NFIRS 5.0 Element: ‘Provider Impression / Assessment’

Definition : The emergency care provider’s primary clinical assessment that led to the management (treatments, medications, procedures) given to the patient.
Purpose : This element identifies whether the treatments or medications provided were consistent with the protocols related to the clinical impression.
Entry : Check or mark the box (one only) that best describes the emergency provider’s impression/assessment.
When more than one choice is applicable to the patient, choose the single most significant clinical assessment that drove the choice of treatment. Check or mark the None/No Patient or Refused Treatment box when there is no patient upon arrival or if the patient refused treatment.

Element Specification

 Specification   Value 
Requirement Optional
Element Type Coded Field – The coded field relating to an entry in the code table. Most coded fields allow for Plus+ One codes. For these fields the expected length of the coded entry is depicted as (National length OR Plus+ One length). Only fields with this notation in the expected length column allow for Plus+ One definitions. If the user has not provided information, an empty field should be transmitted.


10 Abdominal pain. Includes an acute or painful abdomen and cramps. Excludes abdominal trauma (38).
11 Airway obstruction. Includes choking, swelling of the neck, croup, epiglottis, and a foreign body in the air
12 Allergic reaction. Includes reaction to drugs, plants, and insects. Reactions include hives, urticaria, and wheezing.
Excludes stings and venomous bites (35).
13 Altered level of consciousness. Includes patients who appear to be substance abusers or under the influence of
drugs or alcohol.
14 Behavioral: mental status, psychiatric disorder. Includes all situations in which a behavioral or psychiatric
problem is considered the major problem for the EMS provider.
15 Burns.
16 Cardiac arrest.
17 Cardiac dysrhythmia. Includes any rhythm disturbance that was noted on the physical examination or with a
cardiac monitor when the rhythm was the major clinical reason for care rendered by the EMS responder.
18 Chest pain. Includes patients with chest pain related to heart disease, upset stomach, or muscle pain in the
chest wall.
19 Diabetic symptom, related to history of diabetes. Includes hypoglycemia, ketoacidosis, and other complications
of diabetes.
20 Do not resuscitate. Use when there is a legal requirement to prevent emergency medical personnel from initiating
21 Electrocution.
22 General illness.
23 Hemorrhaging/Bleeding. Includes vaginal bleeding, GI bleeding, and epistaxis. When pregnancy is involved,
only use bleeding if this is the major concern to the EMS responder.
24 Hyperthermia.
25 Hypothermia. Usually relates to environmental hypothermia, such as following submersion in cold water,
avalanches, or other environmental exposures.
26 Hypovolemia. Includes patients with clinical shock, usually felt to be hypovolemic.
27 Inhalation injury, toxic gases. Includes smoke inhalation. Excludes overdose and poisoning (29).
28 Obvious death. Patients who were dead upon arrival and no therapy was undertaken.
29 Overdose/Poisoning. Includes taking inappropriate drugs, overdosing, and poisoning from chemicals.
Excludes inhalation of toxic gases (27).
30 Pregnancy/OB. Includes all aspects of obstetric care rendered in the pre-hospital setting.
31 Respiratory arrest. Includes incidents where the patient stops breathing and requires ventilatory support on at
least a temporary basis.
32 Respiratory distress. Includes patients who have only spontaneous breathing.
33 Seizure. Includes major and minor seizures.
34 Apparent sexual assault or rape.
35 Sting/Bite. Includes poisonous snakes, insects, bees, wasps, ants, etc. If an allergic reaction occurs, use code
36 Stroke, cerebrovascular accidents (CVA), or transient ischemic attack (TIA).
37 Syncope, fainting.
38 Trauma. Excludes abdominal pain (10).
00 Provider impression/assessment, other.
NN None/No patient or refused treatment.

Transactions containing ‘Provider Impression / Assessment’

The value of this element is captured by the following transaction :

Need more NFIRS help?

Here are some other useful ressources to learn more about NFIRS.

NFIRS Codes Cheat SheetNFIRS CodingNFIRS ExamplesFDIDsPOCsNFIRS TransactionsNFIRS ModulesNFIRS ElementsNFIRS RulesNFIRS ReferenceNFIRS Compliant ?

You can also read this NFIRS 5.0 Complete Reference Guide, and NFIRS 5.0 Design Documentation in order to have a deeper understanding of NFIRS 5.0. Here are also NFIRS 5.0 Forms ready for you to download and use.

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Last Updated on May 6, 2023