# Radio Reports - Chicago



## BearChicago (Jan 6, 2012)

Hello everybody,

I work for a private in Chicago on the BLS side. At my company, this huge lie has overtaken the entire BLS staff and any new hires who come in. That being, "it's a Chicago hospital; you don't have to call." Rather, if you're transporting a BLS run to a hospital within the City of Chicago, you don't have to give a radio report. Just show up and walk in.

At the same time, everybody at the company is deathly afraid of walking into a suburban hospital without calling, because they know they'll get chewed out by the charge nurse upon arrival if they don't.

Does this go on at anybody else's company? To me, this is a huge load of BS perpetuated to promote laziness.

Thanks.


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## JPINFV (Jan 6, 2012)

Sounds like Boston, but the few times I transported to an ED in MA, I called in regardless. It's not like it takes a lot of time.


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## medicdan (Jan 6, 2012)

That has to be a question for the hospitals on your area. Consider getting in touch with the regional EMS Agency (or coordinator for the city), or state OEMS/DPH. With experience (being chewed out by nurses either way), you learn what hospitals want.

JP-- it's actually quite simple in Boston. Hospitals don't want to hear from you unless your patient is a major trauma, is coding, or will require immediate airway assistance. Anywhere outside of the city, they want to know about everything, even a fingernail injury less than a minute away.


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## JPINFV (Jan 6, 2012)

emt.dan said:


> JP-- it's actually quite simple in Boston. Hospitals don't want to hear from you unless your patient is a major trauma, is coding, or will require immediate airway assistance. Anywhere outside of the city, they want to know about everything, even a fingernail injury less than a minute away.



The funny thing is that I never had anyone complain when I called in, regardless of if it was via cell phone or CMed. Of course I also don't take 5 minutes on a simple entry note like a lot of people do.


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## wyoskibum (Jan 6, 2012)

It really depends on the hospital.  A couple of hospitals that I transport to want a patch regardless.  One of the hospitals do not want a patch unless it is a priority 1 or 2 patient.

If you have any questions, have your Medical director contact the hospital and ascertain their preference


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## Tigger (Jan 7, 2012)

emt.dan said:


> That has to be a question for the hospitals on your area. Consider getting in touch with the regional EMS Agency (or coordinator for the city), or state OEMS/DPH. With experience (being chewed out by nurses either way), you learn what hospitals want.
> 
> JP-- it's actually quite simple in Boston. Hospitals don't want to hear from you unless your patient is a major trauma, is coding, or will require immediate airway assistance. Anywhere outside of the city, they want to know about everything, even a fingernail injury less than a minute away.



That about sums up Massachusetts if you ask me. As you as you leave the city you better call even if the sending facility called a head too.


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## exodus (Jan 7, 2012)

My call in's only take about 15 -20 seconds.

This is blah blah we are 4 out with a 24 yo f with 3/10 neck pain secondary to a minor car accident. We have her in spinal precauation, vitals are 120/80 HR 86 Resps 20. We're about 5 out, again, this is blah blah blah. Do you need anything else?

 I've only had one time where they ask for anything more and that's because they don't know we're BLS.


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## bstone (Jan 7, 2012)

I worked for a Chicago private company for a bunch of years. Whenever I deliver a PT to an ER I call ahead.


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## Fish (Jan 8, 2012)

How is an ER supposed to be prepared for you unless you call?


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## medicdan (Jan 8, 2012)

Fish said:


> How is an ER supposed to be prepared for you unless you call?



What preperation does the hospital need to make for the stable abnormal vitals, or abd pain x12 hours? How about the ankle pain? Other than clearing a bed, what is there to do in the 5-10 minutes before we arrive? 

Clearly, STEMIs/Traumas/Arrests/CVAs are a different story, but there doesn't seem to be much to do for 90% of incoming patients.


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## JPINFV (Jan 8, 2012)

emt.dan said:


> What preperation does the hospital need to make for the stable abnormal vitals, or abd pain x12 hours? How about the ankle pain? Other than clearing a bed, what is there to do in the 5-10 minutes before we arrive?


I've had one hospital where we walked in and half the time we already had a bed assigned on the white board. It could make the difference between that bed getting a patient from triage or the patient in my ambulance.


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## Fish (Jan 8, 2012)

JPINFV said:


> I've had one hospital where we walked in and half the time we already had a bed assigned on the white board. It could make the difference between that bed getting a patient from triage or the patient in my ambulance.



This is what I am getting at, we call ahead for all patients that way the bed is ready when we get there. Or if it is more of an acute level patient the appropriate resources are in the room as well.


PLus, in busy systems like CHicago, LA, San Diego, etc.... isn't it normal for hospitals to go on bypass? That would be a good thing to know before you just showed up, walked in and went "Oh whats that? your on bypass, oh..... my bad, I guess I should have called first.....we will just let the patient sit here on our stretcher for 45mins while a bed clears I guess"


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## bstone (Jan 8, 2012)

Fish said:


> PLus, in busy systems like CHicago, LA, San Diego, etc.... isn't it normal for hospitals to go on bypass? That would be a good thing to know before you just showed up, walked in and went "Oh whats that? your on bypass, oh..... my bad, I guess I should have called first.....we will just let the patient sit here on our stretcher for 45mins while a bed clears I guess"



I worked 5 years on Chicago's north side and bypass was pretty rare. It did happen, just not that often. I do remember CFD bringing a patient to Sweedish ER when they were on bypass. The nurses were extremely unhappy with that.


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## Bullets (Jan 8, 2012)

in my area of NJ, BLS only calls the hospital if it is a trauma, code, stroke, and we dont have ALS. otherwise, BLS 911 calls dont ever get called in


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## Fish (Jan 8, 2012)

bstone said:


> I worked 5 years on Chicago's north side and bypass was pretty rare. It did happen, just not that often. I do remember CFD bringing a patient to Sweedish ER when they were on bypass. The nurses were extremely unhappy with that.



I have never worked in the north just the west and south, seems crazy to me not to give a heads up. San diego over does it with mother may I 3 minute long radio reports. I like the way the service I am with now does it, just a quick heads up. to each their own i guess.


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## JPINFV (Jan 8, 2012)

Fish said:


> This is what I am getting at, we call ahead for all patients that way the bed is ready when we get there. Or if it is more of an acute level patient the appropriate resources are in the room as well.
> 
> 
> PLus, in busy systems like CHicago, LA, San Diego, etc.... isn't it normal for hospitals to go on bypass? That would be a good thing to know before you just showed up, walked in and went "Oh whats that? your on bypass, oh..... my bad, I guess I should have called first.....we will just let the patient sit here on our stretcher for 45mins while a bed clears I guess"



A lot of systems are starting to get away from bypassing unless something is wrong (internal disaster or neuro bypass if CT is down, etc) since it causes more problems down stream than it fixes upstream.


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## Fish (Jan 8, 2012)

JPINFV said:


> A lot of systems are starting to get away from bypassing unless something is wrong (internal disaster or neuro bypass if CT is down, etc) since it causes more problems down stream than it fixes upstream.



Luckily where I am now no one has ever heard of bypass, San Diego however will forever be behind the times.


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## medicdan (Jan 8, 2012)

JPINFV said:


> I've had one hospital where we walked in and half the time we already had a bed assigned on the white board. It could make the difference between that bed getting a patient from triage or the patient in my ambulance.



I guess I just live and work in an alternative universe. I clearly don't understand ED bed management (flow and triage), but if the 5-10 minute heads up you're giving for an incoming patient "saves" the only bed available from a patient in triage, the ED has bigger problems coming to it. That begs the question if we could use "Open Table.com" for ED bed reservations, "I'd like a bed with a window view for 6:30 this evening". 

I also exist in a universe where divert or bypass no longer exists... the state DPH challenged hospitals to (often creatively) eliminate it, and EDs generally only close, as mentioned earlier for internal disaster or the like.


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## Martyn (Jan 8, 2012)

Tigger said:


> That about sums up Massachusetts if you ask me. As you as you leave the city you better call even if the sending facility called a head too.


 

Been on both sides, one time thought facility had called so I didnt and got chewed out (in a nice way), transfer from one hospital to another and called and got a rather short 'we know about that patient, thankyou, goodbye', my bet is CYA...make the call


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## JPINFV (Jan 8, 2012)

To be fair, that hospital was freakishly good at bed management and the last time I saw numbers (The most recent set of data I can find was 4th quarter 2007, which was just after I left) they had the most paramedic runs (despite not being a trauma center) and no saturation downtime. Unlike other hospitals, I don't think I've ever had to wait longer than 10 minutes before getting a bed.


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## the_negro_puppy (Jan 9, 2012)

Fish said:


> How is an ER supposed to be prepared for you unless you call?



We dont call any hospitals (except private) unless it is a trauma alert, STEMI or pt requiring immediate resus.

That being said, due to bed block we sometimes wait for hours with patients. Then again even if we did call ahead for lower category pts its not like they would make any effort to help us offload.


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## DrParasite (Jan 9, 2012)

Fish said:


> How is an ER supposed to be prepared for you unless you call?


short of a trauma, STEMI, CVA, burn or other patient that needs immediate care, why do you need to?

or think of it this way, if a sick patient arrives in triage, via POV, does the patient get treated appropriately?  is the ER properly prepared for the patient?

It is very rare that it takes more than 20 minutes to get a bed.  If it takes more than 10, our staff will occasionally become a pest to the charge nurse or intake nurse (because they are advocating for the patient, and the patient needs a bed), until a bed is assigned. 

And if that doesn't work, a supervisor can be requested to go to the ER and speak to the hospital administrator on call to resolve the delay.


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## Tigger (Jan 9, 2012)

emt.dan said:


> I guess I just live and work in an alternative universe. I clearly don't understand ED bed management (flow and triage), but if the 5-10 minute heads up you're giving for an incoming patient "saves" the only bed available from a patient in triage, the ED has bigger problems coming to it. That begs the question if we could use "Open Table.com" for ED bed reservations, "I'd like a bed with a window view for 6:30 this evening".
> 
> I also exist in a universe where divert or bypass no longer exists... the state DPH challenged hospitals to (often creatively) eliminate it, and EDs generally only close, as mentioned earlier for internal disaster or the like.



I was under the impression that EDs could *only* close for internal disaster type reasons, not overcrowding. 

For what it's worth it seems that the delays at larger hospitals usually occur in triage, generally because ambulance triage is only staffed lightly so more than one ambulance is going to overwhelm ambulance triage. I'd like to think that calling ahead would get more RNs sent to triage but I doubt that would happen seeing as half the time calling in to the hospital nets a staff still surprised to see you.


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## 325Medic (Jan 10, 2012)

In the city of Phila. only STEMIs, strokes, Trauma-1/2 gets a call. In the burbs where I work now, we call everything via cell or patch. One of our level-2 trauma E.D.'s are inside the city line (I work about 5 miles outside of Philly now) and when I call for anything now (force of habit) they ignore you and say that you are bringing the pt. no matter what so who cares.... If I don't call for the silliest of things (stub toe going to triage or psych) some E.D.'s blow a gasket.

325.


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## Fish (Jan 10, 2012)

I like that better than a report for every patient


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## medicdan (Jan 10, 2012)

Tigger said:


> I was under the impression that EDs could *only* close for internal disaster type reasons, not overcrowding.
> 
> For what it's worth it seems that the delays at larger hospitals usually occur in triage, generally because ambulance triage is only staffed lightly so more than one ambulance is going to overwhelm ambulance triage. I'd like to think that calling ahead would get more RNs sent to triage but I doubt that would happen seeing as half the time calling in to the hospital nets a staff still surprised to see you.



Yes, that's true, I was just being nice about it. DPH forbids MA hospitals from "diverting" patients, absent of internal disaster. 

Tig, that's true, at many hospitals (MGH being the exception, it seems), there is only one RN staffed for ambulance triage, and they don't hang out at the amb entrance waiting, we have to call them if we need them. They generally take a look at the line of waiting patients and do a mental triage-- diverting patients to a trauma room if they require a critical intervention before triage. With that said, they will also step away from triage as we move the patient over to give report to treating RN. 

What do other metropolitan cities do? We've heard about Chicago (call for everything), Philly and Boston (don't call unless it's important), but how about NYC? Houston? LA? SF? Miami?


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## Fish (Jan 10, 2012)

emt.dan said:


> Yes, that's true, I was just being nice about it. DPH forbids MA hospitals from "diverting" patients, absent of internal disaster.
> 
> Tig, that's true, at many hospitals (MGH being the exception, it seems), there is only one RN staffed for ambulance triage, and they don't hang out at the amb entrance waiting, we have to call them if we need them. They generally take a look at the line of waiting patients and do a mental triage-- diverting patients to a trauma room if they require a critical intervention before triage. With that said, they will also step away from triage as we move the patient over to give report to treating RN.
> 
> What do other metropolitan cities do? We've heard about Chicago (call for everything), Philly and Boston (don't call unless it's important), but how about NYC? Houston? LA? SF? Miami?




LA has to ask permission from a Hosp. to even Ventilate someone in Cardiac Arrest....... Ok, it is not that bad, but LA is the Model for A Big Brother/Mother May I system.


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## BearChicago (Jan 14, 2012)

Chicago has a BLS radio report for stable BLS patients with no special circumstances:

Provider/Unit
PT age/sex
Complaint
SMO being followed
Destination/ETA

Takes 15 seconds at best. Just call your med control and they'll relay. Or you can call the receiving facility directly. Region IX in the western suburbs (Loyola/Edward/Good Sam/Central DuPage) lets their personnel do the same thing, as does Region VII (south/southwest suburbs).


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