Indiana Administrative Code › Title 836 - INDIANA EMERGENCY MEDICAL SERVICES COMMISSION › Article 1 - EMERGENCY MEDICAL SERVICES › Rule 1 - Definitions and General Requirements › Section 1-5 - Reports and records

Current through July 10, 2024
Authority: IC
				  16-31-2-7;
				  IC 16-31-3
Affected: IC 4-21.5; IC 16-31-3
Sec. 5.
(a) All
				emergency medical service provider organizations shall participate in the
				emergency medical service system review by collecting and reporting data
				elements for all emergency medical service provider organization runs. The
				elements shall be submitted to the agency by 11:59 p.m. of the day following
				the completion of the run by electronic format in the manner specified by the
				commission. The data elements prescribed by the commission are the following
				National Emergency Medical Service Information System (NEMSIS) Version 3 data
				elements:
(1) Emergency medical services (EMS)
				agency unique state identification (ID) (dAgency.01).
(2) EMS agency number (dAgency.02).
(3) EMS agency name (dAgency.03).
(4) EMS agency state (dAgency.04).
(5) EMS agency service area states
				(dAgency.05).
(6) EMS agency
				service area counties (dAgency.06).
(7) EMS agency census tracts
				(dAgency.07).
(8) EMS agency
				service area ZIP codes (dAgency.08).
(9) Primary type of service
				(dAgency.09).
(10) Other types of
				service (dAgency.10).
(11) Level of
				service (dAgency.11).
(12)
				Organization status (dAgency.12).
(13) Organizational type
				(dAgency.13).
(14) EMS agency
				organizational tax status (dAgency.14).
(15) Statistical calendar year
				(dAgency.15).
(16) Total primary
				service area size (dAgency.16).
(17) Total service area population
				(dAgency.17).
(18) 911 EMS call
				center volume per year (dAgency.18).
(19) EMS dispatch volume per year
				(dAgency.19).
(20) EMS patient
				transport volume per year (dAgency.20).
(21) EMS patient contact volume per year
				(dAgency.21).
(22) National
				provider identifier (dAgency.25).
(23) Fire department ID number
				(dAgency.26).
(24) State associated
				with the certification/licensure levels (dConfiguration.01).
(25) State certification/licensure levels
				(dConfiguration.02).
(26)
				Procedures permitted by the state (dConfiguration.03).
(27) Medications permitted by the state
				(dConfiguration.04).
(28) Protocols
				permitted by the state (dConfiguration.05).
(29) EMS certification levels permitted to
				perform each procedure (dConfiguration.06).
(30) EMS agency procedures
				(dConfiguration.07).
(31) EMS
				certification levels permitted to administer each medication
				(dConfiguration.08).
(32) EMS
				agency medications (dConfiguration.09).
(33) EMS agency protocols
				(dConfiguration.10).
(34) EMS
				agency specialty service capability (dConfiguration.11).
(35) Emergency medical dispatch (EMD)
				provided to EMS agency service area (dConfiguration.13).
(36) Patient monitoring capabilities
				(dConfiguration.15).
(37) Crew call
				sign (dConfiguration.16).
(38) EMS
				personnel's state's licensure ID number (dPersonnel.23).
(39) EMS personnel's state EMS certification
				licensure level (dPersonnel.24).
(40) Indications for invasive airway
				(eAirway.01).
(41) Date and time
				airway device placement confirmation (eAirway.02).
(42) Airway device being confirmed
				(eAirway.03).
(43) Airway device
				placement confirmed method (eAirway.04).
(44) Type of individual confirming airway
				device placement (eAirway.06).
(45)
				Crew member ID (eAirway.07).
(46)
				Airway complications encountered (eAirway.08).
(47) Suspected reasons for failed airway
				procedure (eAirway.09).
(48)
				Cardiac arrest (eArrest.01).
(49)
				Cardiac arrest etiology (eArrest.02).
(50) Resuscitation attempted by EMS
				(eArrest.03).
(51) Arrest witnessed
				by (eArrest.04).
(52)
				Cardiopulmonary resuscitation (CPR) care provided prior to EMS arrival
				(eArrest.05).
(53) Who provided CPR
				prior to EMS arrival (eArrest.06).
(54) Automated external defibrillator (AED)
				use prior to EMS arrival (eArrest.07).
(55) Who used AED prior to EMS arrival
				(eArrest.08).
(56) Type of CPR
				provided (eArrest.09).
(57) First
				monitored arrest rhythm of the patient (eArrest.11).
(58) Any return of spontaneous circulation
				(eArrest.12).
(59) Date/time of
				cardiac arrest (eArrest.14).
(60)
				Date/time resuscitation discontinued (eArrest.15).
(61) Reason CPR/resuscitation discontinued
				(eArrest.16).
(62) Cardiac rhythm
				on arrival at destination (eArrest.17).
(63) End of EMS cardiac arrest event
				(eArrest.18).
(64) Crew member ID
				(eCrew.01).
(65) Crew member level
				(eCrew.02).
(66) Crew member
				response role (eCrew.03).
(67)
				Complaint reported by dispatch (eDispatch.01).
(68) EMD performed (eDispatch.02).
(69) Destination transferred to, name
				(eDisposition.01).
(70) Destination
				transferred to, code (eDisposition.02).
(71) Destination state
				(eDisposition.05).
(72) Destination
				county (eDisposition.06).
(73)
				Destination ZIP code (eDisposition.07).
(74) Number of patients transported in this
				EMS unit (eDisposition.11).
(75)
				Incident/patient disposition (eDisposition.12).
(76) EMS transport method
				(eDisposition.16).
(77) Transport
				mode from scene (eDisposition.17).
(78) Additional transport mode descriptors
				(eDisposition.18).
(79) Final
				patient acuity (eDisposition.19).
(80) Reason for choosing destination
				(eDisposition.20).
(81) Type of
				destination (eDisposition.21).
(82)
				Hospital inpatient destination (eDisposition.22).
(83) Hospital capability
				(eDisposition.23).
(84) Destination
				team prearrival alert or activation (eDisposition.24).
(85) Date/time of destination prearrival
				alert or activation (eDisposition.25).
(86) Estimated body weight in kilograms
				(eExam.01).
(87) Barriers to
				patient care (eHistory.01).
(88)
				Advance directives (eHistory.05).
(89) Medication allergies
				(eHistory.06).
(90) Alcohol/drug
				use indicators (eHistory.17).
(91)
				Cause of injury (eInjury.01).
(92)
				Mechanism of injury (eInjury.02).
(93) Trauma center criteria
				(eInjury.03).
(94) Vehicular,
				pedestrian, or other injury risk factor (eInjury.04).
(95) Main area of the vehicle impacted by the
				collision (eInjury.05).
(96)
				Location of patient in vehicle (eInjury.06).
(97) Use of occupant safety equipment
				(eInjury.07).
(98) Airbag
				deployment (eInjury.08).
(99)
				Height of fall (feet) (eInjury.09).
(100) Date/time medication administered
				(eMedications.01).
(101) Medication
				administered prior to this unit's EMS care (eMedications.02).
(102) Medication given
				(eMedications.03).
(103) Medication
				administered route (eMedications.04).
(104) Medication dosage
				(eMedications.05).
(105) Medication
				dosage units (eMedications.06).
(106) Response to medication
				(eMedications.07).
(107) Medication
				complication (eMedications.08).
(108) Medication crew (healthcare
				professionals) ID (eMedications.09).
(109) Role/type of person administering
				medication (eMedications.10).
(110)
				Patient care report narrative (eNarrative.01).
(111) Personal protective equipment used
				(eOther.03).
(112) Suspected EMS
				work related exposure, injury, or death (eOther.05).
(113) Crew member completing this report
				(eOther.08).
(114) Emergency
				department disposition (eOutcome.01).
(115) Hospital disposition
				(eOutcome.02).
(116) Last name
				(ePatient.02).
(117) First name
				(ePatient.03).
(118) Middle
				initial/name (ePatient.04).
(119)
				Patient's home address (ePatient.05).
(120) Patient's home city
				(ePatient.06).
(121) Patient's home
				county (ePatient.07).
(122)
				Patient's home state (ePatient.08).
(123) Patient's home ZIP code
				(ePatient.09).
(124) Gender
				(ePatient.13).
(125) Race
				(ePatient.14).
(126) Age
				(ePatient.15).
(127) Age units
				(ePatient.16).
(128) Date of birth
				(ePatient.17).
(129) Primary method
				of payment (ePayment.01).
(130)
				Closest relative/guardian last name (ePayment.23).
(131) Closest relative/guardian first name
				(ePayment.24).
(132) Centers for
				Medicare and Medicaid Services (CMS) service level (ePayment.50).
(133) Date/time procedure performed
				(eProcedures.01).
(134) Procedure
				performed prior to this unit's EMS care (eProcedures.02).
(135) Procedure (eProcedures.03).
(136) Number of procedure attempts
				(eProcedures.05).
(137) Procedure
				successful (eProcedures.06).
(138)
				Procedure complication (eProcedures.07).
(139) Response to procedure
				(eProcedures.08).
(140) Procedure
				crew members ID (eProcedures.09).
(141) Role/type of person performing the
				procedure (eProcedures.10).
(142)
				Protocols used (eProtocols.01).
(143) Protocol age category
				(eProtocols.02).
(144) Patient care
				report number (eRecord.01).
(145)
				Software creator (eRecord.02).
(146) Software name (eRecord.03).
(147) Software version
				(eRecord.04).
(148) EMS agency
				number (eResponse.01).
(149)
				Incident number (eResponse.03).
(150) EMS response number
				(eResponse.04).
(151) Type of
				service requested (eResponse.05).
(152) Primary role of the unit
				(eResponse.07).
(153) Type of
				dispatch delay (eResponse.08).
(154) Type of response delay
				(eResponse.09).
(155) Type of scene
				delay (eResponse.10).
(156) Type of
				transport delay (eResponse.11).
(157) Type of turnaround delay
				(eResponse.12).
(158) EMS vehicle
				(unit) number (eResponse.13).
(159)
				EMS unit call sign (eResponse.14).
(160) Level of care of this unit
				(eResponse.15).
(161) Response mode
				to scene (eResponse.23).
(162)
				Additional response mode descriptors (eResponse.24).
(163) First EMS unit on scene
				(eScene.01).
(164) Other EMS or
				public safety agencies at scene (eScene.02).
(165) Type of other service at scene
				(eScene.04).
(166) Date/time
				initial responder arrived on scene (eScene.05).
(167) Number of patients at scene
				(eScene.06).
(168) Mass casualty
				incident (eScene.07).
(169) Triage
				classification for mild cognitive impairment (MCI) patient
				(eScene.08).
(170) Incident
				location type (eScene.09).
(171)
				Incident city (eScene.17).
(172)
				Incident state (eScene.18).
(173)
				Incident ZIP code (eScene.19).
(174) Incident county (eScene.21).
(175) Date/time of symptom onset
				(eSituation.01).
(176) Possible
				injury (eSituation.02).
(177)
				Complaint type (eSituation.03).
(178) Complaint (eSituation.04).
(179) Duration of complaint
				(eSituation.05).
(180) Time units
				of duration of complaint (eSituation.06).
(181) Chief complaint anatomic location
				(eSituation.07).
(182) Chief
				complaint organ system (eSituation.08).
(183) Primary symptom
				(eSituation.09).
(184) Other
				associated symptoms (eSituation.10).
(185) Provider's primary impression
				(eSituation.11).
(186) Provider's
				secondary impressions (eSituation.12).
(187) Initial patient acuity
				(eSituation.13).
(188) Public
				safety answering point (PSAP) call date/time (eTimes.01).
(189) Dispatch notified date/time
				(eTimes.02).
(190) Unit notified by
				dispatch date/time (eTimes.03).
(191) Unit en route date/time
				(eTimes.05).
(192) Unit arrived on
				scene date/time (eTimes.06).
(193)
				Arrived at patient date/time (eTimes.07).
(194) Transfer of EMS patient care date/time
				(eTimes.08).
(195) Unit left scene
				date/time (eTimes.09).
(196)
				Patient arrived at destination date/time (eTimes.11).
(197) Destination patient transfer of care
				date/time (eTimes.12).
(198) Unit
				back in service date/time (eTimes.13).
(199) Unit canceled date/time
				(eTimes.14).
(200) Date/time vital
				signs taken (eVitals.01).
(201)
				Obtained prior to this unit's EMS care (eVitals.02).
(202) Cardiac rhythm/electrocardiography
				(ECG) (eVitals.03).
(203) ECG type
				(eVitals.04).
(204) Method of ECG
				interpretation (eVitals.05).
(205)
				Systolic blood pressure (eVitals.06).
(206) Diastolic blood pressure
				(eVitals.07).
(207) Method of blood
				pressure measurement (eVitals.08).
(208) Heart rate (eVitals.10).
(209) Pulse oximetry (eVitals.12).
(210) Respiratory rate
				(eVitals.14).
(211) End tidal
				carbon dioxide (ETCO2) (eVitals.16).
(212) Blood glucose level
				(eVitals.18).
(213) Glasgow coma
				score-eye (eVitals.19).
(214)
				Glasgow coma score-verbal (eVitals.20).
(215) Glasgow coma score-motor
				(eVitals.21).
(216) Glasgow coma
				score-qualifier (eVitals.22).
(217)
				Total Glasgow coma score (eVitals.23).
(218) Temperature (eVitals.24).
(219) Level of responsiveness (AVPU)
				(eVitals.26).
(220) Pain scale
				score (eVitals.27).
(221) Stroke
				scale score (eVitals.29).
(222)
				Stroke scale type (eVitals.30).
(223) Reperfusion checklist (eVitals.31).
Basic life support nontransport provider organizations that
				  are paid or volunteer fire departments that render fire prevention or fire
				  protection services to a political subdivision are not required to submit data
				  under this rule.