DEMOGRAPHIC INFORMATION:

• PATIENT’S HOME ZIP CODE
• PATIENT’S HOME COUNTRY
• PATIENT’S HOME STATE
• PATIENT’S HOME COUNTY
• PATIENT’S HOME CITY
• ALTERNATE HOME RESIDENCE
• DATE OF BIRTH
• AGE
• AGE UNITS
• RACE
• ETHNICITY
• SEX

INJURY INFORMATION:

• INJURY INCIDENT DATE
• INJURY INCIDENT TIME
• WORK-RELATED
• PATIENT’S OCCUPATIONAL INDUSTRY
• PATIENT’S OCCUPATION
• PRIMARY E-CODE
• LOCATION E-CODE
• ADDITIONAL E-CODE
• INCIDENT COUNTRY
• INCIDENT STATE
• INCIDENT COUNTY
• INCIDENT CITY
• INCIDENT LOCATION ZIP CODE
• PROTECTIVE DEVICES
• CHILD SPECIFIC RESTRAINT
• AIRBAG DEPLOYMENT

PRE-HOSPITAL INFORMATION:

• EMS DISPATCH DATE
• EMS DISPATCH TIME
• EMS UNIT ARRIVAL ON SCENE DATE
• EMS UNIT ARRIVAL ON SCENE TIME
• EMS UNIT SCENE DEPARTURE DATE
• EMS UNIT SCENE DEPARTURE TIME
• TRANSPORT MODE
• OTHER TRANSPORT MODE
• INITIAL FIELD SYSTOLIC BLOOD PRESSURE
• INITIAL FIELD PULSE RATE
• INITIAL FIELD RESPIRATORY RATE
• INITIAL FIELD OXYGEN SATURATION
• INITIAL FIELD GCS - EYE
• INITIAL FIELD GCS - VERBAL
• INITIAL FIELD GCS - MOTOR
• INITIAL FIELD GCS - TOTAL
• INTER-FACILITY TRANSFER

EMERGENCY DEPARTMENT INFORMATION:

• ED/HOSPITAL ARRIVAL DATE
• ED/HOSPITAL ARRIVAL TIME
• INITIAL ED/HOSPITAL SYSTOLIC BLOOD PRESSURE
• INITIAL ED/HOSPITAL PULSE RATE
• INITIAL ED/HOSPITAL TEMPERATURE
• INITIAL ED/HOSPITAL RESPIRATORY RATE
• INITIAL ED/HOSPITAL RESPIRATORY ASSISTANCE
• INITIAL ED/HOSPITAL OXYGEN SATURATION
• INITIAL ED/HOSPITAL SUPPLEMENTAL OXYGEN
• INITIAL ED/HOSPITAL GCS - EYE
• INITIAL ED/HOSPITAL GCS - VERBAL
• INITIAL ED/HOSPITAL GCS - MOTOR
• INITIAL ED/HOSPITAL GCS - TOTAL
• INITIAL ED/HOSPITAL GCS ASSESSMENT QUALIFERS
• ALCOHOL USE INDICATOR
• DRUG USE INDICATOR
• ED DISCHARGE DISPOSITION
• ED DEATH
• ED DISCHARGE DATE
• ED DISCHARGE TIME

HOSPITAL PROCEDURE INFORMATION:

• HOSPITAL PROCEDURES
• HOSPITAL PROCEDURE START DATE
• HOSPITAL PROCEDURE START TIME

DIAGNOSES INFORMATION:

• CO-MORBID CONDITIONS
• INJURY DIAGNOSES

INJURY SEVERITY INFORMATION:

• AIS PREDOT CODE
• AIS SEVERITY
• ISS BODY REGION
• AIS VERSION
• LOCALLY CALCULATED ISS

OUTCOME INFORMATION:

• TOTAL ICU LENGTH OF STAY
• TOTAL VENTILATOR DAYS
• HOSPITAL DISCHARGE DATE
• HOSPITAL DISCHARGE TIME
• HOSPITAL DISCHARGE DISPOSITION

FINANCIAL INFORMATION:

• PRIMARY METHOD OF PAYMENT

QUALITY ASSURANCE INFORMATION:

• HOSPITAL COMPLICATIONS