Same Call, Five Formats

The clinical facts do not change when you change headings. This lesson is the transfer exam: take one fictional call and see it in all five methods, then pick the format your agency actually wants.

The shared facts (fictional)

58 y/o male, crushing pain at 09:10 while shoveling, "elephant on my chest," left arm, 8/10, denied SOB at onset, no syncope, stent history. 09:16 BP 148/92 HR 98 SpO2 96% RA, diaphoretic. ASA 324 mg 09:22, NTG 0.4 mg SL 09:25, pain 8→5. ALS to PCI, report given.

SOAP (argument)

S holds the quote and OPQRST. O holds serial vitals. A is suspected ACS. P is timed ASA/NTG, response, PCI necessity.

CHART (EMS workhorse)

C is the elephant quote plus shoveling. H is OPQRST and negatives. A is the pale diaphoretic exam and both vital sets. Rx is ASA and NTG with times. T is PCI, monitoring, spouse POV.

DCHART (FTO default)

D adds Medic 12 dispatched 09:12, on scene 09:14, chair, snow, spouse at the door. Then the same CHART. If you skip D, you skipped how the call started.

CHEATED (reassessment)

Exam is diaphoresis, clear lungs, first vitals. Treatment is ASA/NTG. Evaluation is pain 8→5 and the 09:28 vitals. Disposition is PCI handoff. The second E is not optional.

Chronological (clock)

09:12 dispatched. 09:14 chair, quote. 09:16 vitals. 09:22 ASA. 09:25 NTG. 09:28 pain 5/10. 09:32 departed. 09:44 PCI report. Hang the negatives and the impression on 09:16 so they are not lost.

How to choose

• Policy first. If medical direction says CHART, do not freelance SOAP on a real ePCR.
• Arrest, multi-patient, and long resuscitations often read cleaner as Chronological or DCHART.
• CHEATED if your QA keeps asking "and then what happened after the neb?"
• SOAP if your receiving physicians think in S/O/A/P — still include times and response in P.
• In this trainer, pick the format you are practicing, write it fully, then open Sample narrative in that same format.

Transfer drill

Write the shovel call once in your weakest format. Score. Rewrite using the Sample narrative as a map, not a paste. Then write the CHF orthopnea call in a second format. The excellence bar — quote, times, negatives, dose/route, response, necessity — should survive both.

This academy is a training aid, not an ePCR and not CE. Never put real PHI in these drills.