Turn over to hospital personnel

I

iancg1

Forum Ride Along
Messages
2
Reaction score
0
Points
0
Hi all, how do you do your turn overs to hospital personnel? Others like it short while some are more detailed. Does your agency have guidelines? Thanks.
 
iancg1 said:
Hi all, how do you do your turn overs to hospital personnel? Others like it short while some are more detailed. Does your agency have guidelines? Thanks.
Click to expand...

My company has no guidelines for oral or written reports. I do know of one service that has a call-in guideline sheet for when you give your en-route report. I go to 5 different ER's and it varies with each one. Of course, the situation dictates whether or not you are going to go into detail. Many times in this area if the pt is A/Ox4 and doesnt have anything going on that requires immediate action, they just want to know v/s and tx you administered. The rest they get from pt interview.
 
We use MIST

Mechanism
Injuries
Scene
Treatment

For example

"This is John, 72 years, 18 hours post some sort of nasopharyngeal biopsy which started bleeding about 8pm last night, got progressively worse, has lost about 300ml of blood, BP 100/60, he's had about a half litre of saline"
 
iancg1 said:
Hi all, how do you do your turn overs to hospital personnel? Others like it short while some are more detailed. Does your agency have guidelines? Thanks.
Click to expand...

We have 12 points we have to say when we do a call in enroute. We have to do a call in before we get to the hospital. Then once we arrive we give a more detailed report of our patient and what is going on.
 
I find it depends entirely on the triage RN, the hospital and the Pt.
Some nurses happy to get just a few sentences run down, CTAS and the basics to fill out the form.
Two of our hospitals triage RN handles report to the RN that will be attending to that Pt. At on of our hospitals we give report again when we place the Pt. I prefer the latter and for complex cases I'll still find the RN and give report.
Basic cut and dry Pt's get an obviously quicker report than the more involved ones and the head scratchers.
And finally resus Pt.'s, major trauma, CVA, etc. we end up giving report right to the physician in the treatment room and more often than not hang around and help during the initial work-up.
 
We have 2 hospitals in our city. One is a Level II and the other is a Level III.

The II is really rude to medics and you have about 30 seconds to give bedside report if even that.

The III is much better in that regard. In fact their trauma coordinator tells the RN's that when we are ready to give our report, they will "Shut up" and give us 90 seconds to give our hand off report. The coordinator wants to hear what we have to say since they were not at the scene to get important details.

I realize in critical cases time is important, but so is our findings that we do not give over the radio due to tying up airwaves.
 
EMT-IT753 said:
The III is much better in that regard. In fact their trauma coordinator tells the RN's that when we are ready to give our report, they will "Shut up" and give us 90 seconds to give our hand off report. The coordinator wants to hear what we have to say since they were not at the scene to get important details.
Click to expand...

We have two regional trauma centres in the area. I've only been to St Mike's trauma room in Toronto though and it has a large sign just inside the door called "Trauma Room Expectations." I don't remember all the details but there was one point I enjoyed:
During hand off and report from Paramedics are personnel are to be quiet to allow the trauma team leader and recording RN to hear full report.

And as a result we have seemless transfer of care and are usually kept around for a bit until the TTL and consults have all the first hand info they might need.
 
Simple cases, quick, two-sentence presentation, with any addenda that are needed.

More complex cases, I present the history and ROS just highlighting what's key, and what I did or didn't do. I don't take well to being blown off by the staff, so if they do blow me off, I will say something in that moment like, "I'll just wait right here while you get him settled" or "Am I giving you report or is someone else taking Mr So and So?"

It's easy to demand to be treated like a healthcare provider if you really are one. Manners matter, and making sure the crabby people don't wreck your day or the patients' is important.
 
We call the hospital on our cell phones enroute to give the hospital a good idea of what we are bringing in. Once we arrive a team from the hospital will take over and our medic will give a full report to a RN or Doctor. The medic doesn't have to rush the report because there is already a team working on the patient based on the info we gave enroute. It works extremely well and allows for a seamless hand off.
 
abckidsmom said:
Simple cases, quick, two-sentence presentation, with any addenda that are needed.

More complex cases, I present the history and ROS just highlighting what's key, and what I did or didn't do. I don't take well to being blown off by the staff, so if they do blow me off, I will say something in that moment like, "I'll just wait right here while you get him settled" or "Am I giving you report or is someone else taking Mr So and So?"

It's easy to demand to be treated like a healthcare provider if you really are one. Manners matter, and making sure the crabby people don't wreck your day or the patients' is important.
Click to expand...

^ This.

I do the same. However, when I'm really getting blown off by a nurse, (and it's usually a travel nurse, float, someone who's new or doesn't work in the ER often) I'll stick my head out of the PT's room and ask the charge nurse, "Who's taking report in here?"

Works like a champ.

I'm lucky that I now know most of the nurses at the various EDs pretty well. And if the same nurse who took the radio report is in the room, I'll just say, "nothing changed since we talked last..."
 
I give a short report most of the time (unless it's a complex pt), and ask of there is anything else they'd like to know. (everything I know should be on the run sheet as well).
 
Last edited by a moderator:
I like to keep on the nurses good side. I'll give them whatever pertinent info I got, which varies greatly depending on the situation. While I'm giving my info, I'm usually hooking the patient up to the hospitals monitor, and starting the nurses first set of vitals for them.
(habit I guess, I just finished about 400hrs of clinicals in the ER. While there I was the official IV, Blood Draw, 12 Lead, vitals, patient history guy).
We're getting ready to run about 20 million people through here in the next 5 months of tourist season. With 3 large motorcycle rallies thrown in for some extra excitement. I like being one of the guys the ER nurses like on a crazy Friday night.
 
Thanks guys. Most of the time we do it pretty quickly here too. Pt name, age, and MIST.
 
HotelCo; said:
I give a short report most of the time (unless it's a complex pt), and ask of there is anything else they'd like to know. (everything I know should be on the run sheet as well).
Click to expand...

Be aware that unless your run sheet is completely filled out and handed to the nurse when you move the patient over, it will likely never be looked at. It sucks but fact of life. I know it's often not possible to have your run form done in areas with short transport times. But the MD/RN isn't going to go hunting for the form half an hour later, they are just going to ask the patient the info.
 
Last edited by a moderator:
This is true, the hospital copy of the PRF will go into the folder but will probably never be looked at
 
We had bad interface.

Ambulance company had a form dictated by local health dept, but local ER's felt they were not included in the planning (in fact, no one was). These legal sized three-carbon copy extravaganza's were regularly thrown out as we handed them across.
 
If it's any sort of interfacility, then short due to the fact the nurse has gotten a turnover from the other RN (IE: ER to ER, SNF to ER, vice versa, etc, ad naseum)

If it's a 911 or the like, then detailed as possible.
 
Wait, you hand the nurses your PCR? Like, as in a piece of paper?

You do have computers in your ambulance, right?

Some nurses have a habit of just brushing off the paramedics and getting the subjective from the patient again or waiting to evaluate, which is often like ignoring half the report.

Which is great when the paramedic is actually an ER doctor.
 
AMF said:
Wait, you hand the nurses your PCR? Like, as in a piece of paper?

You do have computers in your ambulance, right?
Click to expand...

My company does paper PCRs too, and no computers in the ambulance.
 
Last edited by a moderator:
AMF said:
Wait, you hand the nurses your PCR? Like, as in a piece of paper?

You do have computers in your ambulance, right?

Some nurses have a habit of just brushing off the paramedics and getting the subjective from the patient again or waiting to evaluate, which is often like ignoring half the report.

Which is great when the paramedic is actually an ER doctor.
Click to expand...

HotelCo said:
My company does paper PCRs too, and no computers in the ambulance.
Click to expand...

So does my service.
 
Last edited by a moderator:
You must log in or register to reply here.
Back
Top