Radio Reports, Do They Listen?

[CAOX3]

Would you listen?

How many twenty-minute dissertations can you listen to on completely stable patients.

At one hospital we get parked near the report radio and crews ramble on so much the nurse or DOC just wanders away.

 

[trevor1189]

Radio reports should not be 20 minutes long. I'm sure you were exaggerating, but I would say you can get all information with priority in less than a minute.

 

[CAOX3]

They want complaint, severity and destination.

Destination would be trauma team, medical team, general pop, chairs or the tank.

Some units think their the only ambulance in the city and their reports reflect that.

 

[mycrofft]

Why not a national standard for civilian incoming radio reports?

Or at least local hospitals in a catchment area get together and set a standard, including your location, patient ID and main malfunction (not necessarily your working diagnosis), and if resuscitation has been in progress (times how long). VS if really outre'.

Basically, think "If I were at the hospital, what sort of pt would require me to muster exceptional resources? What sort of pt will I bump someone else for if I'm full?". Don't recount your course of treatment verbally, have a clear and concise report form to hand over.

The pass-off report needs to be decoupled from the formal report. Make sure it's the same pt, but the pass-off is tactical, the formal is more strategic and cover you arse type.

 

[MrBrown]

We're told like 30 seconds max.

 

[Akulahawk]

Or at least local hospitals in a catchment area get together and set a standard, including your location, patient ID and main malfunction (not necessarily your working diagnosis), and if resuscitation has been in progress (times how long). VS if really outre'.

Basically, think "If I were at the hospital, what sort of pt would require me to muster exceptional resources? What sort of pt will I bump someone else for if I'm full?". Don't recount your course of treatment verbally, have a clear and concise report form to hand over.

The pass-off report needs to be decoupled from the formal report. Make sure it's the same pt, but the pass-off is tactical, the formal is more strategic and cover you arse type.

Santa Clara County did such a thing... and they've had this basic required format for YEARS. Here's their PDF: http://sccemsagency.org/SCC/docs/Em...1.23.08 501 Hospital Radio Reports 012208.pdf

I've use very similar radio report formats in Sacramento and San Joaquin Counties... IIRC, Sacramento County has a radio report format, but I think it's more buried in the protocol manual, within the individual protocols.

 

[Aidey]

For example

"Twenty year old male, status asthmaticus unresponsive to salbutamol and adrenaline, status one, see you in five minutes"

"Eighty five year old female, slip and fall, fractured right neck of femur, no other injury, pain adequately controlled with morphine and ketamine, status two, see you in five minutes"

Quick, simple and to the point.

Our hospitals have a form that gets filled out for every patch they receive. It goes into the pts chart with everything else. They require certain things be filled in, and if you don't give at least level of consciousness, pulse and BP they will ask for it. Not because they don't trust us, but because they have to meet their requirements. If we don't have the info they quote our reason why on the paperwork.

One of my reports would sound basically like that, but with vitals.

 

[RCashRN]

In my years in the Santa Clara County EMS system, it's a little different... The ED's seem learn who is who on the radio (or the phone, now) and either take whatever you give them with a pound of salt or they'll attentively listen to what you have to say about the patient. Good medics, they'll listen to. The not so good, well... thanks for bringing in the patient.

+1

this is how it is where i work. but we (at my ER) want to be called for every patient, no matter how minor, to get a room ready or to decide whether the patient goes the triage or the 'fast track' area. it's much easier when you have a few minutes to decide on which room is best.

 

[RCashRN]

Honestly do they care that much about whether nana has a lock in or some oxygen on? I just cannot understand how it makes the slightest lick of difference!

we do care. that way we nurses know if we need to have IV stuff waiting in the room so nana can get some pain control and be cooperative and a little more comfortable for xrays. it also tells us if we DO need to start the IV on the patient's arrival to the ER, if we can draw the blood while starting the IV or just get lab to do it since they might already have one from in the field. or, if you attempted and were unsuccessful, we'd know to possibly start thinking about a central line or whatever and possibly get supplies ready.

 

[Level1pedstech]

We're told like 30 seconds max.

You are spot on Brown,great advice in one short sentence. May I add that as someone who answers the radio at a level one facility I can tell you that short and sweet is the way to go. In our system level one and two trauma activations are handled seperately by an RN over the phone, everything else coming in is taken buy an RN or a tech over the radio. In six years I have never seen a doc answer the radio unless they are the only ones at the nurses station. Usually its the charge RN that handles the radio reports.

We need to know what acuity level your patient fits into so that we can be prepared for anything that patient may require. Its not uncommon to have a very sick patient upgraded and entered into the trauma system after their initial assessment by one of the ED docs. We want to make sure we get the patient into the right room and have available all the resources that patient may need. The report is really all about preparation on our end just keep that in mind. Be sure to follow your receiving facilities guidelines if they have a particular way they want things done when calling in a report. I have to say that or someone will pop in and say "we do it this way at our hospital" that's fine,just look at this as a basic way to deliver a short and to the point radio report.

Like Brown said you should be able to wrap it up 30 seconds or less. Here is what a good radio report should consist of. This is medic 1615 we are in route to your facility code three with a ten minute ETA, on board we have a 21 year old male who was an unrestrained driver in a single vehicle rollover accident,patient self extricated and was walking around when we arrived on scene,he is complaining of pain in his neck,chest and abdomen,vitals (give a full set BP,Pulse,RR (room air or O2)and LOC), we have an 18g IV established in the right AC, any questions. We will know so much about your patient and how we should prepare just from that short radio report. If the person on the other end wants or needs more information they will ask. I can think of many things this patient may need and I know exactly what to have ready when you arrive.

For the record we will assume all spinal precautions are in place so no need to take up your thirty second with "patient is collared and boarded", if he is not he better be when you hit our doors. I timed that report and came up with 22 seconds. Anything else can be added when you give your hand off report to an RN. Of course I have to add that if you have any additional information you think might help us in preparing for your patient by all means speak up, but for most patients the above report is what we need to get the ball rolling on our end. The main thing to remember is we are not treating your patient over the radio,we want to be able and prepared to give your patient the best care possible when you arrive.

 

[MrBrown]

Our template is

"This is ___ from Ambulance, coming to you from ___ with a ___ m/d/y old M/F, ___ (chief complaint), ___ (pertinant findings, vital signs (BP/HR/RR/SPO2/GCS/ECG as appropriate), ___ (significant interventions), patient is status 1/2/3 and will be with you in ___ minutes"

- Describe findings and vital signs pertinant for chief compaint only
- Routine treatment e.g. oxygen, IV access, cervical collaring, bleeding control and splinting is not to included.

For example (made up) "this is Brown from Ambulance coming to you from Timbuktu with a 6 week old male, stridor query epiglotitis, was moderate on arrival now mild with nebulised adrenaline, RR 16 and SPO2 99, patient is status three and see you in five minutes"

As above, status 1 is immeadiate/critical, 2 is moderate/unstable and 3 is minor/stable

 

[Akulahawk]

In Sacramento, about the only thing I used to add for what they wanted here was whether or not the person was in spinal precautions or not (if trauma patient) and which protocol(s) we were following. Otherwise, I keep it as short and simple as necessary. With some very stable, non-acute patients, I'd just state "VS as expected" and I WILL state them if out of the typical ranges for either the patient or the typical norms. That's mostly a Sacramento thing though, and it does save some radio time.

 

[DrParasite]

BLS report (if we even give one on the air, most hospitals in NJ don't even get them): age/sex/chief complain/anything abnormal/any important interventions given. that's it. if you got something important (pt just coded, active seizure with no ALS, hx of 3 MIs and this looks like #4, etc) a message can get relayed and you can sometimes have a bed waiting, but most of the time it's show up and wait. a much more complete report is always given face to face

ALS report: full 5 minute report goes to medical control only. doc says "monitor and transport call back if you need anything" or says to do more stuff. usually the dispatch agency gives the actual report the the receiving hospital, and then it's "age/sex/chief complain/anything abnormal/any important interventions given." a much more complete report is always given face to face