CDE Detailed Report

Disease: Stroke
Sub-Domain: History of Disease/Injury Event
CRF: Pre-Hospital

Displaying 1 - 34 of 34
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (Question Text) Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C08147 Data source DataSource Source of the data provided on the case report form Source of the data provided on the case report form From whom or from where was the medical history data obtained? (Choose all that apply.) Participant/subject;Mother;Father;Sister;Brother;Son;Daughter;Friend;Physician;Chart/Medical record;Other, specify;Unknown;Spouse Participant/subject;Mother;Father;Sister;Brother;Son;Daughter;Friend;Physician;Chart/Medical record;Other, specify;Unknown;Spouse Alphanumeric

Choose all that apply.

No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:46:24.96 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Multiple Pre-Defined Values Selected

C58811 Pre-hospital severity scale total score PrehospStrokeSevSclTotScore The total score of the severity scale, if completed The total score of the severity scale, if completed If severity scale assessment completed, enter total score Numeric Values

Enter severity scale total score or check "Not documented".

No references available Adult;Pediatric Supplemental 1.00 2020-05-14 14:35:06.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Free-Form Entry

C18667 Data source other text DataSourcOTH The free-text field related to 'Data source' specifying other text. Source of the data provided on the case report form The free-text field related to 'Data source' specifying other text. Source of the data provided on the case report form Other, specify Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2014-05-27 13:34:46.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events 4000

Free-Form Entry

C58812 Pre-hospital severity scale not documented status PrehospStrokeSevSclNotDocStat Indicates if a severity scale was not documented. Indicates if a severity scale was not documented. If severity scale assessment completed, enter total score Not documented Not documented Alphanumeric

Enter severity scale total score or check "Not documented".

No references available Adult;Pediatric Supplemental 1.00 2020-05-14 14:37:33.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C18747 Residence other text ResdncOTH The free-text field related to 'Residence type' specifying other text. Type of residence where the participant/subject is currently living The free-text field related to 'Residence type' specifying other text. Type of residence where the participant/subject is currently living Other, specify Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2014-05-27 13:34:46.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events 4000

Free-Form Entry

C58279 Residence current occupy duration text RsdncCrrntOccpyDuratnTxt Text field for indicating the duration for which the subject/participant has occupied his/her current residence Text field for indicating the duration for which the subject/participant has occupied his/her current residence Duration of residence Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2018-02-07 10:49:00.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events 255

Free-Form Entry

C58804 Emergency Medical Services (EMS) service personnel highest level type EMSPrsnnlHighestLevelTyp Highest level of emergency medical service (EMS) personnel that attended to the participant/subject provided Highest level of emergency medical service (EMS) personnel that attended to the participant/subject provided Highest level of EMS service personnel EMT -Intermediate (or equivalent);EMT-Basic (or equivalent);Paramedic EMT -Intermediate (or equivalent);EMT-Basic (or equivalent);Paramedic or equivalent Alphanumeric

Choose one

No references available Adult;Pediatric Supplemental 1.00 2020-05-14 13:16:34.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C58805 Pre-hospital stroke screen tool type PrehospStrokeScreenToolTyp The stroke screen tool used to determine stroke status by EMS personnel The stroke screen tool used to determine stroke status by EMS personnel Indicate the stroke screen tool used by EMS personnel No stroke screen tool used;Cincinnati Prehospital Stroke Scale (CPSS);Los Angeles Prehospital Stroke Scale (LAPSS);Melbourne Ambulance Stroke Scale (MASS);Ontario Prehospital Stroke Screening Tool (OPSST);Face Arm Speech Test (FAST);Stroke screen tool used, but tool used is unknown;Other, specify;Not documented No stroke screen tool used;Cincinnati Prehospital Stroke Scale (CPSS);Los Angeles Prehospital Stroke Scale (LAPSS);Melbourne Ambulance Stroke Scale (MASS);Ontario Prehospital Stroke Screening Tool (OPSST);Face Arm Speech Test (FAST);Stroke screen tool used, but tool used is unknown;Other specify;Not documented Alphanumeric

Choose only one response. Select the scale most closely aligned with the tool used.

No references available Adult;Pediatric Supplemental 1.00 2020-05-14 13:28:27.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C58806 Pre-hospital stroke screen tool other text PrehospStrokeScreenToolOTH The free-text field related to 'Pre-hospital stroke screen tool' specifying other text. Source of the data provided on the case report form The free-text field related to 'Pre-hospital stroke screen tool' specifying other text. Source of the data provided on the case report form Other, Specify Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2020-05-14 14:12:27.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events 255

Free-Form Entry

C58807 Pre-hospital stroke screen tool outcome status PrehospStrokeScreenTlOutcmStat The outcome status of the pre-hospital stroke screen used The outcome status of the pre-hospital stroke screen used Stroke screen outcome Positive;Negative;Not documented Positive;Negative;Not documented Alphanumeric

Choose only one response.

No references available Adult;Pediatric Supplemental 1.00 2020-05-14 14:15:05.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C58808 Pre-hospital severity scale type PrehospStrokeSevSclTyp The stroke severity scale used to determine stroke severity before hospital intake. The stroke severity scale used to determine stroke severity before hospital intake. Indicate the severity scale used Cincinnati Stroke Triage Assessment Tool (CSTAT);Field Assessment Stroke Triage for Emergency Destination (FAST-ED);Los Angeles Motor Scale (LAMS);Rapid Arterial Occlusion Evaluation (RACE);Severity scale used, but tool used is unknown;No severity scale used;Other,specify;Not documented Cincinnati Stroke Triage Assessment Tool (CSTAT);Field Assessment Stroke Triage for Emergency Destination (FAST-ED);Los Angeles Motor Scale (LAMS);Rapid Arterial Occlusion Evaluation (RACE);Severity scale used, but tool used is unknown;No severity scale used;Other, specify;Not documented Alphanumeric

Choose one. Specify if 'Other'

No references available Adult;Pediatric Supplemental 1.00 2020-05-14 14:19:39.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C04814 Residence type ResdncTyp Type of residence where the participant/subject is currently living Type of residence where the participant/subject is currently living Type of residence (choose one) N/A - patient died;Other, specify;Unknown;Another acute care facility;Homeless/shelter;Inpatient Rehabilitation Facility (IRF);Intermediate Care Facility (ICF);Long Term Care Hospital (LTCH);Not in a healthcare setting (home/private residence/assisted living);Skilled Nursing Facility (SNF) N/A - patient died;Other, specify;Unknown;Another acute care facility;Homeless/shelter;Inpatient Rehabilitation Facility (IRF);Intermediate Care Facility (ICF);Long Term Care Hospital (LTCH);Not in a healthcare setting (home/private residence/assisted living);Skilled Nursing Facility (SNF) Alphanumeric

Choose only one response.

No references available Adult;Pediatric Supplemental?Highly Recommended 3.00 2013-07-20 10:21:25.65 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C58809 Pre-hospital severity scale type other text PrehospStrokeSevSclTypOTH The free-text field related to "Pre-hospital severity scale type" specifying other text. The free-text field related to "Pre-hospital severity scale type" specifying other text. Other, specify Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2020-05-14 14:29:17.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events 255

Free-Form Entry

C05418 Hospital transport type HospTrnsprtTyp Type of transportation from injury scene to hospital Type of transportation from injury scene to hospital Type of EMS vehicle transport to hospital Ground ambulance with physician;Ground ambulance no physician;Private transportation/taxi/other from home/scene;By foot;Mobile Stroke Unit;Air (e.g., helicopter);Other;Unknown Ground ambulance with physician;Ground ambulance no physician;Private transportation/taxi/other from home/scene;By foot;Mobile Stroke Unit;Air (e.g., helicopter);Other;Unknown Alphanumeric

Choose one.

Walter, et al. Diagnosis and treatment of patients with stroke in a mobile stroke unit versus in hospital: a randomised controlled trial. Lancet Neurol 2012; 11: 397–404. Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C58810 Pre-hospital large vessel occlusion indicator PrehospLrgVessOccInd Indicates if the patient has detected positive for suspected Large Vessel Occlusion (LVO). Indicates if the patient has detected positive for suspected Large Vessel Occlusion (LVO). Positive for suspected Large Vessel Occlusion (LVO) No;Yes;Unknown No;Yes;Unknown Alphanumeric

Choose only one response.

No references available Adult;Pediatric Supplemental 1.00 2020-05-14 14:30:59.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C14207 Pre-hospital stroke identification screen indicator PrehospStrokeIdScreenInd Whether a pre-hospital identification stroke screen was documented by EMS personnel. Pre-hospital stroke identification screens are defined as published validated screening algorithms or those required by state EMS agencies (e.g., LAPSS, CPSS, MASS, etc.). Whether a pre-hospital identification stroke screen was documented by EMS personnel. Pre-hospital stroke identification screens are defined as published validated screening algorithms or those required by state EMS agencies (e.g., LAPSS, CPSS, MASS, etc.) Was a pre-hospital stroke identification screen documented by EMS personnel Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose one. 'Unknown' means not documented or cannot be determined.

No references available Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C01000 Glasgow Coma Scale (GCS) - eye response scale GCSEyeRespnsScale Glasgow Coma Scale (GCS) - Best eye response (E). The GCS is a standardized instrument for assessing the level of consciousness. It evaluates three aspects of responsiveness: eye opening, motor response, verbal response. Glasgow Coma Scale (GCS) - Best eye response (E). The GCS is a standardized instrument for assessing the level of consciousness. It evaluates three aspects of responsiveness: eye opening, motor response, verbal response. GCS Best Eye Response 1;Untestable;Unknown;2;3;4 No eye opening;Untestable;Unknown;To pain;To verbal command;Spontaneously Numeric Values

This element should be collected along with the other elements from the Glasgow Coma Scale (GCS).

Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. Jul 1974;2(7872):81-4. Marmarou A, Lu J, Butcher I, et al. Prognostic value of the Glasgow Coma Scale and pupil reactivity in traumatic brain injury assessed pre-hospital and on enrollment: an IMPACT analysis. J Neurotrauma. Feb 2007;24(2):270-80. Stocchetti N, Pagan F, Calappi E, et al. Inaccurate early assessment of neurological severity in head injury. J Neurotrauma. Sep 2004:21(9):1131-40. Balestreri M, Czosnyka M, Chatfield DA, et al. Predictive value of Glasgow Coma Scale after brain trauma: change in trend over the past ten years. J Neurol Neurosurg Psychiatry. Jan 2004;75(1):161-2. Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C124724
C14208 Pre-hospital neurological impairment scale indicator PrehospNeuroImpairScaleInd Whether a pre-hospital neurologic impairment scale screen was documented by EMS personnel. Pre-hospital neurologic impairment scales are defined as published validated scales or those required by state EMS agencies (e.g., GCS for suspected hemorrhagic stroke or any stroke with impaired consciousness, Los Angeles Motor Scale, etc.). Whether a pre-hospital neurologic impairment scale screen was documented by EMS personnel. Was a pre-hospital neurologic impairment screen documented by EMS personnel Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose one

No references available Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C01001 Glasgow Coma Scale (GCS) - motor response scale GCSMotorRespnsScale Glasgow Coma Scale (GCS) - Best motor response (M). The GCS is a standardized instrument for assessing the level of consciousness. It evaluates three aspects of responsiveness: eye opening, motor response, verbal response. Glasgow Coma Scale (GCS) - Best motor response (M). The GCS is a standardized instrument for assessing the level of consciousness. It evaluates three aspects of responsiveness: eye opening, motor response, verbal response. GCS Best Motor Response 1;5;6;Untestable;Unknown;2;3;4 No motor response;Localizes pain;Obeys command;Untestable;Unknown;Extension to pain;Flexion to pain;Withdrawals from pain Numeric Values

This element should be collected along with the other elements from the Glasgow Coma Scale (GCS).

Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. Jul 1974;2(7872):81-4. Marmarou A, Lu J, Butcher I, et al. Prognostic value of the Glasgow Coma Scale and pupil reactivity in traumatic brain injury assessed pre-hospital and on enrollment: an IMPACT analysis. J Neurotrauma. Feb 2007;24(2):270-80. Stocchetti N, Pagan F, Calappi E, et al. Inaccurate early assessment of neurological severity in head injury. J Neurotrauma. Sep 2004:21(9):1131-40. Balestreri M, Czosnyka M, Chatfield DA, et al. Predictive value of Glasgow Coma Scale after brain trauma: change in trend over the past ten years. J Neurol Neurosurg Psychiatry. Jan 2004;75(1):161-2. Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C124725
C14209 Los Angeles Motor Scale (LAMS) - facial smile or grimace result LAMSFacSmlGrimReslt Assess the facial smile/ grimace using the Los Angeles Motor Scale (LAMS). Assess the facial smile/ grimace, as part of the Los Angeles Motor Scale (LAMS). LAMS Facial Droop 0;1 Absent;Present Numeric values

This element should be collected along with the other elements from the Los Angeles Motor Scale (LAMS).

Llanes JN, Kidwell CS, Starkman S, Leary MC, Eckstein M, Saver JL. The Los Angeles Motor Scale (LAMS): a new measure to characterize stroke severity in the field. Prehosp Emerg Care 2004; Jan-Mar; 8 (1): 46-50. Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C01002 Glasgow Coma Scale (GCS) - verbal response scale GCSVerbalRspnsScale Score that describes the participant's verbal response according to the Glasgow Coma Scale (GCS) Score that describes the participant's verbal response according to the Glasgow Coma Scale (GCS) GCS Best Verbal Response 3;4;5;Untestable;Unknown;1;2 Inappropriate words;Confused;Oriented;Untestable;Unknown;No verbal response;Incomprehensible sounds Numeric Values

The form related to this CDE is contains CRFs utilized before the study participant/ subject is seen at a hospital for the stroke event and elements related to the emergency medical services (EMS) course. The Glasgow Coma Scale (GCS) and Los Angeles Motor Scale (LAMS) are included to record information about the participant's/ subject's neurological impairment prior to being admitted at a hospital. (Examples of CDEs included: Level of EMS Service; Pre-hospital stroke identification screen; and Pre-hospital neurological impairment scale)

Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. Jul 1974;2(7872):81-4. Marmarou A, Lu J, Butcher I, et al. Prognostic value of the Glasgow Coma Scale and pupil reactivity in traumatic brain injury assessed pre-hospital and on enrollment: an IMPACT analysis. J Neurotrauma. Feb 2007;24(2):270-80. Stocchetti N, Pagan F, Calappi E, et al. Inaccurate early assessment of neurological severity in head injury. J Neurotrauma. Sep 2004:21(9):1131-40. Balestreri M, Czosnyka M, Chatfield DA, et al. Predictive value of Glasgow Coma Scale after brain trauma: change in trend over the past ten years. J Neurol Neurosurg Psychiatry. Jan 2004;75(1):161-2. Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C124726
C14210 Los Angeles Motor Scale (LAMS) - grip result LAMSGripReslt Assess the grip using the Los Angeles Motor Scale (LAMS). Assess the grip, as part of the Los Angeles Motor Scale (LAMS). LAMS Grip Strength 0;1;2 Normal;Weak grip;No grip Numeric values

If not normal, Choose one choice for the right side and one for the left. This element should be collected along with the other elements from the Los Angeles Motor Scale (LAMS).

Llanes JN, Kidwell CS, Starkman S, Leary MC, Eckstein M, Saver JL. The Los Angeles Motor Scale (LAMS): a new measure to characterize stroke severity in the field. Prehosp Emerg Care 2004; Jan-Mar; 8 (1): 46-50. Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C01016 Glasgow Coma Scale (GCS) - total score GCSTotalScore Glasgow Coma Scale (GCS) - Total Score. The GCS is a standardized instrument for assessing the level of consciousness. It evaluates three aspects of responsiveness: eye opening, motor response, verbal response. The total score is the sum of the scores for the three response types. (3-15) Glasgow Coma Scale (GCS) - Total Score. The GCS is a standardized instrument for assessing the level of consciousness. GCS Total Score 3;4;5;6;7;8;9;10;11;12;13;14;15;Untestable;Unknown 3;4;5;6;7;8;9;10;11;12;13;14;15;Untestable;Unknown Numeric Values

Add scores for eye opening, motor response, and verbal response. Total should be between 3-15 points----http://www.glasgowcomascale.org/faq/ ----*Dealing with missing information: There are various different strategies for dealing with information that is missing because of factors interfering with assessment such as those described above. 1.Assess, communicate and make decisions using the remaining components. Although guidelines are often expressed in terms of a total GCS 'score,' the trend in whichever of the components (eye, motor or verbal) can be assessed is still valuable. 2.Do not use number '1' to record missing component; use 'NT' (Not testable). 3.Do not report a total score when a component is Not Testable because the score will be low and this could be confusing to medical colleagues. This may also imply that the patient is more unwell than they actually are. 4.It is possible using statistical methods to estimate a missing component from the findings in the other components. This is probably more relevant to research than clinical practice. ----Supplemental - Highly Recommended based on study type, disease stage and disease type.

Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. Jul 1974;2(7872):81-4. --- Marmarou A, Lu J, Butcher I, et al. Prognostic value of the Glasgow Coma Scale and pupil reactivity in traumatic brain injury assessed pre-hospital and on enrollment: an IMPACT analysis. J Neurotrauma. Feb 2007;24(2):270-80.--- Stocchetti N, Pagan F, Calappi E, et al. Inaccurate early assessment of neurological severity in head injury. J Neurotrauma. Sep 2004:21(9):1131-40 --- Balestreri M, Czosnyka M, Chatfield DA, et al. Predictive value of Glasgow Coma Scale after brain trauma: change in trend over the past ten years. J Neurol Neurosurg Psychiatry. Jan 2004;75(1):161-2. Adult;Pediatric Supplemental?Highly Recommended 3.00 2013-07-20 10:21:25.65 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C124727
C14211 Los Angeles Motor Scale (LAMS) - arm strength result LAMSArmStrgthReslt Assess the arm strength using the Los Angeles Motor Scale (LAMS). Check all that apply. Assess the arm strength, as part of the Los Angeles Motor Scale (LAMS). Check all that apply. LAMS Arm Drift 0;1;2 Arm drift absent;Arm (left and/or right) drifts down;Arm (left and/or right) falls rapidly Numeric values

If not normal, Choose one choice for the right side and one for the left This element should be collected along with the other elements from the Los Angeles Motor Scale (LAMS).

Llanes JN, Kidwell CS, Starkman S, Leary MC, Eckstein M, Saver JL. The Los Angeles Motor Scale (LAMS): a new measure to characterize stroke severity in the field. Prehosp Emerg Care 2004; Jan-Mar; 8 (1): 46-50. Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C14200 Emergency Medical Services (EMS) call received date and time EMSCallRecvdDateTime Date and time first call was received by the Emergency Medical Services (EMS) dispatcher OR date and time of EMS vehicle dispatch as recorded on the EMS trip sheet or other similar documentation. Date and time first call was received by the Emergency Medical Services (EMS) dispatcher OR date and time of EMS vehicle dispatch as recorded on the EMS trip sheet or other similar documentation. Date and Time first call received by EMS Date or Date & Time

This data element is looking to capture the date and time that EMS was first called to the scene of the stroke (and not meant to capture those patients that are transferred between hospitals via EMS). If a patient is transported by EMS from the scene of the stroke to an outside hospital and is then transferred to EMS to your hospital, enter the time when the first call was received by the EMS. Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).

Paul Coverdell National Acute Stroke Registry Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Free-Form Entry

C14622 Los Angeles Motor Scale (LAMS) - facial smile or grimace abnormal type LAMSFacSmlGrimAbnrmlTyp Type of abnormal facial smile or grimace observed during administration of the Los Angeles Motor Scale (LAMS) Type of abnormal facial smile or grimace observed during administration as part of the Los Angeles Motor Scale (LAMS) LAMS Facial Droop Droop on left side of face;Droop on right side of face Droop on left side of face;Droop on right side of face Alphanumeric

Choose all that apply

No references available Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Multiple Pre-Defined Values Selected

C14201 Emergency Medical Services (EMS) dispatch date and time EMSDispatchDateTime This refers to the date when Emergency Medical Services (EMS) transport (either by ground or air) leaves the station to pick up the patient for transport. This refers to the date when Emergency Medical Services (EMS) transport (either by ground or air) leaves the station to pick up the patient for transport. Date and Time of EMS dispatch Date or Date & Time

Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).

No references available Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Free-Form Entry

C14623 Los Angeles Motor Scale (LAMS) - grip abnormal type LAMSGripAbnrmlTyp Type of abnormal grip observed during administration of the Los Angeles Motor Scale (LAMS) Type of abnormal grip observed during administration as part of the Los Angeles Motor Scale (LAMS) LAMS Grip Strength No grip with left hand;No grip with right hand;Weak grip with left hand;Weak grip with right hand No grip with left hand;No grip with right hand;Weak grip with left hand;Weak grip with right hand Alphanumeric

Choose all that apply

No references available Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Multiple Pre-Defined Values Selected

C14202 Emergency Medical Services (EMS) dispatch priority type EMSDispatchPriorityTyp For EMS systems where there is prioritizing of calls, this item would capture what level of prioritization was assigned to the transport at dispatch. For EMS systems where there is prioritizing of calls, this item would capture what level of prioritization was assigned to the transport at dispatch. EMS dispatch priority High acuity;Moderate acuity;Other;Not documented the highest level assigned to life-threatening illnesses;the next highest level indicating urgent but not life-threatening illnesses;Other;Not documented Alphanumeric

Choose one.

No references available Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C14624 Los Angeles Motor Scale (LAMS) - arm strength abnormal type LAMSArmStrgthAbnrmlTyp Type of abnormal arm strength observed during administration of the Los Angeles Motor Scale (LAMS) Type of abnormal arm strength observed during administration as part of the Los Angeles Motor Scale (LAMS) LAMS Arm Drift Left arm drifts down but does not fall immediately;Left arm falls rapidly;Right arm drifts down but does not fall immediately;Right arm falls rapidly Left arm drifts down but does not fall immediately;Left arm falls rapidly;Right arm drifts down but does not fall immediately;Right arm falls rapidly Alphanumeric

Choose all that apply

No references available Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Multiple Pre-Defined Values Selected

C14203 Emergency Medical Services (EMS) dispatch type code EMSDispatchTypeCode For EMS systems where there is use of a designated stroke dispatch code, this item would capture what code was assigned to the transport at dispatch. For EMS systems where there is use of a designated stroke dispatch code, this item would capture what code was assigned to the transport at dispatch. EMS dispatch type/code Stroke;Other, specify stroke or equivalent designation;a non-stroke code which is then able to be captured as free text if desired Alphanumeric

Choose one. Specify if 'Other'

No references available Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C18907 Emergency Medical Services (EMS) dispatch type other text EMSDispatchTypeOTH The free-text field related to 'Emergency Medical Services (EMS) dispatch type code' specifying other text. For EMS systems where there is use of a designated stroke dispatch code, this item would capture what code was assigned to the transport at dispatch. The free-text field related to 'Emergency Medical Services (EMS) dispatch type code' specifying other text. For EMS systems where there is a designated stroke dispatch code, this item would capture what code was assigned to the transport at dispatch. Other, specify Alphanumeric

Choose one. Specify if 'Other'

No references available Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events 4000

Free-Form Entry

C14205 Emergency Medical Services (EMS) scene arrival date and time EMSSceneArrvlDateTime This refers to the date/time when the Emergency Medical Services (EMS) vehicle arrives on the scene to transport the patient to the hospital. This refers to the date/time when the Emergency Medical Services (EMS) vehicle arrives on the scene to transport the patient to the hospital. Date and Time of EMS arrival at scene Date or Date & Time

This data element refers to the original scene and is not applicable to inter-facility transport or to patients arriving by means other than EMS. Note that EMS includes response by volunteer and professional paramedics, EMTs, fire, police and other municipal service officers responding to 911 calls. Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).

No references available Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Free-Form Entry

C14206 Emergency Medical Services (EMS) scene departure date and time EMSSceneDepartureDateTime Date and time the EMS vehicle departs with the patient from the scene to take the patient to the hospital. Date and time the EMS vehicle departs with the patient from the scene to take the patient to the hospital. Date and Time of EMS departure from scene Date or Date & Time

Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).

No references available Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Pre-Hospital/Emergency Medical Service (EMS) Course History of Disease/Injury Event Disease/Injury Related Events

Free-Form Entry

CSV