Transcription
National Emergency Medical Services Information SystemNEMSISRAFTData DictionaryNHTSA Version 3.0EMS Data StandardDVersion Date: December 17, 2010Funded byNational Highway Traffic Safety Administration (NHTSA)Office of Emergency Medical Services
TABLE OF CONTENTSDAgencyDAgency.01 EMS Agency Unique State ID1DAgency.02 EMS Agency Number2DAgency.03 EMS Agency Name3DAgency.04 EMS Agency State4DAgency.05 EMS Agency Service Area States5DAgency.06 EMS Agency Service Area County(s)6DAgency.07 EMS Agency Census Tracts7DAgency.08 EMS Agency Service Area Zip Codes8DAgency.09 Primary Type of Service9DAgency.10 Other Types of Service10DAgency.11 Level of Service11DAgency.12 Organization Status12DAgency.13 Organizational Type13DAgency.14 EMS Agency Organizational Tax Status14DAgency.15 Statistical Calendar Year15DAgency.16 Total Primary Service Size Area16DAgency.17 Total Service Area Population17DAgency.18 911 EMS Call Center Volume per Year18DAgency.19 EMS Dispatch Volume per Year19DAgency.20 EMS Patient Transport Volume per Year20DAgency.21 EMS Patient Contact Volume per Year21DAgency.22 EMS Billable Calls per Year22DAgency.23 EMS Agency Time Zone23DAgency.24 EMS Agency Daylight Savings Time Use24DAgency.25 National Provider Identifier25DAgency.26 Fire Department ID Number26
DContactDContact.01 Agency Contact Type27DContact.02 Agency Contact Last Name30DContact.03 Agency Contact First Name31DContact.04 Agency Contact Middle Name/Initial32DContact.05 Agency Contact Address33DContact.06 Agency Contact City34DContact.07 Agency Contact State35DContact.08 Agency Contact Zip Code36DContact.09 Agency Contact Country37DContact.10 Agency Contact Telephone Number38DContact.11 Agency Contact Fax Number39DContact.12 Agency Contact Email Address40DContact.13 EMS Agency Contact Web Address41DContact.14 Agency Medical Director Degree42DContact.15 Agency Medical Director Board Certification Type43DContact.16 Medical Director Compensation47DContact.17 EMS Medical Director Fellowship Trained Status48DConfigurationDConfiguration.01 State Associated with the Certification/Licensure Levels49DConfiguration.02 State Certification Licensure Levels50DConfiguration.03 Procedures Permitted by the State51DConfiguration.04 Medications Permitted by the State52DConfiguration.05 EMS Agency Procedures53DConfiguration.06 EMS Professional Level Permitted to Perform the Procedure54DConfiguration.07 EMS Agency Medications55DConfiguration.08 Personnel Level Permitted to Administer the Medication56DConfiguration.09 EMS Agency Protocols57DConfiguration.10 EMS Agency Specialty Service Capability67DConfiguration.11 Billing Status69DConfiguration.12 Emergency Medical Dispatch (EMD) Provided to EMS Agency Service Area70DConfiguration.13 EMD Vendor71
DConfiguration.14 Patient Monitoring Capability(s) available to every relevant patient scenario72DLocationDLocation.01 EMS Location Type74DLocation.02 EMS Location Name75DLocation.03 EMS Location Number76DLocation.04 EMS Location GPS77DLocation.05 EMS Location US National Grid Coordinates78DLocation.06 EMS Location Address79DLocation.07 EMS Location City80DLocation.08 EMS Location State81DLocation.09 EMS Station or Location Zip Code82DLocation.10 EMS Location County83DLocation.11 EMS Location Country84DLocation.12 EMS Location Telephone Number85DVehicleDVehicle.01 Unit/Vehicle Number86DVehicle.02 Vehicle Identification Number87DVehicle.03 Vehicle Type88DVehicle.04 Crew State Certification/Licensure Levels91DVehicle.05 Number Of Each EMS Professional Level on Normal 911 Ambulance Response93DVehicle.06 Number Of Each EMS Professional Level on Normal 911 Response (Non-Transport) Vehicle94DVehicle.07 Number Of Each EMS Professional Level on Normal Medical (Non-911) Transport Ambulance95DVehicle.08 Vehicle Initial Cost96DVehicle.09 Vehicle Model Year97DVehicle.10 Year Miles/Hours Accrued98DVehicle.11 Annual Vehicle Hours99DVehicle.12 Annual Vehicle Miles100DStaffDStaff.01 Professional's Agency ID Number101DStaff.02 State of Licensure102
DStaff.03 EMS Professional's State/Licensure ID Number103DStaff.04 EMS Professional's Employment Status104DStaff.05 Employment Status Date105DStaff.06 Hire Date106DStaff.07 Primary EMS Job Role107DStaff.08 Other Job Responsibilities108DStaff.09 EMS Professional's Practice Level109DStaff.10 Date of Professional's Certification or Licensure for Agency110DProfessionalDProfessional.01 EMS Professional's Last Name111DProfessional.02 EMS Professional's First Name112DProfessional.03 EMS Professional's Middle Name/Initial113DProfessional.04 EMS Professional's Mailing Address114DProfessional.05 EMS Professional's City of Residence115DProfessional.06 EMS Professional's State116DProfessional.07 EMS Professional's Zip Code117DProfessional.08 EMS Professional's Country118DProfessional.09 EMS Professional's Work Telephone119DProfessional.10 EMS Professional's Home Telephone120DProfessional.11 EMS Professional's Email Address121DProfessional.12 EMS Professional's Date Of Birth122DProfessional.13 EMS Professional's Gender123DProfessional.14 EMS Professional's Race124DProfessional.15 EMS Professional's Citizenship125DProfessional.16 EMS Professional's Highest Educational Degree126DProfessional.17 EMS Professional's Degree Subject/Field of Study127DProfessional.18 EMS Professional's Motor Vehicle License Type129DProfessional.19 EMS Professional's Immunization Status132DProfessional.20 EMS Professional's Foreign Language Ability133DProfessional.21 State EMS Certification Licensure Level136DProfessional.22 State EMS Current Certification Date140DProfessional.23 EMS Professional's Initial State/Licensure Issue Date141
DProfessional.24 EMS Professional's Current State/Licensure Expiration Date142DProfessional.25 National Registry Credentialed143DProfessional.26 National Registry Certification Level144DProfessional.27 National Registry Certification Date145DProfessional.28 Total Length of Service in years.146DProfessional.29 Date Length of Service Documented147DDeviceDDevice.01 Medical Device Serial Number148DDevice.02 Device Name or ID149DDevice.03 Medical Device Type150DDevice.04 Device Manufacturer152DDevice.05 Model Number153DDevice.06 Device Purchase Date154DCustomDCustom.01 Demographic Custom Data Element Title155DCustom.02 Demographic Custom Data Element Potential Values156DCustom.03 Demographic Custom Data Element Multiplicity157DCustom.04 Demographic Custom Data Element Usage158DCustom.05 Demographic Custom Data Element Result159Demographic Custom Data Element Values160ERecordERecord.01 Patient Care Report Number161ERecord.02 Software Creator162ERecord.03 Software Name163ERecord.04 Software Version164EResponseEResponse.01 EMS Agency Number165EResponse.02 EMS Agency Name166EResponse.03 Incident Number167
EResponse.04 EMS Vehicle (Unit) Response Number168EResponse.05 Type of Service Requested169EResponse.06 Standby Purpose170EResponse.07 Primary Role of the Unit171EResponse.08 Type of Dispatch Delay172EResponse.09 Type of Response Delay173EResponse.10 Type of Scene Delay175EResponse.11 Type of Transport Delay177EResponse.12 Type of Turn-Around Delay179EResponse.13 EMS Vehicle (Unit) Number180EResponse.14 Vehicle Dispatch Location181EResponse.15 Vehicle Dispatch GPS Location182EResponse.16 Vehicle Dispatch US National Grid Location183EResponse.17 Beginning Odometer Reading of Responding Vehicle184EResponse.18 On-Scene Odometer Reading of Responding Vehicle185EResponse.19 Patient Destination Odometer Reading of Responding Vehicle186EResponse.20 Ending Odometer Reading of Responding Vehicle187EResponse.21 Response Mode to Scene188EResponse.22 Additional Response Mode Descriptors189EDispatchEDispatch.01 Complaint Reported by Dispatch190EDispatch.02 EMD Performed193EDispatch.03 EMD Card Number194ECrewECrew.01 Crew Member ID195ECrew.02 Crew Member Level196ECrew.03 Crew Member Response Role198ETimesETimes.01 PSAP Call Date/Time199ETimes.02 Dispatch Notified Date/Time200
ETimes.03 Unit Notified by Dispatch Date/Time201ETimes.04 Dispatch Acknowledged Date/Time202ETimes.05 Unit En Route Date/Time203ETimes.06 Unit Arrived on Scene Date/Time204ETimes.07 Arrived at Patient Date/Time205ETimes.08 Transfer of EMS Patient Care Date/Time206ETimes.09 Unit Left Scene Date/Time207ETimes.10 Arrival at Destination Landing Area208ETimes.11 Patient Arrived at Destination Date/Time209ETimes.12 Destination Patient Transfer of Care Date/Time210ETimes.13 Unit Back in Service Date/Time211ETimes.14 Unit Cancelled Date/Time212ETimes.15 Unit Back at Home Location Date/Time213ETimes.16 EMS Call Completed Date/Time214EPatientEPatient.01 EMS Patient ID215EPatient.02 Last Name216EPatient.03 First Name217EPatient.04 Middle Initial/Name218EPatient.05 Patient's Home Address219EPatient.06 Patient's Home City220EPatient.07 Patient's Home County221EPatient.08 Patient's Home State222EPatient.09 Patient's Home Zip Code223EPatient.10 Patient's Home Country224EPatient.11 Patient Home Census Tract225EPatient.12 Social Security Number226EPatient.13 Gender227EPatient.14 Race228EPatient.15 Age229EPatient.16 Age Units230EPatient.17 Date of Birth231
EPatient.18 Primary or Home Telephone Number232EPatient.19 Patient's Email Address233EPatient.20 State Issuing Driver's License234EPatient.21 Driver's License Number235EPaymentEPayment.01 Primary Method of Payment236EPayment.02 Physician Certification Statement237EPayment.03 Date Physician Certification Statement Signed238EPayment.04 Reason for Physician Certification Statement239EPayment.05 Healthcare Provider Type Signing Physician Certification Statement241EPayment.06 First Name of Individual Signing Physician Certification Statement242EPayment.07 Last Name of Individual Signing Physician Certification Statement243EPayment.08 Residency Status of the Patient244EPayment.09 Insurance Company ID/Name245EPayment.10 Insurance Company Billing Priority246EPayment.11 Insurance Company Address247EPayment.12 Insurance Company City248EPayment.13 Insurance Company State249EPayment.14 Insurance Company Zip Code250EPayment.15 Insurance Company Country251EPayment.16 Insurance Group ID/Name252EPayment.17 Insurance Policy ID Number253EPayment.18 Last Name of the Insured254EPayment.19 First Name of the Insured255EPayment.20 Middle Initial/Name of the Insured256EPayment.21 Relationship to the Insured257EPayment.22 Closest Relative/Guardian Last Name258EPayment.23 Closest Relative/ Guardian First Name259EPayment.24 Closest Relative/ Guardian Middle Initial/Name260EPayment.25 Closest Relative/ Guardian Street Address261EPayment.26 Closest Relative/ Guardian City262EPayment.27 Closest Relative/ Guardian State263
EPayment.28 Closest Relative/ Guardian Zip Code264EPayment.29 Closest Relative/ Guardian Country265EPayment.30 Closest Relative/ Guardian Phone Number266EPayment.31 Closest Relative/ Guardian Relationship267EPayment.32 Patient's Employer268EPayment.33 Patient's Employer's Address269EPayment.34 Patient's Employer's City270EPayment.35 Patient's Employer's State271EPayment.36 Patient's Employer's Zip Code272EPayment.37 Patient's Employer's Country273EPayment.38 Patient's Work Telephone Number274EPayment.39 Response Urgency275EPayment.40 Patient Transport Assessment276EPayment.41 Specialty Care Transport Care Provider277EPayment.42 Ambulance Transport Code278EPayment.43 Ambulance Transport Reason Code279EPayment.44 Round Trip Purpose Description280EPayment.45 Stretcher Purpose Description281EPayment.46 Ambulance Conditions Indicator282EPayment.47 Mileage to Closest Hospital Facility283EPayment.48 ALS Assessment Performed and Warranted284EPayment.49 CMS Service Level285EPayment.50 EMS Condition Code286EPayment.51 CMS Transportation Indicator291EPayment.52 Transport Authorization Code292EPayment.53 Prior Authorization Code Payor293EPayment.54 Supply Item Used Name294EPayment.55 Number of Supply Item(s) Used295ESceneEScene.01 First EMS Unit on Scene296EScene.02 Other EMS or Public Safety Agencies at Scene297EScene.03 Other Public Safety or EMS Agency ID Number298
EScene.04 Type of Other Service at Scene299EScene.05 Date/Time Initial Responder Arrived on Scene300EScene.06 Number of Patients at Scene301EScene.07 Mass Casualty Incident302EScene.08 Incident Location Type303EScene.09 Incident Facility Code304EScene.10 Scene GPS Location305EScene.11 Scene US National Grid Coordinates306EScene.12 Incident Facility or Location Name307EScene.13 Incident Address Type308EScene.14 Address Number or Mile Post309EScene.15 Scene Street Prefix310EScene.16 Incident Street Address311EScene.17 Street Type312EScene.18 Scene Street Suffix323EScene.19 Scene Apartment, Suite, or Room324EScene.20 Incident City325EScene.21 Incident State326EScene.22 Incident ZIP Code327EScene.23 Scene Cross Street or Directions328EScene.24 Incident County329EScene.25 Incident Country330EScene.26 Incident Census Tract331ESituationESituation.01 Date/Time of Symptom Onset/Last Normal332ESituation.02 Possible Injury333ESituation.03 Complaint Type334ESituation.04 Complaint335ESituation.05 Duration of Complaint336ESituation.06 Time Units of Duration of Complaint337ESituation.07 Chief Complaint Anatomic Location338ESituation.08 Chief Complaint Organ System339
ESituation.09 Primary Symptom340ESituation.10 Other Associated Symptoms341ESituation.11 Providers Primary Impression342ESituation.12 Provider's Secondary Impressions343ESituation.13 Patient's Initial Condition at Scene344ESituation.14 Work-Related Illness/Injury345ESituation.15 Patient's Occupational Industry346ESituation.16 Patient's Occupation347EInjuryEInjury.01 Cause of Injury348EInjury.02 Intent of the Injury350EInjury.03 Mechanism of Injury351EInjury.04 Trauma Center Criteria352EInjury.05 Vehicular, Pedestrian, or Other Injury Risk Factor353EInjury.06 Main Area of the Vehicle impacted by the collision355EInjury.07 Location of Patient in Vehicle356EInjury.08 Use of Occupant Safety Equipment358EInjury.09 Airbag Deployment360EInjury.10 Height of Fall (feet)361EInjury.11 OSHA Personal Protective Equipment Used362EInjury.12 ACN System/Company Providing ACN Data363EInjury.13 ACN Incident ID364EInjury.14 ACN Call Back Phone Number365EInjury.15 ACN Incident Date/Time366EInjury.16 ACN Incident Location367EInjury.17 ACN Incident Vehicle Body Type368EInjury.18 ACN Incident Vehicle Manufacturer369EInjury.19 ACN Incident Vehicle Make370EInjury.20 ACN Incident Vehicle Model371EInjury.21 ACN Incident Vehicle Model Year372EInjury.22 ACN Incident Multiple Impacts373EInjury.23 ACN Incident Delta Velocity374
EInjury.24 ACN High Probability of Injury375EInjury.25 ACN Incident PDOF376EInjury.26 ACN Incident Rollover377EInjury.27 ACN Vehicle Seat Location378EInjury.28 Seat Occupied379EInjury.29 ACN Incident Seatbelt Use380EInjury.30 ACN Incident Airbag Deployed381EArrestEArrest.01 Cardiac Arrest382EArrest.02 Cardiac Arrest Etiology383EArrest.03 Resuscitation Attempted By EMS384EArrest.04 Arrest Witnessed by385EArrest.05 CPR Care Provided Prior to EMS Arrival386EArrest.06 Who Provided CPR Prior to EMS Arrival387EArrest.07 AED Use Prior to EMS Arrival388EArrest.08 Who Used AED Prior to EMS Arrival389EArrest.09 Type of CPR Provided390EArrest.10 Therapeutic Hypothermia Initiated391EArrest.11 First Monitored Arrest Rhythm of the Patient392EArrest.12 Any Return of Spontaneous Circulation393EArrest.13 Neurological Outcome at Hospital Discharge394EArrest.14 Time of Cardiac Arrest395EArrest.15 Date/Time Resuscitation Discontinued396EArrest.16 Reason CPR/Resuscitation Discontinued397EArrest.17 Cardiac Rhythm on Arrival at Destination398EArrest.18 End of EMS Cardiac Arrest Event400EHistoryEHistory.01 Barriers to Patient Care401EHistory.02 Last Name of Patient's Primary Practitioner403EHistory.03 First Name of Patient's Primary Practitioner404EHistory.04 Middle Name of Patient's Primary Practitioner405
EHistory.05 Advance Directives406EHistory.08 Medication Allergies407EHistory.09 Environmental/Food Allergies408EHistory.10 Medical/Surgical History409EHistory.11 Medical History Obtained From412EHistory.12 Immunization History413EHistory.13 Immunization Date416EHistory.14 Current Medications417EHistory.15 Current Medication Dose419EHistory.16 Current Medication Dosage Unit421EHistory.17 Current Medication Administration Route422EHistory.18 Presence of Emergency Information Form423EHistory.19 Alcohol/Drug Use Indicators424EHistory.20 Pregnancy425EHistory.21 Last Oral Intake426ENarrativeENarrative.01 Patient Care Report Narrative427EVitalsEVitals.01 Date/Time Vital Signs Taken428EVitals.02 Obtained Prior to this Units EMS Care429EVitals.03 Cardiac Rhythm and Electrocardiography431EVitals.04 ECG Type434EVitals.05 Method of ECG Interpretation435EVitals.06 SBP (Systolic Blood Pressure)436EVitals.07 DBP (Diastolic Blood Pressure)437EVitals.08 Method of Blood Pressure Measurement438EVitals.09 Mean Arterial Pressure439EVitals.10 Heart Rate440EVitals.11 Method of Heart Rate Measurement441
EVitals.12 Pulse Oximetry442EVitals.13 Pulse Rhythm443EVitals.14 Respiratory Rate444EVitals.15 Respiratory Effort445EVitals.16 Carbon Dioxide (CO2)446EVitals.17 Carbon Monoxide (CO)447EVitals.18 Blood Glucose Level448EVitals.19 Glasgow Coma Score-Eye449EVitals.20 Glasgow Coma Score-Verbal450EVitals.21 Glasgow Coma Score-Motor451EVitals.22 Glasgow Coma Score-Qualifier452EVitals.23 Total Glasgow Coma Score453EVitals.24 Temperature454EVitals.25 Temperature Method455EVitals.26 Level of Responsiveness (APVU)456EVitals.27 Pain Score457EVitals.28 Pain Scale Type458EVitals.29 Stroke Scale Score459EVitals.30 Stroke Scale Type460EVitals.31 Reperfusion Checklist461EVitals.32 APGAR462EVitals.33 Revised Trauma Score463ELabELab.01 Date/Time Laboratory or Imaging Result464ELab.02 Study/Result Prior to this Units EMS Care465ELab.03 Laboratory Result Type466ELab.04 Laboratory Result469ELab.05 Imaging Study Type470ELab.06 Imaging Study Results471EExamEExam.01 Estimated Body Weight in Kilograms472
EExam.02 Length Based Tape Measure473EExam.03 Date/Time of Assessment474EExam.04 Skin Assessment475EExam.05 Head Assessment476EExam.06 Face Assessment477EExam.07 Neck Assessment479EExam.08 Chest/Lungs Assessment481EExam.09 Heart Assessment483EExam.10 Abdomen Assessment484EExam.11 Abdominal Exam Finding Location486EExam.12 Pelvis/Genitourinary Assessment487EExam.13 Back and Spine Assessment489EExam.14 Back and Spine Assessment Finding Location490EExam.15 Extremities Assessment491EExam.16 Extremity Assessment Finding Location493EExam.17 Eye Assessment496EExam.18 Eye Assessment Finding Location498EExam.19 Mental Status Assessment499EExam.20 Neurological Assessment500EProtocolsEProtocols.01 Protocols Used502EProtocols.02 Protocol Age Category512EMedicationsEMedications.01 Date/Time Medication Administered513EMedications.02 Medication Administered Prior to this Units EMS Care514EMedications.03 Medication Given515EMedications.04 Medication Administered Route516EMedications.05 Medication Dosage518EMedications.06 Medication Dosage Units519EMedications.07 Response to Medication521EMedications.08 Medication Complication522
EMedications.09 Medication Crew (Healthcare Professionals) ID524EMedications.10 EMS or Healthcare Professional Type Administering Medication525EMedications.11 Medication Authorization527EMedications.12 Medication Authorizing Physician528EProceduresEProcedures.01 Date/Time Procedure Performed529EProcedures.02 Procedure Performed Prior to this Units EMS Care530EProcedures.03 Procedure531EProcedures.04 Size of Procedure Equipment532EProcedures.05 Number of Procedure Attempts533EProcedures.06 Procedure Successful534EProcedures.07 Procedure Complication535EProcedures.08 Response to Procedure537EProcedures.09 Procedure Crew Members ID538EProcedures.10 EMS or Healthcare Professional Type Performing the Procedure539EProcedures.11 Procedure Authorization541EProcedures.12 Procedure Authorizing Physician542EProcedures.13 IV Site Location543EDispositionEDisposition.01 Destination/Transferred To, Name545EDisposition.02 Destination/Transferred To, Code546EDisposition.03 Destination Street Address547EDisposition.04 Destination City548EDisposition.05 Destination State549EDisposition.06 Destination County550EDisposition.07 Destination Zip Code551EDisposition.08 Destination Country552EDisposition.09 Destination GPS Location553EDisposition.10 Disposition Location US National Grid Coordinates554EDisposition.11 Number of Patients Transported in this EMS Unit555EDisposition.12 Incident/Patient Disposition556
EDisposition.13 How Patient Was Moved to Ambulance558EDisposition.14 Position of Patient During Transport559EDisposition.15 How Patient Was Transported From Ambulance560EDisposition.16 EMS Transport Method561EDisposition.17 Transport Mode from Scene562EDisposition.18 Additional Transport Mode Descriptors563EDisposition.19 Condition of Patient at Destination564EDisposition.20 Reason for Choosing Destination565EDisposition.21 Type of Destination566EDisposition.22 Destination Prearrival Activation567EDisposition.23 Destination Prearrival Activation Date/Time568EDisposition.24 Disposition Instructions Provided569EDeviceEDevice.01 Event Date/Time570EDevice.02 Medical Device Event Name571EDevice.03 Waveform Graphic Type572EDevice.04 Waveform Graphic573EDevice.05 ECG Lead574EDevice.06 ECG Interpretation575EDevice.07 Type of Shock576EDevice.08 Shock or Pacing Energy577EDevice.09 Total Number of Shocks Delivered578EDevice.10 Pacing Rate579EOutcomeEOutcome.01 Emergency Department Disposition580EOutcome.02 Hospital Disposition581EOutcome.03 External Report ID/Number Type582EOutcome.04 External Report ID/Number583EOutcome.05 Emergency Department Chief Complaint584EOutcome.06 First ED Systolic Blood Pressure585EOutcome.07 Emergency Department Recorded Cause of Injury586
EOutcome.08 Emergency Department Procedures587EOutcome.09 Emergency Department Diagnosis588EOutcome.10 Hospital Admission Date/Time589EOutcome.11 Hospital Procedures590EOutcome.12 Hospital Diagnosis591EOutcome.13 Total ICU Length of Stay592EOutcome.14 Total Ventilator Days593EOutcome.15 Hospital Discharge Date/Time594EOtherEOther.01 Review Requested595EOther.02 Potential System of Care/Specialty/Registry Patient596EOther.03 Personal Protective Equipment Used597EOther.04 EMS Professional (Crew Member) ID598EOther.05 Suspected Intentional, or Unintentional Disaster599EOther.06 Suspected EMS Work Related Exposure, Injury, or Death600EOther.07 Type of Suspected EMS Blood/Body Fluid Exposure, Injury, or Death601EOther.08 Who Generated this Report?603EOther.09 External Electronic Documents604EOther.10 File Attachment Type605EOther.11 File Attachment Image606EOther.12 Signature Type607EOther.13 Relationship to the Patient of the Patient Representative, caregiver, or administrator signature.608EOther.14 Signature Status610EOther.15 Signature Graphic612EOther.16 Date/Time of Signature613EOther.17 Signature Last Name614EOther.18 Signature First Name615EAirwayEAirway.01 Indications for Invasive Airway616EAirway.02 Date/Time Airway Device Placement Confirmation617EAirway.03 Airway Device Being Confirmed618
EAirway.04 Airway Device Placement Confirmed Method(s)619EAirway.05 Individual Determining Airway Device Placement620EAirway.06 Airway Complications Encountered621EAirway.07 Suspected Reasons for Failed Airway Procedure622EAirway.08 Decision to Manage the Patient with an Invasive Airway Date/Time623EAirway.09 Date/Time Successful Invasive Airway in Place624EAirway.10 Date/Time Invasive Airway Placement Attempts Abandoned625ECustomECustom.01 EMS Custom Data Element Title626ECustom.02 EMS Custom Data Element Potential Values627ECustom.03 EMS Custom Data Element Multiplicity628ECustom.04 EMS Custom Data Element Usage629ECustom.05 EMS Custom Data Element Result630EMS Custom Data Element Values631
NationalNEMSIS Version 3.0StateDAgency.01EMS Agency Unique State IDDefinitionThe unique ID assigned to the EMS Agency which is associated with all state licensure numbers and information.Version 2 NumberYes as a GroupMultiplicityMandatoryUsageNoAccepts Null ValuesGrouping (Associated Data Elements)DAgency.02EMS Agency NumberDAgency.04EMS Agency StateDAgency.03EMS Agency NameAssociated Performance Measure InitiativesCardiac ArrestOther (Not eMin Value (Inclusive) Max Value (Inclusive) Min LengthRAFValuePediatricTAirwaystring0Max LengthTotal DigitsFraction Digits10Data Element CommentThe may be the EMS Agency Name or a unique number assigned by the state EMS office.This is required to document multiple license types and numbers associated with the same EMS Agency.Version 3 Changes ImplementedDAdded to better define multiple EMS Agency numbers within a single EMS Agency.Version 3.0 (12/17/2010)www.NEMSIS.org1
NationalNEMSIS Version 3.0StateDAgency.02EMS Agency NumberDefinitionThe state-assigned provider (Agency) number of the EMS responding agency.D01 01Version 2 NumberMultiplicityMandatoryUsageYes as a GroupNoAccepts Null ValuesGrouping (Associated Data Elements)DAgency.01EMS Agency Unique State IDDAgency.04EMS Agency StateDAgency.03EMS Agency NameEResponse.01EMS Agency NumberAssociated Performance Measure InitiativesSTEMIAirwayStrokeCodesValueOther (Not Listed)DescriptorPediatricResponseRAFCardiac ArrestTCommon Keys (Similar/Related Data Elements)TraumaTypeMin Value (Inclusive) Max Value (Inclusive) Min Lengthstring3Max LengthTotal DigitsFraction Digits15Data Element CommentThis is the primary identifier to the entire Demographic Section. Each of the Demographic sections must be associated with an EMSAgency Number.An EMS Agency can have more than one Agency Number within a state. This reflects the ability for an EMS Agency to have a differentnumber for each service type or location (based on state implementation).DVersion 3 Changes ImplementedMultiple EMS Agency Numbers may be associated with EAgency.01.Version 3.0 (12/17/2010)www.NEMSIS.org2
StateNEMSIS Version 3.0DAgency.03EMS Agency NameDefinitionThe formal name of the EMS AgencyVersion 2 NumberD01 02MultiplicityUsageRequiredAccepts Null ValuesNot ApplicableNull Values AcceptedNoneYesNot RecordedNot ReportedGrouping (Associated Data Elements)EMS Agency NumberDAgency.04EMS Agency StateDAgency.05EMS Agency Service Area StatesDAgency.06EMS Agency Service Area County(s)DAgency.07EMS Agency Census TractsDAgency.08EMS Agency Service Area Zip CodesDAgency.09Primary Type of ServiceDAgency.11Level of ServiceDAgency.13Organizational TypeDAgency.15TDAgency.02Other Types of ServiceDAgency.12Organization StatusDAgency.14EMS Agency Organizational Tax StatusStatistical Calendar YearDAgency.16Total Primary Service Size AreaDAgency.17Total Service Area PopulationDAgency.18911 EMS Call Center Volume per YearDAgency.19EMS Dispatch Volume per YearDAgency.20EMS Patient Transport Volume per YearDAgency.21EMS Patient Contact Volume per YearDAgency.22EMS Billable Calls per YearDAgency.23EMS Agency Time ZoneDAgency.24EMS Agency Daylight Savings Time UseDAgency.25National Provider IdentifierDAgency.26Fire Department ID NumberRAFDAgency.10Common Keys (Similar/Related Data Elements)EMS Agency NameDEResponse.02Associated Performance Measure InitiativesAirwaySTEMICardiac ArrestOther (Not riptorTypeMin Value (Inclusive) Max Value (Inclusive) Min Lengthstring2Max LengthTotal DigitsFraction Digits50Version 2 to Version 3 Change CommentsThere should be an internally assigned numeric key for each EMS Agency when implemented in a database environment. Text is not thebest implementation for a database key.More than one EMS Agency Number can be assigned by a state to a single EMS Agency.Version 3.0 (12/17/2010)www.NEMSIS.org3
NationalNEMSIS Version 3.0StateDAgency.04EMS Agency StateDefinitionThe state which assigned the EMS Agency NumberD01 03Version 2 NumberMandatoryUsageNoneMultiplicityNoAccepts Null ValuesGrouping (Associated Data Elements)DAgency.01EMS Agency Unique State IDDAgency.03EMS Agency NameDAgency.02EMS Agency NumberAssociated Performance Measure InitiativesCardiac ArrestOther (Not Listed)STEMIStrokeTraumaData Element CommentPediatricResponseTAirwayRAFThis has been clarified to reflect that it is the state in which the EMS Agency resides and the state associated with the EMS Agencynumber.Version 2 to Version 3 Change CommentsDAn additional data element (D01 N04) has been added to document all of the states in which the EMS Agency provides services.Version 3.0 (12/17/2010)www.NEMSIS.org4
NationalNEMSIS Version 3.0StateDAgency.05EMS Agency Service Area StatesDefinitionThe states in which the EMS Agency provides services including the state associated with the EMS Agency Number.Version 2 NumberMultiplicityMandatoryUsageYes as a GroupYes IndividuallyNoAccepts Null ValuesGrouping (Associated Data Elements)DAgency.02EMS Agency NumberDAgency.03EMS Agency NameDAgency.06EMS Agency Service Area County(s)DAgency.07EMS Agency Census TractsDAgency.08EMS Agency Service Area Zip CodesTData Element CommentThis data element was added to better document the service area of the EMS Agency.Each state listed is associated with the counties, census tracts, and zip codes within the EMS Agency Service Area for each state.RAFVersion 3 Changes ImplementedDAdded to better document the EMS Agency service area.Version 3.0 (12/17/2010)www.NEMSIS.org5
NationalNEMSIS Version 3.0StateDAgency.06EMS Agency Service Area County(s)DefinitionThe county(s) within each state for which the agency formally provides service. The county(s) should be associated with the state inD01 N04D01 04Version 2 NumberMandatoryUsageYes IndividuallyMultiplicityYes as a GroupNoAccepts Null ValuesGrouping (Associated Data Elements)EMS Agency NumberDAgency.03EMS Agency NameDAgency.05EMS Agency Service Area StatesDAgency.07EMS Agency Census TractsDAgency.08EMS Agency Service Area Zip CodesAssociated Performance Measure InitiativesTDAgency.02Cardiac ArrestOther (Not Listed)STEMIStrokeTraumaPediatricRespon
NEMSIS . Data Dictionary . NHTSA Version 3.0 . EMS Data Standard . Version Date: December 17, 2010 . Funded by . . DCustom.05 Demographic Custom Data Element Result 159 Demographic Custom Data Element Values 160 . ERecord . ERecord.01 Patient Care Report Number 161 ERecord.02 Software Creator 162
