Utah Dept of Health, Bureau of EMS, AIS Minimum Data Set

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AIS Data File Format (Minimum Data Set)

FIELD	POSITION	LENGTH	COMMENT
Patient Last Name	1-20	20	Text
Patient First Name	21-35	15	Text
Incident Number	36-42	7	Unique patient-incident number
Service Number	43-47	5	State EMS Agency Provider Number (9999X)
Unit Permit Number	48-53	6	See BEMS Regional Coordinator (XXXX99)
Incident Date	54-59	6	YYMMDD
Incident Street	60-84	25	US Postal Abbreviations where possible
Incident City	85-99	15	Text (US Census FIPS place name)
Incident State	100-101	2	US Postal Abbreviation (XX)
Incident Zip	102-106	5	US Postal 5-character zipcode
Incident County	107-108	2	Utah BEMS codes (01 - 29)
Time Dispatched	109-112	4	HHMM
Time Enroute	113-116	4	HHMM
Time Arrived Scene	117-120	4	HHMM
Time Left Scene	121-124	4	HHMM
Time at Destination	125-128	4	HHMM
Dispatch Code	129-131	3	See manual
Patient Age	132-134	3	Years (left fill with "0" as necessary)
Patient Race Code	135-135	1	See manual
Patient Gender	136	1	M, F, U(nknown)
Patient Source Code	137-139	3	See code list in manual
ECG Code 1	140	1	See manual (A-K)
ECG Code 2	141	1	See manual (A-K)
ECG Code 3	142	1	See manual (A-K)
Injury/Illness Code 1	143-145	3	See manual (999)
Injury/Illness Code 2	146-148	3	See manual (999)
Injury/Illness Code 3	149-151	3	See manual (999)
Injury/Illness Code 4	152-154	3	See manual (999)
Injury/Illness Code 5	155-157	3	See manual (999)
Injury/Illness Code 6	158-160	3	See manual (999)
Medication Code 1	161-163	3	See manual (999)
Medication Code 2	164-166	3	See manual (999)
Medication Code 3	167-169	3	See manual (999)
Medication Code 4	170-172	3	See manual (999)
Medication Code 5	173-175	3	See manual (999)
Medication Code 6	176-178	3	See manual (999)
Treatment Code 1	179-181	3	See manual (999)
Treatment Code 2	182-184	3	See manual (999)
Treatment Code 3	185-187	3	See manual (999)
Treatment Code 4	188-190	3	See manual (999)
Treatment Code 5	191-193	3	See manual (999)
Treatment Code 6	194-196	3	See manual (999)
Destination Code	197-199	3	See manual (999)
Disposition Code	200-201	2	See manual (99)
Patient Date of Birth	202-209	8	MMDDYYYY
EMT 1	210-215	6	Crew member completing form (State EMT Number)
EMT 2	216-221	6	Additional Crew member (State EMT Number)
Location Code	222	1	See manual
Init Systolic BP	223-225	3	See manual
Init Respiration	226-227	2	See manual
Init Temperature	228-232	5	999.9
Init Pulse Rate	233-235	3	See manual
Glasgow Eye Open	236	1	See manual
Glasgow Verbal	237	1	See manual
Glasgow Motor	238	1	See manual
Glasgow Total	239-240	2	Sum of Glasgow Eye, Verbal and Motor Scores
Revised Trauma Score (RTS)	241-242	2	See manual (formula)
Narrative Line 1	243-322	80	Text
Narrative Line 2	323-402	80	Text
Narrative Line 3	403-482	80	Text
Narrative Line 4	483-562	80	Text
Narrative Line 5	563-642	80	Text

Updated October 24, 2006