Radio report

At my clinical nurses were getting aggravated due to what they called “Unnecessary” information being given

What bases do you cover on your radio report with an incoming patient?

Age, gender, c/c, current vitals, pertinent info such as intubated or or security needed, and ETA.

Sex age CC vitals ETA.

Our hospitals like our call ins to be around a minute long.

Age, sex, CC, vitals, relevant Hx, treatments, ETA, paramedic name, and unit number.

Our full arrests are easy. “Hey, this is John on company name and medic number, I have a 5 minute ETA, 80 year old male witnessed full arrest, initial rhythm of PEA, have him intubated and just following ACLS algorithm”

Agency name, BLS/ALS, age, sex, cc, vitals/trend, treatment, eta.

I hear "less than a minute" all the time. It's going to take a seriously complicated patient to get to that point, I think 30 seconds is something to strive for.

Locally, for trauma patients you must mention +/-LOC, +/-neuro issues, level of mentation, and blood thinners. Throw some vitals, complaint, and mechanism and that's about it. I'll give a second or two to treatments just so they don't put the arm pain from a mechanical fall in triage when they got fent already.

Thank you all for the feedback. IMO I am a little ashamed of the nurses and the way they talk I understand time is of the essence but they don’t know what we’re seeing in the field and why we are telling them certain things they only know what we tell them so I guess it’s just how it has to be

josh rousseau said:

Thank you all for the feedback. IMO I am a little ashamed of the nurses and the way they talk I understand time is of the essence but they don’t know what we’re seeing in the field and why we are telling them certain things they only know what we tell them so I guess it’s just how it has to be

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There are certainly times where you may need to “paint a picture” over the radio however those times are limited. For your classic chest pain non-STEMI you really don’t need to paint a picture.

I have answered several radio reports and mainly with new EMTs/Medics they will list our all the patients history, medications, allergies, OPQRST, last meal, etc. If that information is relevant then sure list it out but for a patient with a fractured ankle it is not relevant if the patient had an appy 10 years ago and took an Advil last night.

josh rousseau said:

Thank you all for the feedback. IMO I am a little ashamed of the nurses and the way they talk I understand time is of the essence but they don’t know what we’re seeing in the field and why we are telling them certain things they only know what we tell them so I guess it’s just how it has to be

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There's two sides to this, Josh -- the other being prehospital reports that include time-wasters like IV catheter size and location, O2 flow rate, and irrelevant PMH.

Report shouldn't take more than a minute, becoming concise but not skipping pertinent information takes practice and time. Non-sick patients shouldn't have a lot to say, sick patients require your attention and should have you attention being spent reading a novel over the phone. With practice report shouldn't take longer than 20 seconds.

From an ED standpoint I need to know where the patient is going, a general idea of their complaint (trauma, peds vs adults, psych), sick vs not sick, and what resources/alerts I need. If needed I might make a care recommendation, generally this will be a question and not a statement ("did you get a blood sugar?," "do you think this is a patient that will need IV pain meds when they get here?," "it sounds like this patient could be a stroke alert, do you agree?," et cetera).

Long reports are annoying. The charge nurses take most of the reports. If I'm charge I have a department to run and I don't want to be on the phone for more than a couple of minutes. When you give bedside report you can paint all the picture you want, the radio/phone report should not be the same thing.

I would recommend that you use a brief SBARQ until you become comfortable with giving report. Your protocols should also have a destination decision making section for sick patients, use that to guide info you need to give over the phone, for example blood thinners on trauma, onset time for strokes, relevant EKG changes, and so on. Certainly not every bit needs to be filled out, especially on on calls that don't need to be in the ED, let alone an ambulance.

*Situation* "This is EMT/Paramedic/Registered Nurse [name] on [agency] [crew number if relevant], how do you read?" "I'm coming in [emergent or non emergent] [by helicopter if relevant, hot/cold off load] ETA of [minutes] with a [age] [gender]".

*Background* "Patient complains of [chief complaint]. [Relevant assessment findings]. [Most recent set of vitals, trends only if unstable or a significant change].

*Assessment* "[Relevant treatments rendered]"

*Recommendation* "I think that this patient is/may be a [Trauma alert, stroke alert, et cetera]."

*Question* "Do you have any questions?", at end of call [Agency] "clear."

My reports are typically anywhere from 30-45 seconds.

ETA, age, CC, vital signs, any TX I’ve done.

age, CC, pertinent interventions given, anything usual that ER needs a heads up on (if any), any resources I need waiting for me when I walk in the door (security, airway management assistance, trauma/stroke/OB team). a more detailed report can be done in person

However, some systems do want a long winded radio report.

What do the other medics/EMTs do in your system? I've worked in places that wanted basically the whole transfer of care report over the radio, and places that wanted age, sex, chief complaint, and ETA only. Usually the busier the hospital the less they care about radio reports for non-critical patients.

I only report relevant information. Vitals are only relevant if they are abnormal. History is only relevant if it bears on the chief complain. So with a chest pain call, a previous cardiac history is relevant, but back surgery 9 months ago isnt. The back surgery is relevant if the complaint is back pain though. I also don’t list interventions unless they are remarkable or outside that’s expected.

Here are two chest pain reports.

Hospital, rescue 1 inbound priority two with a 55 year old male complaining of 7/10 retrosternal chest pain without radiation for one hour. No other acute complaints. No acute ST segment changes noted on ekg, vitals are stable, eta 10 minutes. Do you have any questions?

Notice I didn’t say I put in an IV, gave asprin, or nitro. These are all standard ‘chest pain things’ and add no value to a radio report. I have painted a picture of an urgent, but not bells and whistles emergent patient that will require a monitored bed, a physician to see the patient immediately, a stat ekg and lab tech. They don’t need any more information to make start that process.

Hospital rescue 1 inbound priority 1 with a STEMI alert, I repeat a STEMI alert. 55 year old male complaining of 9/10 retrosternal chest pain with radiation to left arm. Pt is cool, pale, diaphoretic, nauseous, with a history including MI with stunting and CABG. EKG shows inferior wall Mi with no RV involvement at this time. Pt is hypotensive in the 70’s, and tachycardic at 110. Unable to establish IV access. ETA 7 minutes. Questions?

So this is a little more involved, but is still less than thirty seconds of talking time. The physician should be at the bed side awaiting my arrival, along with the ekg tech, lab tech, and the cath lab teams pagers should have beeped 6 minutes ago. You need every word of it, and there is zero fat.

A nothing, bs call might sound like this

Hospital, rescue 1 inbound priority 3 with a 26 year old male complaining of 8/10 back pain after yard work. No acute findings on physical exam. Pt has history of back spasms. Vitals stable. ETA 10 minutes. Questions?

That <10 seconds on the radio. They know this patient needs no acute intervention, is appropriate for the waiting room or walk in clinic. Again, zero fat.

If you’re telling them about irrelevant history and dumping piles of sub acute data on them on the radio, around here they will literally walk away from the radio. You’re also tying up the channel for somebody that might need stat med control. Zero fat, 100% efficiency. That’s your goal. Use every word you need, and need every word you use.

I keep my radio reports very short and concise. ETA, Mechanism, vitals, and pertinent interventions or things they will need on arrival. If they want more they will ask. Nothing more frustrating than having a 5 min ETA with a critical patient and having to wait for someone to finish their radio report as they drag on about a stable patient. Generally the sicker the patient the shorter the report. "Helicopter X, 5 mins out with an unstable level one trauma"

Most ERs are just trying to figure out how sick the patient is, where they are going to go, and what resources they will need. You will give a full report on arrival.