NEMSIS v3.5.0 EMSDataSet Test Case

 

NEMSIS V3 Test Case for Pre-testing
ID:               2024-EMS-4-CovidTransfer_v350
Description:      Test case for COVID air transfer.
Expected Result:  PASS

 
Element Value
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