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Introduction

The goal of the V3 STEMI Dashboard is to provide the public with an overview dashboard using nationally submitted data that allows them to characterize STEMI incidents in their state. This is done by examining several types of information:

  • Demographics
  • System Times
  • Scene Information
  • Transportation


Global Inclusion Criteria and Filters

The global inclusion criteria defines the minimum characteristics each event record must meet in order for it to be included in any of the calculations for the V3 STEMI Dashboard. For details on each element, its code, and range of values see the NEMSIS Version 3.4 Data Dictionary.

For this dashboard, our inclusion criteria were as follows:


eSituation.11 - Provider's Primary Impression

    • STEMI of anterior wall    I21.0 Or
    • STEMI of inferior wall     I21.1 Or
    • STEMI of other sites        I21.2

Or

eSituation.12 - Provider's Secondary Impression

    • STEMI of anterior wall    I21.0 Or
    • STEMI of inferior wall     I21.1 Or
    • STEMI of other sites        I21.2

Or

eVitals.03 - Cardiac Rhythm / Electrocardiography (ECG)

  • 9901051 STEMI Anterior Ischemia Or
  • 9901053 STEMI Inferior Ischemia Or
  • 9901055 STEMI Lateral Ischemia Or
  • 9901057 STEMI Posterior Ischemia Or
  • 9901021 Left Bundle Branch Block And
    • eSituation.11 - Provider's Primary Impression = Angina, I20.9 Or
      • Angina unstable I20.0

Or

eProtocols.01 - Protocols Used

    • 9914143 Medical-ST-Elevation Myocardial Infarction (STEMI)
And

eScene.19 - Incident Zip Code

    • A valid zip code for the location of the incident

And

eDisposition.07 - Destination Zip Code

    • A valid zip code for the location of the destination of the patient

And

Submitting State limited to the state the user has access to

The dashboard also includes a number of filters. These filters are defined as follows:

  • Type of Service Requested (Response.05): The type of service or category of service requested of the EMS Agency responding for this specific EMS event
  • Type of Destination (eDisposition.21): The type of destination the patient was delivered or transferred to
  • Unit Dispatch Date (eTimes.03):The date/time the responding unit was notified by dispatch

Elements of the Dashboard

This dashboard is divided into four views with one common visualization, Probability of Survival. The four views are Patient Acuity, Trauma Center & Risk Factors, Hospital Capabilities, and Cardiac Arrest.

Probability of Survival

This visualization displays information on injury severity using a complex measure called the revised trauma score (or RTS) to calculate an approximate probability of survival. Patients who present with a probability of survival of 36.1% or less are considered severely injured and should be transported to a level 1 trauma center. RTS is calculated as described in the box below, and its value translate to a probability of survival as described in the companion bar chart.

The probability of survival visualization uses counts to display the number of patients in each category, as there is a large bias toward less injured patients in the NEMSIS activations. To use this visualization as a filter, click on any of the cells or percentages, to exit the filter click on the cell or percentage again.

Patient Acuity

The Demographics section of this dashboard contains three visualizations, which display four metrics: age, gender, dispatch complaint, and level of service.

Initial Patient Acuity

Timeline

Detail

Final Patient Acuity

Timeline

Detail

Trauma Center & Risk Factors

The Demographics section of this dashboard contains three visualizations, which display four metrics: age, gender, dispatch complaint, and level of service.

Trauma Center

Timeline

Detail

Risk Factors

Timeline

Detail

Hospital Capabilities

The Demographics section of this dashboard contains three visualizations, which display four metrics: age, gender, dispatch complaint, and level of service.

Timeline

The age and gender visualization displays the percentages of total motor vehicle activations that fall into the indicated age (ePatient.15 and ePatient.16) and gender groups (ePatient.13). To see a count of activations, simply mouse over a cell in the table, and a tooltip will appear with more information on that grouping. For this table, darker color is indicative of a greater number of patients in the given group.

To use this visualization as a filter, simply click on the cell, row or column you would like to filter on. To exit the filter, click on that cell, row or column again.

Detail

The Dispatch Complaint bar chart displays the percentage of total activations where a given complaint was reported to EMS dispatch (eDispatch.01).

Cardiac Arrest

The Demographics section of this dashboard contains three visualizations, which display four metrics: age, gender, dispatch complaint, and level of service.

Timeline

The age and gender visualization displays the percentages of total motor vehicle activations that fall into the indicated age (ePatient.15 and ePatient.16) and gender groups (ePatient.13). To see a count of activations, simply mouse over a cell in the table, and a tooltip will appear with more information on that grouping. For this table, darker color is indicative of a greater number of patients in the given group.

To use this visualization as a filter, simply click on the cell, row or column you would like to filter on. To exit the filter, click on that cell, row or column again.

Detail

The Dispatch Complaint bar chart displays the percentage of total activations where a given complaint was reported to EMS dispatch (eDispatch.01).

Tableau Toolbar

All Tableau dashboards share the same toolbar at the bottom of the view. Note that while most dashboards will have the same selections, some items may differ based on user permissions.

Undo, Redo, Revert, Refresh and Pause

These selections are found on the left side of the Tableau toolbar and can be used to help navigate the dashboard.

 

Undo will remove the last selection made, if you have used undo to remove a selection, you can then use redo to return to that selection. Revert returns the dashboard to its original view. Refresh will reload the data on the dashboard subject to any selections made. Pause will stop the dashboard from refreshing as you make selections.

As an example, if you want to make a set of complete selections in a dashboard’s filters, you could use these buttons to speed up the process. Normally every time a change is made, the dashboard will refresh. If you select “Pause” however, the dashboard will remain the same no matter how many selections you make. Once you have made all your selections, you can select “Refresh” to reload the dashboard based on those selections.

Subscribe, Custom Views, Edit, Share, and Download

These selections are found on the right side of the Tableau toolbar and can be used to interact with the dashboard in external ways.

 

The Subscribe button allows users to subscribe to a daily or weekly email that will show a static image of the dashboard as well as a link to the view.

You can select either a particular view (tab) or all the views (tabs) available in the dashboard. Under “Email Subscriptions” you can choose the frequency of emails and in “Subject Line” you can assign the subject for the emails. As a default, the subscription will be assigned to the email address associated with your NEMSIS account.

Custom Views allows users to save any particular set of filters or selections for quick access later. A user can create their view and then name it and save it either for their own personal use or use by anyone with access to this dashboard. Previously saved views will appear in the custom views tab.

Edit will open the dashboard in the web editor for Tableau. Note that this option is not available on all dashboards and will require some knowledge of how to use Tableau to build and edit dashboards.

Share will provide a couple of options for sharing the dashboard with others; specifically an embed code and a regular HTML link. While you can use the link to share the dashboard with others, please keep in mind that many of the NEMSIS dashboards will require a username and password so only those with credentials will be able to access them.

The last option is Download. Clicking on the download button opens up several options to download either the workbook, the data within it, or a static image of the view.

Selecting any one of these file types will produce a download of the requested file. Remember that not all options will be available for all dashboards and views.

Contact Info

Any questions, comments, concerns or suggestions with regard to this or other reports made available by the NEMSIS TAC, please contact us or leave a comment below!

Contact information is also available on our website.

Kevin White, BS
University of Utah School of Medicine
NEMSIS Technical Assistance Center
Phone: (801) 213-3408
Fax: (801) 581-8686
Email: kevin.white@hsc.utah.edu
Laurel Baeder, BA, MStat
University of Utah School of Medicine
NEMSIS Technical Assistance Center
Phone: (801) 587-7367
Fax: (801) 581-8686
Email: laurel.baeder@hsc.utah.edu




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