Table 2.

Agreement on adverse events designated by any clinician or group to have resulted in identifiable harm

Medical Record #	Clinician Reviewer	Triggers Selected	Event Description	Proximal Cause	AE Y/N	Severity
11	RN/Medic1	---	---	---	---	---
11	RN/Medic2	T5	Worsening level of consciousness	HEMS provider	No	---
11	RN/Medic3	---	---	---	---	---
11	MC-EMP1	T5	Decrease in mental status after fentanyl dose (>1 mcg/kg)	Non-HEMS	Yes	Harm identified
11	MC-EMP2	T10	Labetalol dose immediately precipitated bradycardia	HEMS provider	Yes	Potential for harm
11	MC-EMP3	T5	ED gave fentanyl and labetalol, patient decompensated	Non-HEMS	Yes	Potential for harm
11	Sr-EMPs	T5	A worsening trend in hemodynamics or mental status after administration of labetalol and fentanyl by ED staff	Non-HEMS	Yes	Harm identified
Medical Record #23 – Event #1
23	RN/Medic1	---	---	---	---	---
23	RN/Medic2	T10	Deviation from standard – no indication for vecuronium at 1932	HEMS provider	Yes	Potential for harm
23	RN/Medic3	T10	Administered paralytic without sedation	HEMS provider	Yes	Harm identified
23	MC-EMP1	T10	Vecuronium administered with inadequate sedation	Non-HEMS	Yes	Potential for harm
23	MC-EMP2	T11	Vecuronium administered for sedation, readministered without consult	HEMS provider	Yes	Potential for harm
23	MC-EMP3	---	---	---	---	---
23	Sr-EMPs	---	---	---	---	---
Medical Record #23 – Event #2
23	RN/Medic1	---	---	---	---	---
23	RN/Medic2	T10	Deviation from standard – Vecuronium at 2030 for facial twitching	HEMS provider	Yes	Potential for harm
23	RN/Medic3	T10	Administered paralytic without sedation	HEMS provider	Yes	Harm identified
23	MC-EMP1	T10	Vecuronium administered with inadequate sedation	HEMS provider	Yes	Potential for harm
23	MC-EMP2	---	---	---	---	---
23	MC-EMP3	---	---	---	---	---
23	Sr-EMPs	---	---	---	---	---
102	RN/Medics	T10	Levophed dose below therapeutic range	Non-HEMS	Yes	Potential for harm
102	MC-EMPs	T8	Failure to adequately manage hypotension	HEMS Provider	Yes	Harm identified
102	Sr-EMPs	---	---	---	---	---
107	RN/Medics	T5	Worsening trend – blood pressure	HEMS provider	Yes	Potential for harm
107	MC-EMPs	T5	Vitals deterioration – hypotension	Undetermined	Yes	Harm identified
107	Sr-EMPs	T5	Declining vital signs	HEMS provider	No	---
109	RN/Medics	T10	Cardizem infusion continued on bradycardic/hypotensive pt.	Non-HEMS	Yes	Harm identified
109	MC-EMPs	---	---	---	---	---
109	Sr-EMPs	T10	Cardizem bradycardic, hypotensive patient by non-hems	Non-HEMS	Yes	Harm identified