Home > EMTrack > EMTrack Form Configuration > Configurable Form Fields


Form fields and field elements are configurable. When you design forms, you select the fields that you want to appear on the form, as well as identify which field elements are shown, required, labeled, and/or include tooltips. Some fields and field configurations may vary slightly on different types of forms, like the Web - Add, Web - Edit, and Mobile forms.

Note: Fields that are formatted with a configurable list must have entries in the associated data element to populate the field options.

Address

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Country

Country in which the person's residence is located.

List of countries

Show

Required

Label

Tooltip

Default

Address 1, Address 2

Street name and number of the person's residence.

Free text; format may be restricted by country

Show

Required

Label

Tooltip

City

City in which the person's residence is located.

Free text; format may be restricted by country

Show

Required

Label

Tooltip

State

State in which the person's residence is located.

Free text and/or list of US state abbreviations; format may be restricted by country  

Show

Required

Label

Tooltip

ZIP/Postal Code

ZIP Code™ in which the person's residence is located.

Free text; format may be restricted by country

Show

Required

Label

Tooltip

Temporary Address

Is the address provided temporary in nature?

Yes, No

Show

Label

Tooltip

Age

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Age

Number that represents the person's age in the selected units.

Number between 0-120; used in conjunction with a selected unit

Show

Required

Label

Tooltip

Approximate

(Unit)

Quantity of time used as a measure of age.

Years

Months

Days

Hours

--

Approximate Age

(only appears if selected in Age configuration options)

Indicates the age entered is an estimate that could not be verified.

Check box

--

Date of Birth

Day, month, and year the person was born. If entered, the person's age is calculated automatically.

mm/dd/yyyy

Show

Required

Label

Tooltip

Alert Type

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Alert Type

Label that identifies the patient's condition or status on prehospital and incoming patient notifications.

  • Stroke

  • STEMI

  • Trauma

  • Sepsis

  • Configurable list

Required

Label

Add Custom Values

Allergies

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Medication Allergies

Indicates any abnormal reaction the person experiences in response to medications.

Configurable list and/or free text

Show

Required

Label

Tooltip

Environmental/Food Allergies

Indicates any abnormal reaction the person experiences in response to natural or synthetic materials or food items.

Configurable list and/or free text

Show

Required

Label

Tooltip

Alternate ID

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Alternate ID

Information about a secondary identification number.

--

Label

Tooltip

Name

Name of the alternate identification.

Free text

--

Description

Description of the alternate identification.

Free text

--

+ Add

Option to add another alternate identification.

Button

--

Appliances

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Appliances

Functional or therapeutic devices located on or with the person.

Free text and/or configurable list

Required

Label

Tooltip

Backboard

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Backboard

Was a backboard used to move the person?

Yes, No

Label

Tooltip

Chief Complaint

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Complaint Category

Category that best describes the person's primary complaint.

Configurable list

Required

Label

Tooltip

Complaint Description

More information about the person's primary complaint.

Free text

Show

Required

Placeholder

Client Type

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Client Type

Identifies the client as being either a patient or person depending on the situation and need. 

Patient, Person

Label

Tooltip

Default Value

Hidden

Clothing

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Shirt

Color, type, and/or style of shirt on the person.

Free text

Show

Required

Label

Tooltip

Pants/Skirt

Color, type, and/or style of pants or skirt on the person.

Free text

Show

Required

Label

Tooltip

Shoes

Color, type, and/or style of shoes on the person.

Free text

Show

Required

Label

Tooltip

Contaminated

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Contaminated

Was the person exposed to some type of contaminant?

Unknown, Yes, No

Required

Label

Tooltip

Description

(only appears if Contaminated = Yes)

Additional information about the contamination.

Free text

Required

Label

Decontaminated

(only appears if Contaminated = Yes)

Was a decontamination process completed on the person?

Yes, No

Show

Label

Tooltip

When

(only appears if Decontaminated = Yes)

When was the decontamination process performed?

mm/dd/yyyy hh:mm

Required

Label

Tooltip

Current Location

Available on Web - Add and Mobile forms.

Element

Description

Format

Configuration Options

Current Location

Site or facility where the person is located.

Configurable list

Required

Label

Sub Location

Secondary location or sub-site where the person is located.

Configurable list

Show

Label

Comments

Additional information the user feels would be helpful to document.

Free text

Show

Label

Destination Location

Available on Web - Add and Mobile forms.

Element

Description

Format

Configuration Options

Destination Location

Site or facility to which the person is being transported.

Configurable list

Required

Label

Tooltip

Sub Location

Secondary location or sub-site to which the person is being transported.

Configurable list

Show

Label

Comment

Additional information the user feels would be helpful to document.

Free text

Show

Label

Provider

Agency responsible for transporting the person.

Configurable list

Label

Provider Unit

Agency unit responsible for transporting the person.

Free text

Required

Label

ETA

Estimated time of arrival at the destination location.

Free text and/or configurable list

Show

Required

Label

Disposition

Available on Mobile forms.

Element

Description

Format

Configuration Options

Disposition

Result of the encounter (for example, transported, bandaged and released, or admitted to hospital).

Configurable list

Required

Label

Driver License

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Driver License

Opens a function that scans barcodes on state-issued driver license identification cards.

Button

Label

Tooltip

Driver License Number

Unique license number assigned to the driver.

Free text

Show

Required

Label

Tooltip

Driver License State

State that issued the driver license.

Configurable list

Show

Required

Label

Tooltip

Email

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Email

Electronic mail address at which the person can be contacted.  

Email address format.
For example, name@domain.com

Required

Label

Tooltip

Equipment

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Type

Equipment used on or transported with the person.

Configurable list

Label

Tooltip

Description

Description of the equipment.

Free text

--

+ Add

Option to add another piece of equipment.

Button

--

Ethnic Background

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Ethnic Background

Category of people that the person identifies with, usually based on a shared social, cultural or national heritage.

Free text and/or configurable list

Required

Label

Tooltip

Files

Available on Web - Edit forms.

Element

Description

Format

Configuration Options

Type

Type of file.

Button

Label

File

File name.


Label

Tooltip

Label

Relevant labels or tags that might help users identify files.

Button

Label

Tooltip

Primary

Indicates if it is the main file associated with the person.

Check box

Label

Tooltip

Description

Description of the file.

Free text

Label

Tooltip

Added By

Person who added the file.

--

Label

Added At

Location at which the person added the file.

--

Label

Actions

Indicates if action is required related to the file.

--

--

+ Add

Option to add another piece of equipment.

Button

--

Found with Objects

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Found with Objects

Objects found with the person, such as glasses, jewelry, or a wallet.

Free text

Label

Tooltip

Gender

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Gender

Whether the person is male or female.

Configurable list

Required

Label

Tooltip

GPS

Available on Web - Add and Mobile forms.

Element

Description

Format

Configuration Options

GPS

Global positioning system that determines location.

--

Label

Tooltip

Lat.

North-south position used to geocode the person's location.

Free text

--

Long.

East-west position used to geocode the person's location.

Free text

--

Acquire

Opens a function that identifies the latitude and longitude of your current location.

Button

--

Height

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Height

Measurement of the person from head to foot while standing.

Number between 0-9 in US customary feet (ft) and 0-11 inches (in); or number between 0-300 in metric centimeters (cm)

Label

Tooltip

Unit conversion

Default units

Housing

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Housing Type

Type of shelter or lodging in which the person resides.

Free text and/or configurable list

Show

Label

Tooltip

Permanent Home Destroyed

Was the person's permanent home destroyed?

Yes, No

Show

Label

Tooltip

Identifying Marks

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Description

Information about marks and/or features on the person that might help to identify or distinguish them.

Free text

Label

Tooltip

+ Add

Option to add another identifying mark.

Button

--

Immunization History

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Immunization History

Retrieves personal protected health information to provide insight into a patient's previous immunizations.

--

Label

Tooltip

Incident Involvement

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Incident Involvement

Incident with which the person is associated.

Configurable list

Required

Label

Tooltip

Insurance

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

InsuranceInformation about the person's health insurance.--Label

Provider Name

Name of the insurance provider.

Free text

Show

Required

Label

Tooltip

Subscriber Number

Number of the insurance policy or membership through which the person is covered.

Free text

Show

Required

Label

Tooltip

Primary Card Holder

Name of the primary card holder of the insurance through which the person is covered.

Free text

Show

Required

Label

Tooltip

Group Number

Number of the insurance group through which the person is covered.

Free text

Show

Required

Label

Tooltip

Insurance Plan IDIdentification number associated with the insurance plan.Free text

Show

Label

Tooltip

Insurance Company IDIdentification number associated with the insurance company.Free text

Show

Label

Tooltip

Isolation Status

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Isolation Status

Types of isolation that might be used during triage and transport of the person.

Configurable list

Required

Label

Tooltip

Reason

Explanation as to why isolation is needed for the person.

Free text

Show

Required

Label

Lab Results

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Date and Time

According to organization policy, day, date, and time the lab was taken or results were presented.

mm/dd/yyyy hh:mm

--

Type

Type of laboratory test administered.

List

--

Results

Information provided as a result of the test.

Free text

--

+ Add

Option to add another lab.

Button

--

Labels

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Labels

Conditions, treatments, or other commonly used ways to identify and search for a person or person's status.

Configurable list

Required

Label

Tooltip

Multi-select

Languages

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Languages Spoken

What languages does the person speak?

Free text and/or configurable list

Show

Label

Tooltip

Translation Required

Is a translator necessary for communication?

Free text and/or configurable list

Show

Label

Tooltip

Location on Body

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Location on Body

Site on the person's body that is affected.

Configurable list

Label

Tooltip

Medical History

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Medical History

Information about previous medical conditions and procedures.

Configurable list

Required

Label

Tooltip

Medical Record Number

Available on Web - Add and Web - Edit forms.

Element

Description

Format

Configuration Options

PCR #

Unique number issued to identify the person's Patient Care Record (PCR).

Free text

Show

Required

Label

EMR #

Unique number issued to identify the person's Electronic Medical Record (EMR).  

Free text

Show

Required

Label

Medication Supply

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Description

Name of and information about medications the person uses.

Free text

Label

Tooltip

Supply

Number of doses, in days, that are being transported with the person.

Free text

--

+ Add

Option to add another medication.

Button

--

Medications Administered

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Updated Time

Time the medication was administered.

mm/dd/yyyy hh:mm

Label

Tooltip

Medication

Name of the medication administered.

Configurable list

--

More

Opens a window with the following fields: Dose, Amount, Route, Sites, Administered By, Ordered By, Reaction, State Administered, Lot #, Manufacturer, Expiration Date, Comment.

Free text

--

+ Add

Option to add another medication.

Button

--

Name

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

First Name

Given name of the person.

Free text

Required

Label

Tooltip

Middle Name

Additional given name of the person.

Free text

Show

Required

Label

Tooltip

Last Name

Family name of the person.

Free text

Required

Label

Tooltip

Maiden NameLast name the person used prior to legally changing it at marriage.Free text

Show

Label

Tooltip

Mother's Maiden NameLast name the person's mother used prior to legally changing it at marriage.Free text

Show

Label

Tooltip

Nationality

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Nationality

Country in which the person has citizenship.

Configurable list

Required

Label

Tooltip

Occupation

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Occupation

Type of employment or work in which the person is engaged.

Free text

Show

Required

Label

Tooltip

Uniform

Distinctive clothing associated with the person's occupation.

Configurable list

Show

Required

Label

Tooltip

Badge Number

Emblem and assigned number that identifies the person's occupation, membership and office.

Configurable list

Show

Required

Label

Tooltip

Assigned Unit

Group to which the person is assigned.

Configurable list

Show

Required

Label

Tooltip

Rank

Relative standing or position of membership.

Configurable list

Show

Required

Label

Tooltip

Personal Characteristics

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Eye Color

Color of the person's iris.  

Free text

Show

Required

Label

Tooltip

Hair Color

Color of hair on the person's head.

Free text

Show

Required

Label

Tooltip

Hair Length

Length of hair on the person's head.

Free text

Show

Required

Label

Tooltip

Facial Hair

Whether the person has some type of hair on their face, chin, and/or neck

Free text

Show

Required

Label

Tooltip

Skin Color

Color of the person's skin.

Free text

Show

Required

Label

Tooltip

Phone Number

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Phone Number

Phone number associated with the person.

Free text; format may be restricted by country

Required

Label

Tooltip

Phone Type

Type of phone the number is associated with.

Free text

Show

Required

Label

Tooltip

Photos

Available on Mobile forms.

Element

Description

Format

Configuration Options

Photos

Allows user to take and upload photos associated with the person, location, or situation.

Button

--

Pre-Screening Questions

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Pre-Screening Questions

Questions asked to determine the person's health and ability to receive a treatment or vaccination.

Configurable list - yes/no or numeric

Label

Tooltip

Procedures Performed

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Updated Time

Day, date, and time at which the procedure was performed.

mm/dd/yyyy hh:mm

Label

Tooltip

Procedure

Name of the procedure performed.

Configurable list

--

More

Opens a window with the following fields: Results, Administered By, Ordered By, Reaction, State Administered.

Free text

--

+ Add

Option to add another procedure.

Button

--

Property

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

ID#

Number or code that identifies property in the person's possession.

Free text

Label

Tooltip

Contact

Main person responsible for the property.

Free text

Show

Label

Description

Description of the property.

Free text

Label

Tooltip

Location

Property source or home location.

Configurable list

Label

Tooltip

Location Comment

Additional information provided at the source or home location.

Free text

Show

Label

Tooltip

Destination

Property destination location.

Configurable list

Show

Label

Tooltip

Destination Comment

Additional information provided at the destination location.

Free text

Show

Label

Tooltip

Destination Contact

Person responsible for the property at the destination location.

Free text

Show

Label

Tooltip

Returned to Owner

Was the item successfully returned to its owner?

Check box

Show

Label

Tooltip

Relatives

Available on Web - Edit forms.

Element

Description

Format

Configuration Options

ID#

Unique identification number that is generated when the person's triage tag is scanned.

Free text

Show

Label

Tooltip

Relationship

Description of the familial relationship between the relative and the person.

Free text


Label

Tooltip

First Name

Given name of the relative.

Free text

Label

Tooltip

Middle Name

Additional given name of the relative.

Free text

Show

Label

Tooltip

Last Name

Family name of the relative.

Free text

Label

Tooltip

Country

Country in which the relative's residence is located.

List of countries

Show

Label

Tooltip

Address

Primary street name and number of the relative's residence.

Free text

Show

Label

Tooltip

City

City in which the relative's residence is located.

Free text

Show

Label

Tooltip

State

State in which the relative's residence is located.

Free text and/or list of US state abbreviations

Show

Label

Tooltip

ZIP/Postal Code

ZIP Code™ in which the relative's residence is located.

Free text

Show

Label

Tooltip

Phone Number

Phone number associated with the relative.

Free text

Show

Label

Tooltip

Email

Electronic mail address at which the person can be contacted.  

Email address format.
For example, name@domain.com

Show

Label

Tooltip

Comments

Additional information the user feels would be helpful to document.

Free text

Show

Label

Tooltip

Sepsis

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

History of Suggestive Infection

Symptoms or conditions that might indicate the presence of infection.

List

Required

Label

Screening Questions

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Screening Question

Questions asked to determine the patient's health and ability to receive a treatment or vaccination.

Configurable list - yes/no or numeric

Label

Tooltip

Signature

Available on Mobile forms.

Element

Description

Format

Configuration Options

Signature

Allows the user to collect written consent from the patient by creating a signature on the mobile device.

Button

Label

Tooltip

STEMI

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

ECG: Acute MI Suspected

Clinical opinion of possible myocardial infarct based on ECG results.

  • Not Recorded

  • No

  • Yes

--

Infarct Location

Indicates arterial location of blockage or damage.

  • Anterior (V3, V4)

  • Inferior (II, III, AVF)

  • Lateral (I, AVL, V5, V6)

  • Posterior (V7, V8, V9)

  • Septal (V1, V2)

--

Bundle Branch Block

Indicates blockage or delay in the electrical conduction system of the heart.

  • Not Recorded

  • No

  • Yes

  • New Onset

--

Onset Time

Day, date, and time symptoms of the current ST-Elevation Myocardial Infarction were first noticed.

  • Unknown

  • Date and Time (mm/dd/yyyy hh:mm)

--

Cardiologist or Group

Symptoms or conditions that might indicate the presence of infection.

Free text

--

Stroke

Available on Web - Add, Web - Edit, and Mobile forms.

Cincinnati Prehospital Stroke Scale (CPSS)

Element

Description

Format

Configuration Options

Facial Droop

Evaluation of facial weakness or paralysis.

  • Not Recorded

  • Normal

  • Abnormal

--

Arm Drift

Evaluation of patient's ability to extend arms, palms up.

  • Not Recorded

  • Normal

  • Abnormal

--

Speech

Evaluation of patient's speech.

  • Not Recorded

  • Normal

  • Abnormal

--

Last Known Well

Day, date, and time the patient last felt well.

  • Unknown

  • Date and Time (mm/dd/yyyy hh:mm)

--

Los Angeles Motor Scale (LAMS)

Element

Description

Format

Configuration Options

Facial Droop

Evaluation of facial weakness or paralysis.

  • Not Recorded

  • Absent (0)

  • Present (+1)

--

Arm Drift

Evaluation of patient's ability to extend arms, palms up.

  • Not Recorded

  • Absent (0)

  • Drifts down (+1)

  • Falls rapidly (+2)

--

Grip

Evaluation of patient's ability to grip.

  • Not Recorded

  • Normal (0)

  • Weak grip (+1)

  • No grip (+2)

--

LAMS Score

Score based on answers provided in assessment.

Dynamic calculation

--

Last Known Well

Day, date, and time the patient last felt well.

  • Unknown

  • Date and Time (mm/dd/yyyy hh:mm)

--

SSN

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

SSN

United States (US) government issued Social Security Number (SSN) of the person.

Free text - nine numeric characters

Required

Label

Tooltip

Symptoms

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Symptoms

Physical or mental features regarded as a condition of disease.

Free text and/or configurable list

Label

Tooltip

Comments

Additional information the user feels would be helpful to document.

Free text

Show

Label

Tracking Number

Available on Web - Add and Mobile forms.

Element

Description

Format

Configuration Options

ID#

Unique identification number that is generated when the person's triage tag is scanned.

Free text

Label

Tooltip

Tracking Number

Unique identification number that is generated when a record is created. Usually reserved for situations in which triage tags are not used. A minimum length can be specified.

List

Do not generate

Generate and hide

Generate and show

Trauma

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Anatomy of Injury

Evaluation of the type and extent of injuries, with two options: Not Recorded and Select from List.

List:

  • Penetrating injuries to head, neck, torso or extremities proximal to elbow or knee

  • Chest wall instability or deformity

  • Two or more proximal long-bone fractures

  • Crushed, degloved, mangled or pulseless extremity

  • Amputation proximal to wrist or ankle

  • Pelvic fracture

  • Open or depressed skull fracture

  • Paralysis

  • None Apply

--

Mechanism of Injury

Cause or reason for the injury, with two options: Not Recorded and Select from List.

List:

  • Fall

    • Adult: >20 feet (on average, one floor of a building equals 10 feet)

    • Child: >10 feet or two - three times the child's height

  • High-Risk Auto Crash

    • Intrusion, including roof: >12 inches at occupant site or >18 inches anywhere

    • Ejection (partial or complete) from auto

    • Death in same passenger compartment

    • Vehicle telemetry data consistent with high risk of injury

    • Auto vs pedestrian or bicyclist: thrown or run over with significant impact (>20 mph)

    • Motorcycle or recreational vehicle crash (>20 mph)

  • None Apply

--

Special Considerations

Other factors or considerations that impact care and the patient's outcome, with two options: Not Recorded and Select from List.

List:

  • Age

    • Older adult (risk of injury or death increases after age 55)

    • Child (triage preferentially to pediatric-capable trauma center)

  • Burns

    • Without trauma mechanism (triage preferentially to burn facility)

    • With trauma mechanism (triage preferentially to trauma center)

  • Other

    • Anticoagulation or bleeding disorder

    • Time-sensitive extremity injury

    • End-stage renal disease (requiring dialysis)

    • Pregnancy >20 weeks

    • EMS provider judgment

  • None Apply

--

Treatment Level

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Treatment Level

Level of care provided (Basic Life Saving or Advanced Life Saving).

BLS, ALS

Required

Label

Tooltip

Comments

Additional information the user feels would be helpful to document.

Free text

Show

Required

Placeholder

Triage Category

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Triage Category

Standard medical triage categories that identify the priority of care required by the person.

Configurable list

Required

Label

Tooltip

Vital Signs

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Vital Signs

Clinical measurements that indicate the relative health of the person, with three general options: Unspecified, Stable, and Unstable.

Configurable table containing the elements listed below.

Show

Required

Label

Tooltip

Date and Time Measured

Date and time vital signs were measured.

mm/dd/yyyy hh:mm

--

Blood Pressure

Pressure of the blood in the circulatory system.

2 numbers between 0-500, one over the other (systolic/diastolic).

For example, 120/80


Show

Required

Label

Tooltip

Pulse

Heart rate per minute.

Number between 0-500

Show

Required

Label

Tooltip

Respiration

Breaths per minute.

Number between 0-300

Show

Required

Label

Tooltip

SpO2

Blood oxygen level.

Number between 0-100

Show

Required

Label

Tooltip

Temperature

Body temperature.

Number between 0-122 with one decimal place in degrees Fahrenheit (°F) or number between 0-50 with one decimal place in degrees Celsius (°C)

Show

Required

Label

Tooltip

Default scale

End Tidal CO2

Concentration of carbon dioxide in an exhaled breath.

Number between 0-200

Show

Required

Label

Tooltip

Pain

According to organization policy, level of pain the patient is experiencing.

Number between 0-10

Show

Required

Label

Tooltip

 

Blood Glucose

Amount of glucose or sugar in the blood.

Free text numeric

Show

Required

Label

Default Scale

 

Glasgow Coma Scale (GCS)

Neurologic scale to evaluate the patient's consciousness.

Lists:

  • Eye Opening

  • Verbal Response

  • Motor Response

  • GCS Score

Show

Required

Label

Tooltip

 

AVPU

Neurologic scale to evaluate the patient's consciousness.

Lists:

  • Unspecified

  • A - Alert (awake and responsive)

  • V - Voice (responds to verbal stimuli)

  • P - Pain (responds to painful stimuli)

  • U - Unresponsive (no response or unconscious)

Show

Required

Label

Tooltip

Weight

Available on Web - Add, Web - Edit, and Mobile forms.

Element

Description

Format

Configuration Options

Weight

Amount the person weighs.

Number between 0-2000 in US customary pounds (lbs) or number between 0-1000 in metric kilograms (kg)

Required

Label

Tooltip

Default units