By Jules Scadden, NREMT-P and Larry Torrey, RN, EMT-P
鈥淐ommunity hospital, this is Herb in Ambulance 81. We are on the way to your place with an old man named Joe John who fell. They鈥檝e used a spineboard to move him to the cot. He鈥檚 talking and answering questions, but I don鈥檛 think the answers are right.
鈥淗is wife said the old fool fell off the roof of the garage when he was checking some shingles that got torn off in the storm last night. I think he might have landed in the bushes before he actually hit the ground. Anyway, he鈥檚 talking but says he hurts. There was a lot of blood in those bushes, probably from his nose.
鈥淗e says he takes medicine for a stomach problem he has a lot, had his tonsils and appendix out when he was a kid, sometimes can feel his heart beating really hard and fast and gets kind of short of breath.
鈥淟ooks like we鈥檒l be at your place in about five minutes. Thanks.鈥�
- What is missing from this radio report to the hospital?
- What should be missing from this radio report?
- How can this report be more pertinent and professional?
Hospital radio report from EMS
Effective hospital radio reporting is a skill not often considered a priority in EMS education. It is also something that, in my personal experience, is not a priority for preceptors when new EMTs enter the field. The hospital radio report is, however, an important piece of the continuum of care and can directly reflect on the perceived ability of the EMS provider.
It is important to note that the hospital radio report is not the same as a request for medical direction. Communication with medical direction may be at the receiving hospital, or it may be at a service-designated medical facility that is not receiving the patient. However, the components of being organized, clear, concise and pertinent fit into all types of radio communication.
Purpose of the EMS radio report
The intent of the hospital radio report is to give the receiving hospital a brief 30-second 鈥渉eads up鈥� on a patient that is on the way to their emergency department. It should be done over a reasonably secure line and in a manner that does not identify the patient. Many systems have moved to strictly using cell phones in place of radio communications, as they provide a more secure means of communication.
While the prehospital radio report should be brief, it should also paint a broad view of the patient鈥檚 overall condition. The ED staff is not, at this point, looking for a comprehensive patient briefing. That report will be appreciated upon arrival. The ED staff鈥檚 immediate goal is to identify critical or unusual patients that will require intensive or special resources.
For example, the arrival of an intubated, post-arrest resuscitation cardiac arrest patient will require a critical care or other appropriate room. They may also need additional resources called in, such as respiratory therapy, cardiology, anesthesia, or the correct allocation of ED staffing to care for this patient. Early notification of this patient is essential to proper continued care.
The patient with a routine and isolated knee injury, in contrast, generally requires no prehospital notification at all. Whether or not you do need to call for this patient is governed by local policy. In those places where they do mandate notification of every patient, the report for routine injuries or illness should only present basic and straightforward information.
Professionalism cannot be stressed strongly enough. Think through your report for a moment before picking up the radio microphone. If you are asking your medical control base for orders, you are more likely to obtain those orders if your request sounds informed and reasoned.
Hospitals radio reports should be about 30 seconds in length and give enough patient information for the hospital to determine the appropriate room, equipment and staffing needs.
Parts of the EMS radio report to the hospital
These are pertinent points that should be included in hospital radio reports:
- Unit鈥檚 identification and level of service (ALS or BLS)
- Patient鈥檚 age and gender
- Estimated time of arrival (ETA)
- Chief complaint and history of present illness
- Pertinent scene assessment findings and mechanism of injury (i.e. fall, or motor vehicle accident)
- Pertinent past medical history (major past illness)
- Patient鈥檚 mental status
- Pertinent findings of the physical exam
- Treatment and vital signs (baseline)
- Patient鈥檚 response to treatment
These key elements in radio communication are often overlooked during orientation of new EMTs, especially within the volunteer setting. Communication policies developed by EMS agencies should include guidelines for appropriate radio and verbal patient reporting to hospitals. Hospital radio reporting is a skill that should be practiced by new EMTs and critiqued as a component of continuing education and recertification.
Here is an example of a concise and informative radio report:
鈥淐ommunity hospital, this is Ambulance 81. We are currently en route to your facility with a 72 y/o male who fell approximately 20 feet from a roof. Patient is conscious, alert and oriented to person, place, time and events. Patient denies any loss of consciousness.
鈥淒eformity noted to the nose with no active bleeding at this time. Patient denies any further injury or discomfort. No further injury noted on physical exam. Current vital signs: blood pressure 150/72, pulse 88, respiration 20, skin is pale, warm and dry. Treatments: spinal motion restriction in place per BLS protocol. ETA five minutes.鈥�
When done correctly, the prehospital patient report can be an effective tool for conveying relevant information to the receiving facility so that the best possible care can be delivered to the arriving patient. I stress relevant here, as spending undue time on extraneous information can be a hindrance to all involved.
This interaction also presents a wonderful opportunity for the EMS provider to reinforce both competence and professionalism to the ED staff, which in turn promotes communication and more collegial interaction in the future.
This article, originally published June 16, 2008, has been updated
Contributing author Larry Torrey is a paramedic and emergency department RN from Maine with more than 20 years of experience as a nurse, medic and instructor. He currently works in a Boston trauma center, and with several other prehospital endeavors.
