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-EMS2 |
eResponse.04
-
EMS Response Number |
350-2024-EMS2-1 |
eResponse.ServiceGroup
-
Group Tag to hold details about EMS category of service and the stand by reason |
|
eResponse.05
-
Type of Service Requested |
Emergency Response (Primary Response Area) |
eResponse.07
-
Unit Transport and Equipment Capability |
Ground Transport (ALS Equipped) |
eResponse.08
-
Type of Dispatch Delay |
Incomplete Address Information Provided |
eResponse.09
-
Type of Response Delay |
Directions/Unable to Locate |
Distance |
eResponse.10
-
Type of Scene Delay |
Patient Access |
eResponse.11
-
Type of Transport Delay |
Distance |
eResponse.12
-
Type of Turn-Around Delay |
None/No Delay |
eResponse.13
-
EMS Vehicle (Unit) Number |
G194 |
eResponse.14
-
EMS Unit Call Sign |
Medic 1 |
eResponse.16
-
Vehicle Dispatch Location |
Poudre Valley Hospital Office |
eResponse.17
-
Vehicle Dispatch GPS Location |
40.572568,-105.057274 |
eResponse.18
-
Vehicle Dispatch Location US National Grid Coordinates |
13TDE95159131 |
eResponse.19
-
Beginning Odometer Reading of Responding Vehicle |
341029.8 |
eResponse.20
-
On-Scene Odometer Reading of Responding Vehicle |
341061.5 |
eResponse.21
-
Patient Destination Odometer Reading of Responding Vehicle |
341093.2 |
eResponse.22
-
Ending Odometer Reading of Responding Vehicle |
341093.3 |
eResponse.23
-
Response Mode to Scene |
Emergent (Immediate Response) |
eResponse.24
-
Additional Response Mode Descriptors |
Lights and No Sirens |
eDispatch
-
Dispatch Information |
|
eDispatch.01
-
Dispatch Reason |
Traumatic Injury |
eDispatch.02
-
EMD Performed |
Yes, Unknown if Pre-Arrival Instructions Given |
eDispatch.03
-
EMD Card Number |
30B3 |
eDispatch.04
-
Dispatch Center Name or ID |
Larimer County Sheriff's Department |
eDispatch.05
-
Dispatch Priority (Patient Acuity) |
Emergent |
eDispatch.06
-
Unit Dispatched CAD Record ID |
LC23-18239 |
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 |
Primary Patient Caregiver-At Scene |
Primary Patient Caregiver-Transport |
eCrew.CrewGroup
-
Group Tag to hold crew information |
|
eCrew.01
-
Crew Member ID |
589631 - Rodrigo R Romaguera |
eCrew.02
-
Crew Member Level |
Emergency Medical Technician (EMT) |
eCrew.03
-
Crew Member Response Role |
Driver/Pilot-Response |
Driver/Pilot-Transport |
Other Patient Caregiver-At Scene |
eTimes
-
Call Event Times Information |
|
eTimes.01
-
PSAP Call Date/Time |
October 5, 2023, 17:03:20 GMT-06:00 |
eTimes.02
-
Dispatch Notified Date/Time |
October 5, 2023, 17:03:58 GMT-06:00 |
eTimes.03
-
Unit Notified by Dispatch Date/Time |
October 5, 2023, 17:07:44 GMT-06:00 |
eTimes.04
-
Dispatch Acknowledged Date/Time |
October 5, 2023, 17:08:12 GMT-06:00 |
eTimes.05
-
Unit En Route Date/Time |
October 5, 2023, 17:09:30 GMT-06:00 |
eTimes.06
-
Unit Arrived on Scene Date/Time |
October 5, 2023, 18:07:29 GMT-06:00 |
eTimes.07
-
Arrived at Patient Date/Time |
October 5, 2023, 18:21:14 GMT-06:00 |
eTimes.08
-
Transfer of EMS Patient Care Date/Time |
[NV
=
Not Applicable] |
eTimes.09
-
Unit Left Scene Date/Time |
October 5, 2023, 19:03:53 GMT-06:00 |
eTimes.11
-
Patient Arrived at Destination Date/Time |
October 5, 2023, 20:00:37 GMT-06:00 |
eTimes.12
-
Destination Patient Transfer of Care Date/Time |
October 5, 2023, 20:06:42 GMT-06:00 |
eTimes.13
-
Unit Back in Service Date/Time |
October 5, 2023, 20:07:23 GMT-06:00 |
eTimes.15
-
Unit Back at Home Location Date/Time |
October 5, 2023, 20:09:01 GMT-06:00 |
eTimes.16
-
EMS Call Completed Date/Time |
October 5, 2023, 20:17:45 GMT-06:00 |
ePatient
-
Patient Information |
|
ePatient.01
-
EMS Patient ID |
46sj1578 |
ePatient.PatientNameGroup
-
Group Tag to hold patient's name |
|
ePatient.02
-
Last Name |
Bayer |
ePatient.03
-
First Name |
Brock |
ePatient.04
-
Middle Initial/Name |
Otto |
ePatient.05
-
Patient's Home Address |
2820 Illinois Street |
ePatient.06
-
Patient's Home City |
City of East Palo Alto |
ePatient.07
-
Patient's Home County |
San Mateo County |
ePatient.08
-
Patient's Home State |
California |
ePatient.09
-
Patient's Home ZIP Code |
80549 |
ePatient.10
-
Patient's Country of Residence |
US |
ePatient.11
-
Patient Home Census Tract |
06081611800 |
ePatient.12
-
Social Security Number |
238562358 |
ePatient.13
-
Gender |
Male |
ePatient.14
-
Race |
White |
ePatient.AgeGroup
-
Group Tag to hold patient's age information |
|
ePatient.15
-
Age |
42 |
ePatient.16
-
Age Units |
Years |
ePatient.17
-
Date of Birth |
October 6, 1980 |
ePatient.18
-
Patient's Phone Number |
[PhoneNumberType
=
Mobile] 650-686-0589 |
ePatient.19
-
Patient's Email Address |
[EmailAddressType
=
Personal] bob78@example.com |
ePatient.20
-
State Issuing Driver's License |
California |
ePatient.21
-
Driver's License Number |
U2006373 |
ePayment
-
Insurance/Payment Information |
|
ePayment.01
-
Primary Method of Payment |
Self Pay |
ePayment.08
-
Patient Resides in Service Area |
Not a Resident Within EMS Service Area |
ePayment.EmployerGroup
-
Group Tag to hold information about patient's employer |
|
ePayment.33
-
Patient's Employer |
Facebook |
ePayment.34
-
Patient's Employer's Address |
1 Hacker Way |
ePayment.35
-
Patient's Employer's City |
Menlo Park |
ePayment.36
-
Patient's Employer's State |
California |
ePayment.37
-
Patient's Employer's ZIP Code |
94025 |
ePayment.38
-
Patient's Employer's Country |
US |
ePayment.39
-
Patient's Employer's Primary Phone Number |
650-853-1300 |
ePayment.40
-
Response Urgency |
Immediate |
ePayment.41
-
Patient Transport Assessment |
Unable to stand without assistance |
Unable to walk without assistance |
ePayment.44
-
Ambulance Transport Reason Code |
Patient was transported to the nearest facility for care of symptoms, complaints, or both |
ePayment.46
-
Stretcher Purpose Description |
Unable to walk over half mile of trail |
ePayment.47
-
Ambulance Conditions Indicator |
Patient was admitted to a hospital |
Patient was moved by stretcher |
Ambulance service was medically necessary |
ePayment.50
-
CMS Service Level |
BLS, Emergency |
ePayment.SupplyItemGroup
-
Group Tag to hold information about the supply used on the patient by the EMS Crew during the EMS event. |
|
ePayment.55
-
Supply Item Used Name |
Gauze Pad |
ePayment.56
-
Number of Supply Item(s) Used |
8 |
ePayment.SupplyItemGroup
-
Group Tag to hold information about the supply used on the patient by the EMS Crew during the EMS event. |
|
ePayment.55
-
Supply Item Used Name |
Irrigation Solution |
ePayment.56
-
Number of Supply Item(s) Used |
1 |
ePayment.SupplyItemGroup
-
Group Tag to hold information about the supply used on the patient by the EMS Crew during the EMS event. |
|
ePayment.55
-
Supply Item Used Name |
Surgical Mask |
ePayment.56
-
Number of Supply Item(s) Used |
2 |
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 |
Y92.838 - Other recreation area as the place of occurrence of the external cause |
eScene.10
-
Incident Facility Code |
[NV
=
Not Applicable] |
eScene.11
-
Scene GPS Location |
40.959610,-105.163771 |
eScene.12
-
Scene US National Grid Coordinates |
13TDF86213428 |
eScene.15
-
Incident Street Address |
Sinking Sun Trail |
eScene.17
-
Incident City |
[NV
=
Not Recorded] |
eScene.18
-
Incident State |
Colorado |
eScene.19
-
Incident ZIP Code |
80549 |
eScene.20
-
Scene Cross Street or Directions |
1/2 mile up trail from end of Red Canyon Road |
eScene.21
-
Incident County |
Larimer County |
eScene.22
-
Incident Country |
US |
eScene.23
-
Incident Census Tract |
08069002503 |
eSituation
-
Situation Information |
|
eSituation.01
-
Date/Time of Symptom Onset |
October 5, 2023, 16:30:00 GMT-06:00 |
eSituation.02
-
Possible Injury |
Yes |
eSituation.PatientComplaintGroup
-
Group Tag to hold information about patient's complaint |
|
eSituation.03
-
Complaint Type |
Chief (Primary) |
eSituation.04
-
Complaint |
Pain in left leg and arm |
eSituation.05
-
Duration of Complaint |
1 |
eSituation.06
-
Time Units of Duration of Complaint |
Hours |
eSituation.PatientComplaintGroup
-
Group Tag to hold information about patient's complaint |
|
eSituation.03
-
Complaint Type |
Secondary |
eSituation.04
-
Complaint |
Scrapes and bleeding |
eSituation.05
-
Duration of Complaint |
1 |
eSituation.06
-
Time Units of Duration of Complaint |
Hours |
eSituation.07
-
Chief Complaint Anatomic Location |
Extremity-Lower |
eSituation.08
-
Chief Complaint Organ System |
Musculoskeletal/Skin |
eSituation.09
-
Primary Symptom |
G89.11 - Acute pain due to trauma |
eSituation.10
-
Other Associated Symptoms |
M79.6 - Pain in limb, hand, foot, fingers and toes |
R22 - Localized swelling, mass and lump of skin and subcutaneous tissue |
R58 - Hemorrhage, not elsewhere classified |
eSituation.11
-
Provider's Primary Impression |
S79.92 - Unspecified injury of thigh |
eSituation.12
-
Provider's Secondary Impressions |
S49.9 - Unspecified injury of shoulder and upper arm |
S69.9 - Unspecified injury of wrist, hand and finger(s) |
S89.9 - Unspecified injury of lower leg |
eSituation.13
-
Initial Patient Acuity |
Emergent (Yellow) |
eSituation.WorkRelatedGroup
-
Group Tag to hold patient details if the illness or injury is work related |
|
eSituation.14
-
Work-Related Illness/Injury |
No |
eSituation.17
-
Patient Activity |
Y93.55 - Activity, bike riding |
eSituation.18
-
Date/Time Last Known Well |
[NV
=
Not Recorded] |
eSituation.20
-
Reason for Interfacility Transfer/Medical Transport |
[NV
=
Not Applicable] |
eInjury
-
Injury Information |
|
eInjury.01
-
Cause of Injury |
V18.0 - Pedal cycle driver injured in noncollision transport accident in nontraffic accident |
W19 - Unspecified fall |
Y29 - Contact with blunt object, undetermined intent |
eInjury.02
-
Mechanism of Injury |
Blunt |
eInjury.03
-
Trauma Triage Criteria (High Risk for Serious Injury) |
[NV
=
Not Recorded] |
eInjury.04
-
Trauma Triage Criteria (Moderate Risk for Serious Injury) |
[NV
=
Not Recorded] |
eInjury.07
-
Use of Occupant Safety Equipment |
Helmet Worn |
Protective Clothing |
eInjury.09
-
Height of Fall (feet) |
2 |
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 |
Physical Barrier (Unable to Access Patient) |
eHistory.06
-
Medication Allergies |
[CodeType
=
RxNorm] 7052 - morphine |
eHistory.08
-
Medical/Surgical History |
[PN
=
None Reported] |
eHistory.09
-
Medical History Obtained From |
Patient |
eHistory.ImmunizationsGroup
-
Group Tag to hold Immunization type and date |
|
eHistory.10
-
The Patient's Type of Immunization |
[Custom Value] COVID-19 |
eHistory.11
-
Immunization Year |
2023 |
eHistory.CurrentMedsGroup
-
Group Tag to hold info about patient's medication |
|
eHistory.12
-
Current Medications |
[PN
=
None Reported] |
eHistory.17
-
Alcohol/Drug Use Indicators |
[PN
=
None Reported] |
eNarrative
-
Call Event Narrative |
|
eNarrative.01
-
Patient Care Report Narrative |
Mountain bike crash. Carried by stretcher to trailhead, then transported. Patient refused any care beyond initial assessment/vitals and cleaning wounds. |
eVitals
-
Patient Vital Sign Information |
|
eVitals.VitalGroup
-
Group Tag to hold eVitals information |
|
eVitals.01
-
Date/Time Vital Signs Taken |
October 5, 2023, 18:24:07 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) |
[NV
=
Not Recorded] |
eVitals.04
-
ECG Type |
[NV
=
Not Recorded] |
eVitals.05
-
Method of ECG Interpretation |
[NV
=
Not Recorded] |
eVitals.BloodPressureGroup
-
Group Tag to hold the details of patient's blood pressure. |
|
eVitals.06
-
SBP (Systolic Blood Pressure) |
110 |
eVitals.07
-
DBP (Diastolic Blood Pressure) |
62 |
eVitals.08
-
Method of Blood Pressure Measurement |
Cuff-Manual Auscultated |
eVitals.HeartRateGroup
-
Group Tag to hold the details of patient's heart rate. |
|
eVitals.10
-
Heart Rate |
86 |
eVitals.11
-
Method of Heart Rate Measurement |
Auscultated |
eVitals.12
-
Pulse Oximetry |
[PN
=
Refused] |
eVitals.13
-
Pulse Rhythm |
Regular |
eVitals.14
-
Respiratory Rate |
30 |
eVitals.15
-
Respiratory Effort |
Shallow |
eVitals.16
-
End Tidal Carbon Dioxide (ETCO2) |
[NV
=
Not Recorded] |
eVitals.18
-
Blood Glucose Level |
[PN
=
Refused] |
eVitals.GlasgowScoreGroup
-
Group Tag to hold the details of patient's glasgow scale |
|
eVitals.19
-
Glasgow Coma Score-Eye |
4 -
Opens Eyes spontaneously (All Age Groups) |
eVitals.20
-
Glasgow Coma Score-Verbal |
5 -
Oriented (>2 Years); Smiles, oriented to sounds, follows objects, interacts |
eVitals.21
-
Glasgow Coma Score-Motor |
5 -
Localizing pain (All Age Groups) |
eVitals.22
-
Glasgow Coma Score-Qualifier |
Initial GCS has legitimate values without interventions such as intubation and sedation |
eVitals.23
-
Total Glasgow Coma Score |
14 |
eVitals.TemperatureGroup
-
Group Tag to hold information about patient's body temperature. |
|
eVitals.24
-
Temperature |
35.2 |
eVitals.25
-
Temperature Method |
Axillary |
eVitals.26
-
Level of Responsiveness (AVPU) |
Alert |
eVitals.PainScaleGroup
-
Group Tag to hold the scale of patient's pain and the type of pain scale used. |
|
eVitals.27
-
Pain Scale Score |
6 |
eVitals.28
-
Pain Scale Type |
Numeric (0-10) |
eVitals.StrokeScaleGroup
-
Group Tag to hold the results of patient's stroke scale and the type of stroke pain scale used. |
|
eVitals.29
-
Stroke Scale Score |
[PN
=
Refused] |
eVitals.30
-
Stroke Scale Type |
[NV
=
Not Recorded] |
eVitals.31
-
Reperfusion Checklist |
[NV
=
Not Recorded] |
eVitals.33
-
Revised Trauma Score |
11 |
eExam
-
Patient Exam Information |
|
eExam.01
-
Estimated Body Weight in Kilograms |
75 |
eExam.AssessmentGroup
-
Group Tag to hold assessment information |
|
eExam.03
-
Date/Time of Assessment |
October 5, 2023, 18:26:00 GMT-06:00 |
eExam.04
-
Skin Assessment |
Cold |
eExam.05
-
Head Assessment |
Normal |
eExam.06
-
Face Assessment |
Normal |
eExam.07
-
Neck Assessment |
Normal |
eExam.09
-
Heart Assessment |
Not Done |
eExam.AbdomenGroup
-
Group Tag to hold abdomen assessment findings information |
|
eExam.10
-
Abdominal Assessment Finding Location |
Generalized |
eExam.11
-
Abdomen Assessment |
Normal |
eExam.12
-
Pelvis/Genitourinary Assessment |
Abrasion |
Contusion |
eExam.SpineGroup
-
Group Tag to hold spine assessment findings information |
|
eExam.13
-
Back and Spine Assessment Finding Location |
Back-General |
eExam.14
-
Back and Spine Assessment |
Normal |
eExam.ExtremityGroup
-
Group Tag to hold extremity assessment findings information |
|
eExam.15
-
Extremity Assessment Finding Location |
Ankle-Left |
eExam.16
-
Extremities Assessment |
Dislocation |
Fracture-Closed |
eExam.ExtremityGroup
-
Group Tag to hold extremity assessment findings information |
|
eExam.15
-
Extremity Assessment Finding Location |
Wrist-Left |
eExam.16
-
Extremities Assessment |
Crush Injury |
eExam.ExtremityGroup
-
Group Tag to hold extremity assessment findings information |
|
eExam.15
-
Extremity Assessment Finding Location |
Arm-Whole Arm and Hand-Left |
eExam.16
-
Extremities Assessment |
Abrasion |
Bleeding Controlled |
Pain |
Swelling |
Contusion |
eExam.ExtremityGroup
-
Group Tag to hold extremity assessment findings information |
|
eExam.15
-
Extremity Assessment Finding Location |
Leg-Whole Leg-Left |
eExam.16
-
Extremities Assessment |
Abrasion |
Bleeding Controlled |
Pain |
Swelling |
Contusion |
eExam.EyeGroup
-
Group Tag to hold eye assessment findings information |
|
eExam.17
-
Eye Assessment Finding Location |
Bilateral |
eExam.18
-
Eye Assessment |
Dilated |
eExam.LungGroup
-
Group Tag to hold lung assessment findings information |
|
eExam.22
-
Lung Assessment Finding Location |
Bilateral |
eExam.23
-
Lung Assessment |
Normal |
eExam.ChestGroup
-
Group Tag to hold chest assessment findings information |
|
eExam.25
-
Chest Assessment |
Normal |
eExam.19
-
Mental Status Assessment |
Normal Baseline for Patient |
eExam.20
-
Neurological Assessment |
Normal Baseline for Patient |
eExam.21
-
Stroke/CVA Symptoms Resolved |
[NV
=
Not Applicable] |
eProtocols
-
Medical Protocols Information |
|
eProtocols.ProtocolGroup
-
Group Tag to hold eProtocol information |
|
eProtocols.01
-
Protocols Used |
General-Universal Patient Care/ Initial Patient Contact |
eProtocols.02
-
Protocol Age Category |
Adult Only |
eProtocols.ProtocolGroup
-
Group Tag to hold eProtocol information |
|
eProtocols.01
-
Protocols Used |
Injury-Bleeding/ Hemorrhage Control |
eProtocols.02
-
Protocol Age Category |
General |
eProtocols.ProtocolGroup
-
Group Tag to hold eProtocol information |
|
eProtocols.01
-
Protocols Used |
Injury-Extremity |
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 |
[NV
=
Not Recorded] |
eMedications.03
-
Medication Administered |
[PN
=
Refused] [CodeType
=
RxNorm] 4337 - fentanyl |
eMedications.04
-
Medication Administered Route |
[NV
=
Not Recorded] |
eMedications.DosageGroup
-
Group Tag to hold info about the medication dosage administered to the patient |
|
eMedications.05
-
Medication Dosage |
[NV
=
Not Recorded] |
eMedications.06
-
Medication Dosage Units |
[NV
=
Not Recorded] |
eMedications.07
-
Response to Medication |
[NV
=
Not Recorded] |
eMedications.08
-
Medication Complication |
[NV
=
Not Recorded] |
eMedications.10
-
Role/Type of Person Administering Medication |
[NV
=
Not Recorded] |
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 |
[NV
=
Not Recorded] |
eMedications.03
-
Medication Administered |
[PN
=
Medication Allergy] [CodeType
=
RxNorm] 7052 - morphine |
eMedications.04
-
Medication Administered Route |
[NV
=
Not Recorded] |
eMedications.DosageGroup
-
Group Tag to hold info about the medication dosage administered to the patient |
|
eMedications.05
-
Medication Dosage |
[NV
=
Not Recorded] |
eMedications.06
-
Medication Dosage Units |
[NV
=
Not Recorded] |
eMedications.07
-
Response to Medication |
[NV
=
Not Recorded] |
eMedications.08
-
Medication Complication |
[NV
=
Not Recorded] |
eMedications.10
-
Role/Type of Person Administering Medication |
[NV
=
Not Recorded] |
eProcedures
-
Intervention Procedures Information |
|
eProcedures.ProcedureGroup
-
Group Tag to hold eProcedures information |
|
eProcedures.01
-
Date/Time Procedure Performed |
October 5, 2023, 18:27:42 GMT-06:00 |
eProcedures.02
-
Procedure Performed Prior to this Unit's EMS Care |
No |
eProcedures.03
-
Procedure |
225116006 - Irrigation of wound |
eProcedures.05
-
Number of Procedure Attempts |
3 |
eProcedures.06
-
Procedure Successful |
Yes |
eProcedures.07
-
Procedure Complication |
Tachypnea |
eProcedures.08
-
Response to Procedure |
Unchanged |
eProcedures.09
-
Procedure Crew Members ID |
589631 - Rodrigo R Romaguera |
eProcedures.10
-
Role/Type of Person Performing the Procedure |
Emergency Medical Technician (EMT) |
eProcedures.11
-
Procedure Authorization |
Protocol (Standing Order) |
eProcedures.ProcedureGroup
-
Group Tag to hold eProcedures information |
|
eProcedures.01
-
Date/Time Procedure Performed |
October 5, 2023, 18:30:33 GMT-06:00 |
eProcedures.02
-
Procedure Performed Prior to this Unit's EMS Care |
No |
eProcedures.03
-
Procedure |
182531007 - Dressing of wound |
eProcedures.05
-
Number of Procedure Attempts |
2 |
eProcedures.06
-
Procedure Successful |
Yes |
eProcedures.07
-
Procedure Complication |
Bleeding |
eProcedures.08
-
Response to Procedure |
Improved |
eProcedures.09
-
Procedure Crew Members ID |
589631 - Rodrigo R Romaguera |
eProcedures.10
-
Role/Type of Person Performing the Procedure |
Emergency Medical Technician (EMT) |
eProcedures.11
-
Procedure Authorization |
Protocol (Standing Order) |
eProcedures.ProcedureGroup
-
Group Tag to hold eProcedures information |
|
eProcedures.01
-
Date/Time Procedure Performed |
October 5, 2023, 18:30:33 GMT-06:00 |
eProcedures.02
-
Procedure Performed Prior to this Unit's EMS Care |
No |
eProcedures.03
-
Procedure |
58715004 - Moving a patient to a stretcher |
eProcedures.05
-
Number of Procedure Attempts |
1 |
eProcedures.06
-
Procedure Successful |
Yes |
eProcedures.07
-
Procedure Complication |
None |
eProcedures.08
-
Response to Procedure |
Unchanged |
eProcedures.09
-
Procedure Crew Members ID |
455258 - Declan Collin Renner |
eProcedures.10
-
Role/Type of Person Performing the Procedure |
Emergency Medical Technician (EMT) |
eProcedures.11
-
Procedure Authorization |
Protocol (Standing Order) |
eProcedures.ProcedureGroup
-
Group Tag to hold eProcedures information |
|
eProcedures.01
-
Date/Time Procedure Performed |
[NV
=
Not Applicable] |
eProcedures.02
-
Procedure Performed Prior to this Unit's EMS Care |
[NV
=
Not Applicable] |
eProcedures.03
-
Procedure |
[PN
=
Refused] 278414003 - Pain management |
eProcedures.05
-
Number of Procedure Attempts |
[NV
=
Not Applicable] |
eProcedures.06
-
Procedure Successful |
[NV
=
Not Applicable] |
eProcedures.07
-
Procedure Complication |
[NV
=
Not Applicable] |
eProcedures.08
-
Response to Procedure |
[NV
=
Not Applicable] |
eProcedures.10
-
Role/Type of Person Performing the Procedure |
[NV
=
Not Applicable] |
eProcedures.ProcedureGroup
-
Group Tag to hold eProcedures information |
|
eProcedures.01
-
Date/Time Procedure Performed |
[NV
=
Not Applicable] |
eProcedures.02
-
Procedure Performed Prior to this Unit's EMS Care |
[NV
=
Not Applicable] |
eProcedures.03
-
Procedure |
[PN
=
Refused] 79321009 - Application of splint |
eProcedures.05
-
Number of Procedure Attempts |
[NV
=
Not Applicable] |
eProcedures.06
-
Procedure Successful |
[NV
=
Not Applicable] |
eProcedures.07
-
Procedure Complication |
[NV
=
Not Applicable] |
eProcedures.08
-
Response to Procedure |
[NV
=
Not Applicable] |
eProcedures.10
-
Role/Type of Person Performing the Procedure |
[NV
=
Not Applicable] |
eDisposition
-
Patient Disposition Information |
|
eDisposition.DestinationGroup
-
Group Tag to hold info about the Destination and the Disposition details |
|
eDisposition.01
-
Destination/Transferred To, Name |
Poudre Valley Hospital |
eDisposition.02
-
Destination/Transferred To, Code |
010305 |
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 Refused Care |
eDisposition.29
-
Crew Disposition |
Back in Service, Care/Support Services Refused |
eDisposition.30
-
Transport Disposition |
Transport by This EMS Unit (This Crew Only) |
eDisposition.31
-
Reason for Refusal/Release |
Against Medical Advice |
eDisposition.13
-
How Patient Was Moved to Ambulance |
Other |
Stretcher |
eDisposition.14
-
Position of Patient During Transport |
Semi-Fowlers |
Supine |
eDisposition.15
-
How Patient Was Moved From Ambulance |
Stretcher |
eDisposition.16
-
EMS Transport Method |
Ground-Ambulance |
eDisposition.17
-
Transport Mode from Scene |
Emergent (Immediate Response) |
eDisposition.18
-
Additional Transport Mode Descriptors |
Intersection Navigation-With Normal Light Patterns |
Speed-Normal Traffic |
No Lights or Sirens |
eDisposition.19
-
Final Patient Acuity |
Emergent (Yellow) |
eDisposition.20
-
Reason for Choosing Destination |
Closest Facility |
eDisposition.21
-
Type of Destination |
Hospital-Emergency Department |
eDisposition.22
-
Hospital In-Patient Destination |
[NV
=
Not Applicable] |
eDisposition.23
-
Hospital Capability |
Hospital (General) |
Trauma Center Level 3 |
eDisposition.HospitalTeamActivationGroup
-
Group Tag to hold info about the destination team pre-arrival activation |
|
eDisposition.24
-
Destination Team Pre-Arrival Alert or Activation |
Yes-Trauma (General) |
eDisposition.25
-
Date/Time of Destination Prearrival Alert or Activation |
October 5, 2023, 19:07:30 GMT-06:00 |
eDisposition.32
-
Level of Care Provided per Protocol |
BLS - All Levels |
eOutcome
-
Patient Outcome Information |
|
eOutcome.01
-
Emergency Department Disposition |
Admitted as an inpatient to this hospital. |
eOutcome.02
-
Hospital Disposition |
Discharged to home or self care (routine discharge) |
eOutcome.EmergencyDepartmentProceduresGroup
-
Group Tag to hold information about emergency department procedures |
|
eOutcome.09
-
Emergency Department Procedures |
[NV
=
Not Recorded] |
eOutcome.19
-
Date/Time Emergency Department Procedure Performed |
[NV
=
Not Recorded] |
eOutcome.10
-
Emergency Department Diagnosis |
[NV
=
Not Applicable] |
eOutcome.11
-
Date/Time of Hospital Admission |
October 5, 2023, 20:24:52 GMT-06:00 |
eOutcome.HospitalProceduresGroup
-
Group Tag to hold information about hospital procedures |
|
eOutcome.12
-
Hospital Procedures |
0QHK34Z - Insertion of Internal Fixation Device into Left Fibula, Percutaneous Approach |
eOutcome.20
-
Date/Time Hospital Procedure Performed |
October 6, 2023, 10:43:00 GMT-06:00 |
eOutcome.HospitalProceduresGroup
-
Group Tag to hold information about hospital procedures |
|
eOutcome.12
-
Hospital Procedures |
0SQG4ZZ - Repair Left Ankle Joint, Percutaneous Endoscopic Approach |
eOutcome.20
-
Date/Time Hospital Procedure Performed |
October 6, 2023, 10:12:00 GMT-06:00 |
eOutcome.HospitalProceduresGroup
-
Group Tag to hold information about hospital procedures |
|
eOutcome.12
-
Hospital Procedures |
0SSNXZZ - Reposition Left Metatarsal-Phalangeal Joint, External Approach |
eOutcome.20
-
Date/Time Hospital Procedure Performed |
October 6, 2023, 10:20:00 GMT-06:00 |
eOutcome.13
-
Hospital Diagnosis |
S60.212A - Contusion of left wrist, initial encounter |
S82.422A - Displaced transverse fracture of shaft of left fibula, initial encounter for closed fracture |
S93.05XA - Dislocation of left ankle joint, initial encounter |
V18.1XXA - Pedal cycle passenger injured in noncollision transport accident in nontraffic accident, initial encounter |
eOutcome.16
-
Date/Time of Hospital Discharge |
October 8, 2023, 12:05:03 GMT-06:00 |
eOutcome.18
-
Date/Time of Emergency Department Admission |
October 5, 2023, 20:15:32 GMT-06:00 |
eOther
-
Other Miscellaneous Information |
|
eOther.01
-
Review Requested |
No |
eOther.02
-
Potential System of Care/Specialty/Registry Patient |
Trauma |
eOther.EMSCrewMemberGroup
-
Group Tag to hold info about the EMS Crew Member |
|
eOther.03
-
Personal Protective Equipment Used |
Gloves |
Mask-Surgical (Non-Fitted) |
Reflective Vest |
eOther.04
-
EMS Professional (Crew Member) ID |
455258 - Declan Collin Renner |
eOther.05
-
Suspected EMS Work Related Exposure, Injury, or Death |
No |
eOther.06
-
The Type of Work-Related Injury, Death or Suspected Exposure |
None |
eOther.EMSCrewMemberGroup
-
Group Tag to hold info about the EMS Crew Member |
|
eOther.03
-
Personal Protective Equipment Used |
Gloves |
Mask-Surgical (Non-Fitted) |
eOther.04
-
EMS Professional (Crew Member) ID |
589631 - Rodrigo R Romaguera |
eOther.05
-
Suspected EMS Work Related Exposure, Injury, or Death |
Yes |
eOther.06
-
The Type of Work-Related Injury, Death or Suspected Exposure |
Injury-Lifting/Back/Musculoskeletal |
eOther.08
-
Crew Member Completing this Report |
455258 - Declan Collin Renner |
eOther.SignatureGroup
-
Group Tag to hold signature details |
|
eOther.12
-
Type of Person Signing |
EMS Crew Member (Other) |
eOther.13
-
Signature Reason |
Other |
eOther.15
-
Signature Status |
Signed |
eOther.19
-
Date/Time of Signature |
October 5, 2023, 20:13:12 GMT-06:00 |
eOther.20
-
Signature Last Name |
Romaguera |
eOther.21
-
Signature First Name |
Rodrigo |
eOther.SignatureGroup
-
Group Tag to hold signature details |
|
eOther.12
-
Type of Person Signing |
EMS Primary Care Provider (for this event) |
eOther.13
-
Signature Reason |
Other |
eOther.15
-
Signature Status |
Signed |
eOther.19
-
Date/Time of Signature |
October 5, 2023, 20:13:30 GMT-06:00 |
eOther.20
-
Signature Last Name |
Renner |
eOther.21
-
Signature First Name |
Declan |
eOther.SignatureGroup
-
Group Tag to hold signature details |
|
eOther.12
-
Type of Person Signing |
Patient |
eOther.13
-
Signature Reason |
HIPAA acknowledgement/Release |
Refusal of Care |
Permission to Transport |
eOther.14
-
Type Of Patient Representative |
Self |
eOther.15
-
Signature Status |
Signed |
eOther.16
-
Signature File Name |
refusal-EMS2.png |
eOther.17
-
Signature File Type |
image/png |
eOther.18
-
Signature Graphic |
|
eOther.19
-
Date/Time of Signature |
October 5, 2023, 19:02:23 GMT-06:00 |
eOther.20
-
Signature Last Name |
Bayer |
eOther.21
-
Signature First Name |
Brock |