How are you triaged? Do you update?

[AnthonyM83]

Anthony,

I'm a little confused on your ALS patching. Are you saying you get orders from a nurse for an IV en route?

Well, kinda...there's a few things you can give before base contact like IV, but each time you have to call in, give entire report, then often your only orders for that patient are: O2 and IV. Or O2, IV, 12-lead. Or O2, IV, Valium if he starts to seize again.

So, you'd have the IV ability anyway before calling in, but you can't just decide that O2 IV is all he needs, you have to get that from the nurse's base station (it's so close to the show Emergency! it's sad).

[JPINFV]

Damn, it's hard to tell which is better, OC or LA. On one hand most of the base contacts I've seen have ended with "Err, good... call us back if you need anything." (i.e. not getting orders that IV/O2 is good enough for the patient), on the other hand LA has a larger procedure list (OC medics can do needle crics).

[northernmedic]

Wow. I'd probably kill myself if I had to get online orders from a nurse for every pt I treated. Fortunately I rarely have to patch for orders and if I do it's only to the emergency physician.

[second_chance]

Our protocols state that we have to:

Upon establishing voice communication with the destination hospital/medical control physician (if needed), present the following information in a concise and clear manner

• Emergency response unit and level of care: paramedic/Intermediate/Basic with ETA

Patient’s age, sex, and status level

Patient’s chief complaint

Patient’s present medical condition

Patient’s vital signs, including level of consciousness

Patient’s physical signs of illness or injury

Patient’s electrocardiogram rhythm, if indicated

Patient’s relevant medical history

Pre-hospital treatment rendered

Give a list of medications and allergies only if requested

With us, it does not matter if its a BLS/ALS call, we have to give the initial patch, and a patch should the patient's condition change, or if we have to divert. Medical Control questions are usually done by cell phone. When we arrive at the ED, we give a full report to the nurse and whoever else is involved in patient care.

[stcommodore]

Good topic...

I've been trying to teach EMT students that your inital notification should be short as in within 30 seconds the RN taking the call should know what they need because anything longer they really don't listen to.

EX. Who you are, what you found, what you did, when you'll be there

Calls to Medical Command you should introduce who you are/cert level and be clear as to what you want, and also find out who they are.

[BVESBC]

You mean that the hospital knows you are coming? We have a system but I have never seen anyone use it! Even w/ a full code.

[ninjaemtff]

Here's my notification:

MC county patch to the hospital

Amb 69 switch to med 8 stand by

once on med 8 : xy hospital go ahead

"XY hospital this is Amb 69 in bound to your facility ALS, 3-5 minute ETA, On board we have a 66 yr old male chest pain trouble breathing, have him on 15 lpm oxygen via nrb, medic 43 is on board providing advanced care, everything seems stable at this point give ya a better report at bedside in about 4."

Even if I go BLS i use the same standards,.

Not that it matters once because 98% of the time the ED staff doesn't listen. Hell I had a cardiac arrest one night, we were working the guy, notified the hospital, got there, as we were walking in (still performing CPR) a nurse stops me and asks what we got... :roll:

[firespec35]

Depends on the county/med control area I'm actually working in

Oakland (Except Beaumont Royal Oak)

ALS-800mhz radio direct contact each hospital has a freq. with alert so they will actually come to the radio and answer you. Call everything in just give them the basics on and off the radio in 30 seconds. Beaumont- only call priority 1 pt's and if you want orders for post radio meds (very few- lasix and 3rd dose of adenosine come to mind)

BLS- VHF HEAR system- Good luck getting them to answer you. If they do give them the basics

Western Wayne county- Same basic protcols (They're actually reigonal protocols for treatment between 5 counties) Use the UHF Medcom system, call HEMS Radio, HEMS will give you a med channel, you switch over and give the ER a report (Call everything in) same thing though just the basics about 30 seconds if good. BLS uses HEAR and calls HEMS and HEMS will patch to the hospital.

DEMCA (City of Detroit) AKA twilight zone- Different drug box, Different protocols, Uses Medcom system same thing as Western Wayne Just call Detroit Medical Dispatch. Only call in 1's and 2's if you need orders.