Pneumonic for Patient Transfer report

[KempoEMT]

Does anybody have any helpful Pneumonic for giving a patient report? We got through the midterm and now we are moving into "scenarios" where we do a mock accident, and have to do a full run through. I'm having trouble remembering what all i have to say at definative care. I am going to re-read the chapter, but i was hoping someone had a pneumonic.

 

[medic417]

http://en.wikipedia.org/wiki/Pneumonic

Pneumonic may refer to:

Lung
Bubonic plague, known as Pneumonic plague
Pneumonic device
Someone with Pneumonia

I think hat you are asking for is a mnemonic.

 

[KempoEMT]

I think that you are asking for is a mnemonic.

Yes, I did mean Mnemonic. Can't spell, and I'm sitting in my english class.

 

[Sasha]

Edited: Yikes. I thought you were talking about radio reports. Silly Sasha, I just reread.

I don't think there are any little tricks, just takes practice.

 

[JPINFV]

Here's how I normally give report

Name, age, sex (yea, I know, kinda of obvious in 99.999999% of the patients, but it helps with the flow), PMD, C/C, events leading up to the call, history/allergy/medications, exam, treatment, changes.


Good morning, this is John Doe. He's a 70 year old male and a patient of Dr. Spand. We were called to his house for abdominal pain that has been going on for 3 days. He was seen at County two days ago and was discharged. It hasn't gotten better since then, so he wanted to come to Big Private Hospital since this is where his doctor is at. He has a history of DM, CHF, and HTN, no known drug allergies, and he's currently on (I don't know, imagine I put drugs here). On arrival he was [pertinent positive and negatives of your exam]. V/S were [with normal limits/abnormal with (B/P, pul, reps being...) If a long transport, trends?]. We started him on 4 LPM via nasal cannula with no change in route. Any questions? Thanks, sign here.

After a while you'll find your own flow and won't even give a second thought to giving report. The point is to make it so that the people who you are transferring care aren't left with nothing to start from, even if everything you did is going to be rechecked anyways. If it helps, remember, you're telling a story. Every story has a beginning (why does the patient want to go to the hospital), a middle (what you found, did, and the result), and an end (questions?). Also, remember that you can always refer to your run sheet if you don't remember all of your patient's medical history or last V/S/trend.

 

[JPINFV]

Edited: Yikes. I thought you were talking about radio reports. Silly Sasha, I just reread.

I don't think there are any little tricks, just takes practice.

Gahh, your edit beat me.

 

[WarDance]

There is one I just have to find it for you.....I forgot it.

 

[berkeman]

The "SOAP" and "CHART" methods should be explained in you EMT textbook.

 

[Sasha]

(yea, I know, kinda of obvious in 99.999999% of the patients, but it helps with the flow),

Bahaha. While dropping off my patient yesterday and going to grab some linens, I passed by a room with a doctor and the patient and family in it. I overheard him "So your father has---" "This is my MOTHER"

 

[medicdan]

JP, that is exactly how I do it. I have learned that different hospitals like it different ways (based on their triage software/paperwork). I know that I have failed my report massivly if the nurse has to ask the patients any questions, or asks me anything other then clarification of previous statement.

 

[Buzz]

JP, that is exactly how I do it. I have learned that different hospitals like it different ways (based on their triage software/paperwork). I know that I have failed my report massivly if the nurse has to ask the patients any questions, or asks me anything other then clarification of previous statement.

Eh, there's nurses around here that basically just say "Yeah, I heard the radio report. I'll sign." and then proceed to ask the patient everything all over again.

 

[medicdan]

I havent had that experience at Boston area hospitals. We dont do entry notes for most patients-- and the nurses know that however incompetent the EMTs are, we can give them straighter answers then the patients and their family-- who tend not to give the more direct answers at first.
I know that the quality of my report directly corresponds to the quality of care that my patient receives for their first 30 min. It is the difference between the optho room for a SOB (when there are other rooms available), and a trauma room for a Hip fx.

 

[BossyCow]

Eh, there's nurses around here that basically just say "Yeah, I heard the radio report. I'll sign." and then proceed to ask the patient everything all over again.

Of course they do, and how many times have you heard the patient answer the same question you already asked with some new vital piece of information that they conveniently neglected to mention to you? I generally tell my patients to expect the nurses, docs to ask them these same questions over and over again.

 

[PapaBear434]

Example of one of my usual reports to our local hospital, Leigh Memorial.

"Leigh Base, Leigh Base, 927S."

"927S, this is Leigh, go ahead."

"Evening, Leigh, this is EMT-E __________, transporting a BLS patient, a 47 year old male complaining of facial pain as a result of trigeminal neuralgia. He says he has suffered pain from this before but this is the worst it's ever been with a pain he rates at 10/10. His vitals are fairly unremarkable, BP 134/78, satting 98% room air, respirations at 20 and slightly labored due to the pain and a pulse of 78. Pt. suffers from advanced MS, so we'd like to avoid triage for this patient if at all possible. ETA is approximately five minutes, do you have any further questions or orders?"

"No, 927, please continue transport and we'll see you when you get here."

"Thank you, Leigh base. See you in a bit, 927 out."

It always sounds awkward at first. Lots of pauses, stops, and reviewing your notes. Some people like to write out what they are going to say (short hand, of course) so they can spout it off, but honestly you just have to do it and get a rhythm to it. I have a cheat cheat on the back of my badge that helped me a lot when I started out.

1) Who you're calling, who you are.
2) What kind of call it is (BLS/ALS)
3) Age/Sex of patient
4) Chief complaint
5) Assessment and pertinent findings
6) Vitals
7) Estimated time of arrival
8) Ask for any questions, comments, or orders

After a while you just get the rhythm, and you go with it.

 

[PapaBear434]

Of course they do, and how many times have you heard the patient answer the same question you already asked with some new vital piece of information that they conveniently neglected to mention to you? I generally tell my patients to expect the nurses, docs to ask them these same questions over and over again.

My first day as a released EMT, I had a guy with a random pain in the inside of his leg up by the crotch. It started when he went on a new treatment for prostate cancer.

On the way, I asked him over and over again "Is there anything else bothering you? Anything at all? Any pain, sores, growths, or second heads growing anywhere I should know about?"

Asked him six ways to Sunday if there was ANYTHING else. I even had him pull away his pants, I palped the area for herniation and looked for discoloration. He told me no each and every time.

We get to the hospital, put him in the bed, and the very first thing he tells the nurse? "Oh, I have a weird sore on my buttock, right on the other side from this weird pain."

I slapped his hand and told him he was a bad man, that he was making me look bad in front of the nurses on my first day, and next time an EMT asks if there is anything else bothering him, LET THEM KNOW."

 

[BossyCow]

My first day as a released EMT, I had a guy with a random pain in the inside of his leg up by the crotch. It started when he went on a new treatment for prostate cancer.

On the way, I asked him over and over again "Is there anything else bothering you? Anything at all? Any pain, sores, growths, or second heads growing anywhere I should know about?"

Asked him six ways to Sunday if there was ANYTHING else. I even had him pull away his pants, I palped the area for herniation and looked for discoloration. He told me no each and every time.

We get to the hospital, put him in the bed, and the very first thing he tells the nurse? "Oh, I have a weird sore on my buttock, right on the other side from this weird pain."

I slapped his hand and told him he was a bad man, that he was making me look bad in front of the nurses on my first day, and next time an EMT asks if there is anything else bothering him, LET THEM KNOW."

My classic example of this was someone who waited until the nurse was there to confess to not having pooped in 3 days... hmm and when I asked about it and you told me everything had been normal???????

 

[WarDance]

Eh, there's nurses around here that basically just say "Yeah, I heard the radio report. I'll sign." and then proceed to ask the patient everything all over again.

This drove me INSANE when I had a bad bike accident back in the fall! I knew why they were doing it but in my head injured mind I couldn't take it! I guess it's a good way to gain empathy for your patients.....although it was painful and expensive.....

 

[AusMed]

If you are talking about over the radio reports we have a format in my service that we follow (in the Land of Oz).

Start with the generic sex, age of patient then go into MISTO
Mechanism of injury/illness
Injury or illness
Signs/Symptoms (obs)
Time of onset and/or treatment
Other pertinent information

We use this format for our 'Code 3' which we use for our sick people when giving a heads up to the recieving hospital. they are usually done in 1-2 minutes and do not have a two way treatment option (the hospital doesn't suggest treatment to be done).

Eg: one that I did the other day......
'North Shore standing by for car 536....
536 thank you. Coming to you with a 45 y/o male. Fall approx 2.5m off scaffolding onto concrete. Pt has R side facial bruising, pain and deformity to R arm, pain in R upper rib cage.
Obs as follows:
HR = 72
BP = 120/75
RR = 16
PEARL
equal breath sounds, SaO2 = 98% on room air
BSL = 6.7
Denies LOC
GCS = 14, amnesic to event
Pt cannulated, spinal precautions, given 10 of max.
Pt initially moved on scene by co-workers.
Enroute to you, ETA 8-10minutes.

Doing a 'Code 3' generally means that we by-pass the triage desk and get buzzed straight into the resus area where a team is ready and waiting for us. This is when we again give a handover (which they already have a heads up on due to the code 3) and can provide a little more detail but generally follow the same pathway.