EMSDataSet
-
Root Tag For Patient Care Report Dataset |
|
Header
-
Header for file |
|
DemographicGroup
-
Demographic information related to this agency |
|
dAgency.01
-
EMS Agency Unique State ID EMS Agency Unique State ID |
A078 |
dAgency.02
-
EMS Agency Number EMS Agency Number |
350-A078 |
dAgency.04
-
EMS Agency State EMS Agency State |
Colorado |
PatientCareReport
-
Container Tag to hold each instance of a patient care report (PCR) |
[UUID
=
[Your UUID]]
|
eRecord
-
Patient Record Information |
|
eRecord.01
-
Patient Care Report Number |
[Your Patient Care Report Number]
|
eRecord.SoftwareApplicationGroup
-
Group Tag to hold information about the software used to generate this patient care report |
|
eRecord.02
-
Software Creator |
[Your Software Creator]
|
eRecord.03
-
Software Name |
[Your Software Name]
|
eRecord.04
-
Software Version |
[Your Software Version]
|
eResponse
-
Unit Agency Information |
|
eResponse.AgencyGroup
-
Group Tag to hold EMS agency number and name |
|
eResponse.01
-
EMS Agency Number |
350-A078 |
eResponse.02
-
EMS Agency Name |
[Value from DEMDataSet]
|
eResponse.03
-
Incident Number |
350-2024-EMS4 |
eResponse.04
-
EMS Response Number |
350-2024-EMS4-1 |
eResponse.ServiceGroup
-
Group Tag to hold details about EMS category of service and the stand by reason |
|
eResponse.05
-
Type of Service Requested |
Hospital-to-Hospital Transfer |
eResponse.07
-
Unit Transport and Equipment Capability |
Air Transport-Helicopter |
eResponse.08
-
Type of Dispatch Delay |
None/No Delay |
eResponse.09
-
Type of Response Delay |
None/No Delay |
eResponse.10
-
Type of Scene Delay |
None/No Delay |
eResponse.11
-
Type of Transport Delay |
None/No Delay |
eResponse.12
-
Type of Turn-Around Delay |
None/No Delay |
eResponse.13
-
EMS Vehicle (Unit) Number |
A090 |
eResponse.14
-
EMS Unit Call Sign |
Air 2 |
eResponse.16
-
Vehicle Dispatch Location |
Cheyenne Regional Medical Center Helipad |
eResponse.17
-
Vehicle Dispatch GPS Location |
41.140689,-104.816451 |
eResponse.18
-
Vehicle Dispatch Location US National Grid Coordinates |
13TEF15405439 |
eResponse.19
-
Beginning Odometer Reading of Responding Vehicle |
14512.1 |
eResponse.20
-
On-Scene Odometer Reading of Responding Vehicle |
14512.1 |
eResponse.21
-
Patient Destination Odometer Reading of Responding Vehicle |
14514.3 |
eResponse.22
-
Ending Odometer Reading of Responding Vehicle |
14514.4 |
eResponse.23
-
Response Mode to Scene |
Non-Emergent |
eResponse.24
-
Additional Response Mode Descriptors |
Scheduled |
eDispatch
-
Dispatch Information |
|
eDispatch.01
-
Dispatch Reason |
Airmedical Transport |
eDispatch.02
-
EMD Performed |
[NV
=
Not Applicable] |
eDispatch.04
-
Dispatch Center Name or ID |
UCHealth Air Dispatch |
eDispatch.06
-
Unit Dispatched CAD Record ID |
UCA216045 |
eCrew
-
Crew Member Information |
|
eCrew.CrewGroup
-
Group Tag to hold crew information |
|
eCrew.01
-
Crew Member ID |
455258 - Declan Collin Renner |
eCrew.02
-
Crew Member Level |
Paramedic |
eCrew.03
-
Crew Member Response Role |
Driver/Pilot-Transport |
eCrew.CrewGroup
-
Group Tag to hold crew information |
|
eCrew.01
-
Crew Member ID |
468211 - Karine Cartwright |
eCrew.02
-
Crew Member Level |
Critical Care Paramedic |
eCrew.03
-
Crew Member Response Role |
Primary Patient Caregiver-Transport |
eTimes
-
Call Event Times Information |
|
eTimes.01
-
PSAP Call Date/Time |
[NV
=
Not Applicable] |
eTimes.02
-
Dispatch Notified Date/Time |
October 10, 2023, 08:30:42 GMT-06:00 |
eTimes.03
-
Unit Notified by Dispatch Date/Time |
October 10, 2023, 08:38:29 GMT-06:00 |
eTimes.04
-
Dispatch Acknowledged Date/Time |
October 10, 2023, 08:40:14 GMT-06:00 |
eTimes.05
-
Unit En Route Date/Time |
October 10, 2023, 10:30:16 GMT-06:00 |
eTimes.06
-
Unit Arrived on Scene Date/Time |
October 10, 2023, 10:45:31 GMT-06:00 |
eTimes.07
-
Arrived at Patient Date/Time |
October 10, 2023, 10:58:41 GMT-06:00 |
eTimes.08
-
Transfer of EMS Patient Care Date/Time |
[NV
=
Not Applicable] |
eTimes.09
-
Unit Left Scene Date/Time |
October 10, 2023, 11:10:55 GMT-06:00 |
eTimes.10
-
Arrival at Destination Landing Area Date/Time |
October 10, 2023, 12:15:30 GMT-06:00 |
eTimes.11
-
Patient Arrived at Destination Date/Time |
October 10, 2023, 12:19:09 GMT-06:00 |
eTimes.12
-
Destination Patient Transfer of Care Date/Time |
October 10, 2023, 12:21:08 GMT-06:00 |
eTimes.13
-
Unit Back in Service Date/Time |
October 10, 2023, 12:30:27 GMT-06:00 |
eTimes.16
-
EMS Call Completed Date/Time |
October 10, 2023, 12:40:22 GMT-06:00 |
ePatient
-
Patient Information |
|
ePatient.01
-
EMS Patient ID |
27kd3251 |
ePatient.PatientNameGroup
-
Group Tag to hold patient's name |
|
ePatient.02
-
Last Name |
Lind |
ePatient.03
-
First Name |
Rebecca |
ePatient.04
-
Middle Initial/Name |
Georgette |
ePatient.05
-
Patient's Home Address |
524 Birch Street |
ePatient.06
-
Patient's Home City |
Bushnell |
ePatient.07
-
Patient's Home County |
Kimball County |
ePatient.08
-
Patient's Home State |
Nebraska |
ePatient.09
-
Patient's Home ZIP Code |
69128 |
ePatient.10
-
Patient's Country of Residence |
US |
ePatient.11
-
Patient Home Census Tract |
31105954500 |
ePatient.12
-
Social Security Number |
503281561 |
ePatient.13
-
Gender |
Female |
ePatient.14
-
Race |
Hispanic or Latino |
White |
ePatient.AgeGroup
-
Group Tag to hold patient's age information |
|
ePatient.15
-
Age |
48 |
ePatient.16
-
Age Units |
Years |
ePatient.17
-
Date of Birth |
February 16, 1975 |
ePatient.18
-
Patient's Phone Number |
308-673-9470 |
ePatient.19
-
Patient's Email Address |
beckyl@example.com |
ePatient.20
-
State Issuing Driver's License |
Nebraska |
ePatient.21
-
Driver's License Number |
V35617567 |
ePayment
-
Insurance/Payment Information |
|
ePayment.01
-
Primary Method of Payment |
Insurance |
ePayment.CertificateGroup
-
Group Tag to hold Certification information |
|
ePayment.02
-
Physician Certification Statement |
Yes |
ePayment.03
-
Date Physician Certification Statement Signed |
October 9, 2023, 20:22:17 GMT-06:00 |
ePayment.04
-
Reason for Physician Certification Statement |
Bed Confined |
Third Party assistance/attendant required to apply, administer, or regulate or adjust oxygen en route |
ePayment.05
-
Healthcare Provider Type Signing Physician Certification Statement |
Case Manager |
ePayment.06
-
Last Name of Individual Signing Physician Certification Statement |
Steuber |
ePayment.07
-
First Name of Individual Signing Physician Certification Statement |
Augustine |
ePayment.InsuranceGroup
-
Group Tag to hold information about the insurance company |
|
ePayment.09
-
Insurance Company ID |
BH |
ePayment.10
-
Insurance Company Name |
Bright Health |
ePayment.11
-
Insurance Company Billing Priority |
Primary |
ePayment.12
-
Insurance Company Address |
8000 Norman Center Drive, Suite 1200 |
ePayment.13
-
Insurance Company City |
Minneapolis |
ePayment.14
-
Insurance Company State |
Minnesota |
ePayment.15
-
Insurance Company ZIP Code |
55437-1030 |
ePayment.16
-
Insurance Company Country |
US |
ePayment.17
-
Insurance Group ID |
8550 |
ePayment.18
-
Insurance Policy ID Number |
4G8E3457 |
ePayment.19
-
Last Name of the Insured |
Lind |
ePayment.20
-
First Name of the Insured |
Earl |
ePayment.21
-
Middle Initial/Name of the Insured |
A |
ePayment.22
-
Relationship to the Insured |
Spouse |
ePayment.58
-
Insurance Group Name |
NE Bronze |
ePayment.59
-
Insurance Company Phone Number |
833-356-1182 |
ePayment.60
-
Date of Birth of the Insured |
November 18, 1972 |
ePayment.InsuranceGroup
-
Group Tag to hold information about the insurance company |
|
ePayment.09
-
Insurance Company ID |
MA |
ePayment.10
-
Insurance Company Name |
Medica |
ePayment.11
-
Insurance Company Billing Priority |
Secondary |
ePayment.12
-
Insurance Company Address |
[StreetAddress2
=
"PO Box 11294"
] 331 Village Pointe Plaza Suite 304 |
ePayment.13
-
Insurance Company City |
Omaha |
ePayment.14
-
Insurance Company State |
Nebraska |
ePayment.15
-
Insurance Company ZIP Code |
68118-1100 |
ePayment.16
-
Insurance Company Country |
US |
ePayment.17
-
Insurance Group ID |
BSP |
ePayment.18
-
Insurance Policy ID Number |
6658455 |
ePayment.19
-
Last Name of the Insured |
Lind |
ePayment.20
-
First Name of the Insured |
Rebecca |
ePayment.21
-
Middle Initial/Name of the Insured |
Georgette |
ePayment.22
-
Relationship to the Insured |
Self |
ePayment.58
-
Insurance Group Name |
Bronze Share Plus |
ePayment.59
-
Insurance Company Phone Number |
888-592-8211 |
ePayment.60
-
Date of Birth of the Insured |
February 16, 1975 |
ePayment.ClosestRelativeGroup
-
Group Tag to hold information about patient's relative or guardian |
|
ePayment.23
-
Closest Relative/Guardian Last Name |
Lind |
ePayment.24
-
Closest Relative/ Guardian First Name |
Earl |
ePayment.25
-
Closest Relative/ Guardian Middle Initial/Name |
A |
ePayment.26
-
Closest Relative/ Guardian Street Address |
524 Birch Street |
ePayment.27
-
Closest Relative/ Guardian City |
Bushnell |
ePayment.28
-
Closest Relative/ Guardian State |
Nebraska |
ePayment.29
-
Closest Relative/ Guardian ZIP Code |
69128 |
ePayment.30
-
Closest Relative/ Guardian Country |
US |
ePayment.31
-
Closest Relative/ Guardian Phone Number |
[PhoneNumberType
=
Work] 308-673-0182 |
[PhoneNumberType
=
Mobile] 308-673-9469 |
ePayment.32
-
Closest Relative/ Guardian Relationship |
Spouse |
ePayment.EmployerGroup
-
Group Tag to hold information about patient's employer |
|
ePayment.33
-
Patient's Employer |
Laramie County School District |
ePayment.34
-
Patient's Employer's Address |
311 East 8th Street |
ePayment.35
-
Patient's Employer's City |
Pine Bluffs |
ePayment.36
-
Patient's Employer's State |
Wyoming |
ePayment.37
-
Patient's Employer's ZIP Code |
82082 |
ePayment.38
-
Patient's Employer's Country |
US |
ePayment.39
-
Patient's Employer's Primary Phone Number |
307-245-3738 |
ePayment.40
-
Response Urgency |
Non-Immediate |
ePayment.41
-
Patient Transport Assessment |
Unable to sit without assistance |
Unable to stand without assistance |
Unable to walk without assistance |
ePayment.42
-
Specialty Care Transport Care Provider |
Paramedic |
Critical Care Paramedic |
ePayment.44
-
Ambulance Transport Reason Code |
Patient was transported for the care of a specialist or for availability of equipment |
ePayment.47
-
Ambulance Conditions Indicator |
Patient was admitted to a hospital |
Patient was unconscious or in shock |
Ambulance service was medically necessary |
ePayment.49
-
ALS Assessment Performed and Warranted |
Yes |
ePayment.50
-
CMS Service Level |
Rotary Wing (Helicopter) |
ePayment.51
-
EMS Condition Code |
B97.29 - Other coronavirus as the cause of diseases classified elsewhere |
J12.82 - Pneumonia due to coronavirus disease 2019 |
U07.1 - COVID-19 |
ePayment.52
-
CMS Transportation Indicator |
Interfacility Transport (Requires Higher level of care) |
IV Medications required en route (ALS) |
Time to the closest appropriate hospital due to the patient's condition precludes ground transport; maximize clinical benefits |
ePayment.53
-
Transport Authorization Code |
BH213761 |
ePayment.54
-
Prior Authorization Code Payer |
Bright Health |
ePayment.57
-
Payer Type |
Commercial Insurance Co. |
eScene
-
Incident Scene Information |
|
eScene.01
-
First EMS Unit on Scene |
[NV
=
Not Applicable] |
eScene.06
-
Number of Patients at Scene |
Single |
eScene.07
-
Mass Casualty Incident |
No |
eScene.08
-
Triage Classification for MCI Patient |
[NV
=
Not Applicable] |
eScene.09
-
Incident Location Type |
Y92.23 - Hospital as the place of occurrence of the external cause |
eScene.10
-
Incident Facility Code |
15356 |
eScene.11
-
Scene GPS Location |
[Value from DEMDataSet]
|
eScene.12
-
Scene US National Grid Coordinates |
[Value from DEMDataSet]
|
eScene.13
-
Incident Facility or Location Name |
[Value from DEMDataSet]
|
eScene.15
-
Incident Street Address |
[Value from DEMDataSet]
|
eScene.17
-
Incident City |
[Value from DEMDataSet]
|
eScene.18
-
Incident State |
[Value from DEMDataSet]
|
eScene.19
-
Incident ZIP Code |
[Value from DEMDataSet]
|
eScene.21
-
Incident County |
[Value from DEMDataSet]
|
eScene.22
-
Incident Country |
[Value from DEMDataSet]
|
eScene.23
-
Incident Census Tract |
56021000700 |
eSituation
-
Situation Information |
|
eSituation.01
-
Date/Time of Symptom Onset |
[NV
=
Not Applicable] |
eSituation.02
-
Possible Injury |
No |
eSituation.07
-
Chief Complaint Anatomic Location |
General/Global |
eSituation.08
-
Chief Complaint Organ System |
Pulmonary |
eSituation.09
-
Primary Symptom |
J80 - Acute respiratory distress syndrome |
eSituation.10
-
Other Associated Symptoms |
[NV
=
Not Recorded] |
eSituation.11
-
Provider's Primary Impression |
J18.9 - Pneumonia, unspecified organism |
eSituation.12
-
Provider's Secondary Impressions |
B99.9 - Unspecified infectious disease |
eSituation.13
-
Initial Patient Acuity |
Critical (Red) |
eSituation.WorkRelatedGroup
-
Group Tag to hold patient details if the illness or injury is work related |
|
eSituation.14
-
Work-Related Illness/Injury |
Unknown |
eSituation.15
-
Patient's Occupational Industry |
Educational Services |
eSituation.16
-
Patient's Occupation |
Educational Instruction and Library Occupations |
eSituation.18
-
Date/Time Last Known Well |
[NV
=
Not Recorded] |
eSituation.20
-
Reason for Interfacility Transfer/Medical Transport |
Medical Specialty Care (Other, Not Listed) |
eInjury
-
Injury Information |
|
eInjury.01
-
Cause of Injury |
[NV
=
Not Applicable] |
eInjury.02
-
Mechanism of Injury |
[NV
=
Not Applicable] |
eInjury.03
-
Trauma Triage Criteria (High Risk for Serious Injury) |
[NV
=
Not Applicable] |
eInjury.04
-
Trauma Triage Criteria (Moderate Risk for Serious Injury) |
[NV
=
Not Applicable] |
eArrest
-
Cardiac Arrest Information |
|
eArrest.01
-
Cardiac Arrest |
No |
eArrest.02
-
Cardiac Arrest Etiology |
[NV
=
Not Applicable] |
eArrest.03
-
Resuscitation Attempted By EMS |
[NV
=
Not Applicable] |
eArrest.04
-
Arrest Witnessed By |
[NV
=
Not Applicable] |
eArrest.07
-
AED Use Prior to EMS Arrival |
[NV
=
Not Applicable] |
eArrest.09
-
Type of CPR Provided |
[NV
=
Not Applicable] |
eArrest.11
-
First Monitored Arrest Rhythm of the Patient |
[NV
=
Not Applicable] |
eArrest.12
-
Any Return of Spontaneous Circulation |
[NV
=
Not Applicable] |
eArrest.14
-
Date/Time of Cardiac Arrest |
[NV
=
Not Applicable] |
eArrest.16
-
Reason CPR/Resuscitation Discontinued |
[NV
=
Not Applicable] |
eArrest.17
-
Cardiac Rhythm on Arrival at Destination |
[NV
=
Not Applicable] |
eArrest.18
-
End of EMS Cardiac Arrest Event |
[NV
=
Not Applicable] |
eArrest.20
-
Who First Initiated CPR |
[NV
=
Not Applicable] |
eArrest.21
-
Who First Applied the AED |
[NV
=
Not Applicable] |
eArrest.22
-
Who First Defibrillated the Patient |
[NV
=
Not Applicable] |
eHistory
-
Patient History Information |
|
eHistory.01
-
Barriers to Patient Care |
Unconscious |
eHistory.PractitionerGroup
-
Group Tag to hold info about practitioner |
|
eHistory.02
-
Last Name of Patient's Practitioner |
Dare |
eHistory.03
-
First Name of Patient's Practitioner |
Fritz |
eHistory.PractitionerGroup
-
Group Tag to hold info about practitioner |
|
eHistory.02
-
Last Name of Patient's Practitioner |
Runolfsson |
eHistory.03
-
First Name of Patient's Practitioner |
Kristin |
eHistory.04
-
Middle Name/Initial of Patient's Practitioner |
K |
eHistory.05
-
Advance Directives |
Other Healthcare Advanced Directive Form |
eHistory.06
-
Medication Allergies |
[CodeType
=
RxNorm] 2371699 - nerolidol |
[CodeType
=
RxNorm] 2379530 - influenza A virus A/Guangdong-Maonan/SWL1536/2019 (H1N1) antigen |
[CodeType
=
ICD-10] Z88.8 - Allergy status to other drugs, medicaments and biological substances |
eHistory.07
-
Environmental/Food Allergies |
1119209001 - Allergy to hair dye |
eHistory.08
-
Medical/Surgical History |
B97.29 - Other coronavirus as the cause of diseases classified elsewhere |
J12.82 - Pneumonia due to coronavirus disease 2019 |
eHistory.09
-
Medical History Obtained From |
Health Care Personnel |
eHistory.ImmunizationsGroup
-
Group Tag to hold Immunization type and date |
|
eHistory.10
-
The Patient's Type of Immunization |
[PN
=
Not Immunized] [Custom Value] COVID-19 |
eHistory.ImmunizationsGroup
-
Group Tag to hold Immunization type and date |
|
eHistory.10
-
The Patient's Type of Immunization |
Tetanus |
eHistory.11
-
Immunization Year |
2020 |
eHistory.ImmunizationsGroup
-
Group Tag to hold Immunization type and date |
|
eHistory.10
-
The Patient's Type of Immunization |
Varicella (Chickenpox) |
eHistory.11
-
Immunization Year |
2014 |
eHistory.CurrentMedsGroup
-
Group Tag to hold info about patient's medication |
|
eHistory.12
-
Current Medications |
2395500 - remdesivir Injection [Veklury] |
eHistory.13
-
Current Medication Dose |
100 |
eHistory.14
-
Current Medication Dosage Unit |
Milligrams (mg) |
eHistory.15
-
Current Medication Administration Route |
Intravenous (IV) |
eHistory.20
-
Current Medication Frequency |
qd (every day) |
eHistory.CurrentMedsGroup
-
Group Tag to hold info about patient's medication |
|
eHistory.12
-
Current Medications |
6470 - lorazepam |
eHistory.13
-
Current Medication Dose |
2.5 |
eHistory.14
-
Current Medication Dosage Unit |
Milliliters per Hour (ml/hr) |
eHistory.15
-
Current Medication Administration Route |
Intravenous (IV) |
eHistory.16
-
Presence of Emergency Information Form |
No |
eHistory.17
-
Alcohol/Drug Use Indicators |
[PN
=
None Reported] |
eHistory.18
-
Pregnancy |
No |
eNarrative
-
Call Event Narrative |
|
eNarrative.01
-
Patient Care Report Narrative |
<Transfer of COVID-19 patient on ventilator for higher level of care.> |
eVitals
-
Patient Vital Sign Information |
|
eVitals.VitalGroup
-
Group Tag to hold eVitals information |
|
eVitals.01
-
Date/Time Vital Signs Taken |
October 10, 2023, 10:50:00 GMT-06:00 |
eVitals.02
-
Obtained Prior to this Unit's EMS Care |
Yes |
eVitals.CardiacRhythmGroup
-
Group Tag to hold information of the type and method used for ECG interpretation associated with the cardiac rhythm. |
|
eVitals.03
-
Cardiac Rhythm / Electrocardiography (ECG) |
Sinus Bradycardia |
eVitals.04
-
ECG Type |
[NV
=
Not Recorded] |
eVitals.05
-
Method of ECG Interpretation |
[NV
=
Not Recorded] |
eVitals.BloodPressureGroup
-
Group Tag to hold the details of patient's blood pressure. |
|
eVitals.06
-
SBP (Systolic Blood Pressure) |
112 |
eVitals.07
-
DBP (Diastolic Blood Pressure) |
58 |
eVitals.08
-
Method of Blood Pressure Measurement |
Venous Line |
eVitals.09
-
Mean Arterial Pressure |
82 |
eVitals.HeartRateGroup
-
Group Tag to hold the details of patient's heart rate. |
|
eVitals.10
-
Heart Rate |
52 |
eVitals.11
-
Method of Heart Rate Measurement |
Electronic Monitor (Other) |
eVitals.12
-
Pulse Oximetry |
86 |
eVitals.13
-
Pulse Rhythm |
Regular |
eVitals.14
-
Respiratory Rate |
10 |
eVitals.15
-
Respiratory Effort |
Mechanically Assisted (BVM, CPAP, etc.) |
eVitals.16
-
End Tidal Carbon Dioxide (ETCO2) |
[ETCO2Type
=
kPa] 4.1 |
eVitals.18
-
Blood Glucose Level |
87 |
eVitals.GlasgowScoreGroup
-
Group Tag to hold the details of patient's glasgow scale |
|
eVitals.19
-
Glasgow Coma Score-Eye |
1 -
No eye movement when assessed (All Age Groups) |
eVitals.20
-
Glasgow Coma Score-Verbal |
1 -
No verbal/vocal response (All Age Groups) |
eVitals.21
-
Glasgow Coma Score-Motor |
1 -
No Motor Response (All Age Groups) |
eVitals.22
-
Glasgow Coma Score-Qualifier |
Patient Chemically Sedated |
Patient Intubated |
eVitals.23
-
Total Glasgow Coma Score |
3 |
eVitals.TemperatureGroup
-
Group Tag to hold information about patient's body temperature. |
|
eVitals.24
-
Temperature |
37.9 |
eVitals.25
-
Temperature Method |
Central (Venous or Arterial) |
eVitals.26
-
Level of Responsiveness (AVPU) |
Unresponsive |
eVitals.PainScaleGroup
-
Group Tag to hold the scale of patient's pain and the type of pain scale used. |
|
eVitals.27
-
Pain Scale Score |
[NV
=
Not Recorded] |
eVitals.StrokeScaleGroup
-
Group Tag to hold the results of patient's stroke scale and the type of stroke pain scale used. |
|
eVitals.29
-
Stroke Scale Score |
[NV
=
Not Recorded] |
eVitals.30
-
Stroke Scale Type |
[NV
=
Not Recorded] |
eVitals.31
-
Reperfusion Checklist |
[NV
=
Not Recorded] |
eVitals.VitalGroup
-
Group Tag to hold eVitals information |
|
eVitals.01
-
Date/Time Vital Signs Taken |
October 10, 2023, 11:12:00 GMT-06:00 |
eVitals.02
-
Obtained Prior to this Unit's EMS Care |
No |
eVitals.CardiacRhythmGroup
-
Group Tag to hold information of the type and method used for ECG interpretation associated with the cardiac rhythm. |
|
eVitals.03
-
Cardiac Rhythm / Electrocardiography (ECG) |
Sinus Bradycardia |
eVitals.04
-
ECG Type |
12 Lead-Left Sided (Normal) |
eVitals.05
-
Method of ECG Interpretation |
Computer Interpretation |
eVitals.BloodPressureGroup
-
Group Tag to hold the details of patient's blood pressure. |
|
eVitals.06
-
SBP (Systolic Blood Pressure) |
108 |
eVitals.07
-
DBP (Diastolic Blood Pressure) |
60 |
eVitals.08
-
Method of Blood Pressure Measurement |
Venous Line |
eVitals.09
-
Mean Arterial Pressure |
80 |
eVitals.HeartRateGroup
-
Group Tag to hold the details of patient's heart rate. |
|
eVitals.10
-
Heart Rate |
56 |
eVitals.11
-
Method of Heart Rate Measurement |
Electronic Monitor - Cardiac |
eVitals.12
-
Pulse Oximetry |
87 |
eVitals.13
-
Pulse Rhythm |
Regular |
eVitals.14
-
Respiratory Rate |
10 |
eVitals.15
-
Respiratory Effort |
Mechanically Assisted (BVM, CPAP, etc.) |
eVitals.16
-
End Tidal Carbon Dioxide (ETCO2) |
[ETCO2Type
=
kPa] 3.8 |
eVitals.18
-
Blood Glucose Level |
86 |
eVitals.GlasgowScoreGroup
-
Group Tag to hold the details of patient's glasgow scale |
|
eVitals.19
-
Glasgow Coma Score-Eye |
1 -
No eye movement when assessed (All Age Groups) |
eVitals.20
-
Glasgow Coma Score-Verbal |
1 -
No verbal/vocal response (All Age Groups) |
eVitals.21
-
Glasgow Coma Score-Motor |
1 -
No Motor Response (All Age Groups) |
eVitals.22
-
Glasgow Coma Score-Qualifier |
Patient Chemically Sedated |
Patient Intubated |
eVitals.23
-
Total Glasgow Coma Score |
3 |
eVitals.TemperatureGroup
-
Group Tag to hold information about patient's body temperature. |
|
eVitals.24
-
Temperature |
37.8 |
eVitals.25
-
Temperature Method |
Central (Venous or Arterial) |
eVitals.26
-
Level of Responsiveness (AVPU) |
Unresponsive |
eVitals.PainScaleGroup
-
Group Tag to hold the scale of patient's pain and the type of pain scale used. |
|
eVitals.27
-
Pain Scale Score |
[NV
=
Not Recorded] |
eVitals.StrokeScaleGroup
-
Group Tag to hold the results of patient's stroke scale and the type of stroke pain scale used. |
|
eVitals.29
-
Stroke Scale Score |
[NV
=
Not Recorded] |
eVitals.30
-
Stroke Scale Type |
[NV
=
Not Recorded] |
eVitals.31
-
Reperfusion Checklist |
[NV
=
Not Recorded] |
eVitals.VitalGroup
-
Group Tag to hold eVitals information |
|
eVitals.01
-
Date/Time Vital Signs Taken |
October 10, 2023, 11:32:00 GMT-06:00 |
eVitals.02
-
Obtained Prior to this Unit's EMS Care |
No |
eVitals.CardiacRhythmGroup
-
Group Tag to hold information of the type and method used for ECG interpretation associated with the cardiac rhythm. |
|
eVitals.03
-
Cardiac Rhythm / Electrocardiography (ECG) |
Sinus Bradycardia |
eVitals.04
-
ECG Type |
12 Lead-Left Sided (Normal) |
eVitals.05
-
Method of ECG Interpretation |
Computer Interpretation |
eVitals.BloodPressureGroup
-
Group Tag to hold the details of patient's blood pressure. |
|
eVitals.06
-
SBP (Systolic Blood Pressure) |
110 |
eVitals.07
-
DBP (Diastolic Blood Pressure) |
65 |
eVitals.08
-
Method of Blood Pressure Measurement |
Venous Line |
eVitals.09
-
Mean Arterial Pressure |
84 |
eVitals.HeartRateGroup
-
Group Tag to hold the details of patient's heart rate. |
|
eVitals.10
-
Heart Rate |
58 |
eVitals.11
-
Method of Heart Rate Measurement |
Electronic Monitor - Cardiac |
eVitals.12
-
Pulse Oximetry |
88 |
eVitals.13
-
Pulse Rhythm |
Regular |
eVitals.14
-
Respiratory Rate |
10 |
eVitals.15
-
Respiratory Effort |
Mechanically Assisted (BVM, CPAP, etc.) |
eVitals.16
-
End Tidal Carbon Dioxide (ETCO2) |
[ETCO2Type
=
kPa] 3.8 |
eVitals.18
-
Blood Glucose Level |
86 |
eVitals.GlasgowScoreGroup
-
Group Tag to hold the details of patient's glasgow scale |
|
eVitals.19
-
Glasgow Coma Score-Eye |
1 -
No eye movement when assessed (All Age Groups) |
eVitals.20
-
Glasgow Coma Score-Verbal |
1 -
No verbal/vocal response (All Age Groups) |
eVitals.21
-
Glasgow Coma Score-Motor |
1 -
No Motor Response (All Age Groups) |
eVitals.22
-
Glasgow Coma Score-Qualifier |
Patient Chemically Sedated |
Patient Intubated |
eVitals.23
-
Total Glasgow Coma Score |
3 |
eVitals.TemperatureGroup
-
Group Tag to hold information about patient's body temperature. |
|
eVitals.24
-
Temperature |
37.9 |
eVitals.25
-
Temperature Method |
Central (Venous or Arterial) |
eVitals.26
-
Level of Responsiveness (AVPU) |
Unresponsive |
eVitals.PainScaleGroup
-
Group Tag to hold the scale of patient's pain and the type of pain scale used. |
|
eVitals.27
-
Pain Scale Score |
[NV
=
Not Recorded] |
eVitals.StrokeScaleGroup
-
Group Tag to hold the results of patient's stroke scale and the type of stroke pain scale used. |
|
eVitals.29
-
Stroke Scale Score |
[NV
=
Not Recorded] |
eVitals.30
-
Stroke Scale Type |
[NV
=
Not Recorded] |
eVitals.31
-
Reperfusion Checklist |
[NV
=
Not Recorded] |
eVitals.VitalGroup
-
Group Tag to hold eVitals information |
|
eVitals.01
-
Date/Time Vital Signs Taken |
October 10, 2023, 11:52:00 GMT-06:00 |
eVitals.02
-
Obtained Prior to this Unit's EMS Care |
No |
eVitals.CardiacRhythmGroup
-
Group Tag to hold information of the type and method used for ECG interpretation associated with the cardiac rhythm. |
|
eVitals.03
-
Cardiac Rhythm / Electrocardiography (ECG) |
Sinus Bradycardia |
eVitals.04
-
ECG Type |
12 Lead-Left Sided (Normal) |
eVitals.05
-
Method of ECG Interpretation |
Computer Interpretation |
eVitals.BloodPressureGroup
-
Group Tag to hold the details of patient's blood pressure. |
|
eVitals.06
-
SBP (Systolic Blood Pressure) |
110 |
eVitals.07
-
DBP (Diastolic Blood Pressure) |
68 |
eVitals.08
-
Method of Blood Pressure Measurement |
Venous Line |
eVitals.09
-
Mean Arterial Pressure |
85 |
eVitals.HeartRateGroup
-
Group Tag to hold the details of patient's heart rate. |
|
eVitals.10
-
Heart Rate |
58 |
eVitals.11
-
Method of Heart Rate Measurement |
Electronic Monitor - Cardiac |
eVitals.12
-
Pulse Oximetry |
89 |
eVitals.13
-
Pulse Rhythm |
Regular |
eVitals.14
-
Respiratory Rate |
10 |
eVitals.15
-
Respiratory Effort |
Mechanically Assisted (BVM, CPAP, etc.) |
eVitals.16
-
End Tidal Carbon Dioxide (ETCO2) |
[ETCO2Type
=
kPa] 3.8 |
eVitals.18
-
Blood Glucose Level |
85 |
eVitals.GlasgowScoreGroup
-
Group Tag to hold the details of patient's glasgow scale |
|
eVitals.19
-
Glasgow Coma Score-Eye |
1 -
No eye movement when assessed (All Age Groups) |
eVitals.20
-
Glasgow Coma Score-Verbal |
1 -
No verbal/vocal response (All Age Groups) |
eVitals.21
-
Glasgow Coma Score-Motor |
1 -
No Motor Response (All Age Groups) |
eVitals.22
-
Glasgow Coma Score-Qualifier |
Patient Chemically Sedated |
Patient Intubated |
eVitals.23
-
Total Glasgow Coma Score |
3 |
eVitals.TemperatureGroup
-
Group Tag to hold information about patient's body temperature. |
|
eVitals.24
-
Temperature |
38.0 |
eVitals.25
-
Temperature Method |
Central (Venous or Arterial) |
eVitals.26
-
Level of Responsiveness (AVPU) |
Unresponsive |
eVitals.PainScaleGroup
-
Group Tag to hold the scale of patient's pain and the type of pain scale used. |
|
eVitals.27
-
Pain Scale Score |
[NV
=
Not Recorded] |
eVitals.StrokeScaleGroup
-
Group Tag to hold the results of patient's stroke scale and the type of stroke pain scale used. |
|
eVitals.29
-
Stroke Scale Score |
[NV
=
Not Recorded] |
eVitals.30
-
Stroke Scale Type |
[NV
=
Not Recorded] |
eVitals.31
-
Reperfusion Checklist |
[NV
=
Not Recorded] |
eVitals.VitalGroup
-
Group Tag to hold eVitals information |
|
eVitals.01
-
Date/Time Vital Signs Taken |
October 10, 2023, 12:20:00 GMT-06:00 |
eVitals.02
-
Obtained Prior to this Unit's EMS Care |
No |
eVitals.CardiacRhythmGroup
-
Group Tag to hold information of the type and method used for ECG interpretation associated with the cardiac rhythm. |
|
eVitals.03
-
Cardiac Rhythm / Electrocardiography (ECG) |
Sinus Bradycardia |
eVitals.04
-
ECG Type |
12 Lead-Left Sided (Normal) |
eVitals.05
-
Method of ECG Interpretation |
Computer Interpretation |
eVitals.BloodPressureGroup
-
Group Tag to hold the details of patient's blood pressure. |
|
eVitals.06
-
SBP (Systolic Blood Pressure) |
106 |
eVitals.07
-
DBP (Diastolic Blood Pressure) |
62 |
eVitals.08
-
Method of Blood Pressure Measurement |
Venous Line |
eVitals.09
-
Mean Arterial Pressure |
82 |
eVitals.HeartRateGroup
-
Group Tag to hold the details of patient's heart rate. |
|
eVitals.10
-
Heart Rate |
52 |
eVitals.11
-
Method of Heart Rate Measurement |
Electronic Monitor - Cardiac |
eVitals.12
-
Pulse Oximetry |
86 |
eVitals.13
-
Pulse Rhythm |
Regular |
eVitals.14
-
Respiratory Rate |
10 |
eVitals.15
-
Respiratory Effort |
Mechanically Assisted (BVM, CPAP, etc.) |
eVitals.16
-
End Tidal Carbon Dioxide (ETCO2) |
[ETCO2Type
=
kPa] 3.6 |
eVitals.18
-
Blood Glucose Level |
83 |
eVitals.GlasgowScoreGroup
-
Group Tag to hold the details of patient's glasgow scale |
|
eVitals.19
-
Glasgow Coma Score-Eye |
1 -
No eye movement when assessed (All Age Groups) |
eVitals.20
-
Glasgow Coma Score-Verbal |
1 -
No verbal/vocal response (All Age Groups) |
eVitals.21
-
Glasgow Coma Score-Motor |
1 -
No Motor Response (All Age Groups) |
eVitals.22
-
Glasgow Coma Score-Qualifier |
Patient Chemically Sedated |
Patient Intubated |
eVitals.23
-
Total Glasgow Coma Score |
3 |
eVitals.TemperatureGroup
-
Group Tag to hold information about patient's body temperature. |
|
eVitals.24
-
Temperature |
37.9 |
eVitals.25
-
Temperature Method |
Central (Venous or Arterial) |
eVitals.26
-
Level of Responsiveness (AVPU) |
Unresponsive |
eVitals.PainScaleGroup
-
Group Tag to hold the scale of patient's pain and the type of pain scale used. |
|
eVitals.27
-
Pain Scale Score |
[NV
=
Not Recorded] |
eVitals.StrokeScaleGroup
-
Group Tag to hold the results of patient's stroke scale and the type of stroke pain scale used. |
|
eVitals.29
-
Stroke Scale Score |
[NV
=
Not Recorded] |
eVitals.30
-
Stroke Scale Type |
[NV
=
Not Recorded] |
eVitals.31
-
Reperfusion Checklist |
[NV
=
Not Recorded] |
eLabs
-
Lab Results Information |
|
eLabs.LabGroup
-
Group Tag to hold Lab information |
|
eLabs.01
-
Date/Time of Laboratory or Imaging Result |
October 9, 2023, 18:35:53 GMT-06:00 |
eLabs.02
-
Study/Result Prior to this Unit's EMS Care |
Yes |
eLabs.LabImageGroup
-
Group Tag to hold info about imaging study or x-ray. |
|
eLabs.05
-
Imaging Study Type |
CAT Scan |
eLabs.06
-
Imaging Study Results |
Peripheral ground-glass opacities & subpleural blebs |
eLabs.WaveformGraphicGroup
-
Tag to hold information about the imaging study to allow for the upload of the imaging results. |
|
eLabs.07
-
Imaging Study File or Waveform Graphic Type |
image/jpeg |
eLabs.08
-
Imaging Study File or Waveform Graphic |
|
eExam
-
Patient Exam Information |
|
eExam.01
-
Estimated Body Weight in Kilograms |
58.1 |
eProtocols
-
Medical Protocols Information |
|
eProtocols.ProtocolGroup
-
Group Tag to hold eProtocol information |
|
eProtocols.01
-
Protocols Used |
General-Individualized Patient Protocol |
eProtocols.02
-
Protocol Age Category |
General |
eProtocols.ProtocolGroup
-
Group Tag to hold eProtocol information |
|
eProtocols.01
-
Protocols Used |
General-Indwelling Medical Devices/Equipment |
eProtocols.02
-
Protocol Age Category |
General |
eProtocols.ProtocolGroup
-
Group Tag to hold eProtocol information |
|
eProtocols.01
-
Protocols Used |
Medical-Influenza-Like Illness/ Upper Respiratory Infection |
eProtocols.02
-
Protocol Age Category |
General |
eProtocols.ProtocolGroup
-
Group Tag to hold eProtocol information |
|
eProtocols.01
-
Protocols Used |
General-Interfacility Transfers |
eProtocols.02
-
Protocol Age Category |
General |
eMedications
-
Intervention Medications Information |
|
eMedications.MedicationGroup
-
Group Tag to hold eMedication information |
|
eMedications.01
-
Date/Time Medication Administered |
[NV
=
Not Recorded] |
eMedications.02
-
Medication Administered Prior to this Unit's EMS Care |
Yes |
eMedications.03
-
Medication Administered |
[CodeType
=
RxNorm] 6470 - lorazepam |
eMedications.04
-
Medication Administered Route |
Intravenous (IV) |
eMedications.DosageGroup
-
Group Tag to hold info about the medication dosage administered to the patient |
|
eMedications.05
-
Medication Dosage |
2.5 |
eMedications.06
-
Medication Dosage Units |
Milligrams per Hour (mg/hr) |
eMedications.07
-
Response to Medication |
[NV
=
Not Recorded] |
eMedications.08
-
Medication Complication |
[NV
=
Not Recorded] |
eMedications.10
-
Role/Type of Person Administering Medication |
Registered Nurse |
eProcedures
-
Intervention Procedures Information |
|
eProcedures.ProcedureGroup
-
Group Tag to hold eProcedures information |
|
eProcedures.01
-
Date/Time Procedure Performed |
October 10, 2023, 11:11:52 GMT-06:00 |
eProcedures.02
-
Procedure Performed Prior to this Unit's EMS Care |
No |
eProcedures.03
-
Procedure |
182777000 - Monitoring of patient |
eProcedures.05
-
Number of Procedure Attempts |
[NV
=
Not Recorded] |
eProcedures.06
-
Procedure Successful |
[NV
=
Not Recorded] |
eProcedures.07
-
Procedure Complication |
[NV
=
Not Recorded] |
eProcedures.08
-
Response to Procedure |
[NV
=
Not Recorded] |
eProcedures.09
-
Procedure Crew Members ID |
468211 - Karine Cartwright |
eProcedures.10
-
Role/Type of Person Performing the Procedure |
Critical Care Paramedic |
eProcedures.11
-
Procedure Authorization |
Written Orders (Patient Specific) |
eProcedures.ProcedureGroup
-
Group Tag to hold eProcedures information |
|
eProcedures.01
-
Date/Time Procedure Performed |
October 10, 2023, 11:15:51 GMT-06:00 |
eProcedures.02
-
Procedure Performed Prior to this Unit's EMS Care |
No |
eProcedures.03
-
Procedure |
385857005 - Ventilator care and adjustment |
eProcedures.05
-
Number of Procedure Attempts |
[NV
=
Not Recorded] |
eProcedures.06
-
Procedure Successful |
[NV
=
Not Recorded] |
eProcedures.07
-
Procedure Complication |
[NV
=
Not Recorded] |
eProcedures.08
-
Response to Procedure |
[NV
=
Not Recorded] |
eProcedures.09
-
Procedure Crew Members ID |
468211 - Karine Cartwright |
eProcedures.10
-
Role/Type of Person Performing the Procedure |
Critical Care Paramedic |
eProcedures.11
-
Procedure Authorization |
Written Orders (Patient Specific) |
eDevice
-
Medical Device Information |
|
eDevice.DeviceGroup
-
Group Tag to hold Device Information |
|
eDevice.01
-
Medical Device Serial Number |
7kf83310 |
eDevice.02
-
Date/Time of Event (per Medical Device) |
October 10, 2023, 12:20:00 GMT-06:00 |
eDevice.03
-
Medical Device Event Type |
CO2 |
ECG-Monitor |
Heart Rate |
Invasive Pressure 1 |
Pulse Oximetry |
Pulse Rate |
Respiratory Rate |
Temperature 2 |
eDevice.WaveformGroup
-
Group Tag to hold info about Wave type |
|
eDevice.04
-
Medical Device Waveform Graphic Type |
image/png |
eDevice.05
-
Medical Device Waveform Graphic |
|
eDevice.06
-
Medical Device Mode (Manual, AED, Pacing, CO2, O2, etc) |
Automated |
eDevice.07
-
Medical Device ECG Lead |
I |
II |
III |
AVR |
AVL |
AVF |
V1 |
V2 |
V3 |
V4 |
V5 |
V6 |
eDevice.08
-
Medical Device ECG Interpretation |
Sinus bradycardia |
eDisposition
-
Patient Disposition Information |
|
eDisposition.DestinationGroup
-
Group Tag to hold info about the Destination and the Disposition details |
|
eDisposition.01
-
Destination/Transferred To, Name |
University of Colorado Hospital |
eDisposition.02
-
Destination/Transferred To, Code |
010432 |
eDisposition.03
-
Destination Street Address |
[Value from DEMDataSet]
|
eDisposition.04
-
Destination City |
[Value from DEMDataSet]
|
eDisposition.05
-
Destination State |
[Value from DEMDataSet]
|
eDisposition.06
-
Destination County |
[Value from DEMDataSet]
|
eDisposition.07
-
Destination ZIP Code |
[Value from DEMDataSet]
|
eDisposition.08
-
Destination Country |
[Value from DEMDataSet]
|
eDisposition.09
-
Destination GPS Location |
[Value from DEMDataSet]
|
eDisposition.10
-
Destination Location US National Grid Coordinates |
[Value from DEMDataSet]
|
eDisposition.11
-
Number of Patients Transported in this EMS Unit |
1 |
eDisposition.IncidentDispositionGroup
-
Group Tag to hold info about the incident disposition details |
|
eDisposition.27
-
Unit Disposition |
Patient Contact Made |
eDisposition.28
-
Patient Evaluation/Care |
Patient Evaluated and Care Provided |
eDisposition.29
-
Crew Disposition |
Initiated and Continued Primary Care |
eDisposition.30
-
Transport Disposition |
Transport by This EMS Unit (This Crew Only) |
eDisposition.13
-
How Patient Was Moved to Ambulance |
Other |
eDisposition.14
-
Position of Patient During Transport |
Semi-Fowlers |
eDisposition.15
-
How Patient Was Moved From Ambulance |
Other |
eDisposition.16
-
EMS Transport Method |
Air Medical-Rotor Craft |
eDisposition.17
-
Transport Mode from Scene |
Non-Emergent |
eDisposition.18
-
Additional Transport Mode Descriptors |
[NV
=
Not Recorded] |
eDisposition.19
-
Final Patient Acuity |
Critical (Red) |
eDisposition.20
-
Reason for Choosing Destination |
Patient's Physician's Choice |
Regional Specialty Center |
eDisposition.21
-
Type of Destination |
Hospital-Non-Emergency Department Bed |
eDisposition.22
-
Hospital In-Patient Destination |
Hospital-ICU |
eDisposition.23
-
Hospital Capability |
[NV
=
Not Recorded] |
eDisposition.HospitalTeamActivationGroup
-
Group Tag to hold info about the destination team pre-arrival activation |
|
eDisposition.24
-
Destination Team Pre-Arrival Alert or Activation |
No |
eDisposition.25
-
Date/Time of Destination Prearrival Alert or Activation |
[NV
=
Not Applicable] |
eDisposition.32
-
Level of Care Provided per Protocol |
Critical Care |
eOutcome
-
Patient Outcome Information |
|
eOutcome.01
-
Emergency Department Disposition |
[NV
=
Not Applicable] |
eOutcome.02
-
Hospital Disposition |
Deceased/Expired (or did not recover - Religious Non Medical Health Care Patient) |
eOutcome.EmergencyDepartmentProceduresGroup
-
Group Tag to hold information about emergency department procedures |
|
eOutcome.09
-
Emergency Department Procedures |
[NV
=
Not Applicable] |
eOutcome.19
-
Date/Time Emergency Department Procedure Performed |
[NV
=
Not Applicable] |
eOutcome.10
-
Emergency Department Diagnosis |
[NV
=
Not Applicable] |
eOutcome.11
-
Date/Time of Hospital Admission |
October 10, 2023, 12:30:31 GMT-06:00 |
eOutcome.HospitalProceduresGroup
-
Group Tag to hold information about hospital procedures |
|
eOutcome.12
-
Hospital Procedures |
[NV
=
Not Recorded] |
eOutcome.20
-
Date/Time Hospital Procedure Performed |
[NV
=
Not Recorded] |
eOutcome.13
-
Hospital Diagnosis |
[NV
=
Not Recorded] |
eOutcome.16
-
Date/Time of Hospital Discharge |
[NV
=
Not Recorded] |
eOutcome.18
-
Date/Time of Emergency Department Admission |
[NV
=
Not Recorded] |
eOther
-
Other Miscellaneous Information |
|
eOther.08
-
Crew Member Completing this Report |
468211 - Karine Cartwright |
eOther.SignatureGroup
-
Group Tag to hold signature details |
|
eOther.12
-
Type of Person Signing |
EMS Primary Care Provider (for this event) |
eOther.13
-
Signature Reason |
Controlled Substance, Administration |
eOther.15
-
Signature Status |
Signed |
eOther.19
-
Date/Time of Signature |
October 10, 2023, 12:32:08 GMT-06:00 |
eOther.20
-
Signature Last Name |
Cartwright |
eOther.21
-
Signature First Name |
Karine |