Mandatory Radio Reports?

Tigger said:
It does? Most patients don't call the ED before they drive down there, at some point the ED is expecting EMS. Bigger places don't need you to bother them with what they already know.
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But most patients who don't call 911 go into the waiting room/triage and not straight to the ER (in my area they all get triaged before going back).

Yes hospitals should be expecting EMS but they don't know what we are bringing in. It allows the hospital time to prepare for what is coming in. How many hospitals have a respiratory team standing at the ER door expecting EMS to arrive? I've yet to see a trauma team all dressed up and expecting a crew to come in with a trauma.

It gives them an ETA and allows them to know what has already been done, so they don't have to do it, and what they need to still do.

The hospital doesn't know anything about the patient I'm bringing in until I call them and inform them.
 
firefite said:
But most patients who don't call 911 go into the waiting room/triage and not straight to the ER (in my area they all get triaged before going back).

Yes hospitals should be expecting EMS but they don't know what we are bringing in. It allows the hospital time to prepare for what is coming in. How many hospitals have a respiratory team standing at the ER door expecting EMS to arrive? I've yet to see a trauma team all dressed up and expecting a crew to come in with a trauma.

It gives them an ETA and allows them to know what has already been done, so they don't have to do it, and what they need to still do.

The hospital doesn't know anything about the patient I'm bringing in until I call them and inform them.
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I should have been more clear. If the ED needs to be prepared for arrival, we'll call ahead. Major trauma, code, STEMI, CVA, severe respiratory, that type of thing. But for the most BLS calls, they do not want us to call. It wastes their time and the call ins are supposed to be for serious things. Plus more I'd bet at least 2/3s of patients brought into city hospitals in Boston are brought in by BLS crews anyway, so we haven't really done anything for them by the time we arrive that they won't do themselves almost immediately.
 
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FeatherWeight said:
Recently I was talking about radio reports with my supervisor who was formerly a medic from Texas, he was telling me how they never even made radio reports and just show up to the hospital without giving them a heads up. I'm not sure if this was just a old school way of running calls or if Texas or anywhere else still does this? Can anyone confirm this because that blows my mind how they would allow this.
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Everywhere I've gone: flight, ALS, etc have wanted/needed radio reports called in. What they do NOT need/want is a 30 minute dissertation covering everything from their meds, complete PMH (including gout, flatulence, halitosis, etc) to their favorite color, shoe size and what they had to eat for and afternoon snack 3 weeks ago.

Basically what I'm saying is brevity is key. They're not listening past 15 secs anyway. They don't have time even if they wanted to. Plus tying up the radio with useless chatter keeps other units with a definite need to communicate being able to do so until you shut up.

Detailed reports are for the bedside. For the radio, get on then get off using the fewest syllables possible. This will take practice and experience.
 
Down here in downtown San Diego all BLS radio reports are to be given in full detail regardless of the severity of the patient. Part of me thinks this is why it is because unfortunatly EMTs have lately been bringing dead patients into the ER that should have been upgraded long before transport.
 
Tigger said:
It does? Most patients don't call the ED before they drive down there, at some point the ED is expecting EMS. Bigger places don't need you to bother them with what they already know.
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I'm sure if the hospital can get a pre-arrivial note from the walk-ins they'd enjoy the warning for the serious ones. Just because a large portion of ED patients don't call ahead doesn't necessarily mean it isn't helpful when they can get a warning.


...besides, it's always nice to have a bed assigned before you arrive (and this wasn't a small hospital that normally did this either).
 
JPINFV said:
I'm sure if the hospital can get a pre-arrivial note from the walk-ins they'd enjoy the warning for the serious ones. Just because a large portion of ED patients don't call ahead doesn't necessarily mean it isn't helpful when they can get a warning.


...besides, it's always nice to have a bed assigned before you arrive (and this wasn't a small hospital that normally did this either).
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I have never transported to a hospital in Massachusetts that assigns beds pre-arrival period. I have in Colorado, where the hospital actually listens to the radio.

I get a bed faster at the places that don't want call ins, but that is probably because they are only larger facilities.

I will also reiterate that for serious patients we do call in, but working a BLS truck, that is a rather rare occurrence. The medics call more often.
 
Featherweight,
When somebody told me that they had to notify the ED for EVERY pt. they brought in, I was just as befuddled/flabbergasted as you are with the notion of NOT notifying the ED with every pt. you bring in.

It depends on where you work. Where I work, it literally could not work unless they dedicated a radio band for that specific purpose because there's too much radio traffic without notifications. And on the hospital end, nobody would be listening. Heck, getting ahold of medical command is an issue. The phone will ring and ring and ring and ring without an answer...
 
When I was working in an area with mandatory "radio" reports (Southern California), the an entry note was age, sex, CC, anything drastically important, PMD, and ETA. 10-15 seconds. The note went through company dispatch, who then called the ED for us.
 
The only hospital we transport to (level 1) has a dedicated comm center. We hail the hospital once toned out with CC and location/town. Hail them again when we are on scene. Usually call via cell phone to give a report or update. Them finally hail them again when arriving. They take a great interest in EMS and our relationship seems better this way. Beds 99% of the time are triaged prior to arrival.
 
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We work through one central "EMS Resource" which is a service provided to the entire county. Resource is a person in an office in the ED of one of the hospitals we transport to. They take all incoming patient reports to any area hospitals for all local agencies.

If its a BLS call they just write down the basics and call the ED your headed towards to pass along the info. If its ALS they patch you straight through to the ED on the phone. They also handle any requests for med-control, helicopters, or specialized resources.

We generally just use cell phones and actually call resource although they are available on the radio if you wanted to do it that way (or just piss off the resource person). The call-in lines and radio channel are all recorded meaning the county has a record of what exactly was said and at what time which is nice.

If I'm calling in a BLS patient I just give age, gender, CC, relevant details, and an ETA. 99% of the time they just say "No Orders, Transport and Advise" occasionally they have questions or will make specific requests. The system seems to work pretty well. In theory the EMS resource is supposed to really help when coordinating MCI transport destinations but experience has not proven that yet.
 
FeatherWeight said:
Down here in downtown San Diego all BLS radio reports are to be given in full detail regardless of the severity of the patient. Part of me thinks this is why it is because unfortunatly EMTs have lately been bringing dead patients into the ER that should have been upgraded long before transport.
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Unless it has recently changed, BLS should never give full reports. When I worked in SD my reports went like this:

Pacific BLS 292 bringing in a 65 yo f weighing 200lbs for non traumatic abdominal pain from a snf. Pt is alert oriented, vs are 120/80. Hr 68, resps 18 full and effective. We are 5 out.

99% it was always followed with, "see you inside." Rest of the time it was, is pt coming from x snf?
 
rwik123 said:
The only hospital we transport to (level 1) has a dedicated comm center. We hail the hospital once toned out with CC and location/town. Hail them again when we are on scene. Usually call via cell phone to give a report or update. Them finally hail them again when arriving. They take a great interest in EMS and our relationship seems better this way. Beds 99% of the time are triaged prior to arrival.
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Why? That's a little absurd, no offense.

A simple 20 second entry note during transport is plenty unless you need to get the wheels rolling for a specialty team (read: STEMI or major trauma) then just call earlier.
 
FeatherWeight said:
Recently I was talking about radio reports with my supervisor who was formerly a medic from Texas, he was telling me how they never even made radio reports and just show up to the hospital without giving them a heads up. I'm not sure if this was just a old school way of running calls or if Texas or anywhere else still does this? Can anyone confirm this because that blows my mind how they would allow this.
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Reports are not mandatory, they're a courtesy to the receiving facility. If I have time, great, if not, oh well. Having said that, I give reports the VAST majority of the time.
 
Linuss said:
Reports are not mandatory, they're a courtesy to the receiving facility. If I have time, great, if not, oh well. Having said that, I give reports the VAST majority of the time.
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A perfect example of how things can be very different place to place.

In Delaware, a radio report is NOT a courtsey, it's required on every patient contact. NOT calling in a report will get you "talked to" as well as tick off the ER nurses.

However, it should be a short report, "Hey, It's Medic 103, inbound with a 75 year old female COPD history diff breather, on CPAP, please have respiratory ready, we'll be there in less than 10." Any more than the bare bones is usually ignored.
 
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DrParasite said:
which is a major EMTALA violation if I'm not mistaken.
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Nope. The EMTALA violation is expecting the EMS crew to care for the patient in the ED. If the hospital is doing the care I doesn't matter who's bed it's on.
 
FeatherWeight said:
Woah, I cant really think of a reason why you wouldnt be able tell the hospital what you have. Do you know of any specific regions where they arnt required to make radio reports?
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I know for a fact our medical control, does not want a radio report to the local hospital unless its something drastic. He is also the medical control for the local ED staff, he has every pt, go through triage. I think this is a great idea, it has cuased a reduction in the number of b***T calls.
 
When I worked in Indianapolis the majority of the hospitals, didn't want one: in fact going into a Level I trauma center one day I got chewed out for wasting time on a radio report that was the following: "6month old, Cardiac arrest, 3 minutes out".

Here in Utah we need to call in for EVERYTHING. and how long the report lasts is up to the nurse on the other end; and I was kept on the phone for 23 minutes one day by the nurse.

Now our closest hospital (45 minutes, one way) wants us to call as soon as we start the transport, and then again about 15 minutes out.
 
I worked in San Diego

The Radio Reports are insane, you have to wait in line to talk to a MICN then give an extremely long and deatiled report. Then repeat it at the Hospital,then repeat it when you do your documentation. People would pride themselves on how well they could go into good detail in these radio reports, all the while your patient is sitting on the stretcher with you behind their head talking on the radio and not paying attention to them.

Where work now, our reports take 20seconds. We never wait in line. We give the Hospital the Meat n Potatoes. We don't rattle off an entire narrative like we had to in San Diego.
 
When I worked in the Indy metro area, we had a couple hospitals that wanted calls for everything, but most of them didn't care unless it was something that warranted a heads up before getting there. Now that I am working in a rural area, where we typically only transport to the local hospital, we call everything in. Since we do the call via cell phone, not only do they want the typical info, we also give name, DOB, and family doctor.
 
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