CHART Documentation Format Example
A Pt. report was called to the ER Ambulance Triage and the call receiver was advised of a possible STEMI ACS Pt. The Pt. did not report any pain improvement with the initial NTG. A second 0.4 mg SL spray was administered. Rx. (Treatment-continued) On arrival @ the ER, the stretcher was removed from the ambulance, rolled into the ER and
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