I need some radio reports!

[Doczilla]

Ladies and Gents-

On Wednesday, I'm helping to conduct our medical control base station course for the second year emergency medicine residents. We've changed some things around this year, and now instead of listening to recordings of call-ins, I wanted to make it more interactive. I was working on some scripts for the medic calling in to read over the phone, but thought that y'all (my expert panel) would have some pretty good ideas along those lines as well. So if you are willing to help me out, here's what I need:

A script for a brief radio or telephone report that a medic would give to the medical control hospital or physician while on scene or enroute to the hospital. They should be complete with vital signs, treatment provided, etc. I will make any necessary changes to reflect our local system guidelines or learning points that I want to illustrate. It would be nice to have a some scripts where the medic has to ask medical control for orders and the resident has to figure out whether or not to give the order. I'll also cut out some information so the residents will learn to ask for certain vital information if not given with the original report. Crappy reports are also welcome, since the resident will have to try to make sense of perhaps incomplete or jumbled prearrival information. So can you help a brother out?

Thanks!

'zilla

[WolfmanHarris]

I'd be happy to do it, but I think our reporting is quite different. Our radio reports when en route are usually under 30 seconds and just include CTAS, chief complaint, vitals if noteworthy, and tx if noteworthy. But if you need someone to record one for you let me know.

[Doczilla]

I'd be happy to do it, but I think our reporting is quite different. Our radio reports when en route are usually under 30 seconds and just include CTAS, chief complaint, vitals if noteworthy, and tx if noteworthy. But if you need someone to record one for you let me know.

That sounds like just what I'm looking for.

'zilla

[mobey]

MD from BLS unit 12, we are coming to you with a 62 y/o male complaining of sudden onset chestpain, & SOB.

Pain = crushing, 8/10 radiating to right arm.

PMHX of angioplasty X2 mos ago, no other Hx.

Monitor shows rapid A-Fib, 172 ventricular rate.

Vitals = P64 Resp 26, SpO2 95, BP 102/64

We have initiated ACS protocol with 160mg ASA, O2, I.V.

Would you like us to try Nitro at this time?

[EMS49393]

I'll give you two, one were I treat and transport, and one where I tell medical control I need pain medication. I'll listen to the radio this week and get you some nice jumbled reports for your students to decipher.

One..

This is 511, Karen and Tim inbound to you with a 65 year old female complaining of acute onset dizziness and nausea without vomiting. Patient is pale and diaphoretic. 12-lead shows an inferior MI, obvious ST elevation in 2, 3, and F without reciprocal changes. Current vital signs, BP 106/60, HR 54 sinus bradycardia, RR 18, SPO2 of 100% on high-flow oxygen. We do have an IV established, normal saline at a slightly faster than KVO rate and well as a second saline lock. Administered aspirin 324 mg, PO, chewed, and Zofran 4 mg IVP. No NTG administered secondary to MI location. If you have no further questions or orders, we’ll see you in 5-8 minutes.

Two...

This is 511, Karen and Tim inbound to you with a 22 year old female complaining of severe left lower quadrant pain and vomiting. Patient states she believes she is 4 weeks pregnant. Patient presents diaphoretic and in obvious distress. Current vital signs, BP 88/40, HR 126 sinus tach on the monitor, RR 22, SPO2 100% on high-flow oxygen. I have two IV’s established, one saline lock, one on blood tubing and am currently administering a 250 ml bolus. I have administered Zofran 4 mg IVP. I’d like to administer fentanyl 50 to 250 mcg titrated to effect for pain control with your order. We have an ETA of approximately 20 minutes and will re-consult pending any changes or when closer in.

Hope this helps,

K.

[WolfmanHarris]

Ambulance: Lindsay, 4142, requesting a patch.

Dispatch: 10-4, switch to Tactical 2.

Hospital: Cobourg Emergency.

Ambulance: This is 4142 en route to your facility CTAS 3 with an 13y/o Male patient. Belted patient in a two car, low speed MVC. Patient complaining of low grade neck pain, vitals unremarkable. Be advised patient is autistic, agitated and unable to effectively communicate. ETA 15 minutes.

Hospital: 10-4.

-------------------------------

Ambulance: Lindsay, 4282 requesting a patch to Base Hospital Physician.

Dispatch: 10-4, switch to Tactical 1 for PRHC BHP.

Hospital: Base Hospital, Dr. Arceri.

Ambulance: Dr. Arceri, this is ACP Chris Johnson, OASIS number 143682. I am on scene with a 42y/o male complaining of severe 10/10 back pain as a result of moving boxes and is unable to ambulate due to pain. Patient does not meet my standing order, but I'd like permission for fentanyl, 25mcg IV. Vitals are pulse 110bpm, resps 24, BP 130/90, SPO2 100% on 8lpm. No known allergies or relevant medical history. Patient is going to require stair chair to extricate from home.

Hope these help.

[akroeze]

Hi Doc this is Alex Kroeze, ACP, OASIS #15411.

I'm calling for a field pronouncement here Doc. I'm in the back yard of a residence with a mid-30s female patient who was found floating face down in the pool, unknown how long she was there. On arrival of the PCP crew the patient was VSA. They performed upfront CPR and then upon analyze discovered Asystole. We arrived as ACP backup just as they were doing their 3rd analyze and patient was still asystole. After one round of epi patient had fine v-fib which was shocked into a bradycardic PEA. Atropine and a 250cc bolus were given and patient was found to be back into v-fib. She has had 2 more epi and 2 lidocaine since then and remains in fine v-fib unresponsive to shocks. Patient is intubated with good air entry however ETCO2 is reading in the middle range on the disposable detector. At this point I'd like to cease resuscitation Doc unless you feel that a trial of bicarb is warranted.

Hi Doc this is Alex Kroeze, ACP, OASIS #15411

I'm 20 minutes from the closest ER. I'm calling for orders for a lidocaine bolus for ventricular bigeminy/trigeminy. Patient is a 75 y/o male with a history of COPD, Angina and Hypertension and is on salbutamol puffers, flovent puffers, nitro patch and metoprolol. Patient this evening while sitting watching TV had a sudden onset of inability to catch his breath as he describes it that doesn't feel like his usual respiratory difficulty. Patient took his own puffers with no relief and when it didn't go away within a few hours he called us. On arrival patient was ambulatory to meet us at the truck. On assessment he is in moderate respiratory distress and pale in colour. BP 102/68, P 68 and weak, R 20, SPO2 98% on NRB. He is in a sinus rhythm with periods of ventricular bigeminy that alternates with ventricular trigeminy. 12 Lead is non-diagnostic. Patient has no allergies. I'd like to give this patient a 1.5mg/kg bolus followed up by 0.75mg/kg q5min prn x2

[JakeEMTP]

Medic 5311 enroute to your facility with a 38 y/o/m c/c of a fall from approx. 50 ft. from a tree.

B/P = 168/84

P = 124

R = 24

SpO2 = 94

A & O x 4

Pt. is fully spinal immobilised at this time. Pt. has a closed left femur fracture, however is refusing traction splint do to pain. Pt. has been administered 100mcg Fentanyl, however is still in extreme pain. Lung sounds are clear and equal bi-laterally, abdomen is soft in all LUQ, RUQ and RLQ. Some distension and pain upon palpation of LLQ. Requesting orders for additional Fentanyl administration and Versed to apply traction splint.

[Echoburger]

Ambulance: "Medic 77 to Region View Hospital, Priority 3."

Hospital:"Region View. Go with it."

Ambulance: "Medic 77, Paramedic Doe transporting a 34 year old male complaining of abdominal pain. Patient states pain is in LRQ, does not radiate. Vitals are: Blood Pressure 145/34, Heart Rate of 80-strong-regular, Respiratory Rate of 20-equal-clear-bilateral, SPO2 is 100% on room air. Patient rates pain as a 8 on an 0-10 scale. Normal sinus rhythm on the monitor, got a saline lock estabished. We'll be there in about 10, any questions?"

Hospital:"Negative. See you upon arrival."

An emergency report:

Ambulance: "Medic 77, Priority 1!"

Hospital: "Go."

Ambulance: "34 year old male, full arrest, full ACLS, 10."

Hospital: "See you in 10. Go to Trauma-1."

Physician's Order:

Ambulance: "Medic 77, Priority 1, Physican needed."

Hospital: "Go, we have Dr. Doe here."

Ambulance: "Medic 77, Paramedic Doe, I'm on-scene, I got a 89 year old male, medical full arrest---unwitnessed. Patient was found in asytole. We've done 30+ minutes of full ACLS. Got the pt. intubated. Pt. has been in asytole the whole time. Requesting permission for field termination."

Hospital: "Has the pt. been confirmed to be in asytole in 2 leads?"

Ambulance: "Affirmitive."

Hospital: "Receive. Time of death: 1553"

Hope this helps.

E

Edited May 4, 2009 by Echoburger

[Richard B the EMT]

47 Adam.

Go 47 Adam.

Notify Hospital 34 (Jamaica Hospital Trauma Center) we're inbound with a 42 year old female GSW (Gun Shot Wound) patient. Shooting was about 15 to 20 in the past.

The vitals are: BP 150 over 60, pulse rate of 130 per minute, weak and thready, and resps (respirations) of 10, shallow, assisted by BVM (bag valve mask) at 100% O2. Patient is fully immobilized.* Patient is shot once to right upper quadrant abdomen, no exit wound visible, moderate to heavy bleeding observed, with dressings in place. PD riding, (47 Willie) ALS is established and on board**, assisting, IV established, and they will give an update enroute when available. ETA 20 minutes.

(30 seconds later)

47 Adam, 47 Willie, Hospital notified.

(FYI, the FDNY EMS Command has the Dispatcher at EMD advise the hospital of the "note" from the ambulance crews. The crews rarely, if at all, have direct contact with the ER/ED crews while enroute.)

*Long backboard, C-Collar, Head Bed

**Law Enforcement Officer is riding in with us, as is the crew of Paramedic Ambulance 47 Willie. My partner is driving the 47 Willie vehicle, following us in.