# how to practice and become proficient with pcr/radio report



## wutthedutch (Dec 24, 2011)

ive got the soap format and the radio format for emergency and non emergency.
are these formats the same for every ems company? and how can i practice or get proficient at this because its the only ems skill im lacking in. i have no problem writting down what happens but the formats show everyhing in a strict sequence of events to remember its just really complicated for me even with the guide at my side. im not sure if my company will have written or electronic pcrs either =/ not sure where to start on practicing but any advice would be greatly apreciated. merry christmas  also if im this terrible at pcrs should i wait until ive mastered it before applying at a company? i still have a week or so before my fbi check goes through


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## Aprz (Dec 24, 2011)

JPINFV wrote a little something on documentation here.

No, it's not the same for every company. SOAP is a commonly taught mnemonics/memory aid in school and used by various agencies, but I've heard of other ones too (e.g. CHART), or some places don't even have a recommended format.


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## JPINFV (Dec 24, 2011)

The first question to ask with radio reports is, "What's required?" Some areas will determine what is required by protocol of policy. 

The next question is what type of radio report. Is it an "entry note" (i.e. "Hi, we're bringing you a patient") or a medical control note ("I need orders and/or help with managing this patient"). 

The key to entry notes is to keep it short and simple. Unit level/ID, priority level if applicable (e.g. priority 1/2/3/4. Not used everyplace and not the same as lights/sirens vs regular traffic) patient demographics (age/sex), chief complaint/specialty team needs/quick description of mechanism, pertinent information (V/S if abnormal, justification for the specialty team, anything that needs to be managed immediately on arrivial. "Lung sounds clear bilaterally" is generally not pertinent at this time), ETA.

"Local Ambulance BLS 75 en-route to your facility with a 60 y/o male with a stroke alert. Patient developed unilateral decrease in grip and facial droop on the right side approximately 30 minutes ago. BGL per patient at the same time was 90 mg/dL. ETA 10 minutes out. Any questions?"   

Chances are the person on the radio isn't going to be the one you're transferring care to, and even if s/he is, you're still going to give a full report when you transfer care anyways.


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## Underoath87 (Dec 24, 2011)

You'll figure it all out through practice/trial and error when you start working.  Nobody is going to expect you to be good at either during your first few weeks.


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## 18G (Dec 25, 2011)

I personally hate the SOAP format and advise all new people to avoid using it. The best thing to do is ask for example narratives from your co-workers. They can show you the narrative without any patient identifiers.  

I type all my reports using a narrative style flow that takes the call from start to finish.


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## WuLabsWuTecH (Dec 26, 2011)

Agreed completely with JP.

A good entry note should not last more than 60 seconds.  However if you are seeking medical control, that discussion could last a great while longer.


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## NomadicMedic (Dec 26, 2011)

WuLabsWuTecH said:


> Agreed completely with JP.
> 
> A good entry note should not last more than 60 seconds.  However if you are seeking medical control, that discussion could last a great while longer.



It all depends on the hospital you're transporting to. Some like a short and sweet quickie, "Medic 104 inbound with a 45 year old Priority 1 COPD, on CPAP. We've got about a 5 minute ETA" Other hospitals what EVERYTHING in the radio report. Vitals, current meds, history. Blah, blah, blah... 

Find out how they do it where you are and practice that. 

Here's a tip. Most ER base stations have a form the nurse will fill out when a medic or EMT calls in a radio report. Next time you're at the hospital, ask for one (or grab one from the radio desk), laminate it and BINGO... Instant cheat sheet in the exact order they're writing stuff down.


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## Handsome Robb (Dec 26, 2011)

WuLabsWuTecH said:


> Agreed completely with JP.
> 
> A good entry note should not last more than 60 seconds.  However if you are seeking medical control, that discussion could last a great while longer.



Like n7 said it is very location specific. If we give a report for an ILS/BLS PT that's more than 20-30 seconds it's pretty much guaranteed the charge nurse is no longer listening to you plus 9 times out of 10 there will be other units on the channel waiting to give their report as well. 

JP gave a good one, I'll give you one I had today:

"Good afternoon *insert facility here*, Rob on Medic xxx inbound to your facility about 5 minutes out, onboard I have a 50 y/o M complaining of general illness, last BGL was 450, all other vitals are WNL I have a 18g placed in his right hand with about 500 mL in, unless you have any other questions I'll see you inside."

ALS reports will be a bit more detailed with pertinent findings that you deem the receiving facility needs to know.


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## Sourmash (Jan 14, 2012)

Repetition is the mother of skill....

Practice, Practice, Practice


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## ethomas4 (Jan 30, 2012)

get with you coworkers, have them fake a call and you report it...do that as much as you can. pretend its real practice practice practice


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## GunneyPenguin (Feb 22, 2012)

I have this bookmarked
medicmadness. com/2011/06/a-guide-to-radio-reports/


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## TheGodfather (Feb 22, 2012)

n7lxi said:


> Here's a tip. Most ER base stations have a form the nurse will fill out when a medic or EMT calls in a radio report. Next time you're at the hospital, ask for one (or grab one from the radio desk), laminate it and BINGO... Instant cheat sheet in the exact order they're writing stuff down.



Agreed.


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## feldy (Feb 22, 2012)

Everyone has their own style of writing paper reports/ radio reports. Read some of your coworkers reports or listen to the give the radio report. Thats pretty much how I learned, Although i never have to do them since im an EMT and technically only Paramedics are allowed to do reports.


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## TheGodfather (Feb 22, 2012)

feldy said:


> Everyone has their own style of writing paper reports/ radio reports. Read some of your coworkers reports or listen to the give the radio report. Thats pretty much how I learned, Although i never have to do them since im an EMT and *technically only Paramedics are allowed to do reports.*



Why? Is that written in your local protocols? 

There's been times that during a cardiac arrest resuscitation with limited manpower, I had my EMT driver call in the report stating PT age, downtime, initial/current rhythm, ETA, and "following ACLS protocols"...


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## JPINFV (Feb 22, 2012)

feldy said:
			
		

> Although i never have to do them since im an EMT and technically only Paramedics are allowed to do reports.



When I worked in the Boston area, I still gave entry notes as an EMT on an EMT ambulance and no one told me to stop.


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## Sasha (Feb 22, 2012)

I write down the info for my radio reports on a note pad and read from there. If I dont, I get flubbed up and do the "uh uh uh"


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## adamjh3 (Feb 22, 2012)

Sasha said:


> I write down the info for my radio reports on a note pad and read from there. If I dont, I get flubbed up and do the "uh uh uh"



This.

It also helps me to view the radio report, the narrative, and the turnover as the same exact thing.


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## NomadicMedic (Feb 22, 2012)

adamjh3 said:


> It also helps me to view the radio report, the narrative, and the turnover as the same exact thing.



But they're not the same thing. The radio report is just a quick heads up, patient condition, what you're doing, and ETA. The handover report, to the RN at bedside, should be significantly more detailed. The narrative, your complete record of the entire patient contact, should be far more detailed still.


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## adamjh3 (Feb 22, 2012)

n7lxi said:


> But they're not the same thing. The radio report is just a quick heads up, patient condition, what you're doing, and ETA. The handover report, to the RN at bedside, should be significantly more detailed. The narrative, your complete record of the entire patient contact, should be far more detailed still.



Depends on the area I guess.around here there's no trust between prehospital personnel and the hospital. Thus every patient going into the ER gets a detailed radio report. 

Also, why should your turn over be any less detailed than your narrative?


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## TheGodfather (Feb 22, 2012)

adamjh3 said:


> Also, why should your turn over be any less detailed than your narrative?



narratives need to be written so that anyone off the street can read it and comprehend it without any possibility for confusion/question; IE: "patient was secured to stretcher with all three belts tightened securely and shoulder straps in place"

nurses generally have a little more common sense in that aspect...


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## Sasha (Feb 22, 2012)

adamjh3 said:


> Depends on the area I guess.around here there's no trust between prehospital personnel and the hospital. Thus every patient going into the ER gets a detailed radio report.
> 
> Also, why should your turn over be any less detailed than your narrative?



The nurses here walk away if your report is too long. They really want age sex chief complaint and if they're stable or not and if they're not then they want a little more but still not much. 

Hand off is where you go into details. 

Written report is where it is idiot proof. My reports can be multipage. Doesn't help that I have big swoopy handwriting.


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## JPINFV (Feb 22, 2012)

TheGodfather said:


> narratives need to be written so that anyone off the street can read it and comprehend it without any possibility for confusion/question; IE: "patient was secured to stretcher with all three belts tightened securely and shoulder straps in place"
> 
> nurses generally have a little more common sense in that aspect...




BS.
An EMS provider shouldn't be concerned because someone off the street might not understand medical terms.

Just because the EMS text books are written at an 8th grade level doesn't mean that EMS reports should be written at an 8th grade level.


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## TheGodfather (Feb 22, 2012)

JPINFV said:


> BS.
> An EMS provider shouldn't be concerned because someone off the street might not understand medical terms.
> 
> Just because the EMS text books are written at an 8th grade level doesn't mean that EMS reports should be written at an 8th grade level.



oh i agree... I don't mean write it without use of terminology or educated context, more along the lines of list every little detail from patient contact to patient handoff to avoid "holes" that could be used against you from a litigation standpoint...


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## adamjh3 (Feb 22, 2012)

Sasha said:


> The nurses here walk away if your report is too long. They really want age sex chief complaint and if they're stable or not and if they're not then they want a little more but still not much.



Like I said, area dependent. Attached is what's expected out of an ALS radio report, except for the tiny part at the bottom that goes into run number etc.

There's online scanners for the hospital radios around here. listen to a single report and you'll see what I mean

And no, I don't work for AMR


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## exodus (Feb 22, 2012)

adamjh3 said:


> Like I said, area dependent. Attached is what's expected out of an ALS radio report, except for the tiny part at the bottom that goes into run number etc.
> 
> There's online scanners for the hospital radios around here. listen to a single report and you'll see what I mean
> 
> And no, I don't work for AMR



Link to the scanner pleaseee!

Here, all I do is this:

This is AMR blah blah we are 5 out with a 54 yo male with non-traumatic left leg pain. The patient is a transfer from an urgent care and was diagnosed with a DVT and is being transferred for treatment and further assessment. Current vitals are 130/82, pulse of 84, respirations of 20. Again, we are 5 out, anything else?

Everytime I get, "Thank you, see you in 5."  My partner got chewed out the other day for giving a full radio report


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## adamjh3 (Feb 23, 2012)

exodus said:


> Link to the scanner pleaseee!



Sharp Grossmont pops up here from time to time. It also used to be on the Scanner Radio app, but I got rid of that about a year ago.


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## Sasha (Feb 23, 2012)

That report would be with me 

22 to (hospital)

Go ahead 22.

We are enroute with a 58yo male with a left leg dvt confirmed by doppler. Vitals stable. Eta less than 10 any further?

No further see you on arrival


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## DesertMedic66 (Feb 23, 2012)

My radio reports depend on the patient and where they are coming from. If its a 5150 hold it's

 "This is EMT Bob on blah ambulance service unit 111 coming at you code 2 with a 34 year old female 5150 hold. Vitals are stable and patient is calm and non-aggressive. Our ETA is 10 mins. How copy and any additional?"

If the call is non IFT, non 5150 hold then I run down a list

Name and title, ambulance company and #, response mode, ETA, age of patient, gender, weight, Chief Complaint, Allergies, medical history, medications (I always say will give copy upon arrival), GCS, A&O status, B/P, Pulse, Resp, skins, cap refil, Pupils, Lung sounds if important, and any treatments started. 

It can easily be said in 1-2 minutes.

This is what the hospitals and protocol requires:


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## R99 (Feb 23, 2012)




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## systemet (Feb 23, 2012)

I vote for R99's.


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## Sasha (Feb 23, 2012)

Why do they need a weight, history, allergies, etc in radio report?


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## adamjh3 (Feb 23, 2012)

Sasha said:


> Why do they need a weight, history, allergies, etc in radio report?



To prepare treatments for a critical patient, maybe? Just stabbing in the dark, but that seems most likely.


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## DesertMedic66 (Feb 23, 2012)

adamjh3 said:


> To prepare treatments for a critical patient, maybe? Just stabbing in the dark, but that seems most likely.



Yep. Weight is so they can get dosages of medications ready before we get to the hospital so things run smoother and quicker. Allergies is so they know if there is a medication they need to avoid. If the patient is in pain but allergic to morphine that is something the hospital should know so they can already have another pain medication at hand.

If I'm bringing in a possible CVA with facial droop, arm sway, slurred speech, unequal grips it is kind of important to tell the hospital if the patient has had a CVA before and if there are any lasting affects from it.


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## Sasha (Feb 23, 2012)

adamjh3 said:


> To prepare treatments for a critical patient, maybe? Just stabbing in the dark, but that seems most likely.



No ones going to start predrawing weight based meds. Honestly bringing in patients and watching them being brought in they don't "prepare" for critical patients beyond calling for respiratory and clearing a bed. 

Allergies you get in triage report. Med list in triage report medical hx in triage report. All those do in a radio report is clog up the radio.


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## DesertMedic66 (Feb 23, 2012)

Sasha said:


> No ones going to start predrawing weight based meds.



Yes.... Yeah they do..


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## DesertMedic66 (Feb 23, 2012)

Sasha said:


> No ones going to start predrawing weight based meds. Honestly bringing in patients and watching them being brought in they don't "prepare" for critical patients beyond calling for respiratory and clearing a bed.
> 
> Allergies you get in triage report. Med list in triage report medical hx in triage report. All those do in a radio report is clog up the radio.



It's different where you work then. If we bring in a critical patient they start setting everything up (the bed and room, extra staff, medications (RSI, pain, etc), the doctor will already be at bedside, tubes if the patient doesn't already have one.

One of the hospitals will have staff members outside so once we get the gurney out of the ambulance they take over compressions for us.


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## JPINFV (Feb 23, 2012)

firefite said:


> It's different where you work then. If we bring in a critical patient they start setting everything up (the bed and room, extra staff, medications (RSI, pain, etc), the doctor will already be at bedside, tubes if the patient doesn't already have one.
> 
> One of the hospitals will have staff members outside so once we get the gurney out of the ambulance they take over compressions for us.



There's a difference between getting the medications out and actually drawing them up. The staff is going to be going off of their own weight estimate, guaranteed.


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## DesertMedic66 (Feb 23, 2012)

JPINFV said:


> There's a difference between getting the medications out and actually drawing them up. The staff is going to be going off of their own weight estimate, guaranteed.



I've seen it both ways. The medication already drawn up and ready to go and still in the vial.


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## systemet (Feb 23, 2012)

I think this depends a lot on where you're transporting to.  When I first started in EMS I used to take patients to a small town rural ER, almost 3 hours by ground from the nearest trauma center, and just a little too far for the helicopter to beat out a fixed wing.  The ER had one RN.  They called a family doc if someone sick came in.  So they wanted a detailed report as soon as possible, because the RN was going to have to decide whether to bother the on-call physician at the family medicine clinic, or at home.  And then they had to still get to the ER.  Depending on the physician, that was where the problems began.  We had some South Africans who were excellent, and some others guy who were probably fantastic at something, but it wasn't acute care.

Then I worked for a while in a larger city.  The bigger hospitals wanted to know ahead of time, if possible, if the patient was intubated, a major trauma, or a true major medical, maybe a sick kid.  Think pre-code, or acute CVA early enough to make a difference, STEMI, or obvious cardiogenic shock.  Otherwise they didn't care.  We didn't take too many sick patients to the medium-sized ERs, but they'd get a notification for STEMI or an intubated drug OD, or something similar.  The rest of the stuff, they didn't care.  Sicker people were walking through their door on a regular basis.  

The forwarded information was pretty basic, usually, "30 year old male, multiple central stab wounds, no radial pulse, not-intubated", for example.


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## Sasha (Feb 23, 2012)

JPINFV said:


> There's a difference between getting the medications out and actually drawing them up. The staff is going to be going off of their own weight estimate, guaranteed.



Don't guesstimate here. The beds have scales. 

For a critical patient here, a Dr will meet you at bedside and will get report directly. Sometimes respiratory will already be down there. That's about it.


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## JPINFV (Feb 23, 2012)

Most of the ED gurneys I've seen do not have scales on them.


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## DesertMedic66 (Feb 23, 2012)

JPINFV said:


> Most of the ED gurneys I've seen do not have scales on them.



The only beds I have seen and heard of are the beds on the floor and ICU.


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## TatuICU (Feb 23, 2012)

In our area we had about a 25 second time limit. If it were something in depth we would just call on the phone.

ex. EMS 8 inbound non-emergent with a 78 year old female coming from home, chief complaint today is shortness breath without other accompanying symptoms.  Pt is afebrile, bp is 132/76, pulse is 91, EKG shows sinus rhythm without ectopy, currently satting 98% on 2L, 20 ga + hep lock to the left hand, pt has received one combivent treatment with relief in symptoms, ETA approx 5 minutes, any questions?

Just keep it short and sweet, you'll be giving a full report in a matter of minutes anyway


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## Sasha (Feb 23, 2012)

JPINFV said:


> Most of the ED gurneys I've seen do not have scales on them.



I'll take a pic next time I'm in the ER but these do. They're also have the buttons to raise and lower the head and feet. It's a weird half manual half power stretcher. But its an ER stretcher not a floor bed.


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## MedicBrew (Feb 23, 2012)

firefite said:


> It's different where you work then. If we bring in a critical patient they start setting everything up (the bed and room, extra staff, medications (RSI, pain, etc), the doctor will already be at bedside, tubes if the patient doesn't already have one.
> 
> One of the hospitals will have staff members outside so once we get the gurney out of the ambulance they take over compressions for us.



WOW! beats the crap out of "Why did you bring them here" that we get all the time. My response: The big red sign out side that says "EMERGENCY DEPARTMENT" <_<


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## exodus (Feb 29, 2012)

Sasha said:


> No ones going to start predrawing weight based meds. Honestly bringing in patients and watching them being brought in they don't "prepare" for critical patients beyond calling for respiratory and clearing a bed.
> 
> Allergies you get in triage report. Med list in triage report medical hx in triage report. All those do in a radio report is clog up the radio.



We also work in a fairly small system where our main ER knows pretty much every medic personally.


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## DesertMedic66 (Feb 29, 2012)

exodus said:


> We also work in a fairly small system where our main ER knows pretty much every medic personally.



Knows them and are dating some haha


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## Always BSI (Feb 29, 2012)

R99 said:


>



Brilliant.


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