Do you give vitals while patching?

[Aidey]

Preemptively, I did use the search function, and I couldn't find an answer to this question. All the threads I found on patching talked about the format.


Anyway, I've worked in a few different systems, and noticed a big difference between the two big systems in what they expected of the radio report. In one large system the hospitals did not want vitals during the patch unless something was abnormal. If you said "within normal limits" or something similar they didn't question it. In the other big system, they want all the vitals including RR, Lung sounds, Eyes etc on the patch. To me, this makes the radio reports really long, which the hospitals don't like either.

How much of the vitals do your hospitals expect you to say on the patch? Do they want vitals if they are normal or only when they are abnormal?

 

[DrankTheKoolaid]

re

Here we usually give VS during reports with 911 calls. IFT's not always the case unless there is a significant change or on a CCT xfer with meds

 

[WuLabsWuTecH]

Both Systems I work usually expect a full set of vitals (St. Louis area and Columbus, OH area).

Here in Columbus, if we say "within normal limits, triage apporpriate" some of them will just assume its a BS case and not ask you further but some of them still will ask for a set of vitals. For the rest of the assessment they just want abnormal findings, like if the pupils are not PERRL. Some cases that are less common, pregnancy etc. they'll want to know normal assessments too, but they'll ask you. They also want full sets on children because they never trust that we know what normal limits are (as they shouldn't trust us, some people might get those wrong!).

If we can't get vitals or if the patient is so unstable that getting vitals would not make sense then we don't get vitals and don't transmit vitals. I remember a radio transmission where a nurse asked for vitals on a guy in cardiac arrest. It made all of us on the air go: "Huh?" One joked to me, "Well what does she want them to be? We can pump faster for a higher pulse or bag slower for fewer respirs!"

In any case, a radio report should be about 60 seconds long unless you need medical control (almost never needed in the Columbus, OH district I work in). If you can't get in a vull set of vitals in 60 seconds, you're saying too much elsewhere. IF the hospitals think 60 seconds is too long of a transmission, too bad.

 

[Aidey]

60 seconds here would be waaay too long. They want 20-30 seconds. Which is why I'm kind of confused about why they want us to say "Lung sounds clear and equal. Eyes PERRL" etc when they are normal.

I can understand Pulse and BP, but when you're listing 10 different things there is no way to have a succinct radio report.

 

[spisco85]

BLS patches are asked to be 30 seconds or less with a very clear format:

Patient sex and age
Chief complaint
vitals if abnormal or say "within normal limits"
interventions and any changes
ETA

 

[Epi-do]

It really depends upon what hospital I am transporting to. We have some hospitals that want a call with every transport, regardless of what it is. For those ERs I will just give them the "within normal limits" bit, unless something is abnormal and then I give the actual numbers. When transporting to ERs that only want a call if we are bringing in something more serious, such as a medical or trauma alert, then I will give a full set of vitals. If I have noticed a trend in any particular VS, I will also tell the ER "initially VS was XXX, has increased/decreased over last xx minutes and is now YYY." Basically, I have learned what hospitals expect what type of information, and make sure I include that along with whatever pertinent info I have for them.

 

[marineman]

I try to stay 25-30 seconds with report, giving patient name and DOB adds a bit on to that which I always try to do for a quicker turn around time but in general I keep it short and sweet.

To me the radio report is to give the hospital a heads up of what's coming in and how to prepare, heck it's not even a requirement that you call them. My report in person when dropping the patient off includes all assessment findings but the radio report itself only includes a findings pertinent to the patients condition or chief complaint. For example I only include lung sounds when there is a respiratory complaint or if they're not normal.

I never use the radio for reports, I always use a cell phone.

 

[WuLabsWuTecH]

I try to stay 25-30 seconds with report, giving patient name and DOB adds a bit on to that which I always try to do for a quicker turn around time but in general I keep it short and sweet.

To me the radio report is to give the hospital a heads up of what's coming in and how to prepare, heck it's not even a requirement that you call them. My report in person when dropping the patient off includes all assessment findings but the radio report itself only includes a findings pertinent to the patients condition or chief complaint. For example I only include lung sounds when there is a respiratory complaint or if they're not normal.

I never use the radio for reports, I always use a cell phone.

There are still hospitals out there that don't require a report for ALL incoming patients? Even in the busiest hospital I've worked at (talking 90k ish patients a year) they still want a call in. The only situation that i've encountered that doesn't require a real call in is if you are so tied up with a critical patient you can't take that time (very rare) in which case it's still expected you call in with "Medic 1 inbound with critical patient, need a full team, ETA 2 minutes"

Marineman--why do you use a cell phone? I mean I might consider it if we were issued cell phone, but to me the radio seems more efficient and easier to work with.

 

[boingo]

I only call if I need a trauma room, a specialty service,i.e OB, interpreter, bariatric bed, or for a consult. The note depends on the case, short and sweet seems to be best unless its something complex and I'm seeking guidance, usually a quick set of vitals, but sometimes not.

 

[JPINFV]

I've worked in two systems. In So Cal, the entry patch was age, sex, PMD, CC, ETA, and any critical details (e.g. abnormal labs, give which lab values). In general, we didn't give V/S, or any other exam/history details, unless life shattering abnormal or directly related to the C/C.

In Boston, what I was told was that they want a full report, but the hospitals rarely to never asked for more when given a shorter report than most of my coworkers. There's a point when the triage nurse just stops listening and a lot of people didn't understand that.

There are still hospitals out there that don't require a report for ALL incoming patients?

Yes. Supposedly the hospitals in Boston proper don't want a patch unless it was critical. I always gave a quick patch anyways, but I generally used the above format.

Marineman--why do you use a cell phone? I mean I might consider it if we were issued cell phone, but to me the radio seems more efficient and easier to work with.

Most of the time we used radios, but if the radio was having issues or it was a more sensitive C/C (genital bleeds, for example), I'll go over a cell phone.

 

[Ridryder911]

V.S. on all reports, I chastize those that say... "v.s. WNL"... Really, you know your patients hx that well? Reports are to be expected to < 30 seconds but v.s should be included especially if there were any changes.

R/r 911

 

[MSDeltaFlt]

I agree. If one doesn't routinely give VS, then why even key up the mic?

 

[marineman]

There are still hospitals out there that don't require a report for ALL incoming patients? Even in the busiest hospital I've worked at (talking 90k ish patients a year) they still want a call in. The only situation that i've encountered that doesn't require a real call in is if you are so tied up with a critical patient you can't take that time (very rare) in which case it's still expected you call in with "Medic 1 inbound with critical patient, need a full team, ETA 2 minutes"

Marineman--why do you use a cell phone? I mean I might consider it if we were issued cell phone, but to me the radio seems more efficient and easier to work with.

It is recommended and appreciated to call in a report but no it's not required at any hospitals we transport to. Yes I use a cell phone every time, over the phone I can give patients name, DOB and social security number. Hospitals appreciate having that as it saves them time in registering the patient and it saves me time getting the information from the hospital that I need.

 

[Hockey]

Patch? huh?

 

[WuLabsWuTecH]

It is recommended and appreciated to call in a report but no it's not required at any hospitals we transport to. Yes I use a cell phone every time, over the phone I can give patients name, DOB and social security number. Hospitals appreciate having that as it saves them time in registering the patient and it saves me time getting the information from the hospital that I need.

Why would giving a DOB, SSN, and Name allow you to get information from the hospital faster? Actually, what information are you getting from the hospital in the first place?

Most of the time we used radios, but if the radio was having issues or it was a more sensitive C/C (genital bleeds, for example), I'll go over a cell phone.

If you're not giving a name, does it mater what the nature of the call is or how sensitive the issue is? And if your radio's down, that's one case it might actually be acceptable to show up to the hospital without a report assuming your radio is totally down (can't even contact dispatch) and the radio on the truck is down, and your partner's radio is down!

Patch? huh?

Slang for radio transmission. In the old days, the dispatcher would have to get you to the right channel by linking up your channel and the hospital's channel. Now this is only needed (at least in my area) if it is not a channel you use often and is not programmed into the radio. In which case the dispatcher finds the channel you want and "patches it through" to a channel that you already have and asks you to tune that channel.

If you are going to an Outside Hospital that is not programmed in your radio dispatch might say something like: "OSH will be available on the talkgroup Batallion 2 Fireground Alternate" and you will tune to BN2FG-Alt when you are ready to talk to that hospital.

V.S. on all reports, I chastize those that say... "v.s. WNL"... Really, you know your patients hx that well? Reports are to be expected to < 30 seconds but v.s should be included especially if there were any changes.

R/r 911

Thank you rid, props to you. I would feel uncomfortable giving a report w/o giving vitals even on a BS patient. All the hospitals I've worked at hate it when that happens, even when there is a legit reason (obese pt and we don't have a cuff for BP, pulse ox OOS, child that is crying/screaming making respirs impossible to get) although they won't blame the EMTs if there is a legit reason. Often times when a call in says "VSS" or "VS WNL" the nurse will get snappy and say, "Can you tell me what the vital actually are?" They get even more pissed when they hear a response from the medic saying "Standby." as that usually indicated they NEVER TOOK THE VITALS in the first place yet just assumed they were all stable.

Another pet peeve i have heard are people calling in AOx1 but not mentioning which one is present or which 3 are missing. Or saying elevated temperature but not saying how much. Or saying pt is complaining of pain, but not where... I think you see the pattern.

To all:

Finally you get cell service in your metal box? We used Nextels and they sometimes had issue where I used to work. Also, wouldn't the cost of cell phones in every truck be very high? I just cant think of any company being able to justify that cost when radios work fine.

 

[Hockey]

Oh, thanks!


Regarding the question it depends on my mood. Sometimes I say within normal limits for our frequent fliers and other times I just want to hear myself talk and rattle everything off. Depends on the hospital. Depends if my mouth is dry. Depends if the nurse sounds like a hawttie and I don't want to sound like an idiot etc etc. You know, discretion
(Before anybody has an aneurysm, and starts to flame me for my last couple statements, it was made in a ha-ha manner.)

Around here, we have the KISS policy. Keep it simple stupid. If its an elbow, its an elbow. Don't need all that medical terminology, especially over the radio when you get laughed at. I've seen it a few times with new people where they say proximal blah blah blah [insert long odd named medical terminology such as Epistaxis or something (I know it doesn't go together with what I just said but you get my point)] when you could have just said in plain simple English, nose bleed, or laceration or something simple.

Thats what they want to hear here.

 

[JPINFV]

If you're not giving a name, does it mater what the nature of the call is or how sensitive the issue is? And if your radio's down, that's one case it might actually be acceptable to show up to the hospital without a report assuming your radio is totally down (can't even contact dispatch) and the radio on the truck is down, and your partner's radio is down!

You're assuming a lot by assuming that there is more than one radio able to give report. In So. Cal, the unit had one radio and the report went through dispatch with dispatch calling the hospital. Some places, specifically San Clemente (for those from the area) are notorious for bad reception. In Boston, report/medical control was conducted through the state wide CMED system, which was a distinct radio in the back from the dispatch radio up front. Additionally, in Boston, my company issued each unit a single Nextel while we had no portables issued at my Southern California company.

 

[marineman]

Every patient we bring to the hospital we get a sheet with their billing information on it, the hospitals can't print that until the patient is registered and they can't register the patient until they have a full name DOB and SS number. Paramedics in my company put in most of the information for billing, the only thing we don't do is print and send a bill. Also the sheet from the hospital has a medical records number on it that we need when we submit our report so as soon as we're done with it, it is automatically sent to the hospital and placed in the patients medical records. This is much different than other areas where you do a handwritten report that must be left at the hospital when you leave but it works quite well for us.

 

[chadwick]

Sometimes

You can usually get by with vitals within normal limits but sometimes they ask. Especially if it is respiratory.

 

[Ridryder911]

Oh, thanks!

Around here, we have the KISS policy. Keep it simple stupid. If its an elbow, its an elbow. Don't need all that medical terminology, especially over the radio when you get laughed at. I've seen it a few times with new people where they say proximal blah blah blah [insert long odd named medical terminology such as Epistaxis or something (I know it doesn't go together with what I just said but you get my point)] when you could have just said in plain simple English, nose bleed, or laceration or something simple.

Thats what they want to hear here.

Knowing when and proper medical terminology will make you look like an idiot. It is usually when most mispronounce or give the wrong word. Too much info on the radio appear that you like to hear yourself talk.

R/r 911