Use this article to correctly record a vital sign, medication, or procedure that happened before your unit took over patient care. CloudPCR has a marker for this called "obtained prior to this unit's EMS care," and getting it right keeps your PCR from crediting your crew with a reading or treatment that someone else did.
What "prior to this unit's EMS care" means
A vital set or treatment is "prior to this unit's EMS care" when it happened before your crew took over the patient. Common examples are a first responder or fire crew who was on scene before you, another agency that started care and handed off, a sending facility on an interfacility transfer, or a reading from the patient's own monitor. NEMSIS keeps these separate from the vitals and treatments your crew performed, so it is worth marking them correctly.
Where the marker is
The marker sits right next to the time on each entry, and it looks slightly different depending on how you add entries (see Adding vital signs for the difference between the Entry and Legacy buttons):
- In the Record Vitals window (Legacy buttons), it is a checkbox labeled Obtained prior to this unit's EMS care.
- In the single Entry window (the default), it is a compact PTA checkbox in the header, short for "prior to arrival." Its tooltip reads "Obtained / performed prior to this unit's EMS care." Because the Entry window can hold several cards at once, the PTA checkbox applies to every card in that entry, and the label turns red when it is checked.
CloudPCR often checks it for you
You usually do not have to set this by hand. CloudPCR compares the entry's time to your Patient Contact time (from the Times section on the Incident tab). If the entry's time is earlier than when you reached the patient, CloudPCR marks it as prior to arrival automatically. It re-checks whenever you click Now, change the time, or change the date. You can always override it by checking or unchecking the box yourself.
Tip: Because the marker keys off your Patient Contact time, fill in your times first. If a prior-to-arrival set is not getting flagged, check that your Patient Contact time is entered and correct.
Saving a prior-to-arrival set without a time
Normally a vital set needs a time before you can save it. There is one exception: if you mark a set as obtained prior to this unit's EMS care, you can save it without a time. This is for the common case where a first responder tells you the numbers but not the exact clock time they were taken.
It works for medications, procedures, and airway too
The same idea is not limited to vitals. Each timeline type has its own version of the marker for treatments a prior crew performed:
- Medications — Administered prior to this unit's EMS care.
- Procedures and airway — Performed prior to this unit's EMS care.
- Labs — a prior-care marker in the same spot.
Mark these the same way so your PCR shows who actually gave the medication or performed the procedure.
Cardiac monitor imports set it automatically
When you import vitals from a Stryker or Zoll cardiac monitor, CloudPCR also compares each imported reading to your Patient Contact time and marks the earlier ones as prior to arrival for you. See Importing cardiac monitor data.
A worked example
You arrive on a cardiac call where the fire department first responders are already doing CPR. They tell you the patient's first blood pressure was 80/50 at about the time they arrived, several minutes before you reached the patient. You add that vital set on the Timeline and enter their time. Because that time is earlier than your Patient Contact time, CloudPCR automatically checks Obtained prior to this unit's EMS care. You then add your own first set of vitals with the current time, and that one stays unmarked, because your crew took it. The PCR now clearly shows which readings were the first responders' and which were yours.