Accident number | Motor vehicle number: | Patient number: | |
---|---|---|---|
Dispatch criterion | Member from research accident team alerted and dispatched by the EMCC | Y N | |
Motor vehicle accident | |||
- suspicion of serious injury or death | |||
Patient record retrieved | Police | Y N | |
EMCC | Y N | ||
Ground ambulance | Y N | ||
Air ambulance | Y N | ||
In case of missing EMS records | Hospital/LEMC | Y N | |
Personal identification data | Patient First name | Y N | |
Patient Family name | Y N | ||
Birth date (6-digit) | Y N | ||
Social security number (11-digit) | Y N | ||
Logistic variables | EMCC Unique Identifier Number | Y N | |
Accident date | Y N | ||
Transport destination | Y N Wrong | ||
Patient encounter times | |||
Alarm at EMCC | Y N | ||
Ground/Air ambulance departure from station | Y N | ||
Ground/Air ambulance arrival on scene | Y N | ||
Ground/Air ambulance departure from scene | Y N | ||
Ground/Air ambulance arrival at destination | Y N | ||
Glasgow coma scale (GCS) | GCS exact value documented | Y N | |
GCS RTS category | 4 3 2 1 0 | ||
GCS RTS category inferred | Y N | ||
GCS assessments repeated every 20 min | Y N | ||
Respiratory rate (RR) | RR exact value documented | Y N | |
RR RTS category | 4 3 2 1 0 | ||
RR RTS category inferred | Y N | ||
RR assessments repeated every 20 min | Y N | ||
Systolic blood pressure (SBP) | SBP exact value documented | Y N | |
SBP RTS category | 4 3 2 1 0 | ||
SBP RTS category inferred | Y N | ||
SBP assessments repeated every 20 min | Y N | ||
Variables relevant for mechanism of injury (MOI) | ≥ 2 MOI factors documented | Y N | |
MOI reported as | Check boxes | Free text | |
Patient location in vehicle | Driver | ||
Front passenger | |||
Rear passenger |