v2.0.0 -- Consolidated release: privacy, trust boundary, clinical accuracy, Chief Paramedic terminology

Paramedic-Narrative v2.0.0

New since your last update

• 14 narrative formats, not just SOAP. SOAPE, SOAPIER, CHART, CHARTE,
  DCHART-E, CHRONOLOGICAL, HEAD-TO-TOE, DRAATT, AT CHART, FACT, a dedicated
  REFUSAL/NON-TRANSPORT template, an IFT (interfacility transfer) template, and
  a CUSTOM format your agency can define. Say "use CHART for this one" to
  override per call.
• Photos plus dictation, together. Add a monitor photo, an ePCR screen, a
  medication label, or facility paperwork alongside your spoken or typed
  description. Everything gets transcribed exactly and confirmed back to you
  before it's used — nothing is ever guessed from a blurry photo.
• Document a call in pieces, whenever you have a minute. Start on scene,
  add more during transport, finish after you clear. The skill tracks what
  it still needs and never asks you to repeat something you already gave it.
• Documenting hours later? Say so. Instead of a blank interview, you get
  targeted questions built from what's already known — the kind that jog
  memory instead of demanding free recall.
• On-request IMIST-AMBO handoff prep, assembled from what you've already
  told the assistant during a call — say "handoff prep" or "IMIST-AMBO now."
• A training example after every draft, modeling a clean structured
  handoff built from your own call data. Clearly labeled, never part of the
  PCR, never a critique of the handoff you actually gave.
• On-request prearrival notification note — a copy-paste block matched to
  your notification platform's fields, built only from what you've stated.

Corrections and clarifications in this release

Clinical reference accuracy

• The adult respiratory-rate reference range now matches NASEMSO's National
  Model EMS Clinical Guidelines (Universal Care, Table 1), which the vital
  threshold table cites directly.
• HEART Score and CURB-65 guidance notes that troponin and urea/BUN are lab
  values: document a full score only if that value was obtained, and use
  CRB-65 (no urea component) otherwise.
• PERC rule guidance notes it applies only when a patient has already been
  assessed as low pretest probability for PE.
• Cincinnati Prehospital Stroke Scale and "CPSS" are the same instrument (a
  general stroke screen), distinct from VAN (a large-vessel occlusion
  screen).
• ACS Field Triage guidance reflects the American College of Surgeons' 2021
  revision: penetrating injury is an Injury Patterns criterion, the
  physiologic criterion is motor GCS below 6, and systolic blood pressure
  thresholds are age-banded.

Privacy guidance

• One consistent rule for photographing anything that might contain patient
  information, stated the same way everywhere it appears: redact identifiers
  before you take the photo, not after. If you can't fully redact it, dictate
  the values instead. Applies the same way to a monitor screen, an ePCR tab,
  or paperwork.

A brief check-in before a full write-up

• Before a complete after-the-fact narrative, the assistant gives you one
  short list of anything still open, so you can confirm, correct, or say you
  don't recall it in one pass. Live handoff prep and prearrival notes stay
  immediate.
• Anything the assistant calculates on your behalf (for example, an estimated
  gestational age worked out from a due date) is always flagged for your
  confirmation, the same as anything else unverified.

Setup instructions

• ChatGPT and Gemini mobile setup: building or editing a Custom GPT or a Gem
  is a web-only feature on both platforms; the mobile apps are for using one
  you've already set up.
• Microsoft Copilot: a declarative agent (Copilot Studio / Agent Builder) can
  hold a persistent knowledge source, as an alternative to the per-session
  paste workflow already documented.

New dictation references

• The printable pocket card is sized as an actual card.
• Two new formats of the same 12-point dictation skeleton: a wallet-size
  business card, and a tall reference image sized to view on a phone screen
  while you're dictating.

Agency configuration template

• Section 2 is now Chief Paramedic Endorsement. Existing configuration files
  need no changes; use the current field names the next time you revise one.

Before you use v2.0.0

A small number of additional clinical-reference items are open for Chief
Paramedic confirmation and unchanged in this release. This tool documents
your clinical reasoning; it does not supply it.

Getting the update

• Claude: replace the Instructions field contents with the new
  system-prompt.md, and replace SKILL.md (and any changed reference files)
  in Files. If your account uses the separate Skill package instead, download
  the new paramedic-narrative.skill from the Releases page and replace it
  under Settings > Skills (browser required for that step).
• ChatGPT: replace the Instructions field with the new
  chatgpt-instructions.md, and replace the uploaded SKILL.md Knowledge
  File — don't leave the old one in place alongside it.
• Gemini: replace your Gem's instructions with the new system-prompt.md.
• Microsoft Copilot: update your Custom Instructions and use the new
  SKILL.md for your per-session paste going forward.

Your provider profile and agency configuration files are unaffected — only the
skill itself needs to be replaced.