| Modified question |
Required to optional |
New required question |
New optional question |
|
Current pre-hospital data elements (0920-1108; exp. 3/31/2019) |
|
Requested changes |
|
Change description |
| Item |
Variable name |
Text prompt |
Legal values |
Item |
Variable name |
Text prompt |
Legal values |
|
|
1 |
|
|
|
|
|
|
|
EMS Agency |
EMSNameU |
EMS agency name is unknown |
1 - Yes; 0 - No |
|
This question is added to be able to differentiate between missing EMS agency numbers and cases when the number is unknown. |
|
|
1 |
|
|
|
|
|
|
|
Run Sheet Number |
EMSRuNoU |
EMS run sheet number is unknown |
1 - Yes; 0 - No |
|
This question is added to be able to differentiate between missing run sheet numbers and cases when the number is unknown |
|
1 |
|
|
|
Scene Arrival |
ScnArrD |
_ _/ _ _/ _ _ _ _ |
Date MMDDYYYY |
|
Scene Arrival |
ScnArrD |
_ _/ _ _/ _ _ _ _ |
Date MMDDYYYY |
|
Question is changed from required to optional. This will reduce overall burden |
|
|
|
1 |
|
|
|
|
|
|
Scene Arrival |
ScnArDND |
Scene arrival date not documented |
1 - Yes; 0 - No |
|
This data element is added to align with GWTG |
|
1 |
|
|
|
Scene Arrival |
ScnArrT |
__:____ |
Time HHMM |
|
Scene Arrival |
ScnArrT |
__:____ |
Time HHMM |
|
Question is changed from required to optional. This will reduce overall burden |
|
|
|
1 |
|
|
|
|
|
|
Scene Arrival |
ScnArTND |
Scene arrival time not documented |
1 - Yes; 0 - No |
|
This data element is added to align with GWTG |
|
|
|
1 |
|
|
|
|
|
|
Arrives at patient |
FstMdCtD |
_ _/ _ _/ _ _ _ _ |
Date MMDDYYYY |
|
This optional question is added as a secondary option to scene arrival date and time |
|
|
|
1 |
|
|
|
|
|
|
Arrives at patient |
FstMdCtT |
__:____ |
Time HHMM |
|
This optional question is added as a secondary option to scene arrival date and time |
|
1 |
|
|
|
Scene Departure |
ScnDptD |
_ _/ _ _/ _ _ _ _ |
Date MMDDYYYY |
|
Scene Departure |
ScnDptD |
_ _/ _ _/ _ _ _ _ |
Date MMDDYYYY |
|
Question is changed from required to optional. This will reduce overall burden |
|
|
|
1 |
|
|
|
|
|
|
Scene Departure |
ScnDpDND |
Scene departure date not documented |
1 - Yes; 0 - No |
|
This data element is added to align with GWTG |
|
1 |
|
|
|
Scene Departure |
ScnDptT |
__:____ |
Time HHMM |
|
Scene Departure |
ScnDptT |
__:____ |
Time HHMM |
|
Question is changed from required to optional. This will reduce overall burden |
|
|
|
1 |
|
|
|
|
|
|
Scene Departure |
ScnDpTND |
Scene departure time not documented |
1 - Yes; 0 - No |
|
This data element is added to align with GWTG |
|
1 |
|
|
|
Hospital Arrival |
HospArrD |
_ _/ _ _/ _ _ _ _ |
Date MMDDYYYY |
|
Hospital Arrival |
HospArrD |
_ _/ _ _/ _ _ _ _ |
Date MMDDYYYY |
|
Question is changed from required to optional. This will reduce overall burden |
|
|
|
1 |
|
|
|
|
|
|
Hospital Arrival |
ArrDDND |
Hospital arrival date not documented |
1 - Yes; 0 - No |
|
This data element is added to align with GWTG |
|
1 |
|
|
|
Hospital Arrival |
HospArrT |
__:____ |
Time HHMM |
|
Hospital Arrival |
HospArrT |
__:____ |
Time HHMM |
|
Question is changed from required to optional. This will reduce overall burden |
|
|
|
1 |
|
|
|
|
|
|
Hospital Arrival |
ArrDTND |
Hospital arrival time not documented |
1 - Yes; 0 - No |
|
This data element is added to align with GWTG |
| 1 |
|
|
|
|
EMS Diagnosis Impression |
EMSDiagn |
Did EMS think this was a possible stroke? (i.e., primary or secondary provider impression) |
1 - Yes; 0- No |
|
EMS Diagnosis Impression |
EMSDiagn |
Did EMS think this was a possible stroke? (i.e., primary or secondary provider impression) |
1 - Yes; 2 - No; 3- not documented |
|
Response options modified to align with AHA GWTG. Alignment reduces burden for awardees who collect data using multiple systems |
| 1 |
|
|
|
|
Hospital pre-notification performed |
EMSPreNt |
Did EMS call the hospital to notify them of a possible stroke patient? |
1 - Yes; 0- No |
|
Hospital pre-notification performed |
EMSPreNt |
Did EMS call the hospital to notify them of a possible stroke patient? |
1 - Yes; 2 – No; 3- N/A |
|
Response options modified to align with AHA GWTG. Alignment reduces burden for awardees who collect data using multiple systems |
|
|
|
1 |
|
|
|
|
|
|
|
EMSAlert |
Did EMS call the hospital to notify them of a possible stroke patient and provide additional stroke information? |
1 - Yes; 2 – No; 3- N/A |
|
New optional question added to capture addional information on stoke patient to previous question |
| 1 |
|
|
|
|
Pre-hospital stroke screen performed |
StkScnYN |
Did EMS perform a pre-hospital stroke screen? |
1 - Yes; 0- No |
|
Pre-hospital stroke screen performed |
StkScn |
Did EMS perform a pre-hospital stroke screen? |
1 - Yes; 2– No; 3 – Not documented |
|
Response options and variable name modified to align with AHA GWTG. Alignment reduces burden for awardees who collect data using multiple systems |
|
|
|
1 |
|
|
|
|
|
|
|
ScnType |
What type of stroke screen did EMS perform? |
1=BE FAST; 2=CPSS; 3=DPSS; 4=FAST; 5=MASS; 6=Med PACS; 7=MEND; 8=mLAPSS; 9=LAPSS 10=OPSST; 11=ROSIER; 12=Other; 13=Stroke screen tool used, but tool used is unknown; 14=No stroke screen used; 15=Not Documented |
|
New optional question added to capture type of stroke screen tool EMS used for suspected stroke patient |
|
|
|
1 |
|
|
|
|
|
|
|
ScrTyUnk |
If other, please specify |
Text, 50 characters |
|
This data element is added to align with GWTG |
|
|
|
1 |
|
|
|
|
|
|
|
ScnReslt |
|
1 - Positive; 2 - Negative; 3 - Not documented |
|
New optional question added to capture result of the stroke screen performed |
|
|
|
1 |
|
|
|
|
|
|
|
SevType |
If stroke severity scale used, what type of scale did EMS perform? |
1=CPSSS/CSTAT; 2=FAST ED; 3=LAMS; 4=RACE; 5=Other; 6 = Severity scale used, but tool used is unknown; 7 = No severity scale used; 8= Not Documented |
|
New optional question added to capture type of stroke severity scale EMS used for suspected stroke patient |
|
|
|
1 |
|
|
|
|
|
|
|
SevTyUnk |
If other, please specify |
Text, 50 characters |
|
This data element is added to align with GWTG |
|
|
|
1 |
|
|
|
|
|
|
|
SevScore |
|
Numeric |
|
New optional question added to capture severity score of suspected stroke |
| 1 |
|
|
|
|
Last known well |
LKWD |
_ _/ _ _/ _ _ _ _ |
Date MMDDYYYY |
|
Last known well |
EMSLKWD |
_ _/ _ _/ _ _ _ _ |
Date MMDDYYYY |
|
Variable name modified to meet character length guidelines |
|
|
1 |
|
|
|
|
|
|
|
Last known well |
ELKWDND |
LKW date not documented |
1 - Yes; 0 - No |
|
This is added to differentiate between cases when the date is not documented versus missing |
| 1 |
|
|
|
|
Last known well |
LKWT |
__:____ |
Time HHMM |
|
Last known well |
EMSLKWT |
__:____ |
Time HHMM |
|
Variable name modified to meet character length guidelines |
|
|
1 |
|
|
|
|
|
|
|
Last known well |
ELKWTND |
LKW time not documented |
1 - Yes; 0 - No |
|
This is added to differentiate between cases when the time is not documented versus missing |
| 1 |
1 |
|
|
|
Time of discovery |
DiscD |
_ _/ _ _/ _ _ _ _ |
Date MMDDYYYY |
|
Time of onset |
OnsetD |
_ _/ _ _/ _ _ _ _ |
Date MMDDYYYY |
|
Changed to optional; modified language and variable name to align with AHA GWTG |
|
|
|
1 |
|
|
|
|
|
|
Time of onset |
OnsetDND |
Onset date not documented |
1 - Yes; 0 - No |
|
This is added to differentiate between cases when the date is not documented versus missing |
| 1 |
1 |
|
|
|
Time of discovery |
DiscT |
__:____ |
Time HHMM |
|
Time of onset |
OnsetT |
__:____ |
Time HHMM |
|
Changed to optional; modified language and variable name to align with AHA GWTG |
|
|
|
1 |
|
|
|
|
|
|
Time of onset |
OnsetTND |
Onset time not documented |
1 - Yes; 0 - No |
|
This is added to differentiate between cases when the time is not documented versus missing |
| 1 |
|
|
|
|
Thrombolytic checklist |
tPAChk |
Was a thrombolytic checklist done for possible tPA eligibility? |
1 - Yes; 0 - No/ND |
|
Thrombolytic checklist |
tPAChk |
Was a thrombolytic checklist done for possible alteplase eligibility? |
1 - Yes; 0 - No/ND |
|
Variable name modified to meet character length guidelines. Legal values modified to align with AHA GWTG |
| 1 |
|
|
|
|
Glucose checked |
GluChkYN |
Was glucose checked? |
1 - Yes; 0 - No |
|
Glucose checked |
GluChk |
Was glucose checked? |
1 - Yes; 0 – No; 2- glucometer not available 3- not documented/ not required to perform; 4-patient refused |
|
Variable name modified to meet character length guidelines. Legal values modified to align with AHA GWTG |
|
|
|
1 |
|
|
|
|
|
|
Glucose checked |
BglVal |
Blood glucose level |
1 - Too high; 2 - Too low |
|
This is added to align with GWTG and appropriate capture instances when glucometers don't produce a numeric reading |
| 1 |
1 |
|
|
|
Destination Decision |
DestDscn |
How did EMS make the decision to come to this hospital? |
1 = Protocol to nearest stroke center; 2 = protocol to nearest hospital; 3 = patient/family choice; 4 = enroute medical direction; 5 = nearest hospital; 6 = other or unknown; |
|
Destination Decision |
DestDscn |
How did EMS make the decision to come to this hospital? |
1 = Protocol to nearest stroke center; 2 = protocol to nearest hospital; 3 = patient/family choice; 4 = enroute medical direction; 5 = nearest hospital; 6 = other or unknown; 7 - unknown/not documented |
|
Changed to optional. Response options modified |
|
|
|
|
|
|
|
|
|
|
Destination Decision |
DesDscnO |
If other reason, please specify |
Text, 200 characters |
|
This is added to align with GWTG. |
|
1 |
|
|
|
Follow-up |
|
Did EMS receive hospital follow-up |
1 = Yes; 0 = No |
|
Follow-up |
EMSFU |
Did EMS receive hospital follow-up |
1 = Yes; 0 = No |
|
Changed to optional. Variable name added |
|
1 |
|
|
|
Follow-up |
|
If yes, did EMS diagnosis of a stroke agree with hospital diagnosis? |
1 = EMS & Hospital both diagnosed a stroke; 2 = EMS called a stroke and Hospital did not diagnose a stroke; 3 = EMS did not call a stroke and Hospital diagnosed a stroke |
|
Follow-up |
DiAgree |
If yes; did EMS diagnosis of a stroke agree with hospital diagnosis? |
1 = EMS & Hospital both diagnosed a stroke; 2 = EMS called a stroke and Hospital did not diagnose a stroke; 3 = EMS did not call a stroke and Hospital diagnosed a stroke |
|
Changed to optional. Variable name added |
|
|
1 |
|
|
|
|
|
|
|
Hospital Coverdell Participation |
HospCovd |
Is this patient transport to a hospital participating in the Coverdell program? (yes/no) |
0 = No; 1 = Yes; 2 = Unknown |
|
This is a new required data element. The information is needed to identify linkage capabilities with in-hospital data |
|
|
1 |
|
|
|
|
|
|
|
EMS Coverdell Participation |
EMSCovd |
Is this patient transport by an EMS agency participating in the Coverdell program? (yes/no) |
0 = No; 1 = Yes; 2 = Unknown |
|
This is a new required data element. The information is needed to identify linkage capabilities with in-hospital data |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| *Variables in the table with the green background are required data elements. Variables in the table with the blue background are optional data elements. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|