Turn over to hospital personnel
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A couple companies that I've worked for over the years had some kind of ePCR (I forget exactly what it was) but also carried a paper version, just in case the computer crashed.
I got really good at doing the PCRs quickly. I'd do the verbal report and end it with something like: "I'll have the chart for you in a couple minutes" and I really would usually have it done by then... and turn it into the team (or the very nurse) that actually took report. Somebody would at least glance at it... before it disappears into the patient's ED chart somewhere.
And once they do, then the only browser the Zoll stuff will work on will be IE. PITA for me and my Mac, but mostly because I am too lazy to partition my HD and boot windows as well
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EMTswag
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over the radio? age, gender, what happened, what he looks like (condition wise), what we did for him, how far away we are, do you require anything further?
In the hospital? whatever it is they ask for.
In the hospital? whatever it is they ask for.
csly27
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we had to call in our reports by radio or cell phone.. I mainly used cells we just gave the basics pt age, cc, hx, how far out we were and if they had any info for us, mostly it went smooth sometimes if u forgot to call in they would get pissy.
No guidelines here. The nurses at the receiving ER's ask us all the questions they need. We give them a copy of our runsheet so they have everything we had. They sign off that they are taking care, and we are out of there.
We used to use HEAR radio's.. before my time (I'm 18, just started last November).. now it's cell phone for most of the ER's except HUMC, where we just show up.
Some services put a printer in each ambulance and expect the crew to complete the PCR and print it before leaving the ED. Others have an EMS printer at the ED (EMS room), still others have the server fax a copy of the PCR to the ED when it is completed (wherever the crew is at the time).
TransportJockey
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Everywhere I've worked we call in a quick heads up via radio or phone (radio here in NM, phone in TX and CO), and then I give the RN/Resus team/Trauma team a longer verbal report that goes more in depth. I've been giving them often enough that I basically do my own thing and when I get done I ask if they have any questions for me. Very rarely do they.
And as for PCRs... We finish them sometime during the day and once we submit them to NM EMSTARS they get faxed to the hospital. We don't give paper run forms to the hospitals.
And as for PCRs... We finish them sometime during the day and once we submit them to NM EMSTARS they get faxed to the hospital. We don't give paper run forms to the hospitals.
EMTswag
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Yeah no hospital in my area actually answers HEAR anymore haha. And I think I know where youre going with that... MOST hospitals we call ahead to, except that one hospital whose staff we all hate
Too Old To Work
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I just keep talking til the nurse has had enough and assigns me a room. It usually doesn't take that long. Sometimes I'll eat onions for lunch and stand real close to her. That often speeds things up. Occasionally, just to see if they are listening, I'll throw in patient's favorite vegetable, shoe size, and birth stone.
8jimi8
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MIVT:
Mechanism of injury
Injuries sustained
Vitals
Treatment
If they need more, give the sample hx. Speak up, so the doc and the techs can hear you.
Mechanism of injury
Injuries sustained
Vitals
Treatment
If they need more, give the sample hx. Speak up, so the doc and the techs can hear you.
Melclin
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All this strict structure makes me think of the staccato talking EMT on American TV shows like ER.
I find in general handover is more of a conversation and the structure changes depending on the pt.
This is John, now you've gotta watch John he's cheeky aren't you John. Anyway John has a 1 month hx of chest pain on exertion. It hasn't been previously investigated or anything, ahhh, he's then experienced the sudden onset at rest of what he describes as heavy central chest pain radiating to to his R shoulder at about 10 this morning, so about 2 hours ago now. He waited around for a bit before calling us and we've got to him about 45 mins ago, found him to have what sounds like cardiac chest pain and some nausea. He's been haemodynamically stable the whole time, obs unremarkable other than some mild hypertension at 160/85, we've given him 300 of aspirin of course, 2 lots of 300mcg GTN, his pain hasn't changed at all, we've then popped a total of 7.5mg of morph in, and he's now pain free. He's also had 10 of maxolon to good effect. Ah...he doesn't have any cardiac hx and the only other medical hx is diabetes...yep type 2... ahh, and no allergies.
Trauma centre handovers are a bit more formal.
This is 62 year old John. John was the driver of a family sedan that was involved in a high speed head on collision at approximately 1630 this afternoon. There was significant cabin intrusion killing the other two passengers and trapping John so there was about a 40 minute delay for extrication and we found him to have significant blunt injuries to his head, a flail segment, and an open fracture to his L tib fib. He was initially GCS 13, hypotensive at 75 systolic before the extrication and in considerable pain, responsive to 2 L of saline and 45 of morphine. Last pressure was 125/85 at HR 98, Saturating well on 8 litres but he does desaturate quickly without o2 and he's been throwing VEs fairly often. Equal breath sound bilaterally, still GCS 13, No meds, hx or allergies that we've been able to ascertain.
Then come the steady stream of further questions from the trauma team.
We rarely give hospital notification unless people are seriously ill. The last hospital note I gave went: "Ah yes, ______ Hospital, we're about 15 out with an 82 year old male post conscious collapse at 2330, presenting with R sided hemiplegia and dysphasia - ?stroke. He's GCS 15 and hypertensive at 185 over 85. Has a BSL of 3.9 that we're correcting now and unless there's anything further we'll see you in 15."
I don't know that they're perfect, but these are all handovers that I've given, they were well received.
I find in general handover is more of a conversation and the structure changes depending on the pt.
This is John, now you've gotta watch John he's cheeky aren't you John. Anyway John has a 1 month hx of chest pain on exertion. It hasn't been previously investigated or anything, ahhh, he's then experienced the sudden onset at rest of what he describes as heavy central chest pain radiating to to his R shoulder at about 10 this morning, so about 2 hours ago now. He waited around for a bit before calling us and we've got to him about 45 mins ago, found him to have what sounds like cardiac chest pain and some nausea. He's been haemodynamically stable the whole time, obs unremarkable other than some mild hypertension at 160/85, we've given him 300 of aspirin of course, 2 lots of 300mcg GTN, his pain hasn't changed at all, we've then popped a total of 7.5mg of morph in, and he's now pain free. He's also had 10 of maxolon to good effect. Ah...he doesn't have any cardiac hx and the only other medical hx is diabetes...yep type 2... ahh, and no allergies.
Trauma centre handovers are a bit more formal.
This is 62 year old John. John was the driver of a family sedan that was involved in a high speed head on collision at approximately 1630 this afternoon. There was significant cabin intrusion killing the other two passengers and trapping John so there was about a 40 minute delay for extrication and we found him to have significant blunt injuries to his head, a flail segment, and an open fracture to his L tib fib. He was initially GCS 13, hypotensive at 75 systolic before the extrication and in considerable pain, responsive to 2 L of saline and 45 of morphine. Last pressure was 125/85 at HR 98, Saturating well on 8 litres but he does desaturate quickly without o2 and he's been throwing VEs fairly often. Equal breath sound bilaterally, still GCS 13, No meds, hx or allergies that we've been able to ascertain.
Then come the steady stream of further questions from the trauma team.
We rarely give hospital notification unless people are seriously ill. The last hospital note I gave went: "Ah yes, ______ Hospital, we're about 15 out with an 82 year old male post conscious collapse at 2330, presenting with R sided hemiplegia and dysphasia - ?stroke. He's GCS 15 and hypertensive at 185 over 85. Has a BSL of 3.9 that we're correcting now and unless there's anything further we'll see you in 15."
I don't know that they're perfect, but these are all handovers that I've given, they were well received.
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lightsandsirens5
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No agency specific SOGs. I have kinda developed my own way. Like Melclin says, it is kind of conversational.
On the way in, we give a quick heads up on the radio. ETA, age, sex, VERY brief rundown of illness or injuries, major treatments (Ie. fully immobilized, intubated, cpr (Ha ha ha), etc), ask for any questions or orders.
We arrive and get a room assignment then we give a more detailed report to the receiving RN. That is when I go into the details like OPQRST, SAMPLE, details of the MVA and the scene, full treatments, pertinent negatives, things like that.
Oh yea, and don't go giving report to a tech, you will only have to give it again to the RN. Ha!
On the way in, we give a quick heads up on the radio. ETA, age, sex, VERY brief rundown of illness or injuries, major treatments (Ie. fully immobilized, intubated, cpr (Ha ha ha), etc), ask for any questions or orders.
We arrive and get a room assignment then we give a more detailed report to the receiving RN. That is when I go into the details like OPQRST, SAMPLE, details of the MVA and the scene, full treatments, pertinent negatives, things like that.
Oh yea, and don't go giving report to a tech, you will only have to give it again to the RN. Ha!
TransportJockey
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Oh yea, and don't go giving report to a tech, you will only have to give it again to the RN. Ha!
Depends where
All three patients I transported yesterday report was given to a tech and care turned over to them. In NM I can turn over to an equivalent or higher cert/licensure. These techs were either EMT-Ps working triage or EMT-I/P working as a senior tech
lightsandsirens5
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Depends where
True. So far as I know however here in WA, a Tech falls below an EMT-B on the food chain.
adamjh3
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When going to the ER we have to make a radio report to the receiving hospital, I have a note pad that I take notes on scene with.
Age, gender, chief, History pertinent to incident, past medical history, meds, allergies, assessment and treatment.
My cat scratch notes end up helping me put out something like this:
And then when I call the hospital they go and rain on my parade and say they just want the patient's, age, gender, chief, and ETA.
My actual turn over to hospital staff runs about like my narratives and radio reports do; if they want it brief I'll let them know how they were found, how they ended up there, quick rundown of what we found (possible fx'd hand, hematoma on the forehead), any abnormal vitals, a brief Hx, and allergies.
Age, gender, chief, History pertinent to incident, past medical history, meds, allergies, assessment and treatment.
My cat scratch notes end up helping me put out something like this:
And then when I call the hospital they go and rain on my parade and say they just want the patient's, age, gender, chief, and ETA.
My actual turn over to hospital staff runs about like my narratives and radio reports do; if they want it brief I'll let them know how they were found, how they ended up there, quick rundown of what we found (possible fx'd hand, hematoma on the forehead), any abnormal vitals, a brief Hx, and allergies.
I've called several nurses the 4 letter word that rhymes with punt and I've called some what you call a female dog. One responded to me with 'I am ten times more qualified then you to treat this patient'.. to which I responded with 'really? you could have fooled me with the way i've seen you handle things'.. I got a death stare, except that one hospital whose staff we all hate
One also said she was old enough to be my mother and I should show some respect.. and then told me to :censored: off.. so I told her she actually looked old enough to be my grandmother. Score.
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And if you were my probationary employee under FTO... You'd be done if I heard you say that. Period. If I were your FTO, you'd be FAILED instantly. If I were your boss and you a regular employee... you'd be looking at spending some quality unpaid time off at the minimum. Yes, we all know people like that. Picking fights with them doesn't do anyone any favors.I've called several nurses the 4 letter word that rhymes with punt and I've called some what you call a female dog. One responded to me with 'I am ten times more qualified then you to treat this patient'.. to which I responded with 'really? you could have fooled me with the way i've seen you handle things'.. I got a death stare
One also said she was old enough to be my mother and I should show some respect.. and then told me to :censored: off.. so I told her she actually looked old enough to be my grandmother. Score.
Those Nurses now probably are looking closely at YOU for med mistakes to report YOU for.
katgrl2003
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Agreed