NEMSIS v3.4.0 EMSDataSet Test Case


NEMSIS V3 Test Case for Pre-testing
ID:               2023-EMS-3-FallTransport_v340
Description:      Test case for elderly fall transport.
Expected Result:  PASS

Element Value
EMSDataSet - Root Tag For Dataset
Header - Header for file
DemographicGroup - Demographic information related to this agency
dAgency.01 - EMS Agency Unique State ID EMS Agency Unique State ID 501
dAgency.02 - EMS Agency Number EMS Agency Number 340-501
dAgency.04 - EMS Agency State EMS Agency State Arkansas
PatientCareReport - Container Tag to hold each instance of a patient care report (PCR)
eRecord - Patient Record Information
eRecord.01 - Patient Care Report Number [Your Patient Care Report Number]
eRecord.SoftwareApplicationGroup - Group Tag to hold information about the software used to generate patient care report
eRecord.02 - Software Creator [Your Software Creator]
eRecord.03 - Software Name [Your Software Name]
eRecord.04 - Software Version [Your Software Version]
eResponse - Unit Agency Information
eResponse.AgencyGroup - Group Tag to hold EMS agency number and name
eResponse.01 - EMS Agency Number 340-501
eResponse.02 - EMS Agency Name [Value from DEMDataSet]
eResponse.03 - Incident Number 340-20221009012
eResponse.04 - EMS Response Number 340-20221009M2012
eResponse.ServiceGroup - Group Tag to hold details about EMS category of service and the stand by reason
eResponse.05 - Type of Service Requested 911 Response (Scene)
eResponse.07 - Primary Role of the Unit Ground Transport
eResponse.08 - Type of Dispatch Delay Language Barrier
Other
eResponse.09 - Type of Response Delay Distance
eResponse.10 - Type of Scene Delay None/No Delay
eResponse.11 - Type of Transport Delay Distance
eResponse.12 - Type of Turn-Around Delay None/No Delay
eResponse.13 - EMS Vehicle (Unit) Number 501.183
eResponse.14 - EMS Unit Call Sign GA 11
eResponse.15 - Level of Care of This Unit ALS-Paramedic
eResponse.16 - Vehicle Dispatch Location Texarkana Arkansas Station
eResponse.17 - Vehicle Dispatch GPS Location 33.460,-94.002
eResponse.18 - Vehicle Dispatch Location US National Grid Coordinates 15SVT06880273
eResponse.19 - Beginning Odometer Reading of Responding Vehicle 189351.0
eResponse.20 - On-Scene Odometer Reading of Responding Vehicle 189381.4
eResponse.21 - Patient Destination Odometer Reading of Responding Vehicle 189414.1
eResponse.22 - Ending Odometer Reading of Responding Vehicle 189420.4
eResponse.23 - Response Mode to Scene Emergent (Immediate Response)
eResponse.24 - Additional Response Mode Descriptors No Lights or Sirens
eDispatch - Dispatch Information
eDispatch.01 - Complaint Reported by Dispatch Falls
eDispatch.02 - EMD Performed Yes, Unknown if Pre-Arrival Instructions Given
eDispatch.03 - EMD Card Number 17C
eDispatch.04 - Dispatch Center Name or ID Texarkana Arkansas Police Department
eDispatch.05 - Dispatch Priority (Patient Acuity) Emergent
eDispatch.06 - Unit Dispatched CAD Record ID 20221009-176
eCrew - Crew Member Information
eCrew.CrewGroup - Group Tag to hold crew information
eCrew.01 - Crew Member ID 7492 - Chase Grey
eCrew.02 - Crew Member Level 2009 Advanced Emergency Medical Technician (AEMT)
eCrew.03 - Crew Member Response Role Driver/Pilot-Response
Driver/Pilot-Transport
Other Patient Caregiver-At Scene
eCrew.CrewGroup - Group Tag to hold crew information
eCrew.01 - Crew Member ID 35781 - Ellen Costa
eCrew.02 - Crew Member Level 2009 Paramedic
eCrew.03 - Crew Member Response Role Primary Patient Caregiver-At Scene
Primary Patient Caregiver-Transport
eTimes - Call Event Times Information
eTimes.01 - PSAP Call Date/Time October 9, 2022, 8:10:12 GMT-05:00
eTimes.02 - Dispatch Notified Date/Time October 9, 2022, 8:10:12 GMT-05:00
eTimes.03 - Unit Notified by Dispatch Date/Time October 9, 2022, 8:14:51 GMT-05:00
eTimes.04 - Dispatch Acknowledged Date/Time October 9, 2022, 8:15:08 GMT-05:00
eTimes.05 - Unit En Route Date/Time October 9, 2022, 8:17:36 GMT-05:00
eTimes.06 - Unit Arrived on Scene Date/Time October 9, 2022, 8:45:58 GMT-05:00
eTimes.07 - Arrived at Patient Date/Time October 9, 2022, 8:46:30 GMT-05:00
eTimes.08 - Transfer of EMS Patient Care Date/Time [NV = Not Applicable]
eTimes.09 - Unit Left Scene Date/Time October 9, 2022, 8:58:24 GMT-05:00
eTimes.11 - Patient Arrived at Destination Date/Time October 9, 2022, 9:35:10 GMT-05:00
eTimes.12 - Destination Patient Transfer of Care Date/Time October 9, 2022, 9:38:43 GMT-05:00
eTimes.13 - Unit Back in Service Date/Time October 9, 2022, 9:52:03 GMT-05:00
eTimes.15 - Unit Back at Home Location Date/Time October 9, 2022, 9:58:28 GMT-05:00
eTimes.16 - EMS Call Completed Date/Time October 9, 2022, 10:05:12 GMT-05:00
ePatient - Patient Information
ePatient.01 - EMS Patient ID 659JEX
ePatient.PatientNameGroup - Group Tag to hold patient's name
ePatient.02 - Last Name Macias
ePatient.03 - First Name Elina
ePatient.04 - Middle Initial/Name R
ePatient.05 - Patient's Home Address 520 South Pine Street
ePatient.06 - Patient's Home City City of Hope
ePatient.07 - Patient's Home County Hempstead County
ePatient.08 - Patient's Home State Arkansas
ePatient.09 - Patient's Home ZIP Code 71801
ePatient.10 - Patient's Country of Residence US
ePatient.11 - Patient Home Census Tract 05057480500
ePatient.12 - Social Security Number 430153583
ePatient.13 - Gender Female
ePatient.14 - Race Black or African American
Hispanic or Latino
ePatient.AgeGroup - Group Tag to hold patient's age information
ePatient.15 - Age 81
ePatient.16 - Age Units Years
ePatient.17 - Date of Birth August 4, 1941
ePayment - Insurance/Payment Information
ePayment.01 - Primary Method of Payment Medicare
ePayment.08 - Patient Resides in Service Area Resident Within EMS Service Area
ePayment.InsuranceGroup - Group Tag to hold information about the insurance company
ePayment.09 - Insurance Company ID MEDICARE
ePayment.10 - Insurance Company Name Medicare
ePayment.11 - Insurance Company Billing Priority Primary
ePayment.12 - Insurance Company Address PO Box 1437, Slot S401
ePayment.13 - Insurance Company City Little Rock
ePayment.14 - Insurance Company State Arkansas
ePayment.15 - Insurance Company ZIP Code 72203-1437
ePayment.16 - Insurance Company Country US
ePayment.18 - Insurance Policy ID Number 37468674
ePayment.19 - Last Name of the Insured Macias
ePayment.20 - First Name of the Insured Elina
ePayment.21 - Middle Initial/Name of the Insured R
ePayment.22 - Relationship to the Insured Self
ePayment.40 - Response Urgency Immediate
ePayment.46 - Stretcher Purpose Description Hip fracture
ePayment.49 - ALS Assessment Performed and Warranted Yes
ePayment.50 - CMS Service Level ALS, Level 1
ePayment.51 - EMS Condition Code W10.9 - Fall (on) (from) unspecified stairs and steps
R27.9 - Unspecified lack of coordination
ePayment.SupplyItemGroup - Group Tag to hold information about the supply used on the patient by the EMS Crew during the EMS event.
ePayment.55 - Supply Item Used Name Surgical Mask
ePayment.56 - Number of Supply Item(s) Used 3
ePayment.57 - Payer Type Medicare Part A
eScene - Incident Scene Information
eScene.01 - First EMS Unit on Scene [NV = Not Recorded]
eScene.06 - Number of Patients at Scene Single
eScene.07 - Mass Casualty Incident [NV = Not Applicable]
eScene.08 - Triage Classification for MCI Patient [NV = Not Applicable]
eScene.09 - Incident Location Type Y92.0 - Non-institutional (private) residence as the place of occurrence of the external cause
eScene.10 - Incident Facility Code [NV = Not Applicable]
eScene.11 - Scene GPS Location 33.663,-93.594
eScene.12 - Scene US National Grid Coordinates 15SVT44922494
eScene.15 - Incident Street Address 520 South Pine Street
eScene.16 - Incident Apartment, Suite, or Room Unit A
eScene.17 - Incident City City of Hope
eScene.18 - Incident State Arkansas
eScene.19 - Incident ZIP Code 71801
eScene.21 - Incident County Hempstead County
eScene.22 - Incident Country US
eScene.23 - Incident Census Tract 05057480500
eSituation - Situation Information
eSituation.01 - Date/Time of Symptom Onset October 9, 2022, 7:30:00 GMT-05:00
eSituation.02 - Possible Injury Yes
eSituation.PatientComplaintGroup - Group Tag to hold information about patient's complaint
eSituation.03 - Complaint Type Chief (Primary)
eSituation.04 - Complaint Fall
eSituation.05 - Duration of Complaint 45
eSituation.06 - Time Units of Duration of Complaint Minutes
eSituation.PatientComplaintGroup - Group Tag to hold information about patient's complaint
eSituation.03 - Complaint Type Secondary
eSituation.04 - Complaint Hip pain
eSituation.05 - Duration of Complaint 30
eSituation.06 - Time Units of Duration of Complaint Minutes
eSituation.PatientComplaintGroup - Group Tag to hold information about patient's complaint
eSituation.03 - Complaint Type Secondary
eSituation.04 - Complaint Bruising
eSituation.05 - Duration of Complaint 30
eSituation.06 - Time Units of Duration of Complaint Minutes
eSituation.07 - Chief Complaint Anatomic Location Extremity-Lower
eSituation.08 - Chief Complaint Organ System Musculoskeletal/Skin
eSituation.09 - Primary Symptom M25.55 - Pain in hip
eSituation.10 - Other Associated Symptoms M79.6 - Pain in limb, hand, foot, fingers and toes
M54.5 - Low back pain
R60.9 - Edema, unspecified
R22 - Localized swelling, mass and lump of skin and subcutaneous tissue
eSituation.11 - Provider's Primary Impression S79.91 - Unspecified injury of hip
eSituation.12 - Provider's Secondary Impressions T07 - Unspecified multiple injuries
eSituation.13 - Initial Patient Acuity Emergent (Yellow)
eSituation.WorkRelatedGroup - Group Tag to hold patient details if the illness or injury is work related
eSituation.14 - Work-Related Illness/Injury No
eSituation.17 - Patient Activity Y93.E2 - Activity, laundry
Y93.E3 - Activity, vacuuming
eInjury - Injury Information
eInjury.01 - Cause of Injury W10.9 - Fall (on) (from) unspecified stairs and steps
Y29 - Contact with blunt object, undetermined intent
eInjury.02 - Mechanism of Injury Blunt
eInjury.03 - Trauma Center Criteria Pelvic fractures
eInjury.04 - Vehicular, Pedestrian, or Other Injury Risk Factor SBP < 110 for age > 65
Anticoagulants and Bleeding Disorders
eInjury.09 - Height of Fall (feet) 1
eArrest - Cardiac Arrest Information
eArrest.01 - Cardiac Arrest No
eArrest.02 - Cardiac Arrest Etiology [NV = Not Applicable]
eArrest.03 - Resuscitation Attempted By EMS [NV = Not Applicable]
eArrest.04 - Arrest Witnessed By [NV = Not Applicable]
eArrest.05 - CPR Care Provided Prior to EMS Arrival [NV = Not Recorded]
eArrest.07 - AED Use Prior to EMS Arrival [NV = Not Applicable]
eArrest.09 - Type of CPR Provided [NV = Not Applicable]
eArrest.11 - First Monitored Arrest Rhythm of the Patient [NV = Not Applicable]
eArrest.12 - Any Return of Spontaneous Circulation [NV = Not Applicable]
eArrest.14 - Date/Time of Cardiac Arrest [NV = Not Applicable]
eArrest.16 - Reason CPR/Resuscitation Discontinued [NV = Not Applicable]
eArrest.17 - Cardiac Rhythm on Arrival at Destination [NV = Not Applicable]
eArrest.18 - End of EMS Cardiac Arrest Event [NV = Not Applicable]
eHistory - Patient History Information
eHistory.01 - Barriers to Patient Care Hearing Impaired
Language
eHistory.PractitionerGroup - Group Tag to hold info about practitioner
eHistory.02 - Last Name of Patient's Practitioner Sadler
eHistory.03 - First Name of Patient's Practitioner Randall
eHistory.04 - Middle Name/Initial of Patient's Practitioner M
eHistory.PractitionerGroup - Group Tag to hold info about practitioner
eHistory.02 - Last Name of Patient's Practitioner Beck
eHistory.03 - First Name of Patient's Practitioner Darlene
eHistory.04 - Middle Name/Initial of Patient's Practitioner T
eHistory.05 - Advance Directives Other Healthcare Advanced Directive Form
State EMS DNR or Medical Order Form
eHistory.06 - Medication Allergies [CodeType = ICD10] Z88.0 - Allergy status to penicillin
[CodeType = RxNorm] 1191 - aspirin
[CodeType = RxNorm] 161 - acetaminophen
[CodeType = RxNorm] 2284718 - remdesivir
eHistory.07 - Environmental/Food Allergies 232346004 - Cat allergy
860604008 - Allergy to apple
eHistory.08 - Medical/Surgical History I51.9 - Heart disease, unspecified
I22.9 - Subsequent ST elevation (STEMI) myocardial infarction of unspecified site
K08.119 - Complete loss of teeth due to trauma, unspecified class
H91.90 - Unspecified hearing loss, unspecified ear
M19.09 - Primary osteoarthritis, other specified site
I83.819 - Varicose veins of unspecified lower extremity with pain
02U03JZ - Supplement Coronary Artery, One Artery with Synthetic Substitute, Percutaneous Approach
0HRCX72 - Replacement of Left Upper Arm Skin with Autologous Tissue Substitute, Cell Suspension Technique, External Approach
eHistory.09 - Medical History Obtained From Family
Health Care Personnel
Patient
eHistory.ImmunizationsGroup - Group Tag to hold Immunization type and date
eHistory.10 - The Patient's Type of Immunization DPT / TDaP (Diphtheria, Pertussis, Tetanus)
eHistory.11 - Immunization Year 1950
eHistory.ImmunizationsGroup - Group Tag to hold Immunization type and date
eHistory.10 - The Patient's Type of Immunization Influenza-Seasonal (In past 12 months)
eHistory.11 - Immunization Year 2022
eHistory.ImmunizationsGroup - Group Tag to hold Immunization type and date
eHistory.10 - The Patient's Type of Immunization MMR (Measles, Mumps, Rubella)
eHistory.11 - Immunization Year 1950
eHistory.ImmunizationsGroup - Group Tag to hold Immunization type and date
eHistory.10 - The Patient's Type of Immunization Other-Not Listed
eHistory.11 - Immunization Year 2022
eHistory.CurrentMedsGroup - Group Tag to hold info about patient's medication
eHistory.12 - Current Medications 11289 - warfarin
eHistory.13 - Current Medication Dose 3
eHistory.14 - Current Medication Dosage Unit Milligrams (mg)
eHistory.15 - Current Medication Administration Route Oral
eHistory.16 - Presence of Emergency Information Form Yes
eHistory.17 - Alcohol/Drug Use Indicators [PN = None Reported]
eHistory.19 - Last Oral Intake October 9, 2022, 7:00:00 GMT-05:00
eNarrative - Call Event Narrative
eNarrative.01 - Patient Care Report Narrative Patient fell from bottom step of stairs while doing house chores. Due to the likelhood of a hip fracture, we transported her to the hospital.
eVitals - Patient Vital Sign Information
eVitals.VitalGroup - Group Tag to hold eVitals information
eVitals.01 - Date/Time Vital Signs Taken October 9, 2022, 8:48:00 GMT-05:00
eVitals.02 - Obtained Prior to this Unit's EMS Care No
eVitals.CardiacRhythmGroup - Group Tag to hold information of the type and method used for ECG interpretation associated with the cardiac rhythm.
eVitals.03 - Cardiac Rhythm / Electrocardiography (ECG) [NV = Not Recorded]
eVitals.04 - ECG Type [NV = Not Recorded]
eVitals.05 - Method of ECG Interpretation [NV = Not Recorded]
eVitals.BloodPressureGroup - Group Tag to hold the details of patient's blood pressure.
eVitals.06 - SBP (Systolic Blood Pressure) 102
eVitals.07 - DBP (Diastolic Blood Pressure) 64
eVitals.08 - Method of Blood Pressure Measurement Cuff-Automated
eVitals.HeartRateGroup - Group Tag to hold the details of patient's heart rate.
eVitals.10 - Heart Rate 80
eVitals.11 - Method of Heart Rate Measurement Palpated
eVitals.12 - Pulse Oximetry 94
eVitals.13 - Pulse Rhythm Regular
eVitals.14 - Respiratory Rate 25
eVitals.15 - Respiratory Effort Normal
eVitals.16 - End Tidal Carbon Dioxide (ETCO2) [NV = Not Recorded]
eVitals.17 - Carbon Monoxide (CO) 2.1
eVitals.18 - Blood Glucose Level 130
eVitals.GlasgowScoreGroup - Group Tag to hold the details of patient's glasgow scale
eVitals.19 - Glasgow Coma Score-Eye 4 - Opens Eyes spontaneously (All Age Groups)
eVitals.20 - Glasgow Coma Score-Verbal 5 - Oriented (>2 Years); Smiles, oriented to sounds, follows objects, interacts
eVitals.21 - Glasgow Coma Score-Motor 5 - Localizing pain (All Age Groups)
eVitals.22 - Glasgow Coma Score-Qualifier Initial GCS has legitimate values without interventions such as intubation and sedation
eVitals.23 - Total Glasgow Coma Score 14
eVitals.TemperatureGroup - Group Tag to hold information about patient's body temperature.
eVitals.24 - Temperature 35.2
eVitals.25 - Temperature Method Tympanic
eVitals.26 - Level of Responsiveness (AVPU) Verbal
eVitals.PainScaleGroup - Group Tag to hold the scale of patient's pain and the type of pain scale used.
eVitals.27 - Pain Scale Score 8
eVitals.28 - Pain Scale Type Numeric (0-10)
eVitals.StrokeScaleGroup - Group Tag to hold the results of patient's stroke scale and the type of stroke pain scale used.
eVitals.29 - Stroke Scale Score Negative
eVitals.30 - Stroke Scale Type Los Angeles
eVitals.31 - Reperfusion Checklist [NV = Not Recorded]
eVitals.33 - Revised Trauma Score 12
eVitals.VitalGroup - Group Tag to hold eVitals information
eVitals.01 - Date/Time Vital Signs Taken October 9, 2022, 9:00:00 GMT-05:00
eVitals.02 - Obtained Prior to this Unit's EMS Care No
eVitals.CardiacRhythmGroup - Group Tag to hold information of the type and method used for ECG interpretation associated with the cardiac rhythm.
eVitals.03 - Cardiac Rhythm / Electrocardiography (ECG) [NV = Not Recorded]
eVitals.04 - ECG Type [NV = Not Recorded]
eVitals.05 - Method of ECG Interpretation [NV = Not Recorded]
eVitals.BloodPressureGroup - Group Tag to hold the details of patient's blood pressure.
eVitals.06 - SBP (Systolic Blood Pressure) 98
eVitals.07 - DBP (Diastolic Blood Pressure) 60
eVitals.08 - Method of Blood Pressure Measurement Cuff-Automated
eVitals.HeartRateGroup - Group Tag to hold the details of patient's heart rate.
eVitals.10 - Heart Rate 70
eVitals.11 - Method of Heart Rate Measurement Palpated
eVitals.12 - Pulse Oximetry 94
eVitals.13 - Pulse Rhythm Regular
eVitals.14 - Respiratory Rate 22
eVitals.15 - Respiratory Effort Normal
eVitals.16 - End Tidal Carbon Dioxide (ETCO2) [NV = Not Recorded]
eVitals.18 - Blood Glucose Level [NV = Not Recorded]
eVitals.GlasgowScoreGroup - Group Tag to hold the details of patient's glasgow scale
eVitals.19 - Glasgow Coma Score-Eye 4 - Opens Eyes spontaneously (All Age Groups)
eVitals.20 - Glasgow Coma Score-Verbal 5 - Oriented (>2 Years); Smiles, oriented to sounds, follows objects, interacts
eVitals.21 - Glasgow Coma Score-Motor 6 - Obeys commands (>2Years); Appropriate response to stimulation
eVitals.22 - Glasgow Coma Score-Qualifier Initial GCS has legitimate values without interventions such as intubation and sedation
eVitals.23 - Total Glasgow Coma Score 15
eVitals.TemperatureGroup - Group Tag to hold information about patient's body temperature.
eVitals.24 - Temperature 35.6
eVitals.25 - Temperature Method Tympanic
eVitals.26 - Level of Responsiveness (AVPU) Verbal
eVitals.PainScaleGroup - Group Tag to hold the scale of patient's pain and the type of pain scale used.
eVitals.27 - Pain Scale Score 5
eVitals.28 - Pain Scale Type Numeric (0-10)
eVitals.StrokeScaleGroup - Group Tag to hold the results of patient's stroke scale and the type of stroke pain scale used.
eVitals.29 - Stroke Scale Score [NV = Not Recorded]
eVitals.30 - Stroke Scale Type [NV = Not Applicable]
eVitals.31 - Reperfusion Checklist [NV = Not Recorded]
eVitals.VitalGroup - Group Tag to hold eVitals information
eVitals.01 - Date/Time Vital Signs Taken October 9, 2022, 9:10:00 GMT-05:00
eVitals.02 - Obtained Prior to this Unit's EMS Care No
eVitals.CardiacRhythmGroup - Group Tag to hold information of the type and method used for ECG interpretation associated with the cardiac rhythm.
eVitals.03 - Cardiac Rhythm / Electrocardiography (ECG) [NV = Not Recorded]
eVitals.04 - ECG Type [NV = Not Recorded]
eVitals.05 - Method of ECG Interpretation [NV = Not Recorded]
eVitals.BloodPressureGroup - Group Tag to hold the details of patient's blood pressure.
eVitals.06 - SBP (Systolic Blood Pressure) 100
eVitals.07 - DBP (Diastolic Blood Pressure) 62
eVitals.08 - Method of Blood Pressure Measurement Cuff-Automated
eVitals.HeartRateGroup - Group Tag to hold the details of patient's heart rate.
eVitals.10 - Heart Rate 66
eVitals.11 - Method of Heart Rate Measurement Palpated
eVitals.12 - Pulse Oximetry 95
eVitals.13 - Pulse Rhythm Regular
eVitals.14 - Respiratory Rate 20
eVitals.15 - Respiratory Effort Normal
eVitals.16 - End Tidal Carbon Dioxide (ETCO2) [NV = Not Recorded]
eVitals.18 - Blood Glucose Level [NV = Not Recorded]
eVitals.GlasgowScoreGroup - Group Tag to hold the details of patient's glasgow scale
eVitals.19 - Glasgow Coma Score-Eye 4 - Opens Eyes spontaneously (All Age Groups)
eVitals.20 - Glasgow Coma Score-Verbal 5 - Oriented (>2 Years); Smiles, oriented to sounds, follows objects, interacts
eVitals.21 - Glasgow Coma Score-Motor 6 - Obeys commands (>2Years); Appropriate response to stimulation
eVitals.22 - Glasgow Coma Score-Qualifier Initial GCS has legitimate values without interventions such as intubation and sedation
eVitals.23 - Total Glasgow Coma Score 15
eVitals.TemperatureGroup - Group Tag to hold information about patient's body temperature.
eVitals.24 - Temperature 35.8
eVitals.25 - Temperature Method Tympanic
eVitals.26 - Level of Responsiveness (AVPU) Verbal
eVitals.PainScaleGroup - Group Tag to hold the scale of patient's pain and the type of pain scale used.
eVitals.27 - Pain Scale Score 5
eVitals.28 - Pain Scale Type Numeric (0-10)
eVitals.StrokeScaleGroup - Group Tag to hold the results of patient's stroke scale and the type of stroke pain scale used.
eVitals.29 - Stroke Scale Score [NV = Not Recorded]
eVitals.30 - Stroke Scale Type [NV = Not Applicable]
eVitals.31 - Reperfusion Checklist [NV = Not Recorded]
eVitals.VitalGroup - Group Tag to hold eVitals information
eVitals.01 - Date/Time Vital Signs Taken October 9, 2022, 9:20:00 GMT-05:00
eVitals.02 - Obtained Prior to this Unit's EMS Care No
eVitals.CardiacRhythmGroup - Group Tag to hold information of the type and method used for ECG interpretation associated with the cardiac rhythm.
eVitals.03 - Cardiac Rhythm / Electrocardiography (ECG) [NV = Not Recorded]
eVitals.04 - ECG Type [NV = Not Recorded]
eVitals.05 - Method of ECG Interpretation [NV = Not Recorded]
eVitals.BloodPressureGroup - Group Tag to hold the details of patient's blood pressure.
eVitals.06 - SBP (Systolic Blood Pressure) 96
eVitals.07 - DBP (Diastolic Blood Pressure) 60
eVitals.08 - Method of Blood Pressure Measurement Cuff-Automated
eVitals.HeartRateGroup - Group Tag to hold the details of patient's heart rate.
eVitals.10 - Heart Rate 68
eVitals.11 - Method of Heart Rate Measurement Palpated
eVitals.12 - Pulse Oximetry 95
eVitals.13 - Pulse Rhythm Regular
eVitals.14 - Respiratory Rate 22
eVitals.15 - Respiratory Effort Normal
eVitals.16 - End Tidal Carbon Dioxide (ETCO2) [NV = Not Recorded]
eVitals.18 - Blood Glucose Level [NV = Not Recorded]
eVitals.GlasgowScoreGroup - Group Tag to hold the details of patient's glasgow scale
eVitals.19 - Glasgow Coma Score-Eye 4 - Opens Eyes spontaneously (All Age Groups)
eVitals.20 - Glasgow Coma Score-Verbal 5 - Oriented (>2 Years); Smiles, oriented to sounds, follows objects, interacts
eVitals.21 - Glasgow Coma Score-Motor 6 - Obeys commands (>2Years); Appropriate response to stimulation
eVitals.22 - Glasgow Coma Score-Qualifier Initial GCS has legitimate values without interventions such as intubation and sedation
eVitals.23 - Total Glasgow Coma Score 15
eVitals.TemperatureGroup - Group Tag to hold information about patient's body temperature.
eVitals.24 - Temperature 35.8
eVitals.25 - Temperature Method Tympanic
eVitals.26 - Level of Responsiveness (AVPU) Verbal
eVitals.PainScaleGroup - Group Tag to hold the scale of patient's pain and the type of pain scale used.
eVitals.27 - Pain Scale Score 5
eVitals.28 - Pain Scale Type Numeric (0-10)
eVitals.StrokeScaleGroup - Group Tag to hold the results of patient's stroke scale and the type of stroke pain scale used.
eVitals.29 - Stroke Scale Score [NV = Not Recorded]
eVitals.30 - Stroke Scale Type [NV = Not Applicable]
eVitals.31 - Reperfusion Checklist [NV = Not Recorded]
eLabs - Lab Results Information
eLabs.LabGroup - Group Tag to hold Lab information
eLabs.01 - Date/Time of Laboratory or Imaging Result October 9, 2022, 9:13:00 GMT-05:00
eLabs.02 - Study/Result Prior to this Unit's EMS Care No
eLabs.LabImageGroup - Group Tag to hold info about imaging study or x-ray.
eLabs.05 - Imaging Study Type Ultrasound
eLabs.06 - Imaging Study Results Hip fracture
eLabs.WaveformGraphicGroup - Tag to hold information about the imaging study to allow for the upload of the imaging results.
eLabs.07 - Imaging Study File or Waveform Graphic Type image/jpg
eLabs.08 - Imaging Study File or Waveform Graphic
eExam - Patient Exam Information
eExam.01 - Estimated Body Weight in Kilograms 53.8
eExam.AssessmentGroup - Group Tag to hold assessment information
eExam.03 - Date/Time of Assessment October 9, 2022, 8:48:30 GMT-05:00
eExam.04 - Skin Assessment Normal
eExam.05 - Head Assessment Normal
eExam.06 - Face Assessment [PN = Exam Finding Not Present] Asymmetric Smile or Droop
Normal
eExam.07 - Neck Assessment Normal
eExam.08 - Chest/Lungs Assessment Normal
eExam.09 - Heart Assessment Normal
eExam.AbdomenGroup - Group Tag to hold abdomen assessment findings information
eExam.10 - Abdominal Assessment Finding Location Generalized
eExam.11 - Abdomen Assessment Normal
eExam.12 - Pelvis/Genitourinary Assessment Pain
Swelling
Contusion
eExam.SpineGroup - Group Tag to hold spine assessment findings information
eExam.13 - Back and Spine Assessment Finding Location Back-General
eExam.14 - Back and Spine Assessment Normal
eExam.ExtremityGroup - Group Tag to hold extremity assessment findings information
eExam.15 - Extremity Assessment Finding Location Leg-Upper-Right
eExam.16 - Extremities Assessment Pain
eExam.ExtremityGroup - Group Tag to hold extremity assessment findings information
eExam.15 - Extremity Assessment Finding Location Foot-Dorsal-Left
eExam.16 - Extremities Assessment Abrasion
Edema
Swelling
eExam.ExtremityGroup - Group Tag to hold extremity assessment findings information
eExam.15 - Extremity Assessment Finding Location Foot-Plantar-Left
eExam.16 - Extremities Assessment Abrasion
Edema
Swelling
eExam.EyeGroup - Group Tag to hold eye assessment findings information
eExam.17 - Eye Assessment Finding Location Bilateral
eExam.18 - Eye Assessment PERRL
eExam.19 - Mental Status Assessment Normal Baseline for Patient
eExam.20 - Neurological Assessment Normal Baseline for Patient
eProtocols - Medical Protocols Information
eProtocols.ProtocolGroup - Group Tag to hold eProtocol information
eProtocols.01 - Protocols Used General-Individualized Patient Protocol
eProtocols.02 - Protocol Age Category General
eProtocols.ProtocolGroup - Group Tag to hold eProtocol information
eProtocols.01 - Protocols Used General-IV Access
eProtocols.02 - Protocol Age Category General
eProtocols.ProtocolGroup - Group Tag to hold eProtocol information
eProtocols.01 - Protocols Used General-Pain Control
eProtocols.02 - Protocol Age Category Adult Only
eProtocols.ProtocolGroup - Group Tag to hold eProtocol information
eProtocols.01 - Protocols Used General-Universal Patient Care/ Initial Patient Contact
eProtocols.02 - Protocol Age Category Adult Only
eMedications - Intervention Medications Information
eMedications.MedicationGroup - Group Tag to hold eMedication information
eMedications.01 - Date/Time Medication Administered October 9, 2022, 8:52:00 GMT-05:00
eMedications.02 - Medication Administered Prior to this Unit's EMS Care No
eMedications.03 - Medication Given 7052 - morphine
eMedications.04 - Medication Administered Route Intravenous (IV)
eMedications.DosageGroup - Group Tag to hold info about the medication dosage given to the patient
eMedications.05 - Medication Dosage 10
eMedications.06 - Medication Dosage Units Milligrams (mg)
eMedications.07 - Response to Medication Improved
eMedications.08 - Medication Complication Bradycardia
Nausea
eMedications.09 - Medication Crew (Healthcare Professionals) ID 35781 - Ellen Costa
eMedications.10 - Role/Type of Person Administering Medication 2009 Paramedic
eMedications.11 - Medication Authorization On-Line (Remote Verbal Order)
eMedications.12 - Medication Authorizing Physician Cleve Woods
eProcedures - Intervention Procedures Information
eProcedures.ProcedureGroup - Group Tag to hold eProcedures information
eProcedures.01 - Date/Time Procedure Performed [NV = Not Recorded]
eProcedures.02 - Procedure Performed Prior to this Unit's EMS Care Yes
eProcedures.03 - Procedure 431949004 - Active external warming of subject
eProcedures.05 - Number of Procedure Attempts [NV = Not Recorded]
eProcedures.06 - Procedure Successful Yes
eProcedures.07 - Procedure Complication [NV = Not Recorded]
eProcedures.08 - Response to Procedure [NV = Not Recorded]
eProcedures.10 - Role/Type of Person Performing the Procedure Patient/Lay Person
eProcedures.ProcedureGroup - Group Tag to hold eProcedures information
eProcedures.01 - Date/Time Procedure Performed October 9, 2022, 8:50:00 GMT-05:00
eProcedures.02 - Procedure Performed Prior to this Unit's EMS Care No
eProcedures.03 - Procedure 304562007 - Informing doctor
eProcedures.05 - Number of Procedure Attempts 1
eProcedures.06 - Procedure Successful Yes
eProcedures.07 - Procedure Complication [NV = Not Applicable]
eProcedures.08 - Response to Procedure [NV = Not Recorded]
eProcedures.09 - Procedure Crew Members ID 7492 - Chase Grey
eProcedures.10 - Role/Type of Person Performing the Procedure 2009 Advanced Emergency Medical Technician (AEMT)
eProcedures.11 - Procedure Authorization Written Orders (Patient Specific)
eProcedures.ProcedureGroup - Group Tag to hold eProcedures information
eProcedures.01 - Date/Time Procedure Performed October 9, 2022, 8:51:00 GMT-05:00
eProcedures.02 - Procedure Performed Prior to this Unit's EMS Care No
eProcedures.03 - Procedure 392230005 - Catheterisation of vein
eProcedures.04 - Size of Procedure Equipment 22G
eProcedures.05 - Number of Procedure Attempts 2
eProcedures.06 - Procedure Successful Yes
eProcedures.07 - Procedure Complication Other
eProcedures.08 - Response to Procedure [NV = Not Recorded]
eProcedures.09 - Procedure Crew Members ID 35781 - Ellen Costa
eProcedures.10 - Role/Type of Person Performing the Procedure 2009 Paramedic
eProcedures.11 - Procedure Authorization Written Orders (Patient Specific)
eProcedures.13 - Vascular Access Location Forearm-Right
eProcedures.ProcedureGroup - Group Tag to hold eProcedures information
eProcedures.01 - Date/Time Procedure Performed October 9, 2022, 8:54:00 GMT-05:00
eProcedures.02 - Procedure Performed Prior to this Unit's EMS Care No
eProcedures.03 - Procedure 79321009 - Application of splint
eProcedures.05 - Number of Procedure Attempts 1
eProcedures.06 - Procedure Successful Yes
eProcedures.07 - Procedure Complication None
eProcedures.08 - Response to Procedure Unchanged
eProcedures.09 - Procedure Crew Members ID 7492 - Chase Grey
eProcedures.10 - Role/Type of Person Performing the Procedure 2009 Advanced Emergency Medical Technician (AEMT)
eProcedures.11 - Procedure Authorization Protocol (Standing Order)
eProcedures.ProcedureGroup - Group Tag to hold eProcedures information
eProcedures.01 - Date/Time Procedure Performed October 9, 2022, 8:55:00 GMT-05:00
eProcedures.02 - Procedure Performed Prior to this Unit's EMS Care No
eProcedures.03 - Procedure 58715004 - Moving a patient to a stretcher
eProcedures.05 - Number of Procedure Attempts 1
eProcedures.06 - Procedure Successful Yes
eProcedures.07 - Procedure Complication None
eProcedures.08 - Response to Procedure Unchanged
eProcedures.09 - Procedure Crew Members ID 7492 - Chase Grey
eProcedures.10 - Role/Type of Person Performing the Procedure 2009 Advanced Emergency Medical Technician (AEMT)
eProcedures.11 - Procedure Authorization Protocol (Standing Order)
eDisposition - Patient Disposition Information
eDisposition.DestinationGroup - Group Tag to hold info about the Destination and the Disposition details
eDisposition.01 - Destination/Transferred To, Name CHRISTUS St. Michael Health System
eDisposition.02 - Destination/Transferred To, Code 1295736734
eDisposition.03 - Destination Street Address [Value from DEMDataSet]
eDisposition.04 - Destination City [Value from DEMDataSet]
eDisposition.05 - Destination State [Value from DEMDataSet]
eDisposition.06 - Destination County [Value from DEMDataSet]
eDisposition.07 - Destination ZIP Code [Value from DEMDataSet]
eDisposition.08 - Destination Country [Value from DEMDataSet]
eDisposition.09 - Destination GPS Location [Value from DEMDataSet]
eDisposition.10 - Destination Location US National Grid Coordinates [Value from DEMDataSet]
eDisposition.11 - Number of Patients Transported in this EMS Unit 1
eDisposition.12 - Incident/Patient Disposition Patient Treated, Transported by this EMS Unit
eDisposition.13 - How Patient Was Moved to Ambulance Stretcher
eDisposition.14 - Position of Patient During Transport Supine
eDisposition.15 - How Patient Was Transported From Ambulance Stretcher
eDisposition.16 - EMS Transport Method Ground-Ambulance
eDisposition.17 - Transport Mode from Scene Emergent (Immediate Response)
eDisposition.18 - Additional Transport Mode Descriptors Speed-Normal Traffic
No Lights or Sirens
eDisposition.19 - Final Patient Acuity Emergent (Yellow)
eDisposition.20 - Reason for Choosing Destination Patient's Physician's Choice
Regional Specialty Center
eDisposition.21 - Type of Destination Hospital-Emergency Department
eDisposition.22 - Hospital In-Patient Destination [NV = Not Applicable]
eDisposition.23 - Hospital Capability Rehab Center
eDisposition.HospitalTeamActivationGroup - Group Tag to hold info about the destination team pre-arrival activation
eDisposition.24 - Destination Team Pre-Arrival Alert or Activation Yes-Trauma (General)
eDisposition.25 - Date/Time of Destination Prearrival Alert or Activation October 9, 2022, 8:56:20 GMT-05:00
eOutcome - Patient Outcome Information
eOutcome.01 - Emergency Department Disposition Admitted as an inpatient to this hospital.
eOutcome.02 - Hospital Disposition Discharged/transferred to a inpatient rehabilitation facility including distinct part units of a hospital.
eOutcome.ExternalDataGroup - Group Tag to hold information about external report or record
eOutcome.03 - External Report ID/Number Type Hospital-Receiving
eOutcome.04 - External Report ID/Number 2020-5248
eOutcome.ExternalDataGroup - Group Tag to hold information about external report or record
eOutcome.03 - External Report ID/Number Type Other Report
eOutcome.04 - External Report ID/Number 2267884554
eOutcome.05 - Other Report Registry Type HIE
eOutcome.ExternalDataGroup - Group Tag to hold information about external report or record
eOutcome.03 - External Report ID/Number Type Trauma Registry
eOutcome.04 - External Report ID/Number CSM.20.0598
eOutcome.06 - Emergency Department Chief Complaint Hip injury
eOutcome.07 - First ED Systolic Blood Pressure 99
eOutcome.08 - Emergency Department Recorded Cause of Injury W10.9XXA - Fall (on) (from) unspecified stairs and steps, initial encounter
Y29.XXXA - Contact with blunt object, undetermined intent, initial encounter
eOutcome.09 - Emergency Department Procedures 4A0FX3Z - Measurement of Musculoskeletal Contractility, External Approach
3E1U38X - Irrigation of Joints using Irrigating Substance, Percutaneous Approach, Diagnostic
0W9J7ZZ - Drainage of Pelvic Cavity, Via Natural or Artificial Opening
eOutcome.10 - Emergency Department Diagnosis M84.359 - Stress fracture, hip, unspecified
M25.59 - Pain in other specified joint
eOutcome.11 - Date/Time of Hospital Admission October 9, 2022, 9:56:20 GMT-05:00
eOutcome.12 - Hospital Procedures BF5C2ZZ - Other Imaging of Hepatobiliary System, All using Fluorescing Agent
0SQ94ZZ - Repair Right Hip Joint, Percutaneous Endoscopic Approach
0SQNXZZ - Repair Left Metatarsal-Phalangeal Joint, External Approach
eOutcome.13 - Hospital Diagnosis M84.359D - Stress fracture, hip, unspecified, subsequent encounter for fracture with routine healing
M84.372A - Stress fracture, left ankle, initial encounter for fracture
eOutcome.16 - Date/Time of Hospital Discharge October 10, 2022, 8:54:12 GMT-05:00
eOutcome.17 - Outcome at Hospital Discharge Moderately severe disability; unable to walk without assistance and unable to attend to own bodily needs without assistance
eOther - Other Miscellaneous Information
eOther.01 - Review Requested No
eOther.02 - Potential System of Care/Specialty/Registry Patient Trauma
eOther.EMSCrewMemberGroup - Group Tag to hold info about the EMS Crew Member
eOther.03 - Personal Protective Equipment Used Gloves
Mask-Surgical (Non-Fitted)
eOther.04 - EMS Professional (Crew Member) ID 7492 - Chase Grey
eOther.05 - Suspected EMS Work Related Exposure, Injury, or Death No
eOther.06 - The Type of Work-Related Injury, Death or Suspected Exposure None
eOther.EMSCrewMemberGroup - Group Tag to hold info about the EMS Crew Member
eOther.03 - Personal Protective Equipment Used Gloves
Mask-Surgical (Non-Fitted)
eOther.04 - EMS Professional (Crew Member) ID 35781 - Ellen Costa
eOther.05 - Suspected EMS Work Related Exposure, Injury, or Death No
eOther.06 - The Type of Work-Related Injury, Death or Suspected Exposure None
eOther.08 - Crew Member Completing this Report 35781 - Ellen Costa
eOther.SignatureGroup - Group Tag to hold signature details
eOther.12 - Type of Person Signing Healthcare Provider
eOther.13 - Signature Reason Transfer of Patient Care
eOther.15 - Signature Status Signed
eOther.16 - Signature File Name signature-a89c.png
eOther.17 - Signature File Type image/png
eOther.18 - Signature Graphic
eOther.19 - Date/Time of Signature October 9, 2022, 9:38:20 GMT-05:00
eOther.20 - Signature Last Name Ortiz
eOther.21 - Signature First Name Leslie
eOther.SignatureGroup - Group Tag to hold signature details
eOther.12 - Type of Person Signing EMS Primary Care Provider (for this event)
eOther.13 - Signature Reason Other
eOther.15 - Signature Status Signed
eOther.19 - Date/Time of Signature October 9, 2022, 17:04:59 GMT-05:00
eOther.20 - Signature Last Name Costa
eOther.21 - Signature First Name Ellen