EMS Syndrome Definitions
The syndrome definitions listed below are used to monitor EMS encounters in NC DETECT.
Abbreviations, misspellings and negation are taken into account when searching for keywords in the free text data (complaints and narrative).
The EMS data feed to NC DETECT transitioned from NEMSIS V.2 to NEMSIS V.3 around May 2018. In the NC DETECT Web Application, use the data source “PreMIS” for data from 2009-2018 (NEMSIS V.2 data) and use the data source “EMS” for data from May 2018 to the present (NEMSIS V.3 data)
| NEMSIS Version | Syndrome | Case Definition |
|---|---|---|
| Version 3: EMS | Alcohol Intoxication | Chief complaint terms: alcohol OR "alcholo*" OR alchohol OR "inebriat*" OR ETOH OR "drunk*"' AND NOT "detox*" OR "withdraw*" OR "feel drunk*" OR "feels like I''m drunk" OR "feel like I''m drunk" OR "feel like Im drunk"' OR symptom / impression ICD-10-CM codes: F10% Exclusions: Patient disposition of Assist, Agency; Assist, Public, Assist; Unit, Canceled (Prior to Arrival At Scene); Canceled on Scene (No Patient Contact); Canceled on Scene (No Patient Found); Standby-No Services or Support Provided; Standby-Public Safety, Fire, or EMS Operational Support Provided; Transport Non-Patient, Organs, etc. |
| Version 3: EMS | Assault | Chief complaint terms: "assault*" OR "assuialt*" OR "assalt*" Dispatch complaint: Assault Any of the following Injury Cause Codes: T42.8X3, T49.93, T71.123, T71.143, T71.193, T71.223, T71.233, X92.9, X93.XXXA, X94.0XXA, X95, X95.9, X95.9XXA, X96.9, X97, X97.XXXA, X98.9, X98.9XXA, X99, X99.9, X99.9XXA, Y00, Y00.XXXA, Y01, Y02, Y02.0, Y02.1, Y02.8, Y03, Y03.0, Y03.0XXA, Y03.8, Y03.8XXA, Y04, Y04.0, Y04.0XXA, Y04.1, Y04.2, Y04.8, Y04.8XXA, Y08, Y08.0, Y08.02, Y08.09, Y08.8, Y08.89, Y08.89XA, Y09 Exclusions: Patient disposition of Assist, Agency; Assist, Public, Assist; Unit, Canceled (Prior to Arrival At Scene); Canceled on Scene (No Patient Contact); Canceled on Scene (No Patient Found); Standby-No Services or Support Provided; Standby-Public Safety, Fire, or EMS Operational Support Provided; Transport Non-Patient, Organs, etc. |
| Version 3: EMS | Falls | Chief complaint terms: "fall*" OR GLF OR "fell*" AND NOT ("fell on him" OR "fell on her" OR "fell on himself" OR "fell on pt" OR "fell on patient" OR "stent fell out" OR "tube fell out" OR "tooth fell out"') OR Dispatch complaint = Falls OR symptom / impression ICD-10-CM codes: R29.6 Exclusions: Patient disposition of Assist, Agency; Assist, Public, Assist; Unit, Canceled (Prior to Arrival At Scene); Canceled on Scene (No Patient Contact); Canceled on Scene (No Patient Found); Standby-No Services or Support Provided; Standby-Public Safety, Fire, or EMS Operational Support Provided; Transport Non-Patient, Organs, etc. |
| Version 3: EMS | Firearm (V1) | Chief complaint terms: GSW or gunshot or "gun shot" or "shot myself" or "shot self*" or firearm or "I got shot" or "been shot" or "shot gun" or shotgun OR (dispatch complaint = Stab/Gunshot Wound/Penetrating Trauma AND narrative keywords of GSW or gun shot or gunshot) OR any of the following injury cause (ICD-10-CM) codes: W34, W34.0, W34.09, W34.00, W34.00XA, W33.02, W33.03, W33.09, W33.01, W32.0, W32, W34.1, W33.0, W33, X94.0XXA, X95.9, X95.9XXA, Y22, Y22.XXXA, Y23.1, X72.XXXA, X74.9, Y35.0, Y35.02, Y35.023, Y35.03, Y35.092, Y35.093, Y35.003, Y23.3, Y22.0, Y24.8, Y23.8, Y23, Y23.0, Y23.0XXA, Y38.4X, Y24.9, Y24.9XXA, Y23.9 Exclusions: Patient disposition of Assist, Agency; Assist, Public, Assist; Unit, Canceled (Prior to Arrival At Scene); Canceled on Scene (No Patient Contact); Canceled on Scene (No Patient Found); Standby-No Services or Support Provided; Standby-Public Safety, Fire, or EMS Operational Support Provided; Transport Non-Patient, Organs, etc. |
| Version 3: EMS | Firearm V2 | Complaint terms: GSW OR Gunshot OR "gun shot" OR gunshout OR gunshoot OR buckshot OR "buck shot" OR revolver OR riffle OR rifle OR shotgun OR "shot gun" OR "firearm*" OR "fire arm*" OR pistol OR handgun OR "hand gun" OR "been shot" OR "I was shot" OR "I got shot" OR (hit OR ricochet OR graze) AND (bullet OR (gun AND wound)) Complaint exclusions: "no gun" OR "remove gun" OR "heard gun" OR "hearing gun" OR "hit head" OR "hit my head" OR kickback OR "kick back" OR "kicked back" OR "water gun" OR watergun OR pelle OR pellt OR bb OR "bebe gun" OR "bb gun" OR bbgun OR "b b gun" OR "bibi gun" OR "bi bi gun" OR "bb pellet" OR "bee bee" OR beebee OR beebe OR "rubber bullet" OR paint OR nerf OR nurf OR airgun OR "air gun" OR airsoft OR "air soft" OR spring OR "pistol whip*" OR nailgun OR "nail gun" OR staplegun OR "staple gun" OR stun OR taser OR tazer OR lazer OR laser OR ((struck OR "hit with") and (gun OR pistol)) OR bloodshot OR "blood shot" OR scope OR fake OR "allergy shot" OR injection OR follow-up OR "follow up" OR followup OR chronic OR (wound and (check OR care OR recheck OR infection OR infected)) OR drainage OR gswel OR gswol OR ((gsw OR gunshot OR "gun shot" OR bullet) and (hx OR "hist*" OR (ago and not "minutes ago") OR "past" OR "pri*" OR "previous" OR "old" )) OR any of the following injury cause (ICD-10-CM) codes: W34, W34.0, W34.09, W34.00, W34.00XA, W33.02, W33.03, W33.09, W33.01, W32.0, W32, W34.1, W33.0, W33, X94.0XXA, X95.9, X95.9XXA, Y22, Y22.XXXA, Y23.1, X72.XXXA, X74.9, Y35.0, Y35.02, Y35.023, Y35.03, Y35.092, Y35.093, Y35.003, Y23.3, Y22.0, Y24.8, Y23.8, Y23, Y23.0, Y23.0XXA, Y38.4X, Y24.9, Y24.9XXA, Y23.9 OR OR (dispatch complaint = Stab/Gunshot Wound/Penetrating Trauma AND narrative keywords of terms listed above with exclusions listed above plus additional exclusion of "stab*") Exclusions: Patient disposition of Assist, Agency; Assist, Public, Assist; Unit, Canceled (Prior to Arrival At Scene); Canceled on Scene (No Patient Contact); Canceled on Scene (No Patient Found); Standby-No Services or Support Provided; Standby-Public Safety, Fire, or EMS Operational Support Provided; Transport Non-Patient, Organs, etc. |
| Version 3: EMS | Hurricane-Related | This syndrome looks for the following keywords in the narrative: flood* OR evacu* OR storm* Exclusions: storm door, storm drain, thyroid storm, storming in, storming off, stormed off, stormed into, stormed out of, stormed in Excludes canceled EMS encounters |
| Version 3: EMS | Influenza-like Illness (ILI) | Mention of flu / influenza OR symptoms (ICD-10-CM): J09-J11.89 OR impressions (ICD-10-CM): J09-J11.89 OR (( body aches or dyspnea or cough or pneumonia or sob or sore throat or cold or cong* or malaise or resp* or runny nose or sneez* or sputum or URI or virus or viral or bron* or rsv or lung inf* OR symptoms (ICD-10-CM): J02, J02.0, J02.9, J18.9, J80, J96.00, J98.9, R05, R06, R06.00, R06.01, R06.02, R06.03, R06.09, R06.2, R06.3, R06.89, R06.9, R07.0, R07.1, R09.1, R09.2, R09.81 OR impressions (ICD-10-CM): J12.1, J12.89, J18, J18.9, J20, J20.9, J21, J21.9, R05, R06, R06.0, R06.00, R06.02, R06.03, R06.2, R06.4, R06.89, R07.0, R07.1, R07.2, R09.2 ) AND ( chief complaint of fever or chills or symptoms (ICD-10-CM): R50.9, R56.0, R56.00, R56.01 )) Exclusions: Patient disposition of Assist, Agency; Assist, Public, Assist; Unit, Canceled (Prior to Arrival At Scene); Canceled on Scene (No Patient Contact); Canceled on Scene (No Patient Found); Standby-No Services or Support Provided; Standby-Public Safety, Fire, or EMS Operational Support Provided; Transport Non-Patient, Organs, etc. |
| Version 3: EMS | Methamphetamine-Related | This syndrome looks for the following keywords in the chief complaint or the narrative: meth (alone) metham* methan* Excludes dispatch complaints of standby and transfer/interfacility/palliative care Excludes the following patient dispositions: Assist, Agency; Assist, Public; Assist, Unit; Canceled (Prior to Arrival At Scene), Canceled on Scene (No Patient Contact), Canceled on Scene (No Patient Found), Standby-No Services or Support Provided, Standby-Public Safety, Fire, or EMS Operational Support Provided; Transport Non-Patient, Organs, etc. |
| Version 3: EMS | Naloxone | This syndrome includes all EMS encounters with an EMS administration of naloxone (medication code = 7242) As of January 2020: Excludes dispatch complaints of standby and transfer/interfacility/palliative care Excludes the following patient dispositions: Assist, Agency; Assist, Public; Assist, Unit; Canceled (Prior to Arrival At Scene), Canceled on Scene (No Patient Contact), Canceled on Scene (No Patient Found), Standby-No Services or Support Provided, Standby-Public Safety, Fire, or EMS Operational Support Provided; Transport Non-Patient, Organs, etc. |
| Version 3: EMS | Naloxone with Improved Response | This syndrome includes all EMS encounters with an EMS administration of naloxone (medication code = 7242) and documentation that the patient's status improved after administration. Excludes dispatch complaints of standby and transfer/interfacility/palliative care Excludes the following patient dispositions: Assist, Agency; Assist, Public; Assist, Unit; Canceled (Prior to Arrival At Scene), Canceled on Scene (No Patient Contact), Canceled on Scene (No Patient Found), Standby-No Services or Support Provided, Standby-Public Safety, Fire, or EMS Operational Support Provided; Transport Non-Patient, Organs, etc. |
| Version 3: EMS | Nursing Home | This syndrome includes all EMS encounters with an incident location of a nursing home that result in transport to a hospital. Excludes dispatch complaints of 'Well Person Check', 'Back Pain (Non-Traumatic)', 'Pregnancy/Childbirth/Miscarriage', and 'Transfer/Interfacility/Palliative Care' |
| Version 3: EMS | Nursing Home Respiratory | It includes all EMS encounters with an incident location of a nursing home that result in transport to a hospital, but limited to encounters with the following: complaint reported by dispatch = breathing problem OR complaints of breathing problems OR cough OR difficulty breathing OR dyspnea OR fever OR respiratory distress OR shortness of breath OR symptoms (ICD-10-CM) = 'R06' OR 'R06.02' OR 'R06.00' OR 'J80' OR 'R05' OR 'R06.82' OR 'R06.4' OR 'R06.89' OR 'R06.1' OR 'R06.3' OR 'R06.9' OR 'R06.09' OR 'R06.03' OR 'R50.9' Excludes dispatch complaints of well person check, back pain (non-traumatic), pregnancy/childbirth/miscarraige and transfer/interfacility/palliative care Excludes the following patient dispositions: Assist, Agency; Assist, Public; Assist, Unit; Canceled (Prior to Arrival At Scene), Canceled on Scene (No Patient Contact), Canceled on Scene (No Patient Found), Standby-No Services or Support Provided, Standby-Public Safety, Fire, or EMS Operational Support Provided; Transport Non-Patient, Organs, etc. |
| Version 3: EMS | Opioid Overdose | This syndrome looks for opioid overdoses and is based on the Rhode Island EMS Opioid Overdose Definition, with two notable exceptions. We do not receive data on EMS administrations prior to EMS arrival so that is not included. We also do not exclude any death dispositions. 1) Patients >= 11 years OLD AND 2) EMS encounters have a opioid-related primary or secondary impression AND documented administration of naloxone OR mention of naloxone and unresponsive keyword terms in the narrative OR 3) EMS encounters have a documented administration of naloxone and patient response is improved OR 4) EMS encounters have a documented administration of naloxone and response is NULL but there is mention of naloxone and unresponsive keyword terms in the narrative EMS encounters that are standby or transfers/interfacility/palliative care are excluded. The following patient dispositions are also excluded: Assist, Agency; Assist, Public; Assist, Unit; Canceled (Prior to Arrival At Scene); Canceled on Scene (No Patient Contact); Canceled on Scene (No Patient Found); Standby-No Services or Support Provided; Standby-Public Safety, Fire, or EMS Operational Support Provided; Transport Non-Patient, Organs, etc. |
| Version 3: EMS | Respiratory | Chief complaint: anthrax or antrax or "plag*" or sars or "tulare*" or "tuler*" or flu or "influ*" or "can not breath" or "can''t breath*" or "cannot breath*" or "cant breath*" or "cough*" or cyanosis or "diff br*" or dyspnea or hemoptysis or hypoxia or "inc resp*" or "inc RR*" or "pleural effusion" or pleurisy or "pneumon*" or SHOB or "short of breath*" or SOB or stridor or "tachyp*" OR symptoms (ICD-10-CM): R06, R06.02, R06.00, J80, R05, J18.9, R07.1, R06.82, R09.2, R06.4, J44.0, R06.89, J02, R23.0, R06.1, R04.2, R09.02, R06.3, J02.0, R06.9, J96.00, R06.09, R06.03, J98.9, R09.1 OR impressions (ICD-10-CM): J12.1, J12.89, J18, J18.9, J20, J20.9, J21, J21.9, R05, R06, R06.0, R06.00, R06.02, R06.03, R06.1, R06.2, R06.4, R06.82, R06.89, R07.1, R07.2, R09.02, R09.2, R09.89 Exclusions: complaint of CHF Patient disposition of Assist, Agency; Assist, Public, Assist; Unit, Canceled (Prior to Arrival At Scene); Canceled on Scene (No Patient Contact); Canceled on Scene (No Patient Found); Standby-No Services or Support Provided; Standby-Public Safety, Fire, or EMS Operational Support Provided; Transport Non-Patient, Organs, etc. |
| Version 3: EMS | Self-Harm | Chief complaint terms: suicid* OR SI OR S/I OR "harm*" OR intentional OR "Self-inflicted" OR "kill self*" OR "kill himself*" OR "kill herself*" OR "kill myself*" OR "want to die*"' OR Symptom / Impression ICD-10-CM Codes: T14.91 OR R45.851 Any of the following Injury Cause Codes: T14.91, T14.91XA, T36.5X2, T39.8X2, T42.3X2, T42.4X2, T43.202, T43.292, T43.592, T45.0X2, T45.512, T46.992, T47.0X2, T47.5X2, T47.8X2, T48.292, T48.5X2, T49.1X2, T49.2X2, T50.992, T51.8X2, T65.892, T71.162, T71.192, X71.9, X72.XXXA, X74.9, X75, X76, X77.9, X78.1, X78.9, X78.9XXA, X79, X80, X81, X82, X83, X83.8XXA Exclusions: Patient disposition of Assist, Agency; Assist, Public, Assist; Unit, Canceled (Prior to Arrival At Scene); Canceled on Scene (No Patient Contact); Canceled on Scene (No Patient Found); Standby-No Services or Support Provided; Standby-Public Safety, Fire, or EMS Operational Support Provided; Transport Non-Patient, Organs, etc. |
| Version 3: EMS | Standing E-Scooter | This syndrome looks for patients < 65 years of age and the following keywords in the narrative: escoot* OR shared electric scooter OR (scooter OR scoter OR "skoot*" OR scotter OR "schoot*" OR "sccot*" AND byrd OR bird OR lime OR uber OR lyft OR "ride share" OR rideshare OR zap OR gotcha OR campus) OR (scooter OR scoter OR "skoot*" OR scotter OR "schoot*" OR "sccot*" AND electric AND dispatch complaint of traffic/transportation incident or traumatic injury) Excludes the following patient dispositions: Assist, Agency; Assist, Public; Assist, Unit; Canceled (Prior to Arrival At Scene), Canceled on Scene (No Patient Contact), Canceled on Scene (No Patient Found), Standby-No Services or Support Provided, Standby-Public Safety, Fire, or EMS Operational Support Provided; Transport Non-Patient, Organs, etc. |
| Version 3: EMS | Traffic-Related | This syndrome includes all EMS encounters with a dispatch complaint of traffic/transportation incident Excludes the following patient dispositions: Assist, Agency; Assist, Public; Assist, Unit; Canceled (Prior to Arrival At Scene), Canceled on Scene (No Patient Contact), Canceled on Scene (No Patient Found), Standby-No Services or Support Provided, Standby-Public Safety, Fire, or EMS Operational Support Provided; Transport Non-Patient, Organs, etc. |
| Version 3: EMS | Traffic-Related: Bicyclists | This syndrome includes all EMS encounters with a dispatch complaint of traffic/transportation incident AND the following keywords in the narrative: BICYCLE OR BIKE OR BICYCLIST Exclusions: MOTOR CYCLIST OR SCOOTER OR MOTORCYCLE OR MOPED OR "DIRT BIKE"OR DIRTBIKE OR "MOTOR BIKE" OR MOTORBIKE Excludes the following patient dispositions: Assist, Agency; Assist, Public; Assist, Unit; Canceled (Prior to Arrival At Scene), Canceled on Scene (No Patient Contact), Canceled on Scene (No Patient Found), Standby-No Services or Support Provided, Standby-Public Safety, Fire, or EMS Operational Support Provided; Transport Non-Patient, Organs, etc. |
| Version 3: EMS | Traffic-Related: Pedestrians | This syndrome includes all EMS encounters with a dispatch complaint of traffic/transportation incident AND the following keywords in the narrative: PEDESTRIAN OR "PED STRUCK" OR "PEDS STRUCK" OR "PED VS MVC" OR "PEDS VS MVC" OR "PED VS CAR" OR "PEDS VS CAR") Exclusions: MOPED OR SCOOTER OR BICYCLE OR BIKE OR MOTORCYCLE Excludes the following patient dispositions: Assist, Agency; Assist, Public; Assist, Unit; Canceled (Prior to Arrival At Scene), Canceled on Scene (No Patient Contact), Canceled on Scene (No Patient Found), Standby-No Services or Support Provided, Standby-Public Safety, Fire, or EMS Operational Support Provided; Transport Non-Patient, Organs, etc. |
| Version 2: PreMIS | Fever | Fever (or Temp > 38) |
| Version 2: PreMIS | Gastro | Dispatch complaint: abdominal pain OR Primary symptoms: Diarrhea OR nausea/vomiting |
| Version 2: PreMIS | Heat Related Illness | Chief Complaint / Secondary Complaint: '%heat ex%' or '%heat cramp%' or '%heat weak%' or '%heat sick%' or '%overheat%' or '%over heat%' or '%heat related%' or '%heat realted%' or '%heat problem%' or '%hypertherm%' or '%to hot%' or '%too hot%' or '%heat str%' or 'heatstr%' or '%hot sun%' or '%hot car%' or '%heat injury%' or '%heat ill%' or '%heat emerg%' or '%heat syn%' or '%heat prostration%' or '%sun str%' or '%sunstr%' or '%Due to heat%' Exclusions: '%radiator%' or '%antifreeze%' or '%Grease%' or '%Liquid%' or '%oil%' or '%Heater%' or '%hot tub%' or '%Sauna%' or '%hot spring%' or '%burn%' |
| Version 2: PreMIS | Hemorrhagic | Dispatch complaint: Hemorrhage/laceration |
| Version 2: PreMIS | Naloxone | Meds administered include naloxone or Narcan |
| Version 2: PreMIS | Naloxone with Poisoning | Meds administered include naloxone or Narcan AND overdos* or OD or O/D or poison* or ingest* OR Provider primary impression = 977.90-POISONING/DRUG INGESTION Exclusions: poison ivy or poison oak |
| Version 2: PreMIS | Neuro | Dispatch complaint: Convulsions/seizure OR headache OR seizures OR unconscious OR Primary symptom(s): Change in responsiveness OR headache OR mental/psych OR mental status change |
| Version 2: PreMIS | Overdose | overdos* or OD or O/D |
| Version 2: PreMIS | Poisoning | overdos* or OD or O/D or poison* or ingest* OR Provider primary impression = 977.90-POISONING/DRUG INGESTION Exclusions: poison ivy or poison oak |
| Version 2: PreMIS | Rash | Dispatch complaint: mass/lesion OR primary symptom(s): Rash/Itching OR Swelling |
| Version 2: PreMIS | Respiratory | Dispatch complaint: breathing problems |
| Version 2: PreMIS | Traffic Accident | Traffic OR motor* OR mv* |