Yhb4p1/Vuz1fIrb5lYze3j/AhsI=000009071 sdV4ERHYTds3s/5FoIUuWXWM16h+U= CARES Demo SubmitData ?

CARES 911 27 Developer Contact Last Name The Last Name of the primary developer of the export file. 9902009 9923001 9903003 Developer Contact Last Name The First Name of the primary developer of the export file. 9902009 9923001 9903003 Developer Contact Phone The phone number of the primary developer of the export file. 9902009 9923001 9903003 Developer Contact Email The email of the primary developer of the export file. 9902009 9923001 9903003 Import Version The version of the import specification used to create this file. 9902009 9923001 9903003 Form ID This field is used internally to determine which form this data should be imported as. This value should always be 90003. 9902009 9923001 9903003 Import Method The method to use during the import. 9902009 9923001 9903003 Booklet ID The myCares.net™/HealthEMS™ booklet number associated to this event. 9902009 9923001 9903007 DOB Unknown Custom Field-single checkbox in CARES to indicate that the date of birth is unknown. 9902005 9923001 9903003 1 Date of Arrest Custom field 9902003 9923001 9903003 Location Type This field is customized since the ICD10-CM does not include accurate wording for some selections 9902005 9923001 9903003 1 2 3 4 6 9 10 14 15 Location Type Other Custom field text entry associated with Location Type. If LocationType code= 14, this field is filled out with location type. 9902009 9923001 9903007 Arrest Witnessed A witnessed arrest is one that is seen or heard by another person 9902005 9923001 9903003 1 2 Arrest After Arrival of 911 Responder Indicates if the patient arrested before or after the arrival of a 911 responder. 9902005 9923001 9903003 1 2 Resuscitation attempted by 911 Responder(or AED shock given prior to EMS arrival) Indication of an attempt to resuscitate the patient who is in cardiac arrest. 9902005 9923001 9903003 1 2 Who Initiated CPR Identifies the initial person to perform CPR. 9902005 9923001 9903003 1 2 3 4 5 8 Type of Bystander CPR Provided Describes type of CPR performed by a bystander. 9902005 9923001 9903007 1 2 3 Were Dispatcher CPR instructions provided Indicates if dispatcher CPR instructions were provided to the caller. 9902005 9923001 9903007 1 2 3 Who First Applied the AED Who first applied the AED 9902005 9923001 9903003 1 2 3 5 Was AED first applied by Police This field is used in conjunction with WhoFirstAppliedAED, if answer is First Responder (3) 9902005 9923001 9903007 1 2 Who First Defibrillated the Patient Identifies the individual who was responsible for first defibrillating the patient. 9902005 9923001 9903003 1 2 3 4 5 8 If yes, did the Police defibrillate the patient This is part of FirstDefibPatient above, if First Responder code 3 is chosen 9902005 9923001 9903003 1 2 Did 911 Responder perform CPR Indicates if 911 responder (BLS and/or ALS) performed CPR. 9902005 9923001 9903007 1 2 First Arrest Rhythm of Patient The first monitored rhythm is the first cardiac rhythm present when a manual (monitor/defibrillator) or AED (automated external defibrillator) is attached to a patient after cardiac arrest. 9902005 9923001 9903003 0 1 2 3 6 7 Sustained ROSC(20 consecutive minutes) or present at end of EMS care Return of Spontaneous Circulation (ROSC) is defined as the restoration of a palpable pulse or a measurable blood pressure 9902005 9923001 9903003 2 3 4 End of Event The reason that CPR or other resuscitation efforts were discontinued. 9902005 9923001 9903003 1 2 3 4 When did sustained ROSC First Occur When did sustained ROSC- Return of Spontaneous Circulation (ROSC) is defined as the restoration of a palpable pulse or a measurable blood pressure, first occur 9902005 9923001 9903007 1 2 3 4 5 6 7 Time of 1st defibrillatory shock The time the first defibrillation was given 9902003 9923001 9903007 Time of 1st CPR Time of 1st CPR given (by anyone) 9902003 9923001 9903007 Mechanical CPR device used Indicates if a mechanical CPR device was used during the course of resuscitation at the ED 9902005 9923001 9903007 1 2 Mechanical CPR device used detail Associated with MechCPRDevice, if yes, specify which device was used 9902005 9923001 9903007 1 2 3 4 Automated CPR feedback device used Indicates if CPR Feedback device was used 9902005 9923001 9903007 1 2 ITD used Indicates that an ITD was used 9902005 9923001 9903007 1 2 If yes, select how Custom Field associated with ITD, if yes, specify.If the device is used during resuscitation, the method of how it was used should be indicated. 9902005 9923001 9903007 1 2 3 4 5 6 7 Were drugs administered Describes drugs that were administered during ED resuscitation. 9902005 9923001 9903007 1 2 Vascular access Describes which, if any, devices were inserted into a vein, which permits administration of intermittent or continuous infusion of parenteral solutions or medications 9902005 9923003 9903007 1 2 3 12 Lead Indicates use of a 12 Lead electrocardiogram (ECG) recording 9902005 9923001 9903007 1 2 STEMI Indicates a myocardial infarction with ST elevation 9902005 9923001 9903007 1 2 3 If yes, select location: Custom Field associated with STEMI. If yes, please select location of anatomical region of the heart that has developed myocardial necrosis 9902005 9923001 9903007 1 2 ER Outcome - Destination Hospital The outcome of the patient from the destination hospital emergency department 9902005 9923001 9903007 1 4 5 Was hypothermia care initiated or continued in the Destination hospital Was hypothermia care initiated or continued in the Destination hospital 9902005 9923001 9903007 1 2 Hospital Outcome - Destination Hospital The outcome of the patient from the destination hospital. 9902005 9923001 9903007 1 2 3 4 11 Patient made DNR Detail - Destination Hospital Custom field associated with Hospital Outcome above. If Patient made DNR (code=4), identify hospital outcome - Destination Hospital 9902005 9923001 9903007 1 2 3 8 ER Outcome Transfer Hospital The outcome from the emergency department at Transfer Hospital 9902005 9923001 9903007 1 5 Was hypothermia care initiated or continued in the transfer hospital Was hypothermia care initiated or continued in the transfer hospital 9902005 9923001 9903007 1 2 Hospital Outcome (Transfer) Outcome - transfer hospital. 9902005 9923001 9903007 1 2 4 11 Patient made DNR Detail Custom field associated with Transfer Hospital Outcome above. If Patient made DNR (code=4), identify transfer hospital outcome 9902005 9923001 9903007 1 2 8 Hospital Disposition (Transfer) The final disposition of the patient from the transfer hospital. 9902005 9923001 9903007 01 62 03 51 Neurological Outcome at Discharge from Transfer Hospital Neurological Outcome at Discharge from Transfer Hospital 9902005 9923001 9903007 3013001 3013003 3013005 3013007 Transfer To Hospital Hospital code patient was transferred to (CARES code) 9902005 9923001 9903005 Transfer_hospital If Transfer_hospitalid/code is not available, String field for transfer hospital 9902009 9923001 9903005 Was the final diagnosis acute myocardial infarction Hospital data- Was the final diagnosis acute myocardial infarction 9902005 9923001 9903007 1 2 Coronary Angiography Performed Hospital data- Was a Coronary Angiography Performed 9902005 9923001 9903007 1 2 3 Coronary Angiography DateTime Hospital data- If Coronary Angiography Performed is yes, provide date and time 9902003 9923001 9903007 Was a cardiac stent placed Hospital data- Was a cardiac stent placed 9902005 9923001 9903007 1 2 3 CABG performed Hospital data- was a CABG performed 9902005 9923001 9903007 1 2 3 Was an ICD placed and/or scheduled Hospital data- Was an ICD placed and/or scheduled 9902005 9923001 9903007 1 2 3 No First Responder Dispatched: Custom field - single checkbox. Indicates that a 911 first responder was not dispatched 9902005 9923001 9903007 1 Time Ambulance dispatched Time Ambulance dispatched 9902003 9923001 9903007 Time Ambulance en route Time Ambulance en route 9902003 9923001 9903007 Time Ambulance arrived at scene Time Ambulance arrived at scene 9902003 9923001 9903007 Time ambulance left scene Time ambulance left scene 9902003 9923001 9903007 Time Ambulance arrived at ED Time Ambulance arrived at ED 9902003 9923001 9903007 First Responder on scene First Responder on scene. Pass one import value for the first responder on scene. Agency sets up import values. 9902009 9923001 9903001 Custom extending ePatient.14- Unknown value code = 8 Custom extending ePatient.14- Unknown value code = 8 9902005 9923001 9903007 8 Custom - extending eMedication.03 Other value Custom - extending eMedication.03 Other value 9902005 9923001 9903005 099 Custom - extending eHistory.08 Other value Custom - extending eHistory.08 Other value 9902005 9923001 9903005 99 Medical History Other - String Custom field text entry associated with MedHistoryOther. If MedHistoryOther=99, then the textual description of the medication can be passed here. 9902009 9923001 9903007 Etiology Other Custom field text entry associated with Presumed Cardiac Etiology (eArrest.02). If Cardiac Etiology (eArrest.02) code= 3002011 Other, Not Listed, this field is can be used to pass the etiology. 9902009 9923001 9903007 111111 XX X X 911 6546544 0192837465 2205001 2207003 X X 2215001 2223001 2301001 2016-06-09T09:36:47+07:00 2016-06-09T09:45:47+07:00 2016-06-09T09:46:47+07:00 2016-06-09T09:49:47+07:00 2016-06-09T09:50:00+07:00 2016-06-09T10:04:47+07:00 2016-06-09T10:10:47+07:00 2016-06-09T10:34:47+07:00 z k 9906003 91 2516007 2012-03-01 oO 8 2704019 1975-12-02T10:08:04+07:00 Y92.0 5 100001 27 55802 27001 3001005 3002007 3003001 3004001 3007005 9923003 3013001 2016-06-09T09:36:47+07:00 I10 9923003 2016-06-09T10:06:47+07:00 317361 2016-05-02T09:36:47+07:00 4003005 CARES CODE 4212001 02 Smith ContactLastName Sally ContactFirstName 800-888-8888 ContactPhone sallysmith@email.com ContactEmail 3.0 ImportVersion 90003 FormID 1 ImportMethod 3.0 ImportVersion 2016-06-09 servicedate 14 LocationType College LocationTypeOther 2 ArrestWitnessed 2 ArrestAfterArrivalEMS 1 ResusAttemptEMS 3 InitiatedCPR BystanderCPRProvidedID 3 CPRInstructionsProvided 3 WhoFirstAppliedAED 1 PoliceAED 3 FirstDefibPatient 2 PoliceDefib 1 911RespCPR 1 FirstRhythm 4 SustainedROSC 3 EndOfEvent 5 ROSCStart 2016-05-20T11:38:26.0Z DefibTime 2016-05-20T11:38:26.0Z CPRTime 1 MechCPRDevice 1 MechCPRDeviceID 2 CPRFeedbackDevice 1 ITD 1 ITDID 1 DrugAdministration 2 VascularAccessID 2 12Lead 1 STEMI 1 STEMIID 4 EROutcome 2 Hypothermia_Provided_Hosp 4 HospOutcome 2 HospOutcomeDNR EROutcomeTrans Hypothermia_Provided_Hosp_Trans HospOutcomeTrans HospOutcomeDNRTrans HospDispositionTrans NeuroOutcomeTrans 0 Transfer_hospitalid ABC Hospital Transfer_hospital 3 MyocardialInfarction 1 CoronaryAngiography 2016-06-09T11:38:26.0Z CoronaryAngiographyDateTime 2 CardiacStent 2 CABGPerformed 2 ICDPlaced NoFRDisp 2016-05-20T11:49:26.0Z AmbDispatched 2016-05-20T11:50:26.0Z AmbEnRoute 2016-05-20T11:52:26.0Z AmbArrivedAtScene 2016-05-20T11:53:26.0Z AmbLeftScene 2016-05-20T11:54:26.0Z AmbArrivedAtED 0345 FirstResponder 8 EthnicityUnknown ePat 099 MedicationOther eMed 99 MedHistoryOther eHist Obesity MedicalHistoryOtherStr Other Etiology CardiacEtiologyOther

NEMSIS EMS 3.3.4