CH EMS (R4), published by HL7 Switzerland. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7ch/ch-ems/ and changes regularly. See the Directory of published versions

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Official URL: http://fhir.ch/ig/ch-ems/ImplementationGuide/ch.fhir.ig.ch-ems				Version: 2.0.0-ballot
Active as of 2026-06-12				Computable Name: CH_EMS
Copyright/Legal: CC0-1.0

Introduction

This FHIR implementation guide defines a standardised information workflow applicable to Swiss emergency services (EMS). It is used as a basis for projects to digitalise the processes in the Swiss emergency services and to connect these organisations to other EMS, hospitals and the Swiss Electronic Patient Record (EPR).
The project is under the leadership of the "Interverband für Rettungswesen".
This exchange format is established as a standard by the association eCH under the number eCH-0207, and by the HL7 User Group Switzerland under the name CH EMS.

Download: You can download this implementation guide in npm format from here.

Identification: OID: 2.16.756.5.30.1.143.1.1

Swiss specific context

The CH EMS implementation guide describes the FHIR representation of the defined Emergency Medical Service protocol. This implementation guide is dependent on CH Core and CH Term, which describe the Swiss specific context, especially related to the Swiss electronic patient record (EPR).

Swiss context

The CH EMS profiles are based on the CH Core basic profiles. Thus, the examples of the EMS protocols are valid in the Swiss context. In order to verify the correctness, the documents can be validated against the CH EMS Document Profile. (The requirements of the CH Core Document Profile are thus also fulfilled and checked).

Validation: see README CH EMS

Swiss EPR context

If the documents are used in the EPR context, the requirements of the CH Core Document Profile EPR must also be fulfilled. For the use case of the emergency services, there are two main aspects that must be considered in the EPR context:

• The social security number (AHVN13) of the patient must not be stored in the EPR
• For a valid EPR document, the name and date of birth of the patient must be known, which is not always guaranteed in emergency services

To support the compatibility check against the CH Core EPR profiles, a warning is generated in case of deviations during validation:
'ch-ems-epr: Warning that the resource is not conform to the CH Core EPR restrictions'

Validation: see README CH Core

Must Support

For the CH EMS exchange format, the mustSupport flag set to true has the following meaning:
If the sending application has data for the element, it is required to populate the element with a non-empty value. If the value is not known, the element may be omitted.

Analysis & Dependencies

The following documentation describes the license and terms of use for various content (IP Statements) used in this IG. The cross-version analysis (Cross Version Analysis) shows the compatibility of this IG with FHIR R4 and R4B. In addition, dependencies and packages ([Dependency Table] (#dependency-table)) and a statement about global profiles ([Globals Table] (#globals-table)) are listed. These sections are automatically generated by the tooling.

IP Statements

This publication includes IP covered under the following statements.

• CC0-1.0
  Show Usage
  • eCH-011 Types: CHEmsPatient
  • IVR Codes: ActRecovAid, ActRespiOwner... Show 105 more, Bundle/1-Einsatzprotokoll, Bundle/1b-Einsatzprotokoll, Bundle/2-Einsatzprotokoll, Bundle/2b-Einsatzprotokoll, CHEmsComposition, CHEmsEncounter, CHEmsExtDisinfection, CHEmsExtEmergencyDoctorSystem, CHEmsExtIdentification, CHEmsExtOwner, CHEmsExtPerformer, CHEmsExtPersonRole, CHEmsExtTeamRole, CHEmsExtUrgencyAdequate, CHEmsExtValuablesPatient, CHEmsExtViolence, CHEmsLocationLocationDestination, CHEmsObservationAVPU, CHEmsObservationAnamnesisEvent, CHEmsObservationAnamnesisSymptom, CHEmsObservationBreathing, CHEmsObservationColdExposure, CHEmsObservationGCS, CHEmsObservationHeartRate, CHEmsObservationHeatExposure, CHEmsObservationMissionTimeStatus, CHEmsObservationNACA, CHEmsPractitioner, CHEmsPractitionerRole, CHEmsProcedurePrecautionsInfection, CHEmsProcedureTransportation, Composition/1-Einsatzprotokoll-Composition, Composition/1b-Einsatzprotokoll-Composition, Composition/2-Einsatzprotokoll-Composition, Composition/2b-Einsatzprotokoll-Composition, ECH0207bedding, Ech0207InfectPersPrecaution, Ech0207personRole, Ech0207transDisinfection, EmergDoctSystem, Encounter/1-Einsatz, Encounter/2-Einsatz, Encounter/EncounterExample, GcsAugenoeffnung, GcsMotoric, GcsVerbal, IVRVSPulseMethod, IVRVScoldExposure, IVRVSevent, IVRVSformation, IVRVSheatExposure, IVRVSidMedium, IVRVSidSource, IVRVSintensity, IVRVSlocationType, IVRVSmissionTimeRole, IVRVSoffender, IVRVSrespirationObservation, IVRVSsymptom, IVRVSteamRole, IVRVStransReason, IVRVSurg_adequate, IVRVSvalTxpe, IVRVSviolenceForm, IVRVSviolenceResult, Location/LocationAmbulance, LogicalModelEmsProtocol, MissionType, NACA, Observation/1-Alarm, Observation/1-ArrivalAtTarget, Observation/1-ArrivalOnScene, Observation/1-ArrivalPatient, Observation/1-DepartureFromScene, Observation/1-Disposition, Observation/1-GCSBefund, Observation/1-GCSUebergabe, Observation/1-NACAUebergabe, Observation/1-Rollout, Observation/1b-DepartureFromTarget, Observation/1b-OperationalReadiness, Observation/2-AVPUBefund, Observation/2-Alarm, Observation/2-ArrivalAtTarget, Observation/2-ArrivalOnScene, Observation/2-ArrivalPatient, Observation/2-DepartureFromScene, Observation/2-Disposition, Observation/2-GCSBefund, Observation/2-GCSUebergabe, Observation/2-NACAUebergabe, Observation/2-Rollout, Observation/2b-DepartureFromTarget, Observation/2b-OperationalReadiness, Observation/ObservationHeartRateTachycardia, Observation/ObservationSecondDegreeBurn, Observation/ObservationSecondDegreeFrostbite, Patient/PatientExample, Practitioner/SaniInAusbildung, PreTreatmen, Procedure/1-Transport, Procedure/ProcedureTransportation, Procedure/Vorbehandlung, Urgency and Vigilanzavpu
  • EDQM - Standard Terms: Bundle/1-Einsatzprotokoll, Bundle/1b-Einsatzprotokoll... Show 4 more, LogicalModelEmsProtocol, MedicationAdministration/1-Infusion, MedicationAdministration/1-Spray and MedicationAdministration/MedAdminFentanyl
• ISO maintains the copyright on the country codes, and controls its use carefully. For further details see the ISO 3166 web page: https://www.iso.org/iso-3166-country-codes.html
  Show Usage
  • ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code: ActRecovAid, ActRespiOwner... Show 125 more, Bundle/1-Einsatzprotokoll, Bundle/1b-Einsatzprotokoll, CHEmsAllergyIntolerance, CHEmsCodeableConcept, CHEmsCoding, CHEmsComposition, CHEmsCoverage, CHEmsDevice, CHEmsDocument, CHEmsEncounter, CHEmsExtDisinfection, CHEmsExtEmergencyDoctorSystem, CHEmsExtIdentification, CHEmsExtLaterality, CHEmsExtOwner, CHEmsExtPerformer, CHEmsExtPersonRole, CHEmsExtTeamRole, CHEmsExtUrgencyAdequate, CHEmsExtValuablesPatient, CHEmsExtViolence, CHEmsLocationAmbulance, CHEmsLocationLocationDestination, CHEmsMedication, CHEmsMedicationAdministration, CHEmsMedicationStatement, CHEmsObservation, CHEmsObservationAVPU, CHEmsObservationAirways, CHEmsObservationAnamnesisEvent, CHEmsObservationAnamnesisSymptom, CHEmsObservationBloodPressure, CHEmsObservationBreathing, CHEmsObservationCardiacArrest, CHEmsObservationColdExposure, CHEmsObservationConditionChange, CHEmsObservationDeathManner, CHEmsObservationDiagnosis, CHEmsObservationGCS, CHEmsObservationHeartRate, CHEmsObservationHeatExposure, CHEmsObservationMissionTimeStatus, CHEmsObservationNACA, CHEmsObservationPupilShape, CHEmsObservationPupilSize, CHEmsObservationStatusPriority, CHEmsObservationStrokeFAST, CHEmsOrganization, CHEmsPatient, CHEmsPractitioner, CHEmsPractitionerRole, CHEmsProcedure, CHEmsProcedureAirways, CHEmsProcedureBreathing, CHEmsProcedurePrecautionsInfection, CHEmsProcedurePretreatment, CHEmsProcedureTransportation, CHEmsProcedureWoundTreatment, CHEmsQuantity, CHEmsServiceRequest, CH_EMS, ECH0207bedding, Ech0207InfectPersPrecaution, Ech0207personRole, Ech0207transDisinfection, EmergDoctSystem, EmsAdministrative2Fhir, EmsAnamnesis2Fhir, EmsAnnotation2Fhir, EmsDiagnosis2Fhir, EmsEventOfDeath2Fhir, EmsFindings2Fhir, EmsHandover2Fhir, EmsMission2Fhir, EmsPatient2Fhir, EmsPretreatment2Fhir, EmsProcedures2Fhir, EmsTransport2Fhir, GcsAugenoeffnung, GcsMotoric, GcsVerbal, IVRCodeSystem, IVRVSPulseMethod, IVRVSambulanceType, IVRVScoldExposure, IVRVSdeathManner, IVRVSdiagType, IVRVSevent, IVRVSeyeForm, IVRVSfindingsAirway, IVRVSformation, IVRVSheatExposure, IVRVShospitalPriority, IVRVSidMedium, IVRVSidSource, IVRVSintensity, IVRVSlaterality, IVRVSlocationType, IVRVSmissionTimeRole, IVRVSoffender, IVRVSpressureMethod, IVRVSprocAirType, IVRVSpulesResult, IVRVSrespirationObservation, IVRVSresult, IVRVSsize, IVRVSsymptom, IVRVSteamRole, IVRVStransReason, IVRVSurg_adequate, IVRVSvalTxpe, IVRVSventilation, IVRVSviolenceForm, IVRVSviolenceResult, IVRVSwoundTreat, IVRVSyesNoUnknown, LogicalModelEmsProtocol, MissionType, NACA, Patient/1-ThomasMueller, Patient/PatientExample, PreTreatType, PreTreatmen, Urgency and Vigilanzavpu
• The UCUM codes, UCUM table (regardless of format), and UCUM Specification are copyright 1999-2009, Regenstrief Institute, Inc. and the Unified Codes for Units of Measures (UCUM) Organization. All rights reserved. https://ucum.org/trac/wiki/TermsOfUse
  Show Usage
  • Unified Code for Units of Measure (UCUM): Bundle/1-Einsatzprotokoll, Bundle/1b-Einsatzprotokoll... Show 12 more, Bundle/2-Einsatzprotokoll, Bundle/2b-Einsatzprotokoll, MedicationAdministration/1-Infusion, MedicationAdministration/1-Spray, MedicationAdministration/MedAdminFentanyl, Observation/1-Blutdruck, Observation/1-GCSBefund, Observation/1-GCSUebergabe, Observation/2-GCSBefund, Observation/2-GCSUebergabe, Observation/ObservationBloodPressure12080 and Observation/ObservationHeartRateTachycardia
• This material contains content from LOINC. LOINC is copyright © 1995-2020, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.
  Show Usage
  • LOINC: Bundle/1-Einsatzprotokoll, Bundle/1b-Einsatzprotokoll... Show 29 more, Bundle/2-Einsatzprotokoll, Bundle/2b-Einsatzprotokoll, CHEmsComposition, CHEmsObservationAVPU, CHEmsObservationBloodPressure, CHEmsObservationConditionChange, CHEmsObservationGCS, CHEmsObservationHeartRate, CHEmsObservationNACA, CHEmsObservationStatusPriority, Composition/1-Einsatzprotokoll-Composition, Composition/1b-Einsatzprotokoll-Composition, Composition/2-Einsatzprotokoll-Composition, Composition/2b-Einsatzprotokoll-Composition, Observation/1-Blutdruck, Observation/1-GCSBefund, Observation/1-GCSUebergabe, Observation/1-NACAUebergabe, Observation/1-ZustandUebergabe, Observation/2-AVPUBefund, Observation/2-GCSBefund, Observation/2-GCSUebergabe, Observation/2-NACAUebergabe, Observation/2-ZustandUebergabe, Observation/ObservationBloodPressure, Observation/ObservationBloodPressure12080, Observation/ObservationHeartRateBradycardia, Observation/ObservationHeartRateTachycardia and Observation/StatusPrioUebergabe
• This material contains content that is copyright of SNOMED International. Implementers of these specifications must have the appropriate SNOMED CT Affiliate license - for more information contact https://www.snomed.org/get-snomed or info@snomed.org.
  Show Usage
  • SNOMED Clinical Terms® (SNOMED CT®): ActRecovAid, ActRespiOwner... Show 139 more, AllergyIntolerance/1-Baumpollen, AllergyIntolerance/1-Medikamente, AllergyIntolerance/AllergyIntoleranceGrassPollen, Bundle/1-Einsatzprotokoll, Bundle/1b-Einsatzprotokoll, Bundle/2-Einsatzprotokoll, Bundle/2b-Einsatzprotokoll, CHEmsAllergyIntolerance, CHEmsExtDisinfection, CHEmsExtIdentification, CHEmsExtLaterality, CHEmsExtOwner, CHEmsExtPerformer, CHEmsExtPersonRole, CHEmsExtTeamRole, CHEmsExtUrgencyAdequate, CHEmsExtValuablesPatient, CHEmsExtViolence, CHEmsLocationAmbulance, CHEmsLocationLocationDestination, CHEmsObservationAirways, CHEmsObservationAnamnesisEvent, CHEmsObservationAnamnesisSymptom, CHEmsObservationBloodPressure, CHEmsObservationBreathing, CHEmsObservationCardiacArrest, CHEmsObservationColdExposure, CHEmsObservationConditionChange, CHEmsObservationDeathManner, CHEmsObservationDiagnosis, CHEmsObservationGCS, CHEmsObservationHeartRate, CHEmsObservationHeatExposure, CHEmsObservationPupilShape, CHEmsObservationPupilSize, CHEmsObservationStatusPriority, CHEmsObservationStrokeFAST, CHEmsPractitioner, CHEmsPractitionerRole, CHEmsProcedureAirways, CHEmsProcedureBreathing, CHEmsProcedurePrecautionsInfection, CHEmsProcedurePretreatment, CHEmsProcedureTransportation, CHEmsProcedureWoundTreatment, Composition/1-Einsatzprotokoll-Composition, Composition/1b-Einsatzprotokoll-Composition, Composition/2-Einsatzprotokoll-Composition, Composition/2b-Einsatzprotokoll-Composition, Device/Device, ECH0207bedding, Ech0207InfectPersPrecaution, Ech0207personRole, Ech0207transDisinfection, Encounter/1-Einsatz, Encounter/2-Einsatz, Encounter/EncounterExample, GcsAugenoeffnung, GcsMotoric, GcsVerbal, IVRVSPulseMethod, IVRVSambulanceType, IVRVSdeathManner, IVRVSdiagType, IVRVSevent, IVRVSeyeForm, IVRVSfindingsAirway, IVRVSformation, IVRVShospitalPriority, IVRVSidSource, IVRVSintensity, IVRVSlaterality, IVRVSlocationType, IVRVSoffender, IVRVSpressureMethod, IVRVSprocAirType, IVRVSpulesResult, IVRVSrespirationObservation, IVRVSresult, IVRVSsize, IVRVSsymptom, IVRVSteamRole, IVRVSurg_adequate, IVRVSvalTxpe, IVRVSventilation, IVRVSviolenceForm, IVRVSviolenceResult, IVRVSwoundTreat, IVRVSyesNoUnknown, Location/LocationAmbulance, LogicalModelEmsProtocol, MedicationAdministration/1-Infusion, MedicationAdministration/1-Spray, MedicationAdministration/MedAdminFentanyl, MedicationStatement/1-AspirinCardio, MedicationStatement/MedStatTriatec, Observation/1-Anamnese, Observation/1-Blutdruck, Observation/1-Diagnose, Observation/1-Symptome, Observation/1-ZustandUebergabe, Observation/2-AirwaysBefund, Observation/2-Diagnose, Observation/2-ZustandUebergabe, Observation/CardiacArrestBefund, Observation/ObservationBloodPressure, Observation/ObservationBloodPressure12080, Observation/ObservationBreathingDyspnea, Observation/ObservationDeathManner, Observation/ObservationHeartRateBradycardia, Observation/ObservationHeartRateTachycardia, Observation/ObservationPupilShapeRound, Observation/ObservationPupilSizeNormal, Observation/ObservationSecondDegreeBurn, Observation/ObservationSecondDegreeFrostbite, Observation/StatusPrioUebergabe, Observation/StrokeBefund, Patient/1-ThomasMueller, Patient/PatientExample, Practitioner/1-NotarztPierreUrgentiste, Practitioner/1-SaniPetraMuster, Practitioner/1-TeamMemberHansTransportsanitaeter, Practitioner/1-TeamMemberPetraMuster, Practitioner/1-TeamMemberPierreUrgentiste, PractitionerRole/1-NotarztPierreUrgentiste-PR, PractitionerRole/1-SaniPetraMuster-PR, PreTreatType, PreTreatmen, Procedure/1-Transport, Procedure/ProcedureAirwaysIntubation, Procedure/ProcedureBreathingVentilated, Procedure/ProcedurePrecautionsInfectionMask, Procedure/ProcedureTransportation, Procedure/ProcedureWoundTreatment, Procedure/Vorbehandlung, Rettungswagen (Z-220), Sternen Oerlikon, Universitätsspital Zürich, Notfall and Waldrand

Cross Version Analysis

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (ch.fhir.ig.ch-ems.r4) and R4B (ch.fhir.ig.ch-ems.r4b) are available.

Dependency Table

Package hl7.fhir.uv.extensions.r4#5.2.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Mon, Feb 10, 2025 21:45+1100+11:00)

Package hl7.fhir.uv.extensions.r4#5.3.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sat, May 16, 2026 18:32+1000+10:00)

Package hl7.fhir.uv.xver-r5.r4#0.1.0 Extensions for Using Data Elements from FHIR R5 in FHIR R4 (built Fri, Mar 20, 2026 15:40+1100+11:00)

Package ch.fhir.ig.ch-core#7.0.0-ballot FHIR implementation guide CH Core (built Wed, Jun 10, 2026 14:59+0000+00:00)

Package ihe.formatcode.fhir#1.4.0 Implementation Guide for IHE defined FormatCode vocabulary. (built Tue, May 20, 2025 09:01-0500-05:00)

Package ch.fhir.ig.ch-term#3.4.0 Implementation Guide for Swiss Terminology (built Wed, Jun 10, 2026 09:49+0000+00:00)

Package hl7.fhir.uv.tools.r4#1.1.2 This IG defines the extensions that the tools use internally. Some of these extensions are content that are being evaluated for elevation into the main spec, and others are tooling concerns (built Tue, Mar 24, 2026 11:13+1100+11:00)

Globals Table

There are no Global profiles defined

Acknowledgements

The development of this implementation guide was supported by the Interverband für Rettungswesen (IVR).