EMERGENCY MEDICAL SERVICE
AMBULANCE CALL REPORT                No. 2-0724807

Date: 8/21/93    Unit:25X3    Crew:   first 2852 and 3036    Message ID 1836

LOCATION:  2728 Henry Hudson Pkwy #51A (Bronx)  TYPE OF CALL:  UNCON

NAME:  Speken, Seth     Sex:  Male   Age:  23    DOB:  7/19/70

CHIEF COMPLAINT:     He passed out

MEDICAL:       (symptoms checked off on form)

1.  Dizziness
2.  Gastrointestinal Distress
3.  Abdominal Pain

Medications:   Only Amitriptylene (Elavil) listed

Presumptive Diagnosis:   Rule Out GI Distress        Condition:    Serious

COMMENTS:    23 year old male found alert and oriented X3  complaints/of
nausea/vomiting X all day.   Patient states Dizziness and Abdominal
pain, family states patient passed out     patient suffered abrasion to fact
patient  (?lost consciousness          Abdominal point tenderness    Patient
states feels worse sitting     rest illegible)

VITAL SIGNS:

1.  Blood Pressure      150/60
2.  Pulse                      130
3.  Respiration             24
4.  Skin                        Moist
5.  Skin                        Cool
6.  Skin Color              Pale
7.  Pupils                     Dilated
8.  Mental Status         Alert/oriented

Treatment:     Oxygen Therapy administered     10 liters per minute

(an Intravenous is checked off.   The balance of the chart contains abbreviations
regarding oxygen flow)

                                                                    Hospital Receiving Agent
                                                                              (?D. Peterson, R.N.)

                                                                    Ambulance Supervisor Only
                                                                    Reviewed by    (Signature KH)

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