Selecting NERIS Medical Incident Types

"NERIS Medical Types are worth reviewing because they cover more than you'd expect, but far from everything we run on."

The transition from NFIRS to the National Emergency Response Information System (NERIS) brings a more descriptive and structured approach to incident typing.

For medical calls, which make up a significant portion of responses for many departments, understanding the new structure is key to accurate reporting. It is no longer simply a NFIRS 321, but there is a short list of medical incident types. Here we will walk you through selecting NERIS medical incident types, and clarify what to do when no choice seems to fit.

The Structure of NERIS Medical Incident Types

Unlike the numeric codes of NFIRS, NERIS uses a hierarchical text-based system. Medical incidents are categorized under the MEDICAL primary group, which is then broken down into three sub-groups:

Injury: For any injury including trauma-related calls such as falls, vehicle collisions, assaults, and burns.
Illness: For medical conditions like chest pain, breathing problems, seizures, or diabetic emergencies.
Other: A category for medical-related calls that are not direct patient care, such as inter-facility transfers, medical alarms, or community health visits.

A complete NERIS medical incident type looks like this: MEDICAL / <Sub-Group> / <Incident-Type>. For example, a response for a person who has fallen would be coded as MEDICAL / INJURY / FALL.

You can find a complete list of medical incident types on the NERIS Incident Type Codes page.

Commonly Used NERIS Medical Incident Types

These are some of the more commonly used medical incident types in NERIS, for VFDs.

Illness

Definition	Editorial	NERIS Value
Breathing Problems	Difficulty breathing, Respiratory distress, Foreign object aspiration	MEDICAL / ILLNESS / BREATHING_PROBLEMS
Cardiac Arrest	Excluding Chest Pain (Non-Trauma), general Heart Problems	MEDICAL / ILLNESS / CARDIAC_ARREST
Stroke / CVA	Cerebrovascular Accident	MEDICAL / ILLNESS / STROKE_CVA
No Appropriate Choice	Nothing is a good fit	MEDICAL / ILLNESS / NO_APPROPRIATE_CHOICE }
Unknown Problem	Unable to determine the medical situation	MEDICAL / ILLNESS / UNKNOWN_PROBLEM

Injury - including Trauma

Injury can include inhalation, and other non-traumatic injuries, as well as the many types of traumatic injury.

Definition	Editorial	NERIS Value
Fall		MEDICAL / INJURY / FALL
Carbon Monoxide / Other Inhalation Injury	Any Inhalation	MEDICAL / INJURY / CARBON_MONOXIDE_OTHER_INHALATION_INJURY
Motor Vehicle Collision		MEDICAL / INJURY / MOTOR_VEHICLE_COLLISION
Other Traumatic Injury	Nothing is a good fit	MEDICAL / INJURY / OTHER_TRAUMATIC_INJURY

Be Precise where Possible:

Some medical incident types overlap slightly.

For heart problems there is Cardiac Arrest MEDICAL / ILLNESS / CARDIAC_ARREST as well as Chest Pain (Non-Trauma) MEDICAL / ILLNESS / CHEST_PAIN_NON_TRAUMA and also Heart Problems MEDICAL / ILLNESS / HEART_PROBLEMS, so do your best to select appropriately.

There is Altered Mental Status MEDICAL / ILLNESS / ALTERED_MENTAL_STATUS as well as Psychological Behavior Issues MEDICAL / ILLNESS / PSYCHOLOGICAL_BEHAVIOR_ISSUES.

Again, you can find a complete list of medical incident types on the NERIS Incident Type Codes page.

What to Do When No Incident Type Fits

One of the most common frustrations with any reporting system is handling calls where no option seems appropriate. NERIS provides a few ways to handle this, both for medical and injury / traumatic.

Selecting `MEDICAL / ILLNESS / NO_APPROPRIATE_CHOICE`

This incident type is your designated fallback when you have assessed a patient, but their condition genuinely does not fit any other defined category within the Illness or Injury sub-groups.

When to use it:

After a patient assessment is complete.
When the patient’s signs and symptoms are clear but do not align with any available incident type.

When NOT to use it:

As a shortcut to avoid looking for the correct code.
When the problem is unknown (see below).

Using NO_APPROPRIATE_CHOICE should be used sparingly. Always try to find the best-fit category first. Overusing this option can diminish the quality of your department’s data.

Selecting `MEDICAL / ILLNESS / UNKNOWN_PROBLEM`

This code has a very different purpose. MEDICAL / ILLNESS / UNKNOWN_PROBLEM should be used when the nature of the medical problem cannot be determined.

A Simple Rule of Thumb for Illness

If you assessed the patient but the condition is not listed, use No Appropriate Choice.
If you assessed the patient but could not determine the problem, use Unknown Problem.

By understanding the structure and nuances of NERIS medical incident types, your department can ensure more accurate and valuable data is captured, which is the ultimate goal of the new system.