HEADER - Demographic EMS Agency Information Group

Transcription

1 Version 3 Requisite National s - EMS DataSet - The Version National Subset of data elements f the EMS DataSet Patient Care Rept (epcr/event) submission is listed below. A total of 133 elements comprise the EMS Incident / Patient Care Rept Dataset (EMSDataSet) submission infmation. Three demographic (DEM DataSet) elements make up the header infmation specific to the EMS Agency. The actual epcr/event infmation consists of 130 elements. V3 (epcr/event Recd) No = submit a real value. Mandaty s. Yes = NOT values and Nils. Required s. HEADER - Demographic EMS Agency Infmation Group 1 dagency.01 EMS Agency Unique State ID Yes No 2 dagency.02 EMS Agency Yes No 3 dagency.04 EMS Agency State Yes No INCIDENT / PATIENT CARE REPORT (epcr/event) Infmation Group - This group repeats to allow multiple incident responses patient encounters to be submitted in the XML file. - The national elements shown below are submitted f each single incident patient recd infmation. erecd Infmation 1 erecd.01 Patient Care Rept Yes No 2 erecd.02 Software Creat Yes No 3 erecd.03 Software Name Yes No 4 erecd.04 Software Version Yes No eresponse Infmation 5 eresponse.01 EMS Agency Yes No 6 eresponse.03 Incident Yes Yes 7 eresponse.04 EMS Response Yes Yes 8 eresponse.05 Type of Service Requested Yes No 9 eresponse.07 Primary Role of the Unit Yes No 10 eresponse.08 Type of Dispatch Delay Yes Yes 11 eresponse.09 Type of Response Delay Yes Yes 12 eresponse.10 Type of Scene Delay Yes Yes 13 eresponse.11 Type of Transpt Delay Yes Yes 14 eresponse.12 Type of Turn-Around Delay Yes Yes 15 eresponse.13 EMS Vehicle (Unit) Yes No EMS (epcr/event) DataSet Requisite s May 2015 Page 1 of 6

2 V3 16 eresponse.14 EMS Unit Call Sign Yes No 17 eresponse.15 Level of Care of This Unit Yes No 18 eresponse.23 Response Mode to Scene Yes No 19 eresponse.24 Additional Response Mode Descripts Yes Yes edispatch Infmation 20 edispatch.01 Complaint Repted by Dispatch Yes No 21 edispatch.02 EMD Perfmed Yes Yes etimes Infmation 22 etimes.01 PSAP Call Date/Time Yes Yes 23 etimes.03 Unit Notified by Dispatch Date/Time Yes No 24 etimes.05 Unit En Route Date/Time Yes Yes 25 etimes.06 Unit Arrived on Scene Date/Time Yes Yes 26 etimes.07 Arrived at Patient Date/Time Yes Yes 27 etimes.09 Unit Left Scene Date/Time Yes Yes 28 etimes etimes.12 Patient Arrived at Destination Date/Time Yes Yes Destination Patient Transfer of Care Date/Time Yes Yes 30 etimes.13 Unit Back in Service Date/Time Yes No epatient Infmation 31 epatient.07 Patient s Home County Yes Yes 32 epatient.08 Patient s Home State Yes Yes 33 epatient.09 Patient s Home ZIP Code Yes Yes 34 epatient.13 Gender Yes Yes 35 epatient.14 Race Yes Yes 36 epatient.15 Age Yes Yes 37 epatient.16 Age Units Yes Yes epayment Infmation 38 epayment.01 Primary Method of Payment Yes Yes 39 epayment.50 CMS Service Level Yes Yes escene Infmation 40 escene.01 First EMS Unit on Scene Yes Yes 41 escene.06 of Patients at Scene Yes Yes 42 escene.07 Mass Casualty Incident Yes Yes EMS (epcr/event) DataSet Requisite s May 2015 Page 2 of 6

3 V3 43 escene.08 Triage Classification f MCI Patient Yes Yes 44 escene.09 Incident Location Type Yes Yes 45 escene.18 Incident State Yes Yes 46 escene.19 Incident ZIP Code Yes Yes 47 escene.21 Incident County Yes Yes esituation Infmation 48 esituation.01 Date/Time of Symptom Onset Yes Yes 49 esituation.02 Possible Injury Yes Yes 50 esituation.07 Chief Complaint Anatomic Location Yes Yes 51 esituation.08 Chief Complaint Organ System Yes Yes 52 esituation.09 Primary Symptom Yes Yes 53 esituation.10 Other Associated Symptoms Yes Yes 54 esituation.11 Provider s Primary Impression Yes Yes 55 esituation.12 Provider s Secondary Impressions Yes Yes 56 esituation.13 Initial Patient Acuity Yes Yes einjury Infmation 57 einjury.01 Cause of Injury Yes Yes 58 einjury.03 Trauma Center Criteria Yes Yes 59 einjury.04 Vehicular, Pedestrian, Other Injury Risk Fact Yes Yes earrest Infmation 60 earrest.01 Cardiac Arrest Yes Yes 61 earrest.02 Cardiac Arrest Etiology Yes Yes 62 earrest.03 Resuscitation Attempted By EMS Yes Yes 63 earrest.04 Arrest Witnessed By Yes Yes 64 earrest.05 CPR Care Provided Pri to EMS Arrival Yes Yes 65 earrest.07 AED Use Pri to EMS Arrival Yes Yes 66 earrest.09 Type of CPR Provided Yes Yes 67 earrest.11 First Monited Arrest Rhythm of the Patient Yes Yes Any Return of Spontaneous 68 earrest.12 Circulation Yes Yes 69 earrest.14 Date/Time of Cardiac Arrest Yes Yes EMS (epcr/event) DataSet Requisite s May 2015 Page 3 of 6

4 V3 70 earrest earrest.17 Reason CPR/Resuscitation Discontinued Yes Yes Cardiac Rhythm on Arrival at Destination Yes Yes 72 earrest.18 End of EMS Cardiac Arrest Event Yes Yes ehisty Infmation 73 ehisty.01 Barriers to Patient Care Yes Yes 74 ehisty.17 Alcohol/Drug Use Indicats Yes Yes evitals Infmation - This group repeats to allow f multiple times where vital sign infmation is captured. 75 evitals.01 Date/Time Vital Signs Taken Yes Yes 76 evitals.02 Obtained Pri to this Unit s EMS Care Yes Yes 77 evitals.03 Cardiac Rhythm / Electrocardiography (ECG) Yes Yes 78 evitals.04 ECG Type Yes Yes 79 evitals.05 Method of ECG Interpretation Yes Yes 80 evitals.06 SBP (Systolic Blood Pressure) Yes Yes 81 evitals.08 Method of Blood Pressure Measurement Yes Yes 82 evitals.10 Heart Rate Yes Yes 83 evitals.12 Pulse Oximetry Yes Yes 84 evitals.14 Respiraty Rate Yes Yes 85 evitals.16 End Tidal Carbon Dioxide (ETCO2) Yes Yes 86 evitals.18 Blood Glucose Level Yes Yes 87 evitals.19 Glasgow Coma Sce-Eye Yes Yes 88 evitals.20 Glasgow Coma Sce-Verbal Yes Yes 89 evitals.21 Glasgow Coma Sce-Mot Yes Yes 90 evitals.22 Glasgow Coma Sce-Qualifier Yes Yes 91 evitals.26 Level of Responsiveness (AVPU) Yes Yes 92 evitals.27 Pain Scale Sce Yes Yes 93 evitals.29 Stroke Scale Sce Yes Yes 94 evitals.30 Stroke Scale Type Yes Yes 95 evitals.31 Reperfusion Checklist Yes Yes eprotocols Infmation - This group repeats to allow f times where multiple protocols are used. 96 eprotocols.01 Protocols Used Yes Yes 97 eprotocols.02 Protocol Age Categy Yes Yes EMS (epcr/event) DataSet Requisite s May 2015 Page 4 of 6

5 V3 emedications Infmation - This group repeats to allow f times where multiple medications are given. 98 emedications.01 Date/Time Medication Administered Yes Yes 99 emedications.02 Medication Administered Pri to this Unit s EMS Care Yes Yes 100 emedications.03 Medication Given Yes Yes 101 emedications.05 Medication Dosage Yes Yes 102 emedications.06 Medication Dosage Units Yes Yes 103 emedications.07 Response to Medication Yes Yes 104 emedications.08 Medication Complication Yes Yes 105 emedications.10 eprocedures Infmation Role/Type of Person Administering Medication Yes Yes - This group repeats to allow f times where multiple procedures are perfmed. Date/Time Procedure 106 eprocedures.01 Perfmed Yes Yes 107 eprocedures.02 Procedure Perfmed Pri to this Unit s EMS Care Yes Yes 108 eprocedures.03 Procedure Yes Yes 119 eprocedures.05 of Procedure Attempts Yes Yes 110 eprocedures.06 Procedure Successful Yes Yes 111 eprocedures.07 Procedure Complication Yes Yes 112 eprocedures.08 Response to Procedure Yes Yes 113 eprocedures.10 Role/Type of Person Perfming the Procedure Yes Yes edisposition Infmation 114 edisposition.05 Destination State Yes Yes 115 edisposition.06 Destination County Yes Yes 116 edisposition.07 Destination ZIP Code Yes Yes 117 edisposition.12 Incident/Patient Disposition Yes No 118 edisposition.16 EMS Transpt Method Yes Yes 119 edisposition.17 Transpt Mode from Scene Yes Yes 120 edisposition.18 Additional Transpt Mode Descripts Yes Yes 121 edisposition.19 Final Patient Acuity Yes Yes 122 edisposition.20 Reason f Choosing Destination Yes Yes 123 edisposition.21 Type of Destination Yes Yes 124 edisposition.22 Hospital In-Patient Destination Yes Yes EMS (epcr/event) DataSet Requisite s May 2015 Page 5 of 6

6 V3 125 edisposition.23 Hospital Capability Yes Yes 126 edisposition edisposition.25 eoutcome Infmation 128 eoutcome.01 Destination Team Pre-Arrival Alert Activation Yes Yes Date/Time of Destination Prearrival Alert Activation Yes Yes Emergency Department Disposition Yes Yes 129 eoutcome.02 Hospital Disposition Yes Yes eother Infmation 130 eother.05 Suspected EMS Wk Related Exposure, Injury, Death Yes Yes EMS (epcr/event) DataSet Requisite s May 2015 Page 6 of 6