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National30892750EmergencyMedicalServicesInformationSystemNEMSISNHTSA Version 2.2.1Data DictionaryFunded byNational Highway Traffic Safety Administration (NHTSA)EMS DivisionWWW.NEMSIS.ORGUS Department of TransportationNational Highway Traffic Safety Administration (NHTSA)NHTSAUniform Pre-HospitalEmergency Medical Services (EMS)DatasetVersion 2.2.1 (2006)Final Documentationand Data DictionaryWWW.NEMSIS.ORGNHTSA Uniform PreHospital EMS Dataset Version 2.2.1National EMS Information Agency Project (NEMSIS)www.nemsis.orgIn 1994, Version 1 of the National Highway Traffic Safety Administration’s Uniform PreHospital EMS Dataset was created through a consensus based national data conference. The NHTSA Version 1 EMS dataset has been acknowledged as the national standard for the EMS industry. The Version 2.2.1 dataset was also created through a national consensus process to update and revise this standard.The NHTSA EMS Uniform PreHospital Dataset, Version 2.2.1 is composed of three separate components. A Demographic Dataset provides a standardized set of definitions describing an EMS System. An EMS Dataset provides a standardized set of definitions describing an EMS event. The third component of the Version 2.2.1 standard is an XML format and definition created to promote the movement of the Version 2.2.1 data elements between data systems.Any implementation of the NHTSA Version 2.2.1 dataset must include the use of the Demographic dataset, EMS dataset, and XML standard. This document provides over 400 definitions which can be implemented by an EMS system. The National EMS Information System Initiative (NEMSIS) serves to provide technical assistance for the implementation of the dataset. National data elements are defined which should be collected by a National EMS Database but additional data elements should be considered for use at the state and local levels depending on each state or local EMS systems need. The goal of NEMSIS is to establish an EMS data system at the local, state, and national levels. Please see www.nemsis.org for more information.Information provided in this document includes the following:Name of the Data ElementDefinition of the Data ElementData Type of the Data Element (many data elements have comments provided to assist in the implementation of a database schema and the NHTSA Version 2 XML standard)How to deal with missing or incomplete information (See Missing Data or Null Values below)The Variables associated with each Data ElementWhat Data Elements are associated with the Data Element (for example Date/Time Medication Administered is associated with each Medication Given Data Element) Whether the Data Element is part of the Data Elements to be collected in the National EMS Database (NDB)Whether the Data Element is part of the medical record information (Patient Care Report) or is a quality management Data Element to be used internally by the EMS system and protected by Peer Review.What Reports are possible through the use of the Data ElementWho is responsible for collecting the Data ElementHow the Data Element is related to other National Data Tools such as NHTSA Version 1, NFIRS, and UtsteinTable of ContentsDemographic DatasetD01 Agency General Information 1D02 Agency Contact Information 23D03 Agency Medical Director Information 35D04 Agency Configuration Information 47D05Agency Station Information67D06 Agency Vehicle Information 77D07 Agency Personnel Information 87D08 General Personnel Information 94D09Medical Device Information115EMS DatasetE00 Common EMS Values 121E01 Record Information 123E02 Unit/ Agency Information 128E03 Unit/ Call Information 149E04 Unit/ Personnel Information 153E05 Times 157E06 Patient 171E07 Billing 191E08 Scene 230E09 Situation 246E10 Situation/ Trauma 264E11 Situation/ CPR 277E12 Medical History 289E13 Narrative 310E14 Assessment/ Vital Signs 312E15 Assessment/ Injury 341E16 Assessment/ Exam 353E17 Intervention 379E18 Intervention/ Medication 381E19 Intervention/ Procedure 393E20 Disposition 409E21 Medical Device Data 427E22 Outcome and Linkage 448E23 Miscellaneous 455Appendix & IndicesAAppendix (Document Changes)IndexIndexNHTSA Uniform Pre-Hospital Emergency Medical Services (EMS) Dataset Version 2.2.1 (2006)SectionD01Agency General InformationSectionD01Agency General Information12006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS AGENCY NUMBERD01_01Data [text]National ElementDefinitionThe state-assigned provider number of the responding agencyXSD Data Typexs:stringXSD Domain (Simple Type)EMSAgencyNumberMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDYesMinimum Constraint3Maximum Constraint15Field ValuesA unique value; no variable list is possible. Additional Information●All EMS Agency demographic information is associated with the EMS agency number●Not Nullable. A unique value must be provided to create a unique record ID within a database●The same as EMS Agency Number (E02_01). This could be used to auto fill E02_01 on the Patient Care Report●This data element is unique and is typically sequentialUses●Agency number (E02_01), agency state (D01_03),unit call sign (E02_12), patient number (E01_01) and date (E05_04) combine to create a unique identifierData Collector●Typically generated by the State EMS Regulatory Office. Collected by the EMS agency or auto-generated by the EMS agency specific software.Other Associated ElementsD01_01EMS Agency NumberReferences in NHTSA Version 1DesirableElement 23Patient Care Record NumberReferences to Other Databases● NFIRS 5.0EMS Module; Title: Patient NumberSectionD01Agency General Information22006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS AGENCY NAMED01_02Data [text]DefinitionThe formal name of the agencyXSD Data Typexs:stringXSD Domain (Simple Type)EMSAgencyNameMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint50Field ValuesA unique value; no variable list is possible. Uses●Component of the EMS Agency Contact information●Used to personalize reports associated with the EMS AgencyData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberSectionD01Agency General Information32006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS AGENCY STATED01_03Data [combo] multiple-choiceNational ElementDefinitionThe state in which the Agency provides servicesXSD Data Typexs:stringXSD Domain (Simple Type)AgencyStateMultiple Entry ConfigurationYesAccepts Null Values NoRequired in XSDYesMinimum Constraint2Maximum Constraint2Field Values● Appropriate 2 digit FIPS codeAdditional Information●2 digit FIPS numeric code (Not State abbreviation)●Not Nullable. A unique value must be provided to create a unique record ID within a databaseUses●Agency number (E02_01), agency state (D01_03),unit call sign (E02_12), patient number (E01_01) and date (E05_04) combine to create a unique identifierData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberReferences to Other Databases● NFIRS 5.0EMS Module, Title: StateSectionD01Agency General Information42006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS AGENCY COUNTYD01_04Data [combo] multiple-choiceNational ElementDefinitionThe county(s) for which the agency formally provides serviceXSD Data Typexs:stringXSD Domain (Simple Type)AgencyCountyMultiple Entry ConfigurationYesAccepts Null Values NoRequired in XSDYesMinimum Constraint5Maximum Constraint5Field Values● Appropriate 5 digit FIPS codeAdditional Information●Stored as a 5 digit FIPS code (combining the state and county code) to take into account agencies may serve more than one state and counties are often named the same from state to stateUses●Used to group data with a stateData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberSectionD01Agency General Information52006 NHTSA Uniform PreHospital Dataset V.2.2.1PRIMARY TYPE OF SERVICED01_05Data [combo] single-choiceDefinitionThe primary service type provided by the agencyXSD Data Typexs:integerXSD Domain (Simple Type)PrimaryTypeOfServiceMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoField Values5610911 Response (Scene) with Transport Capability5620911 Response (Scene) without Transport Capability5630Air Medical5640Hazmat5650Medical Transport (Convalescent)5660Paramedic Intercept5670Rescue5680Specialty Care TransportUses●Important for grouping or comparing EMS AgenciesData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberSectionD01Agency General Information62006 NHTSA Uniform PreHospital Dataset V.2.2.1OTHER TYPES OF SERVICED01_06Data [combo] multiple-choiceDefinitionThe other service type(s) which are provided by the agencyXSD Data Typexs:integerXSD Domain (Simple Type)OtherTypesOfServiceMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available5690911 Response (Scene) with Transport Capability5700911 Response (Scene) without Transport Capability5710Air Medical5720Hazmat5730Medical Transport (Convalescent)5740Paramedic Intercept5750Rescue5760Specialty Care TransportUses●Important for grouping or comparing EMS Agencies●Provides descriptive information when combined with an EMS Agency’s Billing StatusData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberE00Common Null ValuesSectionD01Agency General Information72006 NHTSA Uniform PreHospital Dataset V.2.2.1LEVEL OF SERVICED01_07Data [combo] single-choiceNational ElementDefinitionThe highest credentialed personnel's level of service which the agency provides for every EMS encounter if requested. In a tiered response system, this is the highest level of service which could be sent to any specific call.XSD Data Typexs:string/integerXSD Domain (Simple Type)DemographicStateCertificationLicensureLevelsMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDYesMinimum Constraint2Maximum Constraint100Field Values6090EMT-Basic6100EMT-Intermediate6110EMT-Paramedic6111Nurse6112Physician6120First ResponderAdditional Information●This list can be edited by each state to account for additional certification/licensure level by adding levels as listed in State Certification/Licensure Levels (D04_01). State Certification/Licensure levels (D04_01) should create the list for this item●This value is stored either as the appropriate code or in text if an additional certification/licensure level has been entered by a stateUses●Allows data to be sorted based on an agency's level of service●Provides description of EMS Personnel●Provides descriptive information when combined with an EMS Agency’s Billing StatusData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberReferences in NHTSA Version 1EssentialElement 29Crew Member One TypeEssentialElement 30Crew Member Two TypeDesirableElement 31Crew Member Three TypeReferences to Other Databases● NFIRS 5.0EMS Module, Title: Highest Level of Provider on Scene by Fire Department, Pick-List: First Responder = 1, EMT-B (Basic) = 2, EMT-I (Intermediate) = 3, EMT-P (Paramedic) = 4, Other Health Care Provider, Include Doctors, Nurses = O, No Care Provided = N● NFIRS 5.0EMS Module, Title: Initial Level of FD Provider, Pick-List: First Responder = 1, EMT-B (Basic) = 2, EMT-I (Intermediate) = 3, EMT-P (Paramedic) = 4, Other Health Care Provider, Includes Doctors, Nurses, etc. = O, No Training = NSectionD01Agency General Information82006 NHTSA Uniform PreHospital Dataset V.2.2.1ORGANIZATIONAL TYPED01_08Data [combo] single-choiceNational ElementDefinitionThe organizational structure from which EMS services are delivered (fire, hospital, county, etc.)XSD Data Typexs:stringXSD Domain (Simple Type)OrganizationalTypeMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDYesField Values5810Community, Non-Profit5820Fire Department5830Governmental, Non-Fire5840Hospital5850Private, Non_Hospital5860TribalUses●Allows data to be sorted based on an agency's organizational structure●Provides description of EMS agencies across the nationData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberSectionD01Agency General Information92006 NHTSA Uniform PreHospital Dataset V.2.2.1ORGANIZATION STATUSD01_09Data [combo] single-choiceNational ElementDefinitionThe primary organizational status of the agency. The definition of Volunteer or Non-Volunteer is based on state or local terms.XSD Data Typexs:integerXSD Domain (Simple Type)OrganizationStatusMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDYesField Values5870Mixed5880Non-Volunteer5890VolunteerUses●Allows data to be sorted based on an agency's organizational status●Provides description of EMS agencies across the nationData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberSectionD01Agency General Information102006 NHTSA Uniform PreHospital Dataset V.2.2.1STATISTICAL YEARD01_10Data [date/time]National ElementDefinitionThe year to which the information pertainsXSD Data Typexs:gYearXSD Domain (Simple Type)StatisticalYearMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDYesMinimum Constraint1,920Maximum Constraint2,030XSD Structure: D01_10, D01_12, D01_13, D01_14, D01_15, D01_16, D01_17, and D01_18 are all members of D1_10_0 Statistical Year StructureField ValuesA unique value; no variable list is possible. Additional Information●Format [YYYY]●Multiple entry configuration to allow statistical data to be entered yearly●Used to identify the year to which the data pertainsUses●Associates a year with statistical data to improve reporting capabilitiesData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD01_12Total Service Size AreaD01_13Total Service Area PopulationD01_14911 Call Volume per YearD01_15EMS Dispatch Volume per YearD01_16EMS Transport Volume per YearD01_17EMS Patient Contact Volume per YearD01_18EMS Billable Calls per YearE02_01EMS Agency NumberSectionD01Agency General Information112006 NHTSA Uniform PreHospital Dataset V.2.2.1OTHER AGENCIES IN AREAD01_11Data [text] multiple-entryDefinitionAll other EMS or First Responder Agencies, which are in the service area or are available for mutual aidXSD Data Typexs:stringXSD Domain (Simple Type)OtherAgenciesInAreaMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint50Field ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Can be used to create a list box for Other EMS Agencies at Scene (E08_01). This is the Agency Name, not the EMS Agency NumberUses●Populates information on other EMS resources available to an EMS agencyData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberE00Common Null ValuesSectionD01Agency General Information122006 NHTSA Uniform PreHospital Dataset V.2.2.1TOTAL SERVICE SIZE AREAD01_12Data [number]National ElementDefinitionThe total square miles in the agency's service areaXSD Data Typexs:positiveIntegerXSD Domain (Simple Type)TotalServiceSizeAreaMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDYesMinimum Constraint1Maximum Constraint100,000,000XSD Structure: D01_10, D01_12, D01_13, D01_14, D01_15, D01_16, D01_17, and D01_18 are all members of D1_10_0 Statistical Year StructureField ValuesA unique value; no variable list is possible. Additional Information●Multiple entry configuration to allow statistical data to be entered yearlyUses●Allows data to be sorted based on an agency's service area size●Provides description of EMS agencies across the nationData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD01_10Statistical YearD01_13Total Service Area PopulationD01_14911 Call Volume per YearD01_15EMS Dispatch Volume per YearD01_16EMS Transport Volume per YearD01_17EMS Patient Contact Volume per YearD01_18EMS Billable Calls per YearSectionD01Agency General Information132006 NHTSA Uniform PreHospital Dataset V.2.2.1TOTAL SERVICE AREA POPULATIOND01_13Data [number]National ElementDefinitionThe total population in the agency's service area based on year 2000 census data (if possible). This number does not include population changes associated with daily work flow or seasonal movementsXSD Data Typexs:positiveIntegerXSD Domain (Simple Type)TotalServiceAreaPopulationMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDYesMinimum Constraint1Maximum Constraint100,000,000XSD Structure: D01_10, D01_12, D01_13, D01_14, D01_15, D01_16, D01_17, and D01_18 are all members of D1_10_0 Statistical Year StructureField ValuesA unique value; no variable list is possible. Additional Information●Baseline data should be taken from the 2000 Census data if possible●Multiple entry configuration to allow statistical data to be entered yearlyUses●Allows data to be sorted based on an agency's service area population●Provides description of EMS agencies across the nationData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD01_10Statistical YearD01_12Total Service Size AreaD01_14911 Call Volume per YearD01_15EMS Dispatch Volume per YearD01_16EMS Transport Volume per YearD01_17EMS Patient Contact Volume per YearD01_18EMS Billable Calls per YearSectionD01Agency General Information142006 NHTSA Uniform PreHospital Dataset V.2.2.1911 CALL VOLUME PER YEARD01_14Data [number]National ElementDefinitionThe number of 911 EMS calls for the calendar yearXSD Data Typexs:positiveIntegerXSD Domain (Simple Type)CallVolumeYear911Multiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDYesMinimum Constraint1Maximum Constraint100,000,000XSD Structure: D01_10, D01_12, D01_13, D01_14, D01_15, D01_16, D01_17, and D01_18 are all members of D1_10_0 Statistical Year StructureField ValuesA unique value; no variable list is possible. Additional Information●Multiple entry configuration to allow statistical data to be entered yearlyUses●Allows data to be sorted based on an agency's 911 call volume per year●Provides description of EMS agencies across the nationData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD01_10Statistical YearD01_12Total Service Size AreaD01_13Total Service Area PopulationD01_15EMS Dispatch Volume per YearD01_16EMS Transport Volume per YearD01_17EMS Patient Contact Volume per YearD01_18EMS Billable Calls per YearSectionD01Agency General Information152006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS DISPATCH VOLUME PER YEARD01_15Data [number]National ElementDefinitionThe number of EMS dispatches for the calendar yearXSD Data Typexs:positiveIntegerXSD Domain (Simple Type)EMSDispatchVolumeYearMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDYesMinimum Constraint1Maximum Constraint100,000,000XSD Structure: D01_10, D01_12, D01_13, D01_14, D01_15, D01_16, D01_17, and D01_18 are all members of D1_10_0 Statistical Year StructureField ValuesA unique value; no variable list is possible. Additional Information●Multiple entry configuration to allow statistical data to be entered yearlyUses●Allows data to be sorted based on an agency's Dispatch volume per year●Provides description of EMS agencies across the nationData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD01_10Statistical YearD01_12Total Service Size AreaD01_13Total Service Area PopulationD01_14911 Call Volume per YearD01_16EMS Transport Volume per YearD01_17EMS Patient Contact Volume per YearD01_18EMS Billable Calls per YearSectionD01Agency General Information162006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS TRANSPORT VOLUME PER YEARD01_16Data [number]National ElementDefinitionThe number of EMS transports for the calendar yearXSD Data Typexs:positiveIntegerXSD Domain (Simple Type)EMSTransportVolumeYearMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDYesMinimum Constraint1Maximum Constraint100,000,000XSD Structure: D01_10, D01_12, D01_13, D01_14, D01_15, D01_16, D01_17, and D01_18 are all members of D1_10_0 Statistical Year StructureField ValuesA unique value; no variable list is possible. Additional Information●Multiple entry configuration to allow statistical data to be entered yearlyUses●Allows data to be sorted based on an agency's Transport volume per year●Provides description of EMS agencies across the nationData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD01_10Statistical YearD01_12Total Service Size AreaD01_13Total Service Area PopulationD01_14911 Call Volume per YearD01_15EMS Dispatch Volume per YearD01_17EMS Patient Contact Volume per YearD01_18EMS Billable Calls per YearSectionD01Agency General Information172006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS PATIENT CONTACT VOLUME PER YEARD01_17Data [number]National ElementDefinitionThe number of EMS patient contacts for that calendar yearXSD Data Typexs:positiveIntegerXSD Domain (Simple Type)EMSPatientContactVolumeYearMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDYesMinimum Constraint1Maximum Constraint100,000,000XSD Structure: D01_10, D01_12, D01_13, D01_14, D01_15, D01_16, D01_17, and D01_18 are all members of D1_10_0 Statistical Year StructureField ValuesA unique value; no variable list is possible. Additional Information●Multiple entry configuration to allow statistical data to be entered yearlyUses●Allows data to be sorted based on an agency's Patient Contact volume per year●Provides description of EMS agencies across the nationData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD01_10Statistical YearD01_12Total Service Size AreaD01_13Total Service Area PopulationD01_14911 Call Volume per YearD01_15EMS Dispatch Volume per YearD01_16EMS Transport Volume per YearD01_18EMS Billable Calls per YearSectionD01Agency General Information182006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS BILLABLE CALLS PER YEARD01_18Data [number]DefinitionThe number of EMS patient encounters which are billable for the calendar yearXSD Data Typexs:positiveIntegerXSD Domain (Simple Type)EMSBillableCallsYearMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint1Maximum Constraint100,000,000XSD Structure: D01_10, D01_12, D01_13, D01_14, D01_15, D01_16, D01_17, and D01_18 are all members of D1_10_0 Statistical Year StructureField ValuesA unique value; no variable list is possible. Additional Information●Multiple entry configuration to allow statistical data to be entered yearlyUses●Allows data to be sorted based on an agency's EMS Billable Calls/Year●Provides description of EMS agencies across the nationData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD01_10Statistical YearD01_12Total Service Size AreaD01_13Total Service Area PopulationD01_14911 Call Volume per YearD01_15EMS Dispatch Volume per YearD01_16EMS Transport Volume per YearD01_17EMS Patient Contact Volume per YearSectionD01Agency General Information192006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS AGENCY TIME ZONED01_19Data [text]National ElementDefinitionThe time zone for the EMS AgencyXSD Data Typexs:integerXSD Domain (Simple Type)EMSAgencyTimeZoneMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDYesField Values5900GMT-11:00 Midway Island, Samoa5910GMT-10:00 Hawaii5920GMT-09:00 Alaska5930GMT-08:00 Pacific Time5940GMT-07:00 Mountain Time5950GMT-06:00 Central Time5960GMT-05:00 Eastern Time5970GMT-04:00 Atlantic TimeUses●Allows data to be tracked in comparison to other systems and times to better correlate in any analysisData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberSectionD01Agency General Information202006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS AGENCY DAYLIGHT SAVINGS TIME USED01_20Data [text]DefinitionIndicate if the EMS Agency conforms to Daylight Savings TimeXSD Data Typexs:integerXSD Domain (Simple Type)EMSAgencyDaylightSavingsTimeUseMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoField Values0No1YesUses●Allows data to be tracked in comparison to other systems and times to better correlate in any analysisData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberSectionD01Agency General Information212006 NHTSA Uniform PreHospital Dataset V.2.2.1NATIONAL PROVIDER IDENTIFIERD01_21Data [text]National ElementDefinitionThe National Provider Identifier associated with National Provider System (NPS) and used in all standard HIPAA transactions such as electronic claim filing.XSD Data Typexs:stringXSD Domain (Simple Type)NationalProviderIdentifierMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesMinimum Constraint3Maximum Constraint10Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●The National Provider Identifier is associated with the EMS agency numberUses●Important for HIPAA related transactions such as electronic claims processingData Collector●Generated by the National Provider System within the United States Department of Health and Human Services. Collected by the EMS agency or auto-generated by the EMS agency specific software.Other Associated ElementsD01_01EMS Agency NumberSectionD01Agency General Information222006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionD02Agency Contact InformationSectionD02Agency Contact Information232006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY CONTACT LAST NAMED02_01Data [text]DefinitionThe Last Name of the agency's primary contact.XSD Data Typexs:stringXSD Domain (Simple Type)DemographicLastNameMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint20XSD Structure: D02_01, D02_02, and D02_03 are all members D02_01_0 Agency Contact Name Structure Field ValuesA unique value; no variable list is possible. Uses●Component of the EMS Agency Contact Information/AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD02_02Agency Contact Middle Name/InitialD02_03Agency Contact First NameSectionD02Agency Contact Information242006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY CONTACT MIDDLE NAME/INITIALD02_02Data [text]DefinitionThe Middle Name or initial of the agency's primary contact.XSD Data Typexs:stringXSD Domain (Simple Type)FirstNameMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint20XSD Structure: D02_01, D02_02, and D02_03 are all members D02_01_0 Agency Contact Name Structure Field ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Component of the EMS Agency Contact Information/AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD02_01Agency Contact Last NameD02_03Agency Contact First NameE00Common Null ValuesSectionD02Agency Contact Information252006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY CONTACT FIRST NAMED02_03Data [text]DefinitionThe First Name of the agency's primary contact.XSD Data Typexs:stringXSD Domain (Simple Type)MiddleInitialNameMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint20XSD Structure: D02_01, D02_02, and D02_03 are all members D02_01_0 Agency Contact Name Structure Field ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Component of the EMS Agency Contact Information/AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD02_01Agency Contact Last NameD02_02Agency Contact Middle Name/InitialE00Common Null ValuesSectionD02Agency Contact Information262006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY CONTACT ADDRESSD02_04Data [text]DefinitionThe Agency contact's location or physical address.XSD Data Typexs:stringXSD Domain (Simple Type)StreetAddressMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: D02_04, D02_05, D02_06, and D02_07 are all members of D02_04_0 Agency Contract AddressField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Component of the EMS Agency Contact Information/AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD02_05Agency Contact CityD02_06Agency Contact StateD02_07Agency Contact Zip CodeE00Common Null ValuesSectionD02Agency Contact Information272006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY CONTACT CITYD02_05Data [combo] single-choiceDefinitionThe city of the Agency contact's mailing address.XSD Data Typexs:stringXSD Domain (Simple Type)CityMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: D02_04, D02_05, D02_06, and D02_07 are all members of D02_04_0 Agency Contract AddressField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●5 digit FIPS code●Could be filled in from Zip Code entry (D02_07)Uses●Component of the EMS Agency Contact Information/AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD02_04Agency Contact AddressD02_06Agency Contact StateD02_07Agency Contact Zip CodeE00Common Null ValuesSectionD02Agency Contact Information282006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY CONTACT STATED02_06Data [combo] single-choiceDefinitionThe state of the Agency contact's mailing address.XSD Data Typexs:stringXSD Domain (Simple Type)StateMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint3XSD Structure: D02_04, D02_05, D02_06, and D02_07 are all members of D02_04_0 Agency Contract AddressField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●2 digit FIPS numeric code (Not State abbreviation)●Could be filled in from Zip Code entry (D02_07)Uses●Component of the EMS Agency Contact Information/AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD02_04Agency Contact AddressD02_05Agency Contact CityD02_07Agency Contact Zip CodeE00Common Null ValuesSectionD02Agency Contact Information292006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY CONTACT ZIP CODED02_07Data [text]National ElementDefinitionThe ZIP code of the Agency contact's mailing address.XSD Data Typexs:stringXSD Domain (Simple Type)DemographicZipMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDYesXSD Structure: D02_04, D02_05, D02_06, and D02_07 are all members of D02_04_0 Agency Contract AddressField ValuesA unique value; no variable list is possible. Additional Information●Can be a 5 or 9 digit Zip CodeUses●Allows data to be sorted into a geographical area●Component of the EMS Agency Contact Information/AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD02_04Agency Contact AddressD02_05Agency Contact CityD02_06Agency Contact StateSectionD02Agency Contact Information302006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY CONTACT TELEPHONE NUMBERD02_08Data [text]DefinitionThe primary phone number of the Agency contact.XSD Data Typexs:stringXSD Domain (Simple Type)TelephoneNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint10Field ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●10 digit telephone number Uses●Component of the EMS Agency Contact Information/AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberE00Common Null ValuesSectionD02Agency Contact Information312006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY CONTACT FAX NUMBERD02_09Data [text]DefinitionThe primary fax number of the Agency contact.XSD Data Typexs:stringXSD Domain (Simple Type)TelephoneNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint10Field ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●10 digit telephone number Uses●Component of the EMS Agency Contact Information/AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberE00Common Null ValuesSectionD02Agency Contact Information322006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY CONTACT EMAIL ADDRESSD02_10Data [text]DefinitionThe primary email address of the Agency contact.XSD Data Typexs:stringXSD Domain (Simple Type)EmailAddressMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint100Field ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Component of the EMS Agency Contact Information/AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberE00Common Null ValuesSectionD02Agency Contact Information332006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY CONTACT WEB ADDRESSD02_11Data [text]DefinitionThe primary website address (URL) of the agency.XSD Data Typexs:stringXSD Domain (Simple Type)WebAddressMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint100Field ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Component of the EMS Agency Contact Information/AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberE00Common Null ValuesSectionD02Agency Contact Information342006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionD03Agency Medical Director InformationSectionD03Agency Medical Director Information352006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY MEDICAL DIRECTOR LAST NAMED03_01Data [text]DefinitionThe Last Name of the Agency's Medical DirectorXSD Data Typexs:stringXSD Domain (Simple Type)DemographicLastNameMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint20XSD Structure: D03_01, D03_02, and D03_03 are all members of D03_01_0 Agency Medical Director NameField ValuesA unique value; no variable list is possible. Uses●Component of the EMS Medical Director’s Contact Information/ AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD03_02Agency Medical Director Middle Name/InitialD03_03Agency Medical Director First NameSectionD03Agency Medical Director Information362006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY MEDICAL DIRECTOR MIDDLE NAME/INITIALD03_02Data [text]DefinitionThe Middle Name or Initial of the Agency's Medical DirectorXSD Data Typexs:stringXSD Domain (Simple Type)MiddleInitialNameMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint20XSD Structure: D03_01, D03_02, and D03_03 are all members of D03_01_0 Agency Medical Director NameField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Component of the EMS Medical Director’s Contact Information/ AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD03_01Agency Medical Director Last NameD03_03Agency Medical Director First NameE00Common Null ValuesSectionD03Agency Medical Director Information372006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY MEDICAL DIRECTOR FIRST NAMED03_03Data [text]DefinitionThe First Name of the Agency's Medical DirectorXSD Data Typexs:stringXSD Domain (Simple Type)FirstNameMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint20XSD Structure: D03_01, D03_02, and D03_03 are all members of D03_01_0 Agency Medical Director NameField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Component of the EMS Medical Director’s Contact Information/ AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD03_01Agency Medical Director Last NameD03_02Agency Medical Director Middle Name/InitialE00Common Null ValuesSectionD03Agency Medical Director Information382006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY MEDICAL DIRECTOR ADDRESSD03_04Data [text]DefinitionThe street or mailing address of the Agency's medical directorXSD Data Typexs:stringXSD Domain (Simple Type)StreetAddressMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: D03_04, D03_05, D03_06, and D03_07 are all members of D03_04_0 Agency Medical Director AddressField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Component of the EMS Medical Director’s Contact Information/ AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD03_01Agency Medical Director Last NameD03_05Agency Medical Director CityD03_06Agency Medical Director StateD03_07Agency Medical Director Zip CodeE00Common Null ValuesSectionD03Agency Medical Director Information392006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY MEDICAL DIRECTOR CITYD03_05Data [combo] single-choiceDefinitionThe city of the Agency medical director's mailing addressXSD Data Typexs:stringXSD Domain (Simple Type)CityMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: D03_04, D03_05, D03_06, and D03_07 are all members of D03_04_0 Agency Medical Director AddressField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●5 digit FIPS code●Could be filled in from Zip Code entry (D03_07)Uses●Component of the EMS Medical Director’s Contact Information/ AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD03_01Agency Medical Director Last NameD03_04Agency Medical Director AddressD03_06Agency Medical Director StateD03_07Agency Medical Director Zip CodeE00Common Null ValuesSectionD03Agency Medical Director Information402006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY MEDICAL DIRECTOR STATED03_06Data [combo] single-choiceDefinitionThe state of the Agency medical director's mailing addressXSD Data Typexs:stringXSD Domain (Simple Type)StateMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint3XSD Structure: D03_04, D03_05, D03_06, and D03_07 are all members of D03_04_0 Agency Medical Director AddressField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●2 digit FIPS numeric code (Not State abbreviation)●Could be filled in from Zip Code entry (D03_07)Uses●Component of the EMS Medical Director’s Contact Information/ AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD03_01Agency Medical Director Last NameD03_04Agency Medical Director AddressD03_05Agency Medical Director CityD03_07Agency Medical Director Zip CodeE00Common Null ValuesSectionD03Agency Medical Director Information412006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY MEDICAL DIRECTOR ZIP CODED03_07Data [text]DefinitionThe ZIP code of the Agency medical director's mailing addressXSD Data Typexs:stringXSD Domain (Simple Type)DemographicZipMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoXSD Structure: D03_04, D03_05, D03_06, and D03_07 are all members of D03_04_0 Agency Medical Director AddressField ValuesA unique value; no variable list is possible. Additional Information●Can be a 5 or 9 digit Zip Code Uses●Component of the EMS Medical Director’s Contact Information/ AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD03_01Agency Medical Director Last NameD03_04Agency Medical Director AddressD03_05Agency Medical Director CityD03_06Agency Medical Director StateSectionD03Agency Medical Director Information422006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY MEDICAL DIRECTOR TELEPHONE NUMBERD03_08Data [text]DefinitionThe primary phone number of the Agency's medical directorXSD Data Typexs:stringXSD Domain (Simple Type)TelephoneNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint10Field ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●10 digit telephone number Uses●Component of the EMS Medical Director’s Contact Information/ AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD03_01Agency Medical Director Last NameE00Common Null ValuesSectionD03Agency Medical Director Information432006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY MEDICAL DIRECTOR FAX NUMBERD03_09Data [text]DefinitionThe primary fax number of the Agency's medical directorXSD Data Typexs:stringXSD Domain (Simple Type)TelephoneNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint10Field ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●10 digit telephone number Uses●Component of the EMS Medical Director’s Contact Information/ AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD03_01Agency Medical Director Last NameE00Common Null ValuesSectionD03Agency Medical Director Information442006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY MEDICAL DIRECTOR'S MEDICAL SPECIALTYD03_10Data [combo] single-choiceDefinitionThe primary medical specialty of the Agency Medical DirectorXSD Data Typexs:integerXSD Domain (Simple Type)AgencyMedicalDirectorsMedicalSpecialtyMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available5980Anesthesiology5990Cardiology6000Emergency Medicine6010Family Practice6020General Practice (not board certified)6030Internal Medicine6040Obstetrics and Gynecology6050Orthopedics6060Other6070Pediatrics6080SurgeryUses●Provides description of the Medical Direction of EMS AgenciesData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD03_01Agency Medical Director Last NameE00Common Null ValuesSectionD03Agency Medical Director Information452006 NHTSA Uniform PreHospital Dataset V.2.2.1AGENCY MEDICAL DIRECTOR EMAIL ADDRESSD03_11Data [text]DefinitionThe primary email address of the Agency's medical directorXSD Data Typexs:stringXSD Domain (Simple Type)EmailAddressMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint100Field ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Component of the EMS Medical Director’s Contact Information/ AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD03_01Agency Medical Director Last NameE00Common Null ValuesSectionD03Agency Medical Director Information462006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionD04Agency Configuration InformationSectionD04Agency Configuration Information472006 NHTSA Uniform PreHospital Dataset V.2.2.1STATE CERTIFICATION LICENSURE LEVELSD04_01Data [combo] multiple-choiceDefinitionAll of the potential levels of certification/licensure for EMS personnel recognized by the stateXSD Data Typexs:string/integerXSD Domain (Simple Type)DemographicStateCertificationLicensureLevelsMultiple Entry ConfigurationYesAccepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: D04_01 is a member of D04_01_0 Demographic State Certification Licensure LevelsXSD Attributes: Status (Active or In-active) and Date are included as attributesField Values6090EMT-Basic6100EMT-Intermediate6110EMT-Paramedic6111Nurse6112Physician6120First ResponderAdditional Information●Additional EMS Certification Licensure Levels may be added by each state if a level exists in the state different than the provided variables. If an additional level is added, the new variable should be stored and passed in the xml in text format providing the name of the level●Multiple entry configuration to create a list box for Level of Service (D01_07), Crew Member Level (E04_03), Personnel Level of Vehicle Crew (D06_04), Personnel’s Highest Level of Certification/Licensure for Agency (D07_05), and State EMS Certification/Licensure Level (D08_15)●Other levels should be entered here as per state rules and regulationsUses●Allows data to be sorted based on an agency's credentialing levels●Used to create a list box for Items D01_07, E04_03, D06_04, D07_05, and D08_15Data Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberSectionD04Agency Configuration Information482006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS UNIT CALL SIGND04_02Data [text] multiple-entryDefinitionThe EMS unit number used to dispatch and communicate with the unit. This may be the same as the EMS Unit/Vehicle Number in many agencies.XSD Data Typexs:stringXSD Domain (Simple Type)EMSUnitNumberMultiple Entry ConfigurationYesAccepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: D04_02 is a member of D04_02_0 Demographic State Certification Licensure LevelsXSD Attributes: Status (Active or In-active) and Date are included as attributesField ValuesA unique value; no variable list is possible. Additional Information●Used to create a list box for EMS Unit Call Sign (E02_12)Uses●Allows data to data to be sorted by EMS unit and/or location.Data Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberSectionD04Agency Configuration Information492006 NHTSA Uniform PreHospital Dataset V.2.2.1ZONESD04_03Data [text] multiple-entryDefinitionThe geographic zones used by an agency to divide the service area into smaller geographic components. These zones can be defined locally using any method which will allow easy assignment of locations to their respective zoneXSD Data Typexs:stringXSD Domain (Simple Type)DemographicZoneNumberMultiple Entry ConfigurationYesAccepts Null Values NoRequired in XSDNoMinimum Constraint1Maximum Constraint30XSD Structure: D04_03 is a member of D04_03_0 Demographic State Certification Licensure LevelsField ValuesA unique value; no variable list is possible. Additional Information●If GPS documentation is being done by the EMS Agency, the documentation of a zone is typically not required●Multiple entry configuration to create a list box for Vehicle Dispatch Zone (E02_14), Scene Zone Number (E08_09), Destination Zone Number (E20_09), and Station Zone (D05_03)Uses●Used to create a list box for Items E02_14, E08_09, E20_09, and D05_03Data Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberSectionD04Agency Configuration Information502006 NHTSA Uniform PreHospital Dataset V.2.2.1PROCEDURESD04_04Data [combo] multiple-choiceDefinitionA list of all procedures that the agency has implemented and available for use.XSD Data Typexs:decimalXSD Domain (Simple Type)DemographicProcedureMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint0Maximum Constraint1,000XSD Structure: D04_04 and D04_05 are members of D04_04_0 Demographic Procedure StructureField Values12 Lead ECG-Obtain89.820CPR-Start Rescue Breathing without Compressions99.61212 Lead ECG-Transmitted89.821CPR-Stop99.615Activation-Advanced Hazmat Specialty Service/Response Team101.201Decontamination86.280Activation-Fire Rehabilitation Specialty Service/Response Team101.202Defibrillation-Automated (AED)99.621Activation-Other Specialty Service/Response Team101.203Defibrillation-Manual99.622Activation-Rescue Specialty Service/Response Team101.204Defibrillation-Placement for Monitoring/Analysis99.625Activation-Social Services Notification/Referral101.205Escharotomy86.090Activation-Tactical or SWAT Specialty Service/Response Team101.206Extrication100.200Airway-Bagged (via BVMask)93.931Gastric Tube Insertion-Inserted Nasally96.070Airway-Bagged (via tube)93.930Gastric Tube Insertion-Inserted Orally96.071Airway-BiPAP96.702Injections-SQ/IM99.290Airway-Change Tracheostomy Tube97.230Intra-Aortic Balloon Pump Maintenance37.611Airway-Cleared, Opened, or Heimlich98.130Joint Reduction/Relocation79.700Airway-Combitube Blind Insertion Airway Device96.051Left Ventricular Assist Device Maintenance37.612Airway-CPAP93.900MAST93.580Airway-Direct Laryngoscopy31.420Orthostatic Blood Pressure Measurement89.590Airway-EOA/EGTA96.030Pain Measurement89.702Airway-Extubation96.993Patient Cooling (Cold Pack, etc.)99.810Airway-Foreign Body Removal98.131Patient Cooling-Post Resuscitation99.811Airway-Impedance Threshold Device96.703Patient Loaded100.300Airway-Intubation Confirm Colorimetric ETCO296.991Patient Loaded-Helicopter Hot-Load100.301Airway-Intubation Confirm Esophageal Bulb96.992Patient Monitoring of Pre-existing Devices, Equipment, or Ongoing Medications89.599Airway-Intubation of Existing Tracheostomy Stoma97.231Patient Off-Loaded100.302Airway-King LT Blind Insertion Airway Device96.053Patient Off-Loaded Helicopter Hot Off-Load100.303Airway-Laryngeal Mask Blind Insertion Airway Device96.052Patient Warming (Hot Pack, etc.)93.350Airway-Nasal96.010Pericardiocentesis37.000Airway-Nasotracheal Intubation96.041Pulse Oximetry89.392Airway-Nebulizer Treatment93.940Rescue100.100Airway-Needle Cricothyrotomy31.110Restraints-Pharmacological99.841Airway-Oral96.020Restraints-Physical99.842Airway-Orotracheal Intubation96.040Specialty Center Activation-Adult Trauma101.101Airway-PEEP96.790Specialty Center Activation-Cardiac Arrest101.103Airway-Rapid Sequence Intubation96.042Specialty Center Activation-Pediatric Trauma101.102Airway-Respirator Operation (BLS)93.910Specialty Center Activation-STEMI101.104Airway-Suctioning98.150Specialty Center Activation-Stroke101.105Airway-Surgical Cricothyrotomy31.120Spinal Immobilization93.591Airway-Ventilator Operation96.700Splinting-Basic93.540Airway-Ventilator with PEEP96.701Splinting-Traction93.450Airway-Video Laryngoscopy31.421Temperature Measurement89.703Arterial Access-Blood Draw38.910Thrombolytic Screen89.704Arterial Line Maintenance89.610Urinary Catheterization57.940Assessment-Adult89.700Vagal Maneuver-Carotid Massage99.640Assessment-Pediatric89.701Vagal Maneuver-Valsalva or Other Vagal Maneuver (Not Carotid Massage)99.641Blood Glucose Analysis38.995Venous Access-Blood Draw38.990Capnography (CO2 Measurement)89.391Venous Access-Central Line Maintenance89.620Cardiac Monitor89.510Venous Access-Discontinue39.997Cardiac Pacing-External99.624Venous Access-Existing Catheter38.991Cardiac Pacing-Transvenous99.626Venous Access-External Jugular Line38.993Cardioversion99.623Venous Access-Extremity38.992Chest Decompression34.041Venous Access-Femoral Line38.994Chest Tube Placement34.042Venous Access-Internal Jugular Line39.995Childbirth73.590Venous Access-Intraosseous Adult41.920CNS Catheter-Epidural Maintenance1.181Venous Access-Intraosseous Pediatric41.921CNS Catheter-Intraventricular Maintenance1.182Venous Access-Subclavian Line39.996Contact Medical Control101.500Venous Access-Swan Ganz Maintenance89.640CPR by Other External Automated Device99.601Venous Access-Umbilical Vein Cannulation39.998CPR-AutoPulse Device99.602Wound Care-General93.057CPR-Mechanical Thumper Type Device99.603Wound Care-Hemostatic Agent93.059CPR-Precordial Thump Only99.604Wound Care-Irrigation93.058CPR-Start Compressions and Ventilations99.600Wound Care-Taser Barb Removal93.055CPR-Start Compressions only without Ventilation99.611Wound Care-Tourniquet93.056Additional Information●A multiple-entry configuration with Personnel Level Permitted to use the Procedure (D04_05)●If local systems have procedures which are not listed in the current values, additional procedures may be added using CPT codes from the ICD-9 standard. The CPT code should be stored and passed via the XML. This will allow expansion of the list to formally add new procedures over time●Used to create a list box for Procedure (E19_03)Uses●Allows data to be sorted based on an agency's Procedure capabilities●Provides descriptive information when combined with an EMS Agency’s Billing Status●Used to create a list box for Response to Procedure (E19_08)Data Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD04_05Personnel Level Permitted to Use the ProcedureReferences in NHTSA Version 1DesirableElement 58Time of First CPRDesirableElement 63Time of First Defibrillatory ShockEssentialElement 78Procedure or Treatment NameReferences to Other Databases● NFIRS 5.0EMS Module, Title: Procedures Used, Multi Select List: Airway Insertion = 01, Anti-Shock Trousers = 02, Assisted Ventilation = 03, Bleeding Control = 04, Burn Care = 05, Cardiac Pacing = 06, Cardioversion (defib), Manual = 07, Chest/Abdominal Thrust = 08, CPR = 09, Cricothyroidotomy = 10, Defibrillation by AED = 11, EKG Monitoring = 12, Extrication = 13, Intubation (EGTA) = 14, Intubation (ET) = 15, IO/IV Therapy = 16, Medications Therapy = 17, Oxygen Therapy = 18, Obstetrical Care/Delivery = 19, Pre-Arrival Instruction = 20, Restrained Patient = 21, Spinal Immobilization = 22, Splinted Extremities = 23, Suction/Aspirate = 24, Other Procedure = 00, No Treatment = NNSectionD04Agency Configuration Information522006 NHTSA Uniform PreHospital Dataset V.2.2.1PERSONNEL LEVEL PERMITTED TO USE THE PROCEDURED04_05Data [combo] multiple-choiceDefinitionAll Personnel Levels which are permitted to use the associated procedure.XSD Data Typexs:string/integerXSD Domain (Simple Type)DemographicStateCertificationLicensureLevelsMultiple Entry Configuration(1) Yes with each Procedure. Accepts Null Values No (2) Yes, via structureRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: D04_04 and D04_05 are members of D04_04_0 Demographic Procedure StructureXSD Attributes: Status (Active or In-active) and Date are included as attributesField Values6090EMT-Basic6100EMT-Intermediate6110EMT-Paramedic6111Nurse6112Physician6120First ResponderAdditional Information●This list can be edited by each state to account for additional certification/ licensure level by adding levels as listed in State Certification/Licensure Levels (D04_01). State Certification/Licensure levels (D04_01) should create the list for this item●This value is stored either as the appropriate code or in text if an additional certification/licensure level has been entered by a state Data Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD04_04ProceduresSectionD04Agency Configuration Information532006 NHTSA Uniform PreHospital Dataset V.2.2.1MEDICATIONS GIVEND04_06Data [text] multiple-entryDefinitionA list of all medications the agency has implemented and available for useXSD Data Typexs:stringXSD Domain (Simple Type)DemographicMedicationsGivenMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: D04_06 and D04_07 are members of D04_06_0 Demographic Medication StructureField ValuesA unique value; no variable list is possible. Additional Information●At this time a national drug index or coding scheme, which would allow for a single code to be assigned to a single drug, does not exist●The Drug List may contain any generic or trade name of a drug approved by the FDA and administered by EMS. The medication is stored and passed via XML in a text format●Used to create a list box for Medication Given (E18_03) and Prior Aid (E09_01)Uses●Allows data to be sorted based on an agency's Medication capabilities●Could be used to create a list box for Medication Given (E18_03) and Prior Aid (E09_01)●Provides descriptive information when combined with an EMS Agency’s Billing StatusData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD04_07Personnel Level Permitted to Use the MedicationReferences in NHTSA Version 1EssentialElement 80Medication NameReferences to Other Databases● NFIRS 5.0EMS Module, Title: Procedures Used, Multi Select List: Airway Insertion = 01, Anti-Shock Trousers = 02, Assisted Ventilation = 03, Bleeding Control = 04, Burn Care = 05, Cardiac Pacing = 06, Cardioversion (defib), Manual = 07, Chest/Abdominal Thrust = 08, CPR = 09, Cricothyroidotomy = 10, Defibrillation by AED = 11, EKG Monitoring = 12, Extrication = 13, Intubation (EGTA) = 14, Intubation (ET) = 15, IO/IV Therapy = 16, Medications Therapy = 17, Oxygen Therapy = 18, Obstetrical Care/Delivery = 19, Pre-Arrival Instruction = 20, Restrained Patient = 21, Spinal Immobilization = 22, Splinted Extremities = 23, Suction/Aspirate = 24, Other Procedure = 00, No Treatment = NNSectionD04Agency Configuration Information542006 NHTSA Uniform PreHospital Dataset V.2.2.1PERSONNEL LEVEL PERMITTED TO USE THE MEDICATIOND04_07Data [combo] multiple-choiceDefinitionAll personnel levels which are permitted to use the associated medicationXSD Data Typexs:string/integerXSD Domain (Simple Type)DemographicStateCertificationLicensureLevelsMultiple Entry Configuration(1) Yes with each Procedure. Accepts Null Values No (2) Yes, via structureRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: D04_06 and D04_07 are members of D04_06_0 Demographic Medication StructureXSD Attributes: Status (Active or In-active) and Date are included as attributesField Values6090EMT-Basic6100EMT-Intermediate6110EMT-Paramedic6111Nurse6112Physician6120First ResponderAdditional Information●This list can be edited by each state to account for additional certification/ licensure level by adding levels as listed in State Certification/Licensure Levels (D04_01). State Certification/Licensure levels (D04_01) should create the list for this item●This value is stored either as the appropriate code or in text if an additional certification/licensure level has been entered by a state Data Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD04_06Medications GivenSectionD04Agency Configuration Information552006 NHTSA Uniform PreHospital Dataset V.2.2.1PROTOCOLD04_08Data [text] multiple-entryDefinitionA list of all of the medical treatment protocols that the agency has in place and available for use. Specific Adult or Pediatric Protocols should be mapped to one of these topics if possible.XSD Data Typexs:stringXSD Domain (Simple Type)DemographicProtocolsUsedMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: D04_08 and D04_09 are members of D04_08_0 Demographic Protocol StructureXSD Attributes: Status (Active or In-active) and Date are included as attributesField Values6720Abdominal Pain6730Airway6740Airway-Failed6760Airway-RSI6770Allergic Reaction/Anaphylaxis6780Altered Mental Status6785AltitudeSickness6790Asystole6791Atrial Fibrillation6800Back Pain6810Behavioral6820Bites and Envenomations6830Bradycardia6840Burns6850Cardiac Arrest6860Cardiac Chest Pain6870Childbirth/Labor6875Cold Exposure6880Dental Problems6881Device Malfunction6885Diarrhea6890Drowning/Near Drowning6892Diving Emergencies6900Electrical Injuries6910Epistaxis6911Exposure-Airway Irritants6912Exposure-Biological/Infectious6913Exposure-Blistering Agents6914Exposure-Cyanide6915Exposure-Nerve Agents6916Exposure-Radiologic Agents6917Exposure-Riot Control Agents6920Extremity Trauma6925Eye Trauma6930Fever6935Gynecologic Emergencies6940Head Trauma6945Hyperglycemia6950Hypertension6960Hyperthermia6965Hypoglycemia6970Hypotension/Shock (Non-Trauma)6980Hypothermia6990IV Access7000Trauma-Multisystem7010Newly Born7020Obstetrical Emergencies7030Overdose/Toxic Ingestion7040Pain Control7130Post Resuscitation7140Pulmonary Edema7150Pulseless Electrical Activity7160Respiratory Distress7170Seizure7175Spinal Cord Trauma7180Spinal Immobilization7190Supraventricular Tachycardia7200Stroke/TIA7210Syncope7214Trauma-Arrest7215Trauma-Amputation7220Universal Patient Care7230Ventricular Fibrillation7232Ventricular Ectopy7240Ventricular Tachycardia7251VomitingAdditional Information●Can be used as a qualifying measure to compare care provided to protocol guidanceSectionD04Agency Configuration Information562006 NHTSA Uniform PreHospital Dataset V.2.2.1●If local systems have protocols which are not listed in the current values, additional protocols may be added as a text name. The text value should be stored and passed via the XML This will allow expansion of the list to formally add new procedures over time. Please map all existing protocols to these coded protocol subjects as much as possible.Uses●Allows data to be sorted based on an agency's Protocols●Could be used to create a list box for Protocols Used (E17_01)●Provides description of EMS Agency’s capabilities●Provides descriptive information when combined with an EMS Agency’s Billing StatusData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD04_09Personnel Level Permitted to Use the ProtocolSectionD04Agency Configuration Information572006 NHTSA Uniform PreHospital Dataset V.2.2.1PERSONNEL LEVEL PERMITTED TO USE THE PROTOCOLD04_09Data [combo] single-choiceDefinitionAll personnel levels which are permitted to use the associated ProtocolXSD Data Typexs:string/integerXSD Domain (Simple Type)DemographicStateCertificationLicensureLevelsMultiple Entry Configuration(1) Yes with each Procedure. Accepts Null Values No (2) Yes, via structureRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: D04_08 and D04_09 are members of D04_08_0 Demographic Protocol StructureXSD Attributes: Status (Active or In-active) and Date are included as attributesField Values6090EMT-Basic6100EMT-Intermediate6110EMT-Paramedic6111Nurse6112Physician6120First ResponderAdditional Information●This list can be edited by each state to account for additional certification/ licensure level by adding levels as listed in State Certification/Licensure Levels (D04_01). State Certification/Licensure levels (D04_01) should create the list for this item●This value is stored either as the appropriate code or in text if an additional certification/licensure level has been entered by a state Data Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD04_08ProtocolSectionD04Agency Configuration Information582006 NHTSA Uniform PreHospital Dataset V.2.2.1BILLING STATUSD04_10Data [combo] multiple-choiceDefinitionIndication of whether the EMS agency routinely bills for any segment of the patient populationXSD Data Typexs:stringXSD Domain (Simple Type)BillingStatusMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoXSD Attributes: Status (Active or In-active) and Date are included as attributesField Values0No1YesUses●Allows data to be sorted based on an agency's Billing Status●Provides description of EMS agencies based on credentialing levels recognized by the stateData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberSectionD04Agency Configuration Information592006 NHTSA Uniform PreHospital Dataset V.2.2.1HOSPITALS SERVEDD04_11Data [text] multiple-entryDefinitionA list of all the hospitals the agency transports to or fromXSD Data Typexs:stringXSD Domain (Simple Type)FacilityNameMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint50XSD Structure: D04_11 and D04_12 are members of D04_11_0 Hospitals Served StructureField ValuesA unique value; no variable list is possible. Additional Information●Multiple entry configuration used to create a list box for Destination/ Transferred to (E20_01) and Vehicle Dispatch Location (E02_13)Uses●Could be used to create a list box (along with D04_13) for Destination/ Transferred to (E20_01) and Vehicle Dispatch Location (E02_13)Data Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD04_12Hospital Facility NumberSectionD04Agency Configuration Information602006 NHTSA Uniform PreHospital Dataset V.2.2.1HOSPITAL FACILITY NUMBERD04_12Data [text]DefinitionThe state assigned licensure number (code) for each Hospital Served (D04_11)XSD Data Typexs:stringXSD Domain (Simple Type)FacilityNumberMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: D04_11 and D04_12 are members of D04_11_0 Hospitals Served StructureField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Multiple entry configuration to create a list box for Incident Facility Code (E08_08) and Destination Transferred to Code (E20_02)●This field could also provide linkage to Hospitals Serverd (D04_11) which would allow a list box of Hospital Names to be used instead of entering the Code directlyUses●Could be used to create a list box (along with D04_14) for Incident Facility Code (E08_08) and Destination Transferred to Code (E20_02)Data Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD04_11Hospitals ServedE00Common Null ValuesSectionD04Agency Configuration Information612006 NHTSA Uniform PreHospital Dataset V.2.2.1OTHER DESTINATIONSD04_13Data [text] multiple-entryDefinitionA list of all destinations other than hospitals which an agency transports to or fromXSD Data Typexs:stringXSD Domain (Simple Type)FacilityNameMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint50XSD Structure: D04_13, D04_14 and D04_15 are members of D04_13_0 Other Destinations StructureField ValuesA unique value; no variable list is possible. Additional Information●Multiple entry configuration used to create a list box for Destination/Transferred to (E20_01) and Vehicle Dispatch Location (E02_13)Uses●Could be used to create a list box (along with D04_11) for Destination/ Transferred to (E20_01) and Vehicle Dispatch Location (E02_13)Data Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD04_14Destination Facility NumberD04_15Destination TypeSectionD04Agency Configuration Information622006 NHTSA Uniform PreHospital Dataset V.2.2.1DESTINATION FACILITY NUMBERD04_14Data [text]DefinitionThe state assigned licensure number (code) for each Other Destination (D04_13)XSD Data Typexs:stringXSD Domain (Simple Type)FacilityNumberMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: D04_13, D04_14 and D04_15 are members of D04_13_0 Other Destinations StructureField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Multiple entry configuration to create a list box for Incident Facility Code (E8_08) and Destination Transferred to Code (E20_02)●This field could also provide linkage to Other Destinations (D04_13) which would allow a list box of Other Destination Names to be used instead of entering the Code directlyUses●Allows data to be sorted or grouped based on the EMS transports destination type●Could be used to create a list box (along with D04_12) for Incident Facility Code (E08_08) and Destination Transferred to Code (E20_02)Data Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD04_13Other DestinationsD04_15Destination TypeE00Common Null ValuesSectionD04Agency Configuration Information632006 NHTSA Uniform PreHospital Dataset V.2.2.1DESTINATION TYPED04_15Data [combo] single-choiceDefinitionThe type of facility associated with the Other Destination (D04_13)XSD Data Typexs:integerXSD Domain (Simple Type)FacilityTypeMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoXSD Structure: D04_13, D04_14 and D04_15 are members of D04_13_0 Other Destinations StructureField Values7270Home7280Hospital7290Medical Office/Clinic7300Morgue7320Nursing Home7330Other7340Other EMS Responder (air)7350Other EMS Responder (ground)7360Police/JailAdditional Information●Can be used to auto-fill Type of Destination (E20_17) based on Other Destination (D04_13) or Destination Facility Number (D04_14)Uses●Allows data to be sorted based on an agency's Destination Type●Allows data to be sorted or grouped based on the EMS transports destination type●Provides a component of a list box associated with Other Destinations (D04_13)●Provides description of EMS Agency’s Destination TypesData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD04_13Other DestinationsD04_14Destination Facility NumberReferences in NHTSA Version 1EssentialElement 44Destination/Transferred ToSectionD04Agency Configuration Information642006 NHTSA Uniform PreHospital Dataset V.2.2.1INSURANCE COMPANIES USEDD04_16Data [text] multiple-entryDefinitionA list of insurance companies which are prevalent in the Agencies service areaXSD Data Typexs:stringXSD Domain (Simple Type)InsuranceCompanyNameMultiple Entry ConfigurationYesAccepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint100Field ValuesA unique value; no variable list is possible. Additional Information●Multiple entry configuration to create a list box for Insurance Company Name (E07_03) Uses●Allows data to be sorted or grouped based on the EMS transports destination type●Could be used to create a list box for Insurance Company Name (E07_03)Data Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberSectionD04Agency Configuration Information652006 NHTSA Uniform PreHospital Dataset V.2.2.1EMD VENDORD04_17Data [text]DefinitionThe Vendor or Company associated with the EMD Card set and algorithmsXSD Data Typexs:stringXSD Domain (Simple Type)EMDVendorMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint50XSD Structure: D04_17 is a member of D04_17_0 Demographic State Certification Licensure LevelsXSD Attributes: Status (Active or In-active) and Date are included as attributesField ValuesA unique value; no variable list is possible. Uses●Identifies the type of EMD cards used so they may be used in Quality Management reports which compare EMS systemsData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberSectionD04Agency Configuration Information662006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionD05Agency Station InformationSectionD05Agency Station Information672006 NHTSA Uniform PreHospital Dataset V.2.2.1STATION NAMED05_01Data [text]DefinitionName of the agency's stationXSD Data Typexs:stringXSD Domain (Simple Type)StationNameMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint50XSD Structure: Data Elements D05_01 through D05_09 are all within the Agency Information StructureField ValuesA unique value; no variable list is possible. Additional Information●Multiple Entry Configuration for D05_01 through D05_09●Provides part of the list box for Vehicle Dispatch Location (E02_13)Uses●Allows data to be sorted based on an agency's Station Name●Component of the EMS Agency’s Station AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD05_02Station NumberD05_03Station ZoneD05_04Station GPSD05_05Station AddressD05_06Station CityD05_07Station StateD05_08Station ZipD05_09Station Telephone NumberSectionD05Agency Station Information682006 NHTSA Uniform PreHospital Dataset V.2.2.1STATION NUMBERD05_02Data [text]DefinitionID number of the agency's stationXSD Data Typexs:stringXSD Domain (Simple Type)StationNumberMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint50XSD Structure: Data Elements D05_01 through D05_09 are all within the Agency Information StructureField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Allows data to be sorted based on an agency's Station NumberData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD05_01Station NameD05_03Station ZoneD05_04Station GPSD05_05Station AddressD05_06Station CityD05_07Station StateD05_08Station ZipD05_09Station Telephone NumberE00Common Null ValuesSectionD05Agency Station Information692006 NHTSA Uniform PreHospital Dataset V.2.2.1STATION ZONED05_03Data [text]DefinitionThe geographic zone or location of the agency's stationXSD Data Typexs:stringXSD Domain (Simple Type)DemographicZoneNumberMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint1Maximum Constraint30XSD Structure: Data Elements D05_01 through D05_09 are all within the Agency Information StructureField ValuesA unique value; no variable list is possible. Additional Information●Selected from a list of geographic zones specific for each agency as defined in Zones (D04_03)Uses●Allows data to be sorted based on an agency's Station ZoneData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD05_01Station NameD05_02Station NumberD05_04Station GPSD05_05Station AddressD05_06Station CityD05_07Station StateD05_08Station ZipD05_09Station Telephone NumberSectionD05Agency Station Information702006 NHTSA Uniform PreHospital Dataset V.2.2.1STATION GPSD05_04Data [text]DefinitionThe GPS coordinate for the agency's stationXSD Data Typexs:decimalXSD Domain (Simple Type)GPSLocationMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoXSD Structure: Data Elements D05_01 through D05_09 are all within the Agency Information StructureXSD Attributes: Latitude and Longitude are each included as attributesField ValuesA unique value; no variable list is possible. Uses●Allows data to be sorted based on an agency's Station GPSData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD05_01Station NameD05_02Station NumberD05_03Station ZoneD05_05Station AddressD05_06Station CityD05_07Station StateD05_08Station ZipD05_09Station Telephone NumberSectionD05Agency Station Information712006 NHTSA Uniform PreHospital Dataset V.2.2.1STATION ADDRESSD05_05Data [text]DefinitionAddress of the agency's stationXSD Data Typexs:stringXSD Domain (Simple Type)StreetAddressMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: (1) Data Elements D05_01 through D05_09 are all within the Agency Information Structure. (2) Data Elements D05_05, D05_06, D05_07, and D05_08 are all members of D05_05_0 Station Address StructureField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Component of the EMS Agency’s Station AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD05_01Station NameD05_02Station NumberD05_03Station ZoneD05_04Station GPSD05_06Station CityD05_07Station StateD05_08Station ZipD05_09Station Telephone NumberE00Common Null ValuesSectionD05Agency Station Information722006 NHTSA Uniform PreHospital Dataset V.2.2.1STATION CITYD05_06Data [combo] single-choiceDefinitionCity of the agency's stationXSD Data Typexs:stringXSD Domain (Simple Type)CityMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: (1) Data Elements D05_01 through D05_09 are all within the Agency Information Structure. (2) Data Elements D05_05, D05_06, D05_07, and D05_08 are all members of D05_05_0 Station Address StructureField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●5 digit FIPS code●Could be filled in from Station Zip Code entry (D05_08)Uses●Component of the EMS Agency’s Station AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD05_01Station NameD05_02Station NumberD05_03Station ZoneD05_04Station GPSD05_05Station AddressD05_07Station StateD05_08Station ZipD05_09Station Telephone NumberE00Common Null ValuesSectionD05Agency Station Information732006 NHTSA Uniform PreHospital Dataset V.2.2.1STATION STATED05_07Data [combo] single-choiceDefinitionState of the agency's stationXSD Data Typexs:stringXSD Domain (Simple Type)StateMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint3XSD Structure: (1) Data Elements D05_01 through D05_09 are all within the Agency Information Structure. (2) Data Elements D05_05, D05_06, D05_07, and D05_08 are all members of D05_05_0 Station Address StructureField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●2 digit FIPS numeric code (Not State abbreviation)●Could be filled in from Station Zip Code entry (D05_08)Uses●Component of the EMS Agency’s Station AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD05_01Station NameD05_02Station NumberD05_03Station ZoneD05_04Station GPSD05_05Station AddressD05_06Station CityD05_08Station ZipD05_09Station Telephone NumberE00Common Null ValuesSectionD05Agency Station Information742006 NHTSA Uniform PreHospital Dataset V.2.2.1STATION ZIPD05_08Data [text]DefinitionZIP Code of the agency's stationXSD Data Typexs:stringXSD Domain (Simple Type)DemographicZipMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoXSD Structure: (1) Data Elements D05_01 through D05_09 are all within the Agency Information Structure. (2) Data Elements D05_05, D05_06, D05_07, and D05_08 are all members of D05_05_0 Station Address StructureField ValuesA unique value; no variable list is possible. Additional Information●Can be 5 or 9 digit Zip CodeUses●Component of the EMS Agency’s Station AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD05_01Station NameD05_02Station NumberD05_03Station ZoneD05_04Station GPSD05_05Station AddressD05_06Station CityD05_07Station StateD05_09Station Telephone NumberSectionD05Agency Station Information752006 NHTSA Uniform PreHospital Dataset V.2.2.1STATION TELEPHONE NUMBERD05_09Data [text]DefinitionThe telephone number of the agency's stationXSD Data Typexs:stringXSD Domain (Simple Type)TelephoneNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint10Field ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●10 digit telephone number Uses●Component of the EMS Agency’s Station AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD05_01Station NameD05_02Station NumberD05_03Station ZoneD05_04Station GPSD05_05Station AddressD05_06Station CityD05_07Station StateD05_08Station ZipE00Common Null ValuesSectionD05Agency Station Information762006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionD06Agency Vehicle InformationSectionD06Agency Vehicle Information772006 NHTSA Uniform PreHospital Dataset V.2.2.1UNIT/VEHICLE NUMBERD06_01Data [text]DefinitionThe unique ID number of the unit which is specific for each vehicle; typically the VIN associated with the vehicleXSD Data Typexs:stringXSD Domain (Simple Type)VehicleNumberMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint50XSD Structure: (1) Data Elements D06_01 through D06_10 are all within the Vehicle Information StructureField ValuesA unique value; no variable list is possible. Additional Information●Multiple Entry Configuration for D06_01 through D06_10Uses●Allows data to be sorted based on an agency's Unit Number●Provides geographic descriptive data on EMS agencies●Used to create a list box for EMS Unit/Vehicle Number (E02_11)Data Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD06_03Vehicle TypeD06_04State Certification/Licensure LevelsD06_05Number Of Each Personnel Level on the Vehicle CrewD06_06Vehicle Initial CostD06_07Vehicle Model YearD06_08Year Miles/Hours AccruedD06_09Annual Vehicle HoursD06_10Annual Vehicle MilesReferences in NHTSA Version 1EssentialElement 24Agency/Unit NumberSectionD06Agency Vehicle Information782006 NHTSA Uniform PreHospital Dataset V.2.2.1VEHICLE TYPED06_03Data [combo] single-choiceDefinitionVehicle type of unit (ambulance, fire, truck, etc.)XSD Data Typexs:integerXSD Domain (Simple Type)VehicleTypeMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoXSD Structure: (1) Data Elements D06_01 through D06_10 are all within the Vehicle Information StructureField Values7370Ambulance7380ATV7390Bicycle7400Boat7410Fire Truck7420Fixed Wing7430Motorcycle7440Other7450Private Vehicle7460Quick Response Vehicle (Non-Transport Vehicle other than Fire Truck7470Rescue7480Rotor CraftUses●Allows data to be sorted based on the Vehicle TypeData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD06_01Unit/Vehicle NumberD06_04State Certification/Licensure LevelsD06_05Number Of Each Personnel Level on the Vehicle CrewD06_06Vehicle Initial CostD06_07Vehicle Model YearD06_08Year Miles/Hours AccruedD06_09Annual Vehicle HoursD06_10Annual Vehicle MilesReferences in NHTSA Version 1EssentialElement 25Vehicle TypeSectionD06Agency Vehicle Information792006 NHTSA Uniform PreHospital Dataset V.2.2.1STATE CERTIFICATION/LICENSURE LEVELSD06_04Data [combo] single-choiceDefinitionThe personnel certification/licensure level of the vehicle crew memberXSD Data Typexs:integerXSD Domain (Simple Type)StateCertificationLicensureLevelsMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: (1) Data Elements D06_01 through D06_10 are all within the Vehicle Information Structure. (2) D06_04 and D06_05 are members of D06_04_0 Vehicle Crew StructureField Values6090EMT-Basic6100EMT-Intermediate6110EMT-Paramedic6111Nurse6112Physician6120First ResponderAdditional Information●A list box created from State Certification/ Licensure Level (D04_01)●Multiple Entry Configuration for D06_04 and D06_05Uses●Allows data to be grouped or compared by Vehicle Crew Configuration●Allows data to be sorted based on an agency's Vehicle Crew ConfigurationData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD06_01Unit/Vehicle NumberD06_03Vehicle TypeD06_05Number Of Each Personnel Level on the Vehicle CrewD06_06Vehicle Initial CostD06_07Vehicle Model YearD06_08Year Miles/Hours AccruedD06_09Annual Vehicle HoursD06_10Annual Vehicle MilesSectionD06Agency Vehicle Information802006 NHTSA Uniform PreHospital Dataset V.2.2.1NUMBER OF EACH PERSONNEL LEVEL ON THE VEHICLE CREWD06_05Data [number]DefinitionThe number of each personnel level associated with the vehicle crew.XSD Data Typexs:positiveIntegerXSD Domain (Simple Type)NumberOfPersonnelMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint1Maximum Constraint12XSD Structure: (1) Data Elements D06_01 through D06_10 are all within the Vehicle Information Structure. (2) D06_04 and D06_05 are members of D06_04_0 Vehicle Crew StructureField ValuesA unique value; no variable list is possible. Additional Information●Multiple Entry Configuration for D06_04 and D06_05Uses●Allows data to be grouped or compared by Vehicle Crew Configuration●Allows data to be sorted based on an agency's Vehicle Crew ConfigurationData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD06_01Unit/Vehicle NumberD06_03Vehicle TypeD06_04State Certification/Licensure LevelsD06_06Vehicle Initial CostD06_07Vehicle Model YearD06_08Year Miles/Hours AccruedD06_09Annual Vehicle HoursD06_10Annual Vehicle MilesSectionD06Agency Vehicle Information812006 NHTSA Uniform PreHospital Dataset V.2.2.1VEHICLE INITIAL COSTD06_06Data [number]DefinitionThe initial cost of the vehicle excluding all medical and other equipment not associated with the vehicle operation. This cost should be inclusive of all sources of funding including grants, donations, and any other capital.XSD Data Typexs:positiveIntegerXSD Domain (Simple Type)VehicleInitialCostMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint1Maximum Constraint100,000,000XSD Structure: (1) Data Elements D06_01 through D06_10 are all within the Vehicle Information StructureField ValuesA unique value; no variable list is possible. Uses●Provides description of EMS agencies and resourcesData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD06_01Unit/Vehicle NumberD06_03Vehicle TypeD06_04State Certification/Licensure LevelsD06_05Number Of Each Personnel Level on the D06_07Vehicle Model YearVehicle CrewD06_08Year Miles/Hours AccruedD06_09Annual Vehicle HoursD06_10Annual Vehicle MilesSectionD06Agency Vehicle Information822006 NHTSA Uniform PreHospital Dataset V.2.2.1VEHICLE MODEL YEARD06_07Data [number]DefinitionThe year the vehicle was manufactured. This is defined by the year of the VIN, understanding that some parts of the vehicle may not be original.XSD Data Typexs:gYearXSD Domain (Simple Type)VehicleYearMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint1,900Maximum Constraint2,030XSD Structure: (1) Data Elements D06_01 through D06_10 are all within the Vehicle Information StructureField ValuesA unique value; no variable list is possible. Additional Information●Format [YYYY]Uses●Provides description of EMS agencies and resourcesData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD06_01Unit/Vehicle NumberD06_03Vehicle TypeD06_04State Certification/Licensure LevelsD06_05Number Of Each Personnel Level on the D06_06Vehicle Initial CostVehicle CrewD06_08Year Miles/Hours AccruedD06_09Annual Vehicle HoursD06_10Annual Vehicle MilesSectionD06Agency Vehicle Information832006 NHTSA Uniform PreHospital Dataset V.2.2.1YEAR MILES/HOURS ACCRUEDD06_08Data [date/time]DefinitionThe year the Hours and miles were accumulatedXSD Data Typexs:gYearXSD Domain (Simple Type)VehicleYearMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint1,900Maximum Constraint2,030XSD Structure: (1) Data Elements D06_01 through D06_10 are all within the Vehicle Information Structure. (2) D06_08, D06_09, and D06_10 are all members of D06_08_0 Vehicle Miles/Hours StructureField ValuesA unique value; no variable list is possible. Additional Information●Multiple entry configuration to allow multiple years of data to be collected over time using Year Miles/Hours Accrued (D06_08), Annual Vehicle Hours (D06_09) and Annual Vehicle Miles (D06_10)●Used to identify the use of EMS vehicles over time.Uses●Provides description of EMS agencies and resourcesData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD06_01Unit/Vehicle NumberD06_03Vehicle TypeD06_04State Certification/Licensure LevelsD06_05Number Of Each Personnel Level on the D06_06Vehicle Initial CostVehicle CrewD06_07Vehicle Model YearD06_09Annual Vehicle HoursD06_10Annual Vehicle MilesSectionD06Agency Vehicle Information842006 NHTSA Uniform PreHospital Dataset V.2.2.1ANNUAL VEHICLE HOURSD06_09Data [number]DefinitionThe number of hours the vehicle was in service for the agency for the defined year.XSD Data Typexs:positiveIntegerXSD Domain (Simple Type)VehicleHoursMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint10,000XSD Structure: (1) Data Elements D06_01 through D06_10 are all within the Vehicle Information Structure. (2) D06_08, D06_09, and D06_10 are all members of D06_08_0 Vehicle Miles/Hours StructureField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Depending on the vehicles measurement system, hours (D06_09) or miles (D06_10) should be provided as appropriate●Used to identify the use of EMS vehicles over time.Uses●Provides description of EMS agencies and resourcesData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD06_01Unit/Vehicle NumberD06_03Vehicle TypeD06_04State Certification/Licensure LevelsD06_05Number Of Each Personnel Level on the D06_06Vehicle Initial CostVehicle CrewD06_07Vehicle Model YearD06_08Year Miles/Hours AccruedD06_10Annual Vehicle MilesE00Common Null ValuesSectionD06Agency Vehicle Information852006 NHTSA Uniform PreHospital Dataset V.2.2.1ANNUAL VEHICLE MILESD06_10Data [number]DefinitionThe number of miles the vehicle accumulated in service for the agency for the defined year (Odometer Reading)XSD Data Typexs:decimalXSD Domain (Simple Type)AnnualOdometerReadingMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint0Maximum Constraint1,000,000XSD Structure: (1) Data Elements D06_01 through D06_10 are all within the Vehicle Information Structure. (2) D06_08, D06_09, and D06_10 are all members of D06_08_0 Vehicle Miles/Hours StructureField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Depending on the vehicles measurement system, hours (D06_09) or miles (D06_10) should be provided as appropriate●Used to identify the use of EMS vehicles over time.Uses●Provides description of EMS agencies and resourcesData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD06_01Unit/Vehicle NumberD06_03Vehicle TypeD06_04State Certification/Licensure LevelsD06_05Number Of Each Personnel Level on the D06_06Vehicle Initial CostVehicle CrewD06_07Vehicle Model YearD06_08Year Miles/Hours AccruedD06_09Annual Vehicle HoursE00Common Null ValuesSectionD06Agency Vehicle Information862006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionD07Agency Personnel InformationSectionD07Agency Personnel Information872006 NHTSA Uniform PreHospital Dataset V.2.2.1PERSONNEL'S AGENCY ID NUMBERD07_01Data [text]DefinitionLocal agency ID number for personnelXSD Data Typexs:stringXSD Domain (Simple Type)PersonnelsAgencyIDNumberMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint50XSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number StructureField ValuesA unique value; no variable list is possible. Additional Information●This number should be unique to the individual and never reused after personnel leave the agencyUses●Allows data to be sorted or grouped based on an IndividualData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD07_03Personnel's Employment StatusD07_04Employment Status DateD07_05Personnel's Level of Certification/Licensure D07_06Date of Personnel's Certification or for AgencyLicensure for AgencyReferences in NHTSA Version 1EssentialElement 26Crew Member One NumberEssentialElement 27Crew Member Two NumberDesirableElement 28Crew Member Three NumberSectionD07Agency Personnel Information882006 NHTSA Uniform PreHospital Dataset V.2.2.1STATE/LICENSURE ID NUMBERD07_02Data [text]DefinitionThe state certification/licensure ID number assigned to the crew memberXSD Data Typexs:stringXSD Domain (Simple Type)StateLicensureIDMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDYesMinimum Constraint2Maximum Constraint15XSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number StructureField ValuesA unique value; no variable list is possible. Additional Information●This could be used to configure a list box which will display all of the values of an EMS Personnel’s Name recorded in D08_01 through D08_03Uses●Allows data to be sorted or grouped based on an Individual’s State ID●Used to create a list box for Crew Member ID (E04_01), Medication Crew Member ID (E18_09), Procedure Crew Member ID (E19_09), and Who Generated this Report (E23_10)Data Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_01Personnel's Agency ID NumberD07_03Personnel's Employment StatusD07_04Employment Status DateD07_05Personnel's Level of Certification/Licensure D07_06Date of Personnel's Certification or for AgencyLicensure for AgencyD08_01EMS Personnel's Last NameReferences in NHTSA Version 1EssentialElement 26Crew Member One NumberEssentialElement 27Crew Member Two NumberDesirableElement 28Crew Member Three NumberSectionD07Agency Personnel Information892006 NHTSA Uniform PreHospital Dataset V.2.2.1PERSONNEL'S EMPLOYMENT STATUSD07_03Data [combo] single-choiceDefinitionPersonnel's Employment Status for this AgencyXSD Data Typexs:integerXSD Domain (Simple Type)EmploymentStatusMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoXSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number Structure. (3) D07_03 and D07_04 are members of D07_03_0 Employment Status StructureField Values7490Full Time Paid Employee7500Full Time Unpaid Employee7510Part Time Paid and Part Time Unpaid Employee7520Part Time Paid Employee7530Part Time Unpaid Employee 7535 No Longer Employed By ServiceAdditional Information●Multiple entry configuration associated with Employment Status Date (D07_04)Uses●Allows data to be sorted or grouped based on an Individual’s Employment Status●Provides description of EMS agencies and resourcesData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_01Personnel's Agency ID NumberD07_02State/Licensure ID NumberD07_04Employment Status DateD07_05Personnel's Level of Certification/Licensure D07_06Date of Personnel's Certification or for AgencyLicensure for AgencySectionD07Agency Personnel Information902006 NHTSA Uniform PreHospital Dataset V.2.2.1EMPLOYMENT STATUS DATED07_04Data [date/time]DefinitionThe date that the employee status was assignedXSD Data Typexs:dateXSD Domain (Simple Type)DateMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint1,920Maximum Constraint2,030XSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number Structure. (3) D07_03 and D07_04 are members of D07_03_0 Employment Status StructureField ValuesA unique value; no variable list is possible. Additional Information●Used to identify the effective date of the statusUses●Allows data to be sorted or grouped based on an Individual’s Employment Status●Provides description of EMS agencies and resourcesData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_01Personnel's Agency ID NumberD07_02State/Licensure ID NumberD07_03Personnel's Employment StatusD07_05Personnel's Level of Certification/Licensure D07_06Date of Personnel's Certification or for AgencyLicensure for AgencySectionD07Agency Personnel Information912006 NHTSA Uniform PreHospital Dataset V.2.2.1PERSONNEL'S LEVEL OF CERTIFICATION/LICENSURE FOR AGENCYD07_05Data [combo] single-choiceDefinitionPersonnel's level of certification in this agency in the associated yearXSD Data Typexs:string/integerXSD Domain (Simple Type)DemographicStateCertificationLicensureLevelsMultiple Entry ConfigurationYes, for Structures 1 and 3Accepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number Structure. (3) D07_05 and D07_06 are members of D07_05_0 Level of Certification StructureField Values6090EMT-Basic6100EMT-Intermediate6110EMT-Paramedic6111Nurse6112Physician6120First ResponderAdditional Information●Multiple entry configuration for each Personnel's Agency ID Number (D07_01) and associated with the Date of Personnel's Certification or Licensure for Agency (D07_06)●Other variables as defined in State Certification/ Licensure Level (D04_01)Uses●Allows data to be sorted or grouped based on an Individual’s Credentialed Level●Provides description of EMS agencies and resourcesData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_01Personnel's Agency ID NumberD07_02State/Licensure ID NumberD07_03Personnel's Employment StatusD07_04Employment Status DateD07_06Date of Personnel's Certification or Licensure for AgencySectionD07Agency Personnel Information922006 NHTSA Uniform PreHospital Dataset V.2.2.1DATE OF PERSONNEL'S CERTIFICATION OR LICENSURE FOR AGENCYD07_06Data [date/time]DefinitionThe date that the Certification/Licensure was achievedXSD Data Typexs:dateXSD Domain (Simple Type)DateMultiple Entry ConfigurationYes, for Structures 1 and 3Accepts Null Values NoRequired in XSDNoMinimum Constraint1,920Maximum Constraint2,030XSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number Structure. (3) D07_05 and D07_06 are members of D07_05_0 Level of Certification StructureField ValuesA unique value; no variable list is possible. Additional Information●Used to identify the year the Certification was achievedUses●Allows data to be sorted or grouped based on an Individual’s Credentialed Level●Provides description of EMS agencies and resourcesData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_01Personnel's Agency ID NumberD07_02State/Licensure ID NumberD07_03Personnel's Employment StatusD07_04Employment Status DateD07_05Personnel's Level of Certification/Licensure for AgencySectionD07Agency Personnel Information932006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionD08General Personnel InformationSectionD08General Personnel Information942006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS PERSONNEL'S LAST NAMED08_01Data [text]DefinitionLast Name of personnelXSD Data Typexs:stringXSD Domain (Simple Type)DemographicLastNameMultiple Entry ConfigurationYes, via structure 2Accepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint20XSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number Structure. (3) D08_01, D08_02, and D08_02 are members of D08_01_0 Personnel Name StructureField ValuesA unique value; no variable list is possible. Uses●Component of the EMS Personnel’s Contact Information/ Address●Used to personalize reports associated with the EMS PersonnelData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD08_02EMS Personnel's Middle Name/InitialD08_03EMS Personnel's First NameSectionD08General Personnel Information952006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS PERSONNEL'S MIDDLE NAME/INITIALD08_02Data [text]DefinitionMiddle name or initial of personnelXSD Data Typexs:stringXSD Domain (Simple Type)MiddleInitialNameMultiple Entry ConfigurationYes, via structure 2Accepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint20XSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number Structure. (3) D08_01, D08_02, and D08_02 are members of D08_01_0 Personnel Name StructureField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Component of the EMS Personnel’s Contact Information/ Address●Used to personalize reports associated with the EMS PersonnelData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD08_01EMS Personnel's Last NameD08_03EMS Personnel's First NameE00Common Null ValuesSectionD08General Personnel Information962006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS PERSONNEL'S FIRST NAMED08_03Data [text]DefinitionFirst name of personnelXSD Data Typexs:stringXSD Domain (Simple Type)FirstNameMultiple Entry ConfigurationYes, via structure 2Accepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint20XSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number Structure. (3) D08_01, D08_02, and D08_02 are members of D08_01_0 Personnel Name StructureField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Component of the EMS Personnel’s Contact Information/ Address●Used to personalize reports associated with the EMS PersonnelData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD08_01EMS Personnel's Last NameD08_02EMS Personnel's Middle Name/InitialE00Common Null ValuesSectionD08General Personnel Information972006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS PERSONNEL'S MAILING ADDRESSD08_04Data [text]DefinitionStreet or PO Box of the personnel's mailing addressXSD Data Typexs:stringXSD Domain (Simple Type)StreetAddressMultiple Entry ConfigurationYes, via structure 2Accepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number Structure. (3) D08_04, D08_05, D08_06, D08_07 are members of D08_04_0 Personnel's Address StructureField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Component of the EMS Personnel’s Contact Information/ AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD08_01EMS Personnel's Last NameD08_05EMS Personnel's City of ResidenceD08_06EMS Personnel's StateD08_07EMS Personnel's Zip CodeE00Common Null ValuesSectionD08General Personnel Information982006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS PERSONNEL'S CITY OF RESIDENCED08_05Data [combo] single-choiceDefinitionCity of personnel's mailing addressXSD Data Typexs:stringXSD Domain (Simple Type)CityMultiple Entry ConfigurationYes, via structure 2Accepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number Structure. (3) D08_04, D08_05, D08_06, D08_07 are members of D08_04_0 Personnel's Address StructureField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●5 digit FIPS code●Could be filled in from EMS Personnel’s Zip Code entry (D08_07)Uses●Component of the EMS Personnel’s Contact Information/ AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD08_01EMS Personnel's Last NameD08_04EMS Personnel's Mailing AddressD08_06EMS Personnel's StateD08_07EMS Personnel's Zip CodeE00Common Null ValuesSectionD08General Personnel Information992006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS PERSONNEL'S STATED08_06Data [combo] single-choiceDefinitionState of personnel's mailing addressXSD Data Typexs:stringXSD Domain (Simple Type)StateMultiple Entry ConfigurationYes, via structure 2Accepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint3XSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number Structure. (3) D08_04, D08_05, D08_06, D08_07 are members of D08_04_0 Personnel's Address StructureField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●2 digit FIPS numeric code (Not State abbreviation)●Could be filled in from EMS Personnel’s Zip Code entry (D08_07)Uses●Component of the EMS Personnel’s Contact Information/ AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD08_01EMS Personnel's Last NameD08_04EMS Personnel's Mailing AddressD08_05EMS Personnel's City of ResidenceD08_07EMS Personnel's Zip CodeE00Common Null ValuesSectionD08General Personnel Information1002006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS PERSONNEL'S ZIP CODED08_07Data [text]DefinitionZIP code of personnel's mailing addressXSD Data Typexs:stringXSD Domain (Simple Type)DemographicZipMultiple Entry ConfigurationYes, via structure 2Accepts Null Values NoRequired in XSDNoXSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number Structure. (3) D08_04, D08_05, D08_06, D08_07 are members of D08_04_0 Personnel's Address StructureField ValuesA unique value; no variable list is possible. Additional Information●Can be a 5 or 9 digit Zip CodeUses●Component of the EMS Personnel’s Contact Information/ AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD08_01EMS Personnel's Last NameD08_04EMS Personnel's Mailing AddressD08_05EMS Personnel's City of ResidenceD08_06EMS Personnel's StateSectionD08General Personnel Information1012006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS PERSONNEL'S WORK TELEPHONED08_08Data [text]DefinitionWork phone number of the personnelXSD Data Typexs:stringXSD Domain (Simple Type)TelephoneNumberMultiple Entry ConfigurationYes, via structure 2Accepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint10XSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number StructureField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●10 digit telephone number Uses●Component of the EMS Personnel’s Contact Information/ AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD08_01EMS Personnel's Last NameE00Common Null ValuesSectionD08General Personnel Information1022006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS PERSONNEL'S HOME TELEPHONED08_09Data [text]DefinitionHome phone number of the personnelXSD Data Typexs:stringXSD Domain (Simple Type)TelephoneNumberMultiple Entry ConfigurationYes, via structure 2Accepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint10XSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number StructureField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●10 digit telephone number Uses●Component of the EMS Personnel’s Contact Information/ AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD08_01EMS Personnel's Last NameE00Common Null ValuesSectionD08General Personnel Information1032006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS PERSONNEL'S EMAIL ADDRESSD08_10Data [text]DefinitionPrimary email address of the personnelXSD Data Typexs:stringXSD Domain (Simple Type)EmailAddressMultiple Entry ConfigurationYes, via structure 2Accepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint100XSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number StructureField ValuesA unique value; no variable list is possible. -25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Component of the EMS Personnel’s Contact Information/ AddressData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD08_01EMS Personnel's Last NameE00Common Null ValuesSectionD08General Personnel Information1042006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS PERSONNEL'S DATE OF BIRTHD08_11Data [date]DefinitionThe EMS personnel's date of birth.XSD Data Typexs:dateXSD Domain (Simple Type)DateOfBirthMultiple Entry ConfigurationYes, via structure 2Accepts Null Values NoRequired in XSDNoMinimum Constraint1,890Maximum Constraint2,030XSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number StructureField ValuesA unique value; no variable list is possible. Uses●Allows the EMS workforce to be described in terms of AgeData Collector●EMS Agency and typically only documented once and verified yearlyOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD08_01EMS Personnel's Last NameSectionD08General Personnel Information1052006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS PERSONNEL'S GENDERD08_12Data [combo] single-choiceDefinitionThe EMS personnel's genderXSD Data Typexs:integerXSD Domain (Simple Type)DemographicGenderMultiple Entry ConfigurationYes, via structure 2Accepts Null Values NoRequired in XSDNoXSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available650Male655FemaleUses●Allows the EMS workforce to be described in terms of GenderData Collector●EMS Agency and typically only documented once and verified yearlyOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD08_01EMS Personnel's Last NameSectionD08General Personnel Information1062006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS PERSONNEL'S RACED08_13Data [combo] single-choiceDefinitionThe EMS personnel's race as defined by the OMB (US Office of Management and Budget)XSD Data Typexs:integerXSD Domain (Simple Type)DemographicRaceMultiple Entry ConfigurationYes, via structure 2Accepts Null Values NoRequired in XSDNoXSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number StructureField Values660American Indian or Alaska Native665Asian670Black or African American675Native Hawaiian or Other Pacific Islander680White685Other RaceUses●Allows the EMS workforce to be described in terms of RaceData Collector●EMS Agency and typically only documented once and verified yearlyOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD08_01EMS Personnel's Last NameSectionD08General Personnel Information1072006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS PERSONNEL'S ETHNICITYD08_14Data [combo] single-choiceDefinitionThe EMS personnel's ethnicity as defined by the OMB (US Office of Management and Budget)XSD Data Typexs:integerXSD Domain (Simple Type)DemographicEthnicityMultiple Entry ConfigurationYes, via structure 2Accepts Null Values NoRequired in XSDNoXSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number StructureField Values690Hispanic or Latino695Not Hispanic or LatinoUses●Allows the EMS workforce to be described in terms of EthnicityData Collector●EMS Agency and typically only documented once and verified yearlyOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD08_01EMS Personnel's Last NameSectionD08General Personnel Information1082006 NHTSA Uniform PreHospital Dataset V.2.2.1STATE EMS CERTIFICATION LICENSURE LEVELD08_15Data [combo] single-choiceDefinitionThe personnel's State EMS Certification levelXSD Data Typexs:string/integerXSD Domain (Simple Type)DemographicStateCertificationLicensureLevelsMultiple Entry ConfigurationYes, via structure 2 and 3Accepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number Structure. (3) D08_15, D08_16, D08_17, and D08_19 are all members of D08_15_0 State Certification Levels StructureField Values6090EMT-Basic6100EMT-Intermediate6110EMT-Paramedic6111Nurse6112Physician6120First ResponderAdditional Information●Multiple entry configuration to allow multiple levels for each personnel over time●Other variables as defined in State Certification/ Licensure Level (D04_01)Uses●Allows data to be sorted or grouped based on an Individual’s Credentialed Level●Provides description of EMS agencies based on credentialing levels recognized by the stateData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD08_01EMS Personnel's Last NameD08_16National Registry CredentialedD08_17State EMS Current Certification DateD08_18Initial State Certification DateSectionD08General Personnel Information1092006 NHTSA Uniform PreHospital Dataset V.2.2.1NATIONAL REGISTRY CREDENTIALEDD08_16Data [combo] single-choiceDefinitionIndication of National Registry Credential for the level of Certification/Licensure in D08_15XSD Data Typexs:integerXSD Domain (Simple Type)YesNoValuesMultiple Entry ConfigurationYes, via structure 2 and 3Accepts Null Values YesRequired in XSDNoXSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number Structure. (3) D08_15, D08_16, D08_17, and D08_19 are all members of D08_15_0 State Certification Levels StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available0No1YesAdditional Information●Multiple entry configuration to allow multiple levels for each personnel over timeUses●Allows a report at the EMS Agency level to determine credential details on EMS Personnel●Provides description of EMS agencies based on credentialing levels recognized by the stateData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD08_01EMS Personnel's Last NameD08_15State EMS Certification Licensure LevelD08_17State EMS Current Certification DateD08_18Initial State Certification DateE00Common Null ValuesSectionD08General Personnel Information1102006 NHTSA Uniform PreHospital Dataset V.2.2.1STATE EMS CURRENT CERTIFICATION DATED08_17Data [date/time]DefinitionThe date of the personnel's current certification.XSD Data Typexs:dateXSD Domain (Simple Type)DateMultiple Entry ConfigurationYes, via structure 2 and 3Accepts Null Values NoRequired in XSDNoMinimum Constraint1,920Maximum Constraint2,030XSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number Structure. (3) D08_15, D08_16, D08_17, and D08_19 are all members of D08_15_0 State Certification Levels StructureField ValuesA unique value; no variable list is possible. Additional Information●Format [MMDDYYYY]●Multiple entry configuration to allow multiple levels for each personnel over timeUses●Allows a report at the EMS Agency level to determine credential details on EMS Personnel●Allows data to some descriptive reporting of EMS Personnel longevityData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD08_01EMS Personnel's Last NameD08_15State EMS Certification Licensure LevelD08_16National Registry CredentialedD08_18Initial State Certification DateSectionD08General Personnel Information1112006 NHTSA Uniform PreHospital Dataset V.2.2.1INITIAL STATE CERTIFICATION DATED08_18Data [date/time]DefinitionThe certification date of personnel's current State certificationXSD Data Typexs:dateXSD Domain (Simple Type)DateMultiple Entry ConfigurationYes, via structure 2 and 3Accepts Null Values NoRequired in XSDNoMinimum Constraint1,920Maximum Constraint2,030XSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number Structure. (3) D08_15, D08_16, D08_17, and D08_19 are all members of D08_15_0 State Certification Levels StructureField ValuesA unique value; no variable list is possible. Additional Information●Format [MMDDYYYY]●Multiple entry configuration to allow multiple levels for each personnel over timeUses●Allows a report at the EMS Agency level to determine credential details on EMS Personnel●Allows data to some descriptive reporting of EMS Personnel longevityData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD08_01EMS Personnel's Last NameD08_15State EMS Certification Licensure LevelD08_16National Registry CredentialedD08_17State EMS Current Certification DateSectionD08General Personnel Information1122006 NHTSA Uniform PreHospital Dataset V.2.2.1TOTAL LENGTH OF SERVICED08_19Data [number]DefinitionThe personnel's total length of active EMS service at any level in years. Please do not include time periods not working in EMS.XSD Data Typexs:positiveIntegerXSD Domain (Simple Type)TotalServiceMultiple Entry ConfigurationYes, via structure 2 and 3Accepts Null Values NoRequired in XSDNoMinimum Constraint1Maximum Constraint100XSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number Structure. (3) D08_19, and D08_20 are all members of D08_19_0 Length of Service StructureField ValuesA unique value; no variable list is possible. Additional Information●Document, in years, the number of years the individual has worked in an EMS related capacityUses●Allows a report at the EMS Agency level to determine credential details on EMS Personnel●Allows data to some descriptive reporting of EMS Personnel longevityData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD08_01EMS Personnel's Last NameD08_20Date Length of Service DocumentedSectionD08General Personnel Information1132006 NHTSA Uniform PreHospital Dataset V.2.2.1DATE LENGTH OF SERVICE DOCUMENTEDD08_20Data [date/time]DefinitionThe date which the length of EMS service was documentedXSD Data Typexs:dateXSD Domain (Simple Type)DateMultiple Entry ConfigurationYes, via structure 2 and 3Accepts Null Values NoRequired in XSDNoMinimum Constraint1,920Maximum Constraint2,030XSD Structure: (1) All Section D07 data elements are associated with D07_01 Personnel's Agency Number Structure. (2) All Section D08 data elements are associated with D07_02 State Licensure Number Structure. (3) D08_19, and D08_20 are all members of D08_19_0 Length of Service StructureField ValuesA unique value; no variable list is possible. Additional Information●Format [MMDDYYYY]Uses●Allows a report at the EMS Agency level to determine credential details on EMS Personnel●Allows data to some descriptive reporting of EMS Personnel longevityData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD07_02State/Licensure ID NumberD08_19Total Length of ServiceSectionD08General Personnel Information1142006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionD09Medical Device InformationSectionD09Medical Device Information1152006 NHTSA Uniform PreHospital Dataset V.2.2.1DEVICE SERIAL NUMBERD09_01Data [text]DefinitionThe unique manufacturer's serial number associated with a medical deviceXSD Data Typexs:stringXSD Domain (Simple Type)DeviceSerialNumberMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDYesMinimum Constraint2Maximum Constraint50XSD Structure: All data elements in Section D09 are associated with D09_01 Device StructureField ValuesA unique value; no variable list is possible. Additional Information●Multiple entry configuration to allow multiple Medical Devices to be entered (D09_01 through D09_05)Uses●Allows agencies to track medical devices and report on the specific usage of each deviceData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changed. It could be provided by the Medical Device during electronic transmission of dataOther Associated ElementsD01_01EMS Agency NumberD09_02Device Name or IDD09_03Device ManufacturerD09_04Model NumberD09_05Device Purchase DateSectionD09Medical Device Information1162006 NHTSA Uniform PreHospital Dataset V.2.2.1DEVICE NAME OR IDD09_02Data [text]DefinitionThe local number or configurable ID/Name of the medical deviceXSD Data Typexs:stringXSD Domain (Simple Type)DeviceNameOrIDMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint50XSD Structure: All data elements in Section D09 are associated with D09_01 Device StructureField ValuesA unique value; no variable list is possible. Additional Information●Multiple entry configuration to allow multiple Medical Devices to be entered (D09_01 through D09_05)Uses●Allows agencies to track medical devices and report on the specific usage of each deviceData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changed. It could be provided by the Medical Device during electronic transmission of dataOther Associated ElementsD01_01EMS Agency NumberD09_01Device Serial NumberD09_03Device ManufacturerD09_04Model NumberD09_05Device Purchase DateSectionD09Medical Device Information1172006 NHTSA Uniform PreHospital Dataset V.2.2.1DEVICE MANUFACTURERD09_03Data [text]DefinitionThe manufacturer of the medical deviceXSD Data Typexs:stringXSD Domain (Simple Type)DeviceManufacturerMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint50XSD Structure: All data elements in Section D09 are associated with D09_01 Device StructureField ValuesA unique value; no variable list is possible. Additional Information●Multiple entry configuration to allow multiple Medical Devices to be entered (D09_01 through D09_05)Uses●Allows agencies to track medical devices and report on types of medical devices used by the agencyData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD09_01Device Serial NumberD09_02Device Name or IDD09_04Model NumberD09_05Device Purchase DateSectionD09Medical Device Information1182006 NHTSA Uniform PreHospital Dataset V.2.2.1MODEL NUMBERD09_04Data [text]DefinitionThe specific manufacturer's model number associated with medical deviceXSD Data Typexs:stringXSD Domain (Simple Type)ModelNumberMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint50XSD Structure: All data elements in Section D09 are associated with D09_01 Device StructureField ValuesA unique value; no variable list is possible. Additional Information●Multiple entry configuration to allow multiple Medical Devices to be entered (D09_01 through D09_05)Uses●Allows agencies to track medical devices and report on types of medical devices used by the agencyData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changed. It could be provided by the Medical Device during electronic transmission of dataOther Associated ElementsD01_01EMS Agency NumberD09_01Device Serial NumberD09_02Device Name or IDD09_03Device ManufacturerD09_05Device Purchase DateSectionD09Medical Device Information1192006 NHTSA Uniform PreHospital Dataset V.2.2.1DEVICE PURCHASE DATED09_05Data [date/time]DefinitionThe date the device was placed in service by the EMS agencyXSD Data Typexs:dateXSD Domain (Simple Type)DateMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint1,920Maximum Constraint2,030XSD Structure: All data elements in Section D09 are associated with D09_01 Device StructureField ValuesA unique value; no variable list is possible. Additional Information●Format [MMDDYYYY]●Multiple entry configuration to allow multiple Medical Devices to be entered (D09_01 through D09_05)Uses●Allows agencies to track medical devices and report on the age and life expectancy of each deviceData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsD01_01EMS Agency NumberD09_01Device Serial NumberD09_02Device Name or IDD09_03Device ManufacturerD09_04Model NumberSectionD09Medical Device Information1202006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE00Common EMS ValuesSectionE00Common EMS Values1212006 NHTSA Uniform PreHospital Dataset V.2.2.1COMMON NULL VALUESE00Data [combo] single-choiceDefinitionThese values are to be used in each of the Demographic and EMS Data Elements described in this document which have been defined to accept the E00 Null Values. Please include these variables in the implementation of the NHTSA Version 2 Dataset.Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●For any collection of data to be of value and reliably represent what was intended, a strong commitment must be made to ensure the correct documentation of incomplete data . The described data integrity method must be followed with the NHTSA dataset For data elements being electronically stored in a database or moved from one database to another using XML, the indicated values should be applied when a data element is empty or contains a null value.●Not Applicable: (Code -25) = At the time of an EMS patient care report documentation, information requested was “Not Applicable” to the EMS or patient event. This indicates that it is unnecessary to document mechanism or injury related information on a patient who was not traumatized●Not Available: (Code -5) = At the time of an EMS patient care report documentation, information was “Not Available” to EMS personnel. This documents that needed information did exist but the EMS personnel was unsuccessful in their attempt to obtain it●Not Known: (Code -10) = At the time of an EMS patient care report documentation, information was “Not Known” to patient, family, and EMS personnel. This documents that there was an attempt to obtain information but it was unknown by all parties involved●Not Recorded: (Code -20) = If an EMS documentation or information system has an empty field or nothing is recorded in any data element of the NHTSA dataset, code “-20” should be inserted into the database and/or XML for that data element indicating that the EMS Patient Care Report did not have a value for that specific data element when the EMS event or patient encounter was documented●Not Reporting: (Code -15) = If an EMS documentation or information system is not using any of the "National" data elements of the NHTSA dataset, code “-15” should be inserted into the database and/or XML for that data element. SectionE00Common EMS Values1222006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE01Record InformationSectionE01Record Information1232006 NHTSA Uniform PreHospital Dataset V.2.2.1PATIENT CARE REPORT NUMBERE01_01Data [text]National ElementDefinitionThe unique number automatically assigned by the EMS agency for each patient care report (PCR). This is a unique number to the EMS agency for all of time.XSD Data Typexs:stringXSD Domain (Simple Type)PatientCareReportNumberMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDYesMinimum Constraint3Maximum Constraint32Field ValuesA unique value; no variable list is possible. Additional Information●Not Nullable. A unique value must be provided to create a unique record ID within a databaseUses●A component of the EMS Medical Record: Patient Care Report●Agency number (E02_01), agency state (D01_03),unit call sign (E02_12), patient number (E01_01) and date (E05_04) combine to create a unique identifierData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE01_01Patient Care Report NumberReferences in NHTSA Version 1DesirableElement 23Patient Care Record NumberReferences to Other Databases● NFIRS 5.0EMS Module; Title: Patient Number; Unique NumberSectionE01Record Information1242006 NHTSA Uniform PreHospital Dataset V.2.2.1SOFTWARE CREATORE01_02Data [text]National ElementDefinitionThe name of the software vendor by whom the data collection software was developedXSD Data Typexs:stringXSD Domain (Simple Type)SoftwareCreatedByMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDYesMinimum Constraint3Maximum Constraint30Field ValuesA unique value; no variable list is possible. Uses●Important for grouping or comparing the accuracy of software used by EMS agencies in data collectionData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsE01_01Patient Care Report NumberSectionE01Record Information1252006 NHTSA Uniform PreHospital Dataset V.2.2.1SOFTWARE NAMEE01_03Data [text]National ElementDefinitionThe name of the software package with which the data was collected by the agencyXSD Data Typexs:stringXSD Domain (Simple Type)SoftwareNameMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDYesMinimum Constraint3Maximum Constraint30Field ValuesA unique value; no variable list is possible. Uses●Important for grouping or comparing the accuracy of software used by EMS agencies in data collectionData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsE01_01Patient Care Report NumberSectionE01Record Information1262006 NHTSA Uniform PreHospital Dataset V.2.2.1SOFTWARE VERSIONE01_04Data [text]National ElementDefinitionThe version of the software used by the agency to collect the dataXSD Data Typexs:stringXSD Domain (Simple Type)SoftwareVersionMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDYesMinimum Constraint3Maximum Constraint30Field ValuesA unique value; no variable list is possible. Uses●Important for grouping or comparing the accuracy of software used by EMS agencies in data collectionData Collector●EMS Agency and typically only documented once then verified and updated yearly or when changedOther Associated ElementsE01_01Patient Care Report NumberSectionE01Record Information1272006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE02Unit/ Agency InformationSectionE02Unit/ Agency Information1282006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS AGENCY NUMBERE02_01Data [text]National ElementDefinitionThe state-assigned provider number of the responding agencyXSD Data Typexs:stringXSD Domain (Simple Type)EMSAgencyNumberMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDYesMinimum Constraint3Maximum Constraint15Field ValuesA unique value; no variable list is possible. Additional Information●Not Nullable. A unique value must be provided to create a unique record ID within a database●Same as EMS Agency Number (D01_01)Uses●A component of the EMS Medical Record: Patient Care Report●Agency number (E02_01), agency state (D01_03),unit call sign (E02_12), patient number (E01_01) and date (E05_04) combine to create a unique identifier●Allows data to be sorted by the EMS Agency●Important for grouping and comparing EMS Agencies in Benchmarking and Quality Management●When linked to D01_02 provides the Agency name on the EMS Medical Record: Patient Care ReportData Collector●Typically generated by the State EMS Regulatory Office. Collected by the EMS agency or auto-generated by the EMS agency specific software.Other Associated ElementsE01_01Patient Care Report NumberReferences to Other Databases● NFIRS 5.0EMS Module;Title: FDID; State assigned Fire Department ID numberSectionE02Unit/ Agency Information1292006 NHTSA Uniform PreHospital Dataset V.2.2.1INCIDENT NUMBERE02_02Data [text]DefinitionThe incident number assigned by the 911 Dispatch SystemXSD Data Typexs:stringXSD Domain (Simple Type)IncidentNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint15Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Component of the EMS Agency 911 or Dispatch information which serves as a link to identify and report other Dispatch informationData Collector●911 or Dispatch Center and electronically or verbally transmitted to the EMS agencyOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 21Incident NumberReferences to Other Databases● NFIRS 5.0EMS Module; Title: Incident Number; Unique number for each IncidentSectionE02Unit/ Agency Information1302006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS UNIT (VEHICLE) RESPONSE NUMBERE02_03Data [text]DefinitionThe internal EMS response number which is unique for each EMS unit’s (vehicles) response to an incident within an agency.XSD Data Typexs:stringXSD Domain (Simple Type)EMSUnitResponseNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint15Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Component of the EMS Agency 911 or Dispatch information which serves as a link to identify and report other Dispatch informationData Collector●911 or Dispatch Center and electronically or verbally transmitted to the EMS agencyOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 22Response NumberSectionE02Unit/ Agency Information1312006 NHTSA Uniform PreHospital Dataset V.2.2.1TYPE OF SERVICE REQUESTEDE02_04Data [combo] single-choiceNational ElementDefinitionThe type of service or category of service requested of the EMS service responding for this specific EMS incident.XSD Data Typexs:integerXSD Domain (Simple Type)TypeOfServiceRequestedMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDYesField Values30911 Response (Scene)35Intercept40Interfacility Transfer45Medical Transport50Mutual Aid55StandbyUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted by the Type of Service Requested●Provides descriptive data on EMS call volume and service providedData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 20Service TypeSectionE02Unit/ Agency Information1322006 NHTSA Uniform PreHospital Dataset V.2.2.1PRIMARY ROLE OF THE UNITE02_05Data [combo] single-choiceNational ElementDefinitionThe primary role of the EMS service which was requested for this specific EMS incident.XSD Data Typexs:integerXSD Domain (Simple Type)PrimaryRollOfTheUnitMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDYesField Values60Non-Transport65Rescue70Supervisor75TransportUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted by the role of the responder●Provides descriptive data on EMS call volume and service providedData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE01_01Patient Care Report NumberSectionE02Unit/ Agency Information1332006 NHTSA Uniform PreHospital Dataset V.2.2.1TYPE OF DISPATCH DELAYE02_06Data [combo] multiple-choiceNational ElementDefinitionThe dispatch delays, if any, associated with the dispatch of the EMS unit to the patient encounterXSD Data Typexs:integerXSD Domain (Simple Type)TypeOfDispatchDelayMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available80Caller (Uncooperative)85High Call Volume90Language Barrier95Location (Inability to Obtain)100No Units Available105None110Other115Scene Safety (Not Secure for EMS)120Technical Failure (Computer, Phone etc.)Uses●Allows data to describe the status of Dispatch issuesData Collector●911 or Dispatch Center and electronically or verbally transmitted to the EMS agencyOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1DesirableElement 56Factors Affecting EMS Delivery of CareSectionE02Unit/ Agency Information1342006 NHTSA Uniform PreHospital Dataset V.2.2.1TYPE OF RESPONSE DELAYE02_07Data [combo] multiple-choiceNational ElementDefinitionThe response delays, if any, of the unit associated with the patient encounterXSD Data Typexs:integerXSD Domain (Simple Type)TypeOfResponseDelayMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available125Crowd130Directions135Distance140Diversion145HazMat150None155Other160Safety165Staff Delay170Traffic175Vehicle Crash180Vehicle Failure185WeatherUses●Allows data describe Vehicle Failures and Vehicle Crashes●Allows data to describe the status of Response issuesData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1DesirableElement 56Factors Affecting EMS Delivery of CareSectionE02Unit/ Agency Information1352006 NHTSA Uniform PreHospital Dataset V.2.2.1TYPE OF SCENE DELAYE02_08Data [combo] multiple-choiceNational ElementDefinitionThe scene delays, if any, of the unit associated with the patient encounterXSD Data Typexs:integerXSD Domain (Simple Type)TypeOfSceneDelayMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available190Crowd195Directions200Distance205Diversion210Extrication >20 min.215HazMat220Language Barrier225None230Other235Safety240Staff Delay245Traffic250Vehicle Crash255Vehicle Failure260WeatherUses●Allows data describe Vehicle Failures and Vehicle Crashes●Allows data to describe the status of Scene issuesData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1DesirableElement 56Factors Affecting EMS Delivery of CareSectionE02Unit/ Agency Information1362006 NHTSA Uniform PreHospital Dataset V.2.2.1TYPE OF TRANSPORT DELAYE02_09Data [combo] multiple-choiceNational ElementDefinitionThe transport delays, if any, of the unit associated with the patient encounterXSD Data Typexs:integerXSD Domain (Simple Type)TypeOfTransportDelayMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available265Crowd270Directions275Distance280Diversion285HazMat290None295Other300Safety305Staff Delay310Traffic315Vehicle Crash320Vehicle Failure325WeatherUses●Allows data describe Vehicle Failures and Vehicle Crashes●Allows data to describe the status of Transport issuesData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1DesirableElement 56Factors Affecting EMS Delivery of CareSectionE02Unit/ Agency Information1372006 NHTSA Uniform PreHospital Dataset V.2.2.1TYPE OF TURN-AROUND DELAYE02_10Data [combo] multiple-choiceNational ElementDefinitionThe turn-around delays, if any, associated with the EMS unit associated with the patient encounterXSD Data Typexs:integerXSD Domain (Simple Type)TypeOfTurnAroundDelayMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available330Clean-up335Decontamination340Documentation345ED Overcrowding350Equipment Failure355Equipment Replenishment360None365Other370Staff Delay375Vehicle FailureUses●Allows data describe ED overcrowding and Vehicle Failure●Allows data to describe the status of call time issuesData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE02Unit/ Agency Information1382006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS UNIT/VEHICLE NUMBERE02_11Data [combo] single-choiceDefinitionThe unique physical vehicle number of the responding unitXSD Data Typexs:stringXSD Domain (Simple Type)EMSUnitNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●List box created from EMS Unit/Vehicle Number (D06_01)Uses●A component of the EMS Medical Record: Patient Care Report●Allows data at the vehicle level to better describe EMS vehicle usage and possibly maintenance ●Important for grouping or comparing data by Response Vehicle which also allows data to be sorted by location in many agenciesData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 24Agency/Unit NumberSectionE02Unit/ Agency Information1392006 NHTSA Uniform PreHospital Dataset V.2.2.1EMS UNIT CALL SIGN (RADIO NUMBER)E02_12Data [combo] single-choiceNational ElementDefinitionThe EMS unit number used to dispatch and communicate with the unit. This may be the same as the EMS Unit/Vehicle Number in many agencies.XSD Data Typexs:stringXSD Domain (Simple Type)EMSUnitCallSignMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDYesMinimum Constraint2Maximum Constraint15Field ValuesAdditional Information●List box created from Unit Call Sign (D04_02)●Not Nullable. A unique value must be provided to create a unique record ID within a databaseUses●Allows data at the vehicle level to better describe EMS vehicle usage and possibly maintenance ●Important for grouping or comparing data by Response Vehicle which also allows data to be sorted by location in many agenciesData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE01_01Patient Care Report NumberSectionE02Unit/ Agency Information1402006 NHTSA Uniform PreHospital Dataset V.2.2.1VEHICLE DISPATCH LOCATIONE02_13Data [combo] single-choiceDefinitionThe station (or hospital) name representing the geographic location of the vehicle at the time of dispatchXSD Data Typexs:stringXSD Domain (Simple Type)VehicleDispatchLocationMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint30Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●List box could be created from Station Name (D05_01), Hospitals Served (D04_11), and Other Destinations (D04_13)Uses●Important for grouping or comparing data by dispatch location which also allows data to be sorted by geographic response areas in many agencies●Provides information on overall response patterns and times for agency configuration and evaluationData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences to Other Databases● NFIRS 5.0EMS Module; Title: Station Number; The Fire Department Station number of the first arriving unitSectionE02Unit/ Agency Information1412006 NHTSA Uniform PreHospital Dataset V.2.2.1VEHICLE DISPATCH ZONEE02_14Data [combo] single-choiceDefinitionGeographic zone representing the location of the responding vehicle at the time of dispatch.XSD Data Typexs:stringXSD Domain (Simple Type)ZoneNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint30Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●List box created from Zones (D04_03)Uses●Important for grouping or comparing data by dispatch location which also allows data to be sorted by geographic response areas in many agencies●Provides information on overall response patterns and times for agency configuration and evaluationData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE02Unit/ Agency Information1422006 NHTSA Uniform PreHospital Dataset V.2.2.1VEHICLE DISPATCH GPS LOCATIONE02_15Data [text]DefinitionThe GPS coordinates associated with the EMS unit at the time of dispatch.XSD Data Typexs:decimalXSD Domain (Simple Type)GPSLocationMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoXSD Attributes: Latitude and Longitude are each stored as a separate attributeField ValuesUses●Important for grouping or comparing data by dispatch location which also allows data to be sorted by geographic response areas in many agencies●Provides information on overall response patterns and times for agency configuration and evaluationData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE01_01Patient Care Report NumberSectionE02Unit/ Agency Information1432006 NHTSA Uniform PreHospital Dataset V.2.2.1BEGINNING ODOMETER READING OF RESPONDING VEHICLEE02_16Data [number]DefinitionThe mileage (odometer reading) of the vehicle at the beginning of the call (when the wheels begin moving)XSD Data Typexs:decimalXSD Domain (Simple Type)OdometerReadingMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoMinimum Constraint0Maximum Constraint1,000,000Field ValuesAdditional Information●Number recorded with one digit to the right of decimalUses●Important for EMS billing●Important for grouping or comparing data by dispatch location which also allows data to be sorted by geographic response areas in many agencies●Provides information on overall response patterns and times for agency configuration and evaluationData Collector●EMS personnelOther Associated ElementsE01_01Patient Care Report NumberSectionE02Unit/ Agency Information1442006 NHTSA Uniform PreHospital Dataset V.2.2.1ON-SCENE ODOMETER READING OF RESPONDING VEHICLEE02_17Data [number]DefinitionThe mileage (odometer reading) of the vehicle when it arrives at the patientXSD Data Typexs:decimalXSD Domain (Simple Type)OdometerReadingMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoMinimum Constraint0Maximum Constraint1,000,000Field ValuesAdditional Information●Number recorded with one digit to the right of decimalUses●Important for EMS billing●Important for grouping or comparing data by dispatch location which also allows data to be sorted by geographic response areas in many agencies●Provides information on overall response patterns and times for agency configuration and evaluationData Collector●EMS personnelOther Associated ElementsE01_01Patient Care Report NumberSectionE02Unit/ Agency Information1452006 NHTSA Uniform PreHospital Dataset V.2.2.1PATIENT DESTINATION ODOMETER READING OF RESPONDING VEHICLEE02_18Data [number]DefinitionThe mileage (odometer reading) of the vehicle when it arrives at the patient’s destinationXSD Data Typexs:decimalXSD Domain (Simple Type)OdometerReadingMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoMinimum Constraint0Maximum Constraint1,000,000Field ValuesAdditional Information●Number recorded with one digit to the right of decimalUses●Important for EMS billing●Important for grouping or comparing data by dispatch location which also allows data to be sorted by geographic response areas in many agencies●Provides information on overall response patterns and times for agency configuration and evaluationData Collector●EMS personnelOther Associated ElementsE01_01Patient Care Report NumberSectionE02Unit/ Agency Information1462006 NHTSA Uniform PreHospital Dataset V.2.2.1ENDING ODOMETER READING OF RESPONDING VEHICLEE02_19Data [number]DefinitionThe ending mileage (odometer reading) of the vehicle (at time back in service)XSD Data Typexs:decimalXSD Domain (Simple Type)OdometerReadingMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoMinimum Constraint0Maximum Constraint1,000,000Field ValuesAdditional Information●Number recorded with one digit to the right of decimalUses●Important for EMS billing●Important for grouping or comparing data by dispatch location which also allows data to be sorted by geographic response areas in many agencies●Provides information on overall response patterns and times for agency configuration and evaluationData Collector●EMS personnelOther Associated ElementsE01_01Patient Care Report NumberSectionE02Unit/ Agency Information1472006 NHTSA Uniform PreHospital Dataset V.2.2.1RESPONSE MODE TO SCENEE02_20Data [combo] single-choiceNational ElementDefinitionIndication whether or not lights and/or sirens were used on the vehicle on the way to the sceneXSD Data Typexs:integerXSD Domain (Simple Type)ResponseModeToSceneMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDYesField Values380Initial Lights and Sirens, Downgraded to No Lights or 385Initial No Lights or Sirens, Upgraded to Lights and Sirens Sirens390Lights and Sirens395No Lights or SirensUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted by the Response Mode●Allows data to describe the use of emergent responseData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 19Lights and Sirens to SceneSectionE02Unit/ Agency Information1482006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE03Unit/ Call InformationSectionE03Unit/ Call Information1492006 NHTSA Uniform PreHospital Dataset V.2.2.1COMPLAINT REPORTED BY DISPATCHE03_01Data [combo] single-choiceNational ElementDefinitionThe complaint dispatch reported to the responding unit.XSD Data Typexs:integerXSD Domain (Simple Type)ComplaintReportedByDispatchMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available400Abdominal Pain405Allergies410Animal Bite415Assault420Back Pain425Breathing Problem430Burns435CO Poisoning/Hazmat440Cardiac Arrest445Chest Pain450Choking455Convulsions/Seizure460Diabetic Problem465Drowning470Electrocution475Eye Problem480Fall Victim485Headache490Heart Problems495Heat/Cold Exposure500Hemorrhage/Laceration505Industrial Accident/Inaccessible Incident/Other 510Ingestion/PoisoningEntrapments (non-vehicle)515Pregnancy/Childbirth520Psychiatric Problem525Sick Person530Stab/Gunshot Wound535Stroke/CVA540Traffic Accident545Traumatic Injury550Unconscious/Fainting555Unknown Problem Man Down560Transfer/Interfacility/Palliative Care565MCI (Mass Casualty Incident)Uses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted by the Dispatch Complaint●Allows data to describe Patient Complaint as reported by DispatchData Collector●911 or Dispatch Center and electronically or verbally transmitted to the EMS agencyOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences to Other DatabasesNHTSA EMD Data ElementsChief Complaint TypesSectionE03Unit/ Call Information1502006 NHTSA Uniform PreHospital Dataset V.2.2.1EMD PERFORMEDE03_02Data [combo] single-choiceNational ElementDefinitionIndication of whether EMD was performed for this EMS event.XSD Data Typexs:integerXSD Domain (Simple Type)EMDPerformedMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available0No570Yes, With Pre-Arrival Instructions575Yes, Without Pre-Arrival InstructionsUses●Allows data to be sorted by the Dispatch Complaint●Allows data to describe Patient Complaint as reported by DispatchData Collector●911 or Dispatch Center and electronically or verbally transmitted to the EMS agencyOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE03Unit/ Call Information1512006 NHTSA Uniform PreHospital Dataset V.2.2.1EMD CARD NUMBERE03_03Data [text]DefinitionThe EMD card number reported by dispatch, consisting of the card number, dispatch level, and dispatch modeXSD Data Typexs:stringXSD Domain (Simple Type)EMDCardNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint10Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●The alpha-numeric value (grouped or concatenated) associated with the EMD card number, followed by the Dispatch Level, followed by the Dispatch ModeUses●Provides important data associated with the telephone triage and categorization of the EMS event●Used for evaluating and comparing dispatch and on-scene evaluationsData Collector●911 or Dispatch Center and electronically or verbally transmitted to the EMS agencyOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE03Unit/ Call Information1522006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE04Unit/ Personnel InformationSectionE04Unit/ Personnel Information1532006 NHTSA Uniform PreHospital Dataset V.2.2.1CREW MEMBER IDE04_01Data [text]DefinitionThe State Certification/Licensure ID number assigned to the crew memberXSD Data Typexs:stringXSD Domain (Simple Type)CrewMemberIDMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint15XSD Structure: E04_01, E04_02, E04_03 are all members of the E04 Unit Personnel Information structureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●A multiple entry configuration to allow all crew members to be entered●Linked to State/Licensure ID Number (D07_02)●List box created from the State/ Licensure ID Number (D07_02) which could display the Personnel’s Names as associated with D08_01, D08_02, and D08_03 for easy data entryUses●A component of the EMS Medical Record: Patient Care Report●Associates an EMS event with specific EMS personnel●Useful for reporting EMS personnel statistics related to EMS events and evaluation of EMS personnel performanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE04_02Crew Member RoleE04_03Crew Member LevelReferences in NHTSA Version 1EssentialElement 26Crew Member One NumberEssentialElement 27Crew Member Two NumberDesirableElement 28Crew Member Three NumberSectionE04Unit/ Personnel Information1542006 NHTSA Uniform PreHospital Dataset V.2.2.1CREW MEMBER ROLEE04_02Data [combo] single-choiceDefinitionThe role of the crew member during transport of this call. ● Driver is defined as the driver during the time of patient transport or during the response if there was not transport required. ● Primary Patient Care Giver is defined as the individual responsible for the patient care during the transport of the patient, or if no transport, the individual responsible for the assessment and treatment of the patient on scene. ● Secondary Patient Care Giver is defined as the individual assisting the Primary Patient Care Giver. ● Third Patient Care Giver is defined as the individual assisting in the Primary and Secondary Patient Care Givers.XSD Data Typexs:integerXSD Domain (Simple Type)CrewMemberRoleMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: E04_01, E04_02, E04_03 are all members of the E04 Unit Personnel Information structureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available580Driver585Primary Patient Caregiver590Secondary Patient Caregiver595Third Patient Caregiver600OtherUses●A component of the EMS Medical Record: Patient Care Report●Associates an EMS event with specific EMS personnel●Useful for reporting EMS personnel statistics related to EMS events and evaluation of EMS personnel performanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE04_01Crew Member IDE04_03Crew Member LevelSectionE04Unit/ Personnel Information1552006 NHTSA Uniform PreHospital Dataset V.2.2.1CREW MEMBER LEVELE04_03Data [combo] single-choiceDefinitionThe functioning level of the crew member during this EMS patient encounter.XSD Data Typexs:string/integerXSD Domain (Simple Type)CrewMemberLevelMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: E04_01, E04_02, E04_03 are all members of the E04 Unit Personnel Information structureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available635Student640Other Healthcare Professional645Other Non-Healthcare Professional6090EMT-Basic6100EMT-Intermediate6110EMT-Paramedic6111Nurse6112Physician6120First ResponderAdditional Information●Could be auto-filled using Crew Member ID (E04_01) and connecting to State/ Licensure ID Number (D07_02) to obtain Personnel’s Highest Level of Certification/ Licensure for Agency (D07_05)●This list can be edited by each state to account for additional certification/ licensure levels as defined in (D04_01) and Personnel’s Highest Level of Certification/ Licensure for the Agency (D07_05)Uses●A component of the EMS Medical Record: Patient Care Report●Associates an EMS event with specific EMS personnel●Useful for reporting EMS personnel statistics related to EMS events and evaluation of EMS personnel performanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE04_01Crew Member IDE04_02Crew Member RoleReferences in NHTSA Version 1EssentialElement 29Crew Member One TypeEssentialElement 30Crew Member Two TypeDesirableElement 31Crew Member Three TypeReferences to Other Databases● NFIRS 5.0EMS Module, Title: Highest Level of Provider on Scene by Fire Department, Pick-List: First Responder = 1, EMT-B (Basic) = 2, EMT-I (Intermediate) = 3, EMT-P (Paramedic) = 4, Other Health Care Provider, Include Doctors, Nurses = O, No Care Provided = N● NFIRS 5.0EMS Module; Title: Initial Level of FD Provider; Pick-List: First Responder = 1, EMT-B (Basic) = 2, EMT-I (Intermediate) = 3, EMT-P (Paramedic) = 4, Other Health Care Provider, Includes Doctors, Nurses, etc. = O, No Training = NSectionE04Unit/ Personnel Information1562006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE05TimesSectionE05Times1572006 NHTSA Uniform PreHospital Dataset V.2.2.1INCIDENT OR ONSET DATE/TIME E05_01Data [date/time]DefinitionThe date/time the injury occurred, or the date/time the symptoms or problem startedXSD Data Typexs:dateTimeXSD Domain (Simple Type)DateTimeMultiple Entry ConfigurationNoAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint1,990Maximum Constraint2,030Field ValuesAdditional Information●If the date/time is electronically stored within a database or transmitted via XML as a “tick”, the referenced variables may also be usedUses●Important to identify when the clinical event started to better analyze EMS resource utilization and outcomes●Provides descriptive information on the use of the EMS agencyData Collector●911 or Dispatch Center and electronically or verbally transmitted to the EMS agencyOther Associated ElementsE01_01Patient Care Report NumberReferences in NHTSA Version 1DesirableElement 06Onset DateDesirableElement 07Onset TimeReferences to Other Databases● NFIRS 5.0Basic Module 1; Title: Incident Date; Date Field defined as YYYYMMDD or blankSectionE05Times1582006 NHTSA Uniform PreHospital Dataset V.2.2.1PSAP CALL DATE/TIMEE05_02Data [date/time]National ElementDefinitionThe date/time the phone rings (911 call to public safety answering point or other designated entity) requesting EMS services.XSD Data Typexs:dateTimeXSD Domain (Simple Type)DateTimeMultiple Entry ConfigurationNoAccepts Null Values Yes, but null value is blank or emptyRequired in XSDYesMinimum Constraint1,990Maximum Constraint2,030Field ValuesAdditional Information●If the date/time is electronically stored within a database or transmitted via XML as a “tick”, the referenced variables may also be usedUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on Date and Time●Allows data to describe EMS use by Date and Time, Day of the Week, etcData Collector●911 or Dispatch Center and electronically or verbally transmitted to the EMS agencyOther Associated ElementsE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 08Date Incident ReportedEssentialElement 09Time Incident ReportedReferences to Other Databases● NFIRS 5.0EMS Module; Title: Incident Date; The date the Fire Department received the incident alarmSectionE05Times1592006 NHTSA Uniform PreHospital Dataset V.2.2.1DISPATCH NOTIFIED DATE/TIME E05_03Data [date/time]DefinitionThe date/time dispatch was notified by the 911 call taker (if a separate entity)XSD Data Typexs:dateTimeXSD Domain (Simple Type)DateTimeMultiple Entry ConfigurationNoAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint1,990Maximum Constraint2,030Field ValuesAdditional Information●If the date/time is electronically stored within a database or transmitted via XML as a “tick”, the referenced variables may also be usedUses●Provides information on how EMS requests are progressing through the PSAP and Dispatch Centers●Used in the Quality Management evaluation of the PSAP and Dispatch CentersData Collector●911 or Dispatch Center and electronically or verbally transmitted to the EMS agencyOther Associated ElementsE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 10Time Dispatch NotifiedSectionE05Times1602006 NHTSA Uniform PreHospital Dataset V.2.2.1UNIT NOTIFIED BY DISPATCH DATE/TIME E05_04Data [date/time]National ElementDefinitionThe date the responding unit was notified by dispatchXSD Data Typexs:dateTimeXSD Domain (Simple Type)DateTimeMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDYesMinimum Constraint1,990Maximum Constraint2,030Field ValuesAdditional Information●If the date/time is electronically stored within a database or transmitted via XML as a “tick”, the referenced variables may also be used●Not Nullable. A unique value must be provided to create a unique record ID within a databaseUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on EMS agency time intervals●Allows data to describe EMS agency time intervalsData Collector●911 or Dispatch Center and electronically or verbally transmitted to the EMS agencyOther Associated ElementsE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 11Date Unit NotifiedEssentialElement 12Time Unit NotifiedSectionE05Times1612006 NHTSA Uniform PreHospital Dataset V.2.2.1UNIT EN ROUTE DATE/TIMEE05_05Data [date/time]National ElementDefinitionThe date/time the unit responded; that is, the time the vehicle started movingXSD Data Typexs:dateTimeXSD Domain (Simple Type)DateTimeMultiple Entry ConfigurationNoAccepts Null Values Yes, but null value is blank or emptyRequired in XSDYesMinimum Constraint1,990Maximum Constraint2,030Field ValuesAdditional Information●If the date/time is electronically stored within a database or transmitted via XML as a “tick”, the referenced variables may also be usedUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on EMS agency time intervals●Allows data to describe EMS agency time intervalsData Collector●911 or Dispatch Center and electronically or verbally transmitted to the EMS agencyOther Associated ElementsE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 13Time Unit RespondingSectionE05Times1622006 NHTSA Uniform PreHospital Dataset V.2.2.1UNIT ARRIVED ON SCENE DATE/TIME E05_06Data [date/time]National ElementDefinitionThe date/time the responding unit arrived on the scene; that is, the time the vehicle stopped movingXSD Data Typexs:dateTimeXSD Domain (Simple Type)DateTimeMultiple Entry ConfigurationNoAccepts Null Values Yes, but null value is blank or emptyRequired in XSDYesMinimum Constraint1,990Maximum Constraint2,030Field ValuesAdditional Information●If the date/time is electronically stored within a database or transmitted via XML as a “tick”, the referenced variables may also be usedUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on EMS agency time intervals●Allows data to describe EMS agency time intervalsData Collector●911 or Dispatch Center and electronically or verbally transmitted to the EMS agencyOther Associated ElementsE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 14Time of Arrival at SceneSectionE05Times1632006 NHTSA Uniform PreHospital Dataset V.2.2.1ARRIVED AT PATIENT DATE/TIME E05_07Data [date/time]National ElementDefinitionThe date/time the responding unit arrived at the patient's sideXSD Data Typexs:dateTimeXSD Domain (Simple Type)DateTimeMultiple Entry ConfigurationNoAccepts Null Values Yes, but null value is blank or emptyRequired in XSDYesMinimum Constraint1,990Maximum Constraint2,030Field ValuesAdditional Information●If the date/time is electronically stored within a database or transmitted via XML as a “tick”, the referenced variables may also be usedUses●Provides more accurate information on the true response time of EMS to the patient’s side●Used in Quality Management evaluation of EMS response and performance especially in areas where patient location may be distant from the EMS vehicleData Collector●911 or Dispatch Center and electronically or verbally transmitted to the EMS agencyOther Associated ElementsE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 15Time of Arrival at PatientReferences to Other Databases● NFIRS 5.0EMS Module; Title: Date/Time Arrived; The date and time fire fighters arrived at the patient.SectionE05Times1642006 NHTSA Uniform PreHospital Dataset V.2.2.1TRANSFER OF PATIENT CARE DATE/TIMEE05_08Data [date/time]DefinitionThe date/time the patient was transferred from this EMS agency to another EMS agency for care.XSD Data Typexs:dateTimeXSD Domain (Simple Type)DateTimeMultiple Entry ConfigurationNoAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint1,990Maximum Constraint2,030Field ValuesAdditional Information●If the date/time is electronically stored within a database or transmitted via XML as a “tick”, the referenced variables may also be usedUses●Important for Quality Management when the patient is cared for by more than one EMS agency●Provides documentation of how the patient progresses through the EMS agencyData Collector●911 or Dispatch Center and electronically or verbally transmitted to the EMS agencyOther Associated ElementsE01_01Patient Care Report NumberReferences to Other Databases● NFIRS 5.0EMS Module; Title: Date/Time Transfer; The date and time fire fighters transferred the care of the patient to another EMS agency.SectionE05Times1652006 NHTSA Uniform PreHospital Dataset V.2.2.1UNIT LEFT SCENE DATE/TIME E05_09Data [date/time]National ElementDefinitionThe date/time the responding unit left the scene (started moving)XSD Data Typexs:dateTimeXSD Domain (Simple Type)DateTimeMultiple Entry ConfigurationNoAccepts Null Values Yes, but null value is blank or emptyRequired in XSDYesMinimum Constraint1,990Maximum Constraint2,030Field ValuesAdditional Information●If the date/time is electronically stored within a database or transmitted via XML as a “tick”, the referenced variables may also be usedUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on EMS agency time intervals●Allows data to describe EMS agency time intervalsData Collector●911 or Dispatch Center and electronically or verbally transmitted to the EMS agencyOther Associated ElementsE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 16Time Unit Left SceneSectionE05Times1662006 NHTSA Uniform PreHospital Dataset V.2.2.1PATIENT ARRIVED AT DESTINATION DATE/TIME E05_10Data [date/time]National ElementDefinitionThe date/time the responding unit arrived with the patient at the destination or transfer pointXSD Data Typexs:dateTimeXSD Domain (Simple Type)DateTimeMultiple Entry ConfigurationNoAccepts Null Values Yes, but null value is blank or emptyRequired in XSDYesMinimum Constraint1,990Maximum Constraint2,030Field ValuesAdditional Information●If the date/time is electronically stored within a database or transmitted via XML as a “tick”, the referenced variables may also be usedUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on EMS agency time intervals●Allows data to describe EMS agency time intervalsData Collector●911 or Dispatch Center and electronically or verbally transmitted to the EMS agencyOther Associated ElementsE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 17Time of Arrival at DestinationSectionE05Times1672006 NHTSA Uniform PreHospital Dataset V.2.2.1UNIT BACK IN SERVICE DATE/TIME E05_11Data [date/time]National ElementDefinitionThe date/time the unit back was back in service and available for response (finished with call, but not necessarily back in home location)XSD Data Typexs:dateTimeXSD Domain (Simple Type)DateTimeMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDYesMinimum Constraint1,990Maximum Constraint2,030Field ValuesAdditional Information●If the date/time is electronically stored within a database or transmitted via XML as a “tick”, the referenced variables may also be usedUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on EMS agency time intervals●Allows data to describe EMS agency time intervalsData Collector●911 or Dispatch Center and electronically or verbally transmitted to the EMS agencyOther Associated ElementsE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 18Time Back in ServiceSectionE05Times1682006 NHTSA Uniform PreHospital Dataset V.2.2.1UNIT CANCELLED DATE/TIMEE05_12Data [date/time]DefinitionThe date/time if the unit's call was cancelledXSD Data Typexs:dateTimeXSD Domain (Simple Type)DateTimeMultiple Entry ConfigurationNoAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint1,990Maximum Constraint2,030Field ValuesAdditional Information●If the date/time is electronically stored within a database or transmitted via XML as a “tick”, the referenced variables may also be usedUses●Allows for reports to be generated better evaluating EMS response and usage patternsData Collector●911 or Dispatch Center and electronically or verbally transmitted to the EMS agencyOther Associated ElementsE01_01Patient Care Report NumberSectionE05Times1692006 NHTSA Uniform PreHospital Dataset V.2.2.1UNIT BACK AT HOME LOCATION DATE/TIME E05_13Data [date/time]National ElementDefinitionThe date/time the responding unit was back in their service area. In agencies who utilized Agency Status Management, home location means the service area as assigned through the agency status management protocol.XSD Data Typexs:dateTimeXSD Domain (Simple Type)DateTimeMultiple Entry ConfigurationNoAccepts Null Values Yes, but null value is blank or emptyRequired in XSDYesMinimum Constraint1,990Maximum Constraint2,030Field ValuesAdditional Information●If the date/time is electronically stored within a database or transmitted via XML as a “tick”, the referenced variables may also be usedUses●Allows data to be sorted based on EMS agency time intervals●Allows data to describe EMS agency time intervalsData Collector●911 or Dispatch Center and electronically or verbally transmitted to the EMS agencyOther Associated ElementsE01_01Patient Care Report NumberSectionE05Times1702006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE06PatientSectionE06Patient1712006 NHTSA Uniform PreHospital Dataset V.2.2.1LAST NAMEE06_01Data [text]DefinitionThe patient's last (family) nameXSD Data Typexs:stringXSD Domain (Simple Type)LastNameMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint20XSD Structure: E06_01, E06_02, and E06_03 are all members of the E06_01_0 Patient Name StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Local Policy should dictate how Last Name and First Name should be created if UnknownUses●Allows a patient’s information to be stored and retrieved by Name●Key component of an EMS Medical Record●Provides contact information for multiple purposes including follow-up, billing, bioterrorism syndromic surveillance, etcData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_02First NameE06_03Middle Initial/NameReferences in NHTSA Version 1EssentialElement 32Patient NameSectionE06Patient1722006 NHTSA Uniform PreHospital Dataset V.2.2.1FIRST NAMEE06_02Data [text]DefinitionThe patient's first (given) nameXSD Data Typexs:stringXSD Domain (Simple Type)FirstNameMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint20XSD Structure: E06_01, E06_02, and E06_03 are all members of the E06_01_0 Patient Name StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Local Policy should dictate how Last Name and First Name should be created if UnknownUses●Allows a patient’s information to be stored and retrieved by Name●Key component of an EMS Medical Record●Provides contact information for multiple purposes including follow-up, billing, bioterrorism syndromic surveillance, etcData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE06_03Middle Initial/NameReferences in NHTSA Version 1EssentialElement 32Patient NameSectionE06Patient1732006 NHTSA Uniform PreHospital Dataset V.2.2.1MIDDLE INITIAL/NAMEE06_03Data [text]DefinitionThe patient's middle name, if anyXSD Data Typexs:stringXSD Domain (Simple Type)MiddleInitialNameMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint20XSD Structure: E06_01, E06_02, and E06_03 are all members of the E06_01_0 Patient Name StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Local Policy should dictate how Last Name and First Name should be created if UnknownUses●Allows a patient’s information to be stored and retrieved by Name●Key component of an EMS Medical Record●Provides contact information for multiple purposes including follow-up, billing, bioterrorism syndromic surveillance, etcData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE06_02First NameReferences in NHTSA Version 1EssentialElement 32Patient NameSectionE06Patient1742006 NHTSA Uniform PreHospital Dataset V.2.2.1PATIENT'S HOME ADDRESSE06_04Data [text]DefinitionThe patient's home mailing or street addressXSD Data Typexs:stringXSD Domain (Simple Type)StreetAddressMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: E06_04, E06_05, E06_06, E06_07, E06_08 are all members of the E06_04_0 Patient Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available Uses●Key component of an EMS Medical Record●Provides contact information for multiple purposes including follow-up, billing, bioterrorism syndromic surveillance, etcData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE06_05Patient's Home CityE06_06Patient's Home CountyE06_07Patient's Home StateE06_08Patient's Home Zip CodeReferences in NHTSA Version 1DesirableElement 33Patient Street AddressSectionE06Patient1752006 NHTSA Uniform PreHospital Dataset V.2.2.1PATIENT'S HOME CITYE06_05Data [combo] single-choiceDefinitionThe patient's home city or township or residenceXSD Data Typexs:stringXSD Domain (Simple Type)CityMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: E06_04, E06_05, E06_07, E06_08 are all members of the E06_04_0 Patient Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●5 digit FIPS Code●Could be filled in from Patient’s Home Zip (E06_08)Uses●Key component of an EMS Medical Record●Provides contact information for multiple purposes including follow-up, billing, bioterrorism syndromic surveillance, etcData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE06_04Patient's Home AddressE06_06Patient's Home CountyE06_07Patient's Home StateE06_08Patient's Home Zip CodeReferences in NHTSA Version 1DesirableElement 34City of ResidenceSectionE06Patient1762006 NHTSA Uniform PreHospital Dataset V.2.2.1PATIENT'S HOME COUNTYE06_06Data [combo] single-choiceDefinitionThe patient's home county or parish or residenceXSD Data Typexs:stringXSD Domain (Simple Type)CountyMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint20Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Stored as a 5 digit FIPS code (combining the state and county code) to take into account agencies may server more than one state and counties are often named the same from state to stateUses●Key component of an EMS Medical Record●Provides contact information for multiple purposes including follow-up, billing, bioterrorism syndromic surveillance, etcData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE06_04Patient's Home AddressE06_05Patient's Home CityE06_07Patient's Home StateE06_08Patient's Home Zip CodeReferences in NHTSA Version 1DesirableElement 35County of ResidenceSectionE06Patient1772006 NHTSA Uniform PreHospital Dataset V.2.2.1PATIENT'S HOME STATEE06_07Data [combo] single-choiceDefinitionThe patient's home state, territory, or province, or District of Columbia, where the patient residesXSD Data Typexs:stringXSD Domain (Simple Type)StateMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint3XSD Structure: E06_04, E06_05, E06_06, E06_07, E06_08 are all members of the E06_04_0 Patient Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available Additional Information●2 digit FIPS numeric code (Not State abbreviation)●Could be filled in from Patient’s Home Zip (E06_08)Uses●Key component of an EMS Medical Record●Provides contact information for multiple purposes including follow-up, billing, bioterrorism syndromic surveillance, etcData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE06_04Patient's Home AddressE06_05Patient's Home CityE06_06Patient's Home CountyE06_08Patient's Home Zip CodeReferences in NHTSA Version 1DesirableElement 36State of ResidenceSectionE06Patient1782006 NHTSA Uniform PreHospital Dataset V.2.2.1PATIENT'S HOME ZIP CODEE06_08Data [text]National ElementDefinitionThe patient's home ZIP code of residenceXSD Data Typexs:stringXSD Domain (Simple Type)ZipMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesXSD Structure: E06_04, E06_05, E06_07, E06_08 are all members of the E06_04_0 Patient Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Can be stored as a 5 or 9 digit codeUses●Allows data to be sorted based on the geographic location of the patient's home●Allows data to describe geographic location of the patient's home●Key component of an EMS Medical Record●Provides contact information for multiple purposes including follow-up, billing, bioterrorism syndromic surveillance, etcData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE06_04Patient's Home AddressE06_05Patient's Home CityE06_06Patient's Home CountyE06_07Patient's Home StateReferences in NHTSA Version 1EssentialElement 37Zip Code of ResidenceSectionE06Patient1792006 NHTSA Uniform PreHospital Dataset V.2.2.1PATIENT’S HOME COUNTRYE06_09Data [combo] single-choiceDefinitionThe patient’s country of citizenshipXSD Data Typexs:stringXSD Domain (Simple Type)CountryMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint20Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Stored as a FIPS codeUses●Key component of an EMS Medical Record●Provides contact information for multiple purposes including follow-up, billing, bioterrorism syndromic surveillance, etcData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameSectionE06Patient1802006 NHTSA Uniform PreHospital Dataset V.2.2.1SOCIAL SECURITY NUMBERE06_10Data [number]DefinitionThe patient's social security numberXSD Data Typexs:stringXSD Domain (Simple Type)SocialSecurityNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint9Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available Uses●Key component of an EMS Medical RecordData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameReferences in NHTSA Version 1DesirableElement 39Social Security NumberSectionE06Patient1812006 NHTSA Uniform PreHospital Dataset V.2.2.1GENDERE06_11Data [combo] single-choiceNational ElementDefinitionThe patient's genderXSD Data Typexs:integerXSD Domain (Simple Type)GenderMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available650Male655FemaleUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on gender●Allows data to describe the gender of the EMS patient populationData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameReferences in NHTSA Version 1EssentialElement 42GenderReferences to Other Databases● NFIRS 5.0EMS Module; Title: Gender; Pick-List: Male = 1, Female = 2SectionE06Patient1822006 NHTSA Uniform PreHospital Dataset V.2.2.1RACEE06_12Data [combo] single-choiceNational ElementDefinitionThe patient's race as defined by the OMB (US Office of Management and Budget)XSD Data Typexs:integerXSD Domain (Simple Type)RaceMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available660American Indian or Alaska Native665Asian670Black or African American675Native Hawaiian or Other Pacific Islander680White685Other RaceUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on race as required from a state and federal government reporting perspective●Allows data to describe the race of the EMS patient populationData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameReferences in NHTSA Version 1EssentialElement 43Race/EthnicityReferences to Other Databases● NFIRS 5.0EMS Module; Title: Race; Pick-List: White = 1, Black = 2, American Indian, Eskimo, Aleut = 3, Asian = 4, Other, Multi-racial = 0, Race Undetermined = USectionE06Patient1832006 NHTSA Uniform PreHospital Dataset V.2.2.1ETHNICITYE06_13Data [combo] single-choiceNational ElementDefinitionThe patient's ethnicity as defined by the OMB (US Office of Management and Budget)XSD Data Typexs:integerXSD Domain (Simple Type)EthnicityMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available690Hispanic or Latino695Not Hispanic or LatinoUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on ethnicity as required from a state and federal government reporting perspective●Allows data to describe the ethnicity of the EMS patient populationData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameReferences in NHTSA Version 1EssentialElement 43Race/EthnicityReferences to Other Databases● NFIRS 5.0EMS Module; Title: Ethnicity; Check-Box: Hispanic = Yes or NoSectionE06Patient1842006 NHTSA Uniform PreHospital Dataset V.2.2.1AGEE06_14Data [number]National ElementDefinitionThe patient's age (either calculated from date of birth or best approximation)XSD Data Typexs:integerXSD Domain (Simple Type)AgeMultiple Entry ConfigurationNoAccepts Null Values Yes, but null value is blank or emptyRequired in XSDYesMinimum Constraint1Maximum Constraint120XSD Structure: E06_14 and E06_15 are members of the E06_14_0 Patient's Age StructureField ValuesAdditional Information●Could be calculated from Date of Birth (E06_16)Uses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on age●Allows data to describe the age of the EMS patient populationData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE01_01Patient Care Report NumberE06_01Last NameE06_15Age UnitsReferences in NHTSA Version 1DesirableElement 41AgeReferences to Other Databases● NFIRS 5.0EMS Module; Title: Age; The age of the patient or best approximation. If less than one year then enter the number of months.SectionE06Patient1852006 NHTSA Uniform PreHospital Dataset V.2.2.1AGE UNITSE06_15Data [combo] single-choiceNational ElementDefinitionThe units which the age is documented in (Hours, Days, Months, Years)XSD Data Typexs:integerXSD Domain (Simple Type)AgeUnitsMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesXSD Structure: E06_14 and E06_15 are members of the E06_14_0 Patient's Age StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available700Hours705Days710Months715YearsUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on age●Allows data to describe the age of the EMS patient populationData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_14AgeReferences in NHTSA Version 1DesirableElement 41AgeSectionE06Patient1862006 NHTSA Uniform PreHospital Dataset V.2.2.1DATE OF BIRTHE06_16Data [date]DefinitionThe patient's date of birthXSD Data Typexs:dateXSD Domain (Simple Type)DateOfBirthMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoMinimum Constraint1,890Maximum Constraint2,030Field ValuesUses●Key component of an EMS Medical Record●Provides important information which will allow EMS data to be sorted, grouped and evaluated by age demographicsData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE01_01Patient Care Report NumberE06_01Last NameReferences in NHTSA Version 1EssentialElement 40Date of BirthReferences to Other Databases● NFIRS 5.0EMS Module; Title: Date of Birth; The date of birth of the patient in MMDDYYYY format.SectionE06Patient1872006 NHTSA Uniform PreHospital Dataset V.2.2.1PRIMARY OR HOME TELEPHONE NUMBERE06_17Data [text]DefinitionThe patient's home or primary telephone numberXSD Data Typexs:stringXSD Domain (Simple Type)TelephoneNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint10Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●10 digit telephone numberUses●Key component of an EMS Medical Record●Provides contact information for multiple purposes including follow-up, billing, bioterrorism syndromic surveillance, etcData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameReferences in NHTSA Version 1DesirableElement 38Telephone NumberSectionE06Patient1882006 NHTSA Uniform PreHospital Dataset V.2.2.1STATE ISSUING DRIVER'S LICENSEE06_18Data [combo] single-choiceDefinitionThe state that issued the driver's licenseXSD Data Typexs:stringXSD Domain (Simple Type)StateMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint3XSD Structure: E06_18 and E06_19 are members of the E06_19_0 Patient's Drivers License StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●2 digit FIPS CodeUses●Can provide linkage back to DMV databases for additional patient and event information●Form of identification to allow verification of the patient’s identify and contact informationData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE06_19Driver's License NumberSectionE06Patient1892006 NHTSA Uniform PreHospital Dataset V.2.2.1DRIVER'S LICENSE NUMBERE06_19Data [text]DefinitionThe patient's driver's license numberXSD Data Typexs:stringXSD Domain (Simple Type)DriversLicenseNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint30XSD Structure: E06_18 and E06_19 are members of the E06_19_0 Patient's Drivers License StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Can provide linkage back to DMV databases for additional patient and event information●Form of identification to allow verification of the patient’s identify and contact informationData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE06_18State Issuing Driver's LicenseSectionE06Patient1902006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE07BillingSectionE07Billing1912006 NHTSA Uniform PreHospital Dataset V.2.2.1PRIMARY METHOD OF PAYMENTE07_01Data [combo] single-choiceNational ElementDefinitionThe primary method of payment or type of insurance associated with this EMS encounterXSD Data Typexs:integerXSD Domain (Simple Type)PrimaryMethodOfPaymentMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available720Insurance725Medicaid730Medicare735Not Billed (for any reason)740Other Government745Self Pay750Workers CompensationUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the payer mix●Allows data to describe the EMS patient population's payer mixData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameSectionE07Billing1922006 NHTSA Uniform PreHospital Dataset V.2.2.1CERTIFICATE OF MEDICAL NECESSITYE07_02Data [combo] single-choiceDefinitionIndication of whether a certificate of medical necessity is presentXSD Data Typexs:integerXSD Domain (Simple Type)YesNoValuesMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available0No1YesUses●Key component of an EMS Medical Record for billing of some patient transportsData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameSectionE07Billing1932006 NHTSA Uniform PreHospital Dataset V.2.2.1INSURANCE COMPANY ID/NAMEE07_03Data [text]DefinitionThe ID number of the patient's insurance companyXSD Data Typexs:stringXSD Domain (Simple Type)InsuranceCompanyIDMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: (1) E07_03, E07_05, E07_06, E07_07, E07_08, E07_09, E07_10, E07_11, E07_12, E07_13, E07_14 are all members of E03 Insurance Structure. (2) E07_05, E07_06, E07_07, and E07_08 are all members of E07_05_0 Insurance Company Address Structure. (3) E07_11, E07_12, E07_13 are all members of E07_11_0 Insured Name StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Multiple entry configuration required to allow more than one insurance companyUses●Key component of an EMS Medical Record for billing Data Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE07_04Insurance Company Billing PriorityE07_05Insurance Company AddressE07_06Insurance Company CityE07_07Insurance Company StateE07_08Insurance Company Zip CodeE07_09Insurance Group ID/NameE07_10Insurance Policy ID NumberE07_11Last Name of the InsuredE07_12First Name of the InsuredE07_13Middle Initial/Name of the InsuredE07_14Relationship to the InsuredSectionE07Billing1942006 NHTSA Uniform PreHospital Dataset V.2.2.1INSURANCE COMPANY BILLING PRIORITYE07_04Data [combo] single-choiceDefinitionThe billing priority or order for the insurance company.XSD Data Typexs:integerXSD Domain (Simple Type)InsuranceCompanyBillingPriorityMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: (1) E07_03, E07_05, E07_06, E07_07, E07_08, E07_09, E07_10, E07_11, E07_12, E07_13, E07_14 are all members of E03 Insurance Structure. (2) E07_05, E07_06, E07_07, and E07_08 are all members of E07_05_0 Insurance Company Address Structure. (3) E07_11, E07_12, E07_13 are all members of E07_11_0 Insured Name StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available755Primary760Secondary765OtherUses●Key component of an EMS Medical Record for billing Data Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE07_03Insurance Company ID/NameE07_05Insurance Company AddressE07_06Insurance Company CityE07_07Insurance Company StateE07_08Insurance Company Zip CodeE07_09Insurance Group ID/NameE07_10Insurance Policy ID NumberE07_11Last Name of the InsuredE07_12First Name of the InsuredE07_13Middle Initial/Name of the InsuredE07_14Relationship to the InsuredSectionE07Billing1952006 NHTSA Uniform PreHospital Dataset V.2.2.1INSURANCE COMPANY ADDRESSE07_05Data [text]DefinitionThe mailing address of the Insurance CompanyXSD Data Typexs:stringXSD Domain (Simple Type)StreetAddressMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: (1) E07_03, E07_05, E07_06, E07_07, E07_08, E07_09, E07_10, E07_11, E07_12, E07_13, E07_14 are all members of E03 Insurance Structure. (2) E07_05, E07_06, E07_07, and E07_08 are all members of E07_05_0 Insurance Company Address Structure. (3) E07_11, E07_12, E07_13 are all members of E07_11_0 Insured Name StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●E07_05, E07_06, E07_07 and E07_08 are members of the Insurance Address groupUses●Key component of an EMS Medical Record for billing Data Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE07_03Insurance Company ID/NameE07_04Insurance Company Billing PriorityE07_06Insurance Company CityE07_07Insurance Company StateE07_08Insurance Company Zip CodeE07_09Insurance Group ID/NameE07_10Insurance Policy ID NumberE07_11Last Name of the InsuredE07_12First Name of the InsuredE07_13Middle Initial/Name of the InsuredE07_14Relationship to the InsuredSectionE07Billing1962006 NHTSA Uniform PreHospital Dataset V.2.2.1INSURANCE COMPANY CITYE07_06Data [combo] single-choiceDefinitionThe insurance companies city or townshipXSD Data Typexs:stringXSD Domain (Simple Type)CityMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: (1) E07_03, E07_05, E07_06, E07_07, E07_08, E07_09, E07_10, E07_11, E07_12, E07_13, E07_14 are all members of E03 Insurance Structure. (2) E07_05, E07_06, E07_07, and E07_08 are all members of E07_05_0 Insurance Company Address Structure. (3) E07_11, E07_12, E07_13 are all members of E07_11_0 Insured Name StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●5 digit FIPS Code●Could be filled in from Insurance Company Zip Code (E07_08)●E07_05, E07_06, E07_07 and E07_08 are members of the Insurance Address groupUses●Key component of an EMS Medical Record for billing Data Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE07_03Insurance Company ID/NameE07_04Insurance Company Billing PriorityE07_05Insurance Company AddressE07_07Insurance Company StateE07_08Insurance Company Zip CodeE07_09Insurance Group ID/NameE07_10Insurance Policy ID NumberE07_11Last Name of the InsuredE07_12First Name of the InsuredE07_13Middle Initial/Name of the InsuredE07_14Relationship to the InsuredSectionE07Billing1972006 NHTSA Uniform PreHospital Dataset V.2.2.1INSURANCE COMPANY STATEE07_07Data [combo] single-choiceDefinitionThe insurance companies state, territory, or province, or District of Columbia.XSD Data Typexs:stringXSD Domain (Simple Type)StateMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint3XSD Structure: (1) E07_03, E07_05, E07_06, E07_07, E07_08, E07_09, E07_10, E07_11, E07_12, E07_13, E07_14 are all members of E03 Insurance Structure. (2) E07_05, E07_06, E07_07, and E07_08 are all members of E07_05_0 Insurance Company Address Structure. (3) E07_11, E07_12, E07_13 are all members of E07_11_0 Insured Name StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●2 digit FIPS numeric code (Not State abbreviation)●Could be filled in from Insurance Company Zip Code (E07_08)●E07_05, E07_06, E07_07 and E07_08 are members of the Insurance Address groupUses●Key component of an EMS Medical Record for billing Data Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE07_03Insurance Company ID/NameE07_04Insurance Company Billing PriorityE07_05Insurance Company AddressE07_06Insurance Company CityE07_08Insurance Company Zip CodeE07_09Insurance Group ID/NameE07_10Insurance Policy ID NumberE07_11Last Name of the InsuredE07_12First Name of the InsuredE07_13Middle Initial/Name of the InsuredE07_14Relationship to the InsuredSectionE07Billing1982006 NHTSA Uniform PreHospital Dataset V.2.2.1INSURANCE COMPANY ZIP CODEE07_08Data [text]DefinitionThe insurance companies Zip CodeXSD Data Typexs:stringXSD Domain (Simple Type)ZipMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: (1) E07_03, E07_05, E07_06, E07_07, E07_08, E07_09, E07_10, E07_11, E07_12, E07_13, E07_14 are all members of E03 Insurance Structure. (2) E07_05, E07_06, E07_07, and E07_08 are all members of E07_05_0 Insurance Company Address Structure. (3) E07_11, E07_12, E07_13 are all members of E07_11_0 Insured Name StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Can be a 5 or 9 digit Zip Code●E07_05, E07_06, E07_07 and E07_08 are members of the Insurance Address groupUses●Key component of an EMS Medical Record for billing Data Collector●EMS personnel unless the EMS Agency has professional billing personnel to provide this functionOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE07_03Insurance Company ID/NameE07_04Insurance Company Billing PriorityE07_05Insurance Company AddressE07_06Insurance Company CityE07_07Insurance Company StateE07_09Insurance Group ID/NameE07_10Insurance Policy ID NumberE07_11Last Name of the InsuredE07_12First Name of the InsuredE07_13Middle Initial/Name of the InsuredE07_14Relationship to the InsuredSectionE07Billing1992006 NHTSA Uniform PreHospital Dataset V.2.2.1INSURANCE GROUP ID/NAMEE07_09Data [text]DefinitionThe ID number or name of the patient's insurance groupXSD Data Typexs:stringXSD Domain (Simple Type)InsuranceGroupIDNameMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: (1) E07_03, E07_05, E07_06, E07_07, E07_08, E07_09, E07_10, E07_11, E07_12, E07_13, E07_14 are all members of E03 Insurance Structure. (2) E07_05, E07_06, E07_07, and E07_08 are all members of E07_05_0 Insurance Company Address Structure. (3) E07_11, E07_12, E07_13 are all members of E07_11_0 Insured Name StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Key component of an EMS Medical Record for billing Data Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE07_03Insurance Company ID/NameE07_04Insurance Company Billing PriorityE07_05Insurance Company AddressE07_06Insurance Company CityE07_07Insurance Company StateE07_08Insurance Company Zip CodeE07_10Insurance Policy ID NumberE07_11Last Name of the InsuredE07_12First Name of the InsuredE07_13Middle Initial/Name of the InsuredE07_14Relationship to the InsuredSectionE07Billing2002006 NHTSA Uniform PreHospital Dataset V.2.2.1INSURANCE POLICY ID NUMBERE07_10Data [text]DefinitionThe ID number of the patient's insurance policyXSD Data Typexs:stringXSD Domain (Simple Type)InsurancePolicyIDNumberMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: (1) E07_03, E07_05, E07_06, E07_07, E07_08, E07_09, E07_10, E07_11, E07_12, E07_13, E07_14 are all members of E03 Insurance Structure. (2) E07_05, E07_06, E07_07, and E07_08 are all members of E07_05_0 Insurance Company Address Structure. (3) E07_11, E07_12, E07_13 are all members of E07_11_0 Insured Name StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Key component of an EMS Medical Record for billing Data Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE07_03Insurance Company ID/NameE07_04Insurance Company Billing PriorityE07_05Insurance Company AddressE07_06Insurance Company CityE07_07Insurance Company StateE07_08Insurance Company Zip CodeE07_09Insurance Group ID/NameE07_11Last Name of the InsuredE07_12First Name of the InsuredE07_13Middle Initial/Name of the InsuredE07_14Relationship to the InsuredSectionE07Billing2012006 NHTSA Uniform PreHospital Dataset V.2.2.1LAST NAME OF THE INSUREDE07_11Data [text]DefinitionThe last (family) name of the person insured by the insurance company.XSD Data Typexs:stringXSD Domain (Simple Type)LastNameMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint20XSD Structure: (1) E07_03, E07_05, E07_06, E07_07, E07_08, E07_09, E07_10, E07_11, E07_12, E07_13, E07_14 are all members of E03 Insurance Structure. (2) E07_05, E07_06, E07_07, and E07_08 are all members of E07_05_0 Insurance Company Address Structure. (3) E07_11, E07_12, E07_13 are all members of E07_11_0 Insured Name StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●E07_11, E07_12, and E07_13 are members of the Name of Insured groupUses●Key component of an EMS Medical Record for billing Data Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE07_03Insurance Company ID/NameE07_04Insurance Company Billing PriorityE07_05Insurance Company AddressE07_06Insurance Company CityE07_07Insurance Company StateE07_08Insurance Company Zip CodeE07_09Insurance Group ID/NameE07_10Insurance Policy ID NumberE07_12First Name of the InsuredE07_13Middle Initial/Name of the InsuredE07_14Relationship to the InsuredSectionE07Billing2022006 NHTSA Uniform PreHospital Dataset V.2.2.1FIRST NAME OF THE INSUREDE07_12Data [text]DefinitionThe first (given) name of the person insured by the insurance companyXSD Data Typexs:stringXSD Domain (Simple Type)FirstNameMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint20XSD Structure: (1) E07_03, E07_05, E07_06, E07_07, E07_08, E07_09, E07_10, E07_11, E07_12, E07_13, E07_14 are all members of E03 Insurance Structure. (2) E07_05, E07_06, E07_07, and E07_08 are all members of E07_05_0 Insurance Company Address Structure. (3) E07_11, E07_12, E07_13 are all members of E07_11_0 Insured Name StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●E07_11, E07_12, and E07_13 are members of the Name of Insured groupUses●Key component of an EMS Medical Record for billing Data Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE07_03Insurance Company ID/NameE07_04Insurance Company Billing PriorityE07_05Insurance Company AddressE07_06Insurance Company CityE07_07Insurance Company StateE07_08Insurance Company Zip CodeE07_09Insurance Group ID/NameE07_10Insurance Policy ID NumberE07_11Last Name of the InsuredE07_11Last Name of the InsuredE07_13Middle Initial/Name of the InsuredE07_14Relationship to the InsuredSectionE07Billing2032006 NHTSA Uniform PreHospital Dataset V.2.2.1MIDDLE INITIAL/NAME OF THE INSUREDE07_13Data [text]DefinitionThe middle name, if any, of the person insured by the insurance company.XSD Data Typexs:stringXSD Domain (Simple Type)MiddleInitialNameMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint20XSD Structure: (1) E07_03, E07_05, E07_06, E07_07, E07_08, E07_09, E07_10, E07_11, E07_12, E07_13, E07_14 are all members of E03 Insurance Structure. (2) E07_05, E07_06, E07_07, and E07_08 are all members of E07_05_0 Insurance Company Address Structure. (3) E07_11, E07_12, E07_13 are all members of E07_11_0 Insured Name StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●E07_11, E07_12, and E07_13 are members of the Name of Insured groupUses●Key component of an EMS Medical Record for billing Data Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE07_03Insurance Company ID/NameE07_04Insurance Company Billing PriorityE07_05Insurance Company AddressE07_06Insurance Company CityE07_07Insurance Company StateE07_08Insurance Company Zip CodeE07_09Insurance Group ID/NameE07_10Insurance Policy ID NumberE07_11Last Name of the InsuredE07_11Last Name of the InsuredE07_12First Name of the InsuredE07_12First Name of the InsuredE07_14Relationship to the InsuredSectionE07Billing2042006 NHTSA Uniform PreHospital Dataset V.2.2.1RELATIONSHIP TO THE INSUREDE07_14Data [combo] single-choiceDefinitionThe relationship of the patient to the primary insured personXSD Data Typexs:integerXSD Domain (Simple Type)RelationshipToInsuredMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: (1) E07_03, E07_05, E07_06, E07_07, E07_08, E07_09, E07_10, E07_11, E07_12, E07_13, E07_14 are all members of E03 Insurance Structure. (2) E07_05, E07_06, E07_07, and E07_08 are all members of E07_05_0 Insurance Company Address Structure. (3) E07_11, E07_12, E07_13 are all members of E07_11_0 Insured Name StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available770Self775Spouse780Son/Daughter785OtherUses●Key component of an EMS Medical Record for billing Data Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE07_03Insurance Company ID/NameE07_04Insurance Company Billing PriorityE07_05Insurance Company AddressE07_06Insurance Company CityE07_07Insurance Company StateE07_08Insurance Company Zip CodeE07_09Insurance Group ID/NameE07_10Insurance Policy ID NumberE07_11Last Name of the InsuredE07_12First Name of the InsuredE07_13Middle Initial/Name of the InsuredSectionE07Billing2052006 NHTSA Uniform PreHospital Dataset V.2.2.1WORK-RELATEDE07_15Data [combo] single-choiceDefinitionIndication of whether or not the injury is work related.XSD Data Typexs:integerXSD Domain (Simple Type)YesNoValuesMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available0No1YesAdditional Information●If work related this data point is associated with Patient's Occupational Industry (E07_16) and Patient's Occupation (E07_17)Uses●Can be used to better describe injuries along with the Injury specific data●Key component of an EMS Medical Record for billing Data Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameSectionE07Billing2062006 NHTSA Uniform PreHospital Dataset V.2.2.1PATIENT’S OCCUPATIONAL INDUSTRYE07_16Data [combo] single-choiceDefinitionThe occupational industry of the patient’s workXSD Data Typexs:integerXSD Domain (Simple Type)PatientsOccupationalIndustryMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available790Construction795Finance, Insurance, and Real Estate800Government805Manufacturing810Mining815Retail Trade820Services825Transportation and Public Utilities830Wholesale TradeAdditional Information●Recorded if Work Related (E07_15) also with Patient's Occupation (E07_17)●US Bureau of Labor Statistics Industry ClassificationUses●Can be used to better describe injuries along with the Injury specific data●Key component of an EMS Medical Record for billing Data Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameSectionE07Billing2072006 NHTSA Uniform PreHospital Dataset V.2.2.1PATIENT’S OCCUPATIONE07_17Data [combo] single-choiceDefinitionThe occupation of the patientXSD Data Typexs:integerXSD Domain (Simple Type)PatientsOccupationMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available835Management Occupations840Business and Financial Operations Occupations845Computer and Mathematical Occupations850Architecture and Engineering Occupations855Life, Physical, and Social Science Occupations860Community and Social Services Occupations865Legal Occupations870Education, Training, and Library Occupations875Arts, Design, Entertainment, Sports, and Media Occupations880Healthcare Practitioners and Technical Occupations885Healthcare Support Occupations890Protective Service Occupations895Food Preparation and Serving Related Occupations900Building and Grounds Cleaning and Maintenance 905Personal Care and Service OccupationsOccupations910Sales and Related Occupations915Office and Administrative Support Occupations920Farming, Fishing and Forestry Occupations925Construction and Extraction Occupations930Installation, Maintenance, and Repair Occupations935Production Occupations940Transportation and Material Moving Occupations945Military Specific OccupationsAdditional Information●1999 US Bureau of Labor Statistics Standard Occupational Classification (SOC)●Recorded if Work Related (E07_15) also with Patient's Occupational Industry (E07_16)Uses●Can be used to better describe injuries along with the Injury specific data●Key component of an EMS Medical Record for billing Data Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameSectionE07Billing2082006 NHTSA Uniform PreHospital Dataset V.2.2.1CLOSEST RELATIVE/GUARDIAN LAST NAMEE07_18Data [text]DefinitionThe last (family) name of the patient's closest relative or guardianXSD Data Typexs:stringXSD Domain (Simple Type)LastNameMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint20XSD Structure: E07_18, E07_19, and E07_20 are all members of E07_18_01 Closest Relative StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available Additional Information●The Closest Relataive/Gardian Name group includes E07_18, E07_19, and E07_20Uses●Key component of an EMS Medical Record for contact information associated with billing●Key component of an EMS Medical Record if the patient is a minorData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE07_19First Name of the Closest Relative/ GuardianE07_20Middle Initial/Name of the Closest Relative/ GuardianSectionE07Billing2092006 NHTSA Uniform PreHospital Dataset V.2.2.1FIRST NAME OF THE CLOSEST RELATIVE/ GUARDIANE07_19Data [text]DefinitionThe first (given) name of the patient's closest relative or guardianXSD Data Typexs:stringXSD Domain (Simple Type)FirstNameMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint20XSD Structure: E07_18, E07_19, and E07_20 are all members of E07_18_01 Closest Relative StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●The Closest Relataive/Gardian Name group includes E07_18, E07_19, and E07_20Uses●Key component of an EMS Medical Record for contact information associated with billing●Key component of an EMS Medical Record if the patient is a minorData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE07_18Closest Relative/Guardian Last NameE07_20Middle Initial/Name of the Closest Relative/ GuardianSectionE07Billing2102006 NHTSA Uniform PreHospital Dataset V.2.2.1MIDDLE INITIAL/NAME OF THE CLOSEST RELATIVE/ GUARDIANE07_20Data [text]DefinitionThe middle name/initial, if any, of the closest relative or guardian.XSD Data Typexs:stringXSD Domain (Simple Type)MiddleInitialNameMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint20XSD Structure: E07_18, E07_19, and E07_20 are all members of E07_18_01 Closest Relative StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●The Closest Relataive/Gardian Name group includes E07_18, E07_19, and E07_20Uses●Key component of an EMS Medical Record for contact information associated with billing●Key component of an EMS Medical Record if the patient is a minorData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE07_18Closest Relative/Guardian Last NameE07_19First Name of the Closest Relative/ GuardianSectionE07Billing2112006 NHTSA Uniform PreHospital Dataset V.2.2.1CLOSEST RELATIVE/ GUARDIAN STREET ADDRESSE07_21Data [text]DefinitionThe home street address of the patient's closest relative or guardianXSD Data Typexs:stringXSD Domain (Simple Type)StreetAddressMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: E07_21, E07_22, E07_23, E07_24 are all members of E07_21_0 Closest Relatives Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●The Closest Relataive/Gardian Address group includes E07_21, E07_22, E07_23, and E07_24Uses●Key component of an EMS Medical Record for contact information associated with billing●Key component of an EMS Medical Record if the patient is a minorData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE07_18Closest Relative/Guardian Last NameE07_22Closest Relative/ Guardian CityE07_23Closest Relative/ Guardian StateE07_24Closest Relative/ Guardian Zip CodeSectionE07Billing2122006 NHTSA Uniform PreHospital Dataset V.2.2.1CLOSEST RELATIVE/ GUARDIAN CITYE07_22Data [combo] single-choiceDefinitionThe home city of the patient's closest relative or guardianXSD Data Typexs:stringXSD Domain (Simple Type)CityMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: E07_21, E07_22, E07_23, E07_24 are all members of E07_21_0 Closest Relatives Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●5 digit FIPS Code●Could be filled in from Closest Relative/Guardian Zip Code (E07_24)●The Closest Relataive/Gardian Address group includes E07_21, E07_22, E07_23, and E07_24Uses●Key component of an EMS Medical Record for contact information associated with billing●Key component of an EMS Medical Record if the patient is a minorData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE07_18Closest Relative/Guardian Last NameE07_21Closest Relative/ Guardian Street AddressE07_23Closest Relative/ Guardian StateE07_24Closest Relative/ Guardian Zip CodeSectionE07Billing2132006 NHTSA Uniform PreHospital Dataset V.2.2.1CLOSEST RELATIVE/ GUARDIAN STATEE07_23Data [combo] single-choiceDefinitionThe home state of the patient's closest relative or guardianXSD Data Typexs:stringXSD Domain (Simple Type)StateMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint3XSD Structure: E07_21, E07_22, E07_23, E07_24 are all members of E07_21_0 Closest Relatives Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●2 digit FIPS numeric code (Not State abbreviation)●Could be filled in from Closest Relative/Guardian Zip Code (E07_24)●The Closest Relataive/Gardian Address group includes E07_21, E07_22, E07_23, and E07_24Uses●Key component of an EMS Medical Record for contact information associated with billing●Key component of an EMS Medical Record if the patient is a minorData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE07_18Closest Relative/Guardian Last NameE07_21Closest Relative/ Guardian Street AddressE07_22Closest Relative/ Guardian CityE07_24Closest Relative/ Guardian Zip CodeSectionE07Billing2142006 NHTSA Uniform PreHospital Dataset V.2.2.1CLOSEST RELATIVE/ GUARDIAN ZIP CODEE07_24Data [text]DefinitionThe home Zip Code of the patient's closest relative or guardianXSD Data Typexs:stringXSD Domain (Simple Type)ZipMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoXSD Structure: E07_21, E07_22, E07_23, E07_24 are all members of E07_21_0 Closest Relatives Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Can be a 5 or 9 digit Zip Code●The Closest Relataive/Gardian Address group includes E07_21, E07_22, E07_23, and E07_24Uses●Key component of an EMS Medical Record for contact information associated with billing●Key component of an EMS Medical Record if the patient is a minorData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE07_18Closest Relative/Guardian Last NameE07_21Closest Relative/ Guardian Street AddressE07_22Closest Relative/ Guardian CityE07_23Closest Relative/ Guardian StateSectionE07Billing2152006 NHTSA Uniform PreHospital Dataset V.2.2.1CLOSEST RELATIVE/ GUARDIAN PHONE NUMBERE07_25Data [number]DefinitionThe home or other phone number of the patient's closest relative or guardianXSD Data Typexs:stringXSD Domain (Simple Type)TelephoneNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint10Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●10 digit telephone numberUses●Key component of an EMS Medical Record for contact information associated with billing●Key component of an EMS Medical Record if the patient is a minorData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE07_18Closest Relative/Guardian Last NameSectionE07Billing2162006 NHTSA Uniform PreHospital Dataset V.2.2.1CLOSEST RELATIVE/ GUARDIAN RELATIONSHIPE07_26Data [combo] single-choiceDefinitionThe relationship of the patient's closest relative or guardianXSD Data Typexs:integerXSD Domain (Simple Type)ClosestRelativeGuardianRelationshipMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available950Appointed Guardian955Father960Mother965Other970Son/Daughter975SpouseUses●Key component of an EMS Medical Record for contact information associated with billing●Key component of an EMS Medical Record if the patient is a minorData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE07_18Closest Relative/Guardian Last NameSectionE07Billing2172006 NHTSA Uniform PreHospital Dataset V.2.2.1PATIENT'S EMPLOYERE07_27Data [text]DefinitionThe name of the patient's employerXSD Data Typexs:stringXSD Domain (Simple Type)NameMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: (1) E07_27, E07_28, E07_29, E07_30, E07_31 are all members of E07_27_0 Patient's Employer Structure. (2) E07_28, E07_29, E07_30, and E07_31 are all members of the E07_28_0 Employer's Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●The Patient's Employer's Address group includes E07_27, E07_28, E07_29, E07_30, and E07_31Uses●Key component of an EMS Medical Record for contact information associated with billingData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE07_28Patient's Employer's AddressE07_29Patient’s Employer’s CityE07_30Patient’s Employer’s StateE07_31Patient’s Employer’s Zip CodeSectionE07Billing2182006 NHTSA Uniform PreHospital Dataset V.2.2.1PATIENT'S EMPLOYER'S ADDRESSE07_28Data [text]DefinitionThe street address of the patient's employerXSD Data Typexs:stringXSD Domain (Simple Type)StreetAddressMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: (1) E07_27, E07_28, E07_29, E07_30, E07_31 are all members of E07_27_0 Patient's Employer Structure. (2) E07_28, E07_29, E07_30, and E07_31 are all members of the E07_28_0 Employer's Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●The Patient's Employer's Address group includes E07_27, E07_28, E07_29, E07_30, and E07_31Uses●Key component of an EMS Medical Record for contact information associated with billingData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE07_27Patient's EmployerE07_29Patient’s Employer’s CityE07_30Patient’s Employer’s StateE07_31Patient’s Employer’s Zip CodeSectionE07Billing2192006 NHTSA Uniform PreHospital Dataset V.2.2.1PATIENT’S EMPLOYER’S CITYE07_29Data [combo] single-choiceDefinitionThe home city of the patient's employerXSD Data Typexs:stringXSD Domain (Simple Type)CityMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: (1) E07_27, E07_28, E07_29, E07_30, E07_31 are all members of E07_27_0 Patient's Employer Structure. (2) E07_28, E07_29, E07_30, and E07_31 are all members of the E07_28_0 Employer's Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●5 digit FIPS Code●Could be filled in from Patient’s Employer’s Zip Code (E07_31)●The Patient's Employer's Address group includes E07_27, E07_28, E07_29, E07_30, and E07_31Uses●Key component of an EMS Medical Record for contact information associated with billingData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE07_27Patient's EmployerE07_28Patient's Employer's AddressE07_30Patient’s Employer’s StateE07_31Patient’s Employer’s Zip CodeSectionE07Billing2202006 NHTSA Uniform PreHospital Dataset V.2.2.1PATIENT’S EMPLOYER’S STATEE07_30Data [combo] single-choiceDefinitionThe home state of the patient's employerXSD Data Typexs:stringXSD Domain (Simple Type)StateMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint3XSD Structure: (1) E07_27, E07_28, E07_29, E07_30, E07_31 are all members of E07_27_0 Patient's Employer Structure. (2) E07_28, E07_29, E07_30, and E07_31 are all members of the E07_28_0 Employer's Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●2 digit FIPS numeric code (Not State abbreviation)●Could be filled in from Patient’s Employer’s Zip Code (E07_31)●The Patient's Employer's Address group includes E07_27, E07_28, E07_29, E07_30, and E07_31Uses●Key component of an EMS Medical Record for contact information associated with billingData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE07_27Patient's EmployerE07_28Patient's Employer's AddressE07_29Patient’s Employer’s CityE07_31Patient’s Employer’s Zip CodeSectionE07Billing2212006 NHTSA Uniform PreHospital Dataset V.2.2.1PATIENT’S EMPLOYER’S ZIP CODEE07_31Data [text]DefinitionThe home Zip Code of the patient's employerXSD Data Typexs:stringXSD Domain (Simple Type)ZipMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoXSD Structure: (1) E07_27, E07_28, E07_29, E07_30, E07_31 are all members of E07_27_0 Patient's Employer Structure. (2) E07_28, E07_29, E07_30, and E07_31 are all members of the E07_28_0 Employer's Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Can be a 5 or 9 digit Zip Code●The Patient's Employer's Address group includes E07_27, E07_28, E07_29, E07_30, and E07_31Uses●Key component of an EMS Medical Record for contact information associated with billingData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE07_27Patient's EmployerE07_28Patient's Employer's AddressE07_29Patient’s Employer’s CityE07_30Patient’s Employer’s StateSectionE07Billing2222006 NHTSA Uniform PreHospital Dataset V.2.2.1PATIENT'S WORK TELEPHONE NUMBERE07_32Data [number]DefinitionThe patient's work telephone numberXSD Data Typexs:stringXSD Domain (Simple Type)TelephoneNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint10Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●10 digit telephone numberUses●Key component of an EMS Medical Record for contact information associated with billingData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameSectionE07Billing2232006 NHTSA Uniform PreHospital Dataset V.2.2.1RESPONSE URGENCYE07_33Data [combo] single-choiceDefinitionThe urgency in which the EMS agency began to mobilize resources.XSD Data Typexs:integerXSD Domain (Simple Type)ResponseUrgencyMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available980Immediate985Non-ImmediateUses●Key component of an EMS Medical Record for contact information associated with billingData Collector●EMS personnel unless the EMS Agency has professional billing personnel to provide this functionOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE07Billing2242006 NHTSA Uniform PreHospital Dataset V.2.2.1CMS SERVICE LEVELE07_34Data [combo] single-choiceNational ElementDefinitionThe CMS service level for this EMS encounter.XSD Data Typexs:integerXSD Domain (Simple Type)CMSServiceLevelMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available990BLS995BLS, Emergency1000ALS, Level 11005ALS, Level 1 Emergency1010ALS, Level 21015Paramedic Intercept1020Specialty Care Transport1025Fixed Wing (Airplane)1030Rotary Wing (Helicopter)Uses●Allows data to be quantified and described based on the CMS Service Level●Allows data to be sorted based on the CMS Service Level●Important for EMS billingData Collector●EMS personnel unless the EMS Agency has professional billing personnel to provide this functionOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE07Billing2252006 NHTSA Uniform PreHospital Dataset V.2.2.1CONDITION CODE NUMBERE07_35Data [combo] multiple-choiceNational ElementDefinitionThe condition codes are used to better describe the service and patient care delivery by an EMS service. Please consult CMS documentation for detailed descriptions of these condition codes and their use.XSD Data Typexs:stringXSD Domain (Simple Type)ConditionCodeNumberMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDYesMinimum Constraint2Maximum Constraint30XSD Structure: E07_35, E07_36 are members of E07_35_0 Condition Codes StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available8001Severe Abdominal Pain (ALS-789.00)8002Abdominal Pain (ALS-789.00)8003Abnormal Cardiac Rhythm/Cardiac Dysrhythmia (ALS-427.9)8004Abnormal Skin Signs (ALS-780.8)8005Abnormal Vital Signs (ALS-796.4)8006Allergic Reaction (ALS-995.0)8007Allergic Reaction (BLS-692.9)8008Blood Glucose (ALS-790.21)8009Respiratory Arrest (ALS-799.1)8010Difficulty Breathing (ALS-786.05)8011Cardiac Arrest-Resuscitation in Progress (ALS-427.5)8012Chest Pain (non-traumatic) (ALS-786.50)8013Choking Episode (ALS-784.9)8014Cold Exposure (ALS-991.6)8015Cold Exposure (BLS-991.9)8016Altered Level of Consciousness (non-traumatic) (ALS-8017Convulsions/Seizures (ALS-780.39)780.01)8018Eye Symptoms (non-traumatic) (BLS-379.90)8019Non Traumatic Headache (ALS-437.9)8020Cardiac Symptoms other than Chest Pain (palpitations) 8021Cardiac Symptoms other than Chest Pain (atypical pain) (ALS-785.1)(ALS-536.2)8022Heat Exposure (ALS-992.5)8023Heat Exposure (BLS-992.2)8024Hemorrhage (ALS-459.0)8025Infectious Diseases requiring Isolation/Public Health Risk (BLS-038.9)8026Hazmat Exposure (ALS-987.9)8027Medical Device Failure (ALS-996.0)8028Medical Device Failure (BLS-996.3)8029Neurologic Distress (ALS-436.0)8030Pain (Severe) (ALS-780.99)8031Back Pain (non-traumatic possible cardiac or vascular) (ALS-724.5)8032Back Pain (non-traumatic with neurologic symptoms) 8033Poisons (all routes) (ALS-977.9)(ALS-724.9)8034Alcohol Intoxication or Drug Overdose (BLS-305.0)8035Severe Alcohol Intoxication (ALS-977.3)8036Post-Operative Procedure Complications (BLS-998.9)8037Pregnancy Complication/Childbirth/Labor (ALS-650.0)8038Psychiatric/Behavioral (abnormal mental status) (ALS-8039Psychiatric/Behavioral (threat to self or others) (BLS-292.9)298.9)8040Sick Person-Fever (BLS-036.9)8041Severe Dehydration (ALS-787.01)8042Unconscious/Syncope/Dizziness (ALS-780.02)8043Major Trauma (ALS-959.8)8044Other Trauma (need for monitor or airway) (ALS-518.5)8045Other Trauma (major bleeding) (ALS-958.2)8046Other Trauma (fracture/dislocation) (BLS-829.0)8047Other Trauma (penetrating extremity) (BLS-880.0)8048Other Trauma (amputation digits) (BLS-886.0)8049Other Trauma (amputation other) (ALS-887.4)8050Other Trauma (suspected internal injuries) (ALS-869.0)8051Burns-Major (ALS-949.3)8052Burns-Minor (BLS-949.2)8053Animal Bites/Sting/Envenomation (ALS-989.5)8054Animal Bites/Sting/Envenomation (BLS-879.8)8055Lightning (ALS-994.0)8056Electrocution (ALS-994.8)8057Near Drowning (ALS-994.1)SectionE07Billing2262006 NHTSA Uniform PreHospital Dataset V.2.2.18058Eye Injuries (BLS-921.9)8059Sexual Assault (major injuries) (ALS-995.83)8060Sexual Assault (minor injuries) (BLS-995.8)8061Cardiac/Hemodynamic Monitoring Required (ALS-428.9)8062Advanced Airway Management (ALS-518.81)8063IV Meds Required (ALS-No ICD code provided))8064Chemical Restraint (ALS-293.0)8065Suctioning/Oxygen/IV fluids required (BLS-496.0)8066Airway Control/Positioning Required (BLS-786.09)8067Third Party Assistance/Attendant Required (BLS-496.0)8068Patient Safety (restraints required) (BLS-298.9)8069Patient Safety (monitoring required) (BLS-293.1)8070Patient Safety (seclusion required) (BLS-298.8)8071Patient Safety (risk of falling off stretcher) (BLS-781.3)8072Special Handling (Isolation) (BLS-041.9)8073Special Handling (orthopedic device required) (BLS-907.2)8074Special Handling (positioning required) (BLS-719.45)Additional Information●A list of 95 Condition Codes which are mapped to ICD-9 Codes. At this time the Condition Code List is still in draft. The number of the Condition Code should be stored in this field●From the Center for Medicare and Medicaid Services (CMS) Ambulance Fee Schedule Condition Based CodingUses●Allows data to be quantified and described based on the Condition Code●Allows data to be sorted based on the Condition Code●Important for EMS billingData Collector●EMS personnel unless the EMS Agency has professional billing personnel to provide this functionOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE07_36ICD-9 Code for the Condition Code NumberE07_37Condition Code ModifierSectionE07Billing2272006 NHTSA Uniform PreHospital Dataset V.2.2.1ICD-9 CODE FOR THE CONDITION CODE NUMBERE07_36Data [text]DefinitionThe ICD-9 Code assigned by CMS for the condition code documented in E7.35. Please consult CMS documentation for detailed descriptions of the Condition Codes and their use.XSD Data Typexs:stringXSD Domain (Simple Type)ICD9CodeForConditionCodeMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: E07_35, E07_36 are members of E07_35_0 Condition Codes StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●From the Center for Medicare and Medicaid Services (CMS) Ambulance Fee Schedule Condition Based Coding●Should be automatically filled in based on the Condition Code Number (E07_35)Uses●Allows data to be quantified and described based on the Condition Code●Allows data to be sorted based on the Condition Code●Important for EMS billingData Collector●EMS personnel unless the EMS Agency has professional billing personnel to provide this functionOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE07_35Condition Code NumberE07_37Condition Code ModifierSectionE07Billing2282006 NHTSA Uniform PreHospital Dataset V.2.2.1CONDITION CODE MODIFIERE07_37Data [combo] multiple-choiceDefinitionThe CMS Condition Code Modifier is used to better describe the EMS ground or air medical services response and service delivery. Please consult CMS documentation for detailed descriptions of these modifiers and their use.XSD Data Typexs:integerXSD Domain (Simple Type)AirAmbulanceModifierMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available1035A-Interfacility Transport (requires higher level of care)1036B-Interfacility Transport (service not available)1037C-ALS Response to BLS Patient1038D-Medically Necessary Transport (Not Nearest Facility)1039E-BLS Transport of ALS Patient1040F-Emergency Trauma Dispatch Condition Code (patient 1041Air-A-Long Distanceis BLS)1042Air-B-Traffic Precludes Ground Transport1043Air-C-Time Precludes Ground Transport1044Air-D-Pick up Point not Accessible by Ground TransportAdditional Information●From the Center for Medicare and Medicaid Services (CMS) Ambulance Fee Schedule Condition Based Coding●This coding system is character based to match the CMS Modifier Condition CodeUses●Allows data to be quantified and described based on the Condition Code●Allows data to be sorted based on the Condition Code●Important for EMS billingData Collector●EMS personnel unless the EMS Agency has professional billing personnel to provide this functionOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE07Billing2292006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE08SceneSectionE08Scene2302006 NHTSA Uniform PreHospital Dataset V.2.2.1OTHER EMS AGENCIES AT SCENEE08_01Data [combo] multiple-choiceDefinitionOther EMS agencies that were at the scene, if anyXSD Data Typexs:stringXSD Domain (Simple Type)OtherEMSAgenciesAtSceneMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Created from Other Agencies in Area (D01_11). This is the Agency Name, not the EMS Agency NumberUses●Allows EMS reports to be generated describing all of the resources used in an EMS event●Allows for the evaluation of an EMS response or of EMS responses over time to adjust agency components and plansData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE08Scene2312006 NHTSA Uniform PreHospital Dataset V.2.2.1OTHER SERVICES AT SCENEE08_02Data [combo] multiple-choiceDefinitionOther services that were at the scene, if anyXSD Data Typexs:integerXSD Domain (Simple Type)OtherServicesAtSceneMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available1060EMS Mutual Aid1065Fire1070Hazmat1075Law1080Other Health Care Provider1085Other1090Rescue1095UtilitiesUses●Allows EMS reports to be generated describing all of the resources used in an EMS event●Allows for the evaluation of an EMS response or of EMS responses over time to adjust agency components and plans●Used for Quality Management reports associated with service deliveryData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE08Scene2322006 NHTSA Uniform PreHospital Dataset V.2.2.1ESTIMATED DATE/TIME INITIAL RESPONDER ARRIVED ON SCENEE08_03Data [combo] single-choiceDefinitionThe date/time differential between the initial responder and the EMS unit arriving on the scene, if applicable.XSD Data Typexs:integerXSD Domain (Simple Type)EstimatedDateTimeInitialResponderOnSceneMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available1100>15 minutes11055 - 15 Minutes1110<5 Minutes1115After EMSAdditional Information●EMS Systems can choose to document First Responder Arrival Time either by a time frame (E08_03) or by recording the exact time (E08_04). Systems only need to use one of these two data elementsUses●Allows for the evaluation of First Responder services within an EMS Agency●Used for Quality Management reports associated with service delivery and clinical care/ outcomesData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE08Scene2332006 NHTSA Uniform PreHospital Dataset V.2.2.1DATE/TIME INITIAL RESPONDER ARRIVED ON SCENEE08_04Data [date/time]DefinitionThe time that the initial responder arrived on the scene, if applicable.XSD Data Typexs:dateTimeXSD Domain (Simple Type)DateTimeMultiple Entry ConfigurationNoAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint1,990Maximum Constraint2,030Field Values Additional Information●EMS Systems can choose to document First Responder Arrival Time either by a time frame (E08_03) or by recording the exact time (E08_04). Systems only need to use one of these two data elements●If the date/time is electronically stored within a database or transmitted via XML as a “tick”, the referenced variables may also be usedUses●Allows for the evaluation of First Responder services within an EMS Agency●Used for Quality Management reports associated with service delivery and clinical care/ outcomesData Collector●EMS personnelOther Associated ElementsE01_01Patient Care Report NumberSectionE08Scene2342006 NHTSA Uniform PreHospital Dataset V.2.2.1NUMBER OF PATIENTS AT SCENEE08_05Data [combo] single-choiceNational ElementDefinitionIndicator of how many total patients were at the sceneXSD Data Typexs:integerXSD Domain (Simple Type)NumberOfPatientsAtSceneMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available1120None1125Single1130MultipleUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the number of patients associated with the event and resources required●Allows data to describe the number of EMS events with multiple patient encountersData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences to Other Databases● NFIRS 5.0EMS Module; Title: Number of Patients; The total number of patients.SectionE08Scene2352006 NHTSA Uniform PreHospital Dataset V.2.2.1MASS CASUALTY INCIDENTE08_06Data [combo] single-choiceNational ElementDefinitionIndicator if this event would be considered a mass casualty incident (overwhelmed existing EMS resources)XSD Data Typexs:integerXSD Domain (Simple Type)YesNoValuesMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available0No1YesUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on a Mass Casualty Event●Allows data to describe the number of EMS events which were declared a mass casualty event and is connected with disaster and domestic preparednessData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE08Scene2362006 NHTSA Uniform PreHospital Dataset V.2.2.1INCIDENT LOCATION TYPEE08_07Data [combo] single-choiceNational ElementDefinitionThe kind of location where the incident happenedXSD Data Typexs:integerXSD Domain (Simple Type)IncidentLocationTypeMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available1135Home/Residence1140Farm1145Mine or Quarry1150Industrial Place and Premises1155Place of Recreation or Sport1160Street or Highway1165Public Building (schools, gov. offices)1170Trade or service (business, bars, restaurants, etc)1175Health Care Facility (clinic, hospital, nursing home)1180Residential Institution (Nursing Home, jail/prison)1185Lake, River, Ocean1190Other LocationAdditional Information●Based on ICD-9Uses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the Incident Location and Type●Allows data to describe the Incident Location and the distribution of EMS eventsData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 05Location TypeReferences to Other Databases● UTSTEINTitle: Location of Arrest: Out of Hospital; Same as NHTSA E-CodesSectionE08Scene2372006 NHTSA Uniform PreHospital Dataset V.2.2.1INCIDENT FACILITY CODEE08_08Data [text]DefinitionThe state or regulatory number (code) associated with the facility if the Incident is a Healthcare Facility.XSD Data Typexs:stringXSD Domain (Simple Type)IncidentFacilityCodeMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Could be a editable list box Created from Hospitals Facility Number (D04_12) and Other Destination Facility Number (D04_14)Uses●Allows data to be sorted based on the Incident Location and Type●Allows data to describe the Incident Location and the distribution of EMS eventsData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE08_07Incident Location TypeSectionE08Scene2382006 NHTSA Uniform PreHospital Dataset V.2.2.1SCENE ZONE NUMBERE08_09Data [combo] single-choiceDefinitionGeographic zone representing the location of the sceneXSD Data Typexs:stringXSD Domain (Simple Type)ZoneNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint30Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Created from Zones (D04_03)Uses●Important for grouping or comparing data by Scene location which also allows data to be sorted by geographic response areas in many agencies●Provides information on overall response patterns and times for agency configuration and evaluationData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE08_07Incident Location TypeSectionE08Scene2392006 NHTSA Uniform PreHospital Dataset V.2.2.1SCENE GPS LOCATIONE08_10Data [text]DefinitionThe GPS coordinates associated with the Scene.XSD Data Typexs:decimalXSD Domain (Simple Type)GPSLocationMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoXSD Attributes: Latitude and Longitude are each stored as a separate attributeField ValuesUses●Important for grouping or comparing data by Scene location which also allows data to be sorted by geographic response areas in many agencies●Provides information on overall response patterns and times for agency configuration and evaluationData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE01_01Patient Care Report NumberE08_07Incident Location TypeSectionE08Scene2402006 NHTSA Uniform PreHospital Dataset V.2.2.1INCIDENT ADDRESSE08_11Data [text]DefinitionThe street address (or best approximation) where the patient was found, or, if no patient, the address to which the unit responded.XSD Data Typexs:stringXSD Domain (Simple Type)StreetAddressMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: E08_11, E08_12, E08_14, E08_15 are all members of E08_11_0 Incident Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●A component of the EMS Medical Record: Patient Care Report●Important for grouping or comparing data by Scene location which also allows data to be sorted by geographic response areas in many agencies●Provides information on overall response patterns and times for agency configuration and evaluationData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE08_07Incident Location TypeE08_12Incident CityE08_14Incident StateE08_15Incident ZIP CodeReferences in NHTSA Version 1EssentialElement 01Incident AddressSectionE08Scene2412006 NHTSA Uniform PreHospital Dataset V.2.2.1INCIDENT CITYE08_12Data [combo] single-choiceDefinitionThe city or township (if applicable) where the patient was found or to which the unit responded (or best approximation)XSD Data Typexs:stringXSD Domain (Simple Type)CityMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: E08_11, E08_12, E08_14, E08_15 are all members of E08_11_0 Incident Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available Additional Information●5 digit FIPS Code●Could be filled in from Incident Zip Code entry (E08_15)Uses●A component of the EMS Medical Record: Patient Care Report●Important for grouping or comparing data by Scene location which also allows data to be sorted by geographic response areas in many agencies●Provides information on overall response patterns and times for agency configuration and evaluationData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE08_07Incident Location TypeE08_11Incident AddressE08_14Incident StateE08_15Incident ZIP CodeReferences in NHTSA Version 1EssentialElement 02Incident CitySectionE08Scene2422006 NHTSA Uniform PreHospital Dataset V.2.2.1INCIDENT COUNTYE08_13Data [combo] single-choiceDefinitionThe county or parish where the patient was found or to which the unit responded (or best approximation)XSD Data Typexs:stringXSD Domain (Simple Type)CountyMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint5Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Could be filled in from Incident Zip Code entry (E08_15)●Stored as a 5 digit FIPS code (combining the state and county code) to take into account agencies may serve more than one state and counties are often named the same from state to state●Stored as a FIPS codeUses●A component of the EMS Medical Record: Patient Care Report●Important for grouping or comparing data by Scene location which also allows data to be sorted by geographic response areas in many agencies●Provides information on overall response patterns and times for agency configuration and evaluationData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE08_07Incident Location TypeReferences in NHTSA Version 1EssentialElement 03Incident CountySectionE08Scene2432006 NHTSA Uniform PreHospital Dataset V.2.2.1INCIDENT STATEE08_14Data [combo] single-choiceDefinitionThe state, territory, or province where the patient was found or to which the unit responded (or best approximation)XSD Data Typexs:stringXSD Domain (Simple Type)StateMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint3XSD Structure: E08_11, E08_12, E08_14, E08_15 are all members of E08_11_0 Incident Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●2 digit FIPS numeric code (Not State abbreviation)●Could be filled in from Incident Zip Code entry (E08_15)Uses●A component of the EMS Medical Record: Patient Care Report●Important for grouping or comparing data by Scene location which also allows data to be sorted by geographic response areas in many agencies●Provides information on overall response patterns and times for agency configuration and evaluationData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE08_07Incident Location TypeE08_11Incident AddressE08_12Incident CityE08_15Incident ZIP CodeReferences in NHTSA Version 1EssentialElement 04Incident StateReferences to Other Databases● NFIRS 5.0Basic Module 1; Title: State; 2 digit FIPS; Text Field Size = 2SectionE08Scene2442006 NHTSA Uniform PreHospital Dataset V.2.2.1INCIDENT ZIP CODEE08_15Data [text]National ElementDefinitionThe ZIP code of the incident locationXSD Data Typexs:stringXSD Domain (Simple Type)ZipMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesXSD Structure: E08_11, E08_12, E08_14, E08_15 are all members of E08_11_0 Incident Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the geographic location of the EMS Incident●Allows data to describe geographic location of the EMS IncidentData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE08_07Incident Location TypeE08_11Incident AddressE08_12Incident CityE08_14Incident StateSectionE08Scene2452006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE09SituationSectionE09Situation2462006 NHTSA Uniform PreHospital Dataset V.2.2.1PRIOR AIDE09_01Data [combo] multiple-choiceNational ElementDefinitionAny care which was provided to the patient prior to the arrival of this unit.XSD Data Typexs:stringXSD Domain (Simple Type)PriorAidMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDYesMinimum Constraint2Maximum Constraint30Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●List created from Procedures (D04_04) and Medications (D04_06)Uses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the specific prior aid received or not received by the patient●Allows data to describe aid which was provided prior to EMS arrival●Used as a Quality Management tool to evaluate Bystander and First Responder involvementData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1DesirableElement 58Time of First CPRReferences to Other Databases● NFIRS 5.0EMS Module; Title: Cardiac Arrest; Pick-List: Pre-Arrival Arrest = 1, Post-Arrival Arrest = 2;● NFIRS 5.0EMS Module; Title: Pre-Arrival Details; Pick-List: Witnessed = 1, Bystander CPR = 2● UTSTEINTitle: CPR Before EMS and Rhythm Analysis or Defibrillation before EMS; [combo] Yes = Y, No = No, U = UnknownSectionE09Situation2472006 NHTSA Uniform PreHospital Dataset V.2.2.1PRIOR AID PERFORMED BYE09_02Data [combo] multiple-choiceNational ElementDefinitionThe type of individual who performed the care prior to the arrival of this unit.XSD Data Typexs:integerXSD Domain (Simple Type)PriorAidPerformedByMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available1195EMS Provider1200Law Enforcement1205Lay Person1210Other Healthcare Provider1215PatientUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on who provided specific prior aid●Allows data to describe who performed any aid which was provide prior to EMS arrival to the patient●Used as a Quality Management tool to evaluate Bystander and First Responder involvementData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE09Situation2482006 NHTSA Uniform PreHospital Dataset V.2.2.1OUTCOME OF THE PRIOR AIDE09_03Data [combo] single-choiceNational ElementDefinitionWhat was the outcome or result of the care performed prior to the arrival of the unit?XSD Data Typexs:integerXSD Domain (Simple Type)OutcomeOfPriorAidMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available1220Improved1225Unchanged1230WorseUses●Allows data to be sorted based on the perceived outcome which resulted from specific prior aid received by the patient●Allows data to describe aid which was provided prior to EMS arrival●Used as a Quality Management tool to evaluate Bystander and First Responder involvementData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE09Situation2492006 NHTSA Uniform PreHospital Dataset V.2.2.1POSSIBLE INJURYE09_04Data [combo] single-choiceNational ElementDefinitionIndicates that the reason for the EMS encounter was related to an injury or traumatic event. This data element provides documentation to classify the EMS Reason for Encounter as either injury or non-injury related based on mechanism and not on actual injuryXSD Data Typexs:integerXSD Domain (Simple Type)YesNoValuesMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available0No1YesAdditional Information●Can be used to determine which records should have Section E10: Situation/ Trauma completed. If Injury Present (E09_04) is “Yes”, Section E10 should be completed●Possible Injury (E09_04), Chief Complaint Anatomic Location (E09_11), Chief Complaint Organ System (E09_12), and Primary Symptom (E09_13) are required to calculate the Reason for EncounterUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on trauma vs. non-traumatic events●Allows data to describe trauma within the EMS patient population●Allows for the calculation of the "EMS Reason for Encounter" used to further describe the EMS patient populationData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE09Situation2502006 NHTSA Uniform PreHospital Dataset V.2.2.1CHIEF COMPLAINTE09_05Data [text]DefinitionThe statement of the problem by the patient or the history provider in one or two wordsXSD Data Typexs:stringXSD Domain (Simple Type)ChiefComplaintNarrativeMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint50Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available Uses●Allows data to be sorted based on the use of EMS Chief Complaint●Allows data to describe EMS services delivered based on the EMS patient's chief complaint●Important for an EMS Medical RecordData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1DesirableElement 48Chief ComplaintSectionE09Situation2512006 NHTSA Uniform PreHospital Dataset V.2.2.1DURATION OF CHIEF COMPLAINTE09_06Data [number]DefinitionThe time duration of the chief complaintXSD Data Typexs:integerXSD Domain (Simple Type)DurationOfChiefComplaintMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoMinimum Constraint1Maximum Constraint360XSD Structure: E09_06 and E09_07 are members of E09_06_0 Duration of Chief Complaint StructureField Values Uses●Important for an EMS Medical Record●Important to evaluate clinical conditions which are time dependant such as MI or Stroke to determine appropriate EMS careData Collector●EMS personnelOther Associated ElementsE01_01Patient Care Report NumberE09_05Chief ComplaintE09_07Time Units of Duration of Chief ComplaintSectionE09Situation2522006 NHTSA Uniform PreHospital Dataset V.2.2.1TIME UNITS OF DURATION OF CHIEF COMPLAINTE09_07Data [combo] single-choiceDefinitionThe time units of the duration of the patient's chief complaintXSD Data Typexs:integerXSD Domain (Simple Type)TimeUnitsOfChiefComplaintMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoXSD Structure: E09_06 and E09_07 are members of E09_06_0 Duration of Chief Complaint StructureField Values1235Seconds1240Minutes1245Hours1250Days1255Weeks1260Months1265Years Uses●Important for an EMS Medical Record●Important to evaluate clinical conditions which are time dependant such as MI or Stroke to determine appropriate EMS careData Collector●EMS personnelOther Associated ElementsE01_01Patient Care Report NumberE09_05Chief ComplaintE09_06Duration of Chief ComplaintSectionE09Situation2532006 NHTSA Uniform PreHospital Dataset V.2.2.1SECONDARY COMPLAINT NARRATIVEE09_08Data [text]DefinitionThe narrative of the patient's secondary complaintXSD Data Typexs:stringXSD Domain (Simple Type)SecondaryComplaintNarrativeMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint50Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available Uses●Allows data to be sorted based on the use of EMS Chief Complaint●Allows data to describe EMS services delivered based on the patient's chief complaint●Important for an EMS Medical RecordData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1DesirableElement 48Chief ComplaintSectionE09Situation2542006 NHTSA Uniform PreHospital Dataset V.2.2.1DURATION OF SECONDARY COMPLAINTE09_09Data [number]DefinitionThe duration of the secondary complaintXSD Data Typexs:integerXSD Domain (Simple Type)DurationOfSecondaryComplaintMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoMinimum Constraint1Maximum Constraint360XSD Structure: E09_09 and E09_10 are members of E09_09_0 Duration of Secondary Complaint StructureField ValuesUses●Important for an EMS Medical Record●Important to evaluate clinical conditions which are time dependant such as MI or Stroke to determine appropriate EMS careData Collector●EMS personnelOther Associated ElementsE01_01Patient Care Report NumberE09_08Secondary Complaint NarrativeE09_10Time Units of Duration of Secondary ComplaintSectionE09Situation2552006 NHTSA Uniform PreHospital Dataset V.2.2.1TIME UNITS OF DURATION OF SECONDARY COMPLAINTE09_10Data [combo] single-choiceDefinitionThe time units of the duration of the patient's secondary complaintXSD Data Typexs:integerXSD Domain (Simple Type)TimeUnitsOfSecondaryComplaintMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoXSD Structure: E09_09 and E09_10 are members of E09_09_0 Duration of Secondary Complaint StructureField Values1270Seconds1275Minutes1280Hours1285Days1290Weeks1295Months1300YearsUses●Important for an EMS Medical Record●Important to evaluate clinical conditions which are time dependant such as MI or Stroke to determine appropriate EMS careData Collector●EMS personnelOther Associated ElementsE01_01Patient Care Report NumberE09_08Secondary Complaint NarrativeE09_09Duration of Secondary ComplaintSectionE09Situation2562006 NHTSA Uniform PreHospital Dataset V.2.2.1CHIEF COMPLAINT ANATOMIC LOCATIONE09_11Data [combo] single-choiceNational ElementDefinitionThe primary anatomic location of the chief complaint as identified by EMS personnelXSD Data Typexs:integerXSD Domain (Simple Type)ComplaintAnatomicLocationMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available1305Abdomen1310Back1315Chest1320Extremity-Lower1325Extremity-Upper1330General/Global1335Genitalia1340Head1345NeckAdditional Information●Possible Injury (E09_04), Chief Complaint Anatomic Location (E09_11), Chief Complaint Organ System (E09_12), and Primary Symptom (E09_13) are required to calculate the Reason for EncounterUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the patient's complaint location●Allows data to describe the patient's complaint location●Allows for the calculation of the "EMS Reason for Encounter" used to further describe the EMS patient populationData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE09Situation2572006 NHTSA Uniform PreHospital Dataset V.2.2.1CHIEF COMPLAINT ORGAN SYSTEME09_12Data [combo] single-choiceNational ElementDefinitionThe primary organ system of the patient injured or medically affected. This is to be completed by EMS personnel with a minimum of an EMT-Paramedic level of credentialing.XSD Data Typexs:integerXSD Domain (Simple Type)ComplaintOrganSystemMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available1350Cardiovascular1355CNS/Neuro1360Endocrine/Metabolic1365GI1370Global1375Musculoskeletal1380OB/Gyn1385Psych1390Pulmonary1395Renal1400SkinAdditional Information●Possible Injury (E09_04), Chief Complaint Anatomic Location (E09_11), Chief Complaint Organ System (E09_12), and Primary Symptom (E09_13) are required to calculate the Reason for Encounter●This data element is to be completed by EMS personnel at the EMT-Paramedic level or higherUses●A component of the EMS Medical Record: Patient Care Report●Allows for the calculation of the "EMS Reason for Encounter" used to further describe the EMS patient populationData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE09Situation2582006 NHTSA Uniform PreHospital Dataset V.2.2.1PRIMARY SYMPTOME09_13Data [combo] single-choiceNational ElementDefinitionThe primary sign and symptom present in the patient or observed by EMS personnelXSD Data Typexs:integerXSD Domain (Simple Type)PrimarySymptomMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available1405Bleeding1410Breathing Problem1415Change in responsiveness1420Choking1425Death1430Device/Equipment Problem1435Diarrhea1440Drainage/Discharge1445Fever1450Malaise1455Mass/Lesion1460Mental/Psych1465Nausea/Vomiting1470None1475Pain1480Palpitations1485Rash/Itching1490Swelling1495Transport Only1500Weakness1505WoundAdditional Information●Possible Injury (E09_04), Chief Complaint Anatomic Location (E09_11), Chief Complaint Organ System (E09_12), and Primary Symptom (E09_13) are required to calculate the Reason for EncounterUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the patient's primary symptom●Allows data to describe the patient's primary symptom●Allows for the calculation of the "EMS Reason for Encounter" used to further describe the EMS patient populationData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 52Signs and Symptoms PresentSectionE09Situation2592006 NHTSA Uniform PreHospital Dataset V.2.2.1OTHER ASSOCIATED SYMPTOMSE09_14Data [combo] multiple-choiceNational ElementDefinitionOther symptoms identified by the patient or observed by EMS personnelXSD Data Typexs:integerXSD Domain (Simple Type)OtherAssociatedSymptomsMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available1510Bleeding1515Breathing Problem1520Change in responsiveness1525Choking1530Death1535Device/Equipment Problem1540Diarrhea1545Drainage/Discharge1550Fever1555Malaise1560Mass/Lesion1565Mental/Psych1570Nausea/Vomiting1575None1580Pain1585Palpitations1590Rash/Itching1595Swelling1600Transport Only1605Weakness1610WoundAdditional Information●This data element is used for Bioterrorism Syndromic SurveillanceUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the patient's primary symptom●Allows data to describe the patient's associated symptoms●Allows for potential bio-terrorism surveillance based on the symptomatic presentation of the EMS Patient combined with other data pointsData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 52Signs and Symptoms PresentSectionE09Situation2602006 NHTSA Uniform PreHospital Dataset V.2.2.1PROVIDERS PRIMARY IMPRESSIONE09_15Data [combo] single-choiceNational ElementDefinitionThe EMS personnel’s impression of the patient’s primary problem or most significant condition which led to the management given to the patient (treatments, medications, or procedures).XSD Data Typexs:integerXSD Domain (Simple Type)ProvidersPrimaryImpressionMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available1615789.00- Abdominal pain / problems1620519.80- Airway obstruction1625995.30- Allergic reaction1630780.09- Altered level of consciousness1635312.90- Behavioral / psychiatric disorder1640427.50- Cardiac arrest1645427.90- Cardiac rhythm disturbance1650786.50- Chest pain / discomfort1655250.90- Diabetic symptoms (hypoglycemia)1660994.80- Electrocution1665780.60- Hyperthermia1670780.90- Hypothermia1675785.59- Hypovolemia / shock1680987.90- Inhalation injury (toxic gas)1685798.99- Obvious death1690977.90- Poisoning / drug ingestion1695659.90- Pregnancy / OB delivery1700786.09- Respiratory distress1705799.10- Respiratory arrest1710780.30- Seizure1715959.90- Sexual assault / rape1720987.90- Smoke inhalation1725989.50- Stings / venomous bites1730436.00- Stroke / CVA1735780.20- Syncope / fainting1740959.90- Traumatic injury1745623.80- Vaginal hemorrhageAdditional Information●ICD-9 Codes were retained over ICD-10 due to CMS’s continued use of ICD-9 in the EMS Condition CodesUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the EMS personnel's clinical impression●Allows data to describe the EMS patient population based on EMS personnel impression of the EMS patient's problemData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 50Providers ImpressionReferences to Other Databases● NFIRS 5.0EMS Module; Title: Provider Impression/Assessment; The emergency providers single most important impression/assessment which drove the choice of treatment; [combo] Abdominal Pain = 10, Airway Obstruction = 11, Allergic Reaction, excludes stings & venomous bites = 12, Altered Level of Consciousness = 13, Behavioral-Mental Status, Psychiatric Disorder = 14, Burns = 15, Cardiac Arrest = 16, Cardiac Dysrhythmia = 17, Chest Paid = 18, Diabetic Symptom = 19, Do Not Resuscitate = 20, Electrocution = 21, General Illness = 2, Hemorrhaging/Bleeding = 23, Hyperthermia = 24, Hypothermia = 25, Hypovolemia = 26, Inhalation Injury, Toxic Gases = 27, Obvious Death = 28, Overdose/Poisoning = 29, Pregnancy/OB = 30, Respiratory Arrest = 31, Respiratory Distress = 32, Seizure = 33, Sexual Assault = 34, Sting/Bite = 35, Stroke/CVA = 36, Syncope, Fainting = 37, Trauma = 38, Other Impression/Assessment = 00, None/No patient or refused Treatment = NNSectionE09Situation2612006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE09Situation2622006 NHTSA Uniform PreHospital Dataset V.2.2.1PROVIDER’S SECONDARY IMPRESSIONE09_16Data [combo] single-choiceNational ElementDefinitionThe EMS personnel’s impression of the patient’s secondary problem or which led to the management given to the patient (treatments, medications, or procedures).XSD Data Typexs:integerXSD Domain (Simple Type)ProvidersSecondaryImpressionMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available1750789.00- Abdominal pain / problems1755519.80- Airway obstruction1760995.30- Allergic reaction1765780.09- Altered level of consciousness1770312.90- Behavioral / psychiatric disorder1775427.50- Cardiac arrest1780427.90- Cardiac rhythm disturbance1785786.50- Chest pain / discomfort1790250.90- Diabetic symptoms (hypoglycemia)1795994.80- Electrocution1800780.60- Hyperthermia1805780.90- Hypothermia1810785.59- Hypovolemia / shock1815987.90- Inhalation injury (toxic gas)1820798.99- Obvious death1825977.90- Poisoning / drug ingestion1830659.90- Pregnancy / OB delivery1835786.09- Respiratory distress1840799.10- Respiratory arrest1845780.30- Seizure1850959.90- Sexual assault / rape1855987.90- Smoke inhalation1860989.50- Stings / venomous bites1865436.00- Stroke / CVA1870780.20- Syncope / fainting1875959.90- Traumatic injury1880623.80- Vaginal hemorrhageUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the EMS personnel's clinical impression●Allows data to describe the EMS patient population based on EMS personnel impression of the EMS patient's problemData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 50Providers ImpressionSectionE09Situation2632006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE10Situation/ TraumaSectionE10Situation/ Trauma2642006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE10Situation/ Trauma2652006 NHTSA Uniform PreHospital Dataset V.2.2.1CAUSE OF INJURYE10_01Data [combo] single-choiceNational ElementDefinitionThe category of the reported/suspected external cause of the injuryXSD Data Typexs:integerXSD Domain (Simple Type)CauseOfInjuryMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available1885Bites (E906.0)9500Aircraft related accident (E84X.0)9505Bicycle Accident (E826.0)9515Chemical poisoning (E86X.0)9520Child battering (E967.0)9525Drowning (E910.0)9530Drug poisoning (E85X.0)9535Electrocution (non-lightning) (E925.0)9540Excessive Cold (E901.0)9545Excessive Heat (E900.0)9550Falls (E88X.0)9555Fire and Flames (E89X.0)9560Firearm assault (E965.0)9565Firearm injury (accidental) (E985.0)9570Firearm self inflicted (E955.0)9575Lightning (E907.0)9580Machinery accidents (E919.0)9585Mechanical Suffocation (E913.0)9590Motor Vehicle non-traffic accident (E82X.0)9595Motor Vehicle traffic accident (E81X.0)9600Motorcycle Accident (E81X.1)9605Non-Motorized Vehicle Accident (E848.0)9610Pedestrian traffic accident (E814.0)9615Radiation exposure (E926.0)9620Rape (E960.1)9625Smoke Inhalation (E89X.2)9630Stabbing/Cutting Accidental (E986.0)9635Stabbing/Cutting Assault (E966.0)9640Struck by Blunt/Thrown Object (E968.2)9645Venomous stings (plants, animals) (E905.0)9650Water Transport accident (E83X.0)Additional Information●Complete only if Possible Injury (E09_04) is “Yes”●ICD-9 Codes were retained over ICD-10 due to CMS’s continued use of ICD-9 in the EMS Condition CodesUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the traumatic cause of injury●Allows data to describe the cause of a traumatic eventData Collector●EMS personnel if Possible Injury (E09_04) is answered YesOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 49Cause of InjuryReferences to Other Databases● NFIRS 5.0EMS Module; Title: Cause of Illness/Injury; The immediate cause or condition responsible for the injury or illness; Pick-List: Chemical Exposure = 10, Drug Poisoning = 11, Fall = 12, Aircraft Related = 13, Bite, Includes Animal Bites = 14, Bicycle Accident = 15, Building Collapse/Construction Accident = 16, Downing = 17, Electrical Shock = 18, Cold = 19, Heat = 20, E explosives - 21, Fire and Flames - 22. Firearm = 23, Fireworks = 25, Lightning = 26, Machinery = 27, Mechanical Suffocation = 28, Motor Vehicle Accident = 29, Motor Vehicle Accident, Pedestrian = 30, Non-Traffic Vehicle (off road) Accident = 31, Physical Assault/Abuse = 32, Scalds/Other Thermal = 33, Smoke Inhalation = 34, Stabbing SectionE10Situation/ Trauma2662006 NHTSA Uniform PreHospital Dataset V.2.2.1Assault = 35, Venomous Sting = 36, Water Transport = 37, Other Cause of Injury/Illness = 00, Unknown Cause of Injury/Illness = UUSectionE10Situation/ Trauma2672006 NHTSA Uniform PreHospital Dataset V.2.2.1INTENT OF THE INJURYE10_02Data [combo] single-choiceDefinitionThe intent of the individual inflicting the injuryXSD Data Typexs:integerXSD Domain (Simple Type)IntentOfInjuryMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2020Intentional, Other (Assaulted)2025Intentional, Self2030UnintentionalAdditional Information●Complete only if Possible Injury (E09_04) is “Yes”Uses●Important component of an EMS Medical Record: documentation of Intentional, Self●Used to better define injury cause and describe injury patterns within and EMS communityData Collector●EMS personnel if Possible Injury (E09_04) is answered YesOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1DesirableElement 54Injury IntentReferences to Other Databases● NFIRS 5.0EMS Module; Title: Other Factors; Describes the other factors that contributed to the patient’s injury. Not to be completed with an illness.; Pick-List: Accidental = 1, Self-Inflicted = 2, Inflicted, Not Self. Included are attacks by animals and persons = 3, None or No Other Factors = NSectionE10Situation/ Trauma2682006 NHTSA Uniform PreHospital Dataset V.2.2.1MECHANISM OF INJURYE10_03Data [combo] multiple-choiceDefinitionThe mechanism of the event which caused the injury.XSD Data Typexs:integerXSD Domain (Simple Type)MechanismOfInjuryMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2035Blunt2040Burn2045Other2050PenetratingAdditional Information●Complete only if Possible Injury (E09_04) is “Yes”Uses●A component of the EMS Medical Record: Patient Care Report●Important component of an EMS Medical Record to identify issues of clinical care and agency performance and delivery●Used to better define injury cause and describe injury patterns within and EMS communityData Collector●EMS personnel if Possible Injury (E09_04) is answered YesOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE10Situation/ Trauma2692006 NHTSA Uniform PreHospital Dataset V.2.2.1VEHICULAR INJURY INDICATORSE10_04Data [combo] multiple-choiceDefinitionThe kind of risk factor predictors associated with the vehicle involved in the incidentXSD Data Typexs:integerXSD Domain (Simple Type)VehicularInjuryIndicatorsMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2055Dash Deformity2060DOA Same Vehicle2065Ejection2070Fire2075Rollover/Roof Deformity2080Side Post Deformity2085Space Intrusion >1 foot2090Steering Wheel Deformity2095Windshield Spider/StarAdditional Information●Complete only if Possible Injury (E09_04) is “Yes”Uses●A component of the EMS Medical Record: Patient Care Report●Used to better define injury cause and describe injury patterns within and EMS communityData Collector●EMS personnel if Possible Injury (E09_04) is answered Yes and there is a vehicle involvedOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE10Situation/ Trauma2702006 NHTSA Uniform PreHospital Dataset V.2.2.1AREA OF THE VEHICLE IMPACTED BY THE COLLISIONE10_05Data [combo] multiple-choiceDefinitionThe area or location of impact on the vehicleXSD Data Typexs:integerXSD Domain (Simple Type)AreaOfVehicleImpactMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2100Center Front2105Center Rear2110Left Front2115Left Rear2120Left Side2125Right Front2130Right Rear2135Right Side2140Roll OverAdditional Information●Complete only if Possible Injury (E09_04) is “Yes”Uses●A component of the EMS Medical Record: Patient Care Report●Used to better define injury cause and describe injury patterns within and EMS communityData Collector●EMS personnel if Possible Injury (E09_04) is answered Yes and there is a vehicle involvedOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE10Situation/ Trauma2712006 NHTSA Uniform PreHospital Dataset V.2.2.1SEAT ROW LOCATION OF PATIENT IN VEHICLEE10_06Data [text]DefinitionThe seat row location of the patient in vehicle at the time of the crash with the front seat numbered as 1.XSD Data Typexs:integerXSD Domain (Simple Type)SeatRowLocationMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoMinimum Constraint1Maximum Constraint50XSD Structure: E10_06 and E10_07 are members of E10_06_0 Position of Patient StructureField Values● If a value of 50 is passed, the location is designated "Cargo Area"Additional Information●Complete only if Possible Injury (E09_04) is “Yes”●Could be configured as a single choice combo box●Numbered to take into account large vehicles such as buses or vans (1 = Front) or (Cargo Area = 50)Uses●A component of the EMS Medical Record: Patient Care Report●Important component of an EMS Medical Record to identify issues of clinical care and agency performance and delivery●Used to better define injury cause and describe injury patterns within and EMS communityData Collector●EMS personnel if Possible Injury (E09_04) is answered Yes and there is a vehicle involvedOther Associated ElementsE01_01Patient Care Report NumberE10_07Position of Patient in the Seat of the VehicleSectionE10Situation/ Trauma2722006 NHTSA Uniform PreHospital Dataset V.2.2.1POSITION OF PATIENT IN THE SEAT OF THE VEHICLEE10_07Data [combo] single-choiceDefinitionThe position of the patient in seat of the vehicle at the time of the crashXSD Data Typexs:integerXSD Domain (Simple Type)PositionOfPatientInSeatMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoXSD Structure: E10_06 and E10_07 are members of E10_06_0 Position of Patient StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2145Driver2150Left (non-driver)2155Middle2160Other2165RightAdditional Information●Complete only if Possible Injury (E09_04) is “Yes”Uses●A component of the EMS Medical Record: Patient Care Report●Important component of an EMS Medical Record to identify issues of clinical care and agency performance and delivery●Used to better define injury cause and describe injury patterns within and EMS communityData Collector●EMS personnel if Possible Injury (E09_04) is answered Yes and there is a vehicle involvedOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE10_06Seat Row Location of Patient in VehicleSectionE10Situation/ Trauma2732006 NHTSA Uniform PreHospital Dataset V.2.2.1USE OF OCCUPANT SAFETY EQUIPMENTE10_08Data [combo] multiple-choiceDefinitionSafety equipment in use by the patient at the time of the injuryXSD Data Typexs:integerXSD Domain (Simple Type)UseOfOccupantSafetyEquipmentMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2170Child Restraint2175Eye Protection2180Helmet Worn2185Lap Belt2187None2190Other2195Personal Floatation Device2200Protective Clothing2205Protective Non-Clothing Gear2210Shoulder BeltAdditional Information●Complete only if Possible Injury (E09_04) is “Yes”Uses●A component of the EMS Medical Record: Patient Care Report●Important component of an EMS Medical Record to identify issues of clinical care and agency performance and delivery●Used to better define injury cause and describe injury patterns within and EMS communityData Collector●EMS personnel if Possible Injury (E09_04) is answered Yes and there is a vehicle involvedOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 55Safety EquipmentReferences to Other Databases● NFIRS 5.0EMS Module; Title: Safety Equipment; Multiple Select Pick-List: Safety, Seat Belts =1, Child Safety Seat = 2, Airbag = 3, Helmet = 4, Protective Clothing = 5, Flotation Device = 6, None or No Safety Equipment = N, Other Safety Equipment Used = O, Undetermined Safety Equipment = USectionE10Situation/ Trauma2742006 NHTSA Uniform PreHospital Dataset V.2.2.1AIRBAG DEPLOYMENTE10_09Data [combo] multiple-choiceDefinitionIndication of Airbag deployment during the motor vehicle crash.XSD Data Typexs:integerXSD Domain (Simple Type)AirbagDeploymentMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2215No Airbag Present2220No Airbag Deployed2225Airbag Deployed Front2230Airbag Deployed Side2235Airbag Deployed Other (knee, airbelt, etc.)Additional Information●Complete only if Possible Injury (E09_04) is “Yes”Uses●A component of the EMS Medical Record: Patient Care Report●Important component of an EMS Medical Record to identify issues of clinical care and agency performance and delivery●Used to better define injury cause and describe injury patterns within and EMS communityData Collector●EMS personnel if Possible Injury (E09_04) is answered Yes and there is a vehicle involvedOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 55Safety EquipmentReferences to Other Databases● NFIRS 5.0EMS Module; Title: Safety Equipment; Multiple Select Pick-List: Safety, Seat Belts =1, Child Safety Seat = 2, Airbag = 3, Helmet = 4, Protective Clothing = 5, Flotation Device = 6, None or No Safety Equipment = N, Other Safety Equipment Used = O, Undetermined Safety Equipment = USectionE10Situation/ Trauma2752006 NHTSA Uniform PreHospital Dataset V.2.2.1HEIGHT OF FALLE10_10Data [number]DefinitionThe distance in feet the patient fell, measured from the lowest point of the patient to the ground.XSD Data Typexs:integerXSD Domain (Simple Type)HeightOfFallMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoMinimum Constraint1Maximum Constraint50,000Field ValuesAdditional Information●Complete only if Possible Injury (E09_04) is “Yes”Uses●A component of the EMS Medical Record: Patient Care Report●Important component of an EMS Medical Record to identify issues of clinical care and agency performance and delivery●Used to better define injury cause and describe injury patterns within and EMS communityData Collector●EMS personnel if Possible Injury (E09_04) is answered YesOther Associated ElementsE01_01Patient Care Report NumberSectionE10Situation/ Trauma2762006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE11Situation/ CPRSectionE11Situation/ CPR2772006 NHTSA Uniform PreHospital Dataset V.2.2.1CARDIAC ARRESTE11_01Data [combo] single-choiceNational ElementDefinitionIndication of the presence of a cardiac arrest at any time associated with the EMS evert.XSD Data Typexs:integerXSD Domain (Simple Type)CardiacArrestMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available0No2240Yes, Prior to EMS Arrival2245Yes, After EMS ArrivalAdditional Information●If answered YES, all other data points in the Situation/CPR should be addressedUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the occurrence of a cardiac arrest●Allows data to describe the number of cardiac arrests within the EMS patient populationData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences to Other Databases● NFIRS 5.0EMS Module; Title: Cardiac Arrest; Pick-List: Pre-Arrival Arrest = 1, Post-Arrival Arrest = 2● UTSTEINTitle: Confirmed Cardiac Arrests Considered for ResuscitationSectionE11Situation/ CPR2782006 NHTSA Uniform PreHospital Dataset V.2.2.1CARDIAC ARREST ETIOLOGYE11_02Data [combo] single-choiceNational ElementDefinitionIndication of the etiology or cause of the cardiac arrest (classified as cardiac, non-cardiac, etc.)XSD Data Typexs:integerXSD Domain (Simple Type)CardiacArrestEtiologyMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2250Presumed Cardiac2255Trauma2260Drowning2265Respiratory2270Electrocution2275OtherAdditional Information●Complete only if Cardiac Arrest (E11_01) is “Yes”Uses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the occurrence of a cardiac arrest●Allows data to describe the number of cardiac arrests within the EMS patient populationData Collector●EMS personnel if Cardiac Arrest (E11_01) is answered YesOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences to Other Databases● UTSTEINTitle: Cardiac Etiology; Presumed Cardiac = C, Trauma = T, Drowning = D, Respiratory = R, Other = O, Unknown = USectionE11Situation/ CPR2792006 NHTSA Uniform PreHospital Dataset V.2.2.1RESUSCITATION ATTEMPTEDE11_03Data [combo] multiple-choiceNational ElementDefinitionIndication of an attempt to resuscitate the patient who is in cardiac arrest (attempted, not attempted due to DNR, etc.)XSD Data Typexs:integerXSD Domain (Simple Type)ResucitationAttemptedMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2280Attempted Defibrillation2285Attempted Ventilation2290Initiated Chest Compressions2295Not Attempted-Considered Futile2300Not Attempted-DNR Orders2305Not Attempted-Signs of CirculationAdditional Information●Complete only if Cardiac Arrest (E11_01) is “Yes”Uses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the type of resuscitation initiated during a cardiac arrest●Allows data to describe the number of cardiac arrests within the EMS patient population which resulted in resuscitative effortsData Collector●EMS personnel if Cardiac Arrest (E11_01) is answered YesOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences to Other Databases● UTSTEINTitle: Resuscitations Attempted; Attempted Defibrillation = D, Attempted Chest Compressions = C, Attempted Ventilation = V, Not Attempted-DNR Orders = R, Not Attempted-Considered Futile = F, Not Attempted-Signs of Circulation = A, Unknown = U, Not RecordSectionE11Situation/ CPR2802006 NHTSA Uniform PreHospital Dataset V.2.2.1ARREST WITNESSED BYE11_04Data [combo] single-choiceDefinitionIndication of who the cardiac arrest was witnessed byXSD Data Typexs:integerXSD Domain (Simple Type)ArrestWitnessedByMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2310Witnessed by Healthcare Provider2315Witnessed by Lay Person2320Not WitnessedAdditional Information●Complete only if Cardiac Arrest (E11_01) is “Yes”Uses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the Witnessed or Un-Witnessed Arrest which is a known key element associated with Cardiac Arrest Outcome●Allows data to describe aid which was provided prior to EMS arrival●Used as a Quality Management tool to evaluate Bystander and First Responder involvementData Collector●EMS personnel if Cardiac Arrest (E11_01) is answered YesOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1DesirableElement 62Witness of Cardiac ArrestReferences to Other Databases● NFIRS 5.0EMS Module; Title: Pre-Arrival Details; Pick-List: Witnessed = 1, Bystander CPR = 2● UTSTEINTitle: Arrest Witnessed/Monitored; [combo] Lay Person = L, Healthcare Provider = HSectionE11Situation/ CPR2812006 NHTSA Uniform PreHospital Dataset V.2.2.1FIRST MONITORED RHYTHM OF THE PATIENTE11_05Data [combo] single-choiceDefinitionDocumentation of what the first monitored rhythm which was notedXSD Data Typexs:integerXSD Domain (Simple Type)FirstMonitoredRhythmMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2325Asystole2330Bradycardia2335Normal Sinus Rhythm2340Other2345PEA2350Unknown AED Non-Shockable Rhythm2355Unknown AED Shockable Rhythm2360Ventricular Fibrillation2365Ventricular TachycardiaAdditional Information●Complete only if Cardiac Arrest (E11_01) is “Yes”Uses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the First Monitored Rhythm of a cardiac arrest●Allows for evaluation of Cardiac Arrest data for Quality Improvement of patient care and agency responseData Collector●EMS personnel if Cardiac Arrest (E11_01) is answered YesOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences to Other Databases● NFIRS 5.0EMS Module; Title: Initial Arrest Rhythm; Pick-List: V-Fib//V-Tach = 1, Other = O, Undetermined = U● UTSTEINTitle: First Monitored Rhythm Shockable (in Cardiac Arrest) and First Monitored Rhythm Non-Shockable; [combo] Ventricular Fibrillation, Ventricular Tachycardia, Unknown AED Shockable Rhythm, Asystole, PEA, Bradycardia, Other, Unknown AED Non-Shockable RhSectionE11Situation/ CPR2822006 NHTSA Uniform PreHospital Dataset V.2.2.1ANY RETURN OF SPONTANEOUS CIRCULATIONE11_06Data [combo] single-choiceDefinitionIndication whether or not there was any return of spontaneous circulation at any time during the EMS evert.XSD Data Typexs:integerXSD Domain (Simple Type)ReturnOfSpontaneousCirculationMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2380No2370Yes, Prior to ED Arrival Only2375Yes, Prior to ED Arrival and at the EDAdditional Information●Complete only if Cardiac Arrest (E11_01) is “Yes”Uses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the Return of Spontaneous Circulation associated with a cardiac arrest●Allows for evaluation of Cardiac Arrest data for Quality Improvement of patient care and agency responseData Collector●EMS personnel if Cardiac Arrest (E11_01) is answered YesOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1DesirableElement 64Return of Spontaneous CirculationReferences to Other Databases● UTSTEINTitle: Any Return of Spontaneous Circulation (ROSC); [combo] Yes = Y, No = No, U = UnknownSectionE11Situation/ CPR2832006 NHTSA Uniform PreHospital Dataset V.2.2.1NEUROLOGICAL OUTCOME AT HOSPITAL DISCHARGE E11_07Data [combo] single-choiceDefinitionThe level of cerebral performance of the patient at the time of discharge from the Hospital:● 1 = Good Cerebral Performance: Conscious, Alert, able to work and lead a normal life ● 2 = Moderate Cerebral Disability: Conscious and able to function independently (dress, travel, prepare food) may have hemiplegia, seizures, or permanent memory or mental changes● 3 = Severe Cerebral Disability: Conscious, dependent on others for daily support, functions only in an institution or at home with exceptional family effort● 4 - Coma, vegetative stateXSD Data Typexs:integerXSD Domain (Simple Type)NeurologicalOutcomeAtDischargeMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2380CPC 1 or 22385CPC 3 or 4Additional Information●Complete only if Cardiac Arrest (E11_01) is “Yes”Uses●Allows for evaluation of Cardiac Arrest data for Quality Improvement of patient care and agency responseData Collector●EMS personnel if Cardiac Arrest (E11_01) is answered YesOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences to Other Databases● UTSTEINTitle: Neurological Outcome at Discharge; [combo] CPC 1 or 2, CPC 3 or 4, UnknownSectionE11Situation/ CPR2842006 NHTSA Uniform PreHospital Dataset V.2.2.1ESTIMATED TIME OF ARREST PRIOR TO EMS ARRIVALE11_08Data [combo] single-choiceDefinitionThe length of time the patient was down (estimated) before the responding unit arrived at the patientXSD Data Typexs:integerXSD Domain (Simple Type)EstimatedTimeOfArrestPriorToEMSMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2390>20 Minutes239515-20 Minutes240010-15 Minutes24058-10 Minutes24106-8 Minutes24154-6 Minutes24202-4 Minutes24250-2 MinutesAdditional Information●Complete only if Cardiac Arrest (E11_01) is “Yes”Uses●A component of the EMS Medical Record: Patient Care Report●Allows for evaluation of Cardiac Arrest data for Quality Improvement of patient care and agency responseData Collector●EMS personnel if Cardiac Arrest (E11_01) is answered YesOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE11Situation/ CPR2852006 NHTSA Uniform PreHospital Dataset V.2.2.1DATE/TIME RESUSCITATION DISCONTINUEDE11_09Data [date/time]DefinitionThe date/time the CPR was discontinued (or could be time of death)XSD Data Typexs:dateTimeXSD Domain (Simple Type)DateTimeMultiple Entry ConfigurationNoAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint1,990Maximum Constraint2,030Field ValuesAdditional Information●Complete only if Cardiac Arrest (E11_01) is “Yes”●If the date/time is electronically stored within a database or transmitted via XML as a “tick”, the referenced variables may also be usedUses●A component of the EMS Medical Record: Patient Care Report●Allows for evaluation of Cardiac Arrest data for Quality Improvement of patient care and agency responseData Collector●EMS personnel if Cardiac Arrest (E11_01) is answered YesOther Associated ElementsE01_01Patient Care Report NumberReferences in NHTSA Version 1DesirableElement 60Time CPR DiscontinuedSectionE11Situation/ CPR2862006 NHTSA Uniform PreHospital Dataset V.2.2.1REASON CPR DISCONTINUEDE11_10Data [combo] single-choiceDefinitionThe reason that CPR or the resuscitation efforts were discontinued.XSD Data Typexs:integerXSD Domain (Simple Type)ReasonCPRDiscontinuedMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2430DNR2435Medical Control Order2440Obvious Signs of Death2445Protocol/Policy Requirements Completed2450Return of Spontaneous Circulation (pulse or BP noted)Additional Information●Complete only if Cardiac Arrest (E11_01) is “Yes”Uses●A component of the EMS Medical Record: Patient Care Report●Allows for evaluation of Cardiac Arrest data for Quality Improvement of patient care and agency responseData Collector●EMS personnel if Cardiac Arrest (E11_01) is answered YesOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE11Situation/ CPR2872006 NHTSA Uniform PreHospital Dataset V.2.2.1CARDIAC RHYTHM ON ARRIVAL AT DESTINATIONE11_11Data [combo] multiple-choiceDefinitionThe patient's cardiac rhythm upon delivery or transfer to the destinationXSD Data Typexs:integerXSD Domain (Simple Type)CardiacRythmAtDestinationMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available245512 Lead ECG-Anterior Ischemia246012 Lead ECG-Inferior Ischemia246512 Lead ECG-Lateral Ischemia2470Agonal/Idioventricular2475Artifact2480Asystole2485Atrial Fibrillation/Flutter2490AV Block-1st Degree2495AV Block-2nd Degree-Type 12500AV Block-2nd Degree-Type 22505AV Block-3rd Degree2510Junctional2515Left Bundle Branch Block2520Normal Sinus Rhythm2525Other2530Paced Rhythm2535PEA2540Premature Atrial Contractions2545Premature Ventricular Contractions2550Right Bundle Branch Block2555Sinus Arrhythmia2560Sinus Bradycardia2565Sinus Tachycardia2570Supraventricular Tachycardia2575Torsades De Points2580Unknown AED Non-Shockable Rhythm2585Unknown AED Shockable Rhythm2590Ventricular Fibrillation2595Ventricular TachycardiaAdditional Information●Complete only if Cardiac Arrest (E11_01) is “Yes”●This data point could be completed by documentation of the final rhythm in the Vital Signs Section (E14) with the appropriate timeUses●A component of the EMS Medical Record: Patient Care Report●Allows for evaluation of Cardiac Arrest data for Quality Improvement of patient care and agency responseData Collector●EMS personnel if Cardiac Arrest (E11_01) is answered YesOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1DesirableElement 67Rhythm at DestinationSectionE11Situation/ CPR2882006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE12Medical HistorySectionE12Medical History2892006 NHTSA Uniform PreHospital Dataset V.2.2.1BARRIERS TO PATIENT CAREE12_01Data [combo] multiple-choiceNational ElementDefinitionIndication of whether or not there were any patient specific barriers to serving the patient at the sceneXSD Data Typexs:integerXSD Domain (Simple Type)BarriersToPatientCareMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2600Developmentally Impaired2605Hearing Impaired2610Language2615None2620Physically Impaired2625Physically Restrained2630Speech Impaired2635Unattended or Unsupervised (including minors)2640UnconsciousUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on any barriers to patient care●Allows data to describe any barriers to care within the EMS agency which is important to many federal initiativesData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1DesirableElement 56Factors Affecting EMS Delivery of CareReferences to Other Databases● NFIRS 5.0EMS Module; Title: Human Factors; Describes the human factors that contributed to the patient’s injury; Pick-List: Asleep = 1, Unconscious = 2, Possibly Impaired by Alcohol = 3, Possibly Impaired by Other Drug or Chemical = 4, Possibly Mentally Disabled = 5, Physically Disabled = 6, Physically Restrained = 7, Unattended or Unsupervised Person, Included are too young to act = 8, None or No Human Factors = NSectionE12Medical History2902006 NHTSA Uniform PreHospital Dataset V.2.2.1SENDING FACILITY MEDICAL RECORD NUMBERE12_02Data [text]DefinitionThe medical record number of the medical facility who is transferring care to EMSXSD Data Typexs:stringXSD Domain (Simple Type)SendingFacilityRecordNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●A component of the EMS Medical Record: Patient Care Report●Used to connect information between two hospitals●Used to link EMS data to hospital dataData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE12Medical History2912006 NHTSA Uniform PreHospital Dataset V.2.2.1DESTINATION MEDICAL RECORD NUMBERE12_03Data [text]DefinitionThe patient’s medical record number at the patient’s receiving facilityXSD Data Typexs:stringXSD Domain (Simple Type)DestinationMedicalRecordNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●A component of the EMS Medical Record: Patient Care Report●Used to connect information between two hospitals●Used to link EMS data to hospital dataData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE12Medical History2922006 NHTSA Uniform PreHospital Dataset V.2.2.1FIRST NAME OF PATIENT'S PRIMARY PRACTITIONERE12_04Data [text]DefinitionThe first name of the patient's primary practitionerXSD Data Typexs:stringXSD Domain (Simple Type)FirstNameMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: E12_04, E12_05, and E12_06 are all members of E12_4_0 Primary Practitioner's Name StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Part of an EMS Medical RecordData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE12_05Middle Name of Patient's Primary PractitionerE12_06Last Name of Patient's Primary PractitionerSectionE12Medical History2932006 NHTSA Uniform PreHospital Dataset V.2.2.1MIDDLE NAME OF PATIENT'S PRIMARY PRACTITIONERE12_05Data [text]DefinitionThe middle name of the patient's primary practitionerXSD Data Typexs:stringXSD Domain (Simple Type)MiddleInitialNameMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint20XSD Structure: E12_04, E12_05, and E12_06 are all members of E12_4_0 Primary Practitioner's Name StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Part of an EMS Medical RecordData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE12_04First Name of Patient's Primary PractitionerE12_06Last Name of Patient's Primary PractitionerSectionE12Medical History2942006 NHTSA Uniform PreHospital Dataset V.2.2.1LAST NAME OF PATIENT'S PRIMARY PRACTITIONERE12_06Data [text]DefinitionThe last name of the patient's primary practitionerXSD Data Typexs:stringXSD Domain (Simple Type)LastNameMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint20XSD Structure: E12_04, E12_05, and E12_06 are all members of E12_4_0 Primary Practitioner's Name StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Part of an EMS Medical RecordData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameE12_04First Name of Patient's Primary PractitionerE12_05Middle Name of Patient's Primary PractitionerSectionE12Medical History2952006 NHTSA Uniform PreHospital Dataset V.2.2.1ADVANCED DIRECTIVESE12_07Data [combo] multiple-choiceDefinitionThe presence of a valid for of living will of document directing end of life or healthcare treatment decisionsXSD Data Typexs:integerXSD Domain (Simple Type)AdvanceDirectivesMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2645State/EMS DNR Form2650Other Healthcare DNR Form2655Living Will2660Family/Guardian request DNR (but no documentation)2665Other2670NoneAdditional Information●DNR = Do Not ResuscitateUses●Can be used to describe the EMS population and adjust EMS resources as needed●Part of an EMS Medical RecordData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameSectionE12Medical History2962006 NHTSA Uniform PreHospital Dataset V.2.2.1MEDICATION ALLERGIESE12_08Data [combo] multiple-choiceDefinitionThe patient’s medication allergiesXSD Data Typexs:stringXSD Domain (Simple Type)MedicationAllergiesMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available Additional Information●A Drug List should be created to serve as a list box which can contain any generic or trade name of a drug approved by the FDA●Alternatively, the drugs may be entered as a multiple entry text configurationUses●Part of an EMS Medical RecordData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameSectionE12Medical History2972006 NHTSA Uniform PreHospital Dataset V.2.2.1ENVIRONMENTAL/FOOD ALLERGIESE12_09Data [combo] multiple-choiceDefinitionThe patient’s known allergies to food or environmental agents.XSD Data Typexs:integerXSD Domain (Simple Type)EnvironmentalFoodAllergiesMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2675Insect Sting2680Food Allergy2685Latex2690Chemical2695Other2700NoneUses●Part of an EMS Medical RecordData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameSectionE12Medical History2982006 NHTSA Uniform PreHospital Dataset V.2.2.1MEDICAL/SURGICAL HISTORYE12_10Data [combo or text] multiple-choiceDefinitionThe patient’s pre-existing medical and surgery history of the patientXSD Data Typexs:stringXSD Domain (Simple Type)MedicalSurgicalHistoryMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●A Medical/Surgical History list should be created to serve as a listbox which can contain any ICD-9 coded diagnosis or procedure●The field should store the values of the ICD-9 codes since CMS has not adopted ICD-10 level codes at the time of this documentUses●Part of an EMS Medical RecordData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameReferences in NHTSA Version 1EssentialElement 51Pre-Existing ConditionSectionE12Medical History2992006 NHTSA Uniform PreHospital Dataset V.2.2.1MEDICAL HISTORY OBTAINED FROME12_11Data [combo] single-choiceDefinitionType of person medical history obtained fromXSD Data Typexs:integerXSD Domain (Simple Type)MedicalHistoryObtainedFromMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2705Bystander/Other2710Family2715Health Care Personnel2720None2725PatientUses●Part of an EMS Medical RecordData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE06_01Last NameSectionE12Medical History3002006 NHTSA Uniform PreHospital Dataset V.2.2.1IMMUNIZATION HISTORYE12_12Data [combo] multiple-choiceDefinitionThe type of immunization the patient has received.XSD Data Typexs:integerXSD Domain (Simple Type)ImmunizationTypeMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoXSD Structure: E12_12 and E12_13 are members of E12_12_0 Immunization History StructureField Values2730Anthrax2735DPT (Diphtheria, Tetanus, Pertussis)2740Hemophilus Influenza B2745Hepatitis A2750Hepatitis B2755Influenza (Flu)2760MMR (Measles, Mumps, Rubella)2765Polio = 8, Pneumococcal (pneumonia)2770Small Pox2775Tetanus2780VaricellaUses●Part of the Medical History of the patient and could be important in a Bioterrorism eventData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE01_01Patient Care Report NumberE06_01Last NameE12_13Immunization DateSectionE12Medical History3012006 NHTSA Uniform PreHospital Dataset V.2.2.1IMMUNIZATION DATEE12_13Data [text]DefinitionThe date of the associated immunization type.XSD Data Typexs:gyearXSD Domain (Simple Type)ImmunizationDateMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint1,890Maximum Constraint2,030XSD Structure: E12_12 and E12_13 are members of E12_12_0 Immunization History StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Could be configured with a list box of years formatted as YYYY●Format [YYYY]Uses●Part of the Medical History of the patient and could be important in a Bioterrorism eventData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE12_12Immunization HistorySectionE12Medical History3022006 NHTSA Uniform PreHospital Dataset V.2.2.1CURRENT MEDICATIONSE12_14Data [combo or text] multiple-choiceDefinitionThe medications the patient currently takesXSD Data Typexs:stringXSD Domain (Simple Type)CurrentMedicationNameMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: (1) E12_14, E12_15, E12_16, and E12_17 are all members of E12_14_0 Current Medications Structure. (2) E12_15 and E12_16 are members of E12_15_0 Current Medication Dose StructureField ValuesAdditional Information●A Drug List should be created to serve as a listbox which can contain any generic or trade name of a drug approved by the FDA●Alternatively, the drugs may be entered as a multiple entry text configuration●The Drug List should also include “None”Uses●Part of an EMS Medical RecordData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE01_01Patient Care Report NumberE12_15Current Medication DoseE12_16Current Medication Dosage UnitE12_17Current Medication Administration RouteSectionE12Medical History3032006 NHTSA Uniform PreHospital Dataset V.2.2.1CURRENT MEDICATION DOSEE12_15Data [number]DefinitionThe numeric dose or amount of the patient’s current medicationXSD Data Typexs:decimalXSD Domain (Simple Type)CurrentMedicationDoseMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint0Maximum Constraint1,000,000XSD Structure: (1) E12_14, E12_15, E12_16, and E12_17 are all members of E12_14_0 Current Medications Structure. (2) E12_15 and E12_16 are members of E12_15_0 Current Medication Dose StructureField ValuesUses●Part of an EMS Medical RecordData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE01_01Patient Care Report NumberE12_14Current MedicationsE12_16Current Medication Dosage UnitE12_17Current Medication Administration RouteSectionE12Medical History3042006 NHTSA Uniform PreHospital Dataset V.2.2.1CURRENT MEDICATION DOSAGE UNITE12_16Data [combo] single-choiceDefinitionThe dosage unit of the patient’s current medicationXSD Data Typexs:integerXSD Domain (Simple Type)CurrentMedicationDosageUnitMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoXSD Structure: (1) E12_14, E12_15, E12_16, and E12_17 are all members of E12_14_0 Current Medications Structure. (2) E12_15 and E12_16 are members of E12_15_0 Current Medication Dose StructureField Values2785GMS2790Inches2795IU2800KVO (TKO)2805L/MIN2810LITERS2815LPM2820MCG2825MCG/KG/MIN2830MEQ2835MG2840MG/KG/MIN2845ML2850ML/HR2855Other2860PuffsUses●Part of an EMS Medical RecordData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE01_01Patient Care Report NumberE12_14Current MedicationsE12_15Current Medication DoseE12_17Current Medication Administration RouteReferences to Other Databases● DEEDSDEEDS/HL-7 Version 2.3SectionE12Medical History3052006 NHTSA Uniform PreHospital Dataset V.2.2.1CURRENT MEDICATION ADMINISTRATION ROUTEE12_17Data [combo] single-choiceDefinitionThe administration route (po, SQ, etc.) of the patients current medicationXSD Data Typexs:integerXSD Domain (Simple Type)CurrentMedicationAdministrationRouteMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: (1) E12_14, E12_15, E12_16, and E12_17 are all members of E12_14_0 Current Medications Structure. (2) E12_15 and E12_16 are members of E12_15_0 Current Medication Dose StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2865Endotracheal tube2870Gastrostomy2875Inhalation2880Intramuscular2890Intraocular2895Intravenous2900Nasal2905Nasal prongs2910Nasogastric2915Ophthalmic2920Oral2925Other/miscellaneous2930Otic2935Non Re-breather mask2940Rectal2945Subcutaneous2950Sublingual2955Topical2960Tracheostomy2965Transdermal2970Urethral2975Ventimask2980WoundUses●Part of an EMS Medical RecordData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE12_14Current MedicationsE12_15Current Medication DoseE12_16Current Medication Dosage UnitReferences to Other Databases● DEEDSDEEDS/HL-7 Version 2.3; [combo] Apply externally = AP, Buccal = B, Dental = DT, Epidural = EP, Endotracheal tube = ET, Gastronomy tube = GTT, Genitourinary irrigant = GU, Intraarterial = IA, Intrabursal = IB, Intracardiac = IC, Intracervical (uterus) = ICSectionE12Medical History3062006 NHTSA Uniform PreHospital Dataset V.2.2.1PRESENCE OF EMERGENCY INFORMATION FORME12_18Data [combo] single-choiceDefinitionIndication of the presence of the Emergency Information Form associated with patient’s with special healthcare needs.XSD Data Typexs:integerXSD Domain (Simple Type)YesNoValuesMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available0No1YesUses●A component of the EMS Medical Record: Patient Care Report●Used to identify EMS patient’s who may need special EMS resources within a community●Used to quickly identify patients during an Emergency or Disaster who may need additional resources or evacuationData Collector●EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital databaseOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE12Medical History3072006 NHTSA Uniform PreHospital Dataset V.2.2.1ALCOHOL/DRUG USE INDICATORSE12_19Data [combo] multiple-choiceNational ElementDefinitionIndicators for the potential use of Alcohol or Drugs by the patient.XSD Data Typexs:integerXSD Domain (Simple Type)AlcoholDrugUseIndicatorsMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available2985Smell of Alcohol on Breath2990Patient Admits to Alcohol Use2995Patient Admits to Drug Use3000Alcohol and/or Drug Paraphernalia at Scene3001NoneUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on alcohol/drug use indicators●Allows data to describe Alcohol and Drug use within the EMS patient populationData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 57Suspected Alcohol/Drug UseReferences to Other Databases● NFIRS 5.0EMS Module; Title: Human Factors; Describes the human factors that contributed to the patient’s injury; Pick-List: Asleep = 1, Unconscious = 2, Possibly Impaired by Alcohol = 3, Possibly Impaired by Other Drug or Chemical = 4, Possibly Mentally Disabled = 5, Physically Disabled = 6, Physically Restrained = 7, Unattended or Unsupervised Person, Included are too young to act = 8, None or No Human Factors = NSectionE12Medical History3082006 NHTSA Uniform PreHospital Dataset V.2.2.1PREGNANCYE12_20Data [combo] single-choiceDefinitionIndication of the possibility by the patient’s history of current pregnancyXSD Data Typexs:integerXSD Domain (Simple Type)YesNoValuesMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available0No1YesUses●Part of an EMS Medical RecordData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE12Medical History3092006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE13NarrativeSectionE13Narrative3102006 NHTSA Uniform PreHospital Dataset V.2.2.1RUN REPORT NARRATIVEE13_01Data [text]DefinitionThe narrative of the run reportXSD Data Typexs:stringXSD Domain (Simple Type)RunReportNarrativeMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint4,000Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Large capacity text field such as a “memo” or equivalent Uses●Part of an EMS Medical RecordData Collector●EMS personnel but could be auto-generated based on the information entered into an electronic patient care reportOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE13Narrative3112006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE14Assessment/ Vital SignsSectionE14Assessment/ Vital Signs3122006 NHTSA Uniform PreHospital Dataset V.2.2.1DATE/TIME VITAL SIGNS TAKENE14_01Data [date/time]DefinitionDate/Time Vital Signs TakenXSD Data Typexs:dateTimeXSD Domain (Simple Type)DateTimeMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint1,990Maximum Constraint2,030XSD Structure: Each element is section E14 is associated with a E14_01 Date/TimeField ValuesAdditional Information●If the date/time is electronically stored within a database or transmitted via XML as a “tick”, the referenced variables may also be used●Multiple Entry Configuration to allow multiple sets of Vital SignsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnel or may be provided electronically through a medical deviceOther Associated ElementsE01_01Patient Care Report NumberReferences to Other Databases● NFIRS 5.0EMS Module; Title: Patient Pulse; Presence of a Pulse at the time of patient transfer to another service.; Pick-List: Pulse on Transfer = 1, No; Pulse of Transfer = 2SectionE14Assessment/ Vital Signs3132006 NHTSA Uniform PreHospital Dataset V.2.2.1OBTAINED PRIOR TO THIS UNITS EMS CAREE14_02Data [combo] single-choiceDefinitionIndicates that the information which is documented was obtained prior to the EMS unit's care creting this patient care reportXSD Data Typexs:integerXSD Domain (Simple Type)YesNoValuesMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: Each element is section E14 is associated with a E14_01 Date/TimeField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available0No1YesAdditional Information●If E14_02 is “Yes”, the Date/Time Vital Signs Taken (E14_01) is not requiredUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenSectionE14Assessment/ Vital Signs3142006 NHTSA Uniform PreHospital Dataset V.2.2.1CARDIAC RHYTHME14_03Data [combo] multiple-choiceDefinitionThe initial cardiac rhythm of the patient as interpreted by EMS personnelXSD Data Typexs:integerXSD Domain (Simple Type)CardiacRythmMultiple Entry Configuration(1) Yes, via structure. (2) Accepts Null Values YesYes for each E14_01 Date/TimeRequired in XSDNoXSD Structure: Each element is section E14 is associated with a E14_01 Date/TimeField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available300512 Lead ECG-Anterior Ischemia301012 Lead ECG-Inferior Ischemia301512 Lead ECG-Lateral Ischemia3020Agonal/Idioventricular3025Artifact3030Asystole3035Atrial Fibrillation/Flutter3040AV Block-1st Degree3045AV Block-2nd Degree-Type 13050AV Block-2nd Degree-Type 23055AV Block-3rd Degree3060Junctional3065Left Bundle Branch Block3070Normal Sinus Rhythm3075Other3080Paced Rhythm3085PEA3090Premature Atrial Contractions3095Premature Ventricular Contractions3100Right Bundle Branch Block3105Sinus Arrhythmia3110Sinus Bradycardia3115Sinus Tachycardia3120Supraventricular Tachycardia3125Torsades De Points3130Unknown AED Non-Shockable Rhythm3135Unknown AED Shockable Rhythm3140Ventricular Fibrillation3145Ventricular TachycardiaUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnel or may be provided electronically through a medical deviceOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenReferences in NHTSA Version 1DesirableElement 66Initial Cardiac RhythmSectionE14Assessment/ Vital Signs3152006 NHTSA Uniform PreHospital Dataset V.2.2.1SBP (SYSTOLIC BLOOD PRESSURE)E14_04Data [number]DefinitionThe patient's systolic blood pressureXSD Data Typexs:integerXSD Domain (Simple Type)SBPMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint0Maximum Constraint400XSD Structure: (1) Each element is section E14 is associated with a E14_01 Date/Time. (2) E14_04, E14_05, and E14_06 are all members of E14_04_0 Blood Pressure StructureField Values Additional Information●Could be collected from Device Systolic Blood Pressure (E21_14)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnel or may be provided electronically through a medical deviceOther Associated ElementsE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenE14_05DBP (Diastolic Blood Pressure)E14_06Method of Blood Pressure MeasurementReferences in NHTSA Version 1EssentialElement 70Systolic Blood PressureSectionE14Assessment/ Vital Signs3162006 NHTSA Uniform PreHospital Dataset V.2.2.1DBP (DIASTOLIC BLOOD PRESSURE)E14_05Data [number]DefinitionThe patient's diastolic blood pressureXSD Data Typexs:integerXSD Domain (Simple Type)DBPMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint0Maximum Constraint200XSD Structure: (1) Each element is section E14 is associated with a E14_01 Date/Time. (2) E14_04, E14_05, and E14_06 are all members of E14_04_0 Blood Pressure StructureField Values Additional Information●Could be collected from Device Diastolic Blood Pressure (E21_15)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnel or may be provided electronically through a medical deviceOther Associated ElementsE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenE14_04SBP (Systolic Blood Pressure)E14_06Method of Blood Pressure MeasurementReferences in NHTSA Version 1EssentialElement 71Diastolic Blood PressureSectionE14Assessment/ Vital Signs3172006 NHTSA Uniform PreHospital Dataset V.2.2.1METHOD OF BLOOD PRESSURE MEASUREMENTE14_06Data [combo] single-choiceDefinitionIndication of method of blood pressure procedure.XSD Data Typexs:integerXSD Domain (Simple Type)MethodOfBloodPressureMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoXSD Structure: (1) Each element is section E14 is associated with a E14_01 Date/Time. (2) E14_04, E14_05, and E14_06 are all members of E14_04_0 Blood Pressure StructureField Values3150Arterial Line3155Automated Cuff3160Manual Cuff3165Palpated Cuff3170Venous LineUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnel or may be provided electronically through a medical deviceOther Associated ElementsE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenE14_04SBP (Systolic Blood Pressure)E14_05DBP (Diastolic Blood Pressure)SectionE14Assessment/ Vital Signs3182006 NHTSA Uniform PreHospital Dataset V.2.2.1PULSE RATEE14_07Data [number]DefinitionThe patient's pulse rate, palpated or auscultated, expressed as a number per minuteXSD Data Typexs:integerXSD Domain (Simple Type)PulseRateMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint0Maximum Constraint500XSD Structure: Each element is section E14 is associated with a E14_01 Date/TimeField Values Additional Information●Could be collected from Device Pulse Rate (E21_13)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnel or may be provided electronically through a medical deviceOther Associated ElementsE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenReferences in NHTSA Version 1EssentialElement 65Pulse RateReferences to Other Databases● NFIRS 5.0EMS Module; Title: Patient Pulse; Presence of a Pulse at the time of patient transfer to another service.; Pick-List: Pulse on Transfer = 1, No; Pulse of Transfer = 2SectionE14Assessment/ Vital Signs3192006 NHTSA Uniform PreHospital Dataset V.2.2.1ELECTRONIC MONITOR RATEE14_08Data [number]DefinitionThe patient’s heart rate as recorded by an electronic monitoring device (ECG, pulse oximetry, etc.)XSD Data Typexs:integerXSD Domain (Simple Type)ElectricMonitorRateMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint0Maximum Constraint500XSD Structure: Each element is section E14 is associated with a E14_01 Date/TimeField ValuesAdditional Information●Could be collected from Device Heart Rate (E21_12)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnel or may be provided electronically through a medical deviceOther Associated ElementsE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenSectionE14Assessment/ Vital Signs3202006 NHTSA Uniform PreHospital Dataset V.2.2.1PULSE OXIMETRYE14_09Data [number]DefinitionThe patient's oxygen saturationXSD Data Typexs:integerXSD Domain (Simple Type)PulseOximetryMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint0Maximum Constraint100XSD Structure: Each element is section E14 is associated with a E14_01 Date/TimeField ValuesAdditional Information●Could be collected from Device Pulse Oximetry (E21_17)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnel or may be provided electronically through a medical deviceOther Associated ElementsE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenSectionE14Assessment/ Vital Signs3212006 NHTSA Uniform PreHospital Dataset V.2.2.1PULSE RHYTHME14_10Data [combo] single-choiceDefinitionThe clinical rhythm of the patients pulse (regular, irregular, etc.)XSD Data Typexs:integerXSD Domain (Simple Type)PulseRhythmMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: Each element is section E14 is associated with a E14_01 Date/TimeField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3175Regular3180IrregularUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenSectionE14Assessment/ Vital Signs3222006 NHTSA Uniform PreHospital Dataset V.2.2.1RESPIRATORY RATEE14_11Data [number]DefinitionThe patient's respiratory rate expressed as a number per minuteXSD Data Typexs:integerXSD Domain (Simple Type)RespiratoryRateMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint0Maximum Constraint100XSD Structure: Each element is section E14 is associated with a E14_01 Date/TimeField ValuesAdditional Information●Could be collected from Device Respiratory Rate (E21_16)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnel or may be provided electronically through a medical deviceOther Associated ElementsE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenReferences in NHTSA Version 1EssentialElement 68Respiratory RateSectionE14Assessment/ Vital Signs3232006 NHTSA Uniform PreHospital Dataset V.2.2.1RESPIRATORY EFFORTE14_12Data [text]DefinitionThe patient’s respiratory effort XSD Data Typexs:integerXSD Domain (Simple Type)RespiratoryEffortMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: Each element is section E14 is associated with a E14_01 Date/TimeField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3185Normal3190Labored3195Fatigued3200Absent3205Not AssessedUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenReferences in NHTSA Version 1DesirableElement 69Respiratory EffortSectionE14Assessment/ Vital Signs3242006 NHTSA Uniform PreHospital Dataset V.2.2.1CARBON DIOXIDEE14_13Data [number]DefinitionThe patient’s end-tidal or other CO2 level.XSD Data Typexs:integerXSD Domain (Simple Type)CO2Multiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint0Maximum Constraint100XSD Structure: Each element is section E14 is associated with a E14_01 Date/TimeField ValuesAdditional Information●Could be collected from Device CO2 or ETCO2 (E21_18)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnel or may be provided electronically through a medical deviceOther Associated ElementsE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenSectionE14Assessment/ Vital Signs3252006 NHTSA Uniform PreHospital Dataset V.2.2.1BLOOD GLUCOSE LEVELE14_14Data [number]DefinitionThe patient's blood glucose levelXSD Data Typexs:integerXSD Domain (Simple Type)BloodGlucoseLevelMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint0Maximum Constraint2,000XSD Structure: Each element is section E14 is associated with a E14_01 Date/TimeField ValuesUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnel or may be provided electronically through a medical deviceOther Associated ElementsE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenSectionE14Assessment/ Vital Signs3262006 NHTSA Uniform PreHospital Dataset V.2.2.1GLASGOW COMA SCORE-EYEE14_15Data [number]DefinitionThe patient's Glasgow Coma Score Eye openingXSD Data Typexs:integerXSD Domain (Simple Type)GCSEyeMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint1Maximum Constraint4XSD Structure: (1) Each element is section E14 is associated with a E14_01 Date/Time. (2) E14_15, E14_16, E14_17, and E14_18 are all members of E14_15_0 GCS Score StructureField Values● For All Age Groups: 1 = Does Not Open Eyes● ● For All Age Groups: 2 = Opens Eyes to painful ● stimulation● For All Age Groups: 3 = Opens Eyes to verbal stimulation● ● For All Age Groups: 4 = Opens Eyes spontaneously● Additional Information●Can be configured as a single choice list boxUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenE14_16Glasgow Coma Score-VerbalE14_17Glasgow Coma Score-MotorE14_18Glasgow Coma Score-QualifierE14_19Total Glasgow Coma ScoreReferences in NHTSA Version 1EssentialElement 73Glasgow Eye Opening ComponentSectionE14Assessment/ Vital Signs3272006 NHTSA Uniform PreHospital Dataset V.2.2.1GLASGOW COMA SCORE-VERBALE14_16Data [number]DefinitionThe patient's Glasgow Coma Score VerbalXSD Data Typexs:integerXSD Domain (Simple Type)GCSVerbalMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint1Maximum Constraint5XSD Structure: (1) Each element is section E14 is associated with a E14_01 Date/Time. (2) E14_15, E14_16, E14_17, and E14_18 are all members of E14_15_0 GCS Score StructureField Values● Patients 0-23 months: 1 = None● Patients 2-5 years: 1 = None● Patients 0-23 months: 2 = Persistent cry● Patients 2-5 years: 2 = Grunts● Patients 0-23 months: 3 = Inappropriate cry● Patients 2-5 years: 3 = Cries and/or screams● Patients 0-23 months: 4 = Cries, inconsolable● Patients 2-5 years: 4 = Inappropriate words● Patients 0-23 months: 5 = Smiles, coos, cries ● Patients 2-5 years: 5 = Appropriate wordsappropriately● ● ● Patients >5 years: 1 = None● ● Patients >5 years: 2 = Non-specified sounds● ● Patients >5 years: 3 = Inappropriate words● ● Patients >5 years: 4 = Confused conversation or ● ● Patients >5 years: 5 = Oriented and appropriate speechAdditional Information●Can be configured as a single choice list boxUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenE14_15Glasgow Coma Score-EyeE14_17Glasgow Coma Score-MotorE14_18Glasgow Coma Score-QualifierE14_19Total Glasgow Coma ScoreReferences in NHTSA Version 1EssentialElement 74aGlasgow Verbal Component For patients >5 yearsEssentialElement 74bGlasgow Verbal Component For patients 2-5 yearsEssentialElement 74cGlasgow Verbal Component for patients 0-23 monthsSectionE14Assessment/ Vital Signs3282006 NHTSA Uniform PreHospital Dataset V.2.2.1GLASGOW COMA SCORE-MOTORE14_17Data [number]DefinitionThe patient's Glasgow Coma Score MotorXSD Data Typexs:integerXSD Domain (Simple Type)GCSMotorMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint1Maximum Constraint6XSD Structure: (1) Each element is section E14 is associated with a E14_01 Date/Time. (2) E14_15, E14_16, E14_17, and E14_18 are all members of E14_15_0 GCS Score StructureField Values● Patients up to 5 years: 1 = None● Patients >5 years: 1 = None● Patients up to 5 years: 2 = Extensor posturing in ● Patients >5 years: 2 = Extensor posturing in response response to painful stimulationto painful stimulation● Patients up to 5 years: 3 = Flexor posturing in response● Patients >5 years: 3 = Flexor posturing in response to to painful stimulationpainful stimulation● Patients up to 5 years: 4 = General withdrawal in ● Patients >5 years: 4 = General withdrawal in response response to painful stimulationto painful stimulation● Patients up to 5 years: 5 = Localization of painful ● Patients >5 years: 5 = Localization of painful stimulationstimulation● Patients up to 5 years: 6 = Spontaneous● Patients >5 years: 6 = Obeys commands with appropriate motor responsesAdditional Information●Can be configured as a single choice list boxUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenE14_15Glasgow Coma Score-EyeE14_16Glasgow Coma Score-VerbalE14_18Glasgow Coma Score-QualifierE14_19Total Glasgow Coma ScoreReferences in NHTSA Version 1EssentialElement 75aGlasgow Motor Component For patients >5 yearsEssentialElement 75bGlasgow Motor Component For patients up to 5 yearsSectionE14Assessment/ Vital Signs3292006 NHTSA Uniform PreHospital Dataset V.2.2.1GLASGOW COMA SCORE-QUALIFIERE14_18Data [combo] single-choiceDefinitionDocumentation of factors which make the GCS score more meaningful.XSD Data Typexs:integerXSD Domain (Simple Type)GCSQualifierMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: (1) Each element is section E14 is associated with a E14_01 Date/Time. (2) E14_15, E14_16, E14_17, and E14_18 are all members of E14_15_0 GCS Score StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3210Initial GCS has legitimate values without interventions such as intubation and sedation3215Patient Chemically Sedated3220Patient Intubated3225Patient Intubated and Chemically ParalyzedAdditional Information●Can be configured as a single choice list boxUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenE14_15Glasgow Coma Score-EyeE14_16Glasgow Coma Score-VerbalE14_17Glasgow Coma Score-MotorE14_19Total Glasgow Coma ScoreSectionE14Assessment/ Vital Signs3302006 NHTSA Uniform PreHospital Dataset V.2.2.1TOTAL GLASGOW COMA SCOREE14_19Data [number]DefinitionThe patient's total Glasgow Coma ScoreXSD Data Typexs:integerXSD Domain (Simple Type)TotalGCSMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint1Maximum Constraint15XSD Structure: Each element is section E14 is associated with a E14_01 Date/TimeField ValuesAdditional Information●Calculated from Glasgow Coma Score-Eye (E14_15), Glasgow Coma Score-Verbal (E14_16), and Glasgow Coma Score-Motor (E14_17)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnel but could be auto-generated based on the information entered into an electronic patient care reportOther Associated ElementsE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenE14_15Glasgow Coma Score-EyeE14_16Glasgow Coma Score-VerbalE14_17Glasgow Coma Score-MotorE14_18Glasgow Coma Score-QualifierReferences in NHTSA Version 1DesirableElement 76Glasgow Coma Score (Total)SectionE14Assessment/ Vital Signs3312006 NHTSA Uniform PreHospital Dataset V.2.2.1TEMPERATUREE14_20Data [number]DefinitionThe patient's body temperature in degrees celsius/centigrade.XSD Data Typexs:decimalXSD Domain (Simple Type)BodyTemperatureMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint0Maximum Constraint50XSD Structure: (1) Each element is section E14 is associated with a E14_01 Date/Time. (2) E14_20 and E14_21 are members of E14_20_0 Temperature Structure. Field ValuesUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnel or may be provided electronically through a medical deviceOther Associated ElementsE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenE14_21Temperature MethodSectionE14Assessment/ Vital Signs3322006 NHTSA Uniform PreHospital Dataset V.2.2.1TEMPERATURE METHODE14_21Data [combo] single-choiceDefinitionThe method used to obtain the patient’s body temperatureXSD Data Typexs:integerXSD Domain (Simple Type)TemperatureMethodMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoXSD Structure: (1) Each element is section E14 is associated with a E14_01 Date/Time. (2) E14_20 and E14_21 are members of E14_20_0 Temperature Structure. Field Values3230Axillary3235Oral3240Rectal3245Tympanic3250Urinary catheterUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnel or may be provided electronically through a medical deviceOther Associated ElementsE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenE14_20TemperatureSectionE14Assessment/ Vital Signs3332006 NHTSA Uniform PreHospital Dataset V.2.2.1LEVEL OF RESPONSIVENESSE14_22Data [combo] single-choiceDefinitionThe patients level of responsivenessXSD Data Typexs:integerXSD Domain (Simple Type)LevelOfResponsivenessMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: Each element is section E14 is associated with a E14_01 Date/TimeField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3255Alert3260Verbal3265Painful3270UnresponsiveUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenSectionE14Assessment/ Vital Signs3342006 NHTSA Uniform PreHospital Dataset V.2.2.1PAIN SCALEE14_23Data [number]DefinitionThe patient’s indication of pain from a scale of 0 –10.XSD Data Typexs:integerXSD Domain (Simple Type)PainScaleMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint0Maximum Constraint10XSD Structure: Each element is section E14 is associated with a E14_01 Date/TimeField ValuesAdditional Information●Number from 0 to 10Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS agencyOther Associated ElementsE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenSectionE14Assessment/ Vital Signs3352006 NHTSA Uniform PreHospital Dataset V.2.2.1STROKE SCALEE14_24Data [combo] single-choiceDefinitionThe patient’s Los Angeles or Cincinnati Stroke Scale ResultsXSD Data Typexs:integerXSD Domain (Simple Type)StrokeScaleMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: Each element is section E14 is associated with a E14_01 Date/TimeField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3275Cincinnati Stroke Scale Negative3280Cincinnati Stroke Scale Non-conclusive3285Cincinnati Stroke Scale Positive3290LA Stroke Scale Negative3295LA Stroke Scale Non-conclusive3300LA Stroke Scale PositiveUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenSectionE14Assessment/ Vital Signs3362006 NHTSA Uniform PreHospital Dataset V.2.2.1THROMBOLYTIC SCREENE14_25Data [combo] single-choiceDefinitionThe results of the patient’s Thrombolytic Screen for potential Thrombolytic useXSD Data Typexs:integerXSD Domain (Simple Type)ThrombolyticScreenMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: Each element is section E14 is associated with a E14_01 Date/TimeField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3305Definite Contraindications to Thrombolytic use3310No Contraindications to Thrombolytic Use3315Possible Contraindications to Thrombolytic UseUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenSectionE14Assessment/ Vital Signs3372006 NHTSA Uniform PreHospital Dataset V.2.2.1APGARE14_26Data [number]DefinitionThe patient’s total APGAR score (0-10). Recommended to be taken at 1 and 5 minutes after the infants birthXSD Data Typexs:integerXSD Domain (Simple Type)APGARMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint0Maximum Constraint10XSD Structure: Each element is section E14 is associated with a E14_01 Date/TimeField ValuesAdditional Information●Apgar score could be configured as a single choice combo box with values from 0 -10●Color: 0 = Blue, Pale, 1 = Body Pink, Extremities Blue, 2 = Pink●Heart Rate: 0 = Absent, 1 = <100, 2 = >100●Muscle Tone: 0 = Limp, 1 = Some Flexion, 2 = Good Flexion●Reflex Irritability (when feet stimulated): 0 = No Response, 1 = Some Motion, 2 = Cry●Respiratory Effort: 0 = Absent, 1 = Weak Cry, 2 = Strong Cry●The appropriate number for each of the 5 components should be added togetherUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenSectionE14Assessment/ Vital Signs3382006 NHTSA Uniform PreHospital Dataset V.2.2.1REVISED TRAUMA SCOREE14_27Data [number]DefinitionThe patient's Revised Trauma ScoreXSD Data Typexs:integerXSD Domain (Simple Type)RTSMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint0Maximum Constraint12XSD Structure: Each element is section E14 is associated with a E14_01 Date/TimeField ValuesAdditional Information●Calculated based on 3 components●Can be auto-calculated from Respiratory Rate (E14_11), Systolic Blood Pressure (E14_04), and Total GCS (E14_19), if all three components are documented at the same Time (E14_01)●Neurological Component: 4 = Glasgow coma score 13 - 15, 3 = Glasgow coma score 9 - 12, 2 = Glasgow coma score 6 - 8, 1 = Glasgow coma score 4 - 5, 0 = Glasgow coma score 3●Respiratory Rate Component: 4 = 10 - 29 per minute, 3 = >29 per minute, 2 = 6 - 9 per minute, 1 = 1 - 5 per minute, 0 = None spontaneous●Systolic Blood Pressure Component: 4 = >89 mm Hg, 3 = 76 - 89 mm Hg , 2 = 50 - 75 mm Hg, 1 = 1 - 49 mm Hg, 0 = No pulseUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnel but could be auto-generated based on the information entered into an electronic patient care reportOther Associated ElementsE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenReferences in NHTSA Version 1DesirableElement 77Revised Trauma ScoreSectionE14Assessment/ Vital Signs3392006 NHTSA Uniform PreHospital Dataset V.2.2.1PEDIATRIC TRAUMA SCOREE14_28Data [number]DefinitionThe Trauma Score for patients age 12 and underXSD Data Typexs:integerXSD Domain (Simple Type)PediatricTraumaScoreMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint-6Maximum Constraint12XSD Structure: Each element is section E14 is associated with a E14_01 Date/TimeField ValuesAdditional Information●Age 12 and Under●Calculated by adding the appropriate response for each of the 5 components below:●Can be auto-calculated if programming logic is used to confirm all 5 components ●Component Airway: 2 = Normal, 1 = Maintainable, -1 = Un-maintainable or Intubated●Component CNS: 2 = Awake, 1 = Altered Mental Status/Obtunded, -1 = Coma/Abnormal Flexion●Component Open Wounds: 2 = None, 1 = Minor, -1 = Major/Penetrating●Component Size: 2 = >20 kg, 1 = 10 – 20 kg, -1 = <10 kg●Component Skeletal Injury: 2 = None, 1 = Closed Fracture, -1 = Open/Multiple Fractures●Component Systolic Blood Pressure: 2 = > 90 mmHg (or palpable pulse at wrist), 1 = 50–90 mmHg (or palpable pulse at groin), -1 = < 50 mmHg (or no pulse palpable)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnel but could be auto-generated based on the information entered into an electronic patient care reportOther Associated ElementsE01_01Patient Care Report NumberE14_01Date/Time Vital Signs TakenSectionE14Assessment/ Vital Signs3402006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE15Assessment/ InjurySectionE15Assessment/ Injury3412006 NHTSA Uniform PreHospital Dataset V.2.2.1NHTSA INJURY MATRIX EXTERNAL/SKINE15_01Data [combo] multiple-choiceDefinitionType of injury identified and associated with the external body/Skin (including burns)XSD Data Typexs:integerXSD Domain (Simple Type)NHTSAInjuryMatrixMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3320Amputation3325Bleeding Controlled3330Bleeding Uncontrolled3335Burn3340Crush3345Dislocation Fracture3350Gunshot3355Laceration3360Pain without swelling/bruising3365Puncture/stab3370Soft Tissue Swelling/BruisingAdditional Information●Blunt Injury Removed from NHTSA 1.0Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 53Injury DescriptionReferences to Other Databases● NFIRS 5.0EMS Module; Title: Body Site of Injury; Describes parts of the body where injuries occurred.; Pick-List (limited to 5 max body parts): Head = 1, Neck and Shoulder = 2, Thorax, Includes Chest and Back, Excludes Spine = 3, Abdomen = 4, Spine = 5, Upper Extremities = 6, Lower Extremities = 7, Internal = 8, Multiple Body Parts = 9, No Body Site of Injury = N● NFIRS 5.0EMS Module; Title: Injury Type; Describes the primary injuries sustained by a patient for each part of the body.; Pick-List: Amputation = 10, Blunt Injury = 11, Burn = 12, Crush = 13, Dislocation/Fracture = 14, Gunshot = 15, Laceration = 16, Pain Without Swelling = 17, Puncture/Stab = 18, Soft Tissue Swelling = 19, Other Injury Type = 00SectionE15Assessment/ Injury3422006 NHTSA Uniform PreHospital Dataset V.2.2.1NHTSA INJURY MATRIX HEADE15_02Data [combo] multiple-choiceDefinitionType of injury identified and associated with the Head (excluding face, neck, cervical spine, and ear)XSD Data Typexs:integerXSD Domain (Simple Type)NHTSAInjuryMatrixMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3320Amputation3325Bleeding Controlled3330Bleeding Uncontrolled3335Burn3340Crush3345Dislocation Fracture3350Gunshot3355Laceration3360Pain without swelling/bruising3365Puncture/stab3370Soft Tissue Swelling/BruisingAdditional Information●Blunt Injury Removed from NHTSA 1.0Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 53Injury DescriptionSectionE15Assessment/ Injury3432006 NHTSA Uniform PreHospital Dataset V.2.2.1NHTSA INJURY MATRIX FACEE15_03Data [combo] multiple-choiceDefinitionType of injury identified and associated with the Face (including ear)XSD Data Typexs:integerXSD Domain (Simple Type)NHTSAInjuryMatrixMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3320Amputation3325Bleeding Controlled3330Bleeding Uncontrolled3335Burn3340Crush3345Dislocation Fracture3350Gunshot3355Laceration3360Pain without swelling/bruising3365Puncture/stab3370Soft Tissue Swelling/BruisingAdditional Information●Blunt Injury Removed from NHTSA 1.0Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 53Injury DescriptionSectionE15Assessment/ Injury3442006 NHTSA Uniform PreHospital Dataset V.2.2.1NHTSA INJURY MATRIX NECKE15_04Data [combo] multiple-choiceDefinitionType of injury identified and associated with the NeckXSD Data Typexs:integerXSD Domain (Simple Type)NHTSAInjuryMatrixMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3320Amputation3325Bleeding Controlled3330Bleeding Uncontrolled3335Burn3340Crush3345Dislocation Fracture3350Gunshot3355Laceration3360Pain without swelling/bruising3365Puncture/stab3370Soft Tissue Swelling/BruisingAdditional Information●Blunt Injury Removed from NHTSA 1.0Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 53Injury DescriptionReferences to Other Databases● NFIRS 5.0EMS Module; Title: Body Site of Injury; Describes parts of the body where injuries occurred.; Pick-List (limited to 5 max body parts): Head = 1, Neck and Shoulder = 2, Thorax, Includes Chest and Back, Excludes Spine = 3, Abdomen = 4, Spine = 5, Upper Extremities = 6, Lower Extremities = 7, Internal = 8, Multiple Body Parts = 9, No Body Site of Injury = N● NFIRS 5.0EMS Module; Title: Injury Type; Describes the primary injuries sustained by a patient for each part of the body.; Pick-List: Amputation = 10, Blunt Injury = 11, Burn = 12, Crush = 13, Dislocation/Fracture = 14, Gunshot = 15, Laceration = 16, Pain Without Swelling = 17, Puncture/Stab = 18, Soft Tissue Swelling = 19, Other Injury Type = 00SectionE15Assessment/ Injury3452006 NHTSA Uniform PreHospital Dataset V.2.2.1NHTSA INJURY MATRIX THORAXE15_05Data [combo] multiple-choiceDefinitionType of injury identified and associated with the Thorax (excluding the thoracic spine)XSD Data Typexs:integerXSD Domain (Simple Type)NHTSAInjuryMatrixMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3320Amputation3325Bleeding Controlled3330Bleeding Uncontrolled3335Burn3340Crush3345Dislocation Fracture3350Gunshot3355Laceration3360Pain without swelling/bruising3365Puncture/stab3370Soft Tissue Swelling/BruisingAdditional Information●Blunt Injury Removed from NHTSA 1.0Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 53Injury DescriptionReferences to Other Databases● NFIRS 5.0EMS Module; Title: Body Site of Injury; Describes parts of the body where injuries occurred.; Pick-List (limited to 5 max body parts): Head = 1, Neck and Shoulder = 2, Thorax, Includes Chest and Back, Excludes Spine = 3, Abdomen = 4, Spine = 5, Upper Extremities = 6, Lower Extremities = 7, Internal = 8, Multiple Body Parts = 9, No Body Site of Injury = N● NFIRS 5.0EMS Module; Title: Injury Type; Describes the primary injuries sustained by a patient for each part of the body.; Pick-List: Amputation = 10, Blunt Injury = 11, Burn = 12, Crush = 13, Dislocation/Fracture = 14, Gunshot = 15, Laceration = 16, Pain Without Swelling = 17, Puncture/Stab = 18, Soft Tissue Swelling = 19, Other Injury Type = 00SectionE15Assessment/ Injury3462006 NHTSA Uniform PreHospital Dataset V.2.2.1NHTSA INJURY MATRIX ABDOMENE15_06Data [combo] multiple-choiceDefinitionType of injury identified and associated with the Abdomen (excluding the lumbar spine)XSD Data Typexs:integerXSD Domain (Simple Type)NHTSAInjuryMatrixMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3320Amputation3325Bleeding Controlled3330Bleeding Uncontrolled3335Burn3340Crush3345Dislocation Fracture3350Gunshot3355Laceration3360Pain without swelling/bruising3365Puncture/stab3370Soft Tissue Swelling/BruisingAdditional Information●Blunt Injury Removed from NHTSA 1.0Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 53Injury DescriptionReferences to Other Databases● NFIRS 5.0EMS Module; Title: Body Site of Injury; Describes parts of the body where injuries occurred.; Pick-List (limited to 5 max body parts): Head = 1, Neck and Shoulder = 2, Thorax, Includes Chest and Back, Excludes Spine = 3, Abdomen = 4, Spine = 5, Upper Extremities = 6, Lower Extremities = 7, Internal = 8, Multiple Body Parts = 9, No Body Site of Injury = N● NFIRS 5.0EMS Module; Title: Injury Type; Describes the primary injuries sustained by a patient for each part of the body.; Pick-List: Amputation = 10, Blunt Injury = 11, Burn = 12, Crush = 13, Dislocation/Fracture = 14, Gunshot = 15, Laceration = 16, Pain Without Swelling = 17, Puncture/Stab = 18, Soft Tissue Swelling = 19, Other Injury Type = 00SectionE15Assessment/ Injury3472006 NHTSA Uniform PreHospital Dataset V.2.2.1NHTSA INJURY MATRIX SPINEE15_07Data [combo] multiple-choiceDefinitionType of injury identified and associated with the SpineXSD Data Typexs:integerXSD Domain (Simple Type)NHTSAInjuryMatrixMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3320Amputation3325Bleeding Controlled3330Bleeding Uncontrolled3335Burn3340Crush3345Dislocation Fracture3350Gunshot3355Laceration3360Pain without swelling/bruising3365Puncture/stab3370Soft Tissue Swelling/BruisingAdditional Information●Blunt Injury Removed from NHTSA 1.0Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 53Injury DescriptionReferences to Other Databases● NFIRS 5.0EMS Module; Title: Body Site of Injury; Describes parts of the body where injuries occurred.; Pick-List (limited to 5 max body parts): Head = 1, Neck and Shoulder = 2, Thorax, Includes Chest and Back, Excludes Spine = 3, Abdomen = 4, Spine = 5, Upper Extremities = 6, Lower Extremities = 7, Internal = 8, Multiple Body Parts = 9, No Body Site of Injury = N● NFIRS 5.0EMS Module; Title: Injury Type; Describes the primary injuries sustained by a patient for each part of the body.; Pick-List: Amputation = 10, Blunt Injury = 11, Burn = 12, Crush = 13, Dislocation/Fracture = 14, Gunshot = 15, Laceration = 16, Pain Without Swelling = 17, Puncture/Stab = 18, Soft Tissue Swelling = 19, Other Injury Type = 00SectionE15Assessment/ Injury3482006 NHTSA Uniform PreHospital Dataset V.2.2.1NHTSA INJURY MATRIX UPPER EXTREMITIESE15_08Data [combo] multiple-choiceDefinitionType of injury identified and associated with the Upper ExtremitiesXSD Data Typexs:integerXSD Domain (Simple Type)NHTSAInjuryMatrixMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3320Amputation3325Bleeding Controlled3330Bleeding Uncontrolled3335Burn3340Crush3345Dislocation Fracture3350Gunshot3355Laceration3360Pain without swelling/bruising3365Puncture/stab3370Soft Tissue Swelling/BruisingAdditional Information●Blunt Injury Removed from NHTSA 1.0Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 53Injury DescriptionReferences to Other Databases● NFIRS 5.0EMS Module; Title: Body Site of Injury; Describes parts of the body where injuries occurred.; Pick-List (limited to 5 max body parts): Head = 1, Neck and Shoulder = 2, Thorax, Includes Chest and Back, Excludes Spine = 3, Abdomen = 4, Spine = 5, Upper Extremities = 6, Lower Extremities = 7, Internal = 8, Multiple Body Parts = 9, No Body Site of Injury = N● NFIRS 5.0EMS Module; Title: Injury Type; Describes the primary injuries sustained by a patient for each part of the body.; Pick-List: Amputation = 10, Blunt Injury = 11, Burn = 12, Crush = 13, Dislocation/Fracture = 14, Gunshot = 15, Laceration = 16, Pain Without Swelling = 17, Puncture/Stab = 18, Soft Tissue Swelling = 19, Other Injury Type = 00SectionE15Assessment/ Injury3492006 NHTSA Uniform PreHospital Dataset V.2.2.1NHTSA INJURY MATRIX PELVISE15_09Data [combo] multiple-choiceDefinitionType of injury identified and associated with the PelvisXSD Data Typexs:integerXSD Domain (Simple Type)NHTSAInjuryMatrixMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3320Amputation3325Bleeding Controlled3330Bleeding Uncontrolled3335Burn3340Crush3345Dislocation Fracture3350Gunshot3355Laceration3360Pain without swelling/bruising3365Puncture/stab3370Soft Tissue Swelling/BruisingAdditional Information●Blunt Injury Removed from NHTSA 1.0Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 53Injury DescriptionReferences to Other Databases● NFIRS 5.0EMS Module; Title: Body Site of Injury; Describes parts of the body where injuries occurred.; Pick-List (limited to 5 max body parts): Head = 1, Neck and Shoulder = 2, Thorax, Includes Chest and Back, Excludes Spine = 3, Abdomen = 4, Spine = 5, Upper Extremities = 6, Lower Extremities = 7, Internal = 8, Multiple Body Parts = 9, No Body Site of Injury = N● NFIRS 5.0EMS Module; Title: Injury Type; Describes the primary injuries sustained by a patient for each part of the body.; Pick-List: Amputation = 10, Blunt Injury = 11, Burn = 12, Crush = 13, Dislocation/Fracture = 14, Gunshot = 15, Laceration = 16, Pain Without Swelling = 17, Puncture/Stab = 18, Soft Tissue Swelling = 19, Other Injury Type = 00SectionE15Assessment/ Injury3502006 NHTSA Uniform PreHospital Dataset V.2.2.1NHTSA INJURY MATRIX LOWER EXTREMITIESE15_10Data [combo] multiple-choiceDefinitionType of injury identified and associated with the Lower ExtremitiesXSD Data Typexs:integerXSD Domain (Simple Type)NHTSAInjuryMatrixMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3320Amputation3325Bleeding Controlled3330Bleeding Uncontrolled3335Burn3340Crush3345Dislocation Fracture3350Gunshot3355Laceration3360Pain without swelling/bruising3365Puncture/stab3370Soft Tissue Swelling/BruisingAdditional Information●Blunt Injury Removed from NHTSA 1.0Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 53Injury DescriptionReferences to Other Databases● NFIRS 5.0EMS Module; Title: Body Site of Injury; Describes parts of the body where injuries occurred.; Pick-List (limited to 5 max body parts): Head = 1, Neck and Shoulder = 2, Thorax, Includes Chest and Back, Excludes Spine = 3, Abdomen = 4, Spine = 5, Upper Extremities = 6, Lower Extremities = 7, Internal = 8, Multiple Body Parts = 9, No Body Site of Injury = N● NFIRS 5.0EMS Module; Title: Injury Type; Describes the primary injuries sustained by a patient for each part of the body.; Pick-List: Amputation = 10, Blunt Injury = 11, Burn = 12, Crush = 13, Dislocation/Fracture = 14, Gunshot = 15, Laceration = 16, Pain Without Swelling = 17, Puncture/Stab = 18, Soft Tissue Swelling = 19, Other Injury Type = 00SectionE15Assessment/ Injury3512006 NHTSA Uniform PreHospital Dataset V.2.2.1NHTSA INJURY MATRIX UNSPECIFIEDE15_11Data [combo] multiple-choiceDefinitionType of injury identified and associated with UnspecifiedXSD Data Typexs:integerXSD Domain (Simple Type)NHTSAInjuryMatrixMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3320Amputation3325Bleeding Controlled3330Bleeding Uncontrolled3335Burn3340Crush3345Dislocation Fracture3350Gunshot3355Laceration3360Pain without swelling/bruising3365Puncture/stab3370Soft Tissue Swelling/BruisingAdditional Information●Blunt Injury Removed from NHTSA 1.0Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 53Injury DescriptionReferences to Other Databases● NFIRS 5.0EMS Module; Title: Body Site of Injury; Describes parts of the body where injuries occurred.; Pick-List (limited to 5 max body parts): Head = 1, Neck and Shoulder = 2, Thorax, Includes Chest and Back, Excludes Spine = 3, Abdomen = 4, Spine = 5, Upper Extremities = 6, Lower Extremities = 7, Internal = 8, Multiple Body Parts = 9, No Body Site of Injury = N● NFIRS 5.0EMS Module; Title: Injury Type; Describes the primary injuries sustained by a patient for each part of the body.; Pick-List: Amputation = 10, Blunt Injury = 11, Burn = 12, Crush = 13, Dislocation/Fracture = 14, Gunshot = 15, Laceration = 16, Pain Without Swelling = 17, Puncture/Stab = 18, Soft Tissue Swelling = 19, Other Injury Type = 00SectionE15Assessment/ Injury3522006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE16Assessment/ ExamSectionE16Assessment/ Exam3532006 NHTSA Uniform PreHospital Dataset V.2.2.1ESTIMATED BODY WEIGHTE16_01Data [number]DefinitionThe patient’s body weight in kilograms, either measured or estimatedXSD Data Typexs:integerXSD Domain (Simple Type)EstimatedBodyWeightMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoMinimum Constraint1Maximum Constraint500Field ValuesUses●Part of an EMS Medical Record and to better determine equipment sizes and medication dosages●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE01_01Patient Care Report NumberSectionE16Assessment/ Exam3542006 NHTSA Uniform PreHospital Dataset V.2.2.1BROSELOW/LUTEN COLORE16_02Data [combo] single-choiceDefinitionThe Broselow/Luten Color as take from the tapeXSD Data Typexs:integerXSD Domain (Simple Type)BroselowLutenColorMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3375Blue3380Green3385Grey3390Orange3395Pink3400Purple3405Red3410White3415YellowUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE16Assessment/ Exam3552006 NHTSA Uniform PreHospital Dataset V.2.2.1DATE/TIME OF ASSESSMENTE16_03Data [date/time]DefinitionThe date/time assessment was made on the patientXSD Data Typexs:dateTimeXSD Domain (Simple Type)DateTimeMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint1,990Maximum Constraint2,030XSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField ValuesAdditional Information●If the date/time is electronically stored within a database or transmitted via XML as a “tick”, the referenced variables may also be used●This is a multiple entry configuration which will allow multiple assessments to be documentedUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnel or may be provided electronically through a medical deviceOther Associated ElementsE01_01Patient Care Report NumberE16_04Skin AssessmentE16_05Head/Face AssessmentE16_06Neck AssessmentE16_07Chest/Lungs AssessmentE16_08Heart AssessmentE16_09Abdomen Left Upper AssessmentE16_10Abdomen Left Lower AssessmentE16_11Abdomen Right Upper AssessmentE16_12Abdomen Right Lower AssessmentE16_13GU AssessmentE16_14Back Cervical AssessmentE16_15Back Thoracic AssessmentE16_16Back Lumbar/Sacral AssessmentE16_17Extremities-Right Upper AssessmentE16_18Extremities-Right Lower AssessmentE16_19Extremities-Left Upper AssessmentE16_20Extremities-Left Lower AssessmentE16_21Eyes-Left AssessmentE16_22Eyes-Right AssessmentE16_23Mental Status AssessmentE16_24Neurological AssessmentSectionE16Assessment/ Exam3562006 NHTSA Uniform PreHospital Dataset V.2.2.1SKIN ASSESSMENTE16_04Data [combo] multiple-choiceDefinitionThe assessment of the patient's skin on examinationXSD Data Typexs:integerXSD Domain (Simple Type)SkinAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3420Normal3425Not Done3430Clammy3435Cold3440Cyanotic3445Jaundiced3450Lividity3455Mottled3460Pale3465WarmAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_05Head/Face AssessmentE16_06Neck AssessmentE16_07Chest/Lungs AssessmentE16_08Heart AssessmentE16_09Abdomen Left Upper AssessmentE16_10Abdomen Left Lower AssessmentE16_11Abdomen Right Upper AssessmentE16_12Abdomen Right Lower AssessmentE16_13GU AssessmentE16_14Back Cervical AssessmentE16_15Back Thoracic AssessmentE16_16Back Lumbar/Sacral AssessmentE16_17Extremities-Right Upper AssessmentE16_18Extremities-Right Lower AssessmentE16_19Extremities-Left Upper AssessmentE16_20Extremities-Left Lower AssessmentE16_21Eyes-Left AssessmentE16_22Eyes-Right AssessmentE16_23Mental Status AssessmentE16_24Neurological AssessmentReferences in NHTSA Version 1DesirableElement 72Skin PerfusionSectionE16Assessment/ Exam3572006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE16Assessment/ Exam3582006 NHTSA Uniform PreHospital Dataset V.2.2.1HEAD/FACE ASSESSMENTE16_05Data [combo] multiple-choiceDefinitionThe assessment of the patient’s face on examinationXSD Data Typexs:integerXSD Domain (Simple Type)HeadFaceAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3470Normal3475Not Done3480Asymmetric Smile or Droop3485Drainage3490Mass/Lesion3495SwellingAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_04Skin AssessmentE16_06Neck AssessmentE16_07Chest/Lungs AssessmentE16_08Heart AssessmentE16_09Abdomen Left Upper AssessmentE16_10Abdomen Left Lower AssessmentE16_11Abdomen Right Upper AssessmentE16_12Abdomen Right Lower AssessmentE16_13GU AssessmentE16_14Back Cervical AssessmentE16_15Back Thoracic AssessmentE16_16Back Lumbar/Sacral AssessmentE16_17Extremities-Right Upper AssessmentE16_18Extremities-Right Lower AssessmentE16_19Extremities-Left Upper AssessmentE16_20Extremities-Left Lower AssessmentE16_21Eyes-Left AssessmentE16_22Eyes-Right AssessmentE16_23Mental Status AssessmentE16_24Neurological AssessmentSectionE16Assessment/ Exam3592006 NHTSA Uniform PreHospital Dataset V.2.2.1NECK ASSESSMENTE16_06Data [combo] multiple-choiceDefinitionThe assessment of the patient's head & neck area on examinationXSD Data Typexs:integerXSD Domain (Simple Type)NeckAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3500Normal3505Not Done3510JVD3515Strider3520SubQ Air3525Tracheal DevAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_04Skin AssessmentE16_05Head/Face AssessmentE16_07Chest/Lungs AssessmentE16_08Heart AssessmentE16_09Abdomen Left Upper AssessmentE16_10Abdomen Left Lower AssessmentE16_11Abdomen Right Upper AssessmentE16_12Abdomen Right Lower AssessmentE16_13GU AssessmentE16_14Back Cervical AssessmentE16_15Back Thoracic AssessmentE16_16Back Lumbar/Sacral AssessmentE16_17Extremities-Right Upper AssessmentE16_18Extremities-Right Lower AssessmentE16_19Extremities-Left Upper AssessmentE16_20Extremities-Left Lower AssessmentE16_21Eyes-Left AssessmentE16_22Eyes-Right AssessmentE16_23Mental Status AssessmentE16_24Neurological AssessmentSectionE16Assessment/ Exam3602006 NHTSA Uniform PreHospital Dataset V.2.2.1CHEST/LUNGS ASSESSMENTE16_07Data [combo] multiple-choiceDefinitionThe assessment of the patient's chest on examinationXSD Data Typexs:integerXSD Domain (Simple Type)ChestLungsAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3530Normal3535Not Done3540Accessory Muscles3545Decreased BS-Left3550Decreased BS-Right3555Flail Segment-Left3560Flail Segment-Right3565Increased Effort3570Normal BS3575Rales3580Rhonchi/Wheezing3585Tenderness-Left3590Tenderness-RightAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_04Skin AssessmentE16_05Head/Face AssessmentE16_06Neck AssessmentE16_08Heart AssessmentE16_09Abdomen Left Upper AssessmentE16_10Abdomen Left Lower AssessmentE16_11Abdomen Right Upper AssessmentE16_12Abdomen Right Lower AssessmentE16_13GU AssessmentE16_14Back Cervical AssessmentE16_15Back Thoracic AssessmentE16_16Back Lumbar/Sacral AssessmentE16_17Extremities-Right Upper AssessmentE16_18Extremities-Right Lower AssessmentE16_19Extremities-Left Upper AssessmentE16_20Extremities-Left Lower AssessmentE16_21Eyes-Left AssessmentE16_22Eyes-Right AssessmentE16_23Mental Status AssessmentE16_24Neurological AssessmentSectionE16Assessment/ Exam3612006 NHTSA Uniform PreHospital Dataset V.2.2.1HEART ASSESSMENTE16_08Data [combo] multiple-choiceDefinitionThe assessment of the patient's heart on examinationXSD Data Typexs:integerXSD Domain (Simple Type)HeartAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3595Normal3600Not Done3605Decreased Sounds3610MurmurAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_05Head/Face AssessmentE16_06Neck AssessmentE16_07Chest/Lungs AssessmentE16_07Chest/Lungs AssessmentE16_09Abdomen Left Upper AssessmentE16_10Abdomen Left Lower AssessmentE16_11Abdomen Right Upper AssessmentE16_12Abdomen Right Lower AssessmentE16_13GU AssessmentE16_14Back Cervical AssessmentE16_15Back Thoracic AssessmentE16_16Back Lumbar/Sacral AssessmentE16_17Extremities-Right Upper AssessmentE16_18Extremities-Right Lower AssessmentE16_19Extremities-Left Upper AssessmentE16_20Extremities-Left Lower AssessmentE16_21Eyes-Left AssessmentE16_22Eyes-Right AssessmentE16_23Mental Status AssessmentE16_24Neurological AssessmentSectionE16Assessment/ Exam3622006 NHTSA Uniform PreHospital Dataset V.2.2.1ABDOMEN LEFT UPPER ASSESSMENTE16_09Data [combo] multiple-choiceDefinitionThe assessment of the patient's left upper abdomen on examinationXSD Data Typexs:integerXSD Domain (Simple Type)AbdomenLeftUpperAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3615Normal3620Not Done3625Distention3630Guarding3635Mass3640TendernessAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_04Skin AssessmentE16_05Head/Face AssessmentE16_06Neck AssessmentE16_07Chest/Lungs AssessmentE16_08Heart AssessmentE16_10Abdomen Left Lower AssessmentE16_11Abdomen Right Upper AssessmentE16_12Abdomen Right Lower AssessmentE16_13GU AssessmentE16_14Back Cervical AssessmentE16_15Back Thoracic AssessmentE16_16Back Lumbar/Sacral AssessmentE16_17Extremities-Right Upper AssessmentE16_18Extremities-Right Lower AssessmentE16_19Extremities-Left Upper AssessmentE16_20Extremities-Left Lower AssessmentE16_21Eyes-Left AssessmentE16_22Eyes-Right AssessmentE16_23Mental Status AssessmentE16_24Neurological AssessmentSectionE16Assessment/ Exam3632006 NHTSA Uniform PreHospital Dataset V.2.2.1ABDOMEN LEFT LOWER ASSESSMENTE16_10Data [combo] multiple-choiceDefinitionThe assessment of the patient's left lower abdomen on examinationXSD Data Typexs:integerXSD Domain (Simple Type)AbdomenLowerLeftAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3645Normal3650Not Done3655Distention3660Guarding3665Mass3670TendernessAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_04Skin AssessmentE16_05Head/Face AssessmentE16_06Neck AssessmentE16_07Chest/Lungs AssessmentE16_08Heart AssessmentE16_09Abdomen Left Upper AssessmentE16_11Abdomen Right Upper AssessmentE16_12Abdomen Right Lower AssessmentE16_13GU AssessmentE16_14Back Cervical AssessmentE16_15Back Thoracic AssessmentE16_16Back Lumbar/Sacral AssessmentE16_17Extremities-Right Upper AssessmentE16_18Extremities-Right Lower AssessmentE16_19Extremities-Left Upper AssessmentE16_20Extremities-Left Lower AssessmentE16_21Eyes-Left AssessmentE16_22Eyes-Right AssessmentE16_23Mental Status AssessmentE16_24Neurological AssessmentSectionE16Assessment/ Exam3642006 NHTSA Uniform PreHospital Dataset V.2.2.1ABDOMEN RIGHT UPPER ASSESSMENTE16_11Data [combo] multiple-choiceDefinitionThe assessment of the patient's right upper abdomen on examinationXSD Data Typexs:integerXSD Domain (Simple Type)AbdomenRightUpperAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3675Normal3680Not Done3685Distention3690Guarding3695Mass3700TendernessAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_04Skin AssessmentE16_05Head/Face AssessmentE16_06Neck AssessmentE16_07Chest/Lungs AssessmentE16_08Heart AssessmentE16_09Abdomen Left Upper AssessmentE16_10Abdomen Left Lower AssessmentE16_12Abdomen Right Lower AssessmentE16_13GU AssessmentE16_14Back Cervical AssessmentE16_15Back Thoracic AssessmentE16_16Back Lumbar/Sacral AssessmentE16_17Extremities-Right Upper AssessmentE16_18Extremities-Right Lower AssessmentE16_19Extremities-Left Upper AssessmentE16_20Extremities-Left Lower AssessmentE16_21Eyes-Left AssessmentE16_22Eyes-Right AssessmentE16_23Mental Status AssessmentE16_24Neurological AssessmentSectionE16Assessment/ Exam3652006 NHTSA Uniform PreHospital Dataset V.2.2.1ABDOMEN RIGHT LOWER ASSESSMENTE16_12Data [combo] multiple-choiceDefinitionThe assessment of the patient's right lower abdomen on examinationXSD Data Typexs:integerXSD Domain (Simple Type)AbdomenRightLowerAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3705Normal3710Not Done3715Distention3720Guarding3725Mass3730TendernessAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_04Skin AssessmentE16_05Head/Face AssessmentE16_06Neck AssessmentE16_07Chest/Lungs AssessmentE16_08Heart AssessmentE16_09Abdomen Left Upper AssessmentE16_10Abdomen Left Lower AssessmentE16_11Abdomen Right Upper AssessmentE16_13GU AssessmentE16_14Back Cervical AssessmentE16_15Back Thoracic AssessmentE16_16Back Lumbar/Sacral AssessmentE16_17Extremities-Right Upper AssessmentE16_18Extremities-Right Lower AssessmentE16_19Extremities-Left Upper AssessmentE16_20Extremities-Left Lower AssessmentE16_21Eyes-Left AssessmentE16_22Eyes-Right AssessmentE16_23Mental Status AssessmentE16_24Neurological AssessmentSectionE16Assessment/ Exam3662006 NHTSA Uniform PreHospital Dataset V.2.2.1GU ASSESSMENTE16_13Data [combo] multiple-choiceDefinitionThe assessment of the patient's GU area on examinationXSD Data Typexs:integerXSD Domain (Simple Type)GUAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3735Normal3740Not Done3745Crowning3750Genital Injury3755Tenderness3760UnstableAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_04Skin AssessmentE16_05Head/Face AssessmentE16_06Neck AssessmentE16_07Chest/Lungs AssessmentE16_08Heart AssessmentE16_09Abdomen Left Upper AssessmentE16_10Abdomen Left Lower AssessmentE16_11Abdomen Right Upper AssessmentE16_12Abdomen Right Lower AssessmentE16_14Back Cervical AssessmentE16_15Back Thoracic AssessmentE16_16Back Lumbar/Sacral AssessmentE16_17Extremities-Right Upper AssessmentE16_18Extremities-Right Lower AssessmentE16_19Extremities-Left Upper AssessmentE16_20Extremities-Left Lower AssessmentE16_21Eyes-Left AssessmentE16_22Eyes-Right AssessmentE16_23Mental Status AssessmentE16_24Neurological AssessmentSectionE16Assessment/ Exam3672006 NHTSA Uniform PreHospital Dataset V.2.2.1BACK CERVICAL ASSESSMENTE16_14Data [combo] multiple-choiceDefinitionThe assessment of the patient's back-cervical on examinationXSD Data Typexs:integerXSD Domain (Simple Type)BackCervicalAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3765Normal3770Not Done3775Pain to ROM3780Tender Para-spinous3785Tender Spinous ProcessAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_04Skin AssessmentE16_05Head/Face AssessmentE16_06Neck AssessmentE16_07Chest/Lungs AssessmentE16_08Heart AssessmentE16_09Abdomen Left Upper AssessmentE16_10Abdomen Left Lower AssessmentE16_11Abdomen Right Upper AssessmentE16_12Abdomen Right Lower AssessmentE16_13GU AssessmentE16_15Back Thoracic AssessmentE16_16Back Lumbar/Sacral AssessmentE16_17Extremities-Right Upper AssessmentE16_18Extremities-Right Lower AssessmentE16_19Extremities-Left Upper AssessmentE16_20Extremities-Left Lower AssessmentE16_21Eyes-Left AssessmentE16_22Eyes-Right AssessmentE16_23Mental Status AssessmentE16_24Neurological AssessmentSectionE16Assessment/ Exam3682006 NHTSA Uniform PreHospital Dataset V.2.2.1BACK THORACIC ASSESSMENTE16_15Data [combo] multiple-choiceDefinitionThe assessment of the patient's back-thoracic on examinationXSD Data Typexs:integerXSD Domain (Simple Type)BackThoracicAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3790Normal3795Not Done3800Pain to ROM3805Tender Para-spinous3810Tender Spinous ProcessAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_04Skin AssessmentE16_05Head/Face AssessmentE16_06Neck AssessmentE16_07Chest/Lungs AssessmentE16_08Heart AssessmentE16_09Abdomen Left Upper AssessmentE16_10Abdomen Left Lower AssessmentE16_11Abdomen Right Upper AssessmentE16_12Abdomen Right Lower AssessmentE16_13GU AssessmentE16_14Back Cervical AssessmentE16_16Back Lumbar/Sacral AssessmentE16_17Extremities-Right Upper AssessmentE16_18Extremities-Right Lower AssessmentE16_19Extremities-Left Upper AssessmentE16_20Extremities-Left Lower AssessmentE16_21Eyes-Left AssessmentE16_22Eyes-Right AssessmentE16_23Mental Status AssessmentE16_24Neurological AssessmentSectionE16Assessment/ Exam3692006 NHTSA Uniform PreHospital Dataset V.2.2.1BACK LUMBAR/SACRAL ASSESSMENTE16_16Data [combo] multiple-choiceDefinitionThe assessment of the patient's back-lumbar/sacral on examinationXSD Data Typexs:integerXSD Domain (Simple Type)BackLumbarSacralAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3815Normal3820Not Done3825Pain to ROM3830Tender Para-spinous3835Tender Spinous ProcessAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_04Skin AssessmentE16_05Head/Face AssessmentE16_06Neck AssessmentE16_07Chest/Lungs AssessmentE16_08Heart AssessmentE16_09Abdomen Left Upper AssessmentE16_10Abdomen Left Lower AssessmentE16_11Abdomen Right Upper AssessmentE16_12Abdomen Right Lower AssessmentE16_13GU AssessmentE16_14Back Cervical AssessmentE16_15Back Thoracic AssessmentE16_17Extremities-Right Upper AssessmentE16_18Extremities-Right Lower AssessmentE16_19Extremities-Left Upper AssessmentE16_20Extremities-Left Lower AssessmentE16_21Eyes-Left AssessmentE16_22Eyes-Right AssessmentE16_23Mental Status AssessmentE16_24Neurological AssessmentSectionE16Assessment/ Exam3702006 NHTSA Uniform PreHospital Dataset V.2.2.1EXTREMITIES-RIGHT UPPER ASSESSMENTE16_17Data [combo] multiple-choiceDefinitionThe assessment of the patient's right upper extremities on examinationXSD Data Typexs:integerXSD Domain (Simple Type)ExtremitiesRightUpperAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3840Normal3845Not Done3850Abnormal Pulse3855Abnormal Sensation3860Edema3865Tenderness3870WeaknessAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_04Skin AssessmentE16_05Head/Face AssessmentE16_06Neck AssessmentE16_07Chest/Lungs AssessmentE16_08Heart AssessmentE16_09Abdomen Left Upper AssessmentE16_10Abdomen Left Lower AssessmentE16_11Abdomen Right Upper AssessmentE16_12Abdomen Right Lower AssessmentE16_13GU AssessmentE16_14Back Cervical AssessmentE16_15Back Thoracic AssessmentE16_16Back Lumbar/Sacral AssessmentE16_18Extremities-Right Lower AssessmentE16_19Extremities-Left Upper AssessmentE16_20Extremities-Left Lower AssessmentE16_21Eyes-Left AssessmentE16_22Eyes-Right AssessmentE16_23Mental Status AssessmentE16_24Neurological AssessmentSectionE16Assessment/ Exam3712006 NHTSA Uniform PreHospital Dataset V.2.2.1EXTREMITIES-RIGHT LOWER ASSESSMENTE16_18Data [combo] multiple-choiceDefinitionThe assessment of the patient's right lower extremities on examinationXSD Data Typexs:integerXSD Domain (Simple Type)ExtremitiesRightLowerAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3875Normal3880Not Done3885Abnormal Pulse3890Abnormal Sensation3895Edema3900Tenderness3905WeaknessAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_04Skin AssessmentE16_05Head/Face AssessmentE16_06Neck AssessmentE16_07Chest/Lungs AssessmentE16_08Heart AssessmentE16_09Abdomen Left Upper AssessmentE16_10Abdomen Left Lower AssessmentE16_11Abdomen Right Upper AssessmentE16_12Abdomen Right Lower AssessmentE16_13GU AssessmentE16_14Back Cervical AssessmentE16_15Back Thoracic AssessmentE16_16Back Lumbar/Sacral AssessmentE16_17Extremities-Right Upper AssessmentE16_19Extremities-Left Upper AssessmentE16_20Extremities-Left Lower AssessmentE16_21Eyes-Left AssessmentE16_22Eyes-Right AssessmentE16_23Mental Status AssessmentE16_24Neurological AssessmentSectionE16Assessment/ Exam3722006 NHTSA Uniform PreHospital Dataset V.2.2.1EXTREMITIES-LEFT UPPER ASSESSMENTE16_19Data [combo] multiple-choiceDefinitionThe assessment of the patient's left upper extremities on examinationXSD Data Typexs:integerXSD Domain (Simple Type)ExtremitiesLeftUpperAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3910Normal3915Not Done3920Abnormal Pulse3925Abnormal Sensation3930Edema3935Tenderness3940WeaknessAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_04Skin AssessmentE16_05Head/Face AssessmentE16_06Neck AssessmentE16_07Chest/Lungs AssessmentE16_08Heart AssessmentE16_09Abdomen Left Upper AssessmentE16_10Abdomen Left Lower AssessmentE16_11Abdomen Right Upper AssessmentE16_12Abdomen Right Lower AssessmentE16_13GU AssessmentE16_14Back Cervical AssessmentE16_15Back Thoracic AssessmentE16_16Back Lumbar/Sacral AssessmentE16_17Extremities-Right Upper AssessmentE16_18Extremities-Right Lower AssessmentE16_20Extremities-Left Lower AssessmentE16_21Eyes-Left AssessmentE16_22Eyes-Right AssessmentE16_23Mental Status AssessmentE16_24Neurological AssessmentSectionE16Assessment/ Exam3732006 NHTSA Uniform PreHospital Dataset V.2.2.1EXTREMITIES-LEFT LOWER ASSESSMENTE16_20Data [combo] multiple-choiceDefinitionThe assessment of the patient's left lower extremities on examinationXSD Data Typexs:integerXSD Domain (Simple Type)ExtremitiesLeftLowerAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3945Normal3950Not Done3955Abnormal Pulse3960Abnormal Sensation3965Edema3970Tenderness3975WeaknessAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_04Skin AssessmentE16_05Head/Face AssessmentE16_06Neck AssessmentE16_07Chest/Lungs AssessmentE16_08Heart AssessmentE16_09Abdomen Left Upper AssessmentE16_10Abdomen Left Lower AssessmentE16_11Abdomen Right Upper AssessmentE16_12Abdomen Right Lower AssessmentE16_13GU AssessmentE16_14Back Cervical AssessmentE16_15Back Thoracic AssessmentE16_16Back Lumbar/Sacral AssessmentE16_17Extremities-Right Upper AssessmentE16_18Extremities-Right Lower AssessmentE16_19Extremities-Left Upper AssessmentE16_21Eyes-Left AssessmentE16_22Eyes-Right AssessmentE16_23Mental Status AssessmentE16_24Neurological AssessmentSectionE16Assessment/ Exam3742006 NHTSA Uniform PreHospital Dataset V.2.2.1EYES-LEFT ASSESSMENTE16_21Data [combo] multiple-choiceDefinitionThe assessment of the patient's left eye on examinationXSD Data Typexs:integerXSD Domain (Simple Type)EyesLeftAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available3980Not Done39852-mm39903-mm39954-mm40005-mm40056-mm40107-mm4015Blind4020Reactive4025Non-ReactiveAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_04Skin AssessmentE16_05Head/Face AssessmentE16_06Neck AssessmentE16_07Chest/Lungs AssessmentE16_08Heart AssessmentE16_09Abdomen Left Upper AssessmentE16_10Abdomen Left Lower AssessmentE16_11Abdomen Right Upper AssessmentE16_12Abdomen Right Lower AssessmentE16_13GU AssessmentE16_14Back Cervical AssessmentE16_15Back Thoracic AssessmentE16_16Back Lumbar/Sacral AssessmentE16_17Extremities-Right Upper AssessmentE16_18Extremities-Right Lower AssessmentE16_19Extremities-Left Upper AssessmentE16_20Extremities-Left Lower AssessmentE16_22Eyes-Right AssessmentE16_23Mental Status AssessmentE16_24Neurological AssessmentSectionE16Assessment/ Exam3752006 NHTSA Uniform PreHospital Dataset V.2.2.1EYES-RIGHT ASSESSMENTE16_22Data [combo] multiple-choiceDefinitionThe assessment of the patient's right eye on examinationXSD Data Typexs:integerXSD Domain (Simple Type)EyesRightAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available4030Not Done40352-mm40403-mm40454-mm40505-mm40556-mm40607-mm4065Blind4070Reactive4075Non-ReactiveAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_04Skin AssessmentE16_05Head/Face AssessmentE16_06Neck AssessmentE16_07Chest/Lungs AssessmentE16_08Heart AssessmentE16_09Abdomen Left Upper AssessmentE16_10Abdomen Left Lower AssessmentE16_11Abdomen Right Upper AssessmentE16_12Abdomen Right Lower AssessmentE16_13GU AssessmentE16_14Back Cervical AssessmentE16_15Back Thoracic AssessmentE16_16Back Lumbar/Sacral AssessmentE16_17Extremities-Right Upper AssessmentE16_18Extremities-Right Lower AssessmentE16_19Extremities-Left Upper AssessmentE16_20Extremities-Left Lower AssessmentE16_21Eyes-Left AssessmentE16_23Mental Status AssessmentE16_24Neurological AssessmentSectionE16Assessment/ Exam3762006 NHTSA Uniform PreHospital Dataset V.2.2.1MENTAL STATUS ASSESSMENTE16_23Data [combo] multiple-choiceDefinitionThe assessment of the patient's mental status on examinationXSD Data Typexs:integerXSD Domain (Simple Type)MentalStatusAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available4080Normal4085Not Done4090Combative4095Confused4100Hallucinations4105Oriented-Person4110Oriented-Place4115Oriented-Time4120UnresponsiveAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_04Skin AssessmentE16_05Head/Face AssessmentE16_06Neck AssessmentE16_07Chest/Lungs AssessmentE16_08Heart AssessmentE16_09Abdomen Left Upper AssessmentE16_10Abdomen Left Lower AssessmentE16_11Abdomen Right Upper AssessmentE16_12Abdomen Right Lower AssessmentE16_13GU AssessmentE16_14Back Cervical AssessmentE16_15Back Thoracic AssessmentE16_16Back Lumbar/Sacral AssessmentE16_17Extremities-Right Upper AssessmentE16_18Extremities-Right Lower AssessmentE16_19Extremities-Left Upper AssessmentE16_20Extremities-Left Lower AssessmentE16_21Eyes-Left AssessmentE16_22Eyes-Right AssessmentE16_24Neurological AssessmentSectionE16Assessment/ Exam3772006 NHTSA Uniform PreHospital Dataset V.2.2.1NEUROLOGICAL ASSESSMENTE16_24Data [combo] multiple-choiceDefinitionThe assessment of the patient's neurological status on examinationXSD Data Typexs:integerXSD Domain (Simple Type)NeurologicalAssessmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements beginning with E16_03 and ending with E16_24 are all members of E16_00_0 Assessment StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available4125Normal4130Not Done4135Abnormal Gait4140Facial Droop4145Seizures4150Speech Normal4155Speech Slurring4160Tremors4165Weakness-Left Sided4170Weakness-Right SidedAdditional Information●Associated in Database schema to Date/Time (E16_03) to allow multiple assessmentsUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE16_03Date/Time of AssessmentE16_04Skin AssessmentE16_05Head/Face AssessmentE16_06Neck AssessmentE16_07Chest/Lungs AssessmentE16_08Heart AssessmentE16_09Abdomen Left Upper AssessmentE16_10Abdomen Left Lower AssessmentE16_11Abdomen Right Upper AssessmentE16_12Abdomen Right Lower AssessmentE16_13GU AssessmentE16_14Back Cervical AssessmentE16_15Back Thoracic AssessmentE16_16Back Lumbar/Sacral AssessmentE16_17Extremities-Right Upper AssessmentE16_18Extremities-Right Lower AssessmentE16_19Extremities-Left Upper AssessmentE16_20Extremities-Left Lower AssessmentE16_21Eyes-Left AssessmentE16_22Eyes-Right AssessmentE16_23Mental Status AssessmentSectionE16Assessment/ Exam3782006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE17InterventionSectionE17Intervention3792006 NHTSA Uniform PreHospital Dataset V.2.2.1PROTOCOLS USEDE17_01Data [combo] multiple-choiceDefinitionThe protocol used by EMS personnel to direct the clinical care of the patientXSD Data Typexs:stringXSD Domain (Simple Type)ProtocolsUsedMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available Additional Information●List created from Protocols (D04_08)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE17Intervention3802006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE18Intervention/ MedicationSectionE18Intervention/ Medication3812006 NHTSA Uniform PreHospital Dataset V.2.2.1DATE/TIME MEDICATION ADMINISTEREDE18_01Data [date/time]DefinitionThe date/time medication administered to the patientXSD Data Typexs:dateTimeXSD Domain (Simple Type)DateTimeMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint1,990Maximum Constraint2,030XSD Structure: All data elements section E18 are members of the E18 Medication StructureField Values Additional Information●If the date/time is electronically stored within a database or transmitted via XML as a “tick”, the referenced variables may also be used●This is a multiple entry configuration which will allow multiple medication administrations to be documentedUses●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE01_01Patient Care Report NumberE18_02Medication Administered Prior to this Units EMS CareE18_03Medication GivenE18_04Medication Administered RouteE18_05Medication DosageE18_06Medication Dosage UnitsE18_07Response to MedicationE18_08Medication ComplicationE18_09Medication Crew Member IDE18_10Medication AuthorizationE18_11Medication Authorizing PhysicianSectionE18Intervention/ Medication3822006 NHTSA Uniform PreHospital Dataset V.2.2.1MEDICATION ADMINISTERED PRIOR TO THIS UNITS EMS CAREE18_02Data [combo] single-choiceDefinitionIndicates that the medication administration which is documented was administered prior to this EMS unit’s care.XSD Data Typexs:integerXSD Domain (Simple Type)YesNoValuesMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements section E18 are members of the E18 Medication StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available0No1YesAdditional Information●If E18_02 is “Yes”, the Date/Time Medication Administered (E18_01) is not requiredUses●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE18_01Date/Time Medication AdministeredE18_03Medication GivenE18_04Medication Administered RouteE18_05Medication DosageE18_06Medication Dosage UnitsE18_07Response to MedicationE18_08Medication ComplicationE18_09Medication Crew Member IDE18_10Medication AuthorizationE18_11Medication Authorizing PhysicianSectionE18Intervention/ Medication3832006 NHTSA Uniform PreHospital Dataset V.2.2.1MEDICATION GIVENE18_03Data [combo] single-choiceNational ElementDefinitionThe medication given to the patientXSD Data Typexs:stringXSD Domain (Simple Type)MedicationsGivenMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDYesMinimum Constraint2Maximum Constraint30XSD Structure: All data elements section E18 are members of the E18 Medication StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●List created from Medications (D04_06)Uses●Allows data to be sorted based on the medical treatment●Allows data to describe the medications administered by EMS●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE18_01Date/Time Medication AdministeredE18_02Medication Administered Prior to this Units EMS CareE18_04Medication Administered RouteE18_05Medication DosageE18_06Medication Dosage UnitsE18_07Response to MedicationE18_08Medication ComplicationE18_09Medication Crew Member IDE18_10Medication AuthorizationE18_11Medication Authorizing PhysicianReferences in NHTSA Version 1EssentialElement 80Medication NameReferences to Other Databases● NFIRS 5.0EMS Module, Title: Procedures Used, Multi Select List: Airway Insertion = 01, Anti-Shock Trousers = 02, Assisted Ventilation = 03, Bleeding Control = 04, Burn Care = 05, Cardiac Pacing = 06, Cardioversion (defib), Manual = 07, Chest/Abdominal Thrust = 08, CPR = 09, Cricothyroidotomy = 10, Defibrillation by AED = 11, EKG Monitoring = 12, Extrication = 13, Intubation (EGTA) = 14, Intubation (ET) = 15, IO/IV Therapy = 16, Medications Therapy = 17, Oxygen Therapy = 18, Obstetrical Care/Delivery = 19, Pre-Arrival Instruction = 20, Restrained Patient = 21, Spinal Immobilization = 22, Splinted Extremities = 23, Suction/Aspirate = 24, Other Procedure = 00, No Treatment = NNSectionE18Intervention/ Medication3842006 NHTSA Uniform PreHospital Dataset V.2.2.1MEDICATION ADMINISTERED ROUTEE18_04Data [combo] single-choiceDefinitionThe route that the medication was administered to the patient.XSD Data Typexs:integerXSD Domain (Simple Type)MedicationAdministeredRouteMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements section E18 are members of the E18 Medication StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available4175Endotracheal tube4180Gastrostomy tube4185Inhalation4190Intramuscular4191Intraosseous 4195Intranasal4200Intraocular4205Intravenous4210Nasal4215Nasal prongs4220Nasogastric4225Ophthalmic4230Oral4235Other/miscellaneous4240Otic4245Re-breather mask4250Rectal4255Subcutaneous4260Sublingual4265Topical4270Tracheostomy4275Transdermal4280Urethral4285Ventimask 4290 WoundUses●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE18_01Date/Time Medication AdministeredE18_02Medication Administered Prior to this Units EMS CareE18_03Medication GivenE18_05Medication DosageE18_06Medication Dosage UnitsE18_07Response to MedicationE18_08Medication ComplicationE18_09Medication Crew Member IDE18_10Medication AuthorizationE18_11Medication Authorizing PhysicianReferences to Other Databases● DEEDSDEEDS/HL-7 Version 2.3; [combo] Apply externally = AP, Buccal = B, Dental = DT, Epidural = EP, Endotracheal tube = ET, Gastronomy tube = GTT, Genitourinary irrigant = GU, Intraarterial = IA, Intrabursal = IB, Intracardiac = IC, Intracervical (uterus) = ICSectionE18Intervention/ Medication3852006 NHTSA Uniform PreHospital Dataset V.2.2.1MEDICATION DOSAGEE18_05Data [number]DefinitionThe dose or amount of medication given to the patientXSD Data Typexs:decimalXSD Domain (Simple Type)MedicationDosageMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint0Maximum Constraint1,000,000XSD Structure: (1) All data elements section E18 are members of the E18 Medication Structure. (2) E18_05 and E18_06 are members of E18_05_0 Medication Dosing StructureField Values Uses●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE01_01Patient Care Report NumberE18_01Date/Time Medication AdministeredE18_02Medication Administered Prior to this Units E18_03Medication GivenEMS CareE18_04Medication Administered RouteE18_06Medication Dosage UnitsE18_07Response to MedicationE18_08Medication ComplicationE18_09Medication Crew Member IDE18_10Medication AuthorizationE18_11Medication Authorizing PhysicianSectionE18Intervention/ Medication3862006 NHTSA Uniform PreHospital Dataset V.2.2.1MEDICATION DOSAGE UNITSE18_06Data [combo] single-choiceDefinitionThe units of medication dosage given to patientXSD Data Typexs:integerXSD Domain (Simple Type)MedicationDosageUnitsMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoXSD Structure: (1) All data elements section E18 are members of the E18 Medication Structure. (2) E18_05 and E18_06 are members of E18_05_0 Medication Dosing StructureField Values4295GMS4300Inches4305IU4310KVO (TKO)4315L/MIN4320LITERS4325LPM4330MCG4335MCG/KG/MIN4340MEQ4345MG4350MG/KG/MIN4355ML4360ML/HR4365Other4370PuffsUses●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE01_01Patient Care Report NumberE18_01Date/Time Medication AdministeredE18_02Medication Administered Prior to this Units E18_03Medication GivenEMS CareE18_03Medication GivenE18_04Medication Administered RouteE18_05Medication DosageE18_07Response to MedicationE18_08Medication ComplicationE18_09Medication Crew Member IDE18_10Medication AuthorizationE18_11Medication Authorizing PhysicianReferences to Other Databases● DEEDSDEEDS/HL-7 Version 2.3SectionE18Intervention/ Medication3872006 NHTSA Uniform PreHospital Dataset V.2.2.1RESPONSE TO MEDICATIONE18_07Data [combo] single-choiceDefinitionThe patient’s response to the medication.XSD Data Typexs:integerXSD Domain (Simple Type)ResponseToMedicationMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements section E18 are members of the E18 Medication StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available4375Improved4380Unchanged4385WorseUses●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE18_01Date/Time Medication AdministeredE18_02Medication Administered Prior to this Units EMS CareE18_03Medication GivenE18_04Medication Administered RouteE18_05Medication DosageE18_06Medication Dosage UnitsE18_08Medication ComplicationE18_09Medication Crew Member IDE18_10Medication AuthorizationE18_11Medication Authorizing PhysicianSectionE18Intervention/ Medication3882006 NHTSA Uniform PreHospital Dataset V.2.2.1MEDICATION COMPLICATIONE18_08Data [combo] multiple-choiceNational ElementDefinitionAny complication (abnormal effect on the patient) associated with the administration of the medication to the patient by EMSXSD Data Typexs:integerXSD Domain (Simple Type)MedicationComplicationMultiple Entry Configuration(1) Yes, via structure. (2) Accepts Null Values YesYes for each E14_01 Date/TimeRequired in XSDYesXSD Structure: All data elements section E18 are members of the E18 Medication StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available4390None4395Altered Mental Status4400Apnea4405Bleeding4410Bradycardia4415Diarrhea4420Extravasion4425Hypertension4430Hyperthermia4435Hypotension4440Hypoxia4445Injury4450Itching/Urticaria4455Nausea4460Other4465Respiratory Distress4470Tachycardia4475VomitingUses●Allows data to be sorted based on medication complication●Allows data to describe medication complications which occur as a result of EMS treatment●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE18_01Date/Time Medication AdministeredE18_02Medication Administered Prior to this Units EMS CareE18_03Medication GivenE18_04Medication Administered RouteE18_05Medication DosageE18_06Medication Dosage UnitsE18_07Response to MedicationE18_09Medication Crew Member IDE18_10Medication AuthorizationE18_11Medication Authorizing PhysicianSectionE18Intervention/ Medication3892006 NHTSA Uniform PreHospital Dataset V.2.2.1MEDICATION CREW MEMBER IDE18_09Data [text]DefinitionThe statewide assigned ID number of the EMS crew member giving the treatment to the patientXSD Data Typexs:integerXSD Domain (Simple Type)CrewMemberIDMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint15XSD Structure: All data elements section E18 are members of the E18 Medication StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available Additional Information●Linked to State/Licensure ID Number (D07_02)●List box created from the State/Licensure ID Number (D07_02) which could display the Personnel’s Names as associated with D08_01, D08_02, and D08_03 for easy data entryUses●Part of an EMS Medical Record and to document Medication Administration●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE18_01Date/Time Medication AdministeredE18_02Medication Administered Prior to this Units EMS CareE18_03Medication GivenE18_04Medication Administered RouteE18_05Medication DosageE18_06Medication Dosage UnitsE18_07Response to MedicationE18_08Medication ComplicationE18_10Medication AuthorizationE18_11Medication Authorizing PhysicianReferences in NHTSA Version 1EssentialElement 26Crew Member One NumberEssentialElement 27Crew Member Two NumberDesirableElement 28Crew Member Three NumberSectionE18Intervention/ Medication3902006 NHTSA Uniform PreHospital Dataset V.2.2.1MEDICATION AUTHORIZATIONE18_10Data [combo] single-choiceDefinitionThe type of treatment authorization obtainedXSD Data Typexs:integerXSD Domain (Simple Type)MedicationAuthorizationMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: All data elements section E18 are members of the E18 Medication StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available4480On-Line4485On-Scene4490Protocol (Standing Order)4495Written Orders (Patient Specific)Additional Information●Associated with Medication Authorization (E18_11) if the value is not “Protocol”Uses●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE18_01Date/Time Medication AdministeredE18_02Medication Administered Prior to this Units EMS CareE18_03Medication GivenE18_04Medication Administered RouteE18_05Medication DosageE18_06Medication Dosage UnitsE18_07Response to MedicationE18_08Medication ComplicationE18_09Medication Crew Member IDE18_11Medication Authorizing PhysicianE18_11Medication Authorizing PhysicianReferences in NHTSA Version 1DesirableElement 81Treatment AuthorizationSectionE18Intervention/ Medication3912006 NHTSA Uniform PreHospital Dataset V.2.2.1MEDICATION AUTHORIZING PHYSICIANE18_11Data [text]DefinitionThe last name of the authorizing physician ordering the medication administration if the order was provided by any manner other than protocol (standing order) in E18.10XSD Data Typexs:stringXSD Domain (Simple Type)LastNameMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint20XSD Structure: All data elements section E18 are members of the E18 Medication StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Associated with Medication Authorization (E18_10) if the value is not “Protocol”Uses●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE18_01Date/Time Medication AdministeredE18_02Medication Administered Prior to this Units EMS CareE18_03Medication GivenE18_04Medication Administered RouteE18_05Medication DosageE18_06Medication Dosage UnitsE18_07Response to MedicationE18_08Medication ComplicationE18_09Medication Crew Member IDE18_10Medication AuthorizationSectionE18Intervention/ Medication3922006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE19Intervention/ ProcedureSectionE19Intervention/ Procedure3932006 NHTSA Uniform PreHospital Dataset V.2.2.1DATE/TIME PROCEDURE PERFORMED SUCCESSFULLYE19_01Data [date/time]DefinitionThe date and time the procedure was performed on the patientXSD Data Typexs:dateTimeXSD Domain (Simple Type)DateTimeMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint1,990Maximum Constraint2,030XSD Structure: Data Elements E19_01 through E19_11 are all members of E19_01_0 Procedure StructureField ValuesAdditional Information●If the date/time is electronically stored within a database or transmitted via XML as a “tick”, the referenced variables may also be used●This is a multiple entry configuration which will allow for multiple procedures to be documentedUses●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE01_01Patient Care Report NumberE19_02Procedure Performed Prior to this Units EMS CareE19_03ProcedureE19_04Size of Procedure EquipmentE19_05Number of Procedure AttemptsE19_06Procedure SuccessfulE19_07Procedure ComplicationE19_08Response to ProcedureE19_09Procedure Crew Members IDE19_10Procedure AuthorizationE19_11Procedure Authorizing PhysicianE19_12Successful IV SiteE19_13Tube ConfirmationE19_14Destination Confirmation of Tube PlacementReferences in NHTSA Version 1DesirableElement 58Time of First CPRDesirableElement 63Time of First Defibrillatory ShockSectionE19Intervention/ Procedure3942006 NHTSA Uniform PreHospital Dataset V.2.2.1PROCEDURE PERFORMED PRIOR TO THIS UNITS EMS CAREE19_02Data [combo] single-choiceDefinitionIndicates that the procedure which was performed and documented was performed prior to this EMS unit’s care.XSD Data Typexs:integerXSD Domain (Simple Type)YesNoValuesMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: Data Elements E19_01 through E19_11 are all members of E19_01_0 Procedure StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available0No1YesAdditional Information●If E19_02 is “Yes”, the Date/Time Medication Administered (E19_01) is not requiredUses●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE19_01Date/Time Procedure Performed E19_03ProcedureSuccessfullyE19_04Size of Procedure EquipmentE19_05Number of Procedure AttemptsE19_06Procedure SuccessfulE19_07Procedure ComplicationE19_08Response to ProcedureE19_09Procedure Crew Members IDE19_10Procedure AuthorizationE19_11Procedure Authorizing PhysicianSectionE19Intervention/ Procedure3952006 NHTSA Uniform PreHospital Dataset V.2.2.1PROCEDUREE19_03Data [combo] single-choiceNational ElementDefinitionThe procedure performed on the patient.XSD Data Typexs:decimalXSD Domain (Simple Type)ProcedureMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDYesMinimum Constraint0Maximum Constraint1,000XSD Structure: Data Elements E19_01 through E19_11 are all members of E19_01_0 Procedure StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●List created from Procedures (D04_04)Uses●Allows data to be sorted based on the medical treatment●Allows data to describe the procedures which are performed by EMS●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE19_01Date/Time Procedure Performed E19_02Procedure Performed Prior to this Units SuccessfullyEMS CareE19_04Size of Procedure EquipmentE19_05Number of Procedure AttemptsE19_06Procedure SuccessfulE19_07Procedure ComplicationE19_08Response to ProcedureE19_09Procedure Crew Members IDE19_10Procedure AuthorizationE19_11Procedure Authorizing PhysicianReferences in NHTSA Version 1DesirableElement 58Time of First CPRDesirableElement 63Time of First Defibrillatory ShockReferences to Other Databases● NFIRS 5.0EMS Module, Title: Procedures Used, Multi Select List: Airway Insertion = 01, Anti-Shock Trousers = 02, Assisted Ventilation = 03, Bleeding Control = 04, Burn Care = 05, Cardiac Pacing = 06, Cardioversion (defib), Manual = 07, Chest/Abdominal Thrust = 08, CPR = 09, Cricothyroidotomy = 10, Defibrillation by AED = 11, EKG Monitoring = 12, Extrication = 13, Intubation (EGTA) = 14, Intubation (ET) = 15, IO/IV Therapy = 16, Medications Therapy = 17, Oxygen Therapy = 18, Obstetrical Care/Delivery = 19, Pre-Arrival Instruction = 20, Restrained Patient = 21, Spinal Immobilization = 22, Splinted Extremities = 23, Suction/Aspirate = 24, Other Procedure = 00, No Treatment = NN● UTSTEINArrest after arrival of EMS could be documented by CPR or Defibrillation performed along with the Cardiac Arrest datapoint.; [text] Value orSectionE19Intervention/ Procedure3962006 NHTSA Uniform PreHospital Dataset V.2.2.1SIZE OF PROCEDURE EQUIPMENTE19_04Data [text]DefinitionThe size of equipment used in the procedure on the patientXSD Data Typexs:stringXSD Domain (Simple Type)SizeOfProcedureEquipmentMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint20XSD Structure: Data Elements E19_01 through E19_11 are all members of E19_01_0 Procedure StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Can be entered as text or configured as a List Box with the specific size associated with each Procedure listed for each EMS Agency (D04_04) n the Demographic DatasetUses●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE19_01Date/Time Procedure Performed E19_02Procedure Performed Prior to this Units SuccessfullyEMS CareE19_03ProcedureE19_05Number of Procedure AttemptsE19_06Procedure SuccessfulE19_07Procedure ComplicationE19_08Response to ProcedureE19_09Procedure Crew Members IDE19_10Procedure AuthorizationE19_11Procedure Authorizing PhysicianReferences in NHTSA Version 1EssentialElement 78Procedure or Treatment NameSectionE19Intervention/ Procedure3972006 NHTSA Uniform PreHospital Dataset V.2.2.1NUMBER OF PROCEDURE ATTEMPTSE19_05Data [number]National ElementDefinitionThe number of attempts taken to complete a procedure or intervention regardless of successXSD Data Typexs:integerXSD Domain (Simple Type)NumberOfProcedureAttemptsMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDYesMinimum Constraint-25Maximum Constraint100XSD Structure: Data Elements E19_01 through E19_11 are all members of E19_01_0 Procedure StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available Uses●Allows data to be sorted based on the medical treatment●Allows data to describe the procedures which are performed by EMS●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE19_01Date/Time Procedure Performed E19_02Procedure Performed Prior to this Units SuccessfullyEMS CareE19_03ProcedureE19_04Size of Procedure EquipmentE19_06Procedure SuccessfulE19_07Procedure ComplicationE19_08Response to ProcedureE19_09Procedure Crew Members IDE19_10Procedure AuthorizationE19_11Procedure Authorizing PhysicianSectionE19Intervention/ Procedure3982006 NHTSA Uniform PreHospital Dataset V.2.2.1PROCEDURE SUCCESSFULE19_06Data [combo] single-choiceNational ElementDefinitionIndication of whether or not the procedure performed on the patient was successfulXSD Data Typexs:integerXSD Domain (Simple Type)YesNoValuesMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDYesXSD Structure: Data Elements E19_01 through E19_11 are all members of E19_01_0 Procedure StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available0No1YesUses●Allows data to be sorted based on the medical treatment●Allows data to describe the procedures performed by EMS with respect to numbers and success rates●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE19_01Date/Time Procedure Performed E19_02Procedure Performed Prior to this Units SuccessfullyEMS CareE19_03ProcedureE19_04Size of Procedure EquipmentE19_05Number of Procedure AttemptsE19_07Procedure ComplicationE19_08Response to ProcedureE19_09Procedure Crew Members IDE19_10Procedure AuthorizationE19_11Procedure Authorizing PhysicianSectionE19Intervention/ Procedure3992006 NHTSA Uniform PreHospital Dataset V.2.2.1PROCEDURE COMPLICATIONE19_07Data [combo] multiple-choiceNational ElementDefinitionAny complication associated with the performance of the procedure on the patientXSD Data Typexs:integerXSD Domain (Simple Type)ProcedureComplicationMultiple Entry Configuration(1) Yes, via structure. (2) Accepts Null Values YesYes for each E14_01 Date/TimeRequired in XSDYesXSD Structure: Data Elements E19_01 through E19_11 are all members of E19_01_0 Procedure StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available4500None4505Altered Mental Status4510Apnea4515Bleeding4520Bradycardia4525Diarrhea4530Esophageal Intubation-immediately4535Esophageal Intubation-other4540Extravasion4545Hypertension4550Hyperthermia4555Hypotension4560Hypoxia4565Injury4570Itching/Urticaria4575Nausea4580Other4585Respiratory Distress4590Tachycardia4595VomitingUses●Allows data to be sorted based on procedure complication●Allows data to describe procedure complications which occur as a result of EMS treatment as part of a federal initiative to identify and reduce medical errors●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE19_01Date/Time Procedure Performed E19_02Procedure Performed Prior to this Units SuccessfullyEMS CareE19_03ProcedureE19_04Size of Procedure EquipmentE19_05Number of Procedure AttemptsE19_06Procedure SuccessfulE19_08Response to ProcedureE19_09Procedure Crew Members IDE19_10Procedure AuthorizationE19_11Procedure Authorizing PhysicianSectionE19Intervention/ Procedure4002006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE19Intervention/ Procedure4012006 NHTSA Uniform PreHospital Dataset V.2.2.1RESPONSE TO PROCEDUREE19_08Data [combo] single-choiceDefinitionThe patient’s response to the procedureXSD Data Typexs:integerXSD Domain (Simple Type)ResponseToProcedureMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: Data Elements E19_01 through E19_11 are all members of E19_01_0 Procedure StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available4600Improved4605Unchanged4610WorseUses●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE19_01Date/Time Procedure Performed E19_02Procedure Performed Prior to this Units SuccessfullyEMS CareE19_03ProcedureE19_04Size of Procedure EquipmentE19_05Number of Procedure AttemptsE19_06Procedure SuccessfulE19_07Procedure ComplicationE19_09Procedure Crew Members IDE19_10Procedure AuthorizationE19_11Procedure Authorizing PhysicianSectionE19Intervention/ Procedure4022006 NHTSA Uniform PreHospital Dataset V.2.2.1PROCEDURE CREW MEMBERS IDE19_09Data [text]DefinitionThe statewide assigned ID number of the EMS crew member performing the procedure on the patientXSD Data Typexs:integerXSD Domain (Simple Type)CrewMemberIDMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint15XSD Structure: Data Elements E19_01 through E19_11 are all members of E19_01_0 Procedure StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Linked to State/Licensure ID Number (D07_02)●List box created from the State/Licensure ID Number (D07_02) which could display the Personnel’s Names as associated with D08_01, D08_02, and D08_03 for easy data entryUses●Part of an EMS Medical Record and to document the Procedure performance●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE19_01Date/Time Procedure Performed E19_02Procedure Performed Prior to this Units SuccessfullyEMS CareE19_03ProcedureE19_04Size of Procedure EquipmentE19_05Number of Procedure AttemptsE19_06Procedure SuccessfulE19_07Procedure ComplicationE19_08Response to ProcedureE19_10Procedure AuthorizationE19_11Procedure Authorizing PhysicianReferences in NHTSA Version 1EssentialElement 26Crew Member One NumberEssentialElement 27Crew Member Two NumberDesirableElement 28Crew Member Three NumberSectionE19Intervention/ Procedure4032006 NHTSA Uniform PreHospital Dataset V.2.2.1PROCEDURE AUTHORIZATIONE19_10Data [combo] single-choiceDefinitionThe type of procedure authorization obtainedXSD Data Typexs:integerXSD Domain (Simple Type)ProcedureAuthorizationMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: Data Elements E19_01 through E19_11 are all members of E19_01_0 Procedure StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available4615On-Line4620On-Scene4625Protocol (Standing Order)4630Written Orders (Patient Specific)Additional Information●Associated with Procedure Authorization (E19_11) if the value is not “Protocol”Uses●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE19_01Date/Time Procedure Performed E19_02Procedure Performed Prior to this Units SuccessfullyEMS CareE19_03ProcedureE19_04Size of Procedure EquipmentE19_05Number of Procedure AttemptsE19_06Procedure SuccessfulE19_07Procedure ComplicationE19_08Response to ProcedureE19_09Procedure Crew Members IDE19_11Procedure Authorizing PhysicianReferences in NHTSA Version 1DesirableElement 81Treatment AuthorizationSectionE19Intervention/ Procedure4042006 NHTSA Uniform PreHospital Dataset V.2.2.1PROCEDURE AUTHORIZING PHYSICIANE19_11Data [text]DefinitionThe last name of the authorizing physician ordering the procedure, if the order was provided by any manner other than protocol (standing order)XSD Data Typexs:stringXSD Domain (Simple Type)ProcedureAuthorzingPhysicianMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint20XSD Structure: Data Elements E19_01 through E19_11 are all members of E19_01_0 Procedure StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Associated with Procedure Authorization (E19_10) if the value is not “Protocol”Uses●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE19_01Date/Time Procedure Performed E19_02Procedure Performed Prior to this Units SuccessfullyEMS CareE19_03ProcedureE19_04Size of Procedure EquipmentE19_05Number of Procedure AttemptsE19_06Procedure SuccessfulE19_07Procedure ComplicationE19_08Response to ProcedureE19_09Procedure Crew Members IDE19_10Procedure AuthorizationSectionE19Intervention/ Procedure4052006 NHTSA Uniform PreHospital Dataset V.2.2.1SUCCESSFUL IV SITEE19_12Data [combo] multiple-choiceDefinitionThe location of the IV site (if applicable) on the patientXSD Data Typexs:integerXSD Domain (Simple Type)SuccessfulIVSiteMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available4635Antecubital-Left4640Antecubital-Right4645External Jugular-Left4650External Jugular-Right4655Femoral-Left IV4660Femoral-Left Distal IO4665Femoral-Right IV4670Femoral-Right IO4675Forearm-Left4680Forearm-Right4685Hand-Left4690Hand-Right4695Lower Extremity-Left4700Lower Extremity-Right4705Other4710Scalp4715Sternal IO4720Tibia IO-Left4725Tibia IO-Right4730UmbilicalUses●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE19Intervention/ Procedure4062006 NHTSA Uniform PreHospital Dataset V.2.2.1TUBE CONFIRMATIONE19_13Data [combo] multiple-choiceDefinitionEndotracheal Tube placement verification at the time the airway procedure was doneXSD Data Typexs:integerXSD Domain (Simple Type)TubeConfirmationMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available4735Auscultation of Bilateral Breath Sounds4740Colormetric CO2 Detector Confirmation4745Digital CO2 Confirmation4750Esophageal Bulb Aspiration confirmation4755Negative Auscultation of the Epigastrium4760Visualization of the Chest Rising with ventilation4765Visualization of Tube Passing Through the Cords4770Waveform CO2 ConfirmationAdditional Information●Associated with Procedure (E19_03) if Airway Procedure leads to IntubationUses●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE19_03ProcedureSectionE19Intervention/ Procedure4072006 NHTSA Uniform PreHospital Dataset V.2.2.1DESTINATION CONFIRMATION OF TUBE PLACEMENTE19_14Data [combo] multiple-choiceDefinitionEndotracheal Tube location verification on the arrival at the Destination (if applicable)XSD Data Typexs:integerXSD Domain (Simple Type)DestinationConfirmationOfTubePlacementMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available4775Auscultation of Bilateral Breath Sounds4780Colormetric CO2 Detector Confirmation4785Digital CO2 Confirmation4790Esophageal Bulb Aspiration confirmation4795Negative Auscultation of the Epigastrium4800Visualization of the Chest Rising with ventilation4805Visualization of Tube Passing Through the Cords4810Waveform CO2 ConfirmationAdditional Information●Associated with Procedure (E19_03) if Airway Procedure leads to IntubationUses●Part of an EMS Medical Record●Reports on Medications and Skills performed along with Protocols used provide key performance evaluation tools●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE19_03ProcedureSectionE19Intervention/ Procedure4082006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE20DispositionSectionE20Disposition4092006 NHTSA Uniform PreHospital Dataset V.2.2.1DESTINATION/TRANSFERRED TO, NAMEE20_01Data [text]DefinitionThe destination the patient was delivered or transferred toXSD Data Typexs:stringXSD Domain (Simple Type)DestinationTransferredToIDMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint50Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Could be an editable single choice list box derived from Hospitals Served (D04_11) and Other Destinations (D04_13)Uses●A component of the EMS Medical Record: Patient Care Report●Important for grouping or comparing data by Destination location and type which also allows data to be sorted by geographic areas in many agencies●Provides information on overall service area, patterns and times for agency configuration and evaluationData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE20_02Destination/Transferred To, CodeSectionE20Disposition4102006 NHTSA Uniform PreHospital Dataset V.2.2.1DESTINATION/TRANSFERRED TO, CODEE20_02Data [text]DefinitionThe code of the destination the patient was delivered or transferred to, if present and availableXSD Data Typexs:stringXSD Domain (Simple Type)DestinationTransferredToCodeMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint50Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Could be an editable single choice list box derived from Hospitals Served (D04_12) and Other Destinations (D04_14)Uses●A component of the EMS Medical Record: Patient Care Report●Important for grouping or comparing data by Destination location and type which also allows data to be sorted by geographic areas in many agencies●Provides information on overall service area, patterns and times for agency configuration and evaluationData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE20_01Destination/Transferred To, NameSectionE20Disposition4112006 NHTSA Uniform PreHospital Dataset V.2.2.1DESTINATION STREET ADDRESSE20_03Data [text]DefinitionThe street address of the destination the patient was delivered or transferred toXSD Data Typexs:stringXSD Domain (Simple Type)StreetAddressMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: E20_03, E20_04, E20_05, and E20_07 are all members of E2-_03_0 Destination Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●A component of the EMS Medical Record: Patient Care Report●Important for grouping or comparing data by Destination location and type which also allows data to be sorted by geographic areas in many agencies●Provides information on overall service area, patterns and times for agency configuration and evaluationData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE20_01Destination/Transferred To, NameE20_04Destination CityE20_05Destination StateE20_07Destination Zip CodeSectionE20Disposition4122006 NHTSA Uniform PreHospital Dataset V.2.2.1DESTINATION CITYE20_04Data [combo] single-choiceDefinitionThe city name of the destination the patient was delivered or transferred toXSD Data Typexs:stringXSD Domain (Simple Type)CityMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: E20_03, E20_04, E20_05, and E20_07 are all members of E2-_03_0 Destination Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●5 digit FIPS Code●Could be filled in from Destination Zip Code (E20_07)Uses●A component of the EMS Medical Record: Patient Care Report●Important for grouping or comparing data by Destination location and type which also allows data to be sorted by geographic areas in many agencies●Provides information on overall service area, patterns and times for agency configuration and evaluationData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE20_01Destination/Transferred To, NameE20_03Destination Street AddressE20_05Destination StateE20_07Destination Zip CodeSectionE20Disposition4132006 NHTSA Uniform PreHospital Dataset V.2.2.1DESTINATION STATEE20_05Data [combo] single-choiceDefinitionThe destination State in which the patient was delivered or transferred toXSD Data Typexs:stringXSD Domain (Simple Type)StateMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint3XSD Structure: E20_03, E20_04, E20_05, and E20_07 are all members of E2-_03_0 Destination Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●2 digit FIPS numeric code (Not State abbreviation)●Could be filled in from Destination Zip Code (E20_07)Uses●A component of the EMS Medical Record: Patient Care Report●Important for grouping or comparing data by Destination location and type which also allows data to be sorted by geographic areas in many agencies●Provides information on overall service area, patterns and times for agency configuration and evaluationData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE20_01Destination/Transferred To, NameE20_03Destination Street AddressE20_04Destination CityE20_07Destination Zip CodeSectionE20Disposition4142006 NHTSA Uniform PreHospital Dataset V.2.2.1DESTINATION COUNTYE20_06Data [combo] single-choiceDefinitionThe destination County in which the patient was delivered or transferred toXSD Data Typexs:stringXSD Domain (Simple Type)CountyMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint5Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Stored as a 5 digit FIPS code (combining the state and county code) to take into account agencies may server more than one state and counties are often named the same from state to stateUses●A component of the EMS Medical Record: Patient Care Report●Important for grouping or comparing data by Destination location and type which also allows data to be sorted by geographic areas in many agencies●Provides information on overall service area, patterns and times for agency configuration and evaluationData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE20_01Destination/Transferred To, NameSectionE20Disposition4152006 NHTSA Uniform PreHospital Dataset V.2.2.1DESTINATION ZIP CODEE20_07Data [text]National ElementDefinitionThe destination zip code in which the patient was delivered or transferred toXSD Data Typexs:stringXSD Domain (Simple Type)ZipMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesXSD Structure: E20_03, E20_04, E20_05, and E20_07 are all members of E2-_03_0 Destination Address StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Can be 5 or 9 digit Zip CodeUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the destination location●Allows data to describe patient's geographic destination●Important for grouping or comparing data by Destination location and type which also allows data to be sorted by geographic areas in many agencies●Provides information on overall service area, patterns and times for agency configuration and evaluationData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE20_01Destination/Transferred To, NameE20_03Destination Street AddressE20_04Destination CityE20_05Destination StateSectionE20Disposition4162006 NHTSA Uniform PreHospital Dataset V.2.2.1DESTINATION GPS LOCATIONE20_08Data [text]DefinitionThe destination GPS coordinates to which the patient was delivered or transferred toXSD Data Typexs:decimalXSD Domain (Simple Type)GPSLocationMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDNoXSD Attributes: Latitude and Longitude are each stored as a separate attributeField ValuesUses●Important for grouping or comparing data by Destination location and type which also allows data to be sorted by geographic areas in many agencies●Provides information on overall service area, patterns and times for agency configuration and evaluationData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE01_01Patient Care Report NumberE20_01Destination/Transferred To, NameSectionE20Disposition4172006 NHTSA Uniform PreHospital Dataset V.2.2.1DESTINATION ZONE NUMBERE20_09Data [combo] single-choiceDefinitionThe zone number of the destination the patient was delivered or transferred toXSD Data Typexs:integerXSD Domain (Simple Type)ZoneNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint30Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Created from Zones (D04_03)●Systems using GPS typically do not need to document or create ZonesUses●Important for grouping or comparing data by Destination location and type which also allows data to be sorted by geographic areas in many agencies●Provides information on overall service area, patterns and times for agency configuration and evaluationData Collector●EMS agency or may be electronically provided through the 911 or dispatch centerOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE20_01Destination/Transferred To, NameSectionE20Disposition4182006 NHTSA Uniform PreHospital Dataset V.2.2.1INCIDENT/PATIENT DISPOSITIONE20_10Data [combo] single-choiceNational ElementDefinitionType of disposition treatment and/or transport of the patient.XSD Data Typexs:integerXSD Domain (Simple Type)IncidentPatientDispositionMultiple Entry ConfigurationNoAccepts Null Values NoRequired in XSDYesField Values4815Cancelled4820Dead at Scene4825No Patient Found4830No Treatment Required4835Patient Refused Care4840Treated and Released4845Treated, Transferred Care4850Treated, Transported by EMS4855Treated, Transported by Law Enforcement4860Treated, Transported by Private VehicleUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the EMS disposition●Allows data to describe EMS patient’s dispositionData Collector●EMS personnelOther Associated ElementsE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 47Incident/Patient DispositionReferences to Other Databases● NFIRS 5.0EMS Module; Title: Disposition; Pick-List: FD Transport to Emergency Care Facility (ECF) = 1, Non-FD Transport = 2, Non-FD Transport with FD Attendant = 3, Non-Emergency Transfer = 4, Other = O, Not Transported under EMS = NSectionE20Disposition4192006 NHTSA Uniform PreHospital Dataset V.2.2.1HOW PATIENT WAS MOVED TO AMBULANCEE20_11Data [combo] single-choiceDefinitionThe method the patient was moved to the ambulance from the sceneXSD Data Typexs:integerXSD Domain (Simple Type)HowPatientWasMovedToAmbulanceMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available4865Assisted/Walk4870Carry4875Stairchair4880Stretcher4885OtherUses●Part of an EMS Medical Record●Used in Quality Management for the evaluation of CareData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE20Disposition4202006 NHTSA Uniform PreHospital Dataset V.2.2.1POSITION OF PATIENT DURING TRANSPORTE20_12Data [combo] single-choiceDefinitionThe position of the patient during transport from the sceneXSD Data Typexs:integerXSD Domain (Simple Type)PositionOfPatientDurningTransportMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available4890Car Seat4895Fowlers4900Lateral4905Prone4910Semi-Fowlers4915Sitting4920Supine4925OtherUses●Part of an EMS Medical Record●Used in Quality Management for the evaluation of CareData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE20Disposition4212006 NHTSA Uniform PreHospital Dataset V.2.2.1HOW PATIENT WAS TRANSPORTED FROM AMBULANCEE20_13Data [combo] single-choiceDefinitionThe method the patient was moved from the ambulance to the destinationXSD Data Typexs:integerXSD Domain (Simple Type)HowPatientWasTransportedFromAmbulanceMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available4930Assisted/Walk4935Carry4940Stairchair4945Stretcher4950OtherUses●Part of an EMS Medical Record●Used in Quality Management for the evaluation of CareData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE20Disposition4222006 NHTSA Uniform PreHospital Dataset V.2.2.1TRANSPORT MODE FROM SCENEE20_14Data [combo] single-choiceNational ElementDefinitionIndication whether or not lights and/or sirens were used on the vehicle while leaving sceneXSD Data Typexs:integerXSD Domain (Simple Type)TransportModeFromSceneMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available4955Initial Lights and Sirens, Downgraded to No Lights or Sirens4960Initial No Lights or Sirens, Upgraded to Lights and Sirens4965Lights and Sirens4970No Lights or SirensUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the transportation mode●Allows data to describe transportation mode used by EMSData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 46Lights and Sirens used from the SceneSectionE20Disposition4232006 NHTSA Uniform PreHospital Dataset V.2.2.1CONDITION OF PATIENT AT DESTINATIONE20_15Data [combo] single-choiceDefinitionThe condition of the patient after care by EMSXSD Data Typexs:integerXSD Domain (Simple Type)ConditionOfPatientAtDestinationMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available4975Improved4980Unchanged4985WorseUses●Outcome indicator●Part of an EMS Medical Record●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences to Other Databases● NFIRS 5.0EMS Module; Title: Patient Status; The patient’s status when transferred to another agency.; Pick-List: Improved = 1, Remained Same = 2, Worsened = 3SectionE20Disposition4242006 NHTSA Uniform PreHospital Dataset V.2.2.1REASON FOR CHOOSING DESTINATIONE20_16Data [combo] single-choiceNational ElementDefinitionThe reason the unit chose to deliver or transfer the patient to the destinationXSD Data Typexs:integerXSD Domain (Simple Type)ReasonForChoosingDestinationMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available4990Closest Facility (none below)4995Diversion5000Family Choice5005Insurance Status5010Law Enforcement Choice5015On-Line Medical Direction5020Other5025Patient Choice5030Patient's Physicians Choice5035Protocol5040Specialty Resource CenterUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted based on the destination choice●Allows data to give a reason for choosing the patient’s destination which is important to document from a specialty care agency and diversion/overcrowding perspectiveData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences in NHTSA Version 1EssentialElement 45Destination DeterminationSectionE20Disposition4252006 NHTSA Uniform PreHospital Dataset V.2.2.1TYPE OF DESTINATIONE20_17Data [combo] single-choiceNational ElementDefinitionThe type of destination the patient was delivered or transferred toXSD Data Typexs:integerXSD Domain (Simple Type)TypeOfDestinationMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available7270Home7280Hospital7290Medical Office/Clinic7300Morgue7320Nursing Home7330Other7340Other EMS Responder (air)7350Other EMS Responder (ground)7360Police/JailUses●A component of the EMS Medical Record: Patient Care Report●Allows data to be sorted or grouped based on the EMS transports destination type●Allows data to describe EMS patient’s destination typeData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE20_01Destination/Transferred To, NameReferences in NHTSA Version 1EssentialElement 44Destination/Transferred ToSectionE20Disposition4262006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE21Medical Device DataSectionE21Medical Device Data4272006 NHTSA Uniform PreHospital Dataset V.2.2.1EVENT DATE/TIMEE21_01Data [date/time]DefinitionThe time of the event recorded by the device’s internal clockXSD Data Typexs:dateTimeXSD Domain (Simple Type)DateTimeMultiple Entry ConfigurationYes, via structureAccepts Null Values Yes, but null value is blank or emptyRequired in XSDNoMinimum Constraint1,990Maximum Constraint2,030XSD Structure: (1) Each element is section E21 is associated with a E21_01 Date/Time. Field ValuesAdditional Information●Depending on whether this is a Procedure or a Vital Sign, this can be merged into Date/Time Vital Taken (E14_01) or Date/Time Procedure Performed Successfully (E19_01)●If the date/time is electronically stored within a database or transmitted via XML as a “tick”, the referenced variables may also be used●Multiple entry configuration associated with the entire Medical Device Section (E21) to allow multiple sets of device data to be enteredUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●Medical device and electronically transmitted to the EMS database for further useOther Associated ElementsE01_01Patient Care Report NumberSectionE21Medical Device Data4282006 NHTSA Uniform PreHospital Dataset V.2.2.1MEDICAL DEVICE EVENT NAMEE21_02Data [text]DefinitionThe type of event documented by the medical device.XSD Data Typexs:integerXSD Domain (Simple Type)MedicalDeviceEventIDMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoXSD Structure: (1) Each element is section E21 is associated with a E21_01 Date/Time. Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available509012-Lead ECG5095Analysis (Button Pressed)5100CO25105Date Transmitted5110Defibrillation5115ECG-Monitor5120Heart Rate5125Invasive Pressure 15130Invasive Pressure 25135No Shock Advised5140Non-Invasive BP5145Pacing Electrical Capture5150Pacing Started5155Pacing Stopped5160Patient Connected5165Power On5170Pulse Oximetry5175Pulse Rate5180Respiratory Rate5185Shock Advised5190Sync Off5195Sync OnAdditional Information●Depending on the event, this data can be merged with Vital Sign or Procedure Data defined in Sections E14 and E19Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●Medical device and electronically transmitted to the EMS database for further useOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE21_01Event Date/TimeSectionE21Medical Device Data4292006 NHTSA Uniform PreHospital Dataset V.2.2.1WAVEFORM GRAPHIC TYPEE21_03Data [text]DefinitionThe type of waveform file stored in Waveform Graphic (E21.4)XSD Data Typexs:integerXSD Domain (Simple Type)WaveformGraphicTypeMultiple Entry ConfigurationYes, as associated with Accepts Null Values NoE21_01 Date/TimeRequired in XSDNoXSD Structure: (1) Each element is section E21 is associated with a E21_01 Date/Time. (2) E21_03 and E21_04 are elements of E23_03_0 Waveform Structure. Field Values5200JPG5205PDFAdditional Information●Associated with Event Date/Time (E21_01) and only if appropriate for the Medical Device Event (E21_02)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●Medical device and electronically transmitted to the EMS database for further useOther Associated ElementsE01_01Patient Care Report NumberE21_01Event Date/TimeE21_02Medical Device Event NameE21_04Waveform GraphicSectionE21Medical Device Data4302006 NHTSA Uniform PreHospital Dataset V.2.2.1WAVEFORM GRAPHICE21_04Data [binary]DefinitionThe graphic waveform file in a PDF or JPG format.XSD Data Typexs:base64BinaryXSD Domain (Simple Type)WaveformGraphicMultiple Entry ConfigurationYes, as associated with Accepts Null Values NoE21_01 Date/TimeRequired in XSDNoXSD Structure: (1) Each element is section E21 is associated with a E21_01 Date/Time. (2) E21_03 and E21_04 are elements of E23_03_0 Waveform Structure. Field Values Additional Information●Associated with Event Date/Time (E21_01) and only if appropriate for the Medical Device Event (E21_02)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●Medical device and electronically transmitted to the EMS database for further useOther Associated ElementsE01_01Patient Care Report NumberE21_01Event Date/TimeE21_02Medical Device Event NameE21_03Waveform Graphic TypeSectionE21Medical Device Data4312006 NHTSA Uniform PreHospital Dataset V.2.2.1AED, PACING, OR CO2 MODEE21_05Data [text]DefinitionThe mode of operation the device is operating in during the defibrillation, pacing, or rhythm analysis by the device (if appropriate for the event)XSD Data Typexs:integerXSD Domain (Simple Type)AEDPacingOrCO2ModeMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoXSD Structure: (1) Each element is section E21 is associated with a E21_01 Date/Time. Field Values5210Automated5215Manual5220Advisory5225Demand5230Sensing5235Mid-Stream5240Side-StreamAdditional Information●Associated with Event Date/Time (E21_01) and only if appropriate for the Medical Device Event (E21_02)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●Medical device and electronically transmitted to the EMS database for further useOther Associated ElementsE01_01Patient Care Report NumberE21_01Event Date/TimeE21_02Medical Device Event NameSectionE21Medical Device Data4322006 NHTSA Uniform PreHospital Dataset V.2.2.1ECG LEADE21_06Data [text]DefinitionThe lead or source which the medical device used to obtain the rhythm (if appropriate for the event)XSD Data Typexs:integerXSD Domain (Simple Type)ECGLeadMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoXSD Structure: (1) Each element is section E21 is associated with a E21_01 Date/Time. Field Values5245I5250II5255III5260AVR5265AVL5270AVF5275V15280V25285V35290V45295V55300V65305PaddleAdditional Information●Associated with Event Date/Time (E21_01) and only if appropriate for the Medical Device Event (E21_02)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●Medical device and electronically transmitted to the EMS database for further useOther Associated ElementsE01_01Patient Care Report NumberE21_01Event Date/TimeE21_02Medical Device Event NameSectionE21Medical Device Data4332006 NHTSA Uniform PreHospital Dataset V.2.2.1ECG INTERPRETATIONE21_07Data [text]DefinitionThe interpretation of the rhythm by the device (if appropriate for the event)XSD Data Typexs:stringXSD Domain (Simple Type)ECGInterpretationMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint1Maximum Constraint2,000XSD Structure: (1) Each element is section E21 is associated with a E21_01 Date/Time. Field ValuesAdditional Information●Associated with Event Date/Time (E21_01) and only if appropriate for the Medical Device Event (E21_02)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●Medical device and electronically transmitted to the EMS database for further useOther Associated ElementsE01_01Patient Care Report NumberE21_01Event Date/TimeE21_02Medical Device Event NameSectionE21Medical Device Data4342006 NHTSA Uniform PreHospital Dataset V.2.2.1TYPE OF SHOCKE21_08Data [text]DefinitionThe energy form used by the device for the defibrillation (if appropriate for the event)XSD Data Typexs:integerXSD Domain (Simple Type)TypeOfShockMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoXSD Structure: (1) Each element is section E21 is associated with a E21_01 Date/Time. Field Values5310Biphasic5315MonophasicAdditional Information●Associated with Event Date/Time (E21_01) and only if appropriate for the Medical Device Event (E21_02)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●Medical device and electronically transmitted to the EMS database for further useOther Associated ElementsE01_01Patient Care Report NumberE21_01Event Date/TimeE21_02Medical Device Event NameSectionE21Medical Device Data4352006 NHTSA Uniform PreHospital Dataset V.2.2.1SHOCK OR PACING ENERGYE21_09Data [number]DefinitionThe energy used for the shock or pacing event (if appropriate for the event)XSD Data Typexs:decimalXSD Domain (Simple Type)ShockOrPacingEnergyMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint1Maximum Constraint9,000XSD Structure: (1) Each element is section E21 is associated with a E21_01 Date/Time. Field ValuesAdditional Information●Associated with Event Date/Time (E21_01) and only if appropriate for the Medical Device Event (E21_02)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●Medical device and electronically transmitted to the EMS database for further useOther Associated ElementsE01_01Patient Care Report NumberE21_01Event Date/TimeE21_02Medical Device Event NameSectionE21Medical Device Data4362006 NHTSA Uniform PreHospital Dataset V.2.2.1TOTAL NUMBER OF SHOCKS DELIVEREDE21_10Data [number]DefinitionThe number of times the patient was defibrillated, if the patient was defibrillated during the patient encounter.XSD Data Typexs:integerXSD Domain (Simple Type)TotalNumberOfShocksMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint1Maximum Constraint100XSD Structure: (1) Each element is section E21 is associated with a E21_01 Date/Time. Field ValuesUses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●Medical device and electronically transmitted to the EMS database for further useOther Associated ElementsE01_01Patient Care Report NumberE21_01Event Date/TimeE21_02Medical Device Event NameSectionE21Medical Device Data4372006 NHTSA Uniform PreHospital Dataset V.2.2.1PACING RATEE21_11Data [number]DefinitionThe rate the device was calibrated to pace during the event, if appropriate.XSD Data Typexs:integerXSD Domain (Simple Type)PacingRateMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint1Maximum Constraint1,000XSD Structure: (1) Each element is section E21 is associated with a E21_01 Date/Time. Field ValuesAdditional Information●Associated with Event Date/Time (E21_01) and only if appropriate for the Medical Device Event (E21_02)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●Medical device and electronically transmitted to the EMS database for further useOther Associated ElementsE01_01Patient Care Report NumberE21_01Event Date/TimeE21_02Medical Device Event NameSectionE21Medical Device Data4382006 NHTSA Uniform PreHospital Dataset V.2.2.1DEVICE HEART RATEE21_12Data [number]DefinitionThe heart rate electronically obtained by the device (if appropriate for the event)XSD Data Typexs:integerXSD Domain (Simple Type)PulseRateMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint0Maximum Constraint500XSD Structure: (1) Each element is section E21 is associated with a E21_01 Date/Time. Field ValuesAdditional Information●Associated with Event Date/Time (E21_01) and only if appropriate for the Medical Device Event (E21_02)●Could be merged into Electronic Monitor Rate (E14_08)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●Medical device and electronically transmitted to the EMS database for further useOther Associated ElementsE01_01Patient Care Report NumberE21_01Event Date/TimeE21_02Medical Device Event NameSectionE21Medical Device Data4392006 NHTSA Uniform PreHospital Dataset V.2.2.1DEVICE PULSE RATEE21_13Data [number]DefinitionThe pulse rate as measured from the pulse oximeter, non-invasive pressure, or invasive pressure transducers (if appropriate for the event)XSD Data Typexs:integerXSD Domain (Simple Type)PulseRateMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint0Maximum Constraint500XSD Structure: (1) Each element is section E21 is associated with a E21_01 Date/Time. Field ValuesAdditional Information●Associated with Event Date/Time (E21_01) and only if appropriate for the Medical Device Event (E21_02)●Could be merged into Pulse Rate (E14_07)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●Medical device and electronically transmitted to the EMS database for further useOther Associated ElementsE01_01Patient Care Report NumberE21_01Event Date/TimeE21_02Medical Device Event NameSectionE21Medical Device Data4402006 NHTSA Uniform PreHospital Dataset V.2.2.1DEVICE SYSTOLIC BLOOD PRESSUREE21_14Data [number]DefinitionThe Systolic Blood Pressure as measured either through non-invasive blood pressure, invasive blood pressure monitor 1, or invasive blood pressure monitor 2 (if appropriate for the event)XSD Data Typexs:integerXSD Domain (Simple Type)SBPMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint0Maximum Constraint400XSD Structure: (1) Each element is section E21 is associated with a E21_01 Date/Time. Field ValuesAdditional Information●Associated with Event Date/Time (E21_01) and only if appropriate for the Medical Device Event (E21_02)●Could be merged into Systolic Blood Pressure (E14_04)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●Medical device and electronically transmitted to the EMS database for further useOther Associated ElementsE01_01Patient Care Report NumberE21_01Event Date/TimeE21_02Medical Device Event NameE21_19Device CO2, etCO2, or Invasive Pressure Monitor UnitsSectionE21Medical Device Data4412006 NHTSA Uniform PreHospital Dataset V.2.2.1DEVICE DIASTOLIC BLOOD PRESSUREE21_15Data [number]DefinitionThe Diastolic Blood Pressure as measured either through non-invasive blood pressure, invasive blood pressure monitor 1, or invasive blood pressure monitor 2 (if appropriate for the event)XSD Data Typexs:integerXSD Domain (Simple Type)DBPMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint0Maximum Constraint300XSD Structure: (1) Each element is section E21 is associated with a E21_01 Date/Time. Field ValuesAdditional Information●Associated with Event Date/Time (E21_01) and only if appropriate for the Medical Device Event (E21_02)●Could be merged into Diastolic Blood Pressure (E14_05)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●Medical device and electronically transmitted to the EMS database for further useOther Associated ElementsE01_01Patient Care Report NumberE21_01Event Date/TimeE21_02Medical Device Event NameE21_19Device CO2, etCO2, or Invasive Pressure Monitor UnitsSectionE21Medical Device Data4422006 NHTSA Uniform PreHospital Dataset V.2.2.1DEVICE RESPIRATORY RATEE21_16Data [number]DefinitionThe Respiratory Rate as calculated from the device through one of the various monitoring parameters (if appropriate for the event)XSD Data Typexs:integerXSD Domain (Simple Type)RespiratoryRateMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint0Maximum Constraint100XSD Structure: (1) Each element is section E21 is associated with a E21_01 Date/Time. Field ValuesAdditional Information●Associated with Event Date/Time (E21_01) and only if appropriate for the Medical Device Event (E21_02)●Could be merged into Respiratory Rate (E14_11)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●Medical device and electronically transmitted to the EMS database for further useOther Associated ElementsE01_01Patient Care Report NumberE21_01Event Date/TimeE21_02Medical Device Event NameSectionE21Medical Device Data4432006 NHTSA Uniform PreHospital Dataset V.2.2.1DEVICE PULSE OXIMETRYE21_17Data [number]DefinitionThe Oxygen Saturation as measured from the pulse oximeter in % (if appropriate for the event)XSD Data Typexs:integerXSD Domain (Simple Type)DeviceCO2Multiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint0Maximum Constraint100XSD Structure: (1) Each element is section E21 is associated with a E21_01 Date/Time. Field ValuesAdditional Information●Associated with Event Date/Time (E21_01) and only if appropriate for the Medical Device Event (E21_02)●Could be merged into Pulse Oximetry (E14_09)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●Medical device and electronically transmitted to the EMS database for further useOther Associated ElementsE01_01Patient Care Report NumberE21_01Event Date/TimeE21_02Medical Device Event NameSectionE21Medical Device Data4442006 NHTSA Uniform PreHospital Dataset V.2.2.1DEVICE CO2 OR ETCO2E21_18Data [number]DefinitionThe Carbon Dioxide or end-tidal Carbon Dioxide as measured from the device transducers (if appropriate for the event)XSD Data Typexs:integerXSD Domain (Simple Type)DeviceCO2Multiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint0Maximum Constraint100XSD Structure: (1) Each element is section E21 is associated with a E21_01 Date/Time. (2) Elements E21_18 and E21_19 are members of E21_18_0 CO2 Structure. Field ValuesAdditional Information●Associated with Event Date/Time (E21_01) and only if appropriate for the Medical Device Event (E21_02)●Could be merged into Carbon Dioxide (E14_13)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●Medical device and electronically transmitted to the EMS database for further useOther Associated ElementsE01_01Patient Care Report NumberE21_01Event Date/TimeE21_02Medical Device Event NameE21_19Device CO2, etCO2, or Invasive Pressure Monitor UnitsSectionE21Medical Device Data4452006 NHTSA Uniform PreHospital Dataset V.2.2.1DEVICE CO2, ETCO2, OR INVASIVE PRESSURE MONITOR UNITSE21_19Data [text]DefinitionThe Units of Carbon Dioxide, end-tidal Carbon Dioxide, invasive pressure monitor 1, or invasive pressure monitor 2 as measured from the device transducers (if appropriate for the event)XSD Data Typexs:integerXSD Domain (Simple Type)DeviceCO2etCO2OrInvasivePressureUnitsMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoXSD Structure: (1) Each element is section E21 is associated with a E21_01 Date/Time. (2) Elements E21_18 and E21_19 are members of E21_18_0 CO2 Structure. Field Values5320kPa5325% Volume5330mmHgAdditional Information●Associated with Event Date/Time (E21_01) and only if appropriate for the Medical Device Event (E21_02)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●Medical device and electronically transmitted to the EMS database for further useOther Associated ElementsE01_01Patient Care Report NumberE21_01Event Date/TimeE21_02Medical Device Event NameE21_14Device Systolic Blood PressureE21_15Device Diastolic Blood PressureE21_18Device CO2 or etCO2E21_20Device Invasive Pressure MeanSectionE21Medical Device Data4462006 NHTSA Uniform PreHospital Dataset V.2.2.1DEVICE INVASIVE PRESSURE MEANE21_20Data [number]DefinitionThe Invasive Pressure Mean as calculated either through the invasive pressure monitor 1 or the invasive pressure monitor 2 (if appropriate for the event)XSD Data Typexs:integerXSD Domain (Simple Type)DeviceInvasivePressureMeanMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint1Maximum Constraint1,000XSD Structure: (1) Each element is section E21 is associated with a E21_01 Date/Time. Field ValuesAdditional Information●Associated with Event Date/Time (E21_01) and only if appropriate for the Medical Device Event (E21_02)Uses●Part of an EMS Medical Record●Provides documentation of Assessment and Care●Used in Quality Management for the evaluation of Care and EMS Agency PerformanceData Collector●Medical device and electronically transmitted to the EMS database for further useOther Associated ElementsE01_01Patient Care Report NumberE21_01Event Date/TimeE21_02Medical Device Event NameE21_19Device CO2, etCO2, or Invasive Pressure Monitor UnitsSectionE21Medical Device Data4472006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE22Outcome and LinkageSectionE22Outcome and Linkage4482006 NHTSA Uniform PreHospital Dataset V.2.2.1EMERGENCY DEPARTMENT DISPOSITIONE22_01Data [combo] single-choiceNational ElementDefinitionThe known disposition of the patient from the Emergency Department (ED)XSD Data Typexs:integerXSD Domain (Simple Type)EmergencyDepartmentDispositionMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available5335Admitted to Hospital Floor5340Admitted to Hospital ICU5345Death5350Not Applicable (Not Transported to ED)5355Released5360TransferredUses●Allows data to be sorted based on the EMS patient outcome●Allows data to describe EMS patient outcomeData Collector●EMS Agency: Could be collected by EMS Administration or electronically provided through linkage with hospital databasesOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE22Outcome and Linkage4492006 NHTSA Uniform PreHospital Dataset V.2.2.1HOSPITAL DISPOSITIONE22_02Data [combo] single-choiceNational ElementDefinitionIndication of how the patient was dispositioned from the hospital, if admitted.XSD Data Typexs:integerXSD Domain (Simple Type)HospitalDispositionMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDYesField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available5365Death5370Discharged5375Transfer to Hospital5380Transfer to Nursing Home5385Transfer to Other5390Transfer to Rehabilitation FacilityUses●Allows data to be sorted based on the EMS patient outcome●Allows data to describe EMS patient outcomeData Collector●EMS Agency: Could be collected by EMS Administration or electronically provided through linkage with hospital databasesOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberReferences to Other Databases● UTSTEINTitle: Survived Event to ED/ICU; Admitted to ED, Admitted to ICUSectionE22Outcome and Linkage4502006 NHTSA Uniform PreHospital Dataset V.2.2.1LAW ENFORCEMENT/CRASH REPORT NUMBERE22_03Data [text]DefinitionThe unique number associated with the law enforcement or crash report which can be used for linkage at a later date.XSD Data Typexs:stringXSD Domain (Simple Type)LawEnforcementCrashReportNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint20Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Important linkage between EMS data and Crash or Vehicle Data for Outcome evaluationData Collector●EMS Agency: Could be collected by EMS Administration or electronically provided through linkage with hospital databasesOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE22Outcome and Linkage4512006 NHTSA Uniform PreHospital Dataset V.2.2.1TRAUMA REGISTRY IDE22_04Data [text]DefinitionThe unique number associated with the local or state trauma registry which can be used for linkage at a later date.XSD Data Typexs:stringXSD Domain (Simple Type)TraumaRegistryIDMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint20Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Important for Quality Management of the overall EMS Agency and Clinical performance●Important linkage between EMS data and Trauma Data for Outcome evaluationData Collector●EMS Agency: Could be collected by EMS Administration or electronically provided through linkage with hospital databasesOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE22Outcome and Linkage4522006 NHTSA Uniform PreHospital Dataset V.2.2.1FIRE INCIDENT REPORT NUMBERE22_05Data [text]DefinitionThe unique number associated with the fire incident report which can be used for linkage at a later date.XSD Data Typexs:stringXSD Domain (Simple Type)FireIncidentReportNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint20Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Important for Quality Management of the overall EMS Agency and Clinical performance●Important linkage between EMS data and Fire Data for Outcome evaluationData Collector●EMS Agency: Could be collected by EMS Administration or electronically provided through linkage with hospital databasesOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE22Outcome and Linkage4532006 NHTSA Uniform PreHospital Dataset V.2.2.1PATIENT ID BAND/TAG NUMBERE22_06Data [text]DefinitionThe unique number associated with a patient ID band agency. This is used by a few states as a universal linkage between healthcare data agencies.XSD Data Typexs:stringXSD Domain (Simple Type)PatientIDBandTagNumberMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint20Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableUses●Important for Quality Management of the overall EMS Agency and Clinical performance●Important linkage between EMS data and the other components of the healthcare agencyData Collector●EMS Agency: Could be collected by EMS Administration or electronically provided through linkage with hospital databasesOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE22Outcome and Linkage4542006 NHTSA Uniform PreHospital Dataset V.2.2.1SectionE23MiscellaneousSectionE23Miscellaneous4552006 NHTSA Uniform PreHospital Dataset V.2.2.1REVIEW REQUESTEDE23_01Data [combo] single-choiceDefinitionIndication of whether the form needs review by anyone.XSD Data Typexs:integerXSD Domain (Simple Type)YesNoValuesMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available0No1YesUses●Agency related field to identify records for Quality Management reviewData Collector●EMS personnel or anyone associated with the EMS agencyOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE23Miscellaneous4562006 NHTSA Uniform PreHospital Dataset V.2.2.1POTENTIAL REGISTRY CANDIDATEE23_02Data [combo] multiple-choiceDefinitionAn indication if the patient may meet the entry criteria for a injury or illness specific registryXSD Data Typexs:integerXSD Domain (Simple Type)PotentialRegistryCandidateMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available5395Burn5400Cardiac/MI5405CVA/Stroke5410Drowning5415Spinal Cord Injury5420Trauma5425Traumatic Brain Injury5430OtherUses●Allows reports to be generated to assist in the enrollment of patients in mandated registriesData Collector●EMS Agency: Could be collected by EMS Administration or electronically provided through linkage with hospital databasesOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE23Miscellaneous4572006 NHTSA Uniform PreHospital Dataset V.2.2.1PERSONAL PROTECTIVE EQUIPMENT USEDE23_03Data [combo] multiple-choiceDefinitionThe personal protective equipment which was used by EMS personnel during this EMS patient contact.XSD Data Typexs:integerXSD Domain (Simple Type)PersonalProtectiveEquipmentUsedMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available5435Eye Protection5440Gloves5445Level A Suit5450Level B Suit5455Level C Suit5460Mask5465OtherUses●Important for the Quality Management evaluation of personnel performance and safety initiatives●Part of an EMS Medical RecordData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE23Miscellaneous4582006 NHTSA Uniform PreHospital Dataset V.2.2.1SUSPECTED INTENTIONAL, OR UNINTENTIONAL DISASTERE23_04Data [combo] multiple-choiceDefinitionSuspicion of the listed multi-casualty or domestic terrorism causes.XSD Data Typexs:integerXSD Domain (Simple Type)SuspectedIntentionalOrUnintentionalDisasterMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available5470Biologic Agent5475Building Failure5480Chemical Agent5485Explosive Device5490Fire5495Hostage Event5500Mass Gathering5505Nuclear Agent5510Radioactive Device5515Secondary Destructive Device5520Shooting/Sniper5525Vehicular5530WeatherUses●May assist in the tracking and identification of Disaster or Terrorism related eventsData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE23Miscellaneous4592006 NHTSA Uniform PreHospital Dataset V.2.2.1SUSPECTED CONTACT WITH BLOOD/BODY FLUIDS OF EMS INJURY OR DEATHE23_05Data [combo] single-choiceDefinitionIndication of unprotected contact with blood or body fluidsXSD Data Typexs:integerXSD Domain (Simple Type)YesNoValuesMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available0No1YesAdditional Information●If Suspected Contact with Blood/Body Fluids of EMS Injury or Death (E23_05) is "YES", then Type of Syspected Blood/Body Fluid Exposure, Injury or Death (E23_06) and Personnel Exposed (E23_07) should be completedUses●Important for the Quality Management evaluation of personnel performance and safety initiatives●Part of an EMS Medical RecordData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE23_06Type of Suspected Blood/Body Fluid E23_07Personnel ExposedExposure, Injury, or DeathSectionE23Miscellaneous4602006 NHTSA Uniform PreHospital Dataset V.2.2.1TYPE OF SUSPECTED BLOOD/BODY FLUID EXPOSURE, INJURY, OR E23_06Data [combo] multiple-choiceDefinitionThe type of exposure or unprotected contact with blood or body fluidsXSD Data Typexs:integerXSD Domain (Simple Type)TypeOfSuspectedExposureToBodilyFluidsMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available5540Contact to Broken Skin5545Contact to Intact Skin5550Contact with Eye5555Contact with Mucosal Surface5560Inhalation Exposure5565Needle Stick with Fluid Injection5570Needle Stick without Fluid Injection5575Other Physical injury5580Death5585NoneAdditional Information●If Suspected Contact with Blood/Body Fluids of EMS Injury or Death (E23_05) is "YES", then Type of Syspected Blood/Body Fluid Exposure, Injury or Death (E23_06) and Personnel Exposed (E23_07) should be completedUses●Important for the Quality Management evaluation of personnel performance and safety initiatives●Part of an EMS Medical RecordData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE23_05Suspected Contact with Blood/Body Fluids E23_07Personnel Exposedof EMS Injury or DeathSectionE23Miscellaneous4612006 NHTSA Uniform PreHospital Dataset V.2.2.1PERSONNEL EXPOSEDE23_07Data [combo] multiple-choiceDefinitionThe EMS personnel who was/were exposed to unprotected contact with blood or body fluidsXSD Data Typexs:integerXSD Domain (Simple Type)PersonnelExposedMultiple Entry ConfigurationYesAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available5590This EMS Crew5595Non-EMS individual5600Other EMS PersonnelAdditional Information●If Suspected Contact with Blood/Body Fluids of EMS Injury or Death (E23_05) is "YES", then Type of Syspected Blood/Body Fluid Exposure, Injury or Death (E23_06) and Personnel Exposed (E23_07) should be completedUses●Important for the Quality Management evaluation of personnel performance and safety initiatives●Part of an EMS Medical RecordData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE23_05Suspected Contact with Blood/Body Fluids E23_06Type of Suspected Blood/Body Fluid of EMS Injury or DeathExposure, Injury, or DeathSectionE23Miscellaneous4622006 NHTSA Uniform PreHospital Dataset V.2.2.1REQUIRED REPORTABLE CONDITIONSE23_08Data [combo] single-choiceDefinitionThe presence of any condition which is reportable based on federal or state regulations.XSD Data Typexs:integerXSD Domain (Simple Type)YesNoValuesMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available0No1YesUses●Allows reports to be generated to assist in the required reporting of mandated medical or social conditions●Important for the Quality Management evaluation of personnel performance and safety initiatives●Part of an EMS Medical RecordData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE23Miscellaneous4632006 NHTSA Uniform PreHospital Dataset V.2.2.1RESEARCH SURVEY FIELDE23_09Data [text]DefinitionA customizable field to be used by local agencies for additional documentation or research.XSD Data Typexs:stringXSD Domain (Simple Type)ResearchFieldMultiple Entry ConfigurationYes, via structureAccepts Null Values YesRequired in XSDNoMinimum Constraint1Maximum Constraint50XSD Structure: Elements E23_09 and E23_11 are members of E23_09_0 Research Data StructureField Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not Available Additional Information●A multiple entry configuration to allow multiple Research Survey FieldsUses●Used by local EMS agencies to document issues which are specific to an agency or related to research or short term evaluationData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberE23_11Research Survey Field TitleSectionE23Miscellaneous4642006 NHTSA Uniform PreHospital Dataset V.2.2.1WHO GENERATED THIS REPORT?E23_10Data [text]DefinitionThe statewide assigned ID number of the EMS crew member which completed this patient care reportXSD Data Typexs:integerXSD Domain (Simple Type)CrewMemberIDMultiple Entry ConfigurationNoAccepts Null Values YesRequired in XSDNoMinimum Constraint2Maximum Constraint15Field Values-25Not Applicable-20Not Recorded-15Not Reporting-10Not Known-5Not AvailableAdditional Information●Linked to State/Licensure ID Number (D07_02)●List box created from the State/Licensure ID Number (D07_02) which could display the Personnel’s Names as associated with D08_01, D08_02, and D08_03 for easy data entryUses●Important for the Quality Management evaluation●Part of an EMS Medical RecordData Collector●EMS personnelOther Associated ElementsE00Common Null ValuesE01_01Patient Care Report NumberSectionE23Miscellaneous4652006 NHTSA Uniform PreHospital Dataset V.2.2.1RESEARCH SURVEY FIELD TITLEE23_11Data [text]DefinitionA customizable field to be used by local agencies for additional documentation or research.XSD Data Typexs:stringXSD Domain (Simple Type)ResearchTitleMultiple Entry ConfigurationYes, via structureAccepts Null Values NoRequired in XSDNoMinimum Constraint2Maximum Constraint30XSD Structure: Elements E23_09 and E23_11 are members of E23_09_0 Research Data StructureField Values Additional Information●A multiple entry configuration to allow multiple Research Survey FieldsUses●Used by local EMS agencies to document issues which are specific to an agency or related to research or short term evaluationData Collector●EMS personnelOther Associated ElementsE01_01Patient Care Report NumberE23_09Research Survey FieldSectionE23Miscellaneous4662006 NHTSA Uniform PreHospital Dataset V.2.2.1 Appendix – AModification Date 04 / 09 / 2012E18_04 – Medication Administration RoutePage 3854195 = Intranasal was already in the XML Schema but missing from the Data DictionaryModification Date 05 / 04 / 2010D07_03 - PERSONNEL’S EMPLOYMENT STATUSPage 94According to the NEMSIS XSD the NEMSIS Data Dictionary 2.2.1 was missing a value for Element D07_03. This omission has been corrected. Below is the value that was added: ElementElement NameValueValue NameD07_03Personnel’s Employment Status7535No Longer Employed By ServiceModification Date 02 / 24 / 2010E12_04 - FIRST NAME OF PATIENT'S PRIMARY PRACTITIONER Page 297E12_05 - MIDDLE NAME OF PATIENT'S PRIMARY PRACTITIONER Page 298E12_06 - LAST NAME OF PATIENT'S PRIMARY PRACTITIONER Page 299The Data Dictionary does not accurately reflect the XSD structure for E12_04, E12_05 and E12_06. According to the XSD, these three elements are child elements of E12_4_0 however the Data Dictionary shows E12_04_0: "XSD Structure: E12_04, E12_05, and E12_06 are all members of E12_04_0 Primary Practitioner's Name Structure". This is causing problems for submission of data to Pennsylvania. E12_04_0 has been changed to E12_4_0Modification Date 1 / 24 / 2009 D04_04 - PROCEDURESPage 344Procedures codes have been added to D04_04 as shown in the table below.Modification Date 10 / 27 / 2008E23_09 - RESEARCH SURVEY FIELDPage 464Data Dictionary maximum constraint changed from 2 to 1. Maximum value changed from 30 to 50Modification Date 10 / 14 / 2008E14_05 - DBP (Diastolic Blood Pressure)Page 317Data Dictionary maximum constraint changed to 200, from 300, because XSD has 200 for maximum valueE14_26 - APGAR Page 338“Accept Null Values” changed from “No” to “Yes, but null value is blank or empty”E04_03 - Crew Member Level Page 471D04_01 - State Certification Licensure LevelsPage 473 For element E04_03 the Data Dictionary indicates this field is an integer value. However the values for E04_03 are based on a demographic list pulled from data element D04_01, which allows for text to provide for state-specific crew member levels not included in the NEMSIS set. The “XSD Data Type” for D04_01 indicates “string/integer”. To reflect this, E04_01 “XSD Data Type” was changed to “string/integer”. Modification Date 2007E11_06 - Any Return of Spontaneous CirculationPage 283“0 No” changed to “2380 No”INDEX911 Call Volume per Year15Abdomen Left Lower 364Abdomen Left Upper 363Abdomen Right Lower 366Abdomen Right Upper 365Advanced Directives296AED, Pacing, or CO2 Mode432Age185Age Units186Agency Contact Address27Agency Contact City28Agency Contact Email Address33Agency Contact Fax Number32Agency Contact First Name26Agency Contact Last Name24Agency Contact Middle 25Agency Contact State29Agency Contact Telephone 31Agency Contact Web Address34Agency Contact Zip Code30Agency Medical Director 39Agency Medical Director City40Agency Medical Director 46Agency Medical Director Fax 44Agency Medical Director First38Agency Medical Director Last36Agency Medical Director 37Agency Medical Director 41Agency Medical Director 43Agency Medical Director Zip 42Agency Medical Director's 45Airbag Deployment275Alcohol/Drug Use Indicators308Annual Vehicle Hours85Annual Vehicle Miles86Condition Code Number226Condition of Patient at 424Crew Member ID154Crew Member Level156Crew Member Role155Current Medication 306Current Medication Dosage 305Current Medication Dose304Current Medications303Date Length of Service 114Date of Birth187Date of Personnel's 93Date/Time Initial Responder 234Date/Time Medication 382Date/Time of Assessment356Date/Time Procedure 394Date/Time Resuscitation 286Date/Time Vital Signs Taken313DBP (Diastolic Blood 317Destination City413Destination Confirmation of 408Destination County415Destination Facility Number63Destination GPS Location417Destination Medical Record 292Destination State414Destination Street Address412Destination Type64Destination Zip Code416Destination Zone Number418Destination/Transferred To, 411Destination/Transferred To, 410Device CO2 or etCO2445Device CO2, etCO2, or 446Device Diastolic Blood 442EMS Personnel's First Name97EMS Personnel's Gender106EMS Personnel's Home 103EMS Personnel's Last Name95EMS Personnel's Mailing 98EMS Personnel's Middle 96EMS Personnel's Race107EMS Personnel's State100EMS Personnel's Work 102EMS Personnel's Zip Code101EMS Transport Volume per 17EMS Unit (Vehicle) Response 131EMS Unit Call Sign49EMS Unit Call Sign (Radio 140EMS Unit/Vehicle Number139Ending Odometer Reading of147Environmental/Food 298Estimated Body Weight354Estimated Date/Time Initial 233Estimated Time of Arrest 285Ethnicity184Event Date/Time428Extremities-Left Lower 374Extremities-Left Upper 373Extremities-Right Lower 372Extremities-Right Upper 371Eyes-Left Assessment375Eyes-Right Assessment376Fire Incident Report Number453First Monitored Rhythm of 282First Name173First Name of Patient's 293First Name of the Closest 210First Name of the Insured203Gender182Insurance Policy ID Number201Intent of the Injury268Last Name172Last Name of Patient's 295Last Name of the Insured202Law Enforcement/Crash 451Level of Responsiveness334Level of Service8Mass Casualty Incident236Mechanism of Injury269Medical Device Event Name429Medical History Obtained From300Medical/Surgical History299Medication Administered 383Medication Administered 385Medication Allergies297Medication Authorization391Medication Authorizing 392Medication Complication389Medication Crew Member ID390Medication Dosage386Medication Dosage Units387Medication Given384Medications Given54Mental Status Assessment377Method of Blood Pressure 318Middle Initial/Name174Middle Initial/Name of the 211Middle Initial/Name of the 204Middle Name of Patient's 294Model Number119National Provider Identifier22National Registry Credentialed110Neck Assessment360Neurological Assessment378Neurological Outcome at 284NHTSA Injury Matrix 347NHTSA Injury Matrix 342NHTSA Injury Matrix Face344NHTSA Injury Matrix Head343NHTSA Injury Matrix Lower 351NHTSA Injury Matrix Neck345NHTSA Injury Matrix Pelvis350NHTSA Injury Matrix Spine348NHTSA Injury Matrix Thorax346NHTSA Injury Matrix 352NHTSA Injury Matrix Upper 349Number Of Each Personnel 81Number of Patients at Scene235Number of Procedure 398Obtained Prior to this Units 314On-Scene Odometer Reading145Organization Status10Organizational Type9Other Agencies In Area12Other Associated Symptoms260Other Destinations62Other EMS Agencies at Scene231Other Services at Scene232Other Types of Service7Outcome of the Prior Aid249Pacing Rate438Pain Scale335Patient Arrived at 167Patient Care Report Number124Patient Destination 146Patient ID Band/Tag Number454Patient’s Employer’s City220Patient’s Employer’s State221Patient’s Employer’s Zip 222Patient’s Home Country180Patient’s Occupation208Patient’s Occupational 207Patient's Employer218Patient's Employer's Address219Patient's Home Address175Patient's Home City176Patient's Home County177Patient's Home State178Patient's Home Zip Code179Patient's Work Telephone 223Pediatric Trauma Score340Personal Protective 458Personnel Exposed462Personnel Level Permitted to 55Personnel Level Permitted to 53Personnel Level Permitted to 58Personnel's Agency ID 88Personnel's Employment 90Personnel's Level of 92Position of Patient During 421Position of Patient in the 273Possible Injury250Potential Registry Candidate457Pregnancy309Presence of Emergency 307Primary Method of Payment192Primary or Home Telephone 188Primary Role of the Unit133Primary Symptom259Primary Type of Service6Prior Aid247Prior Aid Performed by248Procedure396Procedure Authorization404Procedure Authorizing 405Procedure Complication400Procedure Crew Members ID403Procedure Performed Prior to395Procedure Successful399Procedures51Protocol56Protocols Used380Provider’s Secondary 263Providers Primary 261PSAP Call Date/Time159Pulse Oximetry321Pulse Rate319Pulse Rhythm322Race183Reason CPR Discontinued287Reason for Choosing 425Relationship to the Insured205Required Reportable 463Research Survey Field464Research Survey Field Title466Respiratory Effort324Respiratory Rate323Response Mode to Scene148Response to Medication388Response to Procedure402Response Urgency224Resuscitation Attempted280Review Requested456Revised Trauma Score339Run Report Narrative311SBP (Systolic Blood 316Scene GPS Location240Scene Zone Number239Seat Row Location of Patient272Secondary Complaint 254Sending Facility Medical 291Shock or Pacing Energy436Size of Procedure Equipment397Skin Assessment357Social Security Number181Software Creator125Software Name126Software Version127State Certification Licensure 48State Certification/Licensure 80State EMS Certification 109State EMS Current 111State Issuing Driver's License189State/Licensure ID Number89Station Address72Station City73Station GPS71Station Name68Station Number69Station State74Station Telephone Number76Station Zip75Station Zone70Statistical Year11Stroke Scale336Successful IV Site406Suspected Contact with 460Suspected Intentional, or 459Temperature332Temperature Method333Thrombolytic Screen337Time Units of Duration of 253Time Units of Duration of 256Total Glasgow Coma Score331Total Length of Service113Total Number of Shocks 437Total Service Area Population14Total Service Size Area13Transfer of Patient Care 165Transport Mode from Scene423Trauma Registry ID452Tube Confirmation407Type of Destination426Type of Dispatch Delay134Type of Response Delay135Type of Scene Delay136Type of Service Requested132Type of Shock435Type of Suspected 461Type of Transport Delay137Type of Turn-Around Delay138Unit Arrived on Scene 163Unit Back at Home Location 170Unit Back in Service 168Unit Cancelled Date/Time169Unit En Route Date/Time162Unit Left Scene Date/Time 166Unit Notified by Dispatch 161Unit/Vehicle Number78Use of Occupant Safety 274Vehicle Dispatch GPS 143Vehicle Dispatch Location141Vehicle Dispatch Zone142Vehicle Initial Cost82Vehicle Model Year83Vehicle Type79Vehicular Injury Indicators270Waveform Graphic431Waveform Graphic Type430Who Generated this Report?465Work-Related206Year Miles/Hours Accrued84Zones50
