The case 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 VersionSyndromeCase Definition
Version 3: EMSHurricane-RelatedThis 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: EMSMethamphetamine-RelatedThis 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: EMSNaloxoneThis 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: EMSNaloxone with Improved ResponseThis 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: EMSOpioid OverdoseThis 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: EMSStanding E-ScooterThis 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: EMSTraffic-RelatedThis 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: EMSTraffic-Related: PedestriansThis 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 3: EMSTraffic-Related: BicyclistsThis 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 2: PreMISFeverFever (or Temp > 38)
Version 2: PreMISGastroDispatch complaint: abdominal pain OR Primary symptoms: Diarrhea OR nausea/vomiting
Version 2: PreMISHeat Related IllnessChief 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: PreMISHemorrhagicDispatch complaint: Hemorrhage/laceration
Version 2: PreMISNaloxoneMeds administered include naloxone or Narcan
Version 2: PreMISNaloxone with PoisoningMeds 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: PreMISNeuroDispatch 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: PreMISOverdoseoverdos* or OD or O/D
Version 2: PreMISPoisoningoverdos* 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: PreMISRashDispatch complaint: mass/lesion OR primary symptom(s): Rash/Itching OR Swelling
Version 2: PreMISRespiratoryDispatch complaint: breathing problems
Version 2: PreMISTraffic AccidentTraffic OR motor* OR mv*