● Allows data to be sorted based on gender
● Allows data to describe the gender of the EMS patient population
Data Collector
● EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital database
Other Associated Elements
E00 Common Null Values E01_01 Patient Care Report Number
E06_01 Last Name
References in NHTSA Version 1
Essential Element 42 Gender
References to Other Databases
● NFIRS 5.0 EMS Module; Title: Gender; Pick-List: Male = 1, Female = 2
Section E06 Patient
MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)
RACE
E06_12
Data Format [combo] single-choice National Element
Definition
The patient's race as defined by the OMB (US Office of Management and Budget)
XSD Data Type xs:integer XSD Domain (Simple Type) Race
Multiple Entry Configuration No Accepts Null Yes
Required in XSD Yes
Field Values
-25 Not Applicable -20 Not Recorded
-15 Not Reporting
660 American Indian or Alaska Native 665 Asian
670 Black or African American 675 Native Hawaiian or Other Pacific Islander
680 White 685 Other Race
Uses
● A component of the EMS Medical Record: Patient Care Report
● Allows data to be sorted based on race as required from a state and federal government reporting perspective
● Allows data to describe the race of the EMS patient population
Data Collector
● EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital database
Other Associated Elements
E00 Common Null Values E01_01 Patient Care Report Number
E06_01 Last Name
References in NHTSA Version 1
Essential Element 43 Race/Ethnicity
References to Other Databases
● NFIRS 5.0 EMS Module; Title: Race; Pick-List: White = 1, Black = 2, American Indian, Eskimo, Aleut = 3, Asian = 4,
Other, Multi-racial = 0, Race Undetermined = U
Section E06 Patient
MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)
ETHNICITY
E06_13
Data Format [combo] single-choice National Element
Definition
The patient's ethnicity as defined by the OMB (US Office of Management and Budget)
XSD Data Type xs:integer XSD Domain (Simple Type) Ethnicity
Multiple Entry Configuration No Accepts Null Yes
Required in XSD Yes
Field Values
-25 Not Applicable -15 Not Reporting
-20 Not Recorded
690 Hispanic or Latino 695 Not Hispanic or Latino
Uses
● A component of the EMS Medical Record: Patient Care Report
● Allows data to be sorted based on ethnicity as required from a state and federal government reporting perspective
● Allows data to describe the ethnicity of the EMS patient population
Data Collector
● EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital database
Other Associated Elements
E00 Common Null Values E01_01 Patient Care Report Number
E06_01 Last Name
References in NHTSA Version 1
Essential Element 43 Race/Ethnicity
References to Other Databases
● NFIRS 5.0 EMS Module; Title: Ethnicity; Check-Box: Hispanic = Yes or No
Section E06 Patient
MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)
AGE
E06_14
Data Format [number] National Element
Definition
The patient's age (either calculated from date of birth or best approximation)
XSD Data Type xs:integer XSD Domain (Simple Type) Age
Multiple Entry Configuration No Accepts Null Yes, but null value is blank or empty
Required in XSD Yes Minimum Constraint 1 Maximum Constraint 120
XSD Structure: E06_14 and E06_15 are members of the E06_14_0 Patient's Age Structure
Field Values
● Relevant Value for Data Element & Patient Care
Additional Information
● Could be calculated from Date of Birth (E06_16)
Uses
● A component of the EMS Medical Record: Patient Care Report
● Allows data to be sorted based on age
● Allows data to describe the age of the EMS patient population
Data Collector
● EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital database
Other Associated Elements
E01_01 Patient Care Report Number E06_01 Last Name
E06_15 Age Units
References in NHTSA Version 1
Desirable Element 41 Age
References to Other Databases
● NFIRS 5.0 EMS Module; Title: Age; The age of the patient or best approximation. If less than one year then enter the
number of months.
Section E06 Patient
MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)
AGE UNITS
E06_15
Data Format [combo] single-choice National Element
Definition
The units which the age is documented in (Hours, Days, Months, Years)
XSD Data Type xs:integer XSD Domain (Simple Type) AgeUnits
Multiple Entry Configuration No Accepts Null Yes
Required in XSD Yes
XSD Structure: E06_14 and E06_15 are members of the E06_14_0 Patient's Age Structure
Field Values
-25 Not Applicable -15 Not Reporting
-20 Not Recorded
700 Hours 705 Days
710 Months 715 Years
Uses
● A component of the EMS Medical Record: Patient Care Report
● Allows data to be sorted based on age
● Allows data to describe the age of the EMS patient population
Data Collector
● EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital database
Other Associated Elements
E00 Common Null Values E01_01 Patient Care Report Number
E06_14 Age
References in NHTSA Version 1
Desirable Element 41 Age
Section E06 Patient
MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)
DATE OF BIRTH
E06_16
Data Format [date]
Definition
The patient's date of birth
XSD Data Type xs:date XSD Domain (Simple Type) DateOfBirth
Multiple Entry Configuration No Accepts Null No
Required in XSD No Minimum Constraint 1,890 Maximum Constraint 2,030
Field Values
● Relevant Value for Data Element & Patient Care
Uses
● Key component of an EMS Medical Record
● Provides important information which will allow EMS data to be sorted, grouped and evaluated by age demographics
Data Collector
● EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital database
Other Associated Elements
E01_01 Patient Care Report Number E06_01 Last Name
References in NHTSA Version 1
Essential Element 40 Date of Birth
References to Other Databases
● NFIRS 5.0 EMS Module; Title: Date of Birth; The date of birth of the patient in MMDDYYYY format.
Section E06 Patient
MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)
Section E07
Billing
Section E07 Billing
MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)
PRIMARY METHOD OF PAYMENT
E07_01
Data Format [combo] single-choice National Element
Definition
The primary method of payment or type of insurance associated with this EMS encounter
XSD Data Type xs:integer XSD Domain (Simple Type) PrimaryMethodOfPayment
Multiple Entry Configuration No Accepts Null Yes
Required in XSD Yes
Field Values
-25 Not Applicable -15 Not Reporting
-20 Not Recorded 720 Insurance
725 Medicaid 730 Medicare
735 Not Billed (for any reason) 740 Other Government
745 Self Pay 750 Workers Compensation
Uses
● A component of the EMS Medical Record: Patient Care Report
● Allows data to be sorted based on the payer mix
● Allows data to describe the EMS patient population's payer mix
Data Collector
● EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital database
Other Associated Elements
E00 Common Null Values E01_01 Patient Care Report Number
E06_01 Last Name
Section E07 Billing
MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)
CMS SERVICE LEVEL
E07_34
Data Format [combo] single-choice National Element
Definition
The CMS service level for this EMS encounter.
XSD Data Type xs:integer XSD Domain (Simple Type) CMSServiceLevel
Multiple Entry Configuration No Accepts Null Yes
Required in XSD Yes
Field Values
-25 Not Applicable -15 Not Reporting
-20 Not Recorded 990 BLS
995 BLS, Emergency
1000 ALS, Level 1 1005 ALS, Level 1 Emergency
1010 ALS, Level 2 1015 Paramedic Intercept
1020 Specialty Care Transport 1025 Fixed Wing (Airplane)
1030 Rotary Wing (Helicopter)
Uses
● Allows data to be quantified and described based on the CMS Service Level
● Allows data to be sorted based on the CMS Service Level
● Important for EMS billing
Data Collector
● EMS personnel unless the EMS Agency has professional billing personnel to provide this function
Other Associated Elements
E00 Common Null Values E01_01 Patient Care Report Number
Section E07 Billing
MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)
CONDITION CODE NUMBER
E07_35
Data Format [combo] multiple-choice National Element
Definition
The condition codes are used to better describe the service and patient care delivery by an EMS service. Please consult CMS
documentation for detailed descriptions of these condition codes and their use.
XSD Data Type xs:string XSD Domain (Simple Type) ConditionCodeNumber
Multiple Entry Configuration Yes, via structure Accepts Null Yes
Required in XSD Yes Minimum Constraint 2 Maximum Constraint 30
XSD Structure: E07_35, E07_36 are members of E07_35_0 Condition Codes Structure
Field Values
-25 Not Applicable -15 Not Reporting
-20 Not Recorded
8001 Severe Abdominal Pain (ALS-789.00) 8002 Abdominal Pain (ALS-789.00)
8003 Abnormal Cardiac Rhythm/Cardiac Dysrhythmia (ALS- 8004 Abnormal Skin Signs (ALS-780.8)
427.9)
8005 Abnormal Vital Signs (ALS-796.4) 8006 Allergic Reaction (ALS-995.0)
8007 Allergic Reaction (BLS-692.9) 8008 Blood Glucose (ALS-790.21)
8009 Respiratory Arrest (ALS-799.1) 8010 Difficulty Breathing (ALS-786.05)
8011 Cardiac Arrest-Resuscitation in Progress (ALS-427.5) 8012 Chest Pain (non-traumatic) (ALS-786.50)
8013 Choking Episode (ALS-784.9) 8014 Cold Exposure (ALS-991.6)
8015 Cold Exposure (BLS-991.9) 8016 Altered Level of Consciousness (non-traumatic) (ALS-
780.01)
8017 Convulsions/Seizures (ALS-780.39) 8018 Eye Symptoms (non-traumatic) (BLS-379.90)
8019 Non Traumatic Headache (ALS-437.9) 8020 Cardiac Symptoms other than Chest Pain (palpitations)
(ALS-785.1)
8021 Cardiac Symptoms other than Chest Pain (atypical pain) 8022 Heat Exposure (ALS-992.5)
(ALS-536.2)
8023 Heat Exposure (BLS-992.2) 8024 Hemorrhage (ALS-459.0)
8025 Infectious Diseases requiring Isolation/Public Health Risk 8026 Hazmat Exposure (ALS-987.9)
(BLS-038.9)
8027 Medical Device Failure (ALS-996.0) 8028 Medical Device Failure (BLS-996.3)
8029 Neurologic Distress (ALS-436.0) 8030 Pain (Severe) (ALS-780.99)
8031 Back Pain (non-traumatic possible cardiac or vascular) 8032 Back Pain (non-traumatic with neurologic symptoms) (ALS-
(ALS-724.5) 724.9)
8033 Poisons (all routes) (ALS-977.9) 8034 Alcohol Intoxication or Drug Overdose (BLS-305.0)
8035 Severe Alcohol Intoxication (ALS-977.3) 8036 Post-Operative Procedure Complications (BLS-998.9)
8037 Pregnancy Complication/Childbirth/Labor (ALS-650.0) 8038 Psychiatric/Behavioral (abnormal mental status) (ALS-
292.9)
8039 Psychiatric/Behavioral (threat to self or others) (BLS-298.9) 8040 Sick Person-Fever (BLS-036.9)
8041 Severe Dehydration (ALS-787.01) 8042 Unconscious/Syncope/Dizziness (ALS-780.02)
8043 Major Trauma (ALS-959.8) 8044 Other Trauma (need for monitor or airway) (ALS-518.5)
8045 Other Trauma (major bleeding) (ALS-958.2) 8046 Other Trauma (fracture/dislocation) (BLS-829.0)
8047 Other Trauma (penetrating extremity) (BLS-880.0) 8048 Other Trauma (amputation digits) (BLS-886.0)
8049 Other Trauma (amputation other) (ALS-887.4) 8050 Other Trauma (suspected internal injuries) (ALS-869.0)
8051 Burns-Major (ALS-949.3) 8052 Burns-Minor (BLS-949.2)
8053 Animal Bites/Sting/Envenomation (ALS-989.5) 8054 Animal Bites/Sting/Envenomation (BLS-879.8)
8055 Lightning (ALS-994.0) 8056 Electrocution (ALS-994.8)
Section E07 Billing
MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)
8057 Near Drowning (ALS-994.1) 8058 Eye Injuries (BLS-921.9)
8059 Sexual Assault (major injuries) (ALS-995.83) 8060 Sexual Assault (minor injuries) (BLS-995.8)
8061 Cardiac/Hemodynamic Monitoring Required (ALS-428.9) 8062 Advanced Airway Management (ALS-518.81)
8063 IV Meds Required (ALS-No ICD code provided)) 8064 Chemical Restraint (ALS-293.0)
8065 Suctioning/Oxygen/IV fluids required (BLS-496.0) 8066 Airway Control/Positioning Required (BLS-786.09)
8067 Third Party Assistance/Attendant Required (BLS-496.0) 8068 Patient Safety (restraints required) (BLS-298.9)
8069 Patient Safety (monitoring required) (BLS-293.1) 8070 Patient Safety (seclusion required) (BLS-298.8)
8071 Patient Safety (risk of falling off stretcher) (BLS-781.3) 8072 Special Handling (Isolation) (BLS-041.9)
8073 Special Handling (orthopedic device required) (BLS-907.2) 8074 Special Handling (positioning required) (BLS-719.45)
Additional Information
● A list of 95 Condition Codes which are mapped to ICD-9 Codes. At this time the Condition Code List is still in draft. The
number of the Condition Code should be stored in this field
● From the Center for Medicare and Medicaid Services (CMS) Ambulance Fee Schedule Condition Based Coding
Uses
● Allows data to be quantified and described based on the Condition Code
● Allows data to be sorted based on the Condition Code
● Important for EMS billing
Data Collector
● EMS personnel unless the EMS Agency has professional billing personnel to provide this function
Other Associated Elements
E00 Common Null Values E01_01 Patient Care Report Number
E07_36 ICD-9 Code for the Condition Code Number E07_37 Condition Code Modifier
Section E07 Billing
MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)
Section E08
Scene
Section E08 Scene
MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)
NUMBER OF PATIENTS AT SCENE
E08_05
Data Format [combo] single-choice National Element
Definition
Indicator of how many total patients were at the scene
XSD Data Type xs:integer XSD Domain (Simple Type) NumberOfPatientsAtScene
Multiple Entry Configuration No Accepts Null Yes
Required in XSD Yes
Field Values
-25 Not Applicable -15 Not Reporting
-20 Not Recorded
1120 None 1125 Single
1130 Multiple
Uses
● A component of the EMS Medical Record: Patient Care Report
● Allows data to be sorted based on the number of patients associated with the event and resources required
● Allows data to describe the number of EMS events with multiple patient encounters
Data Collector
● EMS personnel
Other Associated Elements
E00 Common Null Values E01_01 Patient Care Report Number
References to Other Databases
● NFIRS 5.0 EMS Module; Title: Number of Patients; The total number of patients.
Section E08 Scene
MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)
MASS CASUALTY INCIDENT
E08_06
Data Format [combo] single-choice National Element
Definition
Indicator if this event would be considered a mass casualty incident (overwhelmed existing EMS resources)
XSD Data Type xs:integer XSD Domain (Simple Type) YesNoValues
Multiple Entry Configuration No Accepts Null Yes
Required in XSD Yes
Field Values
-25 Not Applicable -15 Not Reporting
-20 Not Recorded 0 No
1 Yes
Uses
● A component of the EMS Medical Record: Patient Care Report
● Allows data to be sorted based on a Mass Casualty Event
● Allows data to describe the number of EMS events which were declared a mass casualty event and is connected with
disaster and domestic preparedness
Data Collector
● EMS personnel
Other Associated Elements
E00 Common Null Values E01_01 Patient Care Report Number
Section E08 Scene
MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)
INCIDENT LOCATION TYPE
E08_07
Data Format [combo] single-choice National Element
Definition
The kind of location where the incident happened
XSD Data Type xs:integer XSD Domain (Simple Type) IncidentLocationType
Multiple Entry Configuration No Accepts Null Yes
Required in XSD Yes
Field Values
-25 Not Applicable -15 Not Reporting
-20 Not Recorded 1135 Home/Residence
1140 Farm
1145 Mine or Quarry 1150 Industrial Place and Premises
1155 Place of Recreation or Sport 1160 Street or Highway
1165 Public Building (schools, gov. offices) 1170 Trade or service (business, bars, restaurants, etc)
1175 Health Care Facility (clinic, hospital, nursing home) 1180 Residential Institution (Nursing Home, jail/prison)
1185 Lake, River, Ocean 1190 Other Location
Additional Information
● Based on ICD-9
Uses
● A component of the EMS Medical Record: Patient Care Report
● Allows data to be sorted based on the Incident Location and Type
● Allows data to describe the Incident Location and the distribution of EMS events
Data Collector
● EMS personnel
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