Emergency Medical Care Plan Template printable pdf download

EMERGENCY MEDICAL CARE PLAN

Emergency information on children is kept: ____________________________________________________________

Emergency information on staff is kept: _______________________________________________________________

Medical Consultant: Name__________________________________________________________________________

Address (physical street address, city and zip code) ____________________________________________________________

Phone Number _________________________________________________________________________________________

Emergency Room: Name _________________________________________________________________________________

Address (physical street address, city and zip code) ____________________________________________________________

Phone Number _________________________________________________________________________________________

Hospital: Name ________________________________________________________________________________________

Address (physical street address, city, and zip code) ____________________________________________________________

Phone Number _________________________________________________________________________________________

4. Poison Control: Carolinas Poison Center 1-800-222-1222

5. Available emergency transportation:

Name___________________ Means of transportation __________________________Phone Number________________

Rescue Squad __________________________________________________________Phone Number: 911

6. Persons in center responsible for determining the degree of care needed:

Name __________________________________________________Alternate Name: ______________________________

7. Persons in center responsible for giving first aid:

Name: __________________________________________________Alternate Name: _____________________________

8. Persons in center responsible for performing CPR:

Name: __________________________________________________Alternate Name:______________________________

9. Persons in center responsible for contacting medical resource:

Name __________________________________________________Alternate Name: ______________________________

10. Persons in center responsible for determining appropriate transportation:

Name __________________________________________________Alternate Name:______________________________

11. Persons in center responsible for accompanying the ill/injured person for medical attention and assuring that signed authorization is

taken with person to the medical facility:

Name __________________________________________________Alternate Name:_______________________________

12. Persons in center responsible for notifying the medical facility about the ill/injured child being transported for treatment:

Name __________________________________________________Alternate Name:_______________________________

13. Persons in center responsible for notification of parents or emergency contact of illness/accident:

Name __________________________________________________Alternate Name:_______________________________

14. Persons in center responsible for obtaining substitute staff:

Name __________________________________________________Alternate Name:_______________________________

15. Location of telephones: ___________________________________________________________________________________

POST IN SEVERAL LOCATIONS AT THE FACILITY THAT ARE EASILY ACCESSIBLE TO STAFF AND PARENTS

NC Division of Child Development and Early Education

Updated on _______________

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Emergency Medical Care Plan Template