<aside> ⚠️

The below proposed Schematron rules are currently in draft form and are being shared for community review and feedback before formal adoption into the CARES Required Elements schematron. This review process helps ensure the rules meet the needs of all stakeholders while maintaining data quality standards.

We welcome all comments, suggestions, and concerns regarding these proposed rules. Please send your feedback to [email protected]. Your input is valuable in helping us refine and improve these requirements.

Documentation for current CARES Required Elements rules can be found here:

CARES 3.5.0 Required Elements Schematron Rules

</aside>

Additions

34. Patient Evaluation Documentation Rule

<sch:pattern id="pattern_PatientEvaluationReq">
<sch:title>CARES requires Patient Evaluation/Care when patient contact is made</sch:title>
<sch:rule id="rule_PatientEvaluationReq" context="nem:PatientCareReport">
<sch:let name="nemsisElements" value="."/>
<sch:let name="eDisposition27" value="nem:eDisposition/nem:eDisposition.IncidentDispositionGroup/nem:eDisposition.27"/>
<sch:let name="eDisposition28" value="nem:eDisposition/nem:eDisposition.IncidentDispositionGroup/nem:eDisposition.28"/>
<sch:let name="eDisposition28HasContent" value="boolean($eDisposition28[text() != ''])"/>
<sch:let name="eDisposition28IsNil" value="boolean($eDisposition28[@xsi:nil = 'true'])"/>
<sch:let name="eArrest02" value="nem:eArrest/nem:eArrest.02"/>
<sch:let name="eArrest03" value="nem:eArrest/nem:eArrest.03"/>
<sch:let name="PatientContact" value="$eDisposition27 = '4227001'"/>
<sch:let name="ArrestCriteria" value="$eArrest02 != '3002015' and ($eArrest03 = '3003001' or $eArrest03 = '3003003' or $eArrest03 = '3003005')"/>
<sch:assert id="assert_PatientEvaluationReq" role="[ERROR]" diagnostics="nemsisDiagnostic" 
test="not($PatientContact and $ArrestCriteria) or ($eDisposition28HasContent and not($eDisposition28IsNil))">
CARES requires Patient Evaluation/Care (eDisposition.28) to be documented when patient contact is made on CARES eligible incidents.</sch:assert>
</sch:rule>
</sch:pattern>

Documentation:

Pattern ID: pattern_PatientEvaluationReq

Rule Purpose: Ensures that when patient contact made is recorded on a CARES eligible arrest, the patient evaluation/care status is documented with a real value.

Elements:

• Primary: eDisposition.28 (Patient Evaluation/Care)
• Related: -eDisposition.27 (Patient Contact) -eArrest.02 (Cardiac Arrest) -eArrest.03 (Cardiac Arrest Etiology)

Current Valid Codes (for reference):

• 4228001: Patient Evaluated and Care Provided
• 4228003: Patient Evaluated and Refused Care
• 4228005: Patient Evaluated, No Care Required
• 4228007: Patient Refused Evaluation/Care
• 4228009: Patient Support Services Provided

Error Message: “CARES requires Patient Evaluation/Care (eDisposition.28) to be documented when patient contact is made on CARES eligible incidents.”

Conditions: -Required when patient contact is documented (eDisposition.27 = 4227001) -Must have a real value (not empty, not nil, regardless of NV attribute) -Must meet CARES eligibility criteria (non-traumatic arrest with resuscitation attempt) -Error will trigger if eDisposition.28 is missing, empty, nil, or has only NV attributes

35. Crew Disposition Rule

<sch:pattern id="pattern_CrewDispositionReq">
<sch:title>CARES requires Crew Disposition for all cardiac arrest incidents</sch:title>
<sch:rule id="rule_CrewDispositionReq" context="nem:PatientCareReport">
<sch:let name="nemsisElements" value="."/>
<sch:let name="eDisposition29" value="nem:eDisposition/nem:eDisposition.IncidentDispositionGroup/nem:eDisposition.29"/>
<sch:let name="eDisposition29HasContent" value="boolean($eDisposition29[text() != ''])"/>
<sch:let name="eDisposition29IsNil" value="boolean($eDisposition29[@xsi:nil = 'true'])"/>
<sch:let name="eArrest02" value="nem:eArrest/nem:eArrest.02"/>
<sch:let name="eArrest03" value="nem:eArrest/nem:eArrest.03"/>
<sch:let name="ArrestCriteria" value="$eArrest02 != '3002015' and ($eArrest03 = '3003001' or $eArrest03 = '3003003' or $eArrest03 = '3003005')"/>
<sch:assert id="assert_CrewDispositionReq" role="[ERROR]" diagnostics="nemsisDiagnostic" 
test="not($ArrestCriteria) or ($eDisposition29HasContent and not($eDisposition29IsNil))">
CARES requires Crew Disposition (eDisposition.29) to be documented on CARES eligible incidents.</sch:assert>
</sch:rule>
</sch:pattern>

Documentation:

Pattern ID: pattern_CrewDispositionReq

Rule Purpose: Ensures that all CARES-eligible incidents have proper documentation of crew disposition with a real value.

Elements:

• Primary: eDisposition.29 (Crew Disposition)
• Related:
• eArrest.02 (Cardiac Arrest Etiology)
• eArrest.03 (Resuscitation Attempted By EMS)

Current Valid Codes (for reference):

• 4229001: Initiated and Continued Primary Care
• 4229003: Initiated Primary Care and Transferred to Another EMS Crew
• 4229005: Provided Care Supporting Primary EMS Crew
• 4229007: Assumed Primary Care from Another EMS Crew
• 4229009: Incident Support Services Provided (Including Standby)
• 4229011: Back in Service, No Care/Support Services Required
• 4229013: Back in Service, Care/Support Services Refused

Error Message: “CARES requires Crew Disposition (eDisposition.29) to be documented on CARES eligible incidents.”