Impression section

The Impression section is where you record your clinical assessment of what is going on with the patient.

What to fill in

• Primary Symptom — the main thing the patient is feeling, in NEMSIS terms (chest pain, shortness of breath, weakness, altered mental status, and so on).
• Other Associated Symptoms — anything else relevant. Multi-select.
• Provider's Primary Impression — your best clinical guess at what is wrong, picked from the standardized impression list.
• Provider's Secondary Impressions — anything else clinically relevant. Multi-select.

Primary symptom vs primary impression

The primary symptom is what the patient feels: "chest pain." The primary impression is your assessment of the cause: "acute coronary syndrome." These are different fields because the same symptom can have many different causes, and your state cares about both.

An example

You respond to a 60-year-old male with chest pain that radiates to his left arm. His 12-lead shows ST elevation in leads II, III, and aVF. You pick Chest Pain as the primary symptom and Diaphoresis as an associated symptom. You pick STEMI - Inferior Wall as the primary impression. You leave the secondary impressions blank because nothing else is going on.