CDE Detailed Report
Disease: Stroke
Subdomain Name: History of Disease/Injury Event
CRF: Pre-Hospital
Displaying 1 - 34 of 34
Subdomain Name: History of Disease/Injury Event
CRF: Pre-Hospital
Displaying 1 - 34 of 34
| CDE ID | CDE Name | Variable Name | Definition | Short Description | 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 / Guidance) | Subdomain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | External Id Loinc | External Id Snomed | External Id caDSR | External Id CDISC |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 intak | 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 |
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| 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 |
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| 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 tex | 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| C58812 | Pre-hospital severity scale not documented status | PrehospStrokeSevSclNotDocStat | Indicates if a severity scale was not documented | Indicates if a severity scale was not documente | 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 |
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| 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 |
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| 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. 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 | 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 using the Los Angeles Motor Scale (LAMS). Check all that appl | 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 |
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| 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 documentatio | 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 |
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| 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 |
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| 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 transpor | 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 |
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| 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 |
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| 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 dispatc | 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 |
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| 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 |
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| 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 dispatc | 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 |
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| 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 use of a designated stroke dispatch code, this item would capture what code was assigned to the transport at dispatc | 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 |
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| 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 hospita | 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 |
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| 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 hospita | 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 |
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| 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 |
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| 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 respons | 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-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 |
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. 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. | 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 |
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| 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 respons | 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-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 |
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 using 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 |
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| 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-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 |
C124726 | |||||||
| C14210 | Los Angeles Motor Scale (LAMS) - grip result | LAMSGripReslt | Assess the grip using the Los Angeles Motor Scale (LAMS) | Assess the grip using 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 |
