Radio Reports - Chicago

[the_negro_puppy]

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.

 

[DrParasite]

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.

 

[Tigger]

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.

 

[325Medic]

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.

 

[Fish]

I like that better than a report for every patient

 

[medicdan]

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?

 

[Fish]

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.

 

[BearChicago]

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).