Guideline 1-400-72 - Communications: Patient Handoff Report

CMH EMS & MIH Protocols

Scope:

Guideline:

Pre-arrival patient reports should be given to emergency rooms and other facilities receiving patients.

Purpose:

To provide guidelines for ESO Alerting and radio reports.

Procedure:

1. If transporting a patient to a facility, a pre-arrival report should be given.
1. If the transport is a result of a transfer, a report has already been given via doctor-to-doctor, nurse-to-nurse, or other, however, an ambulance heads-up on ETA and any patient changes is polite to the receiving facility.
1. The transfer pre-arrival report should be done by telephone.
2. If the transport destination is an emergency room, make all efforts to provide a pre-arrival patient report at least a ten (10) minutes prior to arrival.
1. Best practice is to create a case in the ESO Alerting app for every patient transport. If the destination hospital does not use ESO Alerting, select "Non Transport" as the destination. Use the information you entered to formulate your radio report and then import into ESO EHR.
2. If the destination is CMH ER and time, patient condition, or other factors do not allow the use of ESO Alerting, contact should be made via the encrypted radio channel "CMH ER Reporting."
3. If the destination is not CMH ER and not a facility that uses ESO Alerting, contact should be made via the analog, unencrypted radio channel "VMed28 HEAR."
4. Another option, but should be rarely used and only as a last resort, is by telephone.

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2. ESO Alerting procedure:
1. Mobile devices in ambulances or personal devices may be used. No patient information is stored at any time on the device.
1. iPads in ambulances may be logged in using "device number" + ".cmhems" (for example "12345.cmhems").
2. Each employee has a login using "username" + ".cmhems" (for example "flast.cmhems").
3. The agency code is "cmhems."
4. The unit number should be "CMH" + short number (for example "CMH 1"). Do not include the full number (i.e. 701 is 1). Do not include "Ops," "Medic," or "Squad."
2. Assume fields are NOT mandatory until the app tells you they are.
3. All hospitals request EMS to OVER TRIAGE (i.e. If your patient might be a TRAUMA, STEMI, or STROKE pick the appropriate TCD).
4. Enter the basics required for a typical radio report and add anything extra you would like.
5. Photos of injuries or videos of assessments can be added at any time and are appreciated by ER staff. However, if you are transporting to CMH ER and want to include the ECG, only transmit via the LifePak modem through LifeNet. Do not include a photo of the ECG in ESO Alerting for CMH ER. Non-CMH destinations will need the ECG.
6. The last page has a required field of "Case Priority." Options are 1, 2, or 3. Think of these like Red, Yellow, or Green.

   Priority 1 (Red): If you are going lights and siren to the ER or this is a TCD patient, select 1 (red).

   Priority 2 (Yellow): All patients that do not meet criteria 1 or 3 are 2 (yellow).

   Priority 3 (Green): If this patient is appropriate for triage, select 3 (green).

7. Keep the app open to be notified when the ER opens your report and if they send you any messages.
8. Estimated Time of Arrival (ETA) is provided by the device's internal GPS. If prompted, select "Always Allow Location Permission."
9. To import into EHR, open the Flowchart tab in EHR and click "Import."
10. Nearby hospitals currently using ESO Alerting:

    CMH

    Cox Branson Cox North Cox South

    Mercy Springfield

11. Fields that import into EHR from Alerting:

Patient name DOB Age Gender

AVPU GCS Vitals

Activation type Medications given Procedures performed Destination hospital

3. CMH ER Reporting radio channel procedure:
1. Follow the procedure below for VMed28-HEAR radio, however, patient identifying information may be provided, if needed.
4. VMed28 HEAR radio channel procedure:
1. Identify your unit and the destination hospital.
2. Allow the receiving ER time here to divert you, if they are on diversion. All requests for diversion should be made clearly and should be repeated (i.e. "Medic 1 copies Hospital XYZ that we are being diverted."). Diversions shall be documented in EHR.
3. Identify your patient by approximate age and gender.
4. Identify the type of patient condition (medical or trauma) and the triage color code (see color codes in ESO Alerting section above).
5. Report your patient's chief complaint or problem along with relevant history and the findings of assessment and exam.
6. Report the patient's vital signs.
7. Report medications and treatments provided and the results of those treatments.
8. Provide an approximate ETA.
9. If physician's orders are provided, repeat back those orders.
5. Face-to-Face handoff procedure:
1. Patient handoff in the field (i.e. rescue services to transporting ambulance or ground ambulance to air ambulance) shall be conducted from the current lead provider to the provider assuming care with as little distractions as possible and face-to-face. For example, let others move the patient while verbal handoff is taking place a few steps away.
2. Patient handoff in the emergency room shall be conducted with the receiving nursing staff with as little distractions as possible and face-to-face. Additionally, EMS crews shall make every effort to seek out the Mid-Level Provider or Physician taking responsibility for the patient and provide a high-level report directly to him or her.

CMH Pre-Hospital Services Mission: "Provide safe, exceptional, and compassionate care to our communities with an emphasis on highly trained and empowered staff."

CMH Mobile Integrated Healthcare Mission: "Provide exceptional, compassionate, and patient-centered care by a mobile collaborative team to improve patient experience, improve quality outcomes, and reduce healthcare costs."

Polk, Hickory, Cedar, & St Clair County EMS Protocols is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.