version 5.0

Version 5.0

Field Bridge

Overview• The Virginia OEMS has been using State Bridge [VPHIB] for over 11

months now. Their initial push was to insure all Virginia agencies were preparing and submitting Patient Care Reports correctly and in a timely manner.

• They feel this task is now complete and are now beginning the next step of reviewing the quality of data submitted.

• Most agencies across Virginia found that they were submitting data at much less than 100% complete.

• We were tasked with determining the states data requirements and creating validation rules that were inline with these requirements.

• As a result, there are many more fields that require data. • This training is designed to show you each screen and tab and answer any

questions about the system.

Ground Rules• Narratives – One must be created for ALL calls.

– Transports, Refusals, Cancelled, Stand-bys… etc .etc.

• CAD Interface – If you are unable to pull CAD data into the laptop:– Check the SPRINT connection. Sometimes Sprint lies, it says you are connected, but you are not. Try

GOOGLE.– If Sprint has been verified and connected and you are still unable to load the data, contact system

administrators.

• “Not Applicable” or “Not Known”. – The state has decided this is not appropriate data submission for some fields. They have been

removed as options in these fields. .

• Some field names have been changed in an attempt to make the data “flow” better.

NEMSISNational Emergency Medical Services Information System.

NEMSIS is the national repository that will be used to potentially store EMS data from every state in the

nation

Terminology

VPHIBVirginia Pre-Hospital Information Bridge

VPHIB is used for a variety of uses including: system planning, system evaluation, grants management, support legislative inquiries,

contribute to other state and national databases, monitor triage programs and more.

Terminology

STATE BRIDGE

The ImageTrend State Bridge enables State EMS agencies to securely collect, analyze and report

on statewide EMS data

Terminology

RESCUE BRIDGE

Rescue Bridge is fire and EMS solution incorporating ePCR, fire inspections, pre-planning and inventory data collection and management in

a paperless environment.

Terminology

FIELD BRIDGE

Field Bridge is a pre-hospital patient care data collection and reporting application. Designed to

assists EMS personnel in quickly generating complete electronic ePCRs in a mobile

environment.

Terminology

NFIRS

National Fire Information Reporting System:A standard national reporting system used by U.S. fire departments to report fires and other

incidents(EMS) to which they respond to.

Terminology

VFIRS

Virginia Fire Information Reporting System:

The Virginia Department of Fire Programs (VDFP) manages these reports. VFIRS is the statewide system

for tracking all emergency responses with fire departments in Virginia.

Terminology

Log into Field Bridge

Image Trend Ver. 5.0Training

• Log into Field Bridge– Username– Password– Verify Database you are signing

into.• DFREM • Co1• Co2• Etc.etc.

• You can SYNC here or once you have signed in.

• SETTINGS is where you would SYNC-ALL.• SYNC-ALL will reload the entire database.


• Field Bridge SYNC actually loads updated database items from the Rescue Bridge server located in Minnesota. – Items in this SYNC include but

are not limited to: • New or updated member

names.• New or updated validation rules. • New or updated medications.• New or updated apparatus.• Many more items.

– Items not loaded are:• Records generated on other

laptops.


• Now you are ready for the next call.

• If you staff units, you can pre-fill some information that will forward to the ePCR when you open a new one.– They are:

• Current Unit:– Select from the dropdown the

unit you will be staffing.• Current Shift:

– Select from the dropdown:» Career, Volunteer, Combo

• Current Crew:– Select Add Personnel– Select from the dropdown the

personnel riding and their position on the unit.

Starting A Call


• When a call comes in:– Select DOWNLOAD CAD

from the top left screen. • A popup of calls, including

your unit number, will appear.

• You can also select [All] which will display all calls and units for several days.

To Scene Tab


• ePCR is now open and ready for input.

• RED tabs indicate missing data that’s required by the State of Virginia for ePCR reporting.

• ALL “To Scene” TABS need to be completed for ALL calls. Even Cancelled Calls.


To Scene – Personnel Tab• If you entered crew on the

dashboard, this will auto fill.• You can also add or remove

personnel here if desired. • You should verify correct

personnel and positions have been added.


To Scene – Dispatch Information Tab• If everything is working with

CAD and the server, this data is automatically loaded with the exception of several type of calls.

• There is a open Image Trend problem ticket on these items.


To Scene – Dispatch Information Tab• If you have to fill any of

these fields these out due to CAD service interrupts, PLEASE enter the Incident number as YYXXXXX. (Max of 7 characters)

• • Rip and Tear will display the

incident as 2011-12345• DO NOT ENTER the “-” or

the “20” for 2011.


To Scene – Incident Address Tab• If everything is working with

CAD and the server, this data is automatically loaded with the exception of several fields. – They are:

• Postal Code:• First Due Zone:


To Scene – Incident Address Tab – Postal Code• Postal Code:

– If you are unsure of the postal code, you can use the :Postal Code reference” dropdown and select the correct code.

– You will find the most used postal codes in and around the Fauquier County area. - If you need one added, see your administrator.


To Scene – Incident Address Tab – First Due Zone• First Due Zone:

– Select the correct “FIRST DUE ZONE”. Use the zone for the dispatched box number.

– Example » Box 0101 would be

zone 01-Warrenton. » Box 0701 would be

zone 07-Catlett.» Etc….


To Scene – Response Information Tab• Response Information has

several fields we are unable to [DEFAULT]. – They are:

• Location Type• Primary Role of Unit

• The other fields [DEFAULT] but should be reviewed.– They are:

• Response Request.• Vehicle Type.• Response Mode to Scene.• Response Urgency.


To Scene – Response Information Tab – Location Type• Location Type:

– Select the correct type.


To Scene – Response Information Tab – Primary Role of Unit• Primary Role of Unit:

– Select the correct role.


To Scene – NFIRS – Incident Type • Incident Type:

– Select the correct type from the dropdown.

– Most used EMS selection are now at the TOP.


To Scene – NFIRS – Primary Action Taken• Primary Action Taken:

– Select the correct action from the dropdown.

– Most used EMS selection are now at the TOP.

Patient Information Tab


Patient Information• Patient Information


Patient Information – Response Disposition • Select the correct option

– Treated and Transported ALS/BLS - if you transport.

– Treated, Transferred - care if you flew the pt, or turned over to another agency.

– Treated, Transported by Law Enforcement.– Treated, Transport by POV.– Treated and Released if you treated and released. – Patient Refused Care – Must obtain a signature

and reason why they refused. State says: All refusals are AMA.

– Dead at Scene – If confirmed code.– No Treatment Required – if no treatment

required. – No Patient found – if unable to locate a patient. – Unable to locate a patient – if unable to locate. – Standby Only – All Fire calls with no patient.– Cancelled – If cancelled.

• Remember - - - Must complete ALL fields on “To Scene” tab and reload CAD times before closing a cancelled call.


Patient Information – Patient Demographics• Enter Last Name and select

the REPEAT PATIENT button above. This will search under your agency to see if this patients data is already there.


Patient Information – Patient Demographics – Repeat Patient• If your agency transported within

the last 6 months, their name should drop down as shown here.

• Place curser over the correct one and double click or select the OPEN button to the right of the name.

• The data will automatically populate the correct fields.

• The Past Medical Hx will populate as well as long as it was entered by the last provider.


Patient Information – Patient Demographics• All fields in RED are

required if you treated in any way, for Patient Refusals, or for DOAs.


Patient Information – Patient Demographics• Last Name – Please not all CAPS or all small letters.

(example-Jones… not jones or JONES) .• First Name – Same rules as Last name. • Enter your Unit Number – (example- M1, A1-1, )

– If you transport more that one patient, please add a unique number at the end of your unit number. (example- M1-1,M1-2. or A1-1-1, A1-1-2)

• Race – Select from dropdown.• Ethnicity – Select from dropdown. • Gender – Select from dropdown.• SSN – Try to obtain, but if you can not, please enter

999-99-9999, Do Not Enter 0’s or 8s. • Date of Birth – MM/DD/YYYY• Age will auto calculate.• Address – If the patient is home, you can select the

“GET INCIDENT ADDRESS” bar above and it will auto fill from the dispatched address.

• Postal code – will auto fill as well. If home address is different, just enter the postal code and select the “ SET FROM POSTAL CODE” bar.


Patient Information – Past Medical History• Medical History selection box –

– Selecting the (+) will give you a dropdown to select from. Place curser over the correct selection and click once, then move to another and click once again. If you want to remove a selection, just place curser over and click again.

• Other medical history – – Enter any history that is not in the dropdown.

• History obtained by-– Select from dropdown

• Pregnancy-– If Female and between 12 and 50, State requires this

data.

• Patient Medications –– Select “Add Patient Medication” and select from

dropdown. If medication is not listed, [email Butch, the name of the drug and It will be added to the list]

• Patient Drug Allergies – – Select “Add Patient Medication” and select from

dropdown.


Patient Information – Barriers to Patient Care• If any barriers to patient

care, change here.• We currently [DEFAULT] to

None.


Patient Information – First Responder Agencies / Prior Aid• We [DEFAULT] all fields. If

any differences just change.


Patient Information – Vehicular Information • If vehicle accident was indicated and

injury was indicated ALL fields are required.

• Select from the dropdowns of each box.

Vitals, Meds, Procedures Tab


• Vitals, Meds, Procedures

Vitals, Meds, Procedures


• Must enter provider impression. – Select from dropdown

• Must also enter secondary impression. State Required.– Can use Not Applicable in this

field.

Vitals, Meds, Procedures – Provider Impression


Vitals, Meds, Procedures – Patient Condition• Onset Date/Time –

– Handy, but not required

• Chief Complaint – Required– Free form text.

• Duration of that complain – Required • Unit of measure –

– Select from dropdown.

• Secondary Complain – – If applicable.

• Duration of Secondary Complaint – If complain.

• Alcohol/drug Use – Required – Required – [DEFAULT] to NO.

• Primary Symptom – Required– Select from dropdown.

• Other Symptoms – Required– Select from dropdown.

• Anatomic Location Complain – Required– Select from dropdown

• Organ System Complaint – Required – Select from dropdown.


Vitals, Meds, Procedures – Patient Condition• Trauma Information

• Possible Injury – Required– Select from dropdown

• Cause of Injury – – Select from dropdown

• Mechanism of Injury – – Select from dropdown.

• Injury Intent – – Select from dropdown.

• Height of Fall (feet) – – Enter number of feet. If from standing position (enter 1 foot).


Vitals, Meds, Procedures – Vitals, Meds, Procedures, EKGs

– Vitals, Meds, Procedures, EKGs tab– Enter your Medications.

• Select the Add Med button.– Enter your Procedures.

• Select the Add Proc button.– Enter your Vitals

• Select the add vitals button.– Enter your EKG assessment.

• Select the Add EKG button

• Each are defined in the next few slides.


Vitals, Medications, Procedures, EKGs – ADD VITALS TAB (1)

• Blood Pressure–– Enter numbers

• Pulse –– Enter pulse.

• Resp –– Enter rate.

• SpO2 –– Enter number

• SpO2 Qualifier –– Select from dropdown

• Pulse Rhythm –– Select from dropdown

• Resp. Rhythm –– Select from dropdown.

• BP Location – – Select from dropdown.

• Patient Position –– Select from dropdown.

• Remember: – Make sure date / time is correct



• Pain Scale –– Enter numbers .

• Blood Glucose –– Enter number. If meter says High or low, check the

appropriate box .

• ETCO2 –– Currently not available. .

• GCS –– Enter number

• APGAR –– Enter a number.

• Temp F C –– Enter a number.

• Temp Method –– Select from dropdown.

• Crew – – Will [DEFAULT] to PCP. Make sure correct name displayed.

• Response Level –– Select from dropdown.

• Remember: – Make sure date / time is correct



• Response Level –– Select from dropdown.

• Stroke Scale –– Select from drop down if appropriate.

• Breathing – – Select from dropdown.

• Airway –– Select from dropdown.

• Prior to arrival –– Select from dropdown.

• Revised trauma Score –– Enter number.

• Pediatric Trauma Score –– Enter number.

• Remember: – Make sure date / time is correct– Click Save or Save and New


Vitals, Medications, Procedures, EKGs – ADD PROC TAB• Procedure Name –

– Select from dropdown

• Size of Equipment –– Enter if appropriate.

• Location –– Select from dropdown

• Attempts –– Enter a number

• Success –– Select from dropdown

• Patient Response –– Select from dropdown

• Prior to Arrival –– Select from dropdown.

• Crew Id –– Make sure correct name is displayed.

• Authorization – – Select from dropdown

• Authorizing Physician –• Complication –

– Select from box.

• Comments – – Short free form to make any comments.

• Remember: – Make sure date / time is correct– Click on Save or Save and New.


Vitals, Medications, Procedures, EKGs – ADD MED TAB• Medication Name –

– Select from dropdown

• Dosage –– Enter number.

• Dosage Unit –– Select from dropdown

• Route –– Select from dropdown.

• Response to Medication –– Select from dropdown

• Prior to Arrival –– Select from dropdown.


• Authorization – – Select from dropdown

• Authorizing Physician –• Complication –

– Select from box.

• Comments – – Short free form to make any comments.



Vitals, Medications, Procedures, EKGs – ADD EKG TAB• Select the correct EKG method –

– Place curser over correct dot and click.

• Interpretation –– Select from dropdown

• EKG Ectopy –– Select from dropdown.

• EKG Lead –– Select from dropdown

• Cause for Change –– Select from dropdown.

• AED, Pacing, Co2 Mode– Select from dropdown.

• Type of Shock –– Select from dropdown.


• Shock or Pacing Energy – – Select from dropdown

• Total Number of Shocks –– Enter number.

• Pacing Rate –– Enter number.



Vitals, Meds, Procedures - Assessments• You can select:

– Medical– Injury– Burn

• Note – If you select any of the three, you will get a picture of a anatomically correct human.

• Open with caution in public.


Vitals, Meds, Procedures – Assessments – Medical

• Click on the anatomical location of the medical incident and add information.



Vitals, Meds, Procedures – Assessments – Injury

• Click on the anatomical location of the injury and add information.



Vitals, Meds, Procedures – Assessments – Burn • Click on the anatomical

location of the burn. – One click causes 1st degree.

(purple)– Two clicks displays 2nd degree.

(yellow)– Three clicks displays 3rd degree.

(red)

• System also calculates BSA as you click.



Vitals, Meds, Procedures – Cardiac Arrest• Cardiac Arrest –

– [DEFAULT] NO – If yes, Change it to YES.

• Required fields will change to RED, however ALL fields should be reviewed if Cardiac Arrest = YES.

From Scene Tab


From Scene• From Scene


From Scene – Patient Transport / Positioning• All three fields must be completed for

transports. – Patient moved to Ambulance –

• Select from dropdown.

– Patient position in Transport –• Semi-Fowlers is the [DEFAULT],

Change if necessary.

– Patient Moved From Ambulance –• Stretcher is the [DEFAULT], Change if

necessary.


From Scene – Transport Mode From Scene

• Select the correct type of mode. – [DEFAULT] - No Lights or sirens


From Scene – Destination Name

• Select the correct destination. – Select the appropriate hospital from

the dropdown.


From Scene – Destination Type

• Select the correct destination type. – Select the appropriate destination

type.


From Scene – Destination Determination

• Select the correct destination determination. – Select the appropriate destination

determination.


From Scene – Mileage• Enter correct mileage from the odometer

and it must include “tenths”. This is a NIMSIS – Starting Mileage – Odometer reading from the

station or your beginning location with tenths. Example-[12034.7]

– At Scene – Odometer reading at the scene of the incident. with tenths Example-[12040.2]

– At Hospital – Odometer reading at the hospital. with tenths Example-[12050.4]

– Ending Mileage – Odometer reading when you are back at the station or your original starting place. with tenths Example-[12060.9]

• Enter LOADED mileage carefully. These are “billed miles” and subject to audit.

• If you do not transport, you still need the Beginning and Ending Mileage.


From Scene – Narrative• Enter your narrative.

– Free form text with spell check. Be specific in your narrative.

– You can use the CHARTED narrative option, HOWEVER, it must be updated and reviewed prior to completion.

– Remember, if you make note of a Procedure, an EKG, a set of Vitals, or Meds administration, YOU MUST document it under the “Vitals, Meds, Procedures TAB.

• Also remember – – If you didn’t document it , in the court of

law, it didn’t happen. – It’s not what you remembered, it’s what

you wrote down.


From Scene – Valuables

• Enter any valuables, belongings the patient may have entrusted you with. – You can select from the dropdown, or enter

others not listed.


From Scene – Delay

• Document any delays you may have encountered. – [DEFAULT] is set to NONE on all four.

• Really only need to document significant delays. • Delays by a one minute train passing versus a

stopped train.• Delays by having to run from outside versus you

were coded.• Delays by taking extra time to load a patient versus

waiting for animal control to gain access to a patient.

• Delays by taking extra time to complete a long narrative versus hospital not finding you a room for 10 minutes.

Signature Tab


Signatures

• Signatures


Signatures – Patient Signature

• Signatures– Select the HIPAA Consent-

• Try to explain what HIPAA is.

– Select the Authorization to Billing.• Try to explain Fauquier County Compassionate

Billing policy.• Billing agency will bill your insurance company first.• If no insurance – they will bill the patient--- BUT if

they are unable to pay, the bill is waived.

– Select the Waiver of Liability only of you obtain a Patient Refusal.

– Have Patient sign whenever possible.• If not possible – (unresponsive)- Just take the pen

and put your initials in the field.


Signatures – Against Medical Advise

• If Patient Refuses transport.– Check the box in the top left called – Attach AMA to

this Incident.

• Fill out as much information as possible.

• Remember this is to cover you.


Signatures – Technician Signature

• Technician signs all reports.


Signatures – Hospital / Receiving Agent Signature

• Signature obtained by nurse you are turning patient over to.

• If only BLS procedures performed, this is the only signature you need from the hospital.


Signatures – Medical Control / Physician Signature

• Signature obtained by any ER Doctor.

• If ALS procedures performed, you must obtain a signature from the Doctor.


Signatures – Controlled Substance Waste Signature 1

• Signature must be obtained by any ER nurse if you waste NARCOTICS.

• If NARCOTICS are used, you must obtain a signature from the Doctor.

• When replacing the NARCOTICS box:– Box must contain all narc’s not used or wasted.– Red tag.– Printed copy of the Run Sheet with a signature of

the Doctor. If you have unused narcotics, the run form must also contain the signature of the nurse that witnessed you waste these narcotics.


Signatures – Controlled Substance Waste Signature 2

• Narcotics that were wasted must be listed below in the dropdown.

• If more than two narcotics were partially used, document in the narrative and let Image Trend Administrator know.

POWER TOOL BARDown Left Side of Screen


Power Tools

• GCS• Select the blue button for each

test:– Eye– Verbal– Motor– Qualifier

• Your GCS score is totaled and posted in the Vitals tab automatically.

• Verify your times field.


Power Tools

• VITALS• Enter appropriate data for each

check:– Pulse– Respirations– Blood Pressure– BP Location– SpO2– Blood Glucose

• Your Vitals are posted in the Vitals tab automatically.



Power Tools• PQRST• Select the blue button for each test:

– Provoked– Quality– Region– Radiation– Duration– Severity– Narrative – Short informative comments

only.

• Your information is posted in the Vitals tab automatically.



Power Tools

• CARDIAC• Select the correct medication as

it is administered. It will display meds and times to the right.

• Press OK at the bottom and your meds information is posted in the Vitals tab automatically.



Power Tools

• MEDS• Select the green button for each

Medication administered:– Medication– Dose– Unit of measure– Route– Site– Response

• Your MEDs are posted in the Vitals tab automatically.



Power Tools

• PEDIATRIC• Select the correct weight of the

child: Example 26-30 lbs

– Correct doses are displayed for that size child. No need for the Pediatric Emergency Tape. (AKA Broselow)


Power Tools

• Same as under the Vitals, Meds, Procedures Tab.

• Click on the anatomical location of the medical incident and add information.



Vitals, Meds, Procedures – Assessments – Injury

• Same as under the Vitals, Meds, Procedures Tab.

• Click on the anatomical location of the injury and add information.



Power Tools• Same as under the Vitals, Meds,

Procedures Tab.

• Click on the anatomical location of the burn. – One click causes 1st degree.(purple)– Two clicks displays 2nd degree.

(yellow)– Three clicks displays 3rd degree.

(red)• System also calculates BSA as you click.


Down Right Side of Screen


Right Side of Screen

• Response Times• All fields should auto-fill from the

CAD data with the exception of:– Arrived Patient

• Only needed if you made patient contact.

– In Service• If you POST before you enter the In

Service time, GO BACK AND FIX and RE-POST.

– This is one of the single most points of STATE failure.

• Loading CAD data again here is a good idea.



• Validation• Now we are synchronized with

the state codes: If you reach 100% here, we actually are 100% with the state.

• By selecting this tab, you can see why we are not 100% complete and how many points the STATE takes off.

• It will take you to the screen with the missing field(s).



• Active Protocols• Select this tab and you get a

dropdown where you can select active protocols. – Placing a check mark in the fields will

auto-fill the vitals tab.



• JotPad• Free form note pad. These notes

become part of your overall report.

Across the top


• Laptop screen overview


• Save Button – Saves the report to the laptop only.

Top Line View


• CAD Button – Loads CAD data to the report.

• Can be used anytime during the call.• Will only overwrite the fields

supplied by CAD. • Incident number• Location of call• Times

• Will not overwrite the any other fields you entered.

Top Line View


• POST Button – Prepares report to be uploaded (POST) to Minnesota (Rescue Bridge).

Top Line View


• POST Button – Note that the system is uploading to Rescue Bridge.

Top Line View


• POST Button – Note that the system is validating the report for Rescue Bridge.

Top Line View


• POST Button – Posting is now complete.

• HOWEVER – Remember the POST/SYNC does two things. • POST – Posts the report to Rescue Bridge.• SYNC – Synchronizes the Field Bridge.

• If the POST fails – SYNC will still show 100% complete.• Don’t be fooled.

Top Line View


• PRINT Button – Prepares report to be printed. • This may take a few seconds because it is

generating a PDF file.

• Print one copy for the hospital.• If you used NARC’s print two copies.

• One for the hospital.• One to accompany the NARCs to the

Pharmacy.

Top Line View


• MORE Button –

• History – • Tracks all activity for the report.

Top Line View


• MORE Button –

• Transfer Run– • Ability to send data to another agency.

• Example - • Catlett starts a call and Medic 1 rendezvous. Catlett

can upload the data they have acquired and Medic 1 can complete from there.

Top Line View


• MORE Button –

• Attach – • Can attach additional documents to the

report. Currently not used.

Top Line View


• MORE Button –

• Delete – • You can delete the entire report if desired.

• Not recommended.

Top Line View


• CLOSE Button –

• Closes that report –• Returns you to the Dash Board.

Top Line View


• Dash Board will display a check mark next to the run.

Verify POST complete

Any Questions ?

version 5.0

Documents

cad data

quality of data

data flow

information reporting

system planning

statewide system

state bridge vphib

training field bridge