Introduction
When paramedics are engaged to stabilize and transport a patient to the emergency department, health care providers can support the process in a number of ways, including by providing an effective handover.
Preparation
If you are working with a team, assign different staff roles, including:
- ensure the path to the patient is clear of obstacles
- meet EMS at the door and direct them
- prepare available documentation (see below)
- remain with the patient, monitoring and supporting their status
Verbal Handover
Paramedics are trained to immediately begin an assessment of the patient, and this is where their initial focus will be.
Accordingly, a verbal introduction should be brief, covering the following information:
- the name and title of the health care provider
- the name and age of the patient
- potential for aggression (if appropriate)
- the chief complaint, in 5 words or less
- a time frame for the complaint
- the patient’s code status
This opening report should take less than 15 seconds, after which the paramedics should be given the time to do an initial assessment. Tell them you have further information to share after this assessment, and provide transfer documentation.
Remain with the patient unless there is an urgent need to attend to other work.
Once their initial assessment is complete, provide further detail using a standard format. These be include:
- SBAR: Situation, Background, Assessment, Response
- MIST
These tools are explained in detail under urgent oral communication.
Of note, do NOT say that you are unfamiliar with their background or status until later in the handover, and if important information is not known. It is imperative to have a grasp on critical details, and to communicate this to instil confidence in the paramedics.
Documentation
Gather relevant documentation as early as possible, so that it can be available when the paramedics arrive. Information can include:
- a transfer page, with name, demographics, and a medical problem list
- a list of current medications
- a DNR form (if available)
- information on their ADLs (if appropriate)