Greetings Everyone,
The weekly data snippet for this week
NYS NEMSIS 3.5.0 | Educational Snip #2024-009
The 2024 Vital Signs EMS Conference is taking place in Rochester from October 16th to the 20th. Register here and stop by our booth to say hi! Next week, due to the conference, the DI Unit will not be sending an educational snip.
The Data and Informatics (DI) Unit at the Bureau of EMS & Trauma Systems is sending weekly Educational Snips highlighting various NEMSIS fields. Our goal is to help providers reduce documentation errors and warnings requiring adjustment throughout documentation. Each Educational Snip will start with a question, an outline of various fields, and elements (answers) within those fields. We are providing the NEMSIS named elements; the ePCR software used by your EMS agency might look different, and you should have custom values selected by the Department of Health available to you. If you have questions about specific documentation scenarios or if you would like clarification on particular data elements, please reach out to your organization’s leadership, Regional Program Agencies, or the DI Unit.
EMS agencies credentialed by New York State are now submitting ePCRs that adhere to the National Emergency Medical Services Information System (NEMSIS) 3.5 documentation standard. NEMSIS establishes a minimum documentation standard that requires fields that must be completed on an ePCR and NYS further defines these requirements to meet minimal additional requirements. Standardized documentation improves quality documentation. Measuring provider effectiveness, system efficiency, and patient outcomes is paramount to the success of EMS organizations across New York State.
Q: How have medication fields changed under NEMSIS 3.5?
Some element names and descriptions were changed. Response values were added/removed from three fields and 2009 standard names were removed.
Note: all fields are named by NEMSIS with the Field Name (Field Identifier) (e.g. EMS Agency Number (eResponse.01))
Medication Administered (eMedications.03, BLSFR 2472 ALFR & Transporting 2473)
This is a required field when a medication is administered. The list of medications has been updated to include codes for blood products. The inclusive list can be found here. Pertinent negatives are also available for this field including:
- Contraindication noted
- Denied by order
- Medication allergy
- Medication already taken
- Refused
- Unable to complete
- Order criteria not met
Medication Administered Route (eMedications.04, BLSFR 2474 ALSFR & Transporting 2475)
This is a required field when a medication is administered. The list was updated to enhance accuracy of documentation:
Blow-by | Re-breather mask |
Buccal | Rectal |
Endotracheal Tube (ET) | Subcutaneous |
Gastrostomy Tube | Sublingual |
Inhalation | Topical |
Intraarterial | Tracheostomy |
Intradermal | Transdermal |
Intramuscular (IM) | Urethral |
Intranasal | Venti mask |
Intraosseous (IO) | Wound |
Intravenous (IV) | Porta Cath |
Nasal Cannula | Auto Injector |
Nasogastric | BVM |
Nasotracheal Tube | CPAP |
Non-Rebreather Mask | IV Pump |
Opthalmic | Nebulizer |
Oral | Umbilical Artery Catheter |
Other/Miscellaneous | Umbilical Venous Catheter |
Otic |
Medication Dosage Units (eMedications.06, BLSFR 2555 ALSFR & Transporting 2556)
This field is required when a medication is administered. Values have been removed and added to the list to enhance accuracy:
Grams (gms) | Other |
Inches (in) | Centimeters (cm) |
International Units (IU) | Drops (ggts) |
Keep Vein Open (KVO) | Liters per Minute (LPM) |
Liters (L) | Micrograms per Minute (mcg/min) |
Metered Dose (MDI) | Milligrams per Kilogram (mg/kg) |
Micrograms (mcg) | Milligrams per Minute (mg/min) |
Micrograms per Kilogram per Minute (mcg/kg/min) | Puffs |
Milliequivalents (mEq) | Units per Hour (units/hr) |
Milligrams (mg) | Micrograms per Kilogram (mcg/kg) |
Milligrams per Kilogram per Minute (mg/kg/min) | Units |
Milliliters (ml) | Units per Kilogram per Hour (units/kg/hr) |
Milliliters per Hour (ml/hr) | Units per Kilogram (units/kg) |
Milligrams per Hour (mg/hr) |
Role/Type of Person Administering Medication (eMedications.10, BLSFR 2735 ALSFR & Transporting 2736)
This field is required when a medication is administered. The list of roles has been updated to be more reflective of current State needs. The “2009” standard names have been removed.
NYS Certified Paramedic | The Patient or Any Lay Person Not Otherwise Specified |
NYS Certified First Responder (CFR) | Respiratory Therapist |
NYS Certified EMT – Critical Care (EMT-CC) | Registered Nurse |
NYS Certified Emergency Medical Technician (EMT) | Physician Assistant |
NYS Certified Advanced EMT (AEMT) | Physician |
Nurse Practitioner | Perfusionist |
Licensed Practical Nurse (LPN) | Other Non-Healthcare Professional |
CT Technologist | |
Any Provider Acting in the Capacity of an EMS Student | |
Any Person Not Otherwise Specified (Not CFR) | |
Any Healthcare Provider Acting Under their Own (Non-EMS) License |
Greetings Everyone,
Last night, our portal developer made some changes to the System that ultimately took some providers “offline”. Fortunately, this was not a very big list of providers, which is exciting to know we are following the WREMAC guidance. I realize that this might be a frustration for some of the providers or agency leadership to have to deal with this change that has occurred, but unfortunately over the years we have put to many bandaids on the system so it was no longer functioning correctly. Last night was a correction of those issues and I wanted to take a moment to explain a few things as we move forward with these changes. Going forward, if a provider does not complete their skills by the deadline of June 30th, it will automatically change your status. To prevent this from happening, please make sure that we are all completing the necessary skills by the due date annually.
One of the other changes that is going to occur sometime in the near future is we are changing the “Online / Offline” to “Compliant / Non-Compliant”. This is more reflective of what is actually occurring in regards to the WREMAC policies and contains a softer tone to providers status. While I do realize some of you find that the portal is pointless and an inconvenience, I do want to say that it does serve a needed purpose. Both the REMSCOs and Program agency are required to collect a a lot of the information that is contained in the portal. It also allows us to track certain expiration dates on your behalf to ensure that your agencies remain compliant with NYS.
Please be patient as we move through these changes. In regards to the recent status change, if you were moved to “offline” please get with your agency and work to correct the deficiencies. It is worth noting that unless you were specifically told by your Medical Director that you are offline, or your Provider card or CPR card is expired, you should not consider yourself “offline” because the portal said so. We understand there is going to be an adjustment period that we need to work through on this and with the changes we are not looking to shake things up.
If you have any questions, please feel free to reach out to your agency or us and we can see what we can do to answer those for you.
Thanks
Greetings Everyone,
A message from the State DOH:
http://ubmdems.com/wp-content/uploads/2024/10/Health-Advisory-EMS-IV-Fluid-Conservation-24.10.09.pdf
Greetings Everyone,
Just to let everyone know, the Pulsara meeting that was scheduled tonight at Tri Community has been cancelled due to low enrollment. We apologize for any inconvenience.
http://ubmdems.com/wp-content/uploads/2024/09/PULSARA-INFORMATIONAL-MEETING.pdf
Greetings Everyone,
A message from Catholic Health:
Mount St. Mary’s Hospital Emergency Room Ramp Stating October 3, 2024 Mount Saint Mary’s Hospital will have a temporary CT trailer parked in the Emergency Ambulance ramp. The trailer will remain in the ramp while we replace our CT machine. We do not have a timeframe for how long this project will last. Ambulances will still be able to access the ER entrance; however, parking will be limited in the ramp. Please see the attached picture. We are asking ambulances to unload their patient, and then move ambulances to the parking area at the bottom of the ramp. If you have any questions, please feel free to reach out to our EMS Liaison Team: Amanda Ohlson (716) 807–4721 Robert Orlowski (716) 330–8482 Scott Then (716) 868–3673 Emily James (716) 812–4275
http://ubmdems.com/wp-content/uploads/2024/10/MSM-ER-ramp-Temp-CT-Trailer_FINAL.pdf
Greetings Everyone:
A message from Erie County:
Erie County EMS is looking to hire 2 Clinical Coordinators to assist with their EMS education programs. Please see the posting attached to learn more about the position and where to apply. All candidates must be a CLI or CIC. Accepting applications until October 14th, 2024.
http://ubmdems.com/wp-content/uploads/2024/10/Erie-County-EMS-Clinical-Coordinator-Job-Posting.pdf
Greetings Everyone,
I have been informed that there are still openings for the Vital Signs EMS Games. If you think that you are interested, please download the attachment and follow directions on registering. The attachment also includes more information on the games.
http://ubmdems.com/wp-content/uploads/2024/10/VITAL-SIGNS-EMS-GAMES.pdf