Tag # NEMSIS FIELD FIREHOUSE FIELD Located Section E1: Record Information E01_01 Patient Care Report Number Patient ID Unique Patient ID that is

Transcription

1 Section E1: Record Information E01_01 Patient Care Report Number Patient ID Unique Patient ID that is generated Section E2: Unit/Agency Information E02_01 EMS Agency Number Service Number E02_02 Incident Number Incident Number EMS Main E02_03 EMS Unit (Vehicle) Response Number Unit ID Unique Unit ID that is generated E02_04 Type of Service Requested Type of Service Requested EMS Main-Basic Tab E02_05 Primary Role of the Unit Primary Role of Unit EMS Patient-Response Tab E02_06 Type of Dispatch Delay Dispatch EMS Patient-Scene Tab-Scene Factors E02_07 Type of Response Delay Respone EMS Patient-Scene Tab-Scene Factors E02_08 Type of Scene Delay Scene EMS Patient-Scene Tab-Scene Factors E02_09 Type of Transport Delay Transport EMS Patient-Scene Tab-Scene Factors E02_10 Type of Turn-Around Delay Turnaround EMS Patient-Scene Tab-Scene Factors E02_11 EMS Unit/Vehicle Number Serial Number or VIN Number Inventory or Unit Code E02_12 EMS Unit Call Sign (Radio Number) Unit Code Unit E02_13 Vehicle Dispatch Location Dispatch Location Responding Units User Field-Pre Defined E02_14 Vehicle Dispatch Zone Dispatch Zone Responding Units User Field-Pre Defined E02_15 Vehicle Dispatch GPS Location Dispatch GPS Location Responding Units User Field-Pre Defined E02_16 Beginning Odometer Reading of Responding Vehicle Odometer Readings EMS Patient-Response Tab E02_17 On-Scene Odometer Reading of Responding Vehicle Odometer Readings EMS Patient-Response Tab E02_18 Patient Destination Odometer Reading of Responding Vehicle Odometer Readings EMS Patient-Response Tab E02_19 Ending Odometer Reading of Responding Vehicle Odometer Readings EMS Patient-Response Tab E02_20 Response Mode to Scene Lights & Sirens to Scene EMS Patient-Response Tab Section E3: Unit/Call Information E03_01 Complaint Reported by Dispatch Dispactched For EMS Main E03_02 EMD Performed EMD Performed EMS Main E03_03 EMD Card Number EMD Card Number EMS Main Section E4: Unit/Personnel Information E04_01 Crew Member ID EMS Cert Number EMS Patient-Other-Crew Member E04_02 Crew Member Role Role Participant Activity Detail PD User Field E04_03 Crew Member Level Cert Level Participant Activity Detail PD User Field Section E5: Times E05_01 Incident or Onset Date/Time Onset Date/Time EMS Patient-Clinical-Complaint E05_02 PSAP Call Date/Time Dispatch Notified Date/Time EMS Main E05_03 Dispatch Notified Date/Time Alarm Date/Time EMS Main E05_04 Unit Notified by Dispatch Date/Time Unit Notified Date/Time EMS Patient-Response Tab E05_05 Unit En Route Date/Time Unit Enroute Date/Time EMS Patient-Response Tab E05_06 Unit Arrived on Scene Date/Time Arrived Scene Date/Time EMS Patient-Response Tab E05_07 Arrived at Patient Date/Time Arrived Patient Date/Time EMS Patient-Response Tab E05_08 Transfer of Patient Care Date/Time Transfer of Care Date/Time EMS Patient-Response Tab E05_09 Unit Left Scene Date/Time Enroute Destination Date/Time EMS Patient-Response Tab E05_10 Patient Arrived at Destination Date/Time Arrived Destination Date/Time EMS Patient-Response Tab E05_11 Unit Back in Service Date/Time Back in Service Date/Time EMS Patient-Response Tab E05_12 Unit Cancelled Date/Time Cancelled Date/Time EMS Patient-Response Tab E05_13 Unit Back at Home Location Date/Time Back at Home Date/Time EMS Patient-Response Tab Section E6: Patient E06_01 Last Name Last Name EMS Patient E06_02 First Name First Name EMS Patient

2 E06_03 Middle Initial/Name Middle Name EMS Patient E06_04 Patient's Home Address Residence Address EMS Patient-Basic E06_05 Patient's Home City Residence Address EMS Patient-Basic E06_06 Patient's Home County Patient County EMS Patient User Field-Pre Defined E06_07 Patient's Home State Residence Address EMS Patient-Basic E06_08 Patient's Home ZIP Residence Address EMS Patient-Basic E06_09 Patient s Home Country Country EMS Patient User Field-Pre Defined E06_10 Social Security Number SSN EMS Patient-Basic E06_11 Gender Gender EMS Patient-Basic E06_12 Race Race EMS Patient-Basic E06_13 Ethnicity Ethnicity EMS Patient-Basic E06_14 Age Age EMS Patient-Basic E06_15 Age Units No Field Code selected in the export E06_16 Date of Birth DOB EMS Patient-Basic E06_17 Primary or Home Telephone Number Phone EMS Patient-Basic E06_18 State Issuing Driver's License Drivers Licence #/State Issue EMS Patient-Basic E06_19 Driver's License Number Drivers Licence #/State Issue EMS Patient-Basic Section E7: Billing E07_01 Primary Method of Payment Insurance Type EMS Patient-Insurance E07_02 Certificate of Medical Necessity Certificate of Medical Necessity EMS Patient User Field-Pre Defined E07_03 Insurance Company ID/Name Insurance Company Description EMS Patient-Insurance E07_04 Insurance Company Billing Priority No Field Code selected in the export E07_05 Insurance Company Address Agent Address EMS Patient-Insurance E07_06 Insurance Company City Agent City EMS Patient-Insurance E07_07 Insurance Company State Agent State EMS Patient-Insurance E07_08 Insurance Company Zip Code Agent Zip EMS Patient-Insurance E07_09 Insurance Group ID/Name Group # EMS Patient-Insurance E07_10 Insurance Policy ID Number Policy # EMS Patient-Insurance E07_11 Last Name of the Insured Insured Name (Last) EMS Patient-Insurance E07_12 First Name of the Insured Insured First EMS Patient-Insurance E07_13 Middle Initial/Name of the Insured Insured Middle EMS Patient-Insurance E07_14 Relationship to the Insured Relationship to Insured/Victim EMS Patient-Insurance E07_15 Work-Related Work Related EMS Patient-Clinical-Injury/Illness E07_16 Patient s Occupational Industry Occupational Industry EMS Patient-Basic-Employment E07_17 Patient s Occupation Patient Occupation EMS Patient-Basic-Employment E07_18 Closest Relative/Guardian Last Name Last Name EMS Patient-Next of Kin E07_19 First Name of the Closest Relative/ Guardian First Name EMS Patient-Next of Kin E07_20 Middle Initial/Name of the Closest Relative/ Guardian Middle EMS Patient-Next of Kin E07_21 Closest Relative/ Guardian Street Address Address 1 EMS Patient-Next of Kin E07_22 Closest Relative/ Guardian City City EMS Patient-Next of Kin E07_23 Closest Relative/ Guardian State State EMS Patient-Next of Kin E07_24 Closest Relative/ Guardian Zip Code Zip EMS Patient-Next of Kin E07_25 Closest Relative/ Guardian Phone Number Phone EMS Patient-Next of Kin E07_26 Closest Relative/ Guardian Relationship Relationship to Patient EMS Patient-Next of Kin E07_27 Patient's Employer Employer Name EMS Patient-Basic-Employment E07_28 Patient's Employer's Address Address 1 EMS Patient-Basic-Employment E07_29 Patient s Employer s City City EMS Patient-Basic-Employment E07_30 Patient s Employer s State State EMS Patient-Basic-Employment

3 E07_31 Patient s Employer s Zip Code Zip EMS Patient-Basic-Employment E07_32 Patient's Work Telephone Number Phone EMS Patient-Basic-Employment E07_33 Response Urgency Response Urgency EMS Patient User Field-Pre Defined E07_34 CMS Service Level Mode of Transport EMS Patient-Status & Transport E07_35 Condition Code Number CMS Condition Code EMS Patient-Clinical-Provider E07_36 ICD-9 Code for the Condition Code Number CMS Condition Code Part of the lookup table for CMS Code E07_37 Air Ambulance Modifier for Condition Code Number Air Ambulance Modifier EMS Patient User Field-Pre Defined Section E8: Scene E08_01 Other EMS Agencies at Scene Other EMS Agencies at Scene EMS Main User Field-Pre Defined E08_02 Other Services at Scene Other Services at Scene EMS Main User Field-Pre Defined E08_03 Estimated Date/Time Initial Responder Arrived on Scene Initial Responder on Scene EMS Patient User Field-Pre Defined E08_04 Date/Time Initial Responder Arrived on Scene Not being used. Option to either use E08_04 or E08_03 E08_05 Number of Patients at Scene Number of Patient EMS Main E08_06 Mass Casualty Incident Mass Casualty EMS Main Check Box E08_07 Incident Location Type Location Type EMS Main E08_08 Incident Facility Code Incident Facility EMS Main User Field-Pre Defined E08_09 Scene Zone Number Zone EMS Main-Supplemental Address E08_10 Scene GPS Location Latitude & Longitude EMS Main-Supplemental Address E08_11 Incident Address Address EMS Main E08_12 Incident City City EMS Main E08_13 Incident County County EMS Main-Supplemental Address E08_14 Incident State State EMS Main E08_15 Incident ZIP Code Zip EMS Main Section E9: Situation E09_01 Prior Aid Type-Description EMS Patient-Scene-Prior Aid Given E09_02 Prior Aid Performed by Code Prior Aid Given EMS Patient-Scene-Prior Aid Given E09_03 Outcome of the Prior Aid Result of Aid EMS Patient-Scene-Prior Aid Given E09_04 Injury Present Injury or Illness EMS Patient-Scene E09_05 Chief Complaint Narrative Chief Complaint EMS Patient-Clinical-Complaint E09_06 Duration of Chief Complaint Duration EMS Patient-Clinical-Complaint E09_07 Time Units of Duration of Chief Complaint Units EMS Patient-Clinical-Complaint E09_08 Secondary Complaint Narrative Secondary Complaint EMS Patient-Clinical-Complaint E09_09 Duration of Secondary Complaint Duration EMS Patient-Clinical-Complaint E09_10 Time Units of Duration of Secondary Complaint Units EMS Patient-Clinical-Complaint E09_11 Complaint Anatomic Location Chief Complaint Anatomic Location EMS Patient-Clinical-Complaint E09_12 Complaint Organ Agency Chief Complaint Organ System EMS Patient-Clinical-Complaint E09_13 Primary Symptom Signs & Symptoms EMS Patient-Clinical-Complaint E09_14 Other Associated Symptoms Signs & Symptoms EMS Patient-Clinical-Complaint E09_15 Providers Primary Impression Preliminary-Provider Impression EMS Patient-Clinical-Provider E09_16 Provider s Secondary Impression Secondary -Provider Impression EMS Patient-Clinical-Provider Section E10: Situation/Trauma E10_01 Cause of Injury Mechanism of Injury EMS Patient-Clinical-Provider E10_02 Intent of the Injury Injury Intent EMS Patient-Scene E10_03 Mechanism of Injury Injury/Illness Code (scene tab) EMS Patient-Clinical-Injury/Illness tab E10_04 Vehicular Injury Indicators Indicators of Injury EMS Patient-Scene-Vehicle Accident E10_05 Area of the Vehicle impacted by the collision Accident Type EMS Patient-Scene-Vehicle Accident E10_06 Seat Row Location of Patient in Vehicle Row and Seat Position EMS Patient-Scene-Vehicle Accident E10_07 Position of Patient in the Seat of the Vehicle Row and Seat Position EMS Patient-Scene-Vehicle Accident

4 E10_08 Use of Occupant Safety Equipment Safety Equipment Worn Code EMS Patient-Scene-Safety Equip Worn E10_09 Airbag Deployment Airbag Deployment EMS Patient-Scene-Vehicle Accident E10_10 Height of Fall Height of Fall EMS Patient User Field-Pre Defined Section E11: Situation/CPR E11_01 Cardiac Arrest Cardiac Arrest Type EMS Patient-Clinical-Cardiac Arrest E11_02 Cardiac Arrest Etiology Cause of Arrest EMS Patient-Clinical-Cardiac Arrest E11_03 Resuscitation Attempted Resuscitation Attempted EMS Patient-Clinical-Cardiac Arrest E11_04 Arrest Witnessed by Arrest Witnessed by EMS Patient-Clinical-Cardiac Arrest E11_05 First Monitored Rhythm of the Patient Initial Arrest Rhythm EMS Patient-Clinical-Cardiac Arrest E11_06 Any Return of Spontaneous Circulation Spontaneous Circulation EMS Patient-Clinical-Cardiac Arrest E11_07 Neurological Outcome at Hospital Discharge Neurological Outcome at Hospital EMS Patient-Clinical-Cardiac Arrest E11_08 Estimated Time of Arrest Prior to EMS Arrival Estimated Time of Arrest EMS Patient-Clinical-Cardiac Arrest E11_09 Date/Time Resuscitation Discontinued CPR Discontinued Date/Time EMS Patient-Clinical-Cardiac Arrest E11_10 Reason CPR Discontinued CPR Discontinued EMS Patient-Clinical-Cardiac Arrest E11_11 Cardiac Rhythm on Arrival at Destination Rhythm at Destination EMS Patient-Clinical-Cardiac Arrest Section E12: Medical History E12_01 Barriers to Patient Care Human Factors EMS Patient-Scene-Human Factors E12_02 Sending Facility Medical Record Number Sending Medical Record EMS Patient User Field-Pre Defined E12_03 Destination Medical Record Number Destination Medical Record EMS Patient User Field-Pre Defined E12_04 First Name of Patient's Primary Practitioner Primary Physician EMS Patient-Basic E12_05 Middle Name of Patient's Primary Practitioner Primary Physician EMS Patient-Basic E12_06 Last Name of Patient's Primary Practitioner Primary Physician EMS Patient-Basic E12_07 Advanced Directives Advanced Directives EMS Patient-Scene E12_08 Medication Allergies Medical Allergs EMS Patient-Scene-Past Medical History E12_09 Environmental/Food Allergies Envrn Allergs EMS Patient-Scene-Past Medical History E12_10 Medical/Surgical History Medical/Surgcl EMS Patient-Scene-Past Medical History E12_11 Medical History Obtained From Obtained From EMS Patient-Scene-Past Medical History E12_12 Immunization History Immunization EMS Patient-Scene-Past Medical History E12_13 Immunization Date Year EMS Patient-Scene-Past Medical History E12_14 Current Medications Cur Medications EMS Patient-Scene-Past Medical History E12_15 Current Medication Dose Dose EMS Patient-Scene-Past Medical History E12_16 Current Medication Dosage Unit Dose Unit EMS Patient-Scene-Past Medical History E12_17 Current Medication Administration Route Dose Route EMS Patient-Scene-Past Medical History E12_18 Presence of Emergency Information Form Presence of Emergency Info EMS Patient User Field-Pre Defined E12_19 Alcohol/Drug Use Indicators Drug/Alcohol Indicator EMS Patient-Scene E12_20 Pregnancy Pregnancy EMS Patient User Field-Pre Defined Section E13: Narrative E31_01 Run Report Narrative Narrative EMS Patient Narrative Section E14: Assessment / Vital Signs E14_01 Date/Time Vital Signs Taken Vital Date/Time EMS Patient-Assessment-Vitals E14_02 Obtained Prior to this Units EMS Care Prior to Unit Check Box EMS Patient-Assessment-Vitals E14_03 Cardiac Rhythm Cardiac Rhythm Interpretation EMS Patient-Assessment-Vitals E14_04 SBP Blood Pressure EMS Patient-Assessment-Vitals E14_05 DBP Blood Pressure EMS Patient-Assessment-Vitals E14_06 Method of Blood Pressure Method EMS Patient-Assessment-Vitals E14_07 Pulse Rate Pulse Rate EMS Patient-Assessment-Vitals E14_08 Electronic Monitor Rate Monitored Heart Rate EMS Patient-Assessment-Vitals E14_09 Pulse Oximetry PaO2 EMS Patient-Assessment-Vitals

5 E14_10 Pulse Rhythm Pulse Rhythm EMS Patient-Assessment-Vitals E14_11 Respiratory Rate Respirations EMS Patient-Assessment-Vitals E14_12 Respiratory Effort Respiratory Effort/Quality EMS Patient-Assessment-Vitals E14_13 CO2 Carbon Dioxide EMS Patient Vitals User Field Pre Defined E14_14 Blood Glucose Level Blood Glucose Level EMS Patient Vitals User Field Pre Defined E14_15 GCS Eye Eyes EMS Patient-Assessment-Vitals E14_16 GCS Verbal Verbal EMS Patient-Assessment-Vitals E14_17 GCS Motor Motor EMS Patient-Assessment-Vitals E14_18 GCS Qualifier Qualifier EMS Patient-Assessment-Vitals E14_19 Total GCS Total GCS EMS Patient-Assessment-Vitals E14_20 Temperature Temperature EMS Patient-Assessment-Vitals E14_21 Temperature Method Method EMS Patient-Assessment-Vitals E14_22 Level of Responsiveness General Level of Consc EMS Patient-Assessment-Vitals E14_23 Pain Scale Pain Scale 1-10 EMS Patient Vitals User Field Pre Defined E14_24 Stroke Scale Stroke Scale EMS Patient Vitals User Field Pre Defined E14_25 Thrombolytic Screen Thrombolytic Screen EMS Patient Vitals User Field Pre Defined E14_26 APGAR APGAR Score EMS Patient Vitals User Field Pre Defined E14_27 RTS RTS EMS Patient-Assessment-Vitals E14_28 Pediatric Trauma Score Pediatric Trauma Score EMS Patient Vitals User Field Pre Defined Section E15: Assessment / Injury E15_01 NHTSA Injury Matrix External/Skin Skin EMS Patient-Clinical-Injury Matrix E15_02 NHTSA Injury Matrix Head Head EMS Patient-Clinical-Injury Matrix E15_03 NHTSA Injury Matrix Face Face EMS Patient-Clinical-Injury Matrix E15_04 NHTSA Injury Matrix Neck Neck EMS Patient-Clinical-Injury Matrix E15_05 NHTSA Injury Matrix Thorax Chest/Thorax EMS Patient-Clinical-Injury Matrix E15_06 NHTSA Injury Matrix Abdomen Abdomen EMS Patient-Clinical-Injury Matrix E15_07 NHTSA Injury Matrix Spine Back/Spine EMS Patient-Clinical-Injury Matrix E15_08 NHTSA Injury Matrix Upper Extremities Upper Extemities EMS Patient-Clinical-Injury Matrix E15_09 NHTSA Injury Matrix Pelvis Pelvis/Genitalia EMS Patient-Clinical-Injury Matrix E15_10 NHTSA Injury Matrix Lower Extremities Lower Extremities EMS Patient-Clinical-Injury Matrix E15_11 NHTSA Injury Matrix Unspecified Unspecified EMS Patient-Clinical-Injury Matrix Section E16: Assessment / Exam E16_01 Estimated Body Weight Weight EMS Patient-Basic E16_02 Broselow/Luten Color Broselow/Luten Color EMS Patient User Field-Pre Defined E16_03 Date/Time of Assessment Vital Date/Time EMS Patient-Assessment-Vitals E16_04 Skin Assessment Skin Assessment EMS Patient Vitals User Field Pre Defined E16_05 Head/Face Assessment Head/Face Assessment EMS Patient Vitals User Field Pre Defined E16_06 Neck Assessment Neck Assessment EMS Patient Vitals User Field Pre Defined E16_07 Chest/Lungs Assessment Chest/Lung Assessment EMS Patient Vitals User Field Pre Defined E16_08 Heart Assessment Heart Assessment EMS Patient Vitals User Field Pre Defined E16_09 Abdomen Left Upper Assessment Abdomen Left Upper Assessment EMS Patient Vitals User Field Pre Defined E16_10 Abdomen Left Lower Assessment Abdomen Left Lower Assessment EMS Patient Vitals User Field Pre Defined E16_11 Abdomen Right Upper Assessment Abdomen Right Upper Assessment EMS Patient Vitals User Field Pre Defined E16_12 Abdomen Right Lower Assessment Abdomen Right Lower Assessment EMS Patient Vitals User Field Pre Defined E16_13 GU Assessment GU Assessment EMS Patient Vitals User Field Pre Defined E16_14 Back Cervical Assessment Back Cervical Assessment EMS Patient Vitals User Field Pre Defined E16_15 Back Thoracic Assessment Back Thoracic Assessment EMS Patient Vitals User Field Pre Defined E16_16 Back Lumbar/Sacral Assessment Back Lumbar Sacral Assessment EMS Patient Vitals User Field Pre Defined

6 E16_17 Extremities-Right Upper Assessment Extremities Right Upper Assessment EMS Patient Vitals User Field Pre Defined E16_18 Extremities-Right Lower Assessment Extremities Right Lower Assessment EMS Patient Vitals User Field Pre Defined E16_19 Extremities-Left Upper Assessment Extremities Left Upper Assessment EMS Patient Vitals User Field Pre Defined E16_20 Extremities-Left Lower Assessment Extremities Left Lower Assessment EMS Patient Vitals User Field Pre Defined E16_21 Eyes-Left Assessment Pupils Left EMS Patient Vitals User Field Pre Defined E16_22 Eyes-Right Assessment Pupils Right EMS Patient Vitals User Field Pre Defined E16_23 Mental Status Assessment Mental Status Assessment EMS Patient Vitals User Field Pre Defined E16_24 Neurological Assessment Neurological Assessment EMS Patient Vitals User Field Pre Defined Section E17: Intervention E17_01 Protocols Used Protocols EMS Patient-Clinical-Provider Section E18: Intervention / Medication E18_01 Date/Time Medication Administered Medication Date/Time EMS Patient-Assessment-Medication E18_02 Medication Administered Prior to this Units EMS Care Prior to Unit Check Box EMS Patient-Assessment-Medication E18_03 Medication Given Medication Code/Description EMS Patient-Assessment-Medication E18_04 Medication Administered Route Route EMS Patient-Assessment-Medication E18_05 Medication Dosage Dosage-Measure EMS Patient-Assessment-Medication E18_06 Medication Dosage Units Dosage-Units EMS Patient-Assessment-Medication E18_07 Response to Medication Response to Medication EMS Patient-Assessment-Medication E18_08 Medication Complication Complication EMS Patient-Assessment-Medication E18_09 Medication Crew Member ID Administered By Cert # EMS Patient-Assessment-Medication E18_10 Medication Authorization Authorization EMS Patient-Assessment-Medication E18_11 Medication Authorizing Physician Authorizing Physician EMS Patient-Assessment-Medication Section E19: Intervention / Procedure E19_01 Date/Time Procedure Performed Successfully Procedure Date/Time EMS Patient-Assessment-Procedure E19_02 Procedure Performed Prior to this Units EMS Care Prior to Unit Check Box EMS Patient-Assessment-Procedure E19_03 Procedure Procedure Code EMS Patient-Assessment-Procedure E19_04 Size of Procedure Equipment Equipment Size EMS Patient Procedure User Field Pre Defined E19_05 Number of Procedure Attempts # Attempts EMS Patient-Assessment-Procedure E19_06 Procedure Successful Successful Check Box EMS Patient-Assessment-Procedure E19_07 Procedure Complication Complications EMS Patient-Assessment-Procedure E19_08 Response to Procedure Response to Procedure EMS Patient-Assessment-Procedure E19_09 Procedure Crew Members ID Administered By Cert # EMS Patient-Assessment-Procedure E19_10 Procedure Authorization Authorization EMS Patient-Assessment-Procedure E19_11 Procedure Authorizing Physician Authorizing Physician EMS Patient-Assessment-Procedure E19_12 Successful IV Site Successful IV Site EMS Patient User Field Pre Defined E19_13 Tube Confirmation Tube Confirmation EMS Patient User Field Pre Defined E19_14 Destination Confirmation of Tube Placement Destination Tube Placement EMS Patient User Field Pre Defined Section E20: Disposition E20_01 Destination/ Transferred To, Name Initial Destination Description EMS Patient-Status & Transport E20_02 Destination/ Transferred To, Code Initial Destination Code EMS Patient-Status & Transport E20_03 Destination Street Address Address Part of the lookup table for Destination Code E20_04 Destination City City Part of the lookup table for Destination Code E20_05 Destination State State Part of the lookup table for Destination Code E20_06 Destination County County Part of the lookup table for Destination Code E20_07 Destination Zip Code Zip Part of the lookup table for Destination Code E20_08 Destination GPS Location Latitude & Longitude Part of the lookup table for Destination Code E20_09 Destination Zone Number Zone Part of the lookup table for Destination Code E20_10 Incident/Patient Disposition Patient Disposition EMS Patient-Basic

7 E20_11 How Patient Was Moved to Ambulance Moved to Ambulance EMS Patient User Field-Pre Defined E20_12 Position of Patient During Transport Patient Position EMS Patient User Field-Pre Defined E20_13 How Patient Was Transported From Ambulance Moved from Ambulance EMS Patient User Field-Pre Defined E20_14 Transport Mode from Scene Lights & Sirens from Scene EMS Patient-Response Tab E20_15 Condition of Patient at Destination Patient Status EMS Patient-Status & Transport E20_16 Reason for Choosing Destination Destination Determined By EMS Patient-Status & Transport E20_17 Type of Destination Hospital Type Part of the lookup table for Destination Code Section E21: Medical Device Data E21_01 Event Date/Time Device Date/time EMS Patient-Clincal-Device Data E21_02 Medical Device Event Name Event Name EMS Patient-Clincal-Device Data E21_03 Waveform Graphic Type Waveform Graphic Type EMS Patient-Clincal-Device Data E21_04 Waveform Graphic Waveform Graphic Attachment -Store on Server EMS Patient-Clincal-Device Data E21_05 AED, Pacing, or CO2 Mode AED, Pacing or CO2Mode EMS Patient-Clincal-Device Data E21_06 ECG Lead ECG Lead EMS Patient-Clincal-Device Data E21_07 ECG Interpretation ECG Interpretation EMS Patient-Clincal-Device Data E21_08 Type of Shock Type of Shock EMS Patient-Clincal-Device Data E21_09 Shock or Pacing Energy Shock/Pacing Energy EMS Patient-Clincal-Device Data E21_10 Total Number of Shocks Delivered Number of Shocks EMS Patient-Clincal-Device Data E21_11 Pacing Rate Pacing Rate EMS Patient-Clincal-Device Data E21_12 Device Heart Rate Heart Rate EMS Patient-Clincal-Device Data E21_13 Device Pulse Rate Pulse Rate EMS Patient-Clincal-Device Data E21_14 Device Systolic Blood Pressure Blood Pressure EMS Patient-Clincal-Device Data E21_15 Device Diastolic Blood Pressure Blood Pressure EMS Patient-Clincal-Device Data E21_16 Device Respiratory Rate Respiratory Rate EMS Patient-Clincal-Device Data E21_17 Device Pulse Oximetry Pulse Oximetry EMS Patient-Clincal-Device Data E21_18 Device CO2 or etco2 CO2/etCO2 EMS Patient-Clincal-Device Data E21_19 Device CO2, etco2, or Invasive Pressure Monitor Units CO2/Inv Press Monitor Units EMS Patient-Clincal-Device Data E21_20 Device Invasive Pressure Mean Invasive Pressure Mean EMS Patient-Clincal-Device Data Section E22: Outcome and Linkage E22_01 Emergency Department Disposition ER Disposition EMS Patient-Status & Transport E22_02 Hospital Disposition Hospital Disposition EMS Patient-Status & Transport E22_03 Law Enforcement / Crash Report Number Crash # EMS Main E22_04 Trauma Registry ID Trauma Registry ID EMS Patient-Clinical-Provider E22_05 Fire Incident Report Number Incident Number EMS Main E22_06 Patient ID Band/Tag Number Patient ID Band Number EMS Patient User Field-Pre Defined Section E23: Miscellaneous E23_01 Review Requested Review Requested EMS Patient User Field-Pre Defined E23_02 Potential Registry Candidate Registry Candidate EMS Patient User Field-Pre Defined E23_03 Personal Protective Equipment Used Exposure Precautions EMS Patient-Clinical-Provider E23_04 Suspected Intentional, or Unintentional Disaster Suspect Intentl/Unintentl Disaster EMS Main User Field-Pre Defined E23_05 Suspected Contact with Blood/Body Fluids of EMS Injury or Death Patient/Staff Exposures EMS Main-Clinical-Provider-Patient/Staff Exposure E23_06 Type of Suspected Blood/Body Fluid Exposure, Injury, or Death Staff Exposure EMS Patient-Clinical-Provider-Staff Exposure E23_07 Personnel Exposed Personnel Types Exposed EMS Patient User Field-Pre Defined E23_08 Required Reportable Conditions Required Reportable Conditions EMS Patient User Field-Pre Defined E23_09 Research Survey Field Special Studies EMS Patient-Special Studies - Value E23_10 Who Generated this Report? MM Report EMS Cert # EMS Patient-Report Authorization E23_11 Research Survey Field Title Special Studies EMS Patient-Special Studies - Description