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CARES Schematron Rules - NEMSIS 3.5.0

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myCARES Schematron Rules - NEMSIS 3.5.0 - updated 02/13/2023

We are currently developing a CARES-specific schematron. The schematron results are available via the File Upload Validation Report in the respective myCARES account.

Below is a list of current schematron ERROR/FATAL errors available for and in test on myCARES Beta. [FATAL] violations will trigger file rejection and are usually due to an incorrect format or value passed in an element. Because the file would fail at database level in these cases, we are now rejecting them before further parsing. Please check back often for updates.

You can access the current 3.5.0 myCARES Schematron here or refer to the below.

  • Date of Arrest is required - eArrest.14 must be present with a valid and non-empty date value. If these are not present, the value of eTimes.03 will be used. Missing eArrest.14 will produce a [WARNING] while improper value will produce a [FATAL] error.
  • Custom elements AgencyID and FormID (this value is 90004 for 3.5.0) must be present with a value - will produce a [FATAL] error if missing or nil.
  • As of February 2023 - Custom elements AgencyID and FormID can`t be empty strings.
  • The following NEMSIS elements are required by CARES and must be present with a value (no NV/nil, except where noted). Except where noted, these are [ERROR] or [WARNING] level:
    • Incident Number (eResponse.03) [FATAL] value required - file will fail in parsing without this, also it can`t be empty string and should be less than 50 characters.
    • Incident Address (eScene.15) - can`t be empty string.
    • Incident County (eScene.21) - can`t be empty string
    • Incident City (eScene.17) - can`t be empty string.
    • Incident State (eScene.18) - can`t be empty string. Also, it validates that the value corresponds to a valid state ID.
    • Incident Zip (eScene.19) - can`t be empty string
    • Location Type (eScene.09) - can`t be empty string
    • Location Type Other - now checks for Location Type (eScene.09) with Other (Y92.89) value.
    • eScene.03 and eScene.24 - First Responder is required or pass eScene.24 = No or eScene.24 N/A
    • First Responder must be present and not nil, unless there is a NoFRDisp element with the value of '9923001'.
    • If NoFRDisp(eScene.24) is 1(9923001), InitiatedCPR(eArrest.20) should not be 3('3020007','3020009','3020011'), and FirstDefibPatient(eArrest.22) should not be 10(3022009), and WhoFirstAppliedAED(eArrest.21) should not be 10(3021009)
    • If NoFRDisp(eScene.24) is present then it must be 1(9923001)
    • Patient Last Name (ePatient.02) - can`t be empty string.
    • Patient First Name (ePatient.03) - can`t be empty string.
    • Either Patient Age (ePatient.15/16, ePatient.15 must be a numeric value between 1 and 99) or Date of Birth (ePatient.17) - can`t be empty string
    • Patient Date of Birth (ePatient.17) - can't be empty string unless there is a DOB_Unknown element with the value of 1
    • Destination Hospital (eDisposition.02) - can't be empty string if End of Event is Pronounced Dead in ED or Ongoing Resuscitation in ED, must be empty/absent if End of Event is Pronounced in the Field or Effort Ceased Due to DNR
    • Patient Gender (ePatient.13) - can`t be empty string.
    • Patient Ethnicity (ePatient.14) - can`t be empty string.
    • Arrest Witness Status (eArrest.01 and eArrest.04)
    • Presumed Cardiac Arrest Etiology (eArrest.02) - can`t be empty string.
    • Presumed Cardiac Arrest Etiology Other - now checks for Presumed Cardiac Arrest Etiology ID - 6 (3002011).
    • Resuscitation Attempted EMS (eArrest.03):
      • Can`t be empty string
      • Requires confirmation if equals to 2 - '3003007', '3003009', '3003011' and eArrest.20 is 3 or 4 - '3020007', '3020009', '3020011', '3020013'
      • Requires confirmation if equals to 2 - '3003007', '3003009', '3003011' and eArrest.18 is 2 or 3 - '3018001', '3018005', '3018007', '3018009', '3018011'
      • Requires confirmation if equals to 2 - '3003007', '3003009', '3003011' and eArrest.07 is 5 - '3007005'
      • Requires confirmation if equals to 2 - '3003007', '3003009', '3003011' and eArrest.22 is '3022001', '3022003', '3022013', '3022005', '3022009', '3022007', '3022011'
      • Requires confirmation if equals to 2 - '3003007', '3003009', '3003011' and custom element 911RespCPR is '1'
    • Resuscitation Attempted By 911 Responder (or AED shock given prior to EMS) (eArrest.03, eArrest.07, eArrest.20, eArrest.22)
    • Was an AED applied prior to EMS Arrival (eArrest.07):
      • Can`t be empty string
      • Requires confirmation if equals to 3007005 and eArrest.22 is 7701001 (Not Applicable)
      • Requires confirmation if equals to 3007005 and eArrest.22 is 3022013
      • Requires confirmation if equals to 3007003 and eArrest.22 is 3022001, 3022003, 3022005, 3022009, 3022007 or 3022011
      • Requires review if equals to 3007003 and eArrest.11 is 3011011, 3011013 or 3011009
      • If equals to 3007005 then eArrest.21 and eArrest.22 must match
    • Was Hypothermia provided in the field (eArrest.10) - can`t be empty string
    • First Arrest Rhythm of Patient (eArrest.11):
      • Requires confirmation if equals to 0('3011011') or 1('3011013') or 6('3011009') and FirstDefibPatient(eArrest.22) is 8('7701001')
    • Sustained ROSC (20 consecutive minutes), or present at end of EMS care (eArrest.12):
      • Can`t be empty string
      • Requires confirmation if equals to 4('3012003', '3012005', '3012007', '3012003', '3012007', '3012003') and eArrest.18 is 1('3018003')
      • Requires confirmation if equals to 3('3012005', '3012007') or 4('3012003', '3012005', '3012007', '3012003', '3012007', '3012003') and the custom element ROSCStart is 1
      • Requires confirmation if equals to 2('3012001') and the custom element ROSCStart is not 1 and is not empty
    • End of Event (either eArrest.16 = DNR and eArrest.18 not nil or vice versa)
    • Who Initiated CPR:
      • Value or NV = 7701001 is allowed
      • Value is required unless resuscitation was not attempted
      • Requires confirmation if equals to 7701001 (Not Applicable) and resuscitation was attempted
      • Requires confirmation if equals to 3020013 and eArrest.07 is 3007003 or 3007005
      • Requires confirmation if equals to 3020007 or 3020009 or 3020011 (first responder codes) and eScene.24 is 9923001 or 7701001 (Not Value)
      • Requires confirmation if equals to 3020013 and eArrest.22 is 3022001, 3022003, 3022005, 3022009, 3022007 or 3022011
    • Who Initiated CPR (eArrest.20) Value or NV = 7701001 is allowed. Requires confirmation if equals to 3020013 and eArrest.07 is 3007003 or 3007005, should not be 3 if NoFRDisp is 1
    • Who First Applied the AED (eArrest.21):
      • Required if eArrest.07 is Yes - (3007003 or 3007005)
      • Requires confirmation if equals to 10('3021009') or 11('3021007', '3021011') and NoFRDisp(eScene.24) is 1('9923001')
      • Requires confirmation if equals to 10('3021009') or 11('3021007', '3021011') and FirstDefibPatient(eArrest.22) is 1('3021009'), 2('3021007'), 5('3021011')
      • Requires confirmation if equals to 1('3021001') or 2('3021003') or 6('3021005') and LocationType(eScene.09) is 1('Y92.01')
    • Who First Defibrillated the Patient (eArrest.22):
      • Can`t be empty string
      • Requires confirmation if equals to 10 ('3022009') and NoFRDisp(eScene.24) is 1('9923001') and WhoFirstAppliedAED(eArrest.21) is 11('3022007', '3022011')
      • Requires confirmation if equals to 8 ('7701001') and custom element ROSCStart is 3 or 5
  • If used, the following optional custom elements must contain the proper value/format (can be omitted or nil). All of the below will constitute a [FATAL] violation, meaning the file will be rejected:
    • BystanderCPRProvidedID - schematron validation results gives the result with the [WARNING] if BystanderCPRProvidedID is 3.
    • CPRInstructionsProvided
    • 911RespCPR:
      • Can`t be empty string
      • Requires confirmation if equals to 2 and ROSCStart is 4
    • EndOfEvent - can`t be empty string
    • ROSCStart:
      • Requires confirmation if equals to 2 and ResusAttemptEMS(eArrest.03) is 1('3003001', '3003003', '3003005')
    • DefibTime
    • FRDispatched - it warn when NoFRDisp is true and FR_DISPATCHED has a value
    • FREnroute - it warn when NoFRDisp is true and FREnroute has a value
    • FROnscene - it warn when NoFRDisp is true and FROnscene has a value
    • MechCPRDeviceID
    • CPRFeedbackDevice
    • DrugAdministration
    • ITDID
    • VascularAccessID
    • STEMI
    • EROutcome
    • Hypothermia_Provided_Hosp
    • HospOutcome
    • HospOutcomeDNR
    • EROutcomeTrans
    • HospOutcomeTrans
    • HospOutcomeDNRTrans
    • HospDispositionTrans
    • NeuroOutcomeTrans
    • Hypothermia_Provided_Hosp_Trans
    • MyocardialInfarction
    • CoronaryAngiography
    • CoronaryAngiographyDateTime
    • CardiacStent
    • CABGPerformed
    • ICDPlaced
    • HypoNotInitiatedHosp
    • DischargeDeathDateTime - can`t be empty string
    • TimeSusRosc

Test data sent to the Beta server should not contain any PHI.


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