History ofbrokenbone_____PERRLA_____Blueeyes_____Traveledoutside thecountry inlast 3 months_____Visiblebruise_____History ofasthma_____Has stairsin home_____Wearinga red shirt_____Lump/mass onskin_____Skinwarm totouch_____Skin coldto touch_____Hasseriousallergy_____Last BM=today_____Cranialnerves I-XII intact_____Frequentheadaches/migraines_____Hasbirthmark_____Takes aprescribedmedication_____Requiresvisualcorrectivedevice_____Palemucousmembranes_____Hazeleyes_____Pastsurgicalhistory_____Respiratoryillness withinlast 30 days_____Diarrheawithin last10 days_____Abnormal skincolor (pallor,cyanosis,mottling)_____Exercisesregularly (3+times perweek)_____Large skinlesion (>6mm)_____GCS lessthan 15_____Visiblescar_____Non-intact skin_____History ofbrokenbone_____PERRLA_____Blueeyes_____Traveledoutside thecountry inlast 3 months_____Visiblebruise_____History ofasthma_____Has stairsin home_____Wearinga red shirt_____Lump/mass onskin_____Skinwarm totouch_____Skin coldto touch_____Hasseriousallergy_____Last BM=today_____Cranialnerves I-XII intact_____Frequentheadaches/migraines_____Hasbirthmark_____Takes aprescribedmedication_____Requiresvisualcorrectivedevice_____Palemucousmembranes_____Hazeleyes_____Pastsurgicalhistory_____Respiratoryillness withinlast 30 days_____Diarrheawithin last10 days_____Abnormal skincolor (pallor,cyanosis,mottling)_____Exercisesregularly (3+times perweek)_____Large skinlesion (>6mm)_____GCS lessthan 15_____Visiblescar_____Non-intact skin_____

H2T Assessment Bingo - Call List

(Print) Use this randomly generated list as your call list when playing the game. There is no need to say the BINGO column name. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.


1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
  1. History of broken bone _____
  2. PERRLA _____
  3. Blue eyes _____
  4. Traveled outside the country in last 3 months _____
  5. Visible bruise _____
  6. History of asthma _____
  7. Has stairs in home _____
  8. Wearing a red shirt _____
  9. Lump/ mass on skin _____
  10. Skin warm to touch _____
  11. Skin cold to touch _____
  12. Has serious allergy _____
  13. Last BM= today _____
  14. Cranial nerves I-XII intact _____
  15. Frequent headaches/ migraines _____
  16. Has birthmark _____
  17. Takes a prescribed medication _____
  18. Requires visual corrective device _____
  19. Pale mucous membranes _____
  20. Hazel eyes _____
  21. Past surgical history _____
  22. Respiratory illness within last 30 days _____
  23. Diarrhea within last 10 days _____
  24. Abnormal skin color (pallor, cyanosis, mottling) _____
  25. Exercises regularly (3+ times per week) _____
  26. Large skin lesion (>6 mm) _____
  27. GCS less than 15 _____
  28. Visible scar _____
  29. Non-intact skin _____