This version of the State EMS Forms was posted on this site on 08/23/2010 and revised by the state on 08/02/2006. 

North Dakota has been submitting to NEMSIS since January 2008. North Dakota is submitting 99% of the National EMS Dataset. There are 98% of the states agencies submitting data to the state.

Every licensed ambulance is required to submit data. N.D.A.C § 33-11-01-09.5 requires that all ambulance runs must be reported to the North Dakota Department of Health, Division of Emergency Medical Services (DEMS) in the manner and form determined by DEMS.

The North Dakota Department of Health has collected ambulance information since the 1970s. Paper copies of trip tickets were received from the various agencies and then a full-time dedicated employee compiled the information. In the early 1990s, the Division of Emergency Health Services started scanning the trip tickets using EMScan. In July 2004, the DEMS entered into a partnership with MedMedia to have online data submission. Ambulances were given one year to transition from submitting paper trip tickets to online data submission.

North Dakota has been part of the national movement for pre-hospital data since the 1970s. The DEMS continues to stay closely aligned with the national dataset set forth by the National
Highway Traffic Safety Administration in the National Emergency Medical Services Information System data standard. In 2007, the DEMS worked with MedMedia to transition the SOAR data set to NEMSIS Silver + Compliance. The transition is set to take place early in 2008.

Click on the thumbnails below to view a full sized image.

Patient Care Report

Select the following to view a printable Acrobat (.PDF) version. 

North Dakota PCR Code Sheet (.PDF,31.8k)

North Dakota PCR Sheet (.PDF,19.1k)

North Dakota State Data Dictionary v2.0 rev.  09/2007 (.PDF,2042.64k)

North Dakota State Data Dictionary v1.3 rev. 06/2004(.PDF,871k)

North Dakota Web Data Entry User Manual rev. 04/2004 (.PDF,464k)

Click on the following links to view the corresponding files:

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