This document describes the methodology used in the Montana EMS QI measures and EMS dashboard.
EMS calls can be categorized by disposition and response type (eResponse.05) in order to characterize call volumes and describe the nature of each response. EMSTSIP uses a derived (non-NEMSIS) variable for disposition due to differences in how NEMSIS 3.4 and 3.5 capture the concept. See Appendix for details.
| Term | Definition | Disposition & Response Type |
|---|---|---|
| EMS Activation | Any initiation of a response by an EMS agency. | All dispositions |
| Patient Contact | Any EMS activation during which EMS personnel make contact with a patient, regardless of transport. | Dispositions 09–16 |
| Patient Transport | Any patient contact that results in transport of the patient. | Dispositions 10, 12, 14, 16 |
| 911 Response | Any EMS activation with an emergent or immediate response to an incident scene, regardless of method of notification (e.g., 911 call, direct dial, walk-in, flagging down, air ambulance scene flight). | All dispositions where eResponse.05 = 2205001, 2205003, 2205009 |
| 911 Patient Contact | Any 911 response during which EMS personnel make contact with a patient, regardless of transport. | Dispositions 09–16 where eResponse.05 = 2205001, 2205003, 2205009 |
| 911 Transport | Any 911 response where EMS transported the patient. | Dispositions 10, 12, 14, 16 where eResponse.05 = 2205001, 2205003, 2205009 |
| Interfacility and Medical Transport (IFM) Response | Any EMS activation triggered by a request for emergent or non-emergent transport from one healthcare facility to another. | All dispositions where eResponse.05 = 2205005, 2205007, 2205015, 2205017, 2205019 |
| IFM Patient Contact | Any IFM response during which EMS personnel make contact with a patient, regardless of transport. | Dispositions 09–16 where eResponse.05 = 2205005, 2205007, 2205015, 2205017, 2205019 |
| IFM Transport | Any IFM response where EMS transported the patient. | Dispositions 10, 12, 14, 16 where eResponse.05 = 2205005, 2205007, 2205015, 2205017, 2205019 |
The demand analysis heatmap shows the count of EMS activations by day of week and hour of day based on the incident date/time. All EMS activations are included regardless of response type or disposition.
Since there is not a specific Incident Date/Time data element collected in NEMSIS, this field is calculated by going through each NEMSIS timestamp in chronological order (eTimes.01-eTimes.16). The first date/time that is found in this list is used as the incident date/time. If none of these are recorded, there will be no incident date/time associated with the incident.
Call category is derived from the provider’s primary impression (eSituation.11). Call category is only displayed for EMS activations where patient contact was made.
| Call Category | Primary Impression Categories |
|---|---|
| Medical | Abdominal, Digestive, Gastrointestinal; Blood-related; Cancer; Cardiovascular/Circulatory; Complications of Surgical and Medical Care; Dependence/Mobility; Endocrine, Nutritional, Metabolic; Eye- or Ear-related; Genetic; Genitourinary; Illness, Fever, Other Infectious Diseases; Malaise; Musculoskeletal and Connective Tissue; Neurological/LOC; Observation/Exam; Obstetric; Obvious Death; Pain; Respiratory; Shock; Skin and Subcutaneous Tissue; Unspecific |
| Trauma | Burns, Corrosions; Environment; Injury |
| SUMH | Abuse/Neglect; Alcohol, Drug, or Other Substance Exposure; Mental Health/Behavioral |
| Uncategorized | Documented but unmappable to any of the above primary impression categories |
| Missing | (missing) |
Primary impression category is a grouping of provider’s primary impression (eSituation.11) into clinically meaningful categories. The top 10 categories by count are displayed separately for 911 and IFM patient contacts.
See Montana EMS Primary Impression Categories for details on how ICD-10-CM codes map to each category.
Response time intervals are calculated in minutes from the timestamps recorded in the ePCR. Averages for each time interval are shown separately for 911 patient contacts with and without transport, as well as IFM patient transports.
The average for each time interval is the mean of all non-missing values. If a call is missing data for a certain interval, it is excluded from the calculation, but can still be included for other intervals. Reasons for missing data include:
Average response time may be skewed by longer intervals even after exclusion of implausible values.
| Time Interval | Definition |
|---|---|
| Chute Time | Time elapsed between “unit notified by dispatch” (eTimes.03) to “unit en route” (eTimes.04). Measures the time it takes the ambulance crew to start moving toward the scene from the time they are notified. |
| Response Time | Time elapsed between “unit notified by dispatch” (eTimes.03) to “unit on scene” (eTimes.06). Measures total time from dispatch notification to arrival on scene. |
| On Scene Time (911) | Time from “unit on scene” (eTimes.06) to “unit left scene” (eTimes.09). Measures the time spent by the EMS crew on scene. |
| Time at Sending Facility (IFM) | Time from “unit on scene” (eTimes.06) to “unit left scene” (eTimes.09). Measures the time spent by EMS at the sending facility while picking up the patient during an interfacility or medical transport. |
| Transport Time | Time from “unit left scene” (eTimes.09) to “patient arrived at destination” (eTimes.11). Measures patient-loaded travel time. |
| Patient Offload Time | Time from “patient arrived at destination” (eTimes.11) to “destination patient transfer of care” (eTimes.12). Measures the time from when the patient arrives at the destination until transfer of care is complete. |
| Turnaround Time | Time from “patient arrived at destination” (eTimes.11) to “unit back in service” (eTimes.13). Measures the time from when the ambulance arrives at the destination with a patient until the EMS unit is back in service. |
| Total Call Time | Time from “unit notified by dispatch” (eTimes.03) to “unit back in service” (eTimes.13). Measures the time from when the ambulance was notified by dispatch until the EMS unit is back in service. |
Response distances are reported in miles and are derived from odometer readings recorded in the ePCR. Missing values indicate one or both odometer readings were not recorded for that interval. Missing counts differ across intervals because each relies on different odometer checkpoints. Averages exclude missing values.
| Interval | Definition |
|---|---|
| Begin to Scene | Distance from unit origin to the scene. |
| Scene to Destination | Distance from scene to destination (patient-loaded miles). |
A record is labeled as “suspected stroke” if one or more of the following are true:
eSituation.11/eSituation.12), symptoms (eSituation.09/eSituation.10), or cause of injury (eInjury.01) contains a stroke-related ICD-10-CM code (sub-codes included): I60, I61, I63, G45, G46.3, G46.4Visit the EMSTSIP stroke documentation guide for documentation tips.
| Measure | Purpose | Numerator1 | Denominator2 |
|---|---|---|---|
| 1.1 Coverdell-01: On-scene time <15 minutes | Assess timeliness once EMS has arrived on scene. AHA/ASA recommends an on-scene time of less than 15 minutes. | Difference between unit arrival on scene (eTimes.06) and unit left scene (eTimes.09) is less than 15 minutes. | Suspected stroke syndrome 911 patient transports |
| 1.2 Coverdell-02: Blood glucose check documented | Blood glucose assessment is an important pre-hospital intervention in the stroke chain of survival. Hypoglycemia is frequently found in patients with stroke-like symptoms; administering glucose may resolve neurological deficits. | Blood glucose level (eVitals.18) is documented with a value >0. | Suspected stroke syndrome 911 patient transports |
| 1.3 Coverdell-03: Stroke alert to hospital | EMS alerting the receiving hospital before they arrive with a stroke patient reduces elapsed time before treatment and ensures appropriate hospital resources are mobilized. | Destination team pre-arrival alert or activation (eDisposition.24) = 4224015 Yes-Stroke. | Suspected stroke syndrome 911 patient transports |
| 1.4 Coverdell-04: Stroke screen documented3 | Identify use of stroke screening tools (BEFAST, Cincinnati, FAST) and severity scales (VAN, LAMS) in the pre-hospital setting. | Stroke Scale Score (eVitals.29) is any of:
|
Suspected stroke syndrome 911 patient transports |
| 1.5 Coverdell-05: Last known well (LKW) time documented4 | Last Known Well time is the date/time at which the patient was last known to be without signs or symptoms of the current stroke, or at their prior baseline. LKW is critical for determining eligibility for time-dependent treatments such as IV tPA and mechanical intervention. | Date/Time Last Known Well (eSituation.18) is documented and occurs prior to incident date/time. | Suspected stroke syndrome 911 patient transports |
| 1.6 Coverdell-06: Symptom onset time documented | Symptom onset time (aka time of discovery) is the date/time of the start of the patient's symptoms or the earliest time the patient was known to have symptoms. If the event was witnessed then LKW and symptom onset time will be identical. Both should be recorded even if identical. | Date/Time of Symptom Onset (eSituation.01) is documented and occurs prior to incident date/time. | Suspected stroke syndrome 911 patient transports |
| 1 The numerator is a subset of records meeting all denominator criteria. | |||
| 2 All denominator criteria must be true for a record to be included. | |||
| 3 Stroke scale counts reflect the number of times each scale was documented across all vital sign sets for the incident. A single incident may contribute to more than one scale count if multiple scales were documented or if the same scale was documented more than once. | |||
| 4 LKW time is stratified by time elapsed from LKW to EMS arrival on scene. These bins are provided because LKW-to-arrival interval is a key factor in treatment eligibility. Records where LKW is missing, not documented, or occurs after incident date/time are counted as Invalid/Missing. | |||
A record is labeled as “suspected cardiac chest pain” if one or more of the following are true:
eSituation.11/eSituation.12), symptoms (eSituation.09/eSituation.10), or cause of injury (eInjury.01) contains a cardiac chest pain-related ICD-10-CM code (sub-codes included): I20-I25, R07.9.A record is labeled as “suspected STEMI” if one or more of the following are true:
eSituation.11/eSituation.12), symptoms (eSituation.09/eSituation.10), or cause of injury (eInjury.01) contains a STEMI-related ICD-10-CM code (sub-codes included): I21.0-I21.3.Visit the EMSTSIP CP/STEMI documentation guide for documentation tips.
| Measure | Purpose | Numerator1 | Denominator2 |
|---|---|---|---|
| 2.1 Aspirin administration | Early aspirin administration is beneficial in patients with cardiac chest pain or STEMI. This measure assesses appropriate pre-hospital treatment. | Medications administered (eMedications.03) is Aspirin (RXCUI code 1191). Includes pertinent negatives. | CP or STEMI syndrome Age ≥ 35 years 911 patient contacts |
| 2.2 12-Lead ECG performed | Performing a 12-lead ECG is important to determine whether a patient with chest pain is experiencing a STEMI prior to aspirin or nitroglycerin administration. | At least one of the following:
|
CP or STEMI syndrome Age ≥ 35 years 911 patient contacts |
| 2.3 12-Lead ECG performed within 10 minutes of EMS arrival | Assess timeliness of 12-lead ECG acquisition on scene. AHA has established acquisition within 10 minutes of arrival as a benchmark for recognition of STEMI. | Difference between unit arrival on scene (eTimes.06) and time of first 12-Lead ECG is less than 10 minutes. First 12-lead ECG time is the earliest of:
|
CP or STEMI syndrome Age ≥ 35 years 911 patient contacts |
| 2.4 STEMI On-scene time <15 minutes | Assess timeliness once EMS has arrived on scene. AHA recommends an on-scene time of less than 15 minutes for STEMI patients. | Difference between unit arrival on scene (eTimes.06) and unit left scene (eTimes.09) is less than 15 minutes. | STEMI syndrome Age ≥ 35 years 911 patient transports |
| 2.5 STEMI Alert to hospital | EMS alerting the receiving hospital before arrival with a STEMI patient reduces elapsed time before treatment and ensures appropriate hospital resources are mobilized. | Destination Team Pre-Arrival Alert or Activation (eDisposition.24) = 4224013 Yes-STEMI | STEMI syndrome Age ≥ 35 years 911 patient transports |
| 2.6 STEMI ECG to Alert time <10 minutes | Measures timeliness of the STEMI alert to the hospital, relative to the first STEMI-positive ECG result. | All of the following:
|
STEMI syndrome Age ≥ 35 years 911 patient transports |
| 1 The numerator is a subset of records meeting all denominator criteria. | |||
| 2 All denominator criteria must be true for a record to be included. | |||
A record is labeled as “suspected OHCA” if one or more of the following are true:
eSituation.11/eSituation.12), symptoms (eSituation.09/eSituation.10), or cause of injury (eInjury.01) contains ICD-10-CM code (sub-codes included): I46.9.Visit the EMSTSIP OHCA documentation guide for documentation tips.
See CARES Sustained ROSC algorithm for more details on how sustained ROSC is determined.
| Measure | Purpose | Numerator1 | Denominator2 |
|---|---|---|---|
| 3.1 Initial cardiac rhythm documented | Evaluate the chance of survival as patients in VF or VT have a higher survival rate than PEA or asystole. | First monitored arrest rhythm (eArrest.11) is documented. | OHCA syndrome Non-traumatic arrest 911 patient contacts |
| 3.2 EMS/First Responder arrival to first CPR < 2 minutes | Early initiation of CPR improves chance of positive outcome. Every 10 minutes of arrest decreases chance of survival by approximately 10%. With no bystander CPR, immediate intervention by EMS is critical. | If arrest prior to EMS arrival (eArrest.01 = 3001003):
|
OHCA syndrome Non-traumatic arrest 911 patient contacts EMS or First Responder initiated CPR (eArrest.20 = EMS Responder or First Responder) |
| 3.3 Sustained ROSC - unwitnessed arrests | Every 10 minutes of arrest decreases chance of survival by approximately 10%. Attaining ROSC in unwitnessed arrests is difficult and uncommon and should be separated from witnessed arrests for tracking purposes. | Sustained ROSC is present, defined as any of:
|
OHCA syndrome Non-traumatic arrest 911 patient contacts Arrest prior to EMS arrival (eArrest.01 = 3001003) Arrest not witnessed (eArrest.04 = Not Witnessed) |
| 3.4 Sustained ROSC - bystander witnessed arrests | Measures successful resuscitation attempts where patients had a better chance of survival due to bystander intervention and EMS care. | Sustained ROSC is present, defined as any of:
|
OHCA syndrome Non-traumatic arrest 911 patient contacts Arrest prior to EMS arrival (eArrest.01 = 3001003) Arrest witnessed by bystander (eArrest.04 = Family Member, Healthcare Provider, Bystander) |
| 3.5 Sustained ROSC - EMS witnessed arrests | Measures successful resuscitation attempts where patients had the best chance of survival due to immediate EMS care. | Sustained ROSC is present, defined as any of:
|
OHCA syndrome Non-traumatic arrest 911 patient contacts Arrest after EMS arrival (eArrest.01 = 3001005) |
| 3.6 Cardiac arrest alert to hospital | EMS alerting the receiving hospital before arrival reduces elapsed time before treatment and ensures appropriate hospital resources are mobilized. | Destination team pre-arrival alert or activation (eDisposition.24) = 4224005 Cardiac Arrest. | OHCA syndrome Non-traumatic arrest 911 patient transports |
| 1 The numerator is a subset of records meeting all denominator criteria. | |||
| 2 All denominator criteria must be true for a record to be included. | |||
| Measure | Purpose | Numerator1 | Denominator2 |
|---|---|---|---|
| 4.1 No lights and sirens during response to scene | Reducing unnecessary use of lights and sirens during response protects the ambulance crew and public from potential danger. Systems with enhanced medical screening at the 911 center can safely reduce lights and sirens use for lower-acuity calls. | Additional Response Mode Descriptors (eResponse.24) includes 2224019 No Lights or Sirens and does not include any value that indicates lights and/or sirens use. | 911 responses |
| 4.2 No lights and sirens during patient transport | Reducing lights and sirens use during patient transport protects EMS providers, patients, and the public. Research supports limited use of lights and sirens during transport. | Additional Transport Mode Descriptors (eDisposition.18) includes 4218015 No Lights or Sirens and does not include any value that indicates lights and/or sirens use. | 911 patient transports |
| 1 The numerator is a subset of records meeting all denominator criteria. | |||
| 2 All denominator criteria must be true for a record to be included. | |||
A record is labeled as “suspected TBI” if one or more of the following are true:
eSituation.11/eSituation.12), symptoms (eSituation.09/eSituation.10), or cause of injury (eInjury.01) contains ICD-10-CM code (sub-codes included): S09.90, S02, S04.02, S04.03, S04.04, S06, S07.1, T74.4.Visit the EMSTSIP TBI documentation guide for documentation tips.
| Measure | Purpose | Numerator1 | Denominator2 |
|---|---|---|---|
| 5.1 Complete vitals documented | GCS, SBP, HR, RR, and SpO2 are fundamental to patient assessment and triage in TBI. Early detection of changes in vital signs is key to timely intervention. | All of the following are documented at least once with a valid value:
|
TBI syndrome 911 patient contacts |
| 5.2 Blood glucose level (BGL) documented | Hypoglycemia can mimic symptoms of head injury such as altered mental status, confusion, and lethargy. Hyperglycemia can exacerbate brain injury and affect neurological outcomes. | Blood glucose level (eVitals.18) is documented at least once with a valid value. | TBI syndrome 911 patient contacts |
| 5.3 Dextrose administered for blood glucose < 70 mg/dL | In hypoglycemic patients, prompt administration of dextrose can reverse neurological symptoms. | A dextrose or glucose product is documented in medications administered (eMedications.03) with no pertinent negative. Qualifying RXCUI codes:
|
TBI syndrome 911 patient contacts At least one blood glucose measurement < 70 mg/dL (eVitals.18) |
| 5.4 No hypoxia (SpO2 <90%) | A single non-spurious episode of hypoxia (SpO2 < 90%) is associated with a doubling of mortality in TBI patients. | No recorded Pulse Oximetry (eVitals.12) less than 90%. | TBI syndrome 911 patient contacts |
| 5.5 No hypotension | A single episode of hypotension (SBP < 90 mmHg) is independently associated with at least a doubling of mortality; repeated episodes can increase risk of death by up to eight times. | No recorded Systolic Blood Pressure (eVitals.06) less than 90 mmHg. | TBI syndrome 911 patient contacts |
| 5.6 No hyperventilation for patients with PPV | Hyperventilation during positive pressure ventilation (PPV) is independently associated with at least a doubling of mortality. Even moderate hyperventilation can increase risk of death by six times. | No recorded End Tidal CO2 (eVitals.16) less than 35 mmHg. | TBI syndrome 911 patient contacts Positive pressure ventilation performed. PPV is identified by any of:
|
| 5.7 Oxygen administration | Supplemental oxygen should be administered to suspected TBI patients to minimize risk of secondary brain injury from hypoxia. | Oxygen (RXCUI 7806) is documented in medications administered (eMedications.03) with no pertinent negative. | TBI syndrome 911 patient contacts |
| 5.8 Altered patients | Patients with concurrent low GCS and low SpO2 are at highest risk for secondary brain injury and represent a priority population for oxygen administration. | GCS ≤ 13 (eVitals.23) AND SpO2 < 92% (eVitals.12), both based on lowest recorded value. | TBI syndrome 911 patient contacts |
| 5.9 Oxygen administration for altered patients | Patients with low GCS and low SpO2 are at highest risk for secondary brain injury from hypoxia and represent a priority for oxygen administration. | Oxygen (RXCUI 7806) is documented in medications administered (eMedications.03) with no pertinent negative. | TBI syndrome 911 patient contacts Altered patient (GCS ≤ 13 AND SpO2 < 92%) |
| 1 The numerator is a subset of records meeting all denominator criteria. | |||
| 2 All denominator criteria must be true for a record to be included. | |||
| 3 Positive pressure ventilation procedures (eProcedures.03): 425447009, 243140006, 232673005, 45851008, 427753009, 424979004, 44806002, 429705000, 232674004, 232675003, 232678001, 418613003, 232679009, 232681006, 232682004, 232680007, 429734006, 397892004, 397874007, 241689008, 385857005, 409088002, 428482009. All require no pertinent negative documented. | |||
A record is labeled as suspected trauma if one or more of the following are true:
eSituation.11/eSituation.12), symptoms (eSituation.09/eSituation.10), or cause of injury (eInjury.01) contains a trauma-related ICD-10-CM code (sub-codes included): G89.11, S00–S99, R58, O71.9, T79, T15–T34, L55.0–L55.2, T07, T14.8, T14.90. Note: G89.1 (Acute Pain, non-traumatic) is excluded.eInjury.03)eArrest.02 = 3002015)eDisposition.24 = 4224003 Yes-Adult Trauma, 4224011 Yes-Pediatric Trauma, or 4224017 Yes-Trauma General)A record is labeled as suspected severe trauma if it meets suspected trauma criteria and one or more of the following are true:
eInjury.03)eArrest.02 = 3002015)eDisposition.24 = 4224003, 4224011, or 4224017)eSituation.02 = Yes)eVitals.23)eVitals.26)eVitals.06)eVitals.06)eVitals.06)eVitals.12)eVitals.14)eVitals.10) ÷ SBP (eVitals.06))eSituation.02 = Yes)eDisposition.19) = Red, Yellow, or CriticaleVitals.23), SBP (eVitals.06), and RR (eVitals.14)eDisposition.19) = Unchanged AND initial acuity (eSituation.13) = Red, Yellow, or CriticaleDisposition.19) = Worse AND initial acuity (eSituation.13) = Green, Non-Acute, or Non-EmergentVisit the EMSTSIP Severe Trauma documentation guide for documentation tips.
| Measure | Purpose | Numerator1 | Denominator2 |
|---|---|---|---|
| 6.1 Altered patients | Patients with concurrent low GCS and low SpO2 are at highest risk for secondary injury and represent a priority population for oxygen administration. | GCS ≤ 13 (eVitals.23) AND SpO2 < 92% (eVitals.12), both based on lowest recorded value. | Trauma syndrome 911 patient contacts |
| 6.2 Oxygen administration for altered patients | Supplemental oxygen treatment is recommended to prevent or correct hypoxia, as this may cause tissue hypoxia with organ injury. | Oxygen (RXCUI 7806) is documented in medications administered (eMedications.03) with no pertinent negative. | Trauma syndrome 911 patient contacts Altered patient (GCS ≤ 13 AND SpO2 < 92%) |
| 6.3 Severe Trauma Complete vitals documented | GCS, SBP, HR, RR, and SpO2 are fundamental to patient assessment and triage in severe trauma. Documenting GCS facilitates multi-disciplinary communication and care coordination. Early detection of changes in vital signs is key to timely intervention. | All of the following are documented at least once with a valid value:
|
Severe trauma syndrome 911 patient contacts |
| 6.4 Severe Trauma On-scene time < 10 minutes | Patients with serious trauma require rapid assessment, treatment, and transportation to a designated trauma center. Minimizing scene time can expedite access to critical care and surgical interventions. | Difference between unit arrival on scene (eTimes.06) and unit left scene (eTimes.09) is less than 10 minutes. | Severe trauma syndrome 911 patient transports |
| 6.5 Severe Trauma alert to hospital | EMS alerting the receiving hospital of an incoming trauma patient prior to arrival allows the hospital to assemble necessary providers and mobilize resources before patient arrival. | Destination team pre-arrival alert or activation (eDisposition.24) is 4224003 Yes-Adult Trauma, 4224011 Yes-Pediatric Trauma, or 4224017 Yes-Trauma General | Severe trauma syndrome 911 patient transports |
| 1 The numerator is a subset of records meeting all denominator criteria. | |||
| 2 All denominator criteria must be true for a record to be included. | |||
A record is labeled as suspected MVC if one or more of the following are true:
eSituation.11/eSituation.12), symptoms (eSituation.09/eSituation.10), or cause of injury (eInjury.01) contains an MVC-related ICD-10-CM code (sub-codes included):
eInjury.06) is documentedeInjury.07) is documented with a value other than Not Recorded, Not Applicable, or Not ReportingeInjury.08) is documentedeInjury.04) contains a crash, pedestrian, or vehicle-related valueeDispatch.01) = 2301069 Traffic/Transportation Incident or 2301009 Automated Crash NotificationeNarrative.01), primary complaint (eSituation.04), secondary complaint, or other complaint contains an MVC-related term (e.g., MVC, MVA, traffic accident, motor vehicle crash, motor vehicle collision, pedestrian struck, airbag deployment, motorcycle crash, ATV, snowmobile collision)Visit the EMSTSIP MVC documentation guide for documentation tips.
| Measure | Purpose | Numerator1 | Denominator2 |
|---|---|---|---|
| 7.1 Location of patient in vehicle documented | Accurate documentation of patient location in the vehicle helps explain factors surrounding the patient's injury, scene delays, or extrication. Understanding patient location associated with different injury patterns can guide safety campaigns and targeted interventions. | Location of patient in vehicle (`eInjury.06`) is documented with a valid value. | MVC syndrome 911 patient contacts |
| 7.2 Occupant safety equipment documented | Accurate documentation of occupant safety equipment use helps explain factors surrounding the patient's injury. Understanding safety equipment use associated with different injury patterns can guide safety campaigns and targeted interventions. | Occupant safety equipment (`eInjury.07`) is documented. Includes 'None' as a valid response. Excludes Not Recorded, Not Applicable, and Not Reporting. | MVC syndrome 911 patient contacts |
| 7.3 Revised Trauma Score (RTS) documented | RTS is a physiologic scoring system used to assess injury severity and predict survival in trauma patients. It is calculated from initial GCS, SBP, and RR. | RTS is calculated from initial values of GCS (`eVitals.23`), Systolic Blood Pressure (`eVitals.06`), and Respiratory Rate (`eVitals.14`), all of which must be documented with valid values. | MVC syndrome 911 patient contacts |
| 1 The numerator is a subset of records meeting all denominator criteria. | |||
| 2 All denominator criteria must be true for a record to be included. | |||
Visit the EMSTSIP overdose documentation guide for documentation tips.
| Measure | Purpose | Numerator1 | Denominator2 |
|---|---|---|---|
| 8.1 Naloxone recorded in medication fields | Naloxone administration documented in the medication administration field is the primary source for identifying naloxone use. Accurate documentation supports surveillance of opioid overdose response. | Naloxone (RXCUI 7242) is documented in medications administered (eMedications.03) with no pertinent negative. | Opioid overdose syndrome 911 patient contacts |
| 8.2 Naloxone recorded in medication fields or narrative | Naloxone may be documented in the narrative or complaint fields rather than the medication administration field. This measure captures naloxone administration from both structured and unstructured data sources. | Naloxone (RXCUI 7242) is documented in medications administered (eMedications.03) with no pertinent negative, OR naloxone-related terms are identified in the narrative or complaint fields using natural language processing, without evidence of negation. | Opioid overdose syndrome 911 patient contacts |
| 1 The numerator is a subset of records meeting all denominator criteria. | |||
| 2 All denominator criteria must be true for a record to be included. | |||
eScene.18 = 30).Each row in the table below defines a valid combination of NEMSIS fields that maps to a disposition value. For NEMSIS 3.4 records, classification is based solely on eDisposition.12. A value of “—” in the eDisposition.12 column indicates no NEMSIS 3.4 equivalent exists. For NEMSIS 3.5 records, classification requires specific combinations of eDisposition.27, eDisposition.28, eDisposition.29, eDisposition.30, and eDisposition.19.
Blank cells in these columns indicate that the field is not part of the logic for that row (not all fields are evaluated for every row). Field combinations that do not match any defined pattern result in a missing disposition value.
| Disposition | NEMSIS 3.4 | NEMSIS 3.5 | ||||
|---|---|---|---|---|---|---|
| eDisposition.12 | eDisposition.27 | eDisposition.28 | eDisposition.29 | eDisposition.30 | eDisposition.19 | |
| 01-Cancelled prior to arrival | 4212007 Canceled (Prior to Arrival At Scene) | 4227005 Cancelled Prior to Arrival at Scene | ||||
| 02-Cancelled on scene | 4212009 Canceled on Scene (No Patient Contact) | 4227003 Cancelled on Scene | ||||
| 03-No patient found | 4212011 Canceled on Scene (No Patient Found) | 4227009 No Patient Found | ||||
| 04-Non-patient incident (no services or support) | 4212039 Standby-No Services or Support Provided | 4227011 Non-Patient Incident (Not Otherwise Listed) | 4229011 Back in Service, No Care/Support Required 4229013 Back in Service, Care/Support Refused or missing |
|||
| 05-Non-patient incident (services/support provided) | 4212003 Assist, Public 4212041 Standby-Public Safety, Fire, or EMS Operational Support Provided |
4227011 Non-Patient Incident (Not Otherwise Listed) | 4229009 Incident Support Services Provided (Including Standby) | 4230013 No Transport or missing |
||
| 06-Non-patient transport | 4212043 Transport Non-Patient, Organs, etc. | 4227011 Non-Patient Incident (Not Otherwise Listed) | 4229009 Incident Support Services Provided (Including Standby) | 4230011 Non-Patient Transport (Not Otherwise Listed) | ||
| 07-No patient contact- no transport | 4212001 Assist, Agency 4212005 Assist, Unit |
4227007 No Patient Contact | 4230013 No Transport or missing |
|||
| 08-No patient contact- transport | — | 4227007 No Patient Contact | 4230003 Transport by This EMS Unit, with a Member of Another Crew 4230011 Non-Patient Transport (Not Otherwise Listed) |
|||
| 09-Patient refusal- no transport | 4212025 Patient Refused Evaluation/Care (Without Transport) | 4227001 Patient Contact Made | 4228003 Patient Evaluated and Refused Care 4228007 Patient Refused Evaluation/Care |
4230009 Patient Refused Transport 4230013 No Transport or missing |
||
| 10-Patient refusal- transport | 4212023 Patient Refused Evaluation/Care (With Transport) | 4227001 Patient Contact Made | 4228003 Patient Evaluated and Refused Care 4228007 Patient Refused Evaluation/Care |
4230001 Transport by This EMS Unit (This Crew Only) 4230003 Transport by This EMS Unit, with a Member of Another Crew 4230005 Transport by Another EMS Unit 4230007 Transport by Another EMS Unit, with a Member of This Crew 4230011 Non-Patient Transport (Not Otherwise Listed) |
||
| 11-Patient dead, no resuscitation- no transport | 4212015 Patient Dead at Scene-No Resuscitation Attempted (Without Transport) | 4227001 Patient Contact Made | 4228005 Patient Evaluated, No Care Required 4228009 Patient Support Services Provided |
4230013 No Transport or missing |
4219007 Dead without Resuscitation Efforts (Black) | |
| 12-Patient dead, no resuscitation- transport | 4212013 Patient Dead at Scene-No Resuscitation Attempted (With Transport) | 4227001 Patient Contact Made | 4228005 Patient Evaluated, No Care Required 4228009 Patient Support Services Provided |
4230001 Transport by This EMS Unit (This Crew Only) 4230003 Transport by This EMS Unit, with a Member of Another Crew 4230005 Transport by Another EMS Unit 4230007 Transport by Another EMS Unit, with a Member of This Crew |
4219007 Dead without Resuscitation Efforts (Black) | |
| 13-Patient evaluated, no care required- no transport | 4212021 Patient Evaluated, No Treatment/Transport Required | 4227001 Patient Contact Made | 4228005 Patient Evaluated, No Care Required 4228009 Patient Support Services Provided |
4230013 No Transport or missing |
Not 4219007; or missing | |
| 14-Patient evaluated, no care required- transport | — | 4227001 Patient Contact Made | 4228005 Patient Evaluated, No Care Required 4228009 Patient Support Services Provided |
4230001 Transport by This EMS Unit (This Crew Only) 4230003 Transport by This EMS Unit, with a Member of Another Crew 4230005 Transport by Another EMS Unit 4230007 Transport by Another EMS Unit, with a Member of This Crew |
Not 4219007; or missing | |
| 15-Patient care provided- no transport by this unit | 4212019 Patient Dead at Scene-Resuscitation Attempted (Without Transport) 4212027 Patient Treated, Released (AMA) 4212029 Patient Treated, Released (per protocol) 4212031 Patient Treated, Transferred Care to Another EMS Unit 4212035 Patient Treated, Transported by Law Enforcement 4212037 Patient Treated, Transported by Private Vehicle |
4227001 Patient Contact Made | 4228001 Patient Evaluated and Care Provided | 4230005 Transport by Another EMS Unit 4230007 Transport by Another EMS Unit, with a Member of This Crew 4230009 Patient Refused Transport 4230013 No Transport or missing |
||
| 16-Patient care provided- transport by this unit | 4212017 Patient Dead at Scene-Resuscitation Attempted (With Transport) 4212033 Patient Treated, Transported by this EMS Unit |
4227001 Patient Contact Made | 4228001 Patient Evaluated and Care Provided | 4230001 Transport by This EMS Unit (This Crew Only) 4230003 Transport by This EMS Unit, with a Member of Another Crew 4230011 Non-Patient Transport (Not Otherwise Listed) † |
4219009 Dead with Resuscitation Efforts (Black) — required only when eDisposition.30 = 4230011 † | |
† When eDisposition.30 = 4230011 (Non-Patient Transport), eDisposition.19 must be 4219009 (Dead with Resuscitation Efforts) to classify as 16. Otherwise the record is unclassified.