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AIS Data File Format (Minimum Data Set)

Patient Last Name1-2020Text
Patient First Name21-3515Text
Incident Number36-427Unique patient-incident number
Service Number43-475State EMS Agency Provider Number (9999X)
Unit Permit Number48-536See BEMS Regional Coordinator (XXXX99)
Incident Date54-596YYMMDD
Incident Street60-8425US Postal Abbreviations where possible
Incident City85-9915Text (US Census FIPS place name)
Incident State100-1012US Postal Abbreviation (XX)
Incident Zip102-1065US Postal 5-character zipcode
Incident County107-1082Utah BEMS codes (01 - 29)
Time Dispatched109-1124HHMM
Time Enroute113-1164HHMM
Time Arrived Scene117-1204HHMM
Time Left Scene121-1244HHMM
Time at Destination125-1284HHMM
Dispatch Code129-1313See manual
Patient Age132-1343Years (left fill with "0" as necessary)
Patient Race Code135-1351See manual
Patient Gender1361M, F, U(nknown)
Patient Source Code137-1393See code list in manual
ECG Code 11401See manual (A-K)
ECG Code 21411See manual (A-K)
ECG Code 31421See manual (A-K)
Injury/Illness Code 1143-1453See manual (999)
Injury/Illness Code 2146-1483See manual (999)
Injury/Illness Code 3149-1513See manual (999)
Injury/Illness Code 4152-1543See manual (999)
Injury/Illness Code 5155-1573See manual (999)
Injury/Illness Code 6158-1603See manual (999)
Medication Code 1161-1633See manual (999)
Medication Code 2164-1663See manual (999)
Medication Code 3167-1693See manual (999)
Medication Code 4170-1723See manual (999)
Medication Code 5173-1753See manual (999)
Medication Code 6176-1783See manual (999)
Treatment Code 1179-1813See manual (999)
Treatment Code 2182-1843See manual (999)
Treatment Code 3185-1873See manual (999)
Treatment Code 4188-1903See manual (999)
Treatment Code 5191-1933See manual (999)
Treatment Code 6194-1963See manual (999)
Destination Code197-1993See manual (999)
Disposition Code200-2012See manual (99)
Patient Date of Birth202-2098MMDDYYYY
EMT 1210-2156Crew member completing form (State EMT Number)
EMT 2216-2216Additional Crew member (State EMT Number)
Location Code2221See manual
Init Systolic BP223-2253See manual
Init Respiration 226-2272See manual
Init Temperature 228-2325999.9
Init Pulse Rate233-2353See manual
Glasgow Eye Open 2361See manual
Glasgow Verbal2371See manual
Glasgow Motor2381See manual
Glasgow Total239-2402Sum of Glasgow Eye, Verbal and Motor Scores
Revised Trauma Score (RTS) 241-2422See manual (formula)
Narrative Line 1243-32280Text
Narrative Line 2323-40280Text
Narrative Line 3403-48280Text
Narrative Line 4483-56280Text
Narrative Line 5563-64280Text

Updated October 24, 2006