# First Responder - Handoff Reports



## benasack2000 (Mar 22, 2015)

Hey Everyone, 

Can anyone tell me what EMT's and Medics like to hear in terms of hand-off reports from first responders. Whether it be first aid staff working at a race or FD/PD first on the scene, what patient info do you want to know when you walk up?

Scenario: 66/yo Male with Chest Pain; I'm an EMR working as Event First Aid at a 10K Run with an EMT-B - 911 has been dialed and additional resources are 5-6 minutes away 

Besides the PT's name, age, chief complaint, and status of their ABCs, do you want us to give you vital signs, SAMPLE, OPQRST, physical exam findings, interventions we have done, the works? (depending on how much time we have before you arrive). What should we do/not do in terms of assessment before you actually get there? Are there some things we should just leave for the ambulance crew to do? 

Thanks,
Ben


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## NomadicMedic (Mar 22, 2015)

Honestly? The patients name and what the problem is. I'll get the rest from the patient.

Unless I know you, and have worked with you before, you're just one more thing that can confuse a scene.


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## Tigger (Mar 23, 2015)

Tell me what's going on in brief (chest pain, been going on for x amount of time) and if you did anything. I'm just going to do my own assessment, but for documentation purposes I'd like to known what you got for vitals and if you rendered any sort of treatment.


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## Flying (Mar 23, 2015)

I find that other providers overwhelmingly prefer the _Short Version (tm).
_
"Hey, this is Lou, he's 64 years old, he appears to be confused and febrile after radiation therapy last week."

Be on point if they ask for any more information though.


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## Angel (Mar 23, 2015)

I'll take whatever information you have. It guides my assessment/treatment but doesn't dictate it, if that makes sense


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## cfd3091 (Mar 23, 2015)

It they are stable, name,age, any meds they are on already written down if possible. Fist set of good vitals but they are going to be done again so it's not imperative. If you did anything, when? Chest pain 4 aspirin, time?,...ect. If the scene is a residence or business that will make getting the stretcher in and out difficult, or stair chair necessary get us up to speed on that. Good first responders can really make a positive difference.


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## PrincessAnika (Mar 23, 2015)

Keep it simple. "This is Joe he's 66 came in 15 minutes ago c/o severe/stabbing/crushing/intermittent chest pain that started 30 min ago while he was running, and shortness of breath. Hx of bypass surgery 3 yrs ago. BP 160/110, pulse 130, resp 24. 
Everything else can be written down - meds allergies other med history and demographics - and other than that, just don't disappear in case there are questions.


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## Ewok Jerky (Mar 23, 2015)

Giving an oral report is an art and needs to be practiced so don't feel dumb about it, everyone struggles until they figure it out, and even then sometimes it can wonky sometimes. 

HPI in 1 sentence, even just repeat what the pt told you when they walked up.
"stable/unstable vitals are normal/abnormal".  DO NOT tell me vitals are normal and then proceed to tell me BP 120/80 HR 70 RR 12. If abnormal just tell me the values.
Physical Exam findings in 1 sentence. "Nothing on physical exam" is sufficient for an oral report.  PERTINENT negatives only if really pertinent.
Tx and response to treatment, again in 1 sentence.


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## Milla3P (Mar 23, 2015)

"Those bags look heavy. I'll carry them."


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## benasack2000 (Mar 24, 2015)

Milla3P said:


> "Those bags look heavy. I'll carry them."



You just made my day.


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## cprted (Mar 24, 2015)

Four points:  1) Who is the patient.   2) What's their problem.   3) What have I found.   4) What have I done.


> Bob is a 66 year old complaining of chest pain.  Its a 7/10 crushing pain, radiating to his left arm and jaw that came on suddenly while he was sitting in the stands.  He denies previous cardiac history.  We've sat him down, put him on 4l by prongs, gave him 162mg of ASA PO and my partner is working up a full set of vitals.



Once I get my initial assessment done then I can ask you more questions as required.  Rambling reports that start out by telling me their pulse was 80 and their respirations were 12 lose my interest very quickly.


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## teedubbyaw (Mar 24, 2015)

CC and accurate vitals including HR/RR since most seem to think a blood pressure is all vital signs consist of. Accurate is also keyword. More times than not, first responders are still trying to get a BP by the time we roll up. If you can't get one, palpate it and move on. Please don't hesitate then throw out a number. 

If the pt is different now than they were before we get on scene, that's kind of important. 

And not every single person needs a NRB.


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## redundantbassist (Mar 24, 2015)

"I'm Ben the EMR. Jimmy over here has chest pains, I gave him an asprin. Do you need any more help?"

If I need any more info, I will ask. You are providing first aid, not ALS.


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## jpregulman (Mar 24, 2015)

Definitely stabilize the patient first. This means giving O2 (if needed), establishing a line (if you can), and taking a set of vitals and an EKG (if you can). Also try to bring them to a place of safety. Try to get where an ambulance can easily get to you. Don't just hang out in the middle of the race.

I would get the basics. Allergies, Medications taken, PMHx. I would also get time of onset of symptoms.

The responding units would want to hear all of that and would really appreciate if you got a 12 lead + IV access. 

I would also avoid giving any medications unless you have too. Don't give nitro if you can not monitor BP!!!!


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## TheLocalMedic (Mar 25, 2015)

Like most have said, give me their name, age and chief complaint... and pretty much stop talking right there.  Everything else i.e their med hx, med list, allergies and anything else you should have been writing down while you collected it and you can just hand me that.


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## gotbeerz001 (Mar 25, 2015)

jpregulman said:


> ...and would really appreciate if you got a 12 lead + IV access.


Only if you have the foresight to know what tx I will do en route to the hospital and have accurate 12L placement. 

I treated a status ep pt and the responding fire medic put the IV in the wrist... Made it very difficult for me to place the restraints required for this pt. 

... And I will always do another 12L. Yours may be helpful for progression.


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## RedAirplane (Mar 25, 2015)

This is something I could learn more about as well. I was taught "Age, Sex, Chief Complaint, Information in order of relevance," which is very unspecific.


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## medicaltransient (Mar 25, 2015)

I like a brief one but I always give a long and detailed one. The thing I want the most is vitals a med rec and the room ready to move them.


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## Jim37F (Mar 25, 2015)

I would want a first responder to give me the same things my medics expect me to be able to give them when they walk up on scene after me....as much as whatever assessment you have gotten.

If I walk up to you and the patient 30 seconds after you do, I really don't expect a whole lot more than "Hey this is Mr._____, complaining of _________".

Now if it takes me 4 to 6 minutes after you to get there I want as much of the ABC's, HAM (Hx, Allergies, Meds), and OPQRST as well as any treatments you've provided. If it's a critical patient and you've been too busy managing the ABC's (I.e. bagging the patient) than I don't expect much beyond "He's not breathing but he still has a pulse, been bagging him at 12 breaths a minute" I'll keep you doing that while I start moving down my assessment...on the flip side if it's a simple medical call and the patient is alert and orientated and if in 6 minutes all you have name and C/C with no OPQRST or HAM or any other assessment I'm going to be wondering what on earth you've been doing the last 6 minutes (talking about the weather?) and I'm going to politely push you off of my scene and you're nothing more than a bystander.


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## gotbeerz001 (Mar 25, 2015)

Jim37F said:


> I would want a first responder to give me the same things my medics expect me to be able to give them when they walk up on scene after me....as much as whatever assessment you have gotten.
> 
> If I walk up to you and the patient 30 seconds after you do, I really don't expect a whole lot more than "Hey this is Mr._____, complaining of _________".
> 
> Now if it takes me 4 to 6 minutes after you to get there I want as much of the ABC's, HAM (Hx, Allergies, Meds), and OPQRST as well as any treatments you've provided. If it's a critical patient and you've been too busy managing the ABC's (I.e. bagging the patient) than I don't expect much beyond "He's not breathing but he still has a pulse, been bagging him at 12 breaths a minute" I'll keep you doing that while I start moving down my assessment...on the flip side if it's a simple medical call and the patient is alert and orientated and if in 6 minutes all you have name and C/C with no OPQRST or HAM or any other assessment I'm going to be wondering what on earth you've been doing the last 6 minutes (talking about the weather?) and I'm going to politely push you off of my scene and you're nothing more than a bystander.



I want Name, Chief Complaint and a basic story. Tell me vitals onlynif they are abnormal. Tell me meds if they are pertinent. 

Write down EVERYTHING you got on the notes you hand over.  Tell me only what I need to know.

I'm going to do everything all over anyways.


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## RedAirplane (Mar 25, 2015)

Something I learned the hard way: have a plan. All six first responders shouldn't start talking to Mr. Paramedic at the same time.


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## RedAirplane (Apr 16, 2015)

Follow up question: 

I've been in cases where the ambulance has been delayed. Taking vitals every five minutes for 25-35 minutes is a lot of numbers to read out in a report! Do you just want the most recent set, the trend, or first and last, or just a sheet of paper?


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## TheLocalMedic (Apr 16, 2015)

Ishan said:


> Follow up question:
> 
> I've been in cases where the ambulance has been delayed. Taking vitals every five minutes for 25-35 minutes is a lot of numbers to read out in a report! Do you just want the most recent set, the trend, or first and last, or just a sheet of paper?



Yeesh, why that many vitals? How about one or two sets (I guess you could argue for more if the patient is really sick)? Jot them down, hand 'em over and just say whether they're stable or not.


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## RedAirplane (Apr 16, 2015)

I've always been told vitals every 5 minutes if sick or every 15 minutes if stable.


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## Angel (Apr 16, 2015)

If even go as far as 20 to 30 mins on LD patients but yea that's what I was taught too.


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## Tigger (Apr 16, 2015)

A trend is what everyone should be looking for with vital signs.


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## jlicp112 (Aug 7, 2015)

name, Chief complaint, your vitals if you took any and any interventions you performed.


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