TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER f: EMERGENCY SERVICES AND HIGHWAY SAFETY
PART 515 EMERGENCY MEDICAL SERVICES, TRAUMA CENTER, COMPREHENSIVE STROKE CENTER, PRIMARY STROKE CENTER AND ACUTE STROKE READY HOSPITAL CODE
SECTION 515.APPENDIX E MINIMUM PRESCRIBED DATA ELEMENTS


 

Section 515.APPENDIX E  Minimum Prescribed Data Elements

 

General information including but not limited to:  agency and unit number, county, crash number (when available), date of call and incident location and type, destination location, type of medical control, transport and non-transport information, resource hospital, crew member identification number, incident number, patient zip code.

 

Response time information including:  time call received, time dispatched, time enroute, arrival time at location, patient contact time, departure time from location, arrival time at destination.

 

Documentation of who, other than the crew, renders assistance at the scene and the nature of the assistance.

 

Patient assessment including but not limited to:  initial vital signs (systolic, diastolic, pulse, respirations), skin condition, Glasgow Coma Scale, past medical history, current illness/symptom (chief and secondary), injury site and type, injury criteria, pupils and where the patient was sitting in the vehicle.

 

Patient information including but not limited to:  gender, ethnic origin, date of birth, possible contributing factors to the injury/illness (i.e., motor vehicle, alcohol, equipment, HAZMAT, sports, etc.), protection used by the patient (i.e., seat belt, helmet, etc.), resuscitation status, approximate pediatric weight.

 

Patient treatment including but not limited to:  actual treatment rendered, medications administered, IV type, rate, site and attempts, EKG, body substance isolation, and CPR information (arrest witnessed, defibrillation, etc.), intubations and number of attempted intubations.

 

(Source:  Added at 21 Ill. Reg. 5170, effective April 15, 1997)