ambulance to the destination
       
    10. Hospital In-Patient Destination - Enter the location within the hospital that the patient was taken directly by EMS (e.g., Cath Lab, ICU, etc.)
       
    11. Final Patient Acuity - Select the acuity of the patient's condition after EMS care
       
    12. Hospital Capability - Choose the primary hospital capability associated with the patient's condition for this transport (e.g., Trauma, STEMI, Peds, etc.)
       
    13. Return Transport Required - This option can be toggled on should the patient require a return trip back to their original location (See Related Article)
       

Adding Hospital Team Activation (When Applicable)

  1. Within Disposition, document Hospital Team Activation if applicable:
    1. Select the Add Hospital Team Activation button to capture this information
    2. Complete the following required fields:
      • Destination Team Pre-Arrival Alert or Activation* - Indicate that an alert (or activation) was called by EMS to the appropriate destination healthcare facility team prior to EMS Unit arrival
      • Pre-Arrival Alert Date* - Enter the Date/Time EMS alerted, notified, or activated the destination healthcare facility prior to EMS arrival
    3. When finished, select the Save button
       

Completing the Narrative Section

  1. The Narrative section allows completion of a comprehensive narrative for the ePCR
     
  2. Enter detailed information about the incident, patient care provided, and any relevant observations or circumstances. 

 

  1. Click the Use Template button to insert a template if your agency has that turned on and configured. 
     
 
  1.  To delete the contents of the Narrative Box completely, Click the Trash Can button. 
 
 
 
 

Troubleshooting & FAQs

Q: What if required fields are highlighted in red after submission?
A: Complete all fields marked with an asterisk (*) and any additional state-required fields. The system will not allow submission until all required information is entered.
 
Q: When should I document a Hospital Team Activation?
A: Document when EMS contacted the receiving facility prior to arrival to activate specialized teams (trauma, STEMI, stroke, etc.) based on patient condition and assessment findings.
 
Q: How detailed should my narrative be?
A: Include comprehensive information about the incident, patient presentation, care provided, patient response to treatment, and disposition. The narrative should tell the complete story for quality assurance and legal documentation purposes.
 
Q: Can I edit the ePCR after submission?
A: This depends on your agency's workflow settings. Some agencies allow post-submission edits with supervisor approval, while others lock records after submission.