I need some radio reports!

[FireMedic65]

You guys are frakkin' awesome. This is exactly what I need.

'zilla

We're using the scripts as a starting point for the training. As you've noticed from the examples here, there are different styles to radio reports. With the number of EMS systems that transport to our facility, we see great variability, even within those systems. I'm trying to train the residents to listen for that which is truly relevant to us in the report. What do we need to know in order to approve an order? What do we need in a notification that makes a difference? Is there something buried in the report that makes this a CAT 1 trauma instead of a CAT 2? I'm going to modify the scripts to snip some information (maybe important info) so they will have to ask for it. So I'm going to make some of these into crappy reports.

The reason we're using scripts is that we need it to be interactive. If there is a piece missing, the residents need to know to ask for it. If an order is requested, the residents need to know how to give it. This will require a live person on the other end.

'zilla

By scripted, I took it as you wanted to spoon feed all the right info to them.

[oz_paramedic_chick]

Hey here in QLD we ring the hospital via phone as opposed to radio (well in metro areas anyway).

Here's an example of what we may give:

363: Caboolture ED this is Fred from QAS Bravo 363 bringing in a pt

ED: Go ahead 363

363: have a 40YOM GCS 15 who has thrown fuel on a fire. Partial thickness burns to approx. 18% on his upper R thigh, stomach, groin and genital area. No known allergies, nil meds, nil medical hx. HR: 120, BP 130/85,IV access gained 10mg Morphine IV given so far and 3ml methoxyflurane. Pt covered with burn aid and cling wrap. Our protocol limits us to a total of 20mg morphine. ETA 20 minutes. Are you willing to give permission for additional pain relief if required?

On this job the Dr gave us permission to give up to a total of 30mg of morphine (so 10mg above our protocol) if required (which it wasn't).

***Names changed***

[brentoli]

Ambulance here requesting medical control....

Requesting orders to transport a 67 year old male. Dispatched on lift assist, got out here and he was face down in the kitchen with food on the stove. He has a laceration above his right eye, and several marks on his arms and torso can't tell if they are from this incident or not. Seems to be alert and oriented. Doesn't have a care taker available for the next 24 hours. Would like to get him brought in, believe he is a hazard to himself. He is refusing transport at this time. Requesting orders.

[mobey]

Here is a short sweet one I gave a few weeks ago... makes them think about what to have prepared.

" Attention recieving hospital we are 4 mins away with a 77 y/o female in full pulmonary edema HR167 BP134/90 R46 SpO2 72. Patient is not responding to Nitro, and is refusing BVM/NRB"

[FireMedic65]

Might also be a good idea to teach them when to release the patient under their own care such as refusals. A lot of the time the dr won't allow it, some other dr's do. Also, getting released from a medical/trauma patient as ALS where you are not needed and the patient can be handled BLS. stuff like that

[Kiwiology]

We don't have to call for orders for anything but we do provide status reports (an R40) to the hospital if we are bringing in a statue 1 (critical) or 2 (unstable) patient; or if we need Police there or something like that.

Example from Thursday:

"Shore ED, Shore 1 how copy?"

"Loud and clear"

"Roger, seventy six year old female, cardiac chest pain relieved with O2 and GTN, our ETA with you is five minutes and we're calling the patient status two"

I've read the examples in textbooks like Brady/Mosby that are about two paragraphs in length and contain a novel of events that we record on the PRF or give at handover so we only give very short reports.

[FireMedic65]

We don't have to call for orders for anything but we do provide status reports (an R40) to the hospital if we are bringing in a statue 1 (critical) or 2 (unstable) patient; or if we need Police there or something like that.

Example from Thursday:

"Shore ED, Shore 1 how copy?"

"Loud and clear"

"Roger, seventy six year old female, cardiac chest pain relieved with O2 and GTN, our ETA with you is five minutes and we're calling the patient status two"

I've read the examples in textbooks like Brady/Mosby that are about two paragraphs in length and contain a novel of events that we record on the PRF or give at handover so we only give very short reports.

I prefer the short and sweet reports, I would rather tend to my patient than sit there on radio. If the patient is stable then I will spend more time talking to the ED and maybe some coffee.

[scoobymedic96]

this is Medic5 enroute with a 50yo female c/o difficulty breathing

pt is ao x 3, labored resp @ 24/min 90% room air, wheezing all lobes

currently taking a nebulizer atrovent & albuterol mix

given 125mg solumed via iv

bp: 150/90 HR 115

154/96 HR 105

140/92 HR 95

Sinus tach

18G left AC

eta is aprox 15 min any questions or orders

medic 5 clear

this info not usually given via radio unless asked for by er:this pts hx as follows:asthma, diabetic, htn multiple meds, allergic to asa and pcn

this is Medic 5 enroute with a 79yo female c/o chest pain and heavieness

pt states 10/10 pain radiating to left arm, hx mi 6months ago

normal sinus with PAC's, 12 lead st elevation in II, III and AVL

18G right AC

324mg asa given

2 sprays nitro given with some relief

1/4" nitro paste applied

vitals are as follows: 131/81 HR 88 02 95% on 6lpm via Nasal cannula

(these were the rest of the vitals during the transport: 140/79 83 96%, 139/79 78 97%, 134/77 87 96%, 138/81 87 97%, 137/83 88 98%)

requesting orders for Morphine

Per Dr.______ 4mg morphine IV ---- confirm order by repeating it back

eta 15 min

no other questions or orders recieved

medic 5 clear

this info not usually given via radio unless asked for by er: this pts hx is as follows: chf, asthma, copd, cardiac stents and bypass, mi 6 months prior, htn. meds plavix, lasix, atenolol, lorazepam, klorcon, nitro tabs. allergic to elavil

This is medic 5 enroute with a 85yo male c/o altered mental status in hypertensive crisis

pt is responsive to verbal stimuli but is unable to follow commands, pt is at times combative with non specific speach and sounds

pts bp 240/122 101 97% room air

18G left AC, bgl 120

sinus tach

hx of cva 4 months ago

+facial droop to left side with right sided weakness

requesting orders for labetolol

per dr._____ denied

eta aprox 20 min any questions or orders

medic 5 clear

this pt's info as follows: previous cva's, cardiac, diabetic, htn. meds multiple. allergies NKDA. Vitals 220/110 105 97%, 232/98 105 97%,

222/104 107 95%, 236/106 104 97%, 218/99 103 97%

[NewParamedic]

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

Wow tha'ts cool

[JPINFV]

For just a basic entry note,

"Hello Elsewhere hospital. We're en route to your facility with a XX y/o M/F with a CC of ____. [any thing excessively important. Decreased LOC than baseline, critical high/low V/S. which lab is abn if CC is abn labs, etc. Very short, very sweet. Relaying a set of V/S that's 70, 120/70, 20 is a waste of air time]. Our ETA is ____, questions?"

I've never been in a situation where I've both had the ability and the need to contact online medical control. More often than not, the "ability" side was missing.

Edited November 22, 2009 by JPINFV