Data Elements
Registry Number Hospital Codes Medical Record Number Patient SSN Patient Name Date of Birth (MMDDYY) Sex Street Patient City Patient County Patient State Patient Zip Code Race If a Transfer Patient: Hospital Transferred From City of Hospital Location Date of Arrival Time of Arrival Parent or Guardian Parent/Guardian SSN Date of Injury (MMDDYY) Time of Injury Time CAT Scan Time X-ray Time Trauma Surgeon Arrived Time Orthopedic Surgeon Arrived Time Neurosurgeon Arrived Time Discharge From Emergency Department Emergency Department Disposition Receiving Hospital Name Date Arrive Operating Room Time Arrive Operating Room Procedures 1-5 Diagnoses 1-5 Admission Date Discharge Date ICU Days |
Injury City Injury County Injury State Place of Injury Contributing Factor Injury Work Related Pre-Intubate Arrive by Transport Type Ambulance Service Number Ambulance Report Number Ambulance Times Unit Dispatched Arrive Location Depart Location Arrive Destination Transfer Hospital Date Arrive Emergency Department Time Arrive Emergency Department Glasgow Coma Score Cardiopulmonary Functions Time Intubated Emergency Department Disposition Degree Disability Source of Payment Abbreviated Injury Scale Injury Severity Score Degree of Disability at Discharge for: Feeding Self (1990-Present) Expressing Self (1990-Present) Locomotion (1990-Present) File Identifier (HSCI or Trauma) (1990-Present) Blood Alcohol Concentration (1990-Present) Billed Hospital Charges (1990-Present) Number of Records per Person per Incident |